bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Accuracy of “Ottawa Ankle Rules” for Predicting Fractures in Acute Ankle and Midfoot Injuries
Authors: Dwivedi R , Ale SB
Published: September 2014

INTRODUCTION: Twisting injuries of ankle and foot are one of the most common injuries seen in emergency department and are the most common sports injuries. Almost all such cases are investigated by X-rays to rule out fractures, but clinically significant fractures are detected only in a small number of cases (approximately 15%). Ottawa Ankle Rules (OARs) are screening tools, applied in acute ankle and foot injuries to exclude those cases that are not likely to have fractures and thereby reduce the number of unnecessary X-rays. At the same time, all clinically significant fractures are included and not a single clinically significant fracture is missed when OARs are applied properly. This study was conducted to evaluate the accuracy of “Ottawa Ankle Rules” in our setup. METHODS: This prospective study was conducted in the Emergency and Orthopaedics Department of Lumbini Medical College Teaching Hospital, Palpa. Eighty patients were included in this study. Fifty one patients were in ankle group and 30 patients were in midfoot group. All patients were sent for X-rays after evaluating them according to OARs. RESULTS: Among 81 cases, 13 clinically significant fractures were detected. Sensitivity of the OARs for detecting fractures was 100%. Specificity of the OARs for detecting fractures was 36.76 % for combined ankle and midfoot zones, 36.36% for the ankle zone, and 37.5% for the midfoot zone. Negative predictive value was calculated as 1(100%). Potential of OARs to reduce unnecessary radiographs was calculated 30.86%. CONCLUSION: OARs are very accurate and highly sensitive tools for detecting fractures in acute ankle and midfoot injuries. Implementation of these rules would lead to significant reduction in the number of radiographs and thereby reduce the cost of the treatment, radiation exposure and waiting time of patients at hospital. DOI: http://dx.doi.org/10.3126/jucms.v2i2.11166 Journal of Universal College of Medical Sciences (2014) Vol.2(2): 2-5
Prevalence and Correlates of Psychiatric Problems among Engineering Students
Authors: Pandey AK , Adhikari BR , Verma SK , Bhojak MM
Published: September 2014

INTRODUCTION: Mental health among students represents an important and growing public health concern. College is a place where student learns new experiences which play a vital role in physical as well as psychological growth for the identity consolidation. Engineering students experience frequent psychological distress as of various underlying reasons leading to psychiatric disorders including anxiety, depression, substance use etc. MATERIAL AND METHODS: The final sample consisted of 196 students (1st year 50, 2nd year 51, 3rd year 48 and final year 47) from the Malviya National Institute of Technology (MNIT) Jaipur, the premier engineering college of Rajasthan, India. Study was conducted in two phases. In first phase, engineering students were administered socio-demographic data sheet and GHQ-60 (General Health Questionnaire) hindi version to ascertain the extent of psychiatric illnesses. False positive cases were dropped and in second phase the diagnosed students with psychiatric problems and control group were individually administered a battery of tests to determine the role of various possible causative factors. Scores obtained on different measures were arranged as per the requirement of research design and statistical procedure.  RESULTS: Out of all the subjects, 24.49% had some psychiatric disorders. Psychiatric disorder was highest i.e. 32% in 1st year students and overall in 36.60% of female students. Statistically significant differences were noted on various applied tools. CONCLUSION: Students who had higher scores on GHQ-60 scale had more neurotic problems, poor coping skills and abnormal personality traits and had high psychiatric morbidity than the vice versa group.DOI: http://dx.doi.org/10.3126/jucms.v2i2.11167 Journal of Universal College of Medical Sciences (2014) Vol.2(2): 6-10
Comparison of Maternal and Perinatal Outcome in Pregnant Women with Hypothyroidism Diagnosed before Conception with Hypothyroidism Diagnosed during Pregnancy
Authors: Basnet P , Aggrawal N , Suri V , Dutta P , Mukhopadhyay K
Published: September 2014

BACKGROUND: Thyroid disorder is one of commonest endocrine disorder in women and hence constitutes a common endocrine disorder complicating pregnancy. Diagnosing and treating hypothyroidism preconceptionally and during early pregnancy appears to be a useful strategy to improve maternal and fetal outcome. OBJECTIVE: To compare the maternal and perinatal outcome in pregnant women with hypothyroidism diagnosed preconceptionally with hypothyroidism diagnosed during pregnancy. METHODS: A prospective study. One hundred pregnant women with hypothyroidism at less than 20 weeks Period of Gestation (POG) were recruited for the study and grouped into two groups: Group A-hypothyroidism diagnosed and on treatment before conception, Group B-hypothyroidism diagnosed and started on treatment during pregnancy. Both groups were intensively monitored during pregnancy with serial Thyroid Function Test (TFT) and thyroxine replacement doses were adjusted accordingly. Various maternal, perinatal and fetal outcome measures were studied in both groups prospectively till delivery. RESULTS: The maternal and fetal complications were comparable in the two groups, however the fetal birth weight was significantly higher in Group A versus Group B (2.89±0.485kg vs. 2.70±0.453kg; p=0.039). All the new born babies had normal thyroid function. CONCLUSION: Hypothyroidism diagnosed preconceptionally or during early pregnancy and treated appropriately has beneficial effect on fetal birth weight, and hence the total pregnancy outcome. Screening for thyroid dysfunction should be judiciously performed in all high risk women prior to a planned conception or during their first antenatal visit. DOI: http://dx.doi.org/10.3126/jucms.v2i2.11170   Journal of Universal College of Medical Sciences (2014) Vol.2(2): 21-27
Study of Factors Determining Outcomes in the Hospitalized Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD)
Authors: Sijapati MJ , Bhatta N , Khanal B , Lamsal M , Chaudhary S
Published: September 2014

