bluuebunny/crossref_metadata_2025 huggingface dataset:
Combined Effect of Traffic and Geometrics on Rear-End Collision Risk
Authors: Bella Francesco , D'Agostini Giulia
Published: October 2010

This paper presents the results of a laboratory experiment that sought to analyze rear-end collision risk under various traffic conditions and given various road geometric configurations. The CRISS (Inter-University Research Center for Road Safety) interactive fixed-base driving simulator was used. An 8–km, two-lane, rural road that incorporated 15 tangents and curves was designed and implemented in the driving simulator. Four distinct traffic conditions were simulated, and 32 drivers drove in four traffic scenarios. The differences in speed and position between each driver's vehicle and other vehicles on the road were collected to calculate two safety indicators, which the scientific literature has suggested to evaluate rear-end collision risk on the basis of the time-to-collision (TTC) notion. The maximum values of these indicators were given for an average traffic-flow condition, which is therefore the most critical condition for rear-end collision risk. In scenarios that entailed lower traffic volumes, significant models of TTC-based indicators were found for tangents with lengths that ranged from 400 m to 1,000 m. The independent significant variables were volume-to-capacity ratio, length of the tangent, and length of the curve approaching the tangent. In traffic scenarios characterized by higher traffic volumes, no significant models were found for any kind of geometric element. This outcome seems to prove that the influence of the geometric features on the rear-end collision risk tends to become negligible whenever the volume-to-capacity ratio reaches high levels. In these conditions driver behavior is exclusively affected by interactions among vehicles.
Effects of insulin-like growth factor–I and platelet-rich plasma on sciatic nerve crush injury in a rat model
Authors: Emel Erhan , Ergün Selma Sönmez , Kotan Dilcan , Gürsoy Esra Başar , Parman Yeşim , Zengin Asli , Nurten Asiye
Published: October 2010

Object

Local administration of insulin-like growth factor–I (IGF-I) has been shown to increase the rate of axon regeneration in crush-injured and freeze-injured rat sciatic nerves. Local administration of platelet-rich plasma (PRP) has been also shown to have a measurable effect on facial nerve regeneration after transection in a rat model. The objective of the study was to compare the effects of locally administered IGF-I and PRP on the parameters of the Sciatic Function Index (SFI), sensory function (SF), axon count, and myelin thickness/axon diameter ratio (G-ratio) in a rat model of crush-injured sciatic nerves.

Methods

The right sciatic nerve of Wistar albino rats (24 animals) was crushed using a Yasargil-Phynox aneurysm clip for 45 minutes. All animals were randomly divided into 3 groups: Group 1 (control group) was treated with saline, Group 2 was treated with IGF-I, and Group 3 was treated with PRP. Injections were performed using the tissue expander's injection port with a connecting tube directed at the crush-injured site. Functional recovery was assessed with improvement in the SFI. Recovery of sensory function was using the pinch test. Histopathological examination was performed 3 months after the injury.

Results

The SFI showed an improved functional recovery in the IGF-I–treated animals (Group 2) compared with the saline-treated animals (Group 1) 30 days after the injury. In IGF-I–treated rats, sensory function returned to the baseline level significantly faster than in saline-treated and PRP-treated rats as shown in values between SF-2 and SF-7. The G-ratios were found to be significantly higher in both experimental groups than in the control group.

Conclusions

This study suggests that the application of IGF-I to the crush-injured site may expedite the functional recovery of paralyzed muscle by increasing the rate of axon regeneration.
The transorbital keyhole approach: early and long-term outcome analysis of approach-related morbidity and cosmetic results
Authors: Beseoglu Kerim , Lodes Sabrina , Stummer Walter , Steiger Hans-Jakob , Hänggi Daniel
Published: October 2010

Object

In 2003 the authors introduced a minimally invasive transorbital keyhole approach. Because this approach requires removal of the orbital rim and orbital roof, there have been concerns regarding perioperative morbidity, long-term morbidity, and cosmetic results. The authors evaluated approach-related morbidity and cosmetic results in their patients to determine the rate of complications and compared this to published reports of similar approaches.

Material

Seventy-one patients (41 female, 30 male) underwent operations using this approach between 2004 and 2008. Immediate approach-related morbidity was recorded after the operation. Late morbidity was determined after 7 months by an independent examiner while cosmetic results were self-rated by the patient using a questionnaire.

Results

Fifty-one (72%) of 71 patients had no postoperative complications and 12 (16.9%) had minor complications, the most common of which was subgaleal CSF collection (7.0%). Other minor complications included facial nerve palsy (2.8%), hyposphagma (2.8%), periorbital swelling due to periorbital hematoma (2.8%), and subdural hematoma (1.4%). Major complications requiring surgical revision occurred in 4 patients (5.6%); these were CSF fistulas in 2 patients, pneumocephalus in 1 patient, and a hematoma in 1 patient. Forty-nine (90.7%) of all 54 examined patients rated the cosmetic results as very good or good. Major long-term morbidity was hyposmia or anosmia (14 patients) followed by hypoesthesia around the scar (9 patients).

