bluuebunny/crossref_metadata_2025 huggingface dataset:
The future of open vascular neurosurgery: perspectives on cavernous malformations, AVMs, and bypasses for complex aneurysms
Authors: Lawton Michael T. , Lang Michael J.
Published: June 2019

Despite the erosion of microsurgical case volume because of advances in endovascular and radiosurgical therapies, indications remain for open resection of pathology and highly technical vascular repairs. Treatment risk, efficacy, and durability make open microsurgery a preferred option for cerebral cavernous malformations, arteriovenous malformations (AVMs), and many aneurysms. In this paper, a 21-year experience with 7348 cases was reviewed to identify trends in microsurgical management. Brainstem cavernous malformations (227 cases), once considered inoperable and managed conservatively, are now resected in increasing numbers through elegant skull base approaches and newly defined safe entry zones, demonstrating that microsurgical techniques can be applied in ways that generate entirely new areas of practice. Despite excellent results with microsurgery for low-grade AVMs, brain AVM management (836 cases) is being challenged by endovascular embolization and radiosurgery, as well as by randomized trials that show superior results with medical management. Reviews of ARUBA-eligible AVM patients treated at high-volume centers have demonstrated that open microsurgery with AVM resection is still better than many new techniques and less invasive approaches that are occlusive or obliterative. Although the volume of open aneurysm surgery is declining (4479 cases), complex aneurysms still require open microsurgery, often with bypass techniques. Intracranial arterial reconstructions with reimplantations, reanastomoses, in situ bypasses, and intracranial interpositional bypasses (third-generation bypasses) augment conventional extracranial-intracranial techniques (first- and second-generation bypasses) and generate innovative bypasses in deep locations, such as for anterior inferior cerebellar artery aneurysms. When conventional combinations of anastomoses and suturing techniques are reshuffled, a fourth generation of bypasses results, with eight new types of bypasses. Type 4A bypasses use in situ suturing techniques within the conventional anastomosis, whereas type 4B bypasses maintain the basic construct of reimplantations or reanastomoses but use an unconventional anastomosis. Bypass surgery (605 cases) demonstrates that open microsurgery will continue to evolve. The best neurosurgeons will be needed to tackle the complex lesions that cannot be managed with other modalities. Becoming an open vascular neurosurgeon will be intensely competitive. The microvascular practice of the future will require subspecialization, collaborative team effort, an academic medical center, regional prominence, and a large catchment population, as well as a health system that funnels patients from hospital networks outside the region. Dexterity and meticulous application of microsurgical technique will remain the fundamental skills of the open vascular neurosurgeon.
Long-term outcome in orbital meningiomas: progression-free survival after targeted resection combined with early or postponed postoperative radiotherapy
Authors: Terpolilli Nicole Angela , Ueberschaer Moritz , Niyazi Maximilian , Hintschich Christoph , Egensperger Rupert , Muacevic Alexander , Thon Niklas , Tonn Jörg-Christian , Schichor Christian
Published: June 2019

OBJECTIVE

In meningiomas involving the orbit and optic canal, surgery is the mainstay of therapy. However, radical resection is often limited to avoid functional damage, so multidisciplinary treatment concepts are implemented. Data on the timing and value of early postoperative radiotherapy (PORT) are scarce. This retrospective study analyzes outcomes in patients who underwent targeted resection alone or in combination with early PORT.

METHODS

Patients undergoing resection of orbit-associated WHO grade I meningiomas from January 1999 to December 2013 who presented to the authors’ department at least twice for follow-up were included. Clinical and radiological findings were analyzed retrospectively. Patients were stratified into two cohorts: follow-up with MRI scans at regular intervals, i.e., the watch and wait (W&W) group, and a PORT group receiving PORT within 6 months after surgery in addition to MRI follow-up. Patients in the W&W group were scheduled for treatment when tumor progression was detected by imaging.

RESULTS

One hundred twenty-two patients were included. The mean follow-up was 70 months. The most common symptoms at presentation were visual disturbances; 87.7% of patients received Simpson grade II–III targeted partial resection. Twenty-three patients received PORT, and 99 patients were regularly observed with MRI scans (W&W group). Tumor recurrence/progression occurred significantly later (76.3 vs 40.7 months) and less frequently in the PORT group (13%) than in the W&W group (46.5%). Cases of recurrence were diagnosed an average of 39 months after initial surgery in both groups. PORT patients demonstrated significantly less visual impairment at last follow-up.

CONCLUSIONS

These results indicate that receiving PORT early after targeted partial resection might help to postpone tumor recurrence and the need for additional treatment, while preserving or even improving visual outcome.
Clinical features and operative technique of transinfundibular craniopharyngioma
Authors: Tang Bin , Xie ShenHao , Huang GuanLin , Wang ZhiGang , Yang Le , Yang XuanYong , Xu Shan , Zeng ErMing , Hong Tao
Published: June 2019

OBJECTIVE

Transinfundibular craniopharyngioma (TC) is one of the 4 subtypes of suprasellar craniopharyngioma. In this study, the authors analyzed the clinical features of and operative technique for TC.

METHODS

A total of 95 consecutive cases of suprasellar craniopharyngioma that had been resected via the endoscopic expanded endonasal approach were retrospectively reviewed. Patients were divided into 2 groups: 34 in the TC group and 61 in the nontransinfundibular craniopharyngioma (NC) group. Clinical and radiographic features, intraoperative findings, histopathological and genetic findings, and surgical outcomes were analyzed and compared between groups.

