bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards Clustering of Mobile and Smartwatch Accelerometer Data for Physical Activity Recognition
Authors: Dobbins Chelsea , Rawassizadeh Reza
Published: June 2018

Mobile and wearable devices now have a greater capability of sensing human activity ubiquitously and unobtrusively through advancements in miniaturization and sensing abilities. However, outstanding issues remain around the energy restrictions of these devices when processing large sets of data. This paper presents our approach that uses feature selection to refine the clustering of accelerometer data to detect physical activity. This also has a positive effect on the computational burden that is associated with processing large sets of data, as energy efficiency and resource use is decreased because less data is processed by the clustering algorithms. Raw accelerometer data, obtained from smartphones and smartwatches, have been preprocessed to extract both time and frequency domain features. Principle component analysis feature selection (PCAFS) and correlation feature selection (CFS) have been used to remove redundant features. The reduced feature sets have then been evaluated against three widely used clustering algorithms, including hierarchical clustering analysis (HCA), k-means, and density-based spatial clustering of applications with noise (DBSCAN). Using the reduced feature sets resulted in improved separability, reduced uncertainty, and improved efficiency compared with the baseline, which utilized all features. Overall, the CFS approach in conjunction with HCA produced higher Dunn Index results of 9.7001 for the phone and 5.1438 for the watch features, which is an improvement over the baseline. The results of this comparative study of feature selection and clustering, with the specific algorithms used, has not been performed previously and provides an optimistic and usable approach to recognize activities using either a smartphone or smartwatch.
Resistance to Permethrin, β-cyfluthrin, and Diazinon in Florida Horn Fly Populations
Authors: Holderman Chris J. , Swale Daniel R. , Bloomquist Jeffery R. , Kaufman Phillip E.
Published: June 2018

Horn flies, Haematobia irritans, a major cattle pest in the USA, cause substantial economic losses and current control methods rely heavily on insecticides. Three horn fly populations were evaluated for insecticide susceptibility to permethrin, β-cyfluthrin, and diazinon. Susceptibility was variable by population, with the greatest resistance exhibited by a 66-fold resistance ratio (RR) to permethrin and >14-fold RR to diazinon. Mechanisms of resistance were determined using molecular techniques and enzymatic assays. The knockdown resistance (kdr) genotype (L150F) associated with pyrethroid resistance, and a G262A mutation in acetylcholinesterase, previously associated with organophosphate resistance, were found in all field populations evaluated. Insensitivity of diazoxon at the acetylcholinesterase (AChE) target site was significantly different in horn flies from one of the field sites. For metabolic detoxifying enzymes, cytochrome P450 nor general esterases showed a significant difference between field strains and a laboratory susceptible strain. Pyrethroid resistance was likely due to the presence of the L150F mutation in the population. In vitro studies targeting the AChE enzyme did not support the notion that the G262A mutation was the sole cause of resistance to organophosphates, and, therefore, the exact resistance mechanism to diazinon was not able to be confirmed.
Slant Removal Technique for Historical Document Images
Authors: Kavallieratou Ergina , Likforman-Sulem Laurence , Vasilopoulos Nikos
Published: June 2018

Slanted text has been demonstrated to be a salient feature of handwriting. Its estimation is a necessary preprocessing task in many document image processing systems in order to improve the required training. This paper describes and evaluates a new technique for removing the slant from historical document pages that avoids the segmentation procedure into text lines and words. The proposed technique first relies on slant angle detection from an accurate selection of fragments. Then, a slant removal technique is applied. However, the presented slant removal technique may be combined with any other slant detection algorithm. Experimental results are provided for four document image databases: two historical document databases, the TrigraphSlant database (the only database dedicated to slant removal), and a printed database in order to check the precision of the proposed technique.
Restoring Waning Production of Volatile Organic Compounds in the Endophytic Fungus Hypoxylon sp. (BS15)
Authors: Wang Yuemin , Harper James K.
Published: June 2018

Certain endophytic fungi belonging to the Hypoxylon genus have recently been found to produce volatile organic compounds (VOCs) that have potential relevance as hydrocarbon fuels. Here, a recently discovered Hypoxylon sp. (BS15) was demonstrated to also produce VOCs, but with diminished VOC production after an extended period of in vitro growth. Restoring VOC production was partially achieved by growing BS15 in growth media containing finely ground woody tissue from the original host plant (Taxodium distichum). In an effort to isolate VOC production modulators, extracts from this woody tissue were made by sequentially extracting with dichloromethane, methanol, and water. Both the dichloromethane and water extracts were found to modulate VOC production, while the methanol extract had no effect. Surprisingly, the woody tissue remaining after exhaustive extraction was also shown to act as a VOC production modulator when included in the growth media, with changes observed in the production of four compounds. This woody tissue also induced production of two compounds not observed in the original BS15 extract. Filter paper had the same modulating effect as exhaustively extracted woody tissue, suggesting the modulation was perhaps due to cellulose degradation products. Overall, this study demonstrated that VOC production in BS15 can be influenced by multiple compounds in the woody tissue rather than a single modulator.
Antiplasmodial Properties and Cytotoxicity of Endophytic Fungi from Symphonia globulifera (Clusiaceae)
Authors: Ateba Joël E. T. , Toghueo Rufin M. K. , Awantu Angelbert F. , Mba’ning Brice M. , Gohlke Sebastian , Sahal Dinkar , Rodrigues-Filho Edson , Tsamo Etienne , Boyom Fabrice F. , Sewald Norbert , Lenta Bruno N.
Published: June 2018

