bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-medication practice among preclinical university students in a medical school from the city of Pokhara, Nepal
Authors: Banerjee Indrajit , Sathian Brijesh , Gupta Rajesh Kumar , Amarendra Annavarapu , Roy Bedanta , Bakthavatchalam Pugazhandhi , Saha Archana , Banerjee Indraneel 
Published: July 2016

Introduction: In developing countries like Nepal medicines can be acquired from the chemist's without of a prescription which sometime may have many drawbacks due to intake of excessive drugs without a proper diagnosis. The primary objective of the study was to find out the pattern of self-medication practice among the preclinical medical students at Manipal College of Medical Sciences.Materials and Methods: This was a cross sectional study carried out using structured questionnaire at Manipal College of Medical Sciences, Pokhara, Nepal between November 2012- July 2014.Results: The overall response rate of this study was 95.31%. 81.35% of the students were practicing self-medication in this institution. Most common group of drugs that were consumed were antipyretics 31%, antibiotics 26.2%, analgesics 18.89%, antihistaminics 10.1% respectively. Paracetamol was the most common drug used for self-medication 31%, followed by Azithromycin 17.6% and combination of Paracetamol and Ibuprofen 15.6%, Cetirizine 8.6%, Amoxicillin 6.5%, Omeprazole 6.3%, Albendazole 3.3%, Mefenemic acid 2.8%, Cefpodoxime2% respectively. Conclusion: Medical student should be educated through awareness programme regarding pros and cons of self-medication practice and they should be motivated regarding the rationale use of antibiotics.
Therapeutic effect of erythropoietin in patients with traumatic brain injury: a meta-analysis of randomized controlled trials
Authors: Liu Wen-Chao , Wen Liang , Xie Tao , Wang Hao , Gong Jiang-Biao , Yang Xiao-Feng 
Published: July 2016

OBJECTIVEErythropoietin (EPO) exerts a neuroprotective effect in animal models of traumatic brain injury (TBI). However, its effectiveness in human patients with TBI is unclear. In this study, the authors conducted the first meta-analysis to assess the effectiveness and safety of EPO in patients with TBI.METHODSIn December 2015, a systematic search was performed of PubMed, Web of Science, MEDLINE, Embase, the Cochrane Library databases, and Google Scholar. Only English-language publications of randomized controlled trials (RCTs) using EPO in patients with TBI were selected for analysis. The assessed outcomes included mortality, favorable neurological outcome, hospital stay, and associated adverse effects. Continuous variables were presented as mean difference (MD) with a 95% confidence interval (CI). Dichotomous variables were presented as risk ratio (RR) or risk difference (RD) with a 95% CI. Statistical heterogeneity was examined using both I2 and chi-square tests.RESULTSOf the 346 studies identified in the search, 5 RCTs involving 915 patients met the inclusion criteria. The overall results demonstrated that EPO significantly reduced mortality (RR 0.69, 95% CI 0.49–0.96, p = 0.03) and shortened the hospitalization time (MD −7.59, 95% CI −9.71 to −5.46, p < 0.0001) for patients with TBI. Pooled results of favorable outcome (RR 1.00, 95% CI 0.88–1.15, p = 0.97) and deep vein thrombosis (DVT; RD 0.00, 95% CI −0.05 to 0.05, p = 1.00) did not show a significant difference.CONCLUSIONSThe authors suggested that EPO is beneficial for patients with TBI in terms of reducing mortality and shortening hospitalization time without increasing the risk of DVT. However, its effect on improving favorable neurological outcomes did not reach statistical significance. Therefore, more well-designed RCTs are necessary to ascertain the optimum dosage and time window of EPO treatment for patients with TBI.
Carotid artery stenosis with a high-intensity signal plaque on time-of-flight magnetic resonance angiography and association with evidence of intraplaque hypoxia
Authors: Ogata Atsushi , Kawashima Masatou , Wakamiya Tomihiro , Nishihara Masashi , Masuoka Jun , Nakahara Yukiko , Ebashi Ryo , Inoue Kohei , Takase Yukinori , Irie Hiroyuki , Abe Tatsuya 
Published: July 2016

