bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic asymptomatic pyuria precedes overt urinary tract infection and deterioration of renal function in autosomal dominant polycystic kidney disease
Authors: Hwang Jin Ho , Park Hayne Cho , Jeong Jong Cheol , ha Baek Seon , Han Mi Yeun , Bang Kitae , Cho Jeong Yeon , Yu Suk Hee , Yang Jaeseok , Oh Kook-Hwan , Hwang Young-Hwan , Ahn Curie
Published: January 2013

Background

Urinary tract infection (UTI) occurs in 30%-50% of individuals with autosomal dominant polycystic kidney disease (ADPKD). However, the clinical relevance of asymptomatic pyuria in ADPKD patients remains unknown.

Methods

We retrospectively reviewed medical records of 256 ADPKD patients who registered to the ADPKD clinic at Seoul National University Hospital from Aug 1999 to Aug 2010. We defined the asymptomatic pyuria as more than 5-9 white blood cells in high-power field with no related symptoms or signs of overt UTI. Patients were categorized into 2 groups depending on its duration and frequency: Group A included non-pyuria and transient pyuria patients; Group B included recurrent and persistent pyuria patients. The association between asymptomatic pyuria and both the development of overt UTI and the deterioration of renal function were examined.

Results

With a mean follow-up duration of 65.3 months, 176 (68.8%) out of 256 patients experienced 681 episodes of asymptomatic pyuria and 50 episodes of UTI. The annual incidence of asymptomatic pyuria was 0.492 episodes/patient/year. The patients in group B showed female predominance (58.5% vs. 42.0%, P=0.01) and experienced an upper UTI more frequently (hazard ratio: 4.612, 95% confidence interval: 1.735-12.258; P=0.002, adjusted for gender and hypertension). The annual change in estimated glomerular filtration rate (ΔeGFR) was significantly larger in magnitude in group B than in group A (-2.7±4.56 vs. -1.17±5.8, respectively; P=0.01). Age and Group B found to be the independent variables for ΔeGFR and developing end-stage renal disease (16.0% vs. 4.3%, respectively; P=0.001).

Conclusions

Chronic asymptomatic pyuria may increase the risk of developing overt UTI and may contribute to declining renal function in ADPKD.
Physiological correlates of ecological divergence along an urbanization gradient: differential tolerance to ammonia among molecular forms of the malaria mosquito Anopheles gambiae
Authors: Tene Fossog Billy , Antonio-Nkondjio Christophe , Kengne Pierre , Njiokou Flobert , Besansky Nora J , Costantini Carlo
Published: January 2013

Background

Limitations in the ability of organisms to tolerate environmental stressors affect their fundamental ecological niche and constrain their distribution to specific habitats. Evolution of tolerance, therefore, can engender ecological niche dynamics. Forest populations of the afro-tropical malaria mosquito Anopheles gambiae have been shown to adapt to historically unsuitable larval habitats polluted with decaying organic matter that are found in densely populated urban agglomerates of Cameroon. This process has resulted in niche expansion from rural to urban environments that is associated with cryptic speciation and ecological divergence of two evolutionarily significant units within this taxon, the molecular forms M and S, among which reproductive isolation is significant but still incomplete. Habitat segregation between the two forms results in a mosaic distribution of clinally parapatric patches, with the M form predominating in the centre of urban agglomerates and the S form in the surrounding rural localities. We hypothesized that development of tolerance to nitrogenous pollutants derived from the decomposition of organic matter, among which ammonia is the most toxic to aquatic organisms, may affect this pattern of distribution and process of niche expansion by the M form.

Results

Acute toxicity bioassays indicated that populations of the two molecular forms occurring at the extremes of an urbanization gradient in Yaounde, the capital of Cameroon, differed in their response to ammonia. The regression lines best describing the dose-mortality profile differed in the scale of the explanatory variable (ammonia concentration log-transformed for the S form and linear for the M form), and in slope (steeper for the S form and shallower for the M form). These features reflected differences in the frequency distribution of individual tolerance thresholds in the two populations as assessed by probit analysis, with the M form exhibiting a greater mean and variance compared to the S form.

Conclusions

In agreement with expectations based on the pattern of habitat partitioning and exposure to ammonia in larval habitats in Yaounde, the M form showed greater tolerance to ammonia compared to the S form. This trait may be part of the physiological machinery allowing forest populations of the M form to colonize polluted larval habitats, which is at the heart of its niche expansion in densely populated human settlements in Cameroon.
Effects of guidelines on adeno-tonsillar surgery on the clinical behaviour of otorhinolaryngologists in Italy
Authors: Motta Giovanni , Motta Sergio , Cassano Pasquale , Conticello Salvatore , Ferretti Massimo , Galletti Bruno , Garozzo Aldo , Larotonda Gennaro , Mansi Nicola , Mevio Emilio , Motta Gaetano , Quaremba Giuseppe , Serra Agostino , Tarantino Vincenzo , Tavormina Paolo , Vicini Claudio , Vigili Giovanni Maurizio , Testa Domenico
Published: January 2013

Background

Several guidelines on adeno-tonsillar disease have been proposed in recent years and some discrepancies in relation both to clinical manifestations and indications for surgical treatment have emerged. The aim of the study was to verify what influence (adeno)-tonsillectomy guidelines have had on the clinical behaviour of ENT specialists in Italy. Our study is a retrospective and multi-centre case series with chart review.

