bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility and Adaptation of Three-Dimensional Model for Surgical Planning and Training
Authors: Chaudhary Binita , Anand Utpal , Kumari Veena , Agrawal Prabhat , Kumar Prem , Priyadarshi Rajeev Nayan 
Published: October 2021

Background:
Three dimensional (3D) printing can produce accurate anatomical model of any part of the body. This study is based on reconstruction of models of the affected body part for preoperative planning and to see its usefulness in training of resident doctors and for patient education.

Methodology:
Thirty surgically operated patients were retrospectively reviewed and were divided into the conventional planning group (n = 14) and planning with 3D printing group (n = 16). Pathological structures from clinical cases were identified on multidetector computed tomography images and were then transferred to Dicom to print software and saved in a standard format digital imaging and communication in medicine. Segmented regions were combined to create 3D models. Printout of models was taken after being edited by Geomagic free form plus software. Models prepared using 3D printing technology were used to simulate the real surgical operation. The models were used by surgeons for surgical planning and to train their resident doctors. Surgical duration and blood loss were recorded during operation. A questionnaire was provided to the surgeons and residents to assess the utility of 3D models in pre-surgical planning.

Results:
The mean surgical time in planning with the 3D printing group and conventional planning group was 129.090 ± 36.79 min and 218 ± 94.932 min (P < 0.05). The intraoperative blood loss in planning with 3D printing group and conventional planning group was 130 ± 69.019 ml and (455 ± 44.122 ml) (P < 0.05). Forty subjects completed the survey. Twenty-nine (96.66%) surgeons gave favorable responses (80% found it to be very helpful and 16% helpful) when asked about the utility of these models in the visualization of abnormal pathological anatomy and preoperative planning.

Conclusion:
Our study suggests that 3D printing technology is useful to aid to surgical planning and provides teaching materials for residents in learning surgery.
May the first-line treatment for foreign body aspiration in childhood be flexible bronchoscopy?
Authors: Yüksel Hasan , Yaşar Adem , Açıkel Arzu , Topçu İsmet , Yılmaz Özge 
Published: October 2021

INTRODUCTION:
Rigid bronchoscopy (RB) is the traditional treatment in foreign body (FB) aspiration in childhood but is a traumatic and invasive procedure. However, flexible optic bronchoscopy (FoB) is a noninvasive and nontraumatic respiratory intervention. The aim of this study was to evaluate FoB as a first-line treatment modality in pediatric cases presenting with a preliminary diagnosis of FB aspiration.

METHODS:
Subjects who underwent FoB under general anesthesia with the preliminary diagnosis of FB aspiration were enrolled in this cross-sectional study. Two cases were inherited from pediatric surgery because they were not removed with FoB. The demographic, clinical, and radiological findings at the presentation were recorded. Results of success rate and complications were recorded.

RESULTS:
Among the FB aspiration cases age range of 7 months to 16 years. FoB demonstrated a FB in the airways of 31 (62.2%) subjects. The duration of the symptoms in the subjects was 9.1 ± 8.8 days. Three of the cases were taken over from pediatric surgery because they were not removed with RB. Most commonly encountered FB's were organic materials (n = 20, 64%). FoB was successful in removing the FB from the proximal and also distal airways in 93% of the subjects. No significant complications and side effects were observed except post-FoB cough.

CONCLUSION:
This result has shown that FoB for the treatment of FB aspiration is successful in removing FB aspiration from both the proximal and distal airway that the RB cannot remove. Furthermore, FoB did not have any significant airway complication. FoB may be used as the first-line treatment modality for FB aspiration instead of RB in childhood the fact that noninvasive and nontraumatic respiratory intervention.
Pain management practices in the emergency departments in Turkey
Authors: Cetin Murat , Kaya Bora , Kilic Turgay Yilmaz , Hanoğlu Nazife Didem , Gökhan Şervan , Eroğlu Serkan Emre , Akar Sakine Neval , Cekic Ozgen Gonenc , Polat Dicle , Üstsoy Emre , Çınar Orhan , Yilmaz Serkan 
Published: October 2021

OBJECTIVES:
This study aimed to evaluate pain management practices in the emergency departments (EDs) in Turkey and to evaluate the prevalence and etiologies of oligoanalgesia to identify possible improvement strategies.

