bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of dimension limestone sludge as filler in asphalt mix
Authors: Choudhary Jayvant , Kumar Brind , Gupta Ankit
Published: November 2018

This study investigates the feasibility of using waste dried sludge dust from the Indian dimension limestone (namely, Kota stone (KS)) industry in the place of conventional stone dust as filler in asphalt concrete mix. First, physical, morphological and chemical characteristics of both fillers were determined by relevant standards. Second, asphalt concrete mixes including both fillers were designed and their performance against primary occurrences of distress (rutting, cracking, long-term ageing, ravelling and moisture susceptibility) was evaluated. The KS mix had lower optimum asphalt content than conventional mixes, which was attributed to the lower porosity of KS dust. KS mixes also displayed superior resistance against permanent deformation, cracking and ravelling due to the finer nature of KS. Although the KS had a relatively high active clay content, KS mixes displayed good active and passive adhesion as well as satisfactory resistance against moisture permeation.
Evaluation of three-dimensional particle shape index from projected two-dimensional image
Authors: Yan W. M. , Su D.
Published: November 2018

Traditionally, the shape of a three-dimensional (3D) particle is inferred from a single parameter called the aspect ratio (AR) that is evaluated from a collection of projected two-dimensional (2D) images of the 3D particle. While this approach could offer an estimate of the particle shape, it is likely that a single parameter is insufficient to describe the 3D shape characteristics of a particle. Conventionally, the shape of a 3D particle can be described by two parameters: the elongation index (EI) and the flatness index (FI), defined as the length ratios of different principal dimensions. This paper presents a novel approach that can be used to evaluate the EI and FI of 3D particles based on their projected 2D images. The novelty of this proposed method is that the distribution of the AR is considered rather than only the mean value. The performance of the algorithm is examined using numerically generated ellipsoids and real sand particles scanned using microfocus X-ray computed tomography. The results appear promising and the plausible combinations of the EI and FI of the 3D particles can be obtained.
Research advances and challenges in biogeotechnologies
Authors: He Jia , Chu Jian , Gao Yufeng , Liu Hanlong
Published: November 2018

In recent years, there has been a surge in the study of applying biotechnologies to geotechnical engineering by using microbial processes to change the physical and mechanical behaviour of soils and rocks. Methods based on this approach have been named biogeotechnologies. An overview of the research and development activities in this area in the past years is presented in this paper. The microbial effects that can be utilised in geotechnical engineering involve biocement, microbial desaturation, biofilm and so on. The applications of biogeotechnologies involve soil strengthening, seepage control, mitigation of soil liquefaction, soil erosion control, remediation of contaminated ground and so on. Problems and challenges related to methods for field implementation, monitoring and investigation techniques and environmental impacts are also discussed in this paper.
The impact of bus fleet size on performance of self-equalise bus headway control method
Authors: Liang Shidong , Ma Minghui , He Shengxue , Zhang Hu
Published: November 2018

Headway fluctuation and bus bunching are common in transit operations, while holding control is a proven strategy for the reduction of bus bunching. Recently, benefited from the advances in technology and tools, adaptive control method for equalising bus headways on the bus route gradually has become successful. Although this method performs well in regulating the bus operation, it does not consider the impact of the number of buses on the bus route. The control method may fail to regulate bus headways due to an insufficient number of buses, despite the control method itself being effective. Therefore, this paper explores the relationship between the number of buses on the bus route and the performance of the self-equalise bus headway control method. A model is proposed to search the suitable number of buses on the bus route by analysing the changes of the bus headway standard deviations with increasing the number of buses. Furthermore, a set of numerical tests were conducted. According to the results of the analysis, under high demand, the performance of the self-equalise bus headway control method is more sensitive to changes of bus number on the bus route.
Gizli Tehdit: Et Yiyen Zoonoz Bakteriler
Authors: SAĞKAN ÖZTÜRK Aliye , KÖSE Serkan İrfan
Published: November 2018

Nekrotizan fasiit, hem insanlarda hem de
hayvanlarda yumuşak dokuların hızla ölümüne sebep olabilen ve bazen daha derin
dokulara kadar ilerleyebilen bakteriyel bir deri hastalığıdır. Bu bakterilerden
bazıları yalnızca insanlarda enfeksiyona neden olur iken bir kısım bakteride
hayvanlarla ya da su canlıları ile bütünlüğü bozulmuş deri ile temas halinde ya
da ısırık/çizikler vasıtası ile vücuda alınıp nekrotizan fasiite sebep olabilen
zoonoz etkenlerdir. Nekrotizan fasiit’e neden olan zoonoz karekterli bakteriler
hakkında pek çok vaka taktimi yapılmıştır. Enfeksiyonun tanımlanmasında
hastanın mutlaka detaylı hikayesi dinlenmeli her hangi bir temas ile karşı
karşıya kalındığında yara bakımının yapılmasına ek olarak sistemik tedavi
girişimlerinde de bulunulmalıdır. Aksi taktirde hastanın genel sağlık durumuna göre
uzuvlarda kayıplar, septisemi ve çoklu organ yetmezliklerine kadar
ilerleyebilen ciddi bir hastalık tablosu meydana gelmekte ve böyle vakaların
çoğu da ölüm ile sonuçlanmaktadır. Bu
derlemenin amacı, hayvanlardan insanlara temas ile bulaşabilen ve nekrotizan
fasiite sebep olan etkenler hakkında bilgi vermek ve hem veteriner hekimleri
hem de hayvan sahipleri/severlerinin farkındalıklarını artırmaktır.
Functional state of the myocardium and criteria for poor prognosis in mitral valve prolapse
Authors: Gadzhieva L R , Muracheva N V , Tkachenko S B
Published: November 2018

