bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical Simulation of 2D Flow around Deforming Fish-Like Body
Authors: Canh Cao Xuan , Zuhal Lavi R. , Muhammad Hari
Published: June 2016

In computational fluid dynamics (CFD), the physical domain is usually discretized by using mesh/grid, cells, nodes or particles generation. Although there are many advantages, these methods are required to have high computational storage/time cost, especially for solving the complex, deforming, and moving flows/bodies. Hence, we developed the vortex-in-cell (VIC) algorithm which is hybrid combination of grid-based and mesh-free method. VIC method, which was originally developed to simulate incompressible single-phase flows, becomes a very promising alternative for simulating complex flows. In addition, to simulate flows over deforming geometries, we utilized an immersed boundary method for enforcing the boundary condition. VIC interpolates the particle strength to an underlying mesh. VIC method has the advantage that the Poisson inversion can be accomplished by Fast Fourier Transform (FFT) techniques, this accelerates the computational time and provides accurate results. Here we consider an anguilliform swimming motion based on lateral displacement of the “backbone” which describes a complex, deforming, and moving body. “Flow over an Impulsively Started Circular Cylinder” problem are also simulated to validate the developed numerical method.
Dynamics Simulation and Analysis of Transition Stage of Tilt-Rotor Aircraft
Authors: Hadytama Muhammad Rafi , Sasongko Rianto A.
Published: June 2016

This paper presents the flight dynamics simulation and analysis of a tilt-rotor vertical takeoff and landing (VTOL) aircraft on transition phase, that is conversion from vertical or hover to horizontal or level flight and vice versa. The model of the aircraft is derived from simplified equations of motion comprising the forces and moments working on the aircraft in the airplane's longitudinal plane of motion. This study focuses on the problem of the airplane's dynamic response during conversion phase, which gives an understanding about the flight characteristics of the vehicle. The understanding about the flight dynamics characteristics is important for the control system design phase. Some simulation results are given to provide better visualization about the behaviour of the tilt-rotor. The simulation results show that both transition phases are quite stable, although an improved stability can give better manoeuver and attitude handling. Improvement on the simulation model is also required to provide more accurate and realistic dynamic response of the vehicle.
Quadrotor Research Platform with Obstacle Avoidance
Authors: Cobankiat Kevin N. , Pua Timothy A. , Que Rembrandt V. , Wee Ebol Willis Jordan Y. , Chua Alvin Y.
Published: June 2016

This study focuses on the development of a quadrotor research platform with effective obstacle avoidance system using Bug Algorithm. The quadrotor system consist of a DJI frame with a Crius All-in-One Pro as a flight controller with an Arduino Mega2560 to process the data from the sensor. It is also equipped with four ultrasonic range finders to provide the sensing for collision avoidance. Bug Algorithm was chosen due to its simplicity and effectiveness in implementation of obstacle avoidance applications. The results shows that the quadrotor system is able to perform basic flight maneuvers and that the collision avoidance system was able to protect the quadrotor from hitting objects in its environment.
Computer Aided Stamped Batik Design and Manufacturing for Batik Machine with Wax Moving Module
Authors: Wibisono Muhammad Arif , Budi Dharma I.G.B. , Rif’ah Mega Inayati , Arsiwi Pramudi
Published: June 2016

Batik is one of the Indonesian heritage culture that needs to be preserved, especially for traditional batik using wax to form batik pattern and resist dyeing color. One way to draw batik on fabric is by using a stamp. Nowadays, most of traditional batiks are still produced manually with limited capacity. On other hand, the number of batik craftsman is decreased due to lack of regeneration of young craftsman. This study aimed to develop software for designing stamped batik, along with its production steps, and information used to execute the design on batik machine with moving module. The software required a batik stamp design, size of fabric (maximum 12 m), pattern of stamping, and color. Digital image of the batik design and its colour will be generate along with the G-Code for executing the design on batik machine with moving module. Batik machine with moving module consists of 13 meters working table and a bridge runs along the table by carrying stamp and wax module. For each step of the bridge, stamp module will stamp wax on fabric along its width. These movements are controlled by programmable computer with G-Code from batik design system. Batik design system and the machine have been tested and is able to give information about size of fabric used, kind of dye used, and G-Code for controlling the machine.
Design and Analysis of Exoskeleton as a Rehabilitation Device
Authors: Wicaksono Romario Aldrian , Hariyanto Satriawan Dini , Prihandoko Panji , Prihandana Gunawan Setia , Sriani Tutik
Published: June 2016

Exoskeleton is an external cantilever to support inner living organism organs. Some animals have the exoskeleton attached naturally on their body as those found in a million species of arthropods order. The word “Arthropods” itself are related to their body plan—their segmented body, hard exoskeleton, and jointed appendages [1]. This structure inspired us to implement the exoskeleton to help humans who are permanently or temporarily have problems with their lower limb, for example those who are recovering from stroke or road-accidents. Stroke is a condition where lower limb is partially paralyzed (Hemiplegia) and causes inability to walk normally or to do other physical activities [2].The exoskeleton consists of four main parts; frame for the leg (XOTF), frame for the thigh (XOF), the belt, and the controller stick. The frame is designed using lightweight material. Considering the material’s availability and price at the local market, we choose Aluminum Composite Panel (ACP) as frame’s material. The belt acts as the brain for the exoskeleton, where it provides electrical power and the source of motion. There are four frames on the exoskeleton which moves simultaneously while walking. In the design, we use two joy-sticks as main controller to adjust position of each exoskeleton frame. The sticks are attached to standing-canes which help the user to improve stability. The sticks have buttons and lever to control the exoskeleton and adjust thighs and legs fit for several moves; stand, sit, walk, going up and downstairs, or any other position which need balance and power.The exoskeleton design has been tested for its motion and stability. The results show that the design is suitable for those who are fully or partially paralyzed on their lower limb.
Design and Fabrication of an Affordable Transfemoral Prosthetic Leg
Authors: Bachtiar Emilio O. , Dirgantara Tatacipta , Mihradi Sandro , Mahyuddin Andi Isra
Published: June 2016

