bluuebunny/crossref_metadata_2025 huggingface dataset:
There’s No Time Like the Present
Authors: Deng Natalja , Latham Andrew J , Miller Kristie , Norton James
Published: July 2024

This chapter investigates the connection between temporal attitudes (attitudes characterized by a concern (or lack thereof) about future and past events), beliefs about temporal ontology (beliefs about the existence of future and past events), and temporal preferences (preferences regarding where in time events are located). Our aim is to probe the connection between these preferences, attitudes, and beliefs, in order to better evaluate the normative status of these preferences. We investigate the hypothesis that there is a three-way association between (a) being present-biased (that is, preferring that positive events are located in the present, and negative events are located in the non-present), (b) believing that past and future events do not exist, and (c) tending to have present-focused rather than non-present-focused temporal attitudes. Our findings have important consequences for, first, explaining why we exhibit these preferences and, second, for their normative evaluation.
Empirical Challenges to the Evidential Problem of Evil
Authors: McAllister Blake , Church Ian , Rezkalla Paul , Nguyen Long
Published: July 2024

This chapter explores how the tools and resources of experimental philosophy might be brought to bear on William Rowe’s seminal, 1979 formulation of the problem of evil, arguing that new empirical findings raise significant questions regarding the ultimate success of Rowe’s argument. Section 1 elucidates Rowe’s formulation of the problem and the intuitions that seem to underwrite it. Section 2 explores how the tools and resources of experimental philosophy might be brought to bear on Rowe’s formulation, outlining some hypotheses and the methods for testing them before showcasing the results. Section 3 discusses the philosophical import of these results—arguing that, when taken together, they pose an initial challenge to Rowe’s seminal argument.
Causal Selection and Egalitarianism
Authors: Bebb Jon , Beebee Helen
Published: July 2024

The chapter explores whether, or to what extent, recent work in experimental philosophy puts pressure on the idea that the concept of causation is ‘egalitarian’. Causal selection—where experimental subjects tend to rate the causal strength of (for example) a norm-violator more strongly than a non-norm-violator—is a well-established phenomenon, and is in prima facie tension with an egalitarian conception of causation; it also, indirectly, puts prima facie pressure on the idea that causation is a worldly phenomenon whose obtaining is independent of facts about norms. The chapter explores both the various psychological mechanisms and the broadly pragmatic approaches to explaining causal selection. It argues that the answer to the question whether or not the concept of causation is egalitarian is currently significantly empirically underdetermined, and suggests some avenues for further investigation.
Experimental Philosophy of Consciousness
Authors: Reuter Kevin
Published: July 2024

Experimental philosophy of consciousness aims to investigate and explain our thinking about phenomenally conscious states. Based on empirical studies, researchers have argued (a) that we lack a folk concept of consciousness, (b) that we do not think entities like Microsoft feel regret, (c) that unfelt pains are widely accepted, and (d) that people do not attribute phenomenally conscious states to duplicated hamsters. In this chapter, I review these and other intriguing claims about people’s understanding of phenomenal consciousness. In doing so, I also show why experimental philosophy of consciousness is challenging, although perhaps not quite as daunting as studying phenomenal consciousness itself.
HBsAg and TLR7/8 dual-targeting antibody-drug conjugates induce sustained anti-HBV activity in AAV/HBV mice: a preliminary study
Authors: Ye Xinya , Chen Xiaoqing , Liu Han , Jiang Yichao , Yang Chengyu , Xu Tao , Chen Ziyou , Wang Yalin , Chen Fentian , Liu Xue , Yu Hai , Yuan Quan , Xia Ningshao , Chen Yuanzhi , Luo Wenxin
Published: July 2024

Hepatitis B virus (HBV) infection is a significant global health concern due to elevated immunosuppressive viral antigen levels, the host immune system’s inability to manage HBV, and the liver’s immunosuppressive conditions. While immunotherapies utilizing broadly reactive HBV neutralizing antibodies present potential due to their antiviral capabilities and Fc-dependent vaccinal effects, they necessitate prolonged and frequent dosing to achieve optimal therapeutic outcomes. Toll-like receptor 7/8 (TLR7/8) agonists have been demonstrated promise for the cure of chronic hepatitis B, but their systemic use often leads to intense side effects. In this study, we introduced immune-stimulating antibody conjugates which consist of TLR7/8 agonists 1-[[4-(aminomethyl)phenyl]methyl]-2-butyl-imidazo[4,5-c]quinolin-4-amine (IMDQ) linked to an anti-hepatitis B surface antigen (HBsAg) antibody 129G1, and designated as 129G1-IMDQ. Our preliminary study highlights that 129G1-IMDQ can prompt robust and sustained anti-HBsAg specific reactions with short-term administration. This underscores the conjugate’s potential as an effective strategy for HBsAg clearance and seroconversion, offering a fresh perspective for a practical therapeutic approach in the functional cure of CHB.

