bluuebunny/crossref_metadata_2025 huggingface dataset:
Causality and irreversibility in health phenomena: The notion of semelfactivity
Authors: François Arnaud
Published: October 2012

This paper aims at pointing a particular aspect of the temporality of health,
namely the ?semelfactivity? (characteristic of what happens only once) of the
phenomena that are connected to it. This semelfactivity, which contributes to
giving an irreversibility to the temporality of health, stems from the fact
that the health phenomena are part of causality networks which are
intrinsically entangled. It compels, thus, to set anew, from a more general
philosophical point of view, the question of the relationship between
causality and irreversibility.
Deliberative democracy: History of an idea
Authors: Jankovic Ivana
Published: October 2012

Deliberative democracy finds its model in ancient democratic practices. Among
modern thinkers, theorists of deliberative democracy find inspiration in
Rousseau's political thought and his concept of the "general will",
especially in his persistence that the general will is not a mere
aggregation of individual wills. However, the idea of ?general will?, public
interest, and the care for the common good of the community, has been widely
criticized as it appears that it does not leave the place for individual
rights and freedoms. The goal of this paper is to to show that deliberative
democracy does, indeed, strats of with individual rights and freedoms, but
that it does not allow for democratic procedure to be reduced to the
aggregation of individual preferences. Theorists of the deliberative
democracy call into question the assumption that a collective
decision-making procedure should be understood solely according the voting
model. Through a process of public and rational discussion, voters do revise
attitudes and initial preferences. Thus, as a result they reach either
unanimous agreement or bring preferences closer to single-peakedness. In
this way the model of deliberative democracy avoids paradoxes and problems
that aggregative model of democracy encounters.
The semantics of indicative conditionals: A counterexample to the horseshoe analysis
Authors: Prelevic Dusko
Published: October 2012

The paper examines a counterexample of the horseshoe analysis of indicative
conditionals (according to which indicative conditionals ??? have the same
truth-conditions as the material implication ???). The example is a modified
and improved version of Jason Decker?s ?playground conditionals? case. The
paper aims to show why Decker?s original example is wrong, and how it can be
improved by using the inverted spectrum thought experiment. It is also shown
in this paper that playground conditionals do not pose any problems to the
epistemic version of the two-dimensional semantics (E2-D), which leads to the
conclusion that we should prefer E2-D to the horseshoe analysis of indicative
conditionals. [Projekat Ministarstva nauke Republike Srbije, br. 179067:
Logicko-epistemoloski osnovi nauke i metafizike].
Numerical study of natural melt convection in cylindrical cavity with hot walls and cold bottom sink
Authors: Ahmanache Abdennacer , Zeraibi Noureddine
Published: October 2012

Numerical study of natural convection heat transfer and fluid flow in
cylindrical cavity with hot walls and cold sink is conducted. Calculations
are performed in terms of the cavity aspect ratio, the heat exchanger length
and the thermo physical properties expressed via the Prandtl number and the
Rayleigh number. Results are presented in the form of isotherms, streamlines,
average Nusselt number and average bulk temperature for a range of Rayleigh
number up to 106. It is observed that Rayleigh number and heat exchanger
length influences fluid flow and heat transfer, whereas the cavity aspect
ratio has no significant effects.
Determining the theoretical reliability function of thermal power system using simple and complex Weibull distribution
Authors: Kalaba Dragan , Radakovic Zoran , Djordjevic Milan , Kirin Snezana
Published: October 2012

The main subject of this paper is the representation of the probabilistic
technique for thermal power system reliability assessment. Exploitation
research of the reliability of the fossil fuel power plant system has
defined the function, or the probabilistic law, according to which the
random variable behaves (occurrence of complete unplanned standstill). Based
on these data, and by applying the reliability theory to this particular
system, using simple and complex Weibull distribution, a hypothesis has been
confirmed that the distribution of the observed random variable fully
describes the behaviour of such a system in terms of reliability.
Establishing a comprehensive insight in the field of probabilistic power
system reliability assessment technique could serve as an input for further
research and development in the area of power system planning and operation.
In vivo microcomputed tomography evaluation of rat alveolar bone and root resorption during orthodontic tooth movement
Authors: Ru Nan , Liu Sean Shih-Yao , Zhuang Li , Li Song , Bai Yuxing
Published: October 2012

Objective:

To observe the real-time microarchitecture changes of the alveolar bone and root resorption during orthodontic treatment.

Materials and Methods:

A 10 g force was delivered to move the maxillary left first molars mesially in twenty 10-week-old rats for 14 days. The first molar and adjacent alveolar bone were scanned using in vivo microcomputed tomography at the following time points: days 0, 3, 7, and 14. Microarchitecture parameters, including bone volume fraction, structure model index, trabecular thickness, trabecular number, and trabecular separation of alveolar bone, were measured on the compression and tension side. The total root volume was measured, and the resorption crater volume at each time point was calculated. Univariate repeated measures analysis of variance with Bonferroni corrections were performed to compare the differences in each parameter between time points with significance level at P < .05.

