bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving Public Health Readiness for Sea Level Rise: A New Initiative in Coastal Virginia
Authors: Becker Steven M.
Published: April 2018

AbstractSea level has been rising around the world, and in recent decades, the rate has been accelerating. Because rising seas have the potential to directly or indirectly affect the health of vast numbers of coastal communities and inhabitants, public health agencies and
professionals—in conjunction with other fields—have a pivotal role to play in helping to protect populations, reduce and prevent health impacts, and foster resilience. This article discusses a novel effort that has been undertaken in Coastal Virginia to help prepare the next generation
of public health professionals to grapple with sea level rise issues. The effort grew out of discussions of the importance of public health issues that took place through the Hampton Roads Sea Level Rise Preparedness and Resilience Intergovernmental Pilot Project. The new training effort focuses
on public health graduate level training and incorporates both classroom and practice-based components. Though still in its early stages, the sea level rise and public health training effort has already achieved significant successes and continues to grow. The article begins by examining sea
level rise as a public health issue. This is followed by a discussion of the new public health training initiative in Coastal Virginia. The article closes by exploring future directions.
Offshore Export Gas Pipeline in Pre Salt Santos Basin - Historic, Optimizations and Lessons Learned
Authors: de Azevedo Fabio Braga , Haverroth Guilherme Eller , de Castro Genaio Monica
Published: April 2018

On November, 2010 Petrobras defined the necessity of one additional gas export pipeline in Santos Basin Pre-Salt area to improve the capacity of the export gas network and assure the objectives defined in the Strategic Plan. Nowadays there are two gas export pipelines in operation to export the gas from pre-salt area: Rota 1 connecting Lula Sul field to onshore facilities in Caraguatatuba/SP and Rota 2 connecting Lula Área de Iracema Sul to onshore facilities in Cabiunas/RJ.

The new 20-in and 24-in gas export pipeline named Rota 3 is approximately 307km long and connects Lula Norte field in Santos Basin to Jaconé Beach/Maricá It has 15 spare hubs and 3 PLEMs for future connections to Sépia, Berbigão, Atapu, Sururu, Buzios and Libra fields. Also, Rota 3 is interconnected to export gas pipeline Rota 2 in a loop to permit gas exportation through Maricá and Cabiúnas.

This paper addresses the pipeline design optimizations based on standard DNV-0S-F101 and on several consulting to national and international pipe suppliers. Full scale qualifications tests were performed in accordance with DNV-0S-F101 to permit the use of the alfafab factor identical to one for the supplied 20-in UOE pipes. All qualification process was witnessed by DNV.

Additional simplifications were introduced aiming to costs reduction and in order to improve attractiveness of EPCI (Engineering, Procurement, Construction and Installation) contract. Installation contractors were invited to suggest simplifications to the project.

Lessons learned during the design, BID process and installation phase of the project are also envisaged.
Impact of gender on small and medium-sized entities’ access to venture capital in South Africa
Authors: Shava Herring
Published: April 2018

Background: The debate on the influence of gender on small and medium-sized entities’ (SMEs) access to finance from a demand-side perspective is still ongoing. This study seeks to contribute to the debate from an emerging economy (South Africa) perspective. Aim: The study investigated whether there is a gender gap in SME access to venture capital, a distinct source of finance. Setting: SMEs play a significant role in South Africa’s economy. Despite the importance of SMEs, access to finance is one of the major constraints affecting their success rate. Globally, to enhance the probability of SME survival, small business practitioners and governments are in search of relevant support measures. One of those measures could be adequate access to venture capital. However, it is sad to note that SMEs seldom use this distinct source of finance. Methods: The study made use of the quantitative method of research and is descriptive by design. Self-administered questionnaires were emailed to respondents for the purposes of gathering primary data. The t-test was used to statistically analyse primary data. Results: The results reveal that there is a statistically significant difference in the accessibility of venture capital between male- and female-owned SMEs. Conclusion: The article concludes that a gender gap in access to venture capital exists owing to differences in business approach between female entrepreneurs and their male counterparts. Female entrepreneurs are cautious about the level of risk they are willing to take and the amount of control they wish to exercise in firm ownership.
The practice turn within strategy: Competitive intelligence as integrating practice
Authors: Maritz Rachel , Du Toit Adeline
Published: April 2018

Background and aim: This article investigated the positioning of competitive intelligence within the field of strategy. Methods: Publications on strategy and competitive intelligence were reviewed through thematic content analysis based on an extended literature review to determine their respective contents and how strategy as practice related to the crystallised competitive intelligence themes. Results: The research demonstrated that strategy and competitive intelligence are inextricably interwoven. Competitive intelligence was shown to be not merely an activity or sequence of activities within the broader strategic management process, but a significant strategic practice. Conclusion: We argued, based on a comprehensive literature review, that competitive intelligence is an integral practice within strategy that should be explored further for its contribution to emergent and deliberate strategies and the linkage between intra-organisational and extra-organisational activities. We proposed a framework to position competitive intelligence within strategy as practice and in relation to the process view of strategy. The conceptualised framework contributes to the corpus of strategy research as it formalised competitive intelligence as a critical part in the thinking about and the practice of strategy. It moved competitive intelligence from a position on the periphery of strategic management literature, where it was regarded as a mere activity, to an integral practice of strategy to be recognised by strategy scholars and worthy of further research.
Type I spinal arteriovenous fistula with ventral intradural venous drainage: A proposal of a modified classification
Authors: Adeeb Nimer , Moore Justin , Alturki Abdulrahman , Bulsara Ketan , Griessenauer Christoph , Patel Apar , Gupta Raghav , Tubbs R , Ogilvy Christopher , Thomas Ajith
Published: April 2018

