bluuebunny/crossref_metadata_2025 huggingface dataset:
Sociodemographic Disparities in Adult Child Informal Caregiving Intensity in the United States: Results from the New National Study of Caregiving
Authors: Cook Sarah K. , Cohen Steven A.
Published: August 2018

The objective of the current study was to assess socioeconomic and demographic disparities in caregiving intensity among informal caregivers. Using a randomized, nationally representative sample of 1,014 adult child informal caregivers from Medicare enrollment databases, the associations between informal caregiving intensity and age, race/ethnicity, and income were examined using binary and ordinal logistic regression. Caregiving intensity varied by demographics. Activities of daily living (ADL) caregiving was highest among Black, non-Hispanic caregivers. Instrumental ADL caregiving and number of hours spent caregiving was highest in female and non-White caregivers. Although the overall association between caregiving intensity and income was not significant, when stratified by race/ethnicity, this association was positive for White caregivers and negative for non-White caregivers. Health care providers frequently interact with informal caregivers and should be aware of trends in caregiving and the needs and supports available to ameliorate caregiver burden. To protect caregivers, policies and programs should be designed to promote well-being and mitigate the potential harms of caregiving to health. [
Journal of Gerontological Nursing, 44
(9), 15–20.]
Differences in Nursing Faculty Satisfaction Teaching Online: A Comparative Descriptive Study
Authors: Howe Deanna L. , Chen Hsiu-Chin , Heitner Keri L. , Morgan Susan A.
Published: August 2018

Background:

Many students today desire an education that can be completed without attending traditional classroom settings. Nursing administrators are responding by increasing the number of online course offerings, which has resulted in more nursing faculty asked to transition coursework from traditional to online classes, often without support.

Method:

The sample for this quantitative, descriptive, comparative study included nursing faculty from 15 randomly selected states who participated in an online survey, producing 185 completed surveys for analysis.

Results:

Satisfaction was significantly higher in nursing faculty who taught 20 or more courses online, compared with those who taught five or fewer. Satisfaction was significantly higher for faculty who received mentoring, release time, technical support for software, hardware, the Learning Management System (LMS), and training for the LMS, compared with faculty who did not.

Conclusion:

Results offer valuable evidence that support services are important to increase overall faculty satisfaction teaching online.
[J Nurs Educ.
2018;57(9):536–543.]
O Tombo do mosteiro de San Xoán da Cova (Vedra). Notas paleográficas e rexestos
Authors: Ares Legaspi Adrián
Published: August 2018

La finalidad de este trabajo es, por un lado, el estudio de la escritura del tumbo inédito de San Xoán da Cova (segunda mitad del siglo XV), a través de su consulta directa y la aplicación de una metodología paleográfica. Para un análisis más completo, iniciamos el trabajo con una breve síntesis de la materialidad del códice y de algunos aspectos de la diplomática del mismo (ciertas fórmulas, las clases de notarios que intervienen o la tipología de los documentos copiados). Tras ello, analizaremos los modelos gráficos empleados en el libro, sus características, la posible identificación de las manos o los motivos que explican la aparición de estas grafías. Por otro lado, el segundo objetivo es la elaboración de los regestos de los documentos del libro, los cuales reflejan su gran diversidad tipológica. Observaremos, por lo tanto, que los modelos góticos, principalmente, la cortesana, fueron los más utilizados en la redacción del códice, en relación con su función administrativa, el carácter notarial de los documentos copiados o el uso del gallego. Estas conclusiones se completan con la existencia de un claro multigrafismo (bastarda-latín, cortesana-gallego) entre los notarios apostólicos de este libro como consecuencia de su formación y apreciable tras la comparación de este tumbo con otras fuentes notariales de Santiago.

[gl] A finalidade deste traballo é, dunha banda, o estudo da escritura do tombo inédito de San Xoán da Cova (segunda metade do século XV), a través da súa consulta directa e a aplicación dunha metodoloxía paleográfica. Para unha análise máis completa, iniciamos o traballo cunha breve síntese da materialidade do códice e dalgúns aspectos da diplomática do mesmo (certas fórmulas, as clases de notarios que interveñen ou a tipoloxía dos documentos copiados). Tras isto, analizaremos os modelos gráficos empregados no libro, as súas características, a posible identificación das mans ou os motivos que explican a aparición destas grafías. Doutra banda, o segundo obxectivo é a elaboración dos rexestos dos documentos do libro, os cales reflicten a gran diversidade documental trasladada. Observaremos, polo tanto, que os modelos góticos, principalmente, a cortesá, foron os máis utilizados na redacción do códice, en relación coa súa función administrativa, o carácter notarial dos documentos copiados ou o uso do galego. Estas conclusións complétanse coa existencia dun claro multigrafismo (bastarda-latín, cortesá-galego) entre os notarios apostólicos deste libro como consecuencia da súa formación e apreciable trala comparación deste tombo con outras fontes notariais de Santiago.
A Coruña en el siglo de Margery Kempe
Authors: Barral Rivadulla María Dolores
Published: August 2018

El siglo XV es el momento más cosmopolita de la villa de A Coruña, puerto de arribada de buques con mercancías y peregrinos de diversas nacionalidades, la ciudad que pudo contemplar Margery Kempe en 1417, en el caso de haber arribado a Coruña antes de partir a Compostela, era una población “antigua” que durante ese siglo asistiría a su mayor desarrollo urbano y a uno de los de los momentos más importantes de su crecimiento económico. Es por tanto una licencia literaria aludir en el título del trabajo al “siglo de Margery Kempe” pero se ha tomado conscientemente con la intención de subrayar el sexto centenario de esta peregrinación que tan limitadas noticias ha dejado.

