bluuebunny/crossref_metadata_2025 huggingface dataset:
Efektivitas Ovitrap Bambu terhadap Jumlah Jentik Aedes sp yang Terperangkap
Authors: Aditama Wiwit , Zulfikar Zulfikar
Published: November 2016

AbstrakDemam berdarah dengue (DBD) masih menjadi masalah kesehatanmasyarakat di Banda Aceh. Banda Aceh merupakan daerah endemik DBDdengan meningkatnya angka kejadian dan case fatality rate setiap tahun.Insiden tertinggi DBD berada di Kecamatan Baiturrahman dengan angkakejadian 120 per 100.000 penduduk dan tertinggi kedua adalah Kecamatan Jaya Baru dengan angka kejadian 84 per 100.000 penduduk. Keberadaan larva Aedes sp di masyarakat merupakan salah satu indikator populasi nyamuk Aedes aegypti di daerah tersebut. Penelitian ini bertujuan untuk mengetahui jumlah jentik nyamuk Aedes sp yang terperangkap pada masing-masing wadah ovitrap (tempurung kelapa, gelas plastik, dan potongan bambu) serta tingkat kepadatan jentik nyamuk Aedes sp sebelum dan setelah pemasangan wadah ovitrap. Jenis penelitian adalah explanatory study dengan desain eksperimental quasi. Teknik pengambilan sampel adalah proportional sampling. Populasi unit penelitian adalah 30 rumah. Ovitrap diletakkan merata pada 30 titik lokasi dari 10 kelurahan secara acak. Data jumlah jentik nyamuk Aedes yang terperangkap diambil empat kali secara berulang dengan selang waktu satu minggu. Analisis dengan rerata jumlah jentik di dalam ovitrap dan indeks ovitrap. Hasil jumlah jentik Aedes aegypti yang terperangkap sebanyak 1.265. Ovitrap yang paling efektif, yaitu potongan bambu rerata = 123, nilai p = 0,006, HI = 10,01% (16,66 – 26,67%), CI = 36,8% (336,06 – 39,74%), BI = 29,97% (73,33 103,3%). Otoritas kesehatan harus mempromosikan ovitrap bambu kepada masyarakat sebagai upaya pengendalian Aedes sp.AbstractDengue hemorrhagic fever (DHF) is a public health problem in Banda Aceh.Banda Aceh is a DHF endemic city by increasing incidence rate (IR) andcase fatality rate every year. The highest DHF incidence was in Baiturrahman District (IR = 120 per 100,000 people) and Jaya Baru District(IR = 84 per 100,000 people). Aedes sp larvae existence among people isone of Aedes aegypti population indicators in such region. This study aimedto find out numbers of Aedes sp trapped in each ovitrap (coconut shell, plastic cup, and piece of bamboo) and Aedes sp density level before and after ovitrap installation. This study was explanatory study using quasi-experimental design. The sampling technique was proportional sampling.Population of study was 30 houses. Ovitraps were randomly located in 30places of 10 subdistricts. Data of trapped Aedes sp larvae numbers was collected four times repeatedly within one week time-lapse. Analysis was conducted using the mean number of larvae in ovitraps and ovitrap index. The number of Aedes sp larvae trapped was 1,265. The most effective ovitrap is piece of bamboo, mean = 123, p value = 0.006, HI = 10.01% (16.66 26.67%), CI = 36.8% (336.06 - 39.74%), BI = 29.97% (73.33 - 103.3%). Health authorities should promote bamboo ovitrap, especially to public as an effort to control Aedes sp.
Temples in the Ghassulian Culture: Terminology and social implications
Authors: Gošić Milena
Published: November 2016

Archaeological discussions on prehistoric ritual are largely concerned with their material remains, including architectural debris. The first step in interpretation of such remains is their precise identification and categorization. There are numerous terms for objects and architectural remains that are widely utilized in the archaeological jargon, including, but not limited to, the terms temple, sanctuary and shrine. During almost a century of studying the Chalcolithic Ghassulian culture of the southern Levant, various architectural structures excavated at the sites of Teleilat Ghassul, Gilat and En Gedi have all been interpreted as temples, sanctuaries, or shrines – terms that in case of the Ghassulian culture are used as synonymous of temples. However, the actual architectural remains from these sites differ significantly and explicit definitions on what is meant by the terms used are rare. Apart from demonstrating the importance of properly defining a term in a context in which it is used, the aim of the present paper is to compare these various architectural remains, as well as various interpretations of Ghassulian society and the role the presumed temples played in them. This will be the basis for evaluating how classifying archaeological structures as temples has influenced interpretations of Ghassulian social organization.
Permanent museum collections from alternative classrooms to tourist attractions: Comparative analysis of visits to National Museum of Valjevo's collections in periods from 1951 to 1961 and from 2001 to 2011
Authors: Krivošejev Vladimir , Bjeljac Željko
Published: November 2016

The purpose of this paper is to fully observe the differences in the structure of the audiences attending permanent museum collections and to point to museums' present day tasks. While the introductory part examines the problematic concerning museum audiences and the varieties of museum programs, the main portion of the paper presents the results of an analysis of the numbers and the structure of museum visitors in two periods set half a century apart: 1951-1961 and 2001-2011, with a control group: a more complete analysis of 2013's visitors.

