bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Overview of Sexual Assault Cases in Nepal
Authors: Hirachan Neelu , Limbu D 
Published: July 2017

Background: Sexual assault is defined as any sexual act performed by one (or more) person(s) on another without consent. It may include the use of threat or force. In some cases, the person cannot give consent to sex because he/she is unconscious or otherwise incapacitated. A person may be raped by a stranger, an acquaintance or date or a family member.Methods: The study was a retrospective and descriptive analysis of cases of sexual assault victims examined by the author in the Forensic Medicine departments at Institute of Medicine, Maharajgunj and Gandaki Medical College Teaching Hospital, Pokhara, Nepal over a period of four years (2012 to 2016). This includes information regarding the age group of the victim at the time of sexual abuse, relationship of the victim to the perpetrator, genital and extra-genital injuries present over the victim’s body and number of cases attended as an expert witness by the author in various courts of Nepal.Results: In the four years period, a total number of 55 cases were examined as sexual assault cases. It was observed that majority were of the 13 - 15 years of age group (46%) followed by <10 years (20%), 16 - 20 years (16%), >20 years (11%) and 10 - 12 years (7%). Regarding the relationship of the victim to the alleged perpetrator, 87% cases (48 out of 55) were related to acquaintances compared to 13% due to strangers. Surprisingly, 3.6% cases (2 out of 48) were due to the biological fathers of the victims. On physical examination of the victim’s body, 36% cases showed genital injuries compared to only 15% with extra genital injuries. The author attended the court as an expert witness in 33% of these cases. Only 7% of the cases were mentally challenged.Conclusion: Young adults remain the most vulnerable group, so education related to sex, morality, humanity and different life skills training should be provided to these groups from their school years itself. The benefits of early intervention and comprehensive care of survivors with the use of standardized protocols along with shorter and lesser traumatic period of court processing to the survivors of these cases should be encouraged.Journal of Gandaki Medical College Volume, 09, Number 2, July December 2016, Page: 43-46
Knowledge of Pressure Ulcer Management among Nurses
Authors: Shrestha Nisha , Shrestha P 
Published: July 2017

Background: Pressure ulcer (PU) development remains a significant complication among at-risk patients. It is considered “never events” because they are preventable and should “never” happen. It has been associated with increased morbidity, mortality, hospital cost and length of stay in the hospital. Prevention of pressure ulcers is considered a nurse-sensitive indicator hence nurses should have adequate knowledge about current evidence-based prevention and management of pressure ulcer. However, non adherence to these guidelines is frequent and lack of knowledge may act as barriers to using guidelines in clinical practice.Objectives: The objectives of the study were to 1. assess the knowledge of pressure ulcer management among nurses 2. determine the level of knowledge of pressure ulcer management among nurses 3. assess the association of knowledge of nurses and baseline variables.Methods: A descriptive cross sectional study was conducted, using pretested self administered questionnaire to assess the knowledge on pressure ulcer management among purposively selected 100 nurses working in Gandaki Medical College Teaching Hospital in 2015. Descriptive statistics as frequency and percentage were used and inferential statistics (Chi-square test) was done to find out association between knowledge and selected baseline variables.Results: The study revealed that 59% of the respondents had adequate knowledge where as 41% of nurse’s knowledge was found to be inadequate. Significant association was not found between age, working ward, experience, education, training, duration and knowledge of pressure ulcer management among Nurses.Conclusion: This result indicates that more than half of the nurses had the adequate knowledge but there is still need of education and training related pressure ulcer management.Journal of Gandaki Medical CollegeVolume, 09, Number 2, July December 2016, Page: 47-51
Anti Escherichia Coli Activity of Some Medicinal Plants of High Altitude of Nepal
Authors: Bhargava Dipak , Saha Abhilasha , Mondal Keshab Chandra , Pandit Bijaya Raj , Shidiki Amrullah , Chaudhary Navin Kumar , Gupta Ravi Shankar , Jha Awadhesh Kumar 
Published: July 2017

