bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Empirical Application of Goal Programming and AHP in Real Estate Assessment
Authors: Jamshidi Hossein 
Published: May 2017

The Goal Programming (GP) is one of the many models which have been developed to deal with the multiple objectives decision-making problems. This model allows taking into account, simultaneously, many objectives while the decision-maker is seeking the best solution from among a set of feasible solutions. At first, the aim of this study is to compare the objectives of the decision maker based on the Analytical Hierarchy Process (AHP) and to rank the objectives according to the AHP process and once the objectives are set then apply the GP to the facility allocation in a real estate rental property. The objective of decision maker is not only to maximize profit rather the decision maker has multiple objective to achieve. The methodology presented in this study can help the decision maker to formulate viable location strategies in the volatile and complex facility allocation environment. This is an empirical study applied to a local business developer utilizing multi objective decision analysis tools.
Comparison of Hand and Semiautomatic Tracing Methods for Creating Maxillofacial Artificial Organs using Sequences of Computed Tomography (CT) and Cone Beam Computed Tomography (CBCT) Images
Authors: Szabo Bence T. , Aksoy Seçil , Repassy Gabor , Csomo Krisztian , Dobo-Nagy Csaba , Orhan Kaan 
Published: May 2017

Introduction The aim of this study was to compare the paranasal sinus volumes obtained by manual and semiautomatic imaging software programs using both CT and CBCT imaging. Methods 121 computed tomography (CT) and 119 cone beam computed tomography (CBCT) examinations were selected from the databases of the authors’ institutes. The Digital Imaging and Communications in Medicine (DICOM) images were imported into 3-dimensonal imaging software, in which hand mode and semiautomatic tracing methods were used to measure the volumes of both maxillary sinuses and the sphenoid sinus. The determined volumetric means were compared to previously published averages. Results Isometric CBCT-based volume determination results were closer to the real volume conditions, whereas the non-isometric CT-based volume measurements defined coherently lower volumes. By comparing the 2 volume measurement modes, the values gained from hand mode were closer to the literature data. Furthermore, CBCT-based image measurement results corresponded to the known averages. Conclusions Our results suggest that CBCT images provide reliable volumetric information that can be depended on for artificial organ construction, and which may aid the guidance of the operator prior to or during the intervention.
Comparison between Mononucleotide and Dinucleotide Marker Panels in Gastric Cancer with Loss of hMLH1 or hMSH2 Expression
Authors: Kim Jeong Goo , Shin Soyoung , Park Joonhong 
Published: May 2017

Background DNA mismatch repair deficiency is an important molecular mechanism of genetic instability in gastric cancer, and a high instability at microsatellites is associated with favorable prognosis. We compared mononucleotide and dinucleotide microsatellite instability (MSI) marker panels in 56 paired gastric tumor and normal samples. Methods The mononucleotide marker panel (mono panel) consisted of 8 markers: BAT25, BAT26, BAT40, BAT-RII, NR21, NR22, NR24 and NR27. The dinucleotide marker panel (di panel) contained D2S123, D5S346, D17S250, D17S261, D17S520, D18S34 and D18S58. The NCI panel was used as reference panel. Results Among 13 gastric tumors showing no hMLH1 or hMSH2 expression, 8 MSI-H (high) and 5 MSI-L (low) were identified. The analytical sensitivities of the NCI, mono and di panels to detect unstable MSI were 61.5% (8/13), 76.9% (10/13) and 84.6% (11/13), respectively. The size change of allele shift was statistically greater in the mono panel than in the di panel (p = 0.02 by Mann-Whitney U-test). The BAT40 (69.2%, 9/13) and D18S34 (76.9%, 10/13) markers showed high sensitivity for determination of MSI status. Conclusions To improve the detection rate of MSI in gastric cancer with loss of hMLH1 or hMSH2 expression, the kind of MSI marker may need to be considered more, instead of the repetitive type of marker. Thus, an MSI panel designed with a combination of both BAT40 and D18S34 is suggested for providing more accurate and sensitive MSI analysis in gastric cancer.
223Ra-dichloride Response in a Patient with Paget Disease and Bone Metastases Secondary to Castration-Resistant Prostate Cancer
Authors: Cañamaque Lina García , Parada Cristina Rioja , De la Peña Paloma García 
Published: May 2017

