bluuebunny/crossref_metadata_2025 huggingface dataset:
ADMINISTRATIVE JUSTICE AS A COMPONENT OF THE ADMINISTRATIVE-LEGAL MECHANISM FOR THE PROTECTION OF PUBLIC INTEREST
Authors: Zolotukhina L. O.
Published: September 2019

In the article the author analyzes the category of administrative and legal mechanism for ensuring the realization of public interest.
Under the administrative-legal mechanism for ensuring the realization of public interest, the author understands complex complexstructured system of regulation of relations between public administration bodies and subjects of power influence, the purpose of functioningof which is the satisfaction of objectively defined social development needs, its peculiar “over-goals”.
It is substantiated that the effectiveness of the administrative-legal mechanism of ensuring public interest is achieved at the normative-legal, organizational, managerial and human-rights levels. It is substantiated that the administrative and procedural component ofthe administrative-legal mechanism for the protection of public interests is intended for the prevention and cessation of offenses in the
realization of a particular public interest.
It is emphasized that protection of public interests should be recognized as the central task of administrative justice, a characteristicof its legal nature, since it is with the help of administrative legal
proceedings that judicial control and supervision of the activity ofstate authorities and local self- government bodies are carried out, protection of the rights, freedoms and legitimate interests of individualsand restored public interests.
It is substantiated that the separate activity form of protection of public interests by administrative justice bodies is the terminationof the issuance of normative legal acts issued by public administration bodies (or the invalidation of their separate provisions) thatviolate public interests.
ACTUAL PROBLEMS OF GENDER EQUALITY IN THE SECURITY AND DEFENSE SECTOR
Authors: Kovalenko Ye. V. , Pletnov O. V.
Published: September 2019

Affirmation of gender equality is one of the aspects of the mankind development process which can be compared by value and closely connected to the global democratization tendency. At the post-industrial stage, the development of men and women equality becomes one of the main aspects of social modernization. The essence of democracy is providing people with rights, the organization of the governmental state on the principle of social contract between equal individuals, who must have the same opportunities for making independent and responsible decisions. Therefore, gender equality is a rather sensitive indicator of the development level of a country.
In the system of world renewal and reform, Ukraine tends to integrate into the Euro-Atlantic security model and create a civil society on a modern basis. Such an approach implies the obligation to define clear state gender strategies and the development of an appropriate state gender policy.
One of the important aspects of ensuring equal and stable social development with the application of the most effective methods of state intervention is the introduction of the gender approach in the security and defense sector of Ukraine, which becomes a purposeful, systemic and multidirectional governmental activity.
It should be noticed that gender policy in this area should be understood as the progress of militaryservice regardless of gender: equality in the perspectives of such service, rights and responsibilities.
A new stage of active public assistance in the development of gender policy in the field of security and defense began in 2018 and is still ongoing. Many significant steps have been taken in gender equality in the army and in the fight against gender discrimination.
But at the same time, it should be mentioned that today there are some problems in providing gender policy in the military spher; and solving and overcoming of such problems will contribute to increasing the efficiency of the functioning and development of the Armed
Forces of Ukraine, as well as the positive implementation of the state gender policy in the context of European choice of Ukraine in the context of its world and European integration.
NATIONAL NORMATIVE-LEGAL ACTIONS OF ANTI-BIOTERRORISM UNDER THE PRIZE OF INTERACTION WITH INTERNATIONAL LAW PROVISIONS
Authors: Kravchuk M. Yu
Published: September 2019

The article analyzes the international legal acts on issues of counteraction to bioterrorism. It has been established that Ukraine is implementing effective cooperation on issues of mutual interest with bioterrorism both at the universal and regional levels (with NATO, CIS, EU), as well as at the bilateral level.
The role of the Convention on the Prohibition of the Development, Production and Stockpiling of Bacteriological (Biological) and Toxic Weapons and on their Destruction (CBTZ), Ukraine as a full member is determined.
To strengthen the provisions of the Convention at the national level, a number of laws and regulations have been adopted, the purpose of which is to exclude the possibility of conducting activities in violation of the requirements of the OSCE. In general, the legal basis for combating bioterrorism is the Law of Ukraine dated March 20, 2003 “On the Fight against Terrorism”; the basis of the national system of “export control” are the laws of Ukraine “On Foreign Economic Activity” of 17.05.1991, “On State Control over International Transfers of Military and Dual-Use Goods” of 20.02.2003, the KPiminal Code of Ukraine of 05.04.2001, in the articles of which (art .439, art. 440) provides for liability for activities contrary to the Constitution.
Information is given about activities of medical, scientific, specialized and production institutions in Ukraine that have micro-organisms banks or work with products of their vital activities, and are included in the scope of the CBT. Also in Ukraine, the inter-governmental intergovernmental organization Ukrainian Science and Technology Center was established in Ukraine. The emphasis is on
Ukraine’s accession to the Global Health Security Agenda, the global initiative of the Centers for Disease
Control (USA), which began in February 2014, to build a safe world protected from the dangers of infectious diseases.
Appropriate conclusions were drawn about the priority task of Ukraine in developing a legislative position on the development of a package of legal acts in the field of combating bioterrorism, adopting recommendations for the implementation of the provisions of the Convention (CBTZ) and implementing other, no less important, strategic plans
THE EVOLUTION OF STUDIES ON SOCIALLY DANGEROUS CONSEQUENCES IN THE NATIONAL DOCTRINE OF CRIMINAL
Authors: Shcherbinina I. Yu.
Published: September 2019