METHODS:
This multicenter cross-sectional observational study was conducted in 10 tertiary care hospitals in Turkey. Patients who were admitted to the ED with pain chief complaints were included in the study. Both patients and physicians were surveyed with two separate forms by the research associates, respectively. The patient survey collected data about the pain and the interventions from the patients' perspective. The pain was evaluated using the Numerical Rating Scale. The physician survey collected data to assess the differences between study centers on pain management strategies and physician attitudes in pain management.

RESULTS:
Ten emergency physicians and 740 patients (male/female: 365/375) enrolled in the study. The median pain score at admission at both triage and ED was 7 (interquartile range: 5–8). The most frequent type of pain at admission was headache (n = 184, 24.7%). The most common analgesics ordered by physicians were nonsteroidal anti-inflammatory drugs (n = 505, 67.9%), and the most frequent route of administration was intramuscular injection (n = 396, 53.2%). About half of the patients (n = 366, 49.2%) received analgesics 10–30 min from ED admission. The posttreatment median pain score decreased to 3 (P < 0.001). About 79.2% of patients did not need a second analgesic administration (n = 589), and opioid analgesics were the most frequently administered analgesic if the second application was required. Physicians prescribed an analgesic at discharge from the ED in 55.6% of the patients (n = 414) and acute pain was present in 7.5% (n = 56) of the patients.

CONCLUSION:
Our study on the pain management practices in the EDs in Turkey suggested that high rate of intramuscular analgesic use and long emergency room stay durations are issues that should constitute the focus of our quality improvement efforts in pain management.
Tie-2-expressing monocytes in hepatitis C virus-related hepatocellular carcinoma
Authors: Abdel-Ghaffar Afaf A. , Mahmoud Ola M. , Zahran Manal Y. , Abdelsabour Amr M. , Safwat Nesma A. 
Published: October 2021

Background
Angiogenesis is a critical step in the development and progression of hepatocellular carcinoma (HCC). Tie-2-expressing monocytes (TEMs) with proangiogenic activity are recruited to the tumor site where they stimulate tumor angiogenesis.

Objective
This study aimed to assess the role of TEMs in diagnosis of hepatitis C virus (HCV)-related HCC.

Patients and methods
The study was conducted on 50 patients diagnosed with HCC and HCV. Patients were categorized into two groups: one included patients with HCC (n=25) and the other included HCV-infected patients (n=25). Moreover, 25 age-matched and sex-matched healthy individuals were recruited as a control group. The frequency of TEMs, as defined as CD14+CD16+Tie-2+ cells, in the peripheral blood was determined by flow cytometry.

Results
The frequency of TEMs in peripheral blood (PB) monocytes was significantly higher in HCC group (53.1±18.2%) than in patients with HCV (27.3±13.9%) and controls (8.4±3.9%). The percentage of TEMs correlates with advanced Child-Pugh stage in patients with HCC and HCV infection (P<0.01). Upon performing receiver operating characteristics curve analysis, a cutoff point of 33% for TEMs was able to differentiate patients with HCC from HCV-infected patients. Regarding differentiating patients with HCC from healthy participants, the cutoff value of 33.8% yielded 88% sensitivity and 100% specificity. The diagnostic performance of combination of TEMs and α-fetoprotein was also assessed, with 98% sensitivity and 100% specificity.

Conclusion
Percentage of TEMs in PB monocytes may be applied as a complementary biomarker for identifying HCV-related HCC along with α-fetoprotein. Inhibiting the proangiogenic functions of TEMs may represent a promising strategy to improve the efficacy of current treatments for HCC.
Comparative study of intravenous high-dose dexamethasone versus intravenous methylprednisolone as an emergent therapy in severe primary immune thrombocytopenia
Authors: Khedr Hager M. , Abuelrus Hanan M. , Mekawy Adel H. , Mohammed Saleh Mostafa F. 
Published: October 2021

Background
In severe immune thrombocytopenia (ITP), high-dose methylprednisolone (MP) alone or combined with intravenous immunoglobulin showed some efficacy. Reports of use of high-dose dexamethasone (HD-DXM) in this setting are lacking.

Objectives
To compare between the efficacy and safety of HD-DXM versus MP as an emergency therapy in patients with severe ITP.

Patients and methods
A total of 50 adult patients with primary severe ITP were divided into two groups (25 in each): HD-DXM was given 40 mg/day intravenous for 4 days, and MP was given 1 g/day intravenous for 3 days. Platelet count was compared on admission and on days 3 and 5 of therapy. After 1 week, response was defined as platelet count more than 30×109/l and complete response when platelet more than 100×109/l.

