bluuebunny/crossref_metadata_2025 huggingface dataset:
The historic River Witham Bridge, Lincoln, UK
Authors: De'Ath Samuel Paul , Heap Christopher B.
Published: June 2019

River Witham Bridge in Lincoln, UK, is an underline railway bridge carrying two tracks over the River Witham and is owned by Network Rail. The bridge was listed in 1999 to recognise the historical significance of the 1848 river span, which comprises very rare tubular edge girders patented by the engineer William Fairbairn. The bridge was found to be in poor condition and have an inadequate assessed capacity for current rail traffic. To address these issues the bridge was successfully reconstructed in 2017, while the historic river span was also repaired and conserved – an essential element of the project. The conserved girders from the original river span were reinstated beneath the reconstructed bridge deck, maintaining the historic fabric and appearance of the original bridge for the benefit of future generations. The asset management, historical significance, maintenance, mitigation, reconstruction and conservation of this historic bridge are described in this paper.
Damages Arising from Contraventions of Competition Act 89 of 1998
Authors: Ratz Malcolm
Published: June 2019

Persons who have suffered loss or damage as a result of a prohibited practice in terms of the Competition Act 89 of 1998 (the Act) have the right to recover such damage in the civil courts. This right is expressly provided for in section 65 of the Act. To date South Africa has failed to usher in an efficient and effective environment for section 65 civil damages actions, despite growing success being achieved by the competition authorities in uncovering and prosecuting firms for contraventions of the Act, including prohibited practices. Understanding how section 65 rights might be vindicated and whether South Africa's damages regime is adequate to deal with potentially complex damages actions within the realm of competition law contraventions, a starting point would be to gain certainty as to the classification of the nature of section 65 damages. This article seeks to evaluate the arguments of whether these damages actions should be properly classified as statutory or delictual actions by the South African civil courts.
GÖKHÖYÜK BAĞLARI HÖYÜĞÜNDEN ERKEN DEMİR ÇAĞI SERAMİĞİ
Authors: GÜNDÜZ Ramazan
Published: June 2019

Yaklaşık olarak MÖ 1200’lerin başlarında
meydana gelen büyük bir kavimler göçü, Anadolu’nun ve Yakındoğu’nun sosyal ve
siyasi yapısında büyük değişimlere sebep olmuştur. Bu göçler sonrasında MÖ 2.
binyılın monarşik birçok devleti (Hitit, Mitanni, III. Babil, ’’Kaşga’’)
ortadan kalkmıştır.  Anadolu coğrafyasındaki
bu kargaşalarla birlikte yazılı kaynakların kesilmesi, burada yaşayan
topluluklar hakkında kısıtlı bilgilerin ele geçmesi bu dönemin Karanlık Çağ
olarak adlandırılmasına sebep olmuştur. Zaman içinde Boğazköy Hattuşa, Gordion Yassı Höyük, Alişar, gibi yerleşmelerde yapılan
kazılarda açığa çıkarılan seramiklerden elde edilen bulgular Orta Anadolu Demir
Çağı’nın aydınlatılmasına önemli katkılar sunmuştur. Boğazköy-Hattuşa, Gordion
ve Kaman Kale Höyük’te son dönemde temiz tabakalardan çıkarılan seramikler üzerinde
yapılan C14 analiz sonuçları Orta Anadolu Demir Çağı’nın daha anlaşılır bir
hale gelmesini sağlamıştır. Konya Ovasında ise kapsamalı bir kazı
çalışması olmadığından bölgenin Erken Demir Çağı hakkındaki bilgilerimiz yüzey
araştırmalarından gelen sonuçlardan elde edilmektedir. Konya Ovası’nın güney
batısında bulunan Gökhöyük Bağları Höyüğünde yapılan kazılarda ortaya çıkarılan
bir grup Erken Demir Çağ seramiği bu çalışmanın konusunu oluşturmaktadır. İncelenen
çanakların bir kısmı üzerinde ip baskı bezeme bulunurken kalan parçalarda
herhangi bir bezeme görülmez. Burada çalışılan seramiklerden yola çıkarak Gökhöyük Bağları Höyüğün de
Erken Demir Çağı’na geçişte kültürel devamlılığın devam edip etmediğinin
anlaşılmasına katkı sağlamak amaçlanmıştır.
Factors of unfavorable prognosis of endovascular interventions in patients with dysfunctional myocardium and concomitant diabetes mellitus type 2
Authors: Rustamova Ya K , Imanov G G , Azizov V. A , Dzhakhangirov T S , Maksimkin D A
Published: June 2019

Aim. Study of the features of endovascular intervention, correction of the lipid and carbohydrate metabolism as well as the role of myocardial visualization methods and their effect on delayed results of treatment of patients with left ventricular dysfunctional myocardium and concomitant diabetes mellitus.

Methods. The analysis of the treatment results of patients with dysfunctional myocardium and concomitant diabetes mellitus type 2 was performed. The analysis included 112 patients. The comparison group included 102 patients without diabetes. Visualization of postinfarction myocardial changes was performed with the use of magnetic resinance imaging of the heart both before and after the assessment of the delayed results.

Results. After 18-months follow-up mortality from cardiovascular comlications as well as the rate of major cardiac events was similar to that among patients without diabetes (1.8 and 1%; 6.25 and 3.92%, respectively). The similar tendency was observed 24 months after the intervention (3.3 and 2.3%; 9.8 and 5.7%, respectively). Among the factors associated with the development of such complications are preoperative values of glycosylated hemoglobin ≥6.5%, fasting plasm level of glucose ≥6.0 mmol/l, total cholesterol ≥5.2%, triglycerides ≥1,7 mmol/l, low-density lipoproteins ≥2.5 mmol/l. Also percutaneous coronary intervention later than 30 days after the myocardial infarction and incomplete myocardial revascularization, SYNTAX score >25, transmurality index ≥0.45, cardiac fibrosis ≥45% and presence of diabetes mellitus were prognostically unfavorable risk factors of cardiovascular events.