There is continuing need for new and improved drugs to tackle malaria, which remains a major public health problem, especially in tropical and subtropical regions of the world. Natural products represent credible sources of new antiplasmodial agents for antimalarial drug development. Endophytes that widely colonize healthy tissues of plants have been shown to synthesize a great variety of secondary metabolites that might possess antiplasmodial benefits. The present study was carried out to evaluate the antiplasmodial potential of extracts from endophytic fungi isolated from Symphonia globulifera against a chloroquine-resistant strain of Plasmodium falciparum (PfINDO). Sixty-one fungal isolates with infection frequency of 67.77% were obtained from the bark of S. globulifera. Twelve selected isolates were classified into six different genera including Fusarium, Paecilomyces, Penicillium, Aspergillus, Mucor, and Bipolaris. Extracts from the 12 isolates were tested against PfINDO, and nine showed good activity (IC50 < 10 μg·mL−1) with three fungi including Paecilomyces lilacinus (IC50 = 0.44 μg·mL−1), Penicillium janthinellum (IC50 = 0.2 μg·mL−1), and Paecilomyces sp. (IC50 = 0.55 μg·mL−1) showing the highest promise. These three isolates were found to be less cytotoxic against the HEK293T cell line with selectivity indices ranging from 24.52 to 70.56. Results from this study indicate that endophytic fungi from Symphonia globulifera are promising sources of hit compounds that might be further investigated as novel drugs against malaria. The chemical investigation of active extracts is ongoing.
Contribution of Traditional Farming to Ecosystem Services Provision: Case Studies from Slovakia
Authors: Špulerová Jana , Petrovič František , Mederly Peter , Mojses Matej , Izakovičová Zita
Published: June 2018

The main aim of this study is to assess the benefits provided by the ecosystems of traditional agricultural landscapes (TAL) and compare them to the outputs of large-scale agriculture. Assessment of ecosystem services (ES) was performed in four case-study areas situated in Slovakia, representing different types of TAL: Viticultural landscape, meadow–pasture landscape, and agricultural landscape with dispersed settlements and mosaics of orchards. The methodological approach was focused on assessment of all the principal types of ES—regulation and maintenance, provisioning, and cultural. Differences in the provision of ES due to the impact of different practices and intensities of agricultural landscape management were subsequently assessed and compared. The results show that TAL are generally more diverse and balanced regarding ES provision, mainly because of their varied patterns and their related functions. In particular they play an important role in water retention and the prevention of soil erosion—both important with respect to changes in climate. Modern intensive agriculture is principally able to fulfil the production functions. Support for traditional farming, landscape diversification and small-scale agricultural management is vital for enhancing the values of rural regions. Such measures could become key drivers for sustainable agricultural management in Slovakia, and elsewhere.
Preparation and Properties of C/C Hollow Spheres and the Energy Absorption Capacity of the Corresponding Aluminum Syntactic Foams
Authors: Yu Qiyong , Zhao Yan , Dong Anqi , Li Ye
Published: June 2018

The present study focuses on the preparation and characterization of lab-scale aluminum syntactic foams (ASFs) filled with hollow carbon spheres (HCSs). A new and original process for the fabrication of HCSs was explored. Firstly, expanded polystyrene beads with an average diameter of 6 mm and coated with carbon fibers/thermoset phenolic resin were produced by the “rolling ball” method. In the next step, the spheres were cured and post-cured, and then carbonized at 1050 °C under vacuum to form the HCSs. The porosity in the shell of the HCSs was decreased by increasing the number of impregnation–carbonization cycles. The aluminum syntactic foams were fabricated by casting the molten aluminum into a crucible filled with HCSs. The morphology of the hollow spheres before and after carbonization was investigated by scanning electron microscope (SEM). The compressive properties of the ASF were tested and the energy absorption capacities were calculated according to stress–strain curves. The results showed that the ASF filled with HCSs which had been treated by more cycles of impregnation–carbonization had higher energy absorption capacity. The aluminum syntactic foam absorbed 34.9 MJ/m3 (28.8 KJ/Kg) at 60% strain, which was much higher than traditional closed cell aluminum foams without particles. The HCSs have a promising future in producing a novel family of metal matrix syntactic foams.
Acoustic Anomalies and Phase Transition Behaviors of Lead-Free Piezoelectric (Na1/2Bi1/2)TiO3-xBaTiO3 Single Crystals as Revealed by Brillouin Light Scattering
Authors: Lee Byoung Wan , Oh Soo Han , Ko Jae-Hyeon , Li Xiaobing , Luo Haosu
Published: June 2018

The elastic properties of unpoled and prepoled (Na1/2Bi1/2)TiO3-xBaTiO3 (NBT-xBT) single crystals near the morphotropic phase boundary were investigated as a function of temperature using Brillouin light scattering. The acoustic mode frequency and the related acoustic damping of unpoled NBT-xBT showed very broad minimum and maximum, respectively, consistent with typical relaxor behaviors. The frequency softening of the longitudinal acoustic mode together with the increase in acoustic damping was largest along the <100> direction, indicating that polarization fluctuations were most substantial along this crystallographic direction. The difference in acoustic behaviors between the unpoled NBT-xBTs with x = 0.05 and 0.08 were negligible, which means that the NBT-xBT system exhibits typical relaxor properties over a certain composition range of at least 5~8%. The obtained relaxation time of polar nanoregions in the paraelectric phase showed a gradual slowing-down character without any critical divergent behavior. The prepoling of NBT-xBT along the <100> direction induced drastic changes in both mode frequency and damping at ~110 °C when the poling field was larger than 1.4 kV/mm, corresponding to the depoling process from macroscopic/mesoscopic ferroelectric order to ergodic relaxor state upon heating. Phase coexistence of ferroelectric and relaxor states was observed at the intermediate poling field of 1.4 kV/mm.
Impact of intervention programs on nurses’ knowledge, attitudes, and willingness to take care of patients with human immunodeficiency virus/acquired immunodeficiency syndrome: a descriptive review
Authors: Mockienė Vida , Suominen Tarja , Välimäki Maritta , Razbadauskas Artūras
Published: June 2018

