bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of midlife on migraine in women: summary of current views
Authors: Pavlović Jelena M.
Published: October 2020

Migraine is three times more common in women than in men and is the 4th leading cause of disability in women. Onset of migraine increases at menarche, with peaks in prevalence in the late 30s, and a rapid decline after menopause. While the prevalence is highest among women of childbearing age the frequency of headache and burden of migraine frequently worsens during midlife. Abundant population data suggest that hormonal factors may trigger headache attacks and influence onset and remission. The midlife worsening of migraine is attributed to hormonal fluctuations characteristic of the menopausal transition. Drops in estrogen presumably lead to increased migraine attacks at the time of menses as well as during the menopausal transition. During the menopausal transition, recommended approaches include both acute and preventive non-hormonal and hormonal options as well as behavioral approaches. Herein, is a brief review on the presentation of migraine in women across the lifespan, with special emphasis on midlife and the menopausal transition and implications for treatment.
Erosion of a right ventricular pacer lead into the left chest wall
Authors: Herr Michael J. , Cottrell J. Macy , Garrett H. Edward , Weiman Darryl S.
Published: October 2020

Background

Erosion of a pacer lead into the chest wall may result in pericardial effusion with cardiac tamponade. Free rupture into the pleura or mediastinum can result in hypotension and cardiac arrest.

Case presentation

We report a unique case of a right ventricular pacer lead which eroded through the right ventricle into the left chest wall and penetrated a rib. The patient presented with a tender chest wall mass without pericardial or pleural effusion. The segment of rib which the pacing lead had penetrated was removed.

Conclusions

The patient tolerated the procedure well and was discharged 1 week after the operation. This case adds to the current literature the justification of removal of temporary and non-functional pacing leads.
Relative Age Effects in Male Japanese Professional Athletes: a 25-Year Historical Analysis
Authors: Sasano Nao , Katsumata Yoichi , Nakata Hiroki
Published: October 2020

Background

The mechanisms underlying the relative age effect (RAE), a biased distribution of birth dates, in sport events have been investigated for more than two decades. The present study comprised an historical analysis involving the most recent quarter-century (1993–2018) on RAEs among Japanese male professional athletes (soccer, baseball, basketball, and volleyball) to clarify how the RAEs changed over time.

Methods

Birth data were obtained from 7805 Japanese male professional athletes registered in 1993, 2001, 2010, and 2018. The athletes were divided into four groups based on their month of birth: quartiles Q1 (April–June), Q2 (July–September), Q3 (October–December), and Q4 (January–March of the following year). In addition, based on the data in 1993 for soccer and baseball and in 2010 for basketball and volleyball, the expected numbers of players were calculated in 2001, 2010, and 2018 for soccer and baseball, and 2018 for basketball and volleyball.

Results

Significant RAEs were observed among soccer and baseball players in 1993, 2001, 2010, and 2018, and strong tendencies of RAEs were found among basketball and volleyball players in 2010 and 2018. The magnitudes of the RAEs in soccer, baseball, and volleyball decreased over time, but not in basketball.

Conclusion

The exact reasons for the decreasing or unchanging RAEs among these professional players remain unclear, but socio-cultural factors, such as low birthrates and the popularity of sports in Japan, might be related to the changing RAEs.
Feasibility of the SINEX program for patients with traumatic anterior shoulder instability
Authors: Hagesæter Amalie Nilssen , Løvold Tonje , Juul-Kristensen Birgit , Blomquist Jesper , Hole Randi , Eshoj Henrik , Magnussen Liv Heide
Published: October 2020

Background

An optimal treatment for traumatic anterior shoulder instability (TASI) remains to be identified. A shoulder instability neuromuscular exercise (SINEX) program has been designed for patients with TASI, but has not yet been tested in patients eligible for surgery. The purpose of this study was to investigate and evaluate the feasibility and safety of the SINEX program for patients diagnosed with TASI and eligible for surgery.

Methods

A feasibility study with an experimental, longitudinal design using both quantitative and qualitative research methods. A total of seven participants underwent the SINEX program, a 12-week exercise program including physiotherapist-supervised sessions. Feasibility data on recruitment, retention, compliance, acceptability and safety was collected through observation and individual semi-structured interviews. Clinical tests and self-report questionnaires were completed at baseline and 12 weeks follow-up. Clinical assessments included apprehension and relocation tests, shoulder joint position sense (SJPS), shoulder sensorimotor control measured by center of pressure path length (COPL) on a force platform, isometric strength measured by Constant Score-Isometric Maximal Voluntary Contraction (CS-iMVC), self-report questionnaires including Western Ontario Shoulder Instability Index (WOSI), Tampa Scale of Kinesiophobia (TSK) and Global Perceived Effect questionnaire (GPE).

Results

With one participant recruited every 2 weeks, the recruitment rate was 50% lower than expected. Two of seven participants achieved compliance, defined as at least 66% completion of the scheduled home exercises and at least 50% attendance for the physiotherapist supervised sessions. Barriers for successful compliance were (1) inability to take along exercise equipment when travelling, (2) sick leave, (3) holidays and (4) lack of time/busy days. Four adverse events occurred, one of which was related to the intervention (patellar redislocation). All participants expressed satisfaction with the intervention and felt safe during the exercises. All participants improved in the GPE. Change greater than minimal detectable change (MDC) was reported in four participants in some of the outcome assessments. One of the seven participants declined surgery.

