bluuebunny/crossref_metadata_2025 huggingface dataset:
Low-field magnetic resonance imaging study on carpal arthritis in systemic sclerosis - low-grade erosive arthritis of carpal bones is an unexpected and frequent disease manifestation
Authors: Akbayrak Elif , Dinser Robert , Müller-Ladner Ulf , Tarner Ingo H
Published: January 2013

Introduction

The aim of the present study was to assess the prevalence and characteristics of subclinical arthritis of carpal and metacarpophalangeal joints in patients with systemic sclerosis (SSc).

Methods

Low-field (0.2 T) magnetic resonance imaging (MRI) was performed in consecutive patients with SSc attending our center between January 2010 and March 2011. Results were assessed in a standardized manner using the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) and standardized assessments of all hand joints. Patients with arthritis due to overlap syndromes were excluded.

Results

Of 38 inpatients and eight outpatients who were screened for inclusion, 30 patients participated in the study and 26 patients could be evaluated. Erosions, bone marrow edema, synovitis, and joint effusions were found in 87%, 37%, 68%, and 58%, respectively, and 24% of patients had additional tenovaginitis. Arthritis affected only a low number of joints per analyzed hand. All bones and joints could be affected, but synovitis and bone marrow edema occurred predominantly in the proximal row of carpal bones, most frequently affecting the lunate bone. The extent of inflammatory changes measured with the RAMRIS correlated significantly with the functional status assessed with the validated German functional score questionnaire Funktionsfragebogen Hannover.

Conclusion

Low-grade arthritic changes on low-field MRI are frequent in patients with pure SSc. The features of arthritis in SSc differ from rheumatoid arthritis. The distribution, the MRI pattern and the predilection for the lunate bone raise the hypothesis that arthritis in SSc may be caused not only by immunological inflammation but also by ischemic mechanisms.
Cbl-associated protein regulates assembly and function of two tension-sensing structures in Drosophila
Authors: Bharadwaj Rajnish , Roy Madhuparna , Ohyama Tomoko , Sivan-Loukianova Elena , Delannoy Michael , Lloyd Thomas E. , Zlatic Marta , Eberl Daniel F. , Kolodkin Alex L.
Published: January 2013

Cbl-associated protein (CAP) localizes to focal adhesions and associates with numerous cytoskeletal proteins; however, its physiological roles remain unknown. Here, we demonstrate that Drosophila CAP regulates the organization of two actin-rich structures in Drosophila: muscle attachment sites (MASs), which connect somatic muscles to the body wall; and scolopale cells, which form an integral component of the fly chordotonal organs and mediate mechanosensation. Drosophila CAP mutants exhibit aberrant junctional invaginations and perturbation of the cytoskeletal organization at the MAS. CAP depletion also results in collapse of scolopale cells within chordotonal organs, leading to deficits in larval vibration sensation and adult hearing. We investigate the roles of different CAP protein domains in its recruitment to, and function at, various muscle subcellular compartments. Depletion of the CAP-interacting protein Vinculin results in a marked reduction in CAP levels at MASs, and vinculin mutants partially phenocopy Drosophila CAP mutants. These results show that CAP regulates junctional membrane and cytoskeletal organization at the membrane-cytoskeletal interface of stretch-sensitive structures, and they implicate integrin signaling through a CAP/Vinculin protein complex in stretch-sensitive organ assembly and function.
A high-throughput template for optimizingDrosophilaorgan culture with response-surface methods
Authors: Zartman Jeremiah , Restrepo Simon , Basler Konrad
Published: January 2013

The Drosophila wing imaginal disc is a key model organ for molecular developmental genetics. Wing disc studies are generally restricted to end-point analyses of fixed tissues. Recently several studies have relied on limited data from discs cultured in uncharacterized conditions. Systematic efforts towards developing Drosophila organ culture techniques are becoming crucial for further progress. Here, we have designed a multi-tiered, high-throughput pipeline that employs design-of-experiment methods to design a culture medium for wing discs. The resulting formula sustains high levels of proliferation for more than 12 hours. This approach results in a statistical model of proliferation as a function of extrinsic growth supplements and identifies synergies that improve insulin-stimulated growth. A more dynamic view of organogenesis emerges from the optimized culture system that highlights important facets of growth: spatiotemporal clustering of cell divisions and cell junction rearrangements. The same approach could be used to improve culture conditions for other organ systems.
Management of chronic obstructive pulmonary disease in India: a systematic review
Authors: Mckay Ailsa J , Pa Mahesh , Patel Raju Kk , Majeed Azeem
Published: January 2013

Objectives

Chronic diseases are fast becoming the largest health burden in India. Despite this, their management in India has not been well studied. We aimed to systematically review the nature and efficacy of current management strategies for chronic obstructive pulmonary disease (COPD) in India.

Methods

We used database searches (MEDLINE, EMBASE, IndMED, CENTRAL and CINAHL), journal hand-searches, scanning of reference lists and contact with experts to identify studies for systematic review. We did not review management strategies aimed at chronic diseases more generally, nor management of acute exacerbations. Due to the heterogeneity of reviewed studies, meta-analysis was not appropriate. Thus, narrative methods were used.

