bluuebunny/crossref_metadata_2025 huggingface dataset:
Real-life Perception and Practice Patterns of NAFLD/NASH in Romania: Results of a Survey Completed by 102 Board-certified Gastroenterologists
Authors: Iacob Speranta , Ester Carmen , Lita Mihaela , Ratziu Vlad , Gheorghe Liana
Published: May 2016

Introduction: Nonalcoholic fatty liver disease (NAFLD) has an increasing incidence worldwide, reflecting the epidemics of obesity and metabolic syndrome. Data on knowledge, attitude and management by the Romanian gastroenterologists with regard to NAFLD are lacking.

Methods: We assessed current diagnostic and treatment patterns of the management of NAFLD among 102 Romanian board certified gastroenterologists using a survey developed to collect information regarding participants’ clinical practice, diagnostic tools and usage of medication in patients with NAFLD.

Results: 71.6% of the surveyed gastroenterologists (SG) had more than 5 years of gastroenterology practice, were university affiliated and 37.3% had predominant activity in hepatology (>60%). In Romania, 60.8% of the SG would diagnose NAFLD only if all other causes of liver disease were absent. All practitioners use a noninvasive tool for staging NAFLD, 45.1% use both serum markers and transient elastography. Liver biopsy is performed by 61.8% of the SG in the presence of a discordant result in two noninvasive methods of fibrosis evaluation. The most frequently prescribed drugs are: silymarin (88.2%), vitamin E (78.4%) and ursodeoxycholic acid (77.4%).

Conclusion: The results of this survey suggest that clinical practice patterns among Romanian gastroenterologists for the diagnosis (mainly liver biopsy) and management of NAFLD frequently diverge from published practice guidelines. Nonalcoholic steatohepatitis is probably underdiagnosed, especially in patients with normal transaminase levels and is also overtreated with drugs that are not recommended in the guidelines.

Abbreviations: ALT: alanine aminotransferase; BMI: body mass index; CLD: chronic liver disease; CAP: controlled attenuation parameter; ESLD: end-stage liver disease; HBV: hepatitis B virus; HCV: hepatitis C virus; HDV: hepatitis delta virus; HCC: hepatocellular carcinoma; HOMA: Homeostasis Model Assessment of Insulin Resistance; LC: liver cirrhosis; LT: liver transplantation; NAFLD: nonalcoholic fatty liver disease; NASH: non-alcoholic steatohepatitis; PCP: primary care practitioners: SG: surveyed gastroenterologists; UDCA: Ursodeoxycholic acid.
Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer
Authors: Seicean Andrada , Gheorghiu Marcel , Zaharia Teodor , Calinici Tudor , Samarghitan Andrada , Marcus Bogdan , Cainap Simona , Seicean Radu
Published: May 2016

Background & Aim: Endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) are considered good tools for the diagnosis of pancreatic cancer and for obtaining material for cytology or histology. The accuracy of EUS-FNA can rise to 85-95%, but it is lower in cases with a chronic pancreatitis background or with previous biliary stenting. We aimed to establish the diagnostic yield of the visible length of the core biopsy samples in pancreatic cancer by using one single type of standard 22G needle and to evaluate the factors which can influence the results.

Method: EUS-FNA was performed by using a 22G standard needle on patients prospectively recruited with the suspicion of pancreatic masses on transabdominal ultrasound or CT scan over a period of eight months. The number of passes was limited by the length of the core obtained. The final diagnosis was based on EUS-FNA or hepatic biopsy for their metastasis or by follow up every three month by imaging methods.

Results: The study included 118 patients. Previous stents were present in 10 patients and chronic pancreatitis features were found in 3 patients. The procedure sensitivity was 89% and the global accuracy was 89%. The presence of biliary stents did not impede the accuracy of results. The number of passes did not influence the results.

Conclusions: The diagnostic rate of core biopsy by using 22G needles had a high accuracy and it is safe when the length of core dictates the number of passes. The presence of biliary stents did not influence the results.

Abbreviations: AUC: area under the curve; EUS: endoscopic ultrasonography; EUS-FNA: fine needle aspiration under endosonographic guidance; FNA: fine needle aspiration; INR: international normalised ratio; OR: odds ratio.
Studying disciplinary corpora to teach the craft of Discussion
Authors: Cotos Elena , Link Stephanie , Huffman Sarah
Published: May 2016

Producing publishable quality research articles is a difficult task for novice scholarly writers. Particularly challenging is writing the Discussion/Conclusion section, which requires taking evaluative and interpretive stances on obtained results and substantiating claims regarding the worth of the scholarly contribution of the article to scientific knowledge. Conforming to the expectations of the target disciplinary community adds another dimension to the challenge. Corpus-based genre analysis can foster postgraduate writing instruction by providing insightful descriptions of rhetorical patterns and variation in disciplinary discourse. This paper introduces a pedagogically-oriented cross-disciplinary model of moves and steps devised through top-down corpus analysis. The model was applied to pedagogical materials and tasks designed to enhance genre and corpus-based teaching of Discussion/ Conclusions with an explicit focus on rhetorical conventions.
A genre-instantiation approach to teaching English for Specific Academic Purposes
Authors: Gardner Sheena
Published: May 2016