OBJECTIVEHypoxia induces angiogenesis and plays a major role in the progression of carotid plaques. During carotid intervention, plaques with high-intensity signals on time-of-flight (TOF) magnetic resonance angiography (MRA) often cause ischemic stroke and embolic complications. However, the role of intraplaque hypoxia before carotid endarterectomy (CEA) and carotid artery stenting is not presently understood. In this study the authors aimed to investigate the relationship between intraplaque hypoxia and MRA findings.METHODSNineteen consecutive patients with 20 carotid artery stenoses who underwent CEA at Saga University Hospital between August 2008 and December 2014 were enrolled in the study. The expressions of hypoxia-inducible transcription factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) were analyzed by immunohistochemical analysis. In addition, the relationship between the findings on TOF MRA and pathology for the carotid plaques was analyzed.RESULTSHigh-intensity plaques on TOF MRA showed higher expression levels of HIF-1α (p = 0.015) and VEGF (p = 0.007) compared with isointensity plaques. The rate of intraplaque hemorrhage (IPH) on TOF MRA was also significantly higher in the high-intensity plaques than in the isointensity plaques (p = 0.024). Finally, the mean number of neovessels was significantly higher in those without plaque hemorrhage than in those with plaque hemorrhage (p = 0.010).CONCLUSIONSPlaques with high-intensity signals on TOF MRA were associated with IPH and evidence of intraplaque hypoxia. This fact may represent an opportunity to establish novel therapeutic agents targeting intraplaque hypoxia.
STABILITY AND OCCURRENCE RATE CONSTRAINTS ON THE PLANETARY SCULPTING HYPOTHESIS FOR “TRANSITIONAL” DISKS
Authors: Dong (董若冰) Ruobing , Dawson (噹噹) Rebekah 
Published: July 2016

ABSTRACT
Transitional disks, protoplanetary disks with deep and wide central gaps, may be the result of planetary sculpting. By comparing numerical planet-opening-gap models with observed gaps, we find systems of 3–6 giant planets are needed in order to open gaps with the observed depths and widths. We explore the dynamical stability of such multi-planet systems using N-body simulations that incorporate prescriptions for gas effects. We find they can be stable over a typical disk lifetime, with the help of eccentricity damping from the residual gap gas that facilitates planets locking into mean motion resonances. However, in order to account for the occurrence rate of transitional disks, the planet sculpting scenario demands gap-opening-friendly disk conditions, in particular, a disk viscosity α ≲ 0.001. In addition, the demography of giant planets at ∼3–30 au separations, poorly constrained by current data, has to largely follow occurrence rates extrapolated outward from radial velocity surveys, not the lower occurrence rates extrapolated inward from direct imaging surveys. Even with the most optimistic occurrence rates, transitional disks cannot be a common phase that most gas disks experience at the end of their life, as popularly assumed, simply because there are not enough planets to open these gaps. Finally, as consequences of demanding almost all giant planets at large separations participate in transitional disk sculpting, the majority of such planets must form early and end up in a chain of mean motion resonances at the end of disk lifetime.
COSMIC REIONIZATION ON COMPUTERS: THE FAINT END OF THE GALAXY LUMINOSITY FUNCTION
Authors: Gnedin Nickolay Y. 
Published: July 2016

ABSTRACT
Using numerical cosmological simulations completed under the “Cosmic Reionization On Computers” project, I explore theoretical predictions for the faint end of the galaxy UV luminosity functions at

. A commonly used Schechter function approximation with the magnitude cut at

provides a reasonable fit to the actual luminosity function of simulated galaxies. When the Schechter functional form is forced on the luminosity functions from the simulations, the magnitude cut

is found to vary between −12 and −14 with a mild redshift dependence. An analytical model of reionization from Madau et al., as used by Robertson et al., provides a good description of the simulated results, which can be improved even further by adding two physically motivated modifications to the original Madau et al. equation.
Device-associated infections in the pediatric intensive care unit at the American University of Beirut Medical Center
Authors: Ismail Ali , El-Hage-Sleiman Abdul-Karim , Majdalani Marianne , Hanna-Wakim Rima , Kanj Souha , Sharara-Chami Rana 
Published: July 2016

