bluuebunny/crossref_metadata_2025 huggingface dataset:
Embryonic Stem Cell Research: Is it merely the means to an end?
Authors: Pop Christina , Williams Jennifer
Published: February 2021

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The Epidemiology Study in Multiple Sclerosis - Relevance to Natural History
Authors: Sloka Jeffrey
Published: February 2021

Multiple sclerosis (MS) is a chronic, demyelinating disease of the central nervous system white matter that has been extensively studied using the epidemiological approach, and yet an etiology for the disease remains elusive. This paper presents a review of past publications that have made suggestions toward the design of epidemiological studies in MS. A formal search strategy is described, and a short summary of these papers is provided. A natural history of MS based on previous studies is proposed as a framework for describing future directions in the neuroepidemiology of the disease, and categorization based on the clinical forms of MS is described. Within the context of a proposed natural history, suggestions are made on the use of sub-regionalization in cluster studies across different domains, as well as on the use of specific reference points in a patient's lifetime in the analysis of clusters.
Annotating the Mycobacterium avium Genome: A Project in Bioinformatics
Authors: Shersher David D. , Kirtsman Maksim , Katz-Lavigne Mikael , Behr Marcel A. , Semret Makeda
Published: February 2021

Bioinformatic tools facilitate efficient processing and formatting of experimental data and are becoming essential to research in the biological sciences. Whole genome sequencing projects, combined with DNA microarray technology, have allowed genomic comparisons between and within species of microorganisms. The genome of Mycobacterium avium subsp. avium (MAA) has been sequenced by The Institute for Genomic Research (TIGR), but a final and annotated version has not yet been made available. The goal of this project was to annotate the sequence of MAA as a foundation for microarray-based genomic comparisons. We used software to identify and predict open reading frames (ORFs) present in this organism. The ORFs were then compared to those catalogued in two large, online genetic databases for other microorganisms and matched to homologous sequences, allowing the determination of putative functions for each predicted gene. The genome of MAA was determined to contain 4480 genes, the majority of which are homologous to genes found in other Mycobacterial species.
12 TIPS FOR POTENTIAL MJM AUTHORS
Authors: Adams Jean
Published: February 2021

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MEDICINE IN THE 21ST CENTURY
Authors: France Nicholas , Rushforth Bruno , Shakur Rameen
Published: February 2021

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Aortic Root Dilatation and Marfan’s Syndrome: An Alternative Diagosis
Authors: Younas Sheraz , Coupe Michael , Younas Shamyla
Published: February 2021

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Impacting the Practice of Medicine by Industry
Authors: Lin Steven
Published: February 2021

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Book Review: A Different Kind of Doctor: Seeking Social Justice through Medicine
Authors: Kittler Anne
Published: February 2021

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Retrospective review of the epidemiology of epilepsy in special schools for children with cerebral palsy, learning difficulties, and language and communication difficulties
Authors: Peet Danielle Samar
Published: February 2021

Purpose of the study: To determine in children the proportion and characteristics of epilepsy associated with cerebral palsy, learning difficulties and language and communication difficulties in a specific population of two special schools.Basic procedures: Retrospective review of case notes for 142 children in two special schools (school A and school B) in Newcastle, UK.Main findings: School A had more children with learning difficulties (X2 = 32.41, p < 0.01) and active epilepsy (X2 = 3.03, p=0.08) than school B. There were more children with cerebral palsy (X2 = 9.56, p < 0.01) and language and communication problems (X2 = 4.25, p = 0.03) at school B compared to school A. Active epilepsy is significantly more common in children with cerebral palsy (X2 = 7.58, p = 0.01). All children with cerebral palsy and learning difficulties had epilepsy (n = 6). Although not statistically significant, those children who developed epilepsy within the first 24 hours of life were more likely to have cerebral palsy than those who developed epilepsy later in life (X2 = 3.10, p = 0.08). Those children with cerebral palsy tended to have a lower birth weight (t = 3.15, p < 0.01) and a shorter gestation (t = 3.17, p < 0.01) than children without cerebral palsy.Principal conclusions: The data supports evidence from previous studies, demonstrating that epilepsy commonly accompanies cerebral palsy, thus complicating this difficult chronic condition. We show an association between both low birth weight and gestational age, and early age of onset of seizures, in children with cerebral palsy. This illustrates the importance, in these children, of past medical history from birth to determine risk factors for epilepsy later in life.
A Case of Intranasal Meningocele
Authors: Bhat Mamantha
Published: February 2021

Intranasal meningoceles occur as a result of herniation of the meninges into the nasal cavity through a defect in the cribriform plate. These are commonly found in the pediatric population due to a congenital defect in the skull base. Intranasal meningoceles are very rare in adults, and tend to arise only when engendered by trauma. Here, we present the case of a patient with seemingly unprovoked intranasal meningocele.
Encapsulated calcium carbonate suspensions: A drug delivery vehicle sensitive to ultrasound disruption
Authors: Lanting Brent , Barfett Joe
Published: February 2021

A calcium carbonate suspension, encapsulated within particles of calcium alginate hydrogel, is proposed as a drug delivery device susceptible to ultrasound disruption. Spheres approximately 1mm in diameter were prepared by the coaxial airflow method from mixtures of 1% sodium alginate (m/v) and each of 50%, 75% and 100% calcium carbonate (m/v) in distilled water. This product was subjected to cycles of 85 Watt ultrasound in 1 second on/off bursts via a lab sonication system until fully disintegrated, a process requiring between 8 and 20 minutes depending upon initial calcium carbonate concentrations. The spheres subjected to vortex did not demonstrate any signs of mechanical degeneration after 30 minutes. Before use as a model implant, further work is required to develop a method of drying the particles to make them impermeable to drug diffusion before the time of their disruption with ultrasound.
Troponin-I release after cardiac surgery with different surgical techniques and post-operative neurological outcomes
Authors: Bappu Nozeihan Jan , Venugopal Panangipalli , Bisoi Akhshay Kumar , Mankad Pankaj S
Published: February 2021