An invalid is a person with physical or mental abnormalities which hinders their ability of doing normal human activities. One of the aforementioned abnormalities is the loss or malfunction of a body part or organ, such as the human leg. Problems brought about by this disability could be alleviated by the use of prosthetic limbs to restore normal bodily functions [1]. While there are many needs for leg prosthetics in Indonesia, the price of commercially available prosthetic is prohibitively high for most amputees. The current available affordable prosthetics are very basic and employ monocentric knee joints. Here an attempt is made towards acquiring an optimal design of an affordable prosthetic leg using previously developed four-bar knee joint [2,3]. The design is carried out by implementing a systematic design method to arrive at an affordable, yet ones with better performances. The procedure involves a rubric and analyzing various alternatives to arrive at an optimal design conclusion. The evaluation objective is to maximize the performance of the leg and knee prosthetics through an extensive analysis with considerations from various stakeholders, including the potential users, fabricator, and hospitals in Indonesia [4]. The final design of the leg consists of a composite socket, an aluminum pylon, and a solid-ankle cushioned-heel foot design. Its components are modular and compatible with prosthetic industry standards. The knee is made of a combination of polymers and stainless steel and employs a polycentric mechanism in order to satisfy design requirements while keeping costs low [4,5]. The leg and knee were then fabricated according to the analysis results. The total cost of fabrication is approximately 5.5 million IDR, significantly cheaper than commercial prosthetics. The prototype is then tested and examined using a gait analysis system previously developed at Institut Teknologi Bandung by the Biomechanics Research Team [6]. The results show satisfactory performance, albeit with a host of potential improvements.
Structures of Water Molecules in Carbon Nanotubes Induced with Electric Fields and its Application for Water-Methanol Separation
Authors: Winarto  , Takaiwa Daisuke , Yamamoto Eiji , Yasuoka Kenji
Published: June 2016

Water confined in carbon nanotubes (CNTs) under the influence of an electric field has interesting properties that are potential for nanofluidic-based applications. With molecular dynamics simulations, this work shows that the electric field induces formation of ordered structures of water molecules in the CNTs. Formation of the ordered structures strengthens the electrostatic interaction between the water molecules. As a result, water strongly prefers to fill CNTs over methanol and it produces a separation effect. Interestingly, the separation effect with the electric field does not decrease for a wide range of CNT diameter.
Analysis of Success Factors for E-Waste Collection in Indonesia
Authors: Anityasari Maria , Nur Yudi Sahdilah
Published: June 2016

There is no doubt that currently the use of electronic products and appliances has escalated tremendously in all over the world including Indonesia. This situation obviously also causes the increase of e-waste (electronic waste). Without proper treatment, e-waste will eventually cause environmental degradation as most of substances in electronic products contain hazardous materials. Proper treatment of e-waste will prevent environmental problems and at the same time will preserve natural resources as most of the materials even components in electronic products are reusable or recyclable. In many developed countries the collection of e-waste has been regulated and professionally managed. The situation is different in Indonesia as there is low law enforcement to handle e-waste at national and local levels. This paper will present a research utilizing Fuzzy Analytical Hierarchy Process (AHP) to determine the best e-waste collection scenario for Indonesia. Criteria and sub-criteria that need to be considered for future implementation as well as recommendation for e-waste collection in Indonesia are presented as the result of the research.
Development of Chatter Threshold Determination Methodology in Milling Process by Using Inclined Workpiece
Authors: Prakosa Tri , Martawirya Yatna Yuwana , Nurhadi Indra , Nurprasetio Ignatius Pulung
Published: June 2016

Machined product quality depends on its dimension and surface quality. The dimension quality depends on machine tool accuracy while the surface quality depends on machining system stiffness. A low machining system stiffness will shift spindle shaft-tool resonance frequencies to low frequencies. When one of these frequencies coincides with spindle rotational speed or its harmonics, chatter will be generated which in turn worsen the workpiece surface roughness. In addition to increasing machining system stiffness, chatter can be eliminated by decreasing the axial depth of cut as well. Maximum axial depth at certain spindle rotational speed which will not generate chatter is called as chatter threshold. A diagram describing chatter thresholds for certain range of spindle rotational speed is called as a SLD (stability lobe diagram). The diagram is very useful for selecting a maximum depth of cut at certain rotational speed in order to obtain chatter-free machining process. The SLD can be generated theoretically or experimentally. The theoretical one is fast and cheap but it is not guaranteed to be correct. On the other hand, although the experimental one will produce exact values but it is long, cumbersome and expensive, because for certain rotational speed many machining with different axial depth of cut must be conducted until chatter threshold is reached. The same process is then repeated for other rotational speeds. This paper deals with a new method in determining the chatter threshold or SLD experimentally, by using inclined workpiece, by which it only needs one time machining-test for each rotational speed. In this method, during machining process, chatter occurrence is detected by using accelerometer and validated by its surface roughness afterwards. It is shown in this paper that the new method works well for machining aluminium workpiece in vertical machining center.
The Influence of Quench Tempering and Carburazing Treatment towards Mechanical Properties and Microstructure of Medium Carbon Steel for Automotive Application
Authors: Aziz Abdul , Fitrullah Muhammad , Suryana  , Firmansyah Febri
Published: June 2016

