bluuebunny/crossref_metadata_2025 huggingface dataset:
SINUSITE CRÔNICA DECORRENTE DE CORPO ESTRANHO EM SEIO MAXILAR
Authors: Silva Rebouças Deyvid , Ribeiro da Silva Lima Rivany , Pellegrini Washington , Freitas Assis Adriano , Prates Soares Zerbinati Lívia
Published: September 2015

A Sinusite crônica em seio maxilar decorrente de corpo estranho pode ser provocada pela presença de dentes, raízes dentárias ou materiais odontológicos, e ocasiona um processo inflamatório e infecção sinusal. O diagnóstico é facilmente obtido através dos achados clínicos e imaginológicos, porém, por desconhecimento e falhas na prevenção da inserção de corpos estranhos no seio maxilar, diversos profissionais de saúde não elucidam precocemente esta enfermidade. O presente trabalho tem como objetivo descrever o caso clínico de uma paciente portadora de sinusite crônica, sem melhoras com tratamento medicamentoso que após avaliação radiográfica, foi possível identificar estrutura metálica em seio maxilar e sugeriu-se o diagnóstico de sinusite crônica decorrente de corpo estranho. Foi instituído tratamento medicamentoso e remoção cirúrgica associada à sinusectomia.
MIOFIBROBLASTOS, CÉLULAS RELEVANTES NA SAÚDE E NA DOENÇA: REVISÕES DE LITERATURA
Authors: Costa Wanderley Flávia Godinho , Almeida Reis Sílvia Regina de , Medrado Alena Peixoto
Published: September 2015

Recentemente, um grande número de estudos sobre miofibroblastos tem sido publicados. Estes elementos celulares foram primariamente descritos há mais de 40 anos e as suas características ultraestruturais, assim como seu papel em diversas condições fisiológicas e patológicas continuam despertando interesse nas áreas de saúde. O presente trabalho objetiva descrever a biologia celular e molecular dos miofibroblastos, contextualizando as descobertas científicas sobre estas células registradas em artigos ao longo dos últimos 40 anos desde a sua descoberta inicial.
A ESCUTA CLÍNICA: UM INSTRUMENTO DE INTERVENÇÃO DO PSICÓLOGO EM DIFERENTES CONTEXTOS
Authors: Braga Ana Aparecida N. M. , Ramos Daltro Mônica , Ferreira Danon Carlos Alberto
Published: September 2015

O presente artigo discute o impacto da experiência de atendimento clínico na formação do psicólogo a partir da disciplina Diagnóstico e Intervenções, que consta de atendimentos clínicos de psicodiagnóstico, realizados no Serviço Escola de uma instituição provada de ensino superior. O estudo põe em evidência a escuta psicológica clínica como instrumento fundamental ao fazer do psicólogo. Seu objetivo é descrever a relação que os estudantes, egressos da disciplina e também já do curso, fazem entre a prática desenvolvida e a formação de psicólogo. Trata-se de um estudo descritivo qualitativo realizado com 10 ex-alunos da instituição formados entre 2008 e 2010. Foi aplicado, ao longo de 2011, um questionário semiestruturado submetido a uma análise de conteúdo posterior.  Conclui-se que a escuta clínica trabalhada em um processo de psicodiagnóstico é de fundamental importância para a formação do psicólogo, em qualquer campo de atuação, não necessariamente no consultório, pois através dela compreende-se o sujeito e sua questão. Faz-se necessário, portanto, ao psicólogo, ocupar um lugar específico que lhe permita escutar a subjetividade implicada nas diferentes experiências do sujeito, como possibilidade de fazer a diferença nas diversas áreas de trabalho.
PRÁTICAS ALTERNATIVAS NO CAMPO DA ATENÇÃO AOS USUÁRIOS DE ÁLCOOL E OUTRAS DROGAS
Authors: Brito de Almeida Alba Riva
Published: September 2015

Este estudo enfoca uma experiência de intervenção junto a usuários de drogas numa instituição de referência. Pretende discutir questões relacionadas às práticas de atenção e cuidado a usuários de drogas e identificar a marca da construção da identidade institucional. A metodologia privilegia a entrevista, análise documental e estudo de caso com abordagem teórica de autores pós-estruturalistas. Identifica-se que a pluralidade de estratégias e de arranjos interdisciplinares utilizados pela instituição funcionam como meios alternativos para ressignificação da droga e revelam as ações face aos modos de assujeitamento dos usuários às práticas com drogas, bem como as leituras interpretativas acerca dos determinantes psicossociais da adesão.
PÓS-MODERNO É A MÃE
Authors: Amélia de Faria Anna
Published: September 2015

Discussão sobre a modernidade e questões deflagradas pela pós-modernidade, conjugadas a elementos da psicanálise, concernentes à estruturação do sujeito desejante, incluindo uma breve discussão sobre a função parental. Melhor dizendo: como se organiza um sujeito desejante. Esses apontamentos são intermitentemente ligados a textos da literatura e da psicanálise.
A FUNÇÃO APAZIGUADORA DOS RITUAIS NAS ORGANIZAÇÕES
Authors: Iasbeck Luiz Carlos A.
Published: September 2015

