bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Analysis Between Objective Structured Clinical Examination (OSCE) and Conventional Examination (CE) As a Formative Evaluation Tool in Pediatrics in Semester Examination for Final MBBS Students
Authors: Mondal R , Sarkar S , Nandi M , Hazra A 
Published: October 2012

Background The use of objective structured clinical examination in pediatrics is not common in undergraduate evaluation process. Objective To evaluate the effectiveness of objective structured clinical examination as compare to conventional examination as formative assessment tool in Pediatrics. Methods We conducted a cross sectional comparative study in defined population of 9th semester MBBS students to evaluate the effectiveness of objective structured clinical examination as comparison to conventional examination as formative assessment tool in Pediatrics. We analyzed the perception of objective structured clinical examination among the students. Results Fifty-two students appeared for the objective structured clinical examination evaluation on the first day and 42 turned up for conventional examination on the next day. The 42 students who turned up for both examinations were asked to respond to the perception evaluation questionnaire. Comparison of the two examination styles showed that students fared better in objective structured clinical examination than in conventional examination both with respect to mean total score (p < 0.001) as well as mean percentage score. Out of the 42 subjects who appeared in both examinations, all passed in objective structured clinical examination and 35 passed in conventional examination – this difference was significant by McNemar’s chi-square test (p = 0.016). 73.8% of the students opined in favor of objective structured clinical examination as a better formative assessment tool whereas 9.5% students preferred conventional examination. Conclusions Objective structured clinical examination a statistically significant better evaluation tool with comparison to conventional examination. KATHMANDU UNIVERSITY MEDICAL JOURNAL VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 62-65 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6917
Determinants of Peritoneal Dialysis Technique Failure in Incident us Patients
Authors: Shen Jenny I. , Mitani Aya A. , Saxena Anjali B. , Goldstein Benjamin A. , Winkelmayer Wolfgang C. 
Published: October 2012

Objectives Switching from peritoneal dialysis (PD) to hemodialysis (HD) is undesirable, because of complications from temporary vascular access, disruption of daily routine, and higher costs. Little is known about the role that social factors play in technique failure. Design, Setting, Participants, Measurements We followed for 3 years a nationally representative cohort of US patients who initiated PD in 1996 – 1997. Technique failure was defined as any switch from PD to HD for 30 days or more. We used Cox regression to examine associations between technique failure and demographic, medical, social, and pre-dialysis factors. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs). Results We identified an inception cohort of 1587 patients undergoing PD. In multivariate analysis, female sex (HR: 0.78; 95% CI: 0.64 to 0.95) was associated with lower rates of technique failure, and black race [compared with white race (HR: 1.48; 95% CI: 1.20 to 1.82)] and receiving Medicaid (HR: 1.48; 95% CI: 1.17 to 1.86) were associated with higher rates. Compared with patients who worked full-time, those who were retired (HR: 1.49; 95% CI: 1.07 to 2.08) or disabled (HR: 1.38; 95% CI: 1.01 to 1.88) had higher rates of failure. Patients with a systolic blood pressure of 140 – 160 mmHg had a higher rate of failure than did those with a pressure of 120 – 140 mmHg (HR: 1.24; 95% CI: 1.00 to 1.52). Earlier referral to a nephrologist (>3 months before dialysis initiation) and the primary decision-maker for the dialysis modality (physician vs patient vs shared) were not associated with technique failure. Conclusions This study confirms that several socio-demographic factors are associated with technique failure, emphasizing the potential importance of social and financial support in maintaining PD.
22-Oxacalcitriol Prevents Progression of Peritoneal Fibrosis in a Mouse Model
Authors: Hirose Misaki , Nishino Tomoya , Obata Yoko , Nakazawa Masayuki , Nakazawa Yuka , Furusu Akira , Abe Katsushige , Miyazaki Masanobu , Koji Takehiko , Kohno Shigeru 
Published: October 2012