Objective. This paper reviews the current literature on intervention programs designed to improve nurses’ knowledge and attitudes to human immunodeficiency virus/acquired immunodeficiency syndrome and their willingness to take care of patients with human immunodeficiency virus/acquired immunodeficiency syndrome. It also explores the impact of these intervention programs. Materials and methods. The MEDLINE and Pubmed, Science Direct, Cochrane Library, EbscoHost, ERIC databases were searched for relevant English-language citations between 1997 and 2007 using the following search terms: human immunodeficiency virus/acquired immunodeficiency syndrome, nurse, intervention, teaching, education, knowledge, attitude, and willingness. Relevant articles were retrieved, reviewed, and assessed. A total of 16 articles were considered appropriate and selected for content analysis. Results. We identified articles that reported on intervention programs to improve nurses’ knowledge and attitudes and their willingness to take care of patients with human immunodeficiency virus/ acquired immunodeficiency syndrome. Eight of the intervention studies included lectures among their methods of educational intervention. The nurse sample sizes (n) ranged from 12 to 552. Many of the studies involved one experimental/intervention group and one control group. The intervention programs varied in terms of their methodological rigor. Almost all reported one or more statistically significant effects. Conclusions. The review highlights the need for well-designed, methodologically sound research on outcomes of nursing education. Future studies should examine not only the short-term effectiveness of intervention programs in terms of changing attitudes and increasing willingness to care, but also their impact in the longer term.
Vyresnio amžiaus pacientų pažinimo funkcijų pooperacinis sutrikimas
Authors: Damulevičienė Gytė , Lesauskaitė Vita , Macijauskienė Jūratė
Published: June 2018

Lengvi pooperaciniai pažinimo funkcijų sutrikimai gali pasireikšti bet kokio amžiaus pacientui, bet žymiai dažniau vyresnio amžiaus pacientui. Ankstyvoji pooperacinė pažinimo disfunkcija gali pasireikšti 20–90 proc. vyresnio amžiaus pacientų priklausomai nuo chirurginių procedūrų sudėtingumo, dažniausiai ši komplikacija randama po širdies ir kraujagyslių operacijų, be to, yra ilgalaikės pažinimo disfunkcijos pranašas. Pooperacinis delyras pasireiškia 50 proc. pagyvenusio amžiaus pacientų, o po širdies ir kraujagyslių operacijų dar dažniau – iki 72 proc. Įrodyta, kad tiek pooperacinis delyras, kaip ir delyras, kuris pasireiškia kartu su kita liga, tiek ilgalaikė pooperacinė pažinimo disfunkcija sukelia funkcinės būklės ir pažinimo funkcijų pablogėjimą vienerių metų laikotarpiu ir yra susiję su ilgesne gydymo trukme, didesnėmis gydymo išlaidomis, pa di dėjusiu sergamumu, mirštamumu bei dažnesniu ligonių apgyvendinimu slaugos ir globos įstaigose. Pooperacinės pažinimo disfunkcijos, kaip ir delyro, patofiziologija ir priežastys iki šiol nėra visiškai aiškios. Sie kiant išvengti pooperacinės pažinimo disfunkcijos ir delyro, prieš operaciją svarbu ištirti pažinimo funkcijas ir įvertinti delyro rizikos veiksnius: vyresnį amžių, depresiją, demenciją, Parkinsono ligą, su trikusią klausą ir regą, operacijos skubumą, anticholinerginių vaistų vartojimą ir kt. Nuodugnus geriatrinis paciento ištyrimas gali padėti nustatyti delyro rizikos veiksnius. Po operacijos pagyvenusio amžiaus pacientai turi būti aktyviai stebimi dėl galimo delyro. Labai svarbu gilinti sveikatos priežiūros darbuotojų žinias apie šias pooperacines pagyvenusio amžiaus pacientų komplikacijas.
Three-port retroperitoneoscopic necrosectomy in management of acute necrotic pancreatitis
Authors: Šileikis Audrius , Beiša Virgilijus , Simutis Gintaras , Tamošiūnas Albinas , Strupas Kęstutis
Published: June 2018

Introduction. Because of major morbidity and mortality after open surgery in acute necrotic pancreatitis, an interest in minimally invasive necrosectomy approaches has increased. We report the results of a recently developed minimally invasive technique that we adopted in 2007. Material and methods. This article contains a retrospective analysis of cases and description of original retroperitoneoscopic necrosectomy technique. There were eight patients aged 25–58 years, who underwent retroperitoneoscopic pancreatic necrosectomy in the Center of Abdominal Surgery, Vilnius University Hospital Santariškių Klinikos, between 2007 and 2009. All patients had at least 30% pancreatic necrosis with extensive retroperitoneal fl uid collections on the left side, proved by CT scan. Operations were performed on the 21st–56th days of illness (median, 36th day). Results. The mean postoperative hospital stay was 49 days (range, 14–99 days). All patients survived. Two patients underwent three additional procedures; two patients, one additional procedure due to remaining infected necrosis. Three patients had no requirement for additional procedures. One patient underwent laparotomy because of bleeding. Conclusions. We assume that minimally invasive techniques should be considered a first-choice surgical option in patients with acute necrotic pancreatitis, whenever it is possible. Pancreatic necrosis less than 30% with large fluid collections in the left retroperitoneal space facilitates employment of three-port retroperitoneoscopic necrosectomy.
Autonominė širdies ritmo reguliacija bei jos pokyčiai sergant miokardo infarktu ir cukriniu diabetu
Authors: Ablonskytė-Dūdonienė Rūta , Ereminienė Eglė
Published: June 2018

