bluuebunny/crossref_metadata_2025_split huggingface dataset:
Level of knowledge, attitude, and practice of family planning and associated factors among disabled persons, north-shewa zone, Amhara regional state, Ethiopia
Authors: Mekonnen Alemayehu Gonie , Bayleyegn Alebachew Demelash , Aynalem Yared Asmare , Adane Tigist Demssew , Muluneh Mikyas Arega , Asefa Meaza 
Published: July 2020

Abstract
Background
In Ethiopia, people with disabilities face socioeconomic disadvantages and they have a limited access to sexual and reproductive health information including family planning service. At present, however, there is a scarcity of research on the association between disability and family planning, and only limited data is available for disabled people in Ethiopia. Hence, this study assessed the level of knowledge, attitude, and practice of family planning and associated factors among disabled persons in North-shewa zone, Amhara regional state, Ethiopia.

Methods
A cross-sectional survey was conducted from June to October 2019. A total of 397 study participants were interviewed using a structured and pre-tested questionnaire. A multistage systematic sampling technique was employed to select study participants. Data were entered into Epi data and exported into Statistical Package for the Social Sciences (SPSS) version 21 for analysis. Logistic regression was performed to analyze the data. A significant association was declared at a p-value of less than 0.05.

Results
Forty-six percent of study participants were knowledgeable about family planning methods. The injectable was the most known method of modern contraception (74.8%) while withdrawal (18.1%) was the least known traditional family planning method. Fifty-five percent of our study participants had a good attitude about family planning methods and one-fourth (24.5%) of disabled persons currently utilized any method of family planning. Those having a good knowledge of family planning were 1.6 times more likely to utilize family planning methods than those having poor knowledge of family planning methods (AOR = 1.61, CI = 1.27, 16.24). Moreover, participants who completed college education were 7 times more likely to have a good knowledge of family planning methods than uneducated participants (AOR = 7.23; 95% CI = 2.28, 22.06).

Conclusions
In this study, the knowledge, attitude, and practice of disabled people about family planning methods were relatively low. Due attention should be given to ensure that disabled people are well informed about family planning methods through information, education, and communication activities.
Cardiac MRI utilizing late gadolinium enhancement (LGE) and T1 mapping in the detection of radiation induced heart disease
Authors: Ricco Anthony , Slade Alexander , Canada Justin M. , Grizzard John , Dana Franklin , Rezai Gharai Leila , Neiderer Keith , Vera Armando , Abbate Antonio , Weiss Elisabeth 
Published: July 2020

Abstract
Background and purpose
Radiotherapy has been associated with late dose-dependent cardiovascular toxicity. In this cross-sectional pilot study, radiation dose distributions were correlated with areas of localized and diffuse myocardial fibrosis as measured by novel cardiac MRI (CMR) sequences including late gadolinium enhancement (LGE) and T1 mapping with the goal to identify early markers of myocardial damage.

Materials and methods
Twenty-eight patients with chest tumors including lung, breast, esophagus, and lymphoma underwent CMR per study protocol on average 46.4 months (range 1.7–344.5) after radiotherapy. Patients without pretreatment cardiac history were included if the volume of heart receiving 5 Gy or more was at least 10% (V5Gy ≥ 10%). The association of LGE with cardiac dosimetric factors, clinical factors (e.g., tumor type, smoking history, BMI), and T1 values was analyzed.

Results
Cardiac maximum (Dmax) and mean dose (Dmean) equivalent to doses delivered in 2 Gy fractions (EQD2) were on average 50.9 Gy (range 6.2–108.0) and 8.2 Gy (range 1.0–35.7), respectively, compared to 60.8 Gy (40.8–108.0) and 6.8 Gy (1.8–21.8) among the 9 patients with LGE. Doses were not different between patients with and without LGE (p = 0.16 and 0.56, respectively). The average T1 value of the left ventricle myocardium was 1009 ms (range 933–1117). No significant correlation was seen for heart Dmax and Dmean and T1 values (p = 0.14 and 0.58, respectively). In addition, no significant association between clinical factors and the development of LGE was identified.

