bluuebunny/crossref_metadata_2025_split huggingface dataset:
Motive, Belief and Desire
Authors: Strawson P. F. , Dancy Jonathan 
Published: November 2024

Abstract
Lecture 5 discusses the question: what is a motive? Motivation is a combination of belief and desire. A moral theory must say more about motivation. Start from the familiar antitheses good/bad and right/wrong. The desire to do the right, the rightness-desire, can occur with incompatible desires. If goodness is to be the ultimate ethical concept, it must include the idea of obligation as part of its meaning: if justice is good, we ought to be just. So both approaches require that the desire to do what one ought is part of ethical motivation.
The Epistemological Question
Authors: Strawson P. F. , Dancy Jonathan 
Published: November 2024

Abstract
Lecture 11 addresses the question of how we come to have the ideas expressed by ‘good’, ‘right’, and so on. They are defined in terms of the fundamental moral experiences of guilt, approval, and disapproval. Strawson distinguishes between real and verbal knowledge: real knowledge requires experience of obligation, guilt, approval, disapproval. General moral knowledge is based on experience; but there are always exceptions to moral generalisations, except to the rule that what I feel morally obliged to do is right. General moral propositions should be of the form: ‘acts of this type tend as such to be right/wrong’. Strawson discusses Broad on the materially right and the formally right. Objections to moral intuitionism are presented: (1) the absence of introspective evidence, (2) fallibility argument, (3) connection between moral concepts, (4) motivation argument, (5) subjective duty argument, (6) necessary connexion, (7) exceptions and tendencies to be right.
Selvester Score as a Predictor of Left Ventricular Systolic Function Recovery in ST-Segment Elevation Myocardial Infarction (STEMI) Patients with Reduced Ejection Fraction after Revascularization; MUST Egypt
Authors: Tamara Ahmed Fathy , Hamid Ibrahim Ibrahim Abdel , Tantawy Mahmoud Ahmed , Abdel Fattah Alaa Ahmed 
Published: November 2024

Abstract

Background
Ischemic heart disease is the most common contributor to left ventricular dysfunction. The extent of left ventricular (LV) function varies considerably among patients with extensive coronary disease. Clinical, demographic, and angiographic characteristics differ among patients and are predictive of LV ejection fraction has not been determined. Early identification, preferably in the emergency department (ED), of patients at the highest risk for developing left ventricular (LV) dysfunction could serve to inform the use of certain therapies.

Objective
To assess the correlation between the Selvester score and the myocardial dysfunction by echocardiography to predict left ventricular dysfunction improvement in patients with anterior STEMI and reduced EF.

Patients and Methods
This prospective observational study was done on 54 patients with acute anterior STEMI with LVSD. All patients were subjected to full history taking a full general examination Further, reperfusion strategy, twelve lead surface ECG, and echocardiography data were performed for all patients.

Results
The difference in the Selvester Score on discharge and after three months showed no statistically significant correlation with LV dysfunction improvement. The studied patients demonstrated a cut-off point of ≥ 7 for the Selvester Score at discharge, the ROC analysis revealed a sensitivity of 85.71% and a specificity of 100.00%. The positive predictive value (+PV) is 100.0%, while the negative predictive value (-PV) is 79.2%.

Conclusion
Our findings may aid in the clinical management of patients with anterior STEMI in the early stages of their hospitalization. A high Selvester score at hospital admission can predict non-improvement of EF but can't be used alone as a follow-up after 3 months as a predictor of function improvement without Echocardiography.
Comparison of Sample Adequacy and Diagnostic Yield of Auto-Aspiration and Manual Aspiration Techniques in Ebus-TBNA
Authors: Elfattah Nevine Abd , Mohamed Mohamed , Emam Wael , Kandil Mahmoud 
Published: November 2024

Abstract

Background
The manual aspiration technique involving high suction force is a new method for EBUS-TBNA. However, its application in EBUS-TBNA has been controversial, and consensus guidelines do not answer this specific question.

Aim of the Work
This study aimed to compare the diagnostic yield and sample volume of EBUS- TBNA using standard auto-aspiration and novel manual aspiration techniques.

