bluuebunny/crossref_metadata_2025 huggingface dataset:
Titanium diffusion coatings on austenitic steel obtained by the pack cementation method
Authors: Britchi Mirela , Ene Niculae , Olteanu Mircea , Radovici Constantin
Published: February 2009

The surface of specimens made of 316L austenitic steel was modified by titanium diffusion. The diffusion coatings were obtained by packing in a powder mixture consisting of titanium powder, NH4Cl and Al2O3 powder. The procedure required high temperatures, over 900 ?C, and long durations. Atomic titanium was formed in the muffle during the process. Titanium atoms from the metallic part surfaces diffuse towards the interior and a diffusion layer is formed as a function of the steel composition. Titanium diffusion into the surface of 316L austenitic steel determines the formation of a complex coating: a thin layer of TiN at the exterior and a layer consisting of compounds containing Ti, Ni and Fe in the interior of the coating. The obtained coatings were continuous, adherent and had a hardness higher than that of the substrate material. The diffusion coatings were investigated by optical and electron microscopy, X-ray diffraction and Vickers microhardness tests.
Mesophilic leaching of copper sulphide sludge
Authors: Cvetkovski Vladimir , Conic Vesna , Vukovic Milovan , Cvetkovska Milena
Published: February 2009

Copper was precipitated using a sodium sulphide solution as the precipitation agent from an acid solution containing 17 g/l copper and 350 g/l sulphuric acid. The particle size of nearly 1 ?m in the sulphide sludge sample was detected by optical microscopy. Based on chemical and X-ray diffraction analyses, covellite was detected as the major sulphide mineral. The batch bioleach amenability test was performed at 32?C on the Tk31 mine mesophilic mixed culture using a residence time of 28 days. The dissolution of copper sulphide by direct catalytic leaching of the sulphides with bacteria attached to the particles was found to be worthy, although a small quantity of ferrous ions had to be added to raise the activity of the bacteria and the redox potential of the culture medium. Throughout the 22-day period of the bioleach test, copper recovery based on residue analysis indicated a copper extraction of 95 %, with copper concentration in the bioleach solution of 15 g/l. The slope of the straight line tangential to the exponential part of the extraction curve gave a copper solubilisation rate of 1.1 g/l per day. This suggests that a copper extraction of 95 % for the period of bioleach test of 13.6 days may be attained in a three-stage bioreactor system.
Morphological and laminar distribution of cholescystokinine - immunoreactive neurons in cortex of human inferior parietal lobule and their clinical significance
Authors: Puskas Laslo , Draganic-Gajic Saveta , Malobabic Slobodan , Puskas Nela , Krivokuca Dragan , Stankovic Gordana
Published: February 2009

Introduction. Cholecystocinine is a neuropeptide whose function in the cortex has not yet been clarified, although its relation with some psychic disorders has been noticed. Previous studies have not provided detailed data about types, or arrangement of neurons that contain those neuropeptide in the cortex of human inferior parietal lobe. The aim of this study was to examine precisely the morphology and typography of neurons containing cholecytocinine in the human cortex of inferior parietal lobule. Material and methods. There were five human brains on which we did the immunocystochemical research of the shape and laminar distribution of cholecystocinine immunoreactive neurons on serial sections of supramarginal gyrus and angular gyrus. The morphological analysis of cholecystocinine-immunoreactive neurons was done on frozen sections using avidin-biotin technique, by antibody to cholecystocinine diluted in the proportion 1:6000 using diamine-benzedine. Results. Cholecystocinine immunorective neurons were found in the first three layers of the cortex of inferior parietal lobule, and their densest concentration was in the 2nd and 3rd layer. The following types of neurons were found: bipolar neurons, then its fusiform subtype, Cajal-Retzius neurons (in the 1st layer), reverse pyramidal (triangular) and unipolar neurons. The diameters of some types of neurons were from 15 to 35 ?m, and the diameters of dendritic arborization were from 85-207 ?m. A special emphasis is put on the finding of Cajal-Retzius neurons that are immunoreactive to cholecystocinine, which demands further research. Conclusion. Bearing in mind numerous clinical studies pointing out the role of cholecystokinine in the pathogenesis of schizophrenia, the presence of a great number of cholecystokinine immunoreactive neurons in the cortex of inferior parietal lobule suggests their role in the pathogenesis of schizophrenia.
External skeletal fixation of femoral shaft fractures in polytrauma patients
Authors: Stojiljkovic Predrag , Golubovic Zoran , Mladenovic Desimir , Micic Ivan , Karalejic Sasa , Stojiljkovic Danilo
Published: February 2009