Purpose Paget disease is commonly asymptomatic and discovered when an imaging test is performed for another clinical indication or when elevated serum alkaline phosphatase is found. Bone pain usually appears late in the disease process and is only present in a minority of patients. For diagnosis, X-ray and bone scan are the most recommended imaging methods; radionuclide imaging of the skeleton has become the standard, since it is the most sensitive test for detecting increased bone activity. For treatment, either bisphosphonates or calcitonin are recommended. Methods We present a 74-year-old patient diagnosed with prostate cancer in 2001 who developed bone metastases concomitant with a Paget bone disease. Results This patient received treatment with Ra-223, having stable disease in bone scan and no relevant toxicities. Conclusions There is no clinical experience with Ra-223 and Paget disease, since it is characterized classically as a high bone turnover disease and therefore there is no rationale to administer a drug that has a high bone affinity. Nevertheless, Ra-223 is not contraindicated.
Imaging Technologies in the Diagnosis and Treatment of Acute Pyelonephritis
Authors: Enikeev Dmitry V. , Glybochko Petr , Alyaev Yuriy , Enikeev Mikhail , Rapoport Leonid 
Published: May 2017

Purpose The aim of this study was to evaluate the possibilities of ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) in diagnosing acute pyelonephritis (AP) and renal abscess. Patients and Methods Two hundred and seven patients with AP were followed up from 2010 throughout 2015. All the patients were divided into three groups. Group 1 included 113 (54.6%) patients with acute nonobstructive pyelonephritis; group 2 included 33 (15.9%) patients with acute obstructive pyelonephritis; and group 3 included 61 (29.5%) pregnant female patients with AP. All 207 patients with AP underwent ultrasound examination of the kidneys. Computed tomography (CT) was performed in 87 patients (42.0%). MRI was performed in 14 patients (6.7%). Results We identified the ultrasound (US), magnetic resonance (MR), and CT-signs of acute renal inflammation at different stages of the process. The main us-signs were decreased mobility of the kidney, its enlargement, thickened parenchyma, hydrophilic parenchyma and an impairment of corticomedullary differentiation. The typical CT-signs of AP were enlargement of the kidney with its thickened parenchyma and an impairment of corticomedullary differentiation. The main MR-signs of AP were enlargement of the kidney (>12 cm lengthwise), thickened parenchyma (<2 cm in the median segment of the kidney) and an impairment of corticomedullary differentiation. Conclusions Assessment of the structural and functional state of renal parenchyma and the upper urinary tract using techniques such as ultrasonography, CT, MRI contributes to more efficacious treatment of patients at different stages of AP and timely drainage with properly adjusted pathogenetic therapy at the infiltrative stage is instrumental in preventing purulent destructive forms of AP.
Near-Infrared Fluorescence with Indocyanine Green for Diagnostics in Urology: Initial Experience
Authors: Morozov Andrey O. , Alyaev Yuri G. , Rapoport Leonid M. , Tsarichenko Dmitrii G. , Bezrukov Eugene A. , Butnaru Denis V. , Sirota Eugene S. 
Published: May 2017