Passamos grande parte de nossas vidas envolvidos em Organizações, grupos sociais e profissionais nos quais os inevitáveis conflitos de interesses são amenizados por práticas rituais. Os ritos atualizam mitos, reforçando, assim, os fundamentos e as forças aglutinadoras que justificam a existência das organizações. Na base dessas práticas encontramos uma tendência unificadora do mundo, herdada da mitologia clássica, que está na origem da necessidade de comunicar.
INSEGURANÇA E VIOLÊNCIA NO TRABALHO DOS DELEGADOS DE POLÍCIA CIVIL DE SALVADOR, BRASIL
Authors: Oliveira Gerfson Moreira , Araújo Tânia Maria de , Martins Carvalho Fernando
Published: September 2015

A violência no âmbito do trabalho policial engloba diversas manifestações, desde atos de agressão à opressão de trabalhadores que estão submetidos a condições e ambientes precários e inseguros. O objetivo deste estudo é descrever as condições do trabalho e de segurança dos delegados de polícia civil da cidade de Salvador, Bahia, Brasil, enfocando os aspectos da violência e vitimização. Método: Estudo de corte transversal incluindo 152 delegados de polícia de Salvador, Bahia, com aplicação de questionário padronizado contendo informações sobre as condições de trabalho e de segurança nas atividades profissionais desenvolvidas e a ocorrência de situações de violência. Resultados: No grupo estudado, 65% dos delegados relatam meios de proteção e segurança insuficientes e 63% consideram o trabalho pesado; 90% dos delegados vivenciam situações emocionalmente demandantes na atividade profissional. Constata-se ainda que 83% consideram violento o cotidiano do trabalho; 30% do grupo afirma ter presenciado atos de agressão ou ameaça praticada entre os colegas no local de trabalho e 38% relatam sofrer agressão psicológica fora do contexto profissional. A prática abusiva de poder foi referida por 19,3% do grupo. Acidentes de trabalho no último ano são relatados por 16% dos entrevistados e 18,9% se ausentaram por mais de 15 dias da atividade profissional por apresentarem problemas de saúde. Conclusão: Identifica-se altas demandas físicas e emocionais no trabalho dos delegados e delegadas de polícia, vulnerabilidade nas relações entre os pares e condições inseguras no contexto profissional. Os problemas de saúde mental são as principais causas de afastamento do trabalho por mais de quinze dias.
Dynamic Regimes of Local Homogeneous Population with Delayed Density Dependence
Authors: Неверова Г.П. , Neverova G.P.
Published: September 2015

It is researched a model of limited homogeneous population size. It is assumed that there is delayed density dependence. It is made the analytical and
numerical investigation of the model with different time lag. It is shown there it is the phenomenon of multiregimism. This phenomenon consists in
the existence of various dynamic regimes under the same values of parameters. This effect arises in the model that simultaneously possesses several different
limit regimes: stable state, regular fluctuations, and chaotic attractor. The research results show if present population dynamics substantially depends
on population size of previous years than it is observed quasi-periodic oscillations. Fluctuations with period 2 occur when the growth of population size
is regulated by density-dependence in the current year.
PSYCHOLOGICAL WELL – BEING CONTENT IN TODAY’S PSYCHOLOGICAL THEORIES
Authors: Kalvāns Ēriks
Published: September 2015

Psychological well-being is a phenomenon that significantly affects an individual's basic functional aspects: everyday sense of self, personal cognitive sphere, interpersonal relationships and professional success. Because of the relatively small theoretical and empirical research, there is a number of psychological well-being concept operationalization difficulties and validate the empirical study of instruments deficit. For these reasons, acquires relevance of sychological well-being of the phenomenon of theoretical and empirical research. This ublication reflects the main approaches to the treatment of psychological well-being of the phenomenon of modern psychology.
DESCRIPTION OF THE 7-YEAR CHILDREN’S 1ST GRADE SOCIAL ADAPTATION MODEL
Authors: Āboltiņa Līga
Published: September 2015

Most studies on 7-year-old children's social adjustment in school focus on situation characterization by setting the adjustment process as a problem instead of offering possible solutions (OECD, 2001; OECD, 2006). According to theoretical knowledge and practical observations the purpose of the article is to promote 7- year-old children's social adjustment in school, creating a model of a 7-year-old child’s social adaptation in 1st grade. The article reveals the key aspects that affect the 7- year-old children's social adjustment, as well as describes the model components that determine the 7-year-old children's social adjustment in 1st grade.
MEDIATION – A MODERN AND PRODUCTIVE WAY OF PROBLEM AND CONFLICT SOLUTION IN SCHOOL
Authors: Truskovska Ženija , Orska Rita , Ušča Svetlana
Published: September 2015

Solution of problems and conflicts by means of mediation is still an innovation in Latvian schools. The social pedagogues are the most interested in mediation since they are the first who interface with the complicated situations in school and have to search for their solutions. In accordance with the demands of a changing world the task of the school is not just to educate schoolchildren but as well to prepare them to live in the future world. An ability to change a perspective is to be considered as a central competence; it is followed by the adequate social activities, ability to collaborate, by the concepts of fairness and moral reasoning. Change of perspective is a competence that could be obtained in the education process, as well as in the process of mediation. The theoretical and practical research on the implementation of the mediation in Latvian schools justifies mediation to be an alternative, successful and productive way of the problem and conflict solution that both improves the psychological environment of the school and fosters the competences of the schoolchildren that will be necessary in their independent life. The article is rooted in the theoretical concepts and ideas of several researchers (Trossen, Hofmann, Rothfischer, 2004; Will, 2005, 2011; et.al.) as well as in the reflection of the experience of the authors of this research. The aim of the paper: to analyse results of the survey of the literature teachers and social pedagogues on the necessity of mediation in the school.
INCLUSIVE EDUCATION IN GENERAL EDUCATION INSTITUTIONS: ASSESSMENT OF TEACHERS - STUDENTS
Authors: Rozenfelde Mārīte
Published: September 2015

