What is the optimal gestational age for twin delivery

BACKGROUND: The question about outcome in twins delivered early versus late remains unanswered. The objective of this study was to evaluate the association of the timing of delivering twins and the perinatal outcome. METHODS: A prospective cohort study was carried-out in Alexandria University Maternity Hospital. We planned to examine the records of twin deliveries over 2 years. The inclusion criteria were twin deliveries with gestational age at delivery at least 36 completed weeks. Twins of mothers with chronic illness and those with congenital anomalies were excluded. Perinatal outcome parameters (morbidity and mortality) were defined and evaluated. RESULTS: Out of 273 twin sets, 197 (72.2%) met the inclusion criteria. They were classified into 3 groups according to the gestational age at delivery. Neonatal morbidity and maternal complications were higher in those delivered earlier. Twins electively delivered had worse outcome than those delivered spontaneously. In the elective group, there was no difference in the outcome between those delivered earlier or later. CONCLUSION: Twins, when the pregnancy is uncomplicated, continue to grow and mature with advancement of the gestational age. In the absence of significant maternal complications, it is advisable to deliver twins only at 38 completed weeks' gestation or later to avoid neonatal complications

Assessment of serum magnesium level in patients with bronchial asthma

AbstractBackgroundAsthma is one of the most common chronic diseases worldwide and has been increasing in prevalence over the last few decades. Magnesium ion has an inhibitory action on smooth muscle contraction, histamine release from mast cells and acetylcholine release from cholinergic nerve terminals. Magnesium has been shown to relax bronchial smooth muscles and influence the function of respiratory muscles. Hypomagnesemia have been associated with diminished respiratory muscle power.AimTo assess the serum Mg levels in bronchial asthma patients during stable and exacerbating clinical conditions.Subjects and methods60 Subjects were enrolled, 40 patients diagnosed as bronchial asthma and 20 healthy individuals as a control group. The asthmatic patients were divided into group (I) chronic stable bronchial asthma and group (II) acute exacerbation of bronchial asthma.ResultsSerum Mg levels were significantly lower in asthmatic patients compared with healthy controls and significantly lower in asthmatic patients during exacerbation compared with stable asthmatics. There was a positive correlation between serum Mg levels and each of FEV1/FVC ratio and FEV1.ConclusionHypomagnesemia was found in patients with chronic stable asthma and also in those with acute asthma exacerbation compared to control. Serum mg levels were significantly lower in asthmatic patients during exacerbations compared with stable asthmatics

Severe respiratory distress in term infants born electively at high altitude

BACKGROUND: We studied the contribution of elective delivery to severe respiratory distress syndrome (RDS) in term babies born at high altitude. METHODS: We prospectively studied the charts of term babies born in Taif Maternity Hospital (1640 m above sea level) between 1/1/2004 and 31/10/2004 who developed RDS and required mechanical ventilation. RESULTS: 8634 deliveries occurred from 37–<41 weeks; 13 (0.15%) had RDS requiring mechanical ventilation. Seven infants delivered at 37–<38 weeks, (OR for RDS = 26 95%CI -4.6 to 5.8), five delivered at 38–<39 weeks, (OR for RDS = 10 95%CI -4.9 to 5.4) and one delivered at >39 weeks. Six of 13 infants were electively delivered without documented lung maturity. CONCLUSION: Infants born at 37 and 38 weeks' gestation remain at significantly increased risk for severe RDS. Elective delivery is responsible for 50% of the potentially avoidable cases. Our data suggest that the altitude does not seem to influence the incidence of severe RDS in term infants born electively

PKCAM: Previous Knowledge Channel Attention Module

Recently, attention mechanisms have been explored with ConvNets, both across the spatial and channel dimensions. However, from our knowledge, all the existing methods devote the attention modules to capture local interactions from a uni-scale. In this paper, we propose a Previous Knowledge Channel Attention Module(PKCAM), that captures channel-wise relations across different layers to model the global context. Our proposed module PKCAM is easily integrated into any feed-forward CNN architectures and trained in an end-to-end fashion with a negligible footprint due to its lightweight property. We validate our novel architecture through extensive experiments on image classification and object detection tasks with different backbones. Our experiments show consistent improvements in performances against their counterparts. Our code is published at https://github.com/eslambakr/EMCA

Dental Decision-Making in Pediatric Dentistry: A Cross-Sectional Case-Based Questionnaire Among Dentists in Germany