This article is dedicated to the evolution of studies on socially dangerous consequences in the national doctrine of criminal law.
Scientific views amongst forensic scholars on how to understand the nature of socially dangerous acts of crime on certain stages of the development of criminal law are subject of the present research. It is universally acknowledge that there were no scientific doctrines on the concept of socially dangerous consequences of crime until the XIX century.
The dogmatic concepts about criminal consequences emerged only with the introduction of the definition of crime and distinguishment of its features, in particular the material one called “social danger”. Based on the inquiry into the establishment and development of studies on socially dangerous consequences of crime in the national doctrine of criminal law, four main stages in the development of scientific thought are distinguished: the first – so-termed “pre-revolutionary stage” of studies onconsequences of crime – was introduced with the publication of the first textbook on criminal law by O.I. Horegliad; the second stage of the development originates from the end of the October Revolution of 1917, from the period when the material concept of crime took place in legislation and had a determinative influence on the development of scholarly judgements about understanding of the consequences of crime; the third
stage in the development of national idea as to the nature of socially dangerous consequences was marked by the forensic scholar A.N. Trainin, whose prominent works revived the development of studies on socially dangerous consequences of crime; the fourth stage is the modern Ukrainian criminal doctrine on how to perceive socially dangerous consequences of crime.
This stage is characterized by lack of consistent approach and innovative work. The results of the research provide for better understanding of the nature of socially dangerous consequences, estimate their significance and foresee further development of the scientific thought on this issue.
Mechanical and self-sensing properties of concrete reinforced with carbon nanofibres
Authors: Faghih Faezeh , Ayoub Ashraf S.
Published: September 2019

Concrete is extensively used in the construction industry, but the formation and development of cracks undermines the integrity of concrete structures. Improving the mechanical properties of concrete and developing efficient health monitoring of structures are thus essential tasks to be tackled. The research described in this paper was concerned with the effect of nanofibres on the mechanical properties of concrete as the use of nanofibres such as carbon nanofibres (CNFs) within cementitious materials has been found to be effective in enhancing the mechanical properties of concrete as well as its sensing ability. Most previous works have focused on evaluating the microstructure and mechanical behaviour of nano-reinforced mortar. Only a few studies have attempted to evaluate the mechanical and sensing properties of nano-reinforced concrete made with coarse aggregates. The objective of this work was to fill this gap in the literature by evaluating the mechanical and self-sensing properties of CNF-reinforced concrete (CNFRC). Material tests were conducted on CNFRC cylinders and beams in order to determine the full compressive, tensile and flexural constitutive behaviour, including the post-peak response, as well evaluating the self-sensing capability. The results obtained are valuable for analysis and design of large critical infrastructures employing CNFRC.
China’s building energy efficiency standards assessment based on fuzzy evaluation algorithm
Authors: Wang Jingjing , Zhang Yurong , Wang Yuanfeng , Gu Lin
Published: September 2019

Building energy efficiency (BEE) is regarded as the key sector in the world for addressing climate change and energy problems, since buildings consume around one-third of global energy and produce a substantial amount of greenhouse gas emissions. It is important to utilise BEE standards (BEESs) to ensure that cost-effective energy efficiency opportunities are incorporated into new and existing buildings. A key question is how the actual performance of BEESs can be measured so that they are developed in a more sustainable way. An effective method that can evaluate BEESs from both quantitative and qualitative perspectives is provided, and it fulfils a dual step: (a) determining a BEES evaluation indicator system, including technological, economical and social indicators, by identification, correction and selection; and (b) establishing the BEES evaluation model: a fuzzy synthetic evaluation model based on the information entropy theory with the analytic hierarchy process. The developed BEES evaluation model and the case study of China‘s ‘Design standard for energy efficiency of public buildings’ could provide a comprehensive framework to understand the energy efficiency performance of BEESs in China. The results will help improve the management of BEESs and ensure more sustainable building practice.
From field sites to field events
Authors: Ahlin Tanja , Li Fangfang
Published: September 2019

The incorporation of various information and communication technologies (ICTs) in ethnographic methods mandates a reconsideration of the understanding and practice of fieldwork. In this article, we explore how the ‘field site’ may be reimagined in today’s highly mobile, ICT-facilitated world. Based on our research among Indian transnational families and young migrant workers from Malaysia, we argue that the field may be conceived as a collection of ‘field events’ that are co-created by ethnographers, their study participants, and ICTs. As ICTs are increasingly intertwined with people’s lives and thereby feature importantly in ethnographic fieldwork, we encourage ethnographers to carefully consider how these devices and platforms actively shape their ethnographic data as well as their relations with study participants.
Death poems for Cindy
Authors: Syvertsen Jennifer L.
Published: September 2019

n/a
Volunteer economies
Authors: Desclaux Alice
Published: September 2019

n/a
Investigation of the Similarities of Industrial Wood Production Statistics of Regional Directorates of Forestry in Turkey Using Cluster and Discriminant Analysis
Authors: AKYÜZ İlker , ERSEN Nadir , BAYRAM Bahadır Çağrı , ACAR Mustafa , AKYÜZ Kadri Cemil , ÜÇÜNCÜ Tutku
Published: September 2019

Aim of study: In this study, the amount of industrial wood production of the
regional directorates of forestry in Turkey was examined deeply and the
similarities between the regional directorates in industrial wood production
were investigated by cluster and discriminant analysis.