Teachers working in classrooms is a key resource to achieve the objective of creating an inclusive education process in a general education institution. Students with special needs require a teacher, who sees and understands what happens around, acts on a basis of this understanding. The article presents a review of research carried out in 2013 on attitude of practicing teachers - Rezekne Higher Education Institution part-time students - in various regions of Latvia with regard to implementation of inclusive education in general education institutions and understanding of the idea of inclusion. For an inclusive school to be realized, many issues depend on teachers' attitudes towards students with needs, from the fact whether teachers have the needed skills, abilities, knowledge, pedagogical approaches, techniques, methods, materials that would help to cope with the diversity, as well as whether a teacher receives the required support from both a school and outside it
Reviving extinct Mediterranean forest communities may improve ecosystem potential in a warmer future
Authors: Henne Paul D , Elkin Ché , Franke Jörg , Colombaroli Daniele , Calò Camilla , La Mantia Tommaso , Pasta Salvatore , Conedera Marco , Dermody Orla , Tinner Willy
Published: September 2015

The Mediterranean Basin is the region of Europe most vulnerable to negative climate‐change impacts, including forest decline, increased wildfire, and biodiversity loss. Because humans have affected Mediterranean ecosystems for millennia, it is unclear whether the region's native ecosystems were more resilient to climate change than current ecosystems, and whether they would provide sustainable management options if restored. We simulated vegetation with the LandClim model, using present‐day climate as well as future climate‐change scenarios, in three representative areas that encompass a broad range of Mediterranean conditions and vegetation types. Sedimentary pollen records that document now‐extinct forests help to validate the simulations. Forests modeled under present climate closely resemble the extinct forests when human disturbance is limited; under future scenarios, characterized by increased temperatures and decreased precipitation, extinct forests are projected to re‐emerge. When combined with modeling, paleoecological evidence reveals the potential of native vegetation to re‐establish under current and future climate conditions, and provides a template for novel management strategies to maintain forest productivity and biodiversity in a warmer and drier future.
Comparisons of Different Suction Control Techniques by Water Retention Curves: Theoretical and Experimental Studies
Authors: Ng C. W. W. , Zhou C. , Leung A. K.
Published: September 2015

The axis‐translation (ATT), osmotic (OMT), and vapor equilibrium (VET) techniques are widely used suction control techniques for investigating the hydraulic and mechanical behavior of unsaturated soils in the vadose zone. Yet there is still debate in the literature regarding their validity and consistency. In this study, four purposely designed experiments were carried out to measure the water retention curves (WRCs) of a compacted silty sand at different densities using the ATT and OMT. The four WRCs obtained from this study, together with extensive existing data published in the literature, were then analyzed using newly derived thermodynamic equations. The aim and novelty of this study were to apply the thermodynamic theory to verify and explain the validity and consistency of WRCs obtained by the three commonly used experimental techniques. By allowing for some possible experimental errors, the analyzed results reveal that the WRCs obtained from the three techniques are remarkably consistent. These consistent results can be explained by the derived thermodynamic equations, which illustrate that the final soil water content at the thermodynamic equilibrium state should be the same regardless of the suction control technique used, even though the techniques involve different processes of moisture exchange.
High-throughput functional screening reveals low frequency of antibiotic resistance genes in DNA recovered from the Upper Mississippi River
Authors: Staley Christopher , Gould Trevor J. , Wang Ping , Phillips Jane , Cotner James B. , Sadowsky Michael J.
Published: September 2015

In this study, we determined the frequency of antibiotic resistance genes (ARGs) in the Upper Mississippi River using a high-throughput, functional, metagenomic screening procedure. Fosmid libraries containing ∼10,000 clones were screened for resistance to ampicillin, cephalothin, kanamycin, and tetracycline. We hypothesized that nutrient concentrations, land cover type, and taxonomic community composition may select for ARGs. Resistance to ampicillin, cephalothin, and kanamycin was low (<1.00%), and no resistance to tetracycline was detected. Ammonium and total dissolved solids (TDS) concentrations were correlated with kanamycin and cephalothin resistances (r = 0.617 and −0.449, P = 0.002 and 0.036, respectively). Cephalothin resistance was also positively correlated with the percentage of forested land cover (r = 0.444, P = 0.039). Only the candidate division OD1, among 35 phyla identified, was correlated with ampicillin resistance (r = 0.456, P = 0.033), suggesting that minority members of the community may be responsible for dissemination of ARGs in this ecosystem. Results of this study suggest that ammonium and TDS may be involved in a complex selection process for ARGs. Furthermore, we suggest that minority species, potentially contributed in low numbers from sediment and biofilm reservoirs, may be the primary carriers of ARGs in this riverine system.
Microbial and chemical safety of non-commercially packaged water stored for emergency use
Authors: Gerla Stephanie R. , Lloyd Michelle A. , Eggett Dennis L. , Pike Oscar A.
Published: September 2015