Results:

From day 3 to day 7, bone volume fraction, structure model index, trabecular thickness, and trabecular separation decreased significantly on the compression side, but the same parameters increased significantly on the tension side from day 7 to day 14. Root resorption volume of the mesial root increased significantly on day 7 of orthodontic loading.

Conclusions:

Real-time root and bone resorption during orthodontic movement can be observed in 3 dimensions using in vivo micro-CT. Alveolar bone resorption and root resorption were observed mostly in the apical third on day 7 on the compression side; bone formation was observed on day 14 on the tension side during orthodontic tooth movement.
IGF-1 and IGFBP 3 in Growth Hormone Deficiency Role of Insulin Like Growth Factor-1 (IGF-1) and IGF Binding Protein 3 in the Diagnosis of Growth Hormone Deficiency: Changing Paradigm
Authors: Kota SK , Jammula S , Gayatri K , Kota SK , Tripathy PR , Modi KD
Published: October 2012

GH stimulation tests are widely used in the diagnosis of GH deficiency (GHD), although they are associated with a high false positive rate. Serum IGF-I levels are monitored during GH replacement treatment in subjects with GH deficiency (GHD) to guide GH dose adjustment and to minimize occurrence of GHrelated side-effects. The need for reliance on provocative testing is based on evidence that the evaluation of spontaneous growth hormone (GH) secretion over 24 hours and the measurement of IGF-I and IGFBP-3 levels do not distinguish between normal and GHD subjects. Regarding IGF-I, it has been demonstrated that very low levels in patients highly suspected for GHD (i.e., patients with childhood-onset, severe GHD, or with multiple hypopituitarism acquired in adulthood) may be considered definitive evidence for severe GHD obviating the need for provocative tests. However, normal IGF-I levels do not rule out severe GHD and therefore adults suspected for GHD and with normal IGF-I levels must undergo a provocative test of GH secretion. We hereby review the various literatures at disposal justifying the use of IGF-1 and IGBP3 for diagnosis of growth hormone deficiency.Data Source: We searched PUBMED and MEDLINE database for relevant articles including key words. References of each article were further reviewed for final synthesis of the manuscript.J Nepal Paediatr Soc 2012;32(2):154-162 doi: http://dx.doi.org/10.3126/jnps.v32i2.5342
Comparison of Pain Response to Venepuncture Versus Heel Lance Blood Sampling in Term Neonates
Authors: Shrestha M , Adhikari RK
Published: October 2012

Introduction: Pain in neonates is largely underestimated and neglected. Pain experience can alter clinical outcome, brain development and subsequent behavior in newborns. Numerous newborns undergo blood sampling routinely in nurseries/NICUs and these procedures are often done without pain relieving measures. Heel lancing and venepuncture are two common procedures for blood sampling in neonates. The objective of this study was to compare pain response to venepuncture versus heel lance in full term neonates. Materials and Methods: A comparative observational study was conducted among 200 term neonates who were undergoing blood sampling for bilirubin or glucose estimation. Neonates were randomly assigned to heel lance (HL) and venepuncture (VP) groups with 100 babies in each group. During the procedure, pain was assessed by Neonatal/Infant pain Scale (NIPS). Heart rate (HR) and oxygen saturation (SpO2) were continuously monitored 5 minutes prior to procedure and upto 5 minutes after the procedure. Results: The median NIPS score in HL and VP were 7 and 3.5 respectively which showed statistically significant (p= 0.0001) higher level of pain experience in HL than in VP. During the procedure, both the groups (HL and VP) showed significant changes in heart rate and oxygen saturation i.e., increase in HR (p= 0.0001) and decrease in SpO2 (p= 0.0001), however the increase in heart rate and decrease in oxygen saturation were significantly more in HL than in VP (p= 0.0001). Conclusion: Neonates perceive pain as demonstrated by Neonatal Pain Scale and venepuncture is the less painful procedure than heel lancing for blood sampling in neonates. J. Nepal Paediatr. Soc. 32(2) 2012 99-104 doi: http://dx.doi.org/10.3126/jnps.v32i2.5477
Ocular Manifestations of Meningitis in Children
Authors: Chaudhary M , Shah DN , Sharma PR
Published: October 2012

Introduction: Meningitis is the most common central nervous system disease affecting children leading to focal neurological deficits and various oculovisual anomalies including blindness in children. The objective of this study was to evaluate the oculovisual anomalies occurring in Nepalese children suffering from different types of bacterial meningitis. Materials and Methods: A Prospective, study was undertaken for 18 months at B.P.Koirala Lion’s Center for ophthalmic studies, TU Teaching Hospital to study the children suffering from bacterial meningitis admitted at Kanti Children’s Hospital for ocular involvement. A through history, anterior and posterior segment ocular examination and investigations like blood, CSF and CT scan were done. Results: A total of 182 cases of bacterial meningitis were screened. Tubercular meningitis cases were 40 (21.97%) and Pyogenic were 142 (78.02%). Oculovisual anomalies were seen in 70 (38.46%) cases. The ocular abnormalities included pupillary changes (34.28%), Cranial Nerve Palsy (22.86%), Fundus changes (35.72%), Cortical Blindness (4.28%), Panophthalmitis and Proptosis (1.43%). Third nerve involvement was seen in 17.14% cases, sixth nerve in 4.29% cases, Papilledema in 11.43 % and Optic atrophy in 22.86 %. Risk factors included late presentation; hydrocephalous and increased CSF cell count and protein level. Conclusion: Oculovisual anomalies formed an important group of clinical manifestations of bacterial meningitis. Incidence of oculovisual anomalies was more frequently seen in Tubercular meningitis (55%).Children with early presentation and intervention had better prognosis. Hence, timely intervention and health education is important. J. Nepal Paediatr. Soc. 32(2) 2012 136-141 doi: http://dx.doi.org/10.3126/jnps.v32i2.5534
Lamotrigine Induced Severe Cutaneous Reaction
Authors: Roka YB , Roka N , Adhikari HB
Published: October 2012