Patients and Methods
48 patients with undiagnosed mediastinal lymphadenopathy or centrally located lung tumors were randomized in a 1:1 manner into 2 equal groups regarding aspiration technique: Group 1 underwent EBUS-TBNA with standard auto-aspiration technique, and Group 2 underwent EBUS-TBNA with novel manual aspiration technique. Diagnostic yield and sample volume were compared between the two groups.

Results
The manual aspiration group showed significantly better diagnostic yield (p = 0.039), with a diagnosis in 91.7% of patients compared to 62.5% in the auto-aspiration group. The manual aspiration group also had a significantly higher sample volume (p &lt; 0.001), with a mean sample volume of 12.80±1.20 mm3 compared to 9.76±1.31 mm3 in the auto-aspiration group.

Conclusion
The manual suction sampling technique via EBUS-TBNA achieved a higher sample volume and diagnostic yield than the auto suction sampling technique. Therefore, we suggest using manual suction sampling technique in the EBUS-TBNA procedure as it appears to be a promising, easy, no-cost, and safe technique variation. This study adds useful information to the technique of EBUS-TBNA and has potential practice-changing implications.
The Value of Rapid On-Site Evaluation during Conventional and Endobronchial Ultrasound Needle Aspiration in Diagnosis of Mediastinal Lymphadenopathy and Lung Cancer
Authors: AbdelDayem Aya , ELMaraghi Ashraf , Ali Maryam , Samy Fatma , Magdy Omnya 
Published: November 2024

Abstract

Background
ROSE EBUS-TBNA is a useful technique that has revolutionized the field of pulmonology. Developed initially for detecting metastasis in lung cancer patients, it is currently used in the diagnosis of sarcoidosis, tuberculosis (TB), and lymphoma. ROSE, which has been a game changer for the pathologists, helps to act as a guide for assessing the adequacy and accuracy of the sample and aid in rapid decision-making.

Aim of the Work
The aim of the study was to evaluate the value of ROSE during EBUS-TBNA and C.TBNA in the diagnosis of mediastinal lymphadenopathy and lung cancer.

Patients and Methods
Our study was a prospective study where we studied 60 cases were divided into two equal groups ROSE group and Non-ROSE group underwent either Conventional TBNA or EBUS TBNA

Results
The total diagnostic yield of Conventional and EBUS TBNA in both groups were 83.3% (50/60 cases). 28 cases (46.7%) positive for malignancy, 22 cases (36.6%) were positive for benign lesion, and 10 cases (16.6%) were not conclusive. Regarding diagnostic accuracy, it was higher in ROSE group than non-ROSE group (100% in ROSE group vs. 66.7% in non-ROSE group)

Conclusion
ROSE during Conventional or EBUS-TBNA improve diagnostic accuracy of mediastinal lesions by excluding suspicious or nondiagnostic specimens and can reduce unnecessary punctures or eliminate the need for additional bronchoscopic procedures when reaching to preliminary diagnosis
Molecular Detection of Helicobacter pylori Clarithromycin Resistance in Stool Samples
Authors: Kassem Névine Nabil , Kamel Eman Mohammed , Saber Sally Mohammed , Elsayed Engy Yousry , Mohamed Menna Allah Samir , Abdelhalim Rania Mohamed 
Published: November 2024

Abstract

Background
Helicobacter pylori is a spiral-shaped bacterium that grows in the digestive tract. Helicobacter pylori infection has a very high prevalence, and may be present in more than half of the world’s population. In developing countries, children are very commonly infected. Helicobacter pylori may be passed from person to person through direct contact. Risk factors for Helicobacter pylori infection are related to living in crowded conditions without a reliable supply of clean water.

Aim of Work
The aim of the present study is to detect point mutations associated with Helicobacter pylori clarithromycin resistance in stool samples using real- time PCR to help clinicians in proper management of H. pylori infected patients.

Methodology
This cross-sectional study included fifty patients with symptoms consistent with Helicobacter pylori infection who attended the endoscopy unit of the Hepatology, Gastroenterology, and Infectious Disease Department, Ain Shams University Hospitals from December 2019 till May 2020.