Conclusions

The transorbital keyhole approach is a feasible approach with a low-risk profile for postoperative or long-term morbidity and excellent cosmetic outcome.
Design and synthesis of a cyclitol-derived scaffold with axial pyridyl appendages and its encapsulation of the silver(I) cation
Authors: Léo Pierre-Marc , Morin Christophe , Philouze Christian
Published: October 2010

Conversion of amyo-inositol derivative into ascyllo-inositol-derived scaffold withC3vsymmetry bearing three axial pyridyl appendages is presented. This pre-organized hexadentate ligand allows complexation of silver(I). The crystal structure of the complex was established.
RESEARCH ON TRANSFERING THE DYNAMIC PROCESS BY THE SPRING
Authors: Bučinskas Vytautas , Dmitrijev Jevgenij
Published: October 2010

The article describes the particulars of transferring the dynamic process applying the spring and explains the possibilities of diagnostics for support bearings insulated from the external body using resilient elements. The carried out research has revealed methodology for investigation and suggested a suitable research stand. The input signal of impulse type was submitted to the system to observe free oscillations in the stand. Also, the system was stimulated employing an electromagnetic vibrator to research the transfer function of the spring. Finally, using output and input signals at the ends of the spring, the transfer function was derived.
ADHESIVE ANALYSIS OF PAINTED COATINGS
Authors: Grinius Deividas , Gedzevičius Irmantas , Garbinčius Giedrius
Published: October 2010

The article presents investigations into adhesion to painted coatings using showcard. The surfaces produced from aluminium, PVC and acrylic glass have been chosen. Different glues have been tested. The influence of surface preparation (roughness and undercoat) for adhesion has been analysed.
THE METHODOLOGY FOR CALCULATING BOOK BACKBONES
Authors: Alūzienė Rūta , Sidaravičius Jonas
Published: October 2010

The article describes the methods of calculating the width of book back. One of the calculation methods used in the printing house was tested. On the basis of the experimental data, the calculation formula is proposed. Due to negative results, the first formula was corrected adding a coefficient evaluating the thickness of the paper which enables to increase calculation accuracy and the results of calculation match with technological requirements. The corrected formula was tested using two methods concerning the measurements of paper thickness. The application of the calculation formula of the developed width of book back was approved experimentally on 72 backs of the book and can be recommended for use in printing houses.
REVIEW OF DEVICES FOR MEASURING ANGLES AND PROSPECTS FOR DEVELOPMENT
Authors: Augustinavičius Giedrius , Čereška Audrius
Published: October 2010

The article analyzes the methods and devices for angle measurement. An accurate analysis of devices for angle measurement was performed. The accuracy of the angle position of the tested device was evaluated. The future perspectives of devices for angle measurement were explored.
PROTECTION OF INTELLECTUAL PROPERTY IN PHARMACEUTICAL INDUSTRY
Authors: Česiulytė Vitalija , Toločka Eligijus , Strazdas Rolandas
Published: October 2010

The development of pharmaceutical and biotechnology industries indicates that people around the world use different types of drugs for disease treatment and prevention. In the case of high demand for medicines, great attention to pharmacy industry is paid. Since the drugs are directly linked to human health and life, the state pays special attention to the safety of medicines and the quality of eligibility. Therefore, the companies wishing to become a part of this area are to obtain and then keep the license. The protection of intellectual property allows companies to use substantial investment in new drugs and treatment methods and to conduct research in the future. This is a particular concern for originator companies. Undefended patents also inhibit the creativity of local people as local innovators know that their products can be immediately copied, thus discouraging investment in new investigation.
METHODS OF FORECASTING IN FOREIGN EXCHANGE MARKET
Authors: Valiulis Donatas
Published: October 2010

The study deals with the interaction of technical and fundamental analysis in forecasting the foreign exchange market. Different forecasting approaches for market participants were discussed and forecasting strategies analyzed. Pressing problems, further areas of research and identified trends to investigations in the future were also reviewed.
RESEARCH OF DEFECTS IN SPUR GEAR
Authors: Skrickij Viktor
Published: October 2010

This study presents a review of gear diagnostic methods. Also presented nonlinear dynamic model of spur gear. We modeled backlash, bearing flexibility and variable teeth stiffness.
Éviter ou réduire la déforestation pour atténuer le changement climatique : le pari de la REDD
Authors: Tsayem Demaze Moïse
Published: October 2010

Depuis quelques années, la Réduction des Emissions de gaz à effet de serre dues à la Déforestation et à la Dégradation forestière (REDD) fait l’objet de débats et de propositions dans le cadre des négociations internationales pour l’élaboration d’un traité devant succéder au protocole de Kyoto. Cet article synthétise les connaissances sur cette initiative émergente qui a un double objectif : intégrer les forêts tropicales dans la lutte contre le changement climatique et faire participer les pays en développement aux efforts internationaux de réduction des émissions de gaz à effet de serre. L’article montre que les divergences entre les propositions formulées par les États, ajoutées aux difﬁcultés de quantiﬁcation de la déforestation et de la dégradation forestière réellement évitées, n’augurent pas d’une évidente et efﬁcace mise en œuvre de cette initiative à forte connotation marchande dans le contexte actuel de crise ﬁnancière et économique.
Du terrain vague à la friche paysagée
Authors: Lizet Bernadette
Published: October 2010

Résumé Le jardin « naturel » est à la mode, et il déstabilise le modèle longtemps hégémonique du jardin fleuri. Il exerce une séduction croissante en ville, où il symbolise la nature ordinaire, concrétise les idées et les valeurs de l’écologie urbaine et du développement « durable ». Le jardin naturel se radicalise dans l’hybridation entre friche et jardin, figure nouvelle qui valorise l’esthétique brouillonne du terrain vague et cristallise toutes les ambiguïtés du rapport à la nature aujourd’hui : accueillir les mécanismes naturels et s’en assurer le contrôle. Une recherche a été effectuée sur une petite friche parisienne, dans un quartier particulièrement dense et soumis à de forts enjeux politiques. Du terrain vague à la friche paysagée, elle a permis de comprendre les paradoxes d’un nouveau modèle de nature urbaine, un « sauvage » singulièrement socialisé.
Filosofía y derechos humanos
Authors: Parellada Ricardo
Published: October 2010

