bluuebunny/crossref_metadata_2025 huggingface dataset:
Peroneal tendon disorders
Authors: Davda Kinner , Malhotra Karan , O’Donnell Paul , Singh Dishan , Cullen Nicholas
Published: June 2017

Pathological abnormality of the peroneal tendons is an under-appreciated source of lateral hindfoot pain and dysfunction that can be difficult to distinguish from lateral ankle ligament injuries. Enclosed within the lateral compartment of the leg, the peroneal tendons are the primary evertors of the foot and function as lateral ankle stabilisers. Pathology of the tendons falls into three broad categories: tendinitis and tenosynovitis, tendon subluxation and dislocation, and tendon splits and tears. These can be associated with ankle instability, hindfoot deformity and anomalous anatomy such as a low lying peroneus brevis or peroneus quartus. A thorough clinical examination should include an assessment of foot type (cavus or planovalgus), palpation of the peronei in the retromalleolar groove on resisted ankle dorsiflexion and eversion as well as testing of lateral ankle ligaments. Imaging including radiographs, ultrasound and MRI will help determine the diagnosis. Treatment recommendations for these disorders are primarily based on case series and expert opinion. The aim of this review is to summarise the current understanding of the anatomy and diagnostic evaluation of the peroneal tendons, and to present both conservative and operative management options of peroneal tendon lesions.

Cite this article: EFORT Open Rev 2017;2:281-292. DOI: 10.1302/2058-5241.2.160047
Design and implementation of an affordable, public sector electronic medical record in rural Nepal
Authors: Raut Anant , Yarbrough Chase , Singh Vivek , Gauchan Bikash , Citrin David , Verma Varun , Hawley Jessica , Schwarz Dan , Harsha Bangura Alex , Shrestha Biplav , Schwarz Ryan , Adhikari Mukesh , Maru Duncan
Published: June 2017

IntroductionGlobally, electronic medical records are central to the infrastructure of modern healthcare systems. Yet the vast majority of electronic medical records have been designed for resource-rich environments and are not feasible in settings of poverty. Here we describe the design and implementation of an electronic medical record at a public sector district hospital in rural Nepal, and its subsequent expansion to an additional public sector facility.DevelopmentThe electronic medical record was designed to solve for the following elements of public sector healthcare delivery: 1) integration of the systems across inpatient, surgical, outpatient, emergency, laboratory, radiology, and pharmacy sites of care; 2) effective data extraction for impact evaluation and government regulation; 3) optimization for longitudinal care provision and patient tracking; and 4) effectiveness for quality improvement initiatives.ApplicationFor these purposes, we adapted Bahmni, a product built with open-source components for patient tracking, clinical protocols, pharmacy, laboratory, imaging, financial management, and supply logistics. In close partnership with government officials, we deployed the system in February of 2015, added on additional functionality, and iteratively improved the system over the following year. This experience enabled us then to deploy the system at an additional district-level hospital in a different part of the country in under four weeks. We discuss the implementation challenges and the strategies we pursued to build an electronic medical record for the public sector in rural Nepal.DiscussionOver the course of 18 months, we were able to develop, deploy and iterate upon the electronic medical record, and then deploy the refined product at an additional facility within only four weeks. Our experience suggests the feasibility of an integrated electronic medical record for public sector care delivery even in settings of rural poverty.
Understanding the use of geographical information systems (GIS) in health informatics research: A review
Authors: Shaw Nicola , McGuire Suzanne
Published: June 2017

Background: The purpose of this literature review is to understand geographical information systems (GIS) and how they can be applied to public health informatics, medical informatics, and epidemiology.Method: Relevant papers that reflected the use of geographical information systems (GIS) in health research were identified from four academic databases: Academic Search Complete, BioMed Central, PubMed Central, and Scholars Portal, as well as Google Scholar. The search strategy used was to identify articles with “geographic information systems”, “GIS”, “public health”, “medical informatics”, “epidemiology”, and “health geography” as main subject headings or text words in titles and abstracts. Papers published between 1997 and 2014 were considered and a total of 39 articles were included to inform the authors on the use of GIS technologies in health informatics research.Results: The main applications of GIS in health informatics and epidemiology include disease surveillance, health risk analysis, health access and planning, and community health profiling. GIS technologies can significantly improve quality and efficiency in health research as substantial connections can be made between a population’s health and their geographical location.Conclusions: Gains in health informatics can be made when GIS are applied through research, however, improvements need to occur in the quantity and quality of data input for these systems to ensure better geographical health maps are used so that proper conclusions between public health and environmental factors may be made.
Children, parents and tablets: Preschool children's tablet use
Authors: Yılmaz Genç Melek Merve , Fidan Ayça
Published: June 2017

The aim of this study is to examine preschoolers' tablet use and evaluate parents' opinions concerning it. To this end, the study made use of a case study design which is a means of qualitative research. The sample of the study consists of five preschoolers and their parents. The study data was gathered with observations related to preschoolers' tablet use, examinations of the applications in children's tablets and semi-structured interviews with parents. The analysis framework for tablet use was structured based on the document review process and data concerning observations and interviews underwent content analysis. The study findings suggest that parents have some specific criteria when determining tablet games, that they worry about children's tablet PC use but they take precautions against them. Also, entertaining children, parental effects and lack of outdoor games are other influential factors in tablet PC use. Parents also accept tablets as useful education tools. The study findings also demonstrate that preschoolers use tablets mainly for playing games, and that parents' knowledge about tablets is generally limited to game applications. The study results can be interpreted as that parents generally emphasize the educational features of game applications in tablets, and they are recommended and supported to learn about different applications so as to improve children's development.
A. Tarskiego kryterium monotoniczności operatora konsekwencji w międzykulturowych badaniach systemów wniskowań
Authors: Sikora Sławomir
Published: June 2017