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of mortality and morbidity across the world. Information related to the factors associated with COPD exacerbation and factors determining outcome in hospitalized patient with acute exacerbation of COPD are very important for effective long-term management of this disease. Within this background we attempted to study the factors determining outcome in hospitalized patients with acute exacerbation of COPD. METHODS: The study was prospective observational study. Hundred consecutive patients hospitalized with acute exacerbation of COPD were prospectively assessed. RESULTS: Patients required mechanical ventilation and Intensive Care Unit (ICU) transfer were 17 (17%). Patients with hypercapnia pCO2 [(80.24 ± 10.76mmHg P=0.001], pH [(7.24 ± 0.062) P=0.004] with type 2 respiratory failure required ICU transfers with mechanical ventilatory support and these variables were statistically significant in univariate analysis. Patients who were in COPD stage III (FEV1/FVC ratio < 0.35) and having the poor arterial blood gas parameters pH (7.24±0.02) P=0.001, pCO2 [(76.5±13.12mmHg,P=0.006] had bad prognosis. The patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) who were smokers and exposed to indoor air pollution due to use of biomass fuels had poor outcomes. CONCLUSION: Patients with AECOPD hospitalized in a tertiary care center in a developing country suggest that FEV1/FVC impairment, decreased pH, increased pC02, current smoking status and presence of biomass exposure are associated with prolonged hospitalization, ICU admission and death. DOI: http://dx.doi.org/10.3126/jucms.v2i2.11171   Journal of Universal College of Medical Sciences (2014) Vol.2(2): 28-34
Endodontic Management of Three Rooted Mandibular First Molar: Report of Three Cases
Authors: Acharya N , Samant PS , Gautam V , Singh O , Shrestha A
Published: September 2014

In everyday endodontic practice, clinicians face various atypical configurations, such as presence of extra root and/or atypical canal configuration. One of the major reason of the treatment failure is the missed extra root and/or canals. Mandibular first molars typically have two roots (one mesial and one distal), but sometimes present with a supernumerary root either distolingually (radix entomolaris), or mesiobuccally (radix paramolaris). Hence, the thorough knowledge of root canal anatomy and morphology along with its variation is crucial for the successful outcome of the root canal treatment. The aim of this paper is to present and describe the three clinical case reports of three rooted mandibular first molars and its endodontic management. DOI: http://dx.doi.org/10.3126/jucms.v2i2.11173 Journal of Universal College of Medical Sciences (2014) Vol.2(2): 40-45
Embedded Metallic Bangle in Vagina
Authors: Gupta T , Gupta N , Bhatia P , Gupta S , Jain J
Published: September 2014

BACKGROUND: Uterovaginal prolapse is a very common morbidity among Indian women. Vaginal pessaries still have role in the management of uterovaginal prolapse. Long forgotten pessaries get incarcerated in the vagina and their removal poses problems. A 65 year old postmenopausal lady presented with pain lower abdomen and thin vaginal discharge. Speculum examination revealed embedded metallic bangle in the vagina. Attempts at removal by gentle traction resulted in pain. Metallic bangle was removed under general anaesthesia and biopsy from the overlying tissue revealed no evidence of malignancy. Vaginal pessary gives symptomatic relief and does not cause any discomfort, women tend to forget it. This case report is unique as here ordinary metallic bangle was used as a vaginal pessary and in spite of long duration it did not cause much discomfort or any serious complication. DOI: http://dx.doi.org/10.3126/jucms.v2i2.11174 Journal of Universal College of Medical Sciences (2014) Vol.2(2): 46-48
Ascending Aortic Aneurysm, Wandering towards Old Problem with New Insight
Authors: Tiwari KK , Bevilacqua S , Salvati A , Varone E , Solinas M , Glauber M
Published: September 2014

Ascending aortic aneurysm is a silent and highly lethal disease. Generally, ascending aorta grows asymptomatically until it dissect or rupture. In case of acute complication mortality is as high as 90%, whereas if treated on time mortality and morbidity decreases significantly. Pathophysiology of the Ascending aortic aneurysm is a complex process. Aorta itself is an organ and it should not be considered merely as a tube transporting blood from heart to the organs. Several non-invasive and invasive imaging methods are available at disposition to diagnose this indolent killer at early stage. However, discrepancies exists about when to operate these patients. Several other methods has been reported to identify these patients at risk of dissection or rupture. Conservative treatment could be used in patients with small aortic diameter, but effectiveness of such approach is under scrutiny. Emerging endovascular treatment using stents should be advocated with caution. Surgical treatment, the gold standard, is recommended for asymptomatic patients with aortic diameter of 5.5cm, whereas 4-4.5cm for patients with Marfan's disease. Postoperative morbidity and mortality has significantly decreased due to better anesthetic management, improved surgical techniques and progress in preoperative and postoperative care. DOI: http://dx.doi.org/10.3126/jucms.v2i2.11175 Journal of Universal College of Medical Sciences (2014) Vol.2(2): 49-59
Framing a Well-Structured Single Best Response Multiple Choice Questions (MCQs) - An Art to be Learned by a Teacher
Authors: Chaudhary N , Bhatia BD , Mahato SK
Published: September 2014

