bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of biochemical parameters of blood serum in patients with chronic pyo-inflammatory diseases of the lower extremities
Authors: Zasorin A A , Andreeva O L , Makarova N P , Konovalov P P
Published: November 2019

Aim. To assess the dynamics of wound healing process based on the biochemical parameters of blood serum in patients with phlegmons of the lower extremities treated with various methods of ozone therapy. Methods. Conducted was dynamic monitoring of the biochemical parameters in patients with pyo-inflammatory diseases of the lower extremities. Depending on the method of treatment the patients were divided into three study groups and a control group, 29 people in each. The first group consisted of patients in whon in combination with traditional treatment local ozone therapy was performed. The second group consisted of patients who received intravenous and local ozone therapy in combination with traditional treatment. The third group consisted of patients who received traditional treatment with intraarterial and local ozone therapy. The control group consisted of patients who received traditional treatment. Results. The results showed that during treatment with ozone therapy a relief of endogenous intoxication and a significant improvement in albumin concentration takes place compared with the control group. Conclusion. A more rapid decrease in endogenous intoxication, relief of inflammation at the local and systemic levels occurs secondary to ozone therapy; most effective are intraarterial and local applications of ozone.
Heart rate variability in the assessment of «benefit/risk» of infusion therapy
Authors: Maksumova N V , Fattakhov V V , Nasrullaev M N
Published: November 2019

In order to assess the correctness of choice of medicinal treatment of a disease, safety of intravenous transfusions, the effectiveness of treatment Chosen was a method for the analysis of heart rate variability using a complex of diagnostic functional changes in the cardiac rhythm, «Kardioanalizator “Expert 01”» (СJSC «NPO “Markiz”», Saint-Petersburg). In patients with hypersympathicotonia marked was a tendency for rigidity of cariac rhythm, overstress condition, depletion and collapse of the adaptive systems. Treatment of such patients, including infusion therapy, should be done in a hospital setting. Among patients with hypervagotonia such phenomena are not registered, although the rigidity of the cardiac rhythm is possible in them as well. For this reason, the planning of rehabilitation programs requires an individual approach. Based on heart rate variability indices, formed were groups of patients for outpatient infusion therapy at the ambulatory hospital. Patients with risk factors for development of acute vascular disease should be referred for inpatient treatment.
Organizational measures for the prevention of complications of blood transfusion
Authors: Stepanova N I , Polyanin N A
Published: November 2019

Organization of the blood transfusion therapy in a hospital is an essential element in delivering medical care to the wounded, injured and sick. In each medical department of the hospital a physician responsible for the organization of transfusion therapy is appointed by the order of the chief. The provision of donor blood and its components for the elective surgical interventions is carried out on the basis of preliminary requests of the attending physicians. It is unacceptable to conduct elective surgical interventions without the required number of screened blood components. In order to conduct blood transfusions when providing emergency care there should be a supply of fresh frozen plasma and frozen erythrocytes in the hospital in the amount of a monthly requirement. All blood transfusion must have a clear clinical rationale and should be performed in strict accordance with current instructions for use of blood components. The completed measures for determination of blood component’s compatibility with the blood of the recipient, the name, amount, passport data of each transfusion environment have to be reflected in the blood transfusion protocol.
Graduate of the medical faculty of Kazan imperial university, health care organizer of the Bashkir ASSR, honorary physician of RSFSR N.N. Bayteryakov
Authors: Ziyatdinov K Sh , Kin’yabulatov A U , Zagidullin Sh Z , Sharafutdinova N Kh , Aminov T Z
Published: November 2019

The outcome of the work of Nurelgayan Nuriakhmedovich Bayteryakov is thousands of saved lives, the fact that always maintained his high morale, energy and high surgical activity. The article discusses the difficult and worthy life path of this amazing man.
Vascular conflicts in andrology. Part 2. Lower level arteryovenous conflicts
Authors: Kapto Alexandr А. , Smyslova Zoja V.
Published: November 2019

This paper presents a review of the literature on the prevalence, classification, symptoms, diagnosis and treatment of lower level arteriovenous conflicts. New approaches in the treatment of both arteriovenous conflicts and comorbid diseases such as varicocele, varicose veins of the pelvic organs, venogenic erectile dysfunction, chronic pelvic pain syndrome are presented. The data of the literature review can form the basis for the revision of approaches to the management of patients with varicocele, erectile dysfunction and chronic recurrent prostatitis. It is shown that x-ray surgical embolization of prostatic plexus veins alone or in combination with testicular vein embolization, angioplasty and iliac vein stenting is possible only at the junction of urology, andrology and x-ray surgery.
Professor A.Ya. Damsky – an urologist-innovator and a teacher (the 150th anniversary of his birth)
Authors: Morgoshiia Temuri Sh. , Kuzmin Igor V. , Sasova Valerija D. , Inkin Aleksandr V.
Published: November 2019

The article is devoted to the 150th anniversary of the birth of Professor Albert Yakovlevich Damsky who was an urologist-innovator and a teacher. The main stages of scientific and pedagogical activity and practical activity of the scientist are presented. A.Ya. Damsky published about 60 scientific papers, also he was the author of the first two Soviet urology textbooks and a creator of an operating cystoscope of his own design. Moreover he was the first to perform transvesical adenomectomy.
Late Pleistocene Record of Off‐Fault Deformation and Vertical Slip Rates from the Wasatch Fault Zone, Utah: Implications for Fault Segmentation from Lake Bonneville Shorelines
Authors: Howe Julia , Jewell Paul , Bruhn Ronald
Published: November 2019

