bluuebunny/crossref_metadata_2025 huggingface dataset:
Cortical Measures of Motor Planning and Balance Training in Patients With Chronic Ankle Instability
Authors: Burcal Christopher J. , Jeon Hyunjae , Gonzales John M. , Faust Mark E. , Thomas Abbey C. , Hubbard-Turner Tricia J. , Wikstrom Erik A.
Published: June 2019

Context

Motor planning, a prerequisite for goal-driven movement, is a complex process that occurs in the cortex. Evidence has suggested that motor planning is altered in patients with chronic ankle instability (CAI). We know balance training can improve balance, but we do not know if it also improves motor planning. Such changes in cortical activity can be assessed using electroencephalography.

Objective

To evaluate changes in cortical measures of motor planning after balance training in patients with CAI.

Design

Controlled laboratory study.

Setting

Research laboratory.

Patients or Other Participants

Fifteen patients with CAI (age = 20.80 ± 2.37 years, height = 169.47 ± 7.95 cm, mass = 70.45 ± 19.25 kg).

Intervention(s)

A 4-week progression-based balance-training program.

Main Outcome Measure(s)

Motor planning was assessed via electroencephalography before a lateral-stepping task. We calculated event-related spectral perturbations in the θ (4–8 Hz), α (8–12 Hz), β (14–25 Hz), and γ (30–50 Hz) bands. The change in power (in decibels) was calculated in each band for the 500 milliseconds before the onset of the lateral-stepping movement. Additional outcomes were the Foot and Ankle Ability Measure (FAAM)–Activities of Daily Living and Sport subscales; the anterior-, posteromedial-, and posterolateral-reach directions of the Star Excursion Balance Test; and static balance. Patients completed 3 test sessions: baseline, 24- to 48-hour posttest, and 1-week posttest. Repeated-measures analyses of variance were used to assess changes over time. The α level was set at .05.

Results

The FAAM–Activities of Daily Living subscale score was improved at both posttests (P < .05), and the FAAM-Sport subscale score was improved at the 1-week posttest (P = .008). Balance was better in all 3 directions of the Star Excursion Balance Test at both posttest sessions (P < .001). After balance training, no differences were identified in cortical activity at either posttest session (P > .05).

Conclusions

No improvements were identified in electroencephalography measures of motor planning during lateral stepping in patients with CAI. Improved balance suggested that sensorimotor adaptations occurred, but they may not have transferred to the lateral-stepping task or they may have been mediated via other processes in patients with CAI.
The Ankle-Joint Complex: A Kinesiologic Approach to Lateral Ankle Sprains
Authors: Medina McKeon Jennifer M. , Hoch Matthew C.
Published: June 2019

Copious research exists regarding ankle instability, yet lateral ankle sprains (LASs) persist in being among the most common recurrent musculoskeletal injuries. Key anatomical structures of the ankle include a triform articulating structure that includes the inferior tibiofibular, talocrural, and subtalar joints. Functionally, force absorption and propulsion through the ankle complex are necessary for any task that occurs in weight bearing. For optimal ankle performance and avoidance of injury, an intricate balance between stability and mobility is necessary to ensure that appropriate force transfer occurs during sports and activities of daily living. Consideration for the many structures that may be directly or indirectly involved in LASs will likely translate into advancements in clinical care. In this clinical review, we present the structure, function, and relevant pathologic states of the ankle complex to stimulate a better understanding of the prevention, evaluation, and treatment of LASs.
Altered Movement Biomechanics in Chronic Ankle Instability, Coper, and Control Groups: Energy Absorption and Distribution Implications
Authors: Kim Hyunsoo , Son S. Jun , Seeley Matthew K. , Hopkins J. Ty
Published: June 2019

Context

Patients with chronic ankle instability (CAI) exhibit deficits in neuromuscular control, resulting in altered movement strategies. However, no researchers have examined neuromuscular adaptations to dynamic movement strategies during multiplanar landing and cutting among patients with CAI, individuals who are ankle-sprain copers, and control participants.

Objective

To investigate lower extremity joint power, stiffness, and ground reaction force (GRF) during a jump-landing and cutting task among CAI, coper, and control groups.

Design

Cross-sectional study.

Setting

Laboratory.

Patients or Other Participants

A total of 22 patients with CAI (age = 22.7 ± 2.0 years, height = 174.6 ± 10.4 cm, mass = 73.4 ± 12.1 kg), 22 ankle-sprain copers (age = 22.1 ± 2.1 years, height = 173.8 ± 8.2 cm, mass = 72.6 ± 12.3 kg), and 22 healthy control participants (age = 22.5 ± 3.3 years, height = 172.4 ± 13.3 cm, mass = 72.6 ± 18.7 kg).

Intervention(s)

Participants performed 5 successful trials of a jump-landing and cutting task.

Main Outcome Measure(s)

Using motion-capture cameras and a force plate, we collected lower extremity ankle-, knee-, and hip-joint power and stiffness and GRFs during the jump-landing and cutting task. Functional analyses of variance were used to evaluate between-groups differences in these dependent variables throughout the contact phase of the task.

