bluuebunny/crossref_metadata_2025 huggingface dataset:
Diversité du genre au conseil d’administration et structure du capital
Authors: Daidai Fouad , Tamnine Larbi , Taghzouti Abdellatif
Published: March 2024

Cette étude vise à examiner l’impact de la diversité du genre au sein du conseil d’administration sur la structure du capital des entreprises cotées au Maroc, et ce, en utilisant les données de panel d’un échantillon de (36) entreprises non financières cotées à la bourse des valeurs de Casablanca pour la période de 2013 à 2018. Pour identifier avec précision les dimensions du conseil d’administration qui déterminent le niveau d’endettement d’une entreprise, nous effectuons une analyse de régression à effets fixes, dans laquelle le ratio dette/actifs d’une entreprise est régressé, directement et indirectement (c’est-à-dire l’effet modérateur de la diversité du genre), sur les attributs clés du conseil d’administration. Cette étude s’appuie sur les propositions complémentaires de la théorie de l’agence et des théories du genre basées sur le comportement différentiel entre l’homme et la femme. Les résultats empiriques de cette étude indiquent que toutes les variables explicatives du modèle d’étude ont une influence significative sur les décisions de financement de l’entreprise. En général, la diversité du genre modère l’effet de la structure du conseil d’administration sur les décisions de financement de l’entreprise. Cette étude fournit des preuves empiriques du rôle modérateur de la diversité du genre sur l’effet de la structure du conseil d’administration sur les décisions de financement de l’entreprise.
Face aux crimes de masse : les procès de masse, entre symbole impossible et pratique délicate
Authors: Hébert-Dolbec Marie-Laurence , Mégret Frédéric , Scalia Damien
Published: March 2024

Résumé Chaque anniversaire du procès de Nuremberg est l'occasion de divers bilans. Les 75 ans n'ont pas fait exception et nous avons vu nombre de conférences revenir sur les succès et insuccès du tribunal d'après-guerre. Néanmoins, peu ont étudié la forme que LE procès a revêtue, à savoir un procès de masse, jugeant simultanément de nombreux individus. Depuis lors, cette forme de justice a été abandonnée au niveau international où ne sont principalement menés que des procès à l'encontre d'une ou deux personnes. Le présent dossier propose une analyse des raisons de cet abandon, ainsi que des avantages et des risques (pratiques, journalistiques, symboliques ou juridiques) tenant à cette forme singulière de procès. En mettant la lumière sur cette dernière, nous entendons renouveler le débat sur les raisons et les finalités d'une justice internationale pénale tout autant critiquée que portée aux nues. Les procès de masse peuvent-ils être autre chose qu'un spectacle ou une remise en cause des responsabilités individuelles ? Ou faut-il y voir une piste de réinvention pour une justice internationale pénale désormais percluse de lenteurs et d'échecs ?
Aspects cliniques de l’irréparable en matière d’agressions sexuelles sur mineurs
Authors: Danion-Grilliat Anne
Published: March 2024

Les sévices sexuels ont des conséquences dramatiques dans la vie d’un enfant. Leur prévention du côté des victimes comme des auteurs et la difficile question du pardon passent par une nécessaire compréhension de ces actes et de leurs conséquences, par le respect de la dignité des enfants, par des prises de positions sociétales, politiques, juridiques et ecclésiales sans ambiguïté, par l’éducation des petits dans la famille, à l’école, dans les institutions et la société, par l’existence enfin de systèmes d’accueil et de soins accessibles, de qualité et coordonnés.
Peines et pénitences dans le code de droit canonique : fondements théologiques et pratiques juridiques à la lumière des agressions sexuelles en Église
Authors: Échappé Olivier
Published: March 2024

Le droit pénal dans l’Église est aujourd’hui questionné par la crise des abus sexuels. Une partie de l’opinion publique lui demande de mettre fin au scandale, sans être toujours consciente que plusieurs de ses caractéristiques ne le rendent pas forcément apte à remplir la mission attendue. Depuis 2002, les papes ont pris des mesures drastiques, qui passent par la centralisation, à Rome, au tribunal du Dicastère pour la doctrine de la foi, des poursuites et du jugement des délits les plus graves. Ce système a été à plusieurs reprises amendé dans le sens de la sévérité. Mais est-il efficace, quand on réalise la tension qui apparaît entre un système répressif ancien, et la persistance, voire l’aggravation, des abus sexuels dans certains pays ?
Cessons de parler des émotions aux enfants… mais accompagnons chacun à apprivoiser les siennes !
Authors: Renaud-Goud Mathilde
Published: March 2024

La tendance actuelle, notamment dans les crèches, est à la prise en considération des émotions des petits enfants. Si l’intention est tout à fait louable, dans la pratique, on voit se multiplier de nombreux outils pédagogiques « prêts-à-penser » offrant la promesse d’aider le tout petit à « gérer » ses émotions. Ces outils, d’un premier abord séduisants peuvent donner lieu à des pratiques quelque peu opératoires où les émotions des enfants sont simplifiées, catégorisées. En revanche, rares sont les lieux où une attention authentique est portée à tous les détails de la vie de l’enfant : comment il manipule les objets, comment il entre en relation avec ses pairs, s’il participe pendant son change… Or c’est bien dans chacun de ces petits moments, plus que dans un tour de table des émotions, que se manifeste, de manière singulière, la richesse et la complexité de sa vie émotionnelle.
Notes sur la mélodie de l’interaction mère-bébé en cas de déficience visuelle maternelle
Authors: Gosme Christelle
Published: March 2024