Cerebral hypoperfusion during cardiopulmonary bypass surgery has been thought to be a factor in the aetiology of brain damage with evidence of post operative neurological deficits. Cardiacspecific biomarkers such as troponin-I, troponin-T and CK-MB have been used extensively to predict myocardial injury and ischaemia. This prospective study investigateed the level of troponin-I release in both off-pump and CPB-technique CABG surgery, as well as postulated a relationship of troponin release and post-operative neurological outcome. A total of 44 adult patients undergoing coronary artery bypass graft (CABG) were enrolled into either an off-pump or on-pump groups, with 22 patients participating in each. Group A (on-pump) underwent myocardial revascularisation with CPB and cardioplegic arrest, while Group B (off pump) underwent beating heart surgery. The measurement of troponin-I is a 1-step enzyme immunoassay method, with specificity and sensitivity set at 0.4 ug/mL. Neurological assessment was done using the NIH Stroke Scale, and neuropsychologic assessment was assessed on cognitive function using modified Weschler Memory Scale, for which scores were standardized to achieve a composite measure of concentration. A set of statistical analysis was done to correlate troponin-I release with different surgical techniques of CPB and OPCAB. Although each independent technique showed a marked rise of troponin-I from baseline to 6 hours post-operatively, the difference in troponin release was not significant between the 2 groups at specified time intervals (p=0.124). There was however a significant correlation of troponin-I release with the number of grafts used in the surgery, irrespective of the type of grafts or surgical technique. None of the patients in either group showed any neurological or cognitive deficits presenting at day 3 and day 7 post-operatively. The findings of this study demonstrate that there is no significant short-term cognitive or neurological dysfunctions post operatively, as indicated by troponin-I release in assessing the severity of myocardial injury.
Editorial
Authors: Carsen Sasha , Xie Chenjia , Fordyce Christopher
Published: February 2021

On the interdisciplinary nature of neuroscience.
An overview of intracranial aneurysms
Authors: Keedy Alexander
Published: February 2021

Intracranial aneurysms are relatively common, with a prevalence of approximately 4%. Unruptured aneurysms may cause symptoms mainly due to a mass effect, but the real danger is when an aneurysm ruptures, leading to a subarachnoid hemorrhage. Most aneurysms are asymptomatic and will not rupture, but they grow unpredictably and even small aneurysms carry a risk of rupture. Intracranial aneurysms are diagnosed and monitored with imaging including intra-arterial digital subtraction angiography, computed tomography angiography, magnetic resonance angiography, and recently transcranial Doppler ultrasonograpy has been proposed as a potential modality. Treatment options include observation, endovascular coiling, and surgical clipping. This paper will review the epidemiology, pathogenesis, clinical presentation, diagnosis, natural history, and management of unruptured saccular intracranial aneurysms.
Acute Toxicity Study of Standardized Faloak Bark ( Sterculia quadrifida R. Br.) Extract on Wistar Rats
Authors: Suci Noviyanah  , Triana Hertiani  , Retno Murwanti  , Siswadi  , Erna Prawita Setyowati
Published: February 2021

The bark of Faloak (Sterculia quadrifida R. Br., Malvaceae) is used for traditional medicine in Indonesia. This study aims to examine the level of toxicity of the Faloak bark standardized ethanolic extract. The barks were collected from East Nusa Tenggara, Indonesia. TLC profile was determined by TLC-densitometry, total phenolic and flavonoid content were determined in ethanolic extract from bark of faloak (S.quadrifida) by UV-V is method. The acute toxicity was performed according to the TD420 method by OECD (2001) on Wistar rats. The animals were grouped into control and treatment groups (2000 mg/kg body weight). All animals were evaluated for possible toxicity signs by measuring body weight, food and water consumption, and histopathological observation. The result of mean concentration of total phenolic content was found to be 17,69±2,01 (%GAE) and concentration of total flavonoid content was found to be 8,56 ± 0,02 (%NE). The results showed that no mortality occurs after 14 days of treatment. In general, no significant changes in animal behavior, body weight, food and water consumption compared to the control group. Histological observation found no sign of toxicity on vital organs. LD50 values obtained from the acute toxicity test results for Faloak ethanol extract (Sterculia quadrifida R. Bark) are higher than 2,000 mg/kg BW and categorized as having a low level of toxicity.
Proportional Counter in X-ray Fluorescence
Authors: QADR Hiwa Mohammad
Published: February 2021

The purpose of this work is to investigate and quantify x-ray fluorescence, its production and its spectroscopy. Characteristic x-ray with different energies was obtained from six various elements using Am-241 source with 59.5 keV. It was found that x-ray energy and intensity increase with increasing atomic number of material. X-ray spectroscopy was studied for such elements in respect to their atomic number and intensity of Kα using proportional counter. Furthermore, x-ray fluorescence was produced from different thicknesses of copper foil using different energies. It was found that there is no substantial difference in x-ray fluorescence yield with higher thickness of the target.
Cesare Zavattini’s Poetics of Objectivity
Authors: Borjan Etami
Published: February 2021