Conclusion

Further assessment is required on several areas before performing an RCT evaluating the efficacy of the SINEX program for patients with TASI considered eligible for surgery. No adverse events suggest that the program is safe, but patients with general hypermobility may need additional adjustments to prevent adverse events in other areas of the body.

Trial registration

ClinicalTrials.gov: NCT04152304, retrospectively registered
Feasibility study on the adoption of the WHO safe childbirth checklist by front-line healthcare providers and managers in Burkina Faso and Côte d’Ivoire
Authors: Kourouma Kadidiatou Raissa , Yaméogo Wambi Maurice Evariste , Doukouré Daouda , Agbré Yacé Marie Laurette , Tano Kamelan Akoua , Coulibaly-Koné Soltié Aminata , Millogo Tiéba , Kouanda Séni
Published: October 2020

Background

The World Health Organization Safe Childbirth Checklist tool was specifically designed for developing countries such as sub-Saharan African countries, to ensure safety and security of the couple mother and newborn around the time of childbirth. However, the implementation of the Safe Childbirth Checklist tool requires a good knowledge of the context setting to face challenges. Our study objectives were (1) to assess the acceptability of the WHO SCC tool and (2) to identify conditions and strategies for a better introduction and use of the WHO SSC tool.

Methods

This was a pilot multi-country study conducted from January to March 2019 in Burkina Faso and Côte d’Ivoire, respectively, in the health regions of central-North and Agnéby-Tiassa-Mé. In each health region, 5 health facilities of different levels within the health system pyramid were selected through a purposive sampling. The study was conducted in 2 phases: 38 healthcare providers and 15 managers were first trained to use the Safe Childbirth Checklist tool; secondly, the trained providers were allowed to use the tool in real-life conditions for 2 weeks. Then, semi-structured interviews were conducted among healthcare providers and managers. The topics covered by the interview guides were acceptability of the tool, barriers and facilitators to its use, as well as strategies for better introduction and use within the healthcare system. Analysis was carried out using the Nvivo 12 software.

Results

Respondents reported an overall good acceptance of using the tool. However, they suggested minor content adaptation. The design of the tool and increased workload were the main barriers to its use. Potential facilitators to its introduction were managers’ commitment, healthcare providers’ motivation, and the availability of supplies. The best strategies for optimal use were its attachment to existing tool such as partograph or/and its display in the maternity ward.

Conclusions

The findings showed that the implementation of the Safe Childbirth Checklist tool is acceptable in Burkina Faso and Côte d’Ivoire. These findings are important and will help to design a trial aiming at assessing the effectiveness of the tool WHO SCC tool in these two countries.
Spinal cord stimulation alleviates intractable pain due to malignant pleural mesothelioma: a case report
Authors: Maeda Aiko , Watanabe Masatsugu , Saigano Chiaki , Nakayama Shoko , Yamaura Ken
Published: October 2020

Background

Patients with malignant pleural mesothelioma (MPM) frequently complain of intractable pain that is resistant to conservative treatments. Although spinal cord stimulation (SCS) may be promising in the alleviation of such devastating pain, the effects of SCS on MPM-associated pain and the appropriate timing of its application remain unknown.

Case presentation

A 66-year-old man diagnosed with MPM presented with severe neuropathic pain due to rapid progression of the tumor to the intercostal nerves. The patient immediately decided to receive SCS implantation and burst stimulus, which relieved the conservative therapy-resistant pain and improved his sleep and daily activities.

Conclusion

This report suggests that the execution of SCS as soon as possible may help to alleviate MPM symptoms. Since MPM extends aggressively to the thorax and nerves that cause mixed nociceptive and/or neuropathic pain, appropriate pain management requires the proper assessment of the etiology by an expert in pain management.
Dialysis efficacy and pain levels in relation to cannulation distance using the buttonhole technique
Authors: Kal Öznur , Duman Enes , Kal Ali
Published: October 2020

Objective

In this study, we investigated whether there was any difference in pain and dialysis efficacy when patients who initially entered dialysis with the rope ladder technique were switched to the buttonhole technique.

Methods

We reduced the space between needles and examined the effects on access blood flow rate, dialysis efficacy, and pain levels with BH technique. Forty-four patients participated, 25with dialysis needles placed 5–7 cm apart using the BH technique, and 19 with needles placed 7–10 cm apart.

Results

There was a significant reduction in the pain sensation in both groups from patients who passed the rope ladder technique to the buttonhole technique from the onset to the sixth month. There was no difference in dialysis efficacy between the patients who passed the lope ladder technique to the buttonhole technique; also, there was no difference in the dialysis efficacy compared to the needle entry interval in two groups of patients who were dialyzed with the BH technique.

