bluuebunny/crossref_metadata_2025_split huggingface dataset:
3241 An Unusual Case of Mixed Connective Tissue Disease Presenting as Abdominal Pain
Authors: Vuittonet Cynthia , Aaron Robert 
Published: October 2019

INTRODUCTION:
Mixed Connective Tissue Disease (MCTD) is a rare systemic autoimmune condition with clinical features similar to systemic lupus erythematous, dermatomyositis, sarcoidosis and rheumatoid arthritis. The diagnosis of MCTD consists of high antibody titers to U1 small nuclear ribonucleoprotein (RNP) in peripheral blood and the presence of clinical manifestations. The most common manifestations are Raynaud phenomenon, joint and muscle pain. Gastrointestinal manifestations of MCTD are less common and are usually gastroesophageal reflux disease or dysphagia. This case describes MCTD presenting as epigastric abdominal pain in a healthy woman.

CASE DESCRIPTION/METHODS:
The patient is a 50-year-old female with no past medical history who was referred to gastroenterology for evaluation of two months of epigastric pain that failed to improve after a thirty-day course of esomeprazole. The pain was described as “squeezing and strangling” in character. A subsequent EGD was unremarkable. The patient was noted to have a mild elevation in her ALT (38) and underwent an ultrasound that demonstrated hepatomegaly and hepatic steatosis. A serological chronic liver disease work-up was negative with the exception of ANA, which was 1:80 in a homogenous pattern. The rest of the patient's laboratory work-up was unremarkable. ANA nine months later was again positive. Anti-RNP antibody was also positive. In the setting of persistent unexplained pain, a repeat ultrasound was performed and was normal. A HIDA scan was done, which demonstrated a borderline ejection fraction of 27%. Biliary dyskinesia was not felt to be cause of the patient's pain given its character and timing. The patient was advised to see a rheumatologist regarding her positive anti-RNP antibody but failed to do so. She presented to a new PCP with continued epigastric pain and new onset arthralgia and edema. The patient was started on methylprednisolone rapid taper which resolved all of the patient's symptoms. The patient was advised to start hydroxychloroquine but she declined due to resolution of her symptoms.

DISCUSSION:
MCTD is a rare systemic autoimmune condition with clinical manifestations affecting multiple organ systems. Gastrointestinal involvement of MCTD is less common. In this case a previously healthy woman presented with epigastric pain and was found to have MCTD as a cause of her symptoms. This case is an unusual presentation of MCTD and is clinically important as early treatment of MCTD decreases the risk of progression to other organ systems.
3242 Unsuspected Proteins
Authors: Steele Joshua , Birris Thomas 
Published: October 2019

INTRODUCTION:
Amyloidosis is a general term used to describe extracellular deposits of circulating proteins. Although the gastrointestinal tract is commonly affected, rarely is gastroparesis the presenting symptom in this devastating illness.

CASE DESCRIPTION/METHODS:
61 year old male with history of HTN and diabetes related ESRD on hemodialysis, and heart failure with preserved ejection fraction that presented to the hospital with 3 months of nausea, recurrent emesis, loose stools, dyspnea, and 60 pound unexplained weight loss. Nausea was fairly constant with emesis occurring typically about 30 minutes after meals. On hospital day 2, patient underwent EGD that was pertinent for atrophic gastric mucosa as well as a large amount of food remaining in the stomach. Biopsies were taken for further investigation. With history of uncontrolled diabetes, diabetic gastroparesis was now considered #1 on differential and gastric emptying study was recommended. Hours after EGD patient became hypotensive and intermittently bradycardic. He was initially responsive to dopamine but after 3 days of wean trials, he was unable to be weaned off dopamine and permanent pacemaker was placed. On day 5, biopsy results came back revealing moderate inflammation of gastric mucosa. Congo red stain was applied to characterize amorphous material seen within the lamina propria. The stain was positive and polarization showed apple green birefringence supporting diagnosis of amyloidosis. Gastric emptying study consistent with prolonged solid phase gastric emptying with 82% of activity remaining in the stomach at 4 hours. On day 7 of hospitalization, patient had a echocardiogram that showed newly reduced ejection fraction of 30% with global hypokinesis, thus supporting the diagnosis of likely cardiac amyloidosis as well. Patient was trialed on reglan but it was discontinued early due to proarrhythmic properties. Patient ultimately expired a few weeks later due to profound cardiogenic and septic shock that was unresponsive to pressor support.