Methods

The survey involved 14,770 children, aged between the ages of 2 and 11, who had undergone adeno-tonsillar surgery between 2002 and 2008 in fourteen Italian tertiary and secondary referral centres. Anova test was used for the statistical analysis, assuming p < 0.05 as the minimum statistical significance value.

Results

The frequency of adeno-tonsillar surgeries did not change significantly (p>0.05) during the study period and following the Italian policy document publication. Overall, adeno-tonsillectomy was the most frequent intervention (64.1%), followed by adenoidectomy (31.1%) and tonsillectomy (4.8%). The indications for surgery did not change significantly for each of the operations (p>0.05), with the exception of adeno-tonsillectomy in case of feverish episodes due to acute recurrent tonsillitis ≥ 5 without nasal obstruction (decreased p= 0.010) , even when the feverish episodes due to acute recurrent tonsillitis were < 5 over the last year. Nasal obstruction was associated with feverish episodes due to acute recurrent tonsillitis in 65.2% of operated cases, while otitis media had been diagnosed in 43.3% of the patients studied.

Conclusions

The recommendations first developed in Italy in a 2003 policy document and then resumed in guidelines in 2008, were not implemented by ENT units involved in the survey. The study highlights the fact that the indications for adeno-tonsillar operations are based on the overall clinical presentation (comorbidity) rather than on a single symptom. Guidelines are necessary to give coherent recommendations based on both the findings obtained through randomized controlled trials and the data collected from observational studies.
Diagnostic performance of CareStart™ malaria HRP2/pLDH (Pf/pan) combo test versus standard microscopy on falciparum and vivax malaria between China-Myanmar endemic borders
Authors: Xiaodong Sun , Tambo Ernest , Chun Wei , Zhibin Cheng , Yan Deng , Jian Wang , Jiazhi Wang , Xiaonong Zhou
Published: January 2013

Background

Rapid diagnostic test (RDT) is becoming an alternative way of establishing quickly the diagnosis of malaria infections, by detecting specific malaria antigens in suspected patients’ blood between the China-Myanmar endemic borders areas, towards achieving the National Malaria Elimination programme by 2020. The objective of this study is to evaluate the performance of CareStart™ Malaria Pf/Pan RDT kit for the diagnosis of malaria infections in suspected patients. Blood examination by microscopy was taken as gold standard to evaluate CareStart™ kit’s sensitivity, specificity and predictive value and corrected with PCR assay.

Results

Overall 126 of 241 (52.28%) malaria cases were detected by microscopy compared to 115 of 241(47.72%) CareStart™ kit and 128 of 241 (53.11%) PCR corrected assay. CareStart™ kit’s sensitivity and specificity for the diagnosis of malaria were 89.68% and 98.26% respectively, compared to standard microscopy, whereas the sensitivity and specificity for falciparum malaria were 88.52% and 98.26%, and for vivax malaria: 90.77% and 100%. The CareStart™ positive predictive values were 98.26% (93.88-99.52%, 95% CI) compared to 100% (96.77-100%, 95% CI) for PCR-corrected, and the negative predictive values of 89.68% (83.15-93.87%, 95% CI) were the same in microscopy as PCR-corrected. The diagnostic accuracy of CareStart™ kit versus microscopy and PCR were 93.78% (89.99-96.19%, 95% CI) and 94.61% (90.99-96.82%, 95% CI) respectively. The likelihood of diagnostic of malaria positive was almost similar between microscopy and CareStart™ kit, with an entropy reduction of 60.0% compared to a weak likelihood of misdiagnosis of 0.10 (0.09-0.12, 95% CI), with an entropy reduction of 36.01%.

Conclusion

The accuracy of CareStart™ kit is comparable to gold standard microscopy in these areas, it is easy to perform and suitable for cross-border diagnosis and monitoring of local or imported malaria patterns by any local health staff in endemic remotes.
NOD-scid IL2R γnull mice engrafted with human peripheral blood mononuclear cells as a model to test therapeutics targeting human signaling pathways
Authors: Zadeh-Khorasani Maryam , Nolte Thomas , Mueller Thomas D , Pechlivanis Markos , Rueff Franziska , Wollenberg Andreas , Fricker Gert , Wolf Eckhard , Siebeck Matthias , Gropp Roswitha
Published: January 2013

Background

Animal models of human inflammatory diseases have limited predictive quality for human clinical trials for various reasons including species specific activation mechanisms and the immunological background of the animals which markedly differs from the genetically heterogeneous and often aged patient population.

Objective

Development of an animal model allowing for testing therapeutics targeting pathways involved in the development of Atopic Dermatitis (AD) with better translatability to the patient.

Methods

NOD-scid IL2R γnull mice engrafted with human peripheral blood mononuclear cells (hPBMC) derived from patients suffering from AD and healthy volunteers were treated with IL-4 and the antagonistic IL-4 variant R121/Y124D (Pitrakinra). Levels of human (h)IgE, amount of B-, T- and plasma- cells and ratio of CD4 : CD8 positive cells served as read out for induction and inhibition of cell proliferation and hIgE secretion. Results were compared to in vitro analysis.

Results

hIgE secretion was induced by IL-4 and inhibited by the IL-4 antagonist Pitrakinra in vivo when formulated with methylcellulose. B-cells proliferated in response to IL-4 in vivo; the effect was abrogated by Pitrakinra. IL-4 shifted CD4 : CD8 ratios in vitro and in vivo when hPBMC derived from healthy volunteers were used. Pitrakinra reversed the effect. Human PBMC derived from patients with AD remained inert and engrafted mice reflected the individual responses observed in vitro.

