bluuebunny/crossref_metadata_2025_split huggingface dataset:
DERMOSCOPY OF THE MONTH Nevi with Site-Related Atypia
Authors: Tirnanić Tanja , Brašanac Dimitrije , Kandolf Sekulović Lidija 
Published: May 2018

AbstractThe term “nevi of special sites” refers to melanocytic nevi of specific anatomic locations including the breast, axillae, umbilicus, genitalia, flexural areas, acral surfaces, ear, scalp and the conjunctiva. Nevi from these anatomic sites display sometimes dermoscopic and histological features of melanoma, resulting in unnecessarily high rates of excisions and re-excisions. Some authors have categorized nevi excised in the axillary, breast, umbilical and perineal areas as the nevi of the milk line. Two patients, a 32-year-old female and 23-year-old male with breast and periumbilical pigmented lesions, presented to our Department during 2017. Dermoscopy revealed features that were highly specific for melanoma. Excisional biopsies were done and histopathology revealed benign nevi with present site-related atypia. Irregular blotches, non-uniform radial streaks, blue-gray veil, and regression are the most specific features of melanoma of the breast and flexural areas. Excision is always recommended in pigmented lesions on the breast and flexural areas, which exhibit these features. However, larger studies are needed to define specific criteria required to distinguish special-site nevi from melanoma.
The isolation and structural elucidation of a new iridoid glycoside from Cymbaria dahurica L.
Authors: Bai Cui-Lan , Wang Qing-Hu , Xu Yan-Hua , Han Jun-Sheng , Bao Yin-Ping 
Published: May 2018

Abstract
A new iridoid glycoside, namely, cymdahoside A (1), together with two known ones, 2 and 3, were isolated from the EtOAc extract of Cymbaria dahurica. The structure elucidation of 1 was carried out by one-dimensional (1D) NMR (1H and 13C NMR) and 2D NMR (correlation spectroscopy, heteronuclear single-quantum coherence, heteronuclear multiple-bond correlation and nuclear Overhauser effect spectroscopy) spectral analyses.
EFFICACY EVALUATION OF THE TRANSITION TO FIXED COMBINATION DRUG PRESTANCE IN PATIENTS WITH INSUFFICIENT CONTROL OF BLOOD PRESSURE BY OTHER ANTIHYPERTENSIVE MEDICATIONS OR COMBINATIONS: REGIONAL PROGRAM OBJECTIVE
Authors: Kravchenko A. Ya. , Alimkhanova Z. Z. 
Published: May 2018

Aim.To evaluate efficacy of the fixed combination of perindopril arginine and amlodipine (original drug PRESTANCE, JSC “Servier”, France) in achievement of blood pressure (BP) control in patients non­controlled with other antihypertensive medications.Material and methods. In the study, in real world setting, 250 arterial hypertension (AH) outpatients were included. The levels of systolic (SBP) and diastolic (DBP) blood pressure were assessed and “vascular age”, at baseline, in 1 and 3 months (visit 2) of treatment with PRESTANCE.Results. In transition of patients to PRESTANCE there was decrease of SBP from 166,6±8,9 to 142,1±6,1 mmHg in 1 month (р<0,001) and to 131,1±6,1 mmHg in 3 months. (р<0,001), that is by 36 mmHg. BP decrease with the studied drug was similar in men and women, in patients older and younger 60. Target BP was reached in 79,6% of patients. The parameter “vascular age” after transition to PRESTANCE decreased in 3 months from 67,3±10,5 y. o. to 59,2±8,86 y. o., that is by 8,1 years.Conclusion.Transition from mono­ or combination therapy to fixed combination of perindopril arginine/amlodipine releases rapid and potent antihypertensive efficacy in patients not reached the target BP at any previous therapy, including combination of perindopril with amlodipine.
ESTABLISHED COMORBIDITY IN ARTERIAL HYPERTENSION PATIENTS IN RURAL AREAS
Authors: Denisov I. N. , Zaugolnikova Т. V. , Popova Т. S. , Morozova Т. Е. 
Published: May 2018

