bluuebunny/crossref_metadata_2025_split huggingface dataset:
Etiological profile of new-onset seizures among adult Egyptians
Authors: Mahmoud Mahmoud Hemeida , Awad Eman Mahmoud , Mohamed Ahmed Khalil , Shafik Mohamed Ahmed 
Published: July 2021

Abstract
Background
New-onset seizure (NOS) is defined as the first seizure within a 24-h period ever experienced by the patient. A first-ever seizure can be the first manifestation of epilepsy. Or it may be a symptom of a brain tumor, a systemic disorder, an infection, or a syndrome that deserves special attention and treatment. This study aims to identify the etiology of NOS among different age and sex groups of adult Egyptian patients. A hundred and twenty adult Egyptian patients (> 18 years) presented with acute NOS were enrolled in a hospital-based cross-sectional observational study from the emergency room and neurology outpatient clinics of our hospitals within a time period of 6 months from March till September 2018. All patients were subjected to neurological examination, laboratory, neuroimaging, and electroencephalogram investigations.

Results
Among 120 adult patients presented with NOS, males were prevalent (63%). Older adults (age group > 55 years) were the most prevalent cohort (60%). Cerebrovascular diseases (CVDs) were the most common identified etiology of NOS (44.17%), followed by idiopathic epilepsy syndrome (18.33%), symptomatic mainly “metabolic” (11%), brain tumors (9.17%), post-traumatic epilepsy (6.67 %), encephalitis (5.83%), and cryptogenic (5%). Idiopathic epilepsy syndrome was the most common etiology (55.56%) of new-onset seizures among the young adult age group (< 36 years), while CVDs were the most common etiology (65.28%) among older adults (> 55 years). Also, CVDs were the most common etiology among males (43.4%) as well as females (45.4%). However, male predominance was the highest among post-traumatic seizures (87.5%). And female predominance was the highest among brain tumors identified etiology of NOS (54.5%).

Conclusion
NOS among adults are prevalent in elder males. CVDs are the most commonly identified etiology of adult NOS across males and females. Idiopathic epilepsy syndromes are the predominant etiology among younger adults.
Brain tumor surgery in the elderly: a single institution experience of short-term outcome—a retrospective case study
Authors: Tantawy Mostafa F. , Nazim Wael M. 
Published: July 2021

Abstract
Background
There is an evolving concern in the management of brain tumors in the elderly. The number of elderly people (aged 65 years or more) increases progressively, and there is a considerable percent of brain tumors affecting this age group. Elderly people may have one or more chronic illnesses that may render cranial surgery of high risk for mortality and morbidity. This study was carried out to evaluate the short-term (30 days) outcome of brain tumor surgery in elderly patients.

Results
This is a single-institution retrospective study of elderly patients harboring brain tumors who were managed by surgery. The study included 31 patients between 2014 and 2019. Elective and emergency cases were included. The mean age for the study population was 68.29 years. The mean functional status using the Karnofsky Performance Scale (KPS) changed from 58.06 before surgery to 70 after surgery. Meningioma grade I and glioblastoma multiforme (GBM) were the most common neoplasms, 41.9 and 29%, respectively. There was a statistically significant relationship between the mortality and GBM (P value < 0.05) while there was no correlation with concomitant diseases, KPS, or extent of resection (P value > 0.05). Preoperative concomitant diseases were found in 16 patients. Mortality occurred in 11 cases (35.4%).

Conclusions
Old age by itself should not be a risk factor alone for increasing mortality or morbidity in cranial surgery for patients with brain tumors. Glioblastoma in old patients with poor KPS carries a significant risk for mortality. Further studies with a larger number of patients and inclusion of more variables are required.
Quantitative determination of energy potential of refuse derived fuel from the waste recovered from Indian landfill
Authors: Cheela Venkata Ravi Sankar , John Michele , Dubey Brajesh 
Published: July 2021

