bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of supplementation of vitamin D on intact parathyroid hormone level in chronic kidney disease patients
Authors: Adhikary Laxman Prasad , Khanal Aarjan 
Published: March 2020

Background: Secondary hyperparathyroidism is present in majority of patients with estimated glomerular filtrate rate less than 60 mL/min/1.73 m2. Sustained elevated parathyroid hormone level can cause osteitis-fibrosa-cystica, fracture, hypercalcemia, hyperphosphatemia, and calciphylaxis. Kidney Disease Improving Global Outcome guidelines for Chronic Kidney Disease Mineral and Bone Disorder 2017 recommends treatment with calcitriol or vitamin D analogue if parathyroid hormone level is progressively increasing and remains persistently above the upper limit despite correction of modiﬁable factors.
Objectives: The objective of this study was to determine the mean change in intact parathyroid hormone aftercalcitriol supplementation in patients with chronic kidney disease (stage 3 to 5).
Methodology: This prospective observational study enrolled 92 patients with chronic kidney disease stage 3 to 5, not under maintenance hemodialysis. Patients who had intact parathyroid hormone level more than 200 pg/ml, serum phosphate level less than 4.5 mg/dl and corrected serum calcium less than 9.5 mg/dl were selected for the study. They were supplemented with oral calcitriol 0.25μg thrice weekly for three months and intact parathyroid hormone level was measured after three months.
Results: Mean intact parathyroid hormone level before supplementation was 332.91 ± 96.046pg/ml and after three months of supplementation with calcitriol was 176.49 ±53.764pg/ml. This finding was statistically significant (Correlation: 0.471, p-value less than 0.05). Thus, supplementation of calcitriol reduced the mean intact parathyroid hormone level in the chronic kidney disease patients in our study.
Conclusion: Calcitriol supplementation seems to be an effective measure to reduce intact parathyroid hormone level in chronic kidney disease patients when it remains persistently high despite correction of modiﬁable factors.
Awareness and concern towards anesthesia among patients undergoing surgical procedure: A cross-sectional study at pre-anesthetic clinic of a Teaching Hospital
Authors: Moktan Sushila Lama , Shrestha Ujma , Sharma Mona , Karki Manan 
Published: March 2020

Background: With the advent of anesthesia, surgery is no longer a race against the clock and surgeons. Many studies in the past have demonstrated limited knowledge among patients about various aspects of anesthesia.Objectives: To assess the awareness and concern of elective surgical patients towards anesthesia.Methodology: A cross-sectional questionnaire survey was conducted over two months’ period in adult patients of age eighteen years and above. Two hundred surgical patients accessing services at the pre-anesthesia check-up clinic were interviewed using 12 questions assessing demographic characteristics, educational status and their knowledge about anesthesia.Results: Out of 200 patients, only 32% knew that anesthesiologists provide anesthesia. It was found that 63% didn’t have any knowledge about the types of anesthesia. The most common fear among the participants about anesthesia was the fear of pain during surgery.Conclusion: The study showed poor knowledge of patients regarding anesthesia.
Maxillary sinus - A tool for sex determination in the Nepalese population
Authors: Singh Pankaj Kumar , Paudel Ram Chandra , Menezes Ritesh G , Khanal Kishor 
Published: March 2020

Background: In forensic science, skeletal examination is often done with primary focus on identification. Complete identification is a rare event in this type of examination. However, anthropological identification can be done in skeletal examination. Skull is the second best for determination of sex next to pelvis. Maxillary sinuses are paranasal sinuses, and a feature for sexual dimorphism which remains intact in partially charred. The study of maxillary sinus is best done on Computed Tomography.Objectives: The primary objective of this study is to evaluate bilateral maxillary sinus for sexual dimorphism using Computed Tomography.Methodology: A total of 104 CT head cases were studied of which 52 were male and 52 female. The anterior posterior length, transverse width and height of bilateral maxillary sinus were measured in male and female through their DICOM images using inbuilt electronic calliper. Descriptive analysis for mean, paired t test to compare right and left maxillary sinus in both male and female, and student t test for compare male and female were used for analysing the value measured and calculated.Results: Male maxillary sinus (Right 12.76±4.62 & Left 12.39±3.81) was found be to larger than that of female (Right 12.16±4.78 & Left 11.80±4.49). Right and left maxillary sinus of both the sexes showed no significant difference when paired t test was used. Using independent t-test showed no sexual dimorphism between the two sexes.Conclusion: Maxillary sinus is not good tool for sex determination in Nepalese population. However further studies could be done on larger population sample, as smaller sample size could be the limitation of this study.
Effectiveness of Prenatal Ultrasound Examination at Second Trimester in Detecting Fetal Congenital Abnormalities-A Preliminary Study
Authors: Thapa Madan , Parajuly Shyam Sundar , Adhikari Rajesh , Shrestha Manish Kiran 
Published: March 2020