Conclusion. In patients with left ventricular dysfunctional myocardium and concomitant diabetes mellitus higher efficacy of endivascular intervention was observed and the prevalence of major cardiac events was camparable to the patients without diabetes; delayed percutaneous coronary intervention, incomplete myocardial revascularization, high indices of transmurality and cardiac fibrosis are prognostically unfavorable risk factors of cardiovascular events.
Blood pressure variability in pregnant women with risk factors of preeclempsia
Authors: Mayanskaya S D , Ganeeva A V , Gabidullina R I
Published: June 2019

Aim. To assess the short-term and long-term variability of blood pressure in women, starting from early pregnancy, to predict the development of complications of gestation, including preeclempsia.

Methods. In 131 pregnant women, systolic blood pressure, diastolic blood pressure, as well as short-term (intra-visit) and long-term (inter-visit) blood pressure variability were assessed during the gestation period and 6 weeks after delivery. At the end of gestation period, depending on the identified complications, all study participants were divided into four groups: group 1 - control (healthy); group 2 - pregnant with preeclempsia; group 3 - with placental insufficiency; group 4 - with chronic arterial hypertension. In patients with placental insufficiency the indices of fetal growth retardation were also analyzed.

Results. In group 4, starting from the second trimester, higher values of short-term blood pressure variability were demonstrated, which increased as pregnancy progressed. Long-term blood pressure variability increased in groups 2 and 4, starting from the second trimester. In pregnant women with fetal growth retardation in the first trimester, blood pressure variability was higher than in pregnant controls and in the second trimester it was higher than in the group with the subsequent development of preeclempsia. Thus, during pregnancy complicated by preeclempsia or placental insufficiency with fetal growth retardation, high long-term blood pressure variability was observed. At the same time, the highest values were observed in the third trimester.

Conclusion. The assessment of long-term blood pressure variability from the early gestation seems to be an effective tool for detecting preclinical changes in the body of a pregnant woman, preceding the development of preeclempsia and fetal growth retardation, and in the presence of risk factors of preeclampsia allows narrowing the group of patients for target follow-up and prevention.
Evaluation of the impact of specific preventive measures on the incidence of tick-borne viral encephalitis in the Altai Krai in 2000-2017
Authors: Saldan I P , Timonin A V , Shirokostup S V , Luk’yanenko N V , Balandovich B A
Published: June 2019

Aim. Analysis of the effectiveness of specific preventive measures against tick-borne viral encephalitis among the urban and rural population of the Altai Krai of different age groups in 2000-2017.

Methods. The paper presents the results of a long-term epidemiological analysis of the incidence among urban and rural population of the Altai Krai of tick-borne viral encephalitis in 2000-2017, the calculation of absolute and relative indicators, long-standing dynamics of the incidence of tick-borne viral encephalitis in RF ad Altai Krai was evaluzted as well as summarized parameter of vaccination and revaccination. Statistical data processing was carried out in the program Statistica 12.0.

Results. The study revealed an inverse moderate correlation between the factor of the volume of emergency prophylaxis and the incidence of tick-borne viral encephalitis among the population of the Altai Krai (r=-0.51; p
Juan Larrea y el Nuevo Mundo: entre la filosofía y la mística
Authors: Andersen Katrine Helene
Published: June 2019

Celem niniejszego opracowania była analiza mistycznych cech doświadczeń J. Larrei w Peru i Meksyku, opisanych w Orbe i Diario del Nuevo Mundo. Zostały one porównane z definicją mistycznego doświadczenia W. Jamesa. Przeprowadzono analizę ich rozwoju i realizacji w celu zbadania relacji między tym, co osobiste i absolutne w filozoficznym projekcie Larrei. Na tej podstawie wskazano, że poprzez mistycyzm Larrea porzuca indywidualne „ja” jako podmiot myślący oraz że podstawą metodologii jego metafizycznego myślenia są Orbe i Diario del Nuevo Mundo.
Le soi chez les autres : comment se transformer sans se perdre?
Authors: Caroux Jacques , Rajotte Pierre
Published: June 2019

Dans cet article, notre enjeu a été d’explorer les différentes modalités du rapport à soi et aux autres s’exprimant dans les récits de voyageurs et de pèlerins québécois du XXe siècle. À partir de l’analyse de plus de soixante récits, nous avons dégagé trois configurations culturelles témoignant de changements importants dans la façon de présenter son identité et d’envisager d’autres cultures, d’autres modes de vie. De l’affirmation endogamique de soi s’articulant à une dévalorisation des autres, nous passons à la recherche chez l’autre d’un trésor perdu puis à une tentative de reconstruction identitaire permettant au soi d’affirmer sa singularité. Abstract In this paper, the aim was to explore the different representations of the relation to the Self and the Other as expressed in Quebec travelers’ and pilgrims’ accounts of the 20th century. Through the study of more than sixty accounts, three cultural configurations that reveal important changes in the ways to represent one’s identity and to contemplate other cultures were observed. First there is an endogamic affirmation of the Self hinging on the disparagement of the Other, then there is the Self seeking in the Other a lost treasure, and finally comes an attempt to reconstruct the identity of the Self, allowing it to assert its singularity.
Américanité et quête identitaire dans La Montagne secrète de Gabrielle Roy
Authors: Doyon Nova
Published: June 2019