AbstractLandfills are urban stocks and resource reservoirs for potential energy recovery. The purpose of this study is to evaluate the amount of energy that could be recovered from aged waste (around 5–20 yr old) recovered from landfills. Investigations were conducted on the physical and chemical properties of refuse-derived fuel (RDF) prepared from recovered landfill waste (RLW) in Andhra Pradesh, India. Waste characterization studies include determination of waste composition, proximity analysis, ultimate analysis, and energy content. The moisture content ranged between 25.7 to 31.3% and no trend was observed with age. In the ultimate analysis, the percentage of carbon increased from 42.9 to 71.7% with the age of the samples, this is due to an increase in the plastic content over time. The calorific value of the recovered landfill waste ranged from 10.4 to 21.8 MJ kg− 1. From the findings, it can be summarized that the RDF can potentially be utilized as a feedstock for the recovery of energy from RLW. The results from this study will assist policy makers and local authorities in designing and developing strategies for resource and energy recovery from landfills in different urban cites across the globe.
Early results from an Egyptian transcatheter aortic valve registry (Egy-TVR)
Authors: Bahaa Hesham , Sadek Yasser , Mostafa Ahmad E. , Kamal Diaa , Baraka Mahmoud , Abdelghani Mohammad , Hassan Ahmed , Shehata Ahmed , Abdelhamid Magdy , Elguindy Ahmed 
Published: July 2021

Abstract
Background
Transcatheter aortic valve implantation (TAVI) is a well-established and standard therapy for patients with symptomatic severe aortic stenosis at moderate or high risk for surgical aortic valve replacement. Recently, it has proven non-inferior in patients with low surgical risk. However, due to its high cost, the availability of TAVI is variable worldwide. Our aim was to assess the demographic and clinical characteristics and short-term and long-term outcome of those patients. A medical registry is believed to be an excellent tool to perform a field analysis of patients’ course, documenting short, intermediate, and long-term outcomes. This is the first registry for patients who underwent TAVI in Egypt.

Results
Ninety-six patients were included in the study; some were retrospective, and the majority were prospective from 5 different cardiac centers from August 2012 till December 2017. The mean age of patients was 77 years SD ± 7.29; females were 52% of the patients and most of the patients were overweight (BMI 30.74, SD ± 6.83). Sixty-three percent of the patients were frail with Katz index ≤ 5. 3.5% had atrial fibrillation (AF) at presentation. General anesthesia was conducted in only 59.37% of the patients. Transfemoral access was the prevailing route of implantation (90%). The median hospital stay was 4 days. In-hospital and 30 days mortality was only 4.16%.

Conclusion
TAVI outcome in Egypt appeared to be very promising with in-hospital complication, and mortality rates being comparable to international registries (4.16% vs. 4.0% in TVT registry) denoting the procedure as safe and beneficial. Establishing a national registry is critical to highlighting strength and weaknesses as well as identifying key areas for improvements.
Bilateral proptosis: an unusual primary presentation of scurvy—a case report
Authors: S. Damini , Dixit Rashmi , Khullar Tamanna , Rajeshwari K. 
Published: July 2021

Abstract
Background
Scurvy is a nutritional vitamin C deficiency disease which shows classical signs on radiographs most commonly along long bones with subperiosteal hemorrhage being a classical finding. Primary presentation of scurvy with orbital hemorrhage presenting as proptosis is however uncommon.

Case presentation
We report an unusual primary presentation of scurvy in a 4-year-old boy with West syndrome and global developmental delay who presented to the emergency with complaints of bilateral proptosis and eyelid swelling (right > left) which on examination revealed bluish discolouration of bilateral eyelids. On further multimodality imaging investigation, orbital subperiosteal hemorrhages were identified as the cause, along with classical radiographic features of scurvy in bilateral lower limb long bones. The diagnosis was further bolstered by rapid resolution of periorbital ecchymosis after initiating oral vitamin C supplementation.