Introduction: Device-associated healthcare-associated infections (DA-HAIs) are the principal threat to patient safety in intensive care units (ICUs). The primary objective of this study was to identify the most common DA-HAIs in the pediatric intensive care unit (PICU) at the American University of Beirut Medical Center (AUBMC). Length of stay (LOS) and mortality, antimicrobial resistance patterns, and suitability of empiric antibiotic choices for DA-HAIs according to the local resistance patterns were also studied. Methodology: This was a retrospective study that included all patients admitted to the PICU at AUBMC between January 2007 and December 2011. All patients admitted to the PICU having a placed central line, an endotracheal tube, and/or a Foley catheter were included. Data was extracted from the patients’ medical records through chart review. A total of 22 patients were identified with 25 central line-associated bloodstream infections (CLABSI), 25 ventilator-associated pneumonia (VAP), and 9 catheter-associated urinary tract infections (CAUTIs). The causing organisms, their resistance patterns, and the appropriateness of empiric antimicrobial therapy were reported. Results: Gram-negative pathogens were found in 53% of the DA-HAIs, Gram-positive ones in 27%, and fungal organisms in 20%. A total of 80% of K. pneumonia isolates were extended-spectrum beta-lactamases (ESBL) producers, and 30% of Pseudomonas isolates were multidrug resistant. No methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE) were isolated. Based on culture results, the choice of empiric antimicrobial therapy was appropriate in 64% of the DA-HAIs. Conclusions: After the care bundle approach is adopted in our PICU, DA-HAIs are expected to decrease further.
A Secure, Social Media–Based “Case of the Month” Module in a Neurocritical Care Unit
Authors: Witherspoon Briana , Braunlin Kathryn , Kumar Avinash B. 
Published: July 2016

Background
Systems to meet the on-demand learning needs of nurses in intensive care units are not well studied beyond the traditional classroom models.

Objective
To study the feasibility and effect of implementing an online discussion forum for nurses in a busy neuroscience intensive care unit.

Methods
A baseline survey was done to highlight the areas of educational need in the unit. Freeform—a password-protected, online discussion forum supported by the university—was used for the pilot project. Freeform has functions similar to Facebook, with “likes,” “follow,” discussion/comment spaces, and the capacity for uploading images and files. A page called “All things NeuroCritical Care” was created. All nurses working in the intensive care unit were automatically enrolled. Clinical vignettes relevant to neurocritical care were posted once a month with 1 to 2 lead questions. All participation was voluntary, and topics were chosen on the basis of the needs survey. At the end of each case, a recent review article on the topic was posted for secure download.

Results
Eight sentinel diagnoses have been presented as clinical vignettes, and 34 of 76 members formally follow the page. The mean number of discussion strings per case is 8.3 posts. The number of unique visitors to the page during active case discussions exceeds 100.

Conclusion
A secure, online, problem-based learning discussion format is a feasible point-of-care learning opportunity that can help overcome some of the traditional barriers to ongoing nursing education needs in a busy intensive care unit.
Crescimento e balanço nutricional de mudas de Enterolobium contortsiliquum com aplicação de substratos orgânicos e água residuária
Authors: Araújo Emanuel França , Arauco Adriana Miranda de Santana , Lacerda Julian Junio de Jesús , Ratke Rafael Felippe , Medeiros João Carlos 
Published: July 2016