Dans les romans et nouvelles de Gabrielle Roy qui ont pour cadre le territoire nordique canadien, l’espace géographique constitue une source d’apprentissage, de prise de conscience, de transformation pour certains personnages. La présente analyse se consacrera à La Montagne secrète pour montrer comment le roman, publié en 1961, réactive un certain nombre de mythes fondateurs de l’imaginaire américain et fait de l’expérience continentale le lieu d’une interrogation personnelle sur le rapport à soi et aux autres. Si la nature sauvage et les grands espaces constituent la source d’inspiration du peintre-trappeur Pierre Cadorai, c’est l’exploration de la condition humaine qui donne sens à sa quête. Proposant une représentation originale de l’espace canadien, La Montagne secrète témoigne d’une réinterprétation du rapport symbolique au territoire sur le mode non plus collectif mais individuel et participe en ce sens à la constitution d’un nouvel imaginaire territorial revendiqué par les institutions littéraires tant québécoise que canadienne-anglaise. Abstract In Gabrielle Roy’s novels and short stories set in the Canadian Northern Territory, geographical space appears as a source for learning, awareness and transformation for certain characters. This analysis will focus on La Montagne secrète to show how the novel, published in 1961, revives a number of founding myths of the American imaginary and turns the continental experience into an opportunity to question one’s relation to oneself and others. If the painter-trapper Pierre Cadorai finds inspiration in wilderness and vast spaces, it is the exploration of the human condition that gives sense to his quest. Proposing an original representation of Canadian space, La Montagne secrète bears witness to a reinterpretation of the symbolic connection with the territory from the individual rather than the collective viewpoint and participates in this sense in the constitution of a new territorial imaginary claimed by both Quebec and English-Canadian literary institutions.
Le ton de Patrick Modiano : du roman ironique au roman affectif
Authors: Amar Ruth
Published: June 2019

Cette étude analyse la manière dont s’exprime le ton de Modiano, la manière par laquelle l’auteur s’individualise. Un ton difficile à saisir, car s’il paraît au premier abord neutre, derrière les phrases, se cachent des éléments qui contribuent à un ton spécifique,voire à la voix de l’auteur. Au fil de l’œuvre, l’on découvre que la voix de Modiano n’est pas homogène. Le ton du jeune écrivain des années 1970 n’est pas celui des années 1980. Il s’est métamorphosé et a évolué de manière considérable. En comparant La Place de l’étoile et Dora Bruder, on est conscient de la transformation : le ton retentissant des débuts de Modiano s’est affaiblit, devenant presque imperceptible, reflétant le fait que la représentation de l’holocauste dans ces deux livres est bien différente. Abstract In this paper I will explore the way in which the characteristics of Modiano’s tone are expressed in the texts, the way in which the author individualizes himself. A tone so hard to cease as it seems at first neutral, but behind the sentences, are hidden elements that contribute to the specific tone and even to the voice of the writer. In considering the work, one finds that the voice of Modiano is not homogeneous. The tone of young writer of the seventies is no longer that of the writer of the nineties. He has suffered metamorphosis and has evolved significantly. In comparing La Place de l’étoile to Dora Bruder, one becomes well aware of the transformation: the tone first shining and thundering, is weakened to become, almost imperceptible and reflects the fact that the representation of the Holocaust in these two books is quite different.
Eustachian tube functional assessment among patients with CSOM undergoing tympanoplasty surgery
Authors: P. Hemalatha , V. J. Vikram
Published: June 2019

Background: Pre-operative test of eustachian tube (ET) function is important for achieving a satisfactory result of tympanoplasty for CSOM patients. The saccharin test and methylene blue test seems to provide adequate information of the mucociliary function and patency of the ET. The aim was to study the ventilatory and mucociliary function of Eustachian tube in patients with chronic suppurative otitis media planned for tympanoplasty surgery and to assess the success rate of tympanoplasty in relation to the Eustachian tube function

Methods: A prospective longitudinal study was conducted for a period of one year. Patients aged more than 15 years with features of chronic suppurative otitis media of either tubotympanic type or atticoantral type were included in the study. The total number of study subjects included in our study was 82 patients with CSOM. The ventilatory and the mucociliary functions of the auditory tube were assessed preoperatively using saccharin test and methylene blue test. All patients with CSOM underwent tympanoplasty surgery and the outcome of the surgery was assessed.  

Results: The overall success rate of tympanoplasty surgery was 76.8%. It was observed in our study that the success rate of tympanoplasty was higher among patients with normal eustachian tube function.

Conclusions: Preoperative evaluation of eustachian tube function is mandatory for all the patients planned for tympanoplasty. Preoperative and intraoperative corrective measures should be taken in patients with partial and absent tubal function to improve the success rate of tympanoplasty surgeries.

 
Loon en arbeidsmarkt in Nederland, 1800-1850. Een overzicht en uitblik
Authors: Bos R.W.J.M.
Published: June 2019

R.T. Griffiths, Industrial retardation in the Netherlands 1830-1850
Een nieuwe generatie kleine bronnenpublikaties
Authors: Wels C.B.
Published: June 2019

J.C. Kort, Nederlandse Historische Bronnen, I, II
De ontwikkeling van de nationalistische beweging in Nederlands-Indië
Authors: Locher-Scholten E.B.
Published: June 2019

R.C. Kwantes, De ontwikkeling van de nationalistische beweging in Nederlandsch-Indië. Bronnenpublicatie, Tweede stuk, Medio 1923-1928
R.C. Kwantes, De ontwikkeling van de nationalistische beweging in Nederlandsch-Indië. Bronnenpublicatie, Derde stuk, 1928-augustus 1933
R.C. Kwantes, De ontwikkeling van de nationalistische beweging in Nederlandsch-Indië. Bronnenpublicatie, Vierde stuk, augustus 1933-1942
Kantelend geschiedbeeld
Authors: Kossmann E.H.
Published: June 2019

W.W. Mijnhardt, Kantelend geschiedbeeld. Nederlandse historiografie sinds 1945
Enkele studies en uitgaven over de scheiding tussen Noord en Zuid Nederland 1830
Authors: Smits A.
Published: June 2019

Acta colloquium over de geschiedenis van de Belgisch-Nederlandse betrekkingen tussen 1815 en 1945. Brussel 10-12 december 1980
Willem van Oranje 1584-1984. Een literatuuroverzicht
Authors: Postma F.R.
Published: June 2019

