bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of failure of early shift from invasive to noninvasive ventilation in weaning chronic obstructive pulmonary disease patients who have failed the initial spontaneous breathing trial: a prospective cohort study
Authors: Moneim Sameh A. , Fahmy Tamer S. , Abed Nashwa 
Published: September 2023

AbstractContextNoninvasive ventilation (NIV) is a well-established modality for difficult and prolonged weaning of chronic obstructive pulmonary disease (COPD) patients. Although several studies have addressed the early shifting to NIV, predictors of its success remain to be determined.AimsThe aim of the study was to find predictors of success of early shift of COPD patients who have failed the spontaneous breathing trail (SBT) to NIV.Design and settingsThis investigation was designed as a double-centered prospective cohort study involving the ICUs of Critical Care Medicine of Cairo University and Shebin El-Kom Teaching Hospital.Patients and methodsConsecutive COPD patients who failed the initial SBT were extubated and shifted to NIV. We compared arterial blood gases, lung mechanics, and spontaneous breathing parameters in successful patients with these parameters in those who failed the early shift to NIV.ResultsOut of the 30 patients, 21 (70%) were successfully weaned by early shift to NIV. The failed group had a significantly higher autopositive end-expiratory pressure (P<0.001), rapid shallow breathing index (RSBI) (P<0.05), and significantly lower static compliance and negative inspiratory pressure (NIP) (P<0.001) on admission.Admission RSBI and NIP were the only predictors of failure of early shift to NIV. Just before SBT, the failed group had a significantly higher autopositive end-expiratory pressure (P<0.001), RSBI (P<0.001), and airway resistance (Raw) (P<0.001) and significantly lower static compliance, NIP, and PO2/FIO2(P/F) ratio. Raw and NIP before SBT were the only predictors of success of early shift to NIV.ConclusionRSBI, NIP, and Raw, rather than arterial blood gases, are the most important predictors for success of early shift to NIV in COPD patients who have failed the initial SBT.
Study of voice disorders in patients with bronchial asthma and chronic obstructive pulmonary disease
Authors: Saeed Adel M. , Riad Nermine M. , Osman Nehad M. , Khattab Ahmed Nabil , Mohammed Shymaa E. 
Published: September 2023

Abstract
Background
Chronic obstructive pulmonary disease (COPD) and bronchial asthma are known to cause adverse effects on voice, which might affect the quality of life of an individual.

Aim
The study was designed to study the voice disorders in patients with COPD and bronchial asthma and its relation to disease severity and medication.

Patients and methods
Totally, 60 patients were recruited: 30 stable bronchial asthma patients and 30 stable COPD patients. All participants underwent spirometry and study of voice parameters using auditory perceptual assessment, videolaryngostroboscopy system, voice recording, and acoustic analysis.

Results
Impaired voice quality and various grades of dysphonia were detected in the COPD group in 30% by means of auditory perceptual assessment; structural changes in the vocal folds (diffuse congestion, unhealthy mucosa, and edema) were detected in 36.6%. In the bronchial asthma group, impaired voice quality and various grades of dysphonia were detected in 16.7% and structural changes were detected in 20% of them, whereas acoustic analysis showed a highly significant increase in jitter and shimmer and decreased harmonic-to-noise ratio in 100% of patients of both groups. These changes were greater in metered dose inhaler users than in dry-powder inhaler users. In the bronchial asthma group, fluticasone propionate users had a significantly decreased harmonic-to-noise ratio compared with beclomethasone dipropionate and budesonide users, as well as the least pitch and highest shimmer and jitter. A significant statistical correlation was found between ipratropium inhalation usage and increased shimmer in the COPD group. There was a highly significant correlation between spirometric severity and both grade of dysphonia and character of voice in bronchial asthma patients.

Conclusion
All COPD and bronchial asthma patients had dysphonia, either due to organic causes or due to functional causes. Voice changes were directly correlated with degree of severity and fluticasone propionate inhalation use in bronchial asthma patients, and with ipratropium bromide inhalation in the COPD group.
Correlation between serum periostin biomarker, spirometric airflow limitation, and airway dimensions by multidetector computed tomography in bronchial asthma
Authors: Al-Adawy Eman R. , Gomaa Ashraf A. , Mohamed Ahmed M. 
Published: September 2023

Abstract
Background
Periostin has shown to be involved in the many aspects of allergic inflammation, such as acceleration of allergen-induced eosinophil recruitment, development of a Th2 phenotype, increased expression of inflammatory mediators, and airway remodeling and fibrosis in bronchial asthma and that fibrosis is one factor that causes steroid resistance or hyporesponsiveness in bronchial asthma.

