bluuebunny/crossref_metadata_2025 huggingface dataset:
Brackish water treatment for reuse using vacuum membrane distillation process
Authors: Sivakumar Muttucumaru , Ramezanianpour Mohammad , O'Halloran Glen
Published: April 2015

The availability of fresh water is vital for all human activities and in particular for improving living conditions, health and overall well-being. Pressure on scarce fresh water resources can be reduced by treating and reusing brackish water by advanced membrane treatment technologies. In this study, brackish water originating from effluent discharge of a local coal mine, seawater, groundwater and salt water swimming pool is treated by a laboratory-scale vacuum membrane distillation (VMD) system. VMD is an emerging technology that has the potential to become as important as conventional distillation system and aims to remove particles and dissolved impurities by evaporation and condensation techniques that mimic what occurs in nature. This study validates the mathematical modeling of the transport mechanisms used in the VMD process using data collected for different experimental situations. The response of flux rate to various process operating parameters, including pressure, temperature, flow rate and salinity concentration, is also demonstrated. This thermally driven separation process enables to remove 99.9% of total dissolved solids (TDS) from brackish water. The quality of the permeate water from all four water sources studied is of acceptable standards for potable use; however, it requires mineralization efforts before direct consumption.
The study on chemical adsorption of dissolved oxygen on naturally formed co-oxides filter film in aqueous solution: combined characterization of XPS and TPD
Authors: Huang Tinglin , Cao Xin , Wen Gang , Guo Yingming
Published: April 2015

The chemical adsorption of dissolved oxygen (DO) by co-oxide filter film-coated sands, formed through the filtration of ground water containing high concentrations of ammonia, manganese and iron, were studied. The results showed that the filter film consisted of silicates, carbonates, manganese and iron oxides and was constructed in a three-layer porous structure. The specific area of film-coated sands was 6.5 m2/g. The chemical adsorption sites of DO are composed of silicates, iron and manganese atoms, and the adsorption was a weak chemical effect. The O2− is the adsorbed species of DO.
Effects of Head Models and Dipole Source Parameters on EEG Fields
Authors: Peng Li , Peng Mingming , Xu Anhuai
Published: April 2015

Head model and an efficient method for computing the forward EEG (electroencephalography)problem are essential to dipole source localization(DSL). In this paper, we use less expensive ovoid geometry to approximate human head, aiming at investigating the effects of head shape and dipole source parameters on EEG fields. The application of point least squares (PLS) based on meshless method was introduced for solving EEG forward problem and numerical simulation is implemented in three kinds of ovoid head models. We present the performances of the surface potential in the face of varying dipole source parameters in detail. The results show that the potential patterns are similar for different dipole position in different head shapes, but the peak value of potential is significantly influenced by the head shape. Dipole position induces a great effect on the peak value of potential and shift of peak potential. The degree of variation between sphere head model and non-sphere head models is seen at the same time. We also show that PLS method with the trigonometric basis is superior to the constant basis, linear basis, and quadratic basis functions in accuracy and efficiency.
Comparison of Physical-chemical and Mechanical Properties of Chlorapatite and Hydroxyapatite Plasma Sprayed Coatings
Authors: Demnati Imane , Grossin David , Marsan Olivier , Bertrand Ghislaine , Collonges Gérard , Combes Christèle , Parco Maria , Braceras Inigo , Alexis Joel , Balcaen Yannick , Rey Christian
Published: April 2015

Chlorapatite can be considered a potential biomaterial for orthopaedic applications. Its use as plasma-sprayed coating could be of interest considering its thermal properties and particularly its ability to melt without decomposition unlike hydroxyapatite. Chlorapatite (ClA) was synthesized by a high-temperature ion exchange reaction starting from commercial stoichiometric hydroxyapatites (HA). The ClA powder showed similar characteristics as the original industrial HA powder, and was obtained in the monoclinic form. The HA and ClA powders were plasma-sprayed using a low-energy plasma spraying system with identical processing parameters. The coatings were characterized by physical-chemical methods, i.e. X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and Raman spectroscopy, including distribution mapping of the main phases detected such as amorphous calcium phosphate (ACP), oxyapatite (OA), and HA or ClA. The unexpected formation of oxyapatite in ClA coatings was assigned to a side reaction with contaminating oxygenated species (O2, H2O). ClA coatings exhibited characteristics different from HA, showing a lower content of oxyapatite and amorphous phase. Although their adhesion strength was found to be lower than that of HA coatings, their application could be an interesting alternative, offering, in particular, a larger range of spraying conditions without formation of massive impurities.
Nanoindentation Study of Phase-pure Highly Crystalline Hydroxyapatite Coatings Deposited by Microplasma Spraying
Authors: Dey Arjun , Mukhopadhyay Anoop Kumar
Published: April 2015