Conclusion

NOD-scid IL2R γnull mice engrafted with human PBMC reflect the immunological history of the donors and provide a complementary tool to in vitro studies. Thus, studies in this model might provide data with better translatability from bench to bedside.
N-terminal Slit2 inhibits HIV-1 replication by regulating the actin cytoskeleton
Authors: Anand Appakkudal R , Zhao Helong , Nagaraja Tirumuru , Robinson Lisa A , Ganju Ramesh K
Published: January 2013

Background

Slit2 is a ~ 200 kDa secreted glycoprotein that has been recently shown to regulate immune functions. However, not much is known about its role in HIV (human immunodeficiency virus)-1 pathogenesis.

Results

In the present study, we have shown that the N-terminal fragment of Slit2 (Slit2N) (~120 kDa) inhibits replication of both CXCR4 and CCR5-tropic HIV-1 viruses in T-cell lines and peripheral blood T-cells. Furthermore, we demonstrated inhibition of HIV-1 infection in resting CD4+ T-cells. In addition, we showed that Slit2N blocks cell-to-cell transmission of HIV-1. We have shown that Slit2N inhibits HIV-1 infection by blocking viral entry into T-cells. We also ruled out Slit2N-mediated inhibition of various other steps in the life cycle including binding, integration and viral transcription. Elucidation of the molecular mechanism revealed that Slit2N mediates its functional effects by binding to Robo1 receptor. Furthermore, we found that Slit2N inhibited Gp120-induced Robo1-actin association suggesting that Slit2N may inhibit cytoskeletal rearrangements facilitating HIV-1 entry. Studies into the mechanism of inhibition of HIV-1 revealed that Slit2N abrogated HIV-1 envelope-induced actin cytoskeletal dynamics in both T-cell lines and primary T-cells. We further showed that Slit2N specifically attenuated the HIV-1 envelope-induced signaling pathway consisting of Rac1, LIMK and cofilin that regulates actin polymerization.

Conclusions

Taken together, our results show that Slit2N inhibits HIV-1 replication through novel mechanisms involving modulation of cytoskeletal dynamics. Our study, thus, provides insights into the role of Slit2N in HIV-1 infection and underscores its potential in limiting viral replication in T-cells.
Chronic HBV infection among pregnant women and their infants in Shenyang, China
Authors: Ding Yang , Sheng Qiuju , Ma Li , Dou Xiaoguang
Published: January 2013

Background

The main transmission route of the hepatitis B virus (HBV) is mother to child transmission and contributes significantly to chronic HBV infection. Even though immunoprophylaxis with hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine is administrated to neonates whose mothers are hepatitis B surface antigen (HBsAg) positive, about 10% of the neonates suffer from HBV infection in their early life.

Objectives

To survey chronic HBV infection among pregnant women and their infants and analyze the reason for immunoprophylaxis failure.

Methods

Serum HBsAg was tested in all pregnant women. HBVDNA and other serum HBV markers including hepatitis B e antigen (HBeAg), hepatitis B core antibody (anti-HBc) and hepatitis B surface antibody (anti-HBs) were tested among HBsAg positive pregnant women. All infants whose mothers were HBsAg positive were vaccinated with a standard immunoprophylaxis. Serum HBV markers and HBVDNA were tested among these infants at 7 months of age. HBV genotypes were analyzed among the infants and pregnant women who were HBVDNA positive.

Results

The prevalence of HBsAg, anti-HBc and anti-HBs among 4,536 pregnant women was 5.49%, 29.65% and 58.55%, respectively. The prevalence of HBsAg, anti-HBc and anti-HBs among pregnant women older than 20 years of age was significantly different compared to pregnant women younger than 20 years of age (4.54, 5.69 and 0.61 times, prevalence older vs. younger, respectively. P<0.05, 0.01, 0.05, respectively). Among 249 HBsAg positive pregnant women, 167 (67.07%) were HBeAg positive, 204 (81.93%) were HBVDNA positive and only 37 (14.86%) had HBVDNA >107 IU/ml. Among the infants whose mothers were HBsAg positive, 214 (85.94%) infants were anti-HBs positive. There were 12 (4.82%) infants who were HBsAg and HBVDNA positive, and all 12 of these infants mothers were HBeAg positive and had HBVDNA >107 IU/ml. Genotypes B and C were present among 165 pregnant women and genotype C was present in 85 pregnant women. There were 12 infants who were HBsAg positive and had the same HBV genotypes as their mothers. There was a significant difference in genotypes between the pregnant women whose infants were infected with HBV compared to those without HBV infection (P < 0.05).

Conclusions

There was a significant decline in HBsAg prevalence among pregnant women and their infants in Shenyang. Genotype C might be a risk factor for mother to child transmission of HBV.
Perioperative application of N-terminal pro-brain natriuretic peptide in patients undergoing cardiac surgery
Authors: Liu Hua , Wang Chunsheng , Liu Lan , Zhuang Yamin , Yang Xiaomei , Zhang Ying
Published: January 2013

Background

The purpose of the research was to find out the factors which influence plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, then to assess whether preoperative plasma NT-proBNP levels could predict postoperative outcomes of cardiac surgery.