Aim. To analyze the specifics of comorbidity forming and age­related correlations of the risk factors (RF) distribution in arterial hypertension (AH) patients living in rural areas.Material and methods. In 2015­2017 a retrospective analysis of 2500 patients database was done at two general practitioners offices in Konakovsky District of Tverskaya Oblast. Of those, 350 were selected (14%) at the age 44­53 (164 males, 186 females) among the charts containing most complete data on the dispanserization. Additionally, surveying of the group was done for more detailed retrospective analysis of comorbidity and RF existence during lifetime of 25­35 years.Results. In the structure of comorbidity AH predominates, which has been diagnosed in 50,86% of patients; mostly it is diagnosed at the age 44­53 (81,06%). After AH, 2nd place is held by dorsopathies (24%), 3rd — gastrointestinal disorders (12%). For chronic pulmonary obstructive disease and cerebrovascular disease — it is less than 3%. 96,1% of men with AH are smokers at the age 18 to 53 y. o. By the age 53, in 40,26% of men and 36,63% of women there is bodyweight increase; and raised cholesterol — in 48,05% and 22,77%, respectively.Conclusion. In rural areas inhabitants, the formation of comorbidity is ongoing mostly at age 44­53 y. o. Of the specifics of comorbidity in these patients, there is often combination of AH with dorsopathies, and quite rare — with chronic obstructive lung disease or cerebrovascular diseases. The observed at the age 34­43 “diagnostic gap” points on the necessity for attention to this exact age strata with the aim of ontime diagnostics and early stages of diseases reveal. The structure of RF during the lifetime is not homogenic and is the highest at the age of comorbidity forming (except smoking and professional harms). All the considered RF are more prominent in men than in women.
RELATION OF THE MARKERS OF MYOCARDIAL DYSFUNCTION AND SYSTEMIC INFLAMMATION WITH STRUCTURAL AND FUNCTIONAL PARAMETERS OF THE LUNGS IN MYOCARDIAL INFARCTION PATIENTS
Authors: Polikutina O. M. , Slepynina Y. S. , Bazdyrev E. D. , Karetnikova V. N. , Barbarach O. L. 
Published: May 2018

Aim. To evaluate the structural and functional changes in the lungs of ST elevation myocardial infarction (STEMI) patients with absence or presence of chronic obstructive lung disease (COPD), and the relation with myocardial dysfunction and systemic inflammation.Material and methods. Totally, 189 STEMI patients included: group 1 — STEMI with COPD of moderate and mild grade, 2 — STEMI with no lung pathology. Groups were comparable by clinical and anamnestic parameters. Assessment of lung function and blood collection were done at 10­12 day of STEMI. For comparison of the parameters representing structural and functional changes in the lungs and comparison of C­reactive protein (CRP), N­terminal pro­brain natriuretic peptide (NT­proBNP) concentration, a control group was formed with no pulmonary pathology, comparable by age and sex with the STEMI patients.Results. In COPD patients, higher values revealed of the parameters representing the part of residual volumes in pulmonary structure. Higher residual volume (RV) was found also in STEMI and no COPD comparing to controls, however the relation RV/TLC (total lung capacity) was not higher than normal range. In both groups there were lower values of diffusion lung capacity (DLCO) comparing to controls. The lowest DLCO found in COPD patients. Concentration of NT­proBNP (H=41,6; p<0,001) and CRP (H=38,6; p<0,001) in COPD was significantly higher in STEMI with no COPD patients than in controls. The negative correlations found for NT­proBNP and CRP with forced expiratory volume 1 sec, FEV/FVC1, DLCO, and positive — with the values of thoracic volume, RV/TLC.Conclusion. In STEMI patients the increase revealed of residual lung volumes. Mostly the level of residual volumes is high in STEMI and COPD patients. There are associations of NT­proBNP and CRP with structural and functional parameters of the lungs regardless of COPD.
CAROTID­SUBCLAVIAN GRAFTING IN OCCLUSION OF THE FIRST PORTION OF SUBCLAVIAN ARTERY AND MULTIFOCAL ATHEROSCLEROSIS: FIVE YEAR FOLLOW­UP DATA
Authors: Tarasov R. S. , Kazantsev A. N. , Burkov N. N. , Anufriev A. I. , Shabaev A. R. , Lider R. Yu. , Mironov А. V. , Barbarash L. S. 
Published: May 2018

Aim.Analysis of the prevalence and structure of hospital and five year postsurgical complications in patients with occlusion of the first portion of subclavian artery and multifocal atherosclerosis.Material and methods.To the study, 45 patients included, who had underwent carotid­subclavian shunting during 2008­2015y.Results.In hospital period of follow­up there were no significant adverse cardiovascular events. Among the comlications, in several cases there were vocal cords paresis, paresis of the diaphragm dome, limphorrhea. The study shows that significant cardiovascular events occurred only in long term of the disease period and were related to the following stage of revascularization.Conclusion.The obtained results underscore the significance of risk stratification and selection of the optimal strategy of revascularization in the cohort of patients, that is impossible unless an approach is personified.
EXPERIENCE OF USING THE NON­SELECTIVE ENDOTHELIN RECEPTOR ANTAGONIST MACITENTAN IN PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION
Authors: Simakova M. A. , Goncharova N. S. , Karelkina E. V. , Moiseeva O. M. 
Published: May 2018