Objectives: Spinal arteriovenous fistula (AVF) is the most common spinal vascular lesion and constitutes an abnormal communication between a feeder artery and a draining vein. Arterialization of the venous plexus leads to venous hypertension; consequent edema and congestion of the spinal cord are associated with progressive neurological decline. Patients and Methods: In this report, we describe two unique cases of type I cervical spinal AVF, in which a radiculomeningeal artery forms an intradural fistula that drains into the ventral venous plexus. Results: Both patients underwent surgical obliteration of the fistula with complete occlusion confirmed on postoperative angiography. Conclusion: Both cases do not fit into the current classification scheme. A modified classification is proposed.
Role of hypertonic sodium lactate in traumatic brain injury management
Authors: Arifianto Muhammad , Ma'ruf Achmad , Ibrahim Arie , Bajamal Abdul
Published: April 2018

Traumatic brain injury (TBI) following increased intracranial pressure (ICP) is a neuroemergency case which should be managed promptly to prevent secondary brain injury. This will lead to a condition called cerebral energy dysfunction which is an important determinant factor toward worse outcome. Lactate, which was historically known as an end waste product, now is considered as an alternative cerebral energetic fuel. Hypertonic sodium lactate (HSL) is a promising hyperosmolar fluid which serves not only to decrease ICP but also to readily supply exogenous lactate to fulfill increased cerebral energy demand. Pioneer studies have shown the harmlessness and usefulness of HSL in treating pathological condition including TBI.
A case study on aneurysmal bone cyst of T2 vertebral body in a 7-year-old girl: Anterior and posterior surgical approach for tumor resection and spinal reconstruction
Authors: Parvaresh Mansour , Taheri Morteza , Azimi Alireza , Rohani Sadra
Published: April 2018

Aneurysmal bone cyst (ABC) is defined as a benign lesion of bone containing blood-filled channels divided by soft-tissue septa and mostly diagnosed in children and adolescents. In the present study, the case of a 7-year-old girl with spastic paraparesia and left foot drop was investigated. Spinal imaging revealed a large lytic mass in the posterior elements of the T2 vertebral body, which resulted in the partial collapse of the T2 vertebral body, a T1 to T3 dislocation, and a spinal sagittal imbalance. The patient underwent a two-stage surgical procedure including an anterior T2 corpectomy, T1/T2 and T2/T3 discectomy, anterior instrumentation, posterior total tumor resection, and posterior fixation with laminar hooks. Postoperative imaging demonstrated cord decompression and good spinal alignment. Although a spinal ABC is a rare entity, it can occur in any segment of the spinal column and cause cord compression and spinal instability. Thus, proper treatment planning is crucial for total tumor resection to avoid tumor recurrence and correct spinal imbalance.
Left deep frontal cavernous angioma mimicking a glioma in an adult patient
Authors: Boschi Andrea , Consoli Arturo , Buccoliero Annamaria , Barbagli Giovanni , Mangiafico Salvatore , Ammannati Franco
Published: April 2018

Cerebral cavernous angiomas are vascular malformations characterized by large adjacent vessels. Usually, these lesions are smaller than 3 cm, the mean age at presentation occurs between 20 and 40 years, and the neuroradiological findings are well described, especially for magnetic resonance imaging, where the “popcorn balls” appearance is due to the presence of locules containing blood. Among these, the giant cavernous angiomas are very rare, particularly in adults. We collected clinical and neuroradiological data from clinical file and hospital diagnostic archive. A comprehensive review of similar cases was performed. We describe the clinical, diagnostic, and surgical management of a giant cerebral cavernous angioma located in the left deep frontal lobe mimicking a high-grade glioma in an adult Chinese patient. Giant cerebral cavernous angioma may be misdiagnosed and should be considered as differential diagnosis.
Assessment of primary brain lymphoma using multimodal magnetic resonance imaging and proton magnetic resonance spectroscopy
Authors: Housni Abdelkhalek , Boujraf Saïd , Alami Badreddine , Benzagmout Mohammed , Maaroufi Mustapha
Published: April 2018

Objectives: The primary lymphoma of the central nervous system is a cancer rare. The diagnosis of this tumoral entity must be considered as an emergency considering the therapeutical involved. Therefore, we report this entity while reporting diagnostic challenges. Patients and Methods: Unfortunately, the conventional clinical and imaging signs can be confusing and might contribute to delay the diagnosis process of potentially curable pathological entity. The diagnosis confirmation in immunocompetent patients is based on a stereotaxic biopsy. Results and Conclusion: In this paper, we report a case illustrating the contribution of multimodal imaging including diffusion-weighted magnetic resonance imaging (MRI), diffusion tensor MRI, perfusion MRI, and proton MR spectroscopy to the diagnostic approach of the atypical primary lymphoma of the central nervous system.
Long term outcome in survivors of decompressive craniectomy following severe traumatic brain injury
Authors: Kaushal Ashutosh , Bindra Ashish , Kumar Abhyuday , Goyal Keshav , Kumar Niraj , Rath Girija , Gupta Deepak
Published: April 2018