Gear is one of the machine components that is widely used in industrial and automotive fields. In machinery process, gear has a very important function to forward speed, power, or torque from one engine component to other components as a mechanical drive. Today a lot of development to obtain a good quality of gear, due to many gears were damage, worn out, and broken because they were not strong enough to resist friction and pressure. In addition, broken gears due to pressure and friction make them did not last long. To increase the hardness value of gear, then it needs though material that can be used when the gear reach optimum rotation. The material that is widely used for gear application is medium carbon steel. The medium carbon steel is a metal material that has carbon composition ranging from 0.30 to 0.59%. This medium carbon steel has hardness value of 174.501 HVN without treatment. The process of quench tempering and carburizing are conducted to increase hardness and toughness value of the material. The hardness value of gear is 140 HVN. The result of the research showed the hardness value at various temperature 780°C, 810°C, and 840°C. The optimum hardness values ​is 165.355 HVN at the temperature of 840°C. Medium carbon steel is expected to be an alternative to produce steel material with certain mechanical properties. This research also conducted heat treatment in austenite area and then detained with holding time of 20, 40, and 60 minutes. Furthermore, quench tempering was conducted and followed by carburizing to obtain a ferrite phase and coarse pearlite and to increase hardness value after quech tempering. It is expected that after quech tempering and carburizing process, steel with better mechanical properties can be produced. This research obtained the increase of hardness value and the number of pearlite and ferrite.
ARAP, a Novel Adaptor Protein, Is Required for TCR Signaling and Integrin-Mediated Adhesion
Authors: Jung Seung Hee , Yoo Eun Hye , Yu Mi Jin , Song Hyeon Myeong , Kang Hee Yoon , Cho Je-Yoel , Lee Jong Ran
Published: June 2016

A novel adaptor protein was identified by analyzing phosphotyrosine proteomes from membrane rafts of activated T cells. This protein showed sequence similarity to a well-known T cell adaptor protein, adhesion and degranulation-promoting adaptor protein (ADAP); therefore, the novel protein was designated activation-dependent, raft-recruited ADAP-like phosphoprotein (ARAP). Suppression of ARAP impaired the major signaling pathways downstream of the TCR. ARAP associated with the Src homology 2 domain of Src homology 2–containing leukocyte protein of 76 kDa via the phosphorylation of two YDDV motifs in response to TCR stimulation. ARAP also mediated integrin activation but was not involved in actin polymerization. The results of this study indicate that a novel T cell adaptor protein, ARAP, plays a unique role in T cells as a part of both the proximal activation signaling and inside–out signaling pathways that result in integrin activation and T cell adhesion.
Packaging Architecture for an Implanted System that Monitors Brain Activity and Applies Therapeutic Stimulation
Authors: Bjune Caroline K. , Marinis Thomas F. , Sriram Tirunelveli S. , Brady Jeanne M. , Moran James , Parks Philip D. , Widge Alik S. , Dougherty Darin D. , Eskandar Emad N.
Published: June 2016

Deep brain stimulation therapies for Parkinson's disease utilize hardware that, from a packaging perspective, resembles those that are used in cardiac pacemakers. A hermetic package that contains stimulation electronics and a primary battery supply is implanted under the scalp into a recess formed in the skull. Stimulation probes, each with up to four electrodes, are inserted into the brain and connected to the electronics package via a plug and cable system. Unlike single-target devices such as cochlear implants and pacemakers, achieving this type of neuropsychiatric therapy requires the ability to record and stimulate in multiple and distributive areas of the brain, both cortical and subcortical. By contrast, the closed-loop neural stimulator being developed under the DARPA SUBNETS program utilizes probes, each of which carries up to 64 electrodes that can be switched between recording and stimulation functions. This capability necessitates locating low-noise amplifiers, switching and communication electronics in close proximity to each probe site. Each of these satellite electronics packages requires 10 electrical connections to the hub package, which significantly increases the complexity of the interconnect system relative to the current practice. The power requirements of this system preclude the use of a primary battery supply, so a large lithium ion battery is used, with a recharging coil and electronics. The hub system is composed of a connector header, electronics package, and battery pack that are fabricated separately and are interconnected by a flex circuit board, to allow it to conform to the skull for implanting. The standardized feedthrough substrate on the satellite, which can interface with multiple types of electrodes, along the system being reconfigurable, enables our architecture to support this new clinical research. It also allows the clinician to select satellite-electrode system based on a patient's needs, thus providing a customized, patient-specific therapeutic system. In this article, we have described the various packaging components of this system and the design considerations that drove our technology choices.
Digit-length ratios (2D:4D) as a phenotypic indicator of in utero androgen exposure is not prognostic for androgenic alopecia: a descriptive-analytic study of 1200 Iranian men
Authors: Feily Amir , Hosseinpoor Masoomeh , Bakhti Ali , Nekuyi Mohamad , Sobhanian Saeed , Fathinezhad Zahra , Sahraei Reza , Ramirez-Fort Marigdalia K.
Published: June 2016