Aim. To present the results of treatment with macitentan of patients included in the clinical trial SERAPHIN in Almazov National Medical Research Centre and define target therapy of pulmonary arterial hypertension (PAH) in real clinical practice.Material and methods. The article presents the results of the 151 patients with PAH followed­up in Almazov National Medical Research Centre from 2009 to 2016.Results. Five­year survival of PAH patients included in the register of Almazov National Medical Research Centre reached 77% for idiopathic PAH, 52% for PAH associated with systemic scleroderma, 81% for PAH associated with non­repaired congenital heart disease, 82% for patients with repaired congenital shunts and 100% for PAH associated with human immunodeficiency virus infection. The group that received PAH specific monotherapy consisted of 47% (n=71) of patients among which phosphodiesterase type 5 inhibitor (PDE­5i) sildenafil was undoubtedly the most prescribed drug — 74% (n=53). The group that received combined PAH specific therapy consisted of 66 (44%) patients: 48 patients received various two­component therapy, 18 patients — threecomponent therapy with endothelin receptor antagonist in combination with PDE­5i and prostanoids. 11 patients with PAH were included in SERAPHIN study of which 9 patients had been already receiving generic PDE­5i therapy. In macitentan group, a statistically significant increase in the 6­minute walk distance (+50 meters) and a decrease in hemodynamic parameters such as mean right atrial pressure (­2,3 mm Hg) and pulmonary vascular resistance (­445 dyn­sec/cm5) were observed after 6 months. No patient had a clinically significant increase in liver transaminases or a decrease in hemoglobin levels.Conclusion. Improvement of prognosis in PAH patients according to the register of the Centre is connected both with early detection of the disease, thanks to the development of specialized healthcare, and more frequent use of combination therapy. Macitentan proved its long­term efficacy and safety as monotherapy and in combination with PDE­5i.
FROM INTUITION TO PROFESSIONALIZATION: A QUALITATIVE STUDY ABOUT THE DEVELOPMENT OF TEACHER IDENTITY IN INTERNAL MEDICINE SENIOR RESIDENTS
Authors: Audétat Marie-Claude , Grégoire Geneviève , Fernandez Nicolas , Laurin Suzanne 
Published: May 2018

Objectives: Professional identity can be defined as a developmental process. Literature suggests that residents aiming to practice in a teaching institution should receive support for the development of teaching competencies as much as they do for medical competencies, but there is limited data on how to recognize teacher identity development in residents. Our study focused on the manifestations of teacher identity development in a group of senior residents in a four-week optional pedagogy rotation. In particular, we were interested in seeing teacher identity development towards the end of the residency program, at a time when clinician identity begins to consolidate. Methods: A qualitative and exploratory approach guided our study design. Participants were internal medicine residents, (from Yr4 to Yr6) at University of Montréal, who intended working in a university setting and were interested in developing a teaching project. Focus groups were held at three separate moments: 1) before rotation, 2) after rotation and, 3) six months after rotation. Direct content analysis was chosen to analyze our findings. Results: We observed the emergence and the evolution of teacher identity and furthermore, we identified six development pathways, which underpin the development of teacher professional identity: 1) From awkward and stereotyped usage to mastery of concepts and teaching techniques, 2) From the reproduction of implicit norms of the clinical setting to the establishment of pedagogical norms 3) From the feeling of powerlessness in teaching to a feeling of mastery and taking initiatives 4) From teaching intuitively to reasoning pedagogically 5) From a teacher based paradigm to the discovery of the learner-centered paradigm and 6) From an emerging identity as a clinician to the simultaneous construction of twin identities: clinician and teacher. Six development indicators providing operational cues to help recognize different facets of teacher identity development were then identified. Conclusion: The identity development pathways allowed us to gain deeper insights about how teacher identity develops in internal medicine residents toward the end of a pedagogical rotation. It is our hope that these findings will help educators recognize and support the development of teacher identity in their residents.
The Photochemical Degradation (PCD) of Nitrobenzene (NB) using UV Light and Fenton Reagent Under Various Conditions
Authors: AHMED Md. Boshir , KUMER Ajoy , ISLAM Muhammad , ISLAM Tajmeri Selima Akhter 
Published: May 2018