Results

Compared with the coper and control groups, the CAI group displayed (1) up to 7% of body weight more posterior and 52% of body weight more vertical GRF during initial landing followed by decreased GRF during the remaining stance and 22% of body weight less medial GRF across most of stance; (2) 8.8 W/kg less eccentric and 3.2 W/kg less concentric ankle power, 6.4 W/kg more eccentric knee and 4.8 W/kg more eccentric hip power during initial landing, and 5.0 W/kg less eccentric knee and 3.9 W/kg less eccentric hip power; and (3) less ankle- and knee-joint stiffness during the landing phase. Concentric power patterns were similar to eccentric power patterns.

Conclusions

The CAI group demonstrated altered neuromechanics, redistributing energy absorption from the distal (ankle) to the proximal (knee and hip) joints, which coincided with decreased ankle and knee stiffness during landing. Our data suggested that although the coper and control groups showed similar landing and cutting strategies, the CAI group used altered strategies to modulate impact forces during the task.
The Prevalence of Pain in People With Chronic Ankle Instability: A Systematic Review
Authors: Al Adal Saeed , Pourkazemi Fereshteh , Mackey Martin , Hiller Claire E.
Published: June 2019

Objective

To identify the prevalence of pain in people with chronic ankle instability (CAI) and how pain is related to the impairments of CAI.

Data Sources

We searched the databases of AMED, CINAHL, EMBASE, MEDLINE, PubMed, Scopus, SPORTDiscus, and Web of Science from inception to March 2017.

Study Selection

Eligible studies were peer-reviewed research in which investigators reported the presence of ankle pain or assessed the effects of pain on impairments in participants with CAI. Age and language were not restricted. Studies that included only surgical interventions were excluded.

Data Extraction

Studies identified by the search strategy were screened according to the eligibility criteria, and 2 independent reviewers extracted the data. Outcome measurements were (1) pain ratings using measures such as a visual analog scale and (2) other residual impairments, such as feelings of weakness, giving way, or deficits in functional performance.

Data Synthesis

Of the 5907 records identified through the database search, 14 studies were included in this review. All authors assessed ankle pain by self-report questionnaires or physical examination, or both. Pain was self-reported by 23% to 79% of participants and present on physical examination in 25% to 75% of participants, depending on the test applied. Among these studies, the highest reported pain level was 4.9 on the 11-point visual analog scale. Studies were heterogeneous for pain measures, participant groups, interventions, and follow-up periods. The relationship between pain and the structural and functional impairments associated with CAI was not investigated in the included studies.

Conclusions

Pain was present in a large proportion of people who had CAI, but pain levels were low. Information about the effects of pain was not reported, so researchers should examine the association between pain and function, balance, or other activities in people with CAI.
Self-Expanding Metallic Stents in Malignant Biliary Obstruction-Patency and Clinical Efficacy: A Prospective Study from North India Tertiary Center
Authors: Gupta Ankit , Gupta Gaurav Kumar , Gawande Atul , Kumar Manoj , Tak Vijyant , Pokharna Rupesh Kumar , Sharma Shyam Sundar , Nijhawan Sandeep
Published: June 2019

Background and Aims: Endoscopic insertion of self-expandable metallic stent (SEMS) is now accepted as first line modality of treatment for palliation in unresectable extra-hepatic biliary obstructive jaundice. This study was done to assess the clinical efficacy and duration of patency of endoscopically inserted metallic stent in un-resectable malignant biliary obstruction. Materials and Methods: Between 2015 to 2017, 101 patients who underwent ERCP and SEMS placement for palliation of malignant biliary obstruction were included prospectively. Main outcome measures were technical success, clinical success, mean duration of SEMS patency, clinical efficacy, rate of biliary re-intervention and survival of patients. Results: Overall technical success and clinical success was achieved in 93% and 82.2% respectively. Mean duration of SEMS patency was 109 days. Analysis in subgroup of patients classified according to site of obstruction (Hilar -68, Distal CBD-33) showed that median duration of stent patency was significantly better in distal biliary stricture (135 days vs 95 days), whereas re-intervention rates were higher in higher biliary stricture than distal stricture (41% Vs 6%). Seven patients with hilar biliary stricture suffered post-SEMS insertion cholangitis. Conclusion: SEMS placement is feasible palliative method for un-resectable malignant biliary obstruction with acceptable technical and clinical success. The duration of SEMS patency and clinical efficacy is significantly better in distal biliary stricture whereas re-intervention rate is higher in hilar biliary stricture.
Results of periacetabular osteotomy in adolescent and young adult hip dysplasia
Authors: Abdelhamid Mohamed Adel , Ragheb Eissa , Seddik Mahmoud
Published: June 2019

Background

Dysplasia of the hip is one of the most common causes of secondary osteoarthritis because of its associated structural instability. The Bernese periacetabular osteotomy (PAO) now is the preferred and the gold standard procedure for the treatment of symptomatic acetabular dysplasia.

Objective

The primary aim of our study was to evaluate the results of PAO in the treatment of adolescent and young adult patients with symptomatic hip dysplasia.