This paper introduces five linked resources and demonstrates, with a focus on Business, Economics and Engineering, their use in a novel genre-instantiation approach to teaching academic writing. The resources centre on the British Academic Written English (BAWE) corpus. They are: (1) published research literature that investigates the student assignment genres and registers; (2) descriptions of the contents of the corpus; (3) the BAWE corpus itself, which can be freely searched by teachers and learners; (4) online teaching materials based on the above; and (5) lesson plans from EAP teachers who use these materials in their teaching of presessional and in-sessional academic English. The genre instantiation approach to teaching academic writing builds on two central principles: the identification of key genres for target discipline-levels, and the exemplification of these through instances of successful student writing. This enables teachers to develop programmes that raise genre awareness, where learners can engage with instances from across specific topics, courses, levels and disciplines. The genre-instantiation approach is illustrated here with specific reference to Business Case Studies, Economics Essays and Engineering Methodology Recounts.
Task-Based Language Learning – Insights from and for L2 Writing
Authors: Li Yu
Published: May 2016

Heidi Byrnes, & Rosa M. Manchón (eds.) (2014) Amsterdam/Philadelphia: John Benjamins Publishing. Pp. 299.
INDUSTRIAL ENTERPRISES REORGANIZATION IN PRIORITY DEVELOPMENT TERRITORIES
Authors: Panagushyn V. P. , Chaika N. K. , Ivanisov V. Y.
Published: May 2016

The reorganization of enterprises on the basis of supply chains between the centers of financial accounting and its further registration in the territories of advanced development is presented. The advantages to businesses in the areas of advanced development are considered. Major tasks of internal and external revenues of the centers of financial accounting are emphasized. The types and principles of functioning of centers of financial accounting are presented. Business results from the reorganization of the enterprise through the organization of centers of financial accounting are specified. There are ways of reducing loss-making enterprises in the territories of advanced development.
Eficacia de intervenciones educativas en la adherencia terapéutica de pacientes hipertensos
Authors: Martínez C. Rina , Medrano M. Sindy Paola , Sequeda B. Eduardo Luis
Published: May 2016

Este estudio exploratorio con abordaje cualitativo fenomenológico busca identificar la eficacia de intervenciones educativas en la adherencia terapéutica de un grupo de pacientes hipertensos, seleccionados de un barrio con alto grado de vulnerabilidad del municipio de Toluviejo, Sucre, a quienes se invitó a participar en la investigación. Para recolectar la información socioeconómica de los participantes, se construyó una ficha de caracterización; para determinar el grado de adherencia al tratamiento farmacológico prescrito para la hipertensión, se utilizó el test de Morisky-Green antes y después de la intervención con estrategias educativas, tales como charlas grupales, grupos focales con pacientes y cuidadores, y jornadas lúdicas. Como resultado se logró establecer que los pacientes modificaron significativamente su respuesta al seguimiento del tratamiento, con un aumento del 26,70% de los pacientes con respuestas indicativas de adherencia, comparado con los resultados iniciales. Se concluye que la intervención educativa pudo tener alguna incidencia de manera directa y efectiva sobre el grupo en estudio, lo cual influyó en los resultados obtenidos.
El arte en la mala conciencia epistemológica: Contexto para un cruce peligroso
Authors: Mombrú Ruggiero Andrés Antonio
Published: May 2016

Ciencia y arte han tenido a lo largo de la historia diferentes tipos de consideracióny se los ha vinculado de diversas maneras. La modernidad, rememorandola tradición platónica, los separa en esferas diferentes, en un contextosocial y cultural en el que el arte, no debe ser, como para el ateniense,condenado al ostracismo, pero si lo deja pendiendo de una tensión entreuna producción que indica lo inefable y una mercancía que sólo cumplecon el propósito de gustar o entretener –como cualquier otra mercancía–careciendo de todo atributo de racionalidad. La ciencia ha sido concebidacomo el ámbito del intelecto, de la razón, de la reflexión; y el arte comouna actividad vinculada a la emoción, a la sensibilidad y a la inspiración.Sin embargo esos arquetipos estereotipados, que han sido funcionales aciertas lógicas del dominio, esconden otras dimensiones y otros vínculosque pueden ser más afines a proyectos emancipadores, capaces de integrarlo que se quiere mantener por separado con el fin de legitimar estructurasde poder. Se reflexiona aquí sobre los motivos de algunas de las controversiasque esta tensión ha generado, que alternativas se ponen en juego en larealización del mundo social y cultural y que consecuencias pueden tenerpara el destino de nuestra cultura.
La alianza del gobierno de Evo Morales y las Fuerzas Armadas en el proceso de transformación del Estado boliviano
Authors: Stola Iván , Frenkel Alejandro
Published: May 2016

El presente trabajo pretende analizar la relación de los gobiernos de Evo Morales con las Fuerzas Armadas Bolivianas en el periodo 2005-2010 y dar respuesta a tres preguntas centrales: ¿Existe una alianza informal entre estos dos actores de la política boliviana? En caso de existir ¿Cuáles son los factores institucionales, históricos, políticos y económicos en que se fundamenta? Y, por último ¿Cuáles son los costos que implica esta alianza? A tales fines se realizará un sucinto análisis de los actores en cuestión y posteriormente se estudiará la relación entre ellos tomando en cuenta los siguientes elementos: la política económica del Movimiento al Socialismo (MAS); la Asamblea Constituyente, los conflictos regionales y los intentos de autonomía; las políticas sociales impulsadas por el gobierno; las concesiones que implica esta relación; y los intentos de redefinición institucional de las Fuerzas Armadas.
El sector salud argentino en los dos modelos de crecimiento en las etapas de la convertibilidad y la posconvertibilidad: factores económicos y políticos que explican su evolución.
Authors: Messina Giuseppe Manuel
Published: May 2016