Objective: Anomaly scan at the second trimester provides the detail anatomical study of fetus. Any structural or morphological defects detected prenatally guides the parents and doctors for further counseling. The main objective of this study was to detect the fetal congenital anomalies in high risk patients at 18-22 weeks and highlight the effectiveness of prenatal ultrasound examination.
Materials and Methods: This was a hospital based descriptive study done during the period of 2017 January to 2019 January in the department of Radiology, ultrasound unit, Pokhara Academy of Health Sciences, Nepal. Pregnant women who were first examined and evaluated by the Obstetrician during the ante-natal check up (ANC) either by asking the patient history or by mother age or any symptoms or chance of being abnormalities or high risk patients during that time frame (18-22 weeks) were enrolled for the study. Maternal age, parity, any history of previous anomalies, previous history of miscarriage/Intra Uterine Fetal Demise ( IUFD) or any exposure to radiation or drugs, history of other disease were recorded during the filling of consent form. High risk patients were identified by the Obstetrician and anomaly examination was prescribed at second trimester (18-20 weeks). Descriptive analysis was done using SPSS 20.
Results: There were two hundred and twenty four patients who had undergone anomaly (targeted fetal anatomy) examination which were referred for “anomaly scan” from the gynaecology and obstetrics department during that period. Among all the cases, fourteen cases had anomalies detected during the scan (18-22 weeks). Out of which seven cases had central nervous system related anomalies, two cases had skeletal deformities (dysplasia), two case had urinary tract related anomalies, one had lungs related anomalies and one had single umbilical artery with polyhydroamnios associated with duodenal atresia and one case had malformation of lymphatic system ( cystic hygroma )
Conclusion: Our study revealed that ultrasound scan performed between 18-22 weeks of pregnancy is effective in diagnosing major fetal abnormalities in the high-risk patients.
Platelet Count/Splenic Diameter Ratio to Predict Oesophageal Varices in Portal Hypertension
Authors: Lamichhane Buddhi Sagar , Koirala Manoj , Baral Bishwo Raj 
Published: March 2020

Background: One of the major causes of morbidity and mortality in Nepal is portal hypertension due to liver cirrhosis. In rural areas where a lot of cases of cirrhosis of liver are prevalent and endoscopic expertise and facilities are not available, predicting the presence of esophageal varices through non-invasive means may reduce a large number of unnecessary endoscopies. This study is to identify the relationship of platelet count /splenic bipolar diameter ratio with the presence of esophageal varices in portal hypertension.
Materials and methods: Eighty patients were included in this study between Jestha 2072 to Baisakh 2073 with the diagnosis of portal hypertension admitted in Bir hospital, Kathmandu which is a tertiary hospital of government of Nepal, which were mostly due to liver cirrhosis. The patients fulfilling the inclusion criteria underwent lab investigations, ultra sonogram and UGI endoscopy. The data were assessed for descriptive studies and means were compared using t-test. The cut off value of platelet count to spleen diameter ratio of 1150 was used to predict the presence or absence of oesophageal varices. Statistical analysis was done using SPSS 20 software
Results: Platelet count to splenic diameter ratio with a cut off value of 1150 has sensitivity of 89.7%, specificity of 83.3%, positive predictive value of 96.8% and negative predictive value of 58.8% (p= 0.002, CI=95%) with 89.5 % accuracy.
Conclusion: Platelet count to splenic bipolar diameter ratio can be a good predictor of presence of esophageal varices in patients with portal hypertension in the resource poor settings.
Mobilność kulturowa w badaniach nad przedstawieniami - perspektywy metodologiczne
Authors: Bal Ewa Jolanta 
Published: March 2020

