bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adenomyosis and IVF Outcomes - where we are and where we need to be
Authors: Maheshwari Abha , Bhattacharya Siladitya 
Published: June 2017

Better imaging techniques will result in more women who are undergoing in vitro fertilization (IVF) being diagnosed with adenomyosis. Preliminary data suggest that adenomyosis may have implications for the outcome of IVF. However, available evidence is limited to data from retrospective studies with major inconsistencies in the diagnostic criteria used to confirm adenomyosis. Despite this uncertainty, a number of therapeutic modifications have been suggested to minimize the impact of adenomyosis in women undergoing IVF. In this brief report, we summarize current limitations in diagnosing adenomyosis and critically evaluate the available evidence on its impact on IVF outcomes. We set out a number of steps needed to generate the evidence to underpin the diagnosis, prognosis and effective treatment so that women undergoing IVF can be adequately counselled.
Management of Endometriomas Prior to IVF
Authors: Maiorana Antonio , Incandela Domenico , Mercurio Antonella , Alio Walter , Giambanco Laura , Alio Luigi 
Published: June 2017

Endometriosis causes a decrease in fertility in affected patients. The different forms of the disease, peritoneal, ovarian, deep infiltrating and adenomyosis, are often present in varying degrees in the same patient, either together or individually, and cause infertility through a pathogenesis that is not yet clear. A significant number of women with endometriosis and endometriomas will eventually seek assisted reproductive technology (ART) for conception. The specific impact of endometriomas alone and the impact of surgical intervention for endometriomas on the reproductive outcome of women undergoing in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) are areas that need further clarification and, for this reason, the management of endometriomas before clinical IVF is a very complex topic. In order to provide useful information for the clinical management of patients with endometriomas having IVF, in this review we investigated: the impact of the presence of endometriomas, both individually and associated with other types of the disease, on IVF techniques; the possible role of surgery and its possible negative effects; the risks and difficulties related to conservative management during IVF procedures.
Involvement of Interferon Regulatory Factor 5 (IRF5) Gene Polymorphisms and Haplotype in Endometriosis-related Infertility
Authors: Bianco Bianca , De Camargo Celeste R. , Christofolini Denise M. , Barbosa Caio P. 
Published: June 2017

Introduction The IRF5 gene belongs to a family of transcription factors involved in modulating cell growth, differentiation, apoptosis, and immune system activity. A growing body of evidence indicates that immunological alterations are involved in the pathogenesis of endometriosis, and as a result, polymorphisms in autoimmune-related genes have emerged as possible candidates linked to disease development. Here, we aimed to evaluate a possible association between IRF5 polymorphisms (rs2004640/T>G, rs3807306/G>T, rs10488631/T>C and rs2280714/T>C) and the pathogenesis of endometriosis. Methods A case-control study was performed comprising an experimental group of 236 infertile women with endometriosis and a control group of 232 fertile women. IRF5 polymorphisms were identified by real-time PCR using the TaqMan method. Genotype distribution and allele frequency were calculated, and haplotype analysis was performed. Results Single-marker analysis revealed that the IRF5 rs10488631 (polymorphic C allele) polymorphism was significantly associated with moderate/severe endometriosis (p = 0.028; OR = 1.79, 95% IC = 1.09–2.94). No association was found with respect to rs2004640, rs3807306 and rs2280714 polymorphisms and the endometriosis group. The combined genotypes of four IRF5 polymorphisms identified the haplotype “GGTT”, which was associated with protection against minimal/mild endometriosis-related infertility (p = 0.003), while the haplotype “GTCT” was associated with a risk of developing moderate/severe endometriosis-related infertility (p = 0.047). Conclusions This is the first study to report an association between IRF5 polymorphisms and endometriosis, and the findings suggest that the IRF5 rs10488631 polymorphism and haplotype “GTCT” were involved in the risk of moderate/severe endometriosis development. The haplotype “GGTT” was associated with protection against minimal/mild endometriosis.
Impact of Arm Selection on the Incidence of PICC Complications: Results of a Randomized Controlled Trial
Authors: Paquet France , Boucher Louis-Martin , Valenti David , Lindsay Richard 
Published: June 2017