Photochemical degradation contributes
to the environmental fate of many pesticides, chemicals, and industrial waste in
surface waters. Photochemical degradation (PCD) of Nitrobenzene (NB) has
been studied using a UV light source and Fenton reagent under different
experimental conditions. The effect of concentration on PCD of NB was monitored
and recorded in the range 0.5 x10-4M to 3.0x10-4M. The
concentration of H2O2 was performed from 5.0 x10-4M
to 2.5 x10-4M and Fe(II) from
1.0 x10-4M to 5.0 x10-4M respectively.In terms of concentration, the
absorbance increases with increasing the concentration of the solution of NB, H2O2
and Fe(II). The initial rate of PCD was
recorded at fixed pH 2.42 of solution. Two optimums for pH were found for PCD
of Nitrobenzene ranging from pH 2.42 to 4.20. The intermediates formed during
PCD of NB were identified, by which a mechanism was then suggested that PCD is
actually found to follow pseudo first order kinetics.
Differences between types of tract dilatation techniques during percutaneous nephrolithotomy (PCNL).
Authors: YUVANÇ Ercan , YİLMAZ Erdal 
Published: May 2018

Aim:
Dilation of the distance
from the skin to the kidney stone is one of the
important steps of percutaneous nephrolithotomy (PCNL).However, due to cost and exposure to
radiation, there is a debate about the proper dilatation method.
For this purpose, a controlled clinical trial was planned to evaluate the
effectiveness of the use of 12 F Amplatz dilator + balloon dilator in terms of
shorter duration of tract dilation and scopy time during PCNL. Material and Methods:
60 patients with kidney stones and performed PCNL were included in the study
and divided into 3 groups. While balloon dilation was maintained after using
12F Amplatz dilator -only- in Group 1, balloon dilation was performed after
using 8/10 dilator/sheat set, dual-lumen ureteral catheter and ZebraTM
angled type guidewire as described in the teachings in Group 2. Dilation in
patients in Group 3 was performed with just Amplatz dilators ranging from 10F
to 30F without using balloon dilation. The access time, dilation time,
operation time, scopy time, cost, nephrostomy tube removal time, hospital stay
period parameters were recorded. Results:
Dilation, operation and scopy times were significantly lower in Group 1
compared to the two other groups (p&lt;0.05). The costs were higher in Group 2.

Conclusion:
Due to the shorter dilation, scopy and operation time and cost benefits, using
12F Amplatz dilator before and then balloon dilator seems advantageous.
La « vive représentation » dans le martyrologe de Crespin et Goulart
Authors: Pietrzak Witold Konstanty 
Published: May 2018

Les protestants ont condamné le recours aux images dans le culte. Est-ce à dire que l’image littéraire relève de la même méfiance ? L’auteur de l’article se propose de chercher la réponse à cette question en se penchant sur le martyrologe des protestants (1554-1619), conçu par Jean Crespin et poursuivi par Simon Goulart. Crespin voulait que son recueil de martyrs fût composé de pièces authentiques dans lesquelles les victimes pourraient prendre la parole pour déclarer leur foi. Mais, au fil des années, il se fait de plus en plus sensible aux attraits de la « vive représentation », tournure qui, au XVIe siècle, peut désigner tantôt l’ekphrasis, tantôt l’hypotypose. L’analyse de quelques exemples montre que Crespin se plaît déjà à amplifier la scène du supplice au point d’en faire une image persuasive, de nature ekphrastique, et capable d’agir sur les émotions du lecteur. Et, quand finit l’ère des bûchers et que commence celle des guerres civiles, Goulart dépeint les massacres des protestants au moyen de l’hypotypose qui suppose une narration dynamique, relativement asyndétique et privée d’interventions auctorielles.
Le génie de Néron : l’hypotypose comme subversion de la rhétorique dans Britannicus de Racine
Authors: Lecompte Jérôme 
Published: May 2018

Depuis le XVIIIe siècle, la critique a souvent célébré la peinture et l’harmonie dans les vers de Racine. Les sédiments de la littérature, avec le déclin de la rhétorique, ont vite recouvert ce qui dépendait de l’art de parler. La subversion de la rhétorique, dans l’hypotypose de Britannicus, a pu contribuer à ce phénomène. En mauvais orateur, Néron porte sur Junie un regard sans attention. Le iudicium se laisse déborder par l’ingenium : négligeant les signes d’un èthos naturel et modeste, Néron adopte la sophistique et ses charmes.
Experimental Evaluation of Colloidal Nanosilica for Improving Bitumen Recovery From Mined Oil-Sand Ore
Authors: Kuznetsov Oleksandr , Agrawal Devesh , Suresh Radhika , Feng Xianhua , Behles Jackie , Khabashesku Valery 
Published: May 2018