Objective Vitamin D plays an important role in calcium homeostasis and is used to treat secondary hyperparathyroidism among dialysis patients. The biologic activity of vitamin D and its analogs is mediated by vitamin D receptor (VDR), which is distributed widely throughout the body. Recent papers have revealed that low vitamin D levels are correlated with severe fibrosis in chronic diseases, including cystic fibrosis and hepatitis. The aim of the present study was to evaluate the protective effects of vitamin D against the progression of peritoneal fibrosis. Methods Peritoneal fibrosis was induced by injection of chlorhexidine gluconate (CG) into the peritoneal cavity of mice every other day for 3 weeks. An analog of vitamin D, 22-oxacalcitriol (OCT), was administered subcutaneously daily from initiation of the CG injections. The peritoneal tissue was excised at 3 weeks. Changes in morphology were assessed by hematoxylin and eosin staining. Expression of VDR, alpha smooth muscle actin (as a marker of myofibroblasts), type III collagen, transforming growth factor β (TGF-β), phosphorylated Smad2/3, F4/80 (as a marker of macrophages), and monocyte chemoattractant protein-1 (MCP-1) was examined by immunohistochemistry. Southwestern histochemistry was used to detect activated nuclear factor κB (NF-κB). Results In the CG-injected mice, immunohistochemical analysis revealed expression of VDR in mesothelial cells, myofibroblasts, and macrophages in the thickened submesothelial zone. Treatment with OCT significantly prevented peritoneal fibrosis and reduced the accumulation of type III collagen in CG-treated mice. Among the markers of fibrosis, the numbers of myofibroblasts, cells positive for TGF-β, and cells positive for phosphorylated Smad2/3 were significantly decreased in the OCT-treated group compared with the vehicle-treated group. Furthermore, OCT suppressed inflammatory mediators of fibrosis, as shown by the reduced numbers of activated NF-κB cells, macrophages, and MCP-1-expressing cells. Conclusions Our results indicate that OCT attenuates peritoneal fibrosis, an effect accompanied by reduced numbers of myofibroblasts, infiltrating macrophages, and TGF-β–positive cells, suggesting that vitamin D has potential as a novel therapeutic agent for preventing peritoneal sclerosis.
Campylobacter Peritonitis Complicating Peritoneal Dialysis: A Review of 12 Consecutive Cases
Authors: Ma Terry King-wing , Lee Kin Ping , Chow Kai Ming , Pang Wing Fai , Kwan Bonnie Ching Ha , Leung Chi Bon , Szeto Cheuk Chun , Li Philip Kam-tao 
Published: October 2012

Background Peritoneal dialysis–associated peritonitis secondary to Campylobacter organisms is uncommon. Few studies have assessed either treatment or clinical outcomes. Methods We reviewed all Campylobacter peritonitis episodes occurring in a single dialysis unit from 1994 to 2011. Results During the study period, 12 episodes of Campylobacter peritonitis (0.45% of all peritonitis episodes) were recorded. Diarrhea was uncommon (8.3%). The overall primary response rate was 91.7%; the complete cure rate was 75.0%. Among 6 patients who failed to respond to standard antibiotics by day 5, all improved after administration of an oral macrolide (erythromycin or clarithromycin). Of those 6 patients, 5 experienced a complete cure, and 1 patient experienced relapse of culture-negative peritonitis. No patient required Tenckhoff catheter removal or temporary hemodialysis support. The 30-day mortality was 0%. Conclusions Campylobacter peritonitis might not respond to first-line conventional antibiotics, and an oral macrolide is recommended if Campylobacter is confirmed. The findings from our analysis do not support the use of fluoroquinolone, which is associated with a high resistance rate.
Infinitely Many Solutions for the Prescribed Boundary Mean Curvature Problem in 𝔹N
Authors: Wang Liping , Zhao Chunyi 
Published: October 2012

AbstractWe consider the prescribed boundary mean curvature problem in 𝔹N with the Euclidean metric where ã(x) is positive and rotationally symmetric on We show that if K∽(x) has a local maximum point, then this problemhas infinitely many positive solutions that are not rotationally symmetric on 𝕊N−1.
Globalization, Evolution and Emergence of Direct-to-Consumer Advertising: Are Emerging Markets the Next Pharmaceutical Marketing Frontier?
Authors: Mackey Timothy Ken 
Published: October 2012