Patients and methods

This prospective case series’ study included 22 patients (26 hips, 13 left hips, 13 right hips) with hip dysplasia after surgical reorientation of the acetabulum by PAO procedure. This study included three male patients and 19 female patients. The mean age of our patients was 23 years (13–40 years). The mean follow-up period was 15 months (6–24 months). Twenty-one hips had undergone isolated PAO, while five hips had undergone combined surgery with the PAO at the same time (three hips had proximal femoral varus osteotomy and two hips had arthrotomy and osteochondroplasty).

Results

Twenty-five hips had good clinical and radiographic outcomes with respect to hip function and radiographic parameters. One patient developed avascular necrosis (AVN) of the femoral head 6 months after PAO and was treated by total hip replacement 1 year after PAO. The mean lateral central edge angle was 10.57°±11.61° preoperatively and was corrected to a mean value of 31.96°±4.42° with a mean correction of 21.38°. The mean postoperative acetabular index was 7.57°±1.81°, with a mean correction of 15.34°. In our series, the mean postoperative Harris hip score was 91.36±4.14, and the mean improvement was 29.08.

Conclusion

The PAO is an effective and valuable method for preservation of the natural hip joint and should be learned in a specialized center before using it in clinical practice.
Evaluating the effect of direct-acting agents on liver fibrosis, by real-time elastography, Fibroscan and FIB4 score in chronic HCV patients
Authors: Mansour Raed H. , Zaky Samy , El Kassas Mohamed , Mamdouh Haitham , Esmat Gamal
Published: June 2019

Background

One of the most important questions is what happens with liver fibrosis following a sustained virological response (SVR), although the current anti-HCV therapies were not designed to be antifibrotic. Liver biopsy was replaced by multiple noninvasive means, which were validated in chronic HCV patients, such as Fibroscan, seromarkers such as aminotransferase-to-platelet ratio index (APRI) and FIB4 scores, and new nonvalidated means such as real-time elastography (RTE). The aim of the study was to evaluate the early changes of liver fibrosis after direct-acting agents (DAAs) using these noninvasive means.

Materials and methods

This was a prospective study that included 200 chronic HCV-naive patients during the period spanning from December 2014 to January 2016. All patients received sofosbuvir − based treatment regimen (with or without pegylated interferon). They were evaluated using Fibroscan, RTE, APRI and FIB4 scores at the baseline and SVR24.

Results

All the studied patients showed a statistically significant decline in ALT, AST, liver stiffness (by Fibroscan), elasticity index (RTE), FIB4 score and APRI score, regardless of the response to DAAs. Moreover, there was a significant increase in platelet count from baseline to SVR24. The average improvement of the liver stiffness in different fibrosis stages was 22%. There was a positive correlation between stiffness score and all other fibrosis markers before and after treatment.

Conclusion

There was a significant improvement of liver stiffness after 12 weeks of end of treatment, regardless of the DAA regimen used, and regardless of the treatment outcome (response), as evidenced by Fibroscan, RTE, FIB4 and APRI scores.
Factors affecting the prognosis of traumatic acute subdural hematomas
Authors: Elhawary Magdy A. , El Shokhaiby Usama M. , Ali Wafik E. , Gafar Abdallah M. , Abd El Rahman Ahmed A.
Published: June 2019

Background

Trauma is the most frequent cause of young adult (under 45 years of age) fatalities worldwide, and traumatic brain injury accounts for up to 50% of these deaths. The incidence of traumatic brain injuries is increasing globally, largely due to an increase in motor vehicle use in low-income and middle-income countries.

Purpose

The aim of study was to investigate the factors that modulate the prognosis of patients with traumatic acute subdural hematoma.

Patients and methods

This study was conducted on 30 patients with acute traumatic subdural hematoma managed in the Department of Neurosurgery, ER, and Surgical ICU, Al-Azhar University Hospitals. All the data collected were statistically analyzed and the results were compared with the international results. Our recommendations were based on that comparison.

Results

Mortality rate was 53.3% (16 patients) in our study. The mean and SD of age in our study was 46.3±20.6 years. The range of age was 64 years (21–85 years). There was no statistical difference between sexes as regards age (P=0.393). The entire study population was subjected to logistic regression analysis, severity of injury, presence of a secondary injury especially hypoxia or both hypoxia and hypotension. Polytrauma, status of conscious level at admission, anemia, thickness of hematoma, and necessity for endotracheal intubation were enrolled. The hypoxia and lower Glasgow coma scale at admission were found to be significant predictors of mortality.

Conclusion

Traumatic acute subdural hematoma still has a high mortality rate despite all developments in neurosurgical interventions. Initially low Glasgow coma scale and hypoxia are important parameters that correlate with the mortality rate.
The prognostic value of lymphocyte-to-monocyte ratio in nephropathy of type 2 diabetes mellitus
Authors: Alsayyad Mohammad M. , Abd Alsamie Hesham S.
Published: June 2019

Background

Inflammatory markers like interleukin-1, 6, and 8, transforming growth factor-β (TGF-β)1, and tumor necrosis factor-α have been found to be associated with diabetic nephropathy (DN), indicating that its pathogenesis may be inflammatory. These inflammatory markers are not routinely used, so, creating the need for easily and routinely done markers aim to enhance the prognostic process of diabetic microvascular complications. Lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) can be routinely assessed, in addition to being considered as predictors for the survival of patients in renal diseases and malignancies.