Setting

India

Participants

All adult populations resident in India

Main outcome measures

1. Trialled interventions and outcomes 2. Extent and efficacy of current management strategies 3. Above outcomes by subgroup

Results

We found information regarding current management – particularly regarding the implementation of national guidelines and primary prevention – to be minimal. This led to difficulty in interpreting studies of management strategies, which were varied and generally of positive effect. Data regarding current management outcomes were very few.

Conclusions

The current understanding of management strategies for COPD in India is limited due to a lack of published data. Determination of the extent of current use of management guidelines, availability and use of treatment, and current primary prevention strategies would be useful. This would also provide evidence on which to interpret existing and future studies of management outcomes and novel interventions.
Epitope Specificity and IgG Subclass Distribution of Autoantibodies to Cardiac Troponin
Authors: Savukoski Tanja , Twarda Aleksandra , Hellberg Sanna , Ristiniemi Noora , Wittfooth Saara , Sinisalo Juha , Pettersson Kim
Published: January 2013

BACKGROUND

Autoantibodies to cardiac troponins (cTnAAbs) can interfere with the measurement of cardiac troponin I (cTnI) by immunoassays for the diagnosis of myocardial infarction. Therefore, we determined the cTnI binding sites and IgG subclasses of circulating cTnAAbs.

METHODS

We studied epitope specificity with sandwich-type immunoassays by measuring the recovery of troponin complex added to 10 cTnAAb-negative and 10 cTnAAb-positive sera from healthy volunteers. To study the IgG subclasses, we analyzed admission and 3-month follow-up sera from chest pain patients with a reference assay measuring total IgG (14 cTnAAb negative and 14 cTnAAb positive at 3 months) and with 4 subclass-specific assays measuring exclusively IgG subclasses 1–4.

RESULTS

Mean recoveries of troponin complex in cTnAAb-positive samples for single cTnI epitopes ranged from 37% to 211%, being lowest for the cTnI midfragment (aa 30–110). However, the lowest sample-specific recoveries, 4%–92%, showed that none of the studied epitopes completely escaped the cTnAAb-related interference. Eight chest pain patients of the cTnAAb-positive group became positive between sampling points, and according to all 5 cTnAAb assays, specific signals were generally higher at follow-up. IgG4, with the highest prevalence, was detected in 68% of samples in the cTnAAb-positive group.

CONCLUSIONS

IgG subclass studies confirm that cTnAAb formation may be triggered/boosted in acute cardiac events. This new information about the epitope specificity of cTnAAbs should be used to reevaluate existing recommendations regarding use of midfragment epitopes in cTnI assays. To circumvent the negative interference of the highly heterogeneous cTnAAbs, use of 3 or more unconventionally selected epitopes should be considered.
Is an “ASEAN Community” Achievable?
Authors: Moorthy Ravichandran , Benny Guido
Published: January 2013

The formulation “ASEAN Community” has been criticized for being too elitist and lacking serious efforts to solicit public opinion. This article examines how the people in Indonesia, Malaysia, and Singapore view the concept of “community building” and the obstacles this initiative may encounter.
Conflict and Diplomacy in the South China Sea
Authors: Simon Sheldon W.
Published: January 2013

Disputes over sovereignty and freedom of navigation in the South China Sea (SCS) involve both the claimants and major maritime powers. Two starkly different approaches to the SCS conflict are discussed: (1) diplomacy among the claimants either bilaterally or multilaterally; (2) if diplomacy fails, the claimants are building their militaries to assert their rights through force.
“Well, I Think There Is Great Variation…”: A Qualitative Study of Oncologists' Experiences and Views Regarding Medical Criteria and Other Factors Relevant to Treatment Decisions in Advanced Cancer
Authors: Schildmann Jan , Tan Jacinta , Salloch Sabine , Vollmann Jochen
Published: January 2013

CME Learning Objectives

List non-medical factors that influence decisions about limiting treatment in advanced cancer. Discuss the problems associated with value-based treatment recommendations. Describe possible strategies for improved ethics and evidence-based treatment decision making in advanced cancer.

Background.

Surveys indicate considerable variation regarding the provision of cancer treatment at the end of life. The variation cannot be fully explained by differences concerning the clinical situation or patients' preferences. The aim of this qualitative study was to explore medical oncologists' experiences with advanced cancer, as well as their views of the relevance of medical and nonmedical criteria for decisions about limiting treatment.

Methods.

Qualitative in-depth interviews were conducted with physicians working in medical oncology in tertiary care hospitals or district general hospitals in England. Purposive sampling and qualitative analysis were performed.

Results.

Physicians reported that a number of nonmedical factors influence professional decisions about the offering or limiting of cancer treatment in advanced cancer in addition to medical criteria. Physicians' individual judgments about the benefit of treatment, as well as the amount of their clinical experience, were cited as such factors. In addition, the physicians' perceptions of the patient's age and life circumstances were reported to influence their treatment decisions. Multiprofessional team discussions and the systematic collection of relevant clinical data regarding the outcomes of different treatment approaches in advanced cancer were suggested as strategies to improve the quality of treatment decisions.

Conclusion.