DOI: http://dx.doi.org/10.3126/jucms.v2i2.11176 Journal of Universal College of Medical Sciences (2014) Vol.2(2): 60-64
Emergency Obstetric Care: Strategy for Reducing Maternal Mortality in Developing Countries
Authors: Bhandari TR , Dangal G
Published: September 2014

Twenty-five years have passed since the global community agreed in Nairobi to address the high maternal mortality by implementing the Safe Motherhood Initiative. However, every year nearly three million women die due to pregnancy related causes. This tragedy is avoidable if women have timely access to required emergency obstetric care. Emergency obstetric care refers to life-saving services for maternal and neonatal complications provided by skilled health workers. Since the beginning of the 1980’s, several efforts have been intensified to improve maternal and child health status and reducing the high morbidity and mortality. There was built on a worldwide consensus to provide improved maternal and child health care for addressing the high morbidity and mortality. All participant countries agreed to integrate emergency obstetric care services in their national health care system. Emergency obstetric care is one of the strategies for reducing the maternal mortality as pregnancy related complications are unpredictable. However, many women in developing countries do not have access to essential health care services including emergency obstetric care. Basic emergency obstetric care by skilled birth attendants or timely referral for further comprehensive emergency obstetric care can reduce maternal deaths and disabilities significantly. This paper is based on the results published in PubMed, Medline, Lancet, WHO and Google Scholar web pages from 1990 to 2013. DOI: http://dx.doi.org/10.3126/njog.v9i1.11179 NJOG 2014 Jan-Jun; 2(1):8-16
Comparison between Laparoscopic Hysterectomy and Abdominal Hysterectomy
Authors: Shrestha R , Yu LH
Published: September 2014

Aims: Hysterectomy can be performed by abdominal, vaginal and laparoscopic methods. Laparoscopic hysterectomy has been reported as an alternative to traditional abdominal hysterectomy with benefit of early recovery, short hospital stay and less operative complications. This study compared laparoscopic versus abdominal hysterectomy in terms of surgery time, blood loss, post-operative recovery, and duration of hospital stay. Methods: This is a retrospective comparative study among sixty patients who underwent laparoscopic or abdominal hysterectomy for various indications in the Department of Obstetrics and Gynaecology of the Third affiliated hospital of Zhengzhou University from January to March 2007. The data of the patients meeting the set criteria were obtained from the hospital records and hospital based computerized coding system. Enrolled cases were divided in two groups with thirty in each arm. Group TLH (total laparoscopic hysterectomy) was designated for patients who underwent total laparoscopic hysterectomy and group TAH (total abdominal hysterectomy) for those who underwent total abdominal hysterectomy. Results: There was comparatively less blood loss in TLH group (60.2±5.17 ml versus 75.7±7.12 ml) but it was statistically insignificant (p=0.12). The laparoscopic hysterectomy took longer time (107.6±32.4 min versus 74.9±31.1 min) than the abdominal (p<0.001). There was early recovery among TLH group 1.6±0.6 days versus 2.1±0.5 days in TAH group (p=0.001). Mean duration of hospital stay was significantly shorter in TLH group 7.6±1.9 days versus 10.1±2.1 days in TAH group (p<0.001). Conclusions: Laparoscopic hyserectomy is an effective alternative to abdominal hysterectomy with the advantage of less intra-operative blood loss, fast recovery and short hospital stay. DOI: http://dx.doi.org/10.3126/njog.v9i1.11183 NJOG 2014 Jan-Jun; 2(1):26-28
Abnormal Thyroid Function and Recurrent Pregnancy Loss
Authors: Shrestha A , Chawla CD
Published: September 2014

Aims: The aim of our study was to observe the benefit of screening for thyroid function amongst women with recurrent pregnancy loss and effect of treatment for thyroid disorder on pregnancy outcome. Methods: This was a longitudinal study conducted from June 2012 to December 2013. One hundred and three patients with recurrent pregnancy loss without features of thyroid disorder were included. They were investigated for thyroid stimulating hormone (TSH), free tri iodothyronin (FT3), free thyroxine (FT4) levels and for auto-antibodies against thyroperoxidase (anti TPO). The patients with abnormal TSH levels were treated with thyroxine depending on the level of TSH. Results: TSH, FT3, FT4 and anti TPO levels were measured. Amongst 103 ladies, thirty-eight (36.89%) had high levels of TSH. Thirty-five (33.98%) of them underwent test for anti TPO, of which two (5.71%) had autoimmune thyroiditis. Nine (8.73%) out of 103 had high FT4 levels. Ladies with diagnosis of hypothyroidism underwent treatment and 17 (44.73%) out of 38 had conceived. Conclusions: Of 103 women with recurrent pregnancy loss, abnormal thyroid function was detected in 47. Seventeen (44.73%) of them with increased TSH level conceived after treatment with thyroxine, which gives a positive message that hypothyroidism is a treatable cause for recurrent pregnancy loss. DOI: http://dx.doi.org/10.3126/njog.v9i1.11184 NJOG 2014 Jan-Jun; 2(1):29-32
Obstetric Emergencies: Feto-maternal Outcome at a Teaching Hospital
Authors: Saha R , Gautam P
Published: September 2014