Results
The results revealed high resistance rate of clarithromycin (46%), of which A2143G was (28%) and A2142G was (18%). There was no significant difference between clarithromycin resistance detection among males and females. There was no statistically significant correlation between Clarithromycin resistance and age.

Conclusion
This study revealed increase rate of clarithromycin-resistant H. pylori (46%) and was mainly associated with the A2143G point mutation. A2142G point mutation was also detected. There was no significant association between age and gender of the patients with clarithromycin resistance. clarithromycin- containing H.pylori eradication therapy might not be recommended as empirical therapy in Egypt.
A Clinicodemographic Analysis of Egyptian Females Condyloma Accuminata Patients
Authors: Lotfi Ranya Adel , El-Husseiny Rania Mahmoud , Sayed Ahmed Selem Eman Ibrahim 
Published: November 2024

Abstract

Background
Human papillomavirus (HPV) is the most common viral infection of the reproductive tract in women and men. Although most HPV infections resolve spontaneously, persistent infections can lead to precancerous lesions and cancer of the cervix, vagina, vulva, anus and penis. HPV related cancers accounted for an estimated 4.5% of all cancers worldwide in 2012.

Objective
To describe the patients’ demographic features, clinical presentations, sexual aspects, and possible risk factors of codyloma accuminata among female patients treated at Dermatology, venereology and Andrology outpatient clinics of Ain Shams University hospitals and Al-Houd Al-Mrsoud hospital, Cairo, Egypt.

Patients and Methods
This prospective cross sectional clinical study was conducted on 500 female patients aged above 18 years old with condyloma accuminata.

Results
Most of the studied patients (71.2%)gave a history of no condom use, (13.7%) of patients gave history of occasional condom use while the rest 7.5% weren’t sexually active. Most of the patients (61.3%) gave a history of cryotherapy, (8.6%) patients gave a history of chemical cautery, (4.5%) patients gave a history of electro surgery and (2.1%) patients gave a history of immunotherapy. Among the studied patients those had chemical cautery as a treatment modality had the highest recurrence rate.

Conclusion
The main risk factors for condyloma accuminata are young age, unprotected sexual intercourse, multiple sex partners and lower socioeconomic and educational levels. Smoking or alcohol together with immunosuppressive medications and chronic diseases as well as other STDs are possible risk factors. History of medical intervention as laser hair removal of genital area, colonoscopy and vaginal ultrasound could play a role in condyloma accuminata transmission in non-sexual active women. Condyloma accuminata occurred in more than one genital sites in relation to laser hair removal of genital areas compared to mostly one site in sexual transmission.
Evaluation of Local Injection of Adipose-Tissue Derived Stromal Vascular Fraction in Localized Scleroderma
Authors: Zu El-Fakkar Nehal Mohamed , Diab Heba Mahmoud , Ahmed Soltan Marwa Yassin , Elsayed Shereen Bendary , Monem Abo Zeid Asmaa Abd El , Hussein Shabaan Engy Amr Hussein 
Published: November 2024

Abstract

Background
Localized scleroderma (LoS) is a rare connective tissue disease affectig children and adults. It comprises a spectrum of sclerotic diseases that primarily affect the skin. Treatment of morphea is a challenge, several immunotherapies that specifically target cytokine or fibrosis signaling pathways, are under investigation and no treatment till now is considered gold standard. Among the most promising therapeutic approaches for fibrosing diseases are Adipose Stem Cells (ASCs). The scientific basis for studying ASCs treatment potential is their potent immunosuppressive, pro-angiogenic, and antifibrotic activities.

Materials and Methods
20 patients suffering from morphea lesions were injected by ASCs locally. Follow up and assessment were done through validated clinical scoring, durometer measurement of skin hardness and histopathological measurements of dermal collagen thickness and density.

Conclusion
ASCs are promising therapeutic option and tool in addressing skin fibrosing diseases.
COVID-19 Pandemic-Induced Changes in Hospital-Based Pattern of Skin Diseases in Gharbia Governorate, Egypt
Authors: Abdel Fattah Nermeen Samy , El-Khateeb Ekramy Ahmed , Waheb Hassan Fatma Safwat 
Published: November 2024

Abstract

Background
Introduction: The COVID-19 pandemic, declared by the World Health Organization in 2020, prompted numerous restrictions and changes in healthcare practices globally. In Egypt, measures such as curfews, the closure of public places, and the suspension of schools and universities were implemented. These changes had significant implications for healthcare delivery, including dermatology services.