The findings of this study provide explanations for the variation in treatment in advanced cancer. Making value judgments explicit and gathering more appropriate clinical data on the outcomes of treatment near the end of life are prerequisites for improved ethical and evidence-based treatment decisions in advanced cancer.
The impact of nitrogen source and crop rotation on nitrogen mass balances in the Mississippi River Basin
Authors: Blesh J , Drinkwater L. E.
Published: January 2013

Nitrogen (N) leaching to surface waters from grain farms in the Mississippi River Basin (MRB), USA, is the primary cause of hypoxia in the Gulf of Mexico. Regional‐scale N mass balances indicate that a small, intensively cropped area of the upper MRB contributes disproportionately to nitrate loading. These aggregate balances miss small‐scale variability, especially that caused by differences in farm management. We constructed N mass balances for a gradient of farm types, from corn–soybean monocultures to diversified grain farms that rely on biological N fixation (BNF) as a primary N source, to compare the relative efficiency of diverse farming systems in the MRB. Five‐year N balances were calculated for a most and least productive field on each farm using data collected from interviews with 95 grain farmers in Iowa, Ohio, Minnesota, and Wisconsin; from legume biomass and corn grain samples collected from a subset of farms; and published values from the literature. Nitrogen balances ranged from high average annual surpluses (149 kg N·ha−1·yr−1) to large deficits (80 kg N·ha−1·yr−1), and differed based on N source and crop rotation. Fields with >50% of total N additions from legume N sources and fields with complex crop rotations that included both annual and perennial species were approximately in balance (3.7 kg N·ha−1·yr−1 and 5.7 kg N·ha−1·yr−1, respectively) compared to fertilizer‐based practices in corn–soybean rotations with average annual surpluses near 35 kg N·ha−1·yr−1. Surplus N was also inversely related to the proportion of total N inputs from BNF for medium (80–160 kg N·ha−1·yr−1) to high (>160 kg N·ha−1·yr−1) N rates. Diversified farmers were more likely to adjust their management practices in response to environmental variability compared to fertilizer‐based farmers. Taken together, results from this study suggest that significantly reducing surplus N in agroecosystems will require reducing N inputs and increasing C availability to support the internal biological mechanisms for storing N in farm fields.
Climatic variation and age‐specific survival in Asian elephants from Myanmar
Authors: Mumby Hannah S. , Courtiol Alexandre , Mar Khyne U. , Lummaa Virpi
Published: January 2013

Concern about climate change has intensified interest in understanding how climatic variability affects animal life histories. Despite such effects being potentially most dramatic in large, long‐lived, and slowly reproducing terrestrial mammals, little is known of the effects of climatic variation on survival in those species. Asian elephants (Elephas maximus) are endangered across their distribution, and inhabit regions characterized by high seasonality of temperature and rainfall. We investigated the effects of monthly climatic variation on survival and causes of death in Asian elephants using a unique demographic data set of 1024 semi‐captive, longitudinally monitored elephants from four sites in Myanmar between 1965 and 2000. Temperature had a significant effect on survival in both sexes and across all ages. For elephants between 1 month and 17 years of age, maximal survival was reached at ∼24°C, and any departures from this temperature increased mortality, whereas neonates and mature elephants had maximal survival at even lower temperatures. Although males experienced higher mortality overall, sex differences in these optimal temperatures were small. Because the elephants spent more time during a year in temperatures above 24°C than in temperatures below it, most deaths occurred at hot (temperatures >24°C) rather than cold periods. Decreased survival at higher temperatures resulted partially from increased deaths from infectious disease and heat stroke, whereas the lower survival in the coldest months was associated with an increase in noninfectious diseases and poor health in general. Survival was also related to rainfall, with the highest survival rates during the wettest months for all ages and sexes. Our results show that even the normal‐range monsoon variation in climate can exert a large impact on elephant survival in Myanmar, leading to extensive absolute differences in mortality; switching from favorable to unfavorable climatic conditions within average years doubled the odds for mortality. The persistence of a long‐term trend toward higher global temperatures, combined with the possibility of higher variation in temperature between seasons, may pose a challenge to the survival of species such as Asian elephants.
Preparing Students in Online Debates with Worked Examples
Authors: Tollison Scott , Xie Kui
Published: January 2013

The current study investigates the effects of preparing students for an online debate through a worked example in terms of student perception, participation, and level of cognitive skills. The study found that students prepared for online debate through a worked example participated more frequently, wrote more words or phrases that encouraged the participation of others, and used higher-order thinking skills. This study provides empirical evidence that worked examples can be used to model behaviors for students to emulate in online debates.
Argumentation in Secondary School Students' Structured and Unstructured Chat Discussions
Authors: Salminen Timo , Marttunen Miika , Laurinen Leena
Published: January 2013