El objeto de este trabajo es la evaluación de las transformaciones que tuvieron lugar en la sociedad argentina entre 1991 y 2011 en el cambio entre el modelo de crecimiento económico y el proyecto político basado en la Convertibilidad, su crisis, y la posterior consolidación del proyecto kirchnerista. El análisis enfoca el sector salud, cuya estructuración en tres subsectores (Estado, seguridad social,privado) refleja la histórica conformación híbrida del régimen de bienestar argentino. El papel del Estado en la erogación de servicios sanitarios paralos individuos y familias de menores recursos sigue siendo fundamental, pese a que la gestión y financiación del sector público está fuertemente descentralizada. Al otro extremo de la distribución, las clases altas recurren a los servicios de pago más individualizados del sector privado. Por otra parte, la afiliación de las clases medias trabajadoras al sistema contributivo de obras sociales depende directamente de su posición en el mercado laboral registrado. A partir de estos elementos, se analiza en qué medida las reformas de inspiración neoliberal modificaron la estructura del Estado de bienestar argentino, cómo estos cambios se originaron en el mercado laboral, y cómo de allí derivaron efectos sobre el sector salud. Por comparación, se evalúa en qué medida la mejora en la cobertura sanitaria de la población en la última década deriva de la evolución positiva coyuntural del mercado laboral, o bien del impacto de cambios en las políticas públicas implementadas por las administraciones de Néstor Kirchner y Cristina Fernández de Kirchner.
Medellín y la seguridad humana: Una lectura desde la política local 2004 -2011
Authors: Avendaño Saray , Romero Elizabeth
Published: May 2016

Durante décadas la ciudad de Medellín ha estado enmarcada por un escenario de violencia. El gobierno local ha recurrido a estrategias para atacar el problema de acuerdo a un enfoque de desarrollo humano, donde la seguridad juega un rol particular en cuanto involucra la protección del núcleo vital de todas las libertades humanas y la realización de las personas. Implica proteger a las personas de situaciones y amenazas en lo económico, lo alimentario, sanitario, medioambiental, personal, comunitario y político, en contraste con la tradicional forma de ejercer la seguridad, monopolizada por el Estado a través de instituciones como la policía, los tribunales, los jueces, el ejército y las cárceles. El objetivo de esta investigación es evaluar, desde el enfoque de la seguridad humana, las estrategias de seguridad formuladas por las dos últimas administraciones locales para la ciudad de Medellín.
Acceso al sistema educativo de la población urbana argentina, 2001-2010
Authors: Donaire Ricardo
Published: May 2016

El ejercicio que presentamos en este trabajo se inserta en el debate reciente sobre el impacto de determinadas políticas públicas en el acceso de la población al sistema educativo. Se busca una aproximación a la forma en que los diferentes grupos y capas sociales acceden al sistema educativo en Argentina, de manera tal de poder avanzar en el conocimiento respecto de hasta qué punto se ha erosionado o no el carácter de clase del acceso a determinados niveles educativos y, complementariamente, a la educación de carácter privado. Como fuente utilizaremos información correspondiente a censos y estadísticas oficiales sobre la población urbana correspondiente a los años 2001 y 2010. Palabras clave: sistema educativo, estructura social, clases sociales, población urbana, Argentina.
La importancia del contexto en el diseño de política social
Authors: Rosas Arellano Jarumy
Published: May 2016

El contexto es un elemento clave en el diseño depolíticas públicas; sin embargo, los esfuerzos porestudiarlo o incluso teorizarlo no han sido satisfactorios,en cuanto es percibido como un espacioinexplicable y complejo que explica la falta deresultados relevantes. Este artículo aspira a realizaruna aportación conceptual y teórica al estudio delcontexto, con el objetivo de reconocer su influenciaen las políticas públicas y particularmente enel diseño de política social a partir de la identificaciónde sus características, atributos y dimensiones–socioeconómico, institucional, político yorganizacional, así como el contexto conceptualde la política pública. La operacionalización de lasdimensiones presentadas en este trabajo abre unafutura línea de investigación que permite realizaraportaciones concretas en el estudio del contextoy su relación con el diseño de políticas públicas.
A Praxis da Ecologia de Saberes: entrevista de Boaventura de Sousa Santos
Authors: CARNEIRO Fernando Ferreira , KREFTA Noemi Margarida , FOLGADO Cleber Adriano Rodrigues
Published: May 2016

Falar de saúde das populações do campo, da floresta e das águas é falar da luta contra um modelo de desenvolvimento que considera essas populações invisíveis ou um empecilho para o “progresso”. Na primeira década do século XXI o Brasil vive um processo de reprimarização de sua economia, fazendo com que as comodities minerais e agrícolas passem a representar a maior parte de tudo o que é exportado. Os movimentos sociais do campo brasileiro vêm denunciando esse modelo neodesenvolvimentista, pois vem impedindo o cumprimento da função socioambiental da terra e a realização da reforma agrária, promovendo a exclusão e a violência, impactando negativamente também nas cidades, agravando a dependência externa e a degradação dos recursos naturais.
Genetic variability, heritability and genetic advance studies for different characters on green fodder yield in oat (Avena sativa L.)
Authors: Bind Harinarayan , Bharti Baudh , Pandey M. K. , Kumar Sanjeev , Vishwanath  , Kerkhi S. A.
Published: May 2016

