bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Design Method for Making Composite of (PMMA/HA/Sericin)
Authors: Tontowi Alva Edy , Raharjo Kristiani P. , Sihaloho Ray I. , Baroroh Dawi K.
Published: July 2017

Biomaterial components (PMMA/HA/Sericin) are composite biomaterial that have complemented each other, which HA is able to improve the mechanical properties, biocompatible and osteoconductivity. PMMA has the ability biocompatible with human tissue and easy manipulated, while sericin can improve cell viability. Analysis of the composite composition is important to do more in depth, but the design method in the analysis of research also has significant impact in generating research output and prediction output. Analysis of the design method to determine the method of designing the optimal research was needed. This research used 3 factors: Poly methyl methacrylate (PMMA) powder (with concentration of 40% to 60%), Hydroxyapatite (HA) powder (with concentration of 10% to 25%) and Sericin (with concentration of 0.16% to 0.32%). This research is done to identify the effect of individual components of the composite and analyze the design method to obtain the best of diametral tensile strength (DTS) with a small error. The result of two methods was found that the 2k factorial design method give higher DTS (PHS401032 = 25.49MPa) than that of Taguchi method (PHS601532 = 24.82MPa). The error of 2k Factorial design method between validation and model prediction is 0.27%, which smaller than Taguchi method (7.45%).
Increasing Yield Strength of AISI 316L Plastically Deformed by Expanded Hole Techniques
Authors: Salim Urip Agus , Suyitno Suyitno , Magetsari Rahadyan , Mahardika Muslim
Published: July 2017

AISI 316L has been used to produce implant plates such as dynamic copmresion plates (DCP). The implant plates might experienced failure due to either suffer higher stresses exceeding the allowable maximum strenght or presents small crack growing through fatigue mechanism. Most of DCP fractures occured at the gliding holes region. This study conducted improving strength of DCP locally on the gliding holes. Strengthening on the gliding holes of DCP was performed by cold working method involving plastically deformation using an expanded hole technique. This study was conducted by both experimental and numerical simulation. Increasing strength locally on the gliding hole region was evaluated by measuring some parameters incorporated with strain hardening mechanism such as hardness and residual stresses. Increasing yields strength locally on the hole region was estimated by Takakuwa’s formulas. By this method, yields strength of the gliding hole of DCP made of AISI 316L increased from 325 MPa to be 600−1050 MPa.
Initial patterns of unilateral great saphenous vein reflux in women with telangiectasias and varicose veins
Authors: Engelhorn Carlos A. , Engelhorn Ana Luiza D.V. , Salles-Cunha Sergio X. , Terna Patricia R. , Kovalski Karine D. , Parizotto Thaina V.
Published: July 2017

Telangiectasias and varicose veins have been linked to chronic venous valvular insufficiency causing great saphenous vein (GSV) reflux. GSV diameter-reflux correlations were determined in women C1 and/or C2 and unilateral GSV reflux. Subgroups were: i) bilateral C1/C1 (n=106) and ii) refluxing GSV C2/contralateral nonrefluxing C1 or C2 (n=50). GSV included saphenofemoral junction (SFJ), GSV, and major veins in and out of the saphenous compartment at knee and calf. Prevalence and diameters were compared by Chi-square and paired t-test. Reflux prevalence at junction, thigh and calf were 5%, 26% and 71% of 106 refluxing C1 extremities, and 18%, 44% and 72% of 50 refluxing C2 extremities (P=0.007, 0.03, 0.87). Significant diameter increase compared to contralateral nonrefluxing segment (P<0.05) were at: C2 junction, 7.9±1.8 vs 6.6±1.5 mm, and C2 mid-thigh, junction refluxing or not, 4.8±1.1 vs 3.6±1.0 or 4.1±0.8 vs 3.6±0.7 mm. Calf GSV diameters averaged 2.5 to 2.7 mm if reflux was below-knee. Unilateral reflux occurred in calf veins without correlation to diameter. Enlarged diameters were noted in refluxing SFJ and thigh GSV of women with varicose veins.
The relationship of helicobacter pylori and dental plaques with gastric dyspepsia
Authors: Yacoubi Amel , Hassan Mohammad , Almogbel Ebtehal , Makhrelouf Leila , Bouziane Djamila , Saleh Ahmed
Published: July 2017

Introduction: Helicobacter pylori (H. pylori) is a pathogen which is capable of colonizing the gastric mucosa and is associated with some pathological changes that may lead to dyspeptic manifestations. Recently, H. pylori was found to be present in the oral cavity and there was a growing body of evidence that the organism is linked to some dental diseases such as periodontitis and gingivitis. Materials and Method: In this study, 123 patients were investigated to explore the possible relationship between the presence of oral H. pylori and gastric dyspepsia. Patients were classified into oral disease group (viz. gingivitis and periodontitis) or gastric disease group (viz. gastritis, gastric ulcer, and duodenal ulcer). A third group had neither had oral nor gastric disease. Based on the presence or absence of H. pylori, patients were also classified as having either oral, gastric, or both oral and gastric organism. Some of the patients were neither having oral nor gastric infection. Results: 59 patients showed the presence of H. pylori in the gastro-duodenal area, 7 showed presence of oral H. pylori, whereas 18 patients showed H. pylori in both gastro- duodenal and oral specimens. Differences between groups were not statistically significant. Conclusions: Although there was a suggestion of a clinical and laboratory evidence of an association between the presence of oral H. pylori and the studied gastric diseases, this association was not statistically significant.
Hematological profile of patients with type 2 diabetic mellitus in El-Beida, Libya
Authors: Al Salhen Khaled , Mahmoud Ameerah
Published: July 2017