In an effort to better understand the Pleistocene history of the Wasatch fault zone, we evaluate the deformation and displacement of the Bonneville and Provo high‐stand shorelines of Lake Bonneville along the Wasatch Front. We apply an automated shoreline elevation measurement application developed as part of this study to measure Lake Bonneville shoreline elevations along the Weber and Brigham City segments of the fault, adding to a previously published dataset of shoreline elevations on the Salt Lake City segment. Tectonically deformed shorelines on the footwall of the fault demonstrate elevation patterns that are inconsistent with the idea that the Pleasant View salient, a bedrock salient marking the segment boundary between the Weber and Brigham City segments of the fault, is a persistent barrier to fault rupture since the late Pleistocene. Shoreline features are elevated ∼20  m across the segment boundary as compared to shoreline features on the northern part of the Brigham City segment. We suggest the possibility that fault rupture through the Pleasant View salient has been common since the late Pleistocene and speculate that a similar relationship could exist between the Provo and Salt Lake City segments, based on similarities between the shoreline elevation patterns on the Brigham City and Salt Lake City segments of the fault. Vertical slip rates measured from displaced shorelines at the Pleasant View salient (Brigham City–Weber segment boundary) are generally higher compared to those at the Honeyville spur (Collinston–Brigham City segment boundary). Statistically significant vertical slip rates calculated from the Provo shoreline at the Pleasant View salient (0.8±0.5 to 0.9±0.6  mm/yr and 0.7±0.5 to 0.9±0.6  mm/yr) suggest that late Pleistocene vertical slip rates are slightly lower than Holocene rates; however, large uncertainties in the shoreline elevation measurements exist.
Change of Arthropod Communities in A Wheat Field After Application of Wood Vinegar Produced from Nutshells
Authors: KOÇ İbrahim
Published: November 2019

This study was conducted to
evaluate the biological effects of wood vinegar obtained from nutshells on
arthropods. The study was conducted randomized as a block design with four
replications in a wheat field in Muş province. Wood vinegar was applied at 0.5%,
1%, 2%, 3%, 4% and 5% ml concentrations via backpack sprayer.
Pitfall-traps were used to determine the effect of wood vinegars. Results
indicated that the mean number of arthropods varied based on the years and
vinegar applications at different concentrations (compared to the control). In addition, it is thought that all wood vinegar
treatments compared to the control lead to a decrease in the average number of
Opiliones and an increase in the average number of Arachnids.
Loop ileostomy versus transverse colostomy as a covering stoma after anterior resection for rectal cancer
Authors: Bendary Saied Hosny , El sheikh Abd Elfatah T. , Ramadan Mahmoud Kamal
Published: November 2019

Background: Most colorectal cancer occurs due to lifestyle and increase age with only a minority of cases associated with underlying genetic disorders and environmental factors enables us to move in the direction of a complete assessment of disease risk. The objective of the present study was to compare between two different types of diverting stoma (loop ileostomy and transverse colostomy) as regard immediate and remote complications in patient with rectal cancer treated by restorative resection.Methods: A prospective randomized comparative clinical study was conducted on 50 patients who underwent anterior resection and low anterior resection for rectal cancer divided into two groups: Group I consisted of 25 patients who underwent by loop ileostomy. Group II consisted of 25 patients who underwent by loop transverse colostomy. All patients attended to surgical oncology unit of Sayed Galal hospital, Al Azhar University, Cairo, Egypt during the period from October 2018 to October 2019. Full history, routine, physical examination, routine and imaging investigations were done.Results: 80% and 84% of loop ileostomy and transverse colostomy patients had anterior resection, respectively with no statistically significant differences between the two studied groups regarding anterior resection. Patient who treated by loop ileostomy had deceased time of closure (5.2±0.25 weeks) and stay in hospital (5.16±1.65 and 3.29±0.55 days) than those treated by transverse colostomy (9.6±0.37 weeks) and (7.44±2.58 and 6.03±1.97 days) respectively.Conclusions: Egyptians have unique tumor characters and behavior, and different compliance with treatment regimens. Multicenter prospective studies, as well as evolving Egyptian treatment guidelines are needed to address this.
Проблемы взаимодействия академического, вузовского и предпринимательского секторов науки
Authors: Донцова Олеся Игоревна
Published: November 2019

Как показывает зарубежный опыт формирования высокотехнологических отраслей промышленности, критически важным является формирование механизма взаимодействия академического и вузовского секторов науки как с коммерциализирующими научные разработки предпринимателями, так и с крупным бизнесом, который выводит инновационный продукты на массовый рынок. Взаимодействие представленного академическим и вузовским сообществом научного сектора с коммерческими организациями, внедряющими инновационные технологии на рынок в статье предлагается направить на координирование направлений фундаментальных исследований в востребованных на рынке отраслях науки и техники.
All You Can Do Is Love It: As You Like it Meets the Bards of Liverpool
Authors: Walter Melissa , Warwick Emily
Published: November 2019