Cesare Zavattini was an acclaimed neorealist screenwriter and a theorist of neorealism. He has played a pivotal role in the critical rethinking of the new postwar Italian cinema although many of his concepts were considered avant-garde for that period. He stood for a direct, spontaneous, and immediate cinema with real people and real events. Despite his desire to eliminate all that was fictional from his films, Zavattini’s concept of new realist cinema cannot simply be described as a documentary approach. He was not so much interested in making documentary films but in making documentary-like fictions. He believed in the potential of cinema to reach a wide audience and in its capacity to be aesthetically subversive. The aspiration for an avant-garde cinema that would reach the masses was a naïve attempt that was too radical for the Italian cinema at the time. Most of his ideas were not accepted in Italy, but he was admired by young filmmakers all over the world. Some of his ideas were realized a few decades later in the works of the famous cinéma vérité and independent avant-garde filmmakers. Throughout his career, Zavattini argued that cinema should be socially committed art. He believed that neorealist films should direct the viewer’s gaze toward specific social issues and voice a subjective judgment on it. In neorealist films, fictional style and documentary rhetoric make the illusion that the experience of characters stands for the experience of the audience.
Samorazumevanje krize humanistike protiv „invazivne” instrumentalne racionalnosti
Authors: Lošonc Alpar
Published: February 2021

Rad se sastoji iz tri dela sa uvodom i konkluzijom. U prvom delu humanistika se sagledava u perspektivi humanizacije i objašnjava se zašto tumačenje njene krize nije samorazumljivo. Na osnovu toga se tretiraju simptomi krize humanistike sada već na osnovu samorazumevanja izabranih aktera čime se tematizuju takvi fenomeni kao što je situacija u obrazovanju, kao i konstelacija određenih oblika znanja koji su neizostavni u pogledu političkog uokvirenja demokratizacije. Osovina kriznih samotumačenja se prezentuje u tome što postoji hegemonski oblik ekonomske racionalnosti koji „invazivnim ispoljavanjem“ transformiše okvire humanistike. Kako može humanistika da reaguje na nastalu situaciju? U drugom delu se traži odgovor upravo na ovo pitanje: koje oblike refleksivnosti može ona da razvija da bi se opirala pomenutoj hegemoniji? Humanistika sadrži u sebi idiosinkratične potencijale koji joj omogućavaju da rastvori vladajuće ideologeme u pogledu instrumentalne racionalnosti i utilitarizma. „Ekonomska humanistika“ je oblik refleksije za humanistiku koja se konfrontira sa pomenutom hegemonijom. U trećem delu se krizom određena humanistika kontekstualizuje posredstvom istorijske dinamike apstraktnosti i pokazuje se zašto je humanistici stalo do toga da reflektira na savremenu finalizaciju apstraktnosti povodom humanizacije. Najzad, iznosi se tvrdnja da mada sadašnja ekspanzija apstraktnosti pogađa humanistiku, kriza podrazumeva postojanje prostora mogućnosti u kojem egzistira neodlučenost.
Priča ili story kao instrument ili mašna (de)humanizacije ili…
Authors: Gajin Igor
Published: February 2021

U znanosti i nastavi humanističke orijentacije sve je vidljivija favorizacija kvantifikacije, mjerljivosti, birokratizirane organizacije sadržaja i neopozitivizma, neo u smislu statističke obradivosti podataka, čime se evidentno prati logika računalne prezentacije informacija (umjesto znanja), a preko toga kapitalističko discipliniranje i nadziranje Gorzovog „nematerijalnog rada“. Internetom, filozofijom mreže, hipertekstom i hiperinformacijskim overloadom fragmentirana, disperzirana i dekontekstualizirana digitalna kultura zaziva u teoriji i praksi opozicijsku reakciju u pravcu reafirmacije klasične priče ili storytellinga kao arhetipske forme humaniziranja, organiziranja i osmišljavanja ljudskoga iskustva i znanja. Međutim, kada Amazon najavljuje da će autora honorirati onoliko koliko je stranica njegova teksta pročitano zahvaljujući aplikacijama za praćenje takvih rezultata, kada Christian Salmon otkriva storytelling kao novi instrument korporativnog businessa, kada storytelling postaje imperativ komercijalne književnosti i sredstvo industrijalizirane standardizacije književnosti, čemu se izlazi u susret trendom radionica za kreativno pisanje, pitanje je kome i čemu priča danas služi. Nije li prošlostoljetna (post)modernistička dekonstrukcija teksta i dezintegracija njegova ideologiziranog smisla bila onoliko humanija koliko se činila nečitljivom, za razliku od današnjeg zavođenja konzumerističkog objekta atrakcijama fabuliranja iz pera „dobavljača sadržaja“?
Prava teksta. Neograničena semioza i granice tumačenja – tragom semiotike Umberta Eca
Authors: Pšihistal Ružica
Published: February 2021

Čitatelju je Eco otvorio vrata još u predsemiotičkoj fazi (Opera aperta, 1962), a potom ga je i naslovom (Lector in fabula, 1979) smjestio u samo središte „priče“ o semiotici književnosti. Preuzevši Peirceov pojam neograničene semioze kao ključ za semiotičku otvorenost teksta, što posljedično otvara potencijalno neograničen broj interpretativnih pokušaja u ekspanziji značenja, Eco je gotovo skrupulozno za- brinut za pogrešna tumačenja semioze. Njegovo ustrajno zagovaranje suradničkoga odnosa čitatelja i teksta sve snažnije poprima oblik apologetskoga zalaganja za prava teksta i nužde ocrtavanja minimalnih granica tumačenja (The Limits of Interpretation, 1990). Potencijalno neograničena semioza, poučavao je Eco, ne vodi apsolutnoj slobodi čitatelja, ne znači da interpretacija nema kriterije i da sve interpretacije imaju happy end. Bio je to glas koji se nije čuo. Eksponencijalni rast čitateljskih „prava“ i „sloboda“ bio je nezaustavljiv u poststrukturalizmu. Zašto su dekonstrukcija i rodni studiji, kao primjeri isključujućih perspektiva (radikalne otvorenosti teksta prepuštenog neograničenoj semiozi / radikalne zatvorenosti teksta koji ima samo ono značenje koje je unaprijed zadano), prekršaji suradničkoga odnosa prema tekstu i možemo li u Ecovoj interpretativnoj semiotici pronaći epistemološka i metodološka uporišta za zaštitu ili ekološku održivost teksta pitanja su koja otvara ova studija.
Hypertensive toxicity of thyrosine kinase inhibitors; Friend or Foe?
Authors: Ergün Barış Kaya , Yusuf Ziya Şener
Published: February 2021