Aim

The aim was to evaluate the prognostic value of LMR in DN of type 2 diabetes mellitus, and to compare it with other ratios: NLR and PLR.

Patients and methods

A case–control study including 100 type 2 diabetes mellitus patients and 25 apparently healthy controls. It was carried out at the inpatient and outpatient clinics, Internal Medicine Department, Al-Azhar University Hospital, New Damietta. Three groups were formed according to urinary albumin-to-creatinine ratio; group I, type 2 diabetics with normoalbuminuria, group II, type 2 diabetics with increased albuminuria, with further division into group IIA: with microalbuminuria/group IIB: macroalbuminuria or overt DN, and group III: controls. Full history, clinical examination, and laboratory tests: urinary albumin-to-creatinine ratio and complete urine analysis, complete blood count with assessment of LMR, NLR, and PLR, beside, blood sugar, HbA1c, renal function with assessment of estimated glomerular filtration rate, liver function, abdominal ultrasonography, fundus examination, and ECG were done for all the participants.

Results

The LMR mean was 2.4/2.8/3.2/2.1 in group I/IIA/IIB/III, respectively, showing the increasing ratios in parallel with the progression of DN severity and albuminuria through the groups, with the highest ratios in group IIB of overt DN. The NLR mean was 1.8/2.9/3.7/1.2 and the PLR mean was 175, 8/249, 2/277, 3/108, 3 in the corresponding group. Receiver operating characteristic curve analysis for ratios between groups I and IIA demonstrated that with a best cutoff point of 2.66 for the LMR, the sensitivity was 44%, the specificity: 92% (the ability of the LMR to predict DN risk); 2.2 for the NLR, the sensitivity: 84%, the specificity: 98%; 207 for the PLR, the sensitivity: 72%, and the specificity: 80%. So, in predicting the DN risk, NLR came first as regards the specificity followed by LMR and then PLR, but followed by PLR and then LMR as regards the sensitivity.

Conclusion

LMR may be considered as a surrogate inflammatory marker for DN in early stages and in between stages, but it is not better than NLR as a screening tool for DN diagnosis.
Frequency of destructive spondyloarthropathy among patients on regular hemodialysis
Authors: Kotb Hend G. , Gad Adela M. , Mohamed Nagwa Abd El-Ghaffar , EL-Din Reham M.N.
Published: June 2019

Objective

Musculosk eletal complications occur in patients suffering from chronic kidney diseases. The cause of destructive spondyloarthropathy (DSA) among those patients is not well known. This study aims to study the frequency of DSA among hemodialysis patients.

Patients and methods

The study was conducted on 75 patients known to be end-stage renal disease patients: they were divided into three groups: chronic kidney disease on regular hemodialysis for more than or equal to 5 years group (n=25), patients on regular hemodialysis for less than 5 years group (n=25), and end-stage renal disease prior to hemodialysis as a control group (n=25). All of them were subjected to: full medical history, clinical examination, and plain radiographs of the whole spine in two views. Serum beta 2-microglobulin (β2-M) levels were determined.

Results

A comparison of β2-M serum levels in three groups showed a highly significant difference being highest in group I and lowest in group III (P<0.001). There was high statistically significant increase in the frequency of DSA in group I compared with group II and in group II compared with group III (P<0.001). As regards the affected site among positive cases, DSA was observed to affect the cervical region in 82.35% more than the lumbar in 11.76%, and rarely to involve both cervical and lumbar in the same patient in 5.88%, DSA was observed to affect men (58.8%) more than the women (41.2 %). Comparison of age, duration of dialysis, and intact parathyroid hormone levels between positive and negative DSA cases revealed that DSA is significantly more prevalent in older age patients (P<0.05), and those with long dialysis duration (P<0.001), and those having higher intact parathyroid hormone levels (P<0.001).

Conclusion

DSA is the most serious spinal complication in patients on long-term hemodialysis. Serum β2-M is elevated in patients receiving long-term hemodialysis (>5 years) and is positively correlated with destructive changes (DSA).
Echocardiographic assessment of right ventricular functions in children after surgical repair of Tetralogy of Fallot
Authors: Shehata Eslam M.A. , El Nagar El-Sayed M. , El Dsoky Shara Mohamed , Abu-Farag Ibrahim M.
Published: June 2019

Introduction

Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. Between 3.5 and 10% of the patients with congenital heart disease have TOF, with males and females being affected equally.

Aim

The aim of this study is to assess right ventricular (RV) functions in children after surgical repair of TOF and to detect echocardiographic indices of prognostic value in these cases.

Patients and methods

This is a cross-sectional analytic study. It was conducted at Bab Elsharia Hospital of Al-Azhar University in Cairo over a period of 18 months from May 2017 till October 2018. It included 30 children who underwent surgical repair for TOF.

Results

A study was conducted on 30 children, comprising 11 male and 19 female children, and their mean age was 54.30±24.30 months. RV function assessment has been employed by MRI in eight cases, and conventional two-dimensional and Doppler echocardiography and finally tissue Doppler imaging in all cases. Postoperative echocardiography showed that the mean value of tricuspid annular plane systolic excursion was 14.78±4.53 mm, Myocardial Performance Index was 0.45±0.07, and RV end-diastolic diameter/left ventricular end-diastolic diameter was 1.03±0.27.