Results
The baseline characteristics of the two groups are well balanced. Mean platelet count on third day showed no significant difference between the two groups (P=0.19). On day 5, HD-DXM group achieved significantly higher platelet count (90.13±11.41×106/ml vs. 65.11±10.38×106/ml) than in MP group (P≤0.001). Response and complete response rates after 1 week of therapy were statistically significant higher in HD-DXM group than in MP group (92 vs. 76%; P≤0.001). Hypertension and hyperglycemia were more significant in MP group (28 and 40%, respectively) than in HD-DXM group (8 and 12%, respectively; P=0.01 and 0.01, respectively).

Conclusion
HD-DXM alone could provide an effective and well-tolerated corticosteroid modality in emergency setting of patients with severe ITP. Prospective randomized trials of HD-DXM alone or in combination with intravenous immunoglobulin for higher efficacy are warranted.
The prognostic significance of dipeptidyl peptidase IV (CD26) expression in B-cell chronic lymphocytic leukemia
Authors: Abaza Hala M.H. , Eltawil Ahmed E. , Safwat Nesma A. , Elzeiny Walaa S. 
Published: October 2021

Background
B-cell chronic lymphocytic leukemia (B-CLL) has a highly variable clinical course. The leukemic transformation is initiated by specific genomic alterations, impairing apoptosis of clonal B-cells. Many prognostic factors have been identified, yet research studies continue to identify new prognostic factors to predict the course of B-CLL.

Aim
This study aimed to evaluate the prognostic value of CD26 expression in Egyptian patients with B-CLL and assess its correlation to other clinical and laboratory parameters with known prognostic significance.

Patients and methods
A total of 30 Egyptian adults with newly diagnosed B-CLL and 15 healthy participants (control group) were subjected to full study of clinical, laboratory, flow cytometry, and cytogenetic data. Testing of CD26% expression was done by flow cytometry-immunophenotyping. Detections of ataxia telangiectasia mutated, P53, 13q14 deletions, and trisomy 12 were performed using fluorescent in-situ hybridization. Immunoglobulin heavy-chain variable mutational status was done by PCR. Moreover, smudge cells % was calculated by microscopic evaluation of stained blood smears.

Results
A statistically significant increase of CD26% expression in patients with B-CLL in comparison with normal participants was documented (P<0.001). CD26% expression on B-CLL was statistically significantly correlated with advanced modified Rai's clinical stage of B-CLL at diagnosis (P<0.001), hepatomegaly (P=0.003), low hemoglobin level (P=0.049), low platelets count (P=0.034), high lactate dehydrogenase blood levels (P=0.001), and atypical lymphocytes % (P=0.049). Correlation studies with other prognostic factors revealed statistically significant correlations between CD26% expression and CD38% (P<0.001), ZAP-70% (P=0.007), the unmutated status of immunoglobulin heavy-chain variable (P<0.001), and low % of smudge cells (P<0.001).

Conclusion
CD26% expression could be considered as an adverse prognostic predictor being associated with high-risk markers in B-CLL. It can be routinely used, as a part of immunophenotyping panel, in third world countries at diagnosis, for prognosis, risk-stratification, and tailoring of therapy.
Micro-RNA 155 in non-Hodgkin lymphoma
Authors: Hamed Hosny B. , Elgammal Sahar A. , Narouz Merna W. , Elnaggar Mohamed G. 
Published: October 2021

Background
Micro-RNAs (miRNAs) are a class of small RNAs of 17–25 nucleotides in length. miRNA-155 has a great role in lymphomagenesis through several mechanisms. Recent years have shown clearly a growth in knowledge of the etiology and pathogenesis of non-Hodgkin lymphomas (NHLs).

Aim
This work aimed to study the expression of miRNA-155 in patients with NHL and its correlation with clinical and pathological criteria of these patients; so that we could achieve a new biomarker in the prediction of progression of the disease.

Settings and study design
This is a cross-sectional study with a nested control group. Cases and controls were recruited from the Clinical Pathology Department at South Egypt Cancer Institute.

Patients and methods
This study was conducted on 32 patients with NHL. Peripheral blood and bone marrow samples were analyzed using 7500 Fast real-time PCR (Applied Biosystems).

Statistical analysis
used Results were performed using IBM SPSS Statistics, version 20 (SPSS Inc.).