Se examina la relevancia de los análisis filosóficos para la conceptualización y para la realización de los derechos humanos, a partir de dos episodios concretos: la elaboración de la declaración universal de los derechos humanos y los planteamientos recientes sobre la justicia global. Se propone que la fuerza y la autoridad moral de los derechos humanos no depende de que se haya llevado a cabo un examen exhaustivo de esta noción, pero también que esa autoridad no es compatible con cualquier teoría sobre ello. Y se defiende la relevancia del análisis filosófico de la idea de justicia global y la irrelevancia de la filosofía para su realización.
Derechos políticos, constitucionalismo y separación de poderes
Authors: Greppi Andrea
Published: October 2010

La relación entre derechos políticos y separación de poderes no ha recibido demasiada atención en el pensamiento democrático de los últimos años donde ha sido predominante una visión centrada en el constitucionalismo de los derechos, con una explícita orientación contra-mayoritaria. El propósito de este artículo es indicar una serie de transformaciones que afectan de manera determinante a la estructura de separación de poderes de nuestros sistemas constitucionales y que suponen un cambio radical en las condiciones de ejercicio de los derechos políticos. Se utiliza para ello el aparato conceptual desarrollado por Luigi Ferrajoli en su reciente Principia Iuris y, en particular, la distinción entre funciones de gobierno y funciones de garantía. La sugerencia con la que se cierra el trabajo es que la distinción entre juicio político y conocimiento cierto es indispensable en el diseño institucional de cualquier democracia representativa pero reposa sobre un conjunto de reglas pragmáticas acerca de la distribución de la autoridad epistémica que se han vuelto extremadamente inestables en las sociedades contemporáneas.
Conflictos entre derechos constitucionales y maneras de resolverlos
Authors: Moreso José Juan
Published: October 2010

En este trabajo se analiza la cuestión de la colisión entre principios constitucionales que reconocen derechos básicos. Se muestra que hay dos posiciones extremas: el enfoque subsuntivo y el enfoque particularista, que encarnan dos grandes concepciones de la racionalidad práctica. Entre ambos enfoques hay lugar para un amplio espectro de opciones. Se toman dos en cuenta: el enfoque proporcionalista, que conserva el alcance de los derechos restringiendo su fuerza y el enfoque especificacionista, a favor del cual se argumenta, que conserva la fuerza de los derechos restringiendo su alcance.
Un approcio giusnaturalista ai diritti umani in una societá plurale
Authors: Parisoli Luca
Published: October 2010

Propongo una versión voluntarista medieval del jusnaturalismo como estrategia plausible para implementar los derechos fundamentales en una sociedad culturalmente no-homogénea; trátase, en particular, de la versión de la escuela franciscana, que propone una discontinuidad sustancial entre el derecho natural que precede a la Caída (esfera de los derechos fundamentales de la persona) y el derecho natural que sigue a la Caída (esfera de los derechos institucionales de los individuos de una sociedad dada, con una pluralidad del bien común). Tras las necesarias precisiones semánticas, esa estrategia conserva el valor político de la tolerancia y la pluralidad efectiva de los modelos culturales en una misma sociedad, aunque quienes pertenecen a una cultura determinada estén persuadidos de la superioridad de su propia cultura sobre las demás. Opónese esa estrategia al legalismo ético, difundido en el debate político contemporáneo, al cual critico por su tendencia homogeneizante y su reducción de la pluralidad a la no-culturalidad.

[it] Si tenta di proporre una versione volontarista medievale del giusnaturalismo come strategia plausibile per gestire i diritti fondamentali in una società non-omogenea culturalmente: si tratta in particolare della versione proposta dalla scuola francescana che propone una non-continuità sostanziale tra il diritto naturale che precede la Caduta (sfera dei diritti universali della persona) e il diritto naturale che segue la Caduta (sfera dei diritti istituzionali degli individui di una data società e pluralità del bene comune). Dopo le necessarie precisazioni semantiche, questa strategia conserva il valore politico della tolleranza e la pluralità effettiva dei modelli culturali in una stessa società, nonostante che gli appartenenti ad una determinata cultura siano persuasi sinceramente della preferibilità della propria cultura sulle altre. Si oppone questa strategia al legalismo etico, diffuso nel dibattito politico contemporaneo, che viene criticato per la sua tendenza omogeneizzatrice e la sua riduzione della pluralità alla a-culturalità.
El derecho a comer: Los alimentos como bien público global
Authors: Ausín Txetxu
Published: October 2010

Comer y beber son necesidades esenciales de todo ser humano, en toda cultura y sociedad, y su carencia produce, evidentemente, daños graves y objetivos. Por ello, el alimento y el agua potable devienen en exigencias morales universales en términos del derecho humano a comer y a beber, uno de esos derechos que dan y preservan la vida. Sin embargo, la humanidad vive sumida en una gravísima e intolerable situación de hambruna a la que contribuyen algunos factores estructurales como las políticas comerciales y financieras internacionales, la producción de biocombustibles y el abandono de la agricultura de consumo, entre otros. Este panorama obliga a una profunda reformulación de las políticas públicas sobre el alimento y el agua potable, que partan de su conceptualización como bienes públicos y no meras mercancías.
Le droit à la santé: des objectifs de l’OMS à ceux ans du Millenium
Authors: Guibet Lafaye Caroline
Published: October 2010

El derecho a la salud viene proclamado por Las Naciones Unidas en la Declaración de los Derechos del Hombre de 1948. En 1981 la ONU erige ese derecho en un objetivo del nuevo Milenio. En este texto muestro que los objetivos del Milenio, por generosos que sean, se basan en una interpretación insuficiente de los bienes primarios de salud. Por el contrario, una política que garantice los bienes sanitarios elementales, concebidos en términos de capacidades, contribuiría no sólo a mejorar el nivel global de salud de las poblaciones del mundo sino también a reducir la pobreza, objetivo-faro de la Declaración del Milenio.