Objectives: The objective of this study is to help identify the hematological profile of patients with diabetes Settings: The study was conducted at El-Beida Hospital, El-Beida City, Libya. Subjects and Methods: The study subjects selected for this study consist of 103 Libyan type 2 diabetic patients (79 males + 24 females) and 39 healthy non-diabetic subjects (29 males and 10 females) acted as controls. They were matched for age (56.1 ± 7.8 years vs. 55.0 ± 6.3 years. The hematocrit value (HCT), hemoglobin content, red blood cells count (RBCs) and mean corpuscular volume (MCV) concentration with increased white blood cells counts (WBCs), mean erythrocyte hemoglobin concentration (MCHC), mean corpuscular hemoglobin (MCH), lymphocytes and neutrophils levels were performed. Results: Hematological studies in the diabetic patients showed significantly lower HCT values, hemoglobin content, RBCs count and MCV concentration than in the controls. Greater total WBC counts, MCHC concentrations, MCH, lymphocytes and neutrophils counts were observed in the patients than in the controls. No differences were found between platelets counts in the diabetic patients and the control. Conclusions: Significant aberrations in some hematological parameters associated with carbohydrate, protein and lipid metabolisms was identified in this selected group of people with diabetes.
Histopathologic identification and pattern recognition of common viral infections in the general pathology practice: An illustrated review
Authors: Yazigi Flora , Kahwash Basil , Al Sufiani Fahd , Conces Miriam , Prasad Vinay , Kahwash Samir
Published: July 2017

Pattern recognition and cytologic features remain essential diagnostic tools in pathology. Viral cytopathic effect may be the first clue to a diagnosis of a viral infection. This paper aims to provide a brief illustrated summary of the histopathologic changes caused by commonly encountered and rare viruses. The list of viruses discussed with characteristic viral inclusions or distinctive cytopathic effect includes cytomegalovirus, adenovirus, herpes virus (herpes simplex virus and varicella zoster virus), human papillomavirus, respiratory syncytial virus, parvovirus, poxvirus (molluscum contagiosum virus), and polyoma virus (JC virus and BK virus). Also reviewed are the characteristic histologic and cytopathic changes for Epstein-Barr virus (EBV), Paramyxoviruses (human parainfluenza virus and measles virus), human immunodeficiency virus (HIV), and hepatitis B virus.
Biomedical research productivity in dentistry and oral medicine from Libya: A bibliometric analysis
Authors: Ahmed Rahma
Published: July 2017

Biomedical research productivity from under developed regions and low income countries are generally low. This has been attributed to multiple reasons even in those relatively rich countries such as Libya. The volume and trends of biomedical publication productivity in the oral medicine and dentistry from Libya was investigated using “PubMed” database with a focus contributions from on Libyan academic institutions. A low quantity and quality of dental and oral research productivity was detected in Libya not matching the wealth of this small nation. Poor distribution of this productivity throughout the geographical landscape of Libya was also evident. Libyan biomedical research infrastructure requires reforms and funding.
Impact of Socializing, Fasting and Feasting on Day to Day Blood Glucose Profiles in Diabetes Elucidated by the FreeStyle® Libre™ System
Authors: Beshyah Salem , Haddad Marcil
Published: July 2017

Background: Total day-time fasting is observed by millions of adult Muslims during the whole lunar month of Ramadan. However, many people, particularly elderly men and women, do fast isolated or somehow consistent days outside Ramadan. This may pose clinical management challenges. Case Report: A case of an elderly diabetic man observing day-time Ramadan-type fasting on Mondays and Thursdays throughout the year is described. Detailed blood glucose (BG) profiles over a 10 week period were captured using the FreeStyle® Libre™ Flash glucose monitoring system. Detailed study of these profiles revealed three distinctly different BG patterns every week. One pattern on the two fasting days (Mondays and Thursdays) with blood glucose peaking after dawn and after sunset with a downward trend throughout the day. A second pattern on Fridays with the BG levels that peak and remain high for a few hours in the early afternoon following the large and rich weekly family meal. The third pattern was seen on the remaining 4 non-fasting days where BG starts to rise in the midmorning reflecting the patient's life style of hosting and sharing with his business clients. Such detailed and visually presented information gave insights into his BG daily patterns enabling his therapeutic plans for hyperglycemia to be tailored on daily basis. Conclusions: This is the first documentation of glucose profiles during “Ramadan-type fasting” and feasting using the flash glucose monitoring system. In addition to detailed clinical and social history, use of medical technology may occasionally help resolve some difficult blood glucose patterns.
First Libyan experience with insulin pump therapy: Impact on glycemic control and patients satisfaction
Authors: BenRajab Faten , Alghazair Nadia , Hamed Wesal , Adala Nour , Gregni Nadia
Published: July 2017