Conclusions

After surgical repair of TOF, the RV systolic and diastolic dysfunction can be detected in most patients by echocardiography in the form of prolonged Myocardial Performance Index, low value of tricuspid annular plane systolic excursion, and decreased myocardial velocities of RV. There is a significant relation between the use of transannular patch and RV dysfunction after complete surgical repair of TOF.
A comparative study between the effect of intrathecal hyperbaric bupivacaine with fentanyl and hyperbaric levobupivacaine with fentanyl for knee arthroscopy
Authors: Hussien Ayman Esmail , Abdel Halim Mohamed Adel Gawad
Published: June 2019

Background

The use of levobupivacaine as a pure S (−) enantiomer of bupivacaine was progressively increased due to lower cardiotoxicity and neurotoxicity and shorter motor block duration. The aim of this work was to compare the effectiveness of lower-dose local anesthetics’ use together with higher opioid dose to decrease the side effects of drugs. We compared sensorial, motor block levels and side effects of equal doses of hyperbaric bupivacaine and levobupivacaine with intrathecal fentanyl addition in knee arthroscopy.

Patients and methods

After hospital ethics committee approval and getting written informed consent from patients, 100 patients with American Society of Anesthesiologists grade I–II, aged 18–40 years were included in the study. They were randomized to either group A receiving 7.5 mg (1.5 ml) hyperbaric levobupivacaine with 25 μg (0.5 ml) fentanyl, or group B receiving 7.5 mg (1.5 ml) hyperbaric bupivacaine with 25 μg (0.5 ml) fentanyl.

Results

Hemodynamic parameters such as the 45th minute mean arterial pressure of group B was found to be lower (P<0.05). In group A, maximum sensorial block level and postoperative visual analog scale scores were higher (P<0.05). Onset of motor block time, time to maximum motor block, time to sensorial block, reversal of two dermatome and first analgesic need were similar in both groups.

Conclusion

Intrathecal hyperbaric levobupivacaine–fentanyl combination is a better and good alternative to bupivacaine–fentanyl combination in knee arthroscopy, as it maintains hemodynamic stability.
Relationship of vitamin D level and microalbuminuria in type 2 diabetic patients
Authors: Abdallah Amany M. , Moustafa Nariman , Soliman Somayh , Abdullatief Bossy , El-Ghaffar Nagwa Abd
Published: June 2019

Background

Great prevalence of patients with type 2 diabetes mellitus (T2DM) has been witnessed in the last decades worldwide. The global prevalence has been estimated to reach 6.4% among adults at the beginning of the current decade. Diabetic nephropathy is considered the most common complication that affects the kidney and plays as a leading cause of end-stage kidney disease. The presence of proteinuria in diabetic patients is a sign of risk. Vitamin D is a multitrait steroid hormone involved in a wide spectrum of cell regulatory and metabolic functions. Multiple diseases were observed to be frequently associated with low levels of vitamin D.

Objective

To estimate the level of vitamin D in T2DM patients, to assess its relation to microalbuminuria, and to estimate the effect of vitamin D replacement on these patients.

Patients and methods

A case–control study was conducted on 50 T2DM patients having microalbuminuria (group 1), 50 T2DM patients with no microalbuminuria (group 2), and 50 apparently healthy persons (group 3) (the control group), Routine tests such as complete blood count, fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin’, liver enzyme tests [alanine aminotransferase (ALT), aspartate aminotransferase (AST)], kidney function tests (urea, creatinine), lipid profiles [cholesterol, Triglyceride (TG)], serum albumin, calcium, phosphorus, intact parathyroid hormone (PTH), 25-hydroxycholecalciferol in the blood, and urinary albumin/creatinine ratio were done.

Results

The study showed highly statistically significant decrease of vitamin D level in group 1 (diabetes with microalbuminuria) compared with group 2 (diabetes without microalbuminuria) and group 3 (control) (P<0.001). A statistically significant negative correlation was found between microalbuminuria and vitamin D (r=−0.946). It also showed a highly statistically significant decrease of microalbuminuria after treatment with vitamin D compared with before treatment. There was a highly statistically significant decrease of glycosylated hemoglobin after vitamin D replacement.

Conclusion

This study demonstrated that vitamin D was significantly deficient in diabetic patients in comparison with the control group and it is significantly deficient in T2DM with microalbuminuria compared with T2DM without microalbuminuria. It showed that microalbuminuria was significantly improved after treatment with vitamin D but not to nonmicroalbminuric level. These findings indicated that there is a potential role of vitamin D in diabetic nephropathy pathogenesis.
Prevalence of learning disabilities among a sample of primary school students
Authors: Ismail Reda M. , Mohamed Hala T. , Soltan Basma G.
Published: June 2019

Objective

The aim was to assess the prevalence and sociodemographic risk factors of learning disabilities in primary school students studying in a governmental school.