Antiepileptic drugs are used commonly by physicians, neurologist and neurosurgeons in Nepal. Lamotrigine is an effective antiepileptic drug used as an add-on and monotherapy for a variety of seizure types in both adults and children. Rashes due to AED including SJS and hypersensitivity syndrome leading to hospitalization occur in approximately 0.33% of adults and 0.8% in children. Reactions due to LTG alone occur in around 5.7% of cases. We report probably the first case of this reaction in a 12-year old girl with a brief discussion on its etiology and management. J Nepal Paediatr Soc 2012;32(2):172-174 doi: http://dx.doi.org/10.3126/jnps.v32i2.5608
Study on Clinico-Laboratory Profile of Children with Scrub Typhus
Authors: Jain N , Jain V
Published: October 2012

Scrub typhus is an acute, febrile, infectious illness caused by Orientia (formerly Rickettsia) tsutsugamushi,an obligate intracellular gram-negative bacterium. Humans are accidental hosts in this zoonotic disease.The present retrospective study describes clinical profile of the children hospitalized in hospital with Scrub Typhus infection during period 2010-2011. 19 hospitalized children with clinical features suggestive of Rickettsial disease (fever, generalized rash) who tested ELISA positive for IgM against Scrub Typhus were included in the present study between the age of 1 years and 15 years. All children presented with fever (100%). 42.10% had lymphadenopathy, 47.36% had eschar and 57.89% patients had cough. 26.31, 21.05%, 10.52%, had hepatomegaly, pain abdomen, and respiratory distress and gastrointestinal bleed respectively. All of the children were investigated and treated with as per protocol. None of them died. We think that Rickettsial infection is not quite common in this region but study showed that it is not an uncommon entity and thus, high degree of suspicion, knowledge of geographical distribution and clinical features of Rickettsial disease helps in its early diagnosis and treatment. J Nepal Paediatr Soc 2012;32(2):187-192 doi: http://dx.doi.org/10.3126/jnps.v32i2.5683
Progeroid Syndrome of De Barsy With Hypocalcemic Seizures
Authors: Cheriathu J , D'souza IE , John LJ , El Bahtimi R
Published: October 2012

De Barsy et al first reported a rare cutaneo-oculo-cerebral malformation-syndrome now commonly referred as ‘progerioid syndrome of de Barsy’. It is the constellation of progeria-like appearance, cutis laxa, intrauterine growth retardation, corneal clouding and hypotonia. We report a case of Debarsy syndrome in a neonate presented at birth with typical clinical features with hypocalcemic seizures. There are no previous reports among Afghani origin and also first case reported from United Arab Emirates, there have been no reported cases of hypocalcemic seizures. J Nepal Paediatr Soc 2012;32(2):175-177 doi: http://dx.doi.org/10.3126/jnps.v32i2.5993
Congenital Anomalies at Birth: A Hospital Based Study in UAE
Authors: Aryasinghe L , Moezzi D , Ansari TA , Mathew E , Sharbatti SA , Shaikh RB
Published: October 2012

Introduction: It is widely acknowledged that congenital anomalies heavily contribute to infant morbidity and mortality worldwide, with an estimated 9 million infants (7% of all births) born annually having a serious congenital anomaly that result in death or lifelong disability. The objective of our study was to estimate the frequency of congenital anomalies at the Gulf Medical College Hospital and Research Center, Ajman and to estimate the proportion of births with congenital anomalies per 1,000 live births. Materials and Methods: It was a Hospital-Record based descriptive study of the 1,222 consecutive live births from December 2007 to June 2008. Results: There were 84 cases of congenital anomalies among the 1,222 live births; the rate of anomalous births was 68.7 per 1,000 live births or 6.9%. Anomalies of the genitourinary system (40.5%) were the most common, followed by musculoskeletal (28.6%) and cardiovascular (10.7%). Gastrointestinal, chromosomal and multiple system anomalies accounted for 3.6% each and miscellaneous anomalies were seen in 7.1%. Central Nervous system (2.4%) anomalies were the least. Congenital hydrocele (19.0%) was seen to have the highest frequency amongst all recorded anomalies, followed by Talipes or Clubfoot (14.3%). 9.3% of the male and 4.3% of the female population of live births had a congenital anomaly. Birth Weight (p=0.005) and Gender (p=0.001) were found to have significant association with the frequency of birth defects. Maternal Age, gravidity, parity, previous abortions, VDRL and Hepatitis B status, Gestational Diabetes, Pregnancy Induced Hypertension, gestational age, maternal and infant blood group, nationality and consanguinity showed no statistically significant association with congenital anomalies. Conclusion: The proportion of congenital anomalies found in our study is alarmingly high and emphasizes the need for more accessible nationwide screening, counseling and surveillance systems. J. Nepal Paediatr. Soc. 32(2) 2012 105-112 doi: http://dx.doi.org/10.3126/jnps.v32i2.5995
Holocord Syrinx, Tethered Cord and Diastematomyelia: Case Report and Review of Literature
Authors: Maheshwari A , Yadav D , Aneja S , Kaur S , Patra B , Seth A
Published: October 2012

