bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Tumor Nekrosis Factor Alpha and Interleukin 6 Levels in Patients with Obstructive Jaundice due to Pancreatobiliary Cancer Who Underwent Biliary Drainage
Authors: Sabarudin Adang , Gani Rino Alvani , Abdullah Murdani , Rumende Cleopas Martin 
Published: April 2017

Background: Obstructive jaundice represents the most common complication of biliary tract malignancy. Obstructive jaundice causes releases of proinflammatory cytokine. There has been controversy about effect of biliary drainage on the change in proinflammatory cytokine level in pancreatobiliary cancer patients. The present study was designed to determine levels of tumor necrosis factor alpha (TNF-alfa) and interleukin 6 (IL-6) in preprocedure of either endoscopic retrograde cholangio pancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTBD) and postprocedure of them in obstructive jaundice patient caused by pancreatobiliary cancer.Method: The study method was before-and-after case study design with consecutive sampling. Blood was collected five days prior to either endoscopic retrograde cholangio pancreatography (ERCP) procedure or percutaneus transhepatic biliary drainage (PTBD) procedure and five days after either of them. Enzyme linked immunosorbed assay (ELISA) was used to determine TNF-alfa and IL-6.Results: Forty subjects were included in this study which consisted of 22 men and 18 women. The age was 55.3 (SD 13.7) years old. According to the results of imaging and endoscopy procedure, twenty-two people were diagnosed cholangicarcinoma, ten people were diagnosed ampulla vateri and eigth people were diagnosed pancreatic tumor. In preprocedure, the TNF-alfa concentration was 4.81 (SD 2.91) pg/mL, the IL-6 concentration was 7.79 (SD 1.57) pg/mL and the bilirubin concentration was 15.5 (SD 6,9) mg%. In postprocedure, the TNF-alfa concentration was 8.05 (SD 6.7) pg/mL, there was a significant increase in TNF-alfa concentration (p = 0.02). However, IL-6 concentration was 7.75 (SD 1.76) pg/mL, there was not any significant chance in IL-6 concentration (p = 0.52). The bilirubin concentration was 11.3 (SD 6,5) mg%.Conclusion: There was a significant increase in mean concentration value of TNF-alfa after biliary drainage procedure. On the other hand there was not any significant decrease in the mean concentration value of IL-6 after biliary drainage procedure.
High Incidence of Hepatitis B Virus Infection in Hemodialysis Patients at Sanglah General Hospital and It’s Risk Factors
Authors: Purnamasidhi Cokorda Agung Wahyu , Mariadi I Ketut , Wibawa I Dewa Nyoman , Kandarini Yenny 
Published: April 2017

Background: Patients receiving maintenance hemodialysis (HD) are at higher risk for Hepatitis B Virus (HBV) infections than in general population. Strict infection control is essential to prevent nosocomial transmission. We aimed to investigate the incidence of HBV infection in the HD population in Sanglah General Hospital as well as risk factors acquired HBV infection.Method: All adult patients receiving maintenance HD (n=267) in 3 dialysis units at Sanglah Hospital were studied between March to June 2016. In this study, medical record of patients on maintenance hemodialysis were reviewed and the patients were interviewed by the researchers to collect data regarding the serology status of these patients before and during HD, and potential risk factors which could be associated with HBV acquisition.Results: Participant mean age was 54.07 ± 0.80 years and 154 (57.7%) were male.We found 21 patients (7.8%) were sero-positive for HBV (HBsAg positive) with mean titer was 9.26±1.85. Of the sero-positive patients,1 patient (4.8%) were known to be infected before the initiation of HD and 20 patients (95.2%) were infected during HD. Incidence of HBV infection during HD was 7.5% (20/266). Sero-positive patients were younger with mean age was 51.81±2.76 years, had longer time on dialysis and had previous blood transfusions. Risk factors, which significant associated with hepatitis B infection were history of transfusion (p0.01; OR: 2.49; 95%CI: 1.29-8.18) and duration of hemodialysis (p 0.01; OR: 1.07; 95% CI: 1.03-3.74).Conclusion: Patients on maintenance HD in Sanglah General Hospital have a high incidence of HBV infection. The factors associated with HBV infection are highly suggestive of nosocomial transmission within HD units. History of transfusion and duration of hemodialysis were significant risk factors for HBV infection in patients receiving maintenance HD.
Concomitant Case of Primary Biliary Cirrhosis and Autoimmune Hemolityc Anemia Responding to Corticosteroid and Ursodeoxycholic Acid in Young Woman
Authors: Kusuma Susanto H , Akil Fardah , Rifai Amelia , Bachtiar Rini R , Daud Numan AS , Parewangi AM Luthfi 
Published: April 2017