DISCUSSION:
Amyloidosis involves the gastrointestinal tract in 70-100% of cases (seen post-mortem) but less than 1% have gastrointestinal symptoms. There are very few case reports citing the association of delayed gastric emptying with amyloidosis and even more rare has it been the presenting symptom. This case raises the need to consider gastric amyloidosis when patients are presenting with rapid weight loss of unknown etiology and the importance of biopsy during EGD to help with diagnosis.
3243 Unusual Presentation of Gastric Adenocarcinoma and Ascites
Authors: Akhavan Shahrzad Anita , Mun Michael , Oak Rachana , Chum Christopher , Lapin Seth 
Published: October 2019

INTRODUCTION:
Approximately 3-6% of patients with gastric carcinoma (GC) present with ascites at their initial presentation of GC. Many studies suggest that GC patients with ascites have poor prognosis due to ascites-related complications, like spontaneous bacterial peritonitis (SBP).

CASE DESCRIPTION/METHODS:
A 69 year-old Asian female active smoker presented with worsening abdominal pain and 10 lbs weight loss for 1 month. She reported one episode of coffee ground emesis. Physical examination revealed reticulated abdominal skin discoloration, right upper quadrant tenderness, and hypoactive bowel sounds. Laboratory studies: Hgb: 12.4 g/dL; MCV 92.3 fL; WBC: 14.2 K/mcL, Lactate: 1.3 mmol/L, BUN 13 mg/dL, Cr < 0.46 mg/dL. CT abdomen revealed distended small bowel loops, moderate ascites, omental caking and gastric thickening greatest at the gastric body with surrounding fat infiltration and tiny nodes. Paracentesis drained 3.8 L of cloudy yellow ascites fluid with a WBC of 385. The patient was started on treatment for SBP. Esophagogastroduodenoscopy was performed revealing a partially obstructing, ulcerating mass at the gastric cardia and gastric body (A). Biopsy confirmed the diagnosis of gastric adenocarcinoma (B).

DISCUSSION:
We present a patient who initially presented with symptoms suggestive of malignancy. Her labs revealed SBP although her presentation was asymptomatic. With only 3-6% of patients with gastric carcinoma (GC) presenting with ascites at their initial presentation of GC, ascites-related complications, like SBP, is associated with poorer prognosis. For this reason, current treatment for GC with ascites is palliation and prevention of ascites-related symptoms.
The meaning of life between the self and the normative process of self-realisation
Authors: Caruso Giovanna 
Published: October 2019

Abstract
Self-research becomes a starting point for the question about the human being in contemporary anthropological approaches. Accordingly, human life is not viewed anymore as the theoretical object of philosophical investigation, but as the concrete performative execution of the individual’s life. Following this existential paradigm, this paper shows, on the basis of Heidegger’s ‘analytic of Dasein’ and Angehrn’s ‘hermeneutic of the self,’ that the meaning of life can be identified with the process of self-realization much more than with any possible meaningful achievements, engagements or qualities. In fact, understanding human being as a self-interpreting being, Heidegger grasps human life based on the analysis of the ‘understanding,’ the ‘mineness’ and the ‘potentiality-to-Being’ as one’s own reflexive process of self-reference. Angehrn discloses this process as an endless self-understanding process, during which the self forms itself, and defines it as the process that characterizes human being. In this sense, the human being is ‘condemned to meaning.’ By grasping man as such a process, one fundamental feature is expressed: his constitutive unfathomability. For the task of becoming, the self comes from the self that has to become. This means that the self is constantly in the process of becoming self-existent and exists only as this process and remains unfathomable to man in his completeness. In this infinite process of self-realization, in this task of becoming oneself consists the meaning of life. And here, its normative-reflexive character arises. For the ‘must’ to become self has its origin in the self that has to become.
Numerical Simulation and Experimental Research on Material Parameters Solution and Shape Control of Sandwich Panels with Aluminum Honeycomb
Authors: Li Dongsheng , Wang Mingming , Zhou Xianbin 
Published: October 2019

Abstract
This paper aims to solve two problems of the sandwich panel with aluminum honeycomb: material parameters solution and shape control. The accurate material parameters of the sandwich panels are the basis of shape control. Therefore, a mixed numerical-experimental method is proposed to inversely solve equivalent material parameters of the sandwich panel using genetic algorithm (GA) in the first place. Then a high efficiency FE model based on equivalent material parameters is established to study shape control of the sandwich panels. For shape control, the key issue aims to search optimum position and adjustment volume of control points where actuators are installed. Toward the end, the FE simulation method is deployed to optimize actuator position and adjustment volume one by one. Finally, an active control platform based on multi-point adjustment is developed to verify the practicability of the approach proposed in this paper. Through the experiment of shape control, the root mean square (RMS) of surface deviation of sandwich panel is decreased from 62.7μm to 15.5μm. The results show that the shape control can significantly improve the surface accuracy of the sandwich panels, and the validity of equivalent material parameters is also proved from the side.
Surplus Power Approach to Diagnose Gas Turbine Engine Starting Characteristics
Authors: Babu C. Jagadish , Samuel Mathews P. , Davis Antonio , Mishra RK 
Published: October 2019