Syringomyelia refers to the presence of cavities within the spinal cord or a dilatation of the central spinal cord canal. In 90% of cases, syringomyelia is associated with a Chiari I malformation. The association of syringomyelia with tethered cord is well known but syrinxes associated with these defects are usually below vertebral level T6. Holocord syrinx associated with tethered cord is rare and is almost always associated with Chiari 1 malformation. To the best of our knowledge, only a single case report of holocord syrinx with tethered cord has been reported, but this patient had multiple overt lumbosacral defects (tethered cord, meningocele and diastematomyelia). We are reporting a three year old child with holocord syrinx with tethered cord and diastematomyelia and no evidence of Chiari malformation, meningocele or any overt spinal malformation and minimal neurological abnormalities. J Nepal Paediatr Soc 2012;32(2):169-171 doi: http://dx.doi.org/10.3126/jnps.v32i2.6098
Leprosy: Before And After Elimination From Nepal
Authors: Jha AK
Published: October 2012

KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 1-2 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6903
Prevalence of Intestinal Parasitosis Among School Children in Baglung District of Western Nepal
Authors: Shrestha A , Narayan KC , Sharma R
Published: October 2012

Background This study was carried out to estimate the prevalence of intestinal parasites among school-going children of the Baglung municipality from December 2010 to January 2011. Objective To find out prevalence of parasitosis among school aged children and to make necessary recommendations for preventive measures. Method A total of 260 stool samples were collected. A structured questionnaire was used to collect data on predisposing factors. Nails were observed without prior information to the subjects so as to find their hygienic practice. The stool samples were examined by direct wet mount and formal ether concentration technique. Results The total prevalence of the intestinal parasitosis was found to be 21.05%. The prevalence for individual parasites was as follows: Entamoeba histolytica (9.23%), Giardia lamblia (5.76%), Trichuris trichuria (5%), Ancylostoma duodenale (2.65%) and Ascaris lumbricoides (2.3%). Nail hygiene and level of education were significantly associated with intestinal parasitosis. The gender and age of the children, sanitary habits including toilet use, hand washing practice, and the use of the antihelminthic drug (albendazole) were not significantly associated with intestinal parasitosis. Higher prevalence was seen in boys, children belonging to age group 10-14 years, lower secondary students, among those who reported gastrointestinal problems within last six months, children from agriculture-based families and children with untrimmed nail. Conclusion Major contributors for the prevalence of parasites were found to be poor personal hygiene and educational level of the children. Health education and mass treatment are recommended as a preventive measures. KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 3-6 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6904
Stigma Related to Tuberculosis Among Patients Attending DOTS Clinics of Dharan Municipality
Authors: Aryal S , Badhu A , Pandey S , Bhandari A , Khatiwoda P , Khatiwada P , Giri A
Published: October 2012

Background The patients suffering from tuberculosis are receiving shame and unfair treatment from the people living around them within their own society attending DOTS clinic of Dharan municipality. Objective To assess the stigma experienced by tuberculosis patients and to find out the association between stigma experienced by Tuberculosis patient and the selected variables (socio-demographic characteristics, clinical profile and illness experience). Methods Descriptive Cross Sectional study was done among sixty tuberculosis patients. Stratified random sampling was used to select the main center and sub center of Tuberculosis treatment and population proportionate simple random sampling using lottery method was done. Data was collected using predesigned, pretested performa from Explanatory Model Interview Catalogue developed by World Health Organization. Results The study revealed that 63.3% of the subjects were stigmatized. There was association between stigma and variables such as occupation, monthly family income and past history of Tuberculosis. There was also association of stigma with treatment phase, category of the patient and past outcome of illness. Conclusion Due to lack of knowledge and awareness about Tuberculosis, many patients were stigmatized. Efforts should be made to educate the public about Tuberculosis to reduce stigma experienced by Tuberculosis patients and improve the compliance of the patient. KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 48-52 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6914
Adenomyosis at Hysterectomy: Prevalence, Patient Characteristics, Clinical Profile and Histopatholgical Findings
Authors: Shrestha A , Shrestha R , Sedhai LB , Pandit U
Published: October 2012