RESULTS

Compared with NC, TC was mostly seen in adult patients (97.1%); it was rare in children (2.9%). Clinical presentations tended toward headache, hydrocephalus, and diabetes insipidus. The relatively smaller volume, midline location (consistent with the stalk position), unidentifiable stalk, no shift of the third ventricle, and greater likelihood to involve the third ventricle and cause hydrocephalus were the characteristic features of TC in the preoperative MRI study. According to the degree of vertical extension of the tumor, the 34 TCs could be classified into 3 subtypes: type 1, entity was limited to stalk (n = 2, 5.9%); type 2, tumor extended up to the third ventricle (type 2a) or down to the subdiaphragmatic cavity (type 2b) (n = 23, 67.6%); and type 3, tumor extended in both directions (n = 9, 26.5%). For TC resection, the chiasm–pituitary corridor, lamina terminalis corridor, and pituitary corridor could be used separately or jointly. Most of the TCs originated from the infundibulum–tuber cinereum, grew within and along the long axis of the infundibulum, and the pituitary stalk was not usually preserved in TCs (20.6%), whereas the rate of preservation was higher (80.3%) in NCs. Bilateral hypothalamic injury was found in nearly all TCs if radical resection was performed, whereas the relationship between NCs and hypothalamus was either compression (32.8%) or unilateral invasion (67.2%). Meanwhile, the postoperative endocrine and neuropsychological function outcomes in patients with TC were worse than in patients with NC. The genetic analysis with whole-exome sequencing studies showed no differential mutations of CTNNB1 (β-catenin) and BRAF (V600E) between TC and NC subtypes, but there was a difference between adamantinomatous craniopharyngioma and papillary craniopharyngioma.

CONCLUSIONS

TC is a special subtype of suprasellar craniopharyngioma, which is remarkably different from NC. Identification of this type of tumor preoperatively is essential for the planning of appropriate surgical approach and degree of excision.
Percival S. Bailey: eminent scholar of neurosciences who revealed the workings of the hypothalamus through clinicopathological research on craniopharyngiomas
Authors: Prieto Ruth , Pascual José M.
Published: June 2019

Percival S. Bailey (1892–1973) was a scholar, neuroscientist, neuropathologist, and neurosurgeon who made decisive contributions in the field of neuro-oncology. Far less known are his groundbreaking insights into understanding hypothalamic physiology through the study of craniopharyngiomas. As one of Harvey W. Cushing’s most talented trainees, Bailey was instrumental in developing Cushing’s project of a histologically based prognostic classification of brain tumors. He worked at Peter Bent Brigham Hospital on and off between 1919 and 1928, owing to frequent clashes with his mentor. A major cause of this long-term conflict was Bailey’s 1921 experimental demonstration of the hypothalamic origin of diabetes insipidus and Fröhlich’s syndrome. This finding challenged Cushing’s view that both alterations were due to pituitary gland insufficiency. In a seminal monograph written with John F. Fulton in 1929, both authors provided the first comprehensive account of the specific hypothalamic disturbances caused by tumors that originated within the infundibulum and third ventricle. The methodical study of Cushing’s craniopharyngioma specimens allowed Bailey to recognize the close contact between these lesions and hypothalamic nuclei, a key concept that Bailey originally advanced for proper surgical planning. This article aims to credit Bailey for his pioneering definition of craniopharyngiomas as tumors with a true intrahypothalamic position.
Surgical treatment of meningiomas located in the rolandic area: the role of navigated transcranial magnetic stimulation for preoperative planning, surgical strategy, and prediction of arachnoidal cleavage and motor outcome
Authors: Raffa Giovanni , Picht Thomas , Scibilia Antonino , Rösler Judith , Rein Johannes , Conti Alfredo , Ricciardo Giuseppe , Cardali Salvatore Massimiliano , Vajkoczy Peter , Germanò Antonino
Published: June 2019

OBJECTIVE

Surgical treatment of convexity meningiomas is usually considered a low-risk procedure. Nevertheless, the risk of postoperative motor deficits is higher (7.1%–24.7% of all cases) for lesions located in the rolandic region, especially when an arachnoidal cleavage plane with the motor pathway is not identifiable. The authors analyzed the possible role of navigated transcranial magnetic stimulation (nTMS) for planning resection of rolandic meningiomas and predicting the presence or lack of an intraoperative arachnoidal cleavage plane as well as the postoperative motor outcome.

METHODS

Clinical data were retrospectively collected from surgical cases involving patients affected by convexity, parasagittal, or falx meningiomas involving the rolandic region, who received preoperative nTMS mapping of the motor cortex (M1) and nTMS-based diffusion tensor imaging (DTI) fiber tracking of the corticospinal tract before surgery at 2 different neurosurgical centers. Surgeons’ self-reported evaluation of the impact of nTMS-based mapping on surgical strategy was analyzed. Moreover, the nTMS mapping accuracy was evaluated in comparison with intraoperative neurophysiological mapping (IONM). Lastly, we assessed the role of nTMS as well as other pre- and intraoperative parameters for predicting the patients’ motor outcome and the presence or absence of an intraoperative arachnoidal cleavage plane.