In this article I refer to the issue of comparative research methodology and methods of philosophical argumentation systems with different cultural areas. In relation to that shown by A. Tarski logical consequence operator, will establish criteria for the comparative analysis of systems inferences different cultural areas of the property based on the operator monotonic consequences.
Dynamic Panel Analysis of Construction Accidents in Hong Kong
Authors: Li Rita Yi Man , Chau Kwong Wing , Ho Daniel Chi Wing
Published: June 2017

The construction industry is one of the riskiest industries with a large number of deaths and injuries every year. Large amounts of money are spent annually on workers’ compensation. Thus, it is important to investigate the factors which affect accident compensation in the eyes of judges. In this research paper, we utilized the court case reports available in HKLII from 2000 to 2015. Most of the victims have studied in secondary schools, are aged between 30 and 49 and have a monthly salary of less than HK$20,000. All the data were then analyzed and summarized by the content analysis method. After that, we used the Markov Chain Monte Carlo simulation and System-GMM dynamic panel econometrics method to study the dynamic relationship between these factors and the compensation for accidents. Academically, analysis of accident compensation in the past usually depended on analysis by the labour department. There is a limited number of quantitative court case reports analysis based on economic modelling. Furthermore, none of the previous research utilized the dynamic panel technique to study the relationships. It also fills the gap of the research in identifying whether non-Cantonese speakers are in disadvantage positions when they seek for compensation, longer hearings favour the contractors and whether mental disorder after accident shall lead to larger amount of compensation. Practically, the research offer important information for contractors and employers who may need to pay compensation due to workers’ accidents. The results show that non-Cantonese speakers receive less compensation as compared to locals and court cases with longer hearings are usually associated with larger amount of compensation. There is, however, no significant difference between victims with and without mental disorder in terms of compensation.
Old English Poetic Superlatives
Authors: Stanley E. G.
Published: June 2017

This paper is designed to show how difficult it is for us in the twenty-first century to establish a valid response to the superlative of adjectives as used in Old English verse. In contradistinction to the monochromatically excessive use of superlatives in modern advertising, the distribution of superlatives is very varied in the English verse of more than a thousand years ago. The first part of the paper consists of a general survey of Old English superlatives, chiefly in the vernacular verse of the Anglo-Saxons, but their prose has not been wholly neglected. The study is evaluative, more so than is usual in sober Linguistics; to this purpose the superlative degree and its statistics contribute to an understanding of the triumphant ending of Beowulf, and grammar is to be seen as the handmaiden of literature.

The second part of the paper is more literary, and is based on the incidence of superlatives as presented in the first part. The density of superlatives in the opening of the minor poem Maxims II is observed, without any reasoning for that density. The density of rare superlatives in the last lines of Beowulf is admired for its aesthetic quality, brought out in Edwin Morgan’s poetic rendering of the poem. It is not forgotten that the rarity of a superlative in the extant verse may be because we cannot know if it would have been less rare had more verse survived. The reading of poetry must, if worthwhile, involve an aesthetic response. The paper, at the same time as exercising that response, stresses our insecurity when we respond to Old English poetry.
Norse Loans in Middle English and their Influence on Late Medieval London English
Authors: Lutz Angelika
Published: June 2017

Most of the Norse legal and administrative terms attested in Old English were replaced by equivalents from the French superstrate soon after the Norman Conquest, whereas a remarkable number of more basic terms are known to have become part of the very basic vocabulary of modern Standard English. This paper focuses on Norse lexical loans that survived during and beyond the period of French rule and became part of this basic vocabulary. It explores (1) the regional and textual conditions for the survival of such loans and (2) their expansion into late medieval London English and into the emerging standard language. Based on selective textual evidence it is argued that they were not quite as basic originally, that they typically survived and developed in regional centres far away from the French-dominated court, and eventually infiltrated the area in and around late medieval London owing to its growing attraction as an economic and intellectual centre. Both the survival of Norse loans and their later usage expansion are shown to be in harmony with the principles of comparative contact linguistics.
Financial Model for Universal Minimum Benefit for Spain
Authors: Pena Miguel Noemi , De la Peña Esteban J. Inaki , Fernandez-Sainz Ana
Published: June 2017

The paper proposes a financial model suitable for ensuring the economic, financial and social sustainability of this basic protection. We have calculated the estimated cost for the Spanish population in 2010 and have estimated the cost for the following 12 years (three legislatures) under a range of demographic and economic assumptions. The results are then analysed to draw conclusions about the viability and sustainability of this basic social protection floor. A remarkable finding is that it is feasible to obtain greater coverage, but by requiring contributions of the State or other financial resources.
A quantitative approach to weighted Carleson condition
Authors: Rivera-Ríos Israel P.
Published: June 2017