Background: The mainstay of contemporary management of type 1 diabetes mellitus (T1DM) is “physiological insulin replacement”. Regimens based on multiple daily injections (MDI) of insulin improve glycemic control and increase the frequency of hypoglycemia. Insulin pump therapy also improves glycemic control, and reduces the within-day and between-day glycemic variability that is seen with insulin injections. Objectives: We aimed to evaluate out first experience with insulin pump therapy by 1) assessing the glycemic control on insulin pump therapy compared to MDI based therapy and 2) to learn the attitude of patients and families towards the use of insulin pump. Patients and Methods: A prospective observational study involving 37 patients who used insulin pump between March & November 2013. Patients were selected according to certain criteria set up by treating physician. Data collected included demographic, clinical and biochemical data before, during and after insulin pump therapy use. Severe hypoglycemia requiring hospital management and diabetic ketoacidosis (DKA) were documented. Health-related quality of life, diabetes knowledge and patient's attitude towards pump therapy were captured before and after pump use. Outcome measures: Change HbA1c, occurrence of severe hypoglycemia and DKA. Change of body mass index (BMI) and difference in score results of health quality questionnaire. Results: 51.4% were males; mean age was 15 years (86.5% of them were between 2 and 22 years. About 94.4% had diabetes for a mean of 6.9 (range 1-14) years. The indications of insulin pump were high HbA1c (29.7%), wide variation of blood glucose (10.8%), severe hypoglycemia and/or hypoglycemic unawareness (18.9%), recurrent DKA (5.4%) and other indications (8.1%). However, 27.0% had a good metabolic control but multiple daily injections (MDI) was reportedly “compromising” their quality of life. The mean HbA1c level decreased from 9.1% to 7.4% (P = 0.001). The mean BMI increased from 21.2 to 22.0 kg/m2 (P=0.026) independent of age (r = 0.180, P = 0.295). Two episodes of DKA in one patient who had severe contact dermatitis at the site of cannula & sensor and one severe hypoglycemia, which required hospital admission due to unmatched carbohydrate intake to insulin dose due to incorrect carbohydrate counting. The health quality questionnaire scores revealed an improvement from 34.2 to 46.7 (P = 0.001). Conclusions: Our first experience with insulin pump therapy was positive in terms of achieving and maintaining good glycemic control in most of patients, it for more contact between patients and health providers and created better opportunities for diabetes education and support.
Mixed medullary-follicular thyroid cancer treated with surgery and radioiodine ablation: An illustrative case
Authors: Bashier Alaaeldin , Abdulrahim Manal , Dawood Shaheena , Rashid Fauzia , Alawadi Fatheya
Published: July 2017

Introduction: Differentiated thyroid cancer is the commonest cancer affecting thyroid gland. Medullary thyroid carcinoma (MTC) constitutes only 2-8% of all thyroid cancers. Simultaneous occurrence of mixed medullary and follicular thyroid carcinoma (mixed MTCFTC) is rare. This may pose challenges in diagnosis, treatment, follow up and future prediction of prognosis. Case presentation: A 24 -year-old female presented with a neck swelling that increased in size over 2 months period. She was clinically and biochemically euthyroid. Thyroid Technetium Pertechnetate (99mTcO4) scan showed a cold nodule in the right lobe and ultrasound thyroid confirmed the presence of hypo-echoic well defined lesion. Fine needle aspiration biopsy (FNAB) revealed a medullary thyroid cancer. She underwent total thyroidectomy and lymph node dissection. The histopathology showed a solitary tumor with mixed features, predominantly medullary with areas of follicular architecture, confirmed by immunohistochemical staining as mixed MTC-FTC. Work up for MEN II and RET-proto-oncogen was negative. Postoperative isotope scan showed an increased uptake in the remnant thyroid tissue. She was treated with adjuvant radioactive iodine therapy. Her initial calcitonin level post operatively was 13.4 pg/ml (NR < 5.0), CEA 36 ng/ml (NR <3.8), and thyroglobulin was 0.7 ng/ml (NR <1). On follow up visits, the thyroglobulin as well as calcitonin and CEA levels were all suppressed. Conclusion: Cases of mixed follicular and medullary cancer present significant diagnostic and management challenges. Although we have managed our case surgically as well as by radioactive iodine and we are satisfied that follow up with calcitonin and thyroglobulin did not show any evidence of recurrence, we propose that mixed tumors be included in thyroid cancer management guidelines.
Smoking prevalence, attitudes and behaviors of primary healthcare providers and its impact on their smoking cessation counseling practices
Authors: Al Hosani Salama , Al Ali Maryam , Al-Marashda Khadija , Al-Shamsi Noura , Al-Ansari Thanaya , Al-Behandy Ammar , Darwish Ebtihal , Elhassan Amira
Published: July 2017