Aim. Study of the fnctional state of left ventricular myocardium and determination of diagnostic criteria of poor prognosis of mitral valve prolapse. Methods. 151 patients (116 males and 35 females) with mitral valve prolapse (MVP) were examined. The average age was 34.8 ± 0.79 years. Division by the groups was performed depending on the severity of structural changes of the valve and width of the cusps: group 1 included 54 patients with classic form of MVP (cusp width ≥5 mm), group 2 included 55 patients with cusp width ≥3 mm, group 3 included 42 patients with MV cusp width less than 3 mm. All patients underwent complex clinical functional examination of cardiovascular system. The state of systolic and diastolic cardiac function was assessed using stationary high-tech ultrasound scanner «Philips iE-33» (Philips, Holland) according to conventional technique with determination of standard heart parameters and calculation of intracardiac hemodynamic parameters. Echocardiography was performed on admission and 12 to 18 month later. Results. The study revealed that the most prominent changes of cardiohemodynamics and unfavorable disease course were observed in 72.2 % of patients with classic form of MVP (group 1). Patients with non-classic form of MVP (group 2) also had poor prognosis in 27.8 % of cases. Diagnostic criteria of poor prognosis of MVP according to echocardiography were determined: severe mitral regurgitation (degree ≥III), mitral valve cusp thickness during diastole over 6 mm, left ventricle dilation (EDS ≥ 60 mm; ESS ≥ 36 mm), left atrial dilation (anterior posterior size of LA ≥ 40 mm, LA volume ≥ 80 ml), mitral annulus dilation (diameter of MA ≥ 35 mm). Conclusion. Differences of functional state of the myocardium of left ventricle were revealed depending on the type of mitral valve prolapse caused by the severity of connective tissue dysplasia. In classic form of MVP more severe disorders of intracardiac hemodynamics were observed as well as more severe mitral insufficiency.
Reaction of hemostasis system in hypercapnic hypoxia after the course of mexidol assessed by the method of thromboelastography
Authors: Moskalenko S V , Shakhmatov I I , Bondarchuk Yu A , Alekseeva O V , Ulitina O M
Published: November 2018

Aim. To study the reaction of hemostasis system to a single effect of hypercapnic hypoxia of maximum intensity in rats and possibility of correcting hemostasis disorders by means of a preliminary course of an antihypoxant - mexidol. Methods. The study involved sexually mature male rats (48 specimens) of the Wistar line with an average mass of 274.0 ± 32.0 g. The rats were kept on a standard diet, food and water were fed once a day between 10 and 11 hours. In the evening, animals underwent a single hypercapnic hypoxia in a special flow chamber. The state of hypercapnic hypoxia of maximum intensity was modeled at O2 content of 5.0 %, CO2 - 5.0 % during a single 20-minute exposure. As a training regimen, a 30-fold course of mexidol was used, the drug was administered intraperitoneally to rats at a dose of 50 mg/kg for 1.5 hours prior to exposure to hypercapnic hypoxia. Results. After a single exposure to hypercapnic hypoxia of maximum intensity, shortening of the onset of clot formation, an increase of alpha angle, and maximum clot density were recorded. Also, the clot formation time shortened and the maximum clot lysis index increased. With a single exposure to hypercapnic hypoxia of maximum intensity after the course of mexidol, a decrease in the maximum clot density was recorded. Conclusion. A single exposure to hypercapnic hypoxia of maximum intensity was characterized by a shift of hemostatic potential toward hypercoagulability along with fibrinolytic system activation. The course use of antihypoxant mexidol, preceding hypercapnic hypoxia of maximum intensity, significantly reduces the risk of clot formation.
Toxic effect of titanium dioxide nanoparticles on morphological characteristics of thymus
Authors: Sharafutdinova L A , Sinel’nikov K N , Valiullin V V
Published: November 2018

Aim. Study of effects of titanium dioxide nanoparticles administered orally on the rodent thymus morphological and functional state. Methods. The study used classical morphological approaches and specific markers of proliferation - Ki-67, apoptosis - p53 protein and macrophages - CD68, which allow adequately identifying not only the cells themselves, but also their functional state. The rodent thymus was analyzed after oral administration (10 mg/kg of body weight of the animal, 28 days) of the TiO2 nanoparticles (rutile form, 40-60 nm) obtained by diluting the TiO2 powder in distilled water. Aggregation of the nanoparticles was prevented by processing a suspension of nanodispersed TiO2 in an ultrasonic bath. The rats of the control group were orally injected with distilled water in the same volume. Serial paraffin sections of the thymus were stained with hematoxylin-eosin, picrofuxin according to Van Gieson, immunohistochemical staining was performed with antibodies to Ki-67, CD68, p53. Results. Significant changes of the tissue of thymus gland under the influence of TiO2 nanoparticles were revealed. In the thymus of experimental animals, a decrease in the proportion of cortex was found to be 17.6 %, a significant decrease in the density of the cell population due to decrease in the number of thymocytes was demonstrated. Immunohistochemical typing revealed that under the influence of TiO2 nanoparticles, a decrease in the number of Ki-67-positive cells in the cortex of the lobule of the thymus gland was observed, which indicates the inhibition of proliferation in these conditions. Under the influence of TiO2 nanoparticles, an increase of the amount of cells entering apoptosis in the cortex of the thymus segment of the experimental group by 5.18 times was observed, as evidenced by the results of immunohistochemical study of the expression of apoptosis marker p53 protein. Perhaps, as a compensatory mechanism there is a pronounced increase in the number of macrophages, as indicated by an increase in the average number of CD68 immunopositive cells in the cortex of the thymus of the test group by 2.61, and in the brain substance by 1.35. Conclusion. The revealed morphological and functional changes of the thymus with oral administration of TiO2 nanoparticles indicate their immunosuppressive effect.
Cervical elasticity during pregnancy: current state of the problem
Authors: Tukhbatullin M G , Yanakova K V
Published: November 2018