[gl] O século XV é o momento máis cosmopolita da vila da Coruña, porto de arribada de buques con mercadorías e peregrinos de diversas nacionalidades, a cidade que puido contemplar Margery Kempe en 1417, no caso de arribar a Coruña antes de partir a Compostela, era unha poboación “antiga” que durante ese século asistiría ao seu maior desenvolvemento urbano e a un dos dos momentos máis importantes do seu crecemento económico. É por tanto unha licenza literaria aludir no título do traballo ao “século de Margery Kempe” pero tomouse conscientemente coa intención de subliñar o sexto centenario desta peregrinación que tan limitadas noticias deixou.
El esclavo negro de la ciudad de Lugo
Authors: Louzao Martínez Francisco Xabier
Published: August 2018

Las actas del consistorio lucense nos permiten conocer la existencia de un esclavo negro que fue comprado por la ciudad en los primeros años del siglo XVIII. Se buscaba con ello, sin duda, estar a la altura de otras más reconocidas, a las que se trataba de emular a través de nuevos símbolos de prestigio, como daba la posesión de un esclavo. No es algo muy habitual en el mundo gallego y menos todavía en la provincia lucense. El hecho de encontrarse bien documentada su corta existencia en la ciudad lo hace acreedor de un especial interés.

[gl] As actas do consistorio lugués permítennos coñecer a existencia dun escravo negro que foi mercado pola cidade nos primeiros anos do século XVIII. Buscábase, sen dúbida, estar á altura doutras máis sobranceiras, ás que se trataba de imitar a través de novos símbolos de prestixio, como daba a posesión dun escravo. Non é algo moi habitual no mundo galego e menos aínda na provincia lucense. O feito de se atopar ben documentada a súa curta existencia na cidade faino acredor dun especial interese.
Cis-trans isomerization of unsaturated fatty acids in edible oils to prepare trans fat
Authors: Liu W. , Lu G. H.
Published: August 2018

Trans fats, unsaturated fatty acids with at least one double bond in the trans configuration, have received a great amount of attention in the field of oleo chemistry and safety. In this work, the cis-trans isomerization of unsaturated fatty acids in edible oils has been successfully developed using simple and cheap p-toluenesulfinic acid as catalyst. The effects of reaction time, temperature, catalyst loading, and the amounts of water and antioxidants on the cis-trans isomerization have been systematically investigated. The results indicate that the amount of water (0–20 wt %) and antioxidants (0–200 mg/kg) had no significant effect on this cis-trans isomerization of unsaturated fatty acids in edible oils. The final products (trans fats) from the cis-trans isomerization reaction were characterized by both GC and React IR. The yield of trans double bonds from the isomerized fat can reach 79.6% after heating at 100 oC for 90 min without changing either the location of the double bonds or the degree of unsaturation. In addition, this convenient method has been applied to various vegetable oils (e.g., olive oil, camellia seed oil, corn oil, sesame oil, sunflower oil and soybean oil) and nearly 80.0% yields of TFA were generated, which shows a promising method to provide trans-fat products for research related to oleo and food chemistry.
Identification of tetrahydrogeranylgeraniol and dihydrogeranylgeraniol in extra virgin olive oil
Authors: Mariani C. , Cesa S. , Ingallina C. , Mannina L.
Published: August 2018

Olive oil contains many different compounds which are responsible for its nutritional and sensorial value. However, some compounds present in olive oil at very low amounts have not yet been identified. Here, the detection of tetrahydrogeranylgeraniol and dihydrogeranylgeraniol, in both the total aliphatic alcohol and waxy fractions of extra virgin olive oil, is reported for the first time using GC and GC-MS methodologies. It was suggested that tetrahydrogeranylgeraniol and dihydrogeranylgeraniol do not originate from the hydrolysis of the chlorophyll but are present as diterpenic esters.
Prisonniers de guerre et affirmation de l’État : les Espagnols dans l’Ouest de la France de Corbie à la paix des Pyrénées (1636-1659)
Authors: Lagadec Yann
Published: August 2018

La première moitié du xviie siècle est marquée par un changement de
statut des prisonniers de guerre en Europe de l’Ouest. Alors que les
siècles précédents n’accordaient d’importance qu’à ceux en mesure de
payer une rançon, ce sont tous les soldats capturés qui, en un temps
où la main-d’oeuvre militaire est de plus en plus recherchée,
intéressent les puissances en guerre. L’étude du conflit
franco-espagnol (1635-1659) permet de montrer, à partir de l’exemple
des villes de l’Ouest de la France, comment l’État royal, tout en
cherchant à s’impliquer dans la prise en charge de prisonniers que
l’on compte désormais par milliers, se trouve contraint d’en déléguer
la gestion quotidienne aux villes. Cette question est alors pour elles
lourde d’enjeux, financiers tout d’abord, mais aussi de pouvoirs face
à un État de plus en plus présent.

