bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strengthening Sustainability in Entrepreneurship Education -Implications for Shifting Entrepreneurial Thinking Towards Sustainability at Universities
Authors: Bruksle Ieva , Chwallek Constanze , Krastina Anzelika 
Published: December 2023

Abstract
By developing innovative solutions to social and environmental problems, sustainable ventures carry great potential. Entrepreneurship which focuses especially on new venture creation can be developed through education and universities, in particular, are called upon to provide an impetus for social change. But social innovations are associated with certain hurdles, which are related to the multi-dimensionality, i.e. the tension between creating social, environmental and economic value and dealing with a multiplicity of stakeholders. The already complex field of entrepreneurship education has to face these challenges. This paper, therefore, aims to identify starting points for the integration of sustainability into entrepreneurship education. To pursue this goal experiences from three different project initiatives between the partner universities: Lapland University of Applied Sciences, FH Aachen University of Applied Sciences and Turiba University are reflected and findings are systematically condensed into recommendations for education on sustainable entrepreneurship.
Article XX of the Gatt 1994 and WTO Members: Sufficient Freedom to Define And Pursue Environmental Policy Objectives
Authors: Ibragimov Zh. I. 
Published: December 2023

Abstract
Providing free trade conditions to all WTO Members, the GATT 1994 includes general exceptions to Article XX, which allows members to adopt trade and legislative restrictions and measures to promote values and interests and the protection of the environment. Driven by the aim of protecting the environment, various countries have been adopting a considerable number of measures to protect the environment and all human, animal and plant life and health under their jurisdiction. However, such restrictions are likely to influence the free trade regime through a clash of interests and relationships between WTO Members, which are challenged through WTO dispute settlement mechanisms. Although the WTO provides exceptions under Article XX of its free trade conditions to protect the environment via the national environmental measures of WTO Members, the justifications for such measures are challenged in meeting the requirements of Article XX.
A New Constraint on the Simulation of the Intergalactic Medium through the Evolution of the Neutral Hydrogen Fraction in the Epoch of Reionization
Authors: Hosseini S. Mobina , Salmasi Bahareh Soleimanpour , Tabasi Seyed Sajad , Firouzjaee Javad T. 
Published: December 2023

Abstract
The thermal history of the intergalactic medium is full of extremely useful data in the field of astrophysics and cosmology. In other words, by examining this environment in different redshifts, the effects of cosmology and astrophysics can be observed side by side. Therefore, simulation is a very powerful tool to reach a suitable model for the intergalactic medium, both in terms of cosmology and astrophysics. In this work, we have simulated the intergalactic medium with the help of the 21cmFAST code and compared the evolution of the neutral hydrogen fraction in different initial conditions. Considerable works have arbitrarily determined many important effective parameters in the thermal history of the intergalactic medium without any constraints, and usually, there is much flexibility in the modeling. Nonetheless, in this work, by focusing on the evolution of the neutral hydrogen fraction in different models and comparing it with observational data, we have eliminated many simulated models and introduced only limited simulation models that could confirm the observations with sufficient accuracy. This issue becomes thoroughly vital from the point of view that in addition to restricting the models through the neutral hydrogen fraction, it can also impose restrictions on the parameters affecting its changes. However, we hope that in future works, by enhancing the observational data and increasing their accuracy, more compatible models with the history of the intergalactic medium can be achieved.
Robotic-assisted laparoscopic low anterior resection versus trans-anal total mesorectal excision for malignant rectal lesion: a prospective cohort trial
Authors: Farag Ahmed F.A. , Mahmoud Ahmed M.A. , Azmy Haitham M. , Mashhour Abdrabbou N. , Khalifa Ahmed S. , Debakey Yasser , Elbarmelgi Mohamed Y. 
Published: December 2023

Introduction
Colorectal carcinoma is one of the most common malignancies of the gastrointestinal tract. The aim of the present study was to compare the trans-anal total mesorectal excision (TaTME) to the robotic-assisted laparoscopic resection of mid- and low rectal carcinoma regarding the clinical and oncological outcome.

Methods
This was a prospective cohort study. This study was held on patients presenting with rectal cancer. Eighty patients were included divided into two groups, 40 patients were subjected to TaTME and 40 patients were subjected to robotic-assisted resection.

