bluuebunny/crossref_metadata_2025 huggingface dataset:
Structural and Optical Properties of Cu2ZnSnS4 Films Prepared by Sol-Gel method
Authors: Saeed Abdulhameed , Jabbar Kasim Sattar
Published: July 2019

Chest x-ray medical images are widely used for diagnostic purposes for Cu2ZnSnS4 thin films are prepared by sol gel and spin coating methods. In this study, some physical properties such as structural and optical properties of Cu2ZnSnS4 thin films are investigated.  Prepared thin films are annealed at 400°C for 1 h under N2 atmosphere. XRD pattern for the peaks 28.31°, 47.26°, and 56.12° which have indexed plans (112), (220) and (312) confirmed that all Cu2ZnSnS4 thin films prepared have kesterite structure. The results of XRD patterns and UV– Visible spectra demonstrated kesterite phase and a great optical absorption coefficient more than 105­ cm-1 in visible region. The estimation of the band gap which equal Eg ≈ 1.5 eV by dependent at the optical characteristics.
Frontal Chest X-Ray Image Colorization Using Various Mathematical Experimental Equations
Authors: H. Al-khafaji Kawther , Abd al Jaleel Al-Yasiri Layla
Published: July 2019

Chest x-ray medical images are widely used for diagnostic purposes for several reasons including it available, attainable  and excellent imaging of hard tissues like bones, but there is difficulty in imaging of the soft tissues, moreover the saturated colour of the x-ray image causing intricacy to read it, therefore, turned attention to the colorization process  which can be used to transform the grayscale medical images to the colour medical images.
In this paper, a new pseudo-coloring method proposed for colorizing the frontal chest x-ray medical images which are very important for disease detection and recognition. The key idea of this method is applying different and various experimental mathematical equations on the proposed medical sample image, which it belongs to the patient with Hydatid cyst parasite disease in the lung. The counterfeit coloring had intense contribute in enhancing of the visual attractiveness of medical images, the output colored images have a better visual description, it has a possibility to describe hidden information better than a conventional monochromatic image, this is an excellent indicator of the algorithm's suitability for the purpose for which it was formulated.
Anatomical Variations of the Paranasal Sinuses and the Nasal Cavity
Authors: Shrestha Kundan Kumar , Acharya K , Joshi RR , Maharjan S , Adhikari D
Published: July 2019

Computed tomography (CT) of the para-nasal sinuses (PNS) has nowadays become the investigation of choice for the diagnosis of sinonasal diseases. Numerous sinonasal anatomic variants exist and are frequently seen on CT scans. A sound knowledge of these variations is important not only for diagnosis but also for planning surgery in order to avoid complications. The aim of this study is to investigate the frequency of these variations in patients with sinonasal symptoms and also to determine their relation to sinonasal disease if any. A total of 76 patients were included in the study from August 2017 to July 2018 of which 43 (56.6%) were males and while 33 (43.4%) were females with male to female ratio of 1.3:1. The ages of patients ranged from 14 to 72 years with a mean age of 33.2±14.2 years. Out of 76 patients, 68 (89.5%) had at least one type of anatomical variation while 8 (10.5%) had no variation. Only one variation was seen in 39 (51.3%) patients while 29 (38.2%) had two or more variations. The most common variant was deviated nasal septum (DNS), occurring in 49 (64.5%) patients followed by concha bullosa (CB) and agger nasi cell (AN) seen in 15 (19.7%) and 14 (18.4%) patients respectively. Genderwise, anatomical variations were seen more in males but the difference was not statistically significant. Some variations were seen more on the right side while others on the left. Some variations were present bilaterally. The difference was not statistically significant. The presence of DNS was statistically significant in the study population (p value 0.012 in nonparametric chi square test). The age group 14 to 30 years showed maximum variations though not significant statistically. Therefore, during management of patients with sinonasal symptoms, these variations need to be addressed, if required, surgically. Proper knowledge of both common and uncommon sinonasal variations in our community could help in better surgical planning and overall management of sinonasal disorders.
Community Based Screening for Diabetes and Prediabetes using the Indian Diabetes Risk Score among Adults in a Semi-Urban Area in Kathmandu, Nepal
Authors: Silvanus Vinutha , Dhakal N , Pokhrel A , Baral BK , Panta PP
Published: July 2019

Diabetes has been recognized as a “global health emergency” with an estimated 9% of adults being affected. However, about half of these adults remain undiagnosed. Conventional screening tools like fasting plasma glucose (FPG), oral glucose tolerance testing (OGTT) and glycosylated haemoglobin (HbA1c) can be inconvenient and expensive in a community-based setting. The Indian Diabetes Risk Score (IDRS) is a simple, non-invasive tool which has been validated for use in the Indian population. Age, abdominal obesity, family history of diabetes and physical activity levels have been weighted for a maximum score of 100. Persons with IDRS of <30 are categorized as low risk, 30-50 as medium risk and those with > 60 as high risk for diabetes. A community based, cross-sectional, analytical study was planned to assess the performance of IDRS among adults in a semi-urban area in Kathmandu, Nepal. A total of 256 (170 female, 86 male) persons without diabetes from 260 households were screened during the study period. A majority (46.09%) were classified as high risk, 44.53% as moderate risk and 9.38% as low risk for developing diabetes. Among them, 162 (63.28%) volunteered for definitive testing. The prevalence of undiagnosed diabetes and prediabetes was 4.32% (95% CI: 1.75% to 8.70%) and 7.14% (95% CI: 3.89% to 12.58%) respectively. IDRS predicted the combined risk of diabetes and prediabetes with sensitivity of 84.21% and specificity of 55.24% in adults with score of 60 and above. The area under the ROC curve (AUC) of IDRS for identifying diabetes and prediabetes was 0.69 as compared to the gold standard (2hour Plasma Glucose) AUC of 0.98. IDRS may be a suitable screening tool for diabetes and prediabetes in the adult Nepalese study population.
Refractive Errors and its Associated Factors among Undergraduate Medical Students in Kathmandu
Authors: Rizyal Aparna , Sunrait JS , Mishal A
Published: July 2019