La guerre franco-espagnole est d’autant plus
importante qu’elle marque le début de la mise en place lente,
difficile et fragile des grands principes de gestion des prisonniers
jusqu’aux guerres de l’Empire.
Dons et transplantations d’organes : le refus de remise en cause des principes éthiques pour faire face à la pénurie de greffons
Authors: Bourdaire-Mignot Camille , Gründler Tatiana
Published: August 2018

États généraux de la bioéthique (rapport de synthèse du Comité consultatif national d’éthique) : cinquième billet*La greffe d’organes ou de tissus permet de soigner des pathologies graves et peut offrir une alternative à des traitements lourds tels que la dialyse dans le cas d’une insuffisance rénale. Elle nécessite de disposer de greffons qui sont prélevés très majoritairement sur des personnes décédées mais qui peuvent l’être aussi sur des personnes vivantes. Le législateur a en effet autorisé de déroger au principe du respect de l’intégrité de la personne en cas de nécessité thérapeutique pour autrui (article 16-3 du Code civil). Malgré les différentes réformes juridiques tendant à faciliter le don, cette activité médicale pâtit d’une situation de pénurie. Ainsi en 2016, 552 patients sont décédés faute de greffons. La question demeure donc celle de la conciliation entre la protection du corps humain et l’augmentation du nombre de greffes pour répondre aux besoins sanitaires. Si les États généraux de la bioéthique ont été l’occasion de rappeler les enjeux, ils n’ont pas permis d’avancer sur les solutions à privilégier.
MODELING AND SIMULATION OF THE NANOFLUID TRANSPORT VIA ELASTIC SHEETS
Authors: Uddin Jashim , Sohail Ayesha , Beg O. A. , Ismail M. D.
Published: August 2018

The field of nanofluidics research has spanned over the past decade with a variety of promising applications. We investigate the “laminar boundary layer flow” of a Newtonian nanofluid past a moving extendable/contractable horizontal plate with surface velocity and thermal slip effects. The passively controlled nanofluid model (PCM) is considered. Such models are physically more realistic as compared to the “actively controlled models” (ACM). Using Lie symmetry group method, the governing equations are reduced by a set of highly coupled nonlinear ODE’s with thermo-solutal coupled boundary conditions. The reduced equations are solved numerically by a generalized collocation method. The influences of the emerging parameters on the local skin friction factor and the local Nusselt number are depicted numerically. The skin friction is decreased as the thermophoresis and buoyancy ratio parameters are decreased. The heat transfer rates reduce with thermophoresis and buoyancy ratio parameters. Velocity slip also leads to a rise in wall temperature gradient. This study is relevant to near-wall flows in nanofluid fuel cells, nano-materials processing, etc.
Identifying and Ranking of Alternative Fuels by Using AHP and PROMETHEE II Methods to Find Best Fuel for Bus Rapid Transit System
Authors: Dadashpour Iman , Rostami Ahmadreza
Published: August 2018

Nowadays, one of the most significant concerns is regarding to air pollution. Carbon dioxide, a greenhouse gas, is the main pollutant that is warming Earth. Industrialized countries have worked to reduce levels of sulfur dioxide, smog, and smoke in order to improve people's health. The problem of air pollution in the metropolises of Iran has been increased. The identification and development of clean fuels and also alternative fuels can play an important role in solving pollution problem. In this article, to find best fuel in terms of economic, social and environmental aspects which are part of sustainability. So, the multi-criteria decision-making techniques like fuzzy hierarchy analysis method and PROMETHEE used to rank and determine the preferred option for alternative fuels used in high-speed buses in Tehran. The results show that the biodiesel was selected as the best fuel to prevent the air pollution emission among the available options.
A Practical Agile Framework for IT Service and Asset Management ITSM/ITAM Through a Case Study
Authors: Sahid Abdelkebir , Maleh Yassine , Belaissaoui Mustapha
Published: August 2018

Agile mode projects are increasingly popular among IT Department, including the most complex organizations. The deployment of agility on a larger scale fits over a long period because the motivations are part of a persistent setting. The deployment of large-scale agility is therefore based on a deep and lasting transformation of the organization. In order to support transformational business changes, IT must streamline the top-down process of new IT processes. The success of an IT service and asset management depends on innovation, agility, and efficiency to accompany the transformation of the organization from a traditional vision to a digital vision. The aim of this article is to propose a practical agile framework to improve IT service and asset management ITSM/ITAM processes through a case study in the organization. The finding will help organizations to assess their capabilities and to address the procedural, technical and human aspects of IT service and asset management.
Operation Patterns in Recommendation Systems
Authors: Cordón-García José Antonio , Gómez-Díaz Raquel , García-Rodríguez Araceli , Dantas Taísa
Published: August 2018

The main purpose of this article is to analyze different recommendation systems and examine how they are used within digital environments to establish classifications for books. Following a bibliographical review of recommendation systems, the performance of a number of book recommendation systems is tested. The systems tested are grouped according to whether recommendations are done by specialists, are based on social networking or use more complex statistical stylometry to help each reader find the reading materials best suited to them. Results indicate that progress in technology implementation is favoring the findability of books by combining the strengths of the various systems. The principal social implication of this research is that recommendation systems enable the reader's optimized use of books, as well as allow the development of content appropriation systems. Concerning to originality and value is important to emphasize there is no previous known work establishing the taxonomy proposed in this paper.
Job Scheduling in Computational Grid Using a Hybrid Algorithm Based on Particle Swarm Optimization and Extremal Optimization
Authors: Ghosh Tarun Kumar , Das Sanjoy
Published: August 2018