R.H. Bremmer, Reformatie en rebellie. Willem van Oranje, de calvinisten en het recht van opstand. Tien ontstuimige jaren: 1572-1581
A.Th. van Deursen, Willem van Oranje. Een strijd voor vrijheid en verdraagzaamheid
E.O.G. Haitsma Mulier, A.E.M. Jansen, Willem van Oranje in de historie. Vier eeuwen beeldvorming en geschiedschrijving
J.H. Kluiver, De correspondentie tussen Willem van Oranje en Jan van Nassau, 1578-1584
F. Wieringa, Republiek tussen Vorsten. Oranje, Opstand, Vrijheid, Geloof
Atypical form of microscopic colitis in 56-year-old patient presenting with long-lasting watery diarrhea
Authors: Kiełtucki Jacek , Zając Joanna
Published: June 2019

Mikroskopowe zapalenie jelita grubego to częsta przyczyna przewlekłej biegunki niewiadomego pochodzenia. Choroba charakteryzuje się obecnością objawów klinicznych, makroskopowo prawidłowym wyglądem błony śluzowej jelita grubego w kolonoskopii i obecnością typowych zmian w badaniu histopatologicznym. Celem pracy jest przedstawienie nietypowego obrazu histologicznego mikroskopowego zapalenia jelita grubego. Autorzy prezentują przypadek 56-letniego mężczyzny z uporczywą, wodnistą biegunką, z pochopnie rozpoznaną niewydolnością zewnątrzwydzielniczą trzustki. Po wykluczeniu infekcyjnego tła biegunki wykonano kolonoskopię, ukazując makroskopowo niemal prawidłowy obraz jelita grubego. Otrzymano niespójne wyniki badań histopatologicznych. W badaniu mikroskopowym wycinków z okrężnicy potwierdzono rozpoznanie kolagenowego mikroskopowego zapalenia jelita grubego (w preparacie grubość kolagenu podnabłonkowego wynosiła > 10 µm, liczba limfocytów śródnabłonkowych < 20 w przeliczeniu na 100 komórek nabłonka). Tymczasem podczas kontrolnej kolonoskopii w wycinkach z jelita grubego ujawniono cechy zapalenia limfocytowego, w badanych próbkach nie wykazano obecności złogów podnabłonkowego kolagenu. Autorzy analizują czynniki ryzyka zachorowania, odpowiedź na zastosowane leczenie, przebieg kliniczny choroby oraz rozbieżne wyniki badań histopatologicznych.
Mechanical complications of acute myocardial infarction considering risk factors, treatment and survival of patients in 10-year clinical observation
Authors: Dąbek Józefa , Skorus Paweł , Potyka Katarzyna , Potyka Marek , Stachoń Krystian , Gąsior Zbigniew
Published: June 2019

Wstęp

Choroby układu krążenia, w tym choroba wieńcowa i jej powikłania, stanowią najczęstszą przyczynę zgonów.
Zawał mięśnia sercowego spowodowany jest zwykle pęknięciem blaszki miażdżycowej i zamknięciem tętnicy wieńcowej
skrzepliną.

Materiał i metody

Badaniem objęto 52 chorych (100%) z mechanicznymi powikłaniami ostrego zawału serca, hospitalizowanych
w II Oddziale Kardiologii oraz Oddziale Anestezjologii i Intensywnej Terapii Górnośląskiego Centrum Medycznego w Katowicach w latach 2006–2016, w tym 23 kobiety (44,2%) i 29 mężczyzn (55,8%) w wieku 54‒84 lat (średnia wieku 69,8 roku).

Wyniki

Najczęstszym powikłaniem było pęknięcie przegrody międzykomorowej (n = 36; 69,2%), natomiast do najrzadszych
należały pęknięcie mięśnia brodawkowatego (n = 4; 7,7%) i pęknięcie ścięgien (n = 4; 7,7%). Nadciśnienie i hipercholesterolemia były najczęstszymi czynnikami ryzyka wystąpienia choroby niedokrwiennej serca w badanej grupie.
Zwiększoną śmiertelność zaobserwowano u pacjentów leczonych farmakologicznie (87,5%), podczas gdy śmiertelność pacjentów leczonych operacyjnie wynosiła 61,4%. U większości pacjentów występował jeden czynnik ryzyka choroby wieńcowej (n = 28; 53,8%).

Wnioski

1. Najczęstszymi powikłaniami były pęknięcie przegrody międzykomorowej i pęknięcie ściany serca.
2. U pacjentów występowało wiele czynników ryzyka dla choroby niedokrwiennej serca, spośród których najczęstszymi
były nadciśnienie i hipercholesterolemia.
3. Śmiertelność w badanej grupie chorych z mechanicznymi powikłaniami ostrego zawału serca znacznie przewyższała
przeżywalność i była większa w grupie leczonych zachowawczo.
MIDWIVES’ COMPLIANCE TO THE STANDARD OPERATING PROCEDURE ON THE EARLY IDENTIFICATION OF PREECLAMPSIA
Authors: Islami Dian
Published: June 2019

Background: The main cause of maternal mortality in East Java was pregnancy hypertension (Preeclampsia/eclampsia). The percentages of pregnant women treated with early identification of preeclampsia care according to Standard Operating Procedure (SOP) in primary healthcare centers of Surabaya was still low (26%).Aim: This study aimed to analyze the factors that influence midwives’ compliance towards the SOP implementation of early identification of preeclampsia in primary healthcare centers of Surabaya.Methods: The study was an observational analytic research with cross sectional. The samples chose midwives at 20 primary healthcare centers as the informants. The independent variables are individual factors, organizational factors, and psychological factors of the midwives. The dependent variable was midwives’ compliance towards the implementation of SOP for early identification of preeclampsia.Results: The results of this study show 35% of primary healthcare centers have not implemented the SOP of early identification of Preeclampsia in pregnant women. The results also showed that the majority of primary healthcare centers in Surabaya had midwives aged 31 to 40 years (50%), graduated from a Diploma 3 education (95%), contracted status (85%) and still worked less than six years (60%).Conclusion: This research highlighted the midwives’ compliance which was determined not only by individual internal factors, but also organizational behavior. Preparing early identification of preeclampsia mechanisms, facility, and equipment proposal is important to do with the implementation of supportive system, quality control team, reward as well as punishment system. Keywords: Compliance, Early identification, Midwives, Preeclampsia, SOP.
Enhanced recovery after surgery (ERAS) pathway for primary hip and knee arthroplasty: study protocol for a randomized controlled trial
Authors: Li Jingyi , Zhu Haibei , Liao Ren
Published: June 2019

