bluuebunny/crossref_metadata_2025_split huggingface dataset:
Higher education in Libya: Challenges and future plans (in Arabic language)
Authors: El-Fakhri Mustafa M. , Bukhatwa Salma A. 
Published: October 2016

AbstractEducational institutions are the principle pillars for establishment of sustainable human development which leads to community progress. Therefore, it is essentially important to develop their infrastructure, programs, and financial resources and assure the quality of their outcome to effectively respond and fulfill community needs.With current unprecedented scientific advancement in all aspects of life, it is becoming a formidable task to stay internationally competent. Continuous development and improving educational programs are therefore a must. The future requirements of education are choosing quality over quantity and adopting modern, reliable teaching methods in order to acquire knowledge, develop skills and attitudes that comply with good professional practice to meet the challenge of globalization.Education in Libya is free for everyone from elementary school up to university level but the general decline in the quality of Libyan higher educational system within the last four decades is well recognized. The efficiency of its product has been proven to be inconsistent with the national economical and developmental needs.Internal challenges of the higher educational system in Libya that affecting its own performance are presented in this paper, even though this does not under estimate the effect of other external threats, but they just remain beyond the scope of this paper.These challenges include; lack of a national strategic plan, poor primary and secondary school output, excessive students' admission, structural problems, poor infrastructure, administrative and legal problems, poor academic staff performance, outdated curricula and teaching methods, poor financial resources, poor research and postgraduate programs.Inevitably, the first step in treatment of such situation is to adopt a national strategy for higher education to know where we stand and to decide where to go and how to reach there. This of course in addition to linking educational programs to local, national and international market needs and promoting investment in education.
Laparoscopic Transabdominal Preperitoneal Hernia Repair. Early experience of 37 patients
Authors: Abuzalout Tawfik A. , Taktuk Salah S. 
Published: October 2016

Abstract
Introduction: Inguinal hernia repair is one of the most frequently performed procedures in surgery and many different techniques have been suggested. This report reviews our experience with 39 transabdominal preperitoneal (TAPP) hernia repairs in 37 patients.
Methods: Thirty-seven patients have been admitted for inguinal hernia repair in Benghazi Medical Center and in Aljala hospital, Benghazi-Libya. Laparoscopic TAPP repair was considered for all reducible inguinal hernias aged (18–70 years). Data was prospectively collected from January 2009 to December 2013,including age, sex, BMI, hernia characteristics, complications, mean operative time and mean hospital stay. Patients with irreducible, obstructed or scrotal hernias, previous lower abdominal surgery, BMI more than thirty fiveand an American Society of Anesthesiologists (ASA) grade higher than II were excluded.
Results: There were 34 males and 3 females, with a mean age of 33.4 ± 13.0 years and BMI of 24.6 ± 1.9. Mean operative time was 75 ± 18.6 minutes .The mean hospital stay was one day ± 0.27. There was no conversion, mesh infection, bladder or vascular injury, death or recurrence after a median follow up for six months. Four minor complications occurred with two seroma formation, one wound bruising and one chronic groin pain due to tackers treated conservatively. Median return to normal activities was 10 days. One fourth of patients required no postoperative analgesia.
Conclusion: Laparoscopic inguinal hernia repair was found in our study to be feasible, safe, with less postoperative pain, shorter hospital stay, and early return to normal activities.
A descriptive retrospective study on children with newly diagnosed nephrotic syndrome presented to Tripoli Children Hospital during the period between Jan. to Dec. 2014
Authors: Rhuma N R , El Boeshi A S , Sabei L T , Kara A M 
Published: October 2016