Pharmaceutical marketing has rapidly evolved over the past century and has now entered the digital revolution.Â This is exemplified by the rise of direct-to-consumer-advertising (â€œDTCAâ€), which has traditionally been only allowed in the United States and New Zealand in developed countries, but is now expanding in reach to other jurisdictions.Â Enabling the â€œglobalizationâ€ of pharmaceutical DTCA is Internet-related technologies that are not limited to geographical borders and are highly unregulated.Â This DTCA digital â€œspilloverâ€ into markets that prohibit it can have adverse impact on health outcomes and health-related spending. Â Emerging markets may represent the next logically step for digital DTCA proliferation, given their untapped market potential and explosive growth.Â Further research and global health policy reform is necessary to address this â€œemergingâ€ global health issue.
MORPHOLOGICAL RESPONSE TO THE DEEP WATERWAY PROJECT AROUND THE CHANGJIANG ESTUARY, CHINA
Authors: Pan Lingzhi , Ding Pingxing , Ge Jianzhong 
Published: October 2012

Changjiang Estuary is characterized by complex branches and outlets (North Branch, North Channel, North Passage and South Passage). The relatively shallow bathymetry around the mouth limits the navigational potentials (Fig.1). The Deep Waterway Project (DWP) was carried out in the North Passage of South Channel for the purpose of deepening the navigational channel from 7.0m in July 1998 to 8.5m in July 2001 (Phase I), 10.0m in May 2005 (Phase II) and 12.5m in May 2010 (Liu et al. 2004). In addition to dredging, two dykes were constructed to reduce the sediment transport from Jiuduansha and Hengsha Shoals into North Passage. A set of groins was built with connection to dykes for the purpose of strengthening the currents in the middle of channel, which helps the maintenance of the navigational capability.
The construction has significantly changed the local bathymetry in the Changjiang Estuary and within the channel. The high-resolution bathymetry measurements were made over seasons. An evolution trend of the morphological change is revealed, which is discussed in this paper.
APPLICABILITY OF THE PREDICTIVE FORMULAE FOR SUSPENDED SEDIMENT CONCENTRATION ON FULL-SCALE RIPPLED BED AND SHEET FLOW
Authors: Jayaratne Ravindra , Shibayama Tomoya 
Published: October 2012

A significant proportion of the sediment transported in coastal waters consists of sand, which moves in suspension. Transport of sediment suspension in and outside the surf zone occurs predominantly due to vortical motion over wave-generated sand ripples, from sheet flow layer and turbulence under breaking waves. A new set of explicit theoretical formulae was deduced to predict sediment concentration over full-scale rippled beds and sheet flows from the predictive models given in Jayaratne and Shibayama (2007). Previous predictive models were derived using 325 test cases from 1977-1996. The new formulae were also established using dimensional analysis and a best-fit technique. Parameterisation of formulae was carried out with the help of large-scale wave, sediment and concentration data appeared in SANTOSS database (see Van der Werf et al., 2009) which covered 298 test cases from 1987-2007. Reference level was taken where the concentration could be measured without affecting the bed.

Formulae for predicting bed reference concentration (ca), diffusion coefficient (Îµs) and concentration profile [c(z)] on full-scale rippled bed and sheet flow from Jayaratne and Shibayama (2007) were initially assessed with the new datasets. It was identified that the measured and predicted concentration do not agree well in magnitudes and distribution profile since the measured field-scale wave tunnel data have stronger bed shear effect than in the wave flume data used for the previous formulation. Therefore, some variables in previous equations were replaced appropriately with suitable parameters such as Shields parameter with the mobility number (Ïˆ) etc. Bed reference levels (z0) were adjusted based on the value of ca. Empirical constants and exponents in those equations were carefully modified in order to match the measured values using the regression analysis. The applicability of modified empirical formulae on full-scale rippled bed and sheet flow depends highly on z and Ïˆ. Two different suspension regions were identified within the datasets over the rippled beds due to the enhanced mixing processes in the upper layer and the coherent vortex structure in the osillatory boundary layer, hence two types of equations were proposed. Conversely, four distinct suspension regimes were identified over full-scale sheet flow and predictive models were given for upper sheet flow (exponential) and suspension layers (power relationship). The cause for this different behaviour was identified as the presence of different mixing processes in the upper sheet flow and suspension layer.

REFERENCES
Jayaratne, M.P.R. and Shibayama, T. (2007). Suspended sediment concentration on beaches under three different mechanisms, Coastal Engineering Journal, 49(4), 357-392.