Grid computing has been used as a new paradigm for solving large and complex scientific problems using resource sharing mechanism through many distributed administrative domains. One of the most challenging issues in computational Grid is efficient scheduling of jobs, because of distributed heterogeneous nature of resources. In other words, the job scheduling in computational Grid is an NP-hard problem. Thus, the use of meta-heuristic is more appropriate option in obtaining optimal results. In this article, the authors propose a novel hybrid scheduling algorithm which combines intelligently the exploration ability of Particle Swarm Optimization (PSO) with the exploitation ability of Extremal Optimization (EO) which is a recently developed local-search heuristic method. The hybrid PSO-EO reduces the schedule makespan, processing cost, and job failure rate and improves resource utilization. The proposed hybrid algorithm is compared with the standard PSO, population-based EO (PEO) and standard Genetic Algorithm (GA) methods on all these parameters. The comparison results exhibit that the proposed algorithm outperforms other three algorithms.
Automatic Detection of Career Recommendation Using Fuzzy Approach
Authors: Krishnamurthi Rajalakshmi , Goyal Mukta
Published: August 2018

In today's era where personalization of the learning material is a key factor towards the success of learning goal for any student according to their personality traits, learning style and cognitive style, choosing a career according to personality traits is also become a key to success of job satisfaction. Hence, this article proposes the recommendation of career on the basis of candidate personality attributes. In this article, Holland's theory is used to detect candidate's personality. Weights are assigned to each personality traits to calculate the scores are calibrated manually with help of research work done in this domain before and the feedback. A survey is conducted to test the accuracy of proposed method on 217 responses. The result shows the 74.35% candidates are satisfied with the recommended career and average rating for personality traits score was 3.58/5. This article also suggests a fuzzy approach to automatic detection of career recommendation based on personality score.
Domain Knowledge Embedding Regularization Neural Networks for Workload Prediction and Analysis in Cloud Computing
Authors: Li Lei , Feng Min , Jin Lianwen , Chen Shenjin , Ma Lihong , Gao Jiakai
Published: August 2018

Online services are now commonly deployed via cloud computing based on Infrastructure as a Service (IaaS) to Platform-as-a-Service (PaaS) and Software-as-a-Service (SaaS). However, workload is not constant over time, so guaranteeing the quality of service (QoS) and resource cost-effectiveness, which is determined by on-demand workload resource requirements, is a challenging issue. In this article, the authors propose a neural network-based-method termed domain knowledge embedding regularization neural networks (DKRNN) for large-scale workload prediction. Based on analyzing the statistical properties of a real large-scale workload, domain knowledge, which provides extended information about workload changes, is embedded into artificial neural networks (ANN) for linear regression to improve prediction accuracy. Furthermore, the regularization with noisy is combined to improve the generalization ability of artificial neural networks. The experiments demonstrate that the model can achieve more accuracy of workload prediction, provide more adaptive resource for higher resource cost effectiveness and have less impact on the QoS.
Meta-Heuristics Based Load Balancing Optimization in Cloud Environment on Underflow and Overflow Conditions
Authors: Kaur Amanpreet , Kaur Bikrampal , Singh Dheerendra
Published: August 2018

In cloud environment, the main challenge is load balancing as it requires distributing the load among many various virtual machines (VM) while avoiding underflow and overflow conditions. In this article, the question that which load-balancing (overflow or underflow) management will better improves the performance and quality of service has been answered with a number of experiments. For experiment purpose, scientific workflow DAG files has been used with one host configuration. Ant Colony Optimization (ACO) and BAT algorithm are used for checking underflow and overflow conditions respectively for VMs. In proposed work, initially the workflow is parsed by Predict Earliest Finish Time (PEFT) heuristic to generate initial seed for meta-heuristic algorithms which will optimize the VM in terms of makespan and cost of execution. Different workflows have been used with varying number of VMs from 2 to 20. The results shows that makespan analysis is approximately overlapped for different workflow tasks and shows no significant difference however, the cost analysis show a significant change for overflow and underflow identification with cost for overflow condition is reduced significantly.
From fix to fit into the autoptic human brains
Authors: Paradiso Beatrice , Simonato Michele , Thiene Gaetano , Lavezzi Anna
Published: August 2018

Formalin-fixed, paraffinembedded (FFPE) human brain tissues are very often stored in formalin for long time. Formalin fixation reduces immunostaining, and the DNA/RNA extraction from FFPE brain tissue becomes suboptimal. At present, there are different protocols of fixation and several procedures and kits to extract DNA/RNA from paraffin embedding tissue, but a gold standard protocol remains distant. In this study, we analyzed four types of fixation systems and compared histo and immuno-staining. Based on our results, we propose a modified method of combined fixation in formalin and formic acid for the autoptic adult brain to obtain easy, fast, safe and efficient immunolabelling of long-stored FFPE tissue. In particular, we have achieved an improved preservation of cellular morphology and obtained success in postmortem immunostaining for NeuN. This nuclear antigen is an important marker for mapping neurons, for example, to evaluate the histopathology of temporal lobe epilepsy or to draw the topography of cardiorespiratory brainstem nuclei in sudden infant death syndrome (SIDS). However, NeuN staining is frequently faint or lost in postmortem human brain tissues. In addition, we attained Fluoro Jade C staining, a marker of neurodegeneration, and immunofluorescent staining for stem cell antigens in the postnatal human brain, utilizing custom fit fixation procedures.
Alexithymia and therapeutic alliance: a multiple case study comparing good and poor outcome cases
Authors: Silva Ana Catarina Nunes da , Branco Vasco António , Watson Jeanne C.
Published: August 2018