Background: Decompressive craniectomy (DC) is done for the management of intracranial hypertension due to severe traumatic brain injury (sTBI). Despite DC, a number of patients die and others suffer from severe neurological disability. We conducted this observational study to assess functional outcome as measured by Glasgow outcome scale-extended (GOSE) in survivors of DC. The correlation between various factors at admission and hospital with functional outcome was also obtained. Materials and Methods: Patients (15–65 years) posted for cranioplasty following DC due to sTBI were prospectively enrolled. Demographic profile, clinical data, and GOSE were noted at the time of admission for cranioplasty from the patient or nearest relative or both. Retrospective data noted from hospital records included admission Marshalls grading, Glasgow coma score (GCS), motor response, mean arterial pressure (MAP), and timing of DC at the time of initial admission following sTBI. Results: A total of 85 patients (71 males and 14 females) were enrolled over a period of 2 years. The mean age of the patients was 33.42 ± 12.70 years. The median GCS at the time of admission due to head injury, at the time of discharge, and at the time of cranioplasty was 8 (interquartile range [IQR] 3–15), 10 (IQR 4–15), and 15 (IQR 7–15), respectively. Thirty-one patients (36%) had good functional outcome (GOSE 5–8) and 54 patients (64%) had poor functional outcome (GOSE 1–4). On univariate analysis tracheostomy (P = 0.00), duration of hospital stay (P = 0.002), MAP at admission (P = 0.01), and GCS at discharge (P = 0.01) correlated with outcome [Table 1]. On multivariate analysis MAP at admission (odds ratio [OR] [95% confidence interval {CI}]; 0.07 [0.01–0.40] and tracheostomy (OR [95% CI]; 15 [1.45–162.9]) were found to be the independent predictors of functional outcome. Conclusion: Significant disability is seen among the survivors of DC. Tracheostomy and MAP at admission were found to be independently associated with the patient outcome.
Clinical and radiological outcomes of day-care posterior foraminotomy and decompression of the cervical spine
Authors: Singrakhia Manoj , Malewar Nikhil , Deshmukh Sonal , Deshmukh Shivaji
Published: April 2018

Purpose: Anterior cervical procedures are associated with many intra- and post-operative complications leading to long-term patient morbidity. In this study, we have evaluated the clinical and radiological Outcome of day care posterior cervical foraminotomy in patients with single-level cervical radiculopathy with or without neurodeficit. Materials and Methods: Seventeen patients underwent single-level posterior cervical foraminotomy for radicular symptoms were studied between June 2011 and May 2016. Clinical outcome was studied by visual analog scale (VAS) score, neck disability index (NDI), and Odom's criteria. Adjacent segment degeneration was evaluated on lateral cervical radiograph at every follow-up by calculating the focal and global angulation of the cervical spine and disc height at the operated level and adjacent segments. Dynamic lateral cervical spine radiograph was done to evaluate segmental instability. Results: After a mean follow-up duration of 30.64 months, 13 patients had excellent, three patients had good, and one patient had fair outcome as per Odom's criteria. The mean VAS score for radicular pain, neck pain, and NDI was significantly reduced postoperatively (P < 0.001). The mean focal angulation, mean global angulation, the disc height at operated and adjacent level were not changed significantly (P > 0.05). There was no instability noted postoperatively on lateral dynamic cervical spine radiographs. There was no complication in our study. Conclusion: Posterior cervical foraminotomy is an effective surgical method for treatment of patients with single-level cervical radiculopathy and helps to achieve good clinical and radiological outcome, prevents postoperative adjacent segment degeneration and instability with minimal complications.
Does age affects the surgical outcome in patients with unruptured cerebral aneurysms? A 2-year retrospective study from a single center in Japan
Authors: Duvuru Shyam , Sae-Ngow Treepob , Kato Yoko , Kawase Tsukasa , Yamada Yasuhiro , Tanaka Riki
Published: April 2018

Background: The management of unruptured cerebral aneurysms (UCA) in elderly population is a challenge. With a very high life expectancy and high risk of rupture in Japan, the need for identifying the best treatment modality is essential to help the patients in decision-making. Methods: This was a 2-year single-center retrospective comparative analysis of the outcomes of surgical clipping (SC) in patients aged above 75 and <75 years. The modified Rankin score was used to stratify the patients and to analyze the functional outcome. Functional status at discharge was the primary end point. Results: There were 224 patients with 239 aneurysms. About 12.5% of the patients were more than 75 years with a mean age of 77.85. The mean age of patients <75 years was 60.96, and it was statistically significant. The overall male-to-female ratio was 1:3.3. The most common location was the middle cerebral artery followed by internal carotid artery at the posterior communicating and ophthalmic segments, and 22 patients had aneurysms of the posterior circulation. Nearly 77% of the aneurysms were <6 mm. There was no significant difference in size of the aneurysm as the age increased to more than 75 years. There were complications in 6 patients, and there was no mortality in the study population. There was no statistically significant difference in the outcome between the groups. Conclusions: SC can be considered a safe option for UCA in the aging population.
Cerebrospinal fluid leakage at the lumbar spine: A unique cause of delayed neurologic deterioration in a traumatic acute subdural hematoma patient
Authors: Mayanagi Keita , Nakatsukasa Masashi , Inamasu Joji
Published: April 2018