Aims: This study was done to know the pattern of obstetric emergencies and its influence on maternal and fetal outcome. Methods: A descriptive study was carried out in the department of obstetrics and gynecology at Kathmandu Medical College Teaching Hospital from 1st June 2013 to 31st May 2014. Cases were categorized as early pregnancy emergencies (ruptured ectopic pregnancy, complications of abortion), ante-partum emergencies and intra-partum emergencies (antepartum haemorrhage, preeclampsia, eclampsia, preterm prelabor rupture of membranes, rupture uterus), post-partum emergencies (postpartum haemorrhage, retained placenta, placenta accreta, uterine inversion), puerperal emergencies (postpartum sepsis), fetal emergencies (cord prolapse, shoulder dystocia). Outcome noted were type of emergency, obstetric intervention done, maternal and perinatal morbidity and mortality. Results: A total of 80 (4.45%) obstetric emergencies occurred among 1796 deliveries .The most common obstetric emergencies were obstetric hemorrhage (62.5%), severe preeclampsia (23.5%) and preterm prelabor rupture of membranes (10%). The obstetric interventions done were cesarean section (43.75%), exploratory laparotomy (33.75%) and blood transfusion (40%). Obstetric emergencies were responsible for 66.6% of total maternal death and 24.56% of total perinatal death. Conclusions: In spite of best efforts, some obstetric emergencies do occur. Obstetric hemorrhage and severe preeclampsia are the frequent obstetric emergencies. Cesarean section, exploratory laparotomy and blood transfusion were the commonly performed interventions. A better outcome can be achieved by national policy of promoting utilization of antenatal care, institutional deliveries, skilled birth attendance at delivery, liberal blood transfusion and regular training of doctors and nurses. DOI: http://dx.doi.org/10.3126/njog.v9i1.11186 NJOG 2014 Jan-Jun; 2(1):37-40
Non-puerperal Acute Uterine Inversion
Authors: Sarkar M , Roy D , Mondal J , Halder M , Ghosh RM , Ghosh BK
Published: September 2014

Non-puerperal acute inversion of uterus is a rare complication that occurs as a complication of intra uterine tumors, especially big sub mucous leiomyoma. It is so rare that many gynecologists may not encounter such a case in their life time professional carrier. This condition causes severe pain, vaginal bleeding and shock. Management consists of manual reposition through cervical ring or surgical corrective measures. We report a case of acute uterine inversion in a 42 years lady due to big sub mucous fibroid. This case was initially managed by vaginal myomectomy then uterus was repositioned by Haultain’s technique, which was abdominal hysterectomy. DOI: http://dx.doi.org/10.3126/njog.v9i1.11190 NJOG 2014 Jan-Jun; 2(1):58-60
Squamous Cell Carcinoma Arising in Mature Cystic Teratoma of the Ovary
Authors: Gupta N , Gupta T , Jindal S
Published: September 2014

Malignant transformation of mature germ cell teratoma is rare and has been reported sporadically. Any of the constituent tissue of a teratoma has the potential to undergo malignant transformation. Squamous cell carcinoma is the most common transformation and is derived from the metaplastic squamous epithelium of teratoma. We are reporting a case of 65 years old postmenopausal women with squamous cell carcinoma arising in mature cystic cell teratoma of the ovary. DOI: http://dx.doi.org/10.3126/njog.v9i1.11191 NJOG 2014 Jan-Jun; 2(1):61-63
High Dose Methylprednisolone: Effective in Pregnancy Associated Post-splenectomy Refractory Chronic Immune Thrombocytopenic Purpura
Authors: Singh A , Solanki A
Published: September 2014

We present a case of 23 years multigravid woman (G2P0+1) with chronic idiopathic thrombocytopenic purpura (ITP), refractory to treatment in forms of oral steroid, dapsone, azathioprine and splenectomy. She presented to the hospital in third trimester of pregnancy, with reduced platelet counts and purpuric rashes over abdomen and both upper extremeties. There was a past history of spontaneous abortion at 18 weeks. The patient responded to intravenous high dose methylprednisolone (HDMP) infusion leading to delivery of full term male baby. The baby also required treatment for thrombocytopenia with intravenous immunoglobulin (IVIG). This case lays down the importance of HDMP in form of using it effectively in managing acute crisis of low platelet counts in pregnant patients with ITP refractory to splenectomy. DOI: http://dx.doi.org/10.3126/njog.v9i1.11192 NJOG 2014 Jan-Jun; 2(1):64-66
Anesthetic Management of a Parturient with Poliomyelitis Associated with Kyphoscoliosis
Authors: Shrestha AB , Shrestha S , Sharma KR , Gurung T
Published: September 2014

A 27-year-old primigravida with poliomyelitis associated with kyphoscoliosis underwent cesarean section under spinal anesthesia. Anesthesia poses a significant risk to a parturient with kyphoscoliosis and there is no single regimen that can be recommended for anesthetic management. Regional anesthesia is also challenging for anesthesiologist because the distortion of the spinous process and rotation of the vertebral column. The perioperative period was uneventful. Spinal anesthesia can be safely administered with less adverse effects in poliomyelitis patients with kyphoscoliosis. DOI: http://dx.doi.org/10.3126/njog.v9i1.11193 NJOG 2014 Jan-Jun; 2(1):67-70
Role of Angiogenic Factors in Preeclampsia
Authors: Pradhan P
Published: September 2014