The present contribution has originated from a critical biomedical engineering issue e.g., loosening of metallic prostheses fixed with poly(methylmethylacrylate) (PMMA) bone cement especially in the case of hip joint replacement which ultimately forces the patient to undergo a revision surgery. Subsequently surgeons invented a cementless fixation technology introducing a bioactive hydroxyapatite (HAp) coating to the metallic implant surface. A wide variety of different coating methods have been developed to make the HAp coating on metallic implants more reliable; of which ultimately the plasma spraying method has been commercially accepted. However, the story was not yet finished at all, as many questions were raised regarding coating adherence, stability and bio-functionality in bothin vitroandin vivoenvironments. Moreover, it has been now realized that the conventional high power plasma spraying (i.e. conventional atmospheric plasma spraying, CAPS) coating method creates many disadvantages in terms of phase impurity; reduced porosity limiting osseointegration and residual stresses which ultimately lead to inadequate mechanical properties and delamination of the coating. Further, poor crystallinity of HAp deposited by CAPS accelerates the rate of bioresorption, which may cause poor adhesion due to quick mass loss of HAp coatings. Therefore, in the present work a very recently developed method e.g., low power microplasma spraying method was utilized to coat HAp on SS316L substrates to minimize the aforementioned problems associated with commercial CAPS HAp coatings. Surgical grade SS316L has been chosen as the substrate material because it is more cost effective than Ti6Al4V and CoCrMo alloys.
Establishment on Evaluation Indicator System for Power System Simulation Software
Authors: Bo Shi , Yanming Li
Published: April 2015

Computer simulation has become an important means of data processing, calculation analysis, online debugging,
closed loop control, fault diagnosis, condition forecasting in power system. In order to solve the problem that there
is a lot of power simulation software and users of the software have difficulty in choosing the evaluation index system,
this paper studies evaluation indicator system of simulation software based on analytic hierarchy process and provides
support for software selection. Firstly, analyzed and summarized the structure of evaluation index system model which
consists of 8 indexes, and the indexes were described; Then, create a mathematical model to calculate the weights, including
judgment matrix, hierarchical ordering, consistency inspection process; Finally, calculate the evaluation index weigh
according to the steps in mathematical model. The results show that posterior simulation function, software maintainability,
eigenvalue analysis function, power flow calculation accuracy, these indicators have bigger impact on the power system
simulation software, when selecting software these indicators should be considered. The content of this paper is the
foundation of system evaluation , and it plays an important role in promoting the informatization level of power system.
Dual-Hop Fixed Gain Relaying Transmissions with Semi-Blind in Asymmetric Multipath/Shadowing Fading Channels
Authors: Cheng Weijun , Chen Teng
Published: April 2015

In this paper, we investigate the end-to-end performance of a dual-hop fixed gain relaying system with semiblind
relay under asymmetric fading environments. In such environments, the wireless links of the considered system undergo
asymmetric multipath/shadowing fading conditions, where one link is subject to only the Nakagami-m fading, the
other link is subject to the composite Nakagami-lognormal fading which is approximated by using mixture gamma fading
model. First, the cumulative distribution function (CDF), the moment generating function (MGF) and the moments of the
end-to-end signal-to-noise ratio (SNR) are derived under two asymmetric scenarios. Then, novel closed-form expressions
of the outage probability, the average end-to-end SNR, the symbol error rate and the ergodic capacity for the dual-hop
system are obtained based on the CDF and the MGF, respectively. Finally, some numerical and simulation results are
shown and discussed to validate the accuracy of the analytical results under different scenarios, such as varying average
SNR, fading parameters per hop, the choice of the semi-blind gain and the location of relaying nodes.
Study About the Design and Experiments of the Vibrating Resistance
Reduction Force Measuring Device
Authors: Xin Lili , Li Chuanqi , Liang Jihui
Published: April 2015

The force measuring device is designed to the study of the relationship between vibration amplitude, frequency,
speed and traction resistance of the tractor If the design of the force measuring device which consists of a force measuring
frame and three octagonal ring transducers is successful, the goal of real-time monitoring of the traction resistance in the
process of vibrating sub soil may be reached. Also, the up, down, left and right margin of frame is designed to be
adjustable, so that different kinds of tractor could link up with the force measuring device. With the vibrating sub-soiler
machine, the vibrating resistance reduction experiments, which are mainly based on the change of the vibration amplitude,
frequency and the speed of the tractor, may be done. The three levels of the vibration amplitude, frequency, and speed are
as follows: vibration amplitude: 0.001 m, 0.002 m, and 0.003 m; frequency: 9 Hz, 10 Hz, and 12 Hz; speed: 0.1 m/s, 0.2
m/s, and 0.3 m/s. The experiment results showed that with the same speed and bigger vibration frequency, the tractor
traction resistance is small and when the amplitude is 0.001 m, the vibration frequency is 10 Hz, and forward speed is 0.2
m/s, and the tractor traction resistance is the minimum.
Research on Flow and Temperature Fields in Aircraft Engines
Authors: Zhao Guochang , Zhao Daniel X. , Li Jing , Du Xia , Tong Xianyi , Zhao Chunlei , Kong Jingru , Lu Tiandong , Cao Lei , Song Liping
Published: April 2015