Artykuł jest próbą nakreślenia metodologicznych perspektyw jakie rysują się przed badaczami performansów artystycznych w związku z ogłoszonym przez Stephena Greenblatta Manifestem kulturowej mobilności w 2010 roku. Autorka poddaje w nim analizie koncepcję stref kontaktu wprowadzoną do humanistyki przez Mary Luise Pratt, rozwiniętą następnie przez Stephena Greenblatta oraz Donnę J. Haraway, pokazując w jaki sposób pozwala ona przeformułować obowiązujące do tej pory w obrębie performatyki rozumienie pojęcia "przedstawienia" (performansu). Sugeruje, że poprzez strefy kontaktu, rozumiane jako przestrzeń wzajemnego spotkania i redefiniowania się uczestniczących w niej heterogenicznych podmiotów jako badacze kultury zyskujemy możliwość nowego sposobu oglądu zastanej rzeczywistości kulturowej i poznawania jej emergentnych znaczeń. Swoje hipotezy autorka rozwija w oparciu o analizę dwóch przykładów: performansu Exhibit B, Bretta Bailey’a z 2013 roku oraz wystawy fotografii Pietera Ugo, Between the Devil and the Deep Blue Sea w Museu Coleção Berardo, Lizbona (05.07.2018 – 07.10.2018).
Sapieżyńska ochrona dóbr Potockich w starostwie owruckim w latach 80. i 90. XVII wieku Przyczynek do badań nad współpracą rodzin magnackich w czasach panowania Jana III Sobieskiego
Authors: Sawicki Mariusz 
Published: March 2020

Sapiehowie i Potoccy byli jednymi z najbardziej wpływowych rodzin w dawnej Rzeczypospolitej. Druga z wymienionych familii posiadała liczne dobra na Ukrainie, które rujnowały częste przemarsze żołnierzy litewskich. Władzę nad nimi sprawował hetman wielki Kazimierz Jan Sapieha. Zasadniczym celem artykułu jest rozpatrzenie kwestii dotyczącej możliwej ochrony przez hetmana Sapiehę dóbr Potockich w zamian za ich głosy poparcia na sejmie i obronę w czasie ataków na litewskiego dowódcę wywołanych jego absencją pod Wiedniem.
A long-term evaluation of a training program on breaking bad news in pediatric neurosurgery: a pilot study
Authors: Zanello Marc , Baugnon Thomas , Roux Alexandre , Di Rocco Federico 
Published: March 2020

OBJECTIVEBreaking bad news is a difficult task in medical practice. Several breaking-bad-news training programs have been proposed. However, long-term results of such training have rarely been investigated. The aim of this study was to compare the short- and long-term evaluations by young neurosurgeons of a training program for breaking bad news to patients and their parents.METHODSBetween 2012 and 2015, pediatric neurosurgery residents participated in a training day on breaking bad news in pediatric neurosurgery with professional actors. A personal debriefing, followed by a theoretical session, completed the training. Immediate feedback was evaluated through a survey administered at the end of the day. Long-term results were explored via an online form sent at least 3 years after the training completion.RESULTSSeventeen participants from 9 different countries were interviewed. Their immediate feedback confirmed their interest. For 71% of them, the program was very interesting, and 77% were extremely satisfied or very satisfied. All trainees wanted more training sessions. At a mean of 4.5 years of follow-up (range 3–6 years), 71% of the trainees fully remembered the session. Most of them (86%) reported a positive impact of the training on their career. Only 21% had another training session on breaking bad news during their residency. At long-term analysis, fewer trainees considered the duration of the training to have been sufficient (p = 0.044).CONCLUSIONSBreaking-bad-news training has a positive long-term educational impact even several years later. Such a training program should be implemented into pediatric neurosurgery residency.
Initial blood pressure is important for long-term outcome after traumatic spinal cord injury
Authors: Haldrup Mette , Dyrskog Stig , Thygesen Mathias Møller , Kirkegaard Hans , Kasch Helge , Rasmussen Mikkel Mylius 
Published: March 2020