Highlights
MyxoPortal: a database of myxobacterial genomic features
Authors: Swetha Rayapadi G , Arakal Benita S , Rajendran Santhosh , Sekar K , Whitworth David E , Ramaiah Sudha , James Philip E , Livingstone Paul G , Anbarasu Anand
Published: July 2024

Myxobacteria are predatory bacteria with antimicrobial activity, utilizing complex mechanisms to kill their prey and assimilate their macromolecules. Having large genomes encoding hundreds of secondary metabolites, hydrolytic enzymes and antimicrobial peptides, these organisms are widely studied for their antibiotic potential. MyxoPortal is a comprehensive genomic database hosting 262 genomes of myxobacterial strains. Datasets included provide genome annotations with gene locations, functions, amino acids and nucleotide sequences, allowing analysis of evolutionary and taxonomical relationships between strains and genes. Biosynthetic gene clusters are identified by AntiSMASH, and dbAMP-generated antimicrobial peptide sequences are included as a resource for novel antimicrobial discoveries, while curated datasets of CRISPR/Cas genes, regulatory protein sequences, and phage associated genes give useful insights into each strain’s biological properties. MyxoPortal is an intuitive open-source database that brings together application-oriented genomic features that can be used in taxonomy, evolution, predation and antimicrobial research. MyxoPortal can be accessed at http://dicsoft1.physics.iisc.ac.in/MyxoPortal/.

Database URL:  http://dicsoft1.physics.iisc.ac.in/MyxoPortal/.

Graphical Abstract
Cancellation for (G,n)-complexes and the Swan Finiteness Obstruction
Authors: Nicholson John
Published: July 2024

In previous work, we related homotopy types of finite $(G,n)$-complexes when $G$ has periodic cohomology to projective ${\mathbb{Z}} G$-modules representing the Swan finiteness obstruction. We use this to determine when $X \vee S^{n} \simeq Y \vee S^{n}$ implies $X \simeq Y$ for finite $(G,n)$-complexes $X$ and $Y$, and give lower bounds on the number of homotopically distinct pairs when this fails. The proof involves constructing projective ${\mathbb{Z}} G$-modules as lifts of locally free modules over orders in products of quaternion algebras, whose existence follows from the Eichler mass formula. In the case $n=2$, difficulties arise that lead to a new approach to finding a counterexample to Wall’s D2 problem.
The Conformal Limit and Projective Structures
Authors: M Silva Pedro , Gothen Peter B
Published: July 2024

The non-abelian Hodge correspondence maps a polystable $\textrm{SL}(2, {\mathbb{R}})$-Higgs bundle on a compact Riemann surface $X$ of genus $g \geq 2$ to a connection that, in some cases, is the holonomy of a branched hyperbolic structure. Gaiotto’s conformal limit maps the same bundle to a partial oper, that is, to a connection whose holonomy is that of a branched complex projective structure compatible with $X$. In this article, we show how these are both instances of the same phenomenon: the family of connections appearing in the conformal limit can be understood as a family of complex projective structures, deforming the hyperbolic ones into the ones compatible with $X$. We also show that, for zero Toledo invariant, this deformation is optimal, inducing a geodesic on Teichmüller’s space.
Optimizing passenger vehicle travel time with Model Predictive Control in multi-region traffic networks
Authors: Saadullah Muhammad , Zhang Zhipeng , Hu Hao
Published: July 2024

This study investigates the impact of truck traffic on passenger vehicles in an urban network. Utilizing the Macroscopic Fundamental Diagram (MFD), a methodology to calculate the travel time spent (TTS) by passenger vehicles has been developed. To address this issue, an optimal control problem was formulated and solved using a Model Predictive Control (MPC) approach. The MPC framework has been applied in a centralized manner, to manage accumulation for various modes. To explore different traffic management strategies, the centralized MPC technique was implemented in two distinct configurations: region-based and vehicle-based approaches. It has been tested for various vehicle mixes and multiple control scenarios to assess the effectiveness in reducing passenger travel time spent (PTTS) and vehicle accumulation. The results demonstrate that the vehicle-based MPC approach tends to minimize the number of vehicles more effectively compared to the region-based approach. However, in terms of reducing passenger travel time, the region-based approach outperforms the vehicle-based strategy. This is attributed to enhanced coordination among traffic flow controllers, highlighting the importance of strategic controller interactions in urban traffic management systems. This research enhances both the theoretical framework for optimizing traffic flow and provides valuable practical insights for city planners and engineers aiming to deploy advanced traffic management strategies. Future studies could explore the scalability of these control systems and their capability to integrate real-time traffic data.
Raman spectroscopic deep learning with signal aggregated representations for enhanced cell phenotype and signature identification
Authors: Lu Songlin , Huang Yuanfang , Shen Wan Xiang , Cao Yu Lin , Cai Mengna , Chen Yan , Tan Ying , Jiang Yu Yang , Chen Yu Zong
Published: July 2024

Feature representation is critical for data learning, particularly in learning spectroscopic data. Machine learning (ML) and deep learning (DL) models learn Raman spectra for rapid, nondestructive, and label-free cell phenotype identification, which facilitate diagnostic, therapeutic, forensic, and microbiological applications. But these are challenged by high-dimensional, unordered, and low-sample spectroscopic data. Here, we introduced novel 2D image-like dual signal and component aggregated representations by restructuring Raman spectra and principal components, which enables spectroscopic DL for enhanced cell phenotype and signature identification. New ConvNet models DSCARNets significantly outperformed the state-of-the-art (SOTA) ML and DL models on six benchmark datasets, mostly with >2% improvement over the SOTA performance of 85–97% accuracies. DSCARNets also performed well on four additional datasets against SOTA models of extremely high performances (>98%) and two datasets without a published supervised phenotype classification model. Explainable DSCARNets identified Raman signatures consistent with experimental indications.
Ultrasound-Guided Pudendal Nerve Block versus Caudal Block for Post-Operative Analgesia in Penile Surgeries in Children
Authors: Mahmoud Hoda Omar , Abd El-malek Fady Adib , Nasr Thabet Aziz , Makram Saleh Mina Mokhles
Published: July 2024

Background

Penile surgeries as hypospadias, urethroplasty and circumcision are of the most frequently performed surgical procedures in the pediatric male population. Using optimal analgesic regimen provide safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery. This study was to compare the effectiveness and safety of ultrasound (US) guided pudendal nerve block (PNB) versus caudal block (CB) for postoperative analgesia in pediatric male patients undergoing penile surgeries.