The similarity criteria which ensure the similarity between flow and temperature fields of both the lowtemperature
turbine cavity model and the actual high-temperature turbine cavity are derived and then verified using
numerical simulation of two different sized rotor-stator system turbine cavities. The analytical solution of threedimensional
dimensionless velocity distribution and the numerical solutions of both the three-dimensional dimensionless
velocity and temperature distributions of the free disk flow field are obtained. Using these solutions as a foundation, the
analytical solutions of the dimensionless temperature distribution within the boundary layer of the isothermal and nonisothermal
free disk model are obtained. The numerical and analytical solutions of velocity and temperature are compared
to ensure that the solutions are consistent with each other. The analytical solutions of the dimensionless velocity and
temperature fields within the laminar boundary layer of the wedge flow are obtained. The approximation solutions of the
dimensionless temperature of the wedge flow under subsonic speed and isothermal wall boundary conditions and the
dimensionless temperature of the wedge flow under supersonic speed and adiabatic wall boundary conditions are
provided. The velocity and temperature distributions of the airflow outside the strut are obtained through numerical
simulation and the pattern of changes in the velocity and temperature within the laminar boundary layer of the strut is
revealed. Numerical simulation on gas jet cooling and regenerative cooling for the strut are simulated and shown to be
effective for thermal protection. Using a strut with rough internal surface and aviation kerosene as the cooling medium is
effective at cooling. The experiment fixture used to simulate the outlet temperature of the combustor and the experimental
fixture used to simulate the dynamic temperature of the compressor are designed and built. The dynamic temperature of
the compressor airflow is measured using combined thermocouples. Experimental results show that the dynamic error
caused by the thermal inertia of the thermocouple can be eliminated by the compensation algorithm.
Root Resorption a 6-Year Follow-up Case Report
Authors: Dias Caroline , Closs Luciane , Barletta Fernando , Reston Eduardo , Tovo Maximiano F , Lambert Paula
Published: April 2015

This paper describes the clinical course of a pediatric patient developing cervical external root resorption (CERR). An 11-year old male patient had sustained dental trauma and was diagnosed with crown fracture affecting the incisal and middle thirds of the maxillary right permanent central incisor and the maxillary right permanent lateral incisor with pulp exposure and CERR after 24 months. Diagnosis and treatment of CERR are a challenge for dental practitioners. In this case, preservation of natural dentition is shown as a successful treatment in a 6-year follow-up.
Epidemiology and Management of Antiretroviral-Associated Cardiovascular Disease
Authors: Chastain Daniel B , Henderson Harold , Stover Kayla R
Published: April 2015

Risk and manifestations of cardiovascular disease (CVD) in patients infected with human immunodeficiency virus (HIV) will continue to evolve as improved treatments and life expectancy of these patients increases. Although initiation of antiretroviral (ARV) therapy has been shown to reduce this risk, some ARV medications may induce metabolic abnormalities, further compounding the risk of CVD. In this patient population, both pharmacologic and nonpharmacologic strategies should be employed to treat and reduce further risk of CVD. This review summarizes epidemiology data of the risk factors and development of CVD in HIV and provides recommendations to manage CVD in HIV-infected patients.
A Three-Fold Classification of Tight Gas Based Primarily on Dynamic
Relationship Between Gas Charging History and Reservoir Tightening
Process and its Application
Authors: Zhang Lei , Zhu Lunwei , Shen Jianian , Huang Qifei
Published: April 2015

Building upon the foundation of the prior investigations, a three-fold classification of tight gas reservoirs is
proposed in this paper which is based primarily on dynamic relationship between gas charging history and reservoir tightening
process, coupled with tectonic evolution, source-reservoir relationship, migration and charging pattern. The three
categories of tight gas are: (1) “pre-existing” basin-centered gas reservoir, in which the reservoir sands experienced earlystage
tightening processes, occurring before peak gas generation, expulsion from source rock, and charging of reservoir;
(2) “pre-existing subsequent-improved” tight gas reservoir, in which the reservoir sands were also tightened before gas
charging and then underwent reservoirs improvement mainly caused by the tectonic activities; and (3) “subsequentconventional”
tight gas reservoir where reserved sands were tightened after the peak of gas generation, expulsion from
source rock, and charging of reservoir. This type of tight gas initially formed conventional gas accumulation during gas
charging of reservoir, and subsequently modified to tight gas reservoir. All the three categories of tight gas have different
geological conditions of gas accumulation and gas accumulation patterns, which can be used as characteristics to classify
these tight gas systems, and thus have distinctive control on regional gas distribution. The results of applying this tight gas
classification for an actual basin show that correctly distinguishing these three kinds of tight gas reservoirs from each
other could contribute greatly to the exploration and development of tight gas reservoirs.
Percolation Mathematical Model for Stepped Horizontal Well in Multilayer
Fault Block Reservoir
Authors: Hong Liu , Jin Pang , Xuejun Chang , Xinan Yu , Xu Zhang
Published: April 2015