Discussion

The BH technique continues to attract interest due to its dramatically reduced pain levels compared to the RL technique and no difference in dialysis efficacy.
A study protocol for the development of a multivariable model predicting 6- and 12-month mortality for people with dementia living in residential aged care facilities (RACFs) in Australia
Authors: Bicknell Ross , Lim Wen Kwang , Maier Andrea B. , LoGiudice Dina
Published: October 2020

Background

For residential aged care facility (RACF) residents with dementia, lack of prognostic guidance presents a significant challenge for end of life care planning. In an attempt to address this issue, models have been developed to assess mortality risk for people with advanced dementia, predominantly using long-term care minimum data set (MDS) information from the USA. A limitation of these models is that the information contained within the MDS used for model development was not collected for the purpose of identifying prognostic factors. The models developed using MDS data have had relatively modest ability to discriminate mortality risk and are difficult to apply outside the MDS setting. This study will aim to develop a model to estimate 6- and 12-month mortality risk for people with dementia from prognostic indicators recorded during usual clinical care provided in RACFs in Australia.

Methods

A secondary analysis will be conducted for a cohort of people with dementia from RACFs participating in a cluster-randomized trial of a palliative care education intervention (IMPETUS-D). Ten prognostic indicator variables were identified based on a literature review of clinical features associated with increased mortality for people with dementia living in RACFs. Variables will be extracted from RACF files at baseline and mortality measured at 6 and 12 months after baseline data collection. A multivariable logistic regression model will be developed for 6- and 12-month mortality outcome measures using backwards elimination with a fractional polynomial approach for continuous variables. Internal validation will be undertaken using bootstrapping methods. Discrimination of the model for 6- and 12-month mortality will be presented as receiver operating curves with c statistics. Calibration curves will be presented comparing observed and predicted event rates for each decile of risk as well as flexible calibration curves derived using loess-based functions.

Discussion

The model developed in this study aims to improve clinical assessment of mortality risk for people with dementia living in RACFs in Australia. Further external validation in different populations will be required before the model could be developed into a tool to assist with clinical decision-making in the future.
Assessment of QIAGEN™ Investigator® 24plex GO! kit workflow for autosomal STR profiling of forensic reference samples
Authors: Hakim Hashom Mohd , Khan Hussein Omar , Ismail Siti Afifah , Lazim Nurul Hazirah Mat , Lalung Japareng , Kofi Abban Edward , Chambers Geoffrey Keith , Edinur Hisham Atan
Published: October 2020

Background

DNA profiling has proven to be a valuable technique for identification of individuals in crime. Currently, the technique targets several short tandem repeat (STR) regions in human genome. However, increasing number of samples submitted for STR analysis may lead to delays due to the limited number of experienced analysts who might be available at any given moment and the time taken to complete lengthy DNA profiling procedures. This study was conducted to test the specificity, repeatability, reproducibility and robustness of Investigator® 24plex GO! kit for genotyping of reference samples submitted to the Royal Malaysian Police Forensic DNA Laboratory for DNA database.

Material and methods

In this study, Investigator® 24plex GO! kit was used to directly amplify STR loci from buccal swab cell of reference samples that had previously been STR typed using GlobalFiler™ Express kit. Capillary electrophoresis was carried out on a 3500xL Genetic Analyser using POP-4® Polymer. Amplified products were assigned to particular STR alleles using the GeneMapper ID-X version 1.4 software.

Results

Our study shows that STR profiles generated using Investigator® 24plex GO! gave concordance results with those previously obtained using the GlobalFiler™ Express kit. In addition, quality sensors included in the kit are of particular importance for determining the effectiveness of the PCR reaction and help to indicate the nature and quantity of DNA template for PCR amplification.

Conclusion

The Investigator® 24plex GO! kit is reliable for STR typing of reference samples.
Perforation index assessment of cowpea seeds against cowpea bruchid, Callosobruchus maculatus (Fabricius) [Coleoptera: Chrysomelidae], infestation using Piper guineense
Authors: Ileke Kayode David , Adesina Jacobs Mobolade , Nwosu Luke Chinaru , Olagunju Abimbola
Published: October 2020

Background

Powders and extracts ofPiper guineenseseeds and leaves were assessed for insecticidal activities againstCallosobruchus maculatusin the laboratory at temperature and relative humidity of 29.6 °C and 75.9%, respectively. Bioactive compounds inP.guineenseleaves and seeds were also investigated. The powders were tested at rates 1.0, 2.0 and 4.0 g/20 g cowpea seeds while extracts were tested at 1.0, 2.0 and 3.0%.

Results

Results of contact toxicity assay of the seed powder caused 100% adult mortality at 96 h post-treatment period whereas leaf powder evoked 90% adult mortality within the same period at concentration of 1.0 g/20 g cowpea seeds. Low adult emergence was observed on cowpea seeds treated with 1 g of seed powder with percentage adult emergence of 10.0% and inhibition rate (IR) of 97.5%. Beetle Perforation Index (BPI) obtained from treated cowpea seeds was significantly different (P< 0.05) from BPI of untreated seeds. Extracts ofP.guineenseseed were more toxic than seed powder.Piper guineenseseed extract caused 87.5% adult mortality ofC.maculatuswhile leaf extract caused 70.0% adult mortality within 24 h of infestation at concentration of 1%. Progeny development ofC.maculatuswas completely inhibited in cowpea treated with 2% and 3% leaf and seed extracts ofP.guineense. β-Pinene was the most abundant active compound inP.guineenseseed (55.6%) and leaf (48.4%). β-Phellandrene occurred 38.2% in seeds while Ocimene had the least value of 0.2% in seed and 0.5% in leaf.