Quantitative versions of weighted estimates obtained by F. Ruiz and J.L. Torrea [30, 31] for the operator are obtained. As a consequence, some sufficient conditions for the boundedness of Min the two weight setting in the spirit of the results obtained by C. Pérez and E. Rela [26] and very recently by M. Lacey and S. Spencer [17] for the Hardy-Littlewood maximal operator are derived. As a byproduct some new quantitative estimates for the Poisson integral are obtained.
Performance properties of rigid polyurethane-polyisocyanurate/brewers’ spent grain foamed composites as function of isocyanate index
Authors: Hejna Aleksander , Haponiuk Józef , Piszczyk Łukasz , Klein Marek , Formela Krzysztof
Published: June 2017

In the presented work, rigid polyurethane-polyisocyanurate (PUR-PIR) foams filled with brewers’ spent grain (BSG) were prepared. The influence of the isocyanate index (II) on its performance was investigated. Foams obtained with higher isocyanate index required a higher amount of hydrofluorocarbon physical blowing agent to provide the same apparent density of material. An increase of isocyanate index resulted in a slight decrease of cell size, which was related to the increased crosslink density due to enhanced generation of allophanate and biuret groups. Deterioration of compressive strength, from 226 to 202 kPa was observed with the rise of the isocyanate index. Dynamic mechanical analysis and swelling tests confirmed the increase of crosslink density with the increasing isocyanate index. The glass transition temperature rose from 165.7°C to 193.2°C. Fourier transform infrared (FTIR) analysis indicated an increase of the isocyanurate rings’ content in composites with a higher isocyanate index, causing noticeable enhancement of thermal stability. The onset of degradation was shifted from 196°C to 211°C.
Longitudinal Mediation Analysis with Time-varying Mediators and Exposures, with Application to Survival Outcomes
Authors: Zheng Wenjing , van der Laan Mark
Published: June 2017

1 In this paper, we study the effect of a time-varying exposure mediated by a time-varying intermediate variable. We consider general longitudinal settings, including survival outcomes. At a given time point, the exposure and mediator of interest are influenced by past covariates, mediators and exposures, and affect future covariates, mediators and exposures. Right censoring, if present, occurs in response to past history. To address the challenges in mediation analysis that are unique to these settings, we propose a formulation in terms of random interventions based on conditional distributions for the mediator. This formulation, in particular, allows for well-defined natural direct and indirect effects in the survival setting, and natural decomposition of the standard total effect. Upon establishing identifiability and the corresponding statistical estimands, we derive the efficient influence curves and establish their robustness properties. Applying Targeted Maximum Likelihood Estimation, we use these efficient influence curves to construct multiply robust and efficient estimators. We also present an inverse probability weighted estimator and a nested non-targeted substitution estimator for these parameters.
Assessment of insulin like growth factor-1 and IGF binding protein-3 in healthy Indian girls from Delhi and their correlation with age, pubertal status, obesity and thyroid hormonal status
Authors: Marwaha Raman K. , Garg M.K. , Gupta Sushil , Khurana A.K. , Narang Archna , Shukla Manoj , Arora Preeti , Chadha Aditi , Nayak Deb Datta , Manchanda R.K.
Published: June 2017

Background:

Population specific data and influence of sub-clinical hypothyroidism on insulin like growth factor-1 (IGF-1) and its binding protein-3 (IGFBP-3) in Indian children is lacking. This study was undertaken to evaluate serum IGF-1 and IGFBP-3 and their correlation with age, gender, pubertal status and thyroid functions.

Methods:

A total of 840 apparently healthy school girls aged 6–18 years, were recruited for the study and underwent assessment of height, weight, body mass index, pubertal status and serum T3, T4, TSH, IGF-1, IGFBP-3 and IGF-1/IGFBP-3 molar ratio.

Results:

The mean serum levels of IGF-1, IGFBP-3 levels and IGF-1/IGFBP-3 molar ratio were 381.8±240.5 ng/mL, 4.19±2.08 μg/mL and 40.5±37.2%, respectively. The serum IGF-1 and IGF-1/IGFBP-3 molar ratio increased significantly (p<0.0001) at 11 years followed by a steady yet non-significant rise till 16 years of age. A similar pattern was observed for IGFBP-3 showing a steep rise at 12 years and peaking at 16 years. Likewise, serum levels of IGF-1 and molar ratio of IGF-1/IGFBP-3 increased significantly with pubertal maturation from stage 1 to 3 and were higher in overweight girls compared to normal weight and obese girls. The growth factors were no different in girls with or without subclinical hypothyroidism.

Conclusions:

There was no significant impact of age on IGF-1 and IGFBP-3 in pre-pubertal girls. A sudden marked increase at 11 years followed by a gradual rise in growth factors till 16 years is indicative of pubertal initiation and maturation. Subclinical hypothyroidism did not influence growth factors in girls.
High prevalence of organ specific autoantibodies in Indian type 1 diabetic patients
Authors: Shivaprasad Channabasappa , Kolly Anish , Pulikkal Annie , Kumar K.M. Prasanna
Published: June 2017

Background:

Type 1 diabetes (T1D) is frequently associated with other autoimmune conditions such as autoimmune thyroiditis, coeliac disease (CD) and Addison’s disease. There are sparse data on the prevalence of antibodies against these conditions in Indian patients with T1D. This study aims to evaluate prevalence of these T1D associated autoantibodies in Indian patients.