Conclusion
To the best of our knowledge, primary presentation of scurvy in the form of bilateral proptosis due to orbital hemorrhages although uncommon can still be a manifestation of scurvy in addition to the more routinely detected subperiosteal hemorrhages along long bones. The significance of establishing the aetiology in such cases of orbital hemorrhage cannot be overemphasised, in view of drastic clinical recovery after starting vitamin C therapy.
Dosimetric feasibility of stereotactic irradiation of primary prostate cancer at 5x9 Gy with a method of urethral sparing
Authors: Benhmida Salim , Beneux Amandine , Udrescu Corina , Rouviere Olivier , Horn Samy , Enachescu Ciprian , Lapierre Ariane , Chapet Olivier 
Published: July 2021

Objective: The most commonly used dose for prostate cancer stereotactic body radiotherapy (SBRT) is 5 × 7.25 Gy. The aim of this study was to evaluate the dosimetric feasibility of a 5 × 9 Gy SBRT regimen while still limiting the dose to the urethra to 5 × 7.25 Gy. This dosimetric study is part of the groundwork for a future Phase III randomized trial. Methods: The prostate, the urethra and the tumors were delineated on 20 dosimetric CT-scans with MRI-registration. The planning target volume (PTVp) was defined as a 5 mm expansion (3 mm posteriorly) of the prostate. The planning at risk volume (PRVu) was defined as a 2 mm expansion of the urethra. The tumors were delineated on the MRI (GTVt) and a 3 mm-margin was added to create a tumoral planning target volume (PTVt). IMRT plans were optimized to deliver 5 × 9 Gy to the PTVp, limiting the dose to the PRVu to 5 × 7.25 Gy. Results are presented using average (range) values. Results: PTVp doses were D98% = 36.2 Gy (35.6–36.8), D2% = 46.9 Gy (46.5–47.5) and mean dose = 44.1 Gy (43.8–44.5). The dose to the PRVu was within tolerance limits for all 20 patients: V34.4Gy = 99.8% (99.2–100) and D5% = 38.7 Gy (38.6–38.8). Dose coverage of PTV-PRVu was D95% = 40.6 Gy (40.5–40.9), D5% = 46.6 Gy (46.2–47.2) and mean dose = 44.6 Gy (44.3–44.9). Dose to the PTVt reached 44.6 Gy (41.2–45.9). Doses to the OAR were respected, except V36Gy ≤1 cc for the rectum. Conclusion: A SBRT dose-escalation to 5 × 9 Gy on the prostate while sparing the urethra + 2 mm at 36.25 Gy is feasible without compromising dose coverage to the tumor. This radiation regimen will be used for a Phase-III trial. Advances in knowledge: In prostate SBRT, dose optimization on the urethra is feasible and could decrease urinary toxicities.
Prostate hypofractionated radiotherapy (62Gy at 3.1Gy per fraction) with injection of hyaluronic acid: final results of the RPAH1 study
Authors: Chapet Olivier , Udrescu Corina , Bin Sylvie , Decullier Evelyne , Fenoglietto Pascal , Beneux Amandine , Segui Bruno , Enachescu Ciprian , Gaudioz Sonya , Ruffion Alain , Azria David 
Published: July 2021