Methods

The study was conducted on 40 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. Patients were divided randomly into two groups (20 each group) either receiving ultrasound-guided pudendal nerve block (PNB group) or caudal epidural block (CB group). In the PNB group, patients were injected with 0.3 mL/kg 0.25% bupivacaine and 1 ug/kg fentanyl. In the CB group, patients were injected with 1 mL/kg 0.25% bupivacaine and 1 ug/kg fentanyl. The two groups were adequately monitored and assessed pre, intra and post-operatively and they were compared regarding demographic data, pre, intra and postoperative hemodynamics, postoperative pain control using objective pain scale (OPS) score, consumption of paracetamol in the 1st 24 hours postoperatively and complications of both anesthetic techniques.

Results

This prospective randomized controlled single-blind clinical study was performed on total 40 patients of age 3 to 10 years scheduled for penile surgeries. For the primary outcome, there was a statistically significant increase in time to first analgesia in PNB group than CB group with p value < 0.001 while there was a statistically significant increase in total dose of paracetamol in CB group than PNB group with p value < 0.001. For OPS score, there was a statistically significant increase in pain score in CB group than PNB group at 6 h, 12 h and 24 h with p value = 0.02, 0.005 and 0.01, respectively.

Conclusion

From our study we can conclude that US guided PNB provided significantly prolonged postoperative analgesia and reduced the postoperative analgesic requirements as compared with caudal block in pediatric patients undergoing penile surgeries and also demonstrated that both analgesic techniques are safe.
Ultrasound Guided Subscapularis and Subomohyoid Plane Blocks versus Interscalene Block with Levobupivacaine for Analgesia in Shoulder Surgery
Authors: Nassar Mohamed Zakaria , Ghobrial Bassem Boulos , Shoukry Randa Ali , Mohamed Abdou Khaled Mohamed Ahmed
Published: July 2024

Background

Now Shoulder surgery is a common procedure, particularly as it is associated with reduced hospitalization times, even though the technique may lead to moderate and severe postoperative pain. In recent years, various studies have been carried out that demonstrated the need for valid anaesthetic techniques that allow adequate control of postoperative pain and also favour early mobilization and rehabilitation. Subscabularis and subomohyoid plane blocks allow pain control after shoulder surgery while decreasing the need of opioids and pain medication after surgery. In contrast to interscalene brachial plexus block, subscabularis and subomohyoid plane blocks carry minor risks of intrathecal injection or post operative respiratory distress.

Aim of the Work

to compare analgesic efficacy of ultrasound guided subomohyoid and subscapularis plane blocks versus interscalene block using levobupivacaine in both techniques for pain control after shoulder surgery.

Patients and Methods

This exploratory randomized clinical trial study was conducted in Ain Shams University hospital after approval of the anesthesia department and the local ethics and research committee over 6 months and after obtaining a written informed consent. Sixty patients underwent shoulder surgery under general anesthesia were included in the study their ages range between 21 and 65 years old and classified as ASA I and II. The patients were randomly divided using computer generated randomization and opaque sealed envelopes into two groups 30 patients in each (n = 30).

Results

In this study we find that combined subscapularis plane and sub-omohyoid injections may serve as an alternative to interscalene block for shoulder analgesia, with less complications. The present study shows no difference in the demographic data between the two groups (p-value >0.05). Also there was no statistically significant difference in the surgery duration between the two groups. But the duration of subomohyoid and subscapularis plane block was longer than the duration of interscalene block, the Mean± SD is (10.80±2.64 minutes) for subomohyoid and subscapularis plane blocks while interscalene block duration is (5.33±1.56 minutes) so there was astatically significant difference P-value <0.001.

Conclusion

Subscapularis plane and subomohyoid plane blocks can be used as an alternative shoulder analgesia with minor risks.
The Efficacy of Ultrasound Guided Bilateral Transversus Thoracic Plane Block for Postoperative Pain Control in Cardiac Surgery
Authors: Zakaria Fahim Joustina Nader , Ewess Hassan Bahaa Eldin , Abd-Elsalam Ehab Hamed , EL-Shourbagy Mohammed Sayed
Published: July 2024

Background

Cardiothoracic surgeries are associated with significant pain. Optimal analgesia is a vital part of strategies intended to improve patients' experience and outcomes. Traditionally, analgesia in these types of surgeries has depended on large doses of I.V. opioids.

Aim of the Work

The aim of the study was to evaluate the effect of postoperative bilateral US guided TTPB block on postoperative pain control in patients undergoing cardiac surgery through mid-line sternotomy compared to systemic analgesia.

Patients and Methods

This study is a randomized clinical trial study at Ain-shams University Hospitals, Cairo, Egypt. In our study, patients were randomly allocated into two groups with 40 patients in each group. Group 1 (study group) received TTP block., whereas Group 2(control group) received systemic analgesics. The two groups were compared regarding their demographic data (age, sex, body weight and height), A numerical rating scale (NRS) for sternal pain, morphin consumption during 24 hours after extubation and time of first rescue analgesia, heart rate and blood pressure in icu, time of extubation, ICU length of stay, total length stay of the hospital.