The etiology of androgenic alopecia (AGA) involves several factors, including genetics, androgens, age and nutrition. Digit-length ratio of the index and ring finger (2D:4D) is an indicator of prenatal exposure to sex hormones. There is a paucity of studies that systemically review the possible positive predictive value of 2D:4D in the development of AGA. We performed a single-site, descriptive-analytical study among a racially homogeneous population. Our results revealed that no significant association was determined between right 2D:4D and AGA severity within our entire population (P=0.384, r=0.025), however a positive correlation coefficient was identified in subjects above the age of 40. Based on the receiver operating characteristic curve analysis, 2D:4D does not predict the development of AGA. AGA is truly a multifactorial disease. Further, our findings suggest that increased in utero exposure to androgens as a fetus does not predispose men to develop AGA.
The effectiveness of health literacy oriented programs on physical activity behaviour in middle aged and older adults with type 2 diabetes: a systematic review
Authors: Lam Michael Huen Sum , Leung Angela Yee Man
Published: June 2016

Health literacy is the first step to self-management of type II diabetes mellitus, of which physical activity is the least compliant behavior. However, no reviews have summarized the effect and the process of interventions of health literacy oriented programs on physical activity behavior among middle aged and older adults with type II diabetes mellitus. This article is the first to examine the effectiveness of health literacy oriented programs on physical activity behavior among middle aged and older adults with type II diabetes mellitus. This systematic review extracted articles from nine electronic databases between 1990 and 2013. Six interventional studies were extracted and reported in accordance with the guidance of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Findings demonstrated that health literacy oriented programs increased the frequency and duration of physical activity among patients with high health literacy. Although some studies effectively improved the health literacy of physical activity, gap in literature remains open for the indistinct and unreliable measurement of physical activity within self-management programs of type II diabetes mellitus, and the questionable cross-culture generalizability of findings. Further studies with well-knit theorybased intervention with respect to patients’ cultural background, duration of intervention and objective measurements are encouraged to elucidate the relationship between health literacy oriented programs and physical activity behavior.
Standard of care and guidelines in prevention and diagnosis of venous thromboembolism: medico-legal implications
Authors: Vassalini Marzia , Verzeletti Andrea , De Ferrari Francesco
Published: June 2016

Concerning recent Italian laws and jurisprudential statements, guidelines application involves several difficulties in clinical practice, regarding prevention, diagnosis and therapy of venous thromboembolism. International scientific community systematically developed statements about this disease in order to optimize the available resources in prophylaxis, diagnosis and therapy. Incongruous prevention, missed or delayed diagnosis and/or inadequate treatment of this disease can frequently give rise to medico-legal litigation.
Left ventricular function in rheumatoid arthritis during anti-TNF-Î± treatment: a speckle tracking prospective echocardiographic study
Authors: Vizzardi Enrico , Cavazzana Ilaria , Franceschini Franco , Bonadei Ivano , Sciatti Edoardo , Lombardi Carlo M , Tincani Angela , Metra Marco
Published: June 2016

Aim. Rheumatoid arthritis (RA) shows a high risk for cardiovascular disease, including heart failure. Although TNF-Î± has been implicated in the pathogenesis of myocardial remodelling, TNF-Î± inhibition did not show any efficacy in patients with advanced heart failure and should be contraindicated in RA with cardiac complications. We aimed to assess global left ventricular (LV) systolic function using global longitudinal strain (GLS) as a measure of myocardial deformation, in a group of RA patients before and during anti-TNF-Î± treatment.Â Methods. 13 patients (female:male 7:6) affected by RA were prospectively followed for one year during anti TNF-Î± treatment. Every subject underwent echocardiography before starting anti-TNF-Î± drugs and after one year of treatment, to evaluate LV ejection fraction (EF), telediastolic diameter, telediastolic volume and global longitudinal strain (GLS) that was calculated using 2D speckle tracking as the mean GLS from three standard apical views (2, 3 and 4 -chambers). The patients showed a mean age of 43 years at RA onset (SD: 13) and a mean follow-up of 7.3 years (SD: 4.8). Steroid and methotrexate were used in 84.6% and 100%, respectively, in association with etanercept (6 cases), adalimumab (4 cases) and infliximab (3 cases).Â Results. Patients globally showed a normal EF before and after one year of treatment (mean: 65% and 65.7%, respectively). GLS did not differ before or after anti-TNF-Î± treatment (mean: -15.8% and -16.7%, respectively).Â Conclusion. Anti-TNF-Î± treatment did not significantly modify myocardial contractility after 12 months.Â Â
Cardiovascular health of the elderly
Authors: Giampaoli Simona , Vanuzzo Diego
Published: June 2016