Conclusion

The study showed thatP.guineenseseed powder and extracts were more effective than leaf powder and extract. Utilization of plant products as alternative to synthetic insecticides in protecting cowpea seeds againstC.maculatusshould be encouraged for enhanced food safety and security.Piper guineenseis used as spice and medicine and interestingly safe for human use.
Energy reserves in Brevicoryne brassicae (Lin.) (Homoptera: Aphididae) instars and their effect on predation and longevity of three coccinellid species under laboratory conditions
Authors: Askar Salama Ibrahim , El Husseini Monir Mohamed
Published: October 2020

Background

Contents of carbohydrates, protein, and lipids in tissues of insect prey constitute the required energy reserve utilized by their predators. Their amounts define the preference of the predator to certain prey on which its biological performance is the optimum. Feeding preferences and longevity of the 3 coccinellid beetles; Coccinella septempunctata L., C. undecimpunctata L., and Scymnus interruptus L. were studied in relation to energy reserve in tissues of the cabbage aphid, Brevicoryne brassicae (Lin.).

Main body

The level of energy reserve increased with increasing of aphid nymphal instars showing the highest in 4th instar (0.10844 cal/mg). Lipids and carbohydrates represented the highest energy reserve average rate in B. brassicae adults (0.29139 and 0.07404 cal/mg), respectively. C. septempunctata larval stage recorded the highest efficiency in daily predation (89.42 prey), when fed on 1st instar nymphs of the aphid. It required 21 days when fed on the 3rd nymphal instar of B. brassicae. S. interruptus larval stage reflected the lowest consumption and longevity in predation where it consumed less than 69.25 prey/day and lasted a period less than 17.5 days. Generation time for C. undecimpunctata lasted the longest (20.89 days) when fed on B. brassicae 1st nymphal instar. It was decreased in S. interruptus recording (12.22 days) when fed on B. brassicae 3rd nymphal instar.

Conclusion

Only C. septempunctata was efficient in predation and its biological performance was the best compared to the other tested coccinellid species. Use of C. septempunctata can be recommended when applying biological control programs in the field against the cabbage aphid.
Statistical optimization of xylanase production, using different agricultural wastes by Aspergillus oryzae MN894021, as a biological control of faba bean root diseases
Authors: Atalla Sherien M. M. , Ahmed Nehad E. , Awad Hassan M. , El Gamal Nadia G. , El Shamy Aliaa R.
Published: October 2020

Background

Xylanase enzyme plays an important role in nature as being a part of protecting the environment from pollution. It has also various industrial applications.

Main body of abstract

Marine fungal isolate was recovered from red sea water at Sharm El-Sheikh province, Egypt, and tested for xylanase activity, using different agricultural wastes as a substrate. It was found that rice straw was the best substrate for xylanase production (0.37 U/ml). Thus, it was subjected for identification by 18S rDNA gene. The phylogenetic analysis results indicated that this fungal isolate belonging toAspergillusspecies with a similarity of 99% and named asA. oryzaeSS_RS-SH (MN894021). The regular two-level factorial design was used to optimize the important medium components, which significantly affected the xylanase production. The model in equation suggested optimal conditions of 2% of rice straw, 8 g/l of yeast extract, 4 g/l of (NH4)2SO4, 2 g/l K2HPO4, and 2.5 g/l MgSO4.7H2O for a maximum xylanase yield. The antifungal activity of crude xylanase on mycelial growth of some pathogenic fungi isolated from different hosts was investigated. The results showed that xylanase T1 had a potent antifungal activity than control. Greenhouse experiments indicated that all treatments with xylanase at different concentrations significantly decreased infection occurrence of beans, which have been effectively infected with root rot pathogens, compared to unprocessed control treatments.

Short conclusion

Xylanase yield increased 2.43-folds than initial screening. The xylanase had a potential antifungal activity both in vitro and under greenhouse conditions. The outcome of this study ensured that this fungal strain could be used as biological control for plant disease.
Parasitism and sex ratio of Diadegma insulare (Cresson) (Hymenoptera: Ichneumonidae) against Plutella xylostella (Linnaeus) (Lepidoptera: Plutellidae) on cruciferous cultivars under different temperatures
Authors: Qureshi Muhammad Sajid , Mohsin Ata ul , Naeem Muhammad , Shah Kausar Nawaz
Published: October 2020

Background

Diadegma insulare (Cresson) is the most efficient parasitoid of Plutella xylostella (L.) in cruciferous crops. Considering its effectiveness, the present study was performed to investigate the impacts of cauliflower and cabbage cultivars under 3 different temperature regimes on the parasitism efficiency and offspring sex ratio of D. insulare.

Main body

This study revealed that D. insulare remained active at all the 3 temperatures (i.e., 19, 23, and 27 °C) and on all selected cruciferous cultivars. However, 23 °C (along with 65±5% RH and 16L: 8D hours) was the most suitable temperature, whereas relatively preferred host plant cultivars were the “White marble” (cauliflower) and “Asha” (cabbage) at which comparatively higher parasitism rates (79.39 and 73.31%, respectively) were recorded. Moreover, non-significant differences were observed in the offspring sex ratios of the parasitoid at different temperature regimes; however, minute differences were found among studied cruciferous cultivars.