The percolation mechanism and regularity for stepped horizontal well in multi-layer complex fault block reservoir
are complex. A percolation mathematical model based on unsteady flow mathematical model is built up in this paper.
In the model, the reservoir couples with one horizontal well in sealed reservoir which perforates through mutually unconnected
formation. Laplace transform, Stehfest inversion and Conjugate gradient are used to solve the model. The pressure
distribution results of different time and production distribution results of different well section can be obtained. The
results of pressure drop and pressure drop derivative calculated by this model are close to the results calculated by the
Saphir software, and the agreement rate is 99%, which proves the model is of great reliability. Compared with Saphir
software, the capacity of horizontal section through multiple sand at the same time can be calculated, which is the advantage
of this model. It is not suitable for heterogeneous reservoir and the reservoir with supply boundary, which is the
limitation. A two-layer block fault reservoir has been used to carry out the field study through the model, simplifying the
irregular shape of reservoir for rectangular reservoir at first. Then a double-stage horizontal well is used to pass through
the upper layer and the lower layer orderly in this reservoir, the simulation calculation of the well can use the double-stage
horizontal well model, and the model can calculate the average pressure drop and pressure drop derivative of various production
phases in the bottom hole accurately .The reservoir flow stage and the flow time in different periods can be judged
through pressure drop and pressure drop derivative in the bottom hole, which can also calculate the distribution of production
along the horizontal section in different periods at the same time. It can provide theoretical foundation of reservoir research
engineering and production engineering design for reservoir development with stepped horizontal well in multilayer
complex fault block reservoir.
The Researching Mode Based on Generating Self-optimization of Global
Optimization
Authors: Zhigang Hua , Guangyu Hu , Zhigong Wu , Yongjie Zhai
Published: April 2015

A method of global optimizing power generation is introduced in this paper. Under the condition of maintaining
the same working hours of different units, electricity quantity generated between the different power suppliers is equal
in one province, and it is also fulfilling the primary electricity schedule with a secure stable power system and low emission.
This method is capable of minimizing resource consumption and emission while satisfying the power requirement by
independently adjusting electricity generating units internally to optimum. Therefore, it is an important and effective way
to promote energy saving in power generating and controlling.
An Experimental Study of Velocity-Saturation Relationships in Volcanic
Rocks
Authors: Liu Zhidi , Zhao Jingzhou
Published: April 2015

In this paper, experiments are carried out under different pressures and water saturations using core samples of
volcanic rocks from the Junggar Basin in China to understand how water saturation affects P- and S-wave velocities. The
results show that water saturated rocks exhibit significantly higher P- and S-wave velocities than gas saturated rocks. In
addition, the P- and S-wave velocity ratio declines with increasing water saturation. Furthermore, a P- and S-wave velocity
ratio vs. resistivity cross plot is created to identify gas reservoirs in the volcanic rocks in the Junggar Basin.
Current Candidate Genes as Biomarkers for Major Depressive Disorders: A Review of Current Approaches and Findings With Respect to Ethnicity
Authors: Nair Shanta , Nair C.H. , Moochhala Shabbir
Published: April 2015

Major Depressive Disorder (MDD) currently affects people worldwide. Despite its multi-faceted origins and symptoms, and its myriad manifestations and outcomes, work is underway to understand the root causes of the disorder. Genetic studies, in particular, have focused on finding candidate genes for MDD, and investigating links between these genes and any particular group of people. It is hoped that these studies may shed light on the types of people that are commonly affected, and what factors make a person more or less vulnerable to depressive disorders. Multiple factors have been considered, including socioeconomic status, urban versus rural environments, ethnicity, lifestyle factors such as substance abuse and both pre- and post-natal early traumas. Through various methods, including network analyses and bioinformatics among others, significant links have been found between socioeconomic status, urban living, and MDD. Moreover, epigenetic links have been discovered between the prevalence of MDD and the prevalence of other diseases such as cardiovascular disease and other forms of mental illness, making it clear that environment plays a key role in overall health and wellbeing. While no statistically significant link between ethnicity and MDD has been found in candidate genes thus far despite certain ethnicity-based polymorphisms influencing clinical outcomes with different treatments, it is much more apparent that urban environments and early stress contribute to the prevalence of MDD.
BOOK REVIEW: Environmental Zeolites and Aqueous Media: Examples on Practical Solutions
Authors: Hu Jin-Li
Published: April 2015

Full text available.
Home Blood Pressure Measurement in the Morning Related to Cancer in
Patients with Type 2 Diabetes Mellitus: 10 Years-Term Results of a Longitudinal
Study and Cancer
Authors: Kamoi Kyuzi
Published: April 2015

Previous longitudinal studies have demonstrated that blood pressure measurements at home (HBP) in the wakening-
up display stronger predictive power for death, and vascular complications in patients with type 2 diabetes mellitus
(T2DM) than clinic blood pressure measurements (CBP). The leading cause of death was cancer. Patients with T2DM
have associated with cancer, and high CBP is a risk factor for cancer. Therefore, this study investigated whether HBP
or CBP is related to cancer event in patients with T2DM for 10 years. At baseline, 400 Japanese patients with T2DM
were classified as hypertensive (HT) or normotensive (NT) based on HBP and CBP. Mean (± SD) duration was 95 ± 35
months. Primary and secondary endpoints were death and cancer, respectively. Differences in outcome between HT and
NT were analyzed using survival curves from Kaplan-Meier analysis and log-rank testing. Associated risk factors were
assessed using Cox proportional hazards. On basis of HBP, death and event of cancer were significantly higher in HT than
in NT. The leading cause of death was cancer. On basis of CBP, there was no significant difference in the incidence of
death and event of cancer between patients with HT and NT at baseline. Associated risk factor for cancer was T2DM.
Home morning HT may be reflected more keenly state of cancer than clinic HT, which may be superior to clinic NT.
When we meet with such patients, it is important that cancer may be one of many causes for morning HT in Japanese patients
with T2DM.
A Comparison of Office Blood Pressure, Telemedical Home Blood Pressure
and Ambulatory Blood Pressure Monitoring
Authors: Hoffmann-Petersen Nikolai , Pedersen Erling B.
Published: April 2015

Background:

Telemonitoring of home blood pressure (HBP) is a new advance in blood pressure monitoring.
The aim of this study was to compare office blood pressure (OBP) and telemedical home blood pressure with daytime
ambulatory blood pressure (ABP).