Background Underlying adenomyosis is often the cause of treatment failure for patients undergoing medical therapy for abnormal uterine bleeding and or chronic pelvic pain. Given the limitation of ultrasonography in diagnosing adenomyosis and MRI being unaffordable to most of the patients belonging to developing countries like us, it often remains undiagnosed before a hysterectomy. Objective To find out the clinical profile associated with adenomyosis and to determine the prevalence of adenomyosis in hysterectomy specimens; frequency distribution, as well as to correlate clinical examination with histopathological examination. Methods A total of 60 women who had undergone hysterectomy with histopathologically proven adenomyosis between April 2009 and March 2010 were included . Data were collected on indication for the intervention, age, symptoms, clinical findings, hemoglobin, menopausal status, gross and histopathological findings. Results A total of 256 women were scheduled for hysterectomy. Adenomyosis was diagnosed in 60 of 256 cases (23.4%). Menorrhagia (91.2%), dysmenorrhoea (84.2%), lower abdominal pain (84.2%) beginning later in reproductive life (mean age- 45yrs) is the classic presentation. Adenomyosis was present in 10 of 61 patients (16.3%) with fibroids; 27 of 60 (45%) with abnormal uterine bleeding; 11 of 55 (20%) with prolapse; four of 35 (11.4%) with ovarian mass; five of 25 (20%) with chronic pelvic pain; three of four (75%) with endometriosis. Conclusion Women undergoing hysterectomy with diagnosis of adenomyosis have a distinct symptomatology. The choice of therapy in adenomyosis is hysterectomy for those women who have completed family and had failed medical therapy . KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 53-56 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6915
Comparative Analysis Between Objective Structured Clinical Examination (OSCE) and Conventional Examination (CE) As a Formative Evaluation Tool in Pediatrics in Semester Examination for Final MBBS Students
Authors: Mondal R , Sarkar S , Nandi M , Hazra A
Published: October 2012

Background The use of objective structured clinical examination in pediatrics is not common in undergraduate evaluation process. Objective To evaluate the effectiveness of objective structured clinical examination as compare to conventional examination as formative assessment tool in Pediatrics. Methods We conducted a cross sectional comparative study in defined population of 9th semester MBBS students to evaluate the effectiveness of objective structured clinical examination as comparison to conventional examination as formative assessment tool in Pediatrics. We analyzed the perception of objective structured clinical examination among the students. Results Fifty-two students appeared for the objective structured clinical examination evaluation on the first day and 42 turned up for conventional examination on the next day. The 42 students who turned up for both examinations were asked to respond to the perception evaluation questionnaire. Comparison of the two examination styles showed that students fared better in objective structured clinical examination than in conventional examination both with respect to mean total score (p < 0.001) as well as mean percentage score. Out of the 42 subjects who appeared in both examinations, all passed in objective structured clinical examination and 35 passed in conventional examination – this difference was significant by McNemar’s chi-square test (p = 0.016). 73.8% of the students opined in favor of objective structured clinical examination as a better formative assessment tool whereas 9.5% students preferred conventional examination. Conclusions Objective structured clinical examination a statistically significant better evaluation tool with comparison to conventional examination. KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 62-65 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6917
Incremental Change, Transition or Transformation? Optimising Change Pathways for Climate Adaptation in Spatial Planning
Authors: Roggema Rob , Vermeend Tim , Dobbelsteen Andy
Published: October 2012

In order to incorporate climate adaptation in spatial planning change is required, because climate change impacts the way we live. This implies that spatial planning, as the arranger of the spatial organisation and layout needs to be able to support this change. Current spatial planning is not yet well equipped to play this role. In this research article three possible routes to navigate change are explored. Incremental change is seen as a slow process, which modifies the landscape only slightly. Transition is seen as a fluent change towards a new future, which is an improved version of the existing; and transformation is seen as a change towards a future that is fundamentally different from the existing. The three pathways are compared and it is concluded that transformational change offers the best perspective in dealing with uncertain, unexpected and unprecedented futures, such as developing in times of climate change. Therefore, transformation is theoretically further elaborated and it is found that a transformational change to a new system already starts at a time when the existing system still fully operates. The change to a new system (called B in this article) therefore already started and the predecessors of B already existed. These ‘B-minuses’ of the new system can be found through network analysis, where the most intense and connective nodes are the most likely ‘B-minuses’. Alternatively B-minuses can be created through locating the areas where key-nodes and existing infrastructure can be related to existing urban functions. As illustrated in the case-study design, these principles are able to guide the design of a climate proof landscape.
Determinants of Peritoneal Dialysis Technique Failure in Incident us Patients
Authors: Shen Jenny I. , Mitani Aya A. , Saxena Anjali B. , Goldstein Benjamin A. , Winkelmayer Wolfgang C.
Published: October 2012

Objectives

Switching from peritoneal dialysis (PD) to hemodialysis (HD) is undesirable, because of complications from temporary vascular access, disruption of daily routine, and higher costs. Little is known about the role that social factors play in technique failure.

Design, Setting, Participants, Measurements

We followed for 3 years a nationally representative cohort of US patients who initiated PD in 1996 – 1997. Technique failure was defined as any switch from PD to HD for 30 days or more. We used Cox regression to examine associations between technique failure and demographic, medical, social, and pre-dialysis factors. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs).