Joint construction of new knowledge demands that persons can express their statements in a convincing way and explore other people's arguments constructively. For this reason, more knowledge on different means to support collaborative argumentation is needed. This study clarifies whether structured interaction supports students' critical and elaborative argumentation. The study compares the quality of secondary school students' argumentation during structured and unstructured chat interaction. The data consist of 16 dyadic chat discussions: 8 discussions concerned vivisection and 8 gender equality. Half of the discussions were carried out through structured chat, and the other half through unstructured chat. The results suggest that a structured chat environment evokes counterargumentation, also in topics that do not spontaneously provoke conflicting viewpoints. Further, structured chat seems to equalize communication between females and males. Overall, the results indicate that the further investigation and design of pedagogical means to structure collaborative argumentation is a worthwhile enterprise.
Computer-Managed Instruction (CMI)-Based Online Forums
Authors: Wee Mee-Chin , Abrizah A. , Por Lip Yee
Published: January 2013

A CMI-based online forum is designed to address the need for a system to manage students' online participation. The proposed system may reduce the time required to manage online participation. The system was evaluated by a total of 64 students enrolled in an academic semester. The evaluation has two objectives. The first was to determine the usability of the forum software. The students' responses were positive for most of the questions asked, which indicated that the students may have minimal difficulty in using the CMI-based online forum. The second was to measure the accuracy of the assessment formula. The evaluation results showed that the performance indicator (PI) score generated by the assessment formula was highly correlated with the actual grades. This study suggests that CMI-based forum software could be employed to assist online facilitators in managing learners' participation in online discussions.
The Inter-Life Project: Inter-Cultural Spaces for Young People to Use Creative Practices and Research to Assist with Life Changes and Transition
Authors: Lally Vic , Sclater Madeleine
Published: January 2013

The aim of the Inter-Life Project was to investigate the use of virtual worlds and creative practices to support the acquisition of transition skills for young people to enhance their management of important life events. In particular, the authors have been investigating the role of the Inter-Life virtual worlds in supporting the development of life transition skills in young people, some of whom were in the care of local authorities. Creative practices, such as photography, digital storytelling and filmmaking, were used as a vehicle to enable young people to access and develop new personal and shared narratives as they worked together with researchers over an extended period on ‘Inter-Life Island’. The Inter-Life Project created an embryonic virtual social research laboratory in order to study how young people can use a virtual world creatively, working together as a research community to develop skills that will help them navigate their key life transitions. The project focuses on how participants act and develop in Inter-Life, while engaged in co-designed creative and research activities. It also examines how the skills and understandings that were developed through a range of creative practices map onto their real-world experience. The project environments (based upon the commercial platform ‘Second Life’) incorporate ‘in-world’ data-gathering tools (as distinct from the ‘transition tools' created for the participants' use) that support content analysis. Such data enable the analysis of complex activities in the virtual world using activity theory as a theoretical perspective. The skills acquired and the development of identities as young people engage in shared activities are reported and analysed. The article concludes by assessing the potential of augmented 3D digital technologies to assist young people in the social and emotional challenges of transition in their lives. It also considers the potential of 3D environments to support student transitions in higher education, with particular reference to art and design education.
China's Progress with IFRS Convergence: Interviews with Chinese Professors
Authors: Nie Ping , Collins Allison B. , Wang Shanping
Published: January 2013

The focus of this paper is to examine China's process of convergence with international accounting standards, through a review of the history and through the experiences of its accounting academics. The review of China's accounting history establishes a framework for understanding the current standards. The experiences of Chinese academics during the convergence process are of particular interest to other academics, and offer insight into the training and development of an internationalized accounting profession.

To gain insights from the Chinese academics, we conducted interviews with ten professors, and solicited comments, suggestions, and advice from these academics. These academics report between 6 to 50 years of experience in Chinese accounting education. The focus of our interviews was to gain an understanding of the forces and circumstances that characterized the period during which China changed from an internal, rules-based accounting system to a system that has now achieved significant progress toward convergence with the International Financial Reporting Standards (IFRS). The insights from these Chinese accounting professors will be of interest to educators in other countries that are dealing with IFRS-related issues in their curriculum.
Lack of Association Between Residual Insulin Production and Glucagon Response to Hypoglycemia in Youth With Short Duration of Type 1 Diabetes
Authors: Sherr Jennifer , Xing Dongyuan , Ruedy Katrina J. , Beck Roy W. , Kollman Craig , Buckingham Bruce , White Neil H. , Fox Larry , Tsalikian Eva , Weinzimer Stuart , Arbelaez Ana Maria , Tamborlane William V. ,   for the Diabetes in Children Network (DirecNet)
Published: January 2013

OBJECTIVE

To examine the loss of glucagon response to hypoglycemia and its relationship with residual β-cell function early in the course of type 1 diabetes (T1D) in youth.

RESEARCH DESIGN AND METHODS

Twenty-one youth with T1D duration <1 year (ages 8–18 years, T1D duration 6–52 weeks) underwent mixed-meal tolerance tests (MMTTs) to assess residual β-cell function and hypoglycemic clamps to assess glucagon responses to hypoglycemia. Glucagon responses to hypoglycemia in T1D subjects were compared with those in 12 nondiabetic young adults (ages 19–25 years).