Methods:

Two hundred and fifty-eight patients with T1D were recruited from the Bangalore Diabetes Hospital and the Vydehi Institute of Medical Sciences and Research Centre (VIMS) for the study. Participants diagnosed with diabetes before the age of 18 years, as per the American Diabetes Association (ADA) criteria, and who were classified as T1D based on clinical grounds were recruited for the study. Anti-thyroid peroxidase antibody (TPO) and IgA tissue transglutaminase antibody (tTG) were estimated in all the patients. 21-Hydroxylase antibody (21-OHAb) were estimated in 170 patients. All assays were done by commercial immunoassay. Eighty-eight unrelated age-matched healthy controls were chosen for comparison.

Results:

The mean age of T1D patients was 14.33 years. The mean duration of diabetes was 4.88 years. Anti-TPO was positive in 43 (16.7%) patients with T1D as compared to 3 (3.4%) in controls. IgA tTG was positive in 12 (4.65%) patients with T1D and was absent in controls. 21-OHAb was positive in two (1.1%) patients with T1D and was absent in controls. Both patients who had positive 21-OHab had the other two antibodies. Five patients had positive anti-TPO and IgA-tTG antibodies.

Conclusions:

Anti-TPO antibody was the most prevalent antibody in patients with T1D. Anti-TPO and IgA-tTG antibodies were significantly higher than in the control population. Further studies will be required to assess the clinical significance of these positive antibodies.
Validation of a new algorithm for the short-term variation of the fetal heart rate: an antepartum prospective study
Authors: Kouskouti Christina , Jonas Hella , Regner Kerstin , Ruisinger Pia , Knabl Julia , Kainer Franz
Published: June 2017

Aims:

Currently one of the most widespread systems for the computerized analysis of the fetal heart rate (FHR) is the Dawes-Redman system, where the short-term variation (STV) of the FHR is measured by dividing each minute into 16 segments (STV16). Technical progress has allowed for the development of a new algorithm, which measures the STV by dividing each minute into 240 segments (STV240), thus approximating the beat-to-beat variation. The STV240 still lacks reference values. Our aim was to develop clinically relevant reference values for the STV240 and compare them to the ones for the STV16.

Methods:

In a single centre, observational study, a total of 228 cardiotocograms were registered and subsequently analyzed with both algorithms (STV240 and STV16).

Results:

The 95% confidence interval (CI) was calculated for both algorithms. The values of the STV240 were significantly lower in comparison to the ones of the STV16. Not only the mean values but also the 95thpercentile of the STV240 lay beneath the existent cut-off value for the STV16.

Conclusions:

Every clinician using the new algorithm must be aware that the normal values for the STV240 lie beneath the, up until now, established cut-off values for the STV16.
Products Liability As Enterprise Liability
Authors: Keating Gregory C.
Published: June 2017

In the American legal academy, the prevailing wisdom about the rise of modern products liability law is framed by a debate which took place more than thirty years ago. George Priest’s brilliant 1985 paper The Invention of Enterprise Liability, asserted that modern American products liability law in its formative moment was enterprise liability incarnate, but condemned this commitment as itself a profound defect in products liability law. With rhetoric worthy of a Biblical Jeremiad, Priest argued that the “unavoidable implication of the three presuppositions of [enterprise liability] is absolute liability. The presuppositions themselves do not incorporate any conceptual limit to manufacturer liability.” Priest’s work was both immensely influential and sharply contested. Gary Schwartz, writing independently at first, argued that products liability law was really fault liability all along. According to Schwartz, the “vitality of negligence” was the driving force behind the expansion of tort liability over the course of the 20th century. Negligence conceptions lurked beneath product liability law’s surface embrace of strict liability. Or so Schwartz argued. Product defect liability was strict liability in name, but the risk-utility test of product defectiveness was in fact an aggressive application of negligence criteria.
Adulterated pharmaceutical chemicals in botanical dietary supplements: novel screening approaches
Authors: Liu Yan , Lu Feng
Published: June 2017

The increased availability and use of botanical dietary supplements (BDS) has been accompanied by an increased frequency of adulteration of these products with pharmaceutical chemicals. These adulterated products are a worldwide problem, and their consumption poses health risks to consumers. The main focus of this paper is to highlight novel screening approaches utilized in the detection of adulterants in BDS marketed for different therapeutic purposes. We summarize spectroscopic methods involving near-infrared, infrared, Raman, and nuclear magnetic resonance spectroscopy as feasible and interesting in-field screening tools for the analysis of suspected products (adulterated or not) before being sent to a laboratory for deeper inspection. In addition, the new approaches based on chromatographic methods such as liquid chromatography-circular dichroism, liquid chromatography-mass spectrometry, thin layer chromatography-surface enhanced Raman spectroscopy, and thin layer chromatography-mass spectrometry are discussed and reviewed. Novel analysis strategies from targeted analysis to post-targeted and non-targeted analysis allowing simultaneous determination of the number of multiclass pharmaceuticals are discussed.
Networks Underpinning Symbiosis Revealed Through Cross-Species eQTL Mapping
Authors: Guo Yuelong , Fudali Sylwia , Gimeno Jacinta , DiGennaro Peter , Chang Stella , Williamson Valerie M , Bird David McK , Nielsen Dahlia M
Published: June 2017

Interactions between species are pervasive among plants, animals, and microbes, and identifying the molecular signals involved is an active area of research..