RESULTS

Forty-seven patients were included in this study. The nTMS-based planning was considered useful in 89.3% of cases, and a change of the surgical strategy was observed in 42.5% of cases. The agreement of nTMS-based planning and IONM-based strategy in 35 patients was 94.2%. A new permanent motor deficit occurred in 8.5% of cases (4 of 47). A higher resting motor threshold (RMT) and the lack of an intraoperative arachnoidal cleavage plane were the only independent predictors of a poor motor outcome (p = 0.04 and p = 0.02, respectively). Moreover, a higher RMT and perilesional edema also predicted the lack of an arachnoidal cleavage plane (p = 0.01 and p = 0.03, respectively). Preoperative motor status, T2 cleft sign, contrast-enhancement pattern, and tumor volume had no predictive value.

CONCLUSIONS

nTMS-based motor mapping is a useful tool for presurgical assessment of rolandic meningiomas, especially when a clear cleavage plane with M1 is not present. Moreover, the RMT can indicate the presence or absence of an intraoperative cleavage plane and predict the motor outcome, thereby helping to identify high-risk patients before surgery.
Characterization of postsurgical functional connectivity changes in temporal lobe epilepsy
Authors: Morgan Victoria L. , Rogers Baxter P. , González Hernán F. J. , Goodale Sarah E. , Englot Dario J.
Published: June 2019

OBJECTIVE

Seizure outcome after mesial temporal lobe epilepsy (mTLE) surgery is complex and diverse, even across patients with homogeneous presurgical clinical profiles. The authors hypothesized that this is due in part to variations in network connectivity across the brain before and after surgery. Although presurgical network connectivity has been previously characterized in these patients, the objective of this study was to characterize presurgical to postsurgical functional network connectivity changes across the brain after mTLE surgery.

METHODS

Twenty patients with drug-refractory unilateral mTLE (5 left side, 10 female, age 39.3 ± 13.5 years) who underwent either selective amygdalohippocampectomy (n = 13) or temporal lobectomy (n = 7) were included in the study. Presurgical and postsurgical (36.6 ± 14.3 months after surgery) functional connectivity (FC) was measured with 3-T MRI and compared with findings in age-matched healthy controls (n = 44, 21 female, age 39.3 ± 14.3 years). Postsurgical connectivity changes were then related to seizure outcome, type of surgery, and presurgical disease parameters.

RESULTS

The results demonstrated significant decreases of FC from control group values across the brain after surgery that were not present before surgery, including many contralateral hippocampal connections distal to the surgical site. Postsurgical impairment of contralateral precuneus to ipsilateral occipital connectivity was associated with seizure recurrence. Presurgical impairment of the contralateral precuneus to contralateral temporal lobe connectivity was associated with those who underwent selective amygdalohippocampectomy compared to those who had temporal lobectomy. Finally, changes in thalamic connectivity after surgery were linearly related to duration of epilepsy and frequency of consciousness-impairing seizures prior to surgery.

CONCLUSIONS

The widespread contralateral hippocampal FC changes after surgery may be a reflection of an ongoing epileptogenic progression that has been altered by the surgery, rather than a direct result of the surgery itself. This network evolution may contribute to long-term seizure outcome. Therefore, the combination of presurgical network mapping with the understanding of the dynamic effects of surgery on the networks may ultimately be used to create predictors of the likelihood of long-term seizure recurrence in individual patients after mTLE surgery.
A biomechanical investigation of the sacroiliac joint in the setting of lumbosacral fusion: impact of pelvic fixation versus sacroiliac joint fixation
Authors: Mushlin Harry , Brooks Daina M. , Olexa Joshua , Ferrick Bryan J. , Carbine Stephen , Hayward Gerald M. , Bucklen Brandon S. , Sansur Charles A.
Published: June 2019

OBJECTIVE

The sacroiliac joint (SIJ) is a known source of low-back pain. Randomized clinical trials support sacroiliac fusion over conservative management for SIJ dysfunction. Clinical studies suggest that SIJ degeneration occurs in the setting of lumbosacral fusions. However, there are few biomechanical studies to provide a good understanding of the effect of lumbosacral fusion on the SIJ. In the present study, researchers performed a biomechanical investigation to discern the effect of pelvic versus SIJ fixation on the SIJ in lumbosacral fusion.

METHODS

Seven fresh-frozen human cadaveric specimens were used. There was one intact specimen and six operative constructs: 1) posterior pedicle screws and rods from T10 to S1 (PS); 2) PS + bilateral iliac screw fixation (BIS); 3) PS + unilateral iliac screw fixation (UIS); 4) PS + UIS + 3 contralateral unilateral SIJ screws (UIS + 3SIJ); 5) PS + 3 unilateral SIJ screws (3SIJ); and 6) PS + 6 bilateral SIJ screws (6SIJ). A custom-built 6 degrees-of-freedom apparatus was used to simulate three bending modes: flexion-extension (FE), lateral bending (LB), and axial rotation (AR). Range of motion (ROM) was recorded at L5–S1 and the SIJ.

RESULTS

All six operative constructs had significantly reduced ROM at L5–S1 in all three bending modes compared to that of the intact specimen (p < 0.05). In the FE mode, the BIS construct had a significant reduction in L5–S1 ROM as compared to the other five constructs (p < 0.05). SIJ ROM was greatest in the FE mode compared to LB and AR. Although the FE mode did not show any statistically significant differences in SIJ ROM across the constructs, there were appreciable differences. The PS construct had the highest SIJ ROM. The BIS construct reduced bilateral SIJ ROM by 44% in comparison to the PS construct. The BIS and 6SIJ constructs showed reductions in SIJ ROM nearly equal to those of the PS construct. UIS and 3SIJ showed an appreciable reduction in unfused SIJ ROM compared to PS.

