bluuebunny/crossref_metadata_2025 huggingface dataset:
Emotional Display Rules of Visually and Hearing Impaired Students
Authors: Ghosh Anjali
Published: March 2024

The objective of the study is to understand the pattern of emotional display rules of visually and hearing impaired students towards different members of the society under two different situations i.e., private and public. This is to be studied for three emotions namely, happiness, sadness and anger. The Display Rule Assessment Inventory of Matsumoto Yoo, Hirayama, and Petrova (2005) was administered on all the participants. The overall expression of emotions varied from target person to target person and also from situation to situation. “Happiness” was observed to be expressed more by visually impaired than hearing impaired students towards parents, friends and teachers in private context. However, overall expression of anger was found to be more for hearing – impaired students. ANOVA results indicate significant main effect of context or situation on overall expression of both positive and negative emotions. The study indicates that impaired individuals like the normal individuals regulate both positive and negative emotions depending upon the target person and social situation.
High Prevalence of Dissociative Amnesia and Related Disorders in Immigrated People
Authors: Staniloiu Angelica , Markowitsch Hans
Published: March 2024

Across various cultures, dissociative amnesic disorders have been shown to be triggered by psychological stress or trauma. In immigrant populations, stressful experiences can arise during pre-emigration, migration or post-migration phase. Preliminary data suggest that stresses related to various phases of migration and acculturation could trigger dissociative amnesic disorders via a dysregulation of hormonal stress responses. These findings are highly relevant in the era of increased globalization and call for culturally sensitive approaches, in order to accurately diagnose and optimally manage these conditions in the future.
A narrative review of intravascular catheters in therapeutic hypothermia
Authors: Gao Yuan , Li Ming , Jiang Miaowen , Zhang Yang , Ji Xunming
Published: March 2024

Therapeutic hypothermia (TH) has been regarded as a promising neuroprotective method for acute ischemic stroke (AIS) for decades. During the development of TH, most researchers focused on improving hypothermic benefits by optimizing treatment processes and conditions. Intravenous thrombolysis and endovascular thrombectomy, for instance, have been introduced into AIS treatment. However, the lack of specialized intervention consumables, especially intervention catheter, led to inaccurate and uncontrolled hypothermic temperature, limited the efficacy of TH. In this review, intervention catheters as well as accessory equipment utilized in TH treatment has been summarized. Hopefully, this review may inspire the future development of TH specialized intervention catheter, enhance the outcome of TH, and neuroprotective efficacy in AIS.
Overt nickel and cobalt hypersensitivity after pipeline embolization device placement: A case report
Authors: Martio Artur Eduardo , Kieling Daniel Marchi , Manzato Luciano Bambini , Vanzin José Ricardo
Published: March 2024

Nickel and cobalt are frequently found in metallic alloys used in the manufacture of aneurysm clips and endovascular prostheses, such as the pipeline embolization device (PED). Nickel hypersensitivity can affect up to 15% of the population, however, it is very rarely overt in patients who undergo endovascular stent placement. Here, we present the case of a 35-year-old woman who developed allergic symptoms after PED placement and was later confirmed to be allergic to both nickel and cobalt by patch testing. Fortunately, she responded well to pharmacologic treatment, rendering surgical intervention unnecessary. To the best of our knowledge, this is the first report of symptomatic nickel hypersensitivity, and the second report of symptomatic cobalt allergy caused by the PED. Despite its low prevalence, we believe that surgeons should actively inquire patients in the postoperative period about allergic symptoms, to facilitate early diagnosis and treatment.
Safety and feasibility of cystic artery control with bipolar electrocauterization during laparoscopic cholecystectomy
Authors: Madany Mohie El-Din M. , Kabbash Mansor M. , Abdallah Hassan A.
Published: March 2024

Background

Securing the cystic artery in laparoscopic cholecystectomy can be achieved with clips, electrocautery, and ultramodern vessel-sealing energy devices. Bipolar electrocoagulation of cystic artery is safe and a cost-effective measure in developing countries.

Patients and methods

The rationale of this current prospective study was to establish the safety and feasibility of bipolar electrocautery in securing cystic artery during laparoscopic cholecystectomy in the local setting. Patients who were eligible for laparoscopic cholecystectomy at the Aswan University Hospital’s General Surgery Department were included.

Results

One hundred twenty patients were included in our study. Most of the participants were females, representing 93.33% of patients. The mean age of participants was 39.93±9.97 years, and 95.83% were overweight or obese. The mean±SD operative time was 88.57±28.06 min, and the median (interquartile range) was 84 min (33.25 min). Also, the mean±SD hospital stay was 1.12±0.57 days, and the median (interquartile range) was 1 (0) day. There was no intraoperative bleeding from the cystic artery nor from the right hepatic artery. No visceral injury was encountered. The success rate of the operation was 100%. None needed to be redone. No case needed conversion to open surgery.

Conclusion

In conclusion, in resource-constrained settings where the harmonic scalpel and all advanced bipolar instruments like ENSEAL and Legasure raise issues regarding cost and accessibility, bipolar diathermy is effective in hemostatic control of the cystic artery during laparoscopic cholecystectomy.
Microwave versus endovenous laser in great saphenous vein ablation: a randomized controlled clinical study
Authors: Abd-Allah Tamer E. , Abdelbary Mostafa S. M. , Zekri Mina G. , El-Awady Karim S. M.
Published: March 2024

Background

Due to the global burden of varicose veins (VVs) and the impact on the quality of life (QoL) of patients, it is essential to search for better treatment modalities.