Results
There was a significant correlation between expression levels of miRNA-155 in patients with NHL and their clinical stages or international prognostic indices.

Conclusion
It has been found that expression levels of miRNA-155 in patients’ samples were higher in cases of advanced clinical stage or higher international prognostic index. In addition, this study showed the correlation between miRNA-155 and behavior of B-NHL subtypes, total leukocytic count, and hemoglobin levels of patients. These findings revealed the great role of miRNA-155 in lymphomagenesis and also its usage as a new predictive biomarker in patients with NHL.
A1 and A2 subtypes of blood group A
Authors: Abdelaziz Hossam M. , Elgawhary Somaya M. , Mohammed Manal N. , Younis Asmaa K. , Eid Mohammed M.A. 
Published: October 2021

Objective
To determine the prevalence of A1 and A2 blood subgroups and detect anti-A1 antibodies in the studied population to assess their implication in transfusion practice.

Background
The A blood type contains ∼20 subgroups, of which A1 and A2 are the most common. The distinction between the A1 and A2 subgroups is usually made by using anti-A1 lectin. A2 and A2B subgroups might have anti-A1 antibody, which become clinically significant if they react at 37°C and may lead to hemolytic transfusion reaction.

Patients and methods
Blood samples were collected from 10 662 participants attending Fayoum University Hospital Blood Bank over a period of 8 months. Analysis of ABO and Rh-D blood groups using column-agglutination technique was done. Subgrouping using anti-A1 lectin was performed for A and AB blood groups. Anti-A1 antibodies detection using AHG microcolumn was done for A2 and A2B subgroups.

Results
Blood group A was present in 40.1% (4274 participants), of whom 39.8% were A1 and 0.3% were A2, whereas group AB was present in 7.8% (836 participants), of whom 6.3% were A1B and 1.5% were A2B. Anti-A1 antibodies were not detected in any of the subgroups A2 and A2B.

Conclusion
Despite the large population sample of this study, A2 and A2B are rare subgroups and were only found in 195/10 662 (1.8%) of studied samples, and anti-A1 antibodies were not detected. However, implementation of A1 and A2 grouping is vital to avoid any reactions that could occur from these minor incompatibilities, leading to overall improvement in blood transfusion practice.
Occult hepatitis C in peripheral blood mononuclear cells in thrombocytopenic patients after achieving sustained virological response with direct-acting antivirals
Authors: Elbedewy Tamer A. , Elkholy Rasha A. , Habba Eslam , Abd El-Khalik Sarah Ragab 
Published: October 2021

Background/aim
Occult hepatitis C virus infection (OCI) may be present in resolved hepatitis C virus (HCV) after direct-acting antivirals (DAAs). DAAs may improve thrombocytopenia after achieving sustained virological response (SVR), but some patients may be manifested with thrombocytopenia after SVR. The aim of our study was to evaluate the presence of OCI in the peripheral blood mononuclear cells (PBMCs) in thrombocytopenic patients after achieving SVR with DAAs.

Patients and methods
This cross-sectional study included 32 thrombocytopenic patients who achieved SVR with DAAs and 32 HCV-infected patients who achieved SVR with DAAs without thrombocytopenia as a control group. All patients were investigated for HCV-ribonucleic acid (RNA) in PBMCs, hepatitis C virus core antigen (HCVcAg), platelet autoantibodies, and serum thrombopoietin.

Results
Among thrombocytopenic, non-thrombocytopenic, and both groups, HCV-RNA in PBMCs were detected in 40.63, 6.25, and 23.44%, respectively, although HCVcAg was detected in 31.25, 3.13, and 17.19%, respectively. The comparisons between thrombocytopenic and non-thrombocytopenic patients regarding HCV-RNA in PBMCs and HCVcAg were statistically significant. Comparisons between thrombocytopenic and non-thrombocytopenic and between positive and negative OCI patients regarding serum thrombopoietin were statistically insignificant. Platelet autoantibodies were detected in 56.25% of thrombocytopenic group.

Conclusion
Our study is the first to provide insights into the relationship between OCI and thrombocytopenia in patients with chronic HCV after achieving SVR with DAAs. The association between OCI and thrombocytopenia may be explained by autoimmune mechanism.
Pulmonary hypertension as a risk factor in JAK2-positive polycythemia rubra vera
Authors: Ahmed Shaimaa A. , Rashad Alaa , Nafady Asmaa , Shazly Asmaa Y. , Alkhateeb Areej , Elsenbesya Mohamed A. 
Published: October 2021

Introduction
The occurrence of primary pulmonary arterial hypertension (PAH (in primary myeloid proliferation neoplasms seems quite high, up to 22% in polycythemia vera. Polycythemia rubra vera (PRV) is one of the myeloproliferative neoplasms. We aimed to study the incidence of PAH among patients with PRV.