Organisms engage in extensive cross-species molecular dialog, yet the underlying molecular actors are known for only a few interactions. Many techniques have been designed to uncover genes involved in signaling between organisms. Typically, these focus on only one of the partners. We developed an expression quantitative trait locus (eQTL) mapping-based approach to identify cause-and-effect relationships between genes from two partners engaged in an interspecific interaction. We demonstrated the approach by assaying expression of 98 isogenic plants (Medicago truncatula), each inoculated with a genetically distinct line of the diploid parasitic nematode Meloidogyne hapla. With this design, systematic differences in gene expression across host plants could be mapped to genetic polymorphisms of their infecting parasites. The effects of parasite genotypes on plant gene expression were often substantial, with up to 90-fold (P = 3.2 × 10−52) changes in expression levels caused by individual parasite loci. Mapped loci included a number of pleiotropic sites, including one 87-kb parasite locus that modulated expression of >60 host genes. The 213 host genes identified were substantially enriched for transcription factors. We distilled higher-order connections between polymorphisms and genes from both species via network inference. To replicate our results and test whether effects were conserved across a broader host range, we performed a confirmatory experiment using M. hapla-infected tomato. This revealed that homologous genes were similarly affected. Finally, to validate the broader utility of cross-species eQTL mapping, we applied the strategy to data from a Salmonella infection study, successfully identifying polymorphisms in the human genome affecting bacterial expression.
Leadership in Community-Based Participatory Research: Individual to Collective
Authors: Mayan Maria , Lo Sanchia , Oleschuk Merin , Paucholo Anna , Laing Daley
Published: June 2017

Multi-sector collaborative partnerships hold much promise in tackling seemingly intractable and complex social issues. However, they often encounter many challenges in achieving their goals. Leadership can play an important role in reducing the impact of factors that threaten a multi-sector partnership’s success. Community-based participatory research (CBPR) partnerships are collaborative and, in many cases, multi-sectored. While there is a developing literature and practice on multi-sector, collaborative partnerships, leadership in CBPR is relatively unexplored, especially at various partnership stages (i.e., formation, implementation, maintenance, and accomplishment of goal). Through the method of focused ethnography, we explored the research question “How is leadership exercised during the formation stage of a CBPR partnership?” Eighteen partners (government, community, and university sectors) were interviewed about the leadership during the formation stage of their partnership, and data were qualitatively content-analyzed. Partners explained that leadership was exercised during the formation stage through (1) individual characteristics, (2) actions, and (3) as a collective. Our findings illustrate that CBPR leadership shares many of the characteristics of traditional leadership and adapts them to support the collaborative process of CBPR, leading to a collective form of leadership. These findings have implications for the study and practice of CBPR leadership.
New record and distribution extension of Melanemerella brasiliana (Ulmer, 1920) (Ephemeroptera: Melanemerellidae) from Bahia, Brazil
Authors: Silva Vinícius A. , Mariano Rodolfo
Published: June 2017

Melanemerella brasiliana (Ulmer, 1920) occurs in São Paulo, Rio de Janeiro, and Espírito Santo states, Brazil. Here, we record it for the first time from the state of Bahia. The new record is based on nymphs collected from Serra Bonita Reserve, municipality of Camacan, Bahia.
KOMPOSISI NUTRISI RUMPUT LAUT Calcareous Halimeda opuntia PADA LINGKUNGAN PERAIRAN INDONESIA
Authors: Nurhayati Nurhayati , Apriani Siti Nurbaity Kartika , Nurbayasari Rodiah , Murdinah Murdinah
Published: June 2017

Halimeda opuntia merupakan rumput laut Chlorophyta berkapur yang memiliki kandungan nutrisi untuk pangan fungsional. Namun, pergeseran komposisi nutrisi dapat terjadi akibat perubahan lingkungan akibat limpasan nutrien dan bahan organik lainnya yang umum terjadi di perairan pesisir Indonesia. Penelitian ini bertujuan untuk melakukan identifikasi pergeseran kandungan nutrisi H. opuntia yang tumbuh di zona intertidal agar dapat digunakan sebagai dasar pemilihan lokasi pengambilan bahan baku H. opuntia untuk produk fungsional. Pengambilan sampel dilakukan di empat lokasi perairan di Indonesia, yaitu perairan Binuangeun (Banten), Lampung Selatan, Lombok Timur (Nusa Tenggara Barat) dan Konawe Selatan (Sulawesi Tenggara). Karakteristik nutrisi dari rumput laut target meliputi kadar air, abu, protein, lemak, karbohidrat, dan serat kasar. Informasi lingkungan dari habitat sampel ditunjukkan melalui variabel kimia air yaitu DO, pH, salinitas, pCO2, kalsium aragonit, nitrogen anorganik terlarut, serta fosfat anorganik terlarut. Hasil analisis menunjukkan kondisi lingkungan eutrofik berpengaruh secara signifikan terhadap komposisi nutrisi H. opuntia. pH dan salinitas menjadi faktor determinan positif (R2 = 0,75 pada p<0,05) terhadap kadar karbohidrat, sementara nitrogen anorganik terlarut menjadi faktor determinan negatif terhadap kadar protein dan lemak (R2= 0,81 dan 0,61 pada p<0,05). Berdasarkan kandungan nutrisinya, maka H. opuntia yang diperoleh dari habitat alamiah merupakan bahan baku produk fungsional yang  lebih baik dibandingkan dengan biota selaras dari perairan eutrofik.
The first experience of successful pregnancy after simultaneous liver-kidney transplantation with reno-portal transposition
Authors: Tkachenko O. V. , Vilchuk K. U. , Rummo O. O. , Kurlovich I. V. , Shcherba A. E. , Naumchik I. V. , Nagibovich C. Yu. , Pankratova O. A. , Rimashevski V. V. , Beluga M. V. , Fedoruk D. A.
Published: June 2017