Methods

Between November 2008 and February 2010,225 patients who underwent cardiac surgery in our department were included in the study. The mean age was 61.25 ± 12.54 years, and 156 (69.3%) patients were male. NT-proBNP, CK-MB, cTnT and creatinine levels were measured preoperatively and 24 hours after operation. Postoperatively outcomes including ventilation time, length of stay in ICU and hospital, and mortality were closely monitored. The endpoints includes: 1) use of inotropic agents or intra-aortic balloon pump ≥24 h; 2) creatinine level elevated to hemodialysis; 3) cardiac events; 4) ICU stay ≥5d; 5) ventilation dependence ≥ 72 h; 6) deaths within 30 days of surgery.

Results

NT-proBNP concentrations (median [interquartile range]) increased from 728.4 pg/ml (IQR 213.5 to 2551 pg/ml) preoperatively to 1940.5 pg/ml (IQR 995.9 to 3892 pg/ml) postoperatively (P = 0.015). Preoperative atrial fibrillation, NYHA class III/IV, ejection fraction, pulmonary arterial pressure, left ventricle end-diastolic diameter (LVEDD), preoperative plasma creatinine and cTnT levels were significantly associated with preoperative NT-proBNP levels in univariate analysis. The preoperative NT-proBNP was closely related to ventilation time (P = 0.009), length of stay in ICU (P = 0.004) and length of stay in hospital (P = 0.019). Receiver operating characteristic curves demonstrated a cut-off value above 2773.5 pg/ml was the best cutoff (sensitivity of 63.6% and specificity of 80.8%) to predict the mortality within 30d of surgery.

Conclusions

Preoperative plasma NT-proBNP level presents a high individual variability in patients undergoing cardiac surgery. NYHA classification, ejection fraction, pulmonary arterial pressure, LVEDD, atrial fibrillation, preoperative plasma creatinine, and cTnT levels are significantly associated with preoperative NT-proBNP levels. Preoperative NT-proBNP is a valuable marker in predicting postoperative outcomes.
Myostatin genetic inactivation inhibits myogenesis by muscle-derived stem cells in vitro but not when implanted in the mdx mouse muscle
Authors: Tsao James , Vernet Dolores A , Gelfand Robert , Kovanecz Istvan , Nolazco Gaby , Bruhn Kevin W , Gonzalez-Cadavid Nestor F
Published: January 2013

Introduction

Stimulating the commitment of implanted dystrophin+ muscle-derived stem cells (MDSCs) into myogenic, as opposed to lipofibrogenic lineages, is a promising therapeutic strategy for Duchenne muscular dystrophy (DMD).

Methods

To examine whether counteracting myostatin, a negative regulator of muscle mass and a pro-lipofibrotic factor, would help this process, we compared the in vitro myogenic and fibrogenic capacity of MDSCs from wild-type (WT) and myostatin knockout (Mst KO) mice under various modulators, the expression of key stem cell and myogenic genes, and the capacity of these MDSCs to repair the injured gastrocnemius in aged dystrophic mdx mice with exacerbated lipofibrosis.

Results

Surprisingly, the potent in vitro myotube formation by WT MDSCs was refractory to modulators of myostatin expression or activity, and the Mst KO MDSCs failed to form myotubes under various conditions, despite both MDSC expressing Oct 4 and various stem cell genes and differentiating into nonmyogenic lineages. The genetic inactivation of myostatin in MDSCs was associated with silencing of critical genes for early myogenesis (Actc1, Acta1, and MyoD). WT MDSCs implanted into the injured gastrocnemius of aged mdx mice significantly improved myofiber repair and reduced fat deposition and, to a lesser extent, fibrosis. In contrast to their in vitro behavior, Mst KO MDSCs in vivo also significantly improved myofiber repair, but had few effects on lipofibrotic degeneration.

Conclusions

Although WT MDSCs are very myogenic in culture and stimulate muscle repair after injury in the aged mdx mouse, myostatin genetic inactivation blocks myotube formation in vitro, but the myogenic capacity is recovered in vivo under the influence of the myostatin+ host-tissue environment, presumably by reactivation of key genes originally silenced in the Mst KO MDSCs.
Medieval Rhetoric and the Commedia
Authors: Bolduc Michelle
Published: January 2013

Survey courses on the history of rhetoric, especially as taught in American universities, often concentrate on classical and modern rhetoric, neglecting the way in which rhetoric was understood during the Middle Ages. This essay offers the teacher of the history of rhetoric a pedagogical answer to the question of how to incorporate medieval rhetoric within courses on the history of rhetoric, by providing a close reading of three symmetrical cantos of Dante’s Commedia that are specifically concerned with the ethics of persuasive discourse.
Suffering in Hell
Authors: Alcorn John
Published: January 2013

This article applies several concepts from psychology to the interpretation of Dante Alighieri’s literary masterpiece Inferno and describes elements of pedagogy for this kind of interdisciplinary approach. A premise is that sinners in Hell experience emotional suffering. Core psychological concepts are outlined. A methodological distinction is drawn between “what is said” and “what is shown” in Dante’s text. Aspects of the psychologies of the glutton Ciacco, the blasphemer Capaneus, and the sinful lover Francesca are analyzed. Three broad patterns of emotional experience are identified. (1) Each class of sinners suffers its own peculiar complex of negative emotions. The article provides close analysis of one such local complex, the emotions that the pusillanimous suffer at the edge of Hell. (2) Sinners do not suffer remorse. The article discusses a paradoxical implication of remorselessness. (3) Damned souls engage in resistance against an imperative to despair. The article also identifies a tension between infernal justice and human psychology. It concludes with brief discussion of how literature, history, and psychology are complementary resources.
The Triple Cord
Authors: Stavreva Kirilka
Published: January 2013