Introduction Fluorescence imaging with indocyanine green is used in urology for the detection of sentinel lymph nodes and identification of prostate margins in radical prostatectomy for delineation of resection zone and selective clamping of vessels in partial nephrectomy; for identification and evaluation of length of ureteral strictures; for assessment of perfusion and viability of anastomoses during reconstructive stage of cystectomy. Safety of this technique is proven, while its diagnostic value and usefulness is still controversial. Methods This pilot study of using the SPY Elite Fluorescence Imaging System for diagnostics was performed in the I.M. Sechenov First Moscow State Medical University. Ten patients were enrolled: four patients underwent retropubic RP and lymph node dissection, five patients underwent partial nephrectomy, and one patient underwent ureteroplasty. Fluorophore was injected transrectally with TRUS guidance during RP in order to assess the lymph nodes. During partial nephrectomy, the compound was injected intravenously to differentiate the tumor from parenchyma by its blood supply. During ureteroplasty, the indocyanine green solution was injected into the renal pelvis to dye the ureter and locate the stricture. Results Sensitivity of this technique for visualization of sentinel lymph nodes was 100%, and specificity was 73.3%. In patients who underwent partial nephrectomy, all lesions were malignant and hypofluorescent when compared with healthy parenchyma. SPY allowed us to determine the location and extension of the stricture during ureteroplasty. No hypersensitivity reactions or complications were observed during injection of the compound.
Complications and Prostate Cancer Diagnosis Rate of TRUS Prostate Biopsies Using 16 and 18G Needles by Clavien Scoring
Authors: Ozcan Serkan , Akif Diri Mehmet , Bagcioglu Murat , Karakan Tolga , Aydın Arif 
Published: May 2017

Aim We aimed to compare the 18 and 16-Gauge (G) needles used in transrectal ultrasonography (TRUS)-guided needle biopsy for cancer detection rates and complications using the Clavien Scoring System. Materials and Methods The 80 patients who were included in the study were randomized and divided into two groups. Group 1 (n = 36) had a TRUS-guided prostate biopsy with an 18G needle and Group 2 had a 16G needle (n = 44). The hematuria, bleeding assessment, and infection events were evaluated on a daily basis. These complications were graded according to the Clavien Scoring. Results In Group 1, only five (13%) patients were diagnosed with prostate cancer, and three patients were reported to have atypical small acinar proliferation (ASAP). In Group 2, 16 (36%) patients were diagnosed with prostate cancer and one patient was reported to have ASAP. The difference in the prostate cancer detection rate between the groups was statistically significant. According to the Clavien grading system, the complications were at the Grade 1 level in 25 people in Group 1 in 29 people in Group 2. Grade 2 level complications were not observed in either group. While one person was Grade 3 in Group 1, two people in Group 2 had this rate. There were no significant differences between the groups. Conclusions We found that cancer detection rate increased by increasing the thickness of the needle used in TRUS-guided prostate biopsy without any increase in the complications.
Status of cold chain management among health care providers in Qatar: Primary health care center-based intervention study
Authors: Salem Enayat Hanafi , Alhajri Mohammed , Al Romaihi Hamad , Rady Mervat , Al-Kohji Sadriya , Kumar Nanda , Al Kuwari Mohamed , Al Yafei Amal 
Published: May 2017

Objective: The study aimed to measure the status of cold chain management among primary health care professionals at primary healthcare centers (PHCC) in Qatar.

Methods: A cross-sectional design with pre-post-intervention study was conducted, and 570 primary health professionals were selected from 21 PHCCs using random sampling. A structured self-administered questionnaire was used to collect data regarding the status of cold chain system of healthcare workers before and after educational intervention.

Results: Of the 570 subjects, 492 (86.3%) participated in the post-intervention evaluation. cold chain management, before the intervention six elements were present in all of the PHCCs (100%), eight were present in >80%, another eight were present in 60–80%, while 13 were present in < 60%. These figures improved to 8, 13, 4, and 10, respectively, after the intervention.

Conclusion: In Qatar, The current status of cold chain status among primary healthcare workers had significantly improved after intervention. The practices of health professionals were also found to be adequate. Therefore, it is recommended that all health professionals working in PHCCs should receive mandatory cold chain management training to ensure delivery of safe and effective vaccines in Qatar.

Keywords: KAP, cold chain, primary health care center, immunization, PHC, Qatar
Incidence of post-partum metabolic syndrome (Mets) in women with gestational diabetes mellitus (GDM) in tertiary care hospital Lahore 2013–2014
Authors: Bashir Saira 
Published: May 2017

Background: Gestational diabetes mellitus is characterized by high blood glucose levels during pregnancy. The reported prevalence of GDM is 7% worldwide while 8% in Pakistan. About 19.5% of the women with GDM develop post-partum metabolic syndrome.