Background: Despite the great efforts done by the government, there has been an increase in the number of people adopting smoking habit, among them health care professionals. Objectives: The aims of this work are 1) to assess the attitudes, behaviors, and risk perceptions among primary health care providers in the ambulatory health services in Abu Dhabi towards smoking and 2) to assess the impact of their smoking status on their practices of smoking counseling. Rationale: The justification of the research was that it provides an understanding on the influence of the smoking behaviour of health care providers and their eventual service delivery especially counselling smoking patients. Subjects and Methods: Self-administered descriptive questionnaires were used to collect data. They were distributed to doctors and nurses who consented to participate and the filled questionnaires were collected in sealed envelopes. Out of 137 health care professionals who were approached, 122 responded (participation rate of 89 %). 47% were physicians and 53% were nurses. Results: The results showed that, among the studied group the rate of smoking was 8.3 % with influence from friends being cited as the greatest contributing factor. Cigarette smoking was used by the 87.5% of the participants and 25% used “Shisha”. Irrespective of its adverse effects, most of healthcare providers have a positive attitude towards smoking cessation policy. An inadequacy in training these personnel on how to counsel their patients with regard to smoking cessation. Conclusion: A pre-service as well as continuous smoking cessation training is needed in order to change the attitude of the primary health care providers and enhance their counselling techniques.
Second Arab Society for Pediatric Endocrinology and Diabetes Conference, 6th-8th November 2014, Abu Dhabi, United Arab Emirates
Authors: Deeb Asma , Tfayli Hala , Hassan Mona , Abusrewil Suliman , Al Khayyat Haya , Abdelrazzaq Dalia , Al Mutair Angham , Habeb Abdelhadi
Published: July 2017

The scientific program of the conference featured 62 oral and 84 poster presentations. Diabetes was the topic most heavily presented due to its widespread prevalence and unique features in our region. Milestones in diabetes care, diabetes education, epidemiology, updates in neonatal diabetes and hyperinsulinemic hypoglycemia as well as insulin resistance and type 2 diabetes mellitus were among the topics discussed by leading world-renown authorities as well as by regional experts. Diabetes technology was a particularly hot topic in the meeting featuring 2 symposia on the recent advances in artificial pancreas and regional experience with insulin pumps and continuous glucose monitoring systems. Experience pertinent to diabetes and fasting was elegantly presented by regional experts. The meeting also featured workshops dedicated to diabetes educators and stimulating discussions with behavioral psychologists. Growth disorders were presented in different formats of plenary, “Meet the Expert”, multicenter research study presentation, case presentations. Surveillance of growth hormone use was presented from Tunisia and Kuwait. In addition, pubertal disorders were widely covered. Speakers highlighted regional trends in precocious puberty, updates on PCOS management, adrenal disorders and novel mutations in a variety of puberty-related disorders. Exciting data regarding survivors of childhood cancer as well as updates in Turner syndrome management were brilliantly presented. A session of particular interest tackled disorders of sexual differentiation (DSDs), starting with an overview of medical approach to DSDs, followed by an animated presentation and discussion of religion point of view regarding DSDs as well as a valuable psychological approach to youth with DSDs and their families. Last but not least, a highly informative session was held on bone disorders and vitamin D status in the region.
The characteristics and outcomes of secondary peritonitis in a Tertiary Hospital, Benghazi, Libya
Authors: Abdulrahman Abdugadir , Elgazwi Khaled , Khudora Mohammed
Published: July 2017

Background: Despite improvements in treatment, secondary peritonitis is still associated with high morbidity and mortality rates. Better knowledge of reallife clinical practices might improve management. Objectives: To identify the common causes and highlight the morbidity and mortality of secondary peritonitis in Al- Jala hospital, Benghazi, Libya. Patients and Methods: Retrospective study (January 2009–August 2010) of 137 patients with secondary peritonitis is reported. Results: Appendicitis and gastroduodenal perforations were the commonest causes of secondary peritonitis, occurring in 61% and 20% of the patients respectively. Other conditions (small bowel perforations, colonic perforations, biliary peritonitis, ruptured hydatid cyst and pancreatitis) accounted for less than 20% of cases. The overall mortality rate was 4.37%. Morbidity developed in 23% of Patients. Conclusions: Acute appendicitis is the most common cause of intra-abdominal infection in our study. The clinical outcomes associated with secondary peritonitis are highly dependent upon the site of contamination (versus others), as well as local and systemic factors.
The third clinical congress of the gulf chapter of the American Association of Clinical Endocrinologists, October, 29th-31st 2015, Dubai, UAE
Authors: Beshyah Salem , Alsyed Nasreen , Al-Ozairi Ebaa , Al Kaabi Jumaa , Lamki Mohamed , Al Zahrani Ali , Khalil Aly , Hassoun Ahmed , Zirie Mahmoud
Published: July 2017

These are the advance abstracts of the third clinical congress of the Gulf Chapter of the American Association of Clinical Endocrinologists to be held on 29-31 of October 2015. The educational objective of the congress is to give a “state of the art in endocrine practice”. International and regional key opinion leaders were invited to address topical issues relating to the practice of diabetes care and clinical endocrinology. We present the abstracts of the congress as submitted by the authors after minimal restyling and editing to suit the publication requirements of the journal. Several major issues and topical themes with wide interests in the profession were addressed in 9 plenary lectures. Six clinical practice symposia were developed to target the specific educational needs of the target audience subgroups. In addition to, 16 practical issues will addressed in “Meet the Expert”- type of interactive workshops. Free communications from abstracts submitted by delegates, reflecting mostly the regional epidemiology and clinical practice in diabetes care and endocrinology, were selected for presentations as either oral (10) or poster presentations (30). By publishing the proceedings of our third annual congress in this open access journal, we hope to extend the benefit to those who could not make it to the live presentations and give a safe home for all the abstracts for future reference. Making them permanently available may facilitate regional and international networking and collaboration between clinicians and academics of shared interests.
Significance of some trace elements in semen of infertile men
Authors: Abed Abdalla , Jarad Amad
Published: July 2017