Diante da geração acentuada de resíduos orgânicos sólidos e efluentes, a utilização desses materiais como fonte primária de nutrientes consiste em uma importante prática de gestão ambiental, sobretudo na produção de mudas com ênfase à recuperação de áreas degradadas. Objetivou-se com este trabalho avaliar o crescimento e o balanço nutricional de mudas de tamboril (Enterolobium contortsiliquum (Vell.) Morong) cultivadas em substratos com diferentes formulações e proporções de resíduos orgânicos irrigados com água residuária. Foram testados cinco proporções de composto orgânico e solo: 0:100; 20:80; 40:60; 60:40 e 80:20 v/v, e duas qualidades de água de irrigação: água de abastecimento e água residuária de suinocultura, dispostos em delineamento inteiramente casualizado em esquema fatorial, 5 x 2, com quatro repetições. Aos 90 dias, foram avaliadas as variáveis morfológicas, índices do sistema integrado de diagnose e recomendação e do balanço nutricional médio das mudas. Constatou-se que o resíduo orgânico contribui para o crescimento e o equilíbrio nutricional das mudas. A proporção 80:20 mostrou-se a mais indicada à produção de mudas de tamboril. O crescimento e balanço nutricional das mudas foram inferiores nos tratamentos que receberam irrigação com água residuária de suinocultura.Growth and nutrient balance of Enterolobium contortsiliquum seedlings with addition of organic substrates and wastewaterGiven the strong generation of solid organic waste and wastewater, the use of these materials as a primary source of nutrients is an important practice in environmental management, especially in the production of seedlings with emphasis on degraded areas. The objective of this study was to evaluate growth and nutrient balance of “tamboril” (Enterolobium contortsiliquum (Vell.) Morong) seedlings grown on substrates with different formulations proportions of organic matter irrigated with wastewater. It was tested five ratios of organic composts and soil: 0:100; 20:80; 40:60; 60:40 and 80:20 v/v. Two procedences of irrigation water was tested: water supply and wastewater from swine farming, arranged in a completely randomized design in a factorial scheme 5 x 2, with four replications. At 90 days, we evaluate seedlings morphological variables, the integrate diagnosis recommendation index and the nutrient balance index. The organic residue contributes to seedlings growth and nutritional balance. The proportion 80:20 proved to be the most suitable for “tamboril” seedlings production. Seedlings presented lower growth and nutritional balance when irrigate with swine farm wastewater.Index terms: “Bagana de carnaúba”; Bed aviary; Swine wastewater
Divergência genética entre progênies de polinização aberta de Pinus caribaea var. hondurensis a partir de caracteres quantitativos
Authors: Santos Wanderley Dos , Araújo Elton Gean , Souza Danilla Cristina Lemos , Silva Janaína Rodrigues da , Recco Camila Regina Silva Baleroni , Moraes Mário Luiz Teixeira de , Aguiar Ananda Virginia de 
Published: July 2016

Este trabalho foi realizado com o objetivo de estimar a divergência genética entre progênies de Pinus caribaea var. hondurensis, por meio de caracteres quantitativos. O experimento foi instalado em delineamento látice 10 x 10, triplo, com 100 tratamentos (96 progênies oriundas de polinização aberta de um pomar clonal da espécie e quatro testemunhas). Foram avaliados os caracteres: diâmetro a 1,30 m do solo, altura total de planta, volume cilíndrico, produção de resina total e resina por área de painel. Utilizou-se a distância generalizada de Mahalanobis (D2) e o método de otimização de Tocher. A maior distância genética observada entre as progênies foi de 100% (D2 = 65,51) e a menor foi de 0,09% (D2 = 0,15). O caractere volume foi o que mais contribuiu para a divergência genética entre os grupos avaliados. O agrupamento a partir do método de otimização de Tocher possibilitou a separação das progênies em quatro grupos, com concentração de 96,9% das progênies em um único grupo. Para que estas progênies possam ser incluídas em programas de melhoramento genético para produção de resina e madeira, cruzamentos controlados deverão ser priorizados entre indivíduos mais produtivos, que apresentaram maior divergência genética.Genetic divergence genetic between Pinus caribaea var. hondurensis progenies based on quantitative traitsThe proposal of this study was to estimate the genetic divergence among Pinus caribaea var. hondurensis progenies through quantitative traits. Trail was established in lattice design 10 x 10, triple, with 100 treatments (96 progenies from clonal seed orchard of P. caribaea var. hondurensis and four controls). The genetic divergence was estimated using the generalized Mahalanobis distance (D2) and Torcher’s optimization method. Diameter at 1.30 above the ground, total plant height, cylindrical volume, total resin production and resin per panel area were evaluated. The largest genetic distance observed between the progenies was 100% (D2 = 65.51) and the lowest was 0,09% (D2 = 0.15). Clustering by Torcher’s optimization method separated the progeny in four groups, with a concentration of 96.9% of the progenies in a single group. Volume was the largest contributor to the genetic divergence among groups. To include these progeny in breeding programs for resin and wood production controlled crossings should be prioritized among the most productive individuals that presented greater genetic divergence.Index terms: Genetic breeding; Generalized Mahalanobis distance; Tocher optimization
Development and Psychometric Tests of Midwife-Mother Relationship Scale (MMRS) in Delivery Room
Authors: Attarha Mahtab , Keshavarz Zohreh , Bakhtiari Marayam , Jamilian Mehri , Zayeri Farid 
Published: July 2016