Results

Our study showed that when compared to general anesthesia with systemic opioids, TTPB block is associated with significantly better postoperative pain control.

Conclusion

Tranversus thoracic plaine block is technically simple, safe and very effective technique and can be used as a part of multimodal analgesia in postoperative cardiac surgical patients for better patient comfort and satisfaction and also helps in superior pulmonary rehabilitation, thus assisting in better outcome and less unwanted side effects of systemic analgesics.
A Comparative Study between Ultrasound Guided Pectoral Nerve Block Type II versus Intravenous Patient Controlled Analgesia for Intra-Operative and Post-Operative Analgesia in Patients Undergoing Modified Radical Mastectomy
Authors: Ali Eman Adel , Salama Awad Hala Gomaa , Tharwat Sayed Ayman Ibraheem , Salem Ahmed Sarah Ahmed
Published: July 2024

Background

Breast surgery is becoming more and more common. Patients are often middle-aged women and with high public awareness around issues of breast cancer. The numbers are increasing. Breast surgery is an exceedingly common procedure and associated with an increased incidence of acute and chronic pain. Regional anaesthesia techniques may improve post-operative analgesia for patients undergoing breast surgery.

Aim of the Work

The primary aim of this study is to compare the efficacy of PECS block versus PCA with iv morphine to provide prolonged post-operative analgesia. The secondary objective is to identify the side effects of both techniques as post-operative analgesic techniques.

Patients and Methods

This study is a randomized clinical trial study conducted in Ain-shams University Hospitals, Cairo, Egypt for 6 months after medical ethical committee approval. The participants were allocated randomly into two groups of 25 patients each: group A: Patients received general anaesthesia followed by PECS block at the end of the operation before extubation, group B: Patients received general anaesthesia followed by the PCA at the end of surgery after extubation.

Results

The VAS score in the PECS group was statistically significantly lower at the 1st, 2nd and 4th hours. In this case, the use of PECS for postoperative analgesia is as effective as intravenous Morphine PCA in pain treatment, but with less systemic side effect as the nausea and vomiting is significantly higher in the PCA group than the PECS group at the 6th hour, however, the need of intra operative opioids in PCA group is significant.

Conclusion

In modified radical mastectomy, PECS block is as effective as intravenous Morphine PCA in pain treatment. Compared with intravenous PCA, PECS block can be considered as a more preferable method because it can avoid the systemic actions of morphine used for PCA, and can decrease the need of analgesia intra-operative, however PCA analgesic effect last longer, less invasive technique and easier to be used while PECS block require hand skills and limited to 24 hours analgesia only.
Effectiveness of Nutritional Supplementation in Liver Transplant Recipients during Early Postoperative Course: A Systematic Review and Meta-Analysis
Authors: AL Ansary Adel Mohamad , Eldin Amin Ghada Essam , Abdelmotaleb Ammar Mona Ahmed Mohamed , Mohamed EL Anany Reem Hussein
Published: July 2024

Background

Nutrition is an integral part of health maintenance. The liver is the largest and most important metabolic organ, playing a pivotal role in integrating several biochemical pathways of carbohydrate, fat, protein, and vitamin metabolism. Malnutrition is a common complication of end- stage liver disease (ESLD). Progressive deterioration of nutritional status has been associated with poor outcome in cirrhotic patients. Liver transplantation (LT) revolutionized the management of liver disease. Nutritional therapy is an integral part of liver transplant care.

Objective

To identity the efficacy of different dietary nutritional supplements as zinc, vit D and immunonutrients (glutamine, omega 3, arginine and ribonucleic acid) for recipient at early post operative course.

Material and Methods

In this systematic review and meta-analysis we enrolled a total of 7 studies for assessing the clinical outcomes of ICU patients underwent liver transplantation surgery and supplied with dietary supplements during early postoperative period. The studies also assessed the laboratory assessment of patients postoperatively during ICU admission period.

Results

Regarding postoperative dietary supplementations with HMB, we found significant difference for appendicular skeletal muscle mass (ASMI) regarding the baseline and the postoperative ASMI in the intervention group with HMB. But we did not report significant difference regarding the baseline and the postoperative Fat-free mass index (FFMI) in both intervention and control group with HMB. Also we did not find significant difference between base line and postoperative in both groups for Mid-arm muscle-circumference (MAMC), Fat mass index (FMI), 6-minute walk test (6MWT), and Handgrip (HG).

Data Sources

Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021.

Conclusion

BCAA as dietary supplementation showing a significant favorable effect regarding the baseline and the postoperative BTR levels, also for BCAA levels, Tyrosine levels, prealbumin levels, retinol binding protein and PTINR levels in both intervention and control groups. For HMB, we found significant difference for appendicular skeletal muscle mass (ASMI) regarding the baseline and the postoperative ASMI in the intervention group with HMB. But we did not report significant difference regarding the baseline and the postoperative Fat-free mass index (FFMI) in both intervention and control group with HMB.
C-Reactive Protein as an Early Marker of Severity and Outcome in Patients with SARS-CoV-2 Infection
Authors: El-khattab Salwa Omar , Eldin Abdelhamid Amr Essam , Ibrahim Waleed Abdalla , Yousef Elsherif Ahmed Ibrahim , Khalil George Mekhael
Published: July 2024

Background

SARS CoV-2 infection is a major cause of morbidity and mortality worldwide. The incidence of SARS CoV-2 infection is rising with millions of people getting infected daily. Mortality rate varies from a country to the other(0.3-6%), most of which are attributed to respiratory failure. Several studies have been performed to identify biomarkers for use in the early identification of patients at risk.