Area of study: The study area is regional directorates of forestry in Turkey.

Material and Method: Seven different variables were used to construct similar clusters. The
arithmetic mean of these seven variables was taken for 4 years (2013-2016).  Cluster and discriminant analysis were used
as method.

Main results: According to the clustering analysis results, it was determined that
regional directorates of forestry could be divided into maximum 6 and minimum 2
groups. As a result of the discriminant analysis conducted to determine the
highest success of the groupings, it was determined that the regional
directorates of forestry distinguished in 100% success in 6 groups. Also, it
was found that a Kastamonu regional directorate of forestry, which has the
highest value in industrial wood production, has formed a group alone.

Highlights: For the production of industrial wood, the regional directorates of
forestry can put more emphasis on the use of forest areas. Thus, we can avoid
the dependence on foreign sources.
Starting a MinION sequencing run using MinKNOW v1
Authors: Quick Josh , Kahn-Kirby Amanda , Cunden Lisa , Miani [Invitae Bianca
Published: September 2019

This protocol contains ARTIC specific run options.
Neuropathy Phentoyping Protocols - Insulin Implantation Protocol v2
Authors: Feldman Eva , Abatan Omorodola
Published: September 2019

Summary: Phenotyping of Rodents for the Presence of Diabetic Neuropathy In man, the development of diabetic neuropathy is dependent on both the degree of glycemic control and the duration of diabetes. Diabetic neuropathy is a progressive disorder, with signs and symptoms that parallel the loss of nerve fibers over time. Consequently, assessments of neuropathy in mice are not performed at one time point, but are characterized at multiple time points during a 6 month period of diabetes. The degree of diabetes is evaluated in 2 ways: tail blood glucose measured following a 6 hour fast and glycated hemoglobin levels. The initial degree of neuropathy is screened using the methods discussed below. Detailed measures of neuropathy are employed when the initial screening instruments indicate a profound or unique phenotypic difference. This document contains protocols used by the DiaComp staff to examine and measure diabetic neuropathy at the whole animal, tissue and cellular levels. Diabetic Complication:
Aortic Banding in Mice v2
Authors: Abel Dale
Published: September 2019

Summary: This protocol describes the procedure used by the DiaComp for inducing pressure overload hypertrophy in mice. Diabetic Complication:
The European Parliament and the Layered Politicization of the External Dimension of the Common Fisheries Policy
Authors: Zimmermann Hubert
Published: September 2019

When the Lisbon Treaty entered into effect, the European Parliament became a core player in the decision-making processes of the EU’s Common Fisheries Policy (CFP) and its external dimensions. This new role suggested a shift towards stronger politicization in what had previously been a rather technocratic policy field. However, the CFP is not yet marked by a clear and consistent level of politicization. I use the concept of ‘layered politicization’ to explain this pattern. Although it is not comparable to the degree of political controversy shaping fully politicized policy fields, some similar political dynamics can be observed. Among them is a transformation in the policy process due to higher ratification requirements; a higher likelihood of political deadlock resulting from an increasing number of veto-players; and a strengthening of the contested legitimacy of EU decision-making. An empirical test of these theoretical propositions is provided here in the form of two case studies; the negotiation of Fisheries Partnership Agreements with Morocco and Mauritania.
Preparatory Bodies as Mediators of Political Conflict in Trilogues: The European Parliament’s Shadows Meetings
Authors: Ripoll Servent Ariadna , Panning Lara
Published: September 2019

Trilogues have become ‘normal’ structures in European Union (EU) decision-making but their functioning, based on secluded decision-making, makes it difficult to understand how institutional positions are formed and managed and which actors are better positioned to influence policy outputs. These are, however, important questions because, first, a coherent position in trilogues (one that withstands the scrutiny of the Council) enhances the European Parliament’s (EP) chances of achieving a favourable outcome following negotiation; second, because it has become more complicated to find a common position within the EP due to increased levels of politicisation and polarisation (especially in the form of Euroscepticism) in EU policy-making. Therefore, this article focuses on preparatory bodies preceding trilogues and the role they play in building Parliament’s positions. With the shift of political conflict from plenary to committees and now to shadows meetings, the latter have become de facto decision-making bodies. Not only do they serve to mediate intra-institutional conflict but also to anticipate Council and Commission positions. This article compares the use of shadows meetings in politicised and non-politicised issues. With the use of ethnographic data provided by participant observation and elite interviews, we aim to provide explanations on how these new instruments serve to informally manage politicisation, focusing in particular on the advantages of insularity in highly publicised negotiations.
A Geodesign Decision Support Environment for Integrating Management of Resource Flows in Spatial Planning
Authors: Arciniegas Gustavo , Šileryté Rusné , Dąbrowski Marcin , Wandl Alexander , Dukai Balázs , Bohnet Max , Gutsche Jens-Martin
Published: September 2019