Primary biliary cirrhosis (PBC) is an autoimmune liver disease of unknown etiology and is characterized by chronic progressive cholestasis with destruction of the small intrahepatic bile ducts and associated most commonly with antimitochondrial antibodies. PBC is most common in women and is often associated with other autoimmune disease such as autoimmune hemolityc anemia (AIHA), rheumatoid arthritis, thyroiditis, and systemic lupus eritomatosus. We report one case, a 20 years old woman with AIHA have been treated by corticosteroid since last year and she came to the outpatient department (OPD) with fatique and jaundice. The result of laboratory were haemoglobin 8.7 mg/dL, white blood cell 8700 mg/dL, coomb test +2, total bilirubin 33.2 mg/dL, direct bilirubin 29.3 mg/dL, γGT: 297 mg/dL and alkalyphospatase: 158 mg/dL. The result of Abdominal CT scan showed the size of liver and spleen increased and normal common bile duct (CBD). The result of ANA test, anti-nuclear (ANA) and antimitochondrial M2 (AMA M2) antibodies were positive. From the physical examination, laboratory and CT scan Abdomen; the diagnose of this patient was AIHA with PBC. After treatment with corticosteroid (prednison 1mg/kg/day) and ursodeoxicholic acid (UDCA) for several weeks, the clinical manifestation of PBC such as jaundice getting better (the laboratory result: total bilirubin 2.7 mg/dL, direct bilirubin 1.5 mg/dL, gamma GT 80 mg/dL).
Changing trends in caesarean deliveries at a tertiary care Centra: a ten year appraisal
Authors: Paudyal Pooja , Gurung G. , Baral J , Rana A 
Published: April 2017

Introduction: Over the last few decades, the rise in the rates of Caesarean Sections (CS) has become a global phenomenon. The objective of this study was to follow the CS rates over the last 10 years and to compute the various indications of CS in an attempt to analyze the possible reasons for this changing trend in the institute.Methods: All deliveries that took place between April 13, 2004 to April 14, 2014 (Baisakh 2061 BS and Chaitra 2070 BS) in TUTH were retrospectively collected. Annual total number of deliveries, rates of CS, instrumental deliveries and Vaginal Birth after Caesarian Section (VBAC) along with indications for CS were computed and analyzed.Result: A total of 38,770 deliveries were conducted over ten years with 26,791 (69.10%) vaginal deliveries and 11,979 (24.80%) CS. There was a steep rise in the rates of CS from 21.04% in 2004 to 39.23% in 2014. Rates of instrumental deliveries and VBAC remained low at 0.86% to 3.35% and 0.15% to 0.7 % respectively. Fetal distress was the commonest indication of emergency CS while previous CS was the commonest indication for elective CS.Conclusion: Over the last decade, the global trend of rising CS rates was also found to be mirrored at TUTH. The causes for rise in CS rates were- increased diagnosis of fetal distress and oligohydramnios, delivery of most breech by Caesarean sections, low rates of VBAC and instrumental deliveries, complicated referrals from all over the country and last but not the least, threat of malpractice litigations.Journal of Society of Surgeons of NepalVol. 17, No. 2, 2014, Page: 7-11
Onomástica personal de los vecinos de Pamplona (siglos XII-XIV)
Authors: Cierbide Martinena Ricardo 
Published: April 2017