Introduction The aim of this study is to determine if right arm peripherally inserted central catheters (PICCs) experienced fewer complications while controlling for gender, hand dominance, history of malignancy, dwell time and catheter size. Methods This was an intention-to-treat randomized controlled trial conducted in an academic medical center on two different sites between September 2012 and September 2015. All patients older than 18 years or age without known history of previous central line, contraindication to the use of a specific arm or hospitalized in the intensive care unit regardless of coagulation status, were considered for the study. Participants were randomized to the left or right arm group and were followed until catheter removal. Data collected included: PICC characteristics, insertion details, gender, arm dominance, history of malignancy, reason for insertion/removal, incidence of a complication and total dwell time. One-tailed hypothesis testing using a univariate logistic regression with odds ratio (OR) calculation was used to analyze the results. There were 202 patients randomly assigned, totaling 7657 catheter-days; 103 patients to the right-side group and 99 patients to the left-side group. Results Participants in both groups were statistically equivalent for right handedness, gender, oncologic status, average dwell time and total catheter days. The overall incidence of complications on the right side was 23% versus 34% on the left side, confirming the hypothesis that right-sided insertions led to fewer complications (p = 0.046). The risk of a complication was reduced by 40% with right-sided insertion (OR 0.58 (CI: 0.31-1.09). Conclusions This study indicated fewer complications with right-sided insertion irrespective of hand dominance.
Transitioning from anatomic landmarks to ultrasound guided central venous catheterizations: guidelines applied to clinical practice
Authors: Oom Rodrigo , Casaca Rui , Barroca Rita , Carvalhal Sara , Santos Catarina , Abecasis Nuno 
Published: June 2017

Introduction Centrally inserted central catheter (CICC) insertion is a commonly performed procedure that may give rise to different complications. Despite the suggestion of guidelines to use ultrasound guidance (USG) for vascular access, not all centers use it systematically. The aim of this study is to illustrate the experience with ultrasound in CICC placement at a high-volume oncological center, in a country where the landmark technique is standard. Methods Retrospective analysis of a prospective database was performed on CICC placement under USG in the Central Venous Catheter Unit of Instituto Português de Oncologia de Lisboa Francisco Gentil, from 2012 to 2015. Results Three thousand five hundred and seventy-two procedures were recorded. From 2728 CICC placements, 1187 (43.5%) were done using USG. The majority of CICC placements were successful without immediate complications (96.1%). In 55 cases (4.6%), more than three attempts were necessary to puncture the vein. Pneumothorax occurred in 5 cases (0.4%) and arterial puncture was registered in 41 cases (3.5%). An increasing use of USG for placing CICCs was planned and observed over the years and, in the last year of the study, 67.3% of the CICC placements were with USG. Conclusions CICC placement with USG is a safe and effective technique. Despite some resistance that is observed, these results support that it is worth following the guidelines that advocate the use of the USG in the placement of CICC.
A Robotic Needle Driver to Facilitate Vescico-Urethral Anastomosis during Laparoscopic Radical Prostatectomy
Authors: Varca Virginia , Benelli Andrea , Pietrantuono Francesco , Suardi Nazareno , Gregori Andrea , Gaboardi Franco 
Published: June 2017