Improving waste and resource management entails working on interrelations between different material flows, territories and groups of actors. This calls for new decision support tools for translating the complex information on flows into accessible knowledge usable by stakeholders in the spatial planning process. This article describes an open source tool based on the geodesign approach, which links the co-creation of design proposals together with stakeholders, impact simulations informed by geographic contexts, systems thinking, and digital technology—the Geodesign Decision Support Environment. Though already used for strategic spatial planning, the potential of geodesign for waste management and recycling is yet to be explored. This article draws on empirical evidence from the pioneering application of the tool to promote spatially explicit circular economy strategies in the Amsterdam Metropolitan Area.
Facilitating Circular Economy in Urban Planning
Authors: Remøy Hilde , Wandl Alexander , Ceric Denis , Van Timmeren Arjan
Published: September 2019

A shift towards a more Circular Economy is crucial to achieve a more sustainable and inclusive built environment that meets future demands. Circular Economy is a promising concept for industry and society. If implemented well, Circular Economy can deliver environmental benefits and economic advantages for which innovation is essential. To achieve a resource-efficient built environment the Circular Economy should be developed and implemented systemically and on a large scale, going beyond cities. To realise this, local authorities, citizens, and other stakeholders need a collaborative and science-informed decision environment that allows for developing different waste and resource management options, and assessing their impacts on the environment, resilience, spatial quality and quality of life. The articles in this special issue all discuss different aspects of research to deliver solutions and strategies for a circular economy in urban planning throughout Europe, focusing on peri-urban locations. The first rticle introduces Living Labs as a methodology to co-create circular solutions and strategies with local stakeholders. The second article focuses on governance for the shift towards a Circular Economy, unravelling hindrances and revealing objectives, whereas the third article develops a means to transfer circular strategies and solutions from one location to another. The fourth article presents an open-source tool based on the geodesign approach which links the co-creation of design proposals to impact simulations informed by geographic contexts, systems thinking, and digital technology—the Geodesign Decision Support Environment. Finally, the fifth article presents the first results of incorporating the concept of Circular Economy in an integrative manner in urban design and planning courses.
Pulp Revascularization or Apexification for the Treatment of Immature Necrotic Permanent Teeth: Systematic Review and Meta-Analysis
Authors: Nicoloso Gabriel Ferreira , Goldenfum Gabriela Maltz , Pizzol Tatiane da Silva Dal , Scarparo Roberta Kochenborger , Montagner Francisco , de Almeida Rodrigues Jonas , Casagrande Luciano
Published: September 2019

This systematic review and meta-analysis assessed clinical, radiographic and functional retention outcomes in immature necrotic permanent teeth treated either with pulp revascularization or apexification after a minimum of three months to determine which one provides the best results. The literature was screened via PubMed/MEDLINE and Embase databases up to June 2017 to select observational studies that compared pulp revascularization and apexification treatments assessing clinical, radiographic and functional retention outcomes. Two reviewers independently performed screening and evaluation of articles. A total of 231 articles were retrieved from databases, wherein only four articles were selected for full-text analyses. After exclusion criteria, three studies remained in quantitative and qualitative analyses. Pooled-effect estimates were obtained comparing clinical and radiographic outcomes (‘overall outcome’) and functional retention rates between apexification and pulp revascularization treatment. The meta-analysis comparing apexification vs. revascularization for ‘overall outcome’ (Z=0.113, p=0.910, RR=1.009, 95%CI:0.869–1.171) and functional retention rates (Z=1.438, p=0.150, RR=1.069, 95%CI:0.976–1.172) showed no statistically significant differences between the treatments. All studies were classified as high quality. The current literature regarding the clinical, radiographic and functional retention outcomes in immature necrotic permanent teeth treated either with pulp revascularization or apexification is limited. Based on our meta-analysis, the results do not favor one treatment modality over the other.
Distal Migration and Ectopic Eruption of the Mandibular First Premolar: A Case Report
Authors: Fux-Noy Avia
Published: September 2019

Migration describes the movement of an unerupted tooth within the bone when normal eruption is prevented and the tooth leaves its normal site of development. This report describes a case of distal migration and ectopic eruption of the mandibular first premolar in an 8.5-year-old boy. Following early extraction of the primary second molar, the first premolar migrated distally through the extraction site of the primary second molar and erupted into occlusion just mesial of the permanent first molar.
Impact of Molar Incisor Hypomineralization on Oral Health-Related Quality of Life in Mexican Schoolchildren
Authors: Gutiérrez Teresa Villanueva , Ortega Cecilia Carlota Barrera , Pérez Nora Pérez , Pérez Alvaro García
Published: September 2019