Objectives: The present multicenter Phase II study evaluated the rate of late grade ≥2 gastrointestinal (GI) toxicities at 3 years, after hypofractionated radiotherapy (HFR) of prostate cancer with injection of hyaluronic acid (HA) between the prostate and the rectum. Methods: Between 2010 and 2013, 36 patients with low- or intermediate-risk prostate cancer were treated by HFR/IMRT-IGRT. 20 fractions of 3.1 Gy were delivered, 5 days per week for a total dose of 62 Gy. A transperineal injection of 10cc of HA was performed between the rectum and the prostate. Late toxicities were evaluated between 3 and 36 months after the end of treatment (CTCAE v4). Results: Median pretreatment prostate-specific antigen was 8 ng ml−1. Among the 36 included patients, 2 were not evaluated because they withdrew the study in the first 3 months of follow-up, and 4 withdrew between 3 and 36 months, the per protocol population was therefore composed. Late grade ≥2 GI toxicities occurred in 4 (12%) patients with 3 (9%) Grade 2 rectal bleedings and one diarrhoea. Therefore, the inefficacy hypothesis following Fleming one-stage design cannot be rejected. None of the patients experienced late Grade 3–4 toxicities. Among the 30 patients completing the 36 months’ visit, none still had a grade ≥2 GI toxicity. Late grade ≥2 genitourinary (GU) toxicities occurred in 14 (41%) patients. The most frequent toxicities were dysuria and pollakiuria. Four patients still experienced a grade ≥2 GU toxicity at 36 months. The biochemical relapse rate (nadir +2 ng ml−1) was 6% (2 patients). Overall, HA was very well tolerated with no pain or discomfort. Conclusion: Despite the inefficacy of HA injection was not rejected, we observed the absence of Grade 3 or 4 rectal toxicity as well as a rate of Grade 2 rectal bleeding below 10% at 36 months of follow-up. Late urinary toxicities are the most frequent but the rate decreases largely at 3 years. Advances in knowledge: With an injection of HA, hypofractionated irradiation in 4 weeks is well tolerated with no Grade 3 or 4 GI toxicity and a rate of Grade 2 rectal bleeding below 10% at 36 months of follow-up.
Impact of hydrogel peri-rectal spacer insertion on seminal vesicles intrafraction motion during 1.5 T-MRI-guided adaptive stereotactic body radiotherapy for localized prostate cancer
Authors: Mazzola Rosario , Sicignano Gianluisa , Cuccia Francesco , Vitale Claudio , Rigo Michele , Giaj-Levra Niccolò , Nicosia Luca , Figlia Vanessa , Ricchetti Francesco , Attinà Giorgio , Pastorello Edoardo , De Simone Antonio , Gurrera Davide , Naccarato Stefania , Ruggieri Ruggero , Alongi Filippo 
Published: July 2021

Objectives
MR-guided daily-adaptive radiotherapy is improving the accuracy in the planning and delivery phases of the treatment. Rectal hydrogel-spacer may help in mitigating organ motion, but few data are currently available.

Methods
We aimed to assess any potential impact of the device on seminal vesicles motion by measuring translational and rotational shifts between the pre- and post-treatment MRI scans of a total of 50 fractions in the first 10 patients who underwent MR-guided prostate SBRT (35 Gy/5 fx). Of them, five patients received the hydrogel-spacer. The comparative analysis was performed using the Mann–Whitney U-test

Results
Median rotational shifts were: in anteroposterior 0° (range, 0.097°/0.112°; SD = 0.05°) vs 0° (−0.162/0.04°; SD = 0.07°) in the no-spacer subgroup (p = 0.36); lateral shifts were 0° (−0.1°/0.54°; SD = 0.28°) vs −0.85° in the no-spacer cohort (−1.56°/0.124°; SD = 0.054°; p = 0.22). Cranio-caudal shifts were 0° (−0.121°/0.029°; SD = 0.06°) in the spacer-cohort vs 0° (−0.066°/0.087°; SD = 0.69°; p = 0.53). Median translational shifts were: in anteroposterior 0.9 mm (−0.014 mm/0.031 mm; SD = 0.036 mm) in the spacer-group vs 0.030 mm (−0.14 mm/0.03 mm; SD = 0.032 mm; p = 0.8); latero-lateral shifts were −0.042 mm (−0.047 mm/0.07 mm; SD = 0.054 mm), vs −0.023 mm (−0.027 mm/−0.01 mm; SD = 0.023 mm) in the no-spacer group (p = 0.94). In cranio-caudal, statistically significant shifts were reported: 0.082 mm (0.06 mm/0.15 mm; SD = 0.04 mm) vs 0.06 mm (−0.06/0.08 mm; SD = 0.09 mm) in the no-spacer cohort (p = 0.031).

Conclusions
A favorable impact of the hydrogel-spacer on seminal vesicles motion was observed only in cranio-caudal translational shifts, although being not clinically significant. Further studies are required to fully investigate the potential contribution of this device on vesicles motion.