The experimental material for present study consisted of 30 diverse genotypes of oat. Observation were recorded on 11 quantitative traits in oat. High estimates of heritability (broad sense) were obtained for all the characters. The magnitude of PCV as expected was greater than the corresponding GCV for all the characters indicating importance of environment in expression of characters On the basis of result Out of 11 characters studied seeds per panicle, dry matter yield per plant, green fodder yield per plant and harvest index showed high GCV and heritability coupled with high genetic advance as percent of mean which revealed that these four traits might be under control of additive gene effects and therefore they are more reliable for effective selection.
Evaluate the establishment techniques on growth and yield of rice
Authors: Kumar* N. Senthil
Published: May 2016

Field experiments were conducted at Agricultural Research Station, Thirupathisaram, Tamil Nadu during kharif and rabi seasons of 2011-12 to evaluate the different establishment techniques on growth and yield of rice. The experiment was laid out in a randomized block design with four replications. The treatment structure comprises of wet seeding, drum seeding, random transplanting, line planting, SRI square planting and SRI machine planting. Among the different establishment techniques, SRI machine planting significantly influenced the growth and yield characters and yield and which was on par with SRI square planting. The maximum plant height, number of tillers hill-1, LAI, dry matter production, number of panicles m-2, number of grains panicle-1, panicle length, grain yield and straw yield were recorded under SRI machine planting during kharif and rabi. The lowest grain yield and straw yield were recorded under wet seeding during both kharif and rabi.
Performance of triploid cultivars of banana (Musa spp.) under Maharashtra conditions
Authors: Shaikh* N.B. , Badgujar C.D. , Rajenimbalkar V.M.
Published: May 2016

The present study was undertaken to evaluate ten cultivars of banana (Musa sp.) belonging to different genomic groups (AAA, AAB and ABB) for growth, yield and quality attributes as well as its reaction to Sigatoka leaf spot disease. From the evaluation of the data for growth, yield and quality parameters, it was evident that cv.Grand naine has recorded better horticultural performance than other cultivars studied. It was also inferred that all the cultivars from AAA genomic group recorded B: C ratio in the range of 1.65to 2.29, while rest of the cultivars from AAB and ABB genomic group recorded B:C ratio in between 0.76 to 1.08. The cv. Grand naine was found better in respect of growth, duration, yield and quality attributes with good market potential under Maharashtra conditions.
Effect of limited irrigation and nitrogen levels on growth, yield attributes and yield of Indian mustard (Brassica juncea L.)
Authors: Saud* R.K. , Singh B.P. , Pannu R.K.
Published: May 2016

A field experiment was conducted during the winter season of 1999-2000 and 2000-2001 to study the effect of limited irrigation and nitrogen levels on growth, yield attributes and yield of Indian Mustard. The yield attributes, seed yield, stover yield and harvest index were more in the variety Laxmi than the variety RH-9304. The seed yield was found highest (1582 kgha-1). With one irrigation at flowering stage over no post sowing irrigation (1269 kgha-1). Nitrogen application influenced significantly the seed yield, stover yield and yield attributes up to 100 kg Nha-1.
Barbarians in/of the Land: Representations of Muslim Youth in the Canadian Press
Authors: Jiwani Yasmin , Dessner Matthew
Published: May 2016

This paper examines representations of Muslim youth in a major Canadian newspaper, The Globe and Mail, over a four-year period (2010 to 2013). The first part of the article reviews some of the relevant literature regarding Muslim representations in the Western, mainstream media, paying particular attention to representations of Muslim youth. Based on a close analysis of a corpus of 158 news stories, a qualitative and quantitative analysis of the coverage is presented. Using a postcolonial and critical race perspective, this article traces the ways in which Muslim youth are represented, illustrating the ways in which a racial logic inscribes them. The findings suggest that Muslim youth are cast not only as an enemy within the nation state, but also as a contaminating force that must be disciplined or ejected from the body politic. They are, in short, barbarians in and of the land. At the same time, these representations cohere to produce an image of the nation as benevolent and dedicated to universal standards of truth and justice.
What Kind of Pedagogy Do We Need to Address Extremism and Terror?
Authors: Naseem Muhammad Ayaz , Arshad-Ayaz Adeela
Published: May 2016

One of our primary objectives of this paper is to examine the veracity of the modern usage of ‘extremism’ in order to broaden the understanding of this phenomenon and relatedly also open up the space in which solution to extremism can be found. Understanding contemporary extremism as a crisis in education, our second objective is to propose a critical counter extremism pedagogy that can make visible vital connections between extremism and the wider interlinked political, economic, social, and cultural processes at the global level.
Does the use of tubular digesters to treat livestock waste lower the risk of infection from Cryptosporidium parvum and Giardia lamblia?
Authors: Kinyua Maureen N. , Wald Ileana , Camacho-Céspedes Fabricio , Izurieta Ricardo , Haas Charles N. , Ergas Sarina J.
Published: May 2016