Aim
This study aimed to evaluate the possible role of serum periostin as a biomarker for airway inflammation, for predicting the patient’s possible response to inhaled corticosteroids (ICS) after its regular use and its correlation with disease severity and control compared with functional and radiological findings.

Patients and methods
Sixty nonsmoker, asthmatic patients of at least 20 years of age and 20 control healthy nonsmokers with matched age and sex were included. Patients were then subclassified into two: first, according to the asthma severity into mild, moderate, and severe and then according to asthma control (controlled, poorly controlled, and uncontrolled). Serum periostin, spirometry, and multidetector computed tomography were performed for all included populations.

Results
There was significant statistical direct relation with increased serum periostin level and wall area and bronchial wall thickening (BWT) with asthma severity and all showed high significant increase among patients with uncontrolled than those with controlled asthma. Highly significant statistical direct correlation was found between BWT and serum periostin level. There was highly statistically significant decreased serum periostin level and BWT among the steroid-treated group of patients than in steroid-naive asthma (nonsteroid treated group of patients) which were significantly decreased after regular daily use of ICS for 6 months and also among uncontrolled patients after being adequately controlled than their baseline states.

Conclusion
Serum periostin marker and BWT had a significant, sensitive, accurate clinically relevant indicative value (especially when combined) as regards asthma control and severity and probable adequate response to ICS. Serum periostin not only could be a reliable biomarker for eosinophilic inflammation but also may contribute to the development of airway remodeling as assessed by multidetector computed tomography.
Clinico-radiography and pulmonary functional assessment of patients with diffuse parenchymal lung diseases in al-fayoum governorate
Authors: AbouYoussef Hoda Ali , Sabri Youssriah Y. Y. , El Essawy Assem F. , Hussein Sabah A. Mohamed , Ibrahim Eman K. , Ahmed Mona I. 
Published: September 2023

Abstract
Background
Diffuse parenchymal lung diseases (DPLDs) constitute a heterogeneous group of lung diseases characterized by variable degrees of inflammation and fibrosis. In some DPLD, significant morbidity and unfavorable prognosis, comparable to those of neoplastic diseases, are seen. Efficient and safe methods for the diagnosis of DPLD are needed.

Aim
of the work To assess the characteristic features of DPLD in Fayoum Governorate based on clinical, radiological, and functional assessment.

Patients and methods
This study included 100 patients with undiagnosed DPLD who were selected from the Chest Department, Fayoum University Hospital, during the period from June 2015 to June 2016. All patients were subjected to written informed consent, full medical history, echocardiography, collagen profile, arterial blood gas analysis, spirometry, 6 min walk test, high-resolution computed tomography (HRCT) of the chest and lung biopsy when indicated.

Results
Out of the 100 patients included in the study, 72 (72%) were women, 28 (28%) were men, 15 (15%) were smokers, and 73 (73%) had a history of raising birds. The mean age was 45.4 years(range, 8–85 years). HRCT showed different patterns of parenchymal affection. Idiopathic interstitial pneumonia was the predominant diagnosis (51%), followed by DPLD of known cause (33%), then granulomatous DPLD (12%), and lastly other rare forms of DPLD (4%).

Conclusion
The historical ‘gold standard’ of histological DPLD diagnosis is replaced by a ‘dynamic integrated approach’ using multidisciplinary discussion. The optimal HRCT technique for the evaluation of DPLD is crucial. HRCT of the chest was the diagnostic tool in 75% of the study patients without the need for biopsy.
Association of stroke severity, leukocytosis, and infarction size with early neurological deterioration in acute ischemic stroke
Authors: Saeed Jehan , Samir Ghada M. , El-Said Ahmed F. 
Published: September 2023

Abstract
Background
About one-third of patients with acute ischemic stroke will endure early neurological deterioration (END), which leads to increased mortality and functional disability. A better understanding of risk factors for END is still required.

Objective
The aim of this study was to determine the risk factors of END in ischemic stroke patients.

Patients and methods
One hundred and twenty patients with first ever ischemic stroke were included in this study. All patients were clinically evaluated to determine the risk factors. END was assessed using the National Institute of Health Stroke Scale (NIHSS) after acute ischemic stroke. Laboratory and radiological investigations were done for all patients.