<p>Midwives have different aspects of responsibility in terms of the normal and high-risk pregnancy in delivery room. Thus, this study aimed to develop a scale for evaluating the midwife- mother relationship in delivery room. This study was conducted from August 2014 and October 2015 in Arak, Iran. The present mixed-methods sequential exploratory (quantitative-qualitative) study used the content analysis method to design an initial Scale through a review of the literature. The validity of the Scale was ensured by assessing the face validity, content validity and construct validity (exploratory factor analysis with 480 mothers who hospitalized at post-partum ward in hospitals of Arak province), and its reliability was ensured by assessing its internal consistency (using Cronbach’s alpha) and by assessing its stability through the test-retest method. The qualitative stage of the study resulted in a 71-item Scale with four domains. Those with impact item index over 1.5, CVR over 0.42, and CVI over 0.79 were considered as valid; while the rest were eliminated resulting in a 48-item scale. After Performing the content and face analysis, a factor analysis was performed on 48 items of the scale, yielding a 43-item questionnaire with four domains, including “outcome”, “expectations” “effective factors on care” and “therapeutic alliance” which explained 60.4% of the variance. The reliability of the scale was confirmed with a Cronbach’s alpha of 0.93 and its stability was confirmed by an Interclass Correlation Coefficient (ICC) of 0.90. MMRS was a valid and reliable instrument for measuring midwife- mother relationship in delivery room. It is easy to use scale and contains the most significant features of midwife-mother relationship. </p>
Religião e linguagem: proposta de articulação de um campo complexo
Authors: Nogueira Paulo Augusto de Souza 
Published: July 2016

<p>As relações entre religião e linguagem estão recebendo um novo tratamento nos programas de pós-graduação no Brasil por meio de grupos de trabalho de congressos, grupos de pesquisa e áreas de concentração dedicadas ao estudo do que se convencionou chamar de Linguagens da Religião. Esse artigo propõe uma articulação para essa nova área de estudos por meio de uma abordagem semiótica e cognitiva da temática, propondo o estudo da religião como sistema secundário de linguagem, por meio de três sistemas semióticos fundamentais: o gesto, a imagem (metáfora) e a narrativa. Esses encontram correlação na tríade: rito – ícone (poesia) – mito. Esses três sistemas se relacionam entre si criando textos híbridos e multicodificados na cultura, com alto poder de geração de novas mensagens. São tratados também os aspectos ficcionais e grotescos das expressões religiosas como alguns dos seus aspectos distintivos. Segundo os mesmos, apesar da religião estruturar o mundo como a linguagem, ela tende a fortalecer e explicitar os jogos de “como se” da cultura, além de levar as representações para os limites dos sistemas estabelecidos. Religião propõe, portanto, à cultura sistemas densos e caleidoscópicos de representação, por meio dos quais aspectos ambíguos e paradoxais da existência e da sociedade são articulados textualmente. </p>
Phyllodes Tumor of the Breast: Histopathologic Features, Differential Diagnosis, and Molecular/Genetic Updates
Authors: Zhang Yanhong , Kleer Celina G 
Published: July 2016

Context.—Phyllodes tumor (PT) of the breast is a rare fibroepithelial neoplasm with risks of local recurrence and uncommon metastases. The classification proposed by the World Health Organization for PTs into benign, borderline, and malignant is based on a combination of several histologic features. The differential diagnosis between PT and fibroadenoma and the histologic grading of PT remain challenging. In addition, the molecular pathogenesis of PT is largely unknown.
Objective.—To provide an updated overview of pathologic features, diagnostic terminology, and molecular alterations of PT.
Data Sources.—Current English literature related to PT of the breast.
Conclusions.—Phyllodes tumor shows a wide spectrum of morphology. There are no clearly distinct boundaries between PT and fibroadenoma. Strict histologic assessment of a combination of histologic features with classification can help to achieve the correct diagnosis and provide useful clinical information. The genomic landscapes of PT generated from genomic sequencing provide insights into the molecular pathogenesis of PT and help to improve diagnostic accuracy and identify potential drug targets in malignant PT.