We present a rare case of traumatic acute subdural hematoma (SDH) in which intracranial hypotension (IC) secondary to cerebrospinal fluid (CSF) leakage at the lumbar spine caused delayed neurological deterioration. A 70-year-old male sustained a head injury after ground-level fall and was brought to our institution. A brain computed tomography (CT) showed a thin acute SDH with mild brain shift, and conservative management was initiated. He exhibited neurological deterioration on the 9th hospital day, however, and a brain CT showed a change in CT density and marked an increase in hematoma volume and brain shift. It was thought that conversion from acute to subacute SDH was associated with the deterioration, and emergency hematoma evacuation was performed. Despite the surgery, neither clinical nor radiographical improvement occurred. The lack of improvement pointed to the presence of underlying IC, and a CT myelography revealed the dural sleeve of the right L2 nerve root as the source of the CSF leakage. An epidural blood patch therapy was performed on the 12th hospital day to seal the CSF leakage. The postprocedural course was uneventful, and the patient was discharged free of symptoms on the 20th hospital day. Spinal CSF leakage should be considered as a cause of delayed neurological deterioration in patients with traumatic acute SDH which exhibits conversion to subacute SDH.
Acute paraplegia revealing a hemorrhagic cauda equina paraganglioma
Authors: Ghedira Khalil , Matar Nidhal , Bouali Sofiene , Zehani Alia , Jemel Hafedh
Published: April 2018

Cauda equina paragangliomas are rare neuroendocrine benign and slow-growing tumors. Acute paraplegia, occurring because of sudden intratumoral hemorrhage, represents an extremely rare clinical picture of this disease. We report the case of a 64-year-old male presenting with a 5-day acute lower back pain, sciatica, and leg weakness. Spinal imaging showed an intradural mass of the cauda equina region and an emergent surgical treatment was achieved. The lesion was removed “en bloc,” and subarachnoid blood was noticed during surgery. The postoperative course was uneventful, with complete regression of pain and progressive motor recovery. The histological study revealed typical microscopic and immunohistochemical features of paragangliomas.
Human tail: A benign condition hidden out of social stigma and shame in young adult – A case report and review
Authors: Giri Pramod , Chavan Vaibhav
Published: April 2018

A human tail is a rare congenital anomaly which mostly presents immediately after birth or in early childhood. Here, we are presenting a case of 17-year-old male who presented with 18-cm long tail, which was hidden till this age because of social stigma and shame. This is longest human tail reported of our knowledge. This patient presented to us because he started having difficulty, pain while sitting, and discomfort in daily activities because of long tail. We suspect there are far more cases of human tails in developing world which are hidden because of lack of knowledge, illiteracy, social stigma, and shame. This patient had no neurological deficit and had no bowel/bladder involvement. The radiological investigation was suggestive of spina bifida at L5and S3–S4 levels (site of attachment of the tail), and tip of the coccyx had bony spur directed posteriorly. Intraoperatively, no connection was found between tail and neural tissue. Human tail is associated with occult spinal lesions in 50% of cases, hence careful neurological and radiological investigations are warranted before surgical exploration.
Endoscopic approach to cerebellar and large putaminal bleed
Authors: Suyama Daisuke , Kumar Brajesh , Watanabe Saiko , Tanaka Riki , Yamada Yasuhiro , Kawase Tsukasa , Kato Yoko
Published: April 2018

Objective: To highlight the basic points of brain endoscopic procedure for Cerebellar and Large Putaminal Hemorrhage to achieve repeatability and reproducibility in the results among the new brain endoscopic surgeons. Method: Sharing the experience of 10 years as an endoscopic surgeon to bring out the basic insight into the method, challenges, points which need special attention during the surgery and discussion of recent advancements in the endoscopic equipment for safe surgery. Conclusion: Procedure of endoscopic evacuation of brain hematoma is simple with learning curve. In the beginning new endoscopic surgeons should operate in the presence of experience surgeon. They should follow standard technique to achieve the good surgical outcome and uniformity in the result every time they perform the surgery.
Skull vault plasmacytoma mimicking parasagittal meningioma: “Mini-brain appearance”
Authors: Munjal Satyashiva , Srivastava Amit , Jain Sunila , Mehta Veer
Published: April 2018

Plasmacytomas occur as lesions in soft tissue or bone. Skull vault plasmacytomas are rare lesions comprising 0.7% of all plasmacytomas. Workup for myeloma must be done in such cases to rule out multiple myeloma. Here, we report a case of a 63-year-old female who presented to us with a large skull vault swelling which appeared to mimic a parasagittal meningioma on imaging. Histopathological imaging revealed it to be a plasmacytoma. A retrospective review of the radiology revealed the characteristic “mini-brain appearance” in our case. Literature on the subject is also reviewed.
Intracranial hemorrhage caused by bacterial meningitis: Case report and review of the literature
Authors: Matsumoto Atsushi , Mino Shogo , Nishiyama Tadashi
Published: April 2018