AbstractSuccessful starting is of utmost importance to any gas turbine engine. In order to ensure successful engine start, the concept ofsurplus powerto accelerate the engine from rest to its idle speed has been proposed in this paper. The concept of surplus power is illustrated with starting data of different types of engines. The effect of variation in surplus power on engine acceleration characteristics has been brought out for in-depth understanding. Analysis of surplus power will provide invaluable information to designers and operators to address issues related to engine starting process. It is found that starting characteristics, i. e. speed vs. time is only a gross characteristic whereas acceleration characteristics dN/dt provides input for minute analysis in surplus power. It is also observed that in case of turbo-shaft engine with free power configuration, turbine is found to come into action much later after light-off whereas in turbo-prop and APU engines with single spool configuration, turbine comes into action immediately after light-off followed by rapid increase in EGT.
Potencial de Zantedeschia aethiopica L. para la rehabilitación de suelos contaminados con cromo hexavalente en zonas alto andinas de Ecuador
Authors: Beltrán Dávalos Andrés Agustìn , Rosero Erazo Carlos , Cargua Catagña Franklin , Echeverría Magdy 
Published: October 2019

Zantedeschia aethiopica L. (Lirio de agua) es una planta vascular ornamental, protectora de humedales y sistemas fluviales con alta distribución en la zona Andina del Ecuador. El objetivo de este trabajo fue evaluar el efecto tóxico del cromo VI (Cr+6) en esta planta, reconociendo sus limitaciones como bioindicadora, para lo cual se determinaron los efectos fisiológicos específicos y no específicos, entre ellos: germinación relativa de semillas (GRS), elongación radicular relativa (ERR) e índice de germinación, en unidades experimentales consistentes en concentraciones de 0, 50, 100, 200 y 300 mg/kg de Cr+6 durante 168 h. Las observaciones fueron realizadas durante 20 semanas en la etapa de germinación en plantas cultivadas en suelo contaminado en condiciones semicontroladas de temperatura, humedad y capacidad de campo. Para determinar el Factor de Bioconcentración (FBC), en poscosecha se utilizaron los índices de traslocación (IT) como concentraciones del metal en la parte aérea de la planta (tallo, hojas y flores) y en el suelo. Los resultados mostraron toxicidad similar de Cr+6 en concentraciones de 100, 200 y 300 mg/kg en la etapa de germinación y con efectos fisiológicos no específicos en el crecimiento de la planta en concentraciones de 200 y 300 mg/kg presentando ausencia de floración, enanismo y marchitamiento. Los resultados mostraron un límite CL50 de 118.96 mg/kg-de Cr+6 en el cual la planta es una especie bioacumuladora y bioindicadora de este metal.
A different technique for sutureless coronary bypass grafting
Authors: Ruttkay Tamás , Bárány László , Grimm András , Patonay Lajos , Petneházy Örs , Rácz Gergely , Baksa Gábor , Galajda Zoltán 
Published: October 2019

Introduction Many coronary anastomotic devices have been designed to replace manual stitching in coronary surgery; however, interestingly, none of them became widespread. Our aim was to work out an easy and fast endoluminal vessel-to-vessel stent bridge distal anastomotic technique. Materials and methods Ten coronary arteries of eight fresh human hearts were used in this study. The anastomosis was performed with the implantation of a graft vessel into the lumen of the coronary artery by performing stent fixation. The technique is described and photo documented in detail. The durability and the conductibility of the anastomosis were examined with intraluminal endoscopy, functional streaming test, and a coloring of the vessels. Results The anastomosis had great results in all cases. Obstruction, dissection, or dislocation of the vessels was not observable. Conclusions This study confirmed the ex-vivo feasibility of the described technique. This method can be an easy, fast, and reliable method applied in the endoscopic distal coronary artery anastomosis surgery. The development of stents adapted to this method and the in-vivo testing of this technique are necessary for the future.
Tüketim Bağlamında Dijital Kadın Dergilerinde Haber-Reklam İlişkisi: Marie Claire Türkiye Örneği
Authors: KAZAN Hüseyin 
Published: October 2019

