bluuebunny/crossref_metadata_2025_split huggingface dataset:
SJLA_2024_A18: Persistent Complex Seroma Treated by Capsulectomy and Argon Beam Coagulator
Authors: AlGhazal Thabet 
Published: September 2024

Background:
Seroma formation is one of the most common events following ventral hernia repair. When mesh is used for the repair of larger and more complex incisional hernias, the risk of seroma formation increases. The mesh onlay technique, which requires more extensive dissection, is associated with an even greater incidence of seroma formation. Treatment options for postoperative seromas include observation for spontaneous resolution, percutaneous aspiration, closed suction drainage, abdominal binders, and sclerosant.

Methods:
The aim of this report is to present a definitive management of a very challenging case of abdominal wall chronic complex seroma following herniorrhaphy with mesh approached by open capsulectomy and scarification of the remnant pseudocapsule.

Results:
Our patient is a 60 years-old male a status post low anterior resection with covering loop ileostomy for rectal cancer. His diverting stoma was taken off after completing the adjuvant chemotherapy treatment. Seven months later, the patient has developed an enlarging midline incisional hernia. This hernia was subsequently repaired by primary fascial closure with suprafascial onlay polypropylene mesh. Postoperatively, he developed a subcutaneous seroma which was initially treated with an abdominal binder without success. Over the following 3 months of observation, seroma was increasing in size.

Discussion:
Having recovered his acute condition, surgical intervention was planned. The patient underwent an excision and evacuation of the complex seroma and pseudocapsule. A 12-cm midline incision was made in line with the previous incision used for the hernia repair. The pseudocapsule of the seroma was encountered when the subcutaneous tissue was incised. The incision was carried superior, inferior, and laterally, and the capsule was exposed. The seroma opening sinus was expanded and fluid was evacuated. There were some fibrous dead tissues and coagulated dark blood. The anterior and lateral aspects of the pseudo capsule were excised. Furthermore, the posterior aspect was cleaned carefully using the curettage instrument without affecting the integrity of the mesh which was looking healthy and intact and without causing injury to the intraabdominal contents. Argon beam coagulator was used to scarify the remaining posterior aspect attaching to the mesh. Hemostasis was secured, and the wound was closed over a Jackson–Pratt drain. A pressure dressing and abdominal binder were applied.

Conclusion:
Factors leading to seroma following incisional herniorrhaphy are poorly understood. Many options are available for treating complicated abdominal wall seroms. capsulectomy and scarification of the remnant pseudocapsule were good option for the treatment of persistence complex seroma.
SJLA_2024_A6: Comparison of One Anastomosis Gastric Bypass versus Roux-en-Y Gastric Bypass Outcome for Treatment of Obesity in Oman: A 3-year Study
Authors: Al Marhoon Mallak 
Published: September 2024

Background:
Obesity and its comorbidities remain a priority public health issue, 30% of the Omani population having body mass index (BMI) of more 30. Roux-en-Y gastric bypass (RYGB) remains one of the gold standard procedures for morbid obesity and metabolic disorders in most of the reference centers. One-anastomosis gastric bypass (OAGB), gaining wide acceptance OAGB, was proposed as a simple and effective treatment for morbid obesity. Published data essentially come from retrospective studies, meta-analysis, and few root canal treatment have been reported the value of OAGB remains debated, high-level evidence regarding its efficacy and safety.

Methods:
A single-institution qualitative retrospective cohort study was conducted in Royal Hospital in the period between 2017 and 2020. Total sample: 45 (28 OAGB and 17 RYGB, the data were collected from the medical record system (Al-Shifa system). Inclusion criteria: all patients who aged 18–65 years with a BMI between 35 and 50 kg/m2. Exclusion criteria who have esophagitis, malignancy “Inflammatory bowel disease” Pregnancy, BMI over 50 kg/m2, and previous bariatric surgery.

Results:
The mean BMI at 3 years was 31.9 for OAGB and 32 for RYGB. There was no significant difference in EWL% in the OAGB compared with the RYGB group, P = 0.86; mean HbA1c at 3 years was not statistically different P = 0.49. The mean decrease in HbA1c was significantly greater in the OAGB arm 2.4% than in the RYGB arm 2%. There was a 68% (n = 15/23) complete type 2 diabetes (T2D) remission rate in the OAGB group versus 31% in the RYGB group. The proportions of T2D remission were not significantly different (P = 0·722). The incidence of malnutrition, anemia, and vitamin deficiencies at 3 years was not significantly different.