The essay describes a pedagogical approach to the rich poetic ground of the Commedia through a sustained artistic effort on the part of the students. In daily class preparation, students craft small-book “reflectories” that combine analytical interpretation with artwork and Danteinspired poetry, whether the students’ own or authored by others. Joining a tradition of “conversations with Dante” that began, in English literature, with Chaucer, students develop creative abilities and attitudes through reflection upon and disciplined participation in the creative process. Course assignments and discussion methods foreground the mutually reinforcing integration of creativity and analytical precision.
Dante in the Italian Renaissance of Art
Authors: Safford Lisa Bixenstine
Published: January 2013

Much of Renaissance art reflects a Dantesque worldview. Addressed here is Dante’s link to early trecento art; to burgeoning pious art patronage resulting from Purgatorio’s salvific promise; to rising individualism resulting in growing civic identity, the cult of artistic fame, the art of portraiture, and biography as an early art historical methodology; and to an enduring fascination with antiquity, all made palatable and patriotic for later generations by glosses widely known in Commedia incunabula.
Virtual Cities
Authors: Hamilton Louis I.
Published: January 2013

This project employs a student-generated geographic database that links the Commedia to relevant passages from Dino Compagni’s Cronica and visual records at appropriate locations in Florence. The database records evidence for social structure, physical infrastructure, and historic events, as well as the civic/religious ritual of the city, in order to consider the broader meanings of the built environment. This database is displayed on satellite images of the city using the open-source SIMILE widget Exhibit. The student can then analyze this evidence and consider how Dante constructed his allegorical societies, infernal, purgative, and paradisiacal, from the life of his contemporary Florence. It is suggested that this permits more rapid immersion into the dynamic of the poem and enables more effectively focused student research.
Introducing Undergraduates to Books in the Age of Dante—in Twenty Minutes or Less
Authors: Conway Melissa
Published: January 2013

This article outlines a twenty-minute introduction to medieval manuscripts in the age of Dante, using a combination of Internet resources for the study of medieval manuscripts and actual medieval manuscripts. The goal of the lecture is to introduce students to the basics of manuscript production, focusing upon the kinds of manuscripts that played such a crucial role in Dante’s intellectual formation. By the end of the lecture, students should have a clear understanding of how laborious and costly book production was, as well as how scarce access to books was among laypersons in Dante’s lifetime. The larger goal is to give students an appreciation of Dante’s remarkable erudition, evident in the hundreds of biblical, mythological, literary, philosophical, and historical allusions in the Divine Comedy. The lecture ends with the distribution of a table of works to which Dante alludes in the Inferno, with links to digital copies of manuscripts available on several websites, including Digital Scriptorium, the British Library’s Catalogue of Illuminated Manuscripts, and the Catalogue of Digitized Medieval Manuscripts.
Teaching Literature Like a Foreign Language; Or, What I Learned When I Switched Departments
Authors: Mainland Catherine
Published: January 2013

In this article, the author explains the habits that she brought to teaching English from the field of second-language acquisition. She began teaching in the Department of Germanic Languages and Literatures at the University of North Carolina, Chapel Hill, where graduate teaching assistants were trained to use the communicative language teaching method, especially as it is developed by Lee and VanPatten in Making Communicative Language Teaching Happen (1995). When the author switched to teaching world literature survey courses in the Department of English at North Carolina State University, she found that many of the techniques she had used in beginner language courses applied beautifully to what she was trying to do in her new field. After briefly explaining the characteristics of communicative language teaching, this article highlights the three main strategies that she found most useful: minimizing “teacher talk” and maximizing the work the students do in the classroom, emphasizing the process of learning to encourage the students’ metacognitive thinking about their own education, and making negotiation a key activity to engage their critical thinking skills. As universities and colleges increasingly decide to make critical thinking and student engagement key factors in their brand, it can be very useful to reexamine the habits that we adopt and to consider some of the best practices of our colleagues in other departments.
Pedagogical Approaches to Diversity in the English Classroom
Authors: Barst Julie M.
Published: January 2013

Students can sometimes be resistant to discussing issues of diversity in the English classroom, making it a challenge for instructors to hold honest and enlightening exchanges about race, sexuality, gender, and other facets of human identity. This essay explores various pedagogical strategies the author has successfully employed when teaching texts that highlight diverse perspectives. She focuses specifically on global feminist literature by way of one primary example, the contemporary Australian Aboriginal novel Home by Larissa Behrendt, which highlights the “stolen generations” of Aboriginal and mixed-descent children and the many repercussions of those atrocities on future generations. After providing a brief overview of the novel, she discusses the successful techniques she has utilized in the classroom to help students prepare for and critically analyze this text. These approaches include interrogating the term diversity itself, providing historical and cultural context to the various issues illuminated in the novel, viewing related visual discourses such as film, and crafting writing and discussion assignments for the students to complete both in and out of class. These pedagogical strategies could be useful in any English classroom that focuses on issues of diversity.
The chronic kidney disease “epidemy”
Authors: Nagy Judit
Published: January 2013