The analysis of attendance during the fifties and the beginning of the 21st century was conducted on the basis of existing physical materials from the museum's internal archive, while the control analysis of 2013 attendance was conducted by a search of an electronic database.

The research pointed to significant differences in the structure of the visitor body in different periods, whether they were concerning the company arriving (individuals or organized groups), or their residence (in or out of town). In the fifties, town residents were the dominating visitors. They were frequenting the museum of their own accord, in their leisure time, as per their own wishes and needs, led by the desire to have a cultural experience and an informal self-education. Half a century later, with a broad spectrum of new media offering pastimes that were unavailable before, the audience was dominated by organized groups arriving from out of town; predominantly students on excursions. These differences indicate that there was a big shift in the function of permanent museum collections in the last fifty years. Their role as permanent educators of local population has significantly diminished, but their role as a leading tourist attraction has inflated nonetheless.
Authority and the production of archaeological knowledge
Authors: Ćosić Natalija
Published: November 2016

The discipline of archaeology is founded upon the interaction of various practices, in the network of individuals and institutions, jointly shaping and formulating the explanations of the past. The registered sites and material remains represent the places where undefined layers and physical structures are converted from heaps of dirt and discarded material into the knowledge of the past. From the perspective of production of knowledge and construction of facts about the times past, the archaeological excavations are not only a process of research. The production of archaeological knowledge, in the field and beyond, always takes place under specific circumstances, including not only the relations among professionals and institutions, but also the relations between material remains and the individuals “discovering” them and translating them into interpretations. Metaphorically speaking, in the complex relationship between archaeologists and material culture, an individual in the process of creating the knowledge of an object creates his/her own professional identity, while an object creates an archaeologist in the process of identification. The final outcome presents a chosen and formulated explanation about the past, stemming from a specific logic of disciplinary practice. However, the question arises: what or who decides which interpretations are more valid than the others, and who is in the position to declare an authentic interpretation of the excavated material. Thus the discussion enters the field of problematizing the concept of authority and its role in the production of archaeological knowledge. The analyses show that authority should not be understood as a definite source, periodically appearing and disappearing, but rather as an achievement of social and cultural interactions and changes. The theoretical grounds for the research of authority is formulated based upon Foucault's interpretation of relation between power and knowledge. The axis for identification of authority in disciplinary practices is determined by the chosen categories of executive, epistemic, and intellectual authority, coupled with archaeological ethnography. The suggested development of the theoretical framework is aimed to secure the tools for considering the shapes and sources of authority in archaeology and its role in the production of archaeological knowledge of the past.
Carbon Sequestration in Response to Grassland–Shrubland–Turfgrass Conversions and a Test for Carbonate Biomineralization in Desert Soils, New Mexico, USA
Authors: Wang Jiaping , Monger Curtis , Wang Xiujun , Serena Matteo , Leinauer Bernhard
Published: November 2016

Core Ideas

Soil carbonate is typically viewed as a soil mineral that requires centuries to accumulate; our study indicates that it can be generated in months to years.

If the source of Ca is directly from silicate minerals, soil carbonate could be managed to sequester atmospheric CO2.

Carbon‐13 values can change in less than a decade for both soil organic and inorganic C.

This study uses an experimental pedology approach using controls, treatments, and replications.

This study uses an experimental pedology approach to examine (i) how the conversion of native C4 grassland to C3 woody shrubs then to irrigated C4 turfgrass affects both soil organic C (SOC) and soil inorganic C (SIC) and (ii) whether SIC can be enhanced by microbial biomineralization. Three sites were studied in the Chihuahuan Desert of New Mexico. At each site, SOC, SIC, and their δ13C values were measured on control soil samples and compared to samples treated with liquid growth medium and Ca(OH)2 at 10 and 40 cm. The treated samples were left to react for 1 mo in February, May, and August of 2014. Using a space‐for‐time substitution, soil organic C decreased when native grasslands converted to desert shrubs, then sharply increased after desert shrubs were converted to irrigated turfgrass. Most surprising, however, was the increase of SIC in the turfgrass site, which doubled in 6 yr. The δ13C values of both SOC and SIC reflected the change from C4 to C3 then back to C4 vegetation and showed how rapidly SOC and SIC can change their isotopic signatures. Soil inorganic C formation was slightly higher for the liquid growth medium, but no statistically significant differences were observed between the treatments and control samples. In addition, no biomineralization was observed with microscopy, perhaps because the 1‐mo reaction time was too short and the amount applied was too small. Although SIC is typically viewed as a soil mineral that requires centuries to accumulate, our study indicate that SIC can be generated in months to years if the soil environment is suitable.
A Simple Approach to Enhance Multiprobe Soil Cone Penetrometer Analyses
Authors: Balkcom Kipling S. , Duzy Leah M. , Mitchell Charles C. , Delaney Dennis P.
Published: November 2016

Core Ideas

We describe a method to quantify soil strength with a multiprobe cone penetrometer.

An area‐under‐the‐curve calculation compares soil strength across treatments.

This value simplifies comparisons for depths and row positions of the soil profile.