Methods: A prospective cohort study carried out at tertiary-care hospital in Lahore from Jan 2013 - Dec 2014 to determine the incidence of Mets in women with GDM. After informed consent, women with and without GDM were enrolled during 28th week of pregnancy. Demographic and personal data were recorded. Presence of Mets was evaluated 6 months after delivery measuring their blood pressure, anthropometry, fasting blood sugar (FBS) and triglycerides. Cumulative incidence of Mets, means of blood pressure, anthropometric measures were calculated. Comparisons of general characteristic and component of metabolic syndrome were done by student t-test.

Results: 102 women with GDM and 104 without GDM were followed. The Cumulative Incidence of Mets was 33% in GDM while 15.4% in non-GDM (P-value = 0.002). GDM group were significantly older than non-GDM group (P-Value < 0.001). In GDM group 29 (28.4%) had impaired FBS while in non-GDM group 7 (7%) had impaired FBS. Diabetes developed in 27 (26.5%) of GDM group while none of non-GDM group. BMI blood pressure fasting glucose, and triglycerides were significantly higher in GDM group than non-GDM group.

Conclusion: The study highlights that GDM group has more risk of developing Mets. They should be monitored as high risk for other cardiovascular diseases along with diabetes after delivery.

Keywords: metabolic syndrome, gestational diabetes mellitus, postpartum period
Risk factors of cerebrovascular accidents among survivors in the Gaza Strip: A case-control study
Authors: Abedelaal Eyad 
Published: May 2017

Background: Cerebrovascular Accident or stroke is a global health problem and is a leading cause of disability. It is one of the leading causes of mortality and morbidity worldwide.

Materials and methods: A retrospective case-control study carried out on stroke patients admitted to the main Ministry of Health hospitals from May to November 2014. The study consisted of 110 proved cases of stroke and 110 controls (selected from patients who attended the study hospital for conditions other than stroke). For each case of stroke, one control was selected. The controls matched to cases in respect to age ( ± 3 years), sex and locality. Analyses performed by calculation of Chi-Square test and confidence interval using SPSS program version 20.

Results: Out of 110 patients, (61.8%) were females and (38.2%) males. Mean age of cases was 65.80 years compared to 65.46 for controls. Most of them were living in Gaza city. The ischemic type found in 81.8% patients. The most important medical risk factors associated with CVA was diabetes mellitus and hypertension; which represent 61.9% diabetes mellitus among cases compared to 38.1% among controls (P-value < 0.001) and represent 61.4% among hypertension cases compared to 38.6% among controls (P-value < 0.001). For cardiac disorders, 60.3% of cases compared to 39.7% of controls have cardiac disorders (P-value < 0.021). For lifestyle risk factors, obese represent 56.9% among cases compared to 43.1% among controls (P-value < 0.010), smoking represent 63.6% among cases compared to 36.4% among controls (P-value < 0.001). Sedentary level represent 78.2% among cases compared to 21.8% among controls, (P-value < 0.001) and stress represent 83.8% among cases compared to 16.2% among controls, (P-value < 0.001).

Conclusion: Hypertension and diabetes are the biggest risk factors for stroke in, which can be controlled with appropriate medication and lifestyle changes.
Stop sepsis, save lives
Authors: Labib Ahmed , Khan Samina 
Published: May 2017

Introduction: A large number of patients present to the Emergency Department (ED) with sepsis, severe sepsis or septic shock. Septic shock is associated with 40% mortality risk and is the most common cause of death in the ICU. Moreover, survivors of septic shock are at risk of permanent organ dysfunction, prolonged hospital stay and long term institutionalization. Many of these complications can be minimized and may be avoided by prevention via public health improvement and education, early identification of sepsis, and timely effective intervention.