CONCLUSIONS

This investigation demonstrated the effects of various fusion constructs using pelvic and sacroiliac fixation in lumbosacral fusion. This study adds biomechanical evidence of adjacent segment stress in the SIJ in fusion constructs extending to S1. Unilateral pelvic fixation, or SIJ fusion, led to an appreciable but nonsignificant reduction in the ROM of the unfused contralateral SIJ. Bilateral pelvic fixation showed the greatest significant reduction of movement at L5–S1 and was equivalent to bilateral sacroiliac fusion in reducing SIJ motion.
Siboglinids (Annelida, Siboglinidae) as possible indicators of carbohydrates on the case of the Sea of Okhotsk
Authors: Karaseva N. P. , Gantsevich M. M. , Obzhirov A. I. , Shakirov R. B. , Starovoytov A. V. , Smirnov R. V. , Malakhov V. V.
Published: June 2019

Siboglinids (Annelida, Siboglinidae) as possible indicators of carbohydrates on the case of the Sea of Okhotsk Geographical and bathymetric distribution of siboglinides in the sea of Okhotsk was studied. More than 75% of all siboglinides were found at a depth of 400 m. These findings were mainly concentrated in the North-Western part of the shelf. A comparison of the distribution of siboglinides in the Sea of Okhotsk and generalized geological data on the distribution of hydrocarbons showed that siboglinides in the sea of Okhotsk were mostly found in the areas of hydrocarbon manifestations and were absent in the central regions, where in the bottom sediments and in the near-surface layer of water we have registered minimal methane and hydrocarbon concentrations.
Transverse deformation and nonlinearity of force interactional interaction of solids
Authors: Sanditov D. S.
Published: June 2019

At this stage, it is necessary to allow the dependence of the Poisson coefficient (parameter of elasticity theory) on the nonlinearity of the interatomic interaction force and the anharmonicity of lattice vibrations (Gruneisen parameter). This dependence follows from the experimental data and finds justification in the framework of the existing theoretical developments, primarily the BRB model (Berlin-Rothenburg-Baserst). The relationship between the linear (harmonic) and nonlinear (anharmonic) properties of solids is discussed using the example of the unambiguous connection of the Poisson coefficient μ with the Gruneisen parameter.
Influence of asphaltenes on wettability of gas and oil saturated reservoir rock
Authors: Mikhailov N. N. , Ermilov O. M. , Sechina L. S.
Published: June 2019

The wettability of terrigenous and carbonate rock cores of oil and gas condensate fields extracted with n-hexane and chloroform by asphaltenes was studied. The obtained values of core wettability with asphaltenes show their contribution to the change of wettability of different rocks.
Muzzle velocity estimation of an electromagnetic launcher using B-dot probe
Authors: Kim Hong-Kyo , Kang Beom-Soo , Kim Jeong
Published: June 2019

An electromagnetic launcher or accelerator is a useful device for obtaining a wide range of payload velocities. Electromagnetic launchers have smaller space requirements compared to compressed air gas launchers and can use easily obtainable grid electricity to provide thrust in place of a conventional propellant. Despite these advantages, it is difficult to measure launcher muzzle velocity, as the flames and light produced by the muzzle during launch make velocity measurement using a light sensor or high-speed camera impossible. To overcome this problem, B-dot probes can be used to track the projectile position within the launcher by sensing changes in the magnetic field, which generate an induced voltage in the probe following Faraday’s law. This paper proposes a B-dot probe based method for measuring an electromagnetic launcher’s muzzle velocity. After determining the sensing effect as the probe positions and orientations through numerical simulation, the B-dot probe was used to measure the muzzle velocity, which was compared to a muzzle velocity obtained using a high-speed camera to validate the proposed method.
ETHNIC DIVERSITY OF BANTENESE SOCIETY
Authors: Humaeni Ayatullah
Published: June 2019

As an area that had ever been under the authority of Hindu Kingdom of Padjajaran in which the majority of its society professed Hindu and it had ever become one of the International trading centres and one of the central spots of Islamic studies in the archipelago during The Islamic Sultanate of Banten period in which many people of various ethnics came into Banten not only for conducting trading activities, but also for conducting religious proselytizing (dakwah) and studying Islam, Banten looked like becoming a magnet for people from many ethnics to earn a living, even to live permanently in Banten. Furthermore, they assimilated, integrated and conducted social interaction with local community of Banten. The majority of Bantenese society basically consisted of two dominant ethnics, "Jawa Banten people" and "Sunda Banten people". However, it is wrong to consider that Sundanese ethnic of Banten is the same as Sundanese people of Priangan, Jawa Barat and Javanese ethnic of Banten is similar to Javanese people in Central and East Java due to the difference of languages and cultures among them. As stated on the title, this article discusses the ethnic diversity of Banten. Furthermore, this article also tries to explain the social structure of Bantenese society in the sultanate period, the pre-colonial period, and post-colonial period.
Marriage and marital disputes in the Old Testament
Authors: Berković Danijel
Published: June 2019

In the introduction, the author emphasizes the significance and the importance of the narrative nature of the Old Testament text. This is with the purpose of emphasizing the directness and openness of the Old Testament narrative, where realistic life issues are openly and unapologetically discussed in the form of a story. Consequently, this raises the issues of understanding marriage and the marital union in the text and context of the Old Testament. The vocabulary and the language are analyzed. In the second part of the paper, the author focuses on the problems pertaining to marital and family communities; to marital disputes as we see them in the OT, using several Biblical marriages and the challenges they faced as examples.
Brak i bračne razmirice u Starom zavjetu
Authors: Berković Danijel
Published: June 2019