The article is dedicated to the problem of pregnancy management and delivery after simultaneous liver-kidney transplantation (SLKT). The article contains general historic and statistic information, and presents the first real world clinical case of favorable pregnancy outcome in patient after simultaneous liver-kidney transplantation with reno-portal transposition.
Organ donation and transplantation in the Russian Federation in 2016 9th report of the National Registry
Authors: Gautier S. V. , Khomyakov S. M.
Published: June 2017

Aim. To carry out monitoring of the organization and tendencies in the development of organ donation and transplantation in the Russian Federation in 2016. Materials and methods. Questioning of the heads of all the centers of transplantation is carried out. The comparative analysis of the obtained data in dynamics of the years, between certain regions of the Russian Federation and transplantation centers is done. Results. According to the register 35 centers of kidney transplantation, 22 centers of liver transplantation and 11 centers of heart transplantation were functioning in the Russian Federation in 2016. The waiting list of kidney transplantation in 2016 included 4818 potential recipients that make 14% of total number of the patients (35 000) receiving dialysis. The rate of donor activity in 2016 made 3.3 p. m. p. Efficiency of donor programs in 2016 continued to increase: the share of multiorgan retrieval made 64.1%, average number of organs received from one effective donor made 2.7. In 2016 the rate of kidney transplantation made 7.4 p. m. p., the rate of liver transplantation made 2.6 p. m. p.; the rate of heart transplantation made 1.5 p. m. p. In 2016 the number of transplantations in the Russian Federation increased by 14.8% in comparison with 2015 having overcome the level of 1700 organs transplantation. The Moscow region still remains to be the core of stability and development of the organ donation and transplantation in the country where 10 centers of transplantation function and half of all kidney transplantations and more than 70% of all liver and heart transplantations are carried out. Conclusion. The results of 2016 were positively affected by the introduction of targeted financial support of medical activity, related to organ donation, from federal budget resources. Among unresolved problems which constrain the development there are collision of legal regulation of licensing of medical activities for organ donation and transplantation, lack of the state order for the organization of transplantological medical care in each region, lack of responsibility of the heads of the regions and medical organizations for the organization of organ donation. Positive tendencies of the development of organ donation and transplantation in Russia call for further monitoring, strengthening and building.
Optimization of Implantable Axial Pump to Increase Efficiency of Mechanical Circulatory Support
Authors: Gautier S. V. , Kuleshov A. P. , Efimov A. E. , Agapov I. I. , Itkin G. P.
Published: June 2017

Aim. To optimize implantable axial pump to increase hydraulic efficiency and reduce blood hemolysis. Materials and methods. In this article the basic geometric parameters of impeller’s geometry (the blade’s angle, the blade’s length and the twist angle’s ratio) were investigated and optimized using methods of computer hydrodynamics. The calculations were carried out for the optimum operation of the pump at the speed of 8000 rpm. Results. The main parameters of impeller’s geometric were determined which made it possible to increase efficiency of the pump by an average of 7.5% (depending on the pump operation mode) and pressure drop of 8% on average. The value of shear stress in the flow region obtained as a result of the calculations did not exceed 147 Pa admissible from the point of view of blood hemolysis.
Traumatic spinal cord injury: current concepts and treatment update
Authors: Rouanet Carolina , Reges Danyelle , Rocha Eva , Gagliardi Vivian , Silva Gisele Sampaio
Published: June 2017

ABSTRACT Spinal cord injury (SCI) affects 1.3 million North Americans, with more than half occurring after trauma. In Brazil, few studies have evaluated the epidemiology of SCI with an estimated incidence of 16 to 26 per million per year. The final extent of the spinal cord damage results from primary and secondary mechanisms that start at the moment of the injury and go on for days, and even weeks, after the event. There is convincing evidence that hypotension contributes to secondary injury after acute SCI. Surgical decompression aims at relieving mechanical pressure on the microvascular circulation, therefore reducing hypoxia and ischemia. The role of methylprednisolone as a therapeutic option is still a matter of debate, however most guidelines do not recommend its regular use. Neuroprotective therapies aiming to reduce further injury have been studied and many others are underway. Neuroregenerative therapies are being extensively investigated, with cell based therapy being very promising.
Key performance indicators for stroke from the Ministry of Health of Brazil: benchmarking and indicator parameters
Authors: Lange Marcos C , Braga Gabriel Pereira , Nóvak Edison M , Harger Rodrigo , Felippe Maria Justina Dalla Bernardina , Canever Mariana , Dall’Asta Isabella , Rauen Jordana , Bazan Rodrigo , Zetola Viviane
Published: June 2017