Išeminė širdies liga ir cukrinis diabetas yra dvi glaudžiai susijusios ligos. Sunkiausia išeminės širdies ligos forma – miokardo infarktas. Ūminio miokardo infarkto eiga ir prognozė cukriniu diabetu sergantiems ligoniams yra daug blogesnė nei to paties amžiaus ir lyties cukriniu diabetu nesergantiems ligoniams. Jau seniai ieškoma, kaip pagerinti tokių ligonių būklės vertinimą ir rizikos patvirtinimą. Daug žadanti sritis – autonominės širdies ir kraujagyslių sistemos bei jos pokyčių, sergant šiomis ligomis, tyrimai. Parasimpatinė ir simpatinė širdies dažnio moduliacija jau daug metų tiriama įvairiuose lygmenyse, tačiau mechanizmai yra sudėtingi ir iki šiol nepakankamai ištirti. Straipsnyje pateikiama literatūros apžvalga apie autonominės širdies ir kraujagyslių sistemos reguliacijos mechanizmų tyrimus bei jų pokyčius sergant miokardo infarktu ir cukriniu diabetu, taip pat apie šiuolaikinius autonominės širdies reguliacijos tyrimo metodus bei galimus intervencinius ir medikamentinius autonominio tonuso keitimo būdus. Norint geriau suprasti patologinių pokyčių atsiradimą ir eigą sergant miokardo infarktu ir cukriniu diabetu, straipsnyje pateikiama ir trumpa širdies ritmo vedlio funkcijos bei normalios autonominės širdies inervacijos bei širdies dažnio reguliacijos apžvalga.
Perioperative use of metformin in cardiac surgery
Authors: Širvinskas Edmundas , Kinduris Šarūnas , Kapturauskas Juozas , Samalavičius Robertas
Published: June 2018

Metformin is an oral antidiabetic agent, used to reduce blood glucose concentration in patients with non–insulin-dependent diabetes mellitus. Metformin was approved in Europe in 1957, and it is used for the treatment of non–insulin-dependent diabetes mellitus for more than 50 years. One of the most serious complications of the treatment with this drug is metformin-induced lactic acidosis. It is a rare but dangerous metabolic complication with a mortality rate of up to 50% that can result from the accumulation of lactates. Lactic acidosis is also associated with conditions such as diabetes mellitus, significant tissue hypoperfusion, and hypoxemia caused by lactic acid overproduction or underutilization. It is characterized by an increased serum lactate level (>5 mmol/L or >45 mg/dL), decreased blood pH (<7.35), and electrolyte imbalance with an increased anion gap. The rate of lactic acidosis in patients receiving metformin is not precisely known. The estimated incidence of this syndrome is 2–9 cases per 100 000 patients. However, in the majority of cases, lactic acidosis is diagnosed in patients with severe acute renal failure, which itself can cause lactic acidosis. Currently, there are no standardized guidelines for metformin administration during the perioperative period, and published data remain controversial. According to some investigators, metformin should be withdrawn before major surgery. Concerns have been raised for the use of metformin in patients with cardiovascular, renal, hepatic, and respiratory failure. The aim of the article is to overview the frequency of metformin-caused lactic acidosis and the latest recommendations for the use of metformin in the perioperative period proposed in recent years.
A role of anesthesiologist in reducing surgical bleeding in endoscopic sinus surgery
Authors: Činčikas Darius , Ivaškevičius Juozas , Martinkėnas Jonas , Balseris Svajūnas
Published: June 2018

Visibility in the surgical field reduced by bleeding is one of the most important problems of endoscopic sinus surgery. It causes the risk of serious complications and reduces intervention quality. Recently, an increasing number of patients undergo surgical interventions under general anesthesia. Since general anesthesia may influence surgical bleeding in physiological and pharmacological pathways, the role of an anesthesiologist is extremely important in reducing bleeding. The impact of different anesthesia methods on quality of the surgical field is being investigated, and the most effective medicines are being sought.
The effects of sevoflurane and propofol on cerebral hemodynamics during intracranial tumors surgery under monitoring the depth of anesthesia
Authors: Banevičius Gediminas , Rugytė Danguolė , Macas Andrius , Tamašauskas Arimantas , Stankevičius Edgaras
Published: June 2018