Worldwide, high incidences of cryptosporidiosis and giardiasis are attributed to livestock waste. Quantitative microbial risk assessment can be used to estimate the risk of livestock related infections from Cryptosporidium parvum and Giardia lamblia. The objective of this paper was to assess the occupational and public health risks associated with management of raw and anaerobically digested livestock waste in two rural communities in Costa Rica based on fomite, soil and crop contamination and livestock waste management exposure pathways. Risks related to cattle waste were greater than swine waste due to cattle shedding more (oo)cysts. Cryptosporidium parvum also posed a greater risk than Giardia lamblia in all exposure pathways due to livestock shedding high loads of Cryptosporidium parvum oocysts and oocysts' lower inactivation rates during anaerobic digestion compared with Giardia lamblia cysts. The risk of infection from exposure to contaminated soil and crops was significantly lower for a community using tubular anaerobic digesters to treat livestock waste compared to a community where the untreated waste was applied to soil. The results indicate that treatment of livestock waste in small-scale tubular anaerobic digesters has the potential to significantly decrease the risk of infection below the World Health Organization's acceptable individual annual risk of infection (10−4).
Effect of Dexmedetomidine on Postoperative Hemodynamics and Outcome of Free Flaps in Head and Neck Reconstructive Surgeries
Authors: Rajan Sunil , Moorthy Sumana , Paul Jerry , Kumar Lakshmi
Published: May 2016

Background and Aims:

Dexmedetomidine is less frequently used during free flap surgeries for fear of causing vasoconstriction leading to flap failure as it is an α2 agonist. But most patients following major resections with free flap reconstruction develop uncontrolled hypertension postoperatively which could lead to complications resulting in reduced flap perfusion. We aimed to compare the effects of dexmedetomidine on postop haemodynamics, re-exploration rates and final outcome of free flaps in patients who underwent reconstructive surgeries.

Material and Methods:

This prospective, randomized study was conducted in 40 patients aged 20-70 years. Patients in both groups received morphine 0.1mg/kg, 30 minutes before end of surgery. In addition, in Group D dexmedetomidine 1mcg/kg bolus was also given at the same time, followed by 0.5mcg/kg/hr infusion. Post operatively the patients received either dexmedetomidine 0.5mcg/kg/h (Group D) or morphine 2mg/hr (Group M) infusion for 12 hours.

Statistical analysis was done using Chi-Square test and independent sample t test.

Results:

Morphine group had significantly higher heart rate (105.2 ± 7.5 vs 90.0 ± 11.7), systolic blood pressure (167.5 ± 7.3 vs 125.4 ±16.6) and mean arterial pressures (103.5 ± 4.6 vs 87.8 ± 12.2) than dexmedetomidine group. Same trend persisted till 12 hours post operatively. More patients in morphine group required re-exploration of the flap (15 vs 10%) and had flap failure (7.5 vs 2.5%), but these differences were not statistically significant.

Conclusion:

Dexmedetomidine can be safely used in patients with free flap reconstruction as it optimizes postoperative hemodynamics and is not associated with any significant increase in re-exploration or flap failures.

Key Messages:

Dexmedetomidine resulted in optimal postoperative hemodynamics, reduced re-exploration rate and better flap outcome.
The Relationship Between Academic Procrastination and Parenting Styles Among Jordanian Undergraduate University Students
Authors: Mahasneh Ahmad M. , Bataineh Omar T. , Al-Zoubi Zohair H.
Published: May 2016

This study aims to identify the level of academic procrastination among a group of students and its correlation with parenting styles. A sample of 685 male and female undergraduate students was chosen from many different faculties at the Hashemite University. Two questionnaires; academic procrastination and parenting styles, were administrated to members of the sample during the academic year 2013/2014. Results indicated that few students (7%) showed a high level of academic procrastination, over half of the students (67%) showed a medium level and approximately a quarter of students (26%) showed a low level of academic procrastination, there was no significant differences between male and female in academic procrastination scores. Final results indicated a significant positive correlation between academic procrastination and parenting styles.
Ability to solve riddles in patients with speech and language impairments after stroke
Authors: Savic Goran
Published: May 2016

Introduction. Successful riddle solving requires recognition of the meaning
of words, attention, concentration, memory, connectivity and analysis of
riddle content, and sufficiently developed associative thinking. Objective.
The aim of the study was to determine the ability to solve riddles in stroke
patients who do or do not have speech and language disorders (SLDs), to
determine the presence of SLDs in relation to the lesion localization, as
well as to define the relationship between riddle-solving and functional
impairment of a body side. Methods. The sample consisted of 88 patients. The
data used included age, sex, educational level, time of stroke onset,
presence of an SLD, lesion localization, and functional damage of the body
side. The patients were presented with a task of solving 10 riddles. Results.
A significant SLD was present in 38.60% of the patients. Brain lesions were
found distributed at 46 different brain sites. Patients with different lesion
localization had different success in solving riddles. Patients with
perisylvian cortex brain lesions, or patients with Wernicke and global
aphasia, had the poorest results. The group with SLDs had an average success
of solved riddles of 26.76% (p = 0.000). The group with right-sided
functional impairments had average success of 37.14%, and the group with
functional impairments of the left side of the body 56.88% (p = 0.002).
Conclusion. Most patients with SLDs had a low ability of solving riddles.
Most of the patients with left brain lesions and perisylvian cortex damage
demonstrated lower ability in solving riddles in relation to patients with
right hemisphere lesions.
Analysis of load distribution in tooth-implant supported fixed partial dentures by the use of resilient abutment
Authors: Glisic Mirko , Stamenkovic Dragoslav , Grbovic Aleksandar , Todorovic Aleksandar , Markovic Aleksa , Trifkovic Branka
Published: May 2016