Within the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 426 men and 376 women, ages 75-79 years, randomly selected from the general population were examined. Participation rate was 50%; within men 78% were hypertensives, 36% had high serum cholesterol, 28% were diabetics, 25% were obese; within women 81% were hypertensives, 55% had high cholesterol, 19% were diabetics, 37% were obese. Preventive actions at individual and community level are urgent, also at this age range.RiassuntoNellâ€™ambito dellâ€™Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey sono stati esaminati 426 uomini e 376 donne di etÃ  compresa fra 75-79 anni, estratti casualmente dalla popolazione generale. Il tasso di partecipazione Ã¨ stato del 50%; fra gli uomini il 78% era iperteso, il 36% ipercolesterolemico, il 28% diabetico e il 25% obeso; fra le donne lâ€™81% era ipertesa, il 55% ipercolesterolemica, il 19% diabetica, il 37% obesa. Azioni di prevenzione a livello individuale e collettivo sono urgenti sulla popolazione generale, anche in questa fascia di etÃ .
Hyperglycemia, hypoglycemia and glycemic variability in the elderly: a fatal triad?
Authors: Monami Matteo , Aleffi Sara
Published: June 2016

Diabetes mellitus is one of the most important causes of cardiovascular morbidity and mortality; the incidence of chronic complications of diabetes appears to be closely related to the degree of hyperglycaemia. However, results of clinical trials showed that intensive treatment of hyperglycaemia prevents microvascular complications, but has little or no effect on the incidence of cardiovascular events. Different hypoglycaemic drugs show different effects on cardiovascular risk. However, those trials have shown a neutral effect on cardiovascular mortality. This paradoxical result could be explained with the frequent use, in the past, of glucose-lowering agents capable of increasing the risk of hypoglicemia, glycemic variability and weight gain. In conclusion, an adequate glycemic control, in particular in elderly patients, should be achieved, whenever possible, using agents not inducing hypogycemia, glucose fluctuations, and weight gain. In fact, hypoglycaemia and glucose variability should be considered as independent cardiovascular risk factors to a similar extent to hyperglycemia. In this article, the author will review literature supporting the hypothesis that hyperglycemia, hypoglycaemia and glycemic variability are a fatal triad capable of increasing morbidity and mortality in patients with diabetes mellitus.Â RiassuntoIl diabete mellito Ã¨ una delle piÃ¹ importanti cause di morbilitÃ  e mortalitÃ  cardiovascolare, ed Ã¨ stata dimostrata una stretta correlazione tra compenso glicometabolico ed incidenza di complicanze croniche del diabete mellito. Tuttavia, negli studi di intervento, il controllo accurato dellâ€™iperglicemia sembra poter prevenire le complicanze microvascolari, ma ha effetti soltanto marginali sullâ€™incidenza di eventi cardiovascolari secondari a malattia macrovascolare. Inoltre, i grandi trial di intervento hanno mostrato come la riduzione degli eventi cardiovascolari non si accompagni ad una riduzione della mortalitÃ  cardiovascolare. Tale paradosso potrebbe essere spiegato dal fatto che spesso, in passato, per ottenere un miglioramento glicometabolico si sono utilizzati farmaci ipoglicemizzanti in grado di aumentare il rischio ipoglicemico, la variabilitÃ  glicemica ed il peso corporeo. In conclusione, il miglioramento del compenso glicemico, specie nel paziente anziano, dovrebbe essere ottenuto, quando possibile, con farmaci a basso rischio ipoglicemico e non inducenti aumenti di peso, per evitare gli effetti negativi di ipoglicemie e eccessive fluttuazioni della glicemia che di per sÃ© costituiscono dei fattori di rischio cardiovascolari al pari dellâ€™iperglicemia. In questo articolo, si esplorerÃ  lâ€™ipotesi che iperglicemia, ipoglicemia e variabilitÃ  glicemica costituiscano una triade fatale in grado di aumentare morbilitÃ  e mortalitÃ  nei pazienti affetti da diabete mellito.
Aging clinical problems: a difficult balance between age and frailty
Authors: Rozzini Renzo
Published: June 2016

Frailty is a common geriatric syndrome that embodies an elevated risk of catastrophic declines in health and function among older adults. Frailty is a condition associated with ageing with associated weakness, slowing, decreased energy, lower activity, and, when severe, unintended weight loss. As a population ages, a central focus of geriatricians and public health practitioners is to understand, and then beneficially intervene on, the factors and processes that put elders at such risk, especially the increased vulnerability to stressors (e.g. extremes of heat and cold, infection, injury, or even changes in medication) that characterizes many older adults. The syndrome of geriatric frailty is hypothesized to reflect impairments in the regulation of multiple physiologic systems, embodying a lack of resilience to physiologic challenges and thus elevated risk for a range of deleterious endpoints. The empirical assessment of geriatric frailty in individuals seeks to capture this or related features.RiassuntoFragilitÃ  Ã¨ la predisposizione alla rottura, al danno. Lâ€™etimologia della parola fragilitÃ  da "frango", rompere, rimanda alla nozione di qualche cosa che se sottoposto a una pressione, a un impatto, rischia di danneggiarsi facilmente. Eâ€™ dunque una nozione ampia e intuitiva che puÃ² avere ambiti di precisazione piÃ¹ diversi a seconda che se ne parli in fisica (dove esistono dei coefficienti esatti) piuttosto che nei campi della morale o del sentimento, dove la valutazione sarÃ  sempre piÃ¹ "poetica" e affidata alla sensibilitÃ  individuale.
High blood pressure in older subjects with cognitive impairment
Authors: Mossello Enrico , Simoni David
Published: June 2016