U uvodnom dijelu ovoga rada autor naglašava vrijednost i važnost narativnosti teksta Staroga zavjeta, prije svega da se istakne neposrednost i otvorenost u starozavjetnoj narativnosti, gdje se u obliku pripovijesti bez zadrške i sasvim otvoreno progovara o realnim životnim problemima. Slijedom toga otvaraju se pitanja i poimanja braka i bračne zajednice u starozavjetnom tekstu i kontekstu. Analizira se vokabular i pojmovnik. U drugom dijelu rada autor se usredotočuje na probleme bračnih i obiteljskih zajednica, bračnih razmirica onako kako to nalazimo u starozavjetnim tekstovima, uzimajući za primjer nekoliko biblijskih brakova i njihovih bračnih izazova.
Hardware Signature Generation Using a Hybrid PUF and FSM Model for an SoC Architecture
Authors: Kokila Jagadeesh , Murali Das Arjun , Begum Basha Shameedha , Ramasubramanian Natarajan
Published: June 2019

Security is becoming an important issue in the recent System on Chip (SoC) design due to various hardware attacks that can affect manufacturers, system designers or end users. Major issues include hardware Trojan attack, hardware intellectual property (IP) theft, such as an illegal sale or use of firm intellectual property cores or integrated circuits (ICs) and physical attacks. A hybrid model consisting of Arbiter PUF and Butterfly PUF are used to generate random responses which are fed to a Finite State Machine (FSM). A three-level FSM was designed to generate the signature correctly to authenticate IPs. The results were obtained with the help of three Intellectual Property (IP) cores – Zedboard OLED IP, ISCAS’89 s1423 Benchmark IP and a Full Adder IP. A 16-bit arbiter PUF and Butterfly PUF have been implemented on a 28nm FPGA. The average execution time to generate hardware signature for three IP cores was found to be 4.78 seconds (5 iterations) which is considerably low.
Metro Passenger Flow Forecast with a Novel Markov-Grey Model
Authors: Wang Yonggang , Ma Jingfeng , Zhang Jun
Published: June 2019

Accurate forecasts of passenger flow entering and leaving metro stations is an important work for Metro operation management, such as for the automatic adjustment of train operation diagrams or station passenger crowd regulation planning measures. In this study, Grey theory is introduced to develop a time series GM (1, 1) model for total passenger forecasting. Two modification factors determined by two minimum mean square error principles are proposed to decrease the discreteness of input data and thus improve the forecast accuracy. Moreover, the Markov chain approach is further used to optimize the residual error series. Passenger flow data entering and leaving the Xiaozhai station of Xi'an Metro Line 2 from September 1-30, 2015, were utilized to verify the effectiveness of the proposed method; the forecast results show that this novel Markov-Grey model performs well in terms of forecast accuracy with smaller SMSE and MAPE values. To this effect, the proposed method is especially well-suited to smooth passenger flow forecasting compared to other forecast techniques.
El cáncer de mama y su relación con los factores de riesgo modificables en mujeres de Armenia- Quindío
Authors: Garcia Castañeda Jheimy J. , Ruiz Hoyos Bayron
Published: June 2019

El cáncer de mama es el cáncer ginecológico más frecuente en mujeres en todo el mundo, con 1,67 millones de nuevos casos reportados. Existen factores de riesgo modificables, como la nuliparidad o la primiparidad luego de los treinta años, no haber lactado, utilizar terapia de reemplazo hormonal, consumo regular de bebidas alcohólicas, obesidad, inactividad física y consumo de tabaco.Objetivo: describir los factores de riesgo modificables en mujeres de Armenia y su relación con cáncer de mama.Metodología: estudio exploratorio con mujeres de una institución prestadora de salud (IPS) privada de Armenia, con cáncer de mama y que consultaron en el segundo semestre de 2013 previo consentimiento informado; se aplicó el instrumento Step V 2.1 previamente validado. Se realizó una prueba piloto, se utilizó la base de datos SPSS 19 y se hizo un análisis univariado y bivariado.
Configuraciones familiares de los pacientes con enfermedad crónica no trasmisible ECNT de una institución prestación de servicios de tercer nivel en la ciudad de Armenia Quindío
Authors: Henao Buritaca Adiela , Fernandez Rincon Carmen Ayde , Garcia Garcia Nancy
Published: June 2019

El propósito fundamental del estudio fue caracterizar la configuración de la familia de los pacientes con ECNT, en términos de composición, valoración de componentes del estilo de vida, estructura y tipología, para reflexionar sobre la importancia de conocer el contexto familiar de la persona con ECNT, en el establecimiento de planes de alta y continuidad del cuidado de los pacientes. Se realizó una investigación cuantitativa descriptiva con una muestra de 360 entre 2973 pacientes adultos consultantes de una IPS de tercer nivel de atención, en la ciudad de Armenia. La información fue recolectada a través de encuesta. Los datos fueron llevados a Bases de Datos construidas en Access y procesadas en el paquete estadístico SPSS versión 21.Resultados: existe gran heterogeneidad en las familias con relación a la distribución por sexo, edad, estado civil, nivel de escolaridad y ocupación. La estructura de las familias es diversa encontrándose desde la existencia de familias unipersonales hasta las conformadas por más de 17 integrantes; familias sin núcleo, y personas con ECNT que viven solas por situaciones como viudez, separación y solterísmo.
Prevalencia del consumo de sustancias licitas e ilícitas en una facultad de salud de una universidad pública de Colombia
Authors: Toro Campo Jaime Horacio , Restrepo Suarez Yolanda , Diaz Monsalve Luz Ever
Published: June 2019