Background and Objectives The most recent guidelines and recommendations regarding treatments of dental caries in children are shifting towards evidence-based minimal or non-invasive approaches aiming to preserve the vitality of teeth and potentially reduce the need for dental general anesthesia. This study investigated the treatment recommendations of dentists actively practicing pediatric dentistry in Germany regarding different patient cases with caries in primary teeth. Materials and Methods The questionnaire was distributed on paper or online to pediatric dentists and general dentists practicing pediatric dentistry. Five cases of children with dental treatment needs representing a variety of clinical situations were selected for the questionnaire. Considering four different scenarios regarding pain symptoms (yes/no) and cooperation level (good/low) for each case resulted in 20 questions, where the preferred treatment option could be chosen out of 21 options ranging from observation only to extraction with/without different sedation techniques. The answers were categorized into three categories for each case and scenario according to guidelines, recent scientific evidence, and recommendations (recommended, acceptable, or not recommended/contraindicated). Results In total, 222 participants responded to the survey (161 female; 72.5%). In 55.2% of the total 4440 answers, the participants chose a “recommended” treatment option, in 16.4% “acceptable”, but in 28.4%, a “not recommended” treatment, which ranged for the five cases between 18.7 and 36.1%. While pain and low cooperation levels led to more invasive and justified treatment choices (only 26.3% “not recommended”), less severe scenarios resulted more often in “not recommended” options (pain with good cooperation: 31.0%; or low cooperation without pain: 32.6%). The dentist’s age, experience, and educational background did not significantly correlate to choosing “not recommended” treatment options. Conclusions A child’s pain and cooperation level greatly impact the treatment decisions made by dentists, with a risk of too invasive treatment options in low-severity cases. Substantial disparities in treatment recommendations for caries in primary teeth persist among dental practitioners regardless of their age, experience, and educational background

MEDIATOR OF BHABINKAMTIBMAS MULYOSARI VILLAGE, WEST METRO SUBDISTRICT, METRO CITY IN RESOLVING HOUSEHOLD PROBLEMS

This article analyzes the role of Bhabinkamtibmas in making problem solving efforts by prioritizing mediation. The purpose of writing this article is the problem solving techniques of the Habibinkamtibmas in mediating married couples who experience domestic conflicts. In addition, to reveal the obstacles faced when mediating, because when making efforts to assist there are challenges from the parties that are difficult to make peace. This type of research is fielresearch, which is a type of field research, conducted in Mulyosari Village, West Metro Subdistrict, Metro City. The fielresearch was analyzed qualitatively. This research approach was analyzed using a case study approach. The result of the research is the problem solving of the Habibinkamtibmas in mediating domestic problems taken by Aibda Ali Iqbal by taking several steps, namely dissecting the siting of the case that occurred then making observations and then implementing the best solution for the parties, the result of mediation is that both parties take the peaceful path. Meanwhile, the obstacle in conducting mediation is the unanimous determination of the married couple to divorce. In addition, the litigants feel reluctant to reconcile, due to the trauma factor of the events that occurred in their household. If peaceful efforts reach a dead end, then Bhabinkamtibmas' efforts are to take repressive measures both criminally and civilly.Keywords: Problem Solving, Bhabinkamtibmas, Media, Household Problem

Kandoolu Kitaaboolu: Collection of Bilingual Texts

The entire manuscript is available for download as a PDF file(s). Higher-resolution images may be available upon request. For technical assistance, please contact [email protected]. Fieldwork Team: Dr. Fallou Ngom (Pricipal Investigator; Director, African Studies Center), Ablaye Diakité (Local Project Manager), Mr. Ibrahima Yaffa (General Field Facilitator), and Ibrahima Ngom (photographer). Technical Team: Professor Fallou Ngom (Principle Investigator, Project Director and former Director of the African Studies Center at Boston University), and Eleni Castro (Technical Lead, BU Libraries). This collection of Mandinka Ajami materials is copied as part of the African Studies Center’s African Ajami Library. This is a joint project between BU and the West African Research Center (WARC), funded by the British Library/Arcadia Endangered Archives Programme. Access Condition and Copyright: These materials are subject to copyright and are distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original author and source are fully cited using the information below. For use, distribution or reproduction beyond these terms, contact Professor Fallou Ngom ([email protected]). Citation: Materials in this web edition should be cited as: Ngom, Fallou, Castro, Eleni, & Diakité, Ablaye. (2018). African Ajami Library: EAP 1042. Digital Preservation of Mandinka Ajami Materials of Casamance, Senegal. Boston: Boston University Libraries: http://hdl.handle.net/2144/27112. For Inquiries: please contact Professor Fallou Ngom ([email protected]). For technical assistance, please contact [email protected] / Custodial history: The owner inherited the materials from his father, El-hadji Ibrahima Kalilou Diebate.The first manuscript in this collection is a copy of an Arabic devotional poem called Marmūz al-Tantaranī written by Aḥmad bin Abū Bakr, with glosses in Arabic and Mandinka. The poem was copied by Sidiya Toure, the uncle of the manuscript owner’s father. The second document is a copy of a devotional Arabic poem with Arabic, Soninke, and Mandinka Ajami glosses. The other documents include: copies of devotional poems by Sitokoto Dabo (the most famous Mandinka Ajami poet); a Mandinka Ajami poem written by El-hadji Ibrahima Kalilou Diebate (the father of the current owner) dealing with the value of education and moral virtues in society; and, a Mandinka Ajami document written with purple ink, dealing with the history of the foundation of the first mosque of Karantaba