Water storage is one of the most important components of emergency preparedness. Potable water is needed for ensuring the survival and well-being of disaster victims. Consumers may store water in previously used beverage or other food-grade containers for emergency use; however, this practice poses potential safety risks. Water stored in various containers for emergency purposes in residences within the state of Utah was tested for various contaminants. Of 240 samples, seven contained coliforms and 14 samples had free chlorine levels over the Environmental Protection Agency (EPA) 4 parts per million limit. There was a negative correlation between chlorine levels and age of water. The probability that a container had free chlorine present decreased by 4% for each month of storage, suggesting the importance of preventing subsequent contamination of water during storage and use. Water in clear polyethylene terephthalate plastic soda bottles (n = 16), even when stored for >18 months, did not exceed 0.3 parts per billion (ppb) antimony, a level significantly lower than the EPA limit of 6.0 ppb antimony. These results support the practice of utilizing previously used containers, when properly cleaned and chlorinated, for emergency water storage.
Modeling benzene permeation through drinking water high density polyethylene (HDPE) pipes
Authors: Mao Feng , Ong Say Kee , Gaunt James A.
Published: September 2015

Organic compounds such as benzene, toluene, ethyl benzene and o-, m-, and p-xylene from contaminated soil and groundwater may permeate through thermoplastic pipes which are used for the conveyance of drinking water in water distribution systems. In this study, permeation parameters of benzene in 25 mm (1 inch) standard inside dimension ratio (SIDR) 9 high density polyethylene (HDPE) pipes were estimated by fitting the measured data to a permeation model based on a combination of equilibrium partitioning and Fick's diffusion. For bulk concentrations between 6.0 and 67.5 mg/L in soil pore water, the concentration-dependent diffusion coefficients of benzene were found to range from 2.0 × 10−9 to 2.8 × 10−9cm2/s while the solubility coefficient was determined to be 23.7. The simulated permeation curves of benzene for SIDR 9 and SIDR 7 series of HDPE pipes indicated that small diameter pipes were more vulnerable to permeation of benzene than large diameter pipes, and the breakthrough of benzene into the HDPE pipe was retarded and the corresponding permeation flux decreased with an increase of the pipe thickness. HDPE pipes exposed to an instantaneous plume exhibited distinguishable permeation characteristics from those exposed to a continuous source with a constant input. The properties of aquifer such as dispersion coefficients (DL) also influenced the permeation behavior of benzene through HDPE pipes.
Adoption of a microbial health-based target for Australian drinking water regulation
Authors: O'Toole Joanne , Sinclair Martha , Gibney Katherine , Leder Karin
Published: September 2015

The health-based targets of 1 in 10,000 for infection and 10−6 disability adjusted life years (DALYs) per person per year are increasingly being considered, or have already been adopted, to define microbial safety targets for water. The aim of this paper is to convey information about how these two targets compare by converting each of the target values to a common metric. The metric chosen for viral (rotavirus and norovirus) and protozoan (Cryptosporidium) reference pathogens is the estimated maximum number of annual drinking water-associated cases of acute diarrhoeal disease tolerated. For the reference bacterial pathogen Campylobacter, sequelae to acute diarrhoeal illness have also been considered in estimating the tolerable number of cases for the DALY target. Also investigated is whether non-compliance with targets would be detected as a waterborne disease outbreak by the health surveillance system in an extreme hypothetical situation whereby all tolerable cases per annum occurred as a single event. The paper highlights that verification of compliance with targets cannot be demonstrated by the absence of reported drinking water-associated outbreaks alone and concludes that introduction of a quantitative health-based outcome for drinking water in Australia would help improve water quality management by providing a common goal directly linked to health outcomes.
Study of phosphate removal from aqueous solution by zinc oxide
Authors: Luo Zhen , Zhu Suiyi , Liu Zhongmou , Liu Jiancong , Huo Mingxin , Yang Wu
Published: September 2015

Zinc oxide (ZnO) was synthesized and used to investigate the mechanism of phosphate removal from aqueous solution. ZnO particles were characterized by X-ray diffraction, scanning electron microscope and Fourier transform infrared spectroscopy before and after adsorption. Batch experiments were carried out to investigate the kinetics, isotherms, effects of initial pH and co-existing anions. The adsorption process was rapid and equilibrium was almost reached within 150 min. The adsorption kinetics were described well by a pseudo-second-order equation, and the maximum phosphate adsorption capacity was 163.4 mg/g at 298 K and pH ∼6.2 ± 0.1. Thermodynamic analysis indicated the phosphate adsorption onto ZnO was endothermic and spontaneous. The point of zero charge of ZnO was around 8.4 according to the pH-drift method. Phosphate adsorption capacity reduced with the increasing initial solution pH values. The ligand exchange and Lewis acid-base interaction dominated the adsorption process in the lower and the higher pH range, respectively. Nitrate, sulfate and chloride ions had a negligible effect on phosphate removal, while carbonate displayed significant inhibition behavior.
Cryptosporidium in small water systems in Puerto Rico: a pilot study
Authors: Robinson Guy , Minnigh Harvey A. , Hunter Paul R. , Chalmers Rachel M. , Ramírez Toro Graciela I.
Published: September 2015