Tyrosine kinase inhibitors (TKIs) are widely used in Oncology practice. Hypertension may develop during cancer treatment and TKIs are well known drugs that are associated with drug related hypertensive toxicity. TKI related hypertensive toxicity is not always the indicator of worse clinical outcomes and it may be the sign of treatment efficacy.
Pig raising practices by unprivileged, ethnic people in Bangladesh
Authors: Ausraful Islam , Ashika Akbar Trisha , Md. Safiul Ahad Sardar , Mohammady Akbor , Abdulla Al Mamun Bhuyan , Md. Sazzad Hossain , Md. Ashraf Zaman Faruk , Sheikh Muhammad Khaled Sharif , Zannatun Nahar , Anisuzzaman Anisuzzaman
Published: February 2021

We interviewed 207 pig raisers from seven different districts of Bangladesh to explore their practices related to their pig farming. We used structured questionnaires to interview the pig raisers and used descriptive statistics for analysis. Most of the pig raisers (54%) were illiterate. 50% (104) of them had a monthly income of less than 10000 BDT and 60% (124) were landless. Most of the pig raisers (92%, 191) were rearing local breed and 67% of them were practicing semi-scavenging system. As feed source 55% (114) pig owners used kitchen waste and 54% (111) used rice husk. The pig raisers mentioned different types of challenges such as social problem (16%), disease (50%), less profitable (20%) and unavailability of feed (19%). In our study, we found that 31% respondents visited veterinarians, 28% visited quack and 21% do not take any action when their pigs were sick. Only 16% pig raisers used vaccines against different infectious diseases and 36% used anthelmintics against parasitic diseases. Awareness buildup of the pig raisers may help them raising pigs in a better way which will improve the farming system and reduce the probability of disease transmission.
Utilization of GeoGebra Application to Increase Students’ Interest and Result
Authors: Samaray Silvana
Published: February 2021

This community service workshop aims to develop students' interest in learning mathematics, especially linear programming using GeoGebra Apllication in order to increase their study results. The teaching and learning process are still used conventional method and have not utilized information and communication technology so far. Mathematics learning tends to be considered abstract and difficult to understand. Therefore, many students become less interested in learning it and it affects low study results. The use of information and communication technology-based learning media can be an alternative to improve the quality of the learning process by providing interesting and effective learning. One of them is by utilizing the GeoGebra application in learning process. The workshop was attended by 32 students using a collaborative approach including lecturing, discussion, question and answer, and demonstration methods. The results of the workshop revealed that students showed high interest during the learning process and their scores increased after learning process using the GeoGebra application. Based on the results of the workshop, it can be concluded that the GeoGebra application can be used as learning media in learning mathematics, especially in understanding linear programming because it can develop students’ interest in learning and improve their study results.
Проблемы и перспективы обеспеченности трудовыми ресурсами сельского хозяйства России
Authors: Ермоленко Ольга Дмитриевна
Published: February 2021

Обеспечение сельского хозяйства трудовыми ресурсами является одним из факторов, обусловливающих эффективность функционирования отрасли. Изучение специфики трудообеспеченности аграрной отрасли на современном этапе развития экономических отношений сохраняет свою актуальность. Рассмотрена обеспеченность отрасли сельского хозяйства трудовыми ресурсами, оценено их состояние, выявлены узкие места кадровой обеспеченности, а также определены факторы, влияющие на формирование кадрового потенциала в отрасли. Проанализировано современное состояние обеспечения трудовыми ресурсами; приведены соотношение городского и сельского населения, а также структура трудовых ресурсов сельского хозяйства по уровню образования.
How the War Began: Conceptualizing Conflict Escalation in Ukraine’s Donbas
Authors: Hauter Jakob
Published: February 2021

This article proposes a new theoretical framework based on conflict escalation theory and the concept of critical junctures to facilitate a more transparent analysis of the war in Ukraine’s Donbas. It argues that researchers have proposed a variety of causes of the outbreak of violence in the region. However, in the absence of an overarching theoretical framework, it remains difficult to analyse the interplay of these causes and compare their explanatory power. In response, this article develops a theory-guided escalation sequence model. According to this model, the conflict’s formative phase consisted of an escalation sequence that lasted from April until August 2014 and comprised six critical junctures. This article argues that attempts to explain the conflict should be evaluated and compared in terms of their ability to explain these critical junctures. It concludes that similar escalation sequence models could improve research on armed conflict beyond the case of the Donbas.
DECORATIVE AND STYLISTIC ORIGINALITY OF UNTSUKUL ORNAMENTAL COMPOSITIONS NOTCHES OF G. GAZIMAGOMEDOV
Authors: Saidova Anzhela Saidovna
Published: February 2021