Objetivo: describir la prevalencia de consumo de sustancias licitas e ilícitas en estudiantes de una facultad de salud, de una Universidad pública.Metodología: estudio descriptivo, transversal, desarrollado con 252 estudiantes a quienes se les aplicó una encuesta compuesta por tres instrumentos, versión para auto-aplicación.Resultados: las sustancias que consumían al momento de la encuesta fueron en su orden, alcohol-(75.8%), tabaco-(14.3%), marihuana-(6%), cocaína-(1.2%). Se encontró que el (53.6%) consumió algún tipo de sustancia antes de ingresar a la universidad.La mayor motivación para el consumo fue por gusto. Por efectos de la sustancia ha tenido problemas disciplinarios el (7.9%) y el (16.3%) ha pensado y/o intentado suicidarse.
Reporte de 4 casos de inversión de cromosoma 9 en una muestra de 4755 líquidos amnióticos en una población Venezolana
Authors: Usta C. , Torres C. , Gómez M. , Lynett D. , Fernández I. , Celis LG.
Published: June 2019

La inversión del cromosoma 9, inv (9), es una reordenación cromosómica relativamente común y generalmente se considera como una variante normal. No obstante, varios estudios han sugerido una posible asociación con Síndrome metabólico, obesidad, galactosemia, diabetes Mellitus y aborto espontáneo recurrente. Este estudio tiene como objetivo describir cuatro casos con la misma inversión cromosómica 9, inv (9) (p12; q12), y compararlo con lo que ha sido expuesto en la literatura. Se realizaron una serie de casos retrospectivos. Se evaluó una gran base de datos de informes de amniocentesis realizados en el centro Policlínica Metropolitana de Caracas entre 2005 y 2016. Como parte del protocolo del centro, todas las muestras de líquido amniótico recuperadas se centrifugaron a 800 rpm. Finalmente, se realizó un análisis de 20 bandas en metafase G para el cariotipo. Se recuperaron todos los cariotipos que informaron inv (9) (p12; q12). De 4755 informes de amniocentesis, se identificaron un total de 4 casos de inv (9) (p12; q12) pericéntrico . Según la literatura, este tipo de reordenamiento se ha asociado a algunas enfermedades metabólicas. Este hallazgo está respaldado por el hecho de que esta región cromosómica contiene el factor 1 promotor de insulina y el factor iniciador para la alfa quinasa 3 del factor de iniciación de traducción eucariótico, ambos implicados en la diabetes transitoria. Existe escasa literatura sobre este tipo de inversión, y se necesitan más estudios para un análisis de correlación adecuado. Los resultados de esta breve serie y los hallazgos de la literatura respaldan la importancia de los primeros estudios de cariotipo para identificar posibles asociaciones.
Formación ética centrada en la perspectiva de la persona. Un aporte metodológico.
Authors: Cluzet Oscar
Published: June 2019

Los lineamientos generales expuestos a continuación constituyen, en nuestra visión, una columna vertebral sobre la cual estructurar un programa de formación ética debidamente centrada en la persona, puesto que ha sido extrapolado a partir de los principios rectores de la Medicina Centrada en la Persona (MCP)(1). Dicho programa se postula como aplicable tanto a nivel de pregrado como de postgrado en cualquiera de las disciplinas integrantes de las Ciencias de la Salud.
Desarrollo de competencias para la investiga- ción en pregrado centradas en la persona
Authors: Garmendia Lorena Fausto
Published: June 2019

La formación de un profesional médico es un proceso permanente, complejo y largo, propiamente inacabable. De acuerdo a la nueva ley universitaria N° 30220 y al Estatuto de la Universidad Nacional Mayor de San Marcos comprende las etapas de estudios generales, pregrado y posgrado sustentadas en los ejes fundamentales de la ética, la investigación y el trabajo en la comunidad.
Healing Myocarditis from a Hypertrophied Heart with Multifocal Fibrosis Mimicking Cardiomyopathy
Authors: Park Sohyung , Herath Jayantha C
Published: June 2019

We report the case of an 18 year old man who unexpectedly died of healing myocarditis. His heart was hypertrophied with multifocal fibrosis which can be a common histological feature of primary and secondary cardiomyopathy as well as the healing phase of myocarditis. However, the pattern of myocardial fibrosis, inflammation with myonecrosis, sparing of the right ventricular myocardium, and cardiomyocytes features in the remaining areas of the heart were considered as the key elements in determining a diagnosis of myocarditis. This case illustrates that meticulous histologic examination and the analysis of the histologic findings in the hypertrophied heart with multifocal fibrosis can be helpful to make a correct diagnosis.
PESTICIDES; ACUTE POISONING, SUICIDES AND DISABILITY IN HUMANS
Authors: Ramzan Muhammad , Naeem-Ullah Unsar , Bokhari Syed Haroon Masood , Saba Shafia
Published: June 2019