Results

We identified an inception cohort of 1587 patients undergoing PD. In multivariate analysis, female sex (HR: 0.78; 95% CI: 0.64 to 0.95) was associated with lower rates of technique failure, and black race [compared with white race (HR: 1.48; 95% CI: 1.20 to 1.82)] and receiving Medicaid (HR: 1.48; 95% CI: 1.17 to 1.86) were associated with higher rates. Compared with patients who worked full-time, those who were retired (HR: 1.49; 95% CI: 1.07 to 2.08) or disabled (HR: 1.38; 95% CI: 1.01 to 1.88) had higher rates of failure. Patients with a systolic blood pressure of 140 – 160 mmHg had a higher rate of failure than did those with a pressure of 120 – 140 mmHg (HR: 1.24; 95% CI: 1.00 to 1.52). Earlier referral to a nephrologist (>3 months before dialysis initiation) and the primary decision-maker for the dialysis modality (physician vs patient vs shared) were not associated with technique failure.

Conclusions

This study confirms that several socio-demographic factors are associated with technique failure, emphasizing the potential importance of social and financial support in maintaining PD.
22-Oxacalcitriol Prevents Progression of Peritoneal Fibrosis in a Mouse Model
Authors: Hirose Misaki , Nishino Tomoya , Obata Yoko , Nakazawa Masayuki , Nakazawa Yuka , Furusu Akira , Abe Katsushige , Miyazaki Masanobu , Koji Takehiko , Kohno Shigeru
Published: October 2012

Objective

Vitamin D plays an important role in calcium homeostasis and is used to treat secondary hyperparathyroidism among dialysis patients. The biologic activity of vitamin D and its analogs is mediated by vitamin D receptor (VDR), which is distributed widely throughout the body. Recent papers have revealed that low vitamin D levels are correlated with severe fibrosis in chronic diseases, including cystic fibrosis and hepatitis. The aim of the present study was to evaluate the protective effects of vitamin D against the progression of peritoneal fibrosis.

Methods

Peritoneal fibrosis was induced by injection of chlorhexidine gluconate (CG) into the peritoneal cavity of mice every other day for 3 weeks. An analog of vitamin D, 22-oxacalcitriol (OCT), was administered subcutaneously daily from initiation of the CG injections. The peritoneal tissue was excised at 3 weeks. Changes in morphology were assessed by hematoxylin and eosin staining. Expression of VDR, alpha smooth muscle actin (as a marker of myofibroblasts), type III collagen, transforming growth factor β (TGF-β), phosphorylated Smad2/3, F4/80 (as a marker of macrophages), and monocyte chemoattractant protein-1 (MCP-1) was examined by immunohistochemistry. Southwestern histochemistry was used to detect activated nuclear factor κB (NF-κB).

Results

In the CG-injected mice, immunohistochemical analysis revealed expression of VDR in mesothelial cells, myofibroblasts, and macrophages in the thickened submesothelial zone. Treatment with OCT significantly prevented peritoneal fibrosis and reduced the accumulation of type III collagen in CG-treated mice. Among the markers of fibrosis, the numbers of myofibroblasts, cells positive for TGF-β, and cells positive for phosphorylated Smad2/3 were significantly decreased in the OCT-treated group compared with the vehicle-treated group. Furthermore, OCT suppressed inflammatory mediators of fibrosis, as shown by the reduced numbers of activated NF-κB cells, macrophages, and MCP-1-expressing cells.

Conclusions

Our results indicate that OCT attenuates peritoneal fibrosis, an effect accompanied by reduced numbers of myofibroblasts, infiltrating macrophages, and TGF-β–positive cells, suggesting that vitamin D has potential as a novel therapeutic agent for preventing peritoneal sclerosis.
Campylobacter Peritonitis Complicating Peritoneal Dialysis: A Review of 12 Consecutive Cases
Authors: Ma Terry King-wing , Lee Kin Ping , Chow Kai Ming , Pang Wing Fai , Kwan Bonnie Ching Ha , Leung Chi Bon , Szeto Cheuk Chun , Li Philip Kam-tao
Published: October 2012

Background

Peritoneal dialysis–associated peritonitis secondary to Campylobacter organisms is uncommon. Few studies have assessed either treatment or clinical outcomes.

Methods

We reviewed all Campylobacter peritonitis episodes occurring in a single dialysis unit from 1994 to 2011.

Results

During the study period, 12 episodes of Campylobacter peritonitis (0.45% of all peritonitis episodes) were recorded. Diarrhea was uncommon (8.3%). The overall primary response rate was 91.7%; the complete cure rate was 75.0%. Among 6 patients who failed to respond to standard antibiotics by day 5, all improved after administration of an oral macrolide (erythromycin or clarithromycin). Of those 6 patients, 5 experienced a complete cure, and 1 patient experienced relapse of culture-negative peritonitis. No patient required Tenckhoff catheter removal or temporary hemodialysis support. The 30-day mortality was 0%.