À partir d’observations issues d’un travail de recherche auprès de mères avec une déficience visuelle et de leur bébé, mené dans le cadre du projet pile , il s’agira de s’intéresser plus particulièrement aux modalités interactives de chaque partenaire de la dyade dans ce contexte singulier. En effet, la déficience visuelle oblige les personnes qui en sont atteintes à s’appuyer sur leurs autres sens, à faire confiance à d’autres sensations, à d’autres ressentis, à trouver d’autres repères. Qu’en est-il pour les mères qui ont une déficience visuelle ? Comment utilisent-elles cette compensation sensorielle dans leurs interactions avec leur bébé ? Que nous apprennent les enfants sur leurs capacités d’ajustement ? Une première partie portera sur les travaux réalisés sur la communication mère-bébé dans ce contexte de déficience visuelle maternelle, puis nous partagerons nos observations et réflexions sur les interactions entre les mères et leur bébé filmés entre l’âge de 3 mois et l’âge de 15 mois. Nos résultats nous amèneront à conclure sur la place du rythme dans les interactions mère-bébé et sur les tentatives de chaque partenaire de s’ajuster à l’autre.
Correspondances et vie privée. Approche comparée des protections de la confidentialité en droits français, américain et anglais
Authors: de Solminihac Arnaud , de Bonnaventure Xavier
Published: March 2024

Rapport d’activité de la Commission nationale de contrôle des techniques de renseignement pour l’année 2022: “En 2021, on comptait un peu moins de 23 000 personnes surveillées. On en dénombre en 2022 un peu moins de 21 000. (…) Si le nombre des personnes surveillées a diminué en 2022, le nombre de demandes de techniques a lui continué sa progression. Autrement dit, la surveillance devient plus intense. Le volume des données recueillies s’accroît. Le contraste finit par devenir inquiétant entre, d’une part la modestie des moyens humains et techniques de la commission, d’autre part la sophistication des outils des services et la progression annoncée de leurs moyens.”
Narrations berbères de la guerre du Rif
Authors: Assam Malika
Published: March 2024

Les récits de la guerre du Rif en langues berbères se multiplient aujourd’hui, depuis les réappropriations des poèmes composés par les Rifains lors de l’événement jusqu’aux écrits diffusés par les militantismes amazighs contemporains. À travers l’analyse du langage et des choix différenciés pour mettre en avant ou occulter certains éléments, cet article interroge ces « traces du passé dans le présent » et, en particulier, la mise en avant du leader rifain Mohand Abdelkrim, personnalité qui dénote avec les « panthéons mémoriels » amazighs habituels. Au-delà des enjeux culturels, ces constructions mémorielles révèlent des défis politiques nouveaux qui touchent l’ensemble du Maghreb entre affirmation du local, logiques régionalistes et pan-berbérisme.
La Reichsstelle Metalle dans l’Europe occupée, juillet-août 1940
Authors: Denton Chad B.
Published: March 2024

Cet article examine la genèse de la collaboration économique entre la France et l’Allemagne en juillet et août 1940, en se concentrant sur la gestion des métaux. Une analyse des archives des bureaux des métaux des administrations allemandes en Norvège, aux Pays-Bas, en Belgique et en France démontre comment Berlin cherchait à intégrer les territoires occupés sur un plan économique commun, formant ainsi un « empire économique ». Cette approche comparative met en évidence les réticences initiales des autorités françaises à accepter les directives allemandes, les vains appels au droit international et l’échec d’une réorganisation économique qui tentait de maintenir le contrôle national de l’économie.
Défense européenne
Authors: Galleri Florian , Pincé Yannick
Published: March 2024

À l’heure où la guerre en Ukraine met la lumière sur les alliances de la France, cet article pose la question de la part de responsabilité d’un tabou gaulliste dans les échecs de mise en place d’une défense européenne. Pour y répondre, les auteurs font un rappel de l’attitude de Charles de Gaulle vis-à-vis des alliances et expliquent les origines d’une supposée doctrine stratégique gaulliste. Ils montrent ensuite qu’il s’agit surtout d’un discours que les différents présidents de la République ont su adapter aux circonstances. Le tabou est néanmoins réel jusqu’aux années 1990, effectivement facteur de freinage de l’approfondissement des alliances, avant de voir une adaptation de la phraséologie gaulliste puis son abandon.
Optimal pair of fixed points for a new class of noncyclic mappings under a $ (\varphi, \mathcal{R}^t) $-enriched contraction condition
Authors: Safari-Hafshejani A. , Gabeleh M. , De la Sen M.
Published: March 2024

In the present study, we commenced by presenting a new class of maps, termed noncyclic $ (\varphi, \mathcal{R}^t) $-enriched quasi-contractions within metric spaces equipped with a transitive relation $ \mathcal{R}^t $. Subsequently, we identified the conditions for the existence of an optimal pair of fixed points pertaining to these mappings, thereby extending and refining a selection of contemporary findings documented in some articles. Specifically, our analysis will encompass the outcomes pertinent to reflexive and strictly convex Banach spaces.
Statistical inference of the Birnbaum-Saunders model using adaptive progressively hybrid censored data and its applications
Authors: Elshahhat Ahmed , Alotaibi Refah , Nassar Mazen
Published: March 2024