Abstract
Introduction: Nephrotic syndrome (NS) is a clinical picture characterized by severe proteinuria, hypoalbuminemia, edema and hypercholesterolemia. A retrospective study was carried out in order to describe disease pattern in newly diagnosed NS of children admitted to Tripoli children hospital during the year 2014.
Methods: The medical data of 56 patients aged between 1 year and 11 years diagnosed with idiopathic nephrotic syndrome were analysed using SPSS software. The data included gender differences, sensitivity to steroid therapy, relapses withen six months of follow up and the effect of variable factors such as family history, hypertension, hematuria, serum urea on the degree of relapse.
Results: Out of 56 patients with newly diagnosed NS, 60.7% were boys and 39.3% were girls, with a mean age 4.2±2.2 years. Age was related significantly to the response to steroid therapy, where 79.5% of patients aged between 2-8 years (group 1) had steroid sensitive NS (SSNS) compared with only 41.7% of patients aged less than 2 years or more than 8 years (group 2) (P<0.001). Although girls relapsed more than boys (70.5% versus 57.1%) during six months of therapy, this difference was not statistically significant. Similarly, no other factors measured such as family history of NS, hypertension, hematuria, serum complement and urea had any effect on the percentage of relapse in patients with newly diagnosed NS.
Conclusion: NS is one of the commonest reasons for admission to nephrology ward. It is more common in boys than girls. The age at presentation related significantly to the response to steroidal therapy. Regarding relapses, girls seems to relapse more frequent than boys and relapses was seen more in age group 1 than group 2, however, these differences were not significant. Other factors studied seems to have no effect on the relapse rate of children with newly diagnosed NS.
Quantification of Bone Marrow Edema by Magnetic Resonance Imaging Only Marginally Reflects Clinical Neck Pain Evaluation in Rheumatoid Arthritis and Ankylosing Spondylitis
Authors: Baraliakos Xenofon , Heldmann Frank , Callhoff Johanna , Suppiah Ravi , McQueen Fiona Marion , Krause Dietmar , Klink Claudia , Schmitz-Bortz Elmar , Igelmann Manfred , Kalthoff Ludwig , Kiltz Uta , Schmuedderich Anna , Braun Juergen 
Published: October 2016

Objective.Neck pain is common in rheumatoid arthritis (RA) and ankylosing spondylitis (AS). We investigated the correlation of bone marrow edema (BME) on magnetic resonance imaging (MRI) in RA and AS and its association with clinical complaints of neck pain.Methods.Cervical spine short-tau inversion recovery-MRI and T1w-MRI of 34 patients with RA and 6 patients with AS complaining about neck pain were obtained. Clinical and laboratory data were available. BME was scored by 2 blinded readers using a modification of a published score, including various cervical sites. Degenerative changes were also quantified.Results.Patients were predominantly women (82.5%), and mean ± SD age was 57.5 ± 11.8 years, C-reactive protein (CRP) was 0.8 ± 1.3 mg/dl, and pain score was 46.0 ± 17.5. BME was detected in 24/40 patients (60%) involving the atlantoaxial region (21%), vertebral bodies (75%), facet joints (29%), and spinous processes (46%). Degenerative changes were identified in 21/40 patients (52.5%), 13 (62%) of whom also had BME in vertebral bodies. No differences were found between patients with versus without cervical BME for clinical assessments: numeric rating scale pain (median ± interquartile range) 5.5 ± 3.0 vs 6.0 ± 4.0 (p = 0.69), Funktionsfragebogen Hannover 68.2 ± 41.0 vs 42.0 ± 55.5 (p = 0.19), Northwick pain score 44.4 ± 21.8 vs 47.2 ± 27.0 (p = 0.83), or CRP 0.40 ± 0.80 vs 0.60 ± 0.66 (p = 0.94). For patients with degenerative changes, symptom duration was longer than for patients without (10 ± 12.5 vs 5.0 ± 18.0 yrs, p = 0.73).Conclusion.In this small study of patients with RA and AS complaining about neck pain, BME was found in many different cervical sites, including the facet joints and the spinous processes. However, the occurrence and severity of BME did not correlate with the severity of neck pain.
Success Rate and Utility of Ultrasound-guided Synovial Biopsies in Clinical Practice
Authors: Najm Aurélie , Orr Carl , Heymann Marie-Françoise , Bart Géraldine , Veale Douglas J. , Le Goff Benoît 
Published: October 2016