Refractive error is a defect in the optical system of the eye which prevents light from being brought to a single point focus on the retina, thus reducing normal vision. This optical defect is the second most common cause of visual impairment globally as well in Nepal. At present, there are 285 million visually impaired people in the world. An estimated 4 out of 5 visual impairment (80%) can be prevented or cured, uncorrected refractive errors are the leading cause (42%) followed by cataract (33%). A descriptive cross sectional study was conducted to determine the proportion of undergraduate medical students with refractive errors in Nepal Medical College, and to identify factors associated with it. A total of 210 medical students volunteered for this study, with 100 males (47.6%) and 110 females (52.4%). The age of these students were between 18 to 26 years, with an average of 20.5 years. The proportion of medical students with refractive error was slightly more than half (51.4%), with simple myopia being the leading type (42.9%), followed by astigmatism (7.1%) and simple hypermetropia (1.4%). Parental history of refractive error was observed to be significantly associated with that of the medical students. There was also a significant association between refractive error and the daily use of mobile phones and laptops. However, years spent in medical education were not observed to be significant.
Comparison of Polyvinyl Acetate Sponge and Medicated Ribbon Gauge Nasal Pack following Nasal Surgery
Authors: Maharjan Shova , Jha AK , Joshi RR , Rijal AS , Shrestha KK , Dhungana A
Published: July 2019

Nasal occlusive dressings are routine after nasal surgeries to arrest hemorrhage, to prevent septal hematoma, and to prevent postoperative adhesions. However, patients describe nasal packing and its removal as their worst experience. Various types of nasal packs are available. Medicated ribbon gauge is the traditional form of nasal pack which consists of an open-mesh cotton as a carrier whereas “Polyvinyl Acetate’ sponge is a compressed dehydrated material, an improvised one which increases in size and compresses blood vessels when rehydrated with normal saline. As Polyvinyl acetate sponge is smooth and spongy, it causes less pain and abrasion while in-situ and removal. This was a prospective comparative study done in tertiary hospital of Nepal. Patients were subjected to either polyvinyl acetate sponge or ribbon gauge nasal pack following nasal surgery. Comparisons were made in terms of pain score, maintenance of hemostasis and wound healing. There were 154 patients in the study with 104 males and 50 females. The pain score when nasal pack was in-situ was similar in both groups whereas it was lesser in the polyvinyl acetate group on its removal. However, bleeding and adhesion were found to be similar. Crust formation was less in polyvinyl acetate group. Six synaechia were noted in ribbon gauge group only. Pain was significantly less during removal of polyvinyl acetate pack.
Radiological Assessment of Femoral Bicondylar Angle among Persons Attending a Tertiary Health Care
Authors: Pradhan Allin , Lama CP , Dhungel S , Ghosh SK
Published: July 2019

Femoral bicondylar angle is the angle between an axis through the shaft of the femur and a line perpendicular to the infracondylar plane. This study aims to assess femoral bicondylar angle measured from radiograph of femur and knee joints obtained from teaching hospitals in Kathmandu Nepal. Total of two hundred AP view radiograph of knee joint were collected, out of which, 50 each were of male right and left knee joint and 50 each were of female right and left knee joint. The mean angle for the right male femur was 7.86° with the range of 5°-10° and mean angle for the right female femur was 8.82° with the range of 6°-11°. On the left side, bicondylar angle ranged in male from 6° -10° with the average of 7.46° and in female range was 6°-11° and average was 8.66°. The bicondylar angle was higher in female on both the side, the difference was statistically significant on the left side (P=0.004) and significant on the right side (P=0.001). The finding of the study showed the femoral bicondylar angles were greater in right femur than left femur in both sexes. The difference in the bicondylar angle between the right and left femur was statistically insignificant in both sexes. (male p=0.144, female p=0.541). The result from this study has shown that femoral bicondylar angles were generally greater amongst the females as compared to the males; greater in right femur than left femur in both sexes.
Jess Fixator for Metacarpal and Phalangeal Fracture
Authors: Mishra Anil Kumar , Adhikari V , Chalise P , Shrestha P , Singh RP
Published: July 2019