Advances in knowledge
MR-guided daily adaptive radiotherapy may represent a game changer for prostate stereotactic body radiotherapy, given the possibility to better visualize soft-tissues anatomy and to daily recalculate the treatment plan based on real-time conditions. The use of devices like rectal ballon or rectal gel spacers has gained interest in the last years for the possibility to better spare the rectum during prostate radiotherapy. This is one of the first experiences exploring the role of rectal spacer on seminal vesicles intrafraction motion during MR-guided SBRT for prostate cancer.
Exploring barriers and facilitators of physical distancing in the context of the COVID-19 pandemic: a qualitative interview study
Authors: Farrell Karen , Durand Hannah , McSharry Jenny , Meade Oonagh ,   The Health Psychology Public Advisory Panel, Kenny Eanna , Noone Chris , O'Connor Laura L. , Lavoie Kim L. , Byrne Molly , Mooney Robert , McGuire Brian E. , Molloy Gerard J. 
Published: July 2021

Background: Physical distancing measures (e.g., keeping a distance of two metres from others, avoiding crowded areas, and reducing the number of close physical contacts) continue to be among the most important preventative measures used to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19). Therefore, it is important to understand barriers and facilitators of physical distancing to help inform future public health campaigns. Methods: The current study aimed to qualitatively explore barriers and facilitators of physical distancing in the context of the COVID-19 pandemic using a qualitative interpretative design. Semi-structured one-to-one phone interviews were conducted with 25 participants aged 18+ years and living in the Republic of Ireland between September and October 2020. A purposive sampling strategy was used to maximise diversity in terms of age, gender, and socioeconomic status. Interviews were analysed using inductive thematic analysis. Results: Analysis resulted in the development of six main themes related to barriers and facilitators of physical distancing: (1) Maintaining and negotiating close relationships; (2) Public environments support or discourage physical distancing; (3) Habituation to threat; (4) Taking risks to protect well-being; (5) Personal responsibility to control the “controllables”; and (6) Confusion and uncertainty around government guidelines. Conclusions: Physical distancing measures were judged to be more or less difficult based on a number of internal and external psychosocial factors. Barriers to distancing included difficulties maintaining and negotiating close relationships, habituation to COVID-19-related threat, risk compensation, and confusion and uncertainty around government guidelines. Having a sense of personal responsibility to prevent COVID-19 transmission through distancing was an important facilitator. The structure of public environments was viewed as both barrier and facilitator. Barriers and facilitators may vary depending on context and life stage, which should be considered in the design of interventions to target physical distancing behaviour.
Problems of Assessing the Health Status of Personnel Working in Conditions of New Technologies for Nuclear Fuel Production
Authors: Lyaginskaya A. , Shandala N. , Metlyaev E. , Kuptsov V. , Parinov O. 
Published: July 2021

Purpose: To identify the problem of assessing the health status of personnel working under the conditions of new technologies for the production of nuclear fuel.
Material and method: The object of the research was the general morbidity of workers in the production of mixed nitride uranium-plutonium fuel (MNUP-fuel). The material for the study was the data presented in the «Health Passports». The paper used the method of comparative analysis of the overall morbidity of workers in the production of MNUP-fuel and workers in enterprises dealing with nuclear fuel.
Results and analysis: At present, in our country, within the framework of the «Breakthrough» project, new technologies are being developed for the fabrication and refurbishment of mixed uranium-plutonium (MNUP) fuel. In the absence of radiation and hygienic standards for the content of fuel products in working rooms, in order to assess the influence of production factors, along with the radiation dose, the incidence of personnel is studied as an integral indicator of health. A study of the incidence of 50 workers in the production of MNUP fuel revealed: Relatively high incidence of general morbidity – 1122 diseases per 100 people or an average of 93.5 diseases per 100 people per year, regardless of the length of service. The leading diseases in the overall morbidity structure are diseases of the respiratory system – 26.0 %
(1st place), eyes – 13.4 % (2nd place), musculoskeletal system – 11.4 % (3rd place), circulatory system – 10,9 % (4th place), injuries and poisoning – 8.4 % (5th place), digestive organs and genitourinary system – 7.7 % and 7.0 %, respectively (6th place), which make up 84.7 % of the total morbidity. Obviously, the effective dose of 4.6 mSv/year cannot be the only reason for the high morbidity in workers in complex radiochemical production, but characterizes only the influence of one of the many nonspecific factors of production. The existing system for assessing the health of personnel working in radiochemical production, in addition to analyzing the risks of deterministic and stochastic effects, should include an assessment of the overall morbidity of personnel.