Background: Plants and plant-based medicaments are the basis of many of the modern pharmaceuticals we use today for our various ailments. The aim of the present study was to find out the bioactive chemical constituents such as flavonoids, alkaloids, tannins, saponins, carbohydrate and to find out the anti E. coli activity of the ethanolic extracts of traditionally used ten medicinal plants of Nepal at an altitude of 1500 ft from above the sea level.Methods: Ethanolic extracts of ten commonly used medicinal plants were analyzed phytochemically and evaluated for their significant antimicrobial activity against the clinical isolates of Escherichia coli. Mean zones of inhibition were calculated for each of the extracts.Results: The results revealed that though all the plants of the high altitude showed some degree of antimicrobial activity, the leaf extract of Syzygium cumini (5.7±0.3 cm), Chromolaena odorata (5.2±0.4 cm), Ocimum sanctum (4.7±0.6 cm) and Justicia adhatoda (3.2±0.3 cm) were most effective against the clinical isolates of E. coli, whereas the other six plant extracts were least effective against the clinical isolates of E. coli. Qualitative phytochemical analysis of the extracts revealed the presence of bioactive components. Seven of the plant extracts contain alkaloids, six of them contain glycosides, four of them contain flavonoids, three of them contain carbohydrate, oil and fats, two of them contain tannins, whereas only one of them contains saponins.Conclusion: The result of this study justified the folkloric usage of the studied plants and concluded that these plants extract have great potential in finding new clinically effective antimicrobial compounds.MED Phoenix Volume (1), Issue (1) July 2016, page: 3-9
Particle-in-Cell Simulations of the Twisted Magnetospheres of Magnetars. I.
Authors: Chen Alexander Y. , Beloborodov Andrei M. 
Published: July 2017

Abstract
The magnetospheres of magnetars are believed to be filled with electron–positron plasma generated by electric discharge. We present a first numerical experiment demonstrating this process in an axisymmetric magnetosphere with a simple threshold prescription for pair creation, which is applicable to the inner magnetosphere with an ultrastrong field. The

discharge occurs in response to the twisting of the closed magnetic field lines by a shear deformation of the magnetar surface, which launches electric currents into the magnetosphere. The simulation shows the formation of an electric “gap” with an unscreened electric field (

) that continually accelerates particles along the magnetic field lines and sustains pair creation. The accelerating voltage is self-regulated to the threshold of the

discharge. It controls the rate of energy release and the lifetime of the magnetic twist. The simulation follows the global evolution of the twisted magnetosphere over a long time and demonstrates its gradual resistive untwisting. A vacuum cavity forms near the star and expands, gradually erasing magnetospheric electric currents j. The active j-bundle shrinks with time and its footprints form shrinking hot spots on the magnetar surface bombarded by the created particles.
The Radiative Efficiency and Spectra of Slowly Accreting Black Holes from Two-temperature GRRMHD Simulations
Authors: Ryan Benjamin R. , Ressler Sean M. , Dolence Joshua C. , Tchekhovskoy Alexander , Gammie Charles , Quataert Eliot 
Published: July 2017

Abstract
We present axisymmetric numerical simulations of radiatively inefficient accretion flows onto black holes combining general relativity, magnetohydrodynamics, self-consistent electron thermodynamics, and frequency-dependent radiation transport. We investigate a range of accretion rates up to

onto a

black hole with spin

. We report on averaged flow thermodynamics as a function of accretion rate. We present the spectra of outgoing radiation and find that it varies strongly with accretion rate, from synchrotron-dominated in the radio at low

to inverse-Compton-dominated at our highest

. In contrast to canonical analytic models, we find that by

, the flow approaches

radiative efficiency, with much of the radiation due to inverse-Compton scattering off Coulomb-heated electrons far from the black hole. These results have broad implications for modeling of accreting black holes across a large fraction of the accretion rates realized in observed systems.
Educational Intervention for Clinical Judgment Skills
Authors: Foo May Lan , Tang Li Yoong , Vimala Ramoo , Chui Ping Lei , Chong Mei Chan 
Published: July 2017