Alexithymia has been associated with poor outcomes in psychotherapy. This association has been attributed to a difficulty in patients expressing emotions, engaging in emotional tasks and also poor therapeutic alliances. This study aims to better understand alexithymic patients in psychotherapy. A multiple case study design was used. Cases were selected from a larger research project considering their alexithymia level and outcome status, based on the reliable change index and the client perspective on change. Four cases are presented: with and without alexithymia with good and poor outcome. The therapeutic alliance was included as a process measure, evaluated from both client and therapist. At the end a semi structured interview was conducted with both participants, individually. The analysis concerned the integration and triangulation of the therapist and client experience for each case. Each patient was briefly presented and then a focus was made regarding the perception of both participants on the therapeutic alliance and the emotional processing and change process of the client. Both alexithymic cases and the non-alexithymic poor outcome case showed difficulties in the therapeutic alliance, especially from the perspective of the therapist. In these cases, emotional impairments may have contributed to a poor therapeutic alliance, impacting on the outcome. We suggest that a great focus on the therapeutic alliance with alexithymic patients may increase the quality of treatment and it may be more useful for case conceptualization to consider each feature of the alexithymia construct individual.
Hepatitis B & C virus infection in HIV seropositive individuals & their association with risk factors
Authors: Sharma Vineeta , Ramachandran V. G. , Mogha Narendra Singh , Bharadwaj Mausumi
Published: August 2018

Background & objectives:

Hepatitis B and hepatitis C virus (HBV and HCV) cause acute and chronic hepatitis, and infections with HBV and HCV are common in HIV-infected patients. The present study was conducted to determine the co-infection of hepatitis B and C virus in stored serum samples of HIV-positive/negative individuals attending an Integrated Counselling and Testing Centre (ICTC) in north India and their association with certain risk factors.

Methods:

This study included a total of 840 serum samples, of which 440 were from HIV seropositive individuals and 400 were from control individuals seeking voluntary check-up of HIV status at ICTC. Serum samples were used for the detection of HBV and HCV infection.

Results:

HBV infection (11%) was found to be less in contrast to HCV (13%) amongst the HIV seropositive. In controls, HBV and HCV infection was two and three per cent, respectively. Co-infection of HBV and HCV was found in 15 of 109, and in controls, it was 2 of 15. Age group between 21 and 40 was significantly associated with HBV and HCV infection. Heterosexual contact was the leading mode of acquiring HBV and HCV infection.

Interpretation & conclusions:

HBV and HCV co-infection was found to be significantly higher in HIV-positive individuals in comparison to normal population. Hepatitis virus infection leads to rapid progression of liver cirrhosis in HIV-infected patients. Routine check-up of HIV seropositive patients for hepatitis virus may be required to monitor clinical outcome.
Post-transfusion hepatitis C virus infection among β-thalassaemic individuals with associated clinical parameters
Authors: Biswas Aritra , Firdaus Rushna , Saha Kallol , Chowdhury Prosanto , Bhattacharya Debyojyoti , Bhattacharyya Maitreyee , Sadhukhan Provash Chandra
Published: August 2018

Background & objectives:

Multiple transfusions in β-thalassaemia patients undergoing regular transfusion regimen are at a risk of developing transfusion transmitted infections, including hepatitis C virus (HCV). The present study was conducted to investigate the association of HCV viraemia and genotype with clinical parameters in HCV seroreactive β-thalassaemic individuals.

Methods:

A total of 172 HCV seroreactive β-thalassaemic individuals aged between 2-35 yr with at least 25 units of blood transfusion were catagorized into four groups (2-12 yr, group 1; 13-19 yr, group 2; 20-29 yr, group 3; 30-35 yr, group 4). Aged matched control samples (n=87; β-thalassaemics without HCV infection) were also included. HCV RNA was detected by nested reverse transcriptase polymerase chain reaction (RT-PCR) based on 5’ UTR of HCV genome, viral load was determined by real-time RT-PCR. Nested RT-PCR amplified partial core region was used for DNA sequencing. Liver function parameters [serum total bilirubin, alanine aminotransferase (ALT) and aspartate aminotransferase (AST)] were also determined.

Results:

Of the 172 HCV seroreactive individuals, 59.30 per cent (n=102) were HCV RNA positive. HCV viral load ranged from 173 to 32.04×10[5] IU/ml; 87.65 per cent were infected with HCV genotype 3. Liver enzymes, such as ALT, AST and serum total bilirubin were significantly elevated in all age groups compared to control groups. Serum ferritin levels were found to be high in all individuals, but 16.27 per cent of HCV-infected individuals with >10,000 IU/ml viral load also showed high ferritin levels (>1500 μg/l) where the majority of them were infected with HCV genotype 3.

Interpretation & conclusions:

HCV genotype 3 was the major circulating genotype among β-thalassaemia patients in this region. Our findings indicated an association between HCV replication and hepatic iron load and also highlighted the need for sensitive quantitative RT-PCR-based detection of HCV RNA in the high risk population.
HLA-DQA1 & DQB1 variants associated with hepatitis B virus-related chronic hepatitis, cirrhosis & hepatocellular carcinoma
Authors: Karra Vijay Kumar , Chowdhury Soumya Jyoti , Ruttala Rajesh , Gumma Phani Kumar , Polipalli Sunil Kumar , Chakravarti Anita , Kar Premashis
Published: August 2018

Background & objectives:

Clinical outcome after hepatitis B virus (HBV) exposure varies extremely from spontaneous clearance to chronic hepatitis B and often progresses to liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Host genetic factor plays an important role in the regulation of immune response. This study was aimed to investigate whether HLA class II DQA1 and DQB1 gene polymorphism were associated with chronic hepatitis B infection and in the development of HBV-related LC and HCC.