Le noyau de la ville de Pampelune au cours du Moyen Age était la vieille civitas de Pompaelo, ancienne cité fondée vers l'année 75 a. J.C.. Elle portait le nom de Navarreria parce qu'elle était peuplée de Navarrais - les autochtones qui parlaient le basque -, l'évêque et les chanoines au service de la Cathédrale et les seigneurs de Navarre. Aux pieds de celle-ci se trouvaient les deux bourgs médiévaux de Saint-Sernin et de Saint-Nicolas, qui appartenaient aux francs, originaires d'une part de l'Occitanie et d'autre part du reste de la France.
D'après la documentation des Archives Municipales de Pampelune, on observe que normalement les habitants de la Navarreria portent des noms de famille typiquement navarrais par les désignations des noms de lieu d'où ils sont originaires. Quant aux habitants des bourgs, nous avons quelques Navarrais et surtout des Occitans.
En quelque sorte, les prénoms et les noms de famille de la population de Pampelune (XIIe - XIV siècles) sont un reflet de la diversité d'origine et de langue de ses habitants.
Solar Models in Light of New High Metallicity Measurements from Solar Wind Data
Authors: Vagnozzi Sunny , Freese Katherine , Zurbuchen Thomas H. 
Published: April 2017

Abstract
We study the impact of new metallicity measurements, from solar wind data, on the solar model. The “solar modeling problem” refers to the persisting discrepancy between helioseismological observations and predictions of solar models computed implementing state-of-the-art photospheric abundances. We critically reassess the problem, in particular considering the new set of abundances of von Steiger & Zurbuchen, determined through the in situ collection of solar wind samples from polar coronal holes. This new set of abundances indicates a solar metallicity

, significantly higher than the currently established value. The new values hint at an abundance of volatile elements (i.e., C, N, O, Ne) close to previous results of Grevesse and Sauval, whereas the abundance of refractory elements (i.e., Mg, Si, S, Fe) is considerably increased. Using the Linear Solar Model formalism, we determine the variation of helioseismological observables in response to the changes in elemental abundances, in order to explore the consistency of these new measurements with constraints from helioseismology. We find that for observables that are particularly sensitive to the abundance of volatile elements, in particular the radius of the convective zone boundary (CZB) and the sound speed around the radius of CZB, improved agreement over previous models is obtained. Conversely, the high abundance of refractories correlates with a higher core temperature, resulting in an overproduction of neutrinos and a huge increase in the surface helium abundance. We conclude that the “solar modeling problem” remains unsolved.
Ultra-diffuse and Ultra-compact Galaxies in the Frontier Fields Cluster Abell 2744
Authors: Janssens Steven , Abraham Roberto , Brodie Jean , Forbes Duncan , Romanowsky Aaron J. , van Dokkum Pieter 
Published: April 2017

Abstract
We report the discovery of a large population of ultra-diffuse galaxies (UDGs) in the massive galaxy cluster Abell 2744 (z = 0.308) as observed by the Hubble Frontier Fields program. Since this cluster is ∼5 times more massive than Coma, our observations allow us to extend 0.7 dex beyond the high-mass end of the relationship between UDG abundance and cluster mass reported by van der Burg et al. Using the same selection criteria as van der Burg et al., A2744 hosts an estimated 1961 ± 577 UDGs, 10 times the number in Coma. As noted by Lee & Jang, A2744 contains numerous unresolved compact objects, which those authors identified predominantly as globular clusters. However, these objects have luminosities that are more consistent with ultra-compact dwarf (UCD) galaxies. The abundances of both UCDs and UDGs scale with cluster mass as a power law with a similar exponent, although UDGs and UCDs have very different radial distributions within the cluster. The radial surface density distribution of UCDs rises sharply toward the cluster center, while the surface density distribution of the UDG population is essentially flat. Together, these observations hint at a picture where some UCDs in A2744 may have once been associated with infalling UDGs. As UDGs fall in and dissolve, they leave behind a residue of unbound UCDs.
Prognostic Value of Vascular Endothelial Growth Factor A in the Prediction of the Tumor Aggressiveness in Clear Cell Renal Cell Carcinoma
Authors: Veselaj Fahredin , Manxhuka-Kerliu Suzana , Neziri Arber , Shahini Labinot , Xharra Shefki , Selmani Liridon , Kerliu Lloreta , Kavaja Floren 
Published: April 2017