Uterine cervix undergoes various changes throughout the pregnancy, which are characterized by the general term “remodeling”. In particular, this process includes changes of the length (shortening) and consistency (softening) of uterine cervix. The latter from the clinical point of view is important not only for observation of pregnant women with normal course of pregnancy but also for predicting such states as an outcome of labor induction or preterm delivery. Traditionally, cervical elasticity has been estimated through digital examination and Bishop score, however, currently there are available imaging techniques, which are more objective and precise. Amongst these methods, elastography plays a special role. Elastography allows measuring the capacity of tissues to deform. The softer the tissues, the higher mentioned capacity under the applied pressure. Currently there are various methods of elastography, starting from real-time elastography, when the capacity to be deformed is registered under the influence of physiologic movements or minimal manual pressure, to shear wave elastography, when the velocity of propagation of shear waves is measured. Although there are number of methods of elastography and perspectives of their use in obstetric practice, at the present time there is no consensus on standardization of these methods. In the cervical elastography this task is even more complicated, because there is no reference tissue to be compared with, especially this is true for strain elastography. The aim of this study was comparative analysis of methods estimating cervical elasticity and underlining current problems from the clinical point of view.
Mechanisms of the resistance of gastrointestinal stromal tumors to imatinib
Authors: Galembikova A R , Boichuk S V
Published: November 2018

The review describes the modern concepts of the primary and secondary (acquired) resistance of gastrointestinal stromal tumors to the targeted drug imatinib. Gastrointestinal stromal tumors are the mesenchymal tumors of gastrointestinal tract that originate from interstitial cells of Cajal or their stem cell precursors. Up to 85 % of gastrointestinal stromal tumors have the mutations of KIT gene that lead to ligand-independent activation of this tyrosine kinase. Imatinib is an inhibitor of KIT tyrosine kinase which is hyperexpressed in 70-85 % of cases on the cell membrane of gastrointestinal stromal tumors. Despite the high effectiveness of imatinib in gastrointestinal stromal tumors, up to 15 % of patients do not respond to this therapy, and over 50 % of patients acquire the resistance to this drug 2 years after initiation of target therapy with imatinib. The mechanisms of primary resistance include basically the mutational status of KIT, PDGFRA and, rarely, mutations of SDH, NF1, BRAF, PI3K3CA, CBL, and KRAS. The mechanisms of secondary resistance of tumor cells to imatinib are not restricted to the secondary mutations of KIT and PDGFRA, but also might be due to the loss of KIT expression associated by overexpression of the alternative receptor- and non-receptor tyrosine kinases, such as MET, AXL, FGFR2α, FAK, etc. Alternative mechanisms of acquired resistance might be due to the mutations of BRAF gene.
The Ketogenic Diet
Authors: Kalra Sanjay ,   Department of Endocrinology, Bharti Hospital, Karnal, India, Singla Rajiv ,   Department of Endocrinology, Kalpavriksh Healthcare, New Delhi, India, Rosha Rahul ,   Department of Nutrition, Novique Healthcare, Pune, India, Dhawan Munish ,   Department of Pediatrics, Miri Piri Hospital, Shahabad, India, Khandelwal Deepak ,   Department of Endocrinology, Maharaja Agrasen Hospital, New Delhi, India, Kalra Bharti ,   Department of Gynecology, Bharti Hospital, Karnal, India
Published: November 2018

The ketogenic diet (KD), a well-established treatment for childhood epilepsy, is gradually gaining acceptance as a therapeutic modality for obesity and type 2 diabetes. The perception of ketone bodies as an unhealthy or “sinful” entity has led to concerns and doubts regarding the efficacy and safety of KD in physicians. This article describes the mechanism of action of KD and shares a pragmatic approach to its usage. It highlights the importance of predietary counseling, screening for indications/contraindications, and clinico-nutritional monitoring during therapy. Robust indications for KD are mentioned, to help place KD’s utility in the management of obesity and type 2 diabetes.
On-Board Ultrasonic Water-in-Diesel Emulsion (WiDE) Fuel System for Low-Emission Diesel Engine Combustion
Authors: Kojima Kotaro , Kojima Jun
Published: November 2018