Background: With the substantially growing trend of the aging populations in China and the rest of the world, the number of total hip and total knee arthroplasty (THA and TKA) cases are increasing dramatically. It’s important to develop practical strategies to improve the quality of healthcare and better outcome for patients undergoing THA and TKA. Enhanced recovery after surgery (ERAS) pathways have been reported to promote earlier recovery and be beneficial for patients. We propose the hypothesis that ERAS pathway could provide better recovery for patients undergoing primary THA or TKA.
Methods/Design: This trial is a prospective, open-labelled, randomized controlled trial that will evaluate the length of stay (LOS) in hospital, and other end points of interest for the patients undergoing ERAS pathway as compared to current non-ERAS clinical practice. A total of 640 patients undergoing primary THA or TKA will be randomly allocated to either ERAS pathway (ERAS group) or conventional care according to individual participating center (non-ERAS group). The primary outcome is the total LOS in hospital, the secondary outcomes include Postoperative LOS, all-cause mortality by 30 days after operation, in-hospital complications, early mobilization, postoperative pain control, total in-hospital cost, and readmission rate by 30 days after discharge from the hospital.
Discussion: This trial is designed to evaluate the superiority of the ERAS pathway to conventional non-ERAS clinical practice in reducing the LOS without increasing the incidence of complications or medical cost. The results will provide new insight into the clinical applications of ERAS pathway for total hip and total knee arthroplasty.
Trial registration: The National Institutes of Health Clinical Trials Registry, NCT03517098. Registered 04, May, 2018. https://register.clinicaltrials.gov/prs/app/action/ SelectProtocol?sid=S0007YV7&selectaction=Edit&uid=U0001B4E&ts=2&cx=97eyz9
Randomised controlled trial on vitreoretinal surgery with and without oral anticoagulants: surgical complications, visual results and perioperative thromboembolic events
Authors: Andonegui Jose , Capdevila Ferran , Zubicoa Alicia , Ibáñez Berta
Published: June 2019

Background Vitreoretinal surgery in anticoagulated patients is a challenging situation for vitreoretinal surgeons, who have to choose between being faced with the systemic thromboembolic risks that the interruption of anticoagulation involves, or the intra and postoperative haemorrhagic risks associated with maintenance of this therapy. So far, no trial has compared, in a prospective and randomized manner, perioperative complications and the visual results associated with continuation or interruption of oral anticoagulant therapy before pars plana vitrectomy under retrobulbar anaesthesia. The main objective of this trial is to compare haemostasis-related perioperative complications of PPV in patients maintaining anticoagulant therapy before surgery compared to patients who interrupt this therapy before surgery. Methods Ninety six patients will be randomly assigned to either the control group, to whom oral anticoagulant therapy will be interrupted and substituted with subcutaneous heparin according to local clinical practice, or the intervention group to whom oral anticoagulant therapy will not be interrupted before surgery. Patients will be stratified according to the oral anticoagulant they were taking (direct or indirect anticoagulation). They will be followed-up for 12 weeks, and the primary outcome, and haemorrhagic complications until 15 days after surgery, will be evaluated. Discusion This trial will provide novel information on the possibility of continuing anticoagulant therapy during PPV. The benefits expected from the change in the current surgical management paradigm for anticoagulated patients would be a decreased risk in the incidence of perioperative thromboembolic events and the possibility of performing surgery without delay and without the need for patients to change their usual anticoagulation protocol to the more complex and less safe substitutive therapy.
Efficacy of integrating vestibular rehabilitation and cognitive behaviour therapy in persons with long-term dizziness in primary care– a study protocol for a randomised controlled trial
Authors: Kristiansen Lene , Magnussen Liv Heide , Wilhelmsen Kjersti Thulin , Mæland Silje , Nordahl Stein-Helge Glad , Clendaniel Richard , Hovland Anders , Juul-Kristensen Birgit
Published: June 2019

Background: Dizziness is a common complaint, and the symptom often persists, together with additional complaints. A treatment combining of Vestibular Rehabilitation (VR) and Cognitive Behaviour Therapy (CBT) is suggested. However, further research is necessary to evaluate the efficacy of such intervention. The objective of this paper is to present the design of a randomised controlled trial aiming at evaluating the efficacy of an integrated treatment of VR and CBT on dizziness, physical function, psychological complaints and quality of life in persons with persistent dizziness. Methods/Design: The randomised controlled trial is an assessor-blinded block randomised parallel-group design, with a 6- and 12- month follow-up. The study includes 125 participants from Bergen (Norway) and surrounding areas. Included participants present with persistent dizziness lasting at least 3 months, triggered or exacerbated by movement. All participants receive a one-session treatment (Brief Intervention) with VR before being randomised into a control-group or an intervention-group. The intervention-group will further be offered an eight-session treatment integrating VR and CBT. The primary outcomes in the study are the dizziness handicap inventory and preferred gait velocity. Discussion: Previous studies combining these treatments have been of varying methodological quality, with small samples, and long-term effects have not been maintained. In addition, only the CBT has been administered in supervised sessions, with VR offered as home-exercises. The current study focuses on the integrated treatment, sufficiently powered sample size, and a standardised treatment program evaluated by validated outcomes using a standardised assessment protocol. Trial registration: The study was registered at www.clinicaltrials.gov (NCT02655575) on January 14th 2016.
Assessing Quality Improvement Capacity in Primary Care Practices
Authors: Parchman Michael , Anderson Melissa L. , Coleman Katie F , Michaels LeAnn , Schuttner Linnaea , Conway Cullen , Hsu Clarissa , Fagnan Lyle J.
Published: June 2019

Background

Healthy Hearts Northwest (H2N) is a study of external support strategies to build quality improvement (QI) capacity in primary care with a focus on cardiovascular risk factors: appropriate aspirin use, blood pressure control, and tobacco screening/cessation.