Methods:

One hundred and two patients were recruited consecutively from our Renal
Outpatients’ Clinic. Office blood pressure was measured three times with the HBP equipment (A&D UA-767Plus BT).
Telemonitoring of HBP was done for four consecutive days with three measurements three times daily followed by ABP
(A&D TM-2430) on the next day. All patients received a questionnaire regarding acceptance of the equipment.

Results:

OBP was a significantly higher than daytime ABP (systolic/diastolic, 3.3/3.8 mmHg). HBP was significantly lower than
daytime ABP (systolic/diastolic, -4.6/-1.6 mmHg). The strongest correlations were seen between all HBP readings day 2-4
and daytime ABP (systolic, r=0.69, p<0.001; diastolic, r=0.61, p<0.001). There were no significant differences between
the different HBP schedules, i.e. 3 measurements twice daily for 3 days and 3 measurements three times daily for 4 days.
Patients were content with and accepted the HBP measuring device.

Conclusion:

The telemedical HBP was lower than
daytime ABP. The observed difference could possible be due to less pain and more relaxation during HBP measurements
or a systematic difference in the algoritms between the blood pressure measuring devices. HBP measurement during three
days was as good as measurement during 4 days.. The equipment was well accepted among patients.
Immunohistochemical expression of p16ink4a in inflammatory, preneoplastic and neoplastic cervical lesions
Authors: Gajanin Radoslav , Gajanin Zivorad , Vujkovic Zoran , Gajanin Vesna , Gojkovic Zdenka , Ljubojevic Vesna
Published: April 2015

Introduction. High-risk human papilloma viruses play a main role in the
development of cervical dysplasias and carcinomas. p16INK4a can be considered
as a surrogate marker of active highrisk human papillomaviruses infection in
dysplastic and neoplastic cells of the cervix. This study was aimed at
determining the presence and level of p16INK4a expression in inflammatory,
preneoplastic and neoplastic lesions of the cervix. Material and Methods. The
study was performed on 109 samples of cervical biopsy. Cervical cancer was
diagnosed in 36 patients, 34 patients had a preneoplastic change (dysplasia)
in stratified squamous cervix epithelium and a nonspecific inflammatory
process was found in 39 patients. In all samples, immunohistochemical
analysis using antibodies to p16INK4a was performed. Results. The expression
of p16INK4a was verified in all cases of cervical cancer (100%), in 67.65% of
dysplastic cervical lesions and in 38.5% of inflammatory lesions. A
statistically highly significant difference was found in the presence and
level of expression among neoplasic, dysplastic and inflammatory lesions of
the cervix (?? = 76.02, p < 0.001). The expression was more frequent and had
a higher level in neoplastic and high grade dysplastic lesions compared to
expression in inflammatory lesions and low grade dysplasias. Conclusion. The
analysis of the presence of p16INK4a can differentiate non-neoplastic, high
grade preneoplastic and neoplastic changes of the cervix. The use of p16INK4a
in interpreting borderline lesions of the cervix can enable a rational
therapeutic treatment of patients.
From aneurysmal bone cyst to telangiectatic osteosarcoma with metastasis in inguinal lymph nodes: Case report
Authors: Janevska Vesna , Spasevska Liljana , Samardziski Milan , Nikodinovska Violeta , Zhivadinovik Julija , Trajkovska Elizabeta
Published: April 2015

Introduction. Aneurysmal bone cyst is a benign bone lesion composed of blood
filled cystic cavities lined by fibrous septa. Its malignant transformation
of is a rare event. Case report. We report a case of a lesion in the second
metatarsal bone in a 29-year-old male, presented as a slight swelling of the
right foot. After the curettage had been done, the diagnosis of aneurysmal
bone cyst was made but the recurrence occurred 4 years later. The biopsy of
the recurrent tumor showed compact neoplastic tissue consistent with
diagnosis of giant cell tumor with malignancy. The malignant component was
recognized as a high grade sarcoma with osteoid production. A tumor mass with
the whole II metatarsal bone was extirpated and a resected part of fibula was
transplanted. A year later, another recurrence occurred, an amputation was
performed and a teleangiectatic osteosarcoma with ingvinal lymph nodes
metastases was diagnosed. No other tumor mass was confirmed, either
clinically or by imaging techniques at the time of his third operation. He
died 4 months later with multiple pulmonary metastases. Conclusion. We
emphasize the importance of team work in order to achieve the accurate
diagnosis, highlighting careful radiological examinations, good sampling and
awareness of unusual cases in bone tumor pathology.
Pyoderma gangrenosum in burned patient: Case report
Authors: Obradovic-Tomasev Milana , Jovanovic Mladen , Popovic Aleksandra
Published: April 2015