Water-in-diesel emulsion (WiDE) fuel is a promising alternative fuel capable of reducing nitrogen oxides (NOX) and particulate matter (PM) in diesel engine exhaust while simultaneously preserving combustion efficiency of the engine. However, the instability of WiDE fuel—and the high costs of production and transportation—hinder its commercialization and widespread use. An on-board ultrasonic WiDE fuel supply system is proposed as a solution to this challenge. This system allows diesel fuel and water to be continuously emulsified on-board a diesel vehicle. Diesel fuel and water, stored in individual reservoirs, are conveyed in specific ratios to an in-line mixing chamber and are rapidly homogenized by ultrasonic cavitation before entering the fuel injectors. The produced emulsion fuel is then supplied to the engine. A proof-of-concept study was conducted to compare exhaust emissions between emulsion fuels and conventional fuels. Open-flame combustion experiments were conducted using a lab-scale burner to test the system with both diesel and biodiesel fuels. Unique optical diagnostics and image-processing techniques were used to estimate PM emission levels. Results showed a reduction of PM with the use of the on-board WiDE system compared to traditional diesel fuels. PM emissions from biodiesel fuel were reduced by 58% when water-in-biodiesel emulsion was combusted with 2% water. Additionally, a PM emission reduction of 35% was achieved through emulsification of diesel fuel with 2% water. This prototype demonstrates the potential for the on-board WiDE fuel supply concept to both overcome the traditional barriers hindering the commercialization of WiDE fuel and preserve its low-emission and superior combustion efficiency characteristics.
Value of Contrast-Enhanced Echocardiography of Left Cardiac Chambers for Clinical Practice
Authors: Alekhin M. N.
Published: November 2018

This literature review in devoted to the potential of application of contrast-enhanced echocardiography (CEE) for assessment of structure and function of left cardiac chambers. It contains based on current recommendations discussion of main indications for CEE and analysis of its possibilities in evaluation of perfusion of the left ventricular myocardium, detection of myocardial ischemia, and assessment of myocardial viability. Data on CEE safety and possible side effects associated with the use of ultrasound contrasts are also presented.
Methods of Pharmacological Treatment of Chronic Thromboembolic Pulmonary Hypertension Current Approaches to the Patients Management
Authors: Ushkalova E. A. , Zyryanov S. K. , Zatolochina K. E.
Published: November 2018

In this paper we have discussed epidemiology, pathogenesis, and approaches to treatment of chronic thromboembolic pulmonary hypertension (CTEPH). CTEPH is a unique potentially curable form of pulmonary hypertension. The gold standard of CTEPH treatment is pulmonary thromboendarterectomy. However, about 40% of patients with CTEPH are inoperable due to distal surgically inaccessible lesions of the pulmonary vasculature, severe hemodynamic impairments, or other contraindications. In addition, nearly half of patients have persistent or recurrent pulmonary hypertension following surgery. Current guidelines support the use of pharmacotherapy in these patients. In the article we have presented results of main clinical studies of targeted drugs therapy (endothelin receptor antagonists, prostanoids, phosphodiesterase type 5 inhibitors, soluble guanylate cyclase stimulators) of patients with CTEPH. The only drug that has demonstrated robust clinical efficacy in terms of improvment hemodynamic parameters, exercise capacity and patients’ quality of life is the stimulator of the soluble guanylate cyclase riociguat. The efficacy and safety of riociguat have been investigated in short-term and long-term studies with follow-up up to 6 years. Results of these studies have constituted the basis forits approval by the regulatory authorities of more than 50 countries for the treatment of inoperable CTEPH and persistent or recurrent CTEPH after pulmonary thromboendarterectomy. In the European Union, USA and many other countries, riociguat is the only pharmacological agent approved for these indications.
Pregnancy outcome in women with previous preeclampsia versus women normotensive in previous pregnancy
Authors: Mulik Jayshree , Suresh Snehalata
Published: November 2018

Background: Women with history of preeclampsia have reportedly higher risk of development of preeclampsia in subsequent pregnancies, along with other adverse pregnancy outcomes. Authors aimed to study the incidence of recurrent preeclampsia and compare the pregnancy outcome in women with history of preeclampsia in previous pregnancy with those who were normotensive in previous pregnancy and further compare outcomes in women with recurrent preeclampsia between their previous and index pregnancy.Methods: Pregnancy outcome was studied in women with preeclampsia in previous pregnancy (cases) and compared with women normotensive in previous pregnancy (controls). Further analysis of cases was done by dividing them into subgroups: those with recurrent preeclampsia in index pregnancy (A1) and those normotensive in index pregnancy despite being pre-eclamptic in previous pregnancy (A2). Total 100 cases and 100 controls were enrolled in the study, which was conducted at present tertiary care centre from January 2012 to June 2013.Results: Out of total 200 participants (100 cases, 100 controls) enrolled in the study; 58 out of 100 cases had recurrent preeclampsia and remaining 42 remained normo-tensive in index pregnancy. Among 100 controls, 93 were normotensive in index pregnancy.Conclusions: Women with history of preeclampsia in previous pregnancy had adverse maternal and perinatal outcome in subsequent pregnancy when compared to the women who were normotensive in the previous pregnancy. But when compared with their own previous preeclamptic pregnancy, they had better pregnancy outcome with good perinatal outcome in their index pregnancy.
A study of perinatal outcome in preterm premature rupture of membranes
Authors: M. Poovathi , Yogalaksmi Yogalaksmi
Published: November 2018