Discussion:
RYGB was first described in 1967, and an IFSO survey showed that RYGB was the most common bariatric procedure from 2003 to 2013 (11, 28). According to the 2018 IFSO survey results, OAGB was considered the third most popular bariatric surgery. Previous studies have suggested that the OAGB learning curve is shorter than that of RYGB and that the learning curve is closely related to surgical complications. However, there is no consistent confirmation of the effect and comorbid remission rate of the two bariatric surgeries. Many articles have shown that the weight loss effect of OAGB is not as worse as that of RYGB; however, the sample size of the comparison articles is small, the randomized trials are few, and they mainly focused on the comparison of weight loss effect, with less research on postoperative complications.

Conclusion:
OAGB appeared to be safe, effective, and not inferior to LRYG. OAGB is associated with more weight loss and better resolution of comorbid conditions. No difference between both surgeries in nutritional outcomes. The clinical utility of OAGB needs to be further validated by future prospective RCTS.
SJLA_2024_A8: Clinical and Survival Patterns of Pulmonary Metastases in Colorectal Cancer Patients
Authors: Al Alawi Ahmed , Al Maqrashi Asma , Al Mayahi Juhaina , Al Lawati Yaseen 
Published: September 2024

Background:
Pulmonary metastasis (PM) from colorectal cancer (CRC) is a rare and incompletely understood entity which affects 10% of CRC patients. The 5-year overall survival (OS) of Stage IV CRC is 11.3% and in pulmonary metastatectomy range from 40% to 69.7%. This study aims to evaluate the overall 5-year survival of PM from CRC and identify potential independent risk factors affecting the OS.

Methods:
A retrospective study was conducted in a tertiary care center (Royal Hospital). The study included all patients diagnosed with Stage IV CRC with PM aged >18 years between 2008 and 2015. Patients with no follow-up and missed data were excluded. Data were retrieved from the electronic record system (Al-Shifaa) and analyzed using SPSS software.

Results:
The prevalence of PM in the overall CRC cases was 15.2% (84/554 patients). Seventy-one patients were included in this study after the application of exclusion criteria with the mean age of patients was 60.35 ± 16.4 years; majority male gender 64.8% (46) and most of them with no comorbidities 57.7% (42). The most common location of primary tumor is sigmoid 31% (22) and diagnosed with T3 40.8% (29) status and N2 32.4% (23) status with high CEA > 5 at presentation and diagnosis. The majority of cases presented with synchronous PM 74.6% (53) and following metastasis features bilateral lung side 69.0% (49), =>10 nodules 42.3% (30), <1 cm size 66.2% (47), and no lymph involvement 57.7% (41). Five-year OS rate is 15.3%, and the median OS time is 15 months. There was a statistically significant difference in the OS distribution between those who received surgery and those who did not receive surgery (Log-rank test, P = 0.004) and 5-year OS rate in the surgical group is 55.6% versus 8.3% in nonsurgical. Median survival time was 71 months versus 13 months, respectively. Several factors were found to be associated with a favorable OS, which include the middle age group (P = 0.007), absence of perineural invasion (P = 0.015), and isolated PM (P = 0.003). In addition, multivariate Cox regression showed OS relatively poor in females (P0.001), metachronous (0.003), T4 (0.005), and normal CEA at diagnosis (0.011).

Conclusion:
The present study showed 5-year OS rate is 15.3%, and the median OS time is 15 months for Stage IV CRC with pulmonary metastasis. Surgical management, middle age group (40–59 years), absence of perineural invasion, and isolated pulmonary metastasis at diagnosis may be associated with improved survival. Female gender, tumor status T4, Carcinoembryonic <=5 at diagnosis, and metachronous lung mts were associated with poorer survival outcomes. Despite the study’s limitations of retrospective design with a small sample size, the results can be considered as part of MDT-based decision-making. These findings will require future large multicenter studies.
SJLA_2024_A9: Surgical Management of Achalasia
Authors: Al-Alawi Samah 
Published: September 2024

Introduction:
Achalasia is a rare neurological disorder, in which the esophagus fails to relax. The esophagus also has a marked absence of peristalsis. In <50% of patients, the lower esophageal sphincter is hypertensive. This condition causes a functional obstruction at the gastroesophageal junction.