The fractures of metacarpal and phalanges of the hand are the most common injury encountered in emergency department. Most often these injuries are neglected as minor injuries and later on develops a functional limit of the hand. Joshi’s external stabilizing system (JESS) fixator based on the principle of ligamentotaxis, stabilize the unstable and intraarticular fractures of metacarpal and phalangeal and also provides an environment for rapid soft tissue healing without further damaging the microvascular circulation. The study includes total number of 38 patients with a diagnosis of fracture of Metacarpal and phalanx of hand admitted in Nepal Medical college and Teaching Hospital who were treated with JESS fixator. The functional outcome after the removal of JESS fixator was assessed by calculating American Society for Surgery of Hand and Total Active flexion (ASSH TAF). Among the 38 patients, all fractures went to union with an average union period of 6 weeks. The mean period of treatment for metacarpal fractures was12 weeks and for phalangeal fractures 16 weeks by which time patients regained full functional activity of hand and returned back to their respective works. The functional outcome assessed by ASSH-TAF score was excellent in 28 patients, good in 10 patients and none of them had a poor result. The complication was seen in 9(23.68%) cases, superficial pin tract infection and K Wire Loosening. JESS fixator is cheap, easily available and less technically demanding, provides with an effective treatment for the metacarpal and phalanges fracture, as it provides adequate stability that allows early rehabilitation with soft tissue care and has got a good functional outcome
Outcome of Myringoplasty with Temporalis Fascia and Perichondrial-Cartilage Composite Graft in High Risk Perforations
Authors: Dhungana Anup , Joshi RR , Rijal AS , Shrestha KK , Maharjan S
Published: July 2019

The objective of this study was to compare the graft uptake results and postoperative hearing of myringoplasty with temporalis fascia and cartilage-perichondrial composite graft in high risk perforations. Patients of age 13 years and above with diagnosis of chronic otitis media – mucosal type with high risk perforation that is >50% perforation of tympanic membrane, revision cases, absent/ eroded handle of malleus, oedematous/unhealthy middle ear mucosa and marginal involvement cases were included for myringoplasty. Pure Tone Audiometry was done within 1 week before surgery. 80 cases were included for myringoplasty which were randomly allocated by lottery method with 40 cases each in temporalis fascia group and cartilage perichondrial composite graft group. Graft uptake results were assessed after 6 weeks and postoperative hearing was evaluated and compared within and between the groups. Graft uptake rate in temporalis fascia group and cartilage perichondrial composite graft group was 90% and 92.5%, respectively with no significance difference in the graft uptake rate (p = 0.692) between the groups. The mean pre and post-operative air bone gap in temporalis fascia group and cartilage perichondrial composite group were 30.69dB±10.19,16.36±8.37dB and 33.73±8.07dB, 20.76±9.47dB, respectively with highly significant difference in both groups (p < 0.001) showing improvement in the hearing after surgery in both groups. The mean air bone gain were 14.33dB and 12.97dB in temporalis fascia and cartilage perichondrial composite group respectively with no significant difference between the groups (p=0.469). The graft uptake rate and hearing results after cartilage perichondrial composite graft are comparable to those of temporalis fascia graft. Furthermore, the cartilage perichondrial composite graft is more rigid and thick so it is more resistant than fascia to anatomic deformation and necrosis. Therefore, we recommend the use of cartilage perichondrial composite graft for tympanic membrane reconstruction in high risk perforation without concern about affecting audiometric results.
Screening for Depression in Adolescents in Gokarneshwor Municipality-4, Kathmandu
Authors: Shrestha Niraj , Pandey S
Published: July 2019

Depression which is characterized by hopelessness and loss of interest in social activities is common during adolescence. However it is often unrecognized and the burden is even more in low income countries. It also increases the risk of suicide in future. Hence in a developing country like Nepal it is important that such cases are detected at the early stage preventing further worsening of the condition. A simple set of questionnaires like Patient Health Questionnaire (PHQ) 9 can be used to screen for depression. Using this questionnaire screening for depression was carried out in adolescents of Gokarneshwor municipality, ward 4. Four hundred and twenty participants were selected by the process of systematic random sampling. Based on answers to nine questions score was given and adolescents categorized as having no, mild, moderate or severe depression. The PHQ 9 score suggested that 13.1% were suffering from depression, out of which 23.6% from moderate to severe depression which required psychiatric consultation. Out of those shown to have some form of depression 40.0% said they had thought of self harm in last 2 weeks. Late adolescence was significantly associated with depression. Thoughts related to self harm were also six times more in late adolescent age group than the early adolescent age group.
Renal Replacement Therapy in Intensive Care Unit at a Tertiary Care Center in Nepal
Authors: Chhetri Pramod Kumar , Manandhar DN , Poudel P , Baidya S , Raju SB , Agrawaal KK
Published: July 2019

Acute kidney injury is a major complication in intensive care unit patients. It is associated with increased in-hospital mortality and length of stay. The provision of renal replacement therapy in intensive care is not widely available in resource poor countries like Nepal. The study aims to look into clinical profile and outcome of patients who received renal replacement therapy in intensive care unit. It was an observational study done from 1st October 2016 till 30th September 2017. Patient’s demographic data, indications, biochemical tests, outcomes, modality of renal replacement therapy were recorded. Statistical package for the social sciences version 17 was used for statistical analysis. There were total of 649 admissions in intensive care, among which 148 had kidney related complications. Of 148 patients, 69 (47%) received renal replacement therapy. Mean age, urea and creatinine on admission were 50.17 ± 18.42 years, 174.54 ± 63.46 mg/dl and 8.05 ± 3.49 mg/ dl respectively. They underwent 4.32 ± 3.09 sessions and 14.94 ± 10.88 hours of renal replacement therapy. Total 42 (61%) had septic shock on admission and underwent sustained low efficiency dialysis as the modality of renal replacement therapy. In-hospital mortality was 19 (28%). Presence of septic shock on admission and mean number of ionotropes required 2.05 ± 1.12 was statistically significant for in-hospital mortality (p=0.01). About half of the patients were on mechanical ventilation which was statistically significant for in-hospital mortality (p<0.001). Sustained low efficiency dialysis can be done in patients on ionotropes and patients can be switched over to intermittent hemodialysis.
KONFLIK DAN PERUBAHAN KEBIJAKAN DI PEGUNUNGAN KARST KENDENG: NARASI BELIEF SYSTEM DALAM ADVOCACY COALITIOAN FRAMEWORK
Authors: Wulandari Catur , Pratama Arif Budy , Purnaweni Hartuti , Kismartini Kismartini
Published: July 2019