Objective.The utility of synovial biopsy in increasing our understanding of the pathogenesis of inflammatory arthropathies, as well as in evaluating treatments, is well established. Ultrasound (US) allows synovial assessment and therefore assists in biopsying synovial tissue in a safe and well-tolerated manner. This study’s objectives were to (1) determine the rate of success in retrieving synovial tissue using US guidance, (2) describe the indications for US-guided synovial biopsies in the clinical setting, (3) determine how frequently the synovial biopsy can lead to a clear diagnosis, and (4) assess the quality of the synovial tissue obtained using this technique.Methods.Synovial biopsies of small and large joints were performed under US guidance between February 2007 and December 2014 using a semiautomatic core biopsy needle. The biopsy procedure was considered successful if synovial tissue was found at histological examination.Results.Seventy-four patients with undifferentiated arthritis underwent 76 synovial biopsies. The success rate in retrieving synovial tissue was 81.6% (62/76). One patient taking acetyl salicylic acid at 75 mg at the time of the biopsy presented with hemarthrosis 48 h after the procedure, which resolved following simple arthrocentesis. A definitive diagnosis was achieved in 16% of the patients where synovial tissue was sampled successfully.Conclusion.US-guided synovial biopsies in clinical practice can be performed safely on patients with undifferentiated arthritis and with heterogeneous presentations. The rate of success in acquiring synovial tissue is high. The procedure usually retrieves quality tissue and leads to a definite diagnosis in a significant minority of patients.
Rheumatoid Arthritis and Coronary Artery Disease: Genetic Analyses Do Not Support a Causal Relation
Authors: Jansen Henning , Willenborg Christina , Lieb Wolfgang , Zeng Lingyao , Ferrario Paola Gloria , Loley Christina , König Inke R. , Erdmann Jeanette , Samani Nilesh J. , Schunkert Heribert ,   The CARDIoGRAM Consortium
Published: October 2016

Objective.Inflammatory diseases, specifically rheumatoid arthritis (RA), are assumed to increase the risk of coronary artery disease (CAD). More recently, multiple single-nucleotide polymorphisms (SNP) associated with RA risk were identified. If causal mechanisms affecting risks of RA and CAD are overlapping, risk alleles for RA might also increase the risk of CAD.Methods.Sixty-one SNP associating with RA in genome-wide significant analyses were tested for association with CAD in CARDIoGRAM (Coronary ARtery DIsease Genome wide Replication and Meta-analysis), a metaanalysis including genome-wide association data (22,233 CAD cases, 64,762 controls). In parallel, a set of SNP being associated with low-density lipoprotein cholesterol (LDL-C) was tested as a positive control.Results.Twenty-nine RA-associated SNP displayed a directionality-consistent association with CAD (OR range 1.002–1.073), whereas 32 RA-associated SNP were not associated with CAD (OR range 0.96–0.99 per RA risk-increasing allele). The proportion (48%) of directionality-consistent associated SNP equaled the proportion expected by chance (50%, p = 0.09). Of only 5 RA-associated SNP showing p values for CAD < 0.05, 4 loci (C5orf30, IL-6R, PTPN22, and RAD51B) showed directionality-consistent effects on CAD, and 1 (rs10774624, locus SH2B3) reached study-wide significance (p = 7.29E-06). By contrast, and as a proof of concept, 46 (74%) out of 62 LDL-C–associated SNP displayed a directionality-consistent association with CAD, a proportion that was significantly different from 50% (p = 5.9E-05).Conclusion.We found no evidence that RA-associated SNP as a group are associated with CAD. Even though we were not able to study potential effects of all genetic variants individually, shared nongenetic factors may more plausibly explain the observed coincidence of the 2 conditions.
Limited Reliability of Radiographic Assessment of Sacroiliac Joints in Patients with Suspected Early Spondyloarthritis
Authors: Christiansen Alice Ashouri , Hendricks Oliver , Kuettel Dorota , Hørslev-Petersen Kim , Jurik Anne Grethe , Nielsen Steen , Rufibach Kaspar , Loft Anne Gitte , Pedersen Susanne Juhl , Hermansen Louise Thuesen , Østergaard Mikkel , Arnbak Bodil , Manniche Claus , Weber Ulrich 
Published: October 2016