Introduction. Polytrauma remains a major social, economic and medicine affliction. A successful surgical treatment of polytrauma patients requires an approach predicated on prioritizing injuries. An isolated femur fractures rarely poses any threat but in association with multiple injuries, this fracture assumes greater significance. The proper management of femur fractures in polytrauma can greatly reduce the mortality and morbidity. Material and methods. We present our results in the treatment of 24 femur shaft fracture in 22 polytrauma patients treated by Mitkovic external fixator in 5 year period (2000-2004) on Orthopeadic and Traumatology Clinic - Clinical Center Nis. The average of patients age was 32.8 years (ranging from 17 to 62). There were 11 (46%) closed and 13 (54%) open fractures. Results. Eighteen fractures were treated by external fixation until union. The remaining six fractures were treated by conversion of the external fixation to internal fixation. Sixteen fractures (88.88%), in which the external fixation was the definitive method of treatment, healed completely. The average healing time was 6.29 (4-9) months. There were three pin-track infections (16.66%), one nonunion (5.55%) and only one deep infection (5.55%). Conclusion. The external fixation by the use of Mitkovic external fixator in the treatment of femur fractures is a safe procedure to achieve temporary rigid stabilisation in polytrauma patients before the subsequent internal fixation (damage control orthopaedics). The external fixation using Mitkovic external fixator can be definitive method of choice in treatment of open and comminutiwe femur fractures in polytrauma patients until union.
Various clinical manifestations of brucellosis infection
Authors: Turkulov Vesna , Madle-Samardzija Nadezda , Canak Grozdana , Gavrancic Cedomir , Vukadinov Jovan , Doder Radoslava
Published: February 2009

Introduction. Brucellosis is an acute, subacute or chronical disease, from the zoonosis group, caused by various types of bacteria belonging to genus Brucellae. It is transmitted to humans from domestic animals: goats, sheep, cattle, pigs and dogs. The course of the disease may either be asymptomatic, or produce a variety of clinical manifestations, ranging from light ones to extremely severe clinical forms. The aim of the study was to follow the clinical features of brucella infection in the hospital-treated patients, as well as its course and outcome. Material and Methods. The investigation included 15 patients, treated for brucella infection at the Clinic for infectious diseases during the last two years (2004 and 2005). Results. All patients were adults, their age ranged from 18 to 71, 49.96 on average. The epidemiological questionnaire was positive in all patients, confirming contacts with the ailing animals, or consumption of cheese made from milk of diseased animals. They all exhibited the classic symptoms - increased body temperature and shiver, fever, sweating, malaise and headache, the so called flu like state. The serum agglutination test was positive in respect to brucellosis, the titre ranged from 1:80 to 1:1280. Eight patients suffered excessive back pain, accompanied with impeded walk. In half of them magnetic resonance imaging confirmed the spondylodiscitis diagnosis. Three patients had clinical features of knee arthritis, two had bronchopneumonia, one pancreatitis, and one developed the signs of an acute kidney insufficiency. The outcome was favorable in all patients - They recuperated or healed completely. In one patient a relapse occurred, leading to the chronic course of the illness. Discussion. Although predominantly Mediterranean Brucellosis is a worldwide spread disease. During the last two years, an increased incidence of the disease has been observed. Conclusion. Due to the variety of clinical futures and the possibility of numerous complications and sequelae, brucella infection should be always taken into consideration while diagnosing undefined febrile states.
Neglected case of uterine leiomyoma: Case report
Authors: Nincic Dejan , Mandic Aljosa , Zikic Dragan , Stojiljkovic Bratislav , Mastilovic Katarina , Ivkovic-Kapicl Tatjana
Published: February 2009

Introduction. Uterine leimyomas are the most common gynaecologacal tumors and represent 30% of all benign gynecological tumors. The vast majority of leiomyomas are asymptomatic and do not need to be treated. Pelvic pain and abnormal uterine bleeding should be considered as the most important reasons for surgical treatment of uterine fibroids. Case report. A female patient, age 69, was treated at the Institute of Oncology in Sremska Kamenica because of a huge abdominal tumor. Major symptoms were increased body temperature, abnormal uterine bleeding and extensive abdominal enlargement. After the clinical, laboratory and imaging evaluation, the offered hysterectomy was performed. The evacuated tumor was 18 kg heavy and 40 cm in length. The pathohystological diagnosis was leiomyoma per magnum. The patient was released after 11 days of hospitalization without any postoperative complications and in good general condition. Discussion. Uterine fibroids can be managed medically and surgically. Hysterectomy should be performed in every case with dominant symptoms like abnormal uterine bleeding, tumor growth and increasing abdominal pain (when other causes are excluded) in postmenopausal women. This particular case is an example of low general and health culture of the reported patient and maybe caused by fear from medical and surgical treatment. Sometimes, making a diagnosis of the nature of pelvic tumor is very hard, but by respecting diagnostic procedure an adequate treatment of those patients can be ensured.
Some questions on nuclear safety of heavy-water power reactor operating in self-sufficient thorium cycle
Authors: Bergelson Boris , Gerasimov Alexander , Tikhomirov Georgy
Published: February 2009