Conclusions
No relation between cardiac doses, the presence of LGE or T1 values was observed. Further study is needed to determine the benefit of CMR for detecting radiotherapy-related myocardial fibrosis.
A report of three cancer patients on opioid analgesia receiving spinal anesthesia: abrupt pain elimination without respiratory depression
Authors: Nozaki-Taguchi Natsuko , Ueda Yuko , Inada Azusa , Son Kyongsuk , Isono Shiroh 
Published: July 2020

Abstract
Background
Complete removal of pain with regional anesthesia has been reported to cause fatal respiratory depression in opioid-dependent patients, which leads us to choose general anesthesia. We hereby report three cases of chronically opioid-treated cancer patients operated under spinal anesthesia without respiratory event.

Case presentation
Case 1: a 32-year-old female treated with high-dose morphine for her cancer pain was planned for cesarean section. Case 2: a 65-year-old female on moderate dose of oxycodone was planned for surgery of her femoral bone fracture. Case 3: a 65-year-old male on low-dose oxycodone was planned for intramedullary nailing for metastatic femoral bone tumor. In all three cases, spinal anesthesia was chosen. Continuous respiratory monitoring revealed no apnea or bradypnea.

Conclusion
Spinal anesthesia was safely performed without respiratory depression in chronic opioid users for cancer pain.
Development of an in situ simulation-based continuing professional development curriculum in pediatric emergency medicine
Authors: Leung James S. , Brar Mandeep , Eltorki Mohamed , Middleton Kevin , Patel Leanne , Doyle Meagan , Ngo Quang 
Published: July 2020

Abstract
Background
Continuing professional development (CPD) activities delivered by simulation to independently practicing physicians are becoming increasingly popular. At present, the educational potential of such simulations is limited by the inability to create effective curricula for the CPD audience. In contrast to medical trainees, CPD activities lack pre-defined learning expectations and, instead, emphasize self-directed learning, which may not encompass true learning needs. We hypothesize that we could generate an interprofessional CPD simulation curriculum for practicing pediatric emergency medicine (PEM) physicians in a single-center tertiary care hospital using a deliberative approach combined with Kern’s six-step method of curriculum development.

Methods
From a comprehensive core list of 94 possible PEM clinical presentations and procedures, we generated an 18-scenario CPD simulation curriculum. We conducted a comprehensive perceived and unperceived needs assessment on topics to include, incorporating opinions of faculty PEM physicians, hospital leadership, interprofessional colleagues, and expert opinion on patient benefit, simulation feasibility, and value of simulating the case for learning. To systematically rank items while balancing the needs of all stakeholders, we used a prioritization matrix to generate objective “priority scores.” These scores were used by CPD planners to deliberately determine the simulation curriculum contents.

Results
We describe a novel three-step CPD simulation curriculum design method involving (1) systematic and deliberate needs assessment, (2) systematic prioritization, and (3) curriculum synthesis. Of practicing PEM physicians, 17/20 responded to the perceived learning needs survey, while 6/6 leaders responded to the unperceived needs assessment. These ranked data were input to a five-variable prioritization matrix generating priority scores. Based on local needs, the highest 18 scoring clinical presentations and procedures were selected for final inclusion in a PEM CPD simulation curriculum. An interim survey of PEM physician (21/24 respondents) opinions was collected, with 90% finding educational value with the curriculum. The curriculum includes items not identified by self-directed learning that PEM physicians thought should be included.

Conclusions
We highlight a novel methodology for PEM physicians that can be adapted by other specialities when designing their own CPD simulation curriculum. This methodology objectively considers and prioritizes the needs of practicing physicians and stakeholders involved in CPD.
The need for COVID-19 research in low- and middle-income countries
Authors: Gupta Madhu , Wahl Brian , Adhikari Binita , Bar-Zeev Naor , Bhandari Sudip , Coria Alexandra , Erchick Daniel J. , Gupta Nidhi , Hariyani Shreya , Kagucia E. Wangeci , Killewo Japhet , Limaye Rupali Jayant , McCollum Eric D. , Pandey Raghukul , Pomat William S. , Rao Krishna D. , Santosham Mathuram , Sauer Molly , Wanyenze Rhoda K. , Peters David H. 
Published: July 2020