Objectives

The main objective of this research was to compare the efficacy, safety, and impact on the QoL of endovenous microwave ablation (EMA) and endovenous laser ablation (EVLA) for the management of varicose veins of the great saphenous vein (GSV).

Methods

A comparative, multicenter, single-blinded, parallel randomized controlled study conducted on 340 patients confirmed to have primary VVs of the GSV who were further randomized into two groups. The study group (n=170) received EMA, and the control group (n=170) received EVLA.

Results

Both the study group and the control group were comparable with regard to their baseline characteristics (P values > 0.05). The study group and the control group were comparable with regard to the limb affected (P=0.184). Only 14.7% and 10.0% of the study group and the control group have both limbs affected. Both the study group and the control group were comparable with regard to CEAP classification (P=0. 068). The study group and the control group were significantly different with regard to operating time (P<0.001).

The operating time is less in the study group than in the control group. The median (IQR) and the mean±SD of the operating time was 7 (4) and 8.7±4.1 min in the study (microwave) group and 9 (5) and 10±3.9 min in the control group. Also, the study group and the control group showed 100% success at the 1-week evaluation as none of the cases in both groups suffered recanalization. At 6-month evaluation, only 1 case in the study group and 2 cases of the control group experienced recanalization; however, the difference is not significant (P=0.537). At the 12-month evaluation, the study group and the control group showed 100% success as none of the cases in both groups suffered recanalization.

QoL is better in the study group than the control group at 6 months Aberdeen score (P=< 0.001). The median IQR and the mean±SD of the postoperative Aberdeen score were 9 (2.7) and 9.3±1.7 in the study (microwave) group and 10.8 (3.4) and 10.8±1.8 in the control group. Moreover, the study group and the control group were comparable (P values > 0.05) with regard to adverse events except for paresthesia (P-value = 0.025). About 11.2% of the control group experienced paresthesia versus only 2.9% of the study group.

Conclusion

In conclusion, EMA has a lower operating time than EVLA. EMA is as effective as EVLA for treating VVS of the GSV. EMA has fewer adverse events than EVLA. EMA has better QoL than EVLA ablation. However, the choice of treatment should be based on individual patient characteristics and the expertise of the treating physician.
Shoulder dysfunction after partial mastectomy and mini-latissimus dorsi or thoracodorsal artery perforator flaps for breast cancer according to the type of axillary surgeries
Authors: Gheda Ahmed A. , Ismail Khalid A. , Ismail Taha A. , Elnahas Waleed , ELdamshety Osama , Ali Reda F.
Published: March 2024

Background

Breast cancer is the most common cancer type among women and can lead to death. Over the past few decades, there has been a significant change in the surgical management of breast cancer. The aim of this study is to assess how shoulder function was affected by reconstruction using latissimus dorsi mini flap (LDMF) and thoracodorsal artery perforator (TDAP) flaps following partial mastectomy according to surgeries to axilla.

Patients and methods

This was a prospective randomized study carried out on 40 consecutive female patients, complaining of early stages of breast cancer (stages I, II), undergo partial breast resection and with small tumor to breast volume ratio. All patients were randomized into two equal groups. Group I: early breast cancer (stages I, II) who underwent mastectomy defect by either TDAP flap. Group II: early breast cancer (stages I, II) who underwent mastectomy LDMF. Axillary surgeries were done to each group either sentinel lymph node biopsy dissection (SLND) or axillary lymph node dissection (ALND).

Results

Shoulder mobility affection 6 months postoperative was significantly higher in LDMF group than TDAP flap group (P=0.045). Regarding relation between types of lymph node surgeries and shoulder mobility affection 3–6 months postoperative, shoulder mobility affection was significantly different among the four groups as affected although ALND and LDMF group was higher. Relation between types of lymph node surgeries and effect on shoulder mobility 6 months, shoulder mobility was normal in 16 (72.73%) patients in sentinel lymph node biopsy (SLNB) and in seven (38.89%) patients in ALND and effected in six (27.27%) patients in SLNB and in 11 (61.11%) patients in ALND. Regarding shoulder mobility, affection was significantly higher in ALND than SLNB (P=0.031).

Conclusions

The LDMF approach with ALND is with higher shoulder mobility affection in postoperative follow-up after partial mastectomy than LDMF with SLND, TDAP flap with ALND, and TDAP flap with SLND. According to the different types of axillary surgery, ALND had higher shoulder mobility affection.
Latissimus dorsi mini flap versus thoracodorsal artery perforator flap in reconstruction of partial mastectomy defects in early breast cancer: a prospective comparative study
Authors: Gheda Ahmed A. , Ismail Khalid A. , Ismail Taha A. , Hamed Emadeldeen , Ali Reda F. , ELdamshety Osama
Published: March 2024

Background

Breast cancer is the most common cancer type among women and can lead to death. The surgical management of breast cancer has witnessed a considerable evolution in the past few decades. The aim was to compare the thoracodorsal artery perforator (TDAP) flap with the latissimus dorsi (LD) mini flap in the reconstruction of outer quadrants partial mastectomy defects in early breast cancer patients regarding feasibility, cosmesis, postoperative complications, and early musculoskeletal functional outcome.