OBJECTIVEPatients with traumatic spinal cord injury (TSCI) are at risk of developing neurogenic shock that causes hypotension and thereby secondary injury to the spinal cord due to ischemia. Hemodynamic treatment of patients with acute TSCI remains inadequately elucidated. Guidelines for management are divergent and based on limited evidence. To this end, the authors evaluated whether mean arterial blood pressure (MABP) during the prehospital and initial hospital phases of TSCI treatment is correlated with long-term neurological outcome.METHODSThe authors performed a retrospective cohort study based on a chart review of MABP data collected during the prehospital transport, in the operating room (OR), and in the neurointensive care unit (NICU) during the first 7 days after trauma. Data from the NICU were divided into two periods: days 1–2 and days 3–7. Data were analyzed using Spearman’s rank correlation to evaluate for any correlation between MABP and changes in the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) score 1 year postinjury. In the analysis, the MABP target value was 80 mm Hg. Hypotension was treated with metaoxedrin or norepinephrine. Statistically significant differences were evaluated using Spearman’s rank correlation coefficient.RESULTSThe chart review yielded 129 patients treated for TSCI. The inclusion period was 2010–2017. For the prehospital transport measurements of MABP, the Spearman’s rank correlation coefficient was a rho of 0.5662 (p < 0.001), for OR measurements it was a rho of 0.6818 (p < 0.001), and for the NICU measurements it was a rho of 0.4611 (p < 0.001); for NICU unit days 1–2 and days 3–7, the Spearman’s rank correlation coefficient was a rho of 0.2209 (p = 0.0681).CONCLUSIONSContinuous MABP levels exceeding 80 mm Hg have a significant impact on neurological outcome—from earliest possible stabilization in the prehospital care, through hospital admission, the surgical phase, and into the first 2 days in the NICU.
Cost-benefit analysis of tranexamic acid and blood transfusion in elective lumbar spine surgery for degenerative pathologies
Authors: Ehresman Jeff , Pennington Zach , Schilling Andrew , Medikonda Ravi , Huq Sakibul , Merkel Kevin R. , Ahmed A. Karim , Cottrill Ethan , Lubelski Daniel , Westbroek Erick M. , Farrokh Salia , Frank Steven M. , Sciubba Daniel M. 
Published: March 2020

OBJECTIVEBlood transfusions are given to approximately one-fifth of patients undergoing elective lumbar spine surgery, and previous studies have shown that transfusions are accompanied by increased complications and additional costs. One method for decreasing transfusions is administration of tranexamic acid (TXA). The authors sought to evaluate whether the cost of TXA is offset by the decrease in blood utilization in lumbar spine surgery patients.METHODSThe authors retrospectively reviewed patients who underwent elective lumbar or thoracolumbar surgery for degenerative conditions at a tertiary care center between 2016 and 2018. Patients who received intraoperative TXA (TXA patients) were matched with patients who did not receive TXA (non-TXA patients) by age, sex, BMI, ASA (American Society of Anesthesiologists) physical status class, and surgical invasiveness score. Primary endpoints were intraoperative blood loss, number of packed red blood cell (PRBC) units transfused, and total hemostasis costs, defined as the sum of TXA costs and blood transfusion costs throughout the hospital stay. A subanalysis was then performed by substratifying both cohorts into short-length (1–4 levels) and long-length (5–8 levels) spinal constructs.RESULTSOf the 1353 patients who met inclusion criteria, 68 TXA patients were matched to 68 non-TXA patients. Patients in the TXA group had significantly decreased mean intraoperative blood loss (1039 vs 1437 mL, p = 0.01). There were no differences between the patient groups in the total costs of blood transfusion and TXA (p = 0.5). When the 2 patient groups were substratified by length of construct, the long-length construct group showed a significant net cost savings of $328.69 per patient in the TXA group (p = 0.027). This result was attributable to the finding that patients undergoing long-length construct surgeries who were given TXA received a lower amount of PRBC units throughout their hospital stay (2.4 vs 4.0, p = 0.007).CONCLUSIONSTXA use was associated with decreased intraoperative blood loss and significant reductions in total hemostasis costs for patients undergoing surgery on more than 4 levels. Furthermore, the use of TXA in patients who received short constructs led to no additional net costs. With the increasing emphasis put on value-based care interventions, use of TXA may represent one mechanism for decreasing total care costs, particularly in the cases of larger spine constructs.
Study of bentonite clays influence on quality indicators of pellets
Authors: Zhuravlev F. M. , Chuprinov E. V. , Lyalyuk V. P. , Kassim D. A. , Lyakhova I. A. 
Published: March 2020