Introduction. Differences between the tooth and implant response to load can
lead to many biological and technical implications in the conditions of
occlusal forces. Objective. The objective of this study was to analyze load
distribution in tooth/implant-supported fixed partial dentures with the use
of resilient TSA (Titan Shock Absorber, BoneCare GmbH, Augsburg, Germany)
abutment and conventional non-resilient abutment using finite element method.
Methods. This study presents two basic 3D models. For one model a standard
non-resilient abutment is used, and on the implant of the second model a
resilient TSA abutment is applied. The virtual model contains drawn contours
of tooth, mucous membranes, implant, cortical bones and spongiosa, abutment
and suprastructure. The experiment used 500 N of vertical force, applied in
three different cases of axial load. Calculations of von Mises equivalent
stresses of the tooth root and periodontium, implants and peri-implant tissue
were made. Results. For the model to which a non-resilient abutment is
applied, maximum stress values in all three cases are observed in the
cortical part of the bone (maximum stress value of 49.7 MPa). Measurements of
stress and deformation in the bone tissue in the model with application of
the resilient TSA abutment demonstrated similar distribution; however, these
values are many times lower than in the model with non-resilient TSA abutment
(maximum stress value of 28.9 MPa). Conclusion. Application of the resilient
TSA abutment results in more equal distribution of stress and deformations in
the bone tissue under vertical forces. These values are many times lower than
in the model with the non-resilient abutment.
Severe neonatal subgaleal hemorrhage as the first presentation of hemophilia A
Authors: Radovanovic Tanja , Spasojevic Slobodan , Stojanovic Vesna , Doronjski Aleksandra
Published: May 2016

Introduction. Subgaleal hemorrhage is a rare but potentially fatal birth
trauma. It is caused by rupture of the emissary veins (connections between
the dural sinuses and scalp veins), followed by the accumulation of blood
between the epicranial aponeurosis and the periosteum. Usually, it is
associated with instrumental delivery (vacuum extraction, forceps delivery),
but it may also occur spontaneously, suggesting the possibility of congenital
bleeding disorder. Case Outline. A full term male neonate was born at 40
weeks gestation by spontaneous vaginal delivery, with birth weight of 3,700
g. The Apgar scores were 9 and 10 at 1 and 5 minutes, respectively. At the
age of 23 hours, the baby became pale and lethargic. Large fluctuant swelling
on his head was noted. He developed severe anemia and hypovolemia as a result
of massive subgaleal hemorrhage. After successful treatment, the baby fully
recovered. Follow-up and further evaluation revealed hemophilia A as a result
of a de novo mutation. Conclusion. This case illustrates that subgaleal
hemorrhage may be the first presentation of hemophilia A. Infants without
obvious risk factors for developing subgaleal hemorrhage should be evaluated
for congenital bleeding disorder. Successful outcome in affected infants
requires early diagnosis, careful monitoring and prompt treatment.
Hypercalcemia with multiple osteolytic lesions and increased circulating tumor necrosis factor in an adult patient with B-cell acute lymphoblastic leukemia
Authors: Virijevic Marijana , Vidovic Ana , Colovic Natasa , Djunic Irena , Mitrovic Mirjana , Suvajdzic-Vukovic Nada , Tomin Dragica
Published: May 2016

Introduction. Acute lymphoblastic leukemia (ALL) is very rarely presented
with diffuse osteolytic lesions and hypercalcemia. Case Outline. We report a
28-year-old male with the B-cell ALL who presented with extensive osteolytic
lesions, bone pain, hepatosplenomegaly, and pancytopenia without circulating
blasts in peripheral blood. An increased serum level of tumor necrosis factor
(TNF-?) was registered while the levels of IL-1? and IL-1? were normal. The
patient failed to achieve remission on two induction regimens but achieved
one after the successful allogeneic stem cell transplantation, which lasted
for six months, after which he developed a relapse and died. Conclusion. The
presented case may serve as a clinical demonstration of possible involvement
of TNF-? as a pathogenic factor in the evolution of osteolytic lesions that
are occasionally observed in patients with ALL. This might have relevance in
the management of such patients as chemotherapy alone may not represent the
beneficial option in this clinical context.
A massive bleeding from a gastrointestinal stromal tumor of a Meckel’s diverticulum
Authors: Chabowski Mariusz , Szymanska-Chabowska Anna , Dorobisz Tadeusz , Janczak Dawid , Jelen Michał , Janczak Dariusz
Published: May 2016

Introduction. Meckel?s diverticulum is the most common congenital anomaly of
the gastro intestinal tract, present in about 2% of population. Case Outline.
The article presents the case of a 44-year-old otherwise healthy man with
anemia, who was diagnosed lower gastrointestinal bleeding. An abdominal CT
scan revealed a clearly demarcated solid tumor in hypogastric region,
measuring 65 ? 45 mm. A laparotomy through lower midline incision was
performed. A surgical resection of a lesion of a Meckel?s diverticulum was
carried out and a final diagnosis of gastrointestinal stromal tumor was made.
The patient made an uneventful recovery. Conclusion. The preoperative
diagnosis of a complicated Meckel?s diverticulum may be challenging. CT is
usually an adequate method to diagnose tumors arising from Meckel?s
diverticulum.
Gestational Diabetes Mellitus From Inactivation of Prolactin Receptor and MafB in Islet β-Cells
Authors: Banerjee Ronadip R. , Cyphert Holly A. , Walker Emily M. , Chakravarthy Harini , Peiris Heshan , Gu Xueying , Liu Yinghua , Conrad Elizabeth , Goodrich Lisa , Stein Roland W. , Kim Seung K.
Published: May 2016