Lately, the Birnbaum-Saunders distribution has gained a lot of attention, mainly due to its different density shapes and the non-monotonicity property of its failure rates. This work considered some estimation issues for the Birnbaum-Saunders distribution using adaptive progressive Type-Ⅱ hybrid censoring. Point and interval estimations were performed employing both conventional and Bayesian methodologies. In addition to estimating the model parameters, we obtained point and interval estimates for the reliability and hazard rate functions. We looked at the method of maximum likelihood as a classical approach, and its asymptotic traits were employed to obtain approximate confidence ranges. From a Bayesian point of perspective, we considered the squared error loss function to obtain the point estimates of the various parameters. The Bayes and highest posterior density credible intervals were additionally determined. For the complex form of the posterior distribution, Bayes estimates and credible intervals were computed by sampling from the posterior distribution through the Markov chain Monte Carlo procedure. For assessing the performance of all of these estimators, a Monte Carlo simulation was employed. Several statistical standards were applied to check the effectiveness of various estimates for multiple levels of censoring with small, moderate, and large sample sizes. Finally, two scenarios for applications were given in order to highlight the usefulness of the supplied approaches.
On $ \psi $-convex functions and related inequalities
Authors: Aydi Hassen , Samet Bessem , De la Sen Manuel
Published: March 2024

We introduce the class of $ \psi $-convex functions $ f:[0, \infty)\to \mathbb{R} $, where $ \psi\in C([0, 1]) $ satisfies $ \psi\geq 0 $ and $ \psi(0)\neq \psi(1) $. This class includes several types of convex functions introduced in previous works. We first study some properties of such functions. Next, we establish a double Hermite-Hadamard-type inequality involving $ \psi $-convex functions and a Simpson-type inequality for functions $ f\in C^1([0, \infty)) $ such that $ |f'| $ is $ \psi $-convex. Our obtained results are new and recover several existing results from the literature.
Analysis of stochastic delay differential equations in the framework of conformable fractional derivatives
Authors: Liaqat Muhammad Imran , Din Fahim Ud , Albalawi Wedad , Nisar Kottakkaran Sooppy , Abdel-Aty Abdel-Haleem
Published: March 2024

In numerous domains, fractional stochastic delay differential equations are used to model various physical phenomena, and the study of well-posedness ensures that the mathematical models accurately represent physical systems, allowing for meaningful predictions and analysis. A fractional stochastic differential equation is considered well-posed if its solution satisfies the existence, uniqueness, and continuous dependency properties. We established the well-posedness and regularity of solutions of conformable fractional stochastic delay differential equations (CFrSDDEs) of order $ \gamma\in(\frac{1}{2}, 1) $ in $ \mathbb{L}^{\mathrm{p}} $ spaces with $ \mathrm{p}\geq2 $, whose coefficients satisfied a standard Lipschitz condition. More specifically, we first demonstrated the existence and uniqueness of solutions; after that, we demonstrated the continuous dependency of solutions on both the initial values and fractional exponent $ \gamma $. The second section was devoted to examining the regularity of time. As a result, we found that, for each $ \Phi\in(0, \gamma-\frac{1}{2}) $, the solution to the considered problem has a $ \Phi- $H$ \ddot o $lder continuous version. Lastly, two examples that highlighted our findings were provided. The two main elements of the proof were the Burkholder-Davis-Gundy inequality and the weighted norm.
Overcrowding in emergency departments: strategies and solutions for an effective reorganization
Authors: Busti Chiara , Marchetti Roberto , Monti Manuel
Published: March 2024

Overcrowding in emergency departments (EDs) is a common and worldwide phenomenon, widely reported even by the non-specialist press. It contributes to a number of consequences that can affect both the number of resources available and the quality of care. Strategies to address this incriminating situation for patients, nurses, doctors, and hospital administrators are urgently needed. For this reason, and based on the input from the Ministry of Health, a series of projects and procedures have been developed in various Italian regions, aimed at reducing the waiting times and the diagnostic-therapeutic process of patients arriving in the ED. In this article, we will examine the main critical issues within EDs and discuss the most impactful strategies and solutions to manage these difficulties.
Brands of Gender and Acculturation in Immigration Process of Second World War Survivors in Southern Brazil
Authors: Krimberg von Muhlen Bruna , Neves Strey Marlene
Published: March 2024

This study focused on how a migration context drives changes in attitudes and identity. We investigate the process of acculturation of Jewish survivors of the Second World War who immigrated to South of Brazil decades ago. This is a complex immigration because the immigrants who survived the Second World War were more vulnerable to experience stress of acculturation since most of them lost their families, homes, and everything but their lives. This research consisted in a documentary and discourse analysis of interviews made with Jewish survivors’ immigrants performed by the Jewish Cultural Institute Marc Chagall in Porto Alegre, Brazil. As results we found that immigrants have gone through a process of acculturation in which their ethnic identity gradually acquired new brands from a new social construction from this international migration to Brazil.
Negative Acculturation Conditions, Wellbeing, and the Mediating Role of Separation in the Workplace
Authors: Jackson Leon , de Koker Dudley
Published: March 2024