Pakistan is a place where only pesticides is considered as an effective source for control of pests and diseases, and we are using these deliberately by involving wide range of pesticides. Majority of chemicals are used in agriculture as data suggests that about 49399 million metric tons of pesticides had been used only in agriculture sector in 2010 in the country. Use of pesticides in other fields such as public health, fisheries, forestry and food industry is not included in the data. Though pesticides are useful in managing pest populations but these have adverse effects on humans, animals and ecosystems. The current work exhibits the effects of pesticides on human health in the country. Acute poisoning is one of the key issues resulted by unsafe handling and storage of pesticides in on-farm and off-farm premises in developing economies. From various areas in the country, pesticides are reported to be used as tool for suicide by teen agers due to easy access. According to department of Plant Protection (Karachi), total of 200 workers get affected showing low enzyme activity in their blood. In Multan, an adverse situation was observed as elevated levels (87.5 %) of acetylcholinesteras (AchE) activity was recorded in female cotton pickers as compared to males which have low (36 %) AchE activity because cotton is picked mostly by women in Pakistan. The aim of this work is to sum-up the weaknesses in practicing / implementing current policies and legislations for safe handling, storage and judicious use of pesticides. The acquired knowledge will later be used in making and improving the existing regulations for the subject
Assessment of Cover Crop Management Strategies in Nebraska, US
Authors: Oliveira Maxwel C. , Butts Liberty , Werle Rodrigo
Published: June 2019

Adoption of cover crops has the potential to increase agricultural sustainability in the US and beyond. In 2017, a survey was conducted with Nebraska stakeholders in an attempt to evaluate current cover crop management strategies adopted in soybean (Glycine max [L.] Merr.), field corn (Zea mays L.), and seed corn production. Eighty-two Nebraska stakeholders answered the survey, of which 80% identified themselves as growers. Eighty-seven percent of respondents manage cover crops, and the average cover crop ha planted on a per farm basis is 32%. The primary method of establishing cover crops following soybeans and field corn is drilling. In seed corn, interseeding is the main seeding strategy for cover crop establishment. Cereal rye (Secale cereale L.) appeared as the most adopted cover crop species (either alone or in mixtures with radish [Raphanus sativus L.] or hairy vetch [Vicia villosa Roth]). Over 95% of respondents utilize herbicides for cover crop termination in the spring before crop planting. Glyphosate is used by 100% of survey respondents that use herbicides for cover crop termination. The major observed impacts of incorporating cover crops into a production system according to survey respondents are reduced soil erosion and weed suppression. According to 93% of respondents, cover crops improve weed control by suppressing winter and/or summer annual weed species. The biggest challenge reported by cover crop adopters is planting and establishing a decent stand before winter. According to the results of this survey, there are different management strategies, positive outcomes, and challenges that accompany cover crop adoption in Nebraska. These results will help growers, agronomists, and researchers better guide cover crop adoption, management, and future research and education needs in Nebraska and beyond.
Integrated Management of Cheatgrass (Bromus tectorum) with Sheep Grazing and Herbicide
Authors: Lehnhoff Erik A. , Rew Lisa J. , Mangold Jane M. , Seipel Tim , Ragen Devon
Published: June 2019

Cheatgrass (Bromus tectorum L.) is one of the most problematic weeds in western United States rangelands and sagebrush steppe. It responds positively to different forms of disturbance, and its management has proven difficult. Herbicide or targeted grazing alone often fail to provide adequate long-term control. Integrating both may afford better control by providing multiple stressors to the weed. We assessed herbicide application, targeted sheep grazing and integrated herbicide and grazing on B. tectorum and the plant community in rangeland in southwestern Montana from 2015 until 2017. Herbicide treatments included spring-applied (May 2015 and 2016) glyphosate, fall-applied (October 2015) glyphosate, imazapic and rimsulfuron, and spring-applied glyphosate plus fall-applied imazapic. Targeted grazing, consisting of four sheep/0.01 ha for a day in 5 m × 20 m plots (all vegetation removed to the ground surface), occurred twice (May 2015 and 2016). While no treatments reduced B. tectorum biomass or seed production, grazing integrated with fall-applied imazapic or rimsulfuron reduced B. tectorum cover from approximately 26% to 14% in 2016 and from 33% to 16% in 2017, compared to ungrazed control plots, and by an even greater amount compared to these herbicides applied without grazing. By 2017, all treatments except spring-applied glyphosate increased total plant cover (excluding B. tectorum) by 8%–12% compared to the control plots, and forbs were generally responsible for this increase. Bromus tectorum management is difficult and our results point to a potential management paradox: Integrating grazing and fall-applied herbicide decreased B. tectorum cover but did not increase native grass cover, while some herbicides without grazing increased native grass cover, but failed to control B. tectorum. Additional research is necessary to determine grazing strategies that will complement herbicide control of B. tectorum while also stimulating native grass recovery, but this initial study demonstrates the potential of integrated management of B. tectorum compared to grazing or herbicide alone.
Synthesis of Lipophilic Esters of Tyrosol, Homovanillyl Alcohol and Hydroxytyrosol
Authors: Bernini Roberta , Carastro Isabella , Santoni Francesca , Clemente Mariangela
Published: June 2019