Objective: To evaluate the impact of Molar Incisor Hypomineralization (MIH) in the OHRQoL in a group of 8 to 10 year-old Mexican schoolchildren. Study design: A cross-sectional study of 411 8 to 10 year-old schoolchildren selected from public schools in Naucalpan, in the State of Mexico. The presence and severity of MIH was evaluated using the European Academy of Pediatric Dentistry (EAPD) criteria. The OHRQoL was evaluated using the Child Perceptions Questionnaire (CPQ). Poisson regression models were performed for the analysis. Results: The prevalence of MIH in the permanent dentition was 40.4%. High scores were found in the four domains of the CPQ for children with MIH compared to children without MIH (p<0.001). In the Poisson model, a greater negative impact in the four CPQ domains was found for schoolchildren with MIH: oral symptoms [RR=1.75 (CI95% 1.63–1.78)]; functional limitations [RR=2.17 (CI95% 2.01–2.35)]; emotional wellbeing [RR=1.94 (CI95% 1.80–2.08)]; and, social well-being [RR=2.62 (CI95% 2.49–2.77)]. A greater impact on the four CPQ domains were found for children with moderate/severe MIH compared to children without MIH (p<0.001). Conclusion: Children with moderate/severe MIH experienced a greater negative impact on their OHRQoL compared to children without MIH.
DIAGNOSIS OF VENOUS ISCHEMIC STROKE. PART II (ALGORITHMS AND SEMIOLOGY OF DIAGNOSTIC RADIOLOGY. LIMITATIONS IN CLINICAL PRACTICE). A REVIEW
Authors: Semenov S. E. , Yurkevich E. A. , Moldavskaia I. V. , Shatokhina M. G. , Semenov A. S.
Published: September 2019

Venous stroke in cerebral venous sinus thrombosis is a rare pathological condition with uncertain diagnostic algorithm to ensure prompt treatment by neurologists and radiologists. All the methods are not obligatory in the workup of acute stroke, except computed tomography (CT) and transcranial Doppler. Researchers and clinicians are commonly guided by their own experiences. Therefore, the diagnosis of venous stroke is an unstable process resulting in its underestimation in the general stroke population. The optimal use of neuroimaging methods within the existing standards of care for patients with stroke, determination of the necessary and sufficient set of diagnostic procedures is an organizational and methodical problem. In addition, there is no complete description of venous ischemic stroke patterns in the medical literature. The article reviews existing evidence-based data on the diagnostic algorithms for venous stroke and discusses the probability of detecting radiologic symptoms based on the diagnostic accuracy and effectiveness of such methods as conventional CT and magnetic resonance imaging (MRI), CT and MR angiography, CT and MR perfusion, transcranial Doppler (TCD) and ultrasound of the brachiocephalic arteries stated in the national and international guidelines, as well as our own experience. Limitations of their use and options to overcome major drawbacks including the introduction of teleradiology are considered.
VASCULAR PATCHES FOR ARTERIAL RECONSTRUCTION, CHALLENGES AND ADVANCED TECHNOLOGIES
Authors: Sevostyanova V. V. , Mironov A. V. , Antonova L. V. , Tarasov R. S.
Published: September 2019

High prevalence of internal carotid atherosclerosis and recent advances in its diagnosis result in an increase in the annual number of carotid endarterectomy procedures to restore carotid patency. Various randomized prospective studies as well as meta-analyses show a decrease in the number of perioperative and postoperative complications following carotid endarterectomy using patches compared with primary arterial closure. Despite the fact that the autologous vein is the material of choice for carotid patch angioplasty, xenogenic and synthetic patches are also widely used in the clinical practice. Furthermore, tissue engineering technologies and the development of novel biomaterials have recently emerged and may encourage manufacturing of vascular patches capable to promote a regenerative potential of the body and restore vascular wall tissues.
THE ROLE OF AUTOANTIBODIES IN VARIOUS CELLULAR AND INTRACELLULAR CARDIAC STRUCTURES IN CHILDREN WITH HEART RHYTHM DISTURBANCES (A REVIEW)
Authors: Plotnikova I. V. , Svintsova L. I. , Dzhaffarova O. Yu.
Published: September 2019

This review discusses the role of autoimmune mechanisms in the development of heart rhythm disturbances and conduction disorders of various origins. The search was performed using PubMed, Medline and Google Scholar. Specific cardiovascular diseases (dilated cardiomyopathy, myocarditis, conduction disorders) developing in childhood and adolescence are associated with an increase in titer to intracellular proteins specific to myocardiocytes and cells of the cardiac conduction system. Candidate autoantibodies markers for autoimmune response have been selected. The rationale for analyzing the immune status of heart rhythm disturbances in children and adolescents has been provided.
Early excision and grafting versus delayed grafting in deep burns of the hand
Authors: Ahmed Badr Mohammed Leithy , Keshk Tarek Fouad , Alkhateeb Yahia Mohammed , Esmail El Refaai Ashraf Moustafa
Published: September 2019

