bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

Abstract

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

Abstract

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

Abstract
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

Abstract
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.
Existence of singular rotationally symmetric gradient Ricci solitons in higher dimensions
Authors: Hui Kin Ming 
Published: March 2024

AbstractBy 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.
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.
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.