Background:
Treatment is to ease the symptoms of achalasia by decreasing the outflow resistance caused by a nonrelaxing and hypertensive lower esophageal sphincter. Surgical options are laparoscopic Heller myotomy (LHM) and peroral endoscopic myotomy. The recommended step for reducing pressure across the lower esophageal sphincter is surgical myotomy, which can be done laparoscopically. This procedure will cut the circular muscle fibers running across the lower esophageal sphincter, leading to relaxation. LHM can potentially cause uncontrolled gastroesophageal reflux, so it typically pairs with an antireflux procedure such as Nissen, the posterior (Toupet), or the anterior (Dor) partial fundoplication. The anterior fundoplication is the more common choice. LHM with partial fundoplication is the surgical procedure of choice. The important thing is that the fundoplication is partial, not complete, so as not to cause postoperative dysphagia, which is more severe with Nissen fundoplication. The clinical success rate of LHM is high (76%–100%) at 35 months, with a low mortality rate of 0.1%. Disease progression after 5 years subsequently reduces the success rate.

Methods:
Video demonstration of case of achalasia treated with Heller myotomy.

Results:
Video demonstration of case of achalasia treated with Heller myotomy.

Discussion:
Video demonstration of case of achalasia treated with Heller myotomy.

Conclusion:
Video demonstration of case of achalasia treated with Heller myotomy.
Molecular Identification of Species Belonging to Culex vishnui Subgroup (Diptera: Culicidae), Vectors of Japanese Encephalitis Virus, in Taiwan
Authors: Chung Han-Hsuan , Chen Tien-Huang , Wang Pei-Feng , Tsuda Yoshio , Teng Hwa-Jen , Chen Shiu-Ling 
Published: September 2024

ABSTRACT.
Classification of mosquitoes with overlapping features remains problematic when using traditional morphological identification alone. In this study, we used molecular methods to elucidate the taxonomic status of Culex tritaeniorhynchus, Culex annulus, and Culex pseudovishnui species as vectors of the Japanese encephalitis virus belonging to the Culex vishnui subgroup and gene flow among them. In this study, 76, 59, and 3 samples of Cx. annulus, Cx. tritaeniorhynchus, and Cx. pseudovishnui, respectively, were collected around Taiwan. Phylogenetic analysis and genetic divergence were based on genomic sequence variations in ribosomal DNA and the internal transcribed spacer (rDNA) and cytochrome c oxidase subunit I (COI). Our results revealed that Cx. annulus and Cx. vishnui are genetically similar and share a gene pool among the species from Taiwan and other Asian countries. However, two hidden taxa of Cx. tritaeniorhynchus, which clustered together according to the rDNA sequences, were discovered based on the COI sequences. In addition, Cx. pseudovishnui has different gene pools from those of the strains from other countries, implying that the population from Taiwan is probably either a unique strain or a sibling species. This study provides molecular information on the taxonomic status of the species in the Cx. vishnui subgroup in Taiwan and gene flow between these species, providing valuable information for vector control operations and the delineation of the evolutionary process.
Efficacy Analysis of Anti-Tuberculosis Chemotherapy Combined with Arthroplasty or Joint Replacement for Tuberculous of the Elbow Joint: A Retrospective Study of 40 Patients
Authors: Tian Qi , Luan Haopeng , Guo Xufeng , Liu Kai , Peng Cong , Du Bin 
Published: September 2024