Hemodynamic effects during cerebral tumor resection surgery under monitoring the depth of anesthesia and during recovery in sevoflurane- or propofol-anesthetized patients have not been previously compared. Objective. To compare cerebral hemodynamic changes using transcranial Doppler sonography during sevoflurane or propofol anesthesia under state entropy (SE) monitoring, and during recovery period. Material and methods. In a randomized manner, 130 patients received sevoflurane (group T-S) or propofol (group T-P) to maintain SE at 40–50. Cerebral blood flow velocity (Vmean) in the middle cerebral artery was evaluated at baseline, after tracheal intubation, opening of the dura mater, tumor resection, skin closure, extubation, and two hours after extubation. Cerebrovascular resistance index (RAP), estimated cerebral perfusion pressure (eCPP), and cerebral blood flow index (CBFI) were calculated off-line. Results. During surgery SE was 40.6 (SD, 8.1) in the group T-S and 44.0 (SD, 7.4) in the group T-P. Blood pressure was significantly higher in the group T-P. Compared to the baseline, Vmean decreased by 16.6% and 23.5% in the groups T-S and T-P, respectively (P<0.05). RAP and eCPP were higher in the group T-P versus the group T-S: 28.9% and 5.2%, respectively, above the baseline for RAP (P<0.005) and 3.2% and 16.9% below the baseline for eCPP (P<0.005). CBFI was below the baseline by 20.1% and 24.0% in the groups T-S and T-P, respectively (P>0.05). After the extubation and 2 hours later, Vmean recovered comparably with no differences in RAP, eCPP, or CBFI between the two groups. Conclusions. At the comparable depth of anesthesia for intracranial tumors surgery and during recovery, sevoflurane had no major effect on cerebral circulation measured by transcranial Doppler sonography as compared with propofol. Our results add to current knowledge on the safety of sevoflurane in neuroanesthesia.
Ūminio širdies nepakankamumo sąsajos su širdies ir kraujagyslių sistemos ligų baigtimis
Authors: Milvidaitė Irena , Lukšienė Dalia , Šlapikienė Birutė , Babarskienė Marija , Šlapikas Rimvydas , Venclovienė Jonė
Published: June 2018

Tyrimo tikslas. Nustatyti ūminių išeminių sindromų ir ūminio širdies nepakankamumo sąsajas su mirtimi nuo širdies ir kraujagyslių sistemos ligų stacionare bei mirtimi nuo širdies ir kraujagyslių sistemos ligų ir lėtiniu širdies nepakankamumu vienerių metų laikotarpiu. Tirtųjų kontingentas ir tyrimo metodika. Tirtųjų kontingentą sudarė nuoseklios imties 1554 ligoniai, susirgę ūminiais išeminiais sindromais (Q bangos miokardo infarktu – 607, miokardo infarktu be Q bangos – 441, nestabiliąja krūtinės angina – 500), 2005 m. gydyti Lietuvos sveikatos mokslų universiteto ligoninės Kauno klinikų (buvusiose Kauno medicinos universiteto klinikose) Kardiologijos klinikoje. Ligonių būklei stacionariniu laikotarpiu įvertinti naudoti Lietuvos sveikatos mokslų universiteto Širdies centro informacinės bazės duomenys. Ligonių būklė stebėta vienerius metus nuo hospitalizavimo dienos. Rezultatai. Ūminis širdies nepakankamumas stacionare diagnozuotas trečdaliui (32,3 proc.) ligonių, postacionariniu vienerių metų laikotarpiu lėtinis širdies nepakankamumas – beveik penktadaliui (17,0 proc.) ligonių. Miokardo revaskulizacija atlikta 70,8 proc. ligonių, kuriems vainikinių arterijų stenozė buvo ≥70 proc. Lėtinis širdies nepakankamumas po vienerių metų įvertintas 1039 ligoniams ir nustatytas tris kartus dažniau nei ligoniams be stacionare nustatyto ūminio širdies nepakankamumo (31,4 ir 11,6 proc., p<0,05). Mirtis nuo širdies ir kraujagyslių sistemos ligų stacionariniu ir postacionariniu laikotarpiu reikšmingai dažniau ištiko ligonius, kuriems buvo ūminis širdies nepakankamumas palyginti su ligoniais, kuriems nebuvo ūminio širdies nepakankamumo (11,5 ir 1,9 proc., p<0,001; 7,7 ir 2,3 proc., p<0,001). Išvada. Ištikus ūminiams išeminiams sindromams, atsiradęs ūminis širdies nepakankamumas reikšmingai didina lėtinio širdies nepakankamumo dažnumą postacionariniu vienerių metų laikotarpiu bei mirties nuo širdies ir kraujagyslių sistemos ligų dažnumą stacionare ir vienerių metų laikotarpiu.
Hospitalinės infekcijos ekonominis įvertinimas vaikų intensyviosios terapijos skyriuose Lietuvoje
Authors: Gurskis Vaidotas , Kėvalas Rimantas , Kerienė Virginija , Vaitkaitienė Eglė , Miciulevičienė Jolanta , Dagys Algirdas , Ašembergienė Jolanta , Grinkevičiūtė Dovilė
Published: June 2018