[fr] Le droit à la santé est proclamé par les Nations Unies dans la Déclaration des Droits de l’Homme de 1948. Elles en font un objectif du nouveau Millénaire en 1981. Dans ce texte nous montrerons que les objectifs du Millénium, aussi généreux soient-ils, proposent et reposent sur une interprétation des biens premiers en santé insuffisante. A l’inverse, une politique garantissant des biens élémentaires en santé, conçus en termes de capabilités, contribuerait non seulement à améliorer le niveau global de santé des populations mondiales mais également à réduire la pauvreté, objectif phare la Déclaration du Millénium.
Formas del Estado de Derecho y delimitación del derecho al Buen Gobierno
Authors: Galán Juárez Mercedes
Published: October 2010

Este artículo analiza cuál es el marco político y jurídico adecuado para que los ciudadanos hagan efectivo su derecho al buen gobierno. Después de exponer la condición social del hombre que le lleva a agruparse con otros hombres y a vincularse a una organización política por medio de un pacto o contrato social, se analizan las distintas formas históricas del Estado de Derecho hasta llegar al Estado Constitucional de Derecho. El Constitucionalismo actual aúna el principio de legalidad y legitimidad, lo que significa que no basta con que una norma sea válida desde un punto de vista estrictamente formal sino que se requiere que su contenido respete los valores, principios y derechos fundamentales establecidos en la Constitución. Por su parte, la Constitución Española de 1978, al resaltar la centralidad de la persona y su dignidad (art. 10.1) y destacar el valor instrumental de la Administración pública como organización política al servicio objetivo de los intereses generales (art. 103.1), establece el marco jurídico adecuado para conseguir no sólo la eficiencia y la eficacia de la gestión pública, sino la calidad de sus servicios. Asimismo, el gobierno tiene unos compromisos morales con los ciudadanos, lo que conlleva realizar políticas coherentes con dichos compromisos y prevenir y perseguir las que no lo sean. Este planteamiento jurídico, político y ético hace posible entender el buen gobierno en toda su complejidad.
La bioética jurídica islámica como fenómeno jurídico-cultural regional: Tensiones internas y externas en la actualidad producidas en su inserción como derechos humanos
Authors: Mikunda Franco Emilio
Published: October 2010

El presente trabajo corona la tercera parte de una trilogía en torno al Mundo islámico, tratando la “bioética jurídica islámica” como fenómeno jurídico regional frente a la occidental, autodenominada universal. (Anteriores partes fueron “Derechos humanos”, y “constitucionalismo” islámicos.) Aporta un glosario terminológico islámico sui generis con connotaciones específicas, similitudes y diferencias frente a la occidental al uso en España, en evitación de posibles confusiones o lapsos debidos al uso de términos de idéntico significante y homólogo significado. Analiza tensiones de todo tipo producidas al asociar “bioética y derechos humanos en el mundo islámico”. Condensa en diez tesis finales la polémica y problemática resultante, que reproduce –según su autor– análoga situación de otrora entre “Derechos humanos universales versus Derechos humanos islámicos regionales”. La bibliografía selectiva abarca temas específicos de Derechos humanos, bioética islámica y constitucionalismo, reseñando in fine aportaciones del autor.
“La vida está fuera del tiempo”. León Tolstói entre la práctica vital y la predicación moral
Authors: Rabe Ana María
Published: October 2010

A finales del XIX y principios del XX León Tolstói fue considerado un importante modelo ético dentro y fuera de Rusia. La gente del pueblo lo veneraba como ejemplo moral que predicaba la vida y el trabajo en el campo en concordancia con la naturaleza, el amor al prójimo, la sencillez y renuncia a la propiedad, valores que el escritor aristócrata parecía llevar él mismo a la práctica. A la vez, las autoridades estatales y eclesiásticas de Rusia temían la gran influencia que ejercían las severas críticas y acusaciones con las que el famoso novelista y predicador desenmascaraba la injusticia, violencia e hipocresía de las instituciones rusas. Como se muestra en el artículo, las ideas tolstoianas acerca del amor realizado aquí y ahora, la renuncia a cualquier recompensa, la resistencia no violenta, el morir como decaer en la cotidianidad y la práctica vital insertada en el presente desempeñaron un papel importante en los círculos intelectuales de la época, p. ej. en Bunin, Gorki, Heidegger, Gandhi, Nietzsche o Lukács. La concepción tolstoiana de la vida en el presente, que se encuentra “fuera del tiempo” y alcanza así la felicidad y eternidad –idea a la que alude San Agustín– impresionaron especialmente al joven Wittgenstein. El artículo presenta estas ideas éticas, religiosas y existenciales tal y como aparecen en los escritos teórico-religiosos y los relatos tolstoianos mostrando al mismo tiempo los polos opuestos del pensamiento y carácter de Tolstói sobre las que se levantan.
Guerra y guerra. La modernidad apocalíptica de Thomas Müntzer a León Tolstói
Authors: Bayón Fernando
Published: October 2010