Background: Deep burns of the hand are considered severe, because even a small wound may cause profound functional disability, ugly scar and psychosocial problems. The aim of the study is to compare early excision and grafting versus delayed grafting in deep burns of the hand.Methods: This study was conducted on 30 patients with deep burns of the hand. Patients were randomly divided in to two equal groups. Group I included 15 patients who were subjected to early excision and grafting within the first week after injury while group II included 15 patients who were subjected to delayed excision and grafting two weeks after injury. The study was conducted on patients presented to Plastic and Reconstructive Surgery Department of Abou Qir General Hospital in the period from December 2016 to December 2017.Results: The results of early excision and grafting were better than delayed grafting regarding the intake, infection and post-burn contraction (mean 91.33±7.67 in group I and 83.67±10.08 in group II with p value=0.026).Conclusions: Early excision and grafting of the hand is a better alternative than delayed excision and grafting as regards better graft intake, less wound infection, less contractures, less risk of regrafting, less hospital stay, less 5D-itching scale and Vancouver score and more cost effectiveness.
Active surveillance: transperineal biopsies and evaluation of multi-parametric magnetic resonance imaging
Authors: Bhat Zubair , Bhat Arshad , Abbaraju Jayasimha , Wani Mudassir , Bhat Tahir , Deen Shameer
Published: September 2019

Background: Active surveillance has emerged as an acceptable choice for low-risk prostate cancer patients and is defined as a treatment strategy of close monitoring through PSA, digital rectal examination, imaging and prostate biopsy, with conversion to curative treatment if progression occurs. An ideal tool for risk-stratification would detect aggressive cancers and exclude such men from taking up active surveillance in the first place.Methods: We retrospectively reviewed patients who underwent transperineal template biopsies from January 2016 till December 2018. All the patients had been classified as low grade prostate cancer after conventional trans-rectal ultrasound guided biopsy and enrolled in AS after discussion in hospital MDM. As per NICE guidelines all patients underwent multi-parametric magnetic resonance imaging (MRI). All suspicious lesions were assigned a PIRAD score; this was followed by Trans-perineal prostate biopsy. 142 patients were on active surveillance and underwent mapping transperineal template biopsies and cognitive target biopsies. 130 of them had multi-parametric MRI prior to the biopsies.Results: In 52% of cases the histology was upgraded. In 34 (24%) the cancer was upgraded to Gleason 3+4 and 39 (28%) it was upgraded to scores higher than Gleason 3+4. Only 64 (45%) patients continued on active surveillance post-template biopsies due to significant upgrading of histology.Conclusions: We advocate combination of MRI and an early transperineal template guided prostatic biopsies for intermediate risk prostate cancer, multiple core involvement, higher PIRAD grades and suspicious prostate on digital rectal examination in order to re-stage the initial disease and provide better safety for this cohort of patients.
Application of non-operative management protocol in pediatric blunt splenic injuries with other associated injuries
Authors: Fahiem-Ul-Hassan Mir , Mufti Gowhar N. , Buch Mudassir H. , Baba Aejaz A. , Bhat Nisar A.
Published: September 2019

Background: Non-operative management (NOM) has become the standard of care for isolated blunt splenic injuries with satisfactory success rates. However, literature is scarce about the non-operative management of blunt splenic injuries (BSI) with other associated injuries (OAI). The main aim of this study is to assess the applicability of protocol-based NOM in BSI with OAI.Methods: Protocol based resuscitative algorithm was followed for the management of patients with BSI and OAI. NOM was taken up in those patients who were hemodynamically stable and was not attempted in patients who remained hemodynamically unstable or developed hemodynamic instability even after the resuscitative efforts. The data was collected and analyzed.Results: Forty patients with the mean age of 7.05±3.9 years were studied. Fall from height formed the commonest mode of injury. The mean AAST grade was 2.55. The most common association was a left lung contusion (20%). Fifteen patients presented with shock among which two failed the protocol-based resuscitative efforts and were hence explored. One of the patients had lung contusion and the other dorsal vertebral fractures (3rd and 4th). Another patient with mesenteric tear and delayed hemorrhage was operated. Two other patients underwent surgical interventions for bowel perforation and fracture of right femur respectively. Spleen was preserved in both of these patients. Though, the NOM was successful in overall 87.5% patients, spleen specific success rate was 92.5%.Conclusions: Application of protocol-based NOM in patients with BSI with OAI is highly successful if instituted in properly selected patients especially those with low grades of injury and also in those with delayed presentation.
Comparative study between lymphocyte-monocyte ratio and platelet-lymphocyte ratio: novel markers for critical limb ischemia in peripheral arterial disease
Authors: Swamy Varsha , Raksha R. , Rajagopalan S.
Published: September 2019

Background: Peripheral arterial occlusive disease (PAOD) is frequent and often not diagnosed in time. If treatment is not initiated early, disease progression and development of Critical limb ischemia (CLI) is one possible complication. CLI is an entity with high mortality and high risk of limb amputation. As monocytes play a leading role in progression of atherosclerosis and platelets play a key role in atherosclerosis and atherothrombosis, we investigated Lymphocyte-monocyte ratio (LMR), Platelet lymphocyte ratio (PLR) and its association with CLI in peripheral arterial disease.Methods: Retrospective observational study conducted between January 2015-December 2017 including 50 patients admitted in Rajarajeswari Medical College and Hospital, Bangalore. As an optimal cut-off value, a PLR of 150 and LMR of 5 were identified. Their association with CLI noted.Results: 50 patients with critical limb ischemia, stage 3 and 4 of Fontaine classification were included in this study. 72% patients had LMR less than 5.40% patients had PLR more than 150 and 36% patients had both LMR less than 5 and PLR more than 150. 96% patients with LMR<5 and 72% patients with PLR>150 underwent amputation.Conclusions: An increased PLR and reduced LMR are significantly associated with patients at high risk for CLI. They are broadly available and cost effective. When done in early stage of the disease serves as a marker for CLI and aggressive treatment in such patients will reduce the risk of amputation.
Surgical outcome of management of perforated peptic ulcer: retrospective analysis of 148 cases
Authors: Khan Salamat , Gupta O. P.
Published: September 2019