This article reports on the results of research which assessed adverse acculturation conditions in the workplace. Acculturation conditions such as racism, discrimination, segregation and separation were evaluated as predictors to ascertain how they affect acculturation outcomes such as intentions to quit and ill-health, both physical and psychological, of workers in the workplace. A convenience sample (N = 327) was taken from various sectors, for example retail, banking, mining, police service, and the municipality. The study aimed to test the mediating role of separation in the relation between adverse acculturation conditions and wellbeing as measured by ill-health and intentions to quit. The results indicated that racism, discrimination, segregation and separation, ill-health and intentions to quit were positively related. The hypothesized model was confirmed in a structural equation modelling analysis. This meant that more mainstream segregation demands, discrimination, and subtle racism, coupled with a dominant ethnic separation acculturation strategy and co-ethnics demanding that their members keep to themselves at work (with limited or no intercultural contact), were associated with the experiences of higher physical and psychological ill-health, and frequent thoughts of intentions to quit. In addition, mainstream segregation demands, compared to subtle racism and discrimination, were much more strongly associated with ethnic preference to separate. Blacks reported higher segregation demands and discrimination experiences at work (conditions), an individual separation acculturation strategy and physical ill-health at work (outcomes) compared to Whites, although the effects were relatively small. Recommendations for future research are provided.
Laparoscopic drainage versus interventional radiology for management of appendicular abscess: a randomized controlled trial
Authors: Negm Said , Farag Ahmed , Allah Ehab A. , Abdelghani Amr A.
Published: March 2024

Background

Laparoscopic drainage of appendicular abscess has become a novel technique due to its advantages over interventional radiology like a complete exploration of the abdomen, exclusion of other pathologies, excision of the appendix at the same session, better cosmesis, decreased incidence of wound infection, better visualization of surgical field, fine handling of edematous tissue and drainage of multiple collections.

Patients and methods

This randomized controlled clinical trial included all patients who developed the manifestations of appendicular abscess and were referred to the Zagazig University Hospital Emergency Department between January 2020 and February 2022. The study was prospectively approved by the Zagazig University Faculty of Medicine Institutional Review Board (Approval Number: 9871/26-9-2022), and was retrospectively submitted to clinicaltrials.gov in June 2022 (ClinicalTrials.gov ID: NCT05419440). The sample size was 172 patients divided into two equal groups, a laparoscopic group involved 86 patients (group 1) and an interventional radiology group involved 86 patients (group 2).

Results

Group 1 (laparoscopic drainage group) included 86 patients: 55.8% were males, with a mean age of 41.2 SD 12.2 years-old, while group 2 (interventional radiology group) included 86 patients: 51.2% were males, with a mean age of 36.8 SD 10.9 years-old. The incidence of reported complications in group (1) was 1 (1.2%) for bowel injury, 3 (3.5%) for fecal fistula, 0 (0%) for recurrence, 0 (0%) for pelvic collection and 0 (0%) for mortality while in group (2) were 5 (5.8%) for bowel injury, 0 (0%) for fecal fistula, 3 (3.5%) for recurrence, 8 (9.3%) for pelvic collection and 1 (1.2%). The incidence rates of quality of life in group (1) were 48 (55.8%) for excellent quality of life, 38 (44.2%) for good quality of life and 0 (0%) for poor quality of life, unlike group (2), the incidence rates of quality of life were 12 (14%) for excellent quality of life, 59 (68.6%) for good quality of life and 15 (17.4%) for poor quality of life.

Conclusion

Laparoscopic management of appendicular abscess was safely applied in a good experienced hand without the need for interval appendectomy.
Evaluation of the impact of breast-conserving surgery on cancer outcomes of multiple (multifocal or multicentric) ipsilateral breast cancer
Authors: Abdelfattah Mohamed F. , Elzohery Yasmine H.
Published: March 2024

Background

Breast conservative therapy (BCT) includes conservative breast surgery (CBS) with adjuvant radiotherapy and is now considered a standard treatment for early-stage breast cancer to achieve survival with acceptable aesthetic outcomes.

Management of multiple ipsilateral breast cancer (MIBC) is a challenge, since the choice of optimal surgical procedures is controversial. Recently, many breast surgeons have advocated CBS is technically feasible to safely excise MIBC in selected cases.

Aim

This study aimed to evaluate the outcome of MIBC patients who received CBS with special attention on local control and recurrence.

Patient and method

This retrospective study was carried out on 90 patients at Al Azhar University Hospital and Ain Shams University Hospitals between January 2021 and January 2023.

Results

The majority of patients 85 (94.4%) had two foci of disease while five (5.5%) patients had three foci. The distance between the lesions ranges between 0.5 and 6.5 cm. The most common type of CBS was wide local excision en bloc resection of all lesions with normal tissue in between was done in 85 (94.4%) patients and five (5.5%) patients had two separate incisions leaving normal tissue in between. Clear margins were reported in 79 (87.7%) patients. 15 (5.5%) patients had different pathological lesion types (heterogeneous). One patient had a recurrence and another had distant metastases.

Conclusion

With good patient selection, there is no difference between CBS and mastectomy in the management of MIBC. CBS is oncological safe provided that an adequate excision with clear margins followed by whole-breast radiation therapy and adjuvant systemic therapy.
Retrospective descriptive analysis of the demographic and clinicopathological presentation of breast cancer patients in Kasr Al-Ainy Hospital over 5 years
Authors: Mohammed Mahmoud A. , Mokhtar Sherif , Osama Esraa , Sherif Omar
Published: March 2024

Background

Breast cancer is the most common type of cancer and the second leading cause of mortalities among women. Early-stage diagnosis of breast cancer increases the chances of survival, and therefore, reduces mortality rates. A national initiative was implemented in Egypt in 2019 when women above the age of 18 years were granted free screening at 3538 healthcare units, and 114 hospitals nationwide.