Aim of the Work
This study aimed to investigate the effect of the COVID-19 pandemic on the pattern of skin diseases in Egypt.

Patients and Methods
Data from 20,509 patients (14,353 in the pre-COVID year and 6,156 during the COVID year) were analyzed at Samanod Hospital, Gharbia Governorate, Egypt. Information on date, age, sex, and diagnoses was collected from dermatology clinic registry files for both pandemic and pre-pandemic years.

Results
A substantial decrease in patient attendance at dermatology clinics was observed during the COVID-19 pandemic, with numbers dropping by over 50%. Age and sex distribution of patients were also influenced, with teenagers and adults showing an increase in attendance, while younger children presented less frequently. Although female patients remained predominant during the pandemic, the female-to-male ratio slightly favored males. All disease groups and subgroups demonstrated a decline in patient numbers during the pandemic compared to the pre-COVID year. Infections increased relative to hypersensitivity, with bacterial and fungal infections remaining the most common subgroups. COVID-19-related dermatoses did not significantly increase, except for herpes zoster, which showed a relative increase. Some dermatoses demonstrated significant relative increases during the pandemic, including impetigo, furunculosis, warts, abscesses, and herpes zoster, while others showed declines, such as acne, candidiasis, tinea capitis, urticaria, herpes simplex, pityriasis alba, pityriasis rosea, tinea corporis, xerosis, and chilblains.

Conclusion
The COVID-19 pandemic had a substantial impact on the pattern of skin diseases in Egypt, affecting patient demographics and disease prevalence. Infection-related dermatoses remained prevalent, with bacterial and fungal infections being the most common subgroups. Although minimal changes were observed in some diseases, especially COVID-related dermatoses, the overall pattern of dermatoses was preserved compared to the previous year. This study underscores the need for healthcare systems to adapt to changing disease patterns during pandemics, ensuring adequate medications, supplies, and medical team training to provide effective care. Further community-based studies are necessary to validate the findings and address potential disparities between hospital-based and community-based disease prevalence.
Assessment of Serum Brain-Derived Neurotrophic Factor Level and Its Relation to Psychiatric Morbidity in Vitiligo Patients and the Effect of Vitiligo on the Quality of Life
Authors: El-Kordy Nourhan Mohamed , Saleh Hanan Mohamed , Ahmed Soltan Marwa Yassin , Moneim Mahmoud Dalia Abdel 
Published: November 2024

Abstract

Background
Vitiligo is a chronic skin disorder with depigmentation of skin patches. Vitiligo exerts a huge burden on the psychiatric health and quality of life of affected patients. Several factors contribute to the pathogenesis of psychiatric morbidity in vitiligo patients, of which neurotrophins as Brain-derived neurotrophic factor (BDNF) was identified.

Aim of the Study
The aim of the present study is to assess serum levels of BDNF and their possible relation to the effect of vitiligo on the quality of life and with psychiatric comorbidities in vitiligo cases.

Patients and Methods
A cross-sectional case control study was conducted and included 50 patients suffering from vitiligo and 50 apparently healthy controls. All included participants were subjected to full history taking, complete general examination and full dermatological assessment and scoring of vitiligo using VETI and VIDA scores. After that, assessment of subjects’ psychiatric condition and quality of life was performed. Estimation of serum BDNF level was done using ELISA assay.

Results
BDNF level revealed significantly lower levels in cases compared to controls irrespective of the disease extent or vitiligo activity. The effect of vitiligo on psychiatric health and quality of life was marked as 76% of vitiligo cases had depressive symptoms in comparison to only 42% of controls. In addition, the physical health, social relations and environmental aspects showed significantly lower scores in patients compared to controls.