This paper aims to investigate the dynamic of environmental policy making in the effort of attaining sustainable development. Using Advocacy Coalition Framework (ACF) as a framework of analysis, our study was conducted in the Kendeng environmental conflict, Rembang Regency. Utilised both primary and secondary data on conflict properties from cement industry’s proponents and opponents, researchers obtained vigorous data and evidence through which the ACF may offer a comprehensive explanation on policy process and change.                 Finding shows that the coalition of actor has a pivotal role to influence value and behaviour among policy actors in the Kendeng environmental conflict. The result of this study fills the lacuna of research which focuses the main discussion on advocacy coalition actor-based policy analysis. It also offers a policy agenda focusing on the belief system actor-based policy analysis in which Government of Indonesia worth to consider in the policy making process.
IMPLEMENTASI PERUBAHAN KEDUA KEBIJAKAN PENGAMPUNAN PAJAK TERKAIT PENGUNGKAPAN ASET SUKARELA DENGAN TARIF FINAL WAJIB PAJAK BADAN KPP MADYA JAKARTA BARAT
Authors: Selvi Selvi
Published: July 2019

This study aims to analyze the implementation of the second amendment to tax amnesty policy related to disclosure of voluntary assets at the final rate of corporate taxpayers at West Jakarta Medium Tax Office. This study uses a qualitative descriptive approach. The results showed that the implementation of the second amendment to the tax amnesty policy related to the disclosure of voluntary assets with the final rate in West Jakarta Medium Tax Office according to six factors used by the authors, namely policy size and objectives, resources, communication between organizations, characteristics of implementing agents, dispositions (tendency) of the implementers, social, economic and political environments have been fulfilled.              But there are some things that need to be observed, namely the target of PAS-Final policy is not appropriate for corporate taxpayers, which are due to corporate taxpayers more obedient, besides most of the corporate taxpayers have revealed their assets in tax amnesty policies, so the target should be more devoted to individual taxpayers. In addition, the participation of taxpayers to participate in this program is till lacking.
UPAYA DINAS KESEHATAN DALAM MENCEGAH PENYEBARAN PENYAKIT HIV AIDS DI KABUPATEN BUNGO
Authors: Susanto Joko
Published: July 2019

Bungo Regency is one of the autonomous regions in Jambi Province. Bungo Regency is an area that shows rapid development in all fields. These developments have a negative impact which one of these impacts is the rampant drug abuse and covert prostitution. Even though these two factors are the main mediators of the spread of HIV / AIDS. The purpose of this study was to find out about the health service's efforts in preventing the spread of HIV AIDS in Bungo District. The method used in this research is descriptive method with a qualitative approach. In this study the population was the Bungo District Health Office and the Bungo District community as a validity test, the number of samples was 12 informants, consisting of 7 informants from the Health Office and 5 informants from the community.            The data collection techniques are through observation, interviews and document review. Processing data is taken from primary data sourced from interviews, secondary data through theoretical analysis sourced from books, reports, and photographs. The results showed that the Health Service's efforts to prevent the spread of HIV / AIDS in Bungo District through various comprehensive measures, including preventive, promotive, curative, and rehabilitative with broad participation and cooperation involving various sectors and non-governmental organizations and communities has been good enough and has progressed but still needs to be improved so that Bungo Regency can be cleared of HIV / AIDS
Lise Öğrencilerinin Çizimlerinden “Ödev” Kavramına ilişkin Düşüncelerinin Analizi
Authors: EKİCİ Gülay , TURGUT Burcu , AKDENİZ Hasan
Published: July 2019