Objective

To describe the sociodemographic factors and clinicopathological presentation of breast cancer among the patients presented to Cairo University Hospital over 5 years.

Patients and methods

We conducted a descriptive historical study at Kasr Al-Ainy Teaching Hospital of Cairo University, we retrospectively assessed all women with primary breast cancer diagnosed over 5 years during the period from the July 1, 2017 to the July 1, 2022. Data was collected from medical records, operative notes, radiology reports, and pathology reports from the database system of the Oncology Department of Cairo University Hospitals (Kasr Al-Ainy). The patient data is put into a spreadsheet that focuses on the demographic and clinicopathological characteristics of the patients (age, size of the tumor, side of breast affected, histopathology findings, imaging characteristics, immunohistochemistry, and TNM staging of breast cancer).

Results

We enrolled a total of 509 female patients who were screened for early detection of breast cancer during the past 5 years in general surgery, radio diagnosis, and oncology departments, Kasr Al-Ainy Teaching Hospital; they showed a mean age of 53.7±11.7 years and ranged between 26 and 88 years. In the current study molecular subtyping showed that 24.4% were Luminal A, 34% were Luminal B1, 19.4% were Luminal B2, 9.2% were HER2-enriched and 13% were triple-negative breast cancer subtype. We found that neoadjuvant therapy was prescribed for 190 (37.3%) patients, 36 (19%) of those patients achieved pCR, while the remaining patients had residual disease in the postoperative specimen.

Conclusion

We concluded that in our center, Egyptian females are diagnosed with breast cancer earlier compared with developed countries; however, the current study reports approximately the same percentages of molecular subtypes, rates of pCR, and metastatic disease at the time of presentation compared with developed countries.
Effect of laparoscopic mini gastric bypass versus laparoscopic single anastomosis sleeve ileal bypass on serum iron and calcium levels
Authors: Nawar Ahmed M. , Baumy Mostafa , Eid Ahmed , Mohamed Ayman T.
Published: March 2024

Background

Although bariatric surgery techniques are very effective in the treatment of obesity, they are usually associated with evident nutritional deficiencies. Such operations require ongoing medical care along with vitamin (Vit) and nutrition supplements.

Aim

Is to determine and compare the effect of Laparoscopic mini gastric bypass (MGB) versus laparoscopic single anastomosis sleeve ileal bypass (SASI) on serum iron and calcium levels.

Methodology

The current prospective Randomized controlled study included 62 patients who were randomly allocated into one of two equal groups. Group A (n=31) underwent MGB while group B (n=31) underwent SASI. Follow-up was designed for 6 and 12 months in both groups for the serum iron profile, serum folate, Vit B12, Vit D, parathyroid hormone, and calcium level.

Results

There was a statistically significant decrease in Excess weight loss (EWL)% in both groups after 1, 6, and 12 months and a significant EWL % in group A more than group B (P=0.045*). There was a statistically significant drop in the Iron profile components’ levels in both groups after 1, 6, and 12 months in comparison with the corresponding baseline levels. There was a statistically significant decrease in the calcium level as well as Vit D3 within both groups at 1, 6, and 12 months follow-up with a significant increase in Parathyroid hormone in both groups at the same interval of follow-up.

Conclusion

Both MGB and SASI are effective methods for the treatment of morbid obesity. However, adherent follow-up for the Iron profile, Vit B12, Vit D3, parathyroid hormone, and calcium levels are mandatory.
The role of renal parenchyma to hydronephrosis area ratio in the evaluation of ureteropelvic junction obstruction in children
Authors: Abuelnaga Mohamed , Kotb Youssef , Mohamed Waleed , Elawady Hossam , Mostafa Diaa
Published: March 2024

Purpose

For the initial assessment and follow-up of patients with ureteropelvic junction obstruction (UPJO), we conducted this prospective study to assess the renal parenchyma to hydronephrosis area ratio (PHAR) in conjunction with the renal scan in patients who will undergo pyeloplasty.

Patients and methods

Patients who had visited the outpatient clinic for 2 years were diagnosed with UPJO, and fit the requirements for requiring surgical intervention were chosen. Before pyeloplasty and 3 months after surgery, PHAR and a renal isotope scan were conducted concurrently.

Results

Thirty-six patients were evaluated. After the operation, 31 (86.1%) cases improved and five (13.9%) cases did not improve. There was a significant change in all parameters at 3 months postoperatively as the mean T½ has significantly decreased (25.22±2.49 vs. 17.57±3.84). Also, there was a significant increase in the mean parenchymal thickness (9.42±4.92 vs. 15.12±4.86), glomerular filtration rate of the affected kidney (34.31±3.31 vs. 48.32±6.99) split renal function (37.30±3.80 vs. 44.03 ±4.11) and PHAR (0.86±0.30 vs. 2.45±0.93) at 3 months postoperative. PHAR postoperatively shows a positive correlation with parenchymal thickness, glomerular filtration rate of the affected kidney, and renal split function, while there is a negative correlation with T½.