AbstractIn the early months of the pandemic, most reported cases and deaths due to COVID-19 occurred in high-income countries. However, insufficient testing could have led to an underestimation of true infections in many low- and middle-income countries. As confirmed cases increase, the ultimate impact of the pandemic on individuals and communities in low- and middle-income countries is uncertain. We therefore propose research in three broad areas as urgently needed to inform responses in low- and middle-income countries: transmission patterns of SARS-CoV-2, the clinical characteristics of the disease, and the impact of pandemic prevention and response measures. Answering these questions will require a multidisciplinary approach led by local investigators and in some cases additional resources. Targeted research activities should be done to help mitigate the potential burden of COVID-19 in low- and middle-income countries without diverting the limited human resources, funding, or medical supplies from response activities.
Longitudinal associations between sleep disturbance and disease severity in patients with COPD
Authors: Luyster Faith S. , Wang Juan , Sciurba Frank C. , Bon Jessica 
Published: July 2020

AbstractBackgroundSleep disturbance is a common complaint among patients with chronic obstructive pulmonary disease (COPD). Studies examining the associations between sleep disturbance and COPD severity have primarily been cross-sectional and produced conflicting results. We extended previous research by investigating the bidirectional longitudinal associations between sleep disturbance and indicators of COPD severity including airway obstruction, dyspnea, health status, exercise capacity, hyperinflation, and diffusing capacity of the lung (DLCO).MethodsWe used longitudinal data from the COPD Specialized Center for Clinically Oriented Research (SCCOR) prospective cohort. One hundred fifty-seven patients with COPD (54.1% male, 66.3 ± 6.4 years) completed assessments at baseline and 2-year follow-up. Primary outcomes of interest were: sleep disturbance based on a single item from the Beck Depression Inventory; airflow obstruction, defined by FEV1% predicted from spirometry; health status, as measured by the St. George’s Respiratory Questionnaire; exercise capacity, as determined by walking distance (meters) during an incremental shuttle walk test; dyspnea, as measured by the modified Medical Research Council scale; DLCO, determined by single breath carbon monoxide diffusion; and hyperinflation, defined by residual volume from body plethysmography. Linear and logistic regression analyses were conducted, correcting for baseline outcome severity.ResultsAfter controlling for covariates of age, sex, race, body mass index, and smoking status, sleep disturbance was associated with worse health status at baseline. Using longitudinal follow-up data, greater disease severity including airflow obstruction, dyspnea, health status, exercise capacity, and DLCO independently predicted sleep disturbance at 2-year follow-up. Baseline sleep disturbance was not associated with subsequent disease severity.ConclusionsDisease severity predicts future sleep disturbance in COPD patients. This suggests that COPD severity may be a risk factor for the development of sleep problems, and therefore better COPD control may be a preventative strategy for sleep disturbance.
Analysis of the finiteness for the first collision time between two randomly moving particles
Authors: Alzulaibani Alaa A. 
Published: July 2020

AbstractThe finiteness of the collision time between two different randomly moving particles is presented by providing more useful analysis that gives stronger and finite moment. The triangular arrays and the uniform integrability conditions of the all probable positions non-stationary random sequence are used. In addition, an important property of Marcinkiewicz laws of large numbers and Hoffman-Jorgensen inequality are presented in this analysis. All of them are deriving to provide the sufficient conditions that give more stronger moments of the first meeting time in the probability space.
Seventh order hybrid block method for solution of first order stiff systems of initial value problems
Authors: Akinfenwa O. A. , Abdulganiy R. I. , Akinnukawe B. I. , Okunuga S. A. 
Published: July 2020

AbstractA hybrid second derivative three-step method of order 7 is proposed for solving first order stiff differential equations. The complementary and main methods are generated from a single continuous scheme through interpolation and collocation procedures. The continuous scheme makes it easy to interpolate at off-grid and grid points. The consistency, stability, and convergence properties of the block formula are presented. The hybrid second derivative block backward differentiation formula is concurrently applied to the first order stiff systems to generate the numerical solution that do not coincide in time over a given interval. The numerical results show that the new method compares favorably with some known methods in the literature.
FISH-based sperm aneuploidy screening in male partner of women with a history of recurrent pregnancy loss
Authors: Pourfahraji Fakhrabadi Marjan , Kalantar Seyed Mahdi , Montazeri Fatemeh , Dehghani Ashkezari Mahmood , Pourfahraji Fakhrabadi Majid , Sabbagh Nejad Yazd Samira 
Published: July 2020