β-Cell proliferation and expansion during pregnancy are crucial for maintaining euglycemia in response to increased metabolic demands placed on the mother. Prolactin and placental lactogen signal through the prolactin receptor (PRLR) and contribute to adaptive β-cell responses in pregnancy; however, the in vivo requirement for PRLR signaling specifically in maternal β-cell adaptations remains unknown. We generated a floxed allele of Prlr, allowing conditional loss of PRLR in β-cells. In this study, we show that loss of PRLR signaling in β-cells results in gestational diabetes mellitus (GDM), reduced β-cell proliferation, and failure to expand β-cell mass during pregnancy. Targeted PRLR loss in maternal β-cells in vivo impaired expression of the transcription factor Foxm1, both G1/S and G2/M cyclins, tryptophan hydroxylase 1 (Tph1), and islet serotonin production, for which synthesis requires Tph1. This conditional system also revealed that PRLR signaling is required for the transient gestational expression of the transcription factor MafB within a subset of β-cells during pregnancy. MafB deletion in maternal β-cells also produced GDM, with inadequate β-cell expansion accompanied by failure to induce PRLR-dependent target genes regulating β-cell proliferation. These results unveil molecular roles for PRLR signaling in orchestrating the physiologic expansion of maternal β-cells during pregnancy.
Effects of γ-Aminobutyric Acid A Receptor Activation on Counterregulatory Responses to Subsequent Exercise in Individuals With Type 1 Diabetes
Authors: Hedrington Maka S. , Mikeladze Maia , Tate Donna B. , Younk Lisa M. , Davis Ian , Davis Stephen N.
Published: May 2016

The effects of γ-aminobutyric acid (GABA) A receptor activation on physiologic responses during next-day exercise in type 1 diabetes are unknown. To test the hypothesis that GABA A activation with the benzodiazepine alprazolam would blunt counterregulatory responses during subsequent exercise, 29 (15 male, 14 female) individuals with type 1 diabetes (HbA1c 7.8 ± 1%) were studied during separate 2-day protocols. Day 1 consisted of morning and afternoon 2-h euglycemic or 2.9 mmol/L hypoglycemic clamps with or without 1 mg alprazolam given 30 min before each clamp. Day 2 consisted of a 90-min euglycemic cycling exercise at 50% VO2max. Tritiated glucose was used to measure glucose kinetics. Despite equivalent day 2 insulin (93 ± 6 pmol/L) and glucose levels (5.3 ± 0.1 mmol/L), plasma epinephrine, norepinephrine, glucagon, cortisol, and growth hormone responses were similarly reduced after alprazolam or day 1 hypoglycemia compared with euglycemic control. Endogenous glucose production, lipolysis (glycerol, nonesterified fatty acid), and glycogenolysis (lactate) were also reduced during day 2 exercise after day 1 GABA A activation. We conclude that activation of GABA A receptors with alprazolam can result in widespread neuroendocrine, autonomic nervous system, and metabolic counterregulatory failure during subsequent submaximal exercise and may increase the risk of exercise-associated hypoglycemia in individuals with type 1 diabetes.
Attention-Deficit/Hyperactivity Disorder–related Symptoms Improved with Allergic Rhinitis Treatment in Children
Authors: Yang Ming-Tao , Chen Chia-Chun , Lee Wang-Tso , Liang Jao-Shwann , Fu Wen-Mei , Yang Yao-Hsu
Published: May 2016

Background

Increased prevalence of attention-deficit/hyperactivity disorder (ADHD) in children with allergic rhinitis (AR) has been reported. Our previous study showed that children with untreated AR had higher ADHD scores than did the controls.

Objective

This prospective follow-up study aimed to investigate whether elevated ADHD scores in children with AR could be decreased by AR treatment.

Methods

Sixty-eight children with AR (age range, 6-14 years) and who were drug naive were enrolled and evaluated by AR symptom score, ADHD symptom scores, and computerized continuous performance test, before and after AR therapy, which included nonpharmacologic intervention, oral antihistamines, and topical steroids. Thirty-one age-matched controls and 13 children with pure ADHD were also enrolled for comparison. The relationship between the AR and ADHD score change was analyzed by a partial correlation test, and univariate and multivariate linear regression models were applied to investigate possible predictors for the improvement of ADHD scores by AR treatment.

Results

AR symptom scores in children with AR decreased significantly after treatment (p < 0.001), and their ADHD scores also decreased significantly (p < 0.001). An improved AR symptom score was positively correlated with improved detectability (rp = 0.617, p = 0.001) and commission error (rp = 0.511, p = 0.011). Significant predictors for the improvement of ADHD scores included age, AR drugs, AR subtypes, and multiple atopic diseases (ps < 0.05).

Conclusion

Higher ADHD scores in children with AR compared with healthy controls decreased significantly with AR treatment. For children with AR and borderline ADHD symptoms, who do not meet full ADHD diagnostic criteria, we recommend initially treating their AR and monitoring improvement of ADHD symptoms.
A New Oxidative Stress Marker for Thiol-Disulphide Homeostasis in Seasonal Allergic Rhinitis
Authors: Ulusoy Seckin , Ayan Nilhan Nurlu , Dinc Mehmet Emre , Is Abdulhalim , Bicer Cemile , Erel Ozcan
Published: May 2016

Background

Reactive oxygen species has a crucial role in the pathogenesis of many diseases. Reactive oxygen species has been effectively documented in patients with asthma, but very little research has been reported in subjects with allergic rhinitis.

Objectives

To investigate thiol (SH)–disulfide (SS) homeostasis, a new oxidative stress marker present in patients with seasonal allergic rhinitis (SAR).