Conclusion

PHAR is a potential noninvasive measure that may be evaluated during ultrasonography assessment to aid in predicting future surgical needs for UPJO and for postpyeloplasty follow-up in pediatric patients.
Outcomes of revisional surgery for stenosed hepaticojejunostomy procedures
Authors: Fadel Bashir A. , Ibraheem Tameem , Hassan Waleed A. , Mohammed Amira E. , Moubark Mahmoud , Elrazik Mahoud H.E.A.
Published: March 2024

Background

Although hepaticojejunostomy provides durable and efficient access for bilioenteric continuity, it is not free from complications, as stenosis could occur in 25% of cases. Radiologically guided interventions are the best options for managing stenosed anastomoses. However, about 30% of stenosed patients show failure. Thus, surgical intervention (redo) is a must in such circumstances. Herein, we describe the outcomes of redo surgery for patients diagnosed with stenosed hepaticojejunostomy after failed radiological interventions.

Patients and methods

During the study period, we encountered 52 patients with stenosed hepaticojejunostomy, from whom 20 cases showed failed radiological intervention, and they were enrolled in our study, and their data were collected and retrospectively reviewed.

Results

The primary procedure was performed for cholecystectomy-related biliary injury (80%), choledochal cyst (15%), and as a step of the Whipple procedure (5%). All patients presented with jaundice, while 25% of them had cholangitis. Radiological assessment showed Bismuth class I, II, III, and IV in 20, 45, 25, and 10%, respectively. The time interval between the primary and the redo procedure ranged between 6 months and 5 years. Operative time ranged between 110 and 150 min, and hospital stay ranged between 4 and 10 days. Postoperative complications included bile leakage (5%), pulmonary embolism (5%), wound infection (20%), and incisional hernia (10%). No patients developed restenosis during the follow-up period. History of cholangitis was a significant risk factor for postoperative morbidity.

Conclusion

Revisional procedures for stenosed hepaticojejunostomy are considered safe and efficacious. The safety is manifested in the accepted complication rate, while the efficacy is manifested in the excellent success rate. However, it should be preserved only for patients with failed radiological interventions.
Giant Coronary Artery Aneurysm Associated with Extraluminal Migration of Stent: Role of Multimodal Imaging
Authors: Shukla Madhu , Mohan Jagdish Chander
Published: March 2024

Extraluminal migration of a drug-eluting intracoronary stent into pericardial space with or without aneurysm formation is a rare complication. It is usually symptomatic although rare asymptomatic cases have been described. Herein, we report a 49-year-old male who presented with atypical chest pain 9 years after intracoronary stent implantation in the right coronary artery and the ramus intermediate branch. Echocardiographic examination showed a 7.4 cm × 3.8 cm large oblong cystic mass along the lateral wall of the left ventricle with inward bulging of the adjacent segments. Computed tomography and invasive coronary angiography showed this mass to be a partly thrombosed giant oblong coronary aneurysm arising from the bifurcation of the left main coronary artery with extraluminal migration of the stent from the ramus branch.
Ex vivo liver resection and auto-transplantation and special systemic therapy in perihilar cholangiocarcinoma treatment
Authors: Tchilikidi Konstantin Y
Published: March 2024

This editorial contains comments on the article “Systematic sequential therapy for ex vivo liver resection and autotransplantation: A case report and review of literature” in the recent issue of World Journal of Gastrointestinal Surgery . It points out the actuality and importance of the article and focuses primarily on the role and place of ex vivo liver resection and autotransplantation (ELRAT) and systemic therapy, underlying molecular mechanisms for targeted therapy in perihilar cholangiocarcinoma (pCCA) management. pCCA is a tough malignancy with a high proportion of advanced disease at the time of diagnosis. The only curative option is radical surgery. Surgical excision and reconstruction become extremely complicated and not always could be performed even in localized disease. On the other hand, ELRAT takes its place among surgical options for carefully selected pCCA patients. In advanced disease, systemic therapy becomes a viable option to prolong survival. This editorial describes current possibilities in chemotherapy and reveals underlying mechanisms and projections in targeted therapy with kinase inhibitors and immunotherapy in both palliative and adjuvant settings. Fibroblast grow factor and fibroblast grow factor receptor, human epidermal growth factor receptor 2, isocitrate dehydrogenase, and protein kinase cAMP activated catalytic subunit alpha (PRKACA) and beta (PRKACB) pathways have been actively investigated in CCA in last years. Several agents were introduced and approved by the Food and Drug Administration. They all demonstrated meaningful activity in CCA patients with no global change in outcomes. That is why every successfully treated patient counts, especially those with advanced disease. In conclusion, pCCA is still hard to treat due to late diagnosis and extremely complicated surgical options. ELRAT also brings some hope, but it could be performed in very carefully selected patients. Advanced disease requires systemic anticancer treatment, which is supposed to be individualized according to the genetic and molecular features of cancer cells. Targeted therapy in combination with chemo-immunotherapy could be effective in susceptible patients.
Clinical study on the relationship between liver cirrhosis, ascites, and hyponatremia
Authors: Li Xuan-Ji , Meng Hui-Hui
Published: March 2024

BACKGROUND

Cirrhosis is a common liver disease, and ascites is one of the common clinical conditions. However, the clinical manifestations of ascites combined with hyponatremia as a high-risk condition and its relationship to patient prognosis have not been fully studied.

AIM

To explore the clinical manifestations, prognostic factors, and relationships of ascites with hyponatremia in patients with cirrhosis to provide better diagnostic and treatment strategies.

METHODS

In this study, we retrospectively analyzed the clinical data of 150 patients diagnosed with cirrhosis and ascites between 2017 and 2022. Patients were divided into two groups: ascites combined with hyponatremia group and ascites group. We compared the general characteristics, degree of hyponatremia, complications, treatment, and prognosis between the two groups.