Patients and methods

A prospective randomized study was carried out on 40 consecutive female patients complaining of early breast cancer (stages I, II), undergoing partial breast resection (lumpectomy or quadrantectomy with axillary lymph node dissection), and with a small tumor to breast volume ratio. All patients were randomized into two equal groups in a parallel manner by computer-generated numbers, and their allocation code was kept in a closed opaque envelope: group I: early breast cancer (stages I, II) who underwent mastectomy defect by either TDAP flap. Group II: early breast cancer (stage I, II) who underwent mastectomy the LD mini flap.

Results

Operation time, drain removal, and hospital stay were significantly lower in LD mini-flap group than TDAP flap group (P=0.032, P<0.05, respectively). Complications and reoperation were insignificantly different between the two groups. Shoulder mobility 6 months and breast scar satisfaction was significantly higher in LD mini-flap group than TDAP flap group (P=0.045 and 0.009, respectively). Breast scar satisfaction and total score of satisfaction were significantly higher in LD mini-flap group than TDAP flap group (P<0.05). Time of adjuvant therapy (first cycle) was insignificantly different between both groups.

Conclusions

In early breast cancer patients, the LD mini flap is a superior technique to TDAP as it had lower operation time, short hospital stays, drain removal, breast scar satisfaction, and total score of patient satisfaction but with high shoulder mobility affection.
Optional management of failed endovascular intervention for infrainguinal arterial occlusive disease
Authors: Shaker Ahmed A. , Mawla Hany A. , Ghoneim Baker M. , Tawfik Ahmed R.
Published: March 2024

Introduction

Endovascular treatment is increasingly chosen as the first option for treating infrainguinal peripheral arterial disease. Although open surgical bypass provides the most durable option for limb salvage, it has substantial morbidity and mortality.

Aim

The aim of the study is to determine the causes of failure of endovascular intervention and treatment modalities of failed endovascular intervention and results of each modality.

Patients and methods

A prospective case series study that addresses the outcomes of managing 40 patients with chronic limb ischemia due to femoropopliteal disease treated by endovascular intervention, and the intervention was failed. Causes of failure within 30 days were analyzed.

Results

We had 13 (27.5%) females and 27 (72.5%) males; their age ranged from 45 to 77 years with a mean of 62.20±7.44. Presentation with rest pain: three (7.5%) patients, minor tissue loss: 18 (45%) patients, major tissue loss: 19 (47.5%) patients the length of lesion was between 5 and 10 cm in three (7.5%) patients and more than 10 cm in 37 (92.5%) patients. Runoff in anterior tibial artery: 23 (57.5%) patients, posterior tibial artery: 19 (47.5%) patients, and peroneal artery: 15 (37.5%) patients. We had no complications in 26 (65%) patients, failure to pass in 12 (30%) patients, and distal embolization in two (5%) patients as intraprocedural complications. During the 30-day follow-up: Acute stent thrombosis in 7 (17.5%) cases, flow-limiting dissection in 8 (20%) cases, residual stenosis in 3 (7.5%) cases, acute thrombosis in 2 (5%) cases, missed iliac lesions in 2 (5%) cases, post-procedural distal arterial tree embolization in 2 (5%) cases, and clinical failure was the cause in 2 (5%) cases. The management was: Redo endovascular in 18 (45%) patients, surgical bypass in 14 (35%) patients, primary amputation in six (15%) patients, and medical treatment in two (5%) patients. After 6 months follow-up limb salvage was in 57.5% of the cases with transmetatarsal amputation in 69.6% of them and major amputation was in 42.5% of the cases

Conclusion

Failed endovascular intervention procedures within 30 days were associated mainly with long lesions. So, surgical bypass appeared to be superior to endovascular intervention for long lesions. Improvements in endovascular equipment and angioplasty technique might ultimately improve the outcome results and decrease the failure rate of endovascular interventions
Carbon nanoparticles versus patent blue dye for detection of sentinel lymph node in patients with early breast cancer
Authors: Elsebaai Mahmoud R. M. , Shehab Mohamed A. H. , Hanafy Dina M. , Abd Al Moaty Karim F.
Published: March 2024

Background

Sentinel lymph nodes biopsy (SLNB) has replaced axillary lymph node dissection (ALND) in a considerable percentage of patients with early-stage breast cancer which was a great advance in preventing many surgical complications and enhancing their health welfare. Although there are different sentinel lymph nodes (SLNs) tracers with different identification rates, there is no agreement about the idealistic method.

Aim

The study was designed to compare carbon nanoparticles and patent blue v dye regarding SLNs detection rate, number of SLNs, time of detection, metastatic SLNs, cost, and safety in patients with early breast cancer and clinically node-negative axilla.

Patients and methods

A total of 40 patients with axillary lymph node-negative early-stage breast cancer patients were divided into two groups and subjected to carbon nanoparticles and patent blue V dye in group A and group B, respectively. Patients who were pregnant or lactating had node-positive axilla (N1-3) or metastatic breast cancer (M1) or had neoadjuvant chemotherapy were excluded.