This article discusses the famous works of the national artist of the Russian Federation G. G. Gazimagomedov, characterizing his ornamental art in a new perspective, through complex formations taken from the traditional material culture of the Avars. The author made an attempt to cover present an artistic of the works of the applied artist, to identify the artistic style and direction in the modern ornamental Untsukul art of notching and inlay. Systematization and analysis of the ornamental notch of G. Gazimagomedov allowed us to get acquainted with the variety of different compositions. The artist in his works uses Arabic calligraphy and ancient Avar sustainable “nakish-ishans” (ornaments). The return to the folk origins contributes significantly to the development of traditional Untsukul art.
CREATIVE ACHIEVEMENTS OF THE POET-SONGWRITER OF MODERNITY MAZHID AKHMEDOV
Authors: Alieva Fatima Abdulovna
Published: February 2021

The article analyses the poetry of Kubachi poet-songwriter Mazhid Akhmedov, whose work has found artistic embodiment of the burning problems of modernity, his poems tell about good and evil, about honor and dishonor, about patriotism, hard work, love for his native land, fellow villagers. The collection especially richly presents love lyrics, which use all kinds of poetic devices and means – epithets, metaphors, comparisons, and figurative expressions characterized by special expressiveness, as well as bearing the imprint of ethnicity.
Immersive virtual reality analgesia in un-medicated laboring women (during stage 1 and 2): a randomized controlled trial
Authors: Momenyan Narges , Safaei Ali Asghar , Hantoushzadeh Sedighe
Published: February 2021

Introduction: In order to manage labor pain, one of the non-pharmacological approaches is immersive virtual reality (VR). This study aimed to evaluate the impact of immersive VR analgesia on labor pain, anxiety and nausea in nulliparous women. Methods: In this interventional study, 52 nulliparous women with a single fetus who expected vaginal delivery were randomly assigned to a VR group (n = 26) and a control group (n = 26). 4 women excluded from the study due to the desire for medical intervention for pain control. A simulated environment (containing nature scenes and sounds) was presented to the women in the VR group. Pain intensity, anxiety, and nausea were measured using a questionnaire. The two groups were compared in terms of cognitive pain, sensory pain, affective pain, anxiety, and nausea. Results: There was a statically significant decrease of cognitive pain during the first stage of labor in the VR intervention group compared to the control group (P = 0.013), whereas in the second stage of labor it was not significant (P = 0.55). There was no significant difference between the two groups in terms of affective pain. Also, sensory pain was significantly decreased only in the first stage of labor in the VR group compared to the control group (P = 0.033). Mothers in the intervention group had a lower level of anxiety compared with those in the control group (P < 0.05), whereas nausea was not significantly different between the two groups (P < 0.05) at all stages of labor. Conclusion: Virtual reality is an effective and feasible non-pharmacological method to reduce pain and anxiety during labor process without major side effects.
Clinical characteristics and outcomes of obstetric patients requiring ICU admission: a 5-year retrospective review
Authors: Zhang Min , Tang Zhan-Hong , Wen Han-Chun , Wu Ying-Lin , Gao Xing-Xin
Published: February 2021

Objective: To investigate the clinical characteristics and outcomes of obstetric patients requiring intensive care unit (ICU) admission in a tertiary hospital. Methods: We retrospectively analyzed the clinical data of all pregnant/postpartum patients admitted to a tertiary ICU from January 2014 to December 2018. Result: One hundred and thirty-three obstetric patients were analyzed. Most patients (114, 85.7%) were admitted postpartum, and 57.9% (n = 77) of ICU admissions were from obstetric causes. The most common obstetric cause of admission was obstetric hemorrhage (32, 24.1%), followed by pregnancy-associated hypertension (25, 18.8%). The most common non-obstetric cause of admission was cardiac disorder (16, 12%). Ninety-eight patients (73.7%) came from non-urban areas. We compared patients from non-urban areas versus urban areas: Acute Physiology and Chronic Health Evaluation (APACHE) II, 8.35 ± 3.14 versus 6.43 ± 2.59 (P = 0.002); standard prenatal care, 62.3% versus 90.3% (P = 0.004); transferred from another hospital, 25.5% versus 2.9% (P = 0.004); blood transfusion, 48% versus 22.9% (P = 0.010); plasmapheresis, 11.2% versus 0% (P = 0.039); multiple-organ dysfunction syndrome, 30.6% versus 11.4% (P = 0.026); mortality, 10.2% versus 2.9% (P = 0.176). Total maternal mortality in ICU was 8.3% (n = 11). The fetal mortality rate was 10.9% (n = 15). Conclusions: A multidisciplinary team approach is essential to improve the management of obstetric hemorrhage, hypertensive disorders and cardiac disorders, which may in turn significantly improve maternal outcomes. Health disparities existed between patients from non-urban versus urban areas: the former was sicker at admission, received less standard prenatal care, were more frequently transferred from other hospitals, received more interventions, developed more complication, and suffered a higher rate of maternal mortality.
Which patients on a gynecologic oncology service will require perioperative transfusion? A single-center retrospective cohort study
Authors: Kirschen Gregory W. , Dayton Samantha M. , Blakey-Cheung Sophia , Pearl Michael L.
Published: February 2021

The purpose of this study was to determine which patient- or surgery-related factors are predictive of need for perioperative transfusion to avoid obtaining unnecessary pre-operative type and screens (T&S). We conducted an observational retrospective cohort study of 1200 women ≥ 18 years old undergoing gynecologic surgery for benign, possibly benign, or malignant indications on a gynecologic oncology service at a university medical center from 2009-2016. A logistic regression model was used to examine patient-related and surgery-related variables predictive of outcome of transfusion. Independent variables included patient demographics, comorbidities, and surgical indication surgical route, and surgical type. Dependent variable was transfusion outcome (T&S only, conversion to type and cross (T&C), or transfusion). Eight hundred ninety-nine (74.9%) women underwent pre-operative T&S, of which 118 (9.8%) were converted to T&C, and 80 (6.7%) received a transfusion of blood or blood products. Cancer indication, major surgery, and preoperative hematocrit less than 36% were significantly associated with need for transfusion (P = 0.002, P < 0.0001, P < 0.0001, respectively). Patients with a benign indication undergoing minor procedures and with normal preoperative hematocrit are least likely to require transfusion.
The knowledge and attitudes of Palestinian women towards different childbirth delivery options
Authors: Samara Bara’a , Sabella Anton R.
Published: February 2021