Aim of the work

This study was done to estimate and evaluate the plasma levels of CRP in patients with SARS CoV-2 and to study the association of CRP levels with severity of disease progression and prognosis of those patients.

Patients and Methods

This retrospective cohort study was conducted on 100 patients admitted to El-Obour Ain Shams University Specialized Hospital for Isolation during the period between January and October 2020.

Results

Regarding history patients whom were old or have any of the following comorbid conditons as hypertension, Diabetes mellitus, chronic liver disease and active cancer were statistically more prone to not surviving. Regarding complete blood picture, there was significant decrease in haemoglobin and or increase in total leukocytic count in those who did not survive. Serum Ferritin and D-Dimer were significantly high in those who did not survive. As regard CRP, it was significantly higher in the non-survivor group, Also it correlated with severity as ICU admission and need of respiratory support. Regarding the ROC curve result the best cut-off of CRP to predict mortality was >129mg/l, with Area under the curve = 0.981, Sensitivity = 90.91%, Specificity= 97.75%, positive predictive value = 83.3% and negative predictive value =98.9%. Regarding the ROC curve result the best cut-off of CRP to predict need of respiratory support was >55.3mg/L, with Area under the curve = 0.976, Sensitivity = 100%, Specificity= 86.21%, positive predictive value = 52.0% and negative predictive value =100.0%. Regarding the ROC curve result the best cut-off of CRP to predict need of ICU admission was >55.3mg/L, with Area under the curve = 0.987, Sensitivity = 100.0%, Specificity= 93.75%, positive predictive value = 80.0% and negative predictive value =100.0%.

Conclusion

Laboratory and clinical medicine groups should actively collaborate and optimize their individual expertise to potentially prove standardized biomarkers assays that will optimize patient care.
Prognostic Value of Cardiac Troponin Release in Head Trauma Patients
Authors: Mohamed Galal Adel , Hussein Noha EL-Sayed , Saleh Ashraf Nabil , Mohammed Mohammed Hassan Hashim
Published: July 2024

Background

Traumatic brain injury (TBI) is defined as damage to the brain sustained after the application of external physical force that causes temporary or permanent functional or structural damage to the brain. TBI stands as a major cause of death among youth in industrialized societies. Brain injury can be mild, moderate, and severe.

Objective

Myocardial dysfunction is frequently described as an underlying cause of mortality in traumatic brain injury (TBI) known as brain-cardiac link. The impact on prognosis of a disease remains uncertain. The present study aimed at investigating the correlation between serum cTnI levels as a biochemical marker of myocardial damage and morbidity, mortality of the patients with mild to moderate TBI.

Patients and Methods

This study was conducted to investigate the relationship between TBI and cTnI elevation, as well as the prognostic usefulness of this relationship and morbidity, mortality in patients with mild to moderate TBI. It has been claimed that there is a relationship between cardiac injury and mortality rate in TBI patients.

Results

In the present study, there was a non-significant relation between incidence of mortality and cause & type of injury among studied cases. This study revealed that there is significant relation between incidence of mortality and hospitalization characteristics (length of ICU stay, GCS, troponin level) among studied cases. However, there is a non-significant relation between incidence of mortality and length of hospital stay, AIS, GOS and troponin release. Results of binary logistic regression for prediction of mortality among studied cases were significant in GCS and troponin; however, were non-significant in length of ICU. Regarding validity of troponin in prediction of mortality among studied cases in the present study population, AUC of troponin was 0.912 (95% CI: 0.756-1.0) with cutoff point 0.265 (P < 0.001).

Conclusion

A non-significant relation was found between release of troponin and cause & type of injury among the studied cases. In addition, there was a non-significant relation between troponin level and mode & type of injury. Increased cTnI levels could be a predictor of mortality among patients with TBI.
Efficacy and Safety of Tocilizumab with Methylprednisolone versus Methylprednisolone Only as a Treatment for Severe Covid-19 Patients
Authors: Elsharnouby Noha Mohamed , Elgendy Mohammed Abdelsalam , Abd Elrahman Heba Mahmoud , Elshoura Ahmed Emam
Published: July 2024

Background

SARS-CoV-2 was identified as a worldwide fatal pandemic that causes acute respiratory infections. The aim of this work was to compare the effect of Using combined therapy: (tocilizumab with Methylprednisolone) versus using (Methylprednisolone alone) as immuno-modulatory therapy on 28 days mortality mortality, need for mechanical ventilation & adverse effects.

Methods

This retrospective observational cohort study was carried out on 60 patients diagnosed as having covid 19 infection with cytokine storm and severe acute respiratory syndrome during the period(2020-2021). Patients were divided into 2 groups: (TCZ+MP)group received 2 doses of tocilizumab within 24 hrs (5 mg/kg in each dose) in addition to a dose of methylprednisolone(2mg/kg/day)for7days and(MP)group:received only a dose of methylprednisolone (2 mg\kg\day) for 7days. All patients were subjected to routine laboratory investigations (Complete blood count, liver function tests, kidney function tests, LDH, ferritin, D-dimer, frequent ABGs (P/F ratio), CRP, IL6, procalcitonin& albumin), and radiology investigation (Chest x-ray and CT chest).