RESULTS

In the study results, patients in the ascites combined with hyponatremia group showed an older average age (58.2 ± 8.9 years), 64.4% were male, and had a significantly longer hospitalization time (12.7 ± 5.3 d). Hyponatremia was more severe in this group, with a mean serum sodium concentration of 128.5 ± 4.3 mmol/L, which was significantly different from the ascites group of 137.6 ± 2.1 mmol/L. Patients with ascites and hyponatremia were more likely to develop hepatic encephalopathy (56.2% vs 39.0%), renal impairment (45.2% vs 28.6%) and infection (37.0% vs 23.4%). Regarding treatment, this group more frequently used diuretics (80.8% vs 62.3%) and salt supplements (60.3% vs 38.9%). Multiple logistic regression analysis identified older age [Odds ratio (OR) = 1.06, P = 0.025] and male gender (OR = 1.72, P = 0.020) as risk factors for hyponatremia combined with ascites. Overall, patients with ascites and hyponatremia present a clear high-risk status, accompanied by severe complications and poor prognosis.

CONCLUSION

In patients with cirrhosis, ascites with hyponatremia is a high-risk condition that is often associated with severe complications.
MH-STRALP: A scoring system for prognostication in patients with upper gastrointestinal bleeding
Authors: Hu Jun-Nan , Xu Fei , Hao Ya-Rong , Sun Chun-Yan , Wu Kai-Ming , Lin Yong , Zhong Lan , Zeng Xin
Published: March 2024

BACKGROUND

Upper gastrointestinal bleeding (UGIB) is a common medical emergency and early assessment of its outcomes is vital for treatment decisions.

AIM

To develop a new scoring system to predict its prognosis.

METHODS

In this retrospective study, 692 patients with UGIB were enrolled from two centers and divided into a training (n = 591) and a validation cohort (n = 101). The clinical data were collected to develop new prognostic prediction models. The endpoint was compound outcome defined as (1) demand for emergency surgery or vascular intervention, (2) being transferred to the intensive care unit, or (3) death during hospitalization. The models’ predictive ability was compared with previously established scores by receiver operating characteristic (ROC) curves.

RESULTS

Totally 22.2% (131/591) patients in the training cohort and 22.8% (23/101) in the validation cohort presented poor outcomes. Based on the stepwise-forward Logistic regression analysis, eight predictors were integrated to determine a new post-endoscopic prognostic scoring system (MH-STRALP); a nomogram was determined to present the model. Compared with the previous scores (GBS, Rockall, ABC, AIMS65, and PNED score), MH-STRALP showed the best prognostic prediction ability with area under the ROC curves (AUROCs) of 0.899 and 0.826 in the training and validation cohorts, respectively. According to the calibration curve, decision curve analysis, and internal cross-validation, the nomogram showed good calibration ability and net clinical benefit in both cohorts. After removing the endoscopic indicators, the pre-endoscopic model (pre-MH-STRALP score) was conducted. Similarly, the pre-MH-STRALP score showed better predictive value (AUROCs of 0.868 and 0.767 in the training and validation cohorts, respectively) than the other pre-endoscopic scores.

CONCLUSION

The MH-STRALP score and pre-MH-STRALP score are simple, convenient, and accurate tools for prognosis prediction of UGIB, and may be applied for early decision on its management strategies.
Early postoperative complications after transverse colostomy closure, a retrospective study
Authors: Liu Fei , Luo Xiao-Juan , Li Zi-Wei , Liu Xiao-Yu , Liu Xu-Rui , Lv Quan , Shu Xin-Peng , Zhang Wei , Peng Dong
Published: March 2024

BACKGROUND

Ostomy is a common surgery usually performed to protect patients from clinical symptoms caused by distal anastomotic leakage after colorectal cancer (CRC) surgery and perforation or to relieve intestinal obstruction.

AIM

To analyze the complications after transverse colostomy closure.

METHODS

Patients who underwent transverse colostomy closure from Jan 2015 to Jan 2022 were retrospectively enrolled in a single clinical center. The differences between the complication group and the no complication group were compared. Logistic regression analyses were conducted to find independent factors for overall complications or incision infection.

RESULTS

A total of 102 patients who underwent transverse colostomy closure were enrolled in the current study. Seventy (68.6%) patients underwent transverse colostomy because of CRC related causes. Postoperative complications occurred in 30 (29.4%) patients and the most frequent complication occurring after transverse colostomy closure was incision infection (46.7%). The complication group had longer hospital stays (P < 0.01). However, no potential risk factors were identified for overall complications and incision infection.

CONCLUSION

The most frequent complication occurring after transverse colostomy closure surgery in our center was incision infection. The operation time, interval from transverse colostomy to reversal, and method of anastomosis might have no impact on the postoperative complications. Surgeons should pay more attention to aseptic techniques.
Inflammatory responses in esophageal mucosa before and after laparoscopic antireflux surgery
Authors: Ergun Pelin , Kipcak Sezgi , Selvi Gunel Nur , Yildirim Sozmen Eser , Bor Serhat
Published: March 2024

BACKGROUND

Currently, the primary treatment for gastroesophageal reflux is acid suppression with proton pump inhibitors, but they are not a cure, and some patients don’t respond well or refuse long-term use. Therefore, alternative therapies are needed to understand the disease and develop better treatments. Laparoscopic anti-reflux surgery (LARS) can resolve symptoms of these patients and plays a significant role in evaluating esophageal healing after preventing harmful effects. Successful LARS improves typical gastroesophageal reflux symptoms in most patients, mainly by reducing the exposure time to gastric contents in the esophagus. Amelioration of the inflammatory response and a recovery response in the esophageal epithelium is expected following the cessation of the noxious attack.