Methods

To guide practice facilitator support, experts in practice transformation identified seven domains of QI capacity and mapped items from a previously validated medical home assessment tool to them. A practice facilitator (PF) met with clinicians and staff in each practice to discuss each item on the Quality Improvement Capacity Assessment (QICA) resulting in a practice-level response to each item. We examined the association between the QICA total and sub-scale scores, practice characteristics, a measure of prior experience with managing practice change, and performance on clinical quality measures (CQMs) for the three cardiovascular risk factors. Field notes kept by the PFs from practices with high and low QICA scores were compared.

Results

The QICA score was associated with prior experience managing change and two of the three CQMs: aspirin use (r=0.16, p=0.049) and blood pressure control (r=0.18, p=0.013). Rural practices and those with 2-5 clinicians had lower QICA scores. PFs notes provide examples of high scoring practices devoting time and attention to quality improvement whereas low scoring practices did not.

Conclusions

The QICA is useful for both assessing QI capacity within a practice and for guiding PFs and practices in efforts to build this capacity. Further work is needed to understand how PFs and practices tailored their work in response to this practice-level assessment and how practices used it to improve their QI capacity.
An unusual Neuronal Intranuclear Inclusion Disease with Chief Complaint of Autonomic Dysfunction
Authors: Liu Xiaoyun , Liu Xiaohui , Du Yifeng , Li Chunxia , liu Cuicui , Lu Lin
Published: June 2019

Background

Neuronal intranuclear inclusion disease (NIID) is a recently defined disease entity of progressive neurodegenerative disease with characterizations of eosinophilic hyaline intranuclear inclusions in neuronal and somatic cells. The sporadic adult-onset NIID cases were previous described as ‘dementia dominant group’. Here we present a NIID case manifested prominently with recurrent vomiting.

Case presentation

A 60-year-old women present with paroxysmal vomiting, hypertention and decreased level of consciousness for 3 years. She was diagnosed with NIID based on history, clinical features, brain magnetic resonance imaging(MRI), skin biopsy.

Conclusion

Autonomic symptoms may manifest as the initial and predominant presentation of NIID. This case presentation may extend the spectrum of NIID and may give new insights in exploring the pathogenic mechanisms of NIID.
High-intensity exercise to promote accelerated improvements in cardiorespiratory fitness (HI-PACE): Study protocol for a randomized controlled trial
Authors: McGee Joshua E. , Barefoot Savanna G. , Gniewek Nicole R. , Brophy Patricia M. , Clark Angela , Dubis Gabriel S. , Ryan Terence E. , Houmard Joseph A. , Vos Paul , Raedeke Thomas D. , Swift Damon L.
Published: June 2019

Background

African Americans have a disproportionate prevalence and incidence of type 2 diabetes compared to Caucasians. Recent evidence indicates low cardiorespiratory fitness (CRF) level, an independent risk factor for type 2 diabetes, is also more prevalent in African Americans than Caucasians. Numerous studies in Caucasian populations suggest vigorous exercise intensity may promote greater improvements in CRF and other type 2 diabetes risk factors (e.g. reduction of glucose/insulin levels, pulse wave velocity, body fat, etc.) than moderate intensity. However, current evidence comparing health benefits of different aerobic exercise intensities on type 2 diabetes risk factors in African Americans is negligible. This is clinically important as African Americans have a greater risk for type 2 diabetes and are less likely to meet public health recommendations for physical activity than Caucasians. The purpose of the High-Intensity exercise to Promote Accelerated improvements in CardiorEspiratory fitness (HI-PACE) study is to evaluate whether high-intensity aerobic exercise elicits greater improvements in CRF, insulin action, and arterial stiffness than moderate-intensity exercise in African Americans.

Methods/Design­

A randomized controlled trial will be performed on overweight and obese (body mass index: 25-45 kg/m2) African Americans (35-65 years) (n=60). Participants will be randomized to moderate-intensity (MOD-INT) or high-intensity (HIGH-INT) aerobic exercise training, or a non-exercise control group (CON) for 24 weeks. Supervised exercise will be performed at a heart rate associated with 45-55% and 70-80% of VO2 max in the MOD-INT and the HIGH-INT groups, respectively, for an exercise dose of 600 MET-minutes/week (consistent with public health recommendations). The primary outcome is change in CRF. Secondary outcomes include change in insulin sensitivity (measured via an intravenous glucose tolerance test), skeletal muscle mitochondrial oxidative capacity (via near infrared spectroscopy), skeletal muscle measurements (i.e. citrate synthase, COX IV, GLUT-4, CPT-1, PGC1-α), arterial stiffness (via carotid-femoral pulse wave velocity), body fat, C-reactive protein, and psychological outcomes (quality of life/exercise enjoyment).