Este artículo analiza cuál es el puesto de León Tolstói en la Modernidad a través de un diálogo con una serie de autores que representan una alternativa al discurso hegemónico en torno a la constitución de la conciencia moderna. Los autores elegidos son representativos de un gran arco temporal que va del siglo XVI hasta el XX: Thomas Müntzer, Jean Paul y Carlo Michelstaedter. La hipótesis del artículo defiende que la Modernidad política quedó fuertemente marcada por formas inéditas de experiencia religiosa que ayudaron a extender por todo el continente una nueva idea de la consumación del tiempo histórico. El argumento principal de este ensayo se dirige a demostrar que la obra de Tolstói participa de un cierto tono apocalíptico que resulta muy sintomático de las fracturas políticas de la modernidad así como de las crisis de la conciencia histórica.
Microscopios del siglo XVIII del Museo Nacional de Ciencias Naturales. CSIC. Dos piezas únicas de la Ilustración para la investigación naturalista
Authors: González-Alcalde Julio , Sáez-Dégano Juan Antonio
Published: October 2010

El objetivo de este trabajo es efectuar un recorrido por la historia, características y proceso de restauración de dos de las piezas más antiguas de la Colección de Arqueología de la Técnica e Industrial del Museo Nacional de Ciencias Naturales. CSIC. Son dos microscopios del siglo XVIII, construidos en Inglaterra. El microscopio simple-compuesto, construido por George Adams hacia 1750-1770 pudo pertenecer a D. Antonio de Ulloa o a Don Pedro Franco Dávila. Sólo se exponen dos piezas semejantes en el Museo de la Ciencia de Ginebra y en el de Londres. El microscopio compuesto, construido por Dollond hacia 1780, fue propiedad de Eugenio Izquierdo de Rivera y Lazaún sucesor de D. Pedro Franco Dávila en la dirección del Real Gabinete de Historia Natural, actual Museo Nacional de Ciencias Naturales. Era un conocido naturalista y, además, juez, diplomático, secretario e informante de Manuel Godoy.
Knowledge of and attitude to foot care amongst Type 2 diabetes patients attending a university-based primary care clinic in Nigeria
Authors: Ekore Rabi I. , Ajayi Ikeoluwapo O. , Arije Ayo , Ekore John O.
Published: October 2010

Background: Individuals living with diabetes mellitus are at an increased risk of developing foot ulcers and cardiovascular complications or a neuropathy that may result in amputations. These complications have been shown to be already present in about 10% of diabetic patients at the time of diagnosis.Objectives: This study was carried out to determine the level of awareness and attitude to foot care among adult diabetic patients attending a university health centre (i.e. a primary care centre) and to emphasise the ever-present need for health education and promotion and early complication detection (especially of foot problems) among diabetic patients.Method: A descriptive cross-sectional, clinic-based study was carried out at the University of Ibadan Health Centre (Jaja Clinic). The study population consisted of consenting adult diabetic patients. Data were collected by the self-administration of structured questionnaires to eligible subjects and were analysed using the SPSS v.15software. Appropriate statistics were employed to analyse the collected data.Results: A total of 137 patients participated in the study and ranged in age from 37 to 75 years, with the mean ± SD age being 58.2 ± 9.2 years. Of the participants, 98 (71.5%) were men and 39 (28.5%)were women; all of the participants were married. The duration of illness ranged from 1 year to 20 years, with the median duration of illness being 3 ± 1.7 years. One hundred and twenty-six (92%)patients had never received any education on foot care from their healthcare providers, while 11(8%) had received some form of foot care education. Among those who had never received any foot care education, 92 (73%) had been diabetic for 1–5 years, while the remaining 34 (27%) had been diabetic for 6 – 20 years. Of the foot care measures that were known, 35 (25.5%) patients knew to wash their feet daily and dry in between the toes thoroughly, 31 (22.6%) knew not to go outdoors barefooted, 27 (19.7%) checked their feet daily, 27 (19.7%) checked inside their shoes daily, 8 (5.8%)consciously made an effort to avoid injuries to their feet and 4 (2.9%) clipped their toenails with care.Conclusion: The results of this study showed that awareness of foot care measures is very poor amongst known diabetic patients and this is largely due to a lack of education of the patients by their health care providers.
Psalm 137: Perspectives on the (neuro-) psychology of loss
Authors: Viviers Hennie
Published: October 2010

The neuro-psychological imperative first implies the formation of neural networks through exposure to the external environment, both physically and ideologically, giving us our �selves�. It in turn implies the projection of this internal world onto the outer to achieve neuro-environmental consonance. Situations like bereavement, immigration or exile break down this consonance and are accompanied by strong negative emotions. When viewing Psalm 137 through the lens of the neuro-psychological imperative, its intense experience of the loss of land (and �self�) becomes transparent as this psalm vividly recalls the devastating experience of the Babylonian exile. The shocking end of the psalm, detailing the desire for the brutal annihilation of enemy infants, expresses the understandable ideological drive of the exiles to, ironically, retrieve their lost �selves.� Although understandable as an upholding of the established internal world, the manner in which this is to be achieved is not to be emulated by modern civilised societies.
Brucellosis: Review on the Recent Trends in Pathogenicity and Laboratory Diagnosis
Authors: Christopher Supriya , L. Umapathy B , L. Ravikumar K
Published: October 2010