Introduction. Pyoderma gangrenosum is a rare, chronic, destructive,
ulcerating skin disease of uncertain etiology. It develops most frequently in
patients between 25-45 years of age and affects both sexes equally. Case
report. We present a case of pyoderma gangrenosum in a young female patient
who sustained a burn injury of 40% total body surface area. She underwent
four operations. She developed a wound infection and urinary infection during
her hospital stay. By the end of hospitalization, the papules followed with
coalesce of ulcerations formed on the previously epithelized areas of her
legs. The patient complained of the intensive pain localized on these
surfaces. Since pyoderma gangrenosum was suspected, a dermatologist was
included in treatment. Therapy was initiated (methylprednisolone 60 mg per
day intravenously) with gradual reduction of the dosage. The patient was
discharged from hospital two weeks later with almost fully complete
cicatrization and epithelization. Conclusion. Pyoderma gangrenosum is still
difficult to be diagnosed in the absence of specific and sensitive diagnostic
methods; however, it is crucial to be suspected as early as possible and to
start treatment immediately. Multidisciplinary approach is essential for
optimal results.
Definite management of bilateral lower leg nonunion fractures by Ilizarov apparatus in polytraumatized patient: Case report
Authors: Lalic Ivica , Obradovic Mirko , Lukic-Sarkanovic Mirka , Djan Vladimir
Published: April 2015

Introduction. Nonunion of long bones may often be associated with significant
function loss of affected extremity, joint stiffness, and even extremity
amputation or systemic manifestations in the case of infection. The aim of
this case report is to highlight the possibilities of Ilizarov apparatus in
the treatment of fracture nonunions of both lower legs treated by different
operative methods and to show that it is not necessary to remove
osteosynthetic material (intramedullary nail) in every case when nonunion
occurs to achieve its recovery. Case Report. A 62 year-old man was injured in
a traffic accident as a pedestrian in April 2012, when he experienced
polytrauma, including shaft fracture of the right femur, and segmental open
fractures of the right (Gustillo-Anderson grade I) and left
(Gustillo-Anderson grade II) lower leg. The fractures of right femur and
right tibia were stabilized initially with intramedullary nails, while the
left lower leg fracture was treated by unilateral external fixator. After 5
months, there were no clinical and radiographic signs of union on lower legs,
therefore the patient underwent re-surgery. Ilizarov apparatus was applied on
both lower legs. The patient was early verticalized and both apparatus were
removed after 4 months. According to the modified protocol of the Association
for the Study and Application of Methods of Ilizarov, the lower leg bony
results were good and excellent, and the functional results were excellent on
both sides. Conclusion. Nonunion fracture of the right lower leg initially
treated by the method of intramedullary osteosynthesis and afterwards by
placing Ilizarov apparatus shows that in some cases it is not indicated to
remove fixative material in order to achieve full recovery of fracture, thus
eliminating the danger of all negative effects resulting from the classical
extensive surgical treatment.
Manipulative Environmental Disclosure: Further Analysis of Corporate Projections of Environmental Capital Spending
Authors: Chen Jason C. , Chen Jennifer C. , Patten Dennis M.
Published: April 2015

Following Patten (2005), we focus on corporate disclosure of environmental capital expenditure projections and spending, and address two separate issues related to the corporate use of manipulative disclosure. First, we investigate whether potential increases in oversight and accountability due to the passage of the Sarbanes-Oxley Act (SOX) in 2002 and the issuance of the Governmental Accountability Office's (GAO 2004) report on its investigation of corporate environmental disclosure may have induced firms to be less egregious in their use of overspending projections. Second, given the flexibility in the disclosure requirements, we explore whether, within the sample of companies providing projections of environmental capital spending, greater legitimacy exposures are associated with differences in the use of language within the disclosures. We find, first, that while the incidence and severity of over-projections of environmental capital spending decreased following the GAO (2004) report, the change was only temporary. Second, we document that companies with greater legitimacy exposures (based on firm size and environmental performance) are more likely to include more specific wording about the nature of the expenditures. However, we also find that the use of the more specific language is associated with a greater likelihood of having overstated projections, although we find no statistically significant differences in the average error amounts relative to firms with only vague language disclosure. We argue that these results suggest that the language specificity is, thus, being used in an attempt to enhance credibility via word choice, as opposed to being about improved transparency and accountability. Thus, making corporate environmental disclosure more meaningful would appear to require more specific standards on what, and how, information is provided.
Effects of Dietary n-3 Fatty Acids on Hepatic and Peripheral Insulin Sensitivity in Insulin-Resistant Humans
Authors: Lalia Antigoni Z. , Johnson Matthew L. , Jensen Michael D. , Hames Kazanna C. , Port John D. , Lanza Ian R.
Published: April 2015

OBJECTIVE

Dietary n-3 polyunsaturated fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), prevent insulin resistance and stimulate mitochondrial biogenesis in rodents, but the findings of translational studies in humans are thus far ambiguous. The aim of this study was to evaluate the influence of EPA and DHA on insulin sensitivity, insulin secretion, and muscle mitochondrial function in insulin-resistant, nondiabetic humans using a robust study design and gold-standard measurements.