Methods:

DQA1 and DQB1 allele polymorphism were studied in 187 patients with HBV-related liver diseases (which included 73 chronic hepatitis B, 84 LC and 30 HCC patients) and 109 controls who had spontaneously recovered from HBV infection using polymerase chain reaction amplification with sequence-specific primers.

Results:

Our data suggested that DQA1*0101/2/4 [odds ratio (OR)=2.78; Pc
=0.003], DQA1*0103 (OR=2.64; Pc
=0.0007) and DQB1*0302/3 (OR=2.15; Pc
=0.01) were associated with the protection from chronic HBV infection, whereas DQB1*0402 (OR=0.25; Pc
=0.001) showed susceptible effect on chronic HBV infection. DQB1*0601 (OR=3.73; Pc
=0.006) conferred protective effect from developing LC; similarly, DQB1*0302/3 (OR=5.53; Pc
=0.05) and DQB1*0402 (OR=0.00; Pc
=0.001) conferred protective effect from developing HCC. However, DQA1*0601 and DQB1*0503 showed susceptible effect on chronic HBV infection; these associations were no longer significant after Bonferroni correction.

Interpretation & conclusions:

Our results revealed HLA-DQA1*0101/2/4 - DQA1*0103 - DQB1*0302/3 and DQB1*0601 as protective and DQB1*0402 as risk alleles. The study suggests that various subtypes of HLA-DQA1 and DQB1 are associated with both HBV clearance and development of chronic HBV infections.
Contrast-enhanced Computed Tomography Imaging of Splenic Artery Aneurysms and Pseudoaneurysms: A Single-center Experience
Authors: Therakathu Jacob , Panwala Hirenkumar Kamleshkumar , Bhargava Salil , Eapen Anu , Keshava Shyamkumar Nidugala , David Deepu
Published: August 2018

Aim:

The aim of our study was to evaluate the computed tomography (CT) imaging features of splenic artery aneurysm and pseudoaneurysm and to identify the disease conditions related to the same. We also wanted to ascertain any relationship between these associated disease conditions and the imaging features of the aneurysms.

Materials and Methods:

This retrospective study included patients diagnosed to have splenic artery aneurysms on contrast-enhanced CT examination between January 2001 and January 2016. Data were obtained from the picture archiving and communication system. The size, number, location, morphology, the presence of thrombosis, calcification, and rupture of the aneurysms were evaluated.

Results:

A total of 45 patients were identified with a mean age of 45 years. Splenic artery aneurysms were idiopathic in 12 (26.6%) patients. In the remaining patients, the main associated disease conditions included pancreatitis 15 (33%), chronic liver disease with portal hypertension 8 (18%), and extrahepatic portal vein obstruction (EHPVO) 6 (13%). Statistically significant findings included the relationship between EHPVO and multiple aneurysms (P = 0.002), chronic liver disease and fusiform aneurysm (P = 0.008), and smaller size of idiopathic aneurysms (P < 0.001).

Conclusion:

Based on this study, splenic artery aneurysms were associated with a variety of etiologies. The characteristics of the aneurysms such as size, location, and morphology vary with the associated disease conditions. These variations may have implications for the management.
Unusual Locations of Pancreatic Pseudocysts in Lumbar Triangle, Psoas Muscle and Intercostal Space, and Obturator Externus
Authors: Khaladkar Sanjay Mhalasakant , Waghmode Akshay Mahadev
Published: August 2018

Pancreatic pseudocyst develops as a complication of both acute and chronic pancreatitis. Although the common location of pseudocyst is lesser sac, extension of pseudocyst can occur into mesentery, retroperitoneum, inguinal region, scrotum, liver, spleen, mediastinum, pleura, and lung. Extension of pseudocyst into psoas muscle and lumbar triangle is extremely rare. The development of pseudocyst in lumbar triangle is radiologically equivalent and further extension of Grey Turner's sign seen clinically in acute pancreatitis. This extension occurs due to the destructive nature of pancreatic enzymes. The lumbar triangle is the site of anatomic weakness in the lateral abdominal wall in the lumbar region. We report the case of a 35-year-old alcoholic male patient who presented with abdominal pain followed by distension and swelling in the right lumbar region for 1 week. On computed tomography scan of the abdomen, acute-on-chronic pancreatitis with multiple pseudocysts in the right posterior pararenal space, extending through the right lumbar triangle in the right lateral abdominal wall, right posterior paraspinal muscles, right iliopsoas, right obturator externus, and medial aspect of the right upper thigh, beneath anterior abdominal wall in the upper abdomen and in the right lateral thoracic wall through the right 11th intercostal space, was detected.
A Study on the Use of Radiation-Protective Apron among Interventionists in Radiology
Authors: Livingstone Roshan Samuel , Varghese Anna , Keshava Shyamkumar N.
Published: August 2018

Objective:

Radiation-protective aprons are commonly used by interventionists to protect against the harmful effects of ionizing radiation. Choice of appropriate aprons with respect to lead equivalence and weight is necessary for effective protection and reduced physical strain. This study evaluates the knowledge and practice of using radiation-protective aprons by interventionists.