Review of the 2018 Bard on the Beach production of As You Like It.
Universal Scientific Education and Research Network (USERN): Step Strong in Scientific Networking
Authors: Rahmani Farzaneh , Keshavarz-Fathi Mahsa , Hanaei Sara , Aminorroaya Arya , Delavari Farnaz , Paryad-Zanjani Sasan , Ahmadi Negar Sadat , Akbari Parya , Ashkevarian Saboura , Barghi Farshad , Ebadirad Saleheh , Jaberipour Ali , Kolahi Mohammad Reza , Moallemian Marjan , Pourebrahimi Ali , Samimiat Alireza , Vahedi Zahra , Seyedian Seyedeh-Sanam Ladi , Rezaei Nima
Published: November 2019

This article is an Editorial and does not include an Abstract.
Severe Decline in Mir-20a and Mir-92a in the Context of the Mir-17-92 Cluster: Ideal Biomarkers of Various COPD Subtypes
Authors: Ghorbani Alvanegh Akbar , Tavallaei Mahmood , Edalat Houri
Published: November 2019

Abstract- Chronic obstructive pulmonary disease (COPD) is going to be the third leading cause of death by 2020. Circulating miRNAs are among the most beneficial feasible non-aggressive biomarkers for diagnosis and treatment of many diseases. Among members of the significant miR-17-92 cluster, miR-20a and miR-92a are greatly involved in both inflammation and hypoxia (known as the main reasons for COPD comorbidities). Thus, the expression of these miRNAs was evaluated in the serum of 26 patients and 19 controls using the sensitive stem-loop RT-qPCR approach. The results revealed a significant reduction of these miRNAs in patients relative to controls (P<0.001). Decreased expression of miR-20a in a patient might reflect a progressive stage of the disease. MiR-92a might be used as an early-detection biomarker of COPD. These miRNAs can be used as therapeutic targets specifically in the context of the miR-17-92 cluster to address the various clinicopathological aspects of the disease.
The Characteristic Clinical and Pathological Features of Incidental and Non-Incidental Papillary Microcarcinoma of the Thyroid
Authors: Akgül Özgün , Kamer Erdinç , Acar Turan , Acar Nihan , Sarı Erdem , Dere Yelda , Dere Özcan , Tarcan Ercüment , Gen Hüdai , Haciyanli Mehmet
Published: November 2019

Abstract- The incidence of papillary microcarcinoma (PMC) keeps raising due to fine needle aspiration (FNA) biopsies and the pathologic evaluation of thyroid specimens of cases operated for benign thyroid disorders. The files of 78 patients who underwent surgery between January 2006 and May 2013 in our department and were diagnosed with PMC were analyzed, retrospectively.Cases were grouped as incidental and non-incidental depending on the preoperative diagnosis. The diameter of the nodules in the preoperativeultrasonographic examination, pathological parameters such as tumor size, bilaterality, multifocality,and capsular invasion were found significantly high in non-incidental group(P<0.05). No significant difference was detected between the two groups’ age, sex, and vascular invasion.Preoperative radiologic examination by experienced radiologists and FNA performed for suspicious nodules may increase the rate of early and correct diagnosis. In our opinion, determining the most useful criteria for malignancy will help to detect incidental PMC in cases followed up for multinodular goiter
What Caused Poverty Reduction In Brazil During The 2000s: Sectoral Growth Or Public Expenditures
Authors: Palacio Chaverra Andrés Fernando , Martins Igor
Published: November 2019

Qué causó la disminución de la pobreza en Brasil durante la primera década del siglo 21 es la pregunta principal en este estudio. Nuestra contribución radica en incorporar una pers­pectiva de cambio estructural para evaluar la evolución de la pobreza en un contexto de altos precios en la agricultura y decentralización de la política social a nivel federal, estatal y mu­nicipal. Presentamos, entonces, un modelo de primeras diferencias para captar los efectos de ingreso medio por sectores y de gasto público descentralizado, sin ningun afán de comprobar causalidad. Confirmamos hallazgos previos en la literatura de que el sector de servicios, en lugar de la agricultura, es el que más con­tribuye a la reducción sostenida de la pobreza. Sorprendentemente, la administración pública es el principal subsector en rama de servicios. También encontramos que los gastos estatales y municipales en capital humano contribu­yen más a la reducción de la pobreza que los gastos federales asociados con los programas de transferencias condicionales de efectivo. En resumen, afirmamos que los beneficios de las políticas descentralizadas asociadas con el capital humano se pueden ver a corto plazo y, por lo tanto, elevan el nivel de los políticos para mantener y cuidar estas políticas. Además, el sector de servicio público, que es uno de los principales empleadores en la economía actual, debe encontrar formas de innovar y mejorar la productividad para que la reducción de la pobreza sea sostenible a largo plazo.
La influencia de la contabilidad creativa en la ética profesional del contador público
Authors: Hernández-Gil Cristian , Losada-Rodríguez Nelson Andrés , Orozco-Calderón Daniela
Published: November 2019

La contaduría pública, como carrera profesional liberal, nace de la necesidad de formar personas, de manera técnica, profesional y ética para que se especialicen y se encarguen del manejo de las finanzas de una persona natural o jurídica. Esto para una posterior presentación de informes financieros con cifras fidedignas, con el fin de perfeccionar el proceso de toma de decisiones, en la gestión de cualquier organización. El objetivo de esta investigación se centró en analizar la ética del profesional, su importancia y cómo la ausencia de la misma hace que se presente la contabilidad creativa. Se desarrolló una investigación de corte descriptivo y de tipo revisión documental, donde se analizaron 51 referencias bibliográficas. Se concluye que la contabilidad creativa es un flagelo que afecta la ética organizacional y profesional, de quien se presta a cometer actos fraudulentos, por la sencilla razón de acomodar cifras y mostrar una realidad que no corresponde con lo verdaderamente ejecutado.
La investigación formativa contable en universidades de Tunja
Authors: Molina-Hurtado Yudy Alexandra , Fonseca-Gordillo José Eustacio
Published: November 2019