Hemorrhagic stroke is an extremely rare complication in bacterial meningitis. Therefore, the incidence and prognosis have not been fully clarified. In this case report, we describe a case of intracranial hemorrhage caused by bacterial meningitis, which originated from paranasal sinusitis. A man visited the hospital due to fever, nonproductive cough, and oppressive pain of cheek. He was diagnosed with purulent sinusitis and received antibiotics. However, he suddenly developed a severe headache and came to our department. Computed tomography scan revealed right subcortical hematoma. We performed hematoma evacuation, but headache and fever did not cease. From the analysis of the cerebrospinal fluid, he was diagnosed with cerebral hemorrhage caused by meningitis and treated with broad-spectrum antibiotics. Through this treatment, his condition rapidly improved. Hemorrhagic stroke is a rare complication of bacterial meningitis, but if this condition develops, then, there is a high risk of mortality and morbidity.
Pilocytic astrocytoma with gangliocytic differentiation to pilomyxoid astrocytoma-expanding the morphological spectrum: Case report and literature review
Authors: Gupta Kirti , Tewari Manoj , Salunke Pravin
Published: April 2018

We present a rare case of pilocytic astrocytoma (PA) with gangliocytic differentiation arising in the suprasellar/chiasmatic region in a young boy that showed a rapid regrowth after the 1st subtotal resection and “differentiated” into pilomyxoid astrocytoma (PMA) in subsequent recurrences. The clinical course, imaging, and histological features have been described with a review of the literature. While PA is well-circumscribed, biphasic tumors with bipolar piloid cells, those arising in the diencephalic region often contain myxoid stroma, angiocentric pattern, and “intermediate” features between PA and PMA. Examples of PMA “maturing” to PA are also on record; however, PA with gangliocytic component differentiating to PMA has not been described in the literature to the best of our knowledge.
Papillary ependymoma of the spinal cord: A case report with summary of prior published cases
Authors: Chaudhuri Priyanka , Chakrabarty Debashis , Chaudhuri Shubhamitra , Chatterjee Uttara
Published: April 2018

Papillary ependymoma is a rare variant of ependymoma. It has been included in Grade II tumors of updated 2016 WHO classification of central nervous system tumors. Only a handful of cases of spinal papillary ependymomas have been reported so far. The differential diagnoses include choroid plexus papilloma, papillary meningioma, metastatic carcinoma, and papillary tumor of the pineal region. Here, we take the opportunity of reporting a rare case of spinal papillary ependymoma along with its squash cytological features and a summary of prior published cases.
The relation between cord signal and clinical outcome after anterior cervical discectomy in patients with degenerative cervical disc herniation
Authors: Hamdan Ali
Published: April 2018

Introduction: Cervical spondylotic myelopathy is a cervical cord compressive lesion that occurs as a result of the normal degenerative process which may cause magnetic resonance imaging (MRI) cord intensity changes that may worsen the clinical outcome even after successful anterior cervical decompression. Objective: To assess the relation between MRI T2 Weighted images (T2 WI) hyperintense cord signal and clinical outcome after anterior cervical discectomy in patients with degenerative cervical disc herniation. Materials and Methods: This is a retrospective observational study that was conducted on twenty-five patients with degenerative cervical disc prolapse associated with MRI T2WI hyperintense cord signal, at the Department of Neurosurgery, Qena University Hospital, South Valley University from August 2014 to December 2016. A complete clinical and radiological evaluation of the patients was done. Anterior cervical discectomy and fusion was done for all patients. Patients were clinically assessed preoperatively and postoperatively at 3, 6, and 12 months using Modified Japanese Orthopedic Association (MJOA) score. Radiographic assessment was done by preoperative and postoperative T2WI MRI. The statistical analysis was done using Statistical Package for the Social Sciences (SPSS) software (version 22.0). Results: There were 25 patients included in the study; 16 (64%) females and 9 (36%) males. The mean age was 46.89 ± 7.52 standard deviation (SD) years with range from 26 to 64 years, 3 (12%) patients had worsened in the form of postoperative motor power deterioration, and 14 (56%) patients has no improvement and remain as preoperative condition. The remaining 8 (32%) patients had a reported postoperative improvement of symptoms and signs according to MJOA score. The mean follow-up period (in months) was 11 ± 2.34 (SD). Conclusion: The presence of T2W hyperintense signal on preoperative MRI predicts a poor surgical outcome in patients with cervical disc prolapse. The regression of T2W ISI postoperatively correlates with better functional outcomes.
Variation of ventricular size after surgical treatment of chronic subdural hematoma
Authors: El Asri Abad , Benzagmout Mohammed , Chakour Khalid , Chaoui Mohamed , Laaguili Jawad , Gazzaz Miloudi , Baallal Hassan , El Mostarchid Brahim
Published: April 2018

Background: Surgical removal is the treatment of choice for chronic subdural hematoma (CSDH). Despite clinical improvement after surgery, computed tomography (CT) scan control often showed residual collection, which may discuss the possibility of failed surgery. The aim of this study is the assessment of ventricular size before and after surgery and to study its relation with residual hematoma. Methods: In this prospective study (2013-2016), 63 patients who had burr-hole drainage of CSDH were sequentially allocated to either two groups; Group 1 with CT scan control under the 3rd day of surgery and Group 2 with delayed CT scan control (from 4th to 7th day). Linear measure of ventricular size was assessed by Evans' index. We reviewed and analyzed the data between both groups. Results: There were 33 patients in Group 1 and 30 patients in Group 2. Preoperatively, the average thickness of hematoma was 20.5 mm in Group 1 versus 19.9 mm in Group 2 (P = 0.67); the mean midline shift was 8.5 mm in each group; Evans' index was 26.7% in Group 1 and 27% in Group 2 (P = 0.7). Postoperatively, the mean thickness of the residual hematoma was 7.7 mm in Group 1 and 8.4 mm in Group 2 (P = 0.57); the mean midline shift was 3.3 mm in Group 1 and 1.9 mm in Group 2 (P = 0.08); Evan's index was 28.5% in Group 1 and 32.1% in Group 2 (P = 0.002). Conclusion: The adoption of Evans' index, for assessing the variation of ventricular size after surgery, by neurosurgeons appears to be a good and simple method for evaluation and following the success of surgical removal of CSDH, despite the observation of some residual collection in early CT scan control.
Effect of sub-axial cervical lateral mass screw fixation on functional outcome in patients with cervical spondylotic myelopathy
Authors: Hamdan Ali , Mahmoud Radwan , Al Mamoun Momen , El Khateeb Eslam
Published: April 2018