Bu
çalışmanın amacı, lise öğrencilerinin çizimlerinden ödev kavramına ilişkin
düşüncelerini analiz etmektir. Çalışma nitel araştırma modeli kapsamında durum
çalışması deseni kullanılarak hazırlanmıştır. Amaçlı çalışma grubu seçilen
araştırma toplam 225 lise öğrencisinin katılımıyla hazırlanmıştır. Verilerin
toplanmasında çizme-yazma tekniği kullanılmıştır. Kodlayıcılar arasındaki
ortalama güvenirlik % 96 olarak bulunmuştur. Bu süreçte verilerin analizinde
NVivo9.3 programından yararlanılarak içerik analizi yapılmıştır. Çalışmada
öğrencilerin oldukça orijinal çizimler yaptıkları ve çok fazla yazıyla açıklama
ihtiyacı duymadıkları belirlenmiştir. Bu kapsamda lise öğrencilerinin ödev
kavramıyla ilgili düşünceleri çizme-yazma tekniğiyle toplam 6 kategori kapsamında
analiz edilmiştir. Bu kategoriler şu şekilde sıralanmaktadır; “Aydınlatıcı/Temizleyici/ Besleyici etkisi,
Kontrol altına alıcı etkisi, Ödev yapabilmenin gerekleri, Sürekli çalışma gerektirmesi,
Paylaşım gerektirmesi ve Oyunu hatırlatması” kategorisine ait çok fazla
görüş belirttikleri tespit edilmiştir. Bu kapsamda ise ödev yapabilmek için geç
saatlere kadar çalışmak gerektiği, masa başında oturmak gerektiği ve ödev
yapmanın kişiyi kontrol altında tuttuğu belirtilmektedir. Ayrıca öğrenciler
çizimlerinde ve yazımlarında ödevin öğrencilerin akademik gelişiminde etkisi
olduğu, paylaşma duygusunu geliştirdiği, bir konuyla ilgili teknolojiyi de
kullanarak geniş kapsamlı bilgi elde edebileceklerini ifade ettikleri
belirlenmiştir. Sonuç olarak; öğrencilerin ödeve yönelik hem olumlu hem de
olumsuz düşüncelere sahip olduklarını söylemek mümkün.
Automatic Analysis of Facebook Posts and Comments Written in Brazilian Portuguese
Authors: Adán Coello Juan Manuel , Junqueira Bruno Augusto
Published: July 2019

Social networks and media are becoming increasingly important sources for knowing people's opinions and sentiments on a wide variety of topics. The huge number of messages published daily in these media makes it impractical to analyze them without the help of natural language processing systems.This article presents an approach to cluster texts by similarity and identifying the sentiments expressed by comments on then (positive, negative and neutral, among others) in an integrated manner. Unlike most of the available studies that focus on the English language and use Twitter as a data source, we treat Brazilian Portuguese posts and comments published on Facebook. The proposed approach employs an unsupervised learning algorithm to group posts and a supervised algorithm to identify the sentiments expressed in comments to posts. In an experimental evaluation, a system that implements the proposed approach showed similar accuracy to that of human evaluators in the tasks of clustering and sentiment analysis, but performed the tasks in much less time.
Endoscopic endonasal anterior clinoidectomy: surgical anatomy, technique nuance, and case series
Authors: Xiao Limin , Xie Shenhao , Tang Bin , Hu Jialing , Hong Tao
Published: July 2019

Advances in endoscopic technique allow for resection of the anterior clinoid process (ACP) via an endoscopic endonasal approach. The authors discuss the endoscopic endonasal anterior clinoidectomy (EEAC) and demonstrate the relevant surgical anatomy and technical nuances. The approach was simulated in 6 cadaveric heads. From a technical point of view, the lateral optic carotid recess was used as the landmark in the proposed technique. The superomedial, superolateral, and inferior vertices of this recess are the main operative points. The EEAC approach was achieved by disconnecting the ACP tip from the base by drilling the 3 vertices. The proposed approach was successfully performed in all cadaveric specimens. Then, in a case series involving 6 patients in whom the EEAC approach was used, there were no vascular injuries; 2 patients had postoperative oculomotor nerve palsy, which improved in one and resolved in the other by 1 month.

The EEAC approach for tumors and vascular lesions in the parasellar region is technically feasible. The surgical corridor is increased by ACP resection, although to a lesser extent than the transcranial anterior clinoidectomy. Based on the authors’ initial anatomical and surgical results, resection of the ACP via the endonasal endoscopic approach is a novel technique worth exploring in suitable cases.
Acute kidney injury after aneurysmal subarachnoid hemorrhage and its effect on patient outcome: an exploratory analysis
Authors: Eagles Matthew E. , Powell Maria F. , Ayling Oliver G. S. , Tso Michael K. , Macdonald R. Loch
Published: July 2019

OBJECTIVE

Acute kidney injury (AKI) is associated with death in critically ill patients, but this complication has not been well characterized after aneurysmal subarachnoid hemorrhage (aSAH). The purpose of this study was to determine the incidence of AKI after aSAH and to identify risk factors for renal dysfunction. Secondary objectives were to examine what effect AKI has on patient mortality and functional outcome at 12 weeks post-aSAH.

METHODS

The authors performed a post hoc analysis of the Clazosentan to Overcome Neurological Ischemia and Infarction Occurring After Subarachnoid Hemorrhage (CONSCIOUS-1) trial data set (clinical trial registration no.: NCT00111085, https://clinicaltrials.gov). The primary outcome of interest was the development of AKI, which was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Secondary outcomes of interest were death and a modified Rankin Scale score greater than 2 at 12 weeks post-aSAH. Propensity score matching was used to assess for a significant treatment effect related to clazosentan administration and AKI. Univariate analysis, locally weighted scatterplot smoothing (LOWESS) curves, and stepwise logistic regression models were used to evaluate for associations between baseline or disease-related characteristics and study outcomes.

RESULTS

One hundred fifty-six (38%) of the 413 patients enrolled in the CONSCIOUS-1 trial developed AKI during their ICU stay. A history of hypertension (p < 0.001) and the number of nephrotoxic medications administered (p = 0.029) were independent predictors of AKI on multivariate analysis. AKI was an independent predictor of death (p = 0.028) but not a poor functional outcome (p = 0.21) on multivariate testing. Unresolved renal dysfunction was the strongest independent predictor of death in this cohort (p < 0.001).