A pilot study was undertaken to investigate the occurrence of Cryptosporidium in four very small drinking water systems supplying communities in rural Puerto Rico. Water samples (40 L) were collected and oocysts were concentrated by calcium carbonate flocculation, recovered by immunomagnetic separation and detected by immunofluorescence microscopy. Cryptosporidium oocysts were identified in all four systems. This is the first report of evidence of the potential public health risk from this chlorine-resistant pathogen in Puerto Rican small water systems. Further work is warranted to fully assess the health risks that Cryptosporidium and other protozoa pose to populations served by community-managed small drinking water systems.
Microbial source markers assessment in the Bogotá River basin (Colombia)
Authors: Venegas Camilo , Diez Hugo , Blanch Anicet R. , Jofre Juan , Campos Claudia
Published: September 2015

The microbiological indicators traditionally used to assess fecal contamination are insufficient to identify the source. The aim of this study was to detect microbial markers to identify the source of fecal pollution in the Bogotá River (Colombia). For this, we determined non-discriminating indicators such as Escherichia coli, somatic coliphages and phages infecting strain RYC2056 of Bacteroides, and potential source tracking markers as phages infecting strains GA17, HB13, and CA8 of Bacteroides, sorbitol-fermenting bifidobacteria, and molecular markers of Bifidobacterium adolescentis, Bifiodobacterium dentium, and Bacteroidetes in raw municipal wastewaters, slaughterhouse wastewaters, and the Bogotá River. Bacteriophages infecting Bacteroides strain GA17 and the molecular markers identified the wastewater sources. In contrast, sorbitol-fermenting bifidobacteria failed regarding specificity. In the Bogotá River, phages infecting strain GA17 were detected in all samples downstream of Bogotá, whereas they should be concentrated from 1 l samples in upstream samples containing less than 103E. coli/100 ml to be detected. In the river water, the fraction of positive detections of molecular markers was lower than that of phages infecting strain GA17. The ratio SOMCPH/GA17PH was shown also to be a good marker. These results provide information that will allow focusing measures for sanitation of the Bogotá River.
Incidence of waterborne lead in private drinking water systems in Virginia
Authors: Pieper Kelsey J. , Krometis Leigh-Anne H. , Gallagher Daniel L. , Benham Brian L. , Edwards Marc
Published: September 2015

Although recent studies suggest contamination by bacteria and nitrate in private drinking water systems is of increasing concern, data describing contaminants associated with the corrosion of onsite plumbing are scarce. This study reports on the analysis of 2,146 samples submitted by private system homeowners. Almost 20% of first draw samples submitted contained lead concentrations above the United States Environmental Protection Agency action level of 15 μg/L, suggesting that corrosion may be a significant public health problem. Correlations between lead, copper, and zinc suggested brass components as a likely lead source, and dug/bored wells had significantly higher lead concentrations as compared to drilled wells. A random subset of samples selected to quantify particulate lead indicated that, on average, 47% of lead in the first draws was in the particulate form, although the occurrence was highly variable. While flushing the tap reduced lead below 15 μg/L for most systems, some systems experienced an increase, perhaps attributable to particulate lead or lead-bearing components upstream of the faucet (e.g., valves, pumps). Results suggest that without including a focus on private as well as municipal systems it will be very difficult to meet the existing national public health goal to eliminate elevated blood lead levels in children.
Mechanism by Which Caloric Restriction Improves Insulin Sensitivity in Sedentary Obese Adults
Authors: Johnson Matthew L. , Distelmaier Klaus , Lanza Ian R. , Irving Brian A. , Robinson Matthew M. , Konopka Adam R. , Shulman Gerald I. , Nair K. Sreekumaran
Published: September 2015

Caloric restriction (CR) improves insulin sensitivity and reduces the incidence of diabetes in obese individuals. The underlying mechanisms whereby CR improves insulin sensitivity are not clear. We evaluated the effect of 16 weeks of CR on whole-body insulin sensitivity by pancreatic clamp before and after CR in 11 obese participants (BMI = 35 kg/m2) compared with 9 matched control subjects (BMI = 34 kg/m2). Compared with the control subjects, CR increased the glucose infusion rate needed to maintain euglycemia during hyperinsulinemia, indicating enhancement of peripheral insulin sensitivity. This improvement in insulin sensitivity was not accompanied by changes in skeletal muscle mitochondrial oxidative capacity or oxidant emissions, nor were there changes in skeletal muscle ceramide, diacylglycerol, or amino acid metabolite levels. However, CR lowered insulin-stimulated thioredoxin-interacting protein (TXNIP) levels and enhanced nonoxidative glucose disposal. These results support a role for TXNIP in mediating the improvement in peripheral insulin sensitivity after CR.
Impact of Lowering BMI Cut Points as Recommended in the Revised American Diabetes Association's Standards of Medical Care in Diabetes—2015 on Diabetes Screening in Asian Americans
Authors: Hsia Daniel S. , Larrivee Sandra , Cefalu William T. , Johnson William D.
Published: September 2015

OBJECTIVE

This study estimated the screening prevalence of prediabetes and diabetes using a lower BMI cutoff of 23 kg/m2 in Asians in the U.S. using the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2012.

RESEARCH DESIGN AND METHODS

A cross-sectional analysis was conducted of non-Hispanic Asians, aged 45 years and older, with available BMI, HbA1c, and fasting glucose data. These overall criteria were met by 341 participants.