Se presenta un estudio sobre la investigación formativa en los programas de Contaduría Pública, de las Instituciones de Educación superior de la ciudad de Tunja, Colombia, en el periodo 2010 a 2015. La investigación asume el enfoque cualitativo, de tipo descriptivo. Los resultados develan que la formación de los Contadores Públicos en Tunja, se encuentra enmarcada en áreas como: Auditoría, Finanzas, Tributaria, Normas Internacionales de Información Financiera, y Costos. Las tendencias predominantes son auditoría y finanzas, reflejando la articulación con las políticas económicas globales que con el tiempo han marcado la pauta dentro de la construcción de mallas curriculares, garantizando procesos formativos actualizados y de calidad. Asimismo, el proceso investigativo representa un porcentaje bajo en relación con las demás opciones para optar al título profesional, como son: pasantías y cursos en un programa de especialización o maestría, afines al campo de formación. Se concluye que queda un largo trayecto por recorrer en el ámbito de la investigación formativa contable, de modo que se generen propuestas para fortalecer su praxis en el área de influencia de las Universidades.
Concepciones del docente en sus formas de percibir el ejercicio de la investigación desde su práctica
Authors: Gutiérrez-Rico Dolores , Almaraz-Rodríguez Omar David , Bocanegra-Vergara Netzahualcóyotl
Published: November 2019

La presente investigación es un estudio fenomenológico, que pretende comprender las concepciones que tiene el profesor sobre la investigación educativa. Se utilizaron como técnicas para la recolección de datos, la entrevista abierta y videos. Los contextos de estudio fueron tres congresos, uno de corte internacional, otro nacional y un estatal. Las categorías centrales que surgieron una vez que se analizó la información, son: Cultura de la investigación, el profesional de la educación en la investigación, la investigación educativa como mejora en la resolución de problemas, creencias y concepciones de la investigación desde diferentes contextos. Se concluye que el principal interés estuvo determinado por el significado que los profesores investigadores atribuyeron a sus experiencias, dados los contextos específicos donde se desempeñan. Además, consideran necesaria la investigación en y desde la realidad en las aulas, que atienda las necesidades de los actores educativos que se ven afectados por las prácticas institucionales.
Nadir Afonso, a arte de uma diáspora
Authors: Ferreira Antonio Quadros
Published: November 2019

Desejamos propor, em Nadir Afonso, a arte como uma diáspora, um olhar mais actual e mais contemporâneo sobre a obra nadiriana numa perspectiva integrada das artes. A muito pouco tempo de se comemorar os cem anos do nascimento deste pintor português (em 4 de Dezembro de 2020), é já num registo de procura de conhecimento e de homenagem que o presente dossier se faz publicar, justamente, no Brasil.
Nadir ou a pintura como pura sugestão
Authors: Almeida Bernardo Pinto de
Published: November 2019

Na história da arte do século XX em Portugal, o nome de Nadir Afonso ascende, merecidamente, ao mais alto cume, e a passagem do tempo apenas o vem confirmando. Não apenas, e desde logo, por ter sido um dos pioneiros da arte abstracta feita entre nós, ao lado de Fernando Lanhas e de poucos mais, como sobretudo pela imensa originalidade do seu trabalho plástico. Ao que se deveria juntar também o reconhecimento internacional que, desde muito cedo, o seu trabalho mereceu, ao ser convidado a expor em Paris numa das galerias marcantes na divulgação das neo-vanguardas europeias da década de cinquenta, a célebre galeria Denise Renée. Ali Nadir expôs ao lado de outros destacados artistas internacionais como Victor Vasarely, Jacobsen, Dewasne ou Mortensen, quase todos associados à exposição-manifesto "Le Mouvement" de 1955.
Nadir Afonso, o pintor (que se formou) arquitecto da paixão pela pintura ao ofício da arquitectura
Authors: Cepeda João
Published: November 2019

Nadir Afonso, um dos mais conhecidos (e reconhecidos) pintores portugueses, dedicou grande parte da sua vida ao exercício da profissão em que (afinal) se formou, a arquitetura, fato que ainda hoje é frequentemente ignorado pelo grande público.
Nadir Afonso, a arte de uma diáspora
Authors: Ferreira António Quadros
Published: November 2019

Desejamos propor, em Nadir Afonso, a arte como uma diáspora, um olhar mais atual e mais contemporâneo sobre a obra nadiriana numa perspectiva integrada das artes. A muito pouco tempo de se comemorar os cem anos do nascimento deste pintor português (em 4 de Dezembro de 2020), é já num registo de procura de conhecimento e de homenagem que o presente dossier se faz publicar, justamente, no Brasil.
Does the ESG matter for the countries that are not part of the European Higher Education Area?
Authors: Dedaj But , Zhushi Genc , Aliu Luljeta , Eckl Peter , Carabregu Vokshi Mjellma
Published: November 2019