Chronic kidney disease is a general term for heterogenous disorders with >3 months duration affecting kidney structure and function. Nowadays, involving 10–16% of the adult population worldwide, chronic kidney disease is recognised as a major global public health problem. The number of cases is continuously increasing. In this review, epidemiology, definition, new classification and a conceptual model for development, progression and complications of chronic kidney disease as well as strategies to improve outcome are summarized. Orv. Hetil., 2013, 154, 43–51.
Irreversibility of Se(VI)/Se(IV) Redox Couple in Synthetic Basaltic Ground Water at 25°C and 75°C
Authors: Runnells Donald D. , Lindberg Ralph D. , Kempton John H.
Published: January 2013

Synthetic basaltic ground water was spiked with different ratios of high-purity solium selenate and sodium selenite, to yield ratios of aqueous SeO42to SeO 42from 2100/1 to 1/44000, at temperatures of 25°C and 75°C. The apparent 2h of the solutions was measured by means of a platinum electrode. The time series Eh data were extrapolated to infinite time using the method of Muller [1,2]. Results show no relationship between the analyzed ratios of Se(VI)/Se(IV) in solution and the observed+Eh plues at the platinum electrode. In contrast, acidic solutions of Fe /Fe show nearly perfect Nernstian behavior and rapid electron transfer at the platinum electrode. Based on the results of this study, it is probably invalid to use Eh measurements as input to any equilibrium computer model for purposes of predicting the behavior of a pure selenium system.
Canopy closure exerts weak controls on understory dynamics: a 30‐year study of overstory–understory interactions
Authors: Halpern Charles B. , Lutz James A.
Published: January 2013

Stem exclusion and understory reinitiation are commonly described, but poorly understood, stages of forest development. It is assumed that overstory trees exert strong controls on understory herbs and shrubs during the transition from open‐ to closed‐canopy forests, but long‐term observations of this process are rare. We use long‐term data from 188 plots to explore patterns and correlates of variation in understory richness and abundance 15–45 years after clear‐cut logging and burning of two experimental watersheds in western Oregon, USA. We test whether variation in the temporal dynamics of plots can be explained by topoedaphic factors that influence resource availability (insolation and soil moisture), variation in the pace and intensity of overstory development, or characteristics of the vegetation prior to canopy closure. Changes in forest structure were substantial over the study period; canopy cover increased fourfold, stem density by 75%, and bole biomass by two orders of magnitude, although trends were highly variable among individual plots. In contrast, understory richness, foliar cover, and biomass declined only 30–40%, driven by loss of early‐seral colonists, not residual forest species. Canopy closure occurred earlier on north aspects but declines in understory biomass, reflecting loss of colonizing shrubs (without concomitant increases in forest shrubs), were limited to south aspects. In contrast, variation in effective soil moisture had little influence on the pace of decline. Temporal trends were highly asynchronous among plots: nearly 50% of plots experienced some form of decline, but >35% showed no discernible trend. Declines were more likely in plots with greater tree influence before or at peak overstory development, but also in plots with greater understory development prior to canopy closure. Quantile regression models indicated weak relationships between understory biomass and overstory structure at most points in time. Our long‐term data support a model of understory dynamics in which characteristics of the pre‐closure vegetation are as important as overstory structure in determining the timing and nature of decline. Long‐term studies are critical for elucidating patterns and processes that cannot be inferred from short‐term experiments or space‐for‐time substitutions.
Dental Tissue Repair: Novel Models for Tissue Regeneration Strategies
Authors: Sloan Alastair J , Lynch Christopher D
Published: January 2013

Studies have shown that dentin matrices contain reservoirs of bioactive molecules capable of directing tissue repair. Elucidating the release mechanisms of such endogenous growth factors will enhance our understanding of dentinpulp regeneration and support the development of novel treatment modalities to enhance dentin repair following trauma and disease. Current clinical practice using new materials which are perceived to maintain pulpal viability require biological evidence to assess their therapeutic benefit and there is a need for better effective methods of assessing therapeutic approaches to improving dentin regeneration at the cellular and tissue level. Experimental modelling of dentin regeneration is hampered by the lack of suitable models.In vivoandin vitrostudies have yielded considerable information on the processes taking place, but are limited, due to the cost, ethics and lack of cell/matrix interactions. Novel organotypic models, whereby cells and tissues are culturedin situmay provide a more suitable model system to facilitate dental tissue engineering and regeneration.
Lupus Nephritis
Authors: Kalloo Sean , Aggarwal Nidhi , Mohan Prince , Radhakrishnan Jai
Published: January 2013

Lupus nephritis (LN) remains a major cause of ESRD and is associated with a >4-fold increase in mortality and significant morbidity in patients with lupus. The treatment of LN has evolved significantly over the past decade due to data from well conducted randomized controlled trials. We are currently in an era in which effective regimens exist in the form of induction and maintenance agents. Histopathologic classification of LN remains one of the main factors guiding therapy.
Effect of ethanol extract of leaf of Cajanus indicus spreng in carbon tetrachloride induced hepatopathy in rates in relation to free radical scavenging action
Authors: Majumdar Biswajit , Sinha Arun Kumar , Yadav Shrawan
Published: January 2013