Results
Rectal resection was performed in both groups and the results were compared; total time was significantly less in TaTME group (mean time was 179.10 min in TaTME and 266.35 in robotic, P value < 0.001), estimated blood loss was significantly less in TaTME group (mean was 130.50 ml in TaTME and 212 ml in robotic, P value=0.017), cost was significantly less in TaTME group (mean cost ×1000L.E was 46.15 in TaTME and 110.70 in robotic, P value less than 0.001), distal margin was significantly more in the robotic group (mean was 2.68 compared with 2.02 in TaTME, P value = 0.002), hospital stay was significantly less in the robotic group (mean of 4.6 days compared with 5.1 for TaTME, P value = 0.014) and there was no statistically significant difference concerning the total number of lymph nodes, proximal and circumferential margins.

Conclusion
This study suggests that robotic surgery is safe and effective and has some advantages concerning distal margins of low rectal resections. Also, TaTME can be compared with robotic surgery and represents an effective and less expensive alternative for robotic surgery.
A single institution experience in the treatment of fistula in ano using diode laser (fistula laser closure): short-term outcomes
Authors: Elsheikh Mostafa M. , Elghamry Elghamry E. , Elsayed Alhassan M. H. , Abdel-Hady Hamdy , Talaat Mohamed , Amer Ahmed H. 
Published: December 2023

Introduction
Management of the perianal fistula has been always a challenge for colorectal surgeons especially when the external sphincter is involved. Several minimally invasive procedures emerged as an alternative to the traditional surgical approach as fibrin glue injection, ligation of the intershpincteric track (LIFT) and injection of platelet-rich plasma (PRP). Recently, the use of diode laser in proctology has emerged as an alternative to conventional surgical treatment. The laser beam causes shrinkage and sealing of the fistulous track that depends on the power and the duration of laser light application.

Patients and methods
This study was carried out on 69 patients with perianal fistula in the Gastrointestinal Surgery Unit, General Surgery Department, Tanta University Hospitals, during the study period from February 2021 to December 2022. Patients underwent fistula laser closure (FILAC) using a diode laser, radial fibers, wavelength 1470 nm, and 10 watts of power.

Results
Sixty nine patients underwent fistula laser closure. The success rate was 74%. There was significance between recurrence and posterior position of the fistulous track of the intersphincteric type. Also, there was significance between recurrence and cases who had a caliber track more than 7 mm but there was no significance between recurrence and length of the track. The procedure was associated with minimal postoperative pain, long period of postoperative discharge, short hospital stay, and early return to normal activities.

Conclusion
Diode laser is a safe minimally invasive and effective procedure for the treatment of straight non branched short track fistula with some considerations as the caliber track should not exceed 7 mm and the posterior intersphincteric fistula should be treated by lay open fistulotomy. The procedure is also associated with less postoperative pain, early return to normal activities, and minimal recurrence rate but high cost remains a limitation.
Comparison between conventional and oncoplastic breast surgeries regarding resection margins and local recurrences in breast cancer: Retrospective study
Authors: Abdelkader Ahmed A. , El-Fayoumi Tarek , Roushdy Ahmed , Asal Mohamed Farouk 
Published: December 2023

Background
Breast cancer is the most common cancer in women and the second-leading cause of cancer-related fatalities globally. Breast-conserving surgery (BCS) is the primary surgical treatment for early-stage breast cancer, with oncoplastic BCS techniques expanding its possibilities. BCS offers a higher quality of life compared to mastectomy. However, it has two absolute contraindications: the inability to produce negative margins without deforming the breast and inflammatory breast cancer. Oncoplastic displacement and replacement BCS allow resections of up to 50% of breast volume without creating deformity. Positive surgical margins often require a second procedure, which can increase pain, complications, and medical expenses.

Patient and methods
This retrospective cohort study analyzed 310 patients with primary invasive breast cancer or DCIS who underwent conventional or oncoplastic breast cancer surgery. Most patients underwent lateral and therapeutic reduction mammoplasties. Other techniques included LD flap, TDAP flap, mini-LD muscle flap, ICAP flap, grisotti flap, LICAP flap, and modified round block technique. Oncoplastic techniques were tailored based on breast cup size, tumor size, tumor location, and patient preference. Wide local excision of the tumor with free margins was confirmed through intraoperative frozen sections.