In recent years the European countries have created a standard form for their Higher Education Systems, the Standards and Guidelines for Quality Assurance in the European Higher Education Area (ESG). In this paper, we have analyzed the levels of the Accreditation Process applied to the Higher Education Institutions (HEIs) in Kosovo and Albania, and the compliance to the ESG guidelines. Furthermore, throughout the entire paper, we have made a comparison of the standards of the Accreditation Process for the HEIs in Kosovo and Albania. In order to capture these stages, we have surveyed both the accreditation agencies and the HEIs in Kosovo and Albania. From this analysis, we came to the conclusion that the accreditation process in Kosovo and Albania for the HEIs are in compliance to the ESG standards, and there is no a huge difference appearing, although Kosova is not part of Bologna Process. The paper gives hands-on information about the accreditation process of the HEIs in Kosovo and Albania that will be in the interest of all Higher Education System designers and developers of these two countries, but also for other transitions countries.
INTERPERIFERIAS DO FUTEBOL: INTERCÂMBIO ESPORTIVO E CULTURAL ENTRE BRASIL (FLORIANÓPOLIS) E URUGUAI (MONTEVIDÉU)
Authors: Pinto Fábio Machado , Lara Ricardo , Bassani Jaison José
Published: November 2019

A realização do Projeto Interperiferias do futebol: intercâmbio esportivo e cultural entre Brasil (Florianópolis) e Uruguai (Montevidéu) proporcionou formação e lazer do trabalhador por meio da prática do futebol comunitário e de atividades artísticas e culturais. Participaram do intercâmbio famílias das classes populares residentes nas periferias de Florianópolis e Montevidéu que buscam por meio da prática esportiva e das trocas de vivências históricas e culturais uma maneira de se solidarizar com os povos e manter vivas as vozes das periferias na construção de melhores condições de vida. A articulação do turismo, história, cultura e lazer esportivo em uma viagem internacional possibilitou a confraternização com atletas, moradores das comunidades e universitários. Entre as atividades desenvolvidas foram apresentados trabalhos sobre sustentabilidade, agroecologia e exposição de obras artísticas realizadas por nossos atletas que tiveram como tema o futebol e a cidade de Florianópolis. Foram realizadas visitas ao Clube Atlético Peñarol, Clube Atlético Cerro e ao Estádio Centenário e seu museu, onde ocorreram palestras e debates sobre futebol e cultura popular.
ESPACIO DE FORMACIÓN INTEGRAL DEPORTE Y SOCIEDAD. ESTUDIOS EXPLORATORIOS Y EXPERIENCIAS DISIDENTES
Authors: Mora Pereyra Bruno , Pastorino Martina , Benítez Líber
Published: November 2019

La relación del deporte con la extensión universitaria en Uruguay se funda con el proyecto tatami en 2010. A partir de esta iniciativa, aparecen una serie de propuestas hasta llegar al EFI Deporte y Sociedad en 2019, que congrega varios proyectos. En este artículo intentaremos resumir abordajes, problematizaciones y resultados que dentro del EFI se congregan, a modo de balance y proyección. Como punto de partida se toma al deporte como una arena pública donde suceden algunos dramas de la sociedad, y que oficia para el equipo de trabajo que lleva adelante el EFI, de espacio privilegiado para estudiar e intervenir sobre algunos de estos problemas sociales y otros que de forma violenta se pretenden ocultar.
EMBODYING LATINNESS IN AUSTRALIA THROUGH DANCE
Authors: Varea Valeria
Published: November 2019

Dance, as an embodied activity, is shaped by culture, and simultaneously shapes culture. Significantly, over the last few years there has been a worldwide boom in Latin dance, which is often considered an ‘exotic’ and ‘sexy’ activity. This paper explores experiences of teaching Latin dance as a service activity (extensión, in Spanish) by an academic in Australia, shaped by the theoretical ideas of public and body pedagogies. The reflections are presented under two broad themes: the potential of Latin dance as a service activity, and the processes of integrating and othering Latinness in Australia.
Performance of a Fracture Liaison Service in an Orthopaedic Setting
Authors: Senay Andréa , Perreault Sylvie , Delisle Josée , Morin Suzanne N. , Fernandes Julio C.
Published: November 2019

Background:

Many Fracture Liaison Services (FLSs) have been successfully implemented, but very few incorporate systematic longitudinal follow-up. The objective of this study was to report on the performance of such an FLS using key performance indicators and longitudinal clinical outcomes.

Methods:

An FLS was implemented in 2 outpatient orthopaedic clinics. Men and women who were ≥40 years of age and had a recent fragility fracture were recruited. Participants were evaluated, treated when appropriate, and systematically followed over a 2-year period. Clinical data including chart review and questionnaires were collected. Medical services and hospitalization claims data were retrieved from administrative databases. The primary outcomes were the following key performance indicators: the numbers of investigated and treated patients, follow-up attendance, and the incidence of subsequent fractures. Secondary outcomes were the changes in bone turnover markers and quality of life, physical capacity, and pain scores between baseline and follow-up visits.

Results:

A total of 532 subjects with a mean age of 63.4 years were recruited; 85.7% were female. Bone mineral density results were collected for 472 subjects (88.7%) and a prescription for anti-osteoporosis medication was given to 86.6% of patients. Overall, 83.6% of patients attended at least 1 follow-up visit. The subsequent fracture incidence rate was 2.6 per 100 person-years (23 fractures). The mean level of type-I collagen C-telopeptide (CTX-1), a bone resorption marker, decreased >35%. Clinically important improvements of functional capacity scores (by 14.4% to 63.7%) and pain level (by 19.3% to 35.7%) were observed over time; however, the increase in quality-of-life scores was not clinically important (by 3% to 15.2%).