Results

The mean age was 48.3±9.5 and 47 ±8.9, while the mean BMI of 33.3±4.8 and 32.834±4.862, the SLN detection rates were 95% and 90% in groups A and B, respectively. A total of 128 sentinel lymph nodes (SLNs) were removed from patients in the two groups (65 with Carbon Nanoparticles and 63 with patent blue dye). The mean number of SLNs was 3.4±0.7 (range, 2–5) and 3.5±1.2 (range, 2–7), mean time of SLNs detection was 13.5±4.5 (range, 7–22) and 12.7± 3.6 (range, 7–18 min) between group A and B, respectively.

Conclusion

There is no significant difference between carbon nanoparticles and patent blue dye regarding axillary SLNs in early breast cancer regarding identification rate, number of SLNs, time of detection, metastatic SLNs, cost, and safety with slight preference to carbon nanoparticles regarding postoperative skin staining and Egyptian market availability.
Effects Of Single Anastomosis Sleeve Ileal (SASI) Bypass on Morbid Obese Patients with Metabolic Syndrome
Authors: Abdelrahman Emad M. , Elgohary Hussein , Kharoub Mohamed S. , Diab Abdallah H. , Elsayed Mohamed A.
Published: March 2024

Background

Metabolic syndrome (MetS) is a silent epidemic that is a major global public health concern. Bariatric surgery is an approved treatment for obesity where weight reduction is crucial for the control of metabolic syndrome. This study aimed to report our institutional experience in the effect of single anastomosis sleeve ileal (SASI) on metabolic syndrome.

Patients and methods

The current prospective study included 50 Morbid Obese Patients with MetS who were eligible for SASI. Follow-up was planned for 1 year.

Results

The mean age of patients was 41.56±6.32 years. The mean % EWL was 56.94±4.65 and 83.16±8.09 at 6 and 12 months, respectively. HbA1c showed significant improvement which decreased from 8.34±1.23 to 5.04±0.38 after 1 year follow-up. Triglycerides (mg/dl) and LDL-C (mg/dl) show significant reduction at 6 months and 1 year postoperative from 177.48±30.95 preoperative to 131.98±17.65 and 104.10±14.03 for Triglycerides, and from 180.76±21.04 preoperative to 104.64±7.13 and 77.56±8.93 for low density lipoprotein-C (LDL-C) (<0.001). HDL-C (mg/dl) showed a significant increase from 40.44±10.93 preoperative to 49.58±8.71 and 57.96±6.64 (<0.001). As regards the blood pressure; mean arterial pressure showed a significant decrease from a baseline of 103.38±11.38 to 88.36±5.72 at 6 months and to 74.46±5.83 at 1 year of follow-up.

Conclusion

As demonstrated by this study, all MetS characteristics significantly improved following the SASI bypass treatment.
Accuracy of positron emission tomography-computed tomography in the assessment of metabolically negative axillary lymph nodes in breast cancer
Authors: Salama Ahmed M. F. , Swilem Mohamed R. , Zidan Ahmed , Sherif Mohamed F. , Nawar Ahmed M.
Published: March 2024

Background

Breast cancer is a significant public health concern, and early detection of breast lesions is crucial for improved patient outcomes. Accurate assessment of axillary lymph node involvement in breast cancer is vital for staging and treatment decisions. The purpose of this study was to assess to what extent positron emission tomography (PET)-computed tomography (CT) can be used in the assessment of negative axillary lymph nodes in breast cancer and to determine if pathological variability can affect the result of the PET-CT.

Patients and methods

This prospective study was carried out on 50 female patients with locally advanced breast cancer and with negative PET-CT scans for active axillary lymph nodes. All studied cases underwent postoperative pathological examination to be compared with preoperative PET-CT results.

Results

Of the studied cases, 84% showed negative axillary lymph node involvement. PET/CT exhibited high sensitivity (95.24%) and specificity (87.5%) in predicting positive nodes, with an axillary maximum standardized uptake value cutoff value of 4.22 (area under the curve=0.923). Logistic regression revealed a significant association between higher T stage and positive lymph nodes (P<0.05).

Conclusion

PET/CT demonstrates strong predictive accuracy in detecting metabolically negative axillary lymph nodes in breast cancer patients.
Efficiency of the new modified inverted Y cleft lift advancement flap in primary and recurrent sacrococcygeal pilonidal sinus disease with low-lying tracts near the anus
Authors: Elshazly Walid G. , Radwan Ahmed , Elhalim Mohmed A. , Moaz Ahmed
Published: March 2024

Propose

This study aimed to assess the efficiency of the new modified inverted Y cleft lift procedure, utilizing an advancement flap technique with off-midline primary wound closure for patients with lower pits of the sinus near the anus.

Patients and methods

This prospective case series was conducted from September 2018 to September 2020. Forty patients with sacrococcygeal pilonidal sinus disease with lower pits near the anus presented either as new cases or recurrent cases. All patients were offered the new modified inverted Y cleft lift advancement flap procedure and were followed up for 48.5 months (range, 21–57 months). Patients were evaluated in terms of operation time, postoperative complications, recurrence rate, return-to-work time, and cosmetic satisfaction.

Results

The average age was 27.4 years (range, 16–52 years); 29 (72.5%) patients were male and 11 (27.5%) were female. The mean operating time was 25 min (range, 22–45 min) and the mean length of hospital stay was 0.8 days (range, 0.4–2 days). Primary healing occurred in 35 (87.5%) patients. Complete healing for complicated wounds (five patients) was achieved in an average of 21 (14–60) days. Two (5%) patients developed a superficial wound infection, four (10%) patients experienced a seroma, and five (12.5%) had partial dehiscence (some complications observed in the same patient). There was no case of deep infection, hematoma formation, or complete dehiscence.