CONCLUSIONS

AKI is a common complication following aSAH. Patients with premorbid hypertension and those treated with nephrotoxic medications may be at greater risk for renal dysfunction. AKI appears to confer an increased probability of death after aSAH.
Impact of temperature decline from the previous day as a trigger of spontaneous subarachnoid hemorrhage: case-crossover study of prefectural stroke database
Authors: Fukuda Hitoshi , Ninomiya Hitoshi , Ueba Yusuke , Ohta Tsuyoshi , Kaneko Toshiaki , Kadota Tomohito , Hamada Fumihiro , Fukui Naoki , Nonaka Motonobu , Watari Yuya , Nishimoto Shota , Fukuda Maki , Hayashi Satoru , Izumidani Tomohiko , Nishimura Hiroyuki , Moriki Akihito , Lo Benjamin , Ueba Tetsuya
Published: July 2019

OBJECTIVE

Several environmental factors have been reported to correlate with incidence of spontaneous subarachnoid hemorrhage (SAH). However, because of different patient selection and study designs among these studies, meteorological factors that trigger the incidence of SAH in a short hazard period remain unknown. Among meteorological factors, daily temperature changes may disrupt and violate homeostasis and predispose to cerebrovascular circulatory disturbances and strokes. The authors aimed to investigate whether a decline in the temperature from the highest of the previous day to the lowest of the event day (temperature decline from the previous day [TDP]) triggers SAH in the prefecture-wide stroke database.

METHODS

All 28 participating institutions with primary or comprehensive stroke centers located throughout Kochi Prefecture, Japan, were included in the study. Data collected between January 2012 and December 2016 were analyzed, and 715 consecutive SAH patients with a defined date of onset were enrolled. Meteorological data in this period were obtained from the Kochi Local Meteorological Observatory. A case-crossover study was performed to investigate association of TDP and other environmental factors with onset of SAH.

RESULTS

The increasing TDP in 1°C on the day of the SAH event was associated with an increased incidence of SAH (OR 1.041, 95% CI 1.007–1.077) after adjustment for other environmental factors. According to the stratified analysis, a significant association between TDP and SAH was observed in women, patients < 65 years old, and patients with weekday onset. Among these factors, increasing TDP had a great impact on SAH onset in patients < 65 years old (p = 0.028, Mann-Whitney U-test).

CONCLUSIONS

TDP, temperature decline from the highest of the previous day to the lowest of the day, was correlated with the incidence of spontaneous SAH, particularly in younger patients < 65 years old.
Retromastoid-transmuscular identification and harvest of the occipital artery during retrosigmoid craniotomy
Authors: Tayebi Meybodi Ali , Lawton Michael T. , Moreira Leandro Borba , Zhao Xiaochun , Lang Michael J. , Nakaji Peter , Preul Mark C.
Published: July 2019

OBJECTIVE

Harvesting the occipital artery (OA) is challenging. The subcutaneous OA is usually found near the superior nuchal line and followed proximally, requiring a large incision and risking damage to the superficially located OA. The authors assessed the anatomical feasibility and safety of exposing the OA through a retromastoid-transmuscular approach.

METHODS

Using 10 cadaveric heads, 20 OAs were harvested though a 5-cm retroauricular incision placed 5 cm posterior to the external auditory meatus. The underlying muscle layers were sequentially cut and recorded before exposing the OA. Changes in the orientation of muscle fibers were used as a roadmap to expose the OA without damaging it.

RESULTS

The suboccipital segment of the OA was exposed without damage after incising two consecutive layers of muscles and their investing fasciae. These muscles displayed different fiber directions: the superficially located sternocleidomastoid muscle with vertically oriented fibers, and the underlying splenius capitis with anteroposteriorly (and mediolaterally) oriented fibers. The OA could be harvested along the entire length of the skin incision in all specimens. If needed, the incision can be extended proximally and/or distally to follow the OA and harvest greater lengths.

CONCLUSIONS

This transmuscular technique for identification of the OA is a reliable method and may facilitate exposure and protection of the OA during a retrosigmoid approach. This technique may obviate the need for larger incisions when planning a bypass to nearby arteries in the posterior circulation via a retrosigmoid craniotomy. Additionally, the small skin incision can be enlarged when a different craniotomy and/or bypass is planned or when a greater length of the OA is needed to be harvested.
Temporal disconnection between pain relief and trigeminal nerve microstructural changes after Gamma Knife radiosurgery for trigeminal neuralgia
Authors: Shih-Ping Hung Peter , Tohyama Sarasa , Zhang Jia Y. , Hodaie Mojgan
Published: July 2019

OBJECTIVE

Gamma Knife radiosurgery (GKRS) is a noninvasive surgical treatment option for patients with medically refractive classic trigeminal neuralgia (TN). The long-term microstructural consequences of radiosurgery and their association with pain relief remain unclear. To better understand this topic, the authors used diffusion tensor imaging (DTI) to characterize the effects of GKRS on trigeminal nerve microstructure over multiple posttreatment time points.

METHODS

Ninety-two sets of 3-T anatomical and diffusion-weighted MR images from 55 patients with TN treated by GKRS were divided within 6-, 12-, and 24-month posttreatment time points into responder and nonresponder subgroups (≥ 75% and < 75% reduction in posttreatment pain intensity, respectively). Within each subgroup, posttreatment pain intensity was then assessed against pretreatment levels and followed by DTI metric analyses, contrasting treated and contralateral control nerves to identify specific biomarkers of successful pain relief.