Materials and Methods:

Ninety-one interventional radiologists who attended an annual interventional conference were provided with a questionnaire which included age, years of experience, area of expertise, type and weight of apron used, and physical strain caused due to the use of apron.

Results:

About 14.3% of the interventionists practiced in an angiographic suite for less than an hour a day, 45% for 2–4 h, 21% for 4–6 h, 10% for 6–10 h, and the rest above 10 h/day. About 68% of the interventionists wore 0.5 mm lead-equivalent (Pbeq) aprons; 15.4% with 0.25 mm Pbeq; about 5.5% with 0.35 mm Pbeq aprons, and the remaining were not aware of the lead equivalence. About 47% reported that they had body aches due to wearing single-sided aprons. Interventionists working more than 10 h/day wearing single-sided lead apron predominantly complained of shoulder pain and back pain.

Conclusion:

A large fraction of interventionists reported that they had physical strain. It is suggestive for interventionists to wear correct fit and light-weight aprons with appropriate lead equivalence.
Clinical Significance of T2*gradient-recalled Echo/susceptibility-weighted Imaging Sequences in Evaluating Superficial Siderosis in the Setting of Intracerebral Tumors: Pilocytic Astrocytoma
Authors: Jetty Sankarsh N. , Badar Zain , Drumsla Douglas , Mangla Rajiv
Published: August 2018

Superficial siderosis is the slow accumulation of hemosiderin on the pial surfaces of the brain and spinal cord. The most common cause of intracranial superficial siderosis is secondary to subarachnoid hemorrhage. Rarely, superficial siderosis can also be caused by tumors. Superficial siderosis presents clinically as hearing loss and gait instability that progressively worsen. The diagnosis is primarily made by magnetic resonance imaging; however, susceptibility-weighted imaging (SWI) and T2* gradient echo (GRE) sequences demonstrate the highest sensitivity in detecting this condition. To the best of our knowledge, there has been only one previous case of superficial siderosis secondary to a pilocytic astrocytoma of the spine. However, we present a case of intracerebral pilocytic astrocytoma resulting in superficial siderosis, with emphasis on acquisition and use of T2*GRE/SWI sequences.
Sociodemographic Profile, Semiology, and Etiology of Patients with Status Epilepticus: A Study from a Tertiary Care Hospital in North India
Authors: Qadir Wasim , Wani Khurshid Ahmad , Bhat Bilal Ahmad
Published: August 2018

Background and Objectives: Despite advance in treatment of status epilepticus (SE), a major neurological emergency, it is still associated with mortality and morbidity. The objective of our study was to estimate sociodemographic profile, semiology, and etiology in the children with SE admitted in pediatric intensive care. Materials and Methods: Children between 1 month and 18 years with continuous seizure activity of >5 min or two or more sequential seizures without full recovery of consciousness between seizures, admitted in the Pediatric Intensive Care Unit of the Department of Pediatrics, Government Medical College, Srinagar, were included in the study. A semi-structured tool was designed to record the sociodemographic details. Detailed history, clinical examination, and investigations (including neuroimaging as and when needed) were used to determine the type of seizure and etiology. Results: A total of 51 patients were included in our study. Most of the patients were <5 years with 47.10% in 1–5 years’ age group and 43.10% in >1-year age group. Males (60.80%) outnumbered females. Thirty-nine patients (76.47%) belonged to “known” or “symptomatic” group with 35 (68.60%) of them presenting with SE as their fresh seizure. Thirty-nine (76.47%) of our patients had generalized tonic–clonic seizure (GTCS) type of SE. Conclusion: Most of the children (90%) were below the age of 5 years with male predominance. Most of the patients had SE as their first seizure without prior history of seizures with GTCSs was the most frequent seizure type.
Astrocytic Tumors in Mexico: An Overview of Characteristics and Prognosis in an Open Reference Center for Low-Income Population
Authors: Beltrán Jesús Quetzalcoatl , Soto-Abraham Julian Eduardo , Vidaurreta-Serrano Jorge , Macias Laura Graciela Chavez , Apo Erick Gómez , Ogando-Rivas Elizabeth
Published: August 2018

Objective: The authors aimed to analyze the current epidemiology of high- and low-grade gliomas, follow-up strategies, and prognosis in a national reference center of a developing country. Materials and Methods: Medical records of patients diagnosed with intracranial gliomas from January 2012 to January 2016 were reviewed. Data were classified by age, symptoms, Karnofsky functional scale (KFS), tumor location, extent of resection (EOR), histopathology, hospital stay, Glasgow outcome scale (GOS), adjuvant treatments, overall survival (OS), and mortality. Results: Astrocytomas accounted for 28.2% of the intracranial tumors and 53.5% were male. Headache was the most common symptom, while sensory disturbance was the least frequent. The right cerebral hemisphere was involved in 56.5% of cases and frontal lobe in 31.3%. Gross total resection (GTR) was achieved in 18.1% cases, 35.3% subtotal resection, and 46.4% biopsy. Regarding the astrocytomas, 43.3% were low grade and 56.4% high grade. Low-grade tumors had the highest frequency in the fourth decade of life, while Grade III and IV in the fifth and seventh decades of life, respectively. In high-grade lesions, there was a slight male predominance (~1.4:1). The initial KFS was regularly 80 for low-grade gliomas and 60 for high-grade. By 1-month postdischarge, the score decreased by 10 points. About half of the patients (47.5%) received adjuvant therapy after surgery. From the Glasgow Outcome Scale (GOS), the majority had a form of disability and 30-month OS was above 88% for Grade I-II and 0% for Grade III and IV. Conclusions: Astrocytic tumors were the most frequently noted intra-axial tumors. Age, histological grade, and EOR are important prognostic factors. These results are similar to other reports; however, increased variability was noted when treatment-related factors were considered. Additional studies are necessary to identify the factors related to these treatment results.