Methods: IHI quality improvement methodology applied to guide our work. The Quality Leaders from ED, ICUs and general wards were invited to participate and collaborate to develop and test the Sepsis 6 Pathway. From the data collected so far we noted the following: Sepsis patients ages range from as young as 19 to 89 years. The most common sepsis diagnoses are septic shock, pneumonia and urosepsis. For the initial management of sepsis patients 49% are managed in the ED. In August we started monitoring delays in time between the patient's admission and criteria met for sepsis diagnosis; and the time between criteria met for sepsis and referral to ICU. If the patient is admitted to the ward this can be as long as days. If the patient is admitted to MICU or ED it ranges from 0 minutes – 1 hrs. The time between criteria met for sepsis and treatment initiated is the most important indicator we are monitoring, which based on the data collected so far averages between 0 minutes – 1 day.

Conclusion: Sepsis causes avoidable and preventable patient harm. A multi-faceted approach may help reduce morbidity and mortality. Early implementation of the sepsis 6 pathway is underway in HMC across main acute care areas. Outcome measures will be collected and compared against international standards.
Role of point-of-care ultrasound in renal colic patients without hydronephrosis to decrease the length of stay in HGH-ED
Authors: Lamei Mishreky Larissa Michael , Abbasy Mohammed , Khan Saad Salahuddin , Shukla Dhramesh , Pathan Sameer Abdulsattar 
Published: May 2017

Introduction: Renal colic is one of the common abdominal emergency presentations to an ED. The cost of imaging, health care resources and time spent in the Emergency Department (ED) is huge. There is good evidence supporting the role of ED bedside ultrasound in detecting hydronephrosis.1,2 We plan to study the role of bedside ultrasound in renal colic as a pilot audit for the QIP.

Method: A convenience sample was selected prospectively. In all patients, a bedside ultrasound was performed by emergency ultrasound fellow, focused to answer presence or absence of hydronephrosis was performed. The results of ultrasound were recorded using online Google docs. A CT-KUB scan was performed for all these patients as per departmental guidelines. The results of CT and USG finding, disposition, and timings for the registration, to perform USG, and to get CT reports were recorded and analyzed.

Results: A total of 24 patients aged between 18 and 65 years were included in the study. The average length of stay (LOS) in ED was 15.1 hours (3.7–60.3 hours). The mean time to perform bedside USG was 4.0 ± 2.4 hour. The average time to get the CT-KUB results was 6.0 ± 2.4 hours. The negative predicative value of bedside USG was 80%. None of the patients without hydronephrosis had obstructing stone or required admission. In patients without hydronephrosis, the average LOS of ED stay, in disposition based on CT results, was 2.08 hours higher than the disposition bedside USG results.

Conclusion: These observations are limited as part of small audit data. However, it could be future direction to explore, the role of bedside USG performed by ED physicians, in renal colic to decrease the ED LOS.
Hamad General Hospital-Emergency Department (HGH-ED) staff with mass casualty incident/disaster involving children
Authors: Jundi Ibrahim Abu , Guerrero Aldwin , Rull Sandra 
Published: May 2017

Introduction: A mass casualty incident (MCI) or disaster can happen at any time. People at the extremes of ages are affected more especially children. Working in the nation's biggest Emergency Department (ED), Hamad General Hospital (HGH)-ED, staff preparedness is crucial to handle such unfortunate event or events. This study aims to assess the preparedness level, knowledge and the willingness of the HGH-ED staff to deal with MCI/Disaster involving children.

Methods: A prospective descriptive study design-using questionnaire to gather data. The study included a 21-item Questionnaire examining preparedness level, knowledge and the willingness of HGH-ED staff dealing with MCI/Disaster involving children. The questionnaire was send to 720 HGH-ED staff, descriptive statistics were used to describe study variables.

Results: Out of the total responders, 73.5% were ED nurse and 26.4% ED physician the average work experience was 7.81 ± 4.94 years. 74% reported that they have never been involved in disaster/MCI involving children's and 82% of the total responders they don't have any formal training in regard of dealing with pediatric victims of disaster. 64% where either unaware or uncertain about the existence of HGH-ED pediatric specific disaster plan.

Conclusion: The result of our study showed that the preparedness level and the knowledge to deal with disaster/MCI involving children in our ED staff were found to be low due to lack of knowledge of children special needs and lack of experience to deal with children involved in MCI and low level of training that ED staff had.