Abstract
Background
Recurrent pregnancy loss is defined as having the experience of three or more repeated pregnancy losses. Despite numerous studies, RPL etiology remains unclear; in this respect, many etiological factors have been thoroughly investigated. However, the contribution of male factors in RPL at the sperm aneuploidy has rarely been examined. The aim of the current study is to assess the existence of autosome and sex chromosome aneuploidy in sperm of men with history of recurrent pregnancy loss. In this prospective study, 50 men with a history of recurrent pregnancy loss were included as case group and 15 men with normal sperm analysis, without abortion history and with at least one child were included as control group. Two- and three-color fluorescence in situ hybridization technique was used for screening aneuploidy in 13, 18, 21, X, and Y chromosomes.

Results
Overall, the comparison of sperm aneuploidies in sex and autosome chromosomes (13, 21, 18) between case and control groups showed that chromosomal abnormality was significantly increased in men with RPL than men without history of RPL. Among all examined cells, about 18.28% nullisomy, 6.48% disomy, and 0.06% trisomy were observed. As well, two cells with XXYY and one cell with XXXY karyotype were observed. Among the analyzed chromosomes, the prevalence of nullisomy of chromosome 13 was higher than other studied chromosomes.

Conclusion
The results suggest the implication of sperm chromosomal abnormalities in recurrent pregnancy loss. Clinical application of FISH-based screening test is recommended for investigating sperm aneuploidy in RPL cases to counsel couples for making informed decision.
Cognitive emotion regulation, anxiety, and depression in infertile women: a cross-sectional study
Authors: Foroudifard Fatemeh , Amini Payam , Navid Behnaz , Omani-Samani Reza , Sepidarkish Mahdi , Maroufizadeh Saman 
Published: July 2020

Abstract
Background
Cognitive strategies play an important role in the prevention of psychological disorders. The aim of this study was to examine the relationships of cognitive emotion regulation with anxiety and depression symptoms in a sample of infertile women in Iran.

Results
According to correlation analysis, all adaptive strategies (i.e., acceptance, positive refocusing, refocus on planning, positive reappraisal, and putting into perspective), except for Acceptance strategy, were indirectly related to both anxiety and depression symptoms. Conversely, four maladaptive strategies (i.e., self-blame, rumination, catastrophizing, and other-blame) were positively related to anxiety and depression symptoms. After controlling for demographic/infertility information, hierarchical regression analyses indicated that acceptance, rumination, and positive refocusing subscales were significantly associated with anxiety; and refocus of planning was related to depression.

Conclusion
In sum, cognitive emotion regulation strategies appeared to be related to anxiety and depression symptoms in women suffering from infertility. These results suggest the use of cognitive therapy to reduce the anxiety and depression in these women.
Impact of preoperative SYNTAX Scores on short-term outcome following coronary artery bypass grafting surgery in the patients with multi-vessels coronary artery disease
Authors: Ramadan Bassem Adel , Zaki Mohamed Ahmed , Etman Wahid Gamal El Din , Agha Mohamed Mostafa , Sobhy Mohamed Ahmed , Hassanein Wael Mahmoud 
Published: July 2020

Abstract
Background
SYNTAX Scores I (SSI) assesses the complexity of CAD; SYNTAX Score II (SSII) uses both SSI and other clinical variables, in estimation of 4 years mortality following both coronary artery bypass grafting surgery (CABG) and percutaneous coronary intervention (PCI) and gives recommendations for the best revascularization strategy in a specific patient. Our aim is to investigate the impact of both SYNTAX Scores on short-term outcome following CABG.

Results
Prospectively, we studied 150 patients with multi-vessels coronary artery disease, referred to perform, elective primary isolated CABG. All cases performed on pump CABG with aortic cross clamping, then followed up for 90 days postoperatively, for onset of mortality from all causes, myocardial infarction (MI), stroke, mediastinitis, and need for renal replacement therapy (RRT).
SSI showed a statistically significant association with in-hospital and 90 days mortality, MI, and mediastinitis (P = < 0.001, 0.015, 0.045 respectively); SSII showed a statistically significant association with in-hospital mortality and 90 days mortality and need for renal replacement therapy (P = 0.007, 0.043, 0.012 respectively); SSI is independent risk factor for overall mortality (OR 1.192, 95% CI 1.018–1.396) (P = 0.029) and MI (OR 1.182, 95% CI 1.016–1.375).