In this paper the comparative calculations of the void coefficient have been made for different types of channel reactors for the coolant density interval 0.8-0.01 g/cm3. These results demonstrate the following. In heavy-water channel reactors, the replacement of D2O coolant by H2O, ensuring significant economic advantage, leads to the essential reducing of nuclear safety of an installation. The comparison of different reactors by the void coefficient demonstrates that at the dehydration of channels the reactivity increase is minimal for HWPR(Th), operating in the self-sufficient mode. The reduction of coolant density in channels in most cases is accompanied by the increase of power and temperatures of fuel assemblies. The calculations show that the reduction of reactivity due to Doppler effect can compensate the effect of dehydration of a channel. However, the result depends on the time dependency of heat-hydraulic processes, occurring in reactor channels in the specific accident. The result obtained in the paper confirms that nuclear safety of HWPR(Th) lies on the same level as nuclear safety of CANDU type reactors approved in practice.
MTR core loading pattern optimization using burnup dependent group constants
Authors: Iqbal Masood , Mirza Sikander , Ali Mohsin
Published: February 2009

A diffusion theory based MTR fuel management methodology has been developed for finding superior core loading patterns at any stage for MTR systems, keeping track of burnup of individual fuel assemblies throughout their history. It is based on using burnup dependent group constants obtained by the WIMS-D/4 computer code for standard fuel elements and control fuel elements. This methodology has been implemented in a computer program named BFMTR, which carries out detailed five group diffusion theory calculations using the CITATION code as a subroutine. The core-wide spatial flux and power profiles thus obtained are used for calculating the peak-to-average power and flux-ratios along with the available excess reactivity of the system. The fuel manager can use the BFMTR code for loading pattern optimization for maximizing the excess reactivity, keeping the peak-to-average power as well as flux-ratio within constraints. The results obtained by the BFMTR code have been found to be in good agreement with the corresponding experimental values for the equilibrium core of the Pakistan Research Reactor-1.
Additional dose assessment from the activation of high-energy linear accelerators used in radiation therapy
Authors: Ateia Embarka , Ciraj-Bjelac Olivera , Kovacevic Milojko , Belicev Petar , Cvetkovic Bratislav , Anicin Ivan
Published: February 2009

It is well known that medical linear accelerators generate activation products when operated above certain electron (photon) energies. The aim of the present work is to assess the activation behavior of a medium-energy radiotherapy linear accelerator by applying in situ gamma-ray spectrometry and dose measurements, and to estimate the additional dose to radiotherapy staff on the basis of these results. Spectral analysis was performed parallel to dose rate measurements in the isocenter of the linear accelerator, immediately after the termination of irradiation. The following radioisotopes were detected by spectral analysis: 28Al, 62Cu, 56Mn, 64Cu, 187W, and 57Ni. The short-lived isotopes such as 28Al and 62Cu are the most important factors of the clinical routine, while the contribution to the radiation dose of medium-lived isotopes such as 56Mn, 57Ni, 64Cu, and 187W increases during the working day. Measured dose rates at the isocenter ranged from 2.2 ?Sv/h to 10 ?Sv/h in various measuring points of interest for the members of the radiotherapy staff. Within the period of 10 minutes, the dose rate decreased to values of 0.8 ?Sv/h. According to actual workloads in radiotherapy departments, a realistic exposure scenario was set, resulting in a maximal additional annual whole body dose to the radiotherapy staff of about 3.5 mSv.
Ground level air beryllium-7 and ozone in Belgrade
Authors: Ajtic Jelena , Todorovic Dragana , Filipovic Anka , Nikolic Jelena
Published: February 2009

Three sets of data covering the 2004-2007 period are examined: two beryllium-7 series and ozone measured in ground level air. The measuring sites are at three different locations in Belgrade, Serbia. The temporal evolution of beryllium-7 and ozone is presented, as well as their mutual correlations. Beryllium-7 data for Belgrade agree well with the results for other locations in the region. The correlation between two beryllium-7 data sets is 0.57. The results for ozone indicate that Belgrade is not a common continental site, as the maximum in ozone distribution is reached in springtime. The overall correlation between beryllium-7 and ozone is good, but varies over different seasons. A large correlation (0.67) is noted between beryllium-7 measured at the site in Vinca, Serbia, and the monthly maximum ozone in autumn. An analysis which assumes the transport of air masses from the stratosphere, along which the only process changing the air mass composition is radioactive decay of beryllium-7, does not conclusively confirm the high correlation between beryllium-7 and ozone in autumn. .
Technical features of the MR reactor decommissioning
Authors: Craig David , Fecitt Lorna , Gorlinsky Yuri , Harman Neil , Jackson Roger , Kolyadin Vyacheslav , Lobach Yuri , Pavlenko Vitaly
Published: February 2009

This paper presents a preliminary technical design for the dismantling of the MR reactor. The goal of the design is the removal of reactor components allowing the re-use of the building for a different nuclear related purpose. The sequence of segmentation procedures is established. Considerations on the size reduction and tooling are presented.
Color influences identification of the moving objects more than shape
Authors: Vidakovic Vesna , Zdravkovic Suncica
Published: February 2009