Background: The role of laminectomy alone as an etiology of postoperative cervical instability is well known. Cervical sagittal malalignment of the spine has been linked to unfavorable functional outcome, so the effect of restoration of sagittal spinal alignment on functional outcomes and treatment effectiveness has recently gained attention. Objective: This is a prospective observational study aims to observe the possible relation between cervical sagittal alignment and functional outcomes following sub-axial cervical lateral mass screw fixation in patients with cervical spondylotic myelopathy. Patients and Methods: Thirty patients were included in this study all suffering from cervical spondylotic mylopathy (CSM) who underwent cervical laminectomy and screw-rod fixation and followed up over 6 months. Functional outcome accessed using Nurick myelopathy score and neck disability index (NDI)?. We also used the Cobb angle method (C2–C7) as a parameter for radiographic assessment of the cervical sagittal alignment which was measured preoperatively and postoperatively on lateral neutral views of cervical X-ray. Results: All the patients underwent cervical laminectomy and fixation in a range of 3–5 levels. Two intraoperative facet fractures and four facet joint violations were observed. All the patients were followed-up for at least 6 months. There were significant improvements of the motor power (88.5%), Nurick score (90%), and NDI (90%) postoperatively. The mean preoperative Cobb angle for all patients was −8.51° ± 14.07° standard deviation (SD) which changed to −10.29 ± 12.43 SD at the end of follow-up. Conclusion: Combing posterior decompression with lateral mass screw– rod in patients with CSM was effective in improving or at least maintaining cervical alignment with the good functional outcome.
Preemptive Effect of Intraurethral Instillation of Ketamine–lidocaine Gel on Postoperative Catheter-related Bladder Discomfort after Lumbar Spine Surgery
Authors: Etezadi Farhad , Sajedi Yasamin , Khajavi Mohammad , Moharari Reza , Amirjamshidi Abbas
Published: April 2018

Background: Catheter-related bladder discomfort (CRBD) is one of the main reasons of agitation after surgery, leading to urgency and frequency during recovery. Ketamine has been used as an effective drug for reducing the signs and severity of this problem. We hypothesized that intraurethral instillation of ketamine–lidocaine gel before urinary catheterization can reduce the incidence of CRBD in the postoperative period. Materials and Methods: A total of 136 male patients, who underwent two-level laminectomy/discectomy were enrolled in this randomized clinical trial. Patients were randomized into the two groups before urinary catheterization. The ketamine group received urethral lubrication with 5 mL xylocaine jelly (2%) in conjunction with 2 mL (100 mg) ketamine. Patients in control group received urethral lubrication with 5 mL xylocaine jelly (2%) in conjunction with 2 mL distilled water. The primary outcome was the incidence of CRBD. CRBD was assessed using four-stage criteria when arriving in the recovery room and at 1, 2, and 6 h after surgery. Postsurgical pain and the number of sedatives given and opioid requirement were also the secondary outcomes in this study. Results: Intraurethral instillation of ketamine–lidocaine gel reduced the incidence of CRBD at recovery (P < 0.001) along with a reduction in the severity of CRBD (P < 0.05) during the 1st and 2nd visit compared with control group. The mean pain intensity score (visual analog scale) and opioid requirement to relieve postsurgical pain were lower in the ketamine group during all the study timepoints from recovery and after transfer to the ward (P < 0.008). A higher rate of sedation (72% vs. 11%) also was seen at recovery period in the ketamine group (P < 0.008). Conclusion: Intraurethral instillation of ketamine–lidocaine gel before bladder catheterization is an effective technique for reducing the incidence and severity of postoperative CRBD.
Intramedullary glioblastoma multiforme of spine with intracranial supratentorial metastasis: Progressive disease with a multifocal picture
Authors: Purkayastha Abhishek , Sharma Neelam , Sridhar Madakasira , Abhishek Dwivedi
Published: April 2018

Primary spinal glioblastoma multiforme (GBM) is very uncommon while an intramedullary spinal GBM with intracranial metastasis is rarely heard of. A 23-year-old male presented with bilateral paraplegia associated with bowel and bladder incontinence. Craniospinal radiograph showed an intramedullary spinal mass lesion, for which he underwent laminectomy and histopathology revealed GBM. He received local radiotherapy (RT) with temozolomide (TMZ). While on adjuvant TMZ, he developed severe headache and recurrent episodes of vomiting. Brain and spine imaging showed intracranial mass lesions associated with expansion of the entire cord. Biopsy from the intracranial lesion was confirmed as GBM on immunohistopathology. He was treated with palliative RT to the brain and was put on metronomic TMZ; however, he succumbed to his illness. Review of literature reveals that our case may be the fourth such case in the world and probably the first case reported in India where the intracranial metastatic GBM again presented with a reverse spinal dissemination.
Role of diffusion-weighted imaging in detecting early ischemic brain injury following aneurysmal subarachnoid hemorrhage
Authors: Aggarwal Varun , Sharma Achal , Sinha V
Published: April 2018