Objectives: The biological significance of trace elements in male infertility was studied. Levels of Zinc, Copper, Iron and Magnesium in the seminal plasma of infertile men and controls were measured. The relationships between these elements, seminal characteristics, and serum reproductive male hormones were explored. Patients and Methods: Seventy two infertile men on no treatment were selected from the central infertility center, Al Shifa hospital, Gaza, Palestine were studied and 72 known fertile males were used as controls. Semen samples were analyzed according to WHO criteria and seminal plasma trace elements were analyzed by atomic absorption spectrophotometry. Serum hormonal levels were measured by conventional methods. Results: The mean values of Zinc and Magnesium were significantly lower in infertile men than controls (69 vs. 122 mg/L and 67 vs 120 mg/L) respectively. All studied seminal parameters (sperm count, forward motility, weak motile and non-motile) were significantly lower in the infertile group than in controls. Serum luteinizing hormone and testosterone were significantly lower in the infertile group than in controls (p<0.05). No significant difference in serum follicle stimulating hormone levels was detected between groups. Within the infertile group, seminal plasma Zinc and Magnesium levels correlated directly to the sperm count (r=0.376, P=0.001 and r=0.293, P=0.013 respectively), and testosterone (r=0.293, P=0.012 and r=0.324, P=0.003 respectively). Zinc and Magnesium were inversely related to the seminal volume (r=-0.251, P=0.034 and r=-0.369 P=0.001 respectively). Conclusion: Our findings supports a possible role for Zinc and Magnesium in spermatogenesis and steroidogenesis.
Percutaneous distal limb perfusion via portable, miniaturized, extracorporeal membrane oxygenation resuscitation
Authors: Whitson Bryan , John Ranjit , Black Sylvester , Berger Alan
Published: July 2017

As extracorporeal membrane oxygenation systems become miniaturized, their role for rapid implementation, as an adjunct to resuscitation and high-risk percutaneous interventions, grows. We describe a percutaneous approach to short term mechanical circulatory support, in the setting of cardiogenic shock, which employs a percutaneous, self-contained, distal limb perfusion system. We feel that this technique is highly important for both interventional cardiologists and cardiothoracic surgeons as well.
Intraoperative ventricular fibrillation arrest caused by accidental intravenous injection of epinephrine
Authors: Ahmed Deyaa , Alam Juniad , Talaat Mahmood , Al-Ahmary Ahmed
Published: July 2017

We describe a 25-year old male who experienced ventricular fibrillation (V-Fib) arrest induced by inadvertent intravenous injection of epinephrine instead of the routine reversal medication. Under general anesthesia with Desflurane inhalation, 1.5% Lidocaine containing 1:100,000 Epinephrine was injected into the nasal mucosa for septoplasty and the procedure went smoothly. Near the end of the surgery, the patient suddenly developed sinus tachycardia followed by V-Fib arrest which responded to a single shock of 300J. Sinus rhythm was restored immediately. The patient developed severe lactic acidosis and a bedside echocardiography showed global hypokinesia and normal right sided pressures. The patient was intubated and admitted to the ICU on mechanical ventilation before being weaned and extubated. Retrospectively while investigating the cause after it was discovered that epinephrine had been given as opposed to the anesthesia reversal medication. This case illustrates an unusual response to epinephrine with cardiac arrest in a healthy young male.
Central hospital of Abu Dhabi: Forty years of service to the community (1968-2008)
Authors: Beshyah Salem , Beshyah Anas
Published: July 2017

In 2008, the “Central Hospital” of Abu Dhabi closed, bringing to an end a long period of service to that community. The site was completely demolished, allowing room for further developments of Sheikh Khalifa Medical City. For 40 years, Abu Dhabi “Central Hospital” had been the main health center for the multi-ethnic community of Abu Dhabi. It was the seed for the local health care system, and its staff made significant health care and academic contributions, particularly in the field of nephrology, infectious disease, and emergency medicine. Its academic contributions were remarkable, relative to its modest facilities. This history note aims to commemorate the life and contributions of this small, yet pioneering, institution to the health services, medical education, and research in the capital of this new nation. It gives an opportunity to pay tribute to all those who served in it at any stage of their career.
Novel oral anticoagulants: A new era in anti-thrombotic therapy
Authors: Shlebak Abdul
Published: July 2017

For over half-a-century vitamin K antagonists (VKAs) served our patients well as effective anticoagulants, several novel oral anticoagulants (NOACs) have emerged and are now available as a suitable alternative for stroke prevention, venous thromboembolism prevention and treatment and to reduce vascular events in acute coronary syndrome. Compared to VKAs, the novel agents have several advantages including an improved efficacy/safety ratio, a faster onset of action, shorter plasma half-life, few drug or food interactions, and no requirement for regular monitoring. Although very promising in many regards their proper use will require new approaches in many daily aspects with dose adjustments may be required for patients with severe renal impairment or in the setting of drug interactions. The lack of specific antidote makes reversing their effect during bleeding or for emergency surgery particularly a major challenge. This article provides a focused overview on their current status.
Microbiology of periodontitis in diabetic patients in Oran, Algeria
Authors: Yacoubi Amel
Published: July 2017