When people track moving objects, they concentrate on different characteristics. Recent results show that people more often concentrate on spatiotemporal than featural properties of the objects. In other words, location and direction of motion seem to be more informative properties than the stable featural characteristics. This finding contradicts some of our knowledge about cognitive system. Current research was done in attempt to specify the effect of featural characteristics, especially color and shape. In Experiment 1, subjects were asked to track four mobile targets presented with another four moving objects. After the motion has stopped, they had to mark the initial four targets. Our results have shown that participants pay more attention to the featural properties than to spatiotemporal characteristics. Since our task was more difficult than the tasks typically reported in the literature, the results might be interpreted as if the subjects relied mostly on attentional processes. The task in Experiment 2 was made even more difficult: the subjects were asked to direct attention on identity of every target. Consequently, the task demanded more complex cognitive processes and emphasizing effects of featural properties. Results suggest that color and shape does not have the same influences on multiple object tracking, but that color has more significant effect.
Falls in the Medicare Population: Incidence, Associated Factors, and Impact on Health Care
Authors: Shumway-Cook Anne , Ciol Marcia A , Hoffman Jeanne , Dudgeon Brian J , Yorkston Kathryn , Chan Leighton
Published: February 2009

Background and Purpose

Falls are a major health problem in the elderly community; however, questions regarding incidence, risk factors, and provider response to falls exist. The purpose of this study was to examine the incidence of falls, associated factors, health care costs, and provider response to falls among Medicare beneficiaries.

Participants

The participants were 12,669 respondents to the Medicare Current Beneficiaries Survey (MCBS).

Methods

Categories of number of falls (none, one, recurrent) and injury type (medically injurious versus not medically injurious) were created from the falls supplement to the MCBS. Means and proportions for the entire Medicare population were estimated using sampling weights. The association between sociodemographic variables and fall status was modeled using ordinal or binary logistic regression. Aggregate health costs by fall category were estimated from claims data.

Results

Population estimates of falls reported in 2002 ranged from 3.7 million (single fall) to 3.1 million (recurrent falls), with an estimated 2.2 million people having a medically injurious fall. Recurrent falls were more likely with increased age, being female, being nonwhite, reporting fair or poor health, and increased number of limitations in personal activities of daily living and instrumental activities of daily living and comorbidities. Although estimates of the actual costs of falls could not be determined, “fallers” consistently had larger utilization costs than “nonfallers” for the year 2002. Fewer than half (48%) of the beneficiaries reported talking to a health care provider following a fall, and 60% of those beneficiaries reported receiving fall prevention information.

Discussion and Conclusions

Falls are common and may be associated with significant health care costs. Most importantly, health care providers may be missing many opportunities to provide fall prevention information to older people.
Training Veterinary Students in Animal Behavior to Preserve the Human–Animal Bond
Authors: Sherman Barbara L. , Serpell James A.
Published: February 2009

Knowledge of animal behavior is an extremely important component of modern veterinary practice. Appreciation of species-typical behavior helps to ensure that veterinary patients are handled safely and humanely, and plays a pivotal role in the diagnosis of health and welfare problems in animals, including the recognition of pain and distress. Veterinary students who acquire a good understanding of animal behavior will be better clinicians and will be best able to promote and repair the “human–animal bond,” that important connection between people and their pets. Animal behavior problems can negatively impact this critical relationship, leading to abandonment, re-homing, relinquishment to an animal shelter, and sometimes premature euthanasia of the animal. Therefore, identifying, preventing, and treating behavior problems is important in maintaining the human–animal bond. Education in animal behavior should be an essential part of the veterinary curriculum; a board-certified veterinary behaviorist should be an integral member of the veterinary college faculty.
Enhancing Human–Animal Relationships through Veterinary Medical Instruction in Animal-Assisted Therapy and Animal-Assisted Activities
Authors: Schaffer Caroline Brunsman
Published: February 2009

Instruction in animal-assisted therapy (AAT) and animal-assisted activities (AAAs) teaches veterinary medical students to confidently and assertively maximize the benefits and minimize the risks of this union of animals and people. Instruction in AAT/AAA also addresses requirements by the American Veterinary Medical Association Council on Education that accredited schools/colleges of veterinary medicine include in their standard curriculum the topics of the human–animal bond, behavior, and the contributions of the veterinarian to the overall public and professional health care teams. Entry-level veterinarians should be prepared to: (1) assure that animals who provide AAT/AAA are healthy enough to visit nursing homes, hospitals, or other institutions; (2) promote behavior testing that selects animals who will feel safe, comfortable, and connected; (3) advise facilities regarding infection control and ways to provide a safe environment where the animals, their handlers, and the people being visited will not be injured or become ill; and (4) advocate for their patients and show compassion for their clients when animals are determined to be inappropriate participants in AAT/AAA programs. This article presents AAT/AAA terminology, ways in which veterinarians can advocate for AAT/AAA, the advantages of being involved in AAT/AAA, a model AAT/AAA practicum from Tuskegee University's School of Veterinary Medicine (TUSVM), and examples of co-curricular activities in AAT/AAA by TUSVM's student volunteers.
TigerPlace: Training Veterinarians about Animal Companionship for the Elderly
Authors: Johnson Rebecca A. , Rantz Marilyn J. , McKenney Charlotte A. , Cline Krista M.C.
Published: February 2009