Background: Aneurysmal SAH is the significant cause of morbidity and mortality in stroke patients. Early brain injury and delayed cerebral ischemia are the two main responsible pathophysiologic processes. Cerebral ischemia needs to be detected early so that early aggressive therapy could be started. Although Diffusion weighted imaging (DWI) has often been utilized for the measurement of acute ischemic strokes, its role in the detection of early cerebral ischemia due to aneurysmal subarachnoid hemorrhage has not been extensively investigated. This study is being carried out to describe the role of DWI in detecting early ischemic brain injury and outcome after aneurysmal SAH. Aim: Efficacy of DWI in detecting ischemic injury and predicting outcome after aneurysmal SAH. Material and Methods: In this prospective study 44 consecutive patients who had aneurysmal SAH; admitted within 7 days of their ictus were included. Hunt and Hess grade on admission and modified Fisher grade of SAH were noted. Plain CT brain and MR DWI was done on day before surgery. Diffusion restriction on DWI was correlated with postoperative neurological deficit, postoperative CT finding and outcome of the patient at 1 month follow-up. Results: DWI revealed restricted diffusion in 12 patients, out of which 1 patient was having infarction in preoperative CT scan, 6 patients were having postoperative deficit in the form of disorientation, hemiparesis and aphasia, and all patients were having infarction in postoperative CT scan. When DWI findings were compared on the basis of postoperative neurological deficit, postoperative CT finding and modified Rankin outcome score at 1month follow-up, results were statistically significant. Conclusion: DWI shows cerebral ischemia much earlier than CT scan in cases of aneurysmal SAH. It has significant correlation with postoperative neurological status and outcome of the patient.
Persisting embryonal infundibular recess masquerading as a nasal mass
Authors: Joshua Shejoy , Sreedhar Shyamsundar , Viswam Vineeth , Panikar Dilip
Published: April 2018

Persisting embryonal infundibular recess (PEIR) is a rare anomaly of the development of the posterior pituitary wherein there is a defect in the third ventricular floor. Earlier reports have found PEIR descending only up to the sella. However, this is the first case of PEIR presenting as a pulsatile nasal mass. A 35-year-old female presented to the otorhinolaryngologist with hyposmia. Diagnostic nasal endoscopy revealed a pulsatile nasal mass. Magnetic resonance imaging revealed a cystic lesion extending from the third ventricular floor to the nasal cavity. There was no associated hydrocephalus or empty sella. The case was successfully managed by the endoscopic endonasal transsphenoidal approach.
A database of 10 min average measurements of solar radiation and meteorological variables in Ostrava, Czech Republic
Authors: Opálková Marie , Navrátil Martin , Špunda Vladimír , Blanc Philippe , Wald Lucien
Published: April 2018

Abstract. A database containing 10 min means of solar irradiance measured on a
horizontal plane in several ultraviolet and visible bands from July 2014 to
December 2016 at three stations in the area of the city of Ostrava (Czech
Republic) is presented. The database contains time series of 10 min average
irradiances or photosynthetic photon flux densities measured in the following
spectral bands: 280–315 nm
(UVB); 315–380 nm (UVA); and 400–700 nm
(photosynthetically active radiation, PAR); 510–700 nm; 600–700 nm;
610–680 nm; 690–780 nm; 400–1100 nm. A series of meteorological
variables including relative air humidity and air temperature at surface is
also provided at the same 10 min time step at all three stations, and
precipitation is provided for two stations. Air pressure, wind speed, wind
direction, and concentrations of air pollutants PM10, SO2, NOx,
NO, NO2 were measured at the 1 h time step at the fourth station owned
by the Public Health Institute of Ostrava. The details of the experimental
sites and instruments used for the measurements are given. Special attention
is given to the data quality, and the original approach to the data quality
which was established is described in detail. About 130 000 records for each
of the three stations are available in the database. This database offers a
unique ensemble of variables having a high temporal resolution and it is a
reliable source for radiation in relation to environment and vegetation in
highly polluted areas of industrial cities in the of northern mid-latitudes.
The database has been placed on the PANGAEA repository
(https://doi.org/10.1594/PANGAEA.879722) and contains individual data files for each
station.
Soil hydraulic material properties and layered architecture from time-lapse GPR
Authors: Jaumann Stefan , Roth Kurt
Published: April 2018