High blood pressure and cognitive impairment often coexist in old age, but their pathophysiological association is complex. Several longitudinal studies have shown that high blood pressure at midlife is a risk factor for cognitive impairment and dementia, although this association is much less clear in old age. The effect of blood pressure lowering in reducing the risk of dementia is only borderline significant in clinical trials of older subjects, partly due to the insufficient follow-up time. Conversely, dementia onset is associated with a decrease of blood pressure values, probably secondary to neurodegeneration. Prognostic effect of blood pressure values in cognitively impaired older subjects is still unclear, with aggressive blood pressure lowering being potentially harmful in this patients category. Brief cognitive screening, coupled with simple motor assessment, are warranted to identify frail older subjects who need a more cautious approach to antihypertensive treatment. Values obtained with ambulatory blood pressure monitoring seem more useful than clinical ones to predict the outcome of cognitively impaired older subjects. Future studies should identify the most appropriate blood pressure targets in older subjects with cognitive impairment.Â RiassuntoIpertensione arteriosa e decadimento cognitivo spesso coesistono in etÃ  avanzata, sebbene la loro associazione sia complessa dal punto di vista fisiopatologico. Diversi studi longitudinali hanno mostrato che elevati valori pressori in etÃ  adulta rappresentano un fattore di rischio per decadimento cognitivo e demenza, sebbene tale associazione sia molto meno chiara in etÃ  avanzata. Lâ€™effetto della terapia antiipertensiva Ã¨ risultato ai limiti della significativitÃ  statistica nel ridurre il rischio di demenza negli studi di intervento su soggetti anziani, in parte a causa della durata insufficiente del follow-up. Dâ€™altra parte, lâ€™insorgenza di demenza Ã¨ associata con una riduzione dei valori pressori, probabilmente secondaria alla neurodegenerazione. Lâ€™effetto prognostico dei valori pressori in anziani con decadimento cognitivo non Ã¨ stato ancora chiarito, in presenza di un possibile effetto dannoso di un trattamento antiipertensivo aggressivo in questa categoria di pazienti. Un breve screening cognitivo, associato con una semplice valutazione motoria, Ã¨ raccomandato per identificare gli anziani fragili, che necessitano di un approccio piÃ¹ cauto alla terapia antiipertensiva. I risultati del monitoraggio della pressione arteriosa nelle 24 ore sembrano piÃ¹ utili della misurazione clinica per predire la prognosi degli anziani cognitivamente compromessi. Studi futuri dovrebbero identificare gli obiettivi pressori piÃ¹ appropriati nel trattamento di anziani con decadimento cognitivo.
Concurrent sensitization to Aspergillus Fumigatus in tropical pulmonary eosinophilia
Authors: Chhabra Sunil K. , Dash Devi Jyoti
Published: June 2016

Tropical pulmonary eosinophilia (TPE) is characterized by lung tissue and peripheral blood eosinophilia. Serum total IgE is also markedly increased in TPE. However, an association with asthma or other hypersensitivity conditions has not been described. During the diagnostic workup of three patients eventually confirmed to have TPE, hypersensitivity to the fungus, Aspergillus Fumigatus was found. However, there was no evidence of diseases of aspergillus hypersensitivity such as severeÂ asthmaÂ with fungal sensitization (SAFS) and allergic bronchopulmonary aspergillosis (ABPA). This association however raises the possibility of a future risk of these potentially serious allergic respiratory manifestations.RiassuntoLâ€™eosinofilia polmonare tropicale (TPE) Ã¨ caratterizzata da tessuto polmonare e eosinofilia nel sangue periferico. Anche il siero IgE totale Ã¨ notevolmente aumentato in TPE. Tuttavia, unâ€™associazione con asma o altre condizioni di ipersensibilitÃ  non Ã¨ stata descritta. Durante l'iter diagnostico di tre pazienti, che alla fine si sono rivelati presentare TPE, ipersensibilitÃ  al fungo, Ã¨ stato trovato lâ€™Aspergillus fumigatus. Tuttavia, non vi era alcuna evidenza di malattie di Aspergillus ipersensibilitÃ  come l'asma grave con sensibilizzazione fungina (SAF) e aspergillosi broncopolmonare allergica (ABPA). Questa associazione pone tuttavia la possibilitÃ  di un rischio futuro di queste potenzialmente gravi manifestazioni allergiche respiratorie.
Cardiac rehabilitation is safe and effective also in the elderly, but don't forget about drugs!
Authors: Del Sindaco Donatella , Tinti Maria Denitza , Pulignano Giovanni , Tolone Stefano , Minardi Giovanni , Uguccioni Massimo , Lax Antonio
Published: June 2016