Conclusions:

In this FLS, the rates of investigation, treatment, and participation were >80% over a 2-year period. The subsequent fragility fracture incidence rate was <3 per 100 person-years. These results suggest that an intensive FLS model of care, with a systematic longitudinal follow-up, is effective. A randomized controlled trial is needed to support these results.

Level of Evidence:

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
American Orthopaedic Association’s (AOA) Council of Orthopaedic Residency Directors (CORD) Summer 2018 Conference: Top Abstracts
Authors: Weistroffer Joseph K. , Patt Joshua C. ,   on behalf of the CORD/Academics Committee
Published: November 2019

This article is a continuation of the collaboration between the American Orthopaedic Association’s (AOA) Council of Orthopaedic Residency Directors (CORD) and JBJS to highlight selected abstracts presented at the CORD Conference held at the AOA’s annual national meeting in June 2018. These abstracts are representative in advancing CORD’s purpose and mission:

“The American Orthopaedic Association Council of Orthopaedic Residency Directors (CORD) program strives to recognize best practices in orthopaedic residency education and fellowship education based on ACGME [Accreditation Council for Graduate Medical Education]-defined essential knowledge and skills in each of the residency education competency areas. CORD provides a forum for academic orthopaedic leaders to exchange ideas, discuss solutions to challenges, and find ways to effectively teach residents in orthopaedic programs.”

The following studies were presented at the 2018 Summer CORD Conference in Boston, Massachusetts. They exemplify education-related research and are offered to inspire further inquiry to advance the development of future orthopaedic surgeons.
Correlations between inflammatory response and percentage of lymphocyte or CD19+ B cell count in Kawasaki disease children of different ages undergoing intravenous immunoglobulin: a retrospective study
Authors: Zhang Chun , Zhang Xuan , Shen Jia , Lu Xiaotong , Zhang Jian , Chen Sun
Published: November 2019

Background: Intravenous immunoglobulin (IVIG) is the most common therapy in Kawasaki Disease (KD), but during this course, the inflammatory response remains unclear. We evaluated the relationship between inflammatory response and lymphocyte count in KD children with different ages undergoing IVIG, to identify the clues in lab parameters of therapeutic effect of IVIG on KD. Methods: We retrospectively reviewed the medical records of 60 KD children and divided the patients into five groups depending on different ages. We investigated the percentage of neutrophil reduced and that of lymphocyte increased after IVIG in all groups and explored the absolute cell count of CD19+ cells before therapy and the level of interleukin-10 (IL-10) in patients aged 4 years and older after IVIG with linear regression and correlation analysis. Results: During the acute phase of KD and after IVIG, patients’ percentage of reduced neutrophil correlated positively with the percentage of increased lymphocyte. With children grew older, the correlation coefficients valued higher which were respectively 0.91 (group of less than 1 year), 0.87 (1 year), 0.91 (2 years), 0.97 (3 years), 0.99 (4 years and older) with p value less than 0.01 in all of groups. Means of age in five groups correlated positively with the value of correlation coefficient (r = 0.88, P < 0.05). In the patients aged 4 years and older, abnormal higher CD19+ cell absolute count before the administration of IVIG correlated positively with the reduced IL-10 after the IVIG (r = 0.71, P < 0.05). Conclusions: During the acute phase of KD, the older the children’s age, the better the regulatory effect of IVIG on the immune response and the following recovery of immune equilibrium. In KD patient aged 4 years and older the abnormal proliferating CD19+ B cell played dominant role in the humoral immune and may be involved in the secretion of IL-10 to balance the overactive humoral immune. Combined assessment of CD19+ B cell absolute count with the expression of decreased IL-10 after IVIG may be potential to evaluate the effect of IVIG on inflammatory immune response in KD children with older age.
Minimally invasive comprehensive treatment for granulomatous lobular mastitis
Authors: Wang Yaohuai , Song Junlong , Tu Yi , Chen Chuang , Sun Shengrong
Published: November 2019

Objective: To describe a minimally invasive comprehensive treatment for granulomatous lobular mastitis (GLM) and compare its effect with the existing methods, particularly in terms of its recurrence rate and esthetic outcomes.
Methods: This retrospective study reviewed 69 GLM patients receiving the minimally invasive comprehensive treatment. Patients’ information, including age, clinical features, image characteristics, histopathological findings, mastitis history, treatment process, operative technique, recurrence, and esthetic effect, was evaluated.
Results: All patients were female with a median age of 32 (range 17 - 55) years. Hospital stays ranged from 2 to 34 days, with a median of 6 days. The shortest time for complete rehabilitation was 2 days and the longest time was 365 days, with a median of 30 days. After a median follow-up of 391 days (range 162 - 690), 7 patients (10.14%) relapsed. The average cosmetic score was 2.62 ± 0.57 points and was mainly related to the past treatment, especially the surgical history.
Conclusion: Minimally invasive comprehensive treatment is a new method for the treatment of GLM, ensuring a therapeutic effect while maintaining the breast beauty.
Perceptions of health care professionals on Governance of Hospital Quality of Care and Accreditation in the Public Hospitals of United Arab Emirates: A Qualitative Study
Authors: Ali Ghada
Published: November 2019