ABSTRACT.
Tuberculous arthritis of the elbow joint (TAEJ) is a relatively rare infectious bone and joint disease. Misdiagnosed owing to inconspicuous early symptoms, often the elbow joint has suffered serious damage at the time of treatment. This study retrospectively investigated the clinical manifestations, population characteristics, clinical diagnosis, surgical treatment, and functional recovery of elbow joint tuberculosis (TB). A retrospective study of 40 patients was conducted. These patients were diagnosed with tuberculous arthritis of the elbow from June 2007 to August 2021 and were diagnosed with TAEJ by fine-needle aspiration biopsy or biopsy of surgically excised lesions. All patients underwent surgery after taking regular anti-TB drugs and chemotherapy for 2 weeks. Visual analogue scale score, Mayo elbow performance score, and hospital for special surgery assessment scale score were used to evaluate postoperative functional recovery. Imaging tests were used to evaluate patients’ postoperative recovery. Forty patients were followed up for an average of 12.5 ±0.5 months. Erythrocyte sedimentation rate and C-reactive protein values returned to normal after anti-TB drug chemotherapy combined with surgical removal of infected lesion tissue; only one patient relapsed 16 months after surgery. Tuberculous arthritis of the elbow joint should be diagnosed in an early stage based on clinical manifestations, laboratory tests, and histopathological examinations. Complete surgical removal of the lesions should be performed after chemotherapy with anti-TB drugs for 2 weeks. The corresponding operation should be selected according to the damage in the elbow joint.
Effectiveness of Systematic Screening and Treatment of Tuberculosis in Prison in Thailand
Authors: Rodgerd Atchara , Morasert Thotsaporn 
Published: September 2024

ABSTRACT.
The global incidence of tuberculosis (TB) in prison is 5 to 70 times greater than that in the general population. The systematic screening and treatment of TB in prison benefit TB control and treatment outcomes. However, no study has supported this in Thailand. Here, we evaluated the effectiveness of long-term, continuous, systematic screening for TB control. We conducted a retrospective study in Suratthani Central Prison, Thailand, using annual TB screening from 2016 to 2020. A positive TB screening was defined as having any TB symptoms or chest radiography abnormality. We collected sputum smear and Xpert® Mycobacterium tuberculosis/rifampicin (MTB/RIF) results from those inmates with positive screening results. Bacteriologically confirmed TB was defined as a positive sputum smear or M. tuberculosis detected by Xpert assay. Inmates with clinically diagnosed TB were also eligible for this study. Those inmates diagnosed with active TB were sent to an isolation zone in prison and received anti-TB medicine using directly observed therapy and were monitored by pulmonologists during the treatment course via telemedicine. Of 18,965 TB screening events, 175 patients were diagnosed with TB. The 5-year prevalence was 922 per 100,000 inmates. The relative reduction in TB prevalence was 60.5% from 2016 to 2020. Overall, 94.3% of TB patients were successfully treated (sum of patients cured and treatment completed). Three TB patients died during the 5-year study period. All occurred in 2016. The systematic screening and treatment of TB in inmates effectively reduced the prevalence and mortality in Suratthani Central Prison. The success rate of treatment in this prison has been consistently high.
Economics and logistics of the Mombasa – Nairobi railway project
Authors: Kurenkov P. V. , Raymond R. S. 
Published: September 2024

The study is devoted to the economic evaluation of the Nairobi – Mombasa Standard Gauge Railway Project in Kenya. The cost-benefit analysis method was used to evaluate this project, the purpose of which is to find the net social benefit by subtracting all the project costs from the total social benefits. Among the various cost analysis methods, the corridor analysis method was used, as well as the empirical method, which included mathematical calculation, analysis and comparison of information from different modes of transport operating between the two cities of Nairobi and Mombasa, obtained from different secondary sources in order to obtain the social present value. There is a social benefit of $ 75 million and thus the project was worth the investment. The analysis of the Nairobi – Mombasa Standard Gauge Railway Project will help reduce the negative reaction that the Kenyan government has faced from local residents for its huge investment in this project, proving that the project is economically beneficial and will have a positive impact on the social welfare of the residents.
Natural and natural-anthropogenic measures for adapting transport infrastructure to climate change
Authors: Akhtyamov R. G. 
Published: September 2024