Participants and methods

The present cross-sectional study was conducted on primary school children. A total of 218 students, of both sexes, represented all primary grades. All students were subjected to modified psychometric tool (MST) to identify the risk students. The students with risk of learning disorders (LDs) on MST were evaluated by the following: (a) visual acuity, hearing test, and intelligent quotient and (b) semistructured clinical interview to confirm diagnosis of LDs according to DSM-IV. In addition, our study explored the correspondence between the prevalence of LDs and the following variables: age, sex, grade level, family history, order of birth of child, and history of epilepsy or severe trauma. Finally, assessment of socioeconomic status was done to identifying the social standards of students’ families.

Results

A total of 36 (16.5%) students of the total screened (n=218) were identified as at risk by MST; of them, six students had visual and hearing impairment and were excluded from the study. There was increasing prevalence of identified LDs with increasing age, grade level, positive family history, and history of epilepsy. Moreover, students who were identified with LDs were more likely to be from low socioeconomic status. In addition, an association was found between LDs and language developmental delay.

Conclusion

Learning disabilities were common in primary school students. Screening students for such disorder should be recognized and identified right within the primary school level.
Study of the association between obesity, plasminogen activator inhibitor-1, and asthma in preschool children
Authors: El-Zayat Tayseer Abd El Hameed , Mohamed Amal G. , Mokhtar Entesar R. , Fathy Walaa A.
Published: June 2019

Background

Asthma and obesity are recognized as pathological conditions characterized by systemic inflammatory state. Plasminogen activator inhibitor-1 (PAI-1) is the most important endogenous inhibitor of tissue plasminogen activator and uro-plasminogen activator and is thus the major physiological inhibitor of both fibrinolysis and plasmin activation.

Purpose

To identify the role of PAI-1 in a group of Egyptian obese asthmatic preschool children and to identify some risk factors for simple obesity and asthma, such as age, sex, socioeconomic status, and type of feeding.

Patients and methods

This study was a cross-sectional case–control study that was carried out on 90 children attending Foua Hospital for health insurance in Kafar Elsheikh and Alzahraa University Hospital from September 2015 to March 2017.

Results

The frequency of obese children with asthma of high socioeconomic level was higher (63.3%) in comparison with nonobese children with asthma and controls. The prevalence of patients with asthma living in urban areas was higher than those living in rural areas (66.7%). Children who received artificial feeding are more frequent in asthmatic obese (66.7%) when compared with asthmatic nonobese and controls. PAI-1 had significant increase in asthmatic obese (1549.24±340.54) in comparison with other groups.

Conclusion

Asthmatic obese children are more frequent among high socioeconomic level and in urban areas. PAI-1 is significantly higher in asthmatic obese than asthmatic nonobese children.
Human hydatidosis with different therapeutic modalities
Authors: Shaheen Hoda Abdel Aziz Al Shinay , El-Ahl Saedia Abdel Hady Sayed , Aal Amany Ahmed Abdel , Raouf Amr Mahmoud Abdel , Badawi Manal Abdel Meged
Published: June 2019

Introduction

In early phase of hydatidosis, the Th1 mediates protective immunity against the parasite and helps to eliminate the larval stage, whereas later, the Th2 subset promotes humoral immune response and reflects susceptibility to disease.

Aim of the study

To investigate the local immunohistochemical pattern of T cell populations in Egyptian patients exposed to variable therapeutic modalities and to identify the dominating type of T cells in patients infected with hydatidosis using two immunocellular markers (STAT-4 and GATA-3), representing Th1 and Th2, respectively, and to evaluate systemic immune response using commercially available indirect hemagglutination (IHA) test.

Patients, materials, and methods

Forty-five cases with human hydatidosis were enrolled and divided according to treatment they received into four groups. Fresh samples of hydatid cyst wall were fixed in 10% formalin for immunohistochemical examination. Antibody titer was measured using commercial available IHA test.

Results

Significantly higher expression levels of GATA-3 in comparison with STAT-4 were recorded in all studied groups. Unexpectedly, IHA test recorded positive findings in only 22 of the 45 cases, exhibiting difficulty in the diagnosis and prognosis of such parasitic infection.

Conclusion

These local and systemic immunological profiles may reflect the efficiency of the parasite to sequestrate its antigen away from the host immune system applying variable therapeutic modalities with pronounced overshadowed Th2 response. Consequently, these data may help to develop new immunotherapeutic strategies to successfully eliminate this serious helminthic infection.
Different patterns of tilt-table test outcome in children and their response to medications
Authors: Ramzy Ali A. , Tamara Ahmed F.
Published: June 2019

Background

Syncope is a common and often frustrating clinical problem encountered by pediatricians in outpatient or emergency room settings. Neurocardiogenic syncope is believed to be the most common cause of syncope in the absence of structural heart disease. In our study, we aimed to study different responses to tilting-table test among children and teenagers with suspected neurocardiogenic syncope.

Patients and methods

We collected data from patients of Ain Shams Hospital who presented with more than two attacks of syncope and got positive tilt-table test findings. All the patients were subjected to thorough history taking, full cardiac examination, and a tilt-table test. Patients were later followed up for 2 months for recurrence.