Soil penetrometers measure penetration resistance to characterize soil strength for different management practices, primarily tillage. Our objective was to demonstrate a simple approach to quantify soil strength differences among treatments collected with a multiprobe cone penetrometer using cone index measurements to complement contour graphs and statistical analyses. The approach involves obtaining average cone index values by row position and calculating the area under the curve for cone index (AUCC.I.), with units of megapascal‐centimeters (MPa‐cm). Data were collected from a tillage and cover crop experiment in Prattville, AL (November 2009), and at the Old Rotation experiment in Auburn, AL (December 2014). Cone index values were averaged across depths for five row positions perpendicular to the center of the row (0 cm) and 22.5 and 45 cm on either side of the crop row. The approach identified that three conservation tillage implements reduced penetration resistance compared with no tillage based on AUCC.I. values from the Prattville experiment. Although no statistical comparisons were possible from the unreplicated Old Rotation experiment, AUCC.I. values were numerically lower for the 3‐yr rotation compared with continuous cotton (Gossypium hirsutum L.) and the 2‐yr rotation. Results from both sets of cone index measurements demonstrated that the area under the curve (AUC) approach can be used to quantitatively distinguish among treatments. Results from the AUC approach can be used to facilitate simple comparisons among treatments in field experiments and aid in the interpretation of traditional statistical analyses combined with contour graphs.
Intrinsic Relationship between Matric Potential and Cation Hydration
Authors: Khorshidi Morteza , Lu Ning , Khorshidi Alireza
Published: November 2016

Core Ideas

Exchangeable cations are important in water sorption, hydraulic conductivity, swelling, flocculation–deflocculation, and fertility.

Intrinsic relationship exists between matric potential and cation hydration at very low water contents.

Proposed model predicts soil water content at low matric potentials for different exchangeable cations in soil.

Model is applicable for soil water retention models and quantification of different types of exchangeable cations.

The origin of matric potential in the tightly adsorbed soil water retention (SWR) regime, where matric potentials are generally less than −150 MPa, remains unsettled. Surface tension in soil pores and van der Waals attraction (VDW) near particle surfaces are known, respectively, as the sources of matric potential for capillary and adsorbed film water. However, theories based on VDW fail to predict the SWR for matric potentials less than −150 MPa. Recent studies show that cation hydration occurs at matric potentials much lower than those predicted by considering a particle surface hydration originating from the VDW forces. With this basis, a theoretical soil water retention curve (SWRC) model for drying path is proposed to quantify matric potential and its retained water by accounting for all water sorption mechanisms on or within soil particles, particularly the cation–water molecule or charge–dipole interaction. It is found that clays at very low soil water content, typically less than a few percentage gravimetric, charge–dipole interaction energy, dominate matric potential. Experimental SWR data for various cation‐exchanged soils confirms the validity of the theoretical SWRC model and its accuracy, indicating that cation hydration is mainly responsible for SWR for matric potentials less than −150 MPa. Furthermore, the predicted lowest matric potentials at zero water content for various soils agree well with experimental data. The lowest matric potential of a soil depends mainly on the type of exchangeable cations and thus is not a universal constant for all soils. These results have potential applications in using SWRC for the determination of cation exchange capacity and types of exchangeable cations in soils.
South Africa and the drought that exposed a young democracy
Authors: Turton Anthony
Published: November 2016

South Africa is a young democracy currently going through a crisis of leadership. The worst drought in recorded history has played out at regional level but against the backdrop of complex political dynamics. The government has lost significant capacity at the technical level, largely the result of political priorities driven by the need to decolonise society and the institutions of higher learning. This has manifest in the water sector as systemic failures of key instrumentation systems, rendering the El Niño event invisible until it hit. This case study of the El Niño event shows that drought management is embedded within a broader political process and is not simply a technical management issue. The Vaal River system sustains 60% of the national economy and 45% of the total population of the country, but water security in this system has been placed at risk because of political dynamics.
Application of Fused Deposition Modelling (FDM) Method of 3D Printing in Drug Delivery
Authors: Long Jingjunjiao , Gholizadeh Hamideh , Lu Jun , Bunt Craig , Seyfoddin Ali
Published: November 2016

Three-dimensional (3D) printing is an emerging manufacturing technology for biomedical and pharmaceutical
applications. Fused deposition modelling (FDM) is a low cost extrusion-based 3D printing technique
that can deposit materials layer-by-layer to create solid geometries. This review article aims to provide an overview
of FDM based 3D printing application in developing new drug delivery systems. The principle methodology,
suitable polymers and important parameters in FDM technology and its applications in fabrication of personalised
tablets and drug delivery devices are discussed in this review. FDM based 3D printing is a novel and versatile
manufacturing technique for creating customised drug delivery devices that contain accurate dose of medicine(
s) and provide controlled drug released profiles.
Polymer-Based Novel Lung Targeted Delivery Systems
Authors: Elmowafy Enas , Osman Rihab , Ishak Rania A.H.
Published: November 2016

Background:

Due to its unique features, the respiratory tract had received great attention as a promising
non-invasive route for drug administration to achieve both local and systemic effects. Efforts spent to tailor
systems able to overcome the lung defence mechanisms and biological barriers are followed in this review. Aerodynamic
diameter, morphology, lung deposition and drug release profiles are the main criteria describing the
selected new smart lung targeted delivery systems.

Methods:

Novel systems such as nanoparticles, nano-embedded-in microparticles (NEM), small microparticles
(MP), large porous particles (LPP), PulmospheresTM and polymeric micelles are used to passively target different
areas in the respiratory tract. The most common preparation methods are outlined in the article. Special emphasis
was given to the characteristics of the polymers used to fabricate the developed systems. Efforts made to prepare
systems using chitosan (CS), alginate (alg), hyaluronic acid (HA), gelatin and albumin as examples of natural
polymers and poly lactic-co-glycolic acid (PLGA) and poly(Ɛ-caprolactone) (PCL) as synthetic polymers were
compiled.