Purpose The completion of the vescico-urethral anastomosis (VUA) represents the most critical step of laparoscopic radical prostatectomy (LRP), and it can often discourage the use of minimally invasive surgery in less experienced laparoscopic surgeons. The aim of this paper is to evaluate the usefulness of a new robotic needle driver named Dextérité in performing the VUA after LRP. Materials and Methods This prospective randomized clinical study enrolled 40 consecutive patients eligible for LRP, which were randomized into four groups: group A, patients undergoing LRP done by an expert surgeon; group B, patients undergoing robotic-assisted radical prostatectomy (RARP) performed by the same expert surgeon; group C, patients undergoing LRP performed by a young surgeon at the beginning of the learning curve; group D, patients undergoing LRP performed by another young surgeon at the beginning of the learning curve with the aid of Dextérité needle driver for completion of the VUA. The two young urologists performed the same steps of LRP so that they are at the same step of the learning curve. All the anastomosis were performed with the same technique in order to be comparable. We use interrupted sutures with Vicryl 2/0 and a 5/8 needle; we performed the Rocco stitch technique before all the anastomosis (6) and we applied bladder neck sparing technique. All patients underwent an ultrasound control of the anastomosis on the seventh postoperative day, as we usually do (9, 10). We consider continent who utilised no pad. Results Operative VUA completion time was 24.9 vs. 25 vs. 86.7 vs. 61 minutes, respectively. When comparing VUA completion time in group 3 and 4, the use of the Dextérité needle driver resulted in a reduction in VUA time. Urinary leakage was seen in zero out of 10 patients in groups 1 and 2 and in three out of 10 and one in 10 patients, respectively, in groups 3 and 4. All urinary leakages were managed conservatively. One-year continence rates were 95%, 97%, 93% and 95%, respectively. Only one patient in group C developed a bladder neck contracture 6 months after the procedure, but he underwent adiuvant radiotherapy after surgery. Conclusions Our data suggest that the use of Dextérité needle holder significantly reduces operative time of VUA completion and reduces the incidence of urinary leakage in laparoscopic surgeons at the beginning of the learning curve.
Is Early Benign Prostatic Hyperplasia (BPH) Treatment Worthwhile?
Authors: Presicce Fabrizio , De Nunzio Cosimo , Tubaro Andrea 
Published: June 2017

Background The medical armamentaria for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) have been extensively implemented over the past decade. Nevertheless, the timeliest moment for a possible treatment has not been fully established. Evidence Acquisition A systematic literature search in January 1996 until June 2016 was performed to answer the following question: in men with LUTS due to BPH, does early treatment result in better outcome? An ad hoc Population/patient Intervention/indicator Comparator/control Outcome (PICO) was developed. The Medline, PubMed and Scopus databases were searched. Each article title and abstract were reviewed for relevance and appropriateness with regard to the topic of this review. Evidence Synthesis Overtime, the introduction of novel medications and the implementation of surgical techniques have significantly improved the treatment outcomes and markedly reduced the rate of BPH surgery. Early treatments in patients at risk of disease progression may result in better clinical outcomes than a delayed approach. However, the evidence to support early intervention remains weak and criteria to identify the patient phenotype that could best benefit from immediate treatment remain ill-defined. On the contrary, the patients who ultimately undergo surgery following prolonged pharmacological treatment present with larger prostates, older age and comorbidities. At the same time, the technological progress has partly compensated this critical scenario, and commonly, a nonpejorative trend has been recorded in perioperative complications. Conclusions The ideal moment to begin a treatment in LUTS/BPH patients is still uncertain, and surprisingly, rare good quality studies are available on this topic.
What Is an International Cybersecurity Regime and How We Can Achieve It?
Authors: Stadnik Ilona 
Published: June 2017

This article explores the two mainstream directions of debates about the possibility of establishing a kind of international cybersecurity regime. It develops the idea of different governance models based on sovereignty, on the one hand, and multistakeholderism on the other. The application of international relations theory helps to understand the current process and stalemate initiatives regarding state cooperation in this field. In addition, the author pays attention to the applicability of the constructivism framework to the understanding of cybersecurity threats and the elaboration of international norms applicable to cyberspace. Finally, the article concludes with the idea that the multistakeholder approach to norm-making may become a viable solution to the problem of constructing an international cybersecurity regime.
Design process and preliminary psychometric study of a video game to detect cognitive impairment in senior adults
Authors: Valladares-Rodriguez Sonia , Perez-Rodriguez Roberto , Facal David , Fernandez-Iglesias Manuel J. , Anido-Rifon Luis , Mouriño-Garcia Marcos 
Published: June 2017

Introduction
Assessment of episodic memory has been traditionally used to evaluate potential cognitive impairments in senior adults. Typically, episodic memory evaluation is based on personal interviews and pen-and-paper tests. This article presents the design, development and a preliminary validation of a novel digital game to assess episodic memory intended to overcome the limitations of traditional methods, such as the cost of its administration, its intrusive character, the lack of early detection capabilities, the lack of ecological validity, the learning effect and the existence of confounding factors.