Result
The mean weight of the specimen was 55.89 gm in the conventional group and 101.55 gm in the oncoplastic group. The mean operative time was 65.9 min in the conventional group, while the oncoplastic group had 72.58 min Complications included seroma, hematoma, wound infection, wound dehiscence, lymphedema, and partial nipple necrosis. The aesthetic outcome was excellent, with 132 patients satisfied with their results in the oncoplastic group compared to 90 in the conventional group.

Conclusion
Oncoplastic breast surgeries are safe, feasible and became the standard of care in breast cancer. Oncoplastic breast surgeries are of choice in cases of multifocal cancer. People who performed oncoplastic breast surgeries had wider free margins, much more aesthetic outcome, better psychological status, less redo surgery, less late deformities, more time consuming, more wound complications improved with frequent dressing, and did not causea delay in the adjuvant therapy, more requirement for contralateral symmetrizing surgery.
Role of drug coated balloon angioplasty in treatment of recurrent dysfunctional arteriovenous fistulae for hemodialysis
Authors: Elnaggar Ahmed A. , Essawy Ayman , Senosi Abdullah Y. , Rahim Amr A. , Tawfik Ahmed R. 
Published: December 2023

Objective
This study aimed to evaluate the safety, clinical benefits, and patency outcomes of using paclitaxel drug-coated balloons (DCBs) for the treatment of recurrent dysfunctional arteriovenous fistulae (AVF) in hemodialysis patients.

Study design
A nonrandomized clinical trial was conducted involving 20 patients who had previously undergone percutaneous transluminal angioplasty (PTA) for failing or failed AVF. Patients were assessed based on clinical criteria, and interventions were performed using paclitaxel-coated balloons. Clinical outcomes, including thrill, bruit, and hemodialysis function, were evaluated, and duplex assessments were conducted after 3 and 6 months to determine recurrent stenosis. Statistical analysis was carried out using SPSS.

Results
The study included 20 end-stage renal disease (ESRD) patients with a mean age of 49.4±17 years. After 2 weeks’ postintervention, all patients had adequate bruit, 16 (80%) patients had adequate thrill, and 19 (95%) patients had adequate hemodialysis. After 6 months, 70% of patients exhibited adequate thrill, while adequate bruit, and hemodialysis were observed in 75% of patients. Duplex assessments showed minimal recurrent stenosis after 3 and 6 months, with only a few cases of new stenotic lesions. Postoperative complications were infrequent, including one unrelated death, and a small number of central venous occlusions and infections. The study indicated a significantly improved efficacy of drug-coated balloon angioplasty over traditional angioplasty in maintaining AVF patency.

Conclusion
Paclitaxel drug-coated balloons offer a promising approach for treating recurrent dysfunctional arteriovenous fistulae in hemodialysis patients. The study demonstrated favorable clinical outcomes, reduced restenosis rates, and improved patency compared with traditional angioplasty.
Prospective study of management in surgical emergency laparotomy patients in Alexandria Main University Hospital
Authors: Sabry Ahmed A. , Abdelsalam Wael N. , Elfayoumi Tarek A. , Sorour Mona G. , Alkafafy Asmaa M. 
Published: December 2023

Background
Emergency laparotomies form a broad group of time-sensitive surgeries done on variable patient population.

Purpose
The purpose of this study was to evaluate the incidence and details of emergency laparotomy, its complications, and mortality rates.

Patients and methods
This prospective study was held in Alexandria University Hospitals in the duration between April 2022 and September 2022 and included all patients were subjected to emergency laparotomies (481 patients). Preoperative, operative, and postoperative data were recorded.

Results
Out of 481 patients, 398 patients had nontraumatic causes and 83 patients had traumatic cause. The commonest nontraumatic cause was appendicitis, and the commonest traumatic cause were stab and road traffic accident. Most of trauma patients were males and had younger age than nontrauma groups. Intraoperative complications were reported at comparable frequencies between both groups and the commonest complications were atrial fibrillation (AF) and failed extubation. Postoperative complications were higher among nontrauma group and septic shock was the main complication. Postoperative mortality was higher among nontrauma group.