Conclusion:

The continuous development and work in the area of lung targeting resulted in the development of
engineered smart platforms with the capability to carry small drug molecules, proteins and genes to treat a variety
of local and systemic diseases.
Polymer Nanoparticles as Smart Carriers for the Enhanced Release of Therapeutic Agents to the CNS
Authors: Gagliardi Mariacristina , Borri Claudia
Published: November 2016

Background:

The brain is the most protected organ in the human body; its protective shield, relying on
a complex system of cells, proteins and transporters, prevents potentially harmful substances from entering the
brain from the bloodstream but, on the other hand, it also stops drugs administered via the systemic route. To
improve the efficacy of pharmacological treatments, targeted drug delivery by means of polymer nanoparticles is
a challenging but, at the same time, efficient strategy.

Methods:

Thanks to a highly multidisciplinary approach, several ways to overcome the brain protection have
provided effective solutions to treat a large number of diseases. Important advances in polymer science, together
with the development of novel techniques for nanocarrier preparation, and the discovery of novel targeting
ligands and molecules, allow a fine-tuning of size, shape, chemicophysical properties and surface chemistry of
functional particulate systems; it enables the improvement of the therapeutic performances for several drugs, also
toward districts that are difficult to be treated, such as the brain.

Conclusion:

This review focuses on the great strides made from scientists and doctors in the development of
polymer nano-sized drug delivery systems for brain diseases. Even though the optimal nanocarrier was not yet
discovered, important advances were made to strive for safer, performant and successful systems, with the expectation
to find soon better solutions to cure some still untreatable pathologies.
Challenges and Future Prospects of Nanoemulsion as a Drug Delivery System
Authors: Yukuyama Megumi Nishitani , Kato Edna Tomiko Myiake , Lobenberg Raimar , Bou-Chacra Nadia Araci
Published: November 2016

Nanoemulsion has the potential to overcome several disadvantages in drug formulation. Loading poor
water-soluble drugs in the appropriate nanoemulsions enhances their wettability and/or solubility. Consequently,
this improves their pharmacokinetics and pharmacodynamics by different routes of administration. Associated
with the optimum nanodroplets size or even combined with key components, the droplets act as a reservoir of
drugs, enabling nanoemulsion to be multifunctional platform to treat diverse diseases. A number of important
advantages, which comprise nanoemulsion attributes, such as efficient drug release with appropriate rate, prolonged
efficacy, drug uptake control, low side effects and drug protection properties from enzymatic or oxidative
processes, have been reported in last decade. The high flexibility of nanoemulsion includes also a variety of
manufacturing process options and a combination of widely assorted components such as surfactants, liquid lipids
or even drug-conjugates. These features provide alternatives for designing innovative nanoemulsions aiming at
high-value applications. This review presents the challenges and prospects of different nanoemulsion types and its
application. The drug interaction with the components of the formulation, as well as the drug mechanistic interaction
with the biological environment of different routes of administration are also presented.
Serum Starvation Induces BACE1 Processing and Secretion
Authors: Stavropoulou A. V. , Mavrofrydi O. , Saftig P. , Efthimiopoulos S.
Published: November 2016

Background:

β-secretase (BACE1) is a type 1 transmembrane protein implicated in Alzheimer’s Disease
(AD) pathogenesis. Cleavage of Amyloid Precursor Protein (APP), initiated by BACE1 and followed by γ-secretase,
leads to the formation of toxic Aβ peptides. Increased levels of BACE1 have been detected in the CSF of AD patients
compared to age-matched healthy controls indicating that neurodegenerative conditions induce shedding of BACE1.

Objective:

To mimic such conditions, we examined whether serum deprivation stimulates proteolysis-dependent
secretion of BACE1.

Method:

Detection of BACE1 secretion in BACE1 overexpressing cells or ADAM10/ADAM17 knockout fibroblasts
cultured under serum deprivation conditions, using western blot analysis.

Results:

We found that serum deprivation of U251 neuroblastoma or HEK293T cells overexpressing BACE1 stimulated
secretion of BACE1. Using ADAM10/ADAM17 knockout fibroblasts and inhibitors of both ADAM10 and
ADAM17, we obtained data indicating that these proteases are involved in serum-starvation induced shedding of
BACE1. This is unexpected since BACE1 is localized mainly in lipid rafts while ADAM10 is localized mainly in
nonlipid raft domains. We hypothesized that serum deprivation results in alterations in the lipid composition of the
membrane which can alter the localization of ADAM10 and BACE1. In support, we obtained results indicating that
extraction of membrane cholesterol following incubation with methyl β cyclodextrin potentiated the effect of serum
deprivation. Secreted BACE1 was also found to be enzymatically active towards immunoprecipiated full length
APP.