Results

60 patients with ARDS(both genders) were included in this study, in TCZ+MPgroup, 8(26.67%) of 30 patients died, compared to 17(56,67%) of 30patients in (MP)group, so mortality rate was significantly lower in patients on TCZ+MPgroup than those on (MP)group (P value =0.018). In TCZ+MPgroup, 12(40%) of 30 patients needed mechanical ventilation compared to 22(73.33%) of 30 patients in MP group, so Number of patients who required mechanical ventilation was significantly lower in patients on TCZ+MPgroup than MP group (P value = 0.009). Adverse effects of intervention drugs after 28 days were insignificantly different between both groups (P value = 0.018).

Conclusions

In patients with severe COVID-19 infection, combination therapy of tocilizumab &methylprednisolone reduced mortality rate and need for mechanical ventilation as compared with the use of methylprednisolone alone.
Metabolic Syndrome as A Prognostic Factor for Outcome of Severe SARS-COV-2 Cases
Authors: Mohamed Sakr Heba Ahmed , El Shaer Ahmed Nagah , Hilal Abdo Amr Mohamed , Refaat Sameh Ahmed , Hamza Amr Hosni
Published: July 2024

Background

SARS-COV-2 (Coronavirus Disease-2019), a disease caused by the coronavirus. SARS-CoV-2 (Sever Acute Respiratory Syndrome-Coronavirus-2) has emerged as a rapidly spreading communicable disease affecting more than 100 countries across the globe at present.

Aim of the Work

To illuminate to what extent metabolic syndrome can be used as a prognostic factor for outcomes of patients infected with SARS-COV-2. Primary outcome measure is ICU stay and outcome. Secondary outcome measures are Patients requiring MV and mortality.

Patients and Methods

This was a retrospective study in order to illuminate to what extent metabolic syndrome can be used as a prognostic factor for outcomes of patients infected with SARS-COV-2, with Primary outcome measure which was ICU stay and outcome, and Secondary outcome measures were Patients requiring MV and mortality. Ninety patients admitted to ICU for Pneumonic COVID-19 with a confirmed positive RT-PCR for COVID-19 and chest computed tomography was divided into two groups in Ain-shams University hospitals.

Results

Components of metabolic syndrome such as hypertension, type 2 diabetes mellitus (T2DM), and obesity are highly prevalent and significantly increase the risk of hospitalization and mortality in SARS-COV-2 patients.

Conclusion

MetS is a better prognostic indicator for severe disease outcomes in patients with COVID-19 than its individual components. Patients with MetS had a significantly higher need for ICU admission irrespective of their age, sex, or race. The need for mechanical ventilation was also higher across all patients with MetS. The association of MetS with higher mortality was significant for females, patients younger than 65 years of age.
Norepinephrine versus Ephedrine in Prevention of Hypotension after Spinal Anesthesia in Cesarean Section
Authors: Moneam El Sheikh Alaa Nagi Abdel , Taha Elsafty Omar Mohamed , Abdellatif Ayman Ahmed
Published: July 2024

Background

Spinal anesthesia is the preferred anesthetic method for elective cesarean section in obstetric anesthesia practice. Cesarean sections normally require an anesthetic block at T4 level, so hypotension is reported in up to 80% of spinal anesthesia cases.

Aim of the Work

This study aims to compare norepinephrine versus ephedrine in Prevention of hypotension in CS under spinal anesthesia.

Patients and Methods

The study was a clinical Prospective, double–blinded and randomized study, the operating theatres of Ain Shams University Hospitals over one year.

Results

We administered the vasopressors by iv infusion when SBP drops 20% below the baseline. We found that no significant difference between both groups regarding fetal Apgar score. We compared two different vasopressors and we chose the regimen of iv infusion.

Conclusion

We found lower numbers of hypotension and hypertension episodes and less frequency of bradycardia and tachycardia in the patients treated with norepinephrine.
Nutritional Support for ICU Patients Receiving Extracorporeal Membrane Oxygenation Therapy: A Meta-Analysis
Authors: Mohamed Elfiky Amira Ahmed , El Sharnouby Noha Mohamad , Moustafa Moustafa El-Houssinie , Allah El Gendy Hanaa Abd
Published: July 2024

Background

ECMO constitutes a mechanical technique that provides extracorporeal gas exchange or/and circulatory support for patients with refractory life-threatening pulmonary or/ and cardiac failure. There is infrequent evidence regarding the optimal nutritional management and related clinical outcomes for adult critically-ill patients receiving ECMO.

Objective

This study was conducted to evaluate the effect of nutritional intervention on clinical outcomes in adult critically ill patients receiving Extracorporeal Membrane Oxygenation Therapy.

Methodology

Advanced search was conducted in Medline, PubMed, google scholar and the Egyptian Knowledge Bank for cohort studies that were published in English until September 2020.

Inclusion Criteria

cohort studies which assess nutrition support in adult critically-ill patients receiving ECMO therapy, and include at least one of these outcomes a) 28-day mortality, b) length of ICU stay, C) duration of mechanical ventilation and d) incidence of infection.

Exclusion Criteria

duplicate reports, Abstracts, case reports, case series, review articles, editorials and clinical guidelines. In addition, studies with unavailable full text or studies with different outcomes were excluded.