Conclusion

Overall, “White marble” (cauliflower) and “Asha” (cabbage) were recommended to be used as potential host plant cultivars for mass rearing of D. insulare.
Potential of standard strains of Bacillus thuringiensis against the tomato pinworm, Tuta absoluta (Meyrick) (Lepidoptera: Gelechiidae)
Authors: Sandeep Kumar J. , Jayaraj J. , Shanthi M. , Theradimani M. , Venkatasamy Balasubramani , Irulandi S. , Prabhu S.
Published: October 2020

Background

The tomato pinworm Tuta absoluta (Meyrick) (Lepidoptera: Gelechiidae) is one of the key pests of tomato worldwide, causing an estimated crop loss of 80 to 100%. This pest has developed resistance to several pesticides due to overuse, resulting in control failures in the field. The use of biological insecticides as Bacillus thuringiensis that expressed insecticidal proteins can be an alternative tool by insecticides to suppress the pest population.

Main body

Laboratory study investigated the efficacy of standard Bacillus thuringiensis (Bt) strains (4D1, 4D4, 4G1, 4K5 and 4XX4) against T. absoluta. Bioassay was conducted using tomato leaf discs treated with spore crystal lysates prepared from the standard strains, and mortality data was subjected to concentration-mortality probit analysis. The LC50 values for Bt 4D1, Bt 4D4 and Bt 4G1 were 6.10, 6.62 and 8.18 μg/ml for the 2nd instar; 9.90, 10.20 and 11.12 μg/ml for the 3rd instar; and 19.82, 23.16 and 24.54 μg/ml for the 4th instar, respectively, while the Bt 4K5 and Bt 4XX4 were not toxic to T. absoluta.

Conclusion

This study suggests that Bt strain 4D1 is effective against different larval instars of the pest and can be used in its management.
Transjugular intrahepatic portosystemic shunt creation via isolated persistent left superior vena cava: a case series
Authors: Lewis Spencer B. , Johnson Guy E. , Valji Karim , Monroe Eric J. , Ingraham Christopher R. , Chick Jeffrey Forris Beecham , Shin David S.
Published: October 2020

Background

Isolated persistent left superior vena cava (PLSVC) is a rare vascular anatomic variant, which can be an incidental finding at the time of an endovascular procedure.

Case presentation

This report describes the technical success, adverse events, and clinical outcomes of transjugular intrahepatic portosystemic shunt (TIPS) creation via isolated PLSVC. Three adult patients with cirrhosis and isolated PLSVC underwent TIPS placement successfully with one major adverse event. Two patients required TIPS revision within 90 days. There were no deaths within 90 days.

Conclusions

TIPS creation via isolated PLSVC is feasible using standard techniques with a left jugular vein approach. Caution is warranted during the procedure to assess for any aberrant drainage pattern to the left atrium and to prepare for potentially challenging instrument navigation through the coronary sinus.
Historic review: the foundation-period and the first 15 years of the “Gesellschaft fuer Neuropaediatrie” (GNP) between 1950 and 1990
Authors: Strassburg Hans Michael
Published: October 2020

After the end of Nazi terrorism with many crimes against neuropsychiatric and disabled people, from 1950 on detection and treatment of these diseases in children and adolescents grew continuously: in the 50s and 60s, several German books on neuropediatric topics were published, a journal was founded, and junior pediatricians established many scientific contacts with foreign neuropediatricians. In 1972, the team of the Kehl-Kork Epilepsy Clinic invited neuropediatric colleagues from Germany, Austria, and Switzerland for a first joint workshop. On March 4th, 1975, the Neuropaediatric Society of the German-speaking countries was founded in Heidelberg and its goals, as well as guidelines for membership, were formulated. The first annual meeting took place 1975 in Heidelberg as well. Between 1975 and 1990, the number of members of the GNP continued to increase from 140 to more than 230, despite strict admission criteria. The president was elected for a one-year term and was responsible for organizing the annual meeting, which took place alternately in Germany, Austria or Switzerland. The continuity of the society was ensured by secretary and treasurer as well as several longtime assessors. The meetings covered the entire spectrum of neurological and neuropsychological disorders in children. In addition to the age-dependent clinical investigation, the most important diagnostic methods were electrophysiology, in particular, the EEG and EMG, the new possibilities of cerebral imaging utilizing X-ray computed tomography and ultrasound, and biochemical analyzes for detection of metabolic diseases. Research projects were mostly carried out in university institutions and were only partially multi-center or financed with public funds. International contacts took place on many levels, e.g. through scholarships and personal exchanges with European and US scientific societies and institutions. Unfortunately, the opportunity to exchange ideas with colleagues from the German Democratic Republic (GDR) was limited. Several working groups addressed controversial issues of developmental neurology, epileptology, and alternative therapies. With the establishment of social pediatric centers in Germany from the late 1980s, there was an increasing demand for well-educated and experienced neuropediatricians.
First live birth after uterus transplantation in the Middle East
Authors: Akouri Randa , Maalouf Ghassan , Abboud Joseph , Nakad Toufic , Bedran Farid , Hajj Pascal , Beaini Chadia , Cricu Laura Mihaela , Aftimos Georges , El Hajj Chebly , Eid Ghada , Waked Abdo , Hallit Rabih , Gerges Christian , Rached Eliane Abi , Matta Matta , El Khoury Mirvat , Barakat Angelique , Kvarnström Niclas , Dahm-Kähler Pernilla , Brännström Mats
Published: October 2020