Students learn more effectively when they are actively engaged in the learning process. Therefore, case studies have become increasingly popular as a way to teach students about a representative subject. This article discusses the benefits of case studies, with a primary focus on how case studies can help veterinary medical students learn about the human–animal bond. The discussion is particularly aimed at veterinary medicine instructors and discusses how case studies can be used and why they are important. TigerPlace, a pet-friendly, innovative housing facility for older adults, is used as an example of a case study that can be used to teach about, and to study, the human–animal bond. In particular, the article addresses the special advantages of TigerPlace to students with respect to learning about older adults and the bond they have with their pets.
The Human–Animal Bond in Veterinary Medical Education: Accessing Web-Based Information
Authors: Hart Lynette A. , Wood Mary W.
Published: February 2009

Various aspects of the field known as the human–animal bond (HAB), or human–animal interactions, have expanded within veterinary medical education over the past quarter of a century. Using a variety of databases and informed search strategies, relevant information can be accessed, including recent articles, databases, journals, academic centers, societies and associations, programs, and key references. In this paper, methods for accessing resources supporting veterinary education on the HAB are organized into four subject areas: the HAB in veterinary school curricula; social work and support services for veterinary clients; the benefits of the HAB for human well-being, with applications of animal-assisted therapies, activities, and education; and companion animal behavior and welfare concerns. A related Web site can be accessed at .
The Colorado State University Pet Hospice Program: End-of-Life Care for Pets and Their Families
Authors: Bishop Gail A. , Long Christie C. , Carlsten Kelly S. , Kennedy Katie C. , Shaw Jane R.
Published: February 2009

While the concept of hospice care for humans has existed for decades and is an integral part of the dying process, providing hospice care for companion animals is a new and growing service. Veterinarians and pet-owners have recently recognized that there is a need and a demand to care for pets with terminal illnesses. The Colorado State University Pet Hospice program meets those needs through supporting pets, their owners, and veterinarians, and educating professional veterinary students in end-of-life care. Developed in 2003, Pet Hospice is a student-run program that trains veterinary students in animal hospice care, and matches them with the family and veterinarian of a terminally ill pet in the community. Since its inception, 101 veterinary student volunteers have been trained and provided support to 68 families. Continued expansion of the client base, enlargement of the network of veterinarians and volunteers, and positive program evaluations reflect the strong impact of Pet Hospice and its support from veterinary students, veterinarians, and the community.
Challenges of Service-Dog Ownership for Families with Autistic Children: Lessons for Veterinary Practitioners
Authors: Burrows Kristen E. , Adams Cindy L.
Published: February 2009

The purpose of this paper is to describe the challenges of service-dog ownership for families with autistic children. Through a qualitative interview process, this study has found that the integration of a service dog into a home environment is a highly dynamic and interactive process with numerous benefits and challenges. Public-access issues, learning to interpret dog behavior, the time constraints of increased social interactions, and the time of year the dog is placed into the family are important components affecting parental satisfaction. Parent, family, and child challenges included the dog being extra work, finding added time to maintain training, financing care for the dog, and the impact on family dynamics. These factors and challenges were appraised in order to understand the impact that they could have on the perceived success of the placement, parental satisfaction, and the dog itself. Despite the effects and consequences of these challenges, the parents overwhelmingly reported that having a service dog to keep their child safe and to provide companionship was well worth the many inconveniences of service-dog ownership. Most importantly, attention needs to be drawn to these challenges to promote the safety of both the child and the dog, minimize stress on the family, and encourage veterinary support of these highly dynamic relationships.
Modern Veterinary Graduates Are Outstanding, But Can They Get Better?
Authors: May Stephen A.
Published: February 2009

Despite periodic debate implying that modern veterinary graduates are less competent than their predecessors, analysis of educational inputs and learning outcomes suggests that they continue to qualify with an excellent knowledge and skill set. However, increased public expectations of veterinarians have led to the need for better-designed, more integrated curricula with increased attention to communication and other professional skills and to elements of individual specialization.

The need for revision of curricular content will continue. A more overriding reason for reducing content, however, is the effect this has on students’ learning. Content overload in all disciplines leads to a superficial acquisition of facts, which overwhelms any drive toward understanding and extracting meaning. Unfortunately, many modern assessment methods permit replication to masquerade as problem solving, leading to short-term gains in grades at the cost of the development of information sourcing and application and other lifelong learning skills.

All involved in education must be clear that our task is to develop the independent professional person. Such a person is much more than the possessor of a collection of facts and a set of individual competences. To facilitate the development of this overall capability, educators must pay as much attention to students’ engagement in the learning process, and to how they understand and make meaning of our discipline, as to the specific scientific and species content of their school's individual degree programs.
I’ll Show You Mine If You Show Me Yours! Portfolio Design in Two UK Veterinary Schools
Authors: Mossop Liz H. , Senior Avril
Published: February 2009

Portfolios are an attractive addition to the veterinary curriculum because they add to the assessment of competencies, are flexible, and encourage the development of reflective and lifelong learning skills. Veterinary schools at the University of Liverpool and the University of Nottingham, UK, have both recently introduced portfolios for year 1 undergraduate students. The key difference between the two institutions is that one uses the portfolio as a summative assessment, while the other allows formative assessment only.