Results

7 studies with a total number of 2358 patients were included in the meta-analysis. Estimates and their 95% confidence intervals (CI) were calculated, then pooled for analysis. Nutrition support in adult critically ill patients receiving ECMO was significantly related to 28-day mortality ( 95% CI 0.428 = 0.329–0.527; p < 0.001), increased ICU length of stay ( 95% CI 29.512 (22.930–36.095), and P value < 0.001), duration of mechanical ventilation (95% CI 17.985 = 4.682–31.288; p < 0.008) and incidence of infection ( 95% CI 0.105 ( 0.066 – 0.144), and P value < 0.001).

Conclusion

The study indicates positive association between effective nutrition support and clinical outcomes for adult critically-ill patients receiving ECMO therapy.
Intrathecal Dexmedetomidine versus Intrathecal Dexamethasone as Adjuvants to Hyperbaric Bupivacaine to Prolong the Duration of Sensory Block in Patients Undergoing Lower Abdominal Surgeries
Authors: Mohamed El taher Waleed Abdel Magied , Salam Elgendy Mohamed Abdel , Attia Engy Samy , Atwa Ali Ali Mohamed
Published: July 2024

Background

Dexmedetomidine can be added to local anesthetics in spinal anesthesia to speed up the block, reduce postoperative pain, increase block duration, and reduce analgesic use. Dexamethasone is used intravenously to lessen shivering because it reduces the body's inflammatory response and tissue temperature gradient. It can also be safely injected into the cerebrospinal fluid as an adjuvant to local anesthetics to improve the quality of regional anesthesia. Intrathecal dexamethasone added to Bupivacaine increased spinal anesthetic sensory block duration without affecting onset time or consequences.

Aim

Comparing the onset and duration of sensory block and Analgesia and onset and duration of motor block and hemodynamic stability when intrathecal 5 mcg Dexmedetomidine added to 15mg heavy bupivacaine 0.5% to that of 4mg dexamethasone when added to 15 mg heavy bupivacaine 0.5% in patients underwent lower abdominal surgeries under spinal anesthesia.

Subject and Methods

This study was conducted at Faculty of Medicine; Ain-Shams University Hospitals on 50 patients.

Results

VAS was significantly lower in group B compared to group A at 8hr and 12hr measurements. there is a significant difference between the groups regarding sensory block duration, motor block duration, onset of sensory block, onset of motor block, time to 2 segment regression, and time to request of 1st analgesia. postoperative opioid consumption was significantly lower in group B always compared to group A.

Conclusion

adverse events. The current study showed that both Dexmedetomidine and dexamethasone were safe and effective as intrathecal adjuvants in lower abdominal surgeries. Both drugs resulted in comparable hemodynamic stability and incidence of
Correlation between Central Venous Pressure and Inferior Vena Cava Diameter for Fluid Assessment in Patients with Chronic Obstructive Pulmonary Disease
Authors: El Deen Habib Ahmed Salah , Nashed Sherif Wadih , Othman Toaima Mohamed Mohamed , Mohamed Abdel Wahab Wael Abdel Moneim
Published: July 2024

Background

Chronic obstructive pulmonary disease (COPD) is now the third leading cause of death globally.3 Although COPD primarily affects the lungs, it is now also recognized as a complex multi-component disease characterized by chronic systemic inflammation that frequently coexists with other conditions known as co morbidities.

Objective

To determine the correlation between central venous pressure (CVP) and the IVC collapsibility index for estimating the fluid status in COPD patients.

Patients and Methods

After obtaining the approval of the Ain Shams University Ethical Committee and written informed consent, 20 patients aged 21 - 60 years of either sex, admitted in the ICU of Ain Shams teaching hospitals who have a functioning central venous catheter inserted for any clinical indication, were involved in this correlational study. CVP measurements were taken with the patient in the supine position from the zero point and the middle line.

Results

The current study showed that there was no statically significant correlation Between CVP (cmH2O) and Heart Rate (beat /min), MABP (mmHg), IVCd max (cm) and IVC CI % at Baseline, After PLR test, After Bolus fluid administration, After 3 hours and After 6 hours.

Conclusion

The measurement of the IVC diameter has a good correlation with CVP and useful for assessment of the volume status. The measurement of the IVC by ultrasonography may be an important additional evaluation of critically ill patients.
Effect of Amiodarone on the Thyroid Gland of Adult Male Albino Rats: A Histological and Morphometric Study
Authors: El-Sayed Nourhan Mahmoud , Hamdy Khaled Naiem , Moustafa Ahmed Yehia , Sadek Ahmed S , Rady Hagar Yousry
Published: July 2024

Background

Amiodarone (AMD) is a benzofuran derivative, used in management of angina and refractory ventricular arrhythmia. Amiodarone has been associated with toxicity on many organs involving the lungs, thyroid gland, liver, eyes, skin, and nerves.

Aim of the Work

The aim of the current work was to study the structural and functional changes of the thyroid gland of adult male albino rats after exposure to the antiarrhythmic drug “Amiodarone”.

Material and Methods

Thirty adult male albino rats were used and divided into three groups. The first group included 10 rats which served as (control); 5 rats received distilled water orally and 5 rats received 3 ml of 0.6% methylcellulose. The second group included 10 rats used as (therapeutic dose treated group), which received 30 mg/Kg B.W. of amiodarone for 12 weeks by oral gavage, while the third group included 10 rats used as a (toxic dose treated group) which received 60 mg/Kg b. w. of amiodarone daily for 6 weeks by oral gavage. Serum concentration of tri-iodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH) were evaluated. Morphometric study and statistical analysis were done.