In the setting of heart failure (HF) pharmacotherapy demonstrates a quantifiable improvement in exercise tolerance also in HF with preserved ejection fraction (HFpEF). For patients with HFpEF, often older, with higher prevalence of hypertension, diabetes mellitus, atrial fibrillation and other comorbidities, endpoints such as quality of life and functional capacity may be more clinically relevant. However several study show as the use of ACE-I and B-blocker were lesser than expected. Beta-blocker therapy is the keystone of pharmacotherapy of HF patients and exercise training is the essential core of rehabilitation programs, it is important to elucidate the relationship between these therapies. Exercise training improves the clinical status of HF, improving left ventricular ejection fraction and improving quality of life, but it is possible that b-blocker may attenuate exercise training adaptations. Despite this, possible adverse b-blocker effects are just presumed and not confirmed by published randomized clinical trials. Metanalysis suggests that b-blocker compared with placebo enhances improvements in cardiorespiratory performance in exercise training intervention. Despite these evidences, prescription of gold standard therapy and adherence are still suboptimal and should be a priority goal for all CR program.Â RiassuntoNellâ€™ambito dei pazienti con scompenso cardiaco (SC) la terapia farmacologica permette di ottenere un miglioramento della tolleranza allâ€™esercizio fisico anche nei pazienti con frazione di eiezione conservata. Questi pazienti spesso piÃ¹ anziani, con una piÃ¹ elevata incidenza di ipertensione, diabete mellito, fibrillazione atriale e comorbiditÃ , endpoints quali qualitÃ  della vita e capacitÃ  funzionale dovrebbero risultare piÃ¹ clinicamente rilevanti. Tuttavia molti studi mostrano come lâ€™utilizzo di ACE-I e Beta-bloccanti sia minore di quanto ci si aspetterebbe. Va evidenziato comunque come la terapia beta-bloccante costituisca il cardine della terapia farmacologica dello SC e come lâ€™esercizio fisico sia il cuore dei programmi di riabilitazione, pertanto Ã¨ importante valutarne le possibili interazioni. Lâ€™esercizio fisico migliora lo stato clinico dei pazienti con SC, ma Ã¨ possibile che la terapia con Beta-bloccanti possa attenuare questi vantaggi. Tale assunto tuttavia rimane solo presunto e non confermato dai risultati dei trial pubblicati. Infatti una metanalisi suggerisce che la terapia Beta-bloccante, confrontata con il placebo, migliori la performance cardiorespiratoria nel gruppo sottoposto ad esercizio fisico. Malgrado tali evidenze, la prescrizione di una terapia medica ottimale e lâ€™aderenza alla stessa rimangono ancora non ottimali e dovrebbe rappresentare un obiettivo primario per tutti i programmi di riabilitazione.Â
Resistance training and sarcopenia
Authors: Giallauria Francesco , Cittadini Antonio , Smart Neil Andrew , Vigorito Carlo
Published: June 2016

Aging is inexorably accompanied by a progressive decline of muscle mass, quality and strength. The resulting condition has been termed sarcopenia. Age-related sarcopenia can be accelerated by a variety of factors including changes in the hormonal milieu, inactivity, poor nutrition, chronic illness, and loss of integrity and function in the peripheral and central nervous systems. The downstream mechanisms by which these risk factors cause sarcopenia are not completely understood. Exercise training (particularly resistance training) has long been identified as the most promising method for increasing muscle mass and strength among older people. New interventions aimed at preventing muscle atrophy, promoting muscle growth and ultimately, maintaining muscle functions during aging are discussed. Understanding how age affects muscle-related gene expression, protein recycling and resynthesis, post-translational modification and turnover will be crucial to identify new treatment options.Â RiassuntoLâ€™invecchiamento Ã¨ inesorabilmente accompagnato da un progressivo declino della massa, della qualitÃ  e della forza muscolare. La conseguente condizione viene definita sarcopenia. La sarcopenia correlata allâ€™invecchiamento puÃ² essere accelerata da una serie di fattori tra cui le modifiche degli equilibri ormonali, la sedentarietÃ , la scarsa nutrizione, le patologie croniche, e la perdita di integritÃ  e funzione del sistema nervoso centrale e periferico. I meccanismi attraverso i quali questi fattori causano sarcopenia sono ancora non completamente chiari. Lâ€™esercizio fisico (in particolare il training di resistenza) Ã¨ da tempo identificato come una delle piÃ¹ promettenti stratefie per aumentare la massa muscolare e la forza negli anziani. Interventi mirati a prevenire la atrofia muscolare, a promuovere la crescita muscolare e, in ultima analisi, preservare le funzioni muscolari durante lâ€™invecchiamento verranno discussi. Comprendere come lâ€™invecchiamento interferisce con lâ€™espressione genica ai livello muscolare, con i sistemi di riciclo e resintesi proteica, con le modifiche post-traslatzionali e il turnover, sarÃ  cruciale per identificare e implementare nuove strategie terapeutiche.
Ataxia and hypogonadotropic hypogonadism with intrafamilial variability caused by RNF216 mutation
Authors: Alqwaifly Mohammed , Bohlega Saeed
Published: June 2016

Gordon Holmes syndrome (GHS) is a distinct phenotype of autosomal recessive cerebellar ataxia, characterized by ataxia, dementia, reproductive defects and hypogonadism; it has been recently found to be associated with RNF216 mutation. We performed whole-exome sequencing and filtered the resulting novel variants by the coordinates of the shared autozygome. We identified a novel splicing variant in RNF216 that is likely to abolish the canonical splice site at the junction of exon/intron 13 (NM_207111.3:c.2061G>A). We herein report two patients with GHS caused by a novel RNF216 mutation as the first follow up report on RNF216-related GHS, and show interfamilial variability of phenotype supporting the previously reported RNF216-related cases.
Slipped capital femoral epiphysis in adults: case report and review of literature
Authors: Macía-Villa C.C. , Sanchez-Lite I. , Medina-Luezas J.
Published: June 2016