RESULTS

GKRS resulted in successful pain relief that was accompanied by asynchronous reductions in fractional anisotropy (FA), which maximized 24 months after treatment. While GKRS responders demonstrated significantly reduced FA within the radiosurgery target 12 and 24 months posttreatment (p < 0.05 and p < 0.01, respectively), nonresponders had statistically indistinguishable DTI metrics between nerve types at each time point.

CONCLUSIONS

Ultimately, this study serves as the first step toward an improved understanding of the long-term microstructural effect of radiosurgery on TN. Given that FA reductions remained specific to responders and were absent in nonresponders up to 24 months posttreatment, FA changes have the potential of serving as temporally consistent biomarkers of optimal pain relief following radiosurgical treatment for classic TN.
A phase II randomized controlled trial of tiopronin for aneurysmal subarachnoid hemorrhage
Authors: Ironside Natasha , Christophe Brandon , Bruce Samuel , Carpenter Amanda M. , Robison Trae , Yoh Nina , Cremers Serge , Landry Donald , Frey Hans-Peter , Chen Ching-Jen , Hoh Brian L. , Kim Louis J. , Claassen Jan , Connolly Edward Sander
Published: July 2019

OBJECTIVE

Delayed cerebral ischemia (DCI) is a significant contributor to poor outcomes after aneurysmal subarachnoid hemorrhage (aSAH). The neurotoxin 3-aminopropanal (3-AP) is upregulated in cerebral ischemia. This phase II clinical trial evaluated the efficacy of tiopronin in reducing CSF 3-AP levels in patients with aSAH.

METHODS

In this prospective, randomized, double-blind, placebo-controlled, multicenter clinical trial, 60 patients were assigned to receive tiopronin or placebo in a 1:1 ratio. Treatment was commenced within 96 hours after aSAH onset, administered at a dose of 3 g daily, and continued until 14 days after aSAH or hospital discharge, whichever occurred earlier. The primary efficacy outcome was the CSF 3-AP level at 7 ± 1 days after aSAH.

RESULTS

Of the 60 enrolled patients, 29 (97%) and 27 (93%) in the tiopronin and placebo arms, respectively, received more than one dose of the study drug or placebo. At post-aSAH day 7 ± 1, CSF samples were available in 41% (n = 12/29) and 48% (n = 13/27) of patients in the tiopronin and placebo arms, respectively. No difference in CSF 3-AP levels at post-aSAH day 7 ± 1 was observed between the study arms (11 ± 12 nmol/mL vs 13 ± 18 nmol/mL; p = 0.766). Prespecified adverse events led to early treatment cessation for 4 patients in the tiopronin arm and 2 in the placebo arm.

CONCLUSIONS

The power of this study was affected by missing data. Therefore, the authors could not establish or refute an effect of tiopronin on CSF 3-AP levels. Additional observational studies investigating the role of 3-AP as a biomarker for DCI may be warranted prior to its use as a molecular target in future clinical trials.

Clinical trial registration no.: NCT01095731 (ClinicalTrials.gov)
The study of soil crumbling when using new working bodies
Authors: Parhomenko G. G
Published: July 2019

Comparison of quality indicators of the results of research and testing on machine-testing stations with with their normalized values characterizes the compliance or non-compliance with the agrotechnical requirements of soil tillage machines and working bodies. According to agrotechnical requirements, one of the main indicators characterizing the quality of tillage is soil crumbling. The crumbs of the field surface depend on the quality of crumbling as with the predominance of the required size of lumps in the treated soil layer, an even field surface is observed. At a high quality of crumbling, soil particles smaller than 1 mm from the upper layer spill to the lower ones, preventing erosion. Objective: to characterize the quality of crumbling of the soil when using new working bodies in terms of compliance with agrotechnical requirements and compare it with analogues by the technological adapter. Compliance with the agrotechnical requirements of the new working bodies was determined according to the regulatory docu-mentation for soil tillage testing machines. It was found that by the quality of the layer crumbling (up to 98,5 %) and by reducing the number of erosion-hazardous particles in the upper soil layer (up to 18,13 %) new working bodies are superior to analogues by the process adapter. A positive impact on the quality of crumbling has had the use of elements of the working body, made in a curvilinear form (87,8-98,5 %) compared with a flat-cutter (65,1-76,8 %). Modernization of the flat-cut design with the possibility of self-setting the cutting angle at the angle of the natural cleavage of the soil allowed improving the quality of crumbling to 80,5-82,0 %, and the use of alternative materials - to 82,0-84,8 %. In terms of the quality of crumbling of the reservoir, new working bodies correspond to agrotechnical requirements of tillage pre-sowing. This reduces the number of technological operations for additional loosening and leveling the field surface before sowing. This reduces the number of technological operations for additional loosening and leveling the field surface before sowing. It was established that new working bodies are not inferior in terms of agrotechnical indicators to modern technical means for tillage.
Heat generation in biofuel tractor diesel engines
Authors: Lihanov V. A , Lopatin O. P
Published: July 2019