Tyrimo tikslas. Įvertinti trijų Lietuvos vaikų intensyviosios terapijos skyrių tiesiogines išlaidas, susijusias su hospitalinių infekcijų atvejais bei apžvelgti hospitalinių infekcijų prevencijos programos (intervencijos) ekonominį efektyvumą. Metodika. Perspektyvusis stebėsenos tyrimas atliktas trijuose Lietuvos vaikų intensyviosios terapijos skyriuose 2005 m. sausio – 2007 m. gruodžio mėn. Tikslinės atrankos būdu į tyrimą įtraukti visi 1 mėn. – 18 metų vaikai, kurie gydyti vaikų intensyviosios terapijos skyriuose ilgiau nei 48 val. Tiesioginės vaikų intensyviosios terapijos skyrių hospitalinių infekcijų sąlygotos išlaidos apskaičiuotos vienam hospitaline infekcija susirgusiam ligoniui ir vienam hospitalinės infekcijos atvejui. Vidutiniam vieno lovadienio įkainiui apskaičiuoti panaudoti hospitalinių infekcijų registro duomenys, taip pat remtasi ligoninių gaunamų lėšų už suteiktas vaikų reanimacijos paslaugas analize pagal 2005 m. spalio 27 d. Lietuvos Respublikos sveikatos apsaugos ministro įsakymu Nr. V-802 patvirtintus stacionarinių sveikatos priežiūros paslaugų įkainius. Pagal gydymo trukmę reanimacijos paslaugų įkainius ir hospitalinių infekcijų sąlygotas išlaidas visi ligoniai suskirstyti į dvi grupes – įgiję ir neįgiję hospitalinių infekcijų. Vertinant intervencijos ekonominį efektyvumą, ligoniai suskirstyti į kitas dvi grupes – prieš ir po intervencijos. Ekonominis įvertinimas apskaičiuotas nacionaline šalies valiuta – litais. Rezultatai. Tyrime dalyvavo 755 pacientai. Pagal daugialypės tiesinės regresijos modelį (r2=0,47), vienam ligoniui įgijus hospitalinę(-es) infekciją(-as), vaikų intensyviosios terapijos skyriaus gydymo trukmės pailgėjimas sudarė vidutiniškai 6,32 (95 proc. PI: 4,32–8,33; p=0,003) lovadienio. Vieno ligonio įgytos(-ų) hospitalinės(-ių) infekcijos(ų) sąlygotos vidutinės išlaidos sudarė 5215,47 litų (95 proc. PI: 3565,00–6874,19). Vieno hospitalinės infekcijos atvejo sąlygotos vidutinės išlaidos sudarė 4070,61 litų (95 proc. PI: 2782,44–5365,22). Hospitalinių infekcijų profilaktikos programos (intervencijos) bendrasis ekonominis efektas buvo 20046,14 litų. Apsaugojus vieną ligonį nuo hospitalinės(-ių) infekcijos(-ų), išlaidų sumažėjimas sudarė 1336,41 litų, pavykus išvengti vieno hospitalinės infekcijos atvejo, išlaidų sumažėjimas sudarė 1113,67 litų, o sąnaudų ir naudos santykis – 1:4. Išvados. Vaikų intensyviosios terapijos skyrių hospitalinių infekcijų sąlygotos išlaidos buvo pakankamai didelės. Įdiegus hospitalinių infekcijų profilaktikos programoje numatytas priemones, užfiksuotas teigiamas ekonominis efektyvumas – hospitalinių infekcijų profilaktikai panaudojus 1 litą, sutaupyti 4 litai lėšų.
Osteoarthritis: etiology, epidemiology, impact on the individual and society and the main principles of management
Authors: Sakalauskienė Giedrė , Jauniškienė Dovilė
Published: June 2018

Etiology, epidemiology, and impact of osteoarthritis on an individual, society, and nation and the main principles of management of this disease are reviewed in the article. Treatment should be tailored to the needs of an individual patient. Physicians should be familiar with pharmacologic and nonpharmacologic treatment modalities to maximize effective utilization and a thorough understanding of short- and long-term complications and costs. Severity of osteoarthritis should be taken into physician’s and patient’s consideration while applying an appropriate treatment. A stepwise management of osteoarthritis has to be taken into account. As effective interventions remain underused, state arthritis programs, including osteoarthritis programs, have to be developed to build an appropriate scientific base in public health, observe burden and impact, assess and disseminate evidence-based interventions, and work to reduce and delay disability, and improve quality of life among people with arthritis. Adequate studies on the costs of osteoarthritis are urgently required so that cogent arguments can be made to governments to appropriately fund prevention and treatment programs for this condition. Its recognition as a major cause of disability, particularly in the aging population, should increase community focus on this important condition. Osteoarthritis as a pathogenic process and its impact on an individual and society should be taken into special consideration by health providers and officers developing the national health policy in Lithuania, because there is a lack of information related to the prevalence of osteoarthritis, risk factors, also osteoarthritisassociated disability, and costs of the management of this disease among Lithuanian inhabitants.
Diagnosis and treatment of conduct disorder related to frontal lobe syndrome in a 16-year-old girl
Authors: Leskauskas Darius , Kunca Gediminas , Adomaitienė Virginija , Gleiznienė Rymantė , Labanauskas Liutauras
Published: June 2018

Conduct disorders are the most frequent psychiatric diagnosis in the pediatric and adolescent population, with different etiology and difficult to treat. Delinquent, aggressive, and impulsive behavior, lack of empathy and inability to predict possible consequences of the behavior lead to significant desadaptation and danger for these patients. In clinical practice, focus is usually given on social and psychological causes of conduct disorders ignoring possible biological factors in etiology and pathophysiology. A clinical case described in this article shows the linkage between frontal brain dysfunction and behavioral symptoms. The first clues of organic brain disorder were multiple and severe symptoms of disinhibition resistant to treatment with dopaminergic drugs and the results of neuropsychological testing. Computed tomography, magnetic resonance imagining, and single-photon emission computed tomography findings were minor and not supported by associated neurological symptoms. However, the location of alterations of brain structure and perfusion significantly correlated with psychopathology. Clarification of the organic cause of the conduct disorder allowed choosing an effective strategy of psychopharmacologic treatment. A positive clinical effect was achieved after switching the treatment from dopaminergic antipsychotic drugs to carbamazepine, which modulates the GABAergic system. Presenting this clinical case, we intended to emphasize the importance of careful attention to the findings of neurovisual and neuropsychological testing diagnosing conduct disorders and individually choosing the most effective psychopharmacologic treatment.
Cost-effectiveness and cost-utility of the treatment of chronic hepatitis B with peginterferon alfa-2a, interferon alfa, and lamivudine in Lithuania
Authors: Vanagas Giedrius , Padaiga Žilvinas , Mickevičienė Aušra
Published: June 2018