Methods

A total of 64 subjects, including 32 patients with SAR and 32 healthy controls, were included in the study. We measured the SH levels as a marker of antioxidant protection and SS as a marker related to oxidant stress. Sera specimens were taken from patients with SAR during exacerbation and during asymptomatic time periods. In addition, sera samples from the control group were also obtained during the pollen season to compare with those from patients with SAR.

Results

In patients with SAR, during exacerbation periods, SH, SS, % SS/SH, % SS to total SH (TT), and % SH/TT were significantly different (p < 0.05) than in patients with SAR during asymptomatic periods. Although SS was significantly higher in patents with SAR during exacerbation periods, SH was significantly higher in patients with SAR during asymptomatic periods. Patients with SAR during asymptomatic periods and the control group did not significantly differ (p > 0.05) regarding SH, SS, TT, % SS/SH, % SS/TT, and % SH/TT.

Conclusion

SAR is a disorder that elevates systemic oxidative stress and reduces antioxidant enzyme activities. Our results shed light on the etiopathogenesis of the disease and can help develop new therapeutic approaches.
Semi-Depot House-Dust Mite Allergen Extract for Chinese with Allergic Rhinitis and Asthma
Authors: Li Xiang , Wang Xueyan , Lin Xiaoping , Xu Geng , Tao Zezhang , Jiang Weihong , Cheng Lei , Guo Yinshi , Lai He , Shen Kunling
Published: May 2016

Background

Real-world data of the subcutaneous immunotherapy (SCIT) with semi-depot house-dust mite (HDM) allergen extract (a HDM allergen extract that contains a 50%-50% mixture of Dermatophagoides pteronyssinus and Dermatophagoides farina) for allergic rhinitis and asthma was unavailable in China until recently.

Aim

To investigate the effectiveness and safety of a HDM-SCIT for allergic rhinitis and asthma in Chinese patients.

Methods

A multicenter, single-arm, open-label, self-controlled study. Chinese patients with allergic rhinitis or allergic asthma and with a history of symptoms from HDM exposure were included and received allergen-specific immunotherapy for 1 year by subcutaneous injection of HDM-SCIT. The primary outcome measure was the percentage of patients with an improvement in symptom severity assessed at 12 months after initiation of the treatment. The occurrence of adverse events and compliance of treatment were also evaluated.

Results

A total of 272 outpatients were included for effectiveness analysis. The subject-evaluated improvement rate in the visual analog scale (VAS) was 76.1% and 71.3% at 6 and 12 months, respectively; corresponding values for investigator-evaluated VAS were 77.9% and 71.7%, respectively (p < 0.0001). Symptom score changes were -2.43 and -3.79 at 6 and 12 months, respectively (both p < 0.0001); the VAS improvement rate and symptom score change did not differ significantly between children and adolescents and/or adults. Good injection schedule adherence was found in 98.8% of the patients. No study drug–related serious adverse events or serious systemic allergic reactions occurred.

Conclusion

HDM-SCIT was safe and effective in the treatment of allergic rhinitis and asthma in a Chinese population, with good compliance.
Endoscopic Repair of Bilateral Choanal Atresia, Starting with Vomer Resection: Evaluation Study
Authors: El-Anwar Mohammad Waheed , Nofal Ahmad Abdel Fattah , El-Ahl Magdy Abdalla Sayed
Published: May 2016

Background

Choanal atresia is the most common inborn nasal anomaly, and its definitive treatment is surgical to achieve proper bilateral nasal patency. Four main surgical approaches were used for repair: transantral, transpalatal, transseptal, and transnasal. The transnasal endoscopic approach is the most widely accepted nowadays. In this study, we aimed to evaluate the long-term results of a transnasal endoscopic repair of congenital choanal atresia started with resection of the posterior portion of the vomer and was completed without the use of stents in a large series of patients.

Methods

Twenty-five patients (age range, 3-15 days) with bilateral congenital choanal atresia had surgery by using stentless endoscopic transnasal repair by starting with resection of the vomer bone. Postoperative control included office fiberoptic nasal endoscopy.

Results

During the follow-up period of 15-66 months (mean [standard deviation], 35.76 ± 16.8 months), 18 patients (72%) had a wide choana with adequate nasal breathing; Six patients (24%) had narrowing of the choana (<50%), still with adequate and satisfactory airway without feeding difficulties, and one patient (4%) developed restenosis (>50%) after 7 months, which necessitated repeated surgery. One patient (the fourth case) developed a palatal defect, which healed conservatively. No other complications were detected.

Conclusion

The described technique proved to be effective and easier, with good long-term satisfactory results in a large series of patients. This technique allows early use of both nasal passages for simultaneous endoscope and instrument insertion to excise both atretic plates without the use of stents or flaps.
Nano-CuCr2O4: An Efficient Catalyst for a One-Pot Synthesis of Tetrahydrodipyrazolopyridine
Authors: Shahbazi-Alavi Hossein , Safaei-Ghomi Javad , Eshteghal Fahime , Zahedi Safura , Nazemzadeh Seyed Hadi , Alemi-Tameh Fatemeh , Tavazo Maryam , Basharnavaz Hadi , Lashkari Mohammad Rasool
Published: May 2016

The efficient synthesis of eleven tetrahydrodipyrazolopyridines (two of which are novel) has been achieved by the multicomponent condensation reaction of ethyl acetoacetate, an araldehyde, hydrazine hydrate and ammonium acetate at room temperature in ethanol in the presence of nano-CuCr2O4. The key advantages of this process are good to high yields, short reaction times, practical simplicity, reusability of the catalyst and low catalyst loading.