Conclusion

This series proved that the new modification inverted Y cleft lift flap reconstruction is an effective operative procedure for primary and recurrent pilonidal sinus cases with pits located very close to the anus, associated with low complication and recurrence rates.

What does this paper add to the literature?

This paper discusses a new modification to the modified cleft lift procedure named the inverted Y flap procedure, achieving off-midline primary wound closure in patients with a difficult situation with lower pits of the sinus very close to the anus, for pilonidal disease either primary or recurrent.
Laser hemorrhoidoplasty procedure versus harmonic scalpel hemorrhoidectomy: a comparative study for the treatment of grades III and IV hemorrhoids
Authors: Loutfy Ehab , Elgohary Hatem , Elkashlan Mahmoud E. , Abdelrahman Mohamed G. , Omar Wael
Published: March 2024

Background

Hemorrhoids are one of the most commonly presented diagnoses of colorectal diseases. This study aimed to evaluate and compare the outcomes of laser hemorrhoidoplasty (LHP) and harmonic scalpel hemorrhoidectomy (HSH) in the management of grades III and IV hemorrhoids, focusing on some postoperative complications.

Patients and methods

A randomized, controlled, clinical trial involving 34 patients with grades III and IV hemorrhoids was conducted at the General Surgery Department, Faculty of Medicine, Helwan University, from June 2022 to March 2023. Ethical considerations were adhered to, and patients provided informed consent. The groups underwent either LHP or HSH, and comprehensive patient information was collected, including demographics and preoperative assessments. Postoperative care and follow-up evaluations assessed outcomes such as pain, bleeding, discharge, wound healing, incontinence, recurrence, and stenosis.

Results

Demographic distribution was similar between the LHP and HSH groups, with comparable operative times. Postoperative bleeding did not significantly differ between groups. HSH was associated with more early discharge, longer wound healing times, and significantly higher postoperative pain levels up to the third week. No significant differences were observed in stenosis, incontinence, or recurrence between the two groups.

Conclusion

Both HSH and LHP techniques were found to be safe and effective for managing hemorrhoids. LHP demonstrated advantages, including lower postoperative pain levels, reduced seromucous discharge, and faster wound healing compared with HSH. These findings provide valuable insights for clinicians in optimizing patient care during the management of hemorrhoids.
The ethics of “net-risk” pediatric research: views of institutional review board members and the US public
Authors: Wendler David , Schupmann Will , Li Xiaobai
Published: March 2024

Background

US regulations allow institutional review boards (IRBs) to approve “net-risk” pediatric research only when the risks are minimal or a minor increase over minimal. This study assessed whether IRB members agree with these risk limits and compared their views with those of US adults.

Procedure

An online survey was conducted for IRB members. The participants were randomized to one out of four studies, which pose increasing risks. They were asked to evaluate three versions of the assigned study that offer increasing potential social value.

Results

A total of 107 individuals met the inclusion criteria. Overall, 98% of the respondents indicated that net-risk pediatric research can be appropriate. Of the 77 respondents who passed the comprehension test, more than 90% indicated that a research blood draw can be appropriate. A majority endorsed a research bone marrow biopsy. Lastly, a majority supported somewhat greater risks when the study has high potential social value. The percentage of those who indicated that the specified research procedure was appropriate increased as the potential social value increased. Compared with US adults, the IRB members were more likely to think that net-risk pediatric research is appropriate when the risks are low but less likely when the risks are higher.

Conclusions

Most IRB members consider it appropriate to expose children to some research risks for the benefit of others. Moreover, a majority think that greater risks can be appropriate when the research has greater potential social value. These findings, together with similar findings from US adults, suggest that current regulations for pediatric research may be overly restrictive.
Total Knee Replacement in Nonambulant Patients: Osteoporosis, Severe Fixed Flexion Deformity, and Weak Extensor Mechanism “the Terrible Triad”
Authors: Metwaly Radwan G. , Zakaria Zeiad M.
Published: March 2024

Background:

Knee osteoarthritis is among the most disabling disorders in elderly. With delay in proper management, muscular weakness, progressive flexion deformity (FD), and disuse osteoporosis “the terrible triad” are serious consequences, which could be major obstacles for the planned total knee replacements (TKRs). High risk for iatrogenic fractures, difficult gap balancing and failure to promote the patient activity are common expectations.

Materials and Methods:

A retrospective analysis of all TKRs that were done in a university specialized unit between January 2015 and January 2021 searching for nonambulant-patients was done. Twenty-two replacements for 15 patients who were unable to walk at least 3 months before surgery were found. The median fixed FD (FFD) before anesthesia was 45°. Osteopenia was evident on X-rays and bone thickness intraoperatively. Quadriceps muscle strength was not more than grade four. The median preoperative functional KSS was 0°. The median preoperative WOMAC score was 90.63.

Results:

Twelve knees had remaining FFD 1 year after surgery with a median of 5°. Ten had iatrogenic fractures mostly affected the medial femoral condyle. One patient could not regain walking capability and 11 patients could not walk without assistance. The median postoperative functional KSS and WOMAC scores were 61 and 21.36, respectively.