Background Hospital accreditation is frequently used as a tool for government directives for the purpose of guaranteeing patient safety or quality of care. The study aims to interview healthcare workers with a diversity of views and perceptions on accreditation experiences, performance and governance of quality of care. Methods: Semi-Structured interviews between June 2017 – Dec 2017 with 155 board members and executives from four public acute care accredited MOHAP hospitals in the United Arab Emirates was undertaken. The interviews mainly highlighted the role played by the management in overseeing the quality of care in their respective hospitals. Perceptions of interviewees’ regarding factors that have influenced their present approach to governance in this area were also elicited. Thematic analysis was utilized for the purpose of identifying the major themes extracted from the interview transcripts. Results A total of four themes emerged from the analysis including (1) Corporate (Hospital) Governance, (2) Accreditation, (3) Employees’ satisfaction, (4) Quality Management and Performance. Interviews with United Arab Emirates health care leaders emphasized on the governance role and affirmed that they had a well-structured governing body. Furthermore, the role of the leadership at their hospital was very essential in making the accreditation happen and in improving the quality of care provided to patients. Staff expressed strong support for implementation as well as development of hospital standards along with requesting for ongoing motivation and recognition. Respondents also cited the need for infrastructure, funding and technical assistance as the major obstacles. Conclusion The study demonstrated a strong support for the implementation or development of hospital standards. Implementing quality improvement programs such as accreditation leads to enhanced quality of care provided at the hospitals and better health outcomes. This study emphasizes the importance of having effective governance, top management commitment and leadership side by side for effective implementation of accreditation. Findings shows that strong governance and support from the top management were critical for implementing accreditation and improving quality of services in the government hospitals.
Potential suitable habitat of Eleusine coracana (L) Gaertn (Finger millet) under the climate change scenarios in Nepal
Authors: Luitel Dol Raj , Siwakoti Mohan , Joshi Mohan D. , Rangaswami Muniappan , Jha Pramod K.
Published: November 2019

Background: Finger millet is the fourth major crop in Nepal and is cultivated in a traditional integrated subsistence system. Timely rain and appropriate temperature predominately affects crop distribution and yield. Climate change is evident in Nepal and it is imperative to understand how it affects habitat suitability of finger millet. Mapping the current suitable habitat and predicting the potential changes in the future is important for maximizing production and minimizing the loss of local landraces. Results: Maxent model was used in this study to quantify the current suitable habitat and changes in the future habitat suitability of finger millet under different climate scenarios, based on representative concentration pathways (RCP)(RCP 2.6, 4.5, 6.0 and 8.5) in two different time periods (2050 and 2070AD) using climatic predictive variables and species localities. The model shows that 39.7% (58512.71km 2 ) area of Nepal is highly suitable for finger millet, with cultivation mostly between 96-2300m above sea level. Eastern and central parts of Nepal have more suitable areas than western parts. Our research clearly shows that the future climatic suitable area of finger millet would shrink by 4.3 to 8.9% in 2050 and 8.9-10.5%under different RCPs by 2070. Conclusion: Finger millet is mostly cultivated in mid-hill terraces. The substantial increase in temperature due to climate change may be one reason for decrease in habitat suitability of finger millet. This situation would further threat loss of local landraces of finger millet in the future. The findings can help in planning and policy framing for climate resilient smart agriculture practice. Key words : Climate change, finger millet, habitat suitability, Maxent model
Identification of transcription factors MYC and C/EBPβ mediated regulatory networks in heart failure
Authors: Wang Haiwei , Wang Xinrui , Xu Liangpu , Cao Hua
Published: November 2019

Background: Heart failure is one of leading cause of death worldwide. However, the transcriptional profiling of heart failure is unclear. Moreover, the signaling pathways and transcription factors involving the heart failure developmental progress also are largely unclear.Methods: The transcriptional profiling of heart failure was identified from integrated gene expression datasets. The enriched pathways and transcription factors were analyzed using DAVID and GSEA assay. The transcriptional networks were created by Cytoscape.Results: Compared with the normal heart tissues, we found 90 genes were particularly differentially expressed in heart failing tissues, and those genes were associated with multiple metabolism pathways and insulin signaling pathway. Metabolism and insulin signaling pathway were both inactivated in heart failing tissues. Transcription factors MYC and C/EBPβ were both negatively associated with the expression profiling of heart failing tissues in GSEA assay. Moreover, compared with normal heart tissues, MYC and C/EBPβ were down regulated in heart failing tissues. Furthermore, MYC and C/EBPβ mediated downstream target genes were decreased in heart failing tissues. MYC and C/EBPβ were positively correlated with each other. At last, we constructed the transcription factor MYC and C/EBPβ mediated regulatory networks in heart failing tissues, and identified the MYC and C/EBPβ target genes which had been reported involving the failure developmental progress by literature research. Conclusions: Our results suggested that transcription factor MYC and C/EBPβ played critical roles in heart failure developmental progress. And new heart failure treatments may be developed by targeting MYC and C/EBPβ.
The relationship of plasma renin , angiotensin , and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension
Authors: Liu Yang , Lin Yao , Zhang Ming-Ming , Zheng Tong , Li Xiao-Hui , Liu Yan-Yan , Zhao Jing , Shi Lin
Published: November 2019