Advantages of assessing the portfolio include engagement in the process and the ability to examine the key professional skill of reflection. Advantages of using the portfolio for formative assessment only are a facilitation of honest self-criticism and that this approach encourages students to view the portfolio as a valuable professional and personal activity. Both portfolio systems will need to be closely analyzed in order to assess these perceived advantages, and the two institutions are learning from each other's experiences. Whether or not the portfolio is summatively assessed, student and tutor training and support are essential. Feedback from these stakeholders must also be analyzed and used to support and shape the portfolios as they become a central part of both veterinary curricula.
Intracoronary Adenosine Induced hyperaemia reduces the incidence of myonecrosis due to micro infraction after elective Percutaneous Coronary Intervention
Authors: Rajib MA Rajib , Siddique Md. Abu , Ahmed Md. Khurshed , Haque KMHS Sirajul , Rahman Md. Mukhlesur , Rahman Fazlur
Published: February 2009

(University Heart Journal 2007; 3 : 73-74)
'Budd Chiari Syndrome' - A Case Report
Authors: Rahman Md. Mukhlesur , Haque KMHS Sirajul , Siddiqui Md. Mahmudur Rahman , Parvin Tanjima , Ahmed Md. Khurshed
Published: February 2009

'Budd Chiari syndrome (BCS)' is an uncommon condition induced by thrombotic or nonthrombotic obstruction to hepatic venous outflow. This disease can be potentially life-threatening but prognosis is more favorable in patient with IVC webs but is extremely poor in malignant and haematological cases. A cooperative collaboration of hepatologist and cardiologist can make the situation easy for diagnosis, even in treatment of some cases.

(University Heart Journal 2007; 3 : 80-82)
Lead Fracture as a Cause of Pacemaker Failure: A Case Report
Authors: Majumder Abdullah Al Shafi , Chowdhury Abdul Wadud , Islam AEM Mazharul , Muttalib Md Abdul , Alam Mahinoor Mortuja
Published: February 2009

(University Heart Journal 2007; 3 : 87-89)
Correlation of Doppler echocardiography with cardiac catheterization in estimating pulmonary capillary wedge pressure: A tertiary level hospital finding in Bangladesh
Authors: Tamanna Rownak Jahan , Jahan Rowshan , Zaher Abduz , Akhanda Abdul Kader
Published: February 2009

This prospective cross sectional study was conducted in the department of cardiology in National Institute of Cardiovascular Diseases (NICVD), Dhaka during the period of January 2002 to December 2002.Atotal of 50 patients with coronary artery disease subjected to diagnostic cardiac catheterization for evaluation of CAD were studied and the patients were grouped into two groups, group I having PCWP â¥12- < 18 mmHg and group II having PCWP â¥18 mmHg. The aims of the study were to correlate the Pulmonary Capillary Wedge Pressure (PCWP) estimated by Doppler echocardiography with that obtained at cardiac catheterization. Among 2D and M mode echocardiographic indices it was observed that ejection fraction was significantly lower and maximal left atrial volume (MLAV) was significantly higher among patients having PCWP â¥18 mmHg (p < 0.05). Among Doppler derived mitral flow variables deceleration rate was significantly higher (p < 0.05) among patients having PCWP â¥18 mmHg. No statistically significant difference was found between two groups in terms of pulmonary venous flow variables. A statistically significant negative correlation of deceleration time (r=-0.483; p=0.001) and ejection fraction (r=-0.334; p=0.01) and a statistically significant positive correlation of peak E wave (r=0.345; p=0.01) and deceleration rate (r=0.651; p=0.001) was found with catheter derived PCWP. The correlation coefficient between measured and estimated PCWP (from equation 1) was (r=0.678) which was highest. When pulmonary venous flow variables were included with mitral flow variables into multiple linear regression analysis, the resulting correlation coefficients were (r=0.670) for equation 2 and (r=0.652) for equation 3. In all three equations deceleration rate was the most important determinant of PCWP. Therefore in patients with coronary artery disease pulmonary capillary wedge pressure can reliably be estimated by combining Doppler echocardiographic variables of mitral flow and pulmonary venous flow and that mitral flow velocity indexes contribute most significantly to such estimation. Among the mitral flow variables, deceleration rate is the most important determinant of PCWP. Key words: Pulmonary Capillary Wedge Pressure, Cardiac Catheterization, Doppler echocardiography, Bangladesh. Â Â  doi:10.3329/uhj.v4i2.2065 University Heart Journal Vol. 4 No. 2 July 2008 p1-8
Changes in plasma brain natriuretic peptide in conventional or direct stenting
Authors: Khan Saidur Rahman , Kurtoglu Nuri , Benli Fehime , Toprak Ahmet , Agirbasli Mehmet , Oktay Ahmet
Published: February 2009