Background: Preterm premature rupture of membranes is defined as rupture of fetal membrane before onset of labour at less than 37 completed weeks of gestation and after 28 weeks of gestation. Incidence ranges from 3-10% of all deliveries. Preterm premature rupture of membrane is one of the important causes of preterm birth can result inhigh perinatal morbidity and mortality. Preterm premature rupture of membranes complicates 3% of pregnancies and leads to one third of preterm birth. Preterm delivery affects one in 10 birth in USA and even greater birth in developing continues and causes 40-75% neonatal death. There are numerous risk factors for preterm premature rupture of membrane such as maternal, socioeconomic class, infection at early gestational age and associated co-morbid condition. Both mother and fetus are at greater risk of infection after preterm premature rupture of membrane.The fetal and neonatal morbidity and mortality risks are significantly affected by severity of oligohydrominos, duration of latency and gestation at preterm premature rupture of membrane. The objective is to study perinatal outcome in preterm premature rupture of membrane.Methods: This is a prospective study conducted in Mahathma Gandhi Memorial Government Hospital attached to K. A. P. V. Government Medical College, Trichy, Tamil Nadu, India. This is a tertiary health centre. This study has been conducted from January 2018 to June 2018.Results: Incidence of PPROM ranges from 3.0-10.0% of all deliveries. PPROM complicates approximately 3% of pregnancies and leads to one third of preterm birth.Conclusions: In present study most of newborn had better 5min Apgar especially late preterm group. In present study RDS was common in early preterm group and hyper bilirubinaemia common in late preterm group. In current study most of patients delivered vaginally compared to 36% of LSCS.
A comparative study of subcuticular and interrupted stitches for episiotomy
Authors: Thukral Pooja , Mendiratta Shweta , Bhola Gunjan
Published: November 2018

Background: Perineal pain is the most common complaint after episiotomy. For more than 70 years researchers have been suggesting that ‘continuous non-locking suture techniques’ for repair of the vagina, perineal muscle and skin are associated with less perineal pain than ‘traditional interrupted methods’. The objective of the present study was to compare the two techniques of episiotomy closure in patients after vaginal delivery with mediolateral episiotomy.Methods: This study was conducted in the Department of Obstetrics and Gynecology, Asian Institute of medical sciences, Faridabad. The duration of study was from July 2017 to August 2017. Total 50 patients were selected and randomly divided in two groups. This was a prospective comparative study between continuous and interrupted suturing used for episiotomy repair.Results: Continuous suturing technique requires lesser number of suture material, needs lesser time and is associated with lesser pain experience.Conclusions: It was concluded from the present study that continuous suturing technique is more economical and causes lesser morbidity than the interrupted suturing technique.
An update on endometriosis associated subfertility: what does the most recent evidence say?
Authors: Abdallah Karim
Published: November 2018

Endometriosis is a chronic debilitating disease that affects 10% of women in the reproductive age. Women with endometriosis present with pain, subfertility or both. The prevalence of endometriosis in women with subfertility is estimated to be within the range of 40%-50%. This is a review of the evidence published in the literature. The review was conducted via searching the databases of the Cochrane reviews, European Society of Human Reproduction and Embryology (ESHRE), American Society of Obstetrics and Gynaecology (ACOG), National Institute for Clinical Excellence (NICE) and British Medical Journal (BMJ) best practice articles. Management of women with endometriosis and subfertility has been extensively assessed in the literature. Medical management, surgical approaches and a combination of both improve the spontaneous pregnancy rates for this cohort of patients.
Assessment of vitamin D status and its association with insulin resistance among type 2 diabetic subjects
Authors: Bhattacharya Jaitra
Published: November 2018

Background: The 21st century has seen the rise of diabetes mellitus as one of the major metabolic issues as is vitamin D deficiency which has been found to be pandemic worldwide. The present study is an endeavor to study the status of serum vitamin D levels in relation to the glycemic and insulin resistance status in type 2 diabetes mellitus patients.Methods: The present is a cross-sectional study with a sample size of 100 type 2 diabetic subjects in the age group of 30-60 years. Serum vitamin D and Insulin levels were estimated using the ELISA technique. HbA1c levels were measured using immunoturbidimetric assays and plasma glucose levels were determined using glucose oxidase- peroxidase method.Results: The fasting plasma glucose, HbA1c and serum insulin levels were found to be significantly higher in those with vitamin D levels below the normal cut-off value of less than 30ng/ml (p value <0.01). Also, the insulin resistance calculated using HOMA-IR was found to be higher in those subjects having vitamin D deficiency or insufficiency.Conclusions: Hence, the study suggests that vitamin D deficiency contributes to further insulin resistance and poorer long-term diabetic control in type 2 diabetes mellitus subjects.
An observational study on pneumococcal and influenza vaccination status of patients with type 2 diabetes mellitus
Authors: Bhat Rafiq A. , Wani Saleem A. , Kharbanda Rajat , Sethi Sumit
Published: November 2018