Purpose: To evaluate the knowledge and attitudes of Palestinian women toward cesarean and vaginal deliveries in public, private and charitable hospitals. Methods: A cross-sectional survey using face-to-face interviews with a sample of 372 pregnant women at 20 and above weeks of pregnancy selected randomly and in proportion to the monthly average antenatal visits to each hospital. Data analysis included descriptive statistics, analysis of variance tests and chi-square tests. Results: The majority of participants 250 (67%) were younger than 29 years old. Most participants 325 (87%) interviewed were aware that pain and muscle weakness are greater after cesarean delivery and as much as 341 (91%) of them knew that a cesarean section (CS) is required if a baby is in the breech position. The results also showed a significant association between women’s knowledge scores and educational level, occupation and income across all 3 types of hospital. Furthermore, most women indicated that they thought it was not a women’s right to request a cesarean and that the decision to deliver by cesarean should rest with the doctors. Conclusion: Approximately 1 in every 4 births was delivered by cesarean among primiparous women (26%). Despite the high cesarean section rates seen in Palestinian hospitals, women in Ramallah predominantly prefer vaginal delivery.
Disseminated intravascular coagulation developed after suction curettage in an adenomyosis patient: a case report and literature review
Authors: Niu Xiao-Cen , Zhu Li-Hua , Qian Zhi-Da , Huang Li-Li
Published: February 2021

Disseminated intravascular coagulation (DIC) is a high mortality coagulopathy. The basic diseases that can induce DIC include: obstetric events, metastatic malignancy, massive trauma and bacterial sepsis. But in this article, we reported on an extremely rare case of DIC in an adenomyosis patient who had undergone suction curettage on account of unwanted pregnancy. The patient had been successfully treated with transfusion of fresh frozen plasma and subcutaneous injection of nadroparin calcium instead of hysterectomy. A decrease in progesterone, bleeding in the adenomyosis lesions, tissue necrosis, releasing of tissue factors, activating of the exogenous coagulation system might play the crucial roles in the pathophysiology of acute DIC. Since early detection and treatment are essential for the prognosis of DIC. It is suggested to strengthen the monitoring of coagulation function in such patients.
The infiltrating ability of abdominal wall endometriosis is associated with ectopic endometrial glandular activity
Authors: Zhang Xiao , He Ying-Ying , Jiang Nan , Sun Zhi-Gang , Yan Feng , Cidanyangzong  , Long Fang , Shi Fang-Xin , Xu Xiao-Guang , Xiao Zhen
Published: February 2021

Introduction: The infiltration pattern of endometriosis is one of the most important pathophysiological features of this lesion. Recent studies indicate the infiltrating nature of endometriosis is associated with a lesion’s genetic characteristics. However, related research regarding abdominal wall endometriosis (AWE) is limited. The aim of this study is to investigate whether AWE lesions with different infiltrating depth have different clinical and pathological features. Material and methods: A retrospective review of all cases of surgically excised AWE from 2001 to 2018 was performed from the records at Dalian Medical University and its affiliated hospitals. Descriptive data were collected and analyzed. Hematoxylin-eosin stained (H&E) slides were re-evaluated by pathologists for the density of ectopic endometrial glands (DOG). Results: Ninety-one cases were included in this study. Cases were divided into three types according to the depth of infiltration of the lesion: the fascia type (38 cases), the muscle type (40 cases) and the peritonieum type (13 cases). The primary analysis showed that mass size (P = 0.009), serum CA125 levels (P = 0.04) and operation time (P = 0.02) were significantly different among the three groups. Analysis showed that the diameter of the lesion was positively correlated with the infiltrating depth of the lesion, as well as the level of serum CA125 and the operation time. Even for lesions larger than 3 cm, serum CA125 levels and operation time still showed positive correlation with the lesion diameter (P = 0.02 and P < 0.01, respectively). Further histological research indicated that ectopic endometrial glands in deep lesions were more active and had higher density compared to masses in the superficial layers. Conclusion: This study suggests the three types of AWEs have different clinical and pathological features. When a lesion infiltrates deep into the abdominal wall, it has a larger size, is associated with increased serum CA125 levels, and needs longer time for surgical excision. The different infiltrating ability of AWEs is associated with different activities of ectopic endometrial glands.
Disability vs the sexual life of women - selected issues
Authors: Plagens-Rotman Katarzyna , Jarząbek-Bielecka Grażyna , Merks Piotr , Mizgier Małgorzata , Kędzia Witold , Wilczak Maciej
Published: February 2021

Sex refers to a set of somatic and mental characteristics. The former are determined according to three criteria: gender, external and internal genital organs, and tertiary sex characteristics (breast, specific hair, specific fat distribution, body proportions), the latter distinguish women from men. Every single person experiences problems related to sex - in childhood, adolescence, maturity, old age. In women, these issues are particularly complex at each stage of development. Additionally, during pregnancy, gynaecologists should discuss sexual health with their patients. The sexual health of women with disabilities is a special issue in this respect. Disabilities are a serious social and health problem in both urban and rural agglomerations. Sexual health problems, in the light of these aspects, should also be the task of rural medicine.
Twin amniotic fluid discordance below 26 weeks of gestation for predicting adverse outcomes
Authors: Fujisaki Midori , Furukawa Seishi , Sameshima Hiroshi
Published: February 2021