BACKGROUND: Clear cell renal cell carcinoma (CCRCC) is the most predominant renal tumour with unpredictable tumour behaviour. The aim of the study is to investigate the prognostic value of vascular endothelial growth factor A (VEGF-A) expression in CCRCC and to correlate it with other histological parameters as well as with patient's survival.MATERIAL AND METHODS: Tumour blocks were taken from 40 patients with histopathology diagnosis of CCRCC and tissue block from 20 normal kidneys as a control group were examined using the immuno-histochemical staining for VEGF-A.RESULTS: The VEGF A expression in CCRCC was significantly higher than in the normal kidney tissues (Uâ€™ = 720, P < 0.0001). VEGF A expression values in CCRCC were positively correlated with Disease Free Survival (r = 0.335, P = 0.034) and the tumor necrosis degree (r = 0.181, P = 0.262). VEGF-A expression values in CCRCC did not correlate with CD 31 expression (r = -0.09, P = 0.549), and Progression Free Survival (r = -0.07, P = 0.838). VEGF A expression values in CCRCC were negatively correlated with the tumor nuclear grade (r = -0.161, P = 0.318); the pathological tumor stage (r = -0.371, P = 0.018); the tumor size (r = -0.361, P = 0.022); the degree of tumor hemorrhage (r = -0.235, P = 0.143); and Cancer Specific SurvivalÂ Â (r = -0.207, P = 0.713).CONCLUSIONS: VEGF-A expression can be used to stratify advanced and metastatic CCRCC patients into low-benefit and high-benefit groups. Based on this study outcome it would be useful to perform IHC staining for VEGF-A expression in all patients with advanced and metastatic CCRCC.
La territorialisation de la politique rurale en Algérie, adaptation ou rupture ? Analyse à partir d’une étude de cas : la wilaya de Tizi Ouzou
Authors: Chenoune Ouarda , Pecqueur Bernard , Djenane Abdelmadjid 
Published: April 2017

En Algérie, une politique faisant référence à un processus ascendant « bottom up » est mise en œuvre depuis 2004, visant la redynamisation des territoires ruraux. Son outil opérationnel est le projet de proximité de développement rural intégré (PPDRI). Après dix années de mise en œuvre, cet article s’interroge sur l’impact de ces politiques. Nous nous appuyons sur les résultats d’une étude de cas, la wilaya de Tizi Ouzou, pour analyser les processus organisationnels et de mise en œuvre des PPDRI, dans une perspective de développement territorial.
Quand le psychanalyste est témoin d’un crime
Authors: Sibony-Malpertu Yaelle 
Published: April 2017

En séance, certains crimes sont révélés. Nous soulignons la difficulté que la pensée ne soit pas entravée par la fascination traumatique exercée par le crime et par la figure du criminel. Nous proposons certaines issues pour s’y soustraire, notamment par une certaine approche des thèses d’Hannah Arendt sur la « banalité du mal ». Enfin, nous donnons certaines précisions concernant l’écoute psychanalytique du réel traumatique, par rapport à celle des fantasmes, hors contexte criminel.
Déplacements meurtriers.
Authors: Bonnellier Roseline 
Published: April 2017