Background: India has more than sixty million subjects with diabetes. Diabetes confers an increased risk of developing and dying from infectious diseases with an enhanced susceptibility to morbidity, mortality and hospitalizations due to influenza and pneumococcal disease. The Advisory Committee on Immunization Practices (ACIP) recommends influenza and pneumococcal vaccines for all individuals with diabetes.Methods: Around 249 patients with type 2 diabetes mellitus were enrolled in the study. All patients were asked a detailed history about diabetes, its duration, type of diabetes and the vaccinations for influenza and pneumococcus, who suggested vaccination and the reasons for declining the vaccination if it had been medically advised. Any other co-morbid condition such as hypertension, diabetes mellitus, heart disease, COPD, hypothyroidism and CKD were noted.Results: Vaccination rates for influenza in patients aged 50 or more were higher (7.6% of 172 patients) as compared to those aged <50 years (0% of 77); (p=0.013) whereas pneumococcal vaccination rates were 8.1% as against 1.3% (p=0.036) respectively. In males the vaccination rates for influenza were 4.7% compared to females (5.8%); (p=0.675), whereas for pneumococcus the respective vaccination rates were 6.2% for male and 5.8% for female (p=0.903). Vaccination uptake among male and female were almost same. Patients having chronic kidney disease on dialysis were having highest vaccination rate.Conclusions: The poor vaccination uptake for influenza and pneumococcus in patients with diabetes, calls for intensive efforts aimed at increasing coverage.
Hypofractionated radiotherapy in post mastectomy locally advanced breast cancer: a study from a regional cancer center in North East India
Authors: Bhattacharyya Mouchumee , Kalita Apurba Kumar , Medhi Partha Pratim , Jagtap Vikas , Sunku Rubu , Hassan Fahim Arman , Kalita Manoj , Krishnatreya Manigreeva , Kataki Amal Chandra
Published: November 2018

Background: Adjuvant radiotherapy has increased local-regional and overall survival rates in breast cancer. Conventional fractionation delivering 50-60 Gray (Gy) over 5-6weeks is a standard approach. A shorter duration of hypofractionated treatment will be more convenient for patients and treatment providers if found safe and equally effective.Methods: Around 50 high risk breast cancer patients who underwent mastectomy were enrolled and randomized into the study arms- CF (Conventional Fractionation) Arm (50Gy/25 Fr @ 2 Gy/fraction/day 5 days a week over 5weeks) and HF (Hypo-Fractionation) arm (40.05 Gy/15 Fr @ 2.67 Gy/fraction/day 5 days a week over 3weeks). Treatment related acute and late toxicities, loco-regional recurrence; distant metastasis and survival rates were recorded for comparison.Results: Twenty-five patients were enrolled in each arm with baseline characters well matched. At median follow up of 44 months, OS was 80% in HF arm against 64% in CF arm (p-value: 0.292). HF arm also showed better DFS at 4 years of 76% compared to 64% in CF arm (p-value: 0.411). Although the difference was not significant statistically, the Hazard Ratio of 1.543 (95% CI: 0.549-4.339) for DFS and 1.801 (95% CI: 0.603-5.377) for OS indicated trends towards better outcomes in HF arm in terms of disease control and survival. Acute and late toxicities were also lesser in HF arm, though not statistically significant (all p-values >0.05).Conclusions: In post mastectomy setting, HFRT is comparable to CFRT in terms of safety and efficacy, will be more convenient for patients and care givers and hence can be a routine standard practice.
Improvement of self efficacy through bibliotherapy in diabetes patient
Authors: Isworo Atyanti
Published: November 2018

Background: Diabetes Mellitus is also known diabetes, as a chronic disease which will trigger various complications both microvascular and macrovascular. This is what leads diabetes patient to have high risk of low self-efficacy. Low of self-efficacy causes a decrease in self care. Therefore, to improve the patient’s self-efficacy is changing their mindset. Bibliotherapy is a treatment using written materials to guide and encourage the patients to challenge unhelpful thoughts. This research aims at discovering the influence of bibliotherapy on self-efficacy of diabetes patients.Methods: This is a quantitative research using quasi-experimental with control group design. The number of samples in this research is 40 respondents, consisting of 20 intervention groups and 20 control group by simple random sampling method. The sample in this research is diabetes patients with such inclusion criteria as (1) 36-60 years of age, (2) having the ability to read well, (3) willing to be a research respondent. Meanwhile, the exclusion criteria are (1) diabetes patient with weak condition, (2) experiencing loss of consciousness, (3) having visual and audio problems, and (4) diabetes patient with mental disability. The intervention group undergoes bibliotherapy for 8 session, each session for 60 minutes. The Diabetes Management Self Efficacy Scale (DMSES) to determine the total score of self-efficacy.Results: Most respondents are middle-aged adults (36-55 years) in both groups. Most respondents have suffered from diabetes for less than 5 years, unemployed and tend to have normal BMIs and also obese category 1. The mean score post test in intervention and control group is 37.00 and 25.65 respectively. The results show that there are differences in self-efficacy scores after treatment in control and intervention groups (p=0.000).Conclusions: From our study we concluded that bibliotherapy could improve self-efficacy in diabetic patients.
How informed are bronchial asthma patients: a questionnaire based study in a tertiary care hospital
Authors: Jadhav Sunil B. , Antony Philips
Published: November 2018