RESULTS

Lowering the screening BMI to 23 kg/m2 increased the sensitivity of screening for prediabetes and diabetes from 50.2 to 74.1% (P < 0.0001) but decreased the specificity from 62.9 to 38.7% (P < 0.0001).

CONCLUSIONS

Although this will add additional health care costs resulting from more widespread screening, early identification of these conditions may be beneficial for primary and secondary prevention in this unique population that develops prediabetes and diabetes at lower BMI levels.
Pain and Giving Way Following Total Knee Arthroplasty
Authors: Cibulka Michael T. , White Douglas M.
Published: September 2015

The patient was a 68-year-old man who had undergone right total knee arthroplasty 3 years prior. Due to the patient's worsening symptoms of pain and giving way, as well as significant joint laxity with varus/valgus stress testing, he was referred to his orthopaedic surgeon. Radiographs of the right knee revealed osteolysis surrounding the femoral component of the prosthesis and subsidence of the tibial tray, which is consistent with prosthetic loosening.

J Orthop Sports Phys Ther 2015;45(9):719. doi:10.2519/jospt.2015.0409
Clinico-Epidemiological Profile and Outcome of Poisonous Snake Bites in Children using the WHO Treatment Protocol in Western Nepal
Authors: Paudel Kiran Mani , Poudyal V P , Rayamajhi Rajan Bikram , Budhathoki Shyam Sundar
Published: September 2015

Background: Snake bite among children is an important public health problem in many tropical and subtropical countries. Limited studies are found on snake-bite in Nepal using the WHO snake-bite management guidelines. This study assessed the clinico-epidemiological profile and their outcome in snake-bite among children using the WHO Guidelines for treatment of snake bite.Methods: This is a descriptive study among 75 children less than 14 years of age admitted in Emergency Room (ER) of Lumbini Zonal Hospital from 2011-2012 with the history of poisonous snake bite.Results: More than half (56%) of the cases were males and 3/5th (58%) were above 10 years of age. About 40% of the patients were brought to ER within 6-12 hrs of snake bite. Common site of snake-bite was lower limbs (32%) followed by upper limbs (29%). Abdominal Pain (44%) was observed as most common sign/symptom of snake-bite poisoning after local pain followed by ptosis (17.3%). The case fatality rate (CFR) was 16.0%.Conclusion: Use of WHO treatment guideline for snakebite case management among children showed low CFR. However further studies need to done to compare the treatment outcomes between WHO guideline and the National Guidelines among snakebite cases among children. Journal of Nobel College of Medicine Vol.4(1) 2015: 21-25
Iridocorneal Endothelial Syndrome
Authors: Sitoula Rakshya Panta
Published: September 2015

The iridocorneal endothelial (ICE) syndrome is characterized by abnormalities of the corneal endothelium, iris, and anterior segment leading to secondary angle closure glaucoma. ICE syndrome is usually unilateral, nonheritable and most common in white women in the third to fifth decades.Journal of Nobel College of Medicine Vol.4(1) 2015: 64-65
A Comparative Study of Bone Marrow Aspiration and Bone Marrow Biopsy in Hematological Diseases
Authors: Mainali Nirajan , Homagai Neha , Tiwari Pratap Sagar , Giri Arun
Published: September 2015

Introduction: Bone marrow examination is an important diagnostic tool to evaluate various disorder including both neoplastic and non-neoplastic hematological diseases. The two most important techniques used for the diagnosis are bone marrow aspiration and bone marrow trephine biopsy which are complementary to each other.Aim and Objectives: To compare the diagnostic value of bone marrow aspiration and biopsy. Material and methods: A total of 88cases with both bone marrow aspiration and biopsy were included in the study. All the aspirate smears were routinely stained by Jenner Giemsa while the trephine biopsy sections were stained by routine Hematoxylin and Eosin stain.. All the smears and sections were reviewed and the findings on BMA and BMB were compared and the final correlation done.Result: Hypolastic marrow was the most common diagnosis followed by immune thrombocytopenic purpura (ITP). But the diagnostic accuracy of ITP on aspiration was 100 % in compare to hypoplastic marrow (81.25%). The diagnosis accuracy of BMA in our study was 84.09%.Conclusion: Bone marrow aspiration and biopsy complement each other. Bone marrow aspiration provides better study of the cell, whereas biopsy provides detail about the pattern of cellular distribution, hence when performed together it gives better diagnostic accuracy. Journal of Nobel College of Medicine Vol.4(1) 2015: 12-14
Deep Neck Infections among the Population Attending at Nobel Medical College Biratnagar
Authors: Suwal Ravi Bhushan , Basnet Meenakshi , Acharya Rabin , Parajuli Kamal
Published: September 2015