Background:Because nurses need to handle a broad range of issues related to patients' health status, it is necessary to make reliable and sound clinical judgments for professional accountability and the patients' safety.Method:A quasi-experimental pre- and posttest design with a control group was used to study the effectiveness of an educational intervention on the clinical judgment skills of 80 RNs from two district hospitals. The change in clinical judgment skills during a 6-week period was evaluated using a complex case-based scenario after the completion of the educational intervention.Results:The mean scores of clinical judgment skills of the experimental group had significantly improved from 24.15 ± 6.92 to 47.38 ± 7.20. (p< .001). However, only a slight change was seen in mean scores for the control group (23.80 ± 5.77 to 26.50 ± 6.53).Conclusion:The educational intervention was effective postintervention. Continuing nursing education using a traditional and case-based method is recommended to improve clinical judgment skills in clinical settings.J Contin Educ Nurs.2017;48(8):347–352.
Health Literacy, Health Care Utilization, and Direct Cost of Care Among Linguistically Diverse Patients with Type 2 Diabetes Mellitus
Authors: Doyle Gerardine , Gibney Sarah , Quan Judy , Martensen Ulrik , Schillinger Dean 
Published: July 2017

Background:
Low functional health literacy (HL) has been associated with poor self-management of chronic conditions, including type 2 diabetes mellitus (T2DM), an inefficient use of health services, and higher health care costs. Low functional HL and limited English language proficiency both independently predict poor glycemic control among Latino and Chinese immigrants in the United States, and is more common among patients with diabetes with limited HL.

Objective:
This study investigated the relationship between low functional HL, health care utilization, and costs of health care among a cohort of low-income patients with T2DM whose primary language was English, Spanish, or Cantonese (N = 277).

Methods:
Patient data were collected from Medicaid administrative health care records as part of a low-income managed care program administered by the San Francisco Health Plan between April 2009 and March 2011. HL was measured with the Brief Questions Screening Tool for Health Literacy, administered via telephone survey. We used negative binomial regression with robust standard errors to estimate the effect of low functional HL on health care utilization, adjusting for demographic, socioeconomic, and health covariates. Results were reported as rate-ratios (RRs). We used two-part regression models to estimate the marginal difference in cost per patient associated with low functional HL. Utilization and cost models were also estimated, stratified by patient language.

Key Results:
We observed a nonsignificant association between low functional HL and lower health care utilization, and lower total health care costs (−$1,493.53, 95% confidence interval [CI]: $3,602 to $615). While we observed a nonsignificant trend for low functional HL and lower utilization and total cost among people who speak English and Cantonese, low functional HL was significantly associated with more outpatient visits among patients who spoke Spanish (RR 1.31, 95% CI 1 to 1.72).

Conclusions:

The relationship between low functional HL and health care utilization among this linguistically diverse cohort of patients with T2DM varied by patient language. Further research is needed to determine if lower utilization and costs in certain linguistic subgroups is indicative of barriers to access.

[
Health Literacy Research and Practice
. 2017;1(3):e116–e126.]

Plain Language Summary:
This study attempts to understand the relationship between health literacy, health care utilization, and costs of health care among an ethnically and linguistically diverse cohort of low-income patients with type 2 diabetes mellitus. We observed differences that could be due to actual differential effects of low HL by language status, or could be explained by unmeasured differences in health-seeking behaviors, access to care, degree of acculturation, or comorbidities.
Mandibular Incisor Position Changes do not Explain Increase in Keratinized Gingiva Height after Periodontally Accelerated Osteogenic Orthodontics
Authors: Ferguson Donald J. , Mazumder Urmi , Makki Laith , Thomas Wilcko M. , Wilcko William M. 
Published: July 2017

Purpose
This study aimed to reexamine the relationship between mandibular incisor inclination, prominence and vertical changes in position, and keratinized gingival tissue (KT) height changes labial to the mandibular incisors after orthodontic treatment with and without augmented corticotomy (Cort).