Conclusion
Emergency laparotomies were indicated for nontraumatic causes at higher rate the traumatic cause with higher postoperative complications and mortality rates.
Pyloric resection with Billroth 1 gastroduodenostomy versus bypass loop gastrojejunostomy for the management of post corrosive long segment pyloric stricture: a retrospective study
Authors: Omar Ahmed S. M. , Gerges Wadie B. , Osman Tarek A. 
Published: December 2023

Background
Accidental or suicidal ingestion of corrosive substances remains a major public health problem. Worldwide, the causative materials for corrosive injury are not the same. Surgery remains the mainstay of treatment with available different surgical options. The selected surgical technique should offer symptomatic treatment with less postoperative morbidity.

Patients and methods
Retrospective evaluation of 62 patients with long segment pyloric stricture postacid ingestion presenting with gastric outlet obstruction in the period between May 2017 and June 2022. They were divided into two groups, (group A (n=24), managed by Billroth 1 gastroduodenostomy; group B (n=38), managed by bypass loop gastrojejunostomy).

Results
In group A, the age ranged 3–59 years with a mean age of 25.7±22.62 years, while in group B, the age ranged 2.5–63 years with a mean age of 19.72±15.71 years. The type of ingested corrosive was hydrochloric acid in 60 patients (96.77%), while in two (3.23%) patients the exact acid was unknown. The interval between initial acid ingestion and symptoms of gastric outlet obstruction was 3 weeks to 18 months. In group A, the mean operative time was 64.125±7.023 min, while in group B, it was 61.763±7.837 min. Postoperative vomiting occurred in three (12.5%) patients in group A and in six (15.78%) patients in group B. In group A, the mean hospital stay was 5.5±0.932 days, while in group B, it was 4.921±1.806 days.

Conclusion
Billroth 1 gastroduodenostomy has the superiority of prophylaxis against long-term low risk of future malignancy. Bypass loop gastrojejunostomy is a safer alternative to Billroth 1 gastroduodenostomy, especially in the presence of severe perigastric adhesions and malnutrition. Future studies should include a large sample of patients with long periods of follow-up.
Laparoscopic exploration versus conservative treatment in stable blunt abdominal trauma patients
Authors: Mohammed Abdelkader A. Abdelatif , Gad Khalied H. , El-hefny Amr M. M. , Saad Ahmed S. 
Published: December 2023

Background:
Laparoscopy is now a standard procedure in general surgery, and as technique and equipment advance, more complicated procedures are being carried out using this minimally invasive approach. With less patient morbidity, postoperative complications, and recovery time than open procedures, laparoscopic surgery aims to offer equal or better visualisation. Numerous laparoscopic procedures, such as cholecystectomy, gastroesophageal reflux procedures, and diagnostic laparoscopy, have demonstrably achieved this goal. Despite the advantages of laparoscopy in the trauma population, its complexity and potential hemodynamic instability due to intra-abdominal injury typically prevent its use. This cutting-edge technology may help carefully chosen trauma patients. According to estimates, 10% of all deaths worldwide were due to trauma.

Methods:
This prospective study included 29 patients with history of blunt abdominal trauma and vitally stable following initial resuscitation admitted to Casualty and Emergency Unit, ainshams university hospitals and Elzhor Hospital port said, during the period from June 2022 to December 2022.

Results:
The patients in study were 21 males (82 % of total) 10 males in (LE) representing approximately 77 % and 11 males in conservative group representing approximately (87 %), and 8 females (18 % of total) 2 females in (LE) and 6 in conservative group. As Regarding the hospital stay, in this study, the patients managed by (LE) had shorter hospital stay in relation to those managed conservatively, as the patients results revealed that the overall hospital stay for (LE) was significantly shorter, with an average of 5.69 ± 1.887 days. In this study, the group that benefit the most from shortening the hospital stay was the patients with haemoperitonium with no definite injuries, followed by patients with splenic injuries, while differences in hospital stay in patients with hepatic injuries were not significant. All patients had access to follow-up information for three months after discharge. There were no infective or late hemorrhagic complications observed.