Direct coronary stenting without balloon predilatation may cause lower postprocedural minor myocardial injury in comparison to conventional stenting with balloon predilatation.Plasma brain natriuretic peptide (BNP) is increased in acute myocardial ischaemia. 40 patients with single vessel and single lesion coronary artey disease who underwent elective stent implantation were divided into Group I (n=20) treated with direct coronary stenting (DS) and Group II (n=20) with conventional stenting (CS). Blood samples for Troponin I and CK-MB measurement were obtained at baseline, just after the intervention procedure, 6 hours after and 12 hours after stenting and for BNP levels at baseline, 6 hours and 12 hours after stenting. In Group II there was a significant increase in Troponin I level 12 hours after the procedure (baseline 0.033 Â± 0.028 ng/ml vs. 0.084 Â± 0.085 ng/ml; p < 0.05).Plasma BNP level in Group I decreased significantly both in base line vs. 6 hours after procedure and baseline vs. 12 hours after procedure (105.2 Â± 73.7 pg/ml vs. 81.3Â± 67.1 pg/ml; p < 0.05 and 105.2 Â± 73.7 pg/ml vs. 89.9 Â± 62.3pg/ml ; p < 0.05 respectively). With direct stenting BNP levels decreased significantly with no change in Troponin I level, while with conventional stenting Troponin I levels increased significantly. Key words: Brain natriuretic peptide, Direct stenting, Conventional stenting. Â  doi:10.3329/uhj.v4i2.2066 University Heart Journal Vol. 4 No. 2 July 2008 p9-15 Â
Trends of permanent pacemaker implantation in University Cardiac Center, BSMMU
Authors: Rahman Fazlur , Ahsan Syed Ali , Ahmed Chaudhury Meshkat , Safiuddin Md , Haque KMHS Sirajul , Banerjee Sajal Krishna , Siddique Md Abu , Mahmood Manzoor , Anam Khairul , Rahman Md Mukhlesur , Zaman SM Mostafa , Ahmed Md Khurshed , Habib SM Ahsan , Salim MA , Uddin Mir J , Faruque Mohammed , Khalil MA , Patauri MA , Rashid Md Abdur , Hafiz G
Published: February 2009

The purpose of the study was to investigate the trends of permanent pacemaker implantations in the University Cardiac Center (UCC), Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. This retrospective study conducted in the department of Cardiology, UCC, BSMMU, Dhaka to evaluate demographic distribution, indications, complications of the permanent pacemaker (PPM) implantation and its hospital outcome. Data of this retrospective study was collected from hospital registry and patient's record files. Total 98 patients were studied. Among them male were 64.28% (n=63) and female were 35.71% (n=35). Most of them were elderly patients (58%). Complete heart block was the most common cause for PPM implantation, which was 67.35% (n=66). Single chamber multiprogrammable PPM (VVI) was implanted in 86.73% (n=85) and Dual chamber PPM (DDI) was implanted in 13.26% (n=13) cases. No Major complications occurred during the procedure and short term in-hospital outcome was good for all the cases. This study showed that PPM implantation is rapidly increasing modality of treatment for patients with cardiac bradyarrhythmias as effective technique with good in-hospital outcome. Â  doi:10.3329/uhj.v4i2.2072 University Heart Journal Vol. 4 No. 2 July 2008 p16-18
Study on serum Lipoprotein (a) level in preeclamptic Bangladeshi women
Authors: E-Ferdous Noor , Khatun Mahmuda , Siddique Md Abu , Hosna Asma Ul , Begum Shirin Akter , Ahmed Md Khurshed
Published: February 2009

It is a case control study which was design to know the association of serum Lipoprotein (a) level in preeclamptic (PE) in women. This study was carried out in department of Obstetrics and Gynecology, Sir Salimullah Medical College Hospital, Mitford, Dhaka. Total number of subjects was 100. Out of which 50 were cases and 50 were controls. Cases were physically and clinically proved PE patients. Controls were age, parity and gestational age matched. Three ml of blood were collected from each subjects, serum fasting LP(a) level were measured The mean age of study group was 24.49 Â± 6.48 years. Serum Lipoprotein(a) level was 51.51 Â± 29.38mg/dl Vs 17.40 Â± 7.89 mg/dl in cases and controls respectively. This difference was statistically significant (p < 0.001). Mean serum Lipoprotein(a) level was found to be raised in severe preeclampsia (74.87mg/dl) and lowest in control subject Severe preeclampsia was found to be associated with higher level of lipoprotein (a) than both control (p < 0.01) and mild preeclamptic (p < 0.01) subjects. Mild preeclampsia was also found to have higher average serum Lipoprotein (a) than the normal (P < 0.01) subjects. Key Words: Lipoprotein(a), Preeclampsia, Bangladeshi women. doi:10.3329/uhj.v4i2.2073 University Heart Journal Vol. 4 No. 2 July 2008 p32-35
A Note on Estimating Treatment Effect for Time-to-event Data in a Literature-based Meta-analysis
Authors: Hamada C. , Yoshimura I. , Hirooka T.
Published: February 2009

Objectives: In a literature-based meta-analysis for time-to-event data, the hazard ratio in each trial is often estimated from the summary statistics described in the article. Several methods have been proposed: the direct method (Peto method); the indirect method using a p-value by the log-rank test and the number of total events; and the survival curve method using the Kaplan-Meier estimate. However, there has been no published report on a detailed investigation of these methods. We evaluated the performance of these methods by simulation.