ABSTRACT The present study aimed to analyze the stroke units in two centers for the key performance indicators (KPIs) required by the Ministry of Health in Brazil. Methods All 16 KPIs were analyzed, including the percentage of patients admitted to the stroke unit, venous thromboembolism prophylaxis in the first 48 hours after admission, pneumonia and hospital mortality due to stroke, and hospital discharge on antithrombotic therapy in patients without cardioembolic mechanism. Results Both centers admitted over 80% of the patients in their stroke unit. The incidence of venous thromboembolism prophylaxis was > 85%, that of in-hospital pneumonia was < 13%, the hospital mortality for stroke was < 15%, and the hospital discharge on antithrombotic therapy was > 70%. Conclusion Our results suggest using the parameters of all of the 16 KPIs required by the Ministry of Health of Brazil, and the present results for the two stroke units for future benchmarking.
Discordant clinical outcomes of congenital Zika virus infection in twin pregnancies
Authors: Linden Vanessa van der , Linden Junior Hélio van der , Leal Mariana de Carvalho , Rolim Filho Epitacio Leite , Linden Ana van der , Aragão Maria de Fátima Viana Vasco , Brainer-Lima Alessandra Mertens , Cruz Danielle Di Cavalcanti Sousa , Ventura Liana O. , Florêncio Telma Lúcia Tabosa , Cordeiro Marli Tenório , Caudas Neto Silvio da Silva , Ramos Regina Coeli
Published: June 2017

ABSTRACT Congenital Zika syndrome is an emergent cause of a congenital infectious disorder, resulting in severe damage to the central nervous system and microcephaly. Despite advances in understanding the pathophysiology of the disease, we still do not know all the mechanisms enrolled in the vertical transmission of the virus. As has already been reported in other types of congenital infectious disorders in dizygotic twin pregnancies, it is possible that the virus affects only one of the fetuses. In this article, we report on two cases of twin pregnancies exposed to the Zika virus, but with only one of the fetuses affected with microcephaly and brain damage. This indicates the urgent need for more studies regarding the pathophysiology of viral infection and the mechanisms involved in the natural protection against the virus.
Inguinodynia in patients submitted to conventional inguinal hernioplasty
Authors: DIAS BRUNO GARCIA , SANTOS MARCELO PROTÁSIO DOS , CHAVES ANA BARBARA DE JESUS , WILLIS MARIANA , GOMES MARCIO COUTO , ANDRADE FERNANDES TAVARES , MELO VALDINALDO ARAGÃO DE , SANTOS FILHO PAULO VICENTE DOS
Published: June 2017

ABSTRACT Objective : to evaluate the incidence of chronic pain and its impact on the quality of life of patients submitted to inguinal hernioplasty using the Lichtenstein technique. Methods : this was a descriptive, cross-sectional study of patients operated under spinal anesthesia from February 2013 to February 2015 and who had already completed six postoperative months. We questioned patients about the presence of chronic inguinal pain and, if confirmed, invited them to a consultation in which we assessed the pain and its impact on quality of life. Results : out of 158 patients submitted to the procedure, we identified 7.6% as having inguinodynia. Of these, there was an impact on the quality of life in 25%. Conclusion : the incidence of inguinodynia after hernioplasty with repercussion in quality of life was similar to the one of found in the world literature.
Evaluation of Telomerase (hTert), Ki67 and p16ink4a expressions in low and high-grade cervical intraepithelial lesions
Authors: GOULART ANA PAULA SZEZEPANIAK , GONÇALVES MANOEL AFONSO GUIMARÃES , DA-SILVA VINICIUS DUVAL
Published: June 2017

ABSTRACT Objective : to study the association between the histological grading of cervical intraepithelial neoplasia (CIN I, CIN II and CIN III) and the immunohistochemical expression for p16ink4a, hTert and Ki67, as well as to evaluate the relationship of these markers with the risk of recurrence after surgical treatment. Methods : we studied a historical cohort of 94 women with intraepithelial lesions CIN I (low grade), CIN II and CIN III (high grades) submitted to conization or electrosurgical excision of the transformation zone. We evaluated all surgical specimens for immunohistochemical expression of p16ink4a, hTert and Ki67. Results : the mean age was 38.2 years; p16ink4a was absent in most CIN I cases. In patients with CIN II or I/II (association of low and high-grade lesions), we observed p16ink4a ≤10%. In patients with CIN III, we found a higher expression frequency of p16ink4a >50%. In CIN I, the majority had Ki67≤10% and low frequency of Ki67>50%. In the CIN III category, there were fewer patients with Ki67≤10%, and Ki67 was absent in most patients of CIN II and III groups. There was no association between hTert expression and histologic grade. There were no statistically significant differences between the expression of the markers in patients with and without recurrence. Conclusion : there was a statistically significant association of p16ink4a and Ki67 with histological grade. The markers' expression, as for disease recurrence, was not statistically significant in the period evaluated.
Does the Attention Deficit Hyperactivity Disorder interfere with bariatric surgery results?
Authors: Marchesi Doglas Gobbi , Ciriaco Jovana Gobbi Marchesi , Miguel Gustavo Peixoto Soares , Batista Gustavo Adolfo Pavan , Cabral Camila Pereira , Fraga Larissa Carvalho
Published: June 2017