Quality of iron ore pellets depends on many factors, including the type and properties of binding materials, in particular, bentonite clays. Laboratory studies of bentonite clays, differing by mineralogical composition and exchange ion complex. To assess the metallurgical characteristics of the pellets obtained with various kinds of binders, the moisture of the pellets, the compressive strength of the wet and dry pellets, the number of the wet pellets discards without destroying, and the “shock” temperature were determined. The carried out tests have shown that the impact strength and compression resistance of wet pellets at a slightly increased specific consumption of bentonite of cherkasy alkaline-earth bentonite does not concede to the correspondent properties of pellets with application of alkaline saryugyshsky bentonite as the binder. It was shown that clays of the IV layer, which are a natural mixture of alkaline-earth bentonite of the II layer and palygorskite III layer of the Cherkassky deposit, are favorable, to ensure good quality of the raw pellets. Tests of composite mixtures of clays IV with II and II with III layers showed that the quality of raw pellets with cherkassky bentonite is slightly worse comparing with sarygyuhsky one, however, the absolute values of their indicators satisfy the industry requirements. Tests of pelletizing of charges with different wetness, with the addition of 0.5% alkaline bentonite and a mixture of clays of the IV and II layers of the cherkassky deposit were carried out. It was shown, that with wetness increasing, pellets with both types of binder additives show the increase of the dynamic strength, porosity and temperature of the “shock” with a minimum difference in the absolute values of indicators with different binders. For confirmation of the possibility of using alkaline-earth bentonite of the Cherkassky deposit (II–III–IV layers) in the production of pellets, it is necessary to accomplish comparative industrial tests at a pelletizing plant (for example, at SevGOK), which uses a concentrate and industrial water of increased hardness.
Influence of technology parameters of free-cutting steel continuous casting on the billet internal structure
Authors: Kunakbaeva A. T. , Stolyarov A. M. , Potapova M. V. 
Published: March 2020

Free-cutting steel gains specific working properties thanks to the high content of sulfur and phosphorus. These elements, especially sulfur, have a rather high tendency to segregation. Therefore, segregation defects in free-cutting steel continuously cast billets can be significantly developed. The aim of the work was to study the influence of the chemical composition of freecutting steel and casting technological parameters on the quality of the macrostructure of continuously cast billets. A metallographic assessment of the internal structure of cast metal made of free-cutting steel and data processing by application of correlation and regression analysis were the research methods. The array of production data of 43 heats of free-cutting steel of grade A12 was studied. Steel casting on a five-strand radial type continuous casting machine was carried out by various methods of metal pouring from tundish into the molds. Metal of 19 heats was poured with an open stream, and 24 heats – by a closed stream through submerged nozzles with a vertical hole. High-quality billets had a cross-sectional size of 150×150 mm. The macrostructure of high-quality square billets made of free-cutting steel of A12 grade is characterized by the presence of central porosity, axial segregation and peripheral point contamination, the degree of development of which was in the range from 1.5 to 2.0 points, segregation cracks and strips – about 1.0 points. In the course of casting with an open stream, almost all of these defects are more developed comparing with the casting by a closed stream. As a result of correlation and regression analysis, linear dependences of the development degree of segregation cracks and strips both axial and angular on the sulfur content in steel and on the ratio of manganese content to sulfur content were established. The degree of these defects development increases with growing of sulfur content in steel of A12 grade. These defects had especially strong development when sulfur content in steel was of more than 0.10%. To improve the quality of cast metal, it is necessary to have the ratio of the manganese content to the sulfur content in the metal more than eight.
"Con el corazón se cree y con los labios se profesa. La fe: don, testimonio y compromiso"
Authors: López Casquete de Prado Manuel 
Published: March 2020

Reseña de la obra de: MARTÍN ARTACHO, Mª R. (coord.) (2014) Con el corazón se cree y con los labios se profesa. La fe: don, testimonio y compromiso, Ávila, Publidisa, 215 pp.
"Balance y nuevas perspectivas de prevención."
Authors: Sequeiros San Roman Leonardo 
Published: March 2020

Reseña de la obra de: DE LA TORRE, J. (editor) (2013) 30 años de VIH–SIDA. Balance y nuevas perspectivas de prevención. Madrid, Universidad Pontiﬁcia Comillas. Aristos Campus Mundus 2015, 600 páginas
"La venganza de la geografía. Cómo los mapas condicionan el destino de las naciones"
Authors: Salinas Pérez José Alberto 
Published: March 2020

Recensión de la obra de: KAPLAN, R. D. (2012) La venganza de la geografía. Cómo los mapas condicionan el destino de las naciones, Barcelona, RBA Libros, 482 pp.
"El Minotauro global. Estados Unidos, Europa y el futuro de la economía mundial"
Authors: Romero Rodríguez José Juan 
Published: March 2020

Recensión de la obra: VAROUFAKIS, Y. (2012) El Minotauro global. Estados Unidos, Europa y el futuro de la economía mundial. Madrid, Ed. Capitán Swing, 340 pp.3