Introduction: The advent of diagnostic tools and antibiotic, incidence of deep neck infections have been reduced but still infections are seen today with definite potential for significant morbidity and mortality. The purpose of this study was to review predisposing factors, bacteriology, treatment and possible complications.Study design: A retrospective review was conducted of patients who were diagnosed as deep neck infections in Department of Otolaryngology at Nobel Medical College from between August 2010 to December 2014.Total 90 patients were included in this study. Their demography, etiology, underlying systemic diseases, infection locality, causative organism and modality of treatment were reviewed.Results: Of 90 patients, 65 were male and 25 were female. Fourty eight patients were in age range of 20-40 years and which was the most affected age group in our series. Odontogenic and parotid infections were the most frequent causes for deep neck infections. Submandibular space and cervical lymphnode were most affected site in neck. Staphylococcus aureus and mixed flora were organisms commonly isolated from culture. The most commonly found systemic diseases were diabetes mellitus and systemic arterial hypertension. In our series 18 patients (20%) had associated diabetes mellitus (DM).The most frequently encountered complication was upper airway obstruction. In our series 3 patients undergone tracheostomy; one patient each with Ludwig’s angina, necrotizing fasciitis and retropharyngeal abscess.Conclusions: It is essential to pay attention to older patients associated with systemic diseases (DM, HTN, Chronic kidney disease), because they can often progress to life threatening complications. The mainstays of treatment are maintenance of the airway, fluid resuscitation, intravenous antibiotics, and timely adequate surgical drainage. Therapeutic needle aspiration and conservative medical treatment are effective in selective cases such as those with minimal abscess formation. Journal of Nobel College of Medicine Vol.4(1) 2015: 26-31
Solid mold investment casting – A replication process for open-cell foam metal production
Authors: Guler Kerem Altug
Published: September 2015

Foam metals have always been an interesting material type because of their unique properties and various production techniques. In this study, solid mold investment casting process, which is one of the replication techniques, was used to produce open-cell aluminum foam specimens. Commercial rubber sponge was tested as foam pattern material. Plaster bonded solid molds were prepared in the stainless steel flasks and infiltration of the slurry into the rubber sponge was carried out under vacuum. Following this, pattern removal and mold firing was carried out gradually. Molten A319 casting and A6063 wrought aluminum alloys were cast into flash molds with vacuum assistance (−105 Pa). Sponge pattern and cast foam specimens were examined and compared by stereo microscope and scanning electron microscope (SEM). It is clearly found that rubber sponge is a very suitable pattern material for producing open-cell foam structures.
CFD simulation of particulate flow in a spiral concentrator
Authors: Mahran Gamal M. A. , Doheim Mohamed A. , Abu-Ali Mohamed H. , Abdel Ahmed F.
Published: September 2015

A spiral concentrator is a gravity concentration device. It was invented by Humphreys in 1941. Firstly, it was designed and developed based on experience and by extensive testing of prototypes and modifications. The main objective of the present study is the simulation of the particulate flow of more realistic solid concentrations (i. e., 15 wt.-% solids) in a spiral separator. This study is based on the Eulerian approach and renormalization group k-∊ turbulence modeling. The results focus on particulate flow characteristics such as velocity, distribution and concentration of particulates on the spiral trough. The predicted results were compared with the experimental results in case of LD9 coal spiral. Comparisons between numerical and measured data showed good agreement.
Mechanical and electrical properties of Sb-Ga50Au10In40 alloys
Authors: Gomidželović Lidija , Živković Dragana , Požega Emina , Ćosović Vladan , Balanović Ljubiša , Manasijević Dragan
Published: September 2015

In this publication, results are presented which have been obtained by investigation of mechanical and electrical properties of alloys belonging to Sb-Ga50Au10In40 section of quaternary Au-Ga-In-Sb system, which is the basis for the development of new lead-free solder materials. The experiments were conducted using Brinell method for hardness measurement, apparatus PTM-3 for microhardness measurement and instrument Foerster SIGMATEST 2.069 for measuring of electrical conductivity. The microstructure of samples was analyzed using optical microscopy.
Magnetic resonance imaging evidence for perineural spread of endometriosis to the lumbosacral plexus: report of 2 cases
Authors: Siquara de Sousa Ana C. , Capek Stepan , Howe Benjamin M. , Jentoft Mark E. , Amrami Kimberly K. , Spinner Robert J.
Published: September 2015

Sciatic nerve endometriosis (EM) is a rare presentation of retroperitoneal EM. The authors present 2 cases of catamenial sciatica diagnosed as sciatic nerve EM. They propose that both cases can be explained by perineural spread of EM from the uterus to the sacral plexus along the pelvic autonomie nerves and then further distally to the sciatic nerve or proximally to the spinal nerves. This explanation is supported by MRI evidence in both cases. As a proof of concept, the authors retrieved and analyzed the original MRI studies of a case reported in the literature and found a similar pattern of spread. They believe that the imaging evidence of their institutional cases together with the outside case is a very compelling indication for perineural spread as a mechanism of EM of the nerve.
Diffusion tensor imaging to visualize axons in the setting of nerve injury and recovery
Authors: Gallagher Thomas Anthony , Simon Neil G. , Kliot Michel
Published: September 2015

Successful management of peripheral nerve trauma relies on accurate localization of the injury and grading of the severity of nerve injury to determine whether surgical intervention is required. Existing techniques, such as electrodiagnostic studies and conventional imaging modalities, provide important information, but are limited by being unable to distinguish severe nerve lesions in continuity that will recover from those that will not. Diffusion tensor imaging (DTI) and tractography of peripheral nerves provide a novel technique to localize and grade nerve injury, by assessing the integrity of the nerve fibers across the site of nerve injury. Diffusion tensor imaging and tractography also hold promise as markers of early nerve regeneration, prior to clinical and electrodiagnostic evidence of recovery. In the present review, the techniques of peripheral nerve DTI and tractography are discussed with respect to peripheral nerve trauma, with illustrative cases demonstrating potential roles of these novel approaches.
Sonographic short-term follow-up after surgical decompression of the median nerve at the carpal tunnel: a single-center prospective observational study
Authors: Tas Sueleyman , Staub Frank , Dombert Thomas , Marquardt Gerhard , Senft Christian , Seifert Volker , Duetzmann Stephan
Published: September 2015

OBJECT

Carpal tunnel syndrome causes increased cross-sectional area (CSA) of the median nerve, which can be assessed by high-definition ultrasonography. It is unclear today, however, whether high-definition ultrasonography may play a role in the postoperative period. This prospective study aimed to determine the natural history of the morphology of the median nerve at the carpal tunnel after surgical decompression assessed by high-definition ultrasonography.