Preeclampsia, the syndrome of hypertension, proteinuria, edema and hyperuricemia occurring during the last trimester of pregnancy remains one of the great mysteries. Recently gene expression profiling of placental tissue from healthy and preeclamptic women used to see which genes were up or down regulated in preeclamptic patients. Alterations in circulating angiogenic proteins correlated with disease severity, earlier onset of preeclampsia and birth of small for gestational age (SGA) fetus. These findings lend support to the hypothesis that circulating angiogenic proteins may have an important biological role in preeclampsia. DOI: http://dx.doi.org/10.3126/njog.v9i1.11194 NJOG 2014 Jan-Jun; 2(1):71-73
Managing Eclampsia in a Medical College
Authors: RC LK , Shrestha S , Das CR
Published: September 2014

Aims: The aim was to analyze patient’s age, gestational age, mode of delivery, types of complication, fetomaternal outcome and prognosis in eclampsia. Methods: This was a retrospective one year study done at Nepalgunj medical college from June 2009 to May 2010. Results: Out of 21 (1.11%) eclampsia, nine (42.85%) were <20 years, nine (42.85%) were at term and 15 (71.43%) were primi para. Systolic blood pressure recorded >160 mm Hg in eight (38.10%) and diastolic blood pressure recorded 91-100 mm Hg were nine (42.8%). Antepartum and intrapartum eclampsia were 18 (85.72%) and two (9.52%) respectively. Nine (42.86%) had lower segment cesarean section. Ten (47.62%) babies were alive. All the patients were treated with magnesium sulphate and survived. Conclusions: Most of the patients in this study were primi para at term pregnancy. Patients were treated with magnesium sulphate that prevented maternal mortality. DOI: http://dx.doi.org/10.3126/njog.v9i1.11195 NJOG 2014 Jan-Jun; 2(1):74-77
Inclusion of Three-Vessel View in Routine Fetal Cardiac Screening
Authors: Subedi K , Chataut D , Khanal UP , Ansari MA , Pradhan S
Published: September 2014

Aims: The purpose of this study was to study the feasibility of inclusion of 3-vessel view (3-VV) of the fetal upper mediastinum in routine fetal anomaly screening; and to study the size relationship of these vessels namely, main pulmonary artery (MPA), ascending aorta (AA) and the superior venacava (SVC) in fetuses between 17 and 24 weeks of pregnancy by antenatal ultrasound. Methods: This was a prospective cross sectional study involving 106 pregnant ladies between 17 and 24 weeks of gestation. The time burden to the examination due to addition of 3-VV in routine anomaly screening was recorded. The relationships of the three great vessels of the fetal upper mediastinum were studied and their diameters were obtained. Regression equations were used to construct the reference ranges for all the parameters of statistical significance. Results: The 3-VV could be easily obtained in all but eight patients within five minutes (the difficulty in these eight patients was due to fetal position). The MPA, AA and SVC were aligned in a straight line from left to right respectively, the MPA being the largest vessel, the SVC being the smallest vessel and the AA having an intermediate diameter. All of these three vessels showed significant correlation of size with advancing gestational age. Conclusions: 3-VV is easily obtained in fetuses at the time of routine anomaly screening. This should be routinely included in the screening ultrasound of fetal heart along with the four-chamber view to detect the anomalies of the outflow tract. DOI: http://dx.doi.org/10.3126/njog.v9i1.11197 NJOG 2014 Jan-Jun; 2(1):82-86
Mullerian Anomaly Presenting as Chronic Pelvic Pain
Authors: Wadhwa L , Nain S , Jindal S , Gupta S
Published: September 2014

DOI: http://dx.doi.org/10.3126/njog.v9i1.11198 NJOG 2014 Jan-Jun; 2(1):87-88
Burst Strength of Composite Cylinders – Assessment of the Type of Statistical Distribution
Authors: Mair Georg W. , Becker Ben , Scherer Florian
Published: September 2014

Composite materials show an extraordinary change of properties depending on service life. This implies the necessity to find tailored methods to determine strength and residual strength of composite cylinders. This determination can be done by load cycle tests [1] or, in some cases, primarily by slow burst tests [2]. The results of both test methods need statistical assessment for the precise description of strength. Especially the statistical assessment of burst related strength properties has a high uncertainty. Sample size [3] and scatter distribution were identified as major influences on uncertainty. It is unclear if a Gaussian normal distribution, a Weibull distribution or others describe the scatter behaviour correctly. An assumption has to be found and confirmed to prevent overestimation of survival rate, respectively reliability, in the interval of one failure per 104 to 108 cylinders.
The Mechanical and Electrical Properties of the Ternary Bi-Ga-Sb System
Authors: Minić Duško , Premović Milena , Čikara Dejan , Mitrovica Kosovska , Manasijević Dragan , Živković Dragana
Published: September 2014

The ternary Bi-Ga-Sb system is a potential soldering material. The gallium-based alloy systems are the subject of numerous investigations due to the constant interest of the semiconductor industry. For a more complete characterization of the ternary Bi-Ga-Sb system, alloys from the three vertical sections were investigated using microstructural analysis as well as electrical conductivity and Brinell hardness measurements. The microstructures of the alloys were investigated by light microscopy and scanning electronic microscopy equipped with energy dispersive spectrometry. Isolines of electrical conductivity and hardness for the entire Bi-Ga-Sb system were calculated using regression models. In addition, a thermodynamic assessment of the system has been carried out by calculation of the isothermal section at 100 °C and by description using the CALPHAD method. Experimental and analytical results were found to be in good agreement.
Effect of thixoforming on morphological changes in iron-bearing intermetallics and mechanical properties of Al–Si–Cu alloys
Authors: Tavakoli Mohammad Mahdi , Shabestari Saeed G. , Ghanbari Mohsen
Published: September 2014