RESULTS

Peak MMTT-stimulated C-peptide levels (range 0.12–1.43) were ≥0.2 nmol/L in all but one T1D subject. As expected, the median of glucagon responses to hypoglycemia in the T1D subjects (18 pg/mL [interquartile range 7–32]) was significantly reduced compared with the responses in nondiabetic control subjects (38 pg/mL [19–66], P = 0.02). However, there was no correlation between the incremental increase in plasma glucagon during the hypoglycemic clamp and the incremental increase and peak plasma C-peptide level during the MMTT. Similarly, the seven T1D subjects who failed to achieve an increase in glucagon ≥12 pg/mL (i.e., 3 SD above baseline values) had C-peptide response ≥0.2 nmol/L (0.54–1.12), and the one T1D subject with peak stimulated <0.2 nmol/L had a 14 pg/mL increase in plasma glucagon in response to hypoglycemia.

CONCLUSIONS

Impaired plasma glucagon responses to hypoglycemia are evident in youth with T1D during the first year of the disease. Moreover, defective and absent glucagon responses to hypoglycemia were observed in patients who retained clinically important residual endogenous β-cell function.
Intravascular ultrasound assisted carotid artery stenting: randomized controlled trial. Preliminary results on 60 patients
Authors: Chiocchi Marcello , Morosetti Daniele , Chiaravalloti Antonio , Loreni Giorgio , Gandini Roberto , Simonetti Giovanni
Published: January 2013

Aims

The primary aim is the evaluation of the usefulness of intravascular ultrasound (IVUS) in the identification of otherwise unnoticed complications during carotid stenting. The secondary aim is the evaluation of the impact of IVUS assistance in the procedural outcomes and long-term patency rates of carotid artery stenting.

Materials and methods

Sixty patients who underwent carotid artery stenting (CAS) during a 14-month period were evaluated prospectively. Thirty patients (50%) underwent IVUS assisted CAS, 30 patients (50%) underwent CAS using angiography as the unique diagnostic tool. All patients were enrolled through a primary duplex ultrasound evaluation; as a secondary evaluation, 54 patients (90%) underwent a preprocedural magnetic resonance angiography, whereas six patients (10%) underwent computed tomography-angiography. Patients with preocclusive stenoses (>85%) were excluded. Mean follow-up was 23 W 5.3 months.

Results

No periprocedural or late complications were observed. No statistical significance was observed in long-term stent patency between the two groups. Mean procedural time length of IVUS-assisted procedures was 10.3 W 5 min longer than non-IVUS-assisted procedures. Virtual histology (VH) IVUS evaluation of plaque morphology led to a different stent choice in three patients. In two cases, the IVUS assessment revealed a suboptimal stent deployment, solved by angioplasty; in one patient VH-IVUS detected plaque protrusion through stent cells, immediately treated by manual aspiration.

Conclusions

Though not recommended as a routine intraprocedural evaluation, IVUS may be useful for a real-time CAS control when treating challenging plaques, such as ‘soft’ or lipidic ones or those prone to rupture, or whenever an intraprocedural morphologic evaluation is required for the appropriate stent choice, or when higher embolic risk is evaluated.
Combining stochastic and deterministic approaches within high efficiency molecular simulations
Authors: Escribano Bruno , Akhmatskaya Elena , Mujika Jon
Published: January 2013

Generalized Shadow Hybrid Monte Carlo (GSHMC) is a method for molecular simulations that rigorously alternates Monte Carlo sampling from a canonical ensemble with integration of trajectories using Molecular Dynamics (MD). While conventional hybrid Monte Carlo methods completely re-sample particle’s velocities between MD trajectories, our method suggests a partial velocity update procedure which keeps a part of the dynamic information throughout the simulation. We use shadow (modified) Hamiltonians, the asymptotic expansions in powers of the discretization parameter corresponding to timestep, which are conserved by symplectic integrators to higher accuracy than true Hamiltonians. We present the implementation of this method into the highly efficient MD code GROMACS and demonstrate its performance and accuracy on computationally expensive systems like proteins in comparison with the molecular dynamics techniques already available in GROMACS. We take advantage of the state-of-the-art algorithms adopted in the code, leading to an optimal implementation of the method. Our implementation introduces virtually no overhead and can accurately recreate complex biological processes, including rare event dynamics, saving much computational time compared with the conventional simulation methods.
A novel tamper detection scheme for BTC-compressed images
Authors: Hu Y. , Chen W. , Lo C. , Wu C.
Published: January 2013

A novel image authentication scheme for the compressed images of block truncation coding (BTC) is proposed in this paper. In the proposed scheme, 1-bit authentication data is generated from the quantization levels of each image block. Multiple block permutations are generated by using the random sequences induced by the selected random number seeds. Multiple copies of the authenticaiton data are embedded into the bit maps of BTC-compressed image blocks based on the block permutations. Experimental results show that the proposed scheme achieves good detecting accuracy while keeping good image quatiy of the embedded image.
Defining spatial priorities for capercaillieTetrao urogalluslekking landscape conservation in south‐central Finland
Authors: Sirkiä Saija , Lehtomäki Joona , Lindén Harto , Tomppo Erkki , Moilanen Atte
Published: January 2013