Background: Poorly controlled diabetes increases the risk of periodontitis. The link between diabetes and periodontal disease is increasingly recognized and that diabetics are more susceptible to periodontal disease. Material and methods: Cultures of sub-gingival plaque from 62 subjects suffering from aggressive periodontitis (37 patients with diabetes and 25 control cases) and 136 patients with chronic periodontitis (92 with diabetes and 44 control cases) were done on selective and nonselective media. The bacterial isolates were identified by conventional biochemical tests. Results: In aggressive periodontitis, Actinomyces israelii was present in patients with diabetes only while Actinomyces naeslundii was positive in the control group only. The rates of Eubacterium nodatum, Capnocytophaga spp, Peptostreptococcus anaerobius, and Eikenella corrodens. Actinobacillus actinomycetemcomitans were remarkably present in diabetic patients. Culture of Prevotella intermedia, Eubacterium spp and Campylobacter spp were more remarkable in control patients with aggressive periodontitis. On the other hand, in chronic periodontitis, Eikenella corrodens, Aggregatibacter aphrophilus, and Eubacterium were more noticeable in patients with diabetes. Conclusions: Periodontal pathogens are distinctly different in patients with diabetes from those without diabetes. The differences are evident in both aggressive and chronic periodontitis. These different microbiological characteristics are relevant in both dental and general medical practices.
Significance of serum vascular endothelial growth factor in chronic liver disease and hepatocellular carcinoma: An exploratory study
Authors: Ghonaim Mabrouk , El-Edel Rawhia
Published: July 2017

Background and Objectives: Vascular endothelial growth factor (VEGF) is the most potent directly acting angiogenic growth factor that plays an important role in inducing tumor-associated angiogenesis. We evaluated the clinical significance of the circulating VEGF in patients with hepatocelluar carcinoma (HCC) and chronic liver disease (CLD). Patients and Methods: The study included 65 patients [20 with chronic viral hepatitis (CVH), 20 with liver cirrhosis (LC) and 25 with HCC] and 15 age- and gender- matched healthy subjects as controls. For each studied subject, detection of hepatitis viral markers, and assessment of liver function tests, α-fetoprotein (AFP) and VEGF were performed. Results: There was a significantly higher VEGF level in the sera of HCC patients as compared to other groups (p< 0.001). Serum VEGF level was significantly associated with portal vein tumor thrombosis (p< 0.01), but was not related to tumor size. There was no significant difference between the serum VEGF levels in either LC or CVH groups when compared to the controls. Moreover, no significant difference was detected between the different Child-Pugh classes among LC patients. Furthermore, no correlation was found between the level of serum VEGF and AFP, serum albumin, aminotransferases or prothrombin time (PT) in all the studied groups. Conclusions: Serum VEGF may be useful as a tumor marker for diagnosis of HCC and as a prognostic marker for tumor invasion. Large studies with greater numbers of patients and controls is required to support our conclusion.
Frost flowers and sea-salt aerosols over seasonal sea-ice areas in northwestern Greenland during winter–spring
Authors: Hara Keiichiro , Matoba Sumito , Hirabayashi Motohiro , Yamasaki Tetsuhide
Published: July 2017

Abstract. Sea salts and halogens in aerosols, frost flowers, and brine play an important role in atmospheric chemistry in polar regions. Simultaneous sampling and observations of frost flowers, brine, and aerosol particles were conducted around Siorapaluk in northwestern Greenland during December 2013 to March 2014. Results show that water-soluble frost flower and brine components are sea-salt components (e.g., Na+, Cl−, Mg2+, K+, Ca2+, Br−, and iodine). Concentration factors of sea-salt components of frost flowers and brine relative to seawater were 1.14–3.67. Sea-salt enrichment of Mg2+, K+, Ca2+, and halogens (Cl−, Br−, and iodine) in frost flowers is associated with sea-salt fractionation by precipitation of mirabilite and hydrohalite. High aerosol number concentrations correspond to the occurrence of higher abundance of sea-salt particles in both coarse and fine modes, and blowing snow and strong winds. Aerosol number concentrations, particularly in coarse mode, are increased considerably by release from the sea-ice surface under strong wind conditions. Sulfate depletion by sea-salt fractionation was found to be limited in sea-salt aerosols because of the presence of non-sea-salt (NSS) SO42−. However, coarse and fine sea-salt particles were found to be rich in Mg. Strong Mg enrichment might be more likely to proceed in fine sea-salt particles. Magnesium-rich sea-salt particles might be released from the surface of snow and slush layer (brine) on sea ice and frost flowers. Mirabilite-like and ikaite-like particles were identified only in aerosol samples collected near new sea-ice areas. From the field evidence and results from earlier studies, we propose and describe sea-salt cycles in seasonal sea-ice areas.
Arctic regional methane fluxes by ecotope as derived using eddy covariance from a low-flying aircraft
Authors: Sayres David S. , Dobosy Ronald , Healy Claire , Dumas Edward , Kochendorfer John , Munster Jason , Wilkerson Jordan , Baker Bruce , Anderson James G.
Published: July 2017