Materials and Methods
Our proposal is based on the gamification of the California Verbal Learning Test (CVLT) and it has been designed to comply with the psychometric characteristics of reliability and validity. Two qualitative focus groups and a first pilot experiment were carried out to validate the proposal.

Results
A more ecological, non-intrusive and better administrable tool to perform cognitive assessment was developed. Initial evidence from the focus groups and pilot experiment confirmed the developed game’s usability and offered promising results insofar its psychometric validity is concerned. Moreover, the potential of this game for the cognitive classification of senior adults was confirmed, and administration time is dramatically reduced with respect to pen-and-paper tests.

Limitations
Additional research is needed to improve the resolution of the game for the identification of specific cognitive impairments, as well as to achieve a complete validation of the psychometric properties of the digital game.

Conclusion
Initial evidence show that serious games can be used as an instrument to assess the cognitive status of senior adults, and even to predict the onset of mild cognitive impairments or Alzheimer’s disease.
CONTRIBUTION TO THE STUDY OF SEDIMENT TRANSPORT ON A HORIZONTAL BED DUE TO WAVE ACTION
Authors: Vincent G. E. 
Published: June 2017

With a view to explaining the phenomena of sediment transport in the open sea, outside the wave breaking area, the author carried out a laboratory investigation of wave action on a horizontal bed. He puts forward a number of new results regarding :

1 - The state of turbulence near the bed and the stability of the oscillatory laminar boundary layer.
2 - The setting in notion of materials under the influence of wave alone.
3 - The entrapment current caused by wave action close to the bed.
4 - The transport of material under wave action only.
5 - The indirect action of wave on the bed.
The main conclusions reached are as follows :
1/ - The results given by Kuon Li regarding the onset of turbulence within the oscillatory boundary layer overestimate the range of laminar conditions. Vo (maximum orbital velocity) and e (roughness) are the principle factors governing the transition. Test waves are either generally laminar, or are only slightly turbulent within the body of liquid, but they are, however, more often turbulent in the immediate neighbourhood of the bed.
2/ - The Investigation of conditions for the onset of grain movement of the bed material shows that the action of wave can be appreciable, even at depths of several tens of metres. A wave of 6 metres amplitude, with a total length of 120 metres, would be capable of putting a 0.3 mm sand grain into motion at a depth of 60 metres.
3/ - The experimental investigation, as well as the viscous fluid theory, shows the existence, close to the bed, of an entrainment current of liquid particles which always works In the direction of wave propagation.
4/ - In test flumes, this entrainment current forms part of a mass transport within the liquid, the vertical distribution of which varies with the characteristics of the fluid motion. On a horizontal bed, It generally gives rise to an effective sediment transport, in the direction of wave propagation, as the preponderant part of the liquid velocity component, near the bed. is in this direction.
5/ - Owing to the existence of the pass transport current and the onset of suspension of material above the bed, some sediment transport can exist out to sea. These results give an explanation of why, under the action of long and regular wave . material tends to be carried in the direction of the waves and build up on the beach whereas, under storm conditions, a strong resultant turbulence produces suspension and favours erosion of the beach.
6/ - On a sloping bed, transport towards the shore is counterbalanced by the effect of gravity, currents caused by winds from seaward and density currents set up in the wave break area so that finally material eroded from land surfaces are, In part, gradually carried away towards the open sea.
MODEL STUDY ON THE IMPACT OF WAVES
Authors: Aartsen M. W. 
Published: June 2017