RESEARCH DESIGN AND METHODS

Thirty-one insulin-resistant adults received 3.9 g/day EPA+DHA or placebo for 6 months in a randomized double-blind study. Hyperinsulinemic-euglycemic clamp with somatostatin was used to assess hepatic and peripheral insulin sensitivity. Postprandial glucose disposal and insulin secretion were measured after a meal. Measurements were performed at baseline and after 6 months of treatment. Abdominal fat distribution was evaluated by MRI. Muscle oxidative capacity was measured in isolated mitochondria using high-resolution respirometry and noninvasively by magnetic resonance spectroscopy.

RESULTS

Compared with placebo, EPA+DHA did not alter peripheral insulin sensitivity, postprandial glucose disposal, or insulin secretion. Hepatic insulin sensitivity, determined from the suppression of endogenous glucose production by insulin, exhibited a small but significant improvement with EPA+DHA compared with placebo. Muscle mitochondrial function was unchanged by EPA+DHA or placebo.

CONCLUSIONS

This study demonstrates that dietary EPA+DHA does not improve peripheral glucose disposal, insulin secretion, or skeletal muscle mitochondrial function in insulin-resistant nondiabetic humans. There was a modest improvement in hepatic insulin sensitivity with EPA+DHA, but this was not associated with any improvements in clinically meaningful outcomes.
Late arrhythmia in patients with repaired tetralogy of Fallot: who is at risk?
Authors: Grigaliūnas Gytis , Gumbienė Lina , Valevičienė Nomeda , Matačiūnas Mindaugas , Tarutis Virgilijus , Marinskis Germanas , Aidietis Audrius
Published: April 2015

Tetralogy of Fallot (TOF) is the most common cause of cyanotic congenital heart defect. Over the last century, the life expectancy of TOF patients has significantly improved. This, however, has brought new challenges both to patients and their health-care providers, the main of them being late arrhythmia. Ironically, late arrhythmia is predominantly generated due to the fibrotic scars caused by the life-saving surgical repair. Once the first two mainly arrhythmia-free decades after the repair pass, the risk of developing late arrhythmia and, therefore, SCD becomes substantial. Consequently, young adults with repaired Tetralogy of Fallot (rTOF) require careful outpatient monitoring.

There have been many attempts to predict the risk of life-threatening arrhythmia in rTOF patients. This has led to the defining of various risk factors, ranging from the widely used QRS prolongation to novel predictors, derived from cardiac magnetic resonance (CMR) based anatomical findings (left ventricular dyssynchrony indexes, right ventricular output tract akinetic length, right ventricular mass-to-volume ratio). The latter predictors have recently established CMR as a tool of high significance in evaluation of rTOF patients.

Although the role of Holter monitoring findings in rTOF patient-assessment remains unclear, it may be useful in those who are 25 years and older. Implantable cardioverter–defibrillator (ICD) implantation is the first-line treatment for secondary prevention of sudden cardiac death (SCD). rTOF patients suffer from the highest rate of inappropriate and the lowest rate of appropriate ICD shocks, when compared to other congenital heart diseases. As a consequence, ICD implantation for primary SCD prevention should be carefully weighed. Catheter-based ablation therapy leads to high rate of initial success when abolishing monomorphic ventricular tachycardia and intra-atrial reentrant tachycardia, however recurrence rates remain high.
Collodion Baby - a Case Report
Authors: Stojanović Vesna , Doronjski Aleksandra , Spasojević Slobodan , Stašuk Nataša , Radulović Anica
Published: April 2015

Colloidon baby describes a highly characteristic clinical entity in newborns encased in a yellowish translucent membrane resembling collodion. In most cases the condition either precedes the development of one of a variety of ichthyoses, the commonest of which are lamellar ichthyosis and non-bullous ichthyosiform erythroderma, or occasionally represents an initial phase of other ichthyoses such as ichthyosis vulgaris. In at least 10% of all cases of collodion baby, the condition is followed by a mild ichthyosis of lamellar type, so mild as to be considered more or less normal, so-called self-healing collodion baby or ‘lamellar ichthyosis of the newborn’. In this report we present a rare case of collodion baby in whom, after collodion membrane peeled-off, the skin retained normal appearance.
A Retrospective Study of Peanut and Tree Nut Allergy: Sensitization and Correlations with Clinical Manifestations
Authors: Yang Lihua , Clements Stacy , Joks Rauno
Published: April 2015

Peanut (PN) and tree nut (TN) allergies are among the leading causes of fatal food-induced anaphylaxis and are increasing in prevalence, especially in children. Their cosensitization and concurrent clinical allergy have been understudied. This retrospective study investigated the correlation between PN and TN allergy, both in terms of in vitro sensitization (IVS) and clinical allergic manifestations. We conducted a retrospective medical record review at the Allergy Clinic at University Hospital of Brooklyn. Fourteen hundred six charts were reviewed, of which 76 (5.4%) had documented relevant clinical allergy: PN allergy but not TN allergy (n = 29) or TN allergy but not PN allergy (n = 11) or both (n = 30). Six patients with PN allergy but no TN exposure history were not included in the analysis. The majority of patients (67/76, 88.1%) had a concurrent history of asthma, rhinoconjunctivitis, or AD. Sensitivity of TN IVS predicting PN IVS was 38/39 (97%). Similarly, sensitivity of PN IVS predicting TN IVS was 38/42 (91%). Sensitivity of TN clinical allergy predicting PN allergy was 30/59 (51%). Sensitivity of PN clinical allergy predicting TN allergy was 30/41 (73%). The total number of organ systems involved in reported clinical reactions correlated with IVS to TN (p = 0.004) but not IVS to PN (p = 0.983). In summary, we found PN sensitization predicts TN sensitization in vitro, with lower predictability for clinical reactions.
Practical Recommendations for Mixing Allergy Immunotherapy Extracts
Authors: Daigle Barbara J. , Rekkerth Donna J.
Published: April 2015