METHODS

Between October and December 2014, patients with suspected carpal tunnel syndrome who were referred to the authors’ center for peripheral neurosurgery were prospectively enrolled and underwent pre- and postoperative (3 months) high-definition ultrasonography, electrophysiology, and clinical testing.

RESULTS

Eighty-one patients were enrolled in the study, and 100% were clinically better at the 3-month follow-up. The mean CSA decreased from 14.7 ± 4.9 mm2 to 12.4 ± 3.4 mm2 (mean ± SD, p < 0.0001). The mean distal motor latency decreased from 6.6 ± 2.4 msec to 4.8 ± 1.0 msec (mean ± SD, p < 0.0001). Ninety-eight percent of patients who were available for electrodiagnostic follow-up showed an improvement of the distal motor latency; only 80% had a reduction in the CSA.

CONCLUSIONS

The authors present the second-largest series of patients with sonographic follow-up after surgical decompression of the carpal tunnel reported in the literature so far. This study, which showed a decrease in size of the median nerve after surgical decompression, suggests that the preoperative increase in median nerve CSA at the carpal tunnel may be due to compression and that enlargement of the median nerve is (partially) reversible.
Intraoperative high-resolution ultrasound and contrast-enhanced ultrasound of peripheral nerve tumors and tumorlike lesions
Authors: Pedro Maria Teresa , Antoniadis Gregor , Scheuerle Angelika , Pham Mirko , Wirtz Christian Rainer , Koenig Ralph W.
Published: September 2015

The diagnostic workup and surgical therapy for peripheral nerve tumors and tumorlike lesions are challenging. Magnetic resonance imaging is the standard diagnostic tool in the preoperative workup. However, even with advanced pulse sequences such as diffusion tensor imaging for MR neurography, the ability to differentiate tumor entities based on histological features remains limited. In particular, rare tumor entities different from schwannomas and neurofibromas are difficult to anticipate before surgical exploration and histological confirmation. High-resolution ultrasound (HRU) has become another important tool in the preoperative evaluation of peripheral nerves. Ongoing software and technical developments with transducers of up to 17–18 MHz enable high spatial resolution with tissue-differentiating properties. Unfortunately, high-frequency ultrasound provides low tissue penetration. The authors developed a setting in which intraoperative HRU was used and in which the direct sterile contact between the ultrasound transducer and the surgically exposed nerve pathology was enabled to increase structural resolution and contrast. In a case-guided fashion, the authors report the sonographic characteristics of rare tumor entities shown by intraoperative HRU and contrast-enhanced ultrasound.
The almost-invisible perineurioma
Authors: Restrepo Carlos E. , Amrami Kimberly K. , Howe Benjamin M. , Dyck P. James B. , Mauermann Michelle L. , Spinner Robert J.
Published: September 2015

Intraneural perineurioma is a rare, benign slow-growing lesion arising from the perineurial cells that surrounds the peripheral nerve fibers. Typically it presents during childhood and young adulthood as a motor mononeuropathy. MRI plays an essential role in the diagnosis and localization of the lesion, which appears as a fusiform enlargement of the nerve fascicles that enhances intensely with gadolinium. Despite the typical clinical and radiological features, intraneural perineurioma remains largely underdiagnosed because of the lack of familiarity with this entity, but also as a result of technical limitations with conventional MRI that is typically performed as a screening test over a large field of view and without contrast sequences. The purpose of this article is to present the pitfalls and pearls learned from years of experience in the diagnosis and management of this relatively rare condition.

Clinical suspicion and detailed neurological examination followed by high-quality electrophysiological studies (EPS) must lead to an adequate preimaging localization of the lesion and narrowing of the imaging area. The use of high-resolution (3-T) MRI combined with gadolinium administration will allow adequate visualization of the internal anatomy of the nerve and help in differentiating other causes of neuropathy. In cases where the lesion is not recognized but clinical suspicion is high, possible errors must be assessed, including the EPS localization, area of imaging, MRI resolution, and slice thickness.
Intraoperative ultrasound-assisted peripheral nerve surgery
Authors: Haldeman Clayton L. , Baggott Christopher D. , Hanna Amgad S.
Published: September 2015

Historically, peripheral nerve surgery has relied on landmarks and fairly extensive dissection for localization of both normal and pathological anatomy. High-resolution ultrasonography is a radiation-free imaging modality that can be used to directly visualize peripheral nerves and their associated pathologies prior to making an incision. It therefore helps in localization of normal and pathological anatomy, which can minimize the need for extensive exposures. The authors found intraoperative ultrasound (US) to be most useful in the management of peripheral nerve tumors and neuromas of nerve branches that are particularly small or have a deep location. This study presents the use of intraoperative US in 5 cases in an effort to illustrate some of the applications of this useful surgical adjunct.