The problem to be investigated is the structural strength of a sluice gate under the influence of wave attack. The gate was designed in view of the hydraulic forces in quasi permanent conditions The fact, however, that the gate is exposed to wave attack, necessitates an investigation of:
1) the transient forces due to impact,
2) the possibilities of modificating the shape of the gate in order to avoid, or at least to diminish, the chance on the occurrence of impacts.
As the mechanism of wave attack is influenced by the hydrodynamic properties of the oncoming waves, the tests are being carried out in a flume in which the waves are generated by wind in order to simulate the expected extreme natural conditions as close as possible.
INVESTIGATIONS OF THE TIDES AND STORM SURGES FOR THE DELTAWORKS IN THE SOUTHWESTERN PART OF THE NETHERLANDS
Authors: Dronkers J.J. 
Published: June 2017

In order to protect the southwestern part of the Netherlands against inundation by storm surges, the "Delta project" has been undertaken. This entails the closure of three large sea arms situated between Western Scheldt and Rotterdam Waterway and will bring about radical changes in the tidal movement and stormflood levels of the estuaries and tidal rivers. The contours of the project are shown in fig. 1. It includes three big dams to be built in the mouths of Eastern Scheldt, Brouwershavense Gat and Haringvliet, as well as two smaller ones to be constructed further inland. An idea of the extent of these works may be gained by knowing the tidal volumes of the estuaries: Veerse Gat 2.5.109 cu. ft; Grevelingen 4.109 cu. ft? Haringvliet 9.109 cu. ft; Brouwershavense Gat 12,5.109 cu. ft and Eastern Scheldt 39>.109 ou.ft. The waters of the Delta area will then be divided into two separate basins by means of a dam in the Volkerak. The southern basin will be entirely cut off from the sea, becoming a fresh water lake. The northern, comprising the mouths of the Rhine and the Meuse will remain in communication with the sea, because the Rotterdam Waterway must stay open to shipping. Consequently, the tides and storm surges will still be able to penetrate inland via this mouth, but they can cause high water levels in the Waterway only; in the rest of the basin their effect will be considerably weakened. In the situation at present, however, the upland flow of the rivers Rhine and Meuse is mainly into the Haringvliet estuary and not the Rotterdam Waterway. As the Haringvliet estuary will be closed, large sluices are to be built in the enclosure dam as a substitute for the existing free discharge of the river water.
Until this project is completed the inhabitants of the area which it will affect are insufficiently safe against storm surges. It is, of course, always possible that floods too high for existing dike systems will occur, but in the present situation the risk is too great. This was demonstrated in February 1953 when the southwestern part of the Netherlands was suddenly hit by an exceptionally high storm surge which caused many dike breaches and vast inundation. The occurrence of a similar surge or a higher one may be estimated as once in two hundred and fifty years, as an average, which is much too high. After the realization of the Deltaplan and the heightening of the dikes of Western Scheldt, Rotterdam Waterway and the northern parts of the country, the dikes are safe tip to very high storm surges of which the occurrence is smaller than once in ten thousand years, or in other words there is only one procent chance in hundred years that a major inundation will occur.
SIMILARITY IN SEDIMENT TRANSPORT DUE TO WAVES
Authors: Yalin S. , Russell R.C.H. 
Published: June 2017

The paper concerns the movement by waves of cohesionless sediment lying on a horizontal bed. In particular it concerns the number of dimensionless parameters that are necessary to define the 2-phase motion at the bed; the specification of which would enable perfect similarity to be obtained. It is shown that in general four dimensionless parameters are necessary but that when the motion of the water at the bed can be adequately defined by an orbit length (a) and a period (T), the two-phase motion can be described by the numerical value of three dimensionless parameters. This condition is satisfied when the wave-height is low, because then the orbital motion at the bed is sinusoidal and the drift velocity is negligible.
Model and prototype experiments were conducted in a wave channel, using low waves, in which the scale for depth of water and for wavelengths was -37?. The dependent parameters, three of -which are sufficient to verify similarity of all aspects of the phenomenon were chosen to be ripple height, ripple length and transport of sediment. The identity of the dimensionless numbers signifying the ripple height, ripple length and transport in model and prototype, shown in Figs, 8, 9 and 11, is proof that similarity had been obtained.