Conclusions
SYNTAX Scores are good predictors of short-term outcome after CABG; increased SSI was associated with increased mortalities (in-hospital and total 90 days), MI and mediastinitis, increased SSII associated with increased mortalities (in-hospital and total 90 days), and need for RRT; SSI is independent risk factor for mortality and MI.
Association of vitamin C status in diabetes mellitus: prevalence and predictors of vitamin C deficiency
Authors: D Praveen , Puvvada Ranadheer Chowdary , M Vijey Aanandhi 
Published: July 2020

Abstract
Background
Vitamin C is one of the most important micronutrient required for various physiological roles in the human system. Evidences suggest that there is an inadequate status of vitamin C in diabetes mellitus. The objectives of this study is to understand the prevalence of vitamin C deficiency in established type II diabetes mellitus patients and to study the correlation between various variables of diabetes mellitus with serum vitamin C levels.

Methods
A prospective cross-sectional study to assess the prevalence of vitamin C deficiency was carried out in diabetes patients. Fasting blood sugar levels, glycated hemoglobin, serum malondialdehyde levels, and lipid profile levels were correlated with serum vitamin C levels.

Results
The prevalence rate of hypovitaminosis C is found to be 55.13% among the enrolled patients. There is a significant increase in the systolic blood pressure levels in patients with inadequate as well as deficient vitamin C levels (p < 0.05). Inverse relationship exists between fasting blood sugar and vitamin C levels (p < 0.001). Similarly total cholesterol levels were also inversely related to the vitamin C levels (p = 0.0031). Body mass index, glycated hemoglobin, and fasting blood sugar levels are important predictors of vitamin C deficiencies.

Conclusion
Vitamin C deficiency is well established among diabetes mellitus patients. Deficiency of vitamin C levels has an impact on the serum malondialdehyde levels suggesting increased oxidative stress. The higher oxidative stress would have led to increase in glycated hemoglobin. Further research must be carried out to understand the beneficial effects of vitamin C supplementation in diabetes mellitus.
Lymphatic sparing laparoscopic varicocelectomy with or without testicular artery preservation: is there a difference?
Authors: Yehya Abdelaziz , Abdalrazek Mohamed , Gamaan Ibrahim , Fathy Ahmed , Batal Wael El 
Published: July 2020

Abstract
Background
Lymphatic sparing laparoscopic Palomo varicocelectomy is a safe and reliable technique for varicocele treatment in adolescents and children. The purpose of this study was to compare the outcomes of lymphatic sparing laparoscopic varicocelectomy with and without testicular artery preservation. The prospective random allocation of selected patients was done at Al-Azhar University Hospital, Pediatric Surgery Department from February 2010 till January 2015. All patients underwent lymphatic sparing laparoscopic varicocelectomy and they were divided into two equal groups, group A underwent laparoscopic Palomo without testicular artery sparing and group B underwent the procedure with testicular artery sparing. The main outcome included operative time, postoperative hydrocele, and persistence of varicocele, together with catch-up testicular growth or testicular atrophy.

Results
One hundred and sixty male patients presented with left-sided primary varicocele that was diagnosed clinically and affirmed by color Doppler ultrasonography. The mean age was 14.25 ± 1.6 years (ranged 13-16 years). There was one case of persistent varicocele in group A, compared to 8 cases in group B with a statistically significant difference (p = 0.016). A significant difference had been found in the operative time (p = 0.001) between both groups. No hydrocele or testicular atrophy had been detected in both groups. No significant inter-group differences were seen in aspects of age, varicocele grade, and catch-up testicular growth. The mean follow-up period was 42 months (24-60 months).

Conclusion
Lymphatic sparing laparoscopic Palomo varicocelectomy was superior to that with testicular artery preservation as regard varicocele persistence and operative time and hence is preferable for the management of primary pediatric varicocele.