Van der Werf, J.J., Schretlen, J.J.L.M., Ribberink, J.S. and O'Donoghue, T. (2009). Database of full-scale laboratory experiments on wave-driven sand transport processes, Coastal Engineering, 56, 726-732.
AN EMPIRICAL APPROACH TO DETECT AN ACCELERATED SEA-LEVEL RISE
Authors: Fickert Maja 
Published: October 2012

Among all consequences of climate change the expected global sea-level rise will have the greatest impact on seaborne navigation and maintaining the seaports. Also for coastal protection planning the knowledge of current sea-level rise is essential.
A hind cast of the global numerical models for the climate scenarios especially for the sea level data is hardly to perform precisely because time series of uneffected sea level data are too short and include no regional aspects. With the knowledge of the sea-level rise in the past and a detection of an accelerated rise the results and predictions of numerical models can be underlined.
Combustion synthesis of high‐purity β‐SiAlON fine powders using natural kaolin
Authors: Niu Jing , Akiyama Tomohiro , Yi Xuemei , Nakatsugawa Isao 
Published: October 2012

SignificanceSingle‐phase β‐SiAlON particles with submicron size were prepared via combustion synthesis (CS) using natural kaolin, Si, and Al as raw materials under a nitrogen atmosphere of 1 MPa. Kaolin could not only act as the raw material to provide the source of oxygen, but also act as the diluent to reduce the reaction temperature by eliminating the structural water during reaction process.
Systematic review of predictors of surgical performance
Authors: Maan Z N , Maan I N , Darzi A W , Aggarwal R 
Published: October 2012

Abstract

Background
Selection criteria for surgical training are not scientifically proven. There is a need to define which attributes predict future surgical performance. The aim of this study was to examine the predictive value of specific attributes that impact on surgical performance.

Methods
All studies assessing the predictive power of specified attributes with regard to outcome measures of surgical performance in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Educational Resources Information Centre databases, and bibliographies of selected articles from 1950 to November 2010 were considered for inclusion by two independent reviewers. Information on study identifiers, participant characteristics, predictors assessed, evaluation methods for predictors, outcome measures, results and statistical analysis was collected. Quality assessment was carried out using the Hayden criteria.

Results
Visual–spatial perception correlated with both subjective and objective assessments of surgical performance, including rate of skill acquisition. Visual–spatial perception did not correlate with operative ability in experts, although it did with operative ability at the end of a training programme. Psychomotor aptitude, assessed collectively, correlated with rate of skill acquisition. Academic achievement predicted completion of a training programme and passing end-of-training examinations, but did not predict clinical performance during the training programme.

Conclusion
Intermediate- and high-level visual–spatial perception, as well as psychomotor aptitude, can be used as criteria for assessing candidates for surgical training. Academic achievement is an effective predictor of successful completion of training programmes and should continue to form part of the assessment of surgical candidates.
Vacuum and mesh-mediated fascial traction for primary closure of the open abdomen in critically ill surgical patients
Authors: Rasilainen S K , Mentula P J , Leppäniemi A K 
Published: October 2012

AbstractBackgroundSeveral temporary abdominal closure techniques have been used in the management of open abdomen. Failure to achieve delayed primary fascial closure results in a large ventral hernia. This retrospective analysis evaluated whether the use of vacuum-assisted closure and mesh-mediated fascial traction (VACM) as temporary abdominal closure improved the delayed primary fascial closure rate compared with non-traction methods.MethodsPatients treated with an open abdomen between 2004 and 2010 were analysed.ResultsAmong 50 patients treated with VACM and 54 using non-traction techniques (control group), the delayed primary fascial closure rate was 78 and 44 per cent respectively (P &lt; 0·001); rates among those who survived to abdominal closure were 93 and 59 per cent respectively. Independent predictors of delayed primary fascial closure in multivariable logistic regression analysis were the use of VACM (odds ratio (OR) 4·43, 95 per cent confidence interval 1·64 to 11·99) and diagnosis other than peritonitis, severe acute pancreatitis or ruptured abdominal aortic aneurysm (OR 3·45, 1·07 to 11·04), which represented the main diagnoses. Prophylactic open abdomen was used to inhibit the development of intra-abdominal hypertension more frequently in the VACM group (28 versus 7 per cent; P = 0·008). Twelve per cent of patients in the VACM group developed an enteroatmospheric fistula compared with 19 per cent of control patients. Among survivors, three of 31 treated with VACM and 17 of 36 controls were left with a planned ventral hernia (P = 0·001).ConclusionThe indication for open abdomen contributed to the probability of delayed primary fascial closure. VACM resulted in a higher fascial closure rate and lower planned hernia rate than methods that did not provide fascial traction.
Accuracy and precision of quantitative digital coronary arteriography: Observer‐, short‐, and medium‐term variabilities
Authors: Reiber Johan H.C. , van der Zwet Pieter M.J. , Koning Gerhard , von Land Craig D. , van Meurs Bert , Gerbrands Jan J. , Buis Beert , van Voorthuisen Ad E. 
Published: October 2012