Conclusions

Campylobacter peritonitis might not respond to first-line conventional antibiotics, and an oral macrolide is recommended if Campylobacter is confirmed. The findings from our analysis do not support the use of fluoroquinolone, which is associated with a high resistance rate.
To Tell or Not to Tell: Shared Decision Making, CAM Use and Disclosure among Underserved Patients with Rheumatic Diseases
Authors: Wallen Gwenyth R. , Brooks Alyssa T.
Published: October 2012

The purpose of this analysis was to assess the impact of perceived shared decision-making (SDM) on complementary and alternative medicine (CAM) use and disclosure in a sample of urban, underserved minority patients (n = 109) with rheumatic diseases. Nearly three quarters of the patients (71.6%) reported CAM use. Of these, 59% disclosed CAM use to their provider. Logistic regression models were created. In model 1 SDM significantly predicted CAM use; however, the overall model fit was not significant. In model 2, gender, ethnicity, and SDM predicted CAM disclosure with 73.2% correctly classified. Females were more likely and Hispanics were less likely to disclose CAM use. Those with higher SDM scores were more likely to disclose CAM use. SDM played a role in whether patients used CAM and disclosed CAM use to their providers. Improving SDM strategies may be especially important among patients who are least likely to disclose CAM use.
Infinitely Many Solutions for the Prescribed Boundary Mean Curvature Problem in 𝔹N
Authors: Wang Liping , Zhao Chunyi
Published: October 2012

We consider the prescribed boundary mean curvature problem in 𝔹N with the Euclidean metric

where ã(x) is positive and rotationally symmetric on We show that if K∽(x) has a local maximum point, then this problemhas infinitely many positive solutions that are not rotationally symmetric on 𝕊N−1.
Biotechnology in Brazil: An Industry Overview
Authors: Zylberberg Ezequiel , Zylberberg Claudia , Oner Asli Ceylan
Published: October 2012

Recently becoming the sixth largest economy in the world, Brazil has relied, in large part, on its comparative advantages of resource extraction and agriculture. Sustained long-term growth will require Brazil moves into higher value industries that build of off its comparative advantage. Biotechnology has surfaced as a sector of strategic importance, and government involvement in finance, education and research and development has created an industry on the cusp of global significance. By examining sources of finance, human capital accumulation, research and development, intellectual property rights and supporting institutions, we seek to provide a broad overview of Brazilâ€™s nascent biotechnology sector. Spotlights of the agriculture, human health and reagent industries as well as an analysis of the Minas Gerais biotechnology cluster flesh out biotechnologyâ€™s place in Brazilâ€™s economy. An antiquated intellectual property rights regime, an insufficient number of qualified researchers and dearth of venture capital firms and private sources of finance are key bottlenecks that must be addressed in order to promote industry growth and consolidation.
Globalization, Evolution and Emergence of Direct-to-Consumer Advertising: Are Emerging Markets the Next Pharmaceutical Marketing Frontier?
Authors: Mackey Timothy Ken
Published: October 2012

Pharmaceutical marketing has rapidly evolved over the past century and has now entered the digital revolution.Â  This is exemplified by the rise of direct-to-consumer-advertising (â€œDTCAâ€), which has traditionally been only allowed in the United States and New Zealand in developed countries, but is now expanding in reach to other jurisdictions.Â  Enabling the â€œglobalizationâ€ of pharmaceutical DTCA is Internet-related technologies that are not limited to geographical borders and are highly unregulated.Â  This DTCA digital â€œspilloverâ€ into markets that prohibit it can have adverse impact on health outcomes and health-related spending. Â Emerging markets may represent the next logically step for digital DTCA proliferation, given their untapped market potential and explosive growth.Â  Further research and global health policy reform is necessary to address this â€œemergingâ€ global health issue.
Emerging Markets and Differential Pricing Policies: A Question of Global Health?
Authors: Class James
Published: October 2012

Over the past decades, global health has moved from discrete disease campaigns to major developmental strategies. However, medication affordability remains an important, unsolved challenge for industry and the global community. This effort requires coordinated actions by multiple stakeholders. Industry can play a specific role through responsible, differentiated pricing of medicines. Public policies should incentivize such pricing policies rather than discouraging them by external reference pricing or parallel trade. Providing opportunities for industry to invest in emerging markets sustainably, patients will benefit from greater access and support attainment of the UN Millennium Development Goals.
Ranch Apocalypse: A Pataphysical Inquiry into the Mount Carmel Siege
Authors: Granden Michelle
Published: October 2012

A total of 84 people were killed in the 1993 Bureau of Alcohol, Tobacco, and Firearms (ATF) raid on Mount Carmel in Waco, Texas. Debates continue about who was responsible—e.g., was it a government conspiracy or cultist militants intent on mass suicide? What hasn’t been fully considered, however, is the role the guns, tanks, toxic gases, and other “theater of war” accoutrements themselves played in the siege and resultant deadly inferno. Traditional metaphysical inquiries rest on the presupposition that the subject is separate from and sovereign over the object it examines. But as we have entered this intensely visual consumer culture, differences between subject and object disappear and the power of the subject collapses. Employing the postmodern metaphysics—here and elsewhere called “pataphysics”—of Jean Baudrillard to investigate this tragic battle, the author will argue that the ATF and the FBI were seduced by the compound’s castle and arsenal as well as their own. The helicopters, snipers, tanks, and CS gas turned what had begun on February 28, 1993, as a raid to serve a search warrant into a full scale military-style attack on a fortress and its peoples. Could it be that the federal agents became and were subordinate to the tools they were using?
Foreword: Proceedings of the 32nd International Conference
Authors: Smith Jane McKee , Lynett Patrick J.
Published: October 2012