Le Fils d’Arthur Schnitzler est une histoire de matricide. Avant de mourir, la mère avoue au médecin sa tentative autrefois de tuer son enfant et lui demande d’aller au tribunal en témoigner pour décharger son fils. L’intérêt de Theodor Reik pour cette nouvelle dans Arthur Schnitzler als Psycholog annonce son essai ultérieur sur la « compulsion d’aveu ». Mais la théorie de l’Œdipe appliquée est réductrice d’une « question du féminin » que posent les personnages de femmes chez Schnitzler.
Evaluation of the True Wavefront Aberrations in Eyes Implanted With a Rotationally Asymmetric Multifocal Intraocular Lens
Authors: Akondi Vyas , Pérez-Merino Pablo , Martinez-Enriquez Eduardo , Dorronsoro Carlos , Alejandre Nicolás , Jiménez-Alfaro Ignacio , Marcos Susana 
Published: April 2017

PURPOSE:
Standard evaluation of aberrations from wavefront slope measurements in patients implanted with a rotationally asymmetric multifocal intraocular lens (IOL), the Lentis Mplus (Oculentis GmbH, Berlin, Germany), results in large magnitude primary vertical coma, which is attributed to the intrinsic IOL design. The new proposed method analyzes aberrometry data, allowing disentangling the IOL power pupillary distribution from the true higher order aberrations of the eye.

METHODS:
The new method of wavefront reconstruction uses retinal spots obtained at both the near and far foci. The method was tested using ray tracing optical simulations in a computer eye model virtually implanted with the Lentis Mplus IOL, with a generic cornea or with anterior segment geometry obtained from custom quantitative spectral-domain optical coherence tomography in a real patient. The method was applied to laser ray tracing aberrometry data at near and far fixation obtained in a patient implanted with the Lentis Mplus IOL.

RESULTS:
Higher order aberrations evaluated from simulated and real retinal spot diagrams following the new reconstruction approach matched the nominal aberrations (approximately 98%). Previously reported primary vertical coma in patients implanted with this IOL lost significance with the application of the proposed reconstruction.

CONCLUSIONS:
Custom analysis of ray tracing–based retinal spot diagrams allowed decoupling of the true higher order aberrations of the patient's eye from the power pupillary distribution of a rotationally asymmetric multifocal IOL, therefore providing the appropriate phase map to accurately evaluate through-focus optical quality.

[
J Refract Surg.
2017;33(4):257–265.]
Introduction of Two Novel Stiffness Parameters and Interpretation of Air Puff–Induced Biomechanical Deformation Parameters With a Dynamic Scheimpflug Analyzer
Authors: Roberts Cynthia J. , Mahmoud Ashraf M. , Bons Jeffrey P. , Hossain Arif , Elsheikh Ahmed , Vinciguerra Riccardo , Vinciguerra Paolo , Ambrósio Renato 
Published: April 2017

PURPOSE:
To investigate two new stiffness parameters and their relationships with the dynamic corneal response (DCR) parameters and compare normal and keratoconic eyes.

METHODS:

Stiffness parameters are defined as Resultant Pressure at inward applanation (A1) divided by corneal displacement. Stiffness parameter A1 uses displacement between the undeformed cornea and A1 and stiffness parameter highest concavity (HC) uses displacement from A1 to maximum deflection during HC. The spatial and temporal profiles of the Corvis ST (Oculus Optikgeräte, Wetzlar, Germany) air puff were characterized using hot wire anemometry. An adjusted air pressure impinging on the cornea at A1 (adjAP1) and an algorithm to biomechanically correct intraocular pressure based on finite element modelling (bIOP) were used for Resultant Pressure calculation (adjAP1 – bIOP). Linear regression analyses between DCR parameters and stiffness parameters were performed on a retrospective dataset of 180 keratoconic eyes and 482 normal eyes. DCR parameters from a subset of 158 eyes of 158 patients in each group were matched for bIOP and compared using
t
tests. A
P
value of less than .05 was considered statistically significant.