Abstract. The Arctic terrestrial and sub-sea permafrost region contains approximately 30 % of the global carbon stock, and therefore understanding Arctic methane emissions and how they might change with a changing climate is important for quantifying the global methane budget and understanding its growth in the atmosphere. Here we present measurements from a new in situ flux observation system designed for use on a small, low-flying aircraft that was deployed over the North Slope of Alaska during August 2013. The system combines a small methane instrument based on integrated cavity output spectroscopy (ICOS) with an air turbulence probe to calculate methane fluxes based on eddy covariance. We group surface fluxes by land class using a map based on LandSat Thematic Mapper (TM) data with 30 m resolution. We find that wet sedge areas dominate the methane fluxes with a mean flux of 2.1 µg m−2 s−1 during the first part of August. Methane emissions from the Sagavanirktok River have the second highest at almost 1 µg m−2 s−1. During the second half of August, after soil temperatures had cooled by 7 °C, methane emissions fell to between 0 and 0.5 µg m−2 s−1 for all areas measured. We compare the aircraft measurements with an eddy covariance flux tower located in a wet sedge area and show that the two measurements agree quantitatively when the footprints of both overlap. However, fluxes from sedge vary at times by a factor of 2 or more even within a few kilometers of the tower demonstrating the importance of making regional measurements to map out methane emissions spatial heterogeneity. Aircraft measurements of surface flux can play an important role in bridging the gap between ground-based measurements and regional measurements from remote sensing instruments and models.
Detectability of the Impacts of Ozone Depleting Substances and
Greenhouse Gases upon Stratospheric Ozone Accounting for
Nonlinearities in Historical Forcings
Authors: Bandoro Justin , Solomon Susan , Santer Benajmin D. , Kinnison Douglas E. , Mills Michael J.
Published: July 2017

Abstract. We perform a formal attribution study of upper and lower stratospheric ozone changes using observations together with simulations from the Whole Atmosphere Community Climate Model. Historical model simulations were used to estimate the zonal-mean response patterns (fingerprints) to combined forcing by ozone depleting substances (ODS) and well-mixed greenhouse gases (GHG), as well as to the individual forcing by each factor. Trends in the similarity between the searched-for fingerprints and homogenized observations of stratospheric ozone were compared to trends in pattern similarity between the fingerprints and the internally and naturally generated variability inferred from long control runs. This yields estimated signal-to-noise (S/N) ratios for each of the three fingerprints (ODS, GHG, and ODS+GHG). In both the upper stratosphere (defined in this paper as 1 to 10 hPa) and lower stratosphere (40 to 100 hPa), the spatial fingerprints of the ODS+GHG and ODS only patterns were consistently detectable not only during the era of maximum ozone depletion, but also throughout the observational record (1984–2016). Furthermore, we develop a fingerprint attribution method to account for forcings whose time evolutions are markedly nonlinear over the observational record. When the nonlinearity of the time evolution of the ODS and ODS+GHG signals are used in the trend regression, we find that the S/N ratios obtained with the stratospheric ODS and ODS+GHG fingerprints are enhanced relative to standard linear trend analysis. With this method, the complete observational record can be used in the S/N analysis, without applying piece-wise linear regression and introducing arbitrary break points. The GHG-driven fingerprint of ozone changes was not statistically identifiable in the either the upper or lower stratospheric SWOOSH data, irrespective of the method used. Use of the nonlinear signal method, instead of directly operating on ozone trends, also reduces the detection time – the estimate of the date at which ODS and GHG impacts on ozone can be formally identified. In the WACCM future simulations, the GHG signal is statistically identifiable between 2020–2030. Our findings demonstrate the importance of continued stratospheric ozone monitoring to improve estimates of the contributions of ODS and GHG forcing to global changes in stratospheric ozone.
On the challenges of using field spectroscopy to measure the impact of soil type on leaf traits
Authors: Nunes Matheus H. , Davey Matthew P. , Coomes David A.
Published: July 2017

Abstract. Understanding the causes of variation in functional plant traits is a central issue in ecology, particularly in the context of global change. Spectroscopy is increasingly used for rapid and non-destructive estimation of foliar traits, but few studies have evaluated its accuracy when assessing phenotypic variation in multiple traits. Working with 24 chemical and physical leaf traits of six European tree species growing on strongly contrasting soil types (i.e. deep alluvium versus nearby shallow chalk), we asked (i) whether variability in leaf traits is greater between tree species or soil type, and (ii) whether field spectroscopy is effective at predicting intraspecific variation in leaf traits as well as interspecific differences. Analysis of variance showed that interspecific differences in traits were generally much stronger than intraspecific differences related to soil type, accounting for 25 % versus 5 % of total trait variation, respectively. Structural traits, phenolic defences and pigments were barely affected by soil type. In contrast, foliar concentrations of rock-derived nutrients did vary: P and K concentrations were lower on chalk than alluvial soils, while Ca, Mg, B, Mn and Zn concentrations were all higher, consistent with the findings of previous ecological studies. Foliar traits were predicted from 400 to 2500 nm reflectance spectra collected by field spectroscopy using partial least square regression, a method that is commonly employed in chemometrics. Pigments were best modelled using reflectance data from the visible region (400–700 nm), while all other traits were best modelled using reflectance data from the shortwave infrared region (1100–2500 nm). Spectroscopy delivered accurate predictions of species-level variation in traits. However, it was ineffective at detecting intraspecific variation in rock-derived nutrients (with the notable exception of P). The explanation for this failure is that rock-derived elements do not have absorption features in the 400–2500 nm region, and their estimation is indirect, relying on elemental concentrations covarying with structural traits that do have absorption features in that spectral region (constellation effects). Since the structural traits did not vary with soil type, it was impossible for our regression models to predict intraspecific variation in rock-derived nutrients via constellation effects. This study demonstrates the value of spectroscopy for rapid, non-destructive estimation of foliar traits across species, but highlights problems with predicting intraspecific variation indirectly. We discuss the implications of these findings for mapping functional traits by airborne imaging spectroscopy.
Direct local building inundation depth determination in 3-D point clouds generated from user-generated flood images
Authors: Griesbaum Luisa , Marx Sabrina , Höfle Bernhard
Published: July 2017