Brucellosis is a zoonotic infection transmitted from animals to humans by the ingestion of infected food products, direct contact with an infected animal or inhalation of aerosols. The last method is remarkably efficient given the relatively low concentration of organisms (10 – 100 bacteria) needed to establish infection in humans, and has brought renewed attention to this old disease. Brucella is a facultative intracellular pathogen that has the ability to survive and multiply in the phagocytes and cause abortion in cattle and undulant fever in humans. Brucella spp particularly B. melitensis, B. abortus, and B. suis represent a significant public health concern. At present, B. melitensis is the principle cause of human brucellosis in India. Molecular studies have demonstrated the phylogenetic affiliation of Brucella to Agrobacterium, Ochrobactrum, and Rhizobium. Human brucellosis still presents scientists and clinicians with several challenges, with regard to the understanding of its pathogenic mechanism, severity, progression, and development of improved treatment regimens. Molecular studies have now highlighted the pathogenesis of Brucella, for the development of newer diagnostic tools that will be useful in developing countries where brucellosis is a common, but often a neglected disease. This review compiles all these issues in general and the pathogenicity and newer diagnostic tools in particular.
Emerging Infections: Shewanella – A Series of Five Cases
Authors: Sharma Krishna Kanchan , Kalawat Usha
Published: October 2010

Background: Shewanella spp. are unusual cause of disease in humans; however, reports of Shewanella infections have been increasing. Shewanella is a ubiquitous organism that has been isolated from many foods, sewage, and both from fresh and salt water. Earlier it was named as Pseudomonas putrefaciens or Shewanella putrefaciens. There are several reports describing this organism causing human infections such as cellulitis, abscesses, bacteremia, wound infection, etc. It is oxidase and catalase-positive non-fermenter gram-negative rod that produces hydrogen sulfide.

Aims: The study was conducted to identify Shewanella spp., which was wrongly reported as Pseudomonas spp.

Materials and Methods: Clinical samples were cultured as per standard clinical laboratory procedure. We tested the non-lactose-fermenting colonies for oxidase positivity. Oxidase-positive colony was inoculated in triple sugar iron slant (TSI) to know the hydrogen sulfide production. Hydrogen sulfide positive colonies were further tested for citrate, urease, indole, and amino acid decarboxylation and acid and gas production from sugars.

Results: Five isolates identified as Pseudomonas spp. during preliminary testing were proved to be Shewanella spp. on further testing.

Conclusions: It will help in better understanding the epidemiology, pathogenesis and risk factors associated with these and prevention of the rare pathogenic organisms.
Effect of Intradialytic Change in Plasma Volume on Blood Pressure in Patients Undergoing Maintenance Hemodialysis
Authors: Khalaj Ali-Reza , Sanavi Suzan , Afshar Reza , Rajabi Muhammad-Reza
Published: October 2010

Background: Hypervolemia is a common complication in patients on hemodialysis (HD). To determine the effect of volume change on blood pressure in HD population, this cohort was conducted.

Materials and Methods: The study population was composed of 60 non-diabetic patients on maintenance HD, with mean age of 59.95±15.28 years. They were divided into hypertensive group A (n=26) and normotensive group B (n=34). Data were collected by a questionnaire. Pre and post-dialysis blood levels of urea, sodium, total protein, and hemoglobin were measured and intradialytic change of plasma volume were calculated. Data analyses were performed by the SPSS v.16.

Results: Out of 60 patients, 58.3% were male and 41.7% female. Post-dialysis systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly lower than pre-dialysis values in both groups (P=0.001, each). No correlation was found between intradialytic change in plasma volume or body weight and alterations of SBP or DBP during HD in the study groups (P>0.05, each). Intradialytic changes of body weight did not correlate to intradialytic changes of plasma volume (P=0.15).

Conclusion: HD effectively reduces blood pressure and volume expansion, however, intradialytic changes of plasma volume and body weight do not influence on SBP and DBP.
Prevalence of Pseudomonas aeruginosa in Post-operative Wound Infection in a Referral Hospital in Haryana, India
Authors: Ranjan K Prabhat , Ranjan Neelima , Bansal Satish K , Arora D R
Published: October 2010

Background: The objective of our study was to determine the prevalence of Pseudomonas aeruginosa in the isolates of postoperative wound and its susceptibility pattern to commonly used antibiotics.

Materials and Methods: During a 2-year period, specimens were received as postoperative wound swabs in Microbiology Laboratory, Maharaja Agrasen Medical College, Agroha (Hisar), Haryana, India.

Result: Of the 300 bacterial isolates, 89 (29.6%) were P. aeruginosa, followed by Escherichia coli (61, 20.3%), Klebsiella spp. (50, 16.6%), Staphylococcus aureus (43, 14.3%), Proteus spp. (19, 6.3%), Acinetobacter spp. (9, 3.0%), and Citrobacter freundii (2, 0.6%). There was no growth in 27 (9.0%) specimens.

Conclusion: P. aeruginosa isolation was higher in male patients and most common in the age group of 21-40 years. The susceptibility pattern showed the organism to be most commonly susceptible to imipenem, followed by meropenem, cefoperazone/sulbactam, ticarcillin/clavulanate, and amikacin.Keywords: Pseudomonas aeruginosa, postoperative wound, prevalence, nosocomial, antibiotic
Prevalence of Methicillin-resistant Staphylococcus Aureus (MRSA) in a Tertiary Care Hospital in Northern India
Authors: Arora Shilpa , Devi Pushpa , Arora Usha , Devi Bimla
Published: October 2010

Aim: The emergence of Methicillin-resistant Staphylococcus aureus (MRSA) has posed a serious therapeutic challenge. We report the prevalence and antibiotic susceptibility pattern of MRSA in the hospitals attached to GMC, Amritsar, Punjab.

Materials and Methods: The study comprised of 250 coagulase-positive staphylococci (COPS) isolated from a total of 6743 clinical specimens (like pus, blood, urine, high vaginal swab, sputum, etc.) of patients admitted in hospitals attached to Government Medical College, Amritsar from January 2008−February 2009. Routine antibiotic susceptibility testing was performed and interpreted as per standard guidelines. Methicillin resistance was detected using oxacillin and cefoxitin disc diffusion method, oxacillin screen agar method, and minimum inhibitory concentration using broth macrodilution method.