Discussion

The anticipated results of the HI-PACE study will provide vital information on the health effects of high-intensity exercise in African Americans. This study will advance health disparity research and has the potential to influence future public health guidelines for physical activity.
Comparison of subfoveal choroidal thickness in eyes with CRVO and BRVO
Authors: Author) Fen Tang(Former Corresponding , Xu Fan , Zhong Haibin , Zhao Xin , Lv Mingliang , Yang Ke , Shen Chaolan , Huang Hui , Lv Jian , Zeng Siming , Author) Min Li(New Corresponding , Chen Qi
Published: June 2019

Backgroud: To evaluate the subfoveal choroidal thickness (SFCT) in eyes with macular edema (ME) secondary to retinal vein occlusion（RVO），and to investigate the short term response after a single intravitreal ranibizumab (IVR) injection. What is more, to compare SFCT and SFCT change between central RVO (CRVO) and branch RVO (BRVO).
Methods: In the retrospective study, we had collected thirty-six treatment-naïve patients with unilateral ME secondary to RVO (including nineteen CRVO and seventeen BRVO). All patients had received IVR injection after newly diagnosed. The SFCT was measured at the onset and after two weeks of IVR injection. Paired t test was performed to compare the SFCT of RVO eyes and fellow eyes, as well as the SFCT of pre-injection and post-injection. In further, independent t test was used to compare SFCT and SFCT change between CRVO eyes and BRVO eyes.
Results: The mean SFCT at the onset was 326.03±30.86 μm in CRVO eyes, which was significantly thicker than that in contralateral fellow eyes (p<0.01, paired t test), and reduced to 294.15±30.83 μm rapidly after two weeks of IVR injection (p<0.01, paired t test). Similarly, the SFCT in BRVO eyes was significantly thicker than that in contralateral eyes at the onset, and decreased significantly after IVR injection. However, our findings showed that there was no statistically significant difference in SFCT and SFCT reduction after IVR injection between CRVO eyes and BRVO eyes.
Conclusions: The SFCT in eyes with ME secondary to CRVO and BRVO was significantly thicker than that in fellow eyes, and decreased significantly within a short time in response to a single IVR injection. In further, the study showed that SFCT and SFCT change had no correlation with RVO subtypes.
Comparison of Spectral Domain and Swept Source Optical Coherence Tomography for Angle Assessment of Chinese elderly subjects
Authors: Qiao Yunsheng , Tan Chen , Zhang Min , Sun Xinghui , Chen Junyi
Published: June 2019

Background This comparative study aimed to demonstrate the differences between swept source OCT (SS-OCT) (1310nm) and spectral domain OCT (SD-OCT) (840nm) for the identification and measurement of anterior chamber angle (ACA) structures. Methods 67 eyes from 67 healthy subjects underwent ACA imaging at the nasal and temporal sides using SS-OCT and SD-OCT with different wavelength (Tomey, 1310nm and RTvue, 840nm). Images were evaluated for the ability to distinguish angle structures including the Schwalbe’s line (SL), the Schlemm’s canal (SC) and the scleral spur (SS). The length of trabecular meshwork (LTM), the angle-opening distance (AOD500 and AOD750) and the length of Schlemm’s canal (LSC) were also measured. Results The nasal/temporal identification rate for angle structures by SS-OCT and SD-OCT were 91.04%/86.57% (SL), 50.75%/68.66% (SC), 100.0%/100.0% (SS) and 89.55%/91.04% (SL), 40.30%/70.15% (SC), 74.63%/65.67% (SS), respectively. Differences between SS-OCT and SD-OCT were found in terms of the visualization of the SS. With respect to the measurements of angle, the evaluation of LTM at the nasal side, LSC at the temporal side and AOD500/750 at both sides showed significant difference between the two devices. However, there existed good correlation between the AOD500/750 measured by SS-OCT and SD-OCT (Spearman's rank correlation coefficient > 0.8, p<0.000). Conclusions SS-OCT displayed a better performance in detecting deeper structures of the angle such as the SS. However, for discriminating structures lying in transparent or semi-transparent tissue such as the SL and the SC, the two devices showed good consistency. Although SS-OCT and SD-OCT demonstrated high correlation for angle measurement (AOD500/750), their agreement was poor.
Karaciğer Biyopsisi Nedenleri ve Sonuçları: Tek Merkez Deneyimi
Authors: GENCDAL Genco
Published: June 2019

AmaçGirişimsel doğasına, olası komplikasyonlarına ve son dönemde geliştirilen radyolojik görüntüleme yöntemlerinin varlığına karşın, karaciğer biyopsisi akut ve kronik karaciğer hastalıklarının tanı ve tedavisinde halen altın standart yöntemdir. Bu çalışmada, karaciğer nakil merkezimizde 2015–2018 döneminde gerçekleştirilmiş olan karaciğer biyopsilerinin neden ve sonuçlarını retrospektif olarak değerlendirmeyi amaçladık.Gereç ve YöntemlerOcak 2015—Mart 2018 döneminde kliniğimizde gerçekleştirilmiş olan karaciğer biyopsilerine dair dijital kayıtlar incelenmiştir. Biyopsi nedenleri ve histopatolojik inceleme sonuçları retrospektif olarak değerlendirilmiştir.Bulgular: Toplam 155 hastaya ait (erkek: 105, % 67,7; yaş ortalaması: 38±13,3) 155 karaciğer biyopsisi çalışmaya dahil edilmiştir. Karaciğer naklinde canlı verici değerlendirmesi en yaygın karaciğer biyopsisi nedeni olarak tespit edilmiş olup bunu karaciğer fonksiyon testlerindeki non-viral yükseklikler izlemiştir. Histopatolojik incelemelerin sonuçları sıklık sırasına göre non-alkolik yağlı karaciğer hastalığı, kronik hepatit B, kronik hepatit C, toksik hepatit, otoimmün hepatit, karaciğer sirozu olarak tespit edilmiştir.Tartışma ve Sonuç: Çalışmamız karaciğer nakli verici değerlendirme biyopsileri içerdiğinden, nonalkolik yağlı karaciğer hastalığı yüksek oranda tespit edilmiştir. Raporlanmış sonuçlardaki çeşitlilik ise histopatolojik incelemenin önemini göstermektedir. Daha sağlıklı değerlendirmeler için çeşitli merkezlerin verilerinin karşılaştırılmasına ve daha büyük ölçekli, prospektif, randomize kontrollü çalışmalara ihtiyaç vardır.
Aerobik Kapasite ve Bilişsel Performans İlişkisi
Authors: ANKARALI Seyit , BAYRAMLAR Zeynep
Published: June 2019