RESULTS:
All DCR parameters evaluated showed significant differences between normal and keratoconic eyes, except peak distance. Keratoconic eyes had lower stiffness parameter values, thinner pachymetry, shorter applanation lengths, greater absolute values of applanation velocities, earlier A1 times and later second applanation times, greater HC deformation amplitudes and HC deflection amplitudes, and lower HC radius of concave curvature (greater concave curvature). Most DCR parameters showed a significant relationship with both stiffness parameters in both groups.

CONCLUSIONS:
Keratoconic eyes demonstrated less resistance to deformation than normal eyes with similar IOP. The stiffness parameters may be useful in future biomechanical studies as potential biomarkers.

[
J Refract Surg.
2017;33(4):266–273.]
Collagen Cross-linking With Photoactivated Riboflavin (PACK-CXL) for Bacterial Keratitis After Small Incision Lenticule Extraction (SMILE)
Authors: Chan Tommy C.Y. , Chow Vanissa W.S. , Jhanji Vishal 
Published: April 2017

PURPOSE:
To report a case of infectious keratitis after small incision lenticule extraction (SMILE) treated with collagen cross-linking with photoactivated riboflavin (PACK-CXL).

METHODS:
Case report and literature review.

RESULTS:
A patient presented with culture-proven bacterial keratitis 5 days after SMILE was treated with fortified topical antibiotics and PACK-CXL. Irrigation of the corneal cap–stromal bed interface, which can be difficult and affect visual outcomes, was not performed. Clinical improvement was seen shortly after treatment and resolution of keratitis was achieved at 2 weeks.

CONCLUSIONS:
This is the first reported use of PACK-CXL in the management of infectious keratitis after SMILE. PACK-CXL may help sterilize the infection and limit its spread within the interface.

[
J Refract Surg.
2017;33(4):278–280.]
Demographic and Socioeconomic Characteristics of Outpatients Could Modify Their Attitude towards Misusing Medications in Northern Jordan
Authors: Haddad Mansour , Ebada Mohamed Elsaed 
Published: April 2017

Background Potentially inappropriate drug use, including prescribed and over-the-counter medications, is associated with increased morbidity and mortality. It also contributes to unnecessary expenditure on health services. This survey was undertaken to investigate the incidence of drug misuse and associated socioeconomic/demographic characteristics in Irbid, Jordan. Design and Methods The present cross section study was conducted using a validated 5-point Likert scale questionnaire to be self-reported by 480 outpatients visiting clinics in three major medical centres in Irbid, Jordan between 20th October 2015 and 27th November 2015. Descriptive analysis, chi-square tests and ordinal logistic regression models were performed. Results Patients demonstrated distinctive attitudes towards medication misuse (P<0.001). Whereas around 40% of patients sometimes stopped taking medications earlier than prescribed or doubled the dose in case of missing a dose, three quarters and two fifth of participants neither used expired drugs nor continued to take a drug when adverse drug reactions occurred, respectively. Also, there were significant associations (P<0.05) between patients’ attitudes towards misusing medications and characteristics like age, gender, income and marital status. For instance, senior patients (>45 years) tended to double a medication's dose in case of no improvement, and to use others’ leftover drugs without medical supervision. Further, male and female patients exhibited different attitude towards misusing medications. Unemployment and little earnings increased the risk for not using drugs properly. Furthermore, married patients were less likely to misuse medications. In particular, the educational level of patients was found to play a major role in modifying patients’ attitudes towards potentially inappropriate drug use. Patients holding one or more university degrees were at lower risk for using medications inappropriately. Conclusions This survey indicated that northern Jordanians inappropriately used medications to a great extent, suggesting that the current policies should be revised, and emphasising the importance of running public antidrug misuse awareness campaigns and establishing advanced educational/training events targeting healthcare professionals.