Conclusion
BDNF serum levels were lower in vitiligo cases. These levels are not related to either the vitiligo disease characteristic or the psychological burden of vitiligo on the patients' life.
Prospective Randomized Study Comparing the Outcomes of Single Anastomosis Sleeve Jejunal Bypass (SAS-J) with One Anastomosis Gastric Bypass (OAGB)
Authors: ElBanna Mohey Eldin Ragab , Abd-ElSamea Karim Sabry , Zaher Amr Sayed , Mohamed Ibrahim Essam Ibrahim 
Published: November 2024

Abstract

Background
One Anastomosis Gastric Bypass is one of the commonest bariatric surgeries worldwide, which has been demonstrated to produce excellent bariatric and metabolic outcomes. Single Anastomosis Sleeve Jejunal Bypass is a novel procedure that was developed in Hazrat e Rasool Hospital by Pazouki and Kermansavari in 2019 to form an anastomosis between the sleeved stomach and the jejunum rather than the ileum as a modification of the previously known SASI.

Objective
To compare the outcome of SASJ with OAGB as regards efficacy and safety in a 6- month postoperative follow up period.

Patients and Methods
This was a comparative prospective randomized study conducted in Ain Shams University Hospitals, over 40 patients devided into 2 groups. First group was composed of 20 patients who underwent SASJ operation, and second group was composed of 20 patients who underwent OAGB operation.

Results
The mean excess weight loss percentage after 6 months of SASJ group of patients was 51.55% ± 15.11, and 58.30% ± 24.32 in OAGB group. Both groups showed excellent outcomes as regards comorbidities resolution. In OAGB group, there was 1 patient who had postoperative bleeding. In SASJ group, we had one case of reflux alkaline gastritis that needed readmission. In addition, we had one case (5%) that needed reoperation and conversion to Roux-en Y configuration. In SASJ group, there were 7 patients complained from bile reflux, and 3 patients in OAGB group. In SASJ group of patients we had only 1 patient who developed postoperative gall bladder stones, and 6 patients in OAGB group.

Conclusion
Both OAGB and SASJ are effective bariatric procedures as regards weight loss and comorbidities resolution such as DM, HTN and hyperlipidemia. Incidence of biliary reflux was found more among the SASJ patients, but it was almost overcomed after performing the antireflux suture.
Comparison between Fibrin Glue vs Mechanical Mesh Fixation in Laparoscopic Inguinal Hernia Repair, A Prospective Study
Authors: Wakim Hany Rafik , Fawzi Fawzi Salah , Emad Moustafa M , Ali Mohammed Baraka Mahmoud AbdRabou 
Published: November 2024

Abstract

Background
Inguinal hernia repair is one of the most common surgical procedure in general surgery. The rate of occurrence of inguinal hernia is about 27– 43% in men and 3– 6% in women. An open or laparoscopic approach can be used. Mesh repair is recommended either by an open procedure or laparoscopic technique. There is no consensus on the best method to do inguinal hernia repair either open or laparoscopic.

Objective
To compare between glue vs mechanical mesh fixation in laparoscopic inguinal hernia repair as regard operative time, blood loss, hospital stay and short term complications.

Patients and Methods
This is a prospective comparative cohort study between fibrin glue versus mechanical mesh fixation in laparoscopic inguinal hernia repair. This study was conducted at (the General surgery department), Ain Shams University Hospitals. Approval of the Ethical Committee and written informed consent from all participants was obtained. Between September 2022 and February 2023 with post-operative follow-up for maximum 6 months.

Results
There are many postoperative complications such seroma, numbness, wound infection and early recurrence. Early recurrence after open hernia repair which can occur in up to 63% of patients and affects quality of life in 5– 10% so there is increase in usage of the laparoscopic method to decrease the post-operative complication. Mesh fixation in laparoscopic inguinal hernia repair (LIHR) remains highly debated, being largely influenced by individual-surgeon preferences, the use of tackers or staples increase postoperative pain and associated with chronic and immediate postoperative pain and may risk neurovascular injury. Non-penetrative methods of mesh fixation using tissue glue have been used for LIHR, and been associated with improved postoperative complications and chronic pain.

Conclusion
The use fibrin glue in mesh fixation for laparoscopic inguinal hernia repair is a safe and viable option. It offers many advantages in terms of less fixation time, less seroma/hematoma rate and less wound infection. Whereas early recurrence and numbness was found to be similar in both groups.