Objective.To determine the reproducibility of evaluation of sacroiliac joint (SIJ) radiographs among readers with varying levels of experience, and to identify potential drivers of disagreement in classification among 5 predefined radiographic lesion types.Methods.The study sample consisted of 104 consecutive patients aged 18–40 with low back pain ≥ 3 months of duration who met the Assessment of SpondyloArthritis international Society (ASAS) definition for a positive SIJ magnetic resonance image, or were HLA-B27–positive and had ≥ 1 spondyloarthritis (SpA)-related clinical/laboratory feature according to the ASAS classification criteria for axial SpA. Seven blinded readers (2 musculoskeletal radiologists, 5 rheumatologists) classified pelvic radiographs according to the modified New York criteria (mNY) and recorded presence/absence of 5 lesion types in both SIJ: erosion, sclerosis, ankylosis, joint space widening, and joint space narrowing. Reproducibility of mNY classification among 21 reader pairs was assessed and potential drivers of disagreement were identified among 5 lesion types. A generalized linear mixed logistic regression model served to analyze to what extent discordance in lesion type was associated with discrepant mNY classification.Results.Mean κ values (percent concordance) were 0.39 (84.1%) for mNY classification over 21 reader pairs, 0.46 (79.8%) between 2 musculoskeletal radiologists, and 0.55 (86.5%) and 0.36 (77.9%) between the most experienced rheumatologist and the 2 radiologists. Erosion showed the lowest agreement (25%) among patients with discordant classification and gave the highest OR of 13.5 for disagreement.Conclusion.Reproducibility of radiographic SIJ classification in an SpA inception cohort was only fair to at best moderate among 7 readers with varying levels of experience, questioning the applicability of mNY in early SpA.
Prevalence of Systemic Sclerosis in Primary Biliary Cholangitis Using the New ACR/EULAR Classification Criteria
Authors: Zheng Boyang , Vincent Catherine , Fritzler Marvin J. , Senécal Jean-Luc , Koenig Martial , Joyal France 
Published: October 2016

Objective.Systemic sclerosis (SSc) is a well-established disease associated with primary biliary cholangitis (PBC). However, the original 1980 American College of Rheumatology (ACR) criteria have poor sensitivity, especially for the detection of earlier SSc in previous studies. The objective was to evaluate the prevalence of SSc in patients with PBC using more sensitive 2001 LeRoy and Medsger criteria and the 2013 ACR/European League Against Rheumatism (EULAR) classification criteria. The secondary objective was to evaluate the frequency of individual clinical features.Methods.One hundred consecutive patients with PBC without previously diagnosed SSc were recruited between 2005 and 2007 from a tertiary care gastroenterology clinic. All patients underwent a complete clinical examination, determination of SSc-specific antibodies, and a nailfold capillary microscopy. Fulfillment of the 3 different criteria sets was analyzed, along with individual disease features.Results.Of 100 patients with PBC, 1% met the ACR 1980 criteria, 22% met the 2001 LeRoy and Medsger criteria for early SSc, and 17% the 2013 ACR/EULAR criteria. Raynaud phenomenon, SSc-related antibodies, and SSc capillaroscopic patterns were the most prevalent findings, with the highest sensitivities to help guide future screening.Conclusion.Our data show a high prevalence of SSc in patients with PBC with probable underestimation by previous studies using the original ACR criteria. Comorbid SSc should be actively searched for based on newly described criteria to improve detection and increase benefits of earlier treatment.
Risk of Diabetes Mellitus among Patients Diagnosed with Giant Cell Arteritis or Granulomatosis with Polyangiitis: Comparison with the General Population
Authors: Faurschou Mikkel , Ahlström Magnus G. , Lindhardsen Jesper , Obel Niels , Baslund Bo 
Published: October 2016

Objective.Patients with organ- or life-threatening vasculitis receive high cumulative glucocorticoid (GC) doses during their disease course. GC have diabetogenic effects, but the risk of diabetes mellitus (DM) related to vasculitis therapy is not well characterized. We assessed the DM risk among patients diagnosed with giant cell arteritis (GCA) or granulomatosis with polyangiitis (GPA), i.e., patients with relatively common forms of systemic vasculitis.Methods.We used Danish healthcare registries to identify 1682 patients diagnosed with GCA and 342 patients diagnosed with GPA from 1997 to 2015 and to obtain information regarding medication exposures. Each patient with vasculitis was matched with 9 population controls. Date of new-onset DM was defined as date of first claimed prescription for an antidiabetic drug. We used Cox regression analyses to calculate incidence rate ratios (IRR) for DM as a measure of the DM risk among patients relative to population controls. Logistic regression was used to study the association between prednisolone/prednisone (PRED) dose and DM.Results.Median duration of followup was 6.5 years [interquartile range (IQR) 2.6–10.4] in the GCA cohort and 5.8 years (IQR 1.7–10.6) in the GPA cohort. During the first year after diagnosis of vasculitis, the IRR for DM was 7.0 (95% CI 5.2–9.3) among patients with GCA and 10.4 (95% CI 4.4–24) among patients with GPA. IRR for DM were not significantly increased in either cohort during later followup periods. Within the first year, treatment with high cumulative prednisolone/PRED doses was associated with new-onset DM among the patients with vasculitis.Conclusion.Patients diagnosed with GCA or GPA have a markedly increased risk of new-onset DM during early treatment phases.
Developing an OMERACT Core Outcome Set for Assessing Safety Components in Rheumatology Trials: The OMERACT Safety Working Group
Authors: Klokker Louise , Tugwell Peter , Furst Daniel E. , Devoe Dan , Williamson Paula , Terwee Caroline B. , Suarez-Almazor Maria E. , Strand Vibeke , Woodworth Thasia , Leong Amye L. , Goel Niti , Boers Maarten , Brooks Peter M. , Simon Lee S. , Christensen Robin 
Published: October 2016