Al–Si–Cu casting alloys are widely used in manufacturing automotive parts. Semisolid forming of these alloys can eliminate major problems in their die casting. In this study, low superheated melt was employed to modify the microstructure and to produce non-dendritic A380 alloy. Melt was poured on a cooling slope plate at 615°C and ingots were obtained through permanent mold casting. They were thixoformed using a hydraulic press after holding at 570°C for 15 min to yield a microstructure having α-Al globules, Si particles, and modified β-phase intermetallic compounds. Image analysis showed that the size and distribution of α-Al phases and iron-bearing intermetallics were modified by using semisolid processing. The results also showed that cooling slope casting and thixoforming have improved the mechanical properties including tensile strength, elongation, and hardness of the high iron content A380 alloys.
Ein schriftlicher Thinktank wird praxisnäher
Authors: Brang Peter , Leuch Barbara Allgaier , Kräuchi Norbert , Hostettler Martin
Published: September 2014

A think tank on paper comes closer to the practitioner

This note informs you about changes which will be put in place in the Swiss Forestry Journal in 2015, as well as the rationale motivating them. The Journal is the most visible product of the Swiss Forestry Society, and has been its flagship for 164 years. The members of the Society accepted in 2013 a new, more streamlined concept for the Journal. From 2015, the Journal will only appear six times a year. It will remain the organ of the Society, and will continue to distribute news on forest related issues. In a survey, many members expressed their wish that the Journal should deal more with practical issues. This request is being followed in three ways: 1) short articles from practitioners and researchers (new section “Notes”), 2) a closer link to practice in every article, and 3) a more flexible interpretation of the rule that contributions must be original work. In this way, the Journal positions itself more clearly at the interface between research and practice. Its role is to promote, like a think tank on paper, high-level professional discussions in the forest sector and thus the sector's evolution, as well as to foster mutual understanding between researchers and practitioners. Also those who are not researchers are invited to take their pen and enhance the Journal's practical relevance by their contributions.
Revisiting Dearing: Higher Education and the Construction of the ’Belabored’ Self
Authors: Apperley Alan
Published: September 2014

Several authors have identified a ’therapeutic turn’ in education in the UK, at all levels of the system. In this paper I focus on and develop this claim, specifically in relation to the Higher Education sector. I seek to do two things: First, I argue that the ‘self’ which is identified by commentators on the therapeutic turn needs to be reworked in the direction of McGee’s idea of the ’belabored’ self. This is because the therapeutic turn serves, I argue, a set of wider economic goals arising from the restructuring of capitalism which followed in the wake of the oil crisis of 1973 and the subsequent breakdown of the post-war (1939-1945) consensus around the purpose of public policy, of which education is an important part. Second, I revisit an important document in the history of the UK Higher Education sector: the National Committee of Inquiry Into Higher Education’s 1997 report Higher Education In The Learning Society (known popularly as the Dearing Report, after its chair, Sir Ron Dearing). I argue that that the committee’s ambition to bring about a learning society characterised by lifelong learning played an important and neglected part in bringing about the therapeutic turn in higher education in the UK. The project of creating a learning society characterised by lifelong learning, advocated by the Dearing Report, should properly be recognised as an exhortation to embark upon a lifetime of labouring upon the self.
Preventative Therapeutics: A Study of Risk and Prevention in Australian Mental Health
Authors: McLachlan Andrew
Published: September 2014

his study investigates the preventative therapeutics of two major Australian mental health organisations – beyondblue and The Black Dog Institute. The aim of this study is to examine how the resilience-based programs of both organisations reconfigure clinical and preventative expertise into new forms of ‘anticipatory action’ (Anderson 2010). First, this article situates beyondblue and the Black Dog Institute within their historical contexts to consider how issues of risk and protection have become essential to mental health care today. Second, it examines the institutional practices of beyondblue and the Black Dog Institute and the role of clinical and preventative expertise as enacted forms of authority. Finally, this study investigates the intellectual and biokeeping technologies promoted through both organisations“ resilience-based pedagogies. The view taken in this study is that such technologies actively participate in the making of new therapeutic cultures and practices. Moreover, as biomarkers continue to act as indicators of future states of ‘unhealth’ (Dumit 2012: 112), biokeeping technologies will continue to act as essential elements in the governmentality of mental health and wellbeing.
Small Mushrooms for Big Business? Gaps in the Sustainable Management of Non-Timber Forest Products in Southwest China
Authors: He Jun , Dong Min , Stark Macro
Published: September 2014

The challenge of managing forests for the production of commercial non-timber forest products (NTFPs) lies in promoting economic development by maintaining and even increasing production while simultaneously maintaining or improving ecological conditions. The discussion of forest management therefore encompasses a wide range of social, economic, political, and ecological questions. Empirically, it is clear that both market and government failure can lead to unsustainable management in commercial NTFP use. How can we manage the market and at the same time formulate good policies? Taking cases from Southwest China, this paper critically examines the current development of NTFP commercialization in the mountainous region of Southwest China. It focuses particularly on three pieces of research on mushroom collection and marketing. By examining empirical data, the paper analyzes current gaps in the policy and the market in mountainous areas in the context of promoting sustainable use of NTFP. It examines the market structure from the perspective of market failure and explores the government’s failure to promote commercial NTFPs. We recommend economic and political decentralization, capacity building, and government investment as means to improve sustainable management.
A Call to Action to Enhance Filovirus Disease Outbreak Preparedness and Response
Authors: Roddy Paul
Published: September 2014