Toplumu bilgilendiren önemli mecralardan olan kadın dergileri özellikle
magazinleşmeden dolayı reklam aracına dönüşmüştür. Bu durum dergilerin
içeriklerini olumsuz etkileyerek içeriğin önüne geçmekte ve tüketime
yönlendirmektedir. Bu çalışmada da başlıklar üzerinden iç içe geçmiş
haber-reklam ilişkisi incelenmektedir. Çalışmada araştırma için köklü bir
geçmişe sahip olması ve çok sayıda ülkede yayınlanmasından dolayı Marie Claire
Dergisi seçilmiştir. Çalışma Marie Claire’in dijital ortamda yayınlanan 2016
yılındaki on iki sayısı ile sınırlandırılmıştır. İçerik analizi ve betimsel
tarama yöntemleri kullanılarak hazırlanan çalışmada haber-reklam ilişkisine
odaklanılmaktadır. On iki sayının bütün sayfalarının çalışmaya dahil edildiği
araştırmada nitel ve nicel olarak derginin reklam ve haber sayıları da ele alınmıştır. Araştırma sonucunda haberlerde genellikle
tüketimi özendiren başlıkların kullanıldığı görülmüştür.
MICROSURGICAL ANATOMY OF THE CONNECTIONS OF CAUDATE NUCLEUS AND PSYCHOSURGICAL CONSIDERATIONS : A UNIQUE CADAVER STUDY
Authors: BİÇEROĞLU Hüseyin 
Published: October 2019

Aim:
Caudate
Nucleus has been discussed as a target for new treatments of neurologic and
psychiatric diseases but the connectivity remains unclear for both microsurgical
procedures and stereotactic interventions despite the basic neuroanatomical
knowledge. We aim to reveal the anatomic relationship of the caudate nucleus
using fiber dissection technique.Material
and Methods: Four brain specimens (8 Hemispheres)
were frozen for 15
days at -16 °C according to Klingler’s Technique. The
freezing process facilitates the dissection of the fiber tracts. After
completion of the freezing process, the dissections were stepwise performed
from lateral to medial, under x6 to x40 magnification using a surgical
microscope, two and three-dimensional anatomic pictures were obtained.Results:
Stepwise
microsurgical fiber dissection of the Caudate Nucleus and adjacent areas were
dissected. The cortical areas communicating with and overlying the Caudate
Nucleus are reviewed. Frontocaudate Connection Fibers and Temporocaudate Fibers
were intense and the microsurgical anatomy of the area were revealed.

Conclusion:
Psychosurgery
has been used primarily in the treatment of depression when the medical
treatments were not adequate. Deep Brain Stimulation of Nucleus Caudatus is not
standard treatment procedure in the clinical practice. It may be considered that
different parts of the Caudate Nucleus
and connection fibers associated with Caudate Nucleus can be used as a target
for Deep Brain Stimulation which could be an alternative treatment for Parkinson's
Disease, Obsessive Compulsive Disorder and Major Depression.
Utilização da biomassa de uva como biossorvente na remoção de metais pesados de águas residuais
Authors: Finazzi da Costa Larissa Fernanda , Maffessoni Daiana 
Published: October 2019

Em 2018, na região da Serra Gaucha foram produzidos cerca de 132,6 milhões de quilos de resíduos sólidos provenientes das atividades da viticultura e que poderiam ser utilizados como matéria prima para o processo de biossorção de metais. O objetivo do presente trabalho foi avaliar o potencial da biomassa de uva como biossorvente na remoção de metais bem como as melhores condições de operações dos parâmetros estudados. A primeira etapa foi o pré- tratamento na qual o engaço e bagaço foram lavados separadamente, secos e triturados. A segunda etapa foi a determinação da melhor composição entre bagaço e engaço foram testados diferentes composições para a remoção de cobre pela técnica de espectrofometria, dentre os melhores resultados optou-se por trabalhar com a proporção 50/50. A determinação do ponto de carga zero foi realizada utilizando soluções de ácido clorídrico e hidróxido de sódio e o resultado foi de 5,9. Nos ensaios de otimização da biossorção utilizou-se solução de CuSO4 e analisou-se o tempo de agitação e pH ideal. Os tempos de agitação analisados foram 30 a 90 minutos e para pH ideial foram testados no intervalo 2 a 12. Os dados de equilibrio surgerem que a adsorção seja em monocamadas, melhor representado pelo modelo de Langmuir,sendo a capacidade máxima de biossorção de 10.000 mg g-1. Tais resultados demonstram que a aplicação da biomassa da uva como biosservente é uma um técnica de 72% de grau de eficiência para a remoção de cobre.
Growth patterns of Holstein Friesian Dairy Cow (FH) from Birth to First Child based on Mathematical Analysis of the Gompertz Model
Authors: Ratnasari Desi , Atabany Afton , Purwanto Bagus Priyo , Salman Lia Budimulyati 
Published: October 2019