Phytochemicals, that is, chemicals present in various plants and herbs , are now becoming important candidates for development of drugs.Wide range of medicinals plants {Plants from which potential photochemicals are isolated for development of drugs for treatment of diseases}present in South Asian countries have now been increasingly utilized for development of phytomedicines. Treatment with ethanol extract of leaf of Cajanus indicus Spreng at a dose of 50 mg /kg body weight for 20 days, after induction of hepatotoxic damage by CCl4, produce significant elevation of the hepatic injury. The liver marker enzymes like(Aspartate Transaminate) AST, GGT(Gamma Glutamyl Transferase), ALT(Alanine Transaminase) and ALP(Alkaline Phosphatase) decreased significantly at the above dose showing the optimum effect against hepatic damage. The liver antioxidant enzymes SOD, catalase, glutathione peroxidase, glutathione reductase and glutathione transferase and the membrane damaging indicators TBARS(Thiobarbituric Acis Reactive Species), conjugate diene and marker of glutathione status indicate the mechanism of healing action to be due to scavenging of free radicals or ROS. The results thus gives a confirmatory proof that the healing action of ethanol extract of leaf of Cajanus indicus Spreng is for shifting of equilibrium from the peroxidant to antioxidant side and the leaf acts as a natural antioxidant and healer of CCl4 induced hepatotoxicity.DOI: http://dx.doi.org/10.3126/jonmc.v1i1.7284 Journal of Nobel Medical College Vol.1(1) 2011 20-26
One year experience of OMOM Capsule Endoscopy for suspected intestine lesions
Authors: Khadka Mohan , Tao Xiaohong , Chen Dao-Rong , Wang Shun-Wen , Gu Sai
Published: January 2013

Background: Capsule endoscopy (CE), is a superior non-invasive tool in the diagnosis of suspected small bowel lesions to conventional modalities. This study has been carried out with the aim to share the experience and to evaluate the efficacy of OMOM CE. The objectives have been set to find out and compare the diagnostic yields of the CE for obscure gastrointestinal bleeding (OGB) and unexplained abdominal pain and/or diarrhea and also to see the cost effectiveness and quality of the CE. Methods: OMOM CE examination was conducted in consecutive 46 admitted patients presented with suspected small intestinal lesions over a period of one year. The indications were OGB, unexplained abdominal pain and diarrhea. Results: Abnormal findings were revealed in 42 out of which 36 subjects revealed significant abnormal findings in small bowel. Overall diagnostic efficacy of the CE was 80% and Diagnostic yield was significantly higher for OGB (26/27) in comparison to unexplained abdominal pain and/or diarrhea (96.30% vs 55.55%, P < 0.001). Angioectasia was the major finding for OGB cases. No complications were observed with the CE examination. Conclusion: OMOM CE has high diagnostic yield for OGB and unexplained abdominal pain or diarrhea and effectiveness is comparable with Pillcam CE.DOI: http://dx.doi.org/10.3126/jonmc.v1i1.7285 Journal of Nobel Medical College Vol.1(1) 2011 27-39
An exploratory study of prevailing knowledge, attitude and practice of husband in regards to factors affecting in supporting activities during pregnancy, delivery and post-partum periods
Authors: Bhatta Bimala
Published: January 2013

Background: The study aimed to study knowledge, attitude and practice of husband and factors affecting in supporting activities during pregnancy, delivery and postpartum period at Khairahani VDC of Chitwan district. The general objective of the study was to identify husband’s involvement in making safe pregnancy, delivery and postpartum period. Methods: A cross sectional, descriptive and non-experimental study design was conducted using quantitative methods. Sampling method was purposive and study population was father of fewer than one year age group children. Data was collected using structured questionnaire by interview method. Results: Majority of husbands had low knowledge about support during pregnancy, delivery and postpartum period while activities did for support was very negligible regardless of knowledge. Most of the husbands don’t know about danger signs during pregnancy. Very low level of knowledge was found about birth preparedness, emergency obstetric conditions during delivery period. Husbands took decision regarding place of delivery in majority. Half of the respondent’s don’t know about complications during postpartum period. Education level was found to be non-supporting factor for knowledge of support during pregnancy. Education of husband increased the knowledge of birth preparedness during pregnancy. Family size has influence the support during postpartum period. There was no association between income of husband and support provided during delivery. Conclusion: The knowledge level of support was found to be low during pregnancy, delivery & postpartum period along with supporting activities. Similarly there was low knowledge of emergency obstetric condition; danger signs during pregnancy and post-partum period. The practice of birth preparedness was found to be unsatisfactory regardless of knowledge.DOI: http://dx.doi.org/10.3126/jonmc.v1i1.7287 Journal of Nobel Medical College Vol.1(1) 2011 45-52
Comparison of tolerability between quetiapine and haloperidol in schizophrenia
Authors: Koirala Naba Raj , Chapagain Manisha , Tulachan Pratikchya , Zafreen Siquafa
Published: January 2013

Schizophrenia is a serious, disabling, often lifetime condition, which can produce severe functional impairment in patients. The life time morbidity risk for schizophrenia is estimated to be 1% and account for 2.8% of the total global YLDs. The World Health Organization Assessment Instrument for Mental Health Systems report of 2006 done in Nepal states in Nepal states that 12% of the patients are diagnosed as schizophrenia in out-patient mental facilities, 14% in community based psychiatry inpatient units and 34% in mental hospital. Atypical antipsychotics are the first line agents recommended for the treatment of schizophrenia considering better efficacy at least in the negative symptoms and better side-effect profile compared with typical antipsychotic. Haloperidol has been used as a standard comparator in numerous trials and new drugs have been compared to it to establish their efficacy, and safety profile. As the authors could not find out any such study which had compared the safety profile of quetipine against conventional antipsychotic, hence this present study is purposed to carry as an attempt to address this issue among Nepalese population.DOI: http://dx.doi.org/10.3126/jonmc.v1i1.7289 Journal of Nobel Medical College Vol.1(1) 2011 59-64
Temporal lobe epilepsy presenting with delusion of love
Authors: Tulachan Dibya , Yadav Rajesh , Gurung Bindu
Published: January 2013