Conclusion:

Serum starvation induces ADAM10-mediated BACE1 secretion.
Inelastic Test and Design Method of Cold-formed Steel Lipped Channel Members in Bending
Authors: Yao Xingyou , Guo Yanli
Published: November 2016

The aim of this paper is to investigate the inelastic bending capacity and design method of cold-formed steel lipped channel bending members. The bending tests were conducted on 30 cold-formed steel lipped channel members. The nominal yield stress and the nominal thickness of the bending members were 235 MPa and 2mm. The theoretical global buckling stress was higher three times than the yield stress which can make sure the failure of members were in inelastic stage. For each specimen, an analytical analysis using Finite Element Method (FEM) was also conducted considering the influence of the boundary, the ultimate bending capacity, and the failure mode could also be captured. The test results show that the Chinese cold-formed steel specification Technical code of cold-formed thin-walled steel structures (GB50018-2002) is conservative for lipped channel bending sections in inelastic stage. The test results are used to put forward to a revised design method based on effective width method for the current Chinese cold-formed steel specification. The comparison on the bending capacity between the test results and the calculated results by using the proposed method, effective width method and direct strength method in North American cold-formed steel specification (AISI-S120-2016(draft)) shows that the proposed method can consider the inelastic reserve capacity of bending members well. The failure modes and bending capacity of bending members obtained using the idealized shell finite element model, which are close to the experimental results, shows that the idealized model is very well to model the buckling behavior and calculate capacity of bending members.
A Review on Adaptive Methods for Structural Control
Authors: Venanzi Ilaria
Published: November 2016

Adaptive control algorithms are widely used in many technical fields like aeronautics and robotics for controlling systems whose characteristics vary with time or are uncertain. In the last decades, with the diffusion of active and semiactive control applications in civil engineering, adaptive methods started to be adopted for structural control. This paper provides an up-to-date survey on strategies currently available for adaptive control and a literature overview of solutions examined until today for structural applications.
Mechanism of Localized Corrosion of Steel Pipe Pile Foundation for Offshore Wind Turbines and Corrosive Action
Authors: Wang Kui , Li Zhanqiang , Zhao Mingjie
Published: November 2016

The wind turbine foundation serves as a permanent construction in the harsh marine corrosive environment, its anti-corrosion design is essential to the safe use of the wind turbine structure. At present, there is a significant controversy over the local corrosion mechanism (such as pitting corrosion, and crevice corrosion) and its diffusion mechanism in the academic circle. In the paper, the Faraday electrochemistry formula was used to compute the local corrosion degree of the steel pipe pile for the wind turbine and obtain the general corrosion equivalent. The local corrosion effect of the offshore steel pipe pile for the wind turbine was converted into homogeneous corrosion thickness loss of certain length, and then the ultimate strength of the offshore steel pipe pile foundation for the wind turbine was analyzed under the conditions of local corrosion. The result indicates that the maximum ultimate strength reductionof the steel pipe pile for the wind turbine induced by the local corrosion in the splash zone is 80.8% of the non-corrosive ultimate strength. The maximum ultimate strength reduction of the steel pipe pile for the wind turbine induced by the local corrosion in the continuous immersion zone is 63% of the non-corrosive ultimate strength. Once the local corrosion rate in the splash zone exceeds 10%, the ultimate strength of the steel pipe pile for the wind turbine will exhibit a negative exponential decrease. The local corrosion in the continuous immersion zone has a huge effect on its ultimate strength. There are no significant signs of the structural strength loss. The areas prone to local corrosion should be prioritized in anti-corrosion design of the steel pipe pile for the wind turbine.
Conservative Socket Regeneration with Buccal Wall Defect Using Guided Tissue
Authors: Al-Juboori Mohammed Jasim
Published: November 2016

Progressive alveolar bone resorption after tooth extraction may lead to surgical and prosthetic-driven difficulties, especially when deciding to use a dental implant to replace the extracted tooth. This case report discusses an irreparable lower left second premolar tooth with a periodontal lesion on the buccal side. A preservative tooth extraction was performed. Then, the socket was grafted with bovine bone, a collagen membrane was placed between the buccal bone and the attached gingiva, covering the bone dehiscence buccally, and the socket without a flap was raised. After a 6-month healing period, there was minimal socket width resorption and a shallow buccal vestibule. The implant was placed with high primary stability and sufficient buccal plate thickness. In conclusion, this guided tissue regeneration technique can minimize alveolar bone resorption in a socket with buccal dehiscence, but technical difficulties and shallowing of the buccal vestibule still exist.
Improving Emergency Department Care to Sexual Assault Survivors Using a Risk Stratification Tool
Authors: Sheridan Trisha G. , Callaway Todd R.
Published: November 2016

Background:

Sexual assault survivors who present to emergency departments are not consistently offerered prophylaxis for HIV prevention because there are currently no national evidence-based practice protocols.

Purpose:

The project aim was to improve the provision rate of (N) PEP to SA survivors by providing a decision guideline risk stratification tool and appropriate training to forensic nurses who treated SA survivors who presented within 72-hours following an assault on how to use the risk assessment and stratification tool.

Methods:

A risk stratification tool provided HIV (N) PEP clinical decision guidelines and framework for use with adult survivors. Forensic and emergency department nurses (n=20 total) were given a pre-training knowledge assessment. Forensic nurses (n = 6) were given specific training in HIV risk stratification and use of the (N) PEP decision guideline tool. Knowledge scores were assessed immediately following training and three months after implementation of the risk stratification tool.

Results:

The average knowledge score of forensic and emergency department nurses increased following training, and remained higher after three months of implementation.

Conclusion:

The implementation of a locally-specific risk stratification decision guideline tool improved both provider knowledge and patient care as measured by an increase in appropriate (N) PEP treatment rates.