The frequency and magnitude of recognized and declared filovirus-disease outbreaks have increased in recent years, while pathogenic filoviruses are potentially ubiquitous throughout sub-Saharan Africa. Meanwhile, the efficiency and effectiveness of filovirus-disease outbreak preparedness and response efforts are currently limited by inherent challenges and persistent shortcomings. This paper delineates some of these challenges and shortcomings and provides a proposal for enhancing future filovirus-disease outbreak preparedness and response. The proposal serves as a call for prompt action by the organizations that comprise filovirus-disease outbreak response teams, namely, Ministries of Health of outbreak-prone countries, the World Health Organization, Médecins Sans Frontières, the Centers for Disease Control and Prevention—Atlanta, and others.
The Role of Magnetic Resonance Imaging in the Evaluation of Thalassemic Syndromes: Current Practice and Future Perspectives
Authors: Mavrogeni Sophie , Markousis-Mavrogenis George , Kolovou Genovefa
Published: September 2014

Iron can be deposited in all internal organs, leading to different types of functional abnormalities. However, myocardial iron overload that contributes to heart failure remains one of the main causes of death in thalassemia major. Using magnetic resonance imaging, tissue iron is detected indirectly by the effects on relaxation times of ferritin and hemosiderin iron interacting with hydrogen nuclei. The presence of iron in the human body results in marked alterations of tissue relaxation times. Currently, cardiovascular magnetic resonance using T2* is routinely used in many countries to identify patients with myocardial iron loading and guide chelation therapy, specifically tailored to the heart. Myocardial T2* is the only clinically validated non-invasive measure of myocardial iron loading and is superior to surrogates such as serum ferritin, liver iron, ventricular ejection fraction and tissue Doppler parameters. Finally, the substantial amelioration of patients’ survival, allows the detection of other organs’ abnormalities due to iron overload, apart from the heart, missed in the past. Recent studies revealed that iron deposition has a different pattern in various parenchymal organs, which is independent from serum ferritin and follows an individual way after chelation treatment application. This new upcoming reality orders a closer monitoring of all organs of the body in order to detect preclinical lesions and early apply adequate treatment.
γA Gene Repeats Polymorphism for the Analysis of Haplotypes of Abnormal Hemoglobins
Authors: Akar Nejat , Sipahi Kadir , Akar Ece , Yilmaz Erkan
Published: September 2014

Aim of this study was to analyze γ A gene repeat polymorphism for the analysis of haplotypes of hemoglobin (Hb) variants such as Hb S, Hb D-Punjab, Hb O-Arab. Sickle cell cases had mainly Benin and Arab/Indian haplotype. We found three different haplotypes among Hb S, Hb O Arab and Hb D-Punjab cases. We named these three variants as Anatolian-1 and Anatolian-2 and Asian. Our data revealed that Hb O Arab may arise twice one from Asia and the other from Europe.
Control of Thalassemia in India
Authors: Colah Roshan B. , Gorakshakar Ajit
Published: September 2014

The β-thalassemias and sickle cell disorders pose a major health burden in the large and diverse Indian population. Education programs for awareness generation are being done by National Institutions, non-governmental organizations and Thalassemia Societies in different states. Several extensive epidemiological studies have shown that there are many non-tribal and tribal communities where the prevalence of b-thalassemia carriers is much higher (5.3 to 17.0%) than the average of 3 to 4% projected for the entire country. These variations have also been shown within small geographic regions in some states, emphasizing the need for micro mapping to estimate the true burden of disease. There are 10 to 12 centers where prenatal diagnosis for hemoglobinopathies is done and the Indian Council of Medical Research is establishing additional regional centers in states where they are most needed. Sixtyeight b-thalassemia mutations have been described so far among Indians and the knowledge on their prevalence and regional distribution has helped to undertake prenatal diagnosis in a cost effective way.
Current status of hematopoietic stem cell transplant in chronic myeloid leukemia
Authors: Gupta Alok , Khattry Navin
Published: September 2014

Indications for hematopoietic stem cell transplant (HSCT) in chronic myeloid leukemia (CML) have changed over time. This change has largely been influenced by the advent of tyrosine kinase inhibitors, increased understanding of the mechanisms underlying disease phase progression as well as drug resistance, refinement of transplant techniques and exploitation of graft versus leukemia effect in this disease. Here, we have discussed the status of HSCT in CML in the present era with regards to the current indications, factors determining outcome and management strategies for posttransplant relapse.
Immature teratoma at umbilicus region presenting as exomphalos: A case report with review of literature
Authors: Chavali Lakshmi V. , Bhaskar R , Reddy J Bhaskar
Published: September 2014

Umbilical cord neoplasms are rare. Teratomas, which are accepted as the only true neoplasms at this site, are exceptional. These tumors are polymorphic in their presentation and are often associated with other abnormalities, with exomphalos being the most common abnormality. Histologically these tumors show mature tissues from all the three-germ layers. Immature elements as seen in our case are rare. Germ cells which have gone astray during embryonic development are thought to be the cells of origin of these tumors.
Case study. Use of a fiber optic camera to perform a trauma assessment during a confined space rescue
Authors: Kotora, DO, MPH Joseph G. , Westrol, MD Michael S. , Merlin, DO Mark A.
Published: September 2014