Materials and Methods
Two orthodontically treated groups of 35 individuals each, with (Cort) and without (conventional [Conv]) alveolar decortication and augmentation bone grafting (periodontally accelerated osteogenic orthodontics [PAOO]), were matched for sample size, gender, mandibular premolar extractions, pretreatment age, posttreatment observation period, and pretreatment KT height in this case–controlled retrospective study. Pre- and post-treatment lateral cephalometric radiographs were evaluated for mandibular incisor vertical, inclination, and prominence changes.

Results
As reported previously (Wilcko 2015), KT height had significantly increased by 0.78 mm (P = 0.001) in the Cort group and decreased by 0.38 mm (P = 0.002) in Conv on an average of 1.5 years after completion of active orthodontic therapy. In this study, Cort mandibular incisors proclined and protruded significantly during therapy while Conv incisors did not. Changes in mandibular incisor inclination and prominence explained neither the decrease in keratinized gingiva height in Conv nor the KT height gain in Cort.

Conclusions
In spite of mandibular incisor proclination and protrusion, orthodontic therapy combined with alveolar decortication and augmentation bone grafting resulted in a clinically significant increase in keratinized gingiva height 1.5 years’ posttreatment.
Risks and Benefits of the Different Types of Gloves used in the Perioperative Setting
Authors: Zura Robert D , Blizzard Daniel J , Morwood Michael P , Agaba Perez , Jerele Jennifer L 
Published: July 2017

ABSTRACT
The role of powder gloves in allergic reactions, infections, wound healing and granuloma formation has been known for many years. Despite a gradual shift away from powder gloves over the last several decades, many healthcare professionals and facilities continue to use powder gloves as the FDA has continued to refrain from issuing a comprehensive formal ban. However, recent advancements in glove technology and position statements by professional societies have continued the push for removal of powder gloves from all clinical and surgical settings and will hopefully entirely eradicate usage in the coming years.
Blizzard DJ, Agaba P, Morwood MP, Jerele JL, Zura RD. Risks and Benefits of the different Types of Gloves used in the Perioperative Setting. The Duke Orthop J 2017;7(1):3-10.
An intercomparison of approaches for improving operational seasonal streamflow forecasts
Authors: Mendoza Pablo A. , Wood Andrew W. , Clark Elizabeth , Rothwell Eric , Clark Martyn P. , Nijssen Bart , Brekke Levi D. , Arnold Jeffrey R. 
Published: July 2017

Abstract. For much of the last century, forecasting centers around the world have offered seasonal streamflow predictions to support water management. Recent work suggests that the two major avenues to advance seasonal predictability are improvements in the estimation of initial hydrologic conditions (IHCs) and the incorporation of climate information. This study investigates the marginal benefits of a variety of methods using IHCs and/or climate information, focusing on seasonal water supply forecasts (WSFs) in five case study watersheds located in the US Pacific Northwest region. We specify two benchmark methods that mimic standard operational approaches – statistical regression against IHCs and model-based ensemble streamflow prediction (ESP) – and then systematically intercompare WSFs across a range of lead times. Additional methods include (i) statistical techniques using climate information either from standard indices or from climate reanalysis variables and (ii) several hybrid/hierarchical approaches harnessing both land surface and climate predictability. In basins where atmospheric teleconnection signals are strong, and when watershed predictability is low, climate information alone provides considerable improvements. For those basins showing weak teleconnections, custom predictors from reanalysis fields were more effective in forecast skill than standard climate indices. ESP predictions tended to have high correlation skill but greater bias compared to other methods, and climate predictors failed to substantially improve these deficiencies within a trace weighting framework. Lower complexity techniques were competitive with more complex methods, and the hierarchical expert regression approach introduced here (hierarchical ensemble streamflow prediction – HESP) provided a robust alternative for skillful and reliable water supply forecasts at all initialization times. Three key findings from this effort are (1) objective approaches supporting methodologically consistent hindcasts open the door to a broad range of beneficial forecasting strategies; (2) the use of climate predictors can add to the seasonal forecast skill available from IHCs; and (3) sample size limitations must be handled rigorously to avoid over-trained forecast solutions. Overall, the results suggest that despite a rich, long heritage of operational use, there remain a number of compelling opportunities to improve the skill and value of seasonal streamflow predictions.
A Biaxial Strain–Based Expansion Mechanism for Auxetic Stent Deployment
Authors: Bukhari Faiza , Ansari Umar , Najabat Ali Murtaza , Akhtar Hafsah , Asif Sarim , Mohammad Umer , Mir Mariam 
Published: July 2017