Highlights:

• There are no data describing the basic epidemiology and prognosis of high-grade and low-grade gliomas in Mexico.

• Intracranial astrocytomas account for 28.2% tumors in our institution.

• Age, histological grade, and EOR are important prognostic factors.

• Poor overall survival was achieved in our target population.
Response of Syrinx Associated with Chiari I Malformation to Posterior Fossa Decompression with or without Duraplasty and Correlation with Functional Outcome: A Prospective Study of 22 Patients
Authors: Kumar Anil , Pruthi Nupur , Devi B. Indira , Gupta Arun Kumar
Published: August 2018

Background: The aim of the study is to correlate the surgical outcome with radiological changes in patients with Chiari I malformation (CMI) with syrinx. We also compared long-term functional and radiographic outcome in CM1 patients treated with posterior fossa decompression (PFD) with or without duroplasty. Patients and Methods: From December 2013 to October 2015, 22 patients who underwent surgery with the diagnosis of CMI and syrinx were included in the study. Measurements were performed on preoperative and postoperative magnetic resonance (MR) scans using the same software. All patients underwent PFD with or without duroplasty. Clinical results were evaluated on the basis of the Chicago Chiari Outcome Scale (CCOS). We assessed the degree of resolution of syrinx and outcome of Chiari decompression with PFD versus PFD with duroplasty. Mean duration of follow-up was 12.4 ± 5.37 months (range: 6–24 months). Results: Out of 19 patients in whom syrinx diameter decreased on postoperative MR imaging, 17 (89.5%) improved based on CCOS and 2 (10.5%) were unchanged while out of three patients in whom syrinx worsened, 2 (66.7%) improved and 1 (33.3%) was unchanged (P = 0.37). The cord diameter was found to have decreased in 12 patients and of these 11 (91.7%) improved. The cord diameter increased in 10 patients, but 8 (80%) improved (P = 0.57). The mean changes in syrinx, cord, and syrinx/cord ratio were studied in both groups with and without duroplasty, were not statistically significant. In this study, radiological parameters failed to predict functional outcome. Conclusions: The outcome does not correlate with change in any of the syrinx-related factors. Surgical decompression with or without duroplasty does not have a statistically significant relationship in the degree of syrinx resolution. Surgical decompression without duroplasty provides the benefits of surgical decompression while avoiding the complications of intradural techniques.
Isolated Wrist Drop Presenting as Acute Stroke: Rare Case Report with Review of Literature
Authors: Goel Khushbu , Singh Saraj Kumar , Agarwal Himanshu , Mukherji Joy Dev , Kumar Mukesh
Published: August 2018

Isolated wrist drop is very unusual clinical presentation due to cerebral stroke. It is highly confused with peripheral neuropathy. However, timely detection of acute stroke as one of the causes of wrist drop is necessary as it changes the line of treatment and prognosis significantly. Here we are presenting a 62 year-old diabetic and hypertensive male patient who came with acute onset weakness of right hand. Initial Magnetic resonance imaging (MRI) of the brain showed hyperacute infarct in the splenium of corpus callosum. Magnetic resonance angiography (MRA) was normal. Repeat brain MRI on next day showed acute infarct at hand area of motor strip in posterior frontal region. The patient underwent intravenous thrombolysis and thereafter improved significantly. Isolated hand palsy is a rare presentation of stroke, often mistaken for peripheral lesion.
Association between Indoor Air Pollution and Cognitive Impairment among Adults in Rural Puducherry, South India
Authors: Krishnamoorthy Yuvaraj , Sarveswaran Gokul , Sivaranjini K. , Sakthivel Manikandanesan , Majella Marie Gilbert , Kumar S. Ganesh
Published: August 2018

Background: Recent evidences showed that outdoor air pollution had significant influence on cognitive functioning of adults. However, little is known regarding the association of indoor air pollution with cognitive dysfunction. Hence, the current study was done to assess the association between indoor air pollution and cognitive impairment among adults in rural Puducherry. Methodology: A community-based cross-sectional study was done among 295 adults residing in rural field practice area of tertiary care institute in Puducherry during February and March 2018. Information regarding sociodemographic profile and household was collected using pretested semi-structured questionnaire. Mini-Mental State Examination was done to assess cognitive function. We calculated adjusted prevalence ratios (aPR) to identify the factors associated with cognitive impairment. Results: Among 295 participants, 173 (58.6) were in 30–59 years; 154 (52.2%) were female; and 59 (20.0%) were exposed to indoor air pollution. Prevalence of cognitive impairment in the general population was 11.9% (95% confidence interval [CI]: 8.7–16.1). Prevalence of cognitive impairment among those who were exposed to indoor air pollution was 27.1% (95% CI: 17.4–39.6). Individuals exposed to indoor air pollution (aPR = 2.18, P = 0.003) were found to have two times more chance of having cognitive impairment. Conclusion: About one-fourth of the participants were exposed to indoor air pollution, out of which more than one-fourth was found to have cognitive impairment which is twice that of the general population. Hence, prevention of exposure to indoor air pollution needs to be done through increased availability to cleaner fuels for household usage.