Recommendations:

Further research is needed to determine if risk stratification decision tools and standardized protocols improve provider knowledge across settings such as communities with different rates of SA, HIV prevalence, and socio-economic levels.
The Deconstruction of a Complex Case of Medical Child Abuse
Authors: Isaac Reena , Creamer Lisa , Trent Mike
Published: November 2016

Background:

Medical child abuse (MCA) is a serious and potentially fatal form of child abuse. The condition of medical child abuse has historically been regarded as a “rare” entity. However, the lack of a standardized definition of medical child abuse may have limited our understanding of the true scope of the problem. Cases may straddle the elements of physical abuse, medical neglect, and psychological abuse. Many cases may have been overlooked as medical child abuse or categorized under another form of child maltreatment, when identified as abuse or neglect. There is no one typical presentation. Medical investigations into suspected cases must be carefully and conservatively conducted.

Method and Result:

An illustrative case is described involving three young chronically-ill siblings with various degrees of medical dependencies, medical and surgical interventions, and multiple subspecialists and is deconstructed with the final outcome of three physically healthy children and a criminal conviction of the perpetrating caregiver.

Conclusion:

Cases of child medical abuse can be complex and challenging. Potential complications and sequelae of unidentified cases are vast, including: pain and suffering from multiple, unnecessary procedures, diminished quality of life and life potential, and ultimately risk of death. Challenges to medical and social investigations can hinder early identification and protection of the children at risk.
Effects of Modification of Pain Protocol on Incidence of Post Operative Nausea and Vomiting
Authors: Schwarzkopf Ran , Snir Nimrod , Sharfman Zachary T. , Rinehart Joseph B. , Calderon Michael-David , Bahn Esther , Harrington Brian , Ahn Kyle
Published: November 2016

Background:

A Perioperative Surgical Home (PSH) care model applies a standardized multidisciplinary approach to patient care using evidence-based medicine to modify and improve protocols. Analysis of patient outcome measures, such as postoperative nausea and vomiting (PONV), allows for refinement of existing protocols to improve patient care. We aim to compare the incidence of PONV in patients who underwent primary total joint arthroplasty before and after modification of our PSH pain protocol.

Methods:

All total joint replacement PSH (TJR-PSH) patients who underwent primary THA (n=149) or TKA (n=212) in the study period were included. The modified protocol added a single dose of intravenous (IV) ketorolac given in the operating room and oxycodone immediate release orally instead of IV Hydromorphone in the Post Anesthesia Care Unit (PACU). The outcomes were (1) incidence of PONV and (2) average pain score in the PACU. We also examined the effect of primary anesthetic (spinal vs. GA) on these outcomes. The groups were compared using chi-square tests of proportions.

Results:

The incidence of post-operative nausea in the PACU decreased significantly with the modified protocol (27.4% vs. 38.1%, p=0.0442). There was no difference in PONV based on choice of anesthetic or procedure. Average PACU pain scores did not differ significantly between the two protocols.

Conclusion:

Simple modifications to TJR-PSH multimodal pain management protocol, with decrease in IV narcotic use, resulted in a lower incidence of postoperative nausea, without compromising average PACU pain scores. This report demonstrates the need for continuous monitoring of PSH pathways and implementation of revisions as needed.
177Lu-DOTA-Bevacizumab: Radioimmunotherapy Agent for Melanoma
Authors: Camacho Ximena , Calzada Victoria , Fernandez Marcelo , Alonso Omar , Chammas Roger , Riva Eloisa , Gambini Juan Pablo , Cabral Pablo
Published: November 2016

Background: Vascular endothelial growth factor (VEGF) is one of the classic factors to
tumor-induced angiogenesis in several types, including melanoma. Bevacizumab is a humanized
monoclonal antibody directed against VEGF.

Objective: To radiolabel Bevacizumab with 177-Lutetium as a potential radioimmunotherapy agent
for melanoma.

Methods: Bevacizumab was derivatized with DOTA-NHS-ester at 4 ºC for 18 h. DOTABevacizumab
was radiolabeled with 177LuCl3 (15 MBq/mg) at 37 ºC for 1 h. The studies were performed
in healthy and B16F1 tumor-bearing C57BL/6J mice at 24 and 48 h (n = 5). Scinthigraphic
imaging studies were performed at 24 h to determine the radiochemical stability, targeting specificity
and pharmacokinetics of the 177Lutetium-labeled antibody.

Results: DOTA-Bevacizumab was efficiently labeled with 177LuCl3 at 37 °C. The in-vitro stability of
labeled product was optimal over 72 h. In-vivo biodistribution studies showed a high liver and tumor
uptake of 177Lu-DOTA-Bevacizumab, with tumor-to-muscle ratios of 11.58 and 6.37 at 24 and 48 h
p.i. Scintigraphic imaging of melanoma tumor-bearing C57BL/6J mice showed liver and a high tumor
selective uptake of 177Lu-DOTA-Bevacizumab at 24 h.

Conclusions: Our results support the potential role of 177Lu-DOTA-Bevacizumab as a novel radioimmunotherapy
agent for melanoma. We hope that these novel molecular imaging agents will open
the path to new diagnostic and therapeutic strategies for Melanoma disease.
Levels of Physical Activity among Kuwaiti Adults and Perceived Barriers
Authors: Al-Baho Abeer Khaled , Al-Naar Ashraaf , Al-Shuaib Hadwa , Panicker Jibu K , Gaber Sherine
Published: November 2016

Background:

Regular Physical activity is associated with many positive health outcomes related to prevention and control of obesity and non-communicable diseases which have a high prevalence in Kuwait. The aim of our study was to investigate the level of physical activity among Kuwaiti adults and interfering barriers.