Low-molecular weight phenols such as tyrosol, homovanillyl alcohol and hydroxytyrosol are valuable compounds that exhibit a high number of health-promoting effects such as antioxidant, anti-inflammatory and anticancer activity. Despite these remarkable properties, their applications such as dietary supplements and stabilizers of foods and cosmetics in non-aqueous media are limited for the hydrophilic character. With the aim to overcome this limitation, the paper describes a simple and low-cost procedure for the synthesis of lipophilic esters of tyrosol, homovanillyl alcohol and hydroxytyrosol. The reactions were carried out under mild and green chemistry conditions, at room temperature, solubilizing the phenolic compounds in dimethyl carbonate, an eco-friendly solvent, and adding a little excess of the appropriate C2–C18 acyl chloride. The final products were isolated in good yields. Finally, according to the “circular economy” strategy, the procedure was applied to hydroxytyrosol-enriched extracts obtained by Olea europaea by-products to prepare a panel of lipophilic extracts that are useful for applications where solubility in lipid media is required.
BG-4 from Bitter Gourd (Momordica charantia) Differentially Affects Inflammation In Vitro and In Vivo
Authors: Nieto-Veloza Andrea , Wang Zhihong , Zhong Qixin , Krishnan Hari B. , Dia Vermont P.
Published: June 2019

BG-4 isolated from bitter gourd has been reported for anti-cancer properties. The objective was to evaluate the anti-inflammatory properties of BG-4 in vitro and in vivo. Comparative study of the anti-inflammatory properties of BG-4 in vitro and in vivo was conducted on lipopolysaccharide (LPS)-activated mouse macrophages, and on dextran sodium sulfate (DSS)-induced colitis in mice. BG-4 reduced the production of pro-inflammatory markers in LPS-activated macrophages. On the other hand, intraperitoneal administration of BG-4 in DSS-induced colitis led to colon shortening, elevated neutrophils infiltration and myeloperoxidase activity, presence of blood in the stool, and loss of body weight, with differential systemic and local effects on pro-inflammatory cytokines in vivo. The results demonstrated that BG-4 differentially affected inflammation in vitro and in vivo.
Mitochondrial Damage and Mitochondria-Targeted Antioxidant Protection in LPS-Induced Acute Kidney Injury
Authors: Plotnikov Egor , Pevzner Irina , Zorova Ljubava , Chernikov Valery , Prusov Andrey , Kireev Igor , Silachev Denis , Skulachev Vladimir , Zorov Dmitry
Published: June 2019

Induced and frequently unwanted alterations in the mitochondrial structure and functions are a key component of the pathological cascade in many kidney pathologies, including those associated with acute damage. One of the principal pathogenic elements causing mitochondrial dysfunction in Acute Kidney Injury (AKI) is oxidative stress. After ischemia and nephrotoxic action of drugs, sepsis and systemic inflammation are the most frequent causes of AKI. As the kidney suffers from oxidative stress during sepsis, one of the most promising approaches to alleviate such damaging consequences is the use of antioxidants. Considering administration of lipopolysaccharide (LPS) as a model of sepsis, we demonstrate that the mitochondria of neonatal renal tissue are severely affected by LPS-induced AKI, with pathological ultrastructural changes observed in both the mitochondria of the renal tubular epithelium and the vascular endothelium. Upon mitochondrial damage, we evaluated the effect of the mitochondria-targeted antioxidant plastoquinol decylrhodamine 19 (SkQR1) on the development of acute renal failure in newborn rats associated with systemic inflammation induced by the administration of LPS. We found that SkQR1 administration 3 h before LPS led to decreased urinal expression of the AKI marker neutrophil gelatinase-associated lipocalin 2 (NGAL), in addition to a decrease in urea and creatinine levels in the blood. Additionally, an observed impairment of proliferative activity in the neonatal kidney caused by LPS treatment was also prevented by the treatment of rat pups with SkQR1. Thus, one of the key events for renal tissue damage in neonatal sepsis is an alteration in the structure and function of the mitochondria and the mitochondria-targeted antioxidant SkQR1 is an effective nephroprotective agent, which protects the neonatal kidney from sepsis-induced AKI.
Gradual Meso-Structural Response Behaviour of Characteristics of Asphalt Mixture Main Skeleton Subjected to Load
Authors: Shi Liwan , Yang Zhen , Wang Duanyi , Qin Xiao , Xiao Xin , Julius Masley Kwaku
Published: June 2019

In order to provide a reference for the gradation design of dense skeleton asphalt mixtures (DSAM), this study conducts a thorough analysis of the gradual meso-structural response behaviour of characteristics of the asphalt mixture main skeleton subjected to load using the digital image processing (DIP) technique. Moreover, gradation optimisation measures and the design criteria of mesoscopic evaluation indices for the main skeleton are proposed. The results indicate that aggregates with particle sizes of 2.36–4.75 mm can effectively increase the number of contact points; however, the stability of the main skeleton remains insufficient. Furthermore, coarse aggregates with a particle size larger than 4.75 mm provide the most significant contribution to the formation of a steady main skeleton; this is the critical particle size for the formation of a steadier main skeleton. Gradation is the major determinant of mesoscopic evaluation indices, including average coordination number ( n ¯ c ) and the ratio of the quantity of coarse aggregates without contact points to the total quantity of coarse aggregates (C value) for the asphalt mixture of the main skeleton. On the other hand, the performance of asphalt has an insignificant influence on mesoscopic evaluation indices; it mainly affects the development trend of macroscopic rutting. In the design process of DSAM, it is necessary to optimise gradation with the aim of increasing n ¯ c and reducing the C value so as to enhance the load resistance capacity of the primary skeleton. When preparing asphalt mixture specimens using the wheel rolling method, the design criteria for the aforementioned indices are n ¯ c ≥ 1.5 and C ≤ 15%, which can be used as bases for the design of DSAM with a nominal maximum particle size of 13.2 mm to ensure that the coarse aggregates are interlocked and form a steady main skeleton.