Critical aspects of formulating allergy immunotherapy vaccines include the selection, total number, and proportions of each allergen component in therapeutic mixtures. The immunotherapy prescription, determined by a medical provider, details the dosing and schedule for treatment as well as the specific composition of the treatment vials. Allergen extracts are composed of many components such as proteins, glycoproteins, and proteases. Some components in allergen extracts are cross-reactive, meaning that treatment with an extract from one species may confer partial protection against a triggering allergen from another species. Conversely, some allergen extracts are incompatible with other extracts when combined in a mixture for treatment, resulting in lowered therapeutic potential for the patient. Therefore, knowledge of allergen extract cross-reactivities and incompatibilities guides the preparation of subcutaneous immunotherapy prescriptions. In a clinical setting, an understanding of what can and can not be mixed is one critical element in improving treatment outcomes.
Monitor Height Ergonomics: A Comparison of Operating Room Video Display Terminals
Authors: Kelts Gregory I. , McMains Kevin C. , Chen Phillip G. , Weitzel Erik K.
Published: April 2015

A surgeon's eyes should be positioned 1 meter (m) distant and no more than 15° below the top of an operating monitor (0.27 m). We sought to determine which operating room video display terminal can best accommodate ergonomically optimized gaze during surgery. Floor to eye height was measured for surgeons in seated, perched, and standing positions. These ranges were then compared to vertical displacement ranges for monitors measured from floor to top of the screen. Eye height was measured for standing (1.56 −1.80 m), perched (1.40 −1.65 m), and seated (1.10 −1.32 m) positions. The minimum distance (min) between the floor and the top of the monitor and the vertical mobility range (VR) of the monitor were measured throughout a tertiary medical center including towers with boom arms (TcB) (min: 1.58 m, VR: 0.37 m), towers without booms (TsB) (min: 1.82 m, VR: 0.025 m), ceiling mounted booms (CMB) (min: 1.34 m:, VR: 1.04 m), and portable monitors (PM) (min: 1.73 m, VR: 0.04 m). The tangent of 15° declination was used to calculate a correction factor to determine the minimum optimal ergonomic display height. The correction factor was subtracted from the eye height at each position to determine the lowest target height and the highest target floor to eye distance for each position. Analysis of variance with least significant difference post hoc testing identified all minimum distances and vertical ranges to be statistically different (p < 0.001). Monitor vertical displacement varied between styles of carts. CMB video display terminal systems can accommodate standing, perched and the tallest seated surgeons. TcB, TsB and PM systems cannot adequately accommodate all standing, perched or seated surgeons.
Outbreak of bloodstream infection with extendedspectrum ß-lactamase-producing Klebsiella pneumoniae at a Teaching Hospital
Authors: Senanayake NP , Karunanayake L
Published: April 2015

Introduction: Klebsiella pneumoniae (K. pneumoniae) is an important hospital-acquired pathogen causing severe infections in neonatal units. Several outbreaks of infection caused by multi-drug-resistant K. pneumoniae isolates have been widely reported among neonates. The aim is to investigate an outbreak of blood stream infection caused by Extended-Spectrum ß-Lactamases (ESBL) producing K.pneumoniae in a Neonatal Intensive Care Unit (NICU) at Teaching Hospital Kandy, Sri Lanka. Materials and Methods: Blood culture samples were collected from the neonates on admission to the NICU and 2 to 3 days later on clinical suspicion of blood stream infection. The blood culture samples were processed according to the standard methods and the antibiotic susceptibility tests were carried out as per Clinical Laboratory Standards Institute (CLSI) guidelines. Results: Of the 140 blood cultures 36 were identified as Extended-Spectrum ß-Lactamases (ESBL) producing K.pneumoniae. All the isolates were susceptible to ciprofloxacin, amikacin, netilmicin, imipenem and meropenem. Twenty eight of the 36 patients responded to treatment with a combination of amikacin and meropenem. Conclusion: ESBL producing K.pneumoniae was responsible for this outbreak at the NICU. Knowing the susceptibility patterns of clinical isolates will allow the rational use of antibiotics, which is important in the treatment of infections with multi-drugresistant bacteria. J Nepal Paediatr Soc 2014;34(3):230-232 DOI: http://dx.doi.org/10.3126/jnps.v34i3.10459
Status Epilepticus Due to Organophosphate Poisoning in an Infant
Authors: Parmar PN
Published: April 2015

We report a case of a three months old female presented with status epilepticus who was diagnosed as organophosphate (OP) poisoning. She was from rural area with agricultural background. Typical clinical features and history of exposure to organophosphate compound were absent. The infant was successfully treated with atropine, pralidoxime and supportive management. Safety and efficacy data of pralidoxime in infants are limited in literature and was found safe in our case. J Nepal Paediatr Soc 2014;34(3):247-249 DOI: http://dx.doi.org/10.3126/jnps.v34i3.10497