Background

The first live birth after uterus transplantation took place in Sweden in 2014. It was the first ever cure for absolute uterine factor infertility. We report the surgery, assisted reproduction, and pregnancy behind the first live birth after uterus transplantation in the Middle East, North Africa, and Turkey (MENAT) region.

A 24-year old woman with congenital absence of the uterus underwent transplantation of the uterus donated by her 50-year-old multiparous mother. In vitro fertilization was performed to cryopreserve embryos. Both graft retrieval and transplantation were performed by laparotomy. Donor surgery included isolation of the uterus, together with major uterine arteries and veins on segments of the internal iliac vessels bilaterally, the round ligaments, and the sacrouterine ligaments, as well as with bladder peritoneum. Recipient surgery included preparation of the vaginal vault, end-to-side anastomosis to the external iliac arteries and veins on each side, and then fixation of the uterus.

Results

One in vitro fertilization cycle prior to transplantation resulted in 11 cryopreserved embryos. Surgical time of the donor was 608 min, and blood loss was 900 mL. Cold ischemia time was 85 min. Recipient surgical time was 363 min, and blood loss was 700 mL. Anastomosis time was 105 min. Hospital stay was 7 days for both patients. Ten months after the transplantation, one previously cryopreserved blastocyst was transferred which resulted in viable pregnancy, which proceeded normally (except for one episode of minor vaginal bleeding in the 1st trimester) until cesarean section at 35 + 1 weeks due to premature contractions and shortened cervix. A healthy girl (Apgar 9-10-10) weighing 2620 g was born in January 2020, and her development has been normal during the first 6 months.

Conclusions

This is the first report of a healthy live birth after uterus transplantation in the MENAT region. We hope that this will motivate further progress and additional clinical trials in this area in the Middle East Region, where the first uterus transplantation attempt ever, however unsuccessful, was performed already three decades ago.
Clinical and angiographic characteristics of patients with STEMI and confirmed diagnosis of COVID-19: an experience of Tanta University Hospital
Authors: Alaarag Ahmed , Hassan Timoor , Samir Sameh , Naseem Mohamed
Published: October 2020

Background

Patients with established cardiovascular diseases have a poor prognosis when affected by the coronavirus disease 2019 (COVID-19). Also, the cardiovascular system, especially the heart, is affected by COVID-19. So we aimed to evaluate the angiographic and clinical characteristics of COVID-19 patients presented by ST-elevation myocardial infarction (STEMI).

Results

Our retrospective study showed that STEMI patients with COVID-19 had elevated inflammatory markers with mean of their CRP (89.69 ± 30.42 mg/dl) and increased laboratory parameters of thrombosis with mean D-dimer (660.15 ± 360.11 ng/ml). In 69.2% of patients, STEMI was the first clinical presentation and symptoms suggestive of COVID-19 developed during the hospital stay; about one third of patients had a non-obstructive CAD, while patients with total occlusion had a high thrombus burden.

Conclusion

STEMI may be the initial presentation of COVID-19. A non-obstructive CAD was found in about one third of patients; on the other hand, in patients who had a total occlusion of their culprit artery, the thrombus burden was high. Identification of the underlying mechanism responsible for the high thrombus burden in these patients is important as it may result in changes in their primary management strategy, either primary PCI, fibrinolytic therapy, or a pharmaco-invasive strategy. Furthermore, adjunctive anticoagulation and antiplatelet therapy may need to be revised.
Role of diffusion-weighted MR imaging in diagnosis of acute pancreatitis
Authors: Abuzeid Hanan M. , Yassin Aya , Kamel Omar F. , Sabry Kareem A.
Published: October 2020

Background

The role of diffusion-weighted magnetic resonance imaging (DW-MRI) in the diagnosis of acute pancreatitis is assessed in this study by measuring the apparent diffusion coefficient (ADC) values in acute pancreatitis and comparing them with a control group. The aim of this study is to compare those two groups thus supporting the diagnosis of this disease.

Sixteen patients with acute pancreatitis and 16 control participants underwent diffusion-weighted imaging with b values of 0, 200, and 800. ADC maps were generated from the DW-MRI and ADC values, which were calculated for the pancreas, and the results of the two groups of patients were compared.

Results

The mean pancreatic ADC value in the acute pancreatitis group (1.15 10(−3) mm(2)/s ± 0.28) was significantly lower than in the normal group (1.6 10−3 mm(2)/s ± 0.2). A threshold ADC value of 1.38 10−3 mm(2)/s yielded 81.25%, specificity of 93.75%, positive predictive value of 92.9%, negative predictive value of 83.3%, and accuracy of 91.8%. Pancreatic ADC values were significantly lower in patients with acute pancreatitis than in the control group.