Results

Biochemical examination revealed statistical highly significant increase (P < 0.001) of serum (T4 & T3) with concomitant statistical highly significant decrease of (TSH) (P < 0.001). Histopathological examination of the thyroid tissues from the therapeutic dose treated group showed marked evidence of thyrotoxicosis in the form of microcystic follicular changes and peripheral scalloping, cellular degeneration with scanty cytoplasm and vesicular nuclei. These changes became more severe in toxic dose treated group in the form of thyroid tissue damage with hemorrhage and necrosis. Epithelial hyperplasia with atypical nuclear features were also detected.

Conclusion

Amiodarone had detrimental effects on the adult male albino rat’s thyroid tissue when administered either in the therapeutic or the toxic doses.
Role of Dapagliflozin in Prevention of Contrast Induced Nephropathy in Diabetic Patients Undergoing Primary Percutaneous Coronary Intervention
Authors: Khalifa Mostafa , Khorshid H , Rezq A , Abdeldayem T
Published: July 2024

Background

Contrast induced nephropathy (CIN), is a known complication of any coronary intervention regardless the amount of contrast. Studies have shown that patients who develop CIN have a greater risk for death or prolonged hospitalization, as well as for other adverse outcomes, including early or late cardiovascular events especially if after percutaneous coronary intervention (PCI). Research is continuous to find pharmacological interventions to prevent CIN. While many therapies in prevention of CIN have been studied, only good hydration has been proven to be of benefit. This Abstractattempt to provide the role of dapagliflozin in prevention of CIN.

Aim and objectives

The aim of the study was to study the efficacy of dapagliflozin administration as a preventive tool for Contrast induced nephropathy (CIN), in diabetic patients undergoing primary percutaneous coronary intervention (PCI).

Patients and Methods

This study included 250 diabetic patients presented to emergency departments of Ain shams university hospitals from July 2021 till June 2022 and diagnosed with STEMI as being defined as Patients with ST elevation myocardial infarction defined as having symptoms of ischemia and ST-segment elevation of at least two contiguous leads with ST-segment elevation ≥ 2.5 mm in men < 40 years, ≥2 mm in men ≥ 40 years, or ≥ 1.5 mm in women in leads V2 – V3 and/or ≥ 1 mm in the other leads 1, that had been revascularized by primary PCI as per the recommendations of The European society of cardiology guidelines for diagnosis and management of ST elevation myocardial infarction published in 2017. CIN was defined by renal function impairment after IV contrast as mirrored by an absolute increase by 0.5mg/dL (or greater) or relative increase by 25% (or greater) of baseline serum creatinine over 48 hours or, better, by a decrease by 25% in the estimated glomerular filtration rate (eGFR(. The patients were randomized using dedicated software programme into two groups. Study group including 125 patients was the dapagliflozin group. Control group including 125 patients was the standard control group.

Results

Our study had demonstrated that a higher proportion of patients developed CIN in the control group (21 (16.8%)) vs (13 (10.4%)) in the study group (dapagliflozin group) but it didn’t reach a statistically significant difference with P-value =0.139.

Conclusion

Dapagliflozin failed to prove any statistically significant prevention against CIN.
Prevalence of cardiac ARRHYTHMIAs in patients recovering from COVID-19
Authors: Mahmoud Ahmed , Amin Mohamed , Effat Emad , Allam Lamyaa
Published: July 2024

Background

The family of seven known human coronaviruses are known for their impact on the respiratory tract, not the heart. However, the most recent coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has marked tropism for the heart and can lead to myocarditis (inflammation of the heart), necrosis of its cells, mimicking of a heart attack, arrhythmias, and heart failure. These complications, which at times are the only features of coronavirus disease 2019 (COVID-19) clinical presentation, have occurred even in cases with mild symptoms and in people who did not experience any symptoms. Recent findings of heart involvement in young athletes, including sudden death, have raised concerns about the current limits of our knowledge and potentially high risk and occult prevalence of COVID-19 heart manifestations.

Aim of the Work

was to detect the prevalence of cardiac arrhythmias in patients recovering from COVID-19 and to find out if it is related to COVID infection.

Patients and Methods

This cross sectional study was to detect the prevalence of cardiac arrhythmias in patients recovered from COVID-19 and to find out its relation to COVID infection. It was carried out on one hundred patients who had been diagnosed as COVID-19 and came after recovery from one to six months Post COVID at Ain Shams University Hospitals .This study was carried out during a period of six months between November 2021 and May 2022.

Results

that among these 100 patients recovering from COVID-19, 17 % of them developed cardiac arrhythmias as follow; 7 (7%) were diagnosed as Inappropriate Sinus Tachycardia, 3 (3%) had PVCs arising from RVOT, 3 (3%) were diagnosed as PACs, 2 (2%) were diagnosed as Paroxysmal AF, 1 (1%) was diagnosed as SVT (AVRT) and 1 (1%) was diagnosed as 1st degree heart block.

Conclusion

we found that Inappropriate sinus tachycardia was the most prevalent Cardiac Arrhythmia in these patients recovering from COVID-19 (7%) while other arrhythmias had lower prevalence with RVOT PVCS found in 3 % of the studied group, PACs in 3%, Paroxysmal AF in 2%, SVT (AVRT) in 1% and 1st degree heart block in 1% of this studied population. Absolute Lymphopenia during the course of COVID-19 illness had an effect on the prevalence of Cardiac Arrhythmias in patients recovering from COVID-19. Correlation among these arrhythmias and symptoms of these patients was called Post COVID syndrome.