ABSTRACT Objective: to analyze possible negative effects of Attention Deficit Hyperactivity Disorder (ADHD) on the success of bariatric surgery. Methods: we evaluated forty patients undergoing bariatric surgery and with regular post-operative follow-up of at least one year. To all, we applied the questionnaire advocated in the fourth edition of the Diagnostic and Statistical Manual (DSM-IV) of the American Psychiatric Association for ADHD, as well as analyzed their postoperative data. Results: fifteen (38%) patients presented a positive questionnaire for ADHD. Patients with ADHD presented higher BMI than patients without the disorder (45.8 vs. 40.9 kg/m2, p=0.017), and the difference remained in all postoperative stages. There was no statistically significant difference in surgery success (33.3% x 66.7%, p=0.505) or in BMI reduction (30.71% x 31.88%, p=0.671) one year after the procedure. Conclusion: ADHD patients have a higher BMI. However, the presence of ADHD does not influence the success of bariatric surgery and the reduction of BMI.
Customized acrylic implants for reconstruction of extensive skull defects: an exception approach for selected patients
Authors: SILVA RAFAEL DENADAI PIGOZZI DA , RAPOSO-AMARAL CESAR AUGUSTO , GUIDI MARCELO CAMPOS , RAPOSO-AMARAL CASSIO EDUARDO , BUZZO CELSO LUIZ
Published: June 2017

ABSTRACT Objective: to present our experience in the surgical treatment of extensive skullcap defects with customized acrylic implants. Methods: we conducted a retrospective analysis of patients with extensive skull defects undergoing acrylic cranioplasties between 2004 and 2013. We carefully selected all patients and classified surgical results based on three scales (craniofacial esthetics, improvement of facial symmetry and need for additional surgery). Results: fifteen patients underwent cranioplasty with intraoperative acrylic implants, whether manually customized (46.67%) or made with prototyped three-dimensional biomodels (53.33%). There were two (13.33%) complications (one infection with implant withdrawal and one seroma). We considered the craniofacial aesthetics excellent (50%), the degree of improvement of craniofacial symmetry satisfactory (57.14%), and the overall mean of surgical results according to the need for new surgeries was 1.5±0.52. Conclusion: cranioplasties of patients with extensive skullcap defects should obey careful and predetermined criteria, both for selection and for the acrylic implant customization method.
Robotic Transversus Abdominis Release (TAR): is it possible to offer minimally invasive surgery for abdominal wall complex defects?
Authors: AMARAL MARIA VITÓRIA FRANÇA DO , GUIMARÃES JOSÉ RICARDO , VOLPE PAULA , OLIVEIRA FLÁVIO MALCHER MARTINS DE , DOMENE CARLOS EDUARDO , ROLL SÉRGIO , CAVAZZOLA LEANDRO TOTTI
Published: June 2017

ABSTRACT We describe the preliminary national experience and the early results of the use of robotic surgery to perform the posterior separation of abdominal wall components by the Transversus Abdominis Release (TAR) technique for the correction of complex defects of the abdominal wall. We performed the procedures between 04/2/2015 and 06/15/2015 and the follow-up time was up to six months, with a minimum of two months. The mean surgical time was five hours and 40 minutes. Two patients required laparoscopic re-intervention, since one developed hernia by peritoneal migration of the mesh and one had mesh extrusion. The procedure proved to be technically feasible, with a still long surgical time. Considering the potential advantages of robotic surgery and those related to TAR and the results obtained when these two techniques are associated, we conclude that they seem to be a good option for the correction of complex abdominal wall defects.
Invasive ductal carcinoma: relationship between pathological characteristics and the presence of axillary metastasis in 220 cases
Authors: AQUINO RANNIERE GURGEL FURTADO DE , VASQUES PAULO HENRIQUE DIÓGENES , CAVALCANTE DIANE ISABELLE MAGNO , OLIVEIRA AYANE LAYNE DE SOUSA , OLIVEIRA BRUNO MASATO KITAGAWA DE , PINHEIRO LUIZ GONZAGA PORTO
Published: June 2017

ABSTRACT Objective: to analyze the relation of anatomopathological features and axillary involvement in cases of invasive ductal carcinoma. Methods: this is a cross-sectional study of 220 breast cancer patients submitted to radical mastectomy or quadrantectomy with axilar emptying, from the Mastology Service of the Assis Chateaubriand Maternity School, Ceará, Brazil. We submitted the tumors to histological processing and determined the histological (HG), tubular (TG) and nuclear (NG) grades, and the mitotic index (MI) by the classification of Scarff-Bloom-Richadson, verified the presence of angiolymphatic invasion (AI) and measured the largest tumor diameter (TD). We then correlated these variables with the presence of axillary metastases. Results: the mean patients'age was 56.81 years ± 13.28. Tumor size ranged from 0.13 to 22 cm, with an average of 2.23cm ± 2.79. HG3, TG3 and NG3 prevailed, respectively 107 (48.6%), 160 (72.7%) and 107 (48.6%). Mitotic indexes 1, 2 and 3 presented a homogeneous distribution, respectively 82 (37.2%), 68 (31%) and 70 (31.8%). We observed no relation between the HG, TG and NG with the occurrence of axillary metastases (p=0.07, p=0.22 and p=0.21, respectively). Mitotic indices 2 and 3 were related with the occurrence of axillary metastases (p=0.03). Tumors larger than 2cm and cases that presented angiolymphatic invasion had a higher index of axillary metastases (p=0.0003 and p<0.0001). Conclusion: elevated mitotic indexes, tumors with a diameter greater than 2cm and the presence of angiolymphatic invasion were individuallyassociatedwith the occurrence of axillary metastases.