Effective wildlife management requires knowledge about the areas th at are most important within the distribution range or specific management unit of the focal species. Using the spatial conservation planning tool, Zonation, and spatial data on Finnish forests, we present a fast and relatively simple way to objectively prioritise large areas for our focal species, the capercaillieTetrao urogallus. We constructed the capercaillie lekking landscape prioritisation using published knowledge on the species' habitat and connectivity requirements, and validated the results via comparison to capercaillie lekking‐site data. The results show that connectivity considerations both at the home range and the population scale are essential in prioritisation of areas suitable for capercaillie lekking sites. In addition, inclusion of negative connectivity to agri‐urban areas further enhances the congruence between the known lekking sites and the areas of high priority (48.7% of known leks falling into the best 20% priority category). We conclude that our approach can be used in several stages of spatial wildlife conservation planning: as a preliminary analysis to find areas subjected to more detailed inventories and modelling, in combination with other analytical tools, or as the main instrument enabling informative use of readily available data in operational large‐scale land‐use planning. The advantages of our approach include: 1) the ability to execute relatively simple and objective analyses covering wide spatial extents at a high resolution, 2) the possibility to incorporate several ecologically realistic species‐specific connectivity components into the analyses, and 3) the potential to help managers target wildlife surveys or conservation and management operations.
Enteric Opportunistic Parasitic Infections Among HIVSeropositive Patients in Kathmandu, Nepal
Authors: Sherchan JB , Ohara H , Sakurada S , Basnet A , Tandukar S , Sherchand JB , Bam DS
Published: January 2013

Background Enteric opportunistic parasitic infections are the major source of diarrheal disease in developing countries mainly in Human Immunodeficiency virus (HIV) infected patients. Objective The study was to detect enteric parasites causing diarrhea and their association with immune status in HIV-seropositive patients. Methods The present study was conducted in Dirgh-Jeevan Health Care Research Center and Tribhuvan University Teaching Hospital, Public Health Research Laboratory, Kathmandu, Nepal between June 2010 and May 2011 involving 146 Human Immunodeficiency virus (HIV) positive patients. Serostatus from these patients were detected by Enzyme Linked Immunosorbent assay. CD4+ T cell counts were done by flow cytometry. Stool was examined for enteric parasites by microscopy with special staining methods. Results A total of 146 HIV sero-positive patients with and without diarrhea age between 20 to 45 years were included in the study. Of the 146 patients, the protozoan parasitic infection was found in 30.13% (44/146). Out of 146 patients, 78 had diarrhea in which parasitic infection was 39 (50%) and 7.35% (5/68) protozoal parasites positive cases did not have diarrhea. A significant difference (p<0.05) was observed in the level of infection of intestinal protozoan between the HIV seropositive with diarrhea and HIV-seropositive without diarrhea. Out of 43 patients whose CD4+ T cells were <200/?l, 29 (67.4%) had opportunistic parasitic infection whereas out of 103 patients whose CD4+ T cells were ?200/?l, only 15 (14.56%) had opportunistic parasitic infection (P < 0.05). Conclusion Enteric opportunistic parasitic infections were detected in 30.1% among HIV-seropositive patients and low CD4+ T count indicated high enteric opportunistic infection. Early detection of enteric parasitic infections will help in the management and to improve the quality of life for HIV-infected individuals. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 14-17 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7336
Bruckner Red Light Reflex Test in a Hospital Setting
Authors: Saiju R , Yun S , Yoon PD , Shrestha MK , Shrestha UD
Published: January 2013

Background Childhood blindness is a major problem in developing world including Nepal that needs to be addressed. Objective The objective of study was to measure the effectiveness of the Bruckner red reflex test for screening of posterior segment opacities in children. Methods Patients aged less than five years who came to the Tilganga Institute of Ophthalmology, Kathmandu from March to August, 2009 were recruited in this cross-sectional descriptive study. Children were screened with the Bruckner red light reflex test in a dark room. Patients with abnormal Bruckner tests had their eyes dilated for further investigations. Abnormalities were recorded. The number of patients with an abnormal Bruckner test was recorded and correlated with their potential pathology. Results A total of 172 patients with 97 boys and 75 girls were included. Twenty-three had abnormal Bruckner test results in either one or both eyes. Four of these twenty-three patients had no pathology diagnosed; hence the sensitivity of the Bruckner screen to diagnose significant pathology was calculated at 82.6%. Of the 153 patients with normal results, two patients were found to have pathology detected, which included cataract and strabismus. Hence, the specificity of this test was 98.7%. The screening test had a positive predictive value of 90.5% and a negative predictive value of 97.4%. Conclusion Bruckner test screening is a sensitive and specific marker for detecting the posterior segment opacities in children. We recommend utilizing the test to evaluate these problems where other technologies are rare. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 23-26 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7338
Lip Prints – An Identification Aid
Authors: Karki RK
Published: January 2013