Aerobik kapasite, dışarıdan alınan
oksijeni iskelet kaslarına iletme kapasitesidir. Aerobik kapasite için en iyi
ve en güvenilir ölçüt, kademeli artan bir test protokolüyle ölçülen mak­simum
oksijen tüketimidir (VO2maks). VO2maks değeri submaksimal ve maksimal egzersiz testlerinde
indirekt ve direkt yöntemle ölçülebilir. Genetik, yaş, cinsiyet, aktivite seviyesi,
vücut kitle indeksi ve egzersiz modu VO2maks değerine etki eden faktörler arasında sayıla­bilir.
Oksijenin kaslara iletimindeki tüm basamaklarda VO2maks üzerinde sınırlandırıcı
etki yapabilecek faktörler olup bunların en etkilisi maksimal kalp debisidir.
Bilişsel performans, zihnin deneyim veya öğrenme ile edinilen bilgiyi işleme ve
değerlendirme yeteneği olup inhibitör kontrol, işlem hızı, çalışan bellek, bilişsel
esneklik, görsel–uzamsal işlem, problem çözme ve öğrenme gibi farklı bilişsel
fonksiyonları içerir. Aerobik aktivite, zihinsel sağlığın gelişimi ve serebral
yapısal değişiklikler için güçlü bir uyarıcıdır. Bu derlemede aerobik ka­pasitenin
ve bu kapasiteyi artırıcı egzersiz seviyesinin bilişsel fonksiyonlarla olan ilişkisi
irdelenmiştir.
The Protective Effect of Korean Red Ginseng Against Rotenone-Induced Parkinson’s Disease in Rat Model: Modulation of Nuclear Factor-κβ and Caspase-3
Authors: Zaafan Mai A. , Abdelhamid Amr M. , Ibrahim Sherine M.
Published: June 2019

Objective: :

Korean red ginseng was reported to have many biological effects like the antioxidant
and the anti-inflammatory activities. Oxidative stress and neuro-inflammation play major roles in
the pathogenesis of Parkinson’s disease (PD). The current study aimed to investigate the protective effects
of ginseng on rotenone-induced PD in rats.

Methods::

Rats were randomly allocated into 4 groups: normal rats, rotenone control, ginseng+rotenone
and ginseng only treated rats. The severity of PD was evaluated through locomotor activity perceived
in the open field test, histological examination and immunohistochemical detection of amyloid-β in
brain tissues, in addition to the biochemical assessment of tyrosine hydroxylase activity in brain tissues.
Moreover, the following parameters were investigated for studying the possible mechanisms of
ginseng neuroprotective effect: nuclear factor-κβ (NF-κβ), tumor necrosis factor-alpha (TNF-α), caspase-
3, lipid peroxides and reduced glutathione (GSH).

Results::

Ginseng exhibited potent neuroprotective effect that was reflected upon the histopathological
examination, marked improvement in the locomotor activity and through its ability to suppress the amyloid-
β deposition in the cortex and striatum along with significant increase in the tyrosine hydroxylase
activity. Ginseng successfully inhibited the NF-κβ inflammatory pathway in brain tissues beside the
inhibition of other oxidative stress and inflammatory mediators. Furthermore, it exhibited antiapoptotic
effect via the inhibition of caspase-3 expression.

Conclusion: :

Ginseng could be a promising treatment in PD. It can suppress dopaminergic neuron degeneration
through variable mechanisms mainly via inhibition of NF-κβ pathway in addition to inhibition
of oxidative stress and apoptosis.
Surgical Management of the Adnexal Mass
Authors: Zeligs Kristen Parrish , Jordan Elizabeth
Published: June 2019

Surgical exploration of an adnexal mass for the management of pelvic pain or to exclude
malignancy is a common gynecologic procedure. While most adnexal masses are benign in nature,
all surgeons performing pelvic surgery should understand the surgical recommendations of how to
proceed when an ovarian neoplasm is identified. Appropriate pre-operative assessment can help to
best identify patients at high-risk of malignancy to ensure appropriate consultation with a gynecologic
oncologist. With the evolution of laparoscopy, most adnexal mass surgeries can be performed
using minimally invasive surgical techniques. As a guiding principle, all adnexal mass surgery
should abide by principles of ovarian cancer staging until malignancy is disproven.
Evaluation of Characteristics of Concrete Mixed with Bamboo Leaf Ash
Authors: Onikeku Oluwaseye , Shitote Stanley Muse , Mwero John , Adedeji Adeola. A.
Published: June 2019

Background:

Concrete production around the globe is in billions of tons. Consequently, million metric tons of carbon dioxide are produced annually due to the cement consumption and production which, in turn, cause environmental menace.

Objective:

This research work examines the use of Bamboo Leaf Ash (BLA) as supplementary cementitious materials.

Methods:

The physical, mechanical, and durability properties were studied by partial substitution of cement with BLA at 0, 5, 10, 15, and 20% sequentially. Concrete cubes were cast and cured at 7, 28, 56, and 90 days. Beams were cast and cured at 28 days. A total number of five mixes were investigated, four out of the mix were dedicated to examining the impacts of BLA on the characteristics of concrete.

Results:

Soundness, consistency, initial and final setting time of cement paste values were lower than bamboo blended paste values at 5%, 10%, 15%, and 20% percentage replacement, respectively. The split tensile, compressive, and flexural strength values of conventional concrete were lower than bamboo leaf ash concrete accordingly. Water absorption, permeable voids, sorptivity, and bulk dry density of conventional concrete were higher than bamboo leaf ash concrete at all level of replacements.

Conclusion:

According to the analysis and experimental results obtained, BLA improved split tensile, compressive, and flexural strength benchmark at 10% as the optimum level of replacement. BLA reduced setting time, consistency, compacting factor, slump, water absorption, permeable voids, sorptivity, and density. To this end, BLA can be considered as a good pozzolanic material which can save the cost of construction, and improved concrete properties.