The purpose of the study is to analyze and develop natural and natural-anthropogenic measures for adapting transport infrastructure to climate change. The analysis was based on national and international regulations, best practices in the development and implementation of technical, organizational, natural and natural-anthropogenic measures for adapting transport infrastructure facilities to a changing climate. Although technical adaptation measures can be seen as the basis for ensuring safety against climate risks, the adoption of complementary or alternative nature-based measures will allow effective adaptation to be achieved more cost-effectively based on sustainable and long-term solutions. In some cases, technical adaptation measures are clearly determined, which largely deprives decision makers of flexibility when choosing a set of measures for a specific territory. Thus, hybrid solutions combining natural and technical measures can provide an optimal level of safety, taking into account the environmental impact, the area required to accommodate adaptation means, and the magnitude of costs.Current engineering adaptation measures used at transport infrastructure facilities have been identified. With the exception of a number of procedural changes to current practice, most current measures are technical solutions. It has been established that complementing technical and organizational measures with natural and natural-human adaptation measures has the potential not only to provide ecosystem services that could increase biodiversity and ecological connectivity, but also to ensure the resilience of transport infrastructure to climate change. The widespread use of these adaptation measures will make it possible to position railway transport as a reliable, sustainable and environmentally friendly mode of transport.
Food Allergy Awareness Champions: Improving Food Safety Standards in Online Food Procurement for People With Food Hypersensitivities
Authors: Koidis Tassos , Jia Wenyang , Stoikidou Theano , Walker Michael , Gowland M Hazel 
Published: September 2024

Background There have been changes more recently in how people commonly acquire and consume food at home. The practice of ordering online food delivery including ready-to-eat meals, drinks, and snacks has increased immensely. The COVID-19 pandemic has likely been a factor in this change in practice as it’s now the case that one in four consumers thinks about using meal delivery services on a regular basis. The aims of this project were: • to improve understanding and knowledge of the behaviours of FHS citizen scientists buying ready-to-eat (takeaway and delivered) food online. • to learn more about the visible procedures and practices of individual food businesses offering online food delivery. • to use accredited methods to determine the presence of certain allergens in selected samples of food procured by participants. Results In general, respondents expressed more trust in nationwide food chains due to their perceived resources, updated information, menu consistency and/or accreditation by a UK allergy charity, such as Allergy UK or Coeliac UK. The citizen scientists revealed some of their behaviours to minimise the risk of contamination including: • eating food alone, before or after the family or work meal • physically separating gluten-containing from non-gluten-containing foods at the table • double checking the food order and the labels provided • following good food hygiene guidelines • using their own senses. Furthermore, there were some indications that older FHS citizens may perceive the risk of ordering online differently from younger age groups.
Post-hypoxic myoclonus (Lance-Adams Syndrome) in post-cardiorespiratory arrest, a case presentation in elderly
Authors: Tristán Melina Samara Rangel , Gonzalez Ericka Giovanna Gonzalez , Vazquez Yasmin Sarahi Rebolledo , Jiménez Karalam Guadalupe Torres , Estephani Arellano Navarro Consuelo , Resendiz Rafael Garcia , Rodríguez Juan Carlos Rivas , Leal Mishell Estefania Heredia 
Published: September 2024

A clinical case report is presented of an elderly adult recovering from cardiac arrest who developed generalized myoclonus or Lance Adams syndrome in a tertiary care hospital. Myoclonus is defined as a sudden, brief muscle contraction (1). The Lance Adams Syndrome is a form of post- hypoxic myoclonus, characterized by action myoclonus that typically involve the trunk, face, and extremities, and whose onset is days to weeks after a hypoxic brain injury. (2) The incidence of post-hypoxic myoclonus is 1. 3 cases per 100,000 people per year, so its differential diagnosis represents a challenge. The etiology may be secondary to cardiorespiratory arrest, anesthetic and surgical accidents, in addition to heart disease and drug overdose. Acute post-hypoxic myoclonus begins hours after the injury, sometimes begins as myoclonic status epilepticus, and if the patient survives, he will progress to a chronic phase with a poor or low life expectancy. Treatment is controversial, several articles agree that patients have shown better response to Levetiracetam, Magnesium Valproate, Lacosamide and Clonazepam.
Literary Significance of Number Archetypes
Authors: O‘g‘li Umarov Umidjon Akram 
Published: September 2024

This article explains the importance of number archetypes, putting emphasize on their roles as symbols that transcend simple numerical value to show deeper meanings and functions across various cultures and their literature. In this work, main number archetypes are also highlighted. For instance, three embodies unity in diversity, seven symbolizes spirituality and perfection, and twelve represents wholeness and order. These symbol archetypes not only contribute layers of meaning to literary works but also facilitate the expression of complex themes and universal truths. By connecting these archetypes to religious texts, myths, and cultural traditions, this article explores that numbers can enrich narratives and provide insight into human experiences. Finally, the discussion presents the examination of number archetypes in literature as a creative pathway to improve our understanding of reality and cultural way of storytelling.