Background Lip prints are the normal lines and furrows in the form of wrinkles and grooves present in the human lip between the inner labial mucosa and outer skin having certain individual characteristics like fingerprints. Objective The aim of the study was to highlight the importance of lip prints in sex determination related to forensic investigation for identification. Methods Study was conducted on 150 medical students which include 75 males and 75 females of Kathmandu University School of Medical Sciences, Dhulikhel, Kavre on 2011. Lip prints were collected and analyzed as per Suzuki’s classification. Results There was significant difference between male and female lip print patterns. Type II was most common combining both. Type I and I’ was more common in male where as Type I was rare in female. Type II in fourth quadrant was seen in almost all female and also the commonest. Similar patterns in all four quadrants were common findings in female. Conclusion The study showed that each lip print is unique and the sex of the person can be predicted on the basis of patterns present in prints. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 55-57 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7345
Clinical and Laboratory Profile of Children with Eosinophilia at Dhulikhel Hospital
Authors: Shrestha S , Singh S Dongol , Shrestha NC , Shrestha RPB
Published: January 2013

Background Eosinophilia in children is commonly caused by or parasitic, allergic and immunologic problems. Objectives To study clinical and laboratory profile of patients with eosinophilia and to identify possible causes. Method A prospective and descriptive study was conducted from January 2009- December 2011. All the cases of eosinophilia with symptoms and signs of single or multiple organ were included. The known caused of eosinophilia like allergy, asthma and drugs were excluded. Results During three years period, 84(2.41%) cases had eosinophilia with single or multiple organ involment. 14.3%, 39.3% and 46.4% had mild, moderate and severe eosinophilia respectively, with cases of hypereosinophilia comprising 85.7%. Eosinophilia is seen predominantly in tamang caste with overall age ranging from 1-14 years. Most common symptoms and signs are abdominal pain (67.9%) hepatomegaly (59.5%) respectively. Gastrointestinal system was most commonly involved organ followed by respiratory system. Nineteen percent had polyserositis involving pleural, pericardial effusion and ascites at presentation. Out of 84 patients only nine serum samples were able to be sent for parasitological analysis. sixteen had identifiable and/ or possible causes. Serum sample for parasitological analysis revealed fascilosis, filariasis, strongylosis stercoralis and toxocariasis. Conclusion Eosinophilia is more common among tamang poulation in our study. Most common symptoms and signs are abdominal pain and hepatomegaly respectively. Parasitic infection seems to be the most common cause however further study has to be done to reach final conclusion. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 58-62 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7346
Sirtuins: The Future Insight
Authors: Suvarna Bs
Published: January 2013

Sirtuins are evolutionary conserved NAD+ dependent acetyl-lysine deacetylases and ADP ribosyltransferases dual-function enzymes involved in the regulation of metabolism and lifespan. Sirtuins represent a promising new class of III NAD dependent histone deacetylases that regulate a number of physiological processes, originally identified in yeast. Sirtuins regulate various normal and abnormal cellular and metabolic processes, including tumorgenesis, neurodegeneration and processes associated with type 2 diabetes and obesity. Several age-related diseases such as Alzheimer’s disease and longevity have also been linked to the functions of sirtuins. Because of these associations, the identification of small molecules sirtuin modulators has been of significant interest. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 77-82 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7350
Diarrhoeal Diseases in Developing Countries: A Situational Analysis
Authors: Kumar SG , Subita L
Published: January 2013

Recent data showed that there is no much reduction in diarrhoea related morbidity in developing countries. This is important in view of the Millennium Developmental Goal (MDG) to be achieved by 2015. This study reviewed and analyzed after gathering the recent literature information from Pubmed, internet and other sources. The authors discussed public health issues related to diarrhoeal diseases that include problem burden, determinants, intervention strategies, management, prevention and recent developments for control of diarrhoea among under-five children in developing countries. The study emphasizes the need for strengthening of comprehensive diarrhoeal disease prevention strategy at primary level including improvement of water quality, hygiene and sanitation, along with provision of oral rehydration solution and zinc supplements, and research in the field of vaccine and cost effective interventions. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 83-88 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7351
Anaesthetic Management of a Patient with Dermatomyositis and Valvular Heart Disease
Authors: Shrestha GS , Aryal D
Published: January 2013

Dermatomyositis is an idiopathic inflammatory myopathy with involvement of muscle, skin and other organs. Valvular heart disease increases the risk of perioperative adverse cardiac events. Only a little information is available about the anaesthetic management of a patient with dermatomyositis and valvular heart disease. Here we considered combined spinal-epidural technique for total abdominal hysterectomy, minimizing the risk of delayed recovery from muscle relaxants, aspiration pneumonitis, arrhythmias and cardiac failure. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 100-102 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7355
Effects of concentration and solvent composition on the electrical conductivity of sodium bromide in pure water and ethanol-water mixed solvent media
Authors: Bhattarai Ajaya , Neupane Sanjay
Published: January 2013

Precise measurements on the conductivity of Sodium Bromide in pure water and ethanol-water mixed solvent media containing 0.10, 0.20, 0.30, 0.40, 0.50 and 0.60 volume fractions of ethanol at room temperature are reported. The concentrations were varied from ~ 0.010 to ~ 0.10 mol.L-1. The results showed a sharp increase in the conductivity with increasing electrolyte concentration. The conductivity of electrolyte decreases with increase in the amount of ethanol.Kathmandu University Journal of Science, Engineering and Technology Vol. 8, No. II, December, 2012, 1-6 DOI: http://dx.doi.org/10.3126/kuset.v8i2.7318
On the 3rd order linear differential equation
Authors: Moreno-Ley BL , Lopez-Bonilla J , Tuladhar B Man
Published: January 2013