Conclusion

Diffusion-weighted magnetic resonance imaging could be an important supportive tool in the diagnosis of acute pancreatitis.
Determinants of an evidence-based practice environment: an interpretive description
Authors: Duff Jed , Cullen Laura , Hanrahan Kirsten , Steelman Victoria
Published: October 2020

Background

Despite the available research to inform nursing practice, many patients still fail to receive evidence-based care. Several evidence-based practice (EBP) models have been developed to guide nurses through the steps in the process, yet these models have not been uniformly adopted or consistently used. The original purpose of this research was to gather perspectives and experiences of nurses using the Iowa Model of EBP to help inform its introduction into other practice settings. As a more in-depth understanding was gained, the emphasis of the study shifted towards understanding the determinants of the EBP environment.

Method

The study was conducted in an 800-bed comprehensive academic medical centre in the USA with a 25-year history of using the Iowa Model of EBP. Semi-structured in-depth interviews were conducted with twelve nurses from various roles to ascertain their perspectives and experiences using the model. The interview transcripts were reviewed alongside relevant published literature and internal documents in a process of synthesising, theorising, and conceptualising. Data were collected during the first half of 2019.

Results

Four determinants of the local EBP environment were identified from the perspectives and experiences of participants: (1) the importance of a shared model to guide staff through the EBP process; (2) support for EBP in the form of education, hands-on training, and knowledge infrastructure; (3) active team facilitation by direct care nurses, nurse managers, nurse specialists, and nurse scientists; and (4) a culture and leadership that encourages EBP.

Conclusion

Introducing an EBP model is an essential first step for an organisation to improve consistent and reliable evidence-based care; to be most effective, this should be done in conjunction with efforts to optimise the EBP environment.
Development and use of a toolkit to facilitate implementation of an evidence-based intervention: a descriptive case study
Authors: Thoele Kelli , Ferren Melora , Moffat Laura , Keen Alyson , Newhouse Robin
Published: October 2020

Background

Implementation of evidence-based clinical interventions in real-world settings becomes a futile effort when effective strategies to foster adoption are not used. A toolkit, or a collection of adaptable documents to inform and facilitate implementation, can increase the use of evidence-based interventions. Most available toolkits provide resources about the intervention but lack guidance for adaptation to different contexts or strategies to support implementation. This paper describes the development and use of a toolkit to guide the implementation of an evidence-based intervention to identify and intervene for people with risky substance use.

Methods

A descriptive case study describes the development and use of a toolkit throughout a two-year study. Investigators and site coordinators from 14 acute care hospitals developed tools and engaged external stakeholders as they prepared for implementation, integrated the clinical intervention into practice, and reflected on implementation.

Results

The final toolkit included 54 different tools selected or created to define the intervention, engage and communicate with stakeholders, assess for readiness and plan for implementation, train clinical nurses and other stakeholders, evaluate training and implementation effectiveness, create policies and procedures for different contexts, and identify opportunities for reimbursement. Each tool corresponds to one or more implementation strategies.

Conclusion

The approach used to develop this implementation toolkit may be used to create resources for the implementation of other evidence-based interventions.
Effect of an oscillating time-dependent pressure gradient on Dean flow: transient solution
Authors: Jha Basant K. , Gambo Dauda
Published: October 2020

Background

Navier-Stokes and continuity equations are utilized to simulate fully developed laminar Dean flow with an oscillating time-dependent pressure gradient. These equations are solved analytically with the appropriate boundary and initial conditions in terms of Laplace domain and inverted to time domain using a numerical inversion technique known as Riemann-Sum Approximation (RSA). The flow is assumed to be triggered by the applied circumferential pressure gradient (azimuthal pressure gradient) and the oscillating time-dependent pressure gradient. The influence of the various flow parameters on the flow formation are depicted graphically. Comparisons with previously established result has been made as a limit case when the frequency of the oscillation is taken as 0 (ω = 0).

Results

It was revealed that maintaining the frequency of oscillation, the velocity and skin frictions can be made increasing functions of time. An increasing frequency of the oscillating time-dependent pressure gradient and relatively a small amount of time is desirable for a decreasing velocity and skin frictions. The fluid vorticity decreases with further distance towards the outer cylinder as time passes.

Conclusion

Findings confirm that increasing the frequency of oscillation weakens the fluid velocity and the drag on both walls of the cylinders.
Characterizing the borehole response for single-well shear-wave reflection imaging
Authors: Li Yang-Hu , Tang Xiao-Ming , Li Huan-Ran , Lee Sheng-Qing
Published: October 2020