Background: Perforated peptic ulcer (PPU) is a common life threatening surgical emergency. Discovery of H. pylori (1985) changed the concept of the management of peptic ulcer. Now-a-days reduction in gastric acid production with proton pump inhibitors along with eradication of H. pylori is recommended.Methods: Clinically suspected cases of PPU were confirmed by radiological and laboratory investigation. These patients were subjected to exploratory laparotomy with Graham’s omental patch repair after adequate fluid resuscitation with optimal hemodynamic status with or without peritoneal drainage, except in too sick patients. Postoperatively; these patients kept in SICU and closely monitored. Data were collected, tabulated and analyzed.Results: Out 150 cases enrolled, 2 cases died before exploratory laparotomy and closure of operation. So only 148 took part in the study. Male patients were predominant than female in a ratio of 148:2. Age ranges from 20 to >60 years. Majority of the patients belongs to the age group 30-40 years of age. The morbidity and mortality rates were 20% and 2.7% respectively.Conclusions: Adequate fluid resuscitation with optimal hemodynamic status and optimal kidney function is the key to decrease morbidity and mortality rates. Simple closure with omental patch followed by H. pylori eradication is effective with excellent outcome in most of survivor despite of late presentation. Old concept of prophylactic peritoneal drainage and “no sunset no sun rise” concept of operation should be discouraged as it is not beneficial. Definitive surgery for ulcer recurrence is no more done except in special situation.
The therapeutic concept and analysis of the effect of hormone package therapy in brain dead organ donors
Authors: Xu Guixing , Xu Ping , Zheng Donghua , Wei Wanjia
Published: September 2019

Background: The present study aimed to assess the effect of hormone package therapy on hemodynamic stability in brain dead organ donors.Methods: In this study, patients were divided into two groups: one administered hormone package therapy, defined as simultaneous treatment with vasopressin, thyroxine and corticosteroids; and the other administered conventional therapy. Clinical findings and hemodynamic parameters were compared to analyze the effect of hormone package therapy on hemodynamic stability. Associations between hormone package therapy and hemodynamic variables were assessed by univariate and multivariate logistic regression analyses.Results: A total of 109 patients were included in the study. Based on time of enrollment, 54 and 55 patients received conventional and hormone package therapy, respectively, with 32 (59.3%) and 45 (81.8%), respectively, achieving hemodynamic stability. High-doses of a single vasoactive agent in the hormone package group better maintained hemodynamic stability and norepinephrine use compared to conventional treatment. Univariate and multivariate analyses showed that an abnormal suprasellar cistern, midline shift, low free T3, axillary temperature >36.5°C and central diabetes insipidus were associated with the effects of hormone package therapy.Conclusions: Hormone package therapy can help maintain hemodynamic stability in brain dead donors and reduce the use of vasoactive agents, thereby improving the quality of donated organs and the success rates of organ donations.
Assessment of thyroid profile in patients with fissure in ano in the South Indian population
Authors: Prabhakaran Madhumitha , Narayanasami Bharath , Rekha Arcot
Published: September 2019

Background: Hard faeces result in local trauma to the rectal mucosa which secondarily activates internal anal sphincter hypertonia. This will compress end arteries of the anus and cause ischemia of the posterior commissure and eventually anal fissures. A precipitating history of constipation is found in approximately 20% of patients with anal fissures. Constipation is one of the classic signs of hypothyroidism.Methods: Patients who presented to the surgical OPD of Saveetha Medical College and Hospital, Thandalam, India during the months of March and April of 2019 with lower abdominal complaints were screened for fissure in ano. The thyroid profile of these patients was analysed.Results: 38.2% of patients with lower gastrointestinal complaints and 3.6% of the total number of patients presenting to the surgical OPD were attributed to an anal fissure. The incidence of hypothyroidism in patients with an anal fissure is 32%. Since the incidence of hypothyroidism in our study is higher than the prevalence of hypothyroidism in the general population as documented by multiple studies in the past, we can conclude that there is a significant association between hypothyroidism and development of anal fissures.Conclusions: By analysing the thyroid profile in patients with anal fissures, we found an association between the two entities. This information can be used to predict and prevent anal fissures in hypothyroid patients.
Colon interposition in the treatment of corrosive esophageal strictures: 100 patients in seven years
Authors: Sharma Praveen , Pancholi Mukesh
Published: September 2019