If for an arbitrary 3th order linear differential equation, non-homogeneous, we know two solutions of its associated homogeneous equation (HE), then we show how to determine the third solution of HE and the particular solution of the original equation. Kathmandu University Journal of Science, Engineering and Technology Vol. 8, No. II, December, 2012, 7-10DOI: http://dx.doi.org/10.3126/kuset.v8i2.7319
Two dimensional temperature distribution model in human dermal region exposed at low ambient temperatures with air flow
Authors: Gurung DB
Published: January 2013

This paper deals with thermo-regulation in human dermal part in a cold atmosphere with significant air flow. The mathematical model involving bio-heat equation has been solved using finite element method and Crank-Nicolson technique to numerically investigate two dimensional temperature distributions. The natural three layers of dermal part – epidermis, dermis, and subcutaneous tissue are considered for the study. The important parameters like blood mass flow rate, metabolic heat generation rate and thermal conductivity are taken distinct in each layer according to their distinct sub-regional activities. The human subject is assumed in static condition. The wind speed is considered in the range from the start of forced convection (? 0.2 m/s) and up to 5 m/s. The loss of heat from the skin surface to the environment is taken due to convection, radiation, and insensible perspiration. Kathmandu University Journal of Science, Engineering and Technology Vol. 8, No. II, December, 2012, 11-24 DOI: http://dx.doi.org/10.3126/kuset.v8i2.7320
A common fixed point of weakly compatible mappings in dislocated metric space
Authors: Panthi D , Jha K
Published: January 2013

The purpose of this paper is to establish a common fixed point theorem for pairs of weakly compatible maps in dislocated metric space which generalizes and improves similar fixed point results. Kathmandu University Journal of Science, Engineering and Technology Vol. 8, No. II, December, 2012, 25-30 DOI: http://dx.doi.org/10.3126/kuset.v8i2.7321
Some matrix transformations and almost convergence
Authors: Sheikh Neyaz Ahmad , Ganie Ab. Hamid
Published: January 2013

The sequence space bv(u,p) has been defined and the classes (bv(u,p):l?), (bv(u,p):c),and (bv(u,p):c0) of infinite matrices have been characterized by Ba?ar, Altay and Mursaleen ( see, [2] ). The main purposes of the present paper is to characterize the classes (bv(u,p):ƒ?),(bv(u, p):ƒ), and (bv(u,p):ƒ0), where ƒ?, ƒ, and ƒ0 denotes the spaces of almost bounded sequences, almost convergent sequences and almost convergent null sequences, respectively, with real or complex terms. Kathmandu University Journal of Science, Engineering and Technology Vol. 8, No. II, December, 2012, 89-92 DOI: http://dx.doi.org/10.3126/kuset.v8i2.7330
Reanimation of elbow extension with medial pectoral nerve transfer in partial injuries to the brachial plexus
Authors: Flores Leandro Pretto
Published: January 2013

Object

Recent advancements in operative treatment of the brachial plexus authorized more extensive repairs and, currently, elbow extension can be included in the rank of desirable functions to be restored. This study aims to describe the author's experience in using the medial pectoral nerve for reinnervation of the triceps brachii in patients sustaining C5–7 palsies of the brachial plexus.

Methods

This is a retrospective study of the outcomes regarding recovery of elbow extension in 12 patients who underwent transfer of the medial pectoral nerve to the radial nerve or to the branch of the long head of the triceps.

Results

The radial nerve was targeted in 3 patients, and the branch to the long head of the triceps was targeted in 9. Grafts were used in 6 patients. Outcomes assessed as Medical Research Council Grades M4 and M3 for elbow extension were noted in 7 (58%) and 5 (42%) patients, respectively.

Conclusions

The medial pectoral nerve is a reliable donor for elbow extension recovery in patients who have sustained C5–7 nerve root injuries.
Use of a clinicoradiological score to determine the presurgical diagnosis of autoimmune hypophysitis in a teenage girl
Authors: Bose Vivek , Caturegli Patrizio , Conrad Jens , Omran Wael , Boor Stephan , Giese Alf , Gutenberg Angelika
Published: January 2013

The distinction between autoimmune hypophysitis and other non–hormone secreting pituitary masses is often difficult to determine with certainty without pituitary biopsy and pathological examination. To aid in this distinction, the authors recently published a clinicoradiological scoring system, which they used in the case of a 15-year-old girl presented here. The patient presented with headache, visual field defects, polydipsia, and polyuria, and she was found to have secondary hypogonadism and hypoadrenalism. Magnetic resonance imaging showed a pituitary mass of approximately 2 cm in diameter. Application of the clinicoradiological parameters gave a score of −6, which favored a diagnosis of hypophysitis over that of adenoma. The presence of pituitary autoantibodies substantiated the diagnosis of hypophysitis. The patient was treated conservatively with high-dose prednisolone, and her symptoms improved markedly. This case illustrates the utility of using a clinicoradiological score when autoimmune hypophysitis is suspected since it can identify patients who can be treated without the need for pituitary surgery.