Results: A total of 115 (46%) strains were found to be methicillin resistant. Multidrug resistance was observed in 73% MRSA strains. However, no strain was resistant to vancomycin.

Conclusion: Regular surveillance of hospital-associated infection and monitoring of antibiotic sensitivity pattern is required to reduce MRSA prevalence.
Prevalence and Antimicrobial Susceptibility Pattern of Methicillin-resistant Staphylococcus Aureus [MRSA] Isolates at a Tertiary Care Hospital in Mangalore, South India
Authors: Pai Vidya , Rao Venkatakrishna I , Rao Sunil P
Published: October 2010

Background/Aim: Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of nosocomial infections worldwide. The aim of this study was to determine the prevalence of MRSA and their antimicrobial susceptibility pattern in our hospital located in Mangalore, India.

Materials and Methods: The bacterial isolates from various clinical specimens of patients admitted in our hospital were cultured as per standard protocol and all isolates of Staphylococcus aureus obtained were included in the study. The isolates were identified by standard methods like catalase test, slide and tube coagulase tests, and growth on Mannitol salt agar (HiMedia Lab, Mumbai). The antimicrobial susceptibility testing was performed by Kirby–Bauer disc diffusion method. The D-test for inducible clindamycin resistance was performed. The isolates were tested for methicillin resistance by using oxacillin disc by disc diffusion method and confirmed by agar screen test (oxacillin 6 μgm/ml). The results were interpreted according to CLSI criteria.

Results: During a period of one year, a total of 237 isolates of S. aureus were studied and 69 (29.1%) were found to be methicillin-resistant. MRSA isolates showed greater resistance to multiple drugs than methicillin sensitive Staphylococcus aureus MSSA isolates. Inducible clindamycin resistance was 18.8% in MRSA as against 3.5% in MSSA. About 40–50% of MRSA were resistant to erythromycin, gentamicin, and chloramphenicol, while less than 30% were resistant to ciprofloxacin and amikacin. However, all strains were sensitive to vancomycin.

Conclusion: The regular surveillance of hospital-acquired infections of MRSA may be helpful in formulating and monitoring the antibiotic policy. This may also help in preserving antibiotics like vancomycin, only for life-threatening staphylococcal diseases.
Bacteriologic Profile and Antibiogram of Blood Culture Isolates in a Pediatric Care Unit
Authors: Prabhu Kavitha , Bhat Sevitha , Rao Sunil
Published: October 2010

Background / Aims: Septicemia is one of the important causes of mortality and morbidity in neonates and children. Blood culture is the gold standard for the diagnosis. Emergence of multidrug resistant bacterial strains is a major problem in the management of sepsis. Present study was undertaken to identify the common bacterial pathogens associated with pediatric sepsis and to determine their antibiotic susceptibility pattern.

Materials and Methods: Blood cultures from 185 suspected cases of sepsis were examined. The growths from the subcultures were identified by conventional biochemical tests. Antibiotic susceptibility testing was performed by modified Kirby-Bauer disk diffusion method and drug resistant strains in primary screening were further processed for extended spectrum beta lactamases (ESBL) and methicillin resistant Staphylococcus aureus (MRSA) status by combination disk method (ESBL) and oxacillin disk diffusion method (MRSA).

Results: Out of the 185 cultures obtained from suspected cases, 81 (44%) were culture positive. Fifty-two (35%) of the culture isolates were Gram negative bacilli. Twenty-eight (64%) of the isolates were Gram positive cocci. One case was of mixed infection. The prevalence of MRSA in 41 strains of S. aureus was found to be 29% (12 strains). The overall prevalence of ESBL producers among 28 Gram negative bacterial isolates was found to be 32% (9 strains).

Conclusion: This study stresses the need for the continuous screening and surveillance for antibiotic resistance in pediatric care unit.
Evaluation of a Rapid Differentiation Test for Mycobacterium Tuberculosis from other Mycobacteria by Selective Inhibition with p-nitrobenzoic Acid using MGIT 960
Authors: Sharma Babita , Pal Nita , Malhotra Bharti , Vyas Leela
Published: October 2010

Tuberculosis is caused by Mycobacterium tuberculosis (M.tb) as well as Non-tubercular mycobacterium (NTM) with similar clinical presentation. Infections due to NTM are reported to have increased in the past few years. Growth of M.tb is inhibited by p-Nitrobenzoic acid (PNB), whereas, NTM are resistant. One hundred and nine isolates from various clinical samples were identified up to species level by their growth rate, pigmentation, and a battery of biochemical tests, including niacin accumulation, nitrate reduction, and heat-stable catalase (68°C) reactions. Para-nitrobenzoic acid (PNB) inhibition test was performed to differentiate between M.tb and NTM. PNB was added to the Lowenstein-Jensen (LJ) medium and BACTECTM MIGIT (Mycobacteria Growth Indicator Tube)960 medium to a final concentration of 500 μg/ml. All the M.tb isolates, including Mycobacterium tuberculosis H37Rv (standard strain), were inhibited by PNB on both LJ and MGIT 960. Of the NTM isolates, all were resistant to PNB on MGIT 960 and on LJ PNB, except one isolate of Mycobacterium marinum that was resistant to MGIT 960 PNB, but was susceptible to LJ PNB. The reporting time for M.tb ranged from 4–11 days (median 5.9 days) by MGIT 960 and for NTM it was 2–10 days with an average of 4.5 days. This study was carried out to establish the accuracy and efficiency of MGIT 960 PNB and to differentiate between M.tb and NTM.
Detection of Viral Citrullinated Peptide Antibodies Directed Against EBV or VCP: In Early Rheumatoid Arthritis Patients of Indian Origin
Authors: Deo Sudha S , Shetty Rashmi R , Mistry Kejal J , Chogle Arun R
Published: October 2010

Aim: Study was undertaken to analyze the frequency of anti-viral citrullinated peptide (anti-VCP) antibodies in sera from patients with early rheumatoid arthritis (ERA).