Results

Our study included data from 30 patients, of which 19 were females, and seven were on antiepileptic drugs. Approximately 20% of patients had a family history of epilepsy, and 10% had a family history of syncope. Prolonged standing especially in hot weather was the most common predisposing factor for their syncopal attacks. Palpitation and dizziness were the most common symptoms occurring before the attack, whereas palpitation and headache commonly affected these patients after syncope. Physical examination of these patients revealed no specific abnormality, and their hemoglobin level and random blood sugar level also revealed no specific abnormality. Tilt-table test was done to all the patients and revealed that ∼75% showed a vasodepressor response; however, only ∼23% showed a mixed response and no patients demonstrated cardioinhibitory response. No complications were reported during the test. The study revealed a significant negative correlation between the frequency of the attacks and initiation-response lag (r=−0.676, P<0.001), meaning that the more the attack numbers of syncope, the earlier the occurrence of positive response in tilt-table test. All patients in the study received midodrine tablets together with diet modification and tilt training for 2 months. They were followed up for recurrence of syncope and only ∼16% of these patients showed recurrence. On asking patients with recurrence, they stated that they were noncompliant neither to the treatment nor to the exercise.

Conclusion

It is evident that tilt-table test is a safe and effective test to diagnose neurocardiogenic syncope in children and teenagers and that vasodepressor response is more common than both mixed and cardioinhibitory responses in children and teenagers. Midodrine, diet modification, and tilt training are effective management of neurocardiogenic syncope in children and teenagers.
Comparative study between different ultrasound-guided techniques for postoperative analgesia in children undergoing lower abdominal surgeries
Authors: El-Garhy Ahmed M.M. , El-Hameed Saeed M.A.
Published: June 2019

Background and aim

Ultrasound (US)-guided transversus abdominis plane (TAP) block, caudal block, and US-guided ilioinguinal/iliohypogastric (II/IH) nerve block are safe and effective methods in children. The aim of the study was to compare the effectiveness and occurrence of complications.

Patients and methods

A total of 100 patients undergoing lower abdominal operations (infraumbilical incision) between 5 and 10 years were included in the study. The patients scheduled for elective operation were randomized into four groups: group A (n=25) received US-guided TAP block; group B (n=25) received US-guided caudal block; group C (n=25) received US-guided II/IH nerve; and group D (n=25) received Ketorolac 0.5 mg/kg intravenously to be considered as the control group. The Objective pain score, postoperative complication, satisfaction of the parents, and postoperative analgesic requirements were recorded.

Results

Postoperative analgesia requirements were significantly higher in group D compared with group A, B, and C; meanwhile, it was significantly highest in group D compared with both groups A and group B. There was significant difference between group A and group D in pain score assessment, but no significant difference between group A and group B. Patient and parent satisfaction was markedly observed in groups A and B more than in group D (the control group) and more satisfaction in group A than group B.

Conclusion

TAP block, caudal block, and US-guided II/IH nerve blockade under US guidance proved to be safe with no recorded postoperative complications. Patient and parent satisfaction was markedly observed in case of TAP block.
Corrigendum and addendum to “Centralizers of finite subgroups in Hall’s universal group”
Authors: Kegel Otto H. , Kuzucuoğlu Mahmut
Published: June 2019

In Hall's universal group every non-trivial conjugacy class satisfies

CC=U

. Hence generalized version of J. G. Thompson's conjecture is true for every non-trivial conjugacy class

C

in

U

. Moreover Ore's conjecture (every element is a commutator) is true for

U

is added to [4]. In [4, Theorem 2.4]

C_U(F)/Z(F)\cong U

is true if

Z(F)=1

.
Pure-minimal chain complexes
Authors: Christensen Lars Winther , Thompson Peder
Published: June 2019

We introduce a notion of
pure-minimality
for chain complexes of modules and show that it coincides with (homotopic) minimality in standard settings, while being a more useful notion for complexes of flat modules. As applications, we characterize von Neumann regular rings and left perfect rings.
Groups with few self-centralizing subgroups which are not self-normalizing
Authors: Hassanzadeh Mahmoud , Mostaghim Zohreh
Published: June 2019

A self-normalizing subgroup is always self-centralizing, but the converse is not necessarily true. Given a finite group

G

, we denote by

w(G)

the number of all self-centralizing subgroups of

G

which are not self-normalizing. We observe that

w(G) = 0

if and only if

G

is abelian, and that if

G

is nonabelian nilpotent then

w(G)\geq 3

. We also prove that if

w(G)\leq 20

then

G

is solvable. Finally, we provide structural information in the case when

w(G)\leq 3

.
$\pi$-exponentials for generalized twisted ramified Witt vectors
Authors: Matsuda Shigeki
Published: June 2019

In this paper, we generalize Hazewinkel’s theory of twisted ramified Witt rings and then generalize

\pi

-exponentials defined by Pulita using newly defined Witt vectors. As an application,we determine the radii of convergence of some formal group exponentials.We also show that

p

-typical part of a theorem of R. Richard [Ric15] on the convergence of

\pi

-exponentials holds for these series and prove some overconvergence properties of related series.
Numerical and Experimental Investigation of Ice Adhesion Using the Blister Test
Authors: Giuffre Christopher , Dawood Bishoy , Yavas Denizhan , Bastawros Ashraf
Published: June 2019