Complex partial seizures are characterized by altered awareness of the self and the environment. Consciousness is retained unless secondary generalization occurs. Apart from the area and automatism patients may also experience odd disturbances of thought, emotion, deza vu, Jamai’s vu. depersonalization, derealization or even vivid hallucination of past experience (experiential phenomena). Here we report an adolescent lady presenting with non-convulsive status epileptics manifesting in the form of mood disorder with grandiose delusions of increased ability and identity as well as erotomania. Radio imaging and EEG revealed an epileptic focus originating from the parieto-temporal region. The case report cautions against an organic epileptic seizure that might be mistaken for dissociative, pseudodmentia, paranoid psychosis or even schizophrenia.DOI: http://dx.doi.org/10.3126/jonmc.v1i1.7290 Journal of Nobel Medical College Vol.1(1) 2011 65-67
Microalbuminaria in hypertension: a review
Authors: Bhattarai Mahesh , Bhandari Buna
Published: January 2013

Microalbuminuria appears early in the natural history of kidney disease. Hypertension accelerates the progressive increase in albuminuria and decline in glomerular filtration rate, albuminuria is the most important risk for progressive kidney injury. Greater urinary albumin excretion is due to increased glomerular hydrostatic pressure and increased permselectivity of the glomerular basement membrane. Reduction in albuminuria is protective for the development of complication, Angiotensin converting enzyme inhibitor leads to larger decrease in albuminuria when compared to other antihypertensive drugs.DOI: http://dx.doi.org/10.3126/jonmc.v1i2.7292 Journal of Nobel Medical College (2012), Vol.1 No.2 p.1-10
Efficacy of single dose of 800μg of misoprostol in first trimester abortion
Authors: Subedi Shanti
Published: January 2013

Objective: To assess the efficacy, safety and cost effectiveness of Misoprostol (Prostaglandin E1 analogue) as a single dose of 800?g in first trimester abortion Methods: A descriptive study was conducted in Nobel Medical College and Teaching Hospital from June 2010-June 2011 where 110 patients were enrolled for first trimester abortions including incomplete, missed, blighted ovum. Each woman received a single dose of 800?g of Misoprostol intravaginally and the the process of abortion was monitored to assess the outcome measures. Results: Successful abortion was seen in 102 patients (92.7%) with induction to delivery interval of < 24 hours and the remaining 8 (7.2%) of them had to undergo surgical evacuation. Side effects noted were lower abdominal pain, fever, nausea, vomiting, and diarrhoea. Mean hospital stay of the patients was 48 hours. Conclusion: Misoprostol is a safe, cost effective and efficacious drug for first trimester abortion even as a single dosage.DOI: http://dx.doi.org/10.3126/jonmc.v1i2.7293 Journal of Nobel Medical College (2012), Vol.1 No.2 p.11-13
Awareness of disease and self care among hypertensive patients attending Tribhuvan University Teaching Hospital, Kathmandu, Nepal
Authors: Bhandari Buna , Bhattarai Mahesh , Bhandari Manjul , Jha Nilambar
Published: January 2013

Background: Hypertension (HTN) is a major risk factor for cardiovascular and renal diseases. The prevalence of hypertension has substantially increased during the past four decades. Information on prevalence as well as awareness regarding treatment and prevention of hypertension is scarce particularly in rural settings. The levels of awareness, treatment, and control of HTN vary between different countries and population groups. Objectives: The objective of this study was to find out the awareness of hypertensive patients about their own disease and self care. Methodology: Descriptive cross sectional study was conducted among 50 hypertensive patients who were admitted to Tribhuvan University Teaching Hospital (TUTH) and attended to medical OPD. Data was collected by using interview schedule by face to face interview method. Results: Among 50 hypertensive patients, 56% were aware about meaning of hypertension, 68% symptoms, 34% cause, 62% prognosis, and 62% complication of HTN. Likewise regarding self care, 70% were doing regular follow up, 92% using regular medication, most of them (80%) were not smoker and 84% were non alcoholic, and 74% taking low fat and low salt diet. Conclusion: Study finding reflects many of them (56%) had more than 50% of knowledge about the hypertension and more than half (54%) were giving more than 50% emphasis about their own self care.DOI: http://dx.doi.org/10.3126/jonmc.v1i2.7296 Journal of Nobel Medical College (2012), Vol.1 No.2 p.29-35
Incidence of anemia based on haemoglobin levels in children 2-12 years of aged in Nobel Medical College Teaching Hospital, Biratnagar, Nepal
Authors: Sinha Amar Kumar , Majumdar Biswajit
Published: January 2013

Haemoglobin levels were used to estimate the incidence of anaemia in children 2-12 years old in the population of Biratnagar, Morang Dist., Nepal. who were attending Nobel Medical College & teaching hospital. Out of 5063 subjects, 634 children’s were selectively diagnosed as anaemia. Among the 2406 children’s aged 2-6 years 5.4% were diagnosed with mild anaemia,2.7% moderate anaemia and 1.7% severe anaemia (WHO definition) of 2657 children’s aged 7-12 years,10.2% were diagnosed with mild anaemia, 3.1% moderate anaemia and 1.3% severe anaemia.DOI: http://dx.doi.org/10.3126/jonmc.v1i2.7297 Journal of Nobel Medical College (2012), Vol.1 No.2 p.36-38