Single-well shear-wave imaging using a dipole source-receiver system is an important application for detecting geologic structures away from the borehole. This development allows for determining the azimuth information of the structures. Existing analyses, however, focus on the data received at the borehole axis and use the elastic reciprocity theorem to model the borehole radiation and recording. We have extended the existing analyses to model the radiation, reflection, and recording response of the borehole for azimuthally spaced receivers off the borehole axis. By treating the mirror image of the borehole source with respect to the reflector plane as a virtual source, the borehole reception problem was shown to be equivalent to the response of the borehole to the spherical wave incidence from the virtual source, which can be solved using the cylindrical-wave expansion method. An asymptotic solution using the steepest-descent method is obtained if the virtual source is far from the borehole. The analytical solution allows us to analyze the borehole response for azimuthally spaced off-axis receivers. The analysis results agree well with those from 3D finite-difference simulations. With this analysis, one can further model multicomponent shear-wave reflection data from the cross-dipole acoustic tool and study the azimuthal variation characteristics of the data. Our results reveal that, whereas the data characteristics are dominated by those of a dipole, nondipole responses due to the off-axis reception can be observed, the magnitude of the responses depending on the off-axis distance and frequency and on the formation elasticity. The nondipole response characteristics have the potential to resolve the 180°-ambiguity problem in the azimuth determination for dipole shear-wave imaging. Our findings, therefore, provide new information for shear-wave reflection imaging analysis and development.
Identifying gas chimneys in gas fields of the West Siberian petroleum basin via geophysical and drilling data
Authors: Zagorovsky Yuri
Published: October 2020

There are many push-down seismic anomalies (gas chimneys or pipes with a diameter of 12–15 km) in natural gas fields in the northern part of the West Siberian basin (Urengoy, Yamburg, Zapolyarnoye, Kharasavey, Yurkharovskoye, etc.). This effect is common in gas-saturated sands. The amplitude of push-downs in West Siberian fields is approximately 300–400 ms from the horizontal surface. Using well data, we have measured how much the velocity of seismic waves decreases and study the hydrocarbon presence, fluid pressure, and other information to gain a better understanding of the cause of this effect. Several wells were drilled in three different gas chimneys. All of the wells in the gas chimneys discovered vertical columnar gas deposits in Jurassic and Cretaceous terrigenous formations. Well data from the Yurkharovskoye gas field show that seismic wave velocity in the gas chimney is 40% less than that outside this object. The wells in the gas chimneys show that formation pressure in the Neocomian and Jurassic formations is 80–90 MPa, which is approximately lithostatic pressure, so high-pressured gas in the pores begins to form cracks. There are gravity anomalies above many gas chimneys identified, indicating a density deficit. Transient electromagnetic sounding data from the Yurkharov gas chimney show a columnar zone of increased electrical resistance, as in gas-saturated formations. To explain all of these observations, we suppose that the West Siberian gas chimneys (pipes) are currently active channels for the vertical migration of high-pressured hydrocarbon gases (mainly methane), forming columnar gas-saturated zones. We think that the crucial cause of push-down seismic velocity anomalies is overpressure (approximately lithostatic). We predict that some new gas fields can be related to the gas chimneys at Gydan Peninsula and in Kara Sea. Many new deep gas deposits can be found in old gas fields with gas chimneys such as Urengoy and Yamburg.
Randomized Trial of Afatinib Plus Cetuximab Versus Afatinib Alone for First-Line Treatment of EGFR-Mutant Non–Small-Cell Lung Cancer: Final Results From SWOG S1403
Authors: Goldberg Sarah B. , Redman Mary W. , Lilenbaum Rogerio , Politi Katerina , Stinchcombe Thomas E. , Horn Leora , Chen Everett H. , Mashru Sandeep H. , Gettinger Scott N. , Melnick Mary Ann , Herbst Roy S. , Baumgart Megan A. , Miao Jieling , Moon James , Kelly Karen , Gandara David R.
Published: October 2020

PURPOSE

The irreversible ErbB family tyrosine kinase inhibitor (TKI) afatinib plus the EGFR monoclonal antibody cetuximab was previously shown to overcome resistance to EGFR TKIs. We studied whether the combination of afatinib plus cetuximab compared with afatinib alone would improve progression-free survival (PFS) in patients with treatment-naive EGFR-mutant non–small-cell lung cancer (NSCLC) by preventing or delaying resistance.

METHODS

Patients with EGFR-mutant NSCLC without prior treatment of advanced disease were enrolled in this phase II, multicenter trial and randomly assigned to receive afatinib 40 mg orally daily plus cetuximab 500 mg/m2 intravenously every 2 weeks or afatinib alone. The primary end point was PFS.

RESULTS

Between March 25, 2015 and April 23, 2018, 174 patients were randomly assigned, and 168 (83 on afatinib + cetuximab and 85 on afatinib) were eligible. There was no improvement in PFS in patients receiving afatinib plus cetuximab compared with afatinib alone (hazard ratio [HR], 1.01; 95% CI, 0.72 to 1.43; P = .94; median, 11.9 months v 13.4 months). Similarly, there was no difference in response rate (67% v 74%; P = .38) or overall survival (HR, 0.82; 95% CI, 0.50 to 1.36; P = .44). Toxicity was greater with the combination: grade ≥ 3 adverse events related to treatment occurred in 72% of patients receiving afatinib plus cetuximab compared with 40% of those receiving afatinib alone, most commonly rash and diarrhea. Dose reductions were more common in patients receiving the combination, and 30% of patients in this arm discontinued cetuximab due to toxicity. At interim analysis, there was insufficient evidence to support continued accrual, and the trial was closed.

CONCLUSIONS

The addition of cetuximab to afatinib did not improve outcomes in previously untreated EGFR-mutant NSCLC, despite recognized activity in the acquired resistance setting.