Structures in cold weather environments are susceptible to atmospheric ice formation. A fracture mechanics based approach is proposed for in situ characterization of the interfacial fracture energy of ice on different substrates. This paper summarizes the development of the experimental and analytical framework to measure the ice adhesion energy, calibrated on static ice. The testing configuration utilizes a shaft-loaded blister test to produce stable crack propagation, from a well-defined pre-crack at the interface of the ice layer and the substrate. Measurements of the fracture energy are taken over a range of ice thicknesses and surface roughnesses. The developed analytical framework to estimate adhesion energy are verified and calibrated via finite element numerical simulation of the proposed geometric configuration and employing cohesive surfaces along the interface to simulate the crack nucleation and propagation process. Several different phenomena were observed include the transition from adhesive to cohesive fracture. The measured interfacial adhesion energy was almost independent of the surface roughness in the range of examined roughness. The measured interfacial R-curve showed a steady state plateau for range of interfacial crack propagation. The proposed experimental framework enables precise measurement of the interfacial fracture toughness over a range of surface finishes and ice layer thickness.
Experimental Aerodynamic Simulation of a Scallop Ice Accretion on a Swept Wing
Authors: Woodard Brian , Broeren Andy , Potapczuk Mark , Lee Sam , Lum Christopher , Bragg Michael , Smith Timothy
Published: June 2019

Understanding the aerodynamic impact of swept-wing ice accretions is a crucial component of the design of modern aircraft. Computer-simulation tools are commonly used to approximate ice shapes, so the necessary level of detail or fidelity of those simulated ice shapes must be understood relative to high-fidelity representations of the ice. Previous tests were performed in the NASA Icing Research Tunnel to acquire high-fidelity ice shapes. From this database, full-span artificial ice shapes were designed and manufactured for both an 8.9%-scale and 13.3%-scale semispan wing model of the CRM65 which has been established as the full-scale baseline for this swept-wing project. These models were tested in the Walter H. Beech wind tunnel at Wichita State University and at the ONERA F1 facility, respectively. The data collected in the Wichita St. University wind tunnel provided a low-Reynolds number baseline study while the pressurized F1 facility produced data over a wide range of Reynolds and Mach numbers with the highest Reynolds number studied being approximately Re = 11.9×106. Past work focused on only three different fidelity variations for ice shapes based on multiple icing conditions. This work presents a more detailed investigation into several fidelity representations of a single highly three-dimensional scallop ice accretion. Sensitivity to roughness size and application technique on a low-fidelity smooth ice shape is described. The data indicate that the aerodynamic performance is not especially sensitive to the grit variations. An ice accretion code was also used to generate ice shapes for aerodynamic testing and comparisons. These ice shapes have a general appearance like the low-fidelity smooth ice shapes, but in this case, the computer-generated ice shape is significantly smaller. As such, the impact of that ice shape on the aerodynamic performance of the wing is reduced compared to the smooth ice shape based on the icing experiment for those same conditions. Spanwise discontinuities were also introduced to a low-fidelity ice shape in an attempt to quantify the impact of those variation in the high-fidelity ice shape. While the lift data indicate good agreement between the high-fidelity ice shapes and the low-fidelity ice shapes with spanwise discontinuities, a closer investigation of the data suggests potential, significant differences in the flowfield. These results were similar at both facilities over the wide range of test conditions utilized.
Influence of Freestream Temperature on Ice Accretion Roughness
Authors: McClain Stephen T. , Vargas Mario , Tsao Jen-Ching , Broeren Andy
Published: June 2019

The influence of freestream static temperature on roughness temporal evolution and spatial variation was investigated in the Icing Research Tunnel (IRT) at NASA Glenn Research Center. A 53.34 cm (21-in.) NACA 0012 airfoil model and a 152.4 cm (60-in.) HAARP-II business jet airfoil model were exposed to Appendix C clouds for fixed exposure times and thus fixed ice accumulation parameter. For the base conditions, the static temperature was varied to produce different stagnation point freezing fractions. The resulting ice shapes were then scanned using a ROMER Absolute Arm system and analyzed using the self-organizing map approach of McClain and Kreeger. The ice accretion prediction program LEWICE was further used to aid in interrogations of the ice accretion point clouds by using the predicted surface variations of local collection efficiency. The resulting equivalent sand-grain roughness heights predicted using the correlation of Flack and Schultz are compared to the roughness correlation employed in LEWICE for roughness convection enhancement predictions. The results demonstrate the influence of the stagnation point freezing fraction on the maximum sand-grain roughness height. A new function is developed to predict the maximum sand-grain roughness height based on the stagnation point freezing fraction and accumulation time.
High Altitude Ice Crystal Detection with Aircraft X-band Weather Radar
Authors: Lukas Jan , Badin Pavel
Published: June 2019

During participation on EU FP7 HAIC project, Honeywell has developed methodology to detect High Altitude Ice Crystals with the Honeywell IntuVue® RDR-4000 X-band Weather Radar. The algorithm utilizes 3D weather buffer of RDR-4000 weather radar and is based on machine learning. The modified RDR-4000 Weather Radar was successfully flight tested during 2016 HAIC Validation Campaign; the technology was granted Technology Readiness Level 6 by HAIC consortium. After the end of HAIC project, the method was also evaluated with respect to newly set preliminary industry standard performance requirements1. This paper discuses technology design rationale, high level technology architecture, technology performance, and challenges associated with performance evaluation.