AbstractCoronary arteriograms are increasingly acquired and stored in digital format, which allows instantaneous review of the pictorial data during the cardiac catheterization procedure. To support the angiographer in choosing the optimal sizes of the recanalization devices and studying the efficacy of the recanalization procedures, we have developed a new analytical software package (Automated Coronary Analysis = ACA) on the Philips DCI (‐SX) digital cardiac imaging system. The ACA‐package allows the objective and reproducible assessment of the morphologic and functional severity of coronary obstructions. Required user interaction is limited to the definition of the start and end points of the coronary segment to be analyzed. Automated contour detection is based on the use of first and second derivative functions along scanlines perpendicular to the automatically computed vessel pathline in the first iteration and perpendicular to the initial contours in the second iteration. These derivative functions have been modified based on the line spread function of the X‐ray imaging chain, which is of particular importance for the accurate measurement of small vessel sizes. Phantom studies have indeed demonstrated that vessel sizes down to 0·66 mm can be measured accurately and reproducibly. Inter‐ and intraobserver variability studies have demonstrated a variability in the obstruction diameter of 0·11 mm and 0·10 mm, respectively, and in the percent diameter stenosis of 5·64% and 3·18%, respectively. These variability studies have been extended to short‐term studies with repeated acquisition in the same angiographic views after 5 min and to medium‐term studies with repeated acquisition in the initial angiographic views at the end of the catheterization procedures. With these standardized repeated acquisition and analysis procedures, the variabilities in the obstruction diameters increased to 0·19 and 0·18 mm, respectively, and remained below 6% in the percent diameter stenosis (5·61 % and 5·28%, respectively). With an analysis time of ∼15 sec on the DCI‐SX, an efficient tool is now available in the catheterization laboratory for the objective and reproducible assessment of vessel dimensions and changes therein as a result of recanalization procedures.
Coronary artery spasm culminating in thrombosis following ergonovine stimulation
Authors: Hays John T. , Hamill R. Dennis , Defelice Clement A. , Raizner Albert E. 
Published: October 2012

AbstractA 53‐yr‐old active man with angina but no angiographically significant obstructive coronary artery disease developed refractory spasm following ergonovine provocation. This resulted in thrombus formation and myocardial infarction. As such, this is the first case in which thrombosis developed at the site of intense coronary artery spasm induced by ergonovine, all of which were documented angiographically. Despite the notable safety of this test, this case re‐emphasizes the potential of ergonovine to produce intractable myocardial ischemia and infarction.
Patent ductus arteriosus presenting in old age
Authors: Hang Chi‐Ling , Sullebarger J. Thompson 
Published: October 2012

AbstractThis report describes an unusual case of patent ductus arteriosus, presenting in old age. The patient is the oldest living female with patent ductus reported thus far in the medical literature [1,2]. She initially presented with chest pressure and dyspnea, and subsequently developed subacute bacterial endocarditis and typical angina pectoris with ECG changes, but with normal coronary anatomy.
Angiographic recognition of a proximal balloon tear during inoue balloon mitral valvotomy
Authors: Chow Wing‐Hing , Chow Tsun‐Cheung , Cheung King‐Loong 
Published: October 2012

AbstractTwo patients in whom a proximal balloon tear accompanied by a unique angiographic appearance occurred during percutaneous balloon mitral valvotomy using the Inoue balloon catheter are described.
Repeat balloon occlusion of a pulmonary arteriovenous fistula following cavopulmonary anastomosis in tetralogy of fallot
Authors: Chen Henry J. , Wargovich Thomas J. , Mickle J. Parker , Hill James A. 
Published: October 2012

AbstractA 30‐year‐old woman with Tetralogy of Fallot and cavopulmonary anastomosis (Glenn shunt) presented with a large pulmonary arteriovenous fistula in the right lower lobe. This report describes the successful management following two successive therapeutic balloon embolizations.