Slipped capital femoral epiphysis (SCFE) mainly affects overweight prepubertal children. It is usually idiopathic, but endocrinological diseases are proposed as the main cause. SCFE occurs before the closing of the femoral physis, which generally occurs at 18 years in males and 16 years in females, therefore it is considered a children’s disease. However, there have been several reports of adults with SCFE and some familial cases. We present a case of bilateral SCFE in a 47 years old female with possible relationship with inhaled corticosteroids, and for the first time we collect and analyze all published cases in adults.
Sea-ice atlas of arctic Canada 1975-1978
Authors: Lindsay D G
Published: June 2016

Systematic aerial surveys of sea ice in the Canadian Arctic Archipelago and adjacent waters were started by the Polar Continental Shelf Project in 1961 and were concluded at the end of 1978. During these years, at various intervals between March and November,
successive sets of observations have been made of distributions of sea-ice types and features, progression of break-up, advance of ablation, patterns of movement and the sequence of freeze-up. These observations, for 197 4 to 1978, are presented on 64 coloured maps, 28 x 38 cm, accompanied by
written descriptions, selected satellite imagery and seasonal summaries. This atlas is the last of a set of three. The first, entitled Sea Ice Atlas of Arctic Canada 1961-1968 was published in 1976. The second volume Sea Ice Atlas of Arctic Canada 1969-1974 was published in
1977.
Linking HIV & family planning services to improve dual methods of contraception among women infected with HIV in Mumbai, Maharashtra, India
Authors: Joshi Beena , Velhal Gajanan , Chauhan Sanjay , Kulkarni Ragini , Begum Shahina
Published: June 2016

Background & objectives:

Preventing unintended pregnancies among people living with HIV (PLHIV) is one of the strategies of WHO for preventing parent-to-child transmission (PPTCT). Given the limitation of only condom use, the objective of this study was to improve use of dual contraceptive methods among HIV infected women.

Methods:

An experimental study among HIV positive women was conducted at two tertiary care level hospitals in Mumbai. Linking HIV with family planning services was the focus of intervention at one site and standard level of care was maintained at the control site. At each site, 150 HIV+ve women attending counselling and testing centres, who did not intend to get pregnant in the next one year and were eligible to use dual methods, were enrolled and followed up to one year.

Results:

At the end of one year, 60 per cent women in the intervention group reached Family Planning Centres compared to eight per cent in the control group. There was three times more acceptance and continuation of use of dual methods along with increase in consistent use of condoms and less number of unplanned pregnancies in the intervention group than the control group.

Interpretation & conclusions:

The study findings demonstrate that linking HIV and family planning services may facilitate the uptake of dual methods of contraception without reducing consistent condom use among HIV infected women. The PPTCT programmes need to focus on the component of Prong 2 of PPTCT which aims to prevent unintended pregnancies among HIV positive women.
Prescription pattern of antidepressants in five tertiary care psychiatric centres of India
Authors: Tripathi Adarsh , Avasthi Ajit , Desousa Avinash , Bhagabati Dipesh , Shah Nilesh , Kallivayalil Roy Abraham , Grover Sandeep , Trivedi J.K. , Shinfuku Naotaka
Published: June 2016

Background & objectives:

Limited data are available on prescription patterns of the antidepressants from India. We studied antidepressants’ prescription pattern from five geographically distant tertiary psychiatric care centers of the India.

Method:

In this cross-sectional study, all patients who attended outpatients department or were admitted in the psychiatry wards at Lucknow, Chandigarh, Tiruvalla, Mumbai and Guwahati on a fixed day, who were using or had been prescribed antidepressant medications, were included. The data were collected on a unified research protocol.

Results:

A total of 312 patients were included. Mean age was 39±14.28 yr and 149 (47.76%) were females, 277 (87.5%) were outpatients. Among the patients receiving antidepressants, 150 (48.1%) were of diagnoses other than depression. Diabetes mellitus 18 (5.78%) was the most common co-morbid medical illness. A total of 194 (62.2%) patients were using selective serotonin reuptake inhibitors (SSRIs) with escitalopram 114 (36.53%) being the most common antidepressant used. Overall, 272 (87.18%) patients were using newer antidepressants. Thirty (9.62%) were prescribed more than one antidepressant; 159 (50.96%) patients were prescribed hypnotic or sedative medications with clonazepam being the most common (n=116; 37.18%).

Interpretation & conclusions:

About half of the patients with diagnoses other than depression were prescribed antidepressants. SSRIs were the most common group and escitalopram was the most common medication used. Concomitant use of two antidepressants was infrequent. Hypnotic and sedatives were frequently prescribed along with antidepressants.
Thoracic Presentations of Small Round Blue Cell Tumors
Authors: Chang Annalice , Pfeifer Kyle , Chen Peter , Kalra Vivek , Shin Myung Soo
Published: June 2016

The term “small round blue cell” is frequently used as a cursory radiologic pathological correlation of aggressive tumors throughout the body. We present a pictorial essay of common and uncommon subtypes of small round blue cell tumors in the chest illustrating the characteristic radiologic findings of each lesion. In addition, we review the pathologic findings of each tumor subtype with characteristic hematoxylin- and eosin-stained photomicrographs and immunohistochemical and molecular studies. Represented tumors include small cell carcinoma, Ewing sarcoma, extranodal marginal zone B-cell lymphoma, embryonal rhabdomyosarcoma, desmoplastic small round cell tumor, and posttransplant lymphoproliferative disorder. Understanding and ability to recognize these lesions are essential to broaden the radiologist's differential diagnosis and help guide patient care.