AIM

To explore the role of inflammatory biomolecules in LARS and assess the time required for esophageal epithelial recovery.

METHODS

Of 22 patients with LARS (pre- and post/5.8 ± 3.8 months after LARS) and 25 healthy controls (HCs) were included. All subjects underwent 24-h multichannel intraluminal impedance-pH monitoring and upper gastrointestinal endoscopy, during which esophageal biopsy samples were collected using endoscopic techniques. Inflammatory molecules in esophageal biopsies were investigated by reverse transcription-polymerase chain reaction and multiplex-enzyme-linked immunosorbent assay.

RESULTS

Post-LARS samples showed significant increases in proinflammatory cytokines [interleukin (IL)-1β, interferon-γ, C-X-C chemokine ligand 2 (CXCL2)], anti-inflammatory cytokines [CC chemokine ligand (CCL) 11, CCL13, CCL17, CCL26, CCL1, CCL7, CCL8, CCL24, IL-4, IL-10], and homeostatic cytokines (CCL27, CCL20, CCL19, CCL23, CCL25, CXCL12, migration inhibitory factor) compared to both HCs and pre-LARS samples. CCL17 and CCL21 levels were higher in pre-LARS than in HCs (P < 0.05). The mRNA expression levels of AKT1, fibroblast growth factor 2, HRAS, and mitogen-activated protein kinase 4 were significantly decreased post-LARS vs pre-LARS. CCL2 and epidermal growth factor gene levels were significantly increased in the pre-LARS compared to the HCs (P < 0.05).

CONCLUSION

The presence of proinflammatory proteins post-LARS suggests ongoing inflammation in the epithelium. Elevated homeostatic cytokine levels indicate cell balance is maintained for about 6 months after LARS. The anti-inflammatory response post-LARS shows suppression of inflammatory damage and ongoing postoperative recovery.
Link between mutations in ACVRL1 and PLA2G4A genes and chronic intestinal ulcers: A case report and review of literature
Authors: Tang Yong-Jing , Zhang Jian , Wang Jie , Tian Ren-Dong , Zhong Wei-Wei , Yao Ben-Sheng , Hou Bing-Yu , Chen Ying-Hua , He Wei , He Yi-Huai
Published: March 2024

BACKGROUND

Genetic factors of chronic intestinal ulcers are increasingly garnering attention. We present a case of chronic intestinal ulcers and bleeding associated with mutations of the activin A receptor type II-like 1 (ACVRL1 ) and phospholipase A2 group IVA (PLA2G4A ) genes and review the available relevant literature.

CASE SUMMARY

A 20-year-old man was admitted to our center with a 6-year history of recurrent abdominal pain, diarrhea, and dark stools. At the onset 6 years ago, the patient had received treatment at a local hospital for abdominal pain persisting for 7 d, under the diagnosis of diffuse peritonitis, acute gangrenous appendicitis with perforation, adhesive intestinal obstruction, and pelvic abscess. The surgical treatment included exploratory laparotomy, appendectomy, intestinal adhesiolysis, and pelvic abscess removal. The patient’s condition improved and he was discharged. However, the recurrent episodes of abdominal pain and passage of black stools started again one year after discharge. On the basis of these features and results of subsequent colonoscopy, the clinical diagnosis was established as inflammatory bowel disease (IBD). Accordingly, aminosalicylic acid, immunotherapy, and related symptomatic treatment were administered, but the symptoms of the patient did not improve significantly. Further investigations revealed mutations in the ACVRL1 and PLA2G4A genes. ACVRL1 and PLA2G4A are involved in angiogenesis and coagulation, respectively. This suggests that the chronic intestinal ulcers and bleeding in this case may be linked to mutations in the ACVRL1 and PLA2G4A genes. Oral Kangfuxin liquid was administered to promote healing of the intestinal mucosa and effectively manage clinical symptoms.

CONCLUSION

Mutations in the ACVRL1 and PLA2G4A genes may be one of the causes of chronic intestinal ulcers and bleeding in IBD. Orally administered Kangfuxin liquid may have therapeutic potential.
Mechanical Strength, Characterization and Suitability of Cement-Plastic Concrete Admixture
Authors: Abubakar S. A. , Hamzat A. O. , Akpenpuun T. D.
Published: March 2024

A significant increment in the consumption of plastic has been monitored globally in recent years, which has led to a high amount of plastic waste. Given its benefits on both an economic and ecological level, recycling plastic waste to create new materials like concrete is considered to be one of the finest ways to get rid of plastic waste. The objective of this paper was to examine the workability, durability, and mechanical strength of concrete with partial replacement of coarse aggregates with plastic waste using standard procedure. The percentages of plastic waste used to replace coarse aggregate were 0%, 5%, 10%, and 15%. Lastly, the mechanical characteristics of the concrete mix specimens was determined by testing them using a testometric and compressor machine.  The specimens are then compared with the conventional mix. The test results demonstrated that the compressive strength exhibited a decreasing trend. For mixes ranging from 0% to 15%, the compressive strength varies from 35.66 to 17.88 N/mm2, however the flexural strength significantly decreases when 15% of the coarse aggregate is replaced with plastic waste. It can be concluded that reusing plastic waste as an aggregate during the concrete-making process reduces waste and conserves resources.