This Proceedings contains 360 papers and 15 posters presented at the 32nd International Conference on Coastal Engineering, which was held in Shanghai, China, 30 June to 5 July 2010. The Proceedings is divided into seven parts: Keynote; Waves; Swash, Nearshore Currents, and Long Waves; Sediment Transport and Morphology; Coastal Structures; Coastal Management, Environment, and Risk, and Posters. The individual papers cover a broad range of topics including theory, numerical and physical modeling, field measurements, case studies, design, and management. These papers provide engineers, scientists, and planners state-of-the-art information on coastal engineering and coastal processes.
COMPARISON OF STORM SURGE DISASTERS IN ASIA
Authors: Shibayama Tomoya
Published: October 2012

Field surveys were performed in the southwest of Bangladesh after cyclone Sidr in 2007 and in Yangon River Basin after Cyclone Nargis in Myanmar in 2008 in order to learn lessons out of severe disasters due to cyclones. Spatial distributions of inundation heights were measured around the most damaged areas. Both Bangladesh and Myanmar were severely damaged, but the preparedness against storm surge and the experiences were different. The resultant total losses in these two countries were significantly different. In Bangladesh, many people witnessed that storm surges inundated with bore-like waves. Counter measured against storm surges should account for the physical mechanisms for the development of such bore-like waves and possible damages due to such waves. Embankment showed significant roles to minimize the damage. Development of riverbanks especially around the river mouth is one of most essential counter-measures to be carried out in Bangladesh. Shelter functioned well to save significant number of lives in Bangladesh. But in Myanmar, there were few experiences on storm surge and no countermeasures such as shelters. These differences results the difference of losses. They were 4,232 including deaths and unknowns in Bangladesh but 138,373 in Myanmar.
THYBORØN HARBOUR - STUDY OF WAVE AGITATION AND SEDIMENTATION
Authors: Niemann Sanne , Sloth Peter , Buhl J¸rgen , Deigaard Rolf , Br¸ker Ida
Published: October 2012

Thyborøn Harbour, one of Denmark's busiest fishing ports, has during the recent years experienced increasing challenges by high waves and by sedimentation in the approach to and at the harbour. The causes for these phenomena were far from obvious, and an extensive study was initiated to identify the causes and find possible solutions. The methodology and the results are described in this paper.
CAUSES OF BACK-SILTATION IN THE NORTH PASSAGE OF YANGTZE ESTUARY AND EVALUATION OF THE ENGINEERING MEASURES
Authors: Fan Qijin
Published: October 2012

This study focused on the fact that the amount of back-siltation in the deep waterway of North Passage has been increased and converged in the middle reach since 2005. This paper systematically analyzed impacts resulting from the change of various factors such as sediment and hydrodynamics conditions, pointed out the major reason resulting in the increase on the amount of back-siltation in the middle reach, and discussed engineering measurements to reduce the siltation. The engineering effects of the measures were evaluated after the constructions as well.
HOW TO DECIDE WHEN TO ADAPT COASTAL PROTECTION TO CLIMATE CHANGE
Authors: Soernesen Per , Jensen John , Klagenberg Peter
Published: October 2012

This paper presents 2 objectives ways to decide when and how to adapt coastal protection to climate change. These two are risk analysis based on the EU-Flooding directive and the other is a socioeconomically analysis based on the Danish Ministry of Transports manual.
MORPHOLOGICAL RESPONSE TO THE DEEP WATERWAY PROJECT AROUND THE CHANGJIANG ESTUARY, CHINA
Authors: Pan Lingzhi , Ding Pingxing , Ge Jianzhong
Published: October 2012

Changjiang Estuary is characterized by complex branches and outlets (North Branch, North Channel, North Passage and South Passage). The relatively shallow bathymetry around the mouth limits the navigational potentials (Fig.1). The Deep Waterway Project (DWP) was carried out in the North Passage of South Channel for the purpose of deepening the navigational channel from 7.0m in July 1998 to 8.5m in July 2001 (Phase I), 10.0m in May 2005 (Phase II) and 12.5m in May 2010 (Liu et al. 2004). In addition to dredging, two dykes were constructed to reduce the sediment transport from Jiuduansha and Hengsha Shoals into North Passage. A set of groins was built with connection to dykes for the purpose of strengthening the currents in the middle of channel, which helps the maintenance of the navigational capability.

The construction has significantly changed the local bathymetry in the Changjiang Estuary and within the channel. The high-resolution bathymetry measurements were made over seasons. An evolution trend of the morphological change is revealed, which is discussed in this paper.