While legal restrictions on the use of fossil fuels are being applied to conserve natural resources, mixed spirit fuels, vegetable oils and their esters are attracting increasing attention as promising alternative sustainable energy sources for tractors and agricultural machinery. The paper substantiates the need for the use of biofuels in tractor diesel engines. It is shown that the choice for diesel alternative biofuel with a perspective should be carried out in accordance with the design features of the engine and during its primary tests. In the paper we investigate such environmentally friendly energy sources such as methanol, ethanol and methyl ester of rapeseed oil (MЕRО). Methanol, ethanol and MЕRО have the potential to lead to some solutions to environmental problems, as there are abundant resources for their production and these sources of energy are characterized by relatively low emissions of harmful substances during combustion. The ways of bioethanol production from various raw materials and the process of rapeseed oil methanolysis are considered. It is shown that agricultural enterprises that consume mainly petroleum products as fuel are now quite capable of producing at least environmentally friendly renewable biofuels for their tractors. Experimental studies of tractor diesel engines on biofuels of the following compositions were carried out: alcohol-fuel emulsion (AFE, alcohol (methanol, ethanol) - 25 %, detergent-dispersing additive succinimide C-5A - 0,5 %, water - 7,0 %, diesel fuel - 67,5 %); methanol (88,0 %) and MЕRО (12,0 %). Based on the studies of the thermal performance of tractor diesel engines running on biofuel, the nature of the influence of their work on the characteristics of heat dissipation and defined their numeric values.
Optimization of parameters and modes of operation of the spiral-screw roller
Authors: Maslov G. G , Evglevskij R. O , Cybulevskij V. V
Published: July 2019

The method of planning a two-factor experiment substantiates the optimal parameters and operation mode of the spiral-helical roller for compacting the soil in order to create its optimum density in the sowing layer, which ensures friendly shoots of the sown seeds of cultivated plants and their sustainable development. The studies were carried out using the provisions of the experiment planning theory and the main measurement methods written in the regulatory documentation. The quantitative factors of the mathematical planning method are the design parameters and operating modes of the press roller. The Vк (plan) was used for its optimization, and the density of the soil in the rolled layer was taken as the optimization criterion (response), which depends on the size of the ballast weight attached to the frame of the roller and the operating speed of the unit. The levels of variation of the factors are chosen so that their optimal values, calculated theoretically, fall into the center of the interval of variation. Using the obtained regression equations in canonical form, we obtained hypersurfaces of dependence of soil density in the sowing layer on the operating speed of the aggregate and ballast weights, as well as dependencies of two-dimensional sections of soil density. The center of the experiment lies within the scope of the experiment. The value of the optimum density of the soil in the sowing layer of 1,25 g/сm3 at a working speed of the unit of 7,6 km/h and a ballast weight of 42,4 kg was obtained.
The transporting ability of the rotor of the soil-cultivating loosening and separating vehicle
Authors: Pashchenko V. F , Syromyatnikov Y. U.N
Published: July 2019

The subject of research is the process of interaction between the working bodies of the rotor of a soil-cultivating loosening and separating vehicle. The object of the study is a rotor knife, the transporting ca-pacity of which is determined by the size of the grooves left in the soil with a cross-sectional shape close to the trapezoid shape. The physical process of interaction with the soil of the rotor blade of a loosening and separating device is considered. In the first phase, when the knife is buried in the soil, a soil build-up is formed in front of the knife. In the second phase of the knife operation, the soil is under the influence of a build-up, the magnitude of which increases until the internal stresses in it reach the limit values and do not partially break it down. In the third phase of the impact of the knife on the soil, the build-up begins to separate from the main part of the soil and is discharged from the separation grid. The direction and mag-nitude of the displacement of the soil, as well as the parameters and shape of the grooves formed after the passage of the knife, are determined. It has been established that the thickness of the applied soil layer to the loosening and separating device and the angle of the rotor knife break have the greatest effect on the transporting ability of the rotor blade, the width of the rotor blade has the least effect. It has been proven that an increase in the transporting capacity of the rotor at the initial moment of entry of the knife into the soil can be achieved mainly by reducing the angle of entry of the rotor knives into the soil. The theoretical studies were applied using mechanical and mathematical modeling of the interaction of the working bodies with the soil. Baseline information to substantiate the study was obtained experimentally and by analyzing literary sources. The urgency lies in the fact that increasing the transporting ability of the rotor by reducing the angle of entry of knives into the soil will give the opportunity not to change the magnitude of the radius and angular velocity of the rotor which determine the energy performance of the loosening and separating device.
EFEKTIFITAS METODE SIKAT GIGI VERTIKAL DAN HORIZONTAL TERHADAP PENURUNAN INDEKS PLAK PADA ANAK USIA 9-11 TAHUN DI MI DDI SEPPANGE DI DESA TUNGKE KECAMATAN BENGO KABUPATEN BONE
Authors: Munadirah Munadirah , Saleh Muhammad
Published: July 2019

Latar belakang, Pembersihan gigi yang kurang baik dapat menyebabkan terjadinya akumulasi plak. Salah satu cara menghilangkan plak yaitu dengan menyikat gigi. Plak adalah lapisan tipis, tidak berwarna, mengandung kumpulan bakteri, melekat pada permukaan gigi dan selalu terbentuk di dalam mulut dan bila bercampur dengan gula yang ada dalam makanan akan membentuk asam. Metode, Penentuan Sampel dalam penelitian ini yaitu menggunakan sampel random sampling dengan mencari 40 siswa siswi MI DDI  Seppange di Desa Tungke Kecamatan Bengo Kabupaten Bone kemudian membaginya menjadi 2 kelompok yaitu 20 siswa dengan metode menyikat gigi secara vertkal dan 20 siswa dengan metode menyikat gigi secra horizontal  yang diberi penyuluhan tentang kesehatan gigi dan mulut