Background. Chronic hepatitis B infection is an important health care problem worldwide. According to the World Health Organization, 10% to 15% of population is infected with hepatitis B virus. Nearly 100 new cases of acute hepatitis B are annually registered in Lithuania, but official statistics covers only 8–25% of all disease incidence. The aim of this study was to evaluate the cost-effectiveness of the treatment of chronic hepatitis B with peginterferon alfa-2a and compare it to treatment with interferon alfa and lamivudine in Lithuania. Material and methods. A Markov model was used to evaluate long-term cost-effectiveness of the treatment with peginterferon alfa-2a and to compare it with treatment with interferon alfa and lamivudine. Peginterferon alfa-2a was administered by subcutaneous injections at a dosage of 180 μg every week for 48 weeks; interferon alfa, 6 million IU three times a week for 24 weeks; and lamivudine, 100 mg per day from 48 weeks to 5 years for HBeAg-positive chronic hepatitis B and 100 mg per day up to 5 years in HBeAg-negative chronic hepatitis B. Results. Treatment with peginterferon alfa-2a gained 1.179 life years as compared to 0.658 life years gained with treatment with interferon alfa; incremental costs per incremental life-year gained (LYG) were 51 256.92 Lt (14 845.03 €). Treatment with peginterferon alfa-2a gained 0.545 quality-adjusted life-years (QALYs) with incremental costs per incremental QALY of 48 980.08 Lt (14 185.61 €). Treatment with peginterferon alfa-2a had twice higher cost-effectiveness than treatment with interferon alfa: 50 4167.00 Lt (146 016.85 €) vs. 954 020.08 Lt (276 303.31 €), respectively. Costs for a complete response were also twice lower. Treatment with peginterferon alfa-2a gained 0.757 incremental LYG more compared to lamivudine (48-week course). Comparing incremental cost-effectiveness using peginterferon alfa-2a for treatment, incremental costs per incremental LYG were 41 993.67 Lt (12 162.21 €); additionally there was a gain of 0.792 incremental QALYs, while incremental costs for incremental QALY were 40 096.19 Lt (11 612.66 €). Complete response costs were 83 515.98 Lt (24 187.89 €) less compared to lamivudine (48-week course). Conclusions. Treatment of chronic hepatitis B prolongs patients’ overall survival and qualityadjusted life. Peginterferon alfa-2a was the most effective drug registered in Lithuania for CHB treatment.
Changes in health-related quality of life among patients with coronary artery disease: a 2-year follow-up
Authors: Staniūtė Margarita , Brožaitienė Julija
Published: June 2018

The aim of this study was to evaluate the changes in health-related quality of life in patients with coronary heart disease according to age, gender, and treatment method. Material and methods. The study enrolled 167 patients after acute myocardial infarction (MI), percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass grafting (CABG). The mean age was 59.3 years; there were 71.9% of males. General health-related quality of life was measured using the SF-36 questionnaire. Patients were examined at the beginning of rehabilitation and after 6-, 12-, 18-, and 24-month follow-up. Effect sizes were computed to assess the changes in health-related quality of life over time. Results. Health-related quality of life significantly improved at 6 months, but improvements did not continue over time. The largest effect size was seen in the pain domain. Effect sizes were greater in the physical health domains among male patients and among female patients in the mental health domain. With regard to age, effect sizes were greater in the physical functioning domain among older patients. With regard to treatment method, at baseline, the CABG patients had the poorest healthrelated quality of life; however, the largest effect sizes were seen in this group. Conclusions. Health-related quality of life improved over 2 years; the greatest improvement was seen at 6 months. Males better improved on the physical component summary domain; there was no significant improvement in the mental component summary domain in males and females. Older patients improved better on the physical activity and physical component summary domains. Changes in health-related quality of life were related to treatment method.
Antioxidant and Anti-Inflammatory Activities of Fractions from Bidens engleri O.E. Schulz (Asteraceae) and Boerhavia erecta L. (Nyctaginaceae)
Authors: COMPAORE Moussa , BAKASSO Sahabi , MEDA Roland , NACOULMA Odile
Published: June 2018

Background: According to recent studies, reactive oxygen is the leader of human metabolic disease development. The use of natural antioxidants is the best way to stop or prevent this problem. Therefore, the aim of this study was to evaluate the antioxidant and anti-inflammatory activities and to determine the polyphenolic contents of the Bidens engleri and Boerhavia erecta fractions. Methods: Plant fractions were obtained using Soxhlet procedures with hexane, dichloromethane, acetonitrile, ethyl acetate, methanol, and butanol solvent, successively. The different fractions were compared according to their antioxidant, anti-inflammatory activities, total phenolic, and total flavonoid contents. The phenolic contribution to the biological activity was evaluated. Result: The Bidens engleri and Boerhavia erecta fractions showed the highest antioxidant abilities, notably the polar fractions, which inhibited significantly the radical 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2-O-azinobis(3-ethylbenzoline-6-sulphonate) (ABTS). The butanol fraction from Bidens engleri and methanol fraction from Boerhavia erecta have presented the best iron (III) reduction power with 211.68 and 198.55 mgAAE/g, respectively. Butanol and acetonitrile were the best solvents for extracting phenolic compounds from Bidens engleri and Boerhavia erecta, respectively. In contrast, dichloromethane was the best solvent for extracting a flavonoid from two plants with anti-COX-2 and anti-LOX-15 active compounds. The phenolic compound contributed significantly to antioxidant activity (r > 0.80). Conclusion: The Bidens engleri and Boerhavia erecta fractions possessed a potential antioxidant for fighting oxidative stress and helping to prevent diabetes, hypertension, and cardiovascular diseases. The uses of this plant could be promoted in Burkina Faso.
Effect of a Traveling Magnetic Field on Micropore Formation in Al-Cu Alloys
Authors: Xu Yanjin , Wei Lijun , Han Baoshuai , Guo Enyu , Wang Mingyue , Su Yanqing
Published: June 2018