Summary
Oil-sand ore flotation is a primary method of bitumen recovery from mined Athabasca tar sands. In bitumen flotation, suspended biwettable ore fines, such as clays, tend to migrate to oil/water interfaces, creating a slime coating on liberated bitumen droplets. Slime coating significantly reduces the efficiency of the flotation process and overall oil recovery. Ultradispersed hydrophilic silica nanoparticles were found to stabilize biwettable ore fines in an aqueous phase by adsorbing onto fines surfaces, even at concentrations as low as 50 ppm. As a result, fine solids move away from oil/water interfaces, reducing the slime coating and increasing bitumen recovery during flotation of low-grade ore by more than 5%. The addition of nanoparticles has no negative effect on froth quality or oil, water, and solid separation in naphthenic and paraffinic froth-treatment processes. The study demonstrated that colloidal nanoparticles affect many stages of the bitumen-extraction process—from bitumen separation to clay-wettability alteration.
Numerical Simulation and Modeling of Critical Sand-Deposition Velocity for Solid/Liquid Flow
Authors: Dabirian Ramin , Arabnejad Khanouki Hadi , Mohan Ram S. , Shoham Ovadia 
Published: May 2018

SummaryEfficient transport of sand or cuttings is very important in the oil and gas industry, and the fluid velocity in these processes should be sufficiently high to keep particles continuously moving along the pipe. This minimum fluid velocity below which particles deposit—defined as the critical velocity—depends on various factors, including flow regime, particle size, particle concentration, phase velocities, and fluid viscosity. The objective of this study is to investigate the effect of parameters such as particle size and liquid viscosity on solid/particle transport in horizontal pipelines by use of computational-fluid-dynamics (CFD) simulations and to validate the numerical-model predictions with experimental data. Also, a mechanistic model that is based on force balance is proposed to predict the critical velocity under various experimental conditions.CFD simulations have been conducted with a commercially available software (ANSYS-FLUENT). An Eulerian model with a k-ω shear-stress transport (SST) turbulence-closure model is used to simulate the fluid flow while particles are tracked as the Lagrangian phase. In these simulations, an eddy-interaction model is included to consider the effect of flow turbulence on particle tracking. The simulations are created for a 0.05-m pipe diameter with a 4-m length. The simulations are initialized at relatively high fluid velocity, which is gradually reduced until the particle velocity drops below the acceptable critical velocity.The CFD simulation and proposed mechanistic model results are validated with experimental data from literature (Najmi 2015; Najmi et al. 2016) for two particle sizes and multiple liquid viscosities. The simulation and model results show that, depending on the flow regimes (laminar or turbulent) and particle size, the critical velocity demonstrates a similar trend with carrier liquid viscosity as that of the experimental data. However, both the CFD and developed models show poor performance for higher particle size (600 µm). Also, the CFD simulations, experimental data, and proposed-model results are compared with three models currently used in the industry, namely, the Oroskar and Turian (1980) model, the Salama (2000) model, and the Danielson (2007) model.
Point-of-use water chlorination among urban and rural households with under-five-year children: a comparative study in Kersa Health and Demographic Surveillance Site, Eastern Ethiopia
Authors: Geremew Abraham , Mengistie Bezatu , Alemayehu Esayas , Lantagne Daniele Susan , Mellor Jonathan , Sahilu Geremew 
Published: May 2018

AbstractPoint-of-use water chlorination is one of the most effective means to prevent diarrhea in under-five children although challenges remain in its adoption and effective use. In Ethiopia, evidence of point-of-use water chlorination among households with under-five children in rural and urban settings that is verified with water testing is scarce. A comparative cross-sectional study was conducted among urban and rural households with under-five child in Kersa Health and Demographic Surveillance Site, Eastern Ethiopia from June to August, 2016. Data were collected from a caregiver of systematically selected households and analyzed using multivariable logistic regression. A total of 1,912 households were included in the analysis with a 96.5% response rate. In rural areas, 4.6% of caregivers were reportedly chlorinating water at point-of-use and 1.2% were confirmed with free residual chlorine. In urban areas, 17.1% of caregivers were reportedly chlorinating water and 6.6% were confirmed to have free residual chlorine. In two settings, caregivers' point-of-use water chlorination was associated with chlorine taste and water quality perception. Inaccessibility to treatment products in rural areas and use of bottled water in urban areas were among the reasons to discontinue point-of-use water chlorination. Behavior changing interventions with proper distribution and marketing is needed for sustainable point-of-use chlorination.