Abstract. Quantitative knowledge of the subsurface material distribution and
its effective soil hydraulic material properties is essential to predict soil
water movement. Ground-penetrating radar (GPR) is a noninvasive and
nondestructive geophysical measurement method that is suitable to monitor
hydraulic processes. Previous studies showed that the GPR signal from a
fluctuating groundwater table is sensitive to the soil water characteristic
and the hydraulic conductivity function. In this work, we show that the GPR
signal originating from both the subsurface architecture and the fluctuating
groundwater table is suitable to estimate the position of layers within the
subsurface architecture together with the associated effective soil hydraulic
material properties with inversion methods. To that end, we parameterize the
subsurface architecture, solve the Richards equation, convert the resulting
water content to relative permittivity with the complex
refractive index model (CRIM), and solve Maxwell's equations numerically.
In order to analyze the GPR signal, we implemented a new heuristic algorithm
that detects relevant signals in the radargram (events) and extracts the
corresponding signal travel time and amplitude. This algorithm is applied to
simulated as well as measured radargrams and the detected events are
associated automatically. Using events instead of the full wave regularizes
the inversion focussing on the relevant measurement signal. For optimization,
we use a global–local approach with preconditioning. Starting from an
ensemble of initial parameter sets drawn with a Latin hypercube algorithm, we
sequentially couple a simulated annealing algorithm with a
Levenberg–Marquardt algorithm. The method is applied to synthetic as well as
measured data from the ASSESS test site. We show that the
method yields reasonable estimates for the position of the layers as well as
for the soil hydraulic material properties by comparing the results to
references derived from ground truth data as well as from time domain
reflectometry (TDR).
Transnational Life: Where’d I Be Happy? A Research on the Films of Immigrant Directors From Turkey Living in Austria
Authors: Gürkan Hasan
Published: April 2018

This study aims to analyse the representation of different cultural notions in Turkish-Austrian Migrant Cinema. This study is based on migrant problem, hybrid identities and national values, taking Austria as a sample. Turkish-Austrian migrant films include multiculturalism, Turkish national values and Turkish national cinema narrative by keeping optimism and hope. The sampling of this study consists of films by Umut Dağ and Hüseyin Tabak. The films by both of these directors focus on traditional values of Turkish culture, the reflection of these values on Austria and cover the features of immigration from Turkey to Austria. The films portray Turkish immigrants going back and forth between Turkish and Austrian cultures in their daily lives. The films of these directors show the experiences in during and post-migration processes and emphasize the phenomenon of not belonging either culture.
Women Trauma and Stereotype Tradition in Tunde Kelani’s Film, Thunderbolt
Authors: Elegbe Olugbenga
Published: April 2018

Stereotype tradition and gender injustice constitute the trauma that majority of women face in the marital relationship in Yoruba cultural setting. These issues was explore in Tunde Kelani’s film, Thunderbolt (Magun). Employing the narrative content analysis technique the film reveals various issues relating to women trauma in Yoruba stereotype tradition which empowers men against women. Suspicion, cultural chauvinism, betrayal, ambition, poor communication, lack of trust, wrong accusation and dominance constitute conflicts between couples in the film. This shows that the issue of conflict and gender injustice against women is a common traits in Yoruba cultural setting. The film is a lesson on many unresolved conflicts in marriages relationships while proposing trust and open communication which will improve and contribute to positive conjugal relationship development.
La independencia del banco central y el desempeño macroeconómico: algunas evidencias comparativas
Authors: Alesina Alberto , Summers Lawrence H.
Published: April 2018

No abstract available.Realidad: Revista de Ciencias Sociales y Humanidades No. 66, 1998: 587-601
Tropical Soil Labile Fractions of Copper in the Experimental Plots ±Ten Years after Application of Copper-Containing-Waste
Authors: Salam Abdul Kadir , Ginanjar Kiat
Published: April 2018

Copper is reported to be retained in soils for a quite long time particularly in soil treated with some amendments.  This research was intended to evaluate the soil labile fractions of Cu ±10 years after application of Cu-containing industrial waste, lime, and cassava-leaf compost.  Soil samples were taken from topsoils and subsoils of ±10 years old experimental plots set up in 1998 and factorially treated with a metal-spoon industrial waste at 0, 15, and 60 Mg ha-1, lime at 0 and 5 Mg ha-1, and cassava-leaf compost at 0 and 5 Mg ha-1.  The measured Cu labile fractions were compared to those in soils sampled at ±1.5 years and ±3 years after treatments. The results showed that the soil Cu labile fractions in waste treated soils were higher than those in the control treatments eventhough their concentrations decreased with the years of sampling.  Lime showed a decreasing effect on soil labile Cu fractions, but the effect decreased with the years of sampling. The effect of cassava-leaf compost application on soil Cu labile fraction was in general not evidenced ±10 years after treatment.
Determination of Site-specific NPK Fertilizer Rates for Rice Grown on Tidal Lowland
Authors: Aksani Dila , Budianta Dedik , Hermawan Agus
Published: April 2018

This research aimed to determine site specific NPK fertilizer rates combined with rice straw compost application for rice grown on the tidal lowland. This research was conducted in a greenhouse in Indralaya, Ogan Ilir, South Sumatera in February  until September 2017 using a factorial completely randomized design with two factors and three replications. The first factor was NPK fertilizer rate calculated based on the results of soil chemical analysis, consisting of five levels, namely 50% (D1), 75% (D2), 100% (D3), 125% (D4) and 150% (D5) of the site-specific fertilizer rate. The second factor was rice straw compost rate consisting of two levels, namely 5 Mg ha-1 (J1) and 10 Mg ha-1 (J2). The results showed that the application of 150% NPK rate and 10 Mg ha-1 rice straw compost resulted in the best effects on the rice growth grown on the tidal lowland. The application of those fertilizer doses produced the highest maximum number of tillers and productive tillers. In this regard the doses of NPK fertilizers that should be applied are 315 kg urea ha-1, 135 kg SP-36 ha-1 and 90 kg KCl ha-1.