Abstract. In recent years, the number of people affected by flooding caused by extreme weather events has increased considerably. In order to provide support in disaster recovery or to develop mitigation plans, accurate flood information is necessary. Particularly pluvial urban floods, characterized by high temporal and spatial variations, are not well documented. This study proposes a new, low-cost approach to determining local flood elevation and inundation depth of buildings based on user-generated flood images. It first applies close-range digital photogrammetry to generate a geo-referenced 3-D point cloud. Second, based on estimated camera orientation parameters, the flood level captured in a single flood image is mapped to the previously derived point cloud. The local flood elevation and the building inundation depth can then be derived automatically from the point cloud. The proposed method is carried out once for each of 66 different flood images showing the same building façade. An overall accuracy of 0.05 m with an uncertainty of ±0.13 m for the derived flood elevation within the area of interest as well as an accuracy of 0.13 m ± 0.10 m for the determined building inundation depth is achieved. Our results demonstrate that the proposed method can provide reliable flood information on a local scale using user-generated flood images as input. The approach can thus allow inundation depth maps to be derived even in complex urban environments with relatively high accuracies.
Design and results of the ice sheet model initialisation experiments
initMIP-Greenland: an ISMIP6 intercomparison
Authors: Goelzer Heiko , Nowicki Sophie , Edwards Tamsin , Beckley Matthew , Abe-Ouchi Ayako , Aschwanden Andy , Calov Reinhard , Gagliardini Olivier , Gillet-Chaulet Fabien , Golledge Nicholas R. , Gregory Jonathan , Greve Ralf , Humbert Angelika , Huybrechts Philippe , Kennedy Joseph H. , Larour Eric , Lipscomb William H. , Le clec´h Sébastien , Lee Victoria , Morlighem Mathieu , Pattyn Frank , Payne Antony J. , Rodehacke Christian , Rückamp Martin , Saito Fuyuki , Schlegel Nicole , Seroussi Helene , Shepherd Andrew , Sun Sainan , van de Wal Roderik , Ziemen Florian A.
Published: July 2017

Abstract. Earlier large-scale Greenland ice sheet sea-level projections (e.g., those run during the ice2sea and SeaRISE initiatives) have shown that ice sheet initial conditions can have a large effect on the projections and give rise to important uncertainties. The goal of the initMIP-Greenland intercomparison exercise is to compare, evaluate and improve the initialisation techniques used in the ice sheet modelling community and to estimate the associated uncertainties. initMIP-Greenland is the first in a series of ice sheet model intercomparison activities within ISMIP6 (the Ice Sheet Model Intercomparison Project for CMIP6). Two experiments for the large-scale Greenland ice sheet have been designed to allow intercomparison between participating models of 1) the initial present-day state of the ice sheet and 2) the response in two schematic forward experiments. The forward experiments serve to evaluate the initialisation in terms of model drift (forward run without additional forcing) and in response to a large perturbation (prescribed surface mass balance anomaly), and should not be interpreted as sea-level projections. We present and discuss results that highlight the wide diversity of data sets, boundary conditions and initialisation techniques used in the community to generate initial states of the Greenland ice sheet. We find good agreement across the ensemble for the dynamic response to SMB changes in areas where the simulated ice sheets overlap, but in general differences arise due to the initial size of the ice sheet. The spread in model drift is reduced compared to earlier intercomparison exercises.
The risks of extreme load extrapolation
Authors: van Eijk Stefan F. , Bos René , Bierbooms Wim A. A. M.
Published: July 2017

Abstract. An important problem in wind turbine design is the prediction of the 50-year load, as set by the IEC 61400-1 Design Load Case (DLC) 1.1. In most cases, designers work with limited simulation budgets and are forced to use extrapolation schemes to obtain the required return level. That this is no easy task is proven by the many studies dedicated to finding the best distribution and fitting method to capture the extreme load behavior as well as possible. However, the issue that is often overlooked is the effect that the sheer uncertainty around the 50-year load has on a design process. In this paper, we use a collection of 96 years' worth of extreme loads to perform a large number of hypothetical design problems. The results show that, even with sample sizes exceeding N = 103 10 min extremes, designs are often falsely rejected or falsely accepted based on an over- or underpredicted 50-year load. Therefore, designers are advised to be critical of the outcome of DLC 1.1 and should be prepared to invest in large sample sizes.