Methods: In a set of simulation experiments, performance of five methods was evaluated by the bias of estimated log hazard ratio and coverage probability of the confidence interval. The methods evaluated were: 1) Cox regression analysis, 2) direct method, 3) indirect method, 4) survival curve method, and 5) modified survival curve method with an alternative weighting scheme.

Results: The direct method was confirmed to have a high degree of accuracy. Although the indirect method was also highly accurate, it tended to underestimate effect size when there was a strong effect. The survival curve method tended to underestimate effect size when event numbers were small and effect size was large. The modified survival curve method could alleviate this tendency toward underestimation of effect size found with the original survival curve method.

Conclusions: When the Kaplan-Meier curve is used to estimate hazard ratios in trials with small sample size in the literature-based meta-analysis, we should check critically whether those trials’ hazard ratios and overall hazard ratio are underestimated or not.
Comparative Evaluation of Balancing Properties of Stratified Randomization Procedures
Authors: Kundt G.
Published: February 2009

Objectives: If in a clinical trial prognostic factors are known in advance to be associated with the outcome of a patient it is often recommended that the randomization for a clinical trial should be stratified on these factors, particularly in a multicenter trial. Unfortunately, stratified or covariate-adaptive randomization does not always promote greater balance between the numbers of treatment assignments to A and B within each stratum and thus overall. Because such designs have numerous parameters that must be specified, simulation is a good tool to investigate the impact of these parameters on balance.

Methods: We investigate and discuss in more detail the difference in balancing performance of three stratified randomization procedures. The permuted-block randomization within strata, the “minimization” method and “self-adjusting” design are assessed overall, within levels of prognostic factors, and within strata.

Results: We show the superior performance of “self-adjusting” design and the extent of balancing losses occurring with permuted-block randomization within levels of factors and with “minimization” within strata. A summary of principal conclusions regarding the balancing properties of stratified randomization procedures is presented and general recommendations are offered.

Conclusions: The relative merits of each procedure should be weighted carefully in relation to the characteristics of the trial. Considering the likelihood of imbalances, the sample size and values of parameters of stratified randomization procedures (number of prognostic factors, number of factor levels, block size) are important when choosing a randomization procedure.
Reproducible Extraction of Local and Global Parameters for Functional Analysis of the Left Ventricle in 4D MR Image Data
Authors: Relan J. , Ehrhardt J. , Müllerleile K. , Bahrmeyer A. , Groth M. , Handels H. , Säring D.
Published: February 2009

Objectives: Left ventricle (LV) segmentation is required to quantify LV volume and mass parameters. Therefore, spatiotemporal Cine MR sequences in the short and long axis of the heart are acquired. Generally, LV segmentation methods consider short-axis sequences only. The reduced resolution in long-axis direction is one of the main reasons for inaccurate parameter extraction in the apical and basal area. The segmentation approach presented combines short- and long-axis information as well as motion tracking to enable the functional LV analysis in 4D MR Image Data.

Methods: First, anatomical landmarks like the mitral valve and the apex are defined in long-axis views in diastolic and systolic phase in order to specify the upper and lower boundary of the LV. Second, motion field approximation using non-linear registration enables the automatic contour propagation to all time points. Third, intersection planes are defined parallel to the mitral valve plane covering the whole ventricle. Finally, the 4D LV surface model is generated appending all in-plane contours. The segmentation results in short-axis images are checked and adjusted interactively and quantitative parameters are extracted.

Results: For evaluation the contours of 19 different datasets were traced by two medical experts using a contour drawing tool and the new segmentation tool. The results were compared to evaluate automatic contour propagation, robustness of the segmentation as well as interaction time.

Conclusion: The automatic contour propagation enables the fast and reproducible generation of a 4D model for the functional analysis of the heart. The interaction time is decreased from approx. 60 minutes to 10 minutes per case. Inter- and intraobserver differences of the extracted parameters are decreased significantly.
Enhanced Semantic Interoperability by Profiling Health Informatics Standards
Authors: Blobel B. , Lopez D. M.
Published: February 2009

Objectives: Several standards applied to the healthcare domain support semantic inter-operability. These standards are far from being completely adopted in health information system development, however. The objective of this paper is to provide a method and suggest the necessary tooling for reusing standard health information models, by that way supporting the development of semantically interoperable systems and components.

Methods: The approach is based on the definition of UML Profiles. UML profiling is a formal modeling mechanism to specialize reference meta-models in such a way that it is possible to adapt those meta-models to specific platforms or domains. A health information model can be considered as such a meta-model.

Results: The first step of the introduced method identifies the standard health information models and tasks in the software development process in which healthcare information models can be reused. Then, the selected information model is formalized as a UML Profile. That Profile is finally applied to system models, annotating them with the semantics of the information model. The approach is supported on Eclipse-based UML modeling tools. The method is integrated into a comprehensive framework for health information systems development, and the feasibility of the approach is demonstrated in the analysis, design, and implementation of a public health surveillance system, reusing HL7 RIM and DIMs specifications.

Conclusions: The paper describes a method and the necessary tooling for reusing standard healthcare information models. UML offers several advantages such as tooling support, graphical notation, exchangeability, extensibility, semi-automatic code generation, etc. The approach presented is also applicable for harmonizing different standard specifications.