Aim: To identify the threshold of monochorionic twins with amniotic fluid discordance (TAFD) below 26 weeks for predicting progression to adverse outcomes. Method: A retrospective study involving 68 women of monochorionic twins that do not meet fetoscope laser photocoagulation criteria was conducted. The TAFD was calculated as the vertical pocket of Twin 1 minus that of Twin 2, and the maximum TAFD in any period from 14 weeks to below 26 weeks was identified. We then calculated the ratio of the vertical pocket of Twin 1 to that of Twin 2 as the maximum TAFD ratio. We attempted to elucidate the cut-off value of the maximum TAFD ratio for adverse outcomes including cases that progressed to twin-twin transfusion syndrome (TTTS) after 26 weeks, twin anemia-polycythemia sequence, or neurologic abnormalities. Results: There were 21 cases of selective intrauterine growth restriction (sIUGR), 4 cases of twins that developed TTTS, one case of twins that developed TTTS with neurologic abnormalities, and 4 cases of twins that developed neurologic abnormalities. The median maximum TAFD ratio of the study group was 1.5. ROC curve analysis showed that a maximum TAFD ratio of 1.9 was the optimal cut-off value. In cases where the maximum TAFD ratio was greater than 1.9, the odds ratio for adverse outcomes was 15.4 when considering the presence of sIUGR. All cases of twins with neurological abnormalities had a maximum TAFD ratio greater than 1.9. Conclusion: Maximum TAFD ratio greater than 1.9 below 26 weeks increased adverse outcomes in monochorionic twins.
Is visual inspection with acetic acid (VIA) a useful method of finding pre-invasive cervical cancer?
Authors: Arab Maliheh , Moridi Atefeh , Fazli Ghazaleh , Ghodssi-Ghasemabadi Robabeh , Maktabi Maryam , Saraeian Samaneh , Sanati Mahdie
Published: February 2021

Purpose of investigation: The prospects for effective cytological screening in the majority of developing countries are limited. This study evaluated visual inspection with acetic acid (VIA) for the diagnosis of CIN 2-3 in case findings. Materials and Methods: In this prospective study, 1437 asymptomatic women were screened using VIA followed by colposcopy-biopsy of all cases. The predictive efficacy of VIA was determined based on pathological confirmation of CIN 2-3 on colposcopy-directed biopsy. Results: In 388 (27%) out of 1437 cases, the VIA was positive. In 31 (2.1%) cases, CIN 2-3 was confirmed on cervical biopsy. The sensitivity, specificity and negative predictive value (NPV) of the VIA were 41.9%, 73.3%, and 98.2%, respectively. Conclusion: The present study confirmed the value of VIA for screening, with sensitivity of 41.9% and NPV of 98.2%. Future studies should determine the best place for VIA testing alongside other types of testing in screening algorithms.
Uterine torsion in a 25-week pregnant female with congenital uterine didelphys and intraoperative complication of uterine atony: a report of a rare clinical case
Authors: Chau Khac Tu , Le Minh Tam , Tran Doan Tu , Nguyen Vu Quoc Huy
Published: February 2021

Uterine torsion is an extremely rare pregnancy-related complication. Its diagnosis is often difficult due to unspecific clinical symptoms, which can be mistaken for other conditions such as placental abruption. A 23-year-old pregnant woman with gestational age of 25 weeks presented with acute abdominal pain and hypertonic uterus. Vaginal examination revealed a septated vagina, double cervix, and double uterus. Bedside sonography revealed absence of fetal cardiac activity and signs of placental abruption. The patient was emergently operated with a preliminary diagnosis of severe placental abruption in the uterus didelphys. During surgery, we noted a double uterus and the fetus had implanted in the right uterus, which was twisted 180 degrees to the left. After detorsion, a low transverse hysterotomy was performed to extract the dead fetus. However, subsequently, the patient developed uterine atony. Subtotal hysterectomy and right adnexectomy were inevitable due to failure of conservative treatment with B-lynch suture. The patient’s postoperative condition was stable, and she was discharged after 5 days.
Tenofovir disoproxil fumarate for preventing mother-to-child transmission of hepatitis B: a literature review
Authors: Baciu Iulia , Domuncu Dalila-Ana , Domuncu Tiberiu , Ciobanu AncaMarina , Voiosu Theodor , Peltecu Gheorghe , Panaitescu AncaMaria
Published: February 2021

Infection with the hepatitis B virus (HBV) is one of the leading global public health issues. Over 250 million people worldwide have chronic HBV infection, out of which roughly 65 million are women in their reproductive age. The most common route of passing the infection in areas of high endemicity is by mother-to-child transmission (MTCT). In children the infection may still occur despite adequate immunoprophylaxis, however, antiviral medication, such as Tenofovir disoproxil fumarate (TDF), may be helpful in reducing the risk of MTCT. A literature review was conducted concerning TDF’s role in preventing MTCT and its safety in pregnancy. Studies were identified by researching various databases up to 2020 for variations of the following sentence: “Tenofovir disoproxil fumarate and Lamivudine and Telbivudine and Entecavir and pregnancy and transmission and safety and HBV”. Prenatal and perinatal adequate management of maternal HBV infection is of utmost importance, with focus on prevention of MTCT as the key strategy to reduce the global HBV infection burden. This review discusses the most up-to-date evidence from a multidisciplinary perspective of using TDF to reduce MTCT of HBV infection as well as its safety profile for pregnant women.
Effective doses 50% and 95% of subarachnoid injection of sufentanil with ropivacaine in lumbar anesthesia for cesarean section in severe preeclampsia
Authors: Wang Jing , Zhou Min , Zhang Li , Zhang Long-Xin
Published: February 2021