Conclusion:

TKRs in nonambulant patients with evident terrible triad (muscle weakness, osteoporosis, and FFD) is a risky procedure. Common complications include iatrogenic fractures and inability to regain normal physical capabilities. Despite the magnificent improvement in function, we do not recommend performing TKRs in such patients without strict patient counseling with possible drawbacks.
Functional Outcomes of Arthroscopic Bankart Repair in Indian Population: A Systematic Review and a Meta-analysis
Authors: Kalia R. B. , Arora Manit , Paul Souvik , Chitten Jojin Jose
Published: March 2024

Introduction:

The past two decades have witnessed significant development in arthroscopic management for recurrent anterior shoulder instability. Currently, arthroscopic Bankart repair (ABR) is popular in the treatment of anterior shoulder instability. There is a dramatic rise in the number of orthopedic surgeons in India specializing in shoulder surgery and is believed to be secondary to the advancement in arthroscopic techniques and implants. However, there is a paucity of Indian literature on functional outcomes of ABR. The purpose of the current review is to better understand the functional outcomes of ABR in the Indian population.

Methods:

A search of major databases (Embase, Ovid Medline, Google Scholar, and Cochrane Library) was performed in April 2020. Reference lists of selected research articles were further screened in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion and exclusion criteria for analysis were used to generate the final list of studies.

Results:

A total of ten research studies were included in the final analysis representing a pooled patient population set of 391 patients. The mean age for patients across the studies was 27 years (range: 24–29) of age and the average number of dislocations before surgery was five (range: 0–14). The average follow-up period post-surgery was 20 months (range: 6–27 months). Among the functional scores, the average UCLA score improved from 22 (range: 18–30) at preoperatively to 32 (range: 31–35), and the mean Rowe score improved from an average of 27 (range: 24–63) preoperatively to 91 (range: 90–94) during the follow up duration. The average postoperative re-dislocation rate was 7% (range: 0%–10%).

Conclusion:

In the Indian population, ABR provides consistently good functional outcomes with a low postoperative re-dislocation rate, which is at par with the global data. Further studies with larger sample sizes and longer follow-ups are needed to validate these results.
Case Report of Absent Pulmonary Valve with Intact Interventricular Septum
Authors: Nagar Deendayal , Ul Ayoub Touseef , Koirala Satish , Awasthy Neeraj
Published: March 2024

Absent pulmonary valve syndrome is a rare cardiac malformation, usually associated with tetralogy of Fallot. Its presence with intact interventricular septum is even less common with case reports or very small series in the literature. We describe a case who presented with symptoms of right heart failure due to an absent pulmonary valve with severe pulmonary regurgitation and small atrial septal defect. Diagnostic evaluation revealed grossly dilated main pulmonary artery and rudimentary leaflets of the pulmonary valve with severe regurgitation. Ventricular septum was intact and there was no patent ductus arteriosus. Later, the patient underwent surgical prosthetic pulmonary valve implantation.
Cardiac Amyloidosis: Mutimodality Imaging for Diagnosis and Prognosis
Authors: Burkule Nitin J.
Published: March 2024

Cardiac amyloid cardiomyopathy (CM) is a rapidly progressive disease that is frequently underrecognized and frequently diagnosed late in a significant number of individuals suffering from heart failure. Cardiac amyloid infiltration resulting in myocardial hypertrophy and restrictive CM is primarily caused by the misfolding of precursor proteins such as transthyretin, light chain immunoglobulin, and apolipoprotein AI-IV. The utilization of echocardiography, cardiac magnetic resonance, and bone avid radiotracer scintigraphy are essential in establishing a reliable diagnosis and prognosis of cardiac amyloidosis in the majority of patients. However, in certain clinical scenarios, the use of cardiac or extracardiac biopsy is necessary. There are significant developments in the understanding of the pathobiology of amyloid formation, which has paved the way for the development of new-targeted therapies, specifically for transthyretin cardiac amyloidosis. Imaging techniques are developing to monitor quantitatively the progression and regression of cardiac and systemic amyloid infiltration.
Brain Tumor Detection based on Multiple Deep Learning Models for MRI Images
Authors: Kumar Gokapay Dilip , Mohanty Sachi Nandan
Published: March 2024

INTRODUCTION: Medical imaging techniques are used to analyze the inner workings of the human body. In today's scientific world, medical image analysis is the most demanding and rising discipline, with brain tumor being the most deadly and destructive kind of malignancy. A brain tumor is an abnormal growth of cells within the skull that disrupts normal brain function by damaging neighboring cells. Brain tumors are regarded as one of the most dangerous, visible, and potentially fatal illnesses in the world. Because of the fast proliferation of tumor cells, brain tumors kill thousands of people each year all over the world. To save the lives of thousands of individuals worldwide, prompt analysis and automated identification of brain tumors are essential.
OBJECTIVES: To design a enhanced deep learning model for brain tumor detection and classification from MRI analysis.
METHODS: The proposed models Densenet-121, Resnet-101 Mobilenet-V2 is used to perform the task of Brain tumor detection for multi- class classification.
RESULTS: The proposed models achieved an accuracy of up to 99% in our evaluations, and when compared to competing models, they yield superior results.
CONCLUSION: The MRI image collection has been used to train deep learning models. The experimental findings show that the Densnet-121 model delivers the highest accuracy (99%) compared to other models. The system will have significant applications in the medical field. The presence or absence of a tumour can be ascertained using the proposed method.
Existence of singular rotationally symmetric gradient Ricci solitons in higher dimensions
Authors: Hui Kin Ming
Published: March 2024