Background: The purpose of this study is to represent the change in our concept of principles and techniques of esophagocoloplasty (midcolon esophagocoloplasty) with repetitive performance of the operation and approach of early surgical intervention (within 4-6 month of corrosive ingestion) in place of repetitive trials of dilatations and medical management, provides early better quality of life with lesser period of suffering and saving expenditure of treatment.Methods: This retrospective study comprises of consecutive 100 patients operated for colon interposition for corrosive stricture of esophagus done at two university linked government teaching hospitals during March 2011 to March 2018. Out of 100 patients, 77 female and 23 male (3:1), mean age 30.6 years (range from 21 to 47 years), mean hospital stay was 14.5 days (range 10 to 25 days) and mean operative duration was 4.5 hours (range 2.5 to 7 hours).Results: The 30 day in hospital mortality rate was 9%. There were 14 instances of leak at the esophagocolic anastomosis (14%), graft necrosis occurred in 01 patient, 08 patients (8%) developed stenosis at the esophagocolic anastomosis. More than 90% patients (n=77) had ‘Good’ result, 06 patients had ‘Fair’ and 02 had ‘Poor’ result.Conclusions: Midcolon graft is a solution for confusion in judgment of adequate length of graft and offer uniformity in procedure with effectively lesser operative time. Early (4-6 months after ingestion) operative intervention is advantageous to patients suffering from crippling dysphagia with repeated admission and expenditure from multiple endoscopic dilatations.
A prospective study of uroflowmetry in 100 patients with lower urinary tract symptoms
Authors: Gohil Vikram B. , Vyas Adhish V. , Kinjal K. Dodiya
Published: September 2019

Background: Uroflowmetry is diagnostic procedure of various urinary tract diseases like urethral stricture, benign prostatic hyperplasia, neurogenic bladder, detrusor muscle overactivity by calculating the rate of urine expulsion against the time unit in second. Uroflowmetry is simple and non-invasive diagnostic method.Methods: This is a prospective study of 100 cases which fulfil inclusion and exclusion criteria. After taking informed written consent of the patients, they have gone under uroflowmetry study by Urocap 3 uroflowmeter, and graphs were obtained and result analysed.Results: Maximum number of patients has prolonged curve graph were diagnosed as benign prostate hypertrophy (BPH) (53%), dysfunctional voiding curve for detrusor overactivity (20%) intermittent flow curve for neurogenic bladder (7%), Box variety for urethral stricture (7%).Conclusions: In present study we found that uroflowmetry is helpful in diagnosis of certain urological pathologies. Common lower urinary symptoms were burning micturition, frequency and difficulty in micturition. Age group from 50-70 years was often presented with bladder outflow obstruction. Uroflowmetry overall useful in diagnosis of BPH and urethral stricture which can be supported by ultrasonography of prostate with PVRV and RGU respectively to avoid other invasive and more difficult pressure or flow urodynamic study.
Annular pancreas with choledocholithiasis in an adult male patient: a case report
Authors: Milev Ilija , Karagjozov Panche , Mitevski Aleksandar , Mihailov Marjan
Published: September 2019

Annular pancreas is very rarely presented with a clinical picture of obstructive jaundice, usually due to some biliopancreatic malignancy rather than choledocholithiasis which make our case unique. We are presenting a 60-year-old male patient with a 6 mounts old medical history of right upper quadrant pain and intermittent jaundice. On ultrasonography a common bile duct stone was detected with dilatation of the biliary tree and gallstones with edematous wall of the gallbladder. On gastroscopy narrowing of the duodenum was registered. On ERCP the papilla Vateri could not be cannulated and there was a substantial amount of retained food in the duodenal bulb and antral part of the stomach. MRCP showed extensive dilatation of the whole biliary tree from several stones in the distal part of the common bile duct. At the operation there was a ring of pancreatic tissue about 2 cm wide that surrounded the second portion of the duodenum. The operation proceeded with choledochotomy, choledocholythotomy, L-L choledocho-duodenostomy and partial resection of the pancreatic ring. After three mounts the patient had gain weight, had no pain or any other symptoms and control gastroscopy showed normal finding.
Median arcuate ligament syndrome presenting with unintentional weight loss and epigastric pain
Authors: Mujahid Mohammed Taher , Soni Virendra Kumar , Saini Rahul
Published: September 2019

Median arcuate ligament syndrome is a rare condition characterized by extrinsic compression of celiac artery and celiac plexus by the median arcuate ligament. Patients typically present with chronic postprandial pain, nausea and occasionally, vomiting and weight loss. Treatment of this syndrome is laparoscopic or open surgical release of median arcuate ligament and gangliectomy. We report a rare case of median arcuate ligament syndrome in a patient who presented with abdominal pain and nausea. The patient was evaluated, investigated and planned for surgical intervention but the patient refused for treatment.
A large ureteric calculus: is there a role for open surgery in the modern era?
Authors: Maranna Haraesh , Hameed Tariq , Lal Pawan
Published: September 2019

A 36 year old gentleman presented with recurrent urinary tract infections, hematuria and lump in the left side of abdomen for 4 months. Clinically a soft, non-tender lump in left lumbar region with well-defined margins was palpable. CT scan of abdomen revealed a calculus of size 45 mm at the left vesico-ureteric junction with gross left hydronephrosis. Patient underwent open ureterolithotomy in view of the large size of calculus and due to stone impaction. Post-operative period was uneventful. Patient was followed up for 6 months and remained asymptomatic.