Objective: This study aimed to determine the ED50 and ED95 of 10 mg of 0.5% ropivacaine combined with different doses of sufentanil in lumbar anesthesia for cesarean sections in patients with severe preeclampsia by the sequential method. Methods: A total of 47 patients with severe preeclampsia, who underwent cesarean section, were enrolled in the present study. The first patient was given a subarachnoid injection of 10 mg of isobaric 0.5% ropivacaine plus 2.5 μg of sufentanil. If the anesthetic effect was satisfactory, the dose of sufentanil used for the next patient was reduced by 0.5 μg. If the anesthetic effect was unsatisfactory, the dose of sufentanil used for the next patient was increased by 0.5 μg. Results: The ED50 of sufentanil was 1.830 μg, with a 95% CI ranging within 1.517-2.128 μg, while the ED95 of sufentanil was 2.852 μg with a 95% CI ranging within 2.429-4.338 μg. Conclusion: The ED50 and ED95 of 10 mg of isobaric 0.5% ropivacaine combined with different doses of sufentanil in lumbar anesthesia for cesarean sections in patients with severe preeclampsia were 1.830 μg and 2.852 μg, respectively.
Anti-Müllerian hormone levels following laparoscopic ovarian cystectomy with subcutaneous abdominal wall lifting for ovarian endometriomas
Authors: Ono Masataka , Kojima Junya , Hasegawa Ei , Takaesu Yotaro , Sasaki Toru , Nishi Hirotaka
Published: February 2021

Purpose of investigation: To examine changes in anti-Müllerian hormone (AMH) levels following laparoscopic ovarian endometriotic cystectomy with abdominal wall lifting. Materials and methods: This prospective cohort study analyzed 32 patients with endometriomas who underwent laparoscopic surgery between October 2014 and December 2016 in private and university hospitals. We measured blood AMH levels at baseline and at 1, 3, 6, and 9 months following a cystectomy. We also examined the correlations of AMH levels with age at time of surgery, bilateral cysts, cyst diameter, and Douglas fossa occlusion. Main outcome measures include the ovarian reserve based on AMH levels. Results: Compared to baseline (2.14 ± 1.66 ng/mL), AMH levels were significantly reduced at 1 (1.22 ± 1.08 ng/mL) and 3 (1.18 ± 1.02 ng/mL) months post-surgery. However, there were no significant differences between baseline and 6 (1.35 ± 1.02 ng/mL) or 9 (1.37 ± 0.95 ng/mL) months post-surgery. AMH levels were significantly reduced in patients aged ≥ 35 years (1.10 ± 0.98 versus 3.15 ± 1.85 ng/mL, P = 0.001), those with bilateral cysts (1.58 ± 0.98 versus 3.15 ± 1.85 ng/mL, P = 0.006), and those with pouch of Douglas occlusion (1.16 ± 0.90 versus 2.93 ± 1.60 ng/mL, P = 0.002). Conclusions: Abdominal wall lifting yielded the same AMH level changes as insufflation, suggesting that their effects on recurrence and preservation of the ovarian reserve following ovarian cystectomy are comparable. Abdominal wall lifting should be proactively considered when performing laparoscopic surgery for patients with endometriosis. If the ovarian reserve is preserved in the long term despite transient postoperative reduction in the ovarian reserve, physicians should consider surgery with consideration of postoperative artificial reproductive therapy for these patients who desire to have children.
Sâmirî Kıssasıyla İlgili Tevrât’taki İfadelerin Müfessirlere Etkileri
Authors: YALÇIN Selami
Published: February 2021

Hz. Mûsâ Tevrât’ı almak üzere kırk geceliğine Tûr-i Sinâ’ya çıktığında İsrâiloğulları Sâmirî’nin yaptığı altın buzağı heykeline tapmışlardı. Kur’ân’da birkaç sûrede bahsedilen kıssayla ilgili müfessirlerin bazen hem kendileriyle hem de Kur’ân’ın ifadeleriyle çelişen açıklamalarına rastlanılmaktadır. Bu makale bu çelişkile-rin nereden kaynaklandığını tespit etmeyi hedeflemektedir. Kur’ân’da ve Tevrât’ta tafsilatlı olarak anlatılan bu kıssanın benzeşen ve ayrışan yönleri vardır. Makalede önce her iki kutsal kitapta anlatılan kıssa özet-lenmiş, benzerliklerin ve farklılıkların analizi yapılmıştır. Sonra ayrışan noktaların müfessirlerin yorumları üzerindeki etkileri açıklanmıştır. Müfessirlerin bir müphemi veya Kur’ân’ın bahsetmediği bir hususu açık-larken bazen Kur’ân’la örtüşmeyen veya onunla çelişen Tevrât’taki bazı ifadeleri kaynak belirtmeden tef-sirlerine aktardıkları görülmüştür. Yapılan bu nakillerin kaynağının belirtilmemesi, takip eden asırlarda yazılan tefsirlerde çelişkilerin sürdürülmesine yol açmıştır. Ayrıca Hz. Ali (ra) ve İbn Abbâs’tan bu konu-da nakledilen mevkûf rivâyetler de içerik olarak Kur’ân’la örtüşmemektedir. Müfessirlerin, tabiînden nak-ledilen rivâyetlerin kritiğini de pek yapmadıkları görülmektedir. Makalede hedeflenen bir diğer nokta ise bu tür kıssalar üzerinde de eleştirel çalışmaların yapılmasına katkı sağlamaktır.