Background: Asthma has been considered as one of the most common chronic diseases worldwide. Asthma due to its effects on bronchial passage compromises the respiration and intern impairs the quality of life. Aim was to evaluate the knowledge of asthma among patients attending our tertiary care hospital.Methods: The patients were subjected to chest X-ray and spirometry followed by the knowledge on asthma questionnaire which consisted of 28 questions.Results: Out of 75 patients, aged between 18-80 years, majority were males. Out of 75 patients, 60 (80%) patients had obtained a total score below 10 out of the total of 28 score. The causative factors for asthma, 60 (80%) patients believed that asthma was due to allergy. Only 2-3 patients (3-4%) had knowledge of the underlying pathologic process during an asthma attack. Fifty nine (79%) patients were aware of the symptoms of asthma. However, only 10 (13%) patients knew about the early signs of worsening of asthma and only 14 (19%) patients could judge the severity of asthma. Only 5 (7%) patients knew which drug was for regular use and which was to be used if breathlessness occurred. Merely around 4-10 (5 to 13%) patients knew that asthma could be prevented by avoiding trigger factors and by taking medication regularly.Conclusions: A good level of knowledge about asthma and better practices are rigorously important to prevent asthma exacerbations. More comprehensive, regular and patient centred counselling programs will be beneficial in improving awareness of asthma.
Neuroimaging in drug resistant epilepsy
Authors: Sachdev Namrita , Gupta Shivani , Prasad Akhila
Published: November 2018

Background: Epilepsy is a common serious neurological condition and 30 to 40 % of people with epilepsy have seizures that are not controlled by medication. Patients are considered to have drug resistant epilepsy if disabling seizures continue despite appropriate trials of two anti-epileptic drugs. Most lesions causing drug resistant epilepsy can be detected by 3T MR Imaging using dedicated epilepsy protocol which is crucial for diagnostic and subsequent therapeutic planning with benefit from surgery. We present a review of the major abnormalities related to drug resistant epilepsy, highlighting the key findings of 3 T MRI.Methods: A Cross-sectional Observational study was done in 30 patients. Patients less than 60 yrs of age of either sex, diagnosed with DRE as per ILAE criteria, were included in the study. 3T MRI was performed using dedicated epilepsy protocol, with additional 3D imaging for manual hippocampal volumetric evaluation.Results: About 77% cases showed an MRI abnormality on visual assessment, with additional 16% cases showing abnormal MRI findings on manual hippocampal volumetry. Nearly 50% of the abnormal MRI cases showed Mesial Temporal Sclerosis, followed by neoplasms as etiology of DRE.Conclusions: MR imaging has significantly improved detection of pathologies related to epilepsy, especially with the advent of epilepsy protocol. The total percentage of MRI abnormalities increased after incorporating manual hippocampal volumetry.
The Promise of Partnership: Perspectives from Kenya and the U.S.
Authors: Grant Candice J
Published: November 2018

Universities have come to be viewed as essential in accelerating a country
Consent and Dissent: A Study of the Reaction of Chinese School Teachers in Guangzhou City Schools to Government Educational Reforms
Authors: Seifert Roger , Li Yingfei
Published: November 2018

This paper presents detailed qualitative evidence from a case study of teachers in five Chinese schools in one city. It explicitly seeks to show how developments in government policy towards education have altered the management of teacher labour inside schools as well as the teacher labour process as expressed by the teachers themselves in interviews and questionnaires. In this paper, we explore supervision, work intensification, and the erosion of professionalism. We conclude that some changes have taken place as predicted by the labour process model, but that the reaction of the teachers to more extensive controls has been variable. In particular senior school managers did have greater control with high levels of supervision, but that was generally welcomed as preferable to the previous system of outside control and neglect. While workload increased overall, the teachers were more likely to have to work outside of normal duties rather than experience any increase in formal contractual obligations. The full text of the article can be found at 10.18275/fire201401021008
Краудсорсинг, блокчейн и артели
Authors: Сухарев Михаил Валентинович
Published: November 2018

В статье проведен анализ новых явлений в мировой экономике (интернет-торговли, крадусорсинга, краудфандинга, блокчейна и криптовалют) с точки зрения усиления различных видов сетевых взаимодействий людей на глобальном рынке. В основе этих явлений лежат системы цифровых коммуникаций, но последствия новых форм коммуникации гораздо шире, нежели просто снижение цены и ускорение передачи сообщений. Подобным образом возникновение, дополняющих устный язык письменности и печати, привело к опережающему прогрессу некоторых цивилизаций. Новые способы коммуникации создают возможности для креативного эволюционного процесса по созданию новых видов социальных систем, начиная с уровня экономических организаций и кончая транснациональными образованиями. Проведен обзор литературы по сетевым формам самоорганизации, блокчейн-технологиям и потенциальным последствиям синтеза блокчейн и сетевых сообществ, для анализа использовался системный подход, включая анализ и сопоставление структур сетевых взаимодействий в инновационной, производственной, торговой и финансовой сферах. На основании анализа выдвигается тезис о происходящих фундаментальных изменениях структуры социально-экономических отношений в обществе и замене корпораций с вертикальной системой управления на динамические сетевые структуры. Обосновывается влияние сетевых сообществ на развитие социального и человеческого капитала.
Сообщество практиков: создание и распространение знаний
Authors: Бабак Лариса Николаевна , Хегай Елена Валентиновна , Мухсян Тамара Викторовна
Published: November 2018

В работе представлены результаты исследования научно-исследовательских лабораторий ДВФУ как формальных сообществ практиков. Основным методом для проведения эмпирического исследования был выбран кейс-стади. Проведенное исследование показало, что научно-исследовательские лаборатории полностью соответствуют формальным сообществам практиков по блокам «Характеристика персонала научно-исследовательских лабораторий», «Выгоды, обеспечиваемые научно-исследовательскими лабораториями» и частично соответствуют по блокам «Характеристика научно-исследовательских лабораторий и их процессов», «Характеристика системы коммуникаций научно-исследовательских лабораторий».
The Everyday Life of a European Man: Knausgård’s Literary Project as Social Imagination
Authors: Heynders Odile
Published: November 2018