Background Auxetics, a special class of materials, tend to expand both in the radial and longitudinal directions when a unidirectional tensile force is applied. Recently, studies have come up with new designs for auxetic vascular and nonvascular stents which are deployed with commercial balloon catheters. There are some inherent limitations associated with a unidirectional application of expansion force in the effective deployment of stents. This work proposed a solution to some of these limitations through the use of a biaxial mode of a predetermined strain-based expansion mechanism. Method The design incorporated a pressure-activated crank-slider mechanism. Fabrication of a prototype for experimental verification was carried out through milling and high-speed lathe machining. The testing of the device employed the use of auxetic stents, fabricated from a biocompatible polymer. A finite element study is presented to extrapolate experimental results to a broader range of operation and working conditions. Results and Conclusions The expansion mechanism is similar in operation to the opening of an umbrella. The length of the connected auxetic stent increases when internal hydraulic pressure is applied. The degree of linear expansion in 1 direction influences the expansion of auxetic stent in the lateral direction. As the device exerts pressure longitudinally, a larger amount of the force is distributed on the unit cells/hinges which ultimately results in an increased expansion of the stent.
Automatic bone drilling using a novel robot in orthopedic trauma surgery
Authors: Kastelov Rumen , Boiadjiev George , Boiadjiev Tony , Delchev Kamen , Zagurski Kazimir , Gueorguiev Boyko 
Published: July 2017

Background: Currently, applications of robotized systems in orthopedic trauma surgery steadily increase due to their functional abilities facilitating surgeon skills. The aim of this study is to present the functional advantages of a recently developed robot for bone drilling.Methods: Ex-vivo experiments were performed on fresh porcine and bovine bones, as well as on fresh and embalmed human bones such as femora, vertebrae and rips, by the use of the robot for bone drilling to identify diverse control parameters and analyse thrust force and drill bit temperature during drilling.Results: Experimental data during drilling is shown, control algorithms are described and bone drilling modes are characterized. Maximal values of thrust force and temperature are detected. Controlling thrust force seems to be the proper way to reduce force resistance and hence temperature during drilling. In automatic drilling mode, preliminary defined channel depth is drilled with accuracy of 0.1 mm, and far cortex end recognition is proved to work reliably for automatic stop with minimal controlled soft tissue penetration. Cortex and bone marrow thickness are measured and analysed in real time.Conclusion: The bone drilling robot is programmed to follow with high accuracy parameters defined by the surgeon. Enhancing surgeon’s freedom and responsibility to make decisions, it can perform precise manipulations, decreasing the influence of subjective factors and increasing patient’s safety.
Símbolos gráficos da floresta: a arte marajoara nas aprendizagens visuais
Authors: Souza Aldair José Batista de Souza Batista 
Published: July 2017

O presente trabalho apresenta uma abordagem pedagógica para o tema a Cerâmica Marajoara no ensino da Arte. Este estudo fundamenta-se no uso da cerâmica no ambiente escolar. O objetivo deste ensaio é apresentar estratégias de ensino e aprendizagem em Arte, fazendo uso da Arte Marajoara na sala de aula, para ser utilizado com a intermediação do professor. Desse modo, pretende-se apresentar a experiência de docente fazendo uso da arte da cerâmica da Amazônia, na Escola Municipal Maria Valdionice Pereira na cidade de Carutapera-MA. Este trabalho revela a sintonia entre as áreas de pesquisa arqueológica preocupadas em partilhar o conhecimento científico com a sociedade. Ademais, poderá ser um instrumento auxiliar para as escolas na demonstração metodológica de que os acervos dos museus são importantes documentos reveladores de informações e, portanto, um valioso e útil patrimônio para a sociedade. Enviado em: 17 de julho de 2016. Aprovado em: 3 de março de 2017