Materials and Methods: Viral citrullinated peptide (VCP) and Epstein-Barr nuclear antigen (EBNA-1) peptide were commercially prepared and antibodies to these were determined in 25 patients of ERA, 40 disease control patients constituting 25 rheumatoid arthritis (RA), 7 systemic lupus erythematosus (SLE), 2 scleroderma, 1 spondyloarthritis (SpA), 1 juvenile rheumatoid arthritis (JRA), 1 osteoarthritis (OA), 1 psoriatic arthritis (PsA), 1 undifferentiated arthritis (UA), and 1 gout and 25 healthy controls (HCs) were taken for comparison. In-house ELISA was established for both the antibodies while cyclic citrullinated peptide (CCP) antibody was detected by commercial ELISA kit.

Results: Significant increase in VCP antibody by ERA and disease controls than healthy normal was observed. VCP IgM antibody was significantly increased in RA patients than HC. The presence of VCP antibody signifies a good marker for ERA. We observed significant difference in the VCP IgG and IgM antibody when compared to EBNA-1. In-house ELISA established for EBNA-1 and VCP antibodies showed low sensitivity but 96% specificity.

Conclusions: We observed that sera from early RA patients reacted to the deiminated protein encoded by Epstain Barr Virus (EBV). Thus a possible role of virus in inducing an anti-citrullinated peptide antibody (ACPA) response reveals viral etiology in this disease.
Comparative Study for the Presence of Enterococcal Virulence Factors Gelatinase, Hemolysin and Biofilm Among Clinical and Commensal Isolates of Enterococcus Faecalis
Authors: M. Giridhara Upadhyaya P , L. Umapathy B , L. Ravikumar K
Published: October 2010

Background: Biofilm production, gelatinase and hemolysin are the potential virulence factors of Enterococci. Gelatinase and hemolysin producing strains of Enterococcus faecalis have been shown to cause severe infections in animal models. Biofilm production has been shown to enhance the persistence of E. faecalis in urinary bladder and other medical indwelling devices infections.

Aims: To compare the presence of gelatinase, hemolysin and biofilm formation among clinical and commensal isolates and to study the co-relation between virulence factors with respect to different clinical specimens.

Settings and Design: During the study period of 2 years from July 2004 to July 2006, 200 clinical isolates from nosocomial infections and 100 commensal isolates of E. faecalis were taken for the study.

Materials and Methods: The clinical and commensal isolates were tested for the presence of gelatinase, hemolysin and biofilm and compared. The presence of these virulence factors among different clinical isolates was also studied.

Materials and Methods: Viral citrullinated peptide (VCP) and Epstein-Barr nuclear antigen (EBNA-1) peptide were commercially prepared and antibodies to these were determined in 25 patients of ERA, 40 disease control patients constituting 25 rheumatoid arthritis (RA), 7 systemic lupus erythematosus (SLE), 2 scleroderma, 1 spondyloarthritis (SpA), 1 juvenile rheumatoid arthritis (JRA), 1 osteoarthritis (OA), 1 psoriatic arthritis (PsA), 1 undifferentiated arthritis (UA), and 1 gout and 25 healthy controls (HCs) were taken for comparison. In-house ELISA was established for both the antibodies while cyclic citrullinated peptide (CCP) antibody was detected by commercial ELISA kit.

Statistical Analysis: Chi-square and likelihood ratio analysis were carried out using SSPS version 5.1 software.

Results: Results: The clinical isolates produced 39, 16.5 and 32.5% of gelatinase, hemolysin and biofilm, respectively, as compared to 31, 19 and 16% produced by the commensal isolates, respectively. Endotracheal tube infection, urinary tract infection, umbilical catheter tip infected isolates produced 60.8, 86.6 and 100% biofilm, respectively.

Conclusion: Significant difference in the production of biofilm (P<0.001) was noted between clinical and commensal isolates. Organism isolated from medically indwelling devices produced high amount of biofilm, confirming its role in colonization and causing nosocomial infections.
Splenic Abscess due to Brucella Melitensis − A Rare Pediatric Complication
Authors: Parande Aisha M , Mantur B G , Kore Mahesh , Palled Eranna
Published: October 2010

Splenic abscess due to Brucella species is an extremely rare complication especially in acute illness. Here we report a case of splenic abscess caused by Brucella melitensis biotype 1 in a child with acute infection who was successfully treated with only antibiotics.
Neuromuscular and Vascular Hamartoma of the Small Bowel: A Rare Cause of Intestinal Obstruction
Authors: Krishnamurthy Vani , Basavaraj Vijiya , Vimalambike Manjunath Gubbanna ,   Sunila
Published: October 2010

Neuromuscular and vascular hamartoma (NMVH) is a rare lesion arising chiefly in the small intestine. As it shares many of the histological features with other commonly occurring stricturous conditions of the small bowel, there is an ongoing debate whether it is truly hamartomatous or represents just a reactive condition. We are reporting a case of NMVH in the terminal ileum in a 32-year-old male who presented with symptoms of intestinal obstruction.