Patients and methods
A prospective cross-section study was performed on 60 (PRV) patients with PRV confirmed by bone marrow and JAK2 positivity. Abdominal ultrasonography, transthoracic echocardiography, and computed tomography chest were done to estimate the pulmonary hypertension (HTN) and exclude other chest diseases.

Results
Among the studied 60 patients, we found 14 patients with pulmonary HTN (23.4%) who had significantly increased incidence of comorbidities than patients with normal pulmonary pressure (P=0.009). Moreover, there were statistically significant differences in the size of spleen by ultrasound between the two groups (P=0.008). Patients with pulmonary HTN had a higher hemoglobin level compared with those with normal pulmonary pressure (P=0.006). There was a significant positive correlation between pulmonary pressure and existing comorbidities (diabetes mellitus, HTN, or both) but no correlation with the size of the spleen, hemoglobin level, or white blood cells.

Conclusion
The prevalence of PAH in JAK2-positive patients with PRV is 76.6%, and there was significant relationship between hematological parameters (hemoglobin, white blood cells, lactate dehydrogenase, and urea level and PAH in JAK2-positive patients with PRV.
Uterine Parameters of Clinical Importance in North Indian Females of Reproductive Age – An Ultrasonographic Evaluation
Authors: Arya Aruna , Tomar Sushma , Diwan Rakesh K , Pandey Amita , Manik Punita 
Published: October 2021

Introduction:
The uterine size is important during planning of assisted reproductive techniques and hysterectomy and there is no established normative data from the women of northern India, this study was undertaken with the objective to report the normal length, width and anteroposterior lengths of non-gravid uterus.

Methodology:
In a prospective observational study, conducted in Department of Anatomy in collaboration with Departments of Radiology, Obstetrics and Gynecology of King George's Medical University, Lucknow, the ultrasonographic measurements of non-gravid uterus were noted. The ultrasonography was performed on females in dorsal decubitus position having full urinary bladder. Uterine position was identified by placing the probe on suprapubic area Length and anteroposterior diameter of uterus were measured by placing the probe in longitudinal direction (sagittal plane). Length was measured from fundus to external os. The anteroposterior diameter is maximum measurement in mid sagittal plane of body of uterus. The transducer was rotated up to 90 degree to measure the transverse diameter. Transverse diameter is the maximum measurement in transverse plane across the fundus. The volume of uterus was calculated.

Results:
The study included transabdominal ultrasonographic measurements of 100 females of age range 19-49 years (mean age 34.06 ± 0.35 years). Mean length, transverse diameter, anteroposterior diameters and volume noted were 7.71 (±0.47) cm, 4.63 (±0.33) cm, 3.75 (±0.31) cm and 70.54 (± 9.68) cm3.

Conclusion:
Normative values of uterine length, width and anteroposterior diameters of one-hundred non-pregnant women of northern India reported. Accurate measurement of uterine parameters is useful in timely management of various pathologies associated with abnormal size of uterus, infertility related procedures; such as in-vitro fertilization (IVF), embryo transfer (ET) and intrauterine device insertion.
A Mathematical Analysis of an In-vivo Ebola Virus Transmission Dynamics Model
Authors: Ismail Seleman , Mtunya Adeline Peter 
Published: October 2021

Ebola virus (EBOV) infection is a hemorrhagic and hazardous disease, which is among the most shocking threats to human health causing a large number of deaths. Currently, there are no approved curative therapies for the disease. In this study, a mathematical model for in-vivo Ebola virus transmission dynamics was analyzed. The analysis of the model mainly focused on the sensitivity of basic reproductive number, pertaining to the model parameters. Particularly, the sensitivity indices of all parameters of were computed by using the forward normalized sensitivity index method. The results showed that a slight change in the infection rate immensely influences while the same change in the production rate of the virus has the least impact on . Thus, , being a determining factor of the disease progression, deliberate control measures targeting the infection rate, the most positively sensitive parameter, are required. This implies that reducing infection rate will redirect the disease to extinction.
Keywords: Ebola virus infection, immune response, sensitivity index, mathematical model.