Conclusion:
Laparoscopic exploration was found to be most beneficial in patients with blunt abdominal trauma who had a CT scan that revealed haemoperitonium but no organ injuries., and to less extent in cases with splenic injuries, while there was no significant data favoring (LE) on conservative treatment in patients with hepatic injuries.
Correlation Analysis of DNA UGT1A1 Gene Expression in Hyperbilirubinemia and Central Nervous System-Related Adverse Reactions Following Oral Dolutegravir Administration
Authors: Bunu Samuel J. , Adugo Midia , Vaikosen Edebi N. , Jonathan Nanakede T. , Ebeshi Benjamin U. 
Published: December 2023

Major pharmaceutical guidelines have identified Dolutegravir (DTG) as a critical medicine in the first-line treatment of HIV/AIDS. The goal of the study was to correlate DNA UGT1A1 gene expression in hyperbilirubinemia and central nervous system-related adverse reactions following oral Dolutegravir administration, using a NanoDrop-1000 spectrophotometer and rt-PCR. 52 seropositive patients were recruited using a standardized questionnaire having different components, including gender, demographic data, educational qualifications, when Highly Active-Antiretroviral Therapy (HAART) was initiated, the nature of adverse or side effects experienced, modalities used to overcome such events, and other laboratory parameters were carefully collected. Informed consent was obtained from all potential participants after an adequate explanation of the study and possible areas they would be involved, as well as samples to be collected. Blood samples were collected via venous puncture from all participants, and the same was used to quantify the level of UGT1A1 expressed in each participant using the NanoDrop-1000 spectrophotometer and rt-PCR. The outcome was compared with the side effects or adverse events experienced by each participant using ANOVA. The NanoDrop-1000 spectrophotometric results showed adequate DNA yield from 0.65 (lowest) to 104.71 ng/µl (highest) at 260nm and 280nm, respectively. At 260nm, the absorbance ranges from 0.01 to 2.09, while at 280nm from -0.01 to 1.12, respectively. Some of these participants reported having some level of anxiety, consistent headache, insomnia, drowsiness, dizziness, etc., which are clear neuropsychiatric symptoms, loss of appetite, dry throat, and anemia as adverse reactions due to HAART. There was a positive but mildly significant correlation between UGT1A1 gene expression and CNS-related adverse reactions and hyperbilirubinemia, with a p-value of 0.08.

Received: 1 August 2023 | Revised: 25 September 2023 | Accepted: 23 October 2023

Conflicts of Interest
The authors declare that they have no conflicts of interest to this work.

Data Availability Statement
The data that support this work are available upon reasonable request to the corresponding author.
Contribuição ao estudo histopatológico do epineuro cubital em doentes de hanseníase indiferenciada
Authors: KATZ Daisy R. , ALMEIDA NETO Estevam de , MARTINS José Eduardo Costa , TSANACLIS Ana Maria Crous 
Published: December 2023

Doze doentes de hanseníase, grupo indiferenciado, com baciloscopia negativa e virgens de tratamento, foram submetidos a biopsia de epineuro cubital para estudo histopatológico. Todos os doentes foram observados clinicamente um mês após, e seis destes puderam ser examinados 4 a 5 anos após. A histopatologia do epineuro mostrou existência de bacilos álcool-ácido-resistentes em um doente e tendência à formação de granuloma tuberculóide em outro. Em nove doentes, pôde-se observar espessamento epineural e, em seis, infiltrado inflamatório linfomononuclear perivascular. O exame clínico após 1 mês nos 12 doentes e também após 4 a 5 anos em 6 deles demonstrou a inocuidade da biopsia realizada. Quatro a cinco anos após a observação inicial, o exame clínico mostrou que dois doentes que permaneciam Mitsuda negativos não apresentavam epineuro histopatologicamente espessado no início, enquanto que em quatro doentes, que passaram a apresentar Mitsuda positivo, o exame histopatológico inicial revelara espessamento epineural. Dos nove doentes que apresentavam epineuro histopatologicamente espessado, seis não mostravam lesões iniciais nos membros superiores. O estudo do espessamento precoce do epineuro cubital merece, portanto, especial destaque, devendo ser realizado em maior número de doentes e em grupo de controle, pois no seguimento de quatro dos seis doentes, observou-se espessamento epineural e viragem da reação de Mitsuda.