The effect of traveling magnetic fields (TMFs) on the grain and micro-pore formation in an Al alloy was studied by scanning electron microscope and X-ray microtomography in this work. The results show that with the increasing magnetic flux density, the three-dimensional morphology of the micro-pores transformed from dendrite to a relatively equiaxed structure. Quantified results show that both the micro-pore volume fraction and the average grain size of the primary phase decreased as the TMF density increased. The analyses show that the forced convection induced by TMF can break the dendrites, refine the grain size, and promote the liquid feeding, leading to the decrease in the volume fraction of the porosity and improved mechanical property. The TMF performed at different stages during solidification reveal that the maximum effect of TMF on reducing the micro-pore formation was found when TMF was applied in the stage of nucleation and the early stage of grain growth during solidification.
Sequential Contribution of Parenchymal and Neural Stem Cell-Derived Oligodendrocyte Precursor Cells toward Remyelination
Authors: Serwanski David , Rasmussen Andrew , Brunquell Christopher , Perkins Scott , Nishiyama Akiko
Published: June 2018

In the adult mammalian forebrain, oligodendrocyte precursor cells (OPCs), also known as NG2 glia are distributed ubiquitously throughout the gray and white matter. They remain proliferative and continuously generate myelinating oligodendrocytes throughout life. In response to a demyelinating insult, OPCs proliferate rapidly and differentiate into oligodendrocytes which contribute to myelin repair. In addition to OPCs, neural stem cells (NSCs) in the subventricular zone (SVZ) also contribute to remyelinating oligodendrocytes, particularly in demyelinated lesions in the vicinity of the SVZ, such as the corpus callosum. To determine the relative contribution of local OPCs and NSC-derived cells toward myelin repair, we performed genetic fate mapping of OPCs and NSCs and compared their ability to generate oligodendrocytes after acute demyelination in the corpus callosum created by local injection of α-lysophosphatidylcholine (LPC). We have found that local OPCs responded rapidly to acute demyelination, expanded in the lesion within seven days, and produced oligodendrocytes by two weeks after lesioning. By contrast, NSC-derived NG2 cells did not significantly increase in the lesion until four weeks after demyelination and generated fewer oligodendrocytes than parenchymal OPCs. These observations suggest that local OPCs could function as the primary responders to repair acutely demyelinated lesion, and that NSCs in the SVZ contribute to repopulating OPCs following their depletion due to oligodendrocyte differentiation.
Immunological Comparison of Native and Recombinant Hen’s Egg Yolk Allergen, Chicken Serum Albumin (Gal d 5), Produced in Kluveromyces lactis
Authors: De Silva Chamika , Dhanapala Pathum , King Samuel , Doran Timothy , Tang Mimi , Suphioglu Cenk
Published: June 2018

Chicken serum albumin (CSA) is a hen’s egg yolk allergen causing IgE-mediated allergy. The objective of this study was to produce a recombinant version of CSA and compare its IgE reactivity to natural CSA (nCSA). CSA was cloned and expressed as a soluble fraction in the yeast Kluyveromyces lactis (K. lactis) protein expression system. The gene encoding CSA was amplified with a C-terminal hemagglutinin epitope tag by polymerase chain reaction (PCR) and cloned into the pKLAC2 expression vector prior to transforming into K. lactis. Recombinant CSA (rCSA) was purified by immunoprecipitation. Twenty-one patients allergic to hen’s egg white were examined for sensitisation against nCSA. 38% of patients were found to be sensitised to CSA based on Western immunoassay. Immunoglobulin E (IgE) binding capacity of rCSA and nCSA was analysed by ELISA using sera from patients sensitised to CSA. Levels of IgE-binding were similar for both the recombinant and the natural CSA, indicating the existence of similar epitopes. rCSA produced in this study is a potential candidate to be used in component-resolved diagnosis (CRD) of egg yolk allergy. The usefulness of rCSA in CRD of egg yolk allergy warrants further characterisation using sera from patients with allergy to hen’s egg yolk in future studies.
Briefing Note: Proceedings of the Singapore National Clinical Pharmacy Colloquium—Health Manpower Development Planning
Authors: Parrish Richard H. , Chew Lita
Published: June 2018

The nation of Singapore highly values its health service as well as the component of healthcare delivery that includes clinical pharmacy and administration. The Ministry of Health (MOH) engaged the services of Dr. Richard Parrish to better understand the relationship between the Singaporean citizenry and its clinical pharmacists. Through a series of five lectures, structured from the national to local unit level, four roundtables, two hands-on sessions, and three workshops, clinical pharmacists and administrative leadership participated in “open-mic” style lectures, discussed the issues facing Singapore pharmacy in its current provision of healthcare services, and deliberated on the future resources required to meet projected healthcare needs. From three distinct perspectives, these discussions were very frank, transparent, and passionate about what practitioners and administrators thought Singaporean health leadership needed to address in terms of (1) what programs and practices to continue; (2) what ones to start; and (3) what ones to evaluate. Each of the areas below will be framed using these three perspectives in order to clearly reflect the ideas and suggestions expressed in each of the 14 group sessions. These recommendations are forwarded to MOH pharmacy leadership for consideration and action. In addition, we met with MOH leaders regarding non-medical prescribing (NMP), and discussed strategies and tactics that seemed successful as well as unsuccessful in other jurisdictions when adopting expanded scope models for clinical pharmacists and other qualified healthcare providers that include prescribing of medications.