This aims of this study was to estimate the bodyweight of FH dairy cows from birth to first child by knowing growth patterns and creating a standard curve for dairy cattle growth at BBPTU-HPT Baturraden dairy cow in Baturraden district, Banyumas Regency, Purwokerto, Central Java. Data obtained in the form of secondary data from births in 2005-2016 were 1437 tails and primary data were 353 tails. Data were analyzed using SAS 9.4 program with NLIN procedures (Non-Linear) using Gompertz models. The results show that the Gompertz models is easy in the calculation process with the data deviations that are close to the field of data and the models have a high degree of accuracy with the coefficient of determination (R2 ) 99.83%. The conclusion of this study is that the resulting curve of the Gompertz model can be used as a standard growth curve of Friesian Holstein dairy cattle in Indonesia from birth to first calf.
A ALIMENTAÇÃO DOS JOVENS E OS ESTUDOS: QUAL É A RELAÇÃO?
Authors: Piñol Susana , Frizon Amanda Albarello , Silva Ana Carolina Pereira da , Carvalho Layla dos Santos , Suzena Milena Cardoso , Costa Victória de Oliveira 
Published: October 2019

De acordo com o dicionário online de português, publicado em 2009, a alimentação é o abastecimento das substâncias imprescindíveis à manutenção da vida. Saudável remete o que é bom para a saúde; salutar: alimentação saudável. Que é útil e benéfico; vantajoso, propício. Segundo Espaço da Ciência (2011), o ser humano precisa se alimentar para se manter vivo. Nos alimentos são encontrados carboidratos, gorduras, proteínas, sais minerais, vitaminas, fibra e água para a manutenção e formação dos tecidos e funcionamento dos órgãos que compõem o organismo humano.A alimentação balanceada na adolescência é tão importante quanto na primeira infância, porque além de satisfazer as necessidades de nutrientes durante essa fase, ela serve para criar e manter bons hábitos alimentares para o resto da vida. (DIETNET, 2010). Pela importância, Basílio (2016) destaca a resolução 26 de 17 de julho de 2013, do Fundo Nacional para o Desenvolvimento da Educação, (que dispõe sobre o atendimento da alimentação escolar aos alunos da Educação Básica no âmbito do PNAE). Esta resolução determina que as unidades escolares que atuam em período integral atendam, no mínimo, 70% das necessidades nutricionais diárias das crianças e adolescentes.Para Zanin (2017), a má alimentação pode provocar doenças que dificultam o desenvolvimento físico e mental nas crianças em desenvolvimento e adolescentes. De acordo com o site Psicologia, a memória é o que permite a aprendizagem pois é através dela que os conhecimentos se consolidam. E só o que aprendemos com a memória, nos possibilita aprender coisas novas (aumentando assim o nosso conhecimento). É a funçãomental que permite reter a informação. Sousa (2006) adverte que o comportamento alimentar das crianças, assim como as suas preferências alimentares, são influenciadas por fatores genéticos ou hereditários e também por fatores ambientais. Com uma boa alimentação a criança ou o jovem terá um bom desenvolvimento e capacidade de aprendizado, capacidade física, atenção, memória, concentração, energia necessária para trabalhar o cérebro. Para que isso aconteça, a alimentação deve ser diversificada contendo carboidratos, lipídios, proteínas, sais minerais, água, fibras, sal, gorduras, vitaminas na quantidade certa, além da prática de exercícios.Neste contexto, este projeto apresenta como objetivo geral: verificar informações presentes em sites/blogs que versam sobre nutrição para estudantes; buscando atender os seguintes objetivos específicos: analisar se os sites/blogs trazem informações sobres as doenças causadas pela má alimentação, verificar se os sites/blogs abordam as dificuldades que podem ser causadas na vida do estudante, investigar os benefícios causados na vida dos discentes, saber os alimentos inadequados e adequados para um melhor funcionamento corpóreo considerando o público estudantil e verificar se os sites/blogs divulgam contato de nutricionistas.