Methods:

A cross sectional randomized study was used to collect data about physical activity level among 858 Kuwaiti adults using the International Physical Activity Questionnaire, Arabic version and perceived barriers to physical activity were investigated using an ecological framework. Regression analysis was used to determine the predictors of physical activity among participants.

Results:

The results revealed that 19.13% of the sample did not perform any physical activity and 38.1% had low physical activity level, with no significant difference between males and females. The most common perceived barriers were hot weather (75.9%), work duties (71.21%), laziness (44.3%), lack of time (38.6%), family responsibilities (36.1%) and chronic diseases (33.33%).

Conclusion:

The level of physical activity among Kuwaiti adults was found to be low. This could be a reason for high levels of obesity in Kuwait. A comprehensive health promotion program including environmental and social modifications in addition to health education is suggested to improve physical activity among Kuwaiti adults.
Можливості корекції поєднаної патології стравоходу та гастродуоденальної зони в дітей із використанням багатокомпонентного фітопрепарату
Authors: Belousova O.Yu. , Pavlenko N.V. , Ganziy E.B. , Voloshin K.V. , Kaafarani A.M.
Published: November 2016

У статті наведені власні результати дослідження клінічної ефективності та безпеки застосування багатокомпонентного фітопрепарату Гастритол як монотерапії поєднаних функціональних порушень стравоходу і шлунка в дітей молодшого віку і в складі комплексної терапії при гастроезофагеальній рефлюксній хворобі в поєднанні з хронічним гастродуоденітом і виразковою хворобою у пацієнтів старшого віку. Надано рекомендації щодо використання препарату, засновані на отриманих результатах із його ефективності, безпеки для різних варіантів терапії у дітей усіх вікових груп.
Застосування полуелементних сумішей в ентеральному харчуванні дітей із тяжкими неврологічними захворюваннями
Authors: Koreniuk O.S. , Ivanchenko V.I. , Alekseeva O.G.
Published: November 2016

У статті розглянуто проблемні питання харчування дітей-інвалідів із неврологічними захворюваннями — дитячим церебральним паралічем та вродженими вадами розвитку головного мозку. Відмічено особливості та складності годування цього контингенту хворих. Наведено досвід застосування поживної суміші повний гідролізат в ентеральному харчуванні дітей із вторинною дистрофією на тлі тяжкої неврологічної патології. Відзначено ефективність даної методики вигодовування, позитивну динаміку нутритивного статусу пацієнтів.
До питання дієтотерапії синдрому ацетонемічного блювання в дітей
Authors: Gnatenko T.М.
Published: November 2016

Актуальність. Синдром ацетонемічного блювання (недіабетичний кетоацидоз) — це поширена мультифакторіальна патологія дитячого віку, значну роль при якій відіграють метаболічні порушення. Дієтотерапія є одним із ключових ланок терапії ацетонемічного кризу. Мета: визначити доцільність включення спеціалізованого дитячого харчування ПедіаШур 1.5 у комплексну терапію синдрому ацетонемічного блювання в дітей, оцінити динаміку основних клінічних проявів. Матеріали та методи. У дослідження були включені 30 дітей віком від 5 до 10 років із рецидивуючим ацетонемічним синдромом. Усі 30 дітей мали клінічні прояви ацетонемічного кризу у вигляді блювання, нудоти, відсутності апетиту, слабкості, кетонурії. Діти були розподілені в 2 групи: основну (середній вік дітей — 5,90 ± 0,52 року) і контрольну (середній вік дітей — 6,0 ± 0,4 року). Усі діти отримували терапію відповідно до протоколів МОЗ, перебували на гіпокетогенній дієті. Терапія дітей основної групи була доповнена застосуванням ПедіаШур 1.5, по 1 пляшці на день у декілька прийомів курсом 10 днів. Було проведено статистичний аналіз порівняння тривалості кетонурії, динаміки клінічних проявів в основній і контрольній групах. Результати. Нутритивна корекція у вигляді застосування ПедіаШур 1.5 у комплексній терапії ацетонемічного кризу дозволила статистично вірогідно скоротити тривалість основних клінічних проявів: нудоти, блювання, слабкості, кетонурії. Переносимість ПедіаШур 1.5, згідно з опитуванням батьків, оцінювалася позитивно в усіх випадках. Небажаних ефектів або побічних реакцій на тлі прийому ПедіаШур 1.5 у дослідженні виявлено не було. Висновки. Отримані результати свідчать про доцільність застосування ПедіаШур 1.5 у комплексній терапії синдрому ацетонемічного блювання в дітей, що сприяє більш швидкому купіруванню основних клінічних проявів.
Порушення травлення у дітей з антибіотик-асоційованою діареєю
Authors: Radutna O.A. , Kysyma N.V.
Published: November 2016