By using fixed point argument, we give a proof for the existence of singular rotationally symmetric steady and expanding gradient Ricci solitons in higher dimensions with metric
$g=\frac {da^2}{h(a^2)}+a^2g_{S^n}$
for some function h where
$g_{S^n}$
is the standard metric on the unit sphere
$S^n$
in
$\mathbb {R}^n$
for any
$n\ge 2$
. More precisely, for any
$\lambda \ge 0$
and
$c_0>0$
, we prove that there exist infinitely many solutions
${h\in C^2((0,\infty );\mathbb {R}^+)}$
for the equation
$2r^2h(r)h_{rr}(r)=(n-1)h(r)(h(r)-1)+rh_r(r)(rh_r(r)-\lambda r-(n-1))$
,
$h(r)>0$
, in
$(0,\infty )$
satisfying
$\underset {\substack {r\to 0}}{\lim }\,r^{\sqrt {n}-1}h(r)=c_0$
and prove the higher-order asymptotic behavior of the global singular solutions near the origin. We also find conditions for the existence of unique global singular solution of such equation in terms of its asymptotic behavior near the origin.
Constant term functors with $\mathbb{F}_{p}$-coefficients
Authors: Cass Robert , Pépin Cédric
Published: March 2024

We study the constant term functor for

\mathbb{F}_{p}

-sheaves on the affine Grassmannian in characteristic

p

with respect to a Levi subgroup. Our main result is that the constant term functor induces a tensor functor between categories of equivariant perverse

\mathbb{F}_{p}

-sheaves. We apply this fact to get information about the Tannakian monoids of the corresponding categories of perverse sheaves. As a byproduct we also obtain geometric proofs of several results due to Herzig on the mod

p

Satake transform and the structure of the space of mod

p

Satake parameters.
Rigidity of the ball for an isoperimetric problem with strong capacitary repulsion
Authors: Goldman Michael , Novaga Matteo , Ruffini Berardo
Published: March 2024

We consider a variational problem involving competition between surface tension and charge repulsion. We show that, as opposed to the case of weak (short-range) interactions where we proved ill-posedness of the problem in a previous paper, when the repulsion is stronger the perimeter dominates the capacitary term at small scales. In particular, we prove existence of minimizers for small charges as well as their regularity. Combining this with the stability of the ball under small 

C^{1,\gamma}

perturbations, this ultimately leads to the minimality of the ball for small charges. We cover in particular the borderline case of the

1

-capacity where both terms in the energy are of the same order.
Characters of classical groups, Schur-type functions and discrete splines
Authors: Olshanski Grigorii Iosifovich
Published: March 2024

We study a spectral problem related to finite-dimensional characters of the groups $Sp(2N)$, $SO(2N+1)$ and $SO(2N)$, which form the classical series $\mathcal{C}$, $\mathcal{B}$ and $\mathcal{D}$, respectively. Irreducible characters of these three series are given by $N$-variate symmetric polynomials. The spectral problem in question consists in the decomposition of characters after their restriction to subgroups of the same type but smaller rank $K<N$. The main result of the paper is the derivation of explicit determinantal formulae for the coefficients of the expansion.
In fact, first we compute these coefficients in greater generality - for the multivariate symmetric Jacobi polynomials depending on two continuous parameters. Next, we show that the formulae are drastically simplified in the three special cases of Jacobi polynomials corresponding to characters of the series $\mathcal{C}$, $\mathcal{B}$ and $\mathcal{D}$. In particular, we show that then these coefficients are given by piecewise polynomial functions. This is where a link with discrete splines arises.
For characters of the series $\mathcal{A}$ (that is, of the unitary groups $U(N)$) similar results were obtained previously by Borodin and this author [5], and then reproved by Petrov [39] by another method. The case of symplectic and orthogonal characters is more intricate.
Bibliography: 58 titles.
Clinical study of enhanced recovery after surgery in laparoscopic appendectomy for acute appendicitis
Authors: Li Zhu-Lin , Ma Hua-Chong , Yang Yong , Chen Jian-Jun , Wang Zhen-Jun
Published: March 2024

BACKGROUND

Enhanced recovery after surgery (ERAS) protocol is a comprehensive management modality that promotes patient recovery, especially in the patients undergoing digestive tumor surgeries. However, it is less commonly used in the appendectomy.

AIM

To study the application value of ERAS in laparoscopic surgery for acute appendicitis.

METHODS

A total of 120 patients who underwent laparoscopic appendectomy due to acute appendicitis were divided into experimental group and control group by random number table method, including 63 patients in the experimental group and 57 patients in the control group. Patients in the experimental group were managed with the ERAS protocol, and those in the control group were received the traditional treatment. The exhaust time, the hospitalization duration, the hospitalization expense and the pain score between the two groups were compared.

RESULTS

There was no significant difference in age, gender, body mass index and Sunshine Appendicitis Grading System score between the experimental group and the control group (P > 0.05). Compared to the control group, the patients in the experimental group had earlier exhaust time, shorter hospitalization time, less hospitalization cost and lower degree of pain sensation. The differences were statistically significant (P < 0.01).