Objective: Accurate medical evaluation of victims injured during confined space rescues poses significant operational, medical, and logistical challenges for medical providers of all disciplines and experience levels. The Federal Emergency Management Agency (FEMA) teaches rescuers to begin their assessment as soon as verbal contact is obtained with the victim. While a significant amount of information can be obtained by talking to the victim, an accurate assessment of the victim's condition is often limited or impossible. Many professional rescue agencies currently use cameras to locate a victim's position or visualize obstacles that prevent the successful extraction of casualties. However, there is no published literature describing the use of a camera to complete a medical evaluation.Results: The authors describe their use of a fiber optic camera to complete a limited but accurate primary and secondary trauma evaluation of a patient trapped inside an 18 in water pipe for a prolonged period of time. The providers' assessment provided critical information to the rescue team and assisted in the planning and eventual extrication of the patient from the confined space. Moreover, there was very little variation between the findings obtained during the assessment at the scene and the assessment in the receiving facility's trauma bay.Conclusion: When evaluating a trauma patient, there is no substitution for visual inspection and physical diagnosis. The use of a fiber optic camera can assist rescuers and medical providers in obtaining the information they desire, and enable the completion of an accurate patient assessment. The camera may also provide psychological reassurance and ease anxiety, as well as generate prehospital images that can be transmitted to the receiving facility for use in preparation of the casualty. Emergency medical service providers, urban search rescue teams, fire departments, and other professional rescuers should be trained on the use and limitations of fiber optic cameras during confined space rescues. Furthermore, regulatory agencies such as FEMA should consider integrating the use of fiber optic camera and audiovisual devices into the current training courses offered to professional rescuers.
X-ray fluorescence mapping of mercury on suspended mineral particles and diatoms in a contaminated freshwater system
Authors: Gu B. , Mishra B. , Miller C. , Wang W. , Lai B. , Brooks S. C. , Kemner K. M. , Liang L.
Published: September 2014

Abstract. Mercury (Hg) bioavailability and geochemical cycling is affected by its partitioning between the aqueous and particulate phases. We applied a synchrotron-based X-ray fluorescence (XRF) microprobe to visualize and quantify directly the spatial localization of Hg and its correlations with other elements of interest on suspended particles from a Hg-contaminated freshwater system. Up to 175 μg g−1 Hg is found on suspended particles, but less than 0.01% is in the form of methylmercury. Mercury is heterogeneously distributed among phytoplankton (e.g., diatoms) and mineral particles that are rich in iron oxides and natural organic matter (NOM). The diatom-bound Hg is mostly found on outer surfaces of the cells, suggesting passive sorption of Hg on diatoms. Our results indicate that localized sorption of Hg onto suspended particles, including diatoms and NOM-coated oxide minerals, may play an important role in affecting the partitioning, reactivity, and biogeochemical cycling of Hg in natural aquatic environments.
Deriving a per-field land use and land cover map in an agricultural mosaic catchment
Authors: Seo B. , Bogner C. , Poppenborg P. , Martin E. , Hoffmeister M. , Jun M. , Koellner T. , Reineking B. , Shope C. L. , Tenhunen J.
Published: September 2014

Abstract. Detailed data on land use and land cover constitute important information for Earth system models, environmental monitoring and ecosystem services research. Global land cover products are evolving rapidly; however, there is still a lack of information particularly for heterogeneous agricultural landscapes. We censused land use and land cover field by field in the agricultural mosaic catchment Haean in South Korea. We recorded the land cover types with additional information on agricultural practice. In this paper we introduce the data, their collection and the post-processing protocol. Furthermore, because it is important to quantitatively evaluate available land use and land cover products, we compared our data with the MODIS Land Cover Type product (MCD12Q1). During the studied period, a large portion of dry fields was converted to perennial crops. Compared to our data, the forested area was underrepresented and the agricultural area overrepresented in MCD12Q1. In addition, linear landscape elements such as waterbodies were missing in the MODIS product due to its coarse spatial resolution. The data presented here can be useful for earth science and ecosystem services research. The data are available at the public repository Pangaea (doi:110.1594/PANGAEA.823677).
Natural Gas Supply Behavior under Interventionism: The Case of Argentina
Authors: Barril Diego , Navajas Fernando
Published: September 2014

We address the causes behind the significant drop in natural gas production in the 2000s in Argentina, starting from a basic supply model that depends on economic incentives, and adding control variables related to different potential explanations such as firm specific (or area specific) behavior and the role of contractual renegotiation of concessions extensions. Results from a panel data of production areas between 2003 and 2013 show that once a basic supply-past production (or reserve) relationship is modeled, other often mentioned effects become non-significant. Chiefly among them are firm specific effects that were used as a central argument for the nationalization of YPF in 2012. Rather, the evidence shows that the observed downcycle conforms to the prediction of a simple model of depressed economic incentives acting upon mature conventional natural gas fields and hindering investment in reserve additions or new technologies. The results are robust to the nationalization of YPF, after which aggregate production continued a downward trend for two years, although are insufficient to capture an ongoing reconfiguration of incentives and risks in the forthcoming transition to shale gas production.