Objective.Failure to report harmful outcomes in clinical research can introduce bias favoring a potentially harmful intervention. While core outcome sets (COS) are available for benefits in randomized controlled trials in many rheumatic conditions, less attention has been paid to safety in such COS. The Outcome Measures in Rheumatology (OMERACT) Filter 2.0 emphasizes the importance of measuring harms. The Safety Working Group was reestablished at the OMERACT 2016 with the objective to develop a COS for assessing safety components in trials across rheumatologic conditions.Methods.The safety issue has previously been discussed at OMERACT, but without a consistent approach to ensure harms were included in COS. Our methods include (1) identifying harmful outcomes in trials of interventions studied in patients with rheumatic diseases by a systematic literature review, (2) identifying components of safety that should be measured in such trials by use of a patient-driven approach including qualitative data collection and statistical organization of data, and (3) developing a COS through consensus processes including everyone involved.Results.Members of OMERACT including patients, clinicians, researchers, methodologists, and industry representatives reached consensus on the need to continue the efforts on developing a COS for safety in rheumatology trials. There was a general agreement about the need to identify safety-related outcomes that are meaningful to patients, framed in terms that patients consider relevant so that they will be able to make informed decisions.Conclusion.The OMERACT Safety Working Group will advance the work previously done within OMERACT using a new patient-driven approach.
Noms collectifs humains : nomination et prédication
Authors: Lecolle Michelle 
Published: October 2016

L’article porte sur la nomination collective d’êtres humains : il s’agit, plus précisément, d’aborder la sémantique des noms collectifs humains (Ncoll-H), sous l’angle d’une dimension évaluative ou prédicative potentielle. On observe, à propos des Ncoll-H, cette dimension prédicative sous différents aspects : elle peut être liée à la sémantique du nom collectif même, aux traits lexicaux de telle série de Ncoll-H ou à leurs emplois préférentiels. Une première partie explore le rapprochement entre nomination et prédication. Dans une deuxième partie, on présente les propriétés sémantiques des Ncoll-H et la signification lexicale de certains, en rapport avec leurs potentialités prédicatives ou évaluatives. Une dernière partie aborde les emplois attributifs de Ncoll-H. Cette étude permet de situer les « enjeux socio-politiques » de la nomination de groupes humains dans le cadre d’une analyse sémantique et discursive plus générale.
De quoi Intégration est-il le nom ? L’importation d’une querelle de mots dans le champ de la formation linguistique des migrants
Authors: Vadot Maude 
Published: October 2016

Le présent article vise à étudier l’articulation entre argumentation et nomination à partir du conflit nominatif réactivé par la parution du Référentiel Français Langue d'Intégration (FLI), dans une perspective d'analyse de discours praxématique et sociolinguistique. Après avoir resitué brièvement la querelle qui touche la nomination Intégration, nos analyses poursuivront un double objectif. Il s’agira d’une part de décrire une situation dans laquelle le mot devient un enjeu de l'argumentation : par quelles stratégies socio-discursives les locuteurs légitiment-ils et justifient-ils leur choix ? On cherchera d’autre part à documenter et à éclairer le conflit en mettant au jour, dans une démarche sémasiologique inspirée de l’analyse de discours à entrée lexicale, des éléments du programme de sens du praxème Intégration que les auteurs, de façon dialectique, actualisent et contribuent en même temps à imposer dans le champ de la formation linguistique. L'ensemble du propos constitue un éclairage critique supplémentaire sur le référentiel FLI, ses conditions de production et ses contenus, dans la continuité des débats intervenus depuis sa sortie.