Актуальність. Найбільш відчутною проблемою широкого використання антибіотиків є зміни мікробної екології, порушення рівноваги біоценозу кишечника, поява антибіотикорезистентних штамів мікроорганізмів з патогенними властивостями та виникнення у зв’язку з цим патологічних змін в кишечнику, що й обумовлюють симптоми порушення травлення у хворих з антибіотик-асоційованою діареєю. Мета дослідження. Визначення проявів синдрому мальабсорбції для удосконалення діагностики антибіотик-асоційованої діареї в дітей. Матеріали й методи. Об’єкт дослідження становили 116 хворих, які отримували антибіотики, віком від 6 місяців до 18 років. Обстеження дітей включало загальноклінічні, біохімічні, бактеріологічні, імуноферментні, імунохроматографічні, інструментальні, математичні методи дослідження. Результати. При розвитку діареї у хворих за умов негативних тестів на клостридіальні токсини кваліфікували ці випадки як ідіопатичну антибіотик-асоційовану діарею, при позитивних — як кишкову інфекцію Clostridium difficilе. У ході дослідження були виявлені вірогідні відмінності за копрологічними показниками між дітьми з гострою ідіопатичною й обумовленою клостридіальною інфекцією антибіотик-асоційованою діареєю. При мікроскопічному та біохімічному дослідженні випорожнень виявлено маніфестні ознаки порушення травлення та всмоктування жирів і вуглеводів, які проявляються клінічними симптомами мальабсорбції. Усім дітям з антибіотик-асоційованою діареєю притаманні підвищені концентрації вуглеводів у випорожненнях. Виявлені ознаки порушення травлення з розвитком мальабсорбції ліпідів у дітей з антибіотик-асоційованою діареєю, і в першу чергу обумовленою інфекцією Clostridium difficile. Висновки. Порушення травлення та всмоктування вуглеводів та ліпідів, а також показники запальної реакції кишечника (лейкоцити, прихована кров, слиз) є маркерами антибіотик-асоційованої діареї та можуть використовуватися для її ранньої діагностики, у тому числі в разі інфекції Clostridium difficile.
Фактори формування різних типів діастолічного наповнення лівого шлуночка в підлітків із патологією міокарда
Authors: Bogmat L.F. , Nikonova V.V.
Published: November 2016

Мета: вивчення головних компонентів формування порушеного діастолічного наповнення лівого шлуночка в підлітків із патологією міокарда. Матеріали та методи. Обстежено 110 підлітків із патологією міокарда віком 13–18 років, серед яких 40 — із порушенням ритму серця, 40 — із диспластичною кардіоміопатією, 30 — із первинною артеріальною гіпертензією. Морфофункціональні параметри серця вивчалися за допомогою ультразвукового дослідження за стандартною методикою. Функцію діастоли лівого шлуночка вивчали в імпульсному допплерівському режимі з картируванням трансмітрального потоку з верхівкового доступу чотирикамерного серця. Для адекватної оцінки діастолічної функції лівого шлуночка і визначення найбільш ранніх її порушень підліткам проводилася проба з ізометричним навантаженням. На підставі отриманих результатів підлітки були розподілені за показником співвідношення Е/А. З метою виявлення прихованих загальних факторів, що пояснюють зв’язок між показниками, було застосовано факторний аналіз, а саме метод головних компонент. Усі статистичні процедури проводили з використанням пакетів прикладних програм Statgrafics Centurion. Результати. На початкових етапах становлення діастолічної дисфункції міокарда лівого шлуночка серця в підлітків значну роль відіграє низка факторів, що можна умовно позначити як геометричний, функціональний та нейрогуморальний фактори, які включаються послідовно в патологічний процес. Так, при формуванні 1-го типу діастолічної дисфункції лівого шлуночка на першому місці знаходиться нейрогуморальний фактор, а саме активація симпатоадреналової системи, далі в патологічний процес залучається периферичний судинний тонус та, як наслідок, геометричний фактор — зміна розмірів лівого передсердя. При формуванні 2-го типу діастолічної дисфункції лівого шлуночка в процес послідовно залучається ренін-ангіотензинова система, а саме ренін, функціональний фактор представлено показниками загального периферичного судинного опору та хвилинного об’єму, а геометричний складається з діаметра лівого передсердя та кінцево-діастолічного розміру лівого шлуночка. Формування 3-го типу діастолічної дисфункції лівого шлуночка відбувається під впливом таких складових нейрогуморальної системи, як ренін та ангіотензин II, потім послідовно в процес залучаються периферичний судинний тонус та геометричний фактор у вигляді показників діаметра лівого передсердя та кінцево-діастолічного розміру лівого шлуночка. Отже, на початкових етапах становлення діастолічної дисфункції лівого шлуночка в підлітків із патологією міокарда значну роль відіграють симпатоадреналова система, периферичний судинний тонус та функція лівого передсердя, а далі послідовно підключається ренін-ангіотензинова система, що викликає підвищення жорсткості міокарда та, як наслідок, включення в патологічний процес не тільки лівого передсердя, але й структури (кінцево-діастолічний об’єм) і функції лівого шлуночка серця (ударний об’єм).
Спороутворюючі пробіотики, дефіцит заліза та імунітет
Authors: Kvashnina L.V.
Published: November 2016

У статті надані дані про біологічні властивості спороутворюючої бактерії Bacillus coagulans. Показані ефективність та перевага пробіотика Лактовіт Форте, який містить спори Bacillus coagulans, що підтверджено методами доказової медицини. Надані факти впливу на імунітет та гемопоез, а також доцільність комбінацій із вітамінами В9 і В12.