CONCLUSION

ERAS could significantly accelerate the recovery of patients who underwent laparoscopic appendectomy for acute appendicitis, shorten the hospitalization time and reduce hospitalization costs. It is a safe and effective approach.
Comparative Effects of Potassium Iodate and SAAF-Fungicide on the Control of Fusarium Wilt (Fusarium oxysporum) And the Yield of Pepper (Capsicum spp. L.)
Authors: Oyelakin O. O. , Ganiyu S. A. , Oloyede A. R. , Popoola A. R.
Published: March 2024

SAAF Fungicide is a systemic and contact fungicide that is used to prevent leaf spot, blast disease, rust disease, and other types of fungi pests in all kinds of crops, especially on vegetable plant. Hence, the objective of this paper as to compare the effects of Potassium Iodate and SAAF-fungicide on the control of Fusarium Wilt (Fusarium oxysporum) and the Yield of Pepper (Capsicum spp L.) using appropriate standard methods.  Agronomic data such as number of leaves, plant height and flowers was collected. Disease incidence and severity as well as yield were measured and analyzed using Analysis of Variance (ANOVA). Among all the treatment, Gulpinar F1 with KIO3 has the highest height and number of leaves across the experiment while negative control has the least height and number of leaves. De cayenne with SAAF has the highest yield of pepper harvested followed by Gulpinar F1 with KIO3, the negative control has the highest disease infection and severity, there are very mild infection on the treated plots. The two treatments have positive effect on the growth, disease control and yield of pepper. The highest pepper yield was achieved from SAAF treated sample.
Mechanistic insights into fasting-induced autophagy in the aging heart
Authors: Parvaresh Hannaneh , Paczek Katarzyna , Al-Bari Md Abdul Alim , Eid Nabil
Published: March 2024

Autophagy is a prosurvival mechanism for the clearance of accumulated abnormal proteins, damaged organelles, and excessive lipids within mammalian cells. A growing body of data indicates that autophagy is reduced in aging cells. This reduction leads to various diseases, such as myocardial hypertrophy, infarction, and atherosclerosis. Recent studies in animal models of an aging heart showed that fasting-induced autophagy improved cardiac function and longevity. This improvement is related to autophagic clearance of damaged cellular components via either bulk or selective autophagy (such as mitophagy). In this editorial, we summarize the mechanisms of autophagy in normal and aging hearts. In addition, the protective effect of fasting-induced autophagy in cardiac aging has been highlighted.
Cardiac arrest, stony heart, and cardiopulmonary resuscitation: An updated revisit
Authors: El-Menyar Ayman , Wahlen Bianca M
Published: March 2024

The post-resuscitation period is recognized as the main predictor of cardiopulmonary resuscitation (CPR) outcomes. The first description of post-resuscitation syndrome and stony heart was published over 50 years ago. Major manifestations may include but are not limited to, persistent precipitating pathology, systemic ischemia/reperfusion response, post-cardiac arrest brain injury, and finally, post-cardiac arrest myocardial dysfunction (PAMD) after successful resuscitation. Why do some patients initially survive successful resuscitation, and others do not? Also, why does the myocardium response vary after resuscitation? These questions have kept scientists busy for several decades since the first successful resuscitation was described. By modifying the conventional modalities of resuscitation together with new promising agents, rescuers will be able to salvage the jeopardized post-resuscitation myocardium and prevent its progression to a dismal, stony heart. Community awareness and staff education are crucial for shortening the resuscitation time and improving short- and long-term outcomes. Awareness of these components before and early after the restoration of circulation will enhance the resuscitation outcomes. This review extensively addresses the underlying pathophysiology, management, and outcomes of post-resuscitation syndrome. The pattern, management, and outcome of PAMD and post-cardiac arrest shock are different based on many factors, including in-hospital cardiac arrest vs out-of-hospital cardiac arrest (OHCA), witnessed vs unwitnessed cardiac arrest, the underlying cause of arrest, the duration, and protocol used for CPR. Although restoring spontaneous circulation is a vital sign, it should not be the end of the game or lone primary outcome; it calls for better understanding and aggressive multi-disciplinary interventions and care. The development of stony heart post-CPR and OHCA remain the main challenges in emergency and critical care medicine.
Tariffs and Vietnam’s exports of Mach and Elec products to CPTPP partners
Authors: Thao Nguyen Duc , Yen Le Thi Hoang , Quynh Ta Thuy , Minh Dinh Ngoc , Linh Le Thao
Published: March 2024

Mach and Elec is a vital sector greatly contributing to Vietnam’s economic growth and the trade liberalization mechanism in the Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) has further enhanced our opportunities to boost exporting these products. Hence, in this paper, we made the first attempt to analyze the impact of tariffs on Vietnam’s export of Mach and Elec products to partners within CPTPP. This study utilized a modified gravity model and simultaneous quantile regression to analyze Vietnam’s export turnover of machinery and electronic products to 10 CPTPP member countries from 2005 to 2020 on different quantiles of the export distribution. The primary variable of interest was the applied tariffs (AHS). The results indicate that the most preferential tariff available still has a significantly detrimental impact on Vietnam’s export turnover. Also, exports of Mach and Elec products to larger markets in CPTPP tend to be more affected by tariffs than smaller ones. Our research findings have important implications for Vietnam enterprises and the government exporting machinery and electronic products to make the most of the preferential tariff under the CPTPP agreement.