Between 2009 and 2011, Norwegian author Karl Ove Knausgård published a monumental novel project in six parts (over 3,500 pages) in which he described the minutiae of daily life: family troubles, ordinary routines, everyday discourse, drinking, strolling through town and so on. The literary project became a media sensation with translations in many languages, readers all over the Western world, and a lot of interviews and reviews to be found online. Why were the books so successful; what is it in them that engages readers? Drawing on theories of sociologist C. Wright Mills and philosopher Henri Lefebvre, this article argues that this ambitious as well as paradoxical literary project sheds light on the social and cultural position of the late modern subject in a European middle class. Knausgård in his self-narration creates an Everyman, while at the same time fashioning a self as an obsessed artist that is everything but ordinary. In a crucial part of the final book, Knausgård shows us Adolf Hitler as a bitter young man, but also as someone ‘whose youth resembles my own’. Here the self-positioning relates to ongoing European history as well as to the lack of historical perspective in our current age.
DESCONFORTOS ESPERADOS E VIVENCIADOS POR PACIENTES NO PÓS-OPERATÓRIO IMEDIATO
Authors: Pickina Juvencio Silva Robertha , Pontello Rampazzo Ana Raquel , Alves do Nascimento Leonel , Fahl Fonseca Ligia
Published: November 2018

Objetivo: verificar os desconfortos esperados e vivenciados por pacientes no pós-operatório imediato. Método: estudo descritivo, quantitativo, pré e pós-teste, realizado em dois hospitais públicos. No pré-operatório, os pacientes enumeraram os desconfortos que esperavam vivenciar, dentre dez desconfortos mais comuns, citados em literatura. No pós-operatório imediato indicavam quais desconfortos realmente vivenciaram e atribuíram valores monetários fictícios para evitá-los. A coleta de dados foi realizada de agosto a outubro de 2016. Resultados: participaram da pesquisa 160 pacientes. Os desconfortos esperados, vivenciados e com maiores valores monetários fictícios para preveni-los foram dor (5.870), sede (2.255) e fome (2.125). Estes desconfortos apresentaram correlação significativa entre seu ranqueamento e o valor distribuído para sua prevenção. Conclusão: a dor foi o desconforto mais antecipado e o mais vivenciado, assim como o que teve maior valor atribuído para sua prevenção. Os desconfortos vivenciados sede, fome, fraqueza e frio ultrapassaram as expectativas de desconfortos esperados no pós-operatório imediato.
Descritores: Assistência perioperatória. Cuidados pós-operatórios. Complicações pós-operatórias. Dor. Sede.
Analysis of patients with premature rupture of membranes
between 22 and 33 weeks of gestation
Authors: Knapik Dorota , Nowak Leszek , Kozak-Darmas Iwona , Kawulok Maja , Roztoczyński Ryszard , Olejek Anita
Published: November 2018

Wstęp

Pęknięcie pęcherza owodniowego pomiędzy 22 a 33 tygodniem ciąży (preterm premature rupture of
membranes – PPROM) jest szczególnym scenariuszem klinicznym, kiedy losy noworodka są niepewne, ale jego przeżycie jest prawdopodobne. Celem pracy było przedstawienie pełnego spektrum problemów podczas diagnostyki i leczenia ciężarnej w tej szczególnie trudnej sytuacji.

Materiał i metody

Przeanalizowano przebieg leczenia u 38 pacjentek w wieku 18–42 lat, które zostały przyjęte do szpitala pomiędzy 22 a 33 tygodniem ciąży z powodu podejrzenia PPROM. Zebrano komplet danych na temat diagnostyki, leczenia i dalszego przebiegu ciąży. Uzyskane wyniki poddano analizie statystycznej.

Wyniki

Przedwczesne pęknięcie błon płodowych potwierdzono u 31 ciężarnych. Średni wiek ciążowy, w jakim wystąpiło PPROM, wynosił 28,2 tygodnia. Badanie ultrasonograficzne miało bardzo wysoką wartość diagnostyczną w rozpoznawaniu PPROM. Czas latencji pacjentek z potwierdzonym PPROM wynosił średnio 11 dni, jednak rozrzut uzyskiwanych wartości był znaczny (1–85 dni) i nie wykazywał istotnego związku z wiekiem ciążowym (r = 0,29,
p = 0,106). W chwili zakończenia obserwacji (miesiąc po porodzie) 16% noworodków zmarło, a kolejne 16% nadal przebywało w szpitalu z niepewną prognozą co do przeżycia. W grupie, w której do rozwiązania ciąży doszło w 32 tygodniu lub później, nie odnotowano ani jednego zgonu.

Wnioski

Śmiertelność noworodków urodzonych wskutek PPROM przed 32 tygodniem ciąży jest zróżnicowana i zależna od wieku ciążowego. Wstępne badanie kliniczne powinno być zawsze potwierdzone przez badanie ultrasonograficzne. Ze względu na konsekwencje społeczno-ekonomiczne zagadnienie to wymaga dalszych prospektywnych badań.