Background To investigate the relationships of plasma RAAS levels to BPV and TOD in children with essential hypertension.Methods A case-control study was conducted on 132 children diagnosed with essential hypertension, comprising 103 males and 29 females with the mean age of 11.8 ± 2.4 years. The plasma RAAS levels were measured by enhanced chemiluminescence method, and the ambulatory blood pressure was monitored for 24h, followed by calculation of the coefficients of variability (CV). Data on indicators for assessing fundus, cardiac, and renal damages. The correlations of plasma RAAS levels to BPV and TOD were studied. Comparison between groups was analyzed by SPSS 20．Results Among the 132 children, 88 cases had target organ damage. The daytime CV of systolic blood pressure of the high angiotensin II (AT II) group was significantly higher than that of the normal AT II group (t = 2.365, P = 0.019). Plasma AT II and aldosterone levels were significantly associated with left ventricular mass index (r = 0.316, P < 0.01; r = 0.176, P = 0.043), and plasma AT II was positively correlated with the LVMI (r = 0.316; P < 0.01).Conclusions The AT II level in children with essential hypertension affected the variability of daytime SBP. Plasma AT II and aldosterone levels were associated with cardiac damage, especially the AT II. Results from this study provide an objective basis for the protection against subclinical cardiac damage in childhood hypertension.Keywords Blood pressure monitoring · Child · Hypertension · Renin-angiotensin-aldosterone system
Cerebrovascular and neurological impact of chronic smoking on post traumatic brain injury outcome and recovery: an in vivo study
Authors: Sivandzade Farzane , Alqahtani Faleh , Sifat Ali , Cucullo Luca
Published: November 2019

Background: Traumatic Brain Injury (TBI) is among the most prevalent causes of cerebrovascular and neurological damage worldwide. To this end, tobacco smoking (TS) has been shown to promote vascular inflammation, neurovascular impairments and risk of cerebrovascular and neurological disorders through oxidative stress (OS) stimuli targeting the blood-brain barrier (BBB) endothelium among others. It has been recently suggested that premorbid conditions such as TS may exacerbate post-TBI brain damage and impact recovery. The present study aims to investigate and dissect out the pathophysiological mechanisms underlying the exacerbation of TBI in a weight-drop model following chronic TS exposure.
Methods: C57BL/6J male mice, age range 6–8 weeks were chronically exposed to TS for three weeks. Test animals were then subjected to TBI by guided vertical head weight drop using a 30 g metal weight free felling from an 80 cm distance before reaching the target. Physical activity and body weight of the mice were analyzed before TBI and 1 h, 24 h and 3 days post-injury. Finally, mice were sacrificed to collect blood and brain samples for subsequent biochemical and molecular analysis. Western blotting was applied to assess the expression of Nrf2 (a key antioxidant transcription factor) as well as tight junction proteins associated with BBB integrity including, ZO-1, Occludin, Claudin-5 from brain tissues homogenates. Levels of NF-kB (a pro-inflammatory transcript factor which antagonizes Nrf2 activity) along with pro-inflammatory cytokines IL-6, IL-10 and TNF-α were measured by ELISA on blood samples.
Results: TS promoted significantly increased inflammation and loss of BBB integrity in TBI when compared to TS-Free test mice. Additionally, mice chronically exposed to TS prior to TBI experienced a more significant weight loss, behavioral, and motor activity deficiency and slower post-TBI recovery when compared to TS-free TBI mice.
Conclusion: TS promotes a significant exacerbation of post-TBI neurovascular and neurological impairments. Whereas BBB impairment and pro-inflammatory vascular responses induced by chronic TS exposure are likely responsible for the retardation of post-traumatic recovery observed in these animals.
The role of high-mobility group box protein 1 in chronic cerebral hypoperfusion-induced vascular cognitive impairment animals
Authors: Vidyanti Amelia Nur , Hsieh Jia-Yu , Lin Kun-Ju , Fang Yao-Ching , Setyopranoto Ismail , Hu Chaur-Jong
Published: November 2019

Background: The molecular mechanisms of vascular cognitive impairment (VCI) are diverse and still in puzzle. VCI could be attributed to chronic cerebral hypoperfusion (CCH). CCH may cause a cascade of reactions involved in ischemia and neuro-inflammation which plays important roles in the pathophysiology of VCI. High-mobility group box protein 1 (HMGB1) is a non-histone protein that serves as a damage-associated molecular signal leading to cascades of inflammation. Increased level of HMGB1 has been established in the acute phase of CCH. However, the role of HMGB1 at the chronic phase of CCH remains elucidated.
Methods: We performed modified bilateral common carotid artery occlusion (BCCAO) in C57BL/6 mice to induce CCH. We examined the cerebral blood flow (CBF) reduction by laser doppler flowmetry, the protein expression of HMGB1 and its pro-inflammatory cytokines (TNF-a, IL-1b, and IL-6) by western blotting and immunohistochemistry. The brain pathology was assessed by 7T-animal MRI and amyloid-b accumulation was assessed by amyloid-PET scanning. We further evaluated the effect of HMGB1 suppression by injecting CRISPR/Cas9 knock-out plasmid intra-hippocampus bilaterally.
Results: There were reduction of CBF up to 50% which persisted three months after CCH. The modified-BCCAO animals developed significant cognitive decline. The 7T-MRI image showed hippocampal atrophy, although the amyloid-PET showed no significant amyloid-beta accumulation. Increased protein levels of HMGB1, TNF-a and IL-1b were found three months after BCCAO. HMGB1 suppression by CRISPR/Cas9 knock-out plasmid restored the CBF, IL-1B, TNF-alpha, IL-6, and attenuated hippocampal atrophy and cognitive decline.
Conclusion: HMGB1 plays a pivotal role in the pathophysiology of the animal model of CCH and it might be a candidate as therapeutic targets of VCI.