Results
In all, 35% patients showed clinical END after stroke onset and 65% patients were stable or improved. END patients had statistically significant high body temperature, increased leukocyte count, serum blood glucose, triglycerides, NIHSS at admission, high-sensitivity C-reactive protein, and infarction size. Multivariable logistic regression analysis for different variables showed that leukocyte count, stroke severity using NIHSS, and lesion size were independent factors associated with neurological deterioration.

Conclusion
Stroke severity, white blood cell, and lesion size of infarction were the only independent factors associated with END.
Serum and expression profiles of glucose-dependent insulinotropic polypeptide in correlation with cardiometabolic risk factors among patients with systemic lupus erythematosus
Authors: Rashad Nearmeen M. , Allam Reem M. , Ebaid Amany M. , Yousef Mohammed S. , Fathy Maha A. 
Published: September 2023

Abstract
Background
Premature atherosclerosis has been recognized as a major co-morbid condition in systemic lupus erythematosus (SLE). Glucose-dependent insulinotropic polypeptide (GIP) is closely related to cardiovascular (CV) risk factors. We aimed to evaluate GIP expression level in SLE and to explore the possible associations of GIP expression profile with carotid intima-media thickness and insulin resistance (IR).

Patients and methods
A cross-sectional controlled study was conducted, comprising 170 patients with SLE and 120 controls. GIP expression level was measured by multiplex polymerase chain reaction. The carotid intimamedia thickness was measured. Serum GIP levels, homeostasis model assessments (HOMA-IR and HOMA-b), fibrinogen, and homocysteine were measured.

Results
In the patients with SLE with IR, there were significantly higher values of serum GIP (37.99±13.64) compared with patients with SLE without IR (24.61±10.74), as well as the control group (21.7±3.46). In addition, there were significant positive correlations between GIP serum level and cardiovascular risks. Regarding GIP gene expression levels, there were significantly lower levels of GIP gene expression in patients with SLE with IR (1.29±0.72) compared with patients with SLE without IR (2.43±0.61) as well as the control group. Receiver operating characteristic analysis revealed that the diagnostic power of GIP expression was stronger than GIP serum levels in differentiating SLE from control.
In conclusion, in the SLE group, there were lower GIP expression and higher serum levels than control, especially in IR subgroup. GIP expression and serum levels were associated with cardiovascular disease pathogenesis and progression.
Cyclophilin A: a novel biomarker for cardiovascular disease in patients with type 2 diabetes
Authors: Hussain Manal M. , Abdel Hady Mohammed Emad A. M. , El-Sherbeny Alyaa A. , Shehata Amira R. 
Published: September 2023

Abstract
Background and aims
Type 2 diabetes mellitus (DM) is a strong independent risk factor for coronary heart disease. Cyclophilin A (CyPA) is a protein secreted from vascular smooth muscle cells in response to reactive oxygen species. It is suggested that CyPA plays an important role in later stages of atherosclerosis and plaque rupture. It was demonstrated that plasma levels of CyPA are significantly higher in patients with coronary artery disease (CAD) in proportion to severity of disorder. Moreover, several studies have demonstrated a role of CyPA as a biomarker of CADs. Indeed studies revealed significantly higher plasma levels of CyPA in patients with CAD with type 2 DM.

Objective
To assess the severity of CAD among diabetic and prediabetic patients and predict future cardiovascular events.

Patients and methods
The study was conducted on 65 patients with CAD diagnosed by coronary angiography, stratified according to GRACE score into low/intermediate/high death risk categories and subdivided into diabetic, prediabetic, and nondiabetic, and 20 age-matched and sex-matched patients, who had normal angiography as a control group. Blood samples were collected for determination of glycated hemoglobin (HbA1c), serum creatinine, cardiac troponin, and CyPA level using double-antibody sandwich enzyme-linked immunosorbent assay technique.

Results
There were significantly higher levels of CyPA among patient group than control group (P<0.001). Moreover, significantly higher CyPA levels were detected in diabetic group when compared with normal and prediabetic groups (P<0.029). CyPA was positively correlated with HbA1c in all patients and with diabetic patients. HbA1c was negatively correlated with serum creatinine and positively with estimated glomerular filtration rate in prediabetic group and with systolic blood pressure in diabetic group. The number of occluded vessels was positively correlated with both CyPA and HbA1c. The diagnostic sensitivity and specificity of CyPA were 76.92 and 95%, respectively, at a cutoff value of more than 13 ng/ml.

Conclusion
CyPA can be used as an early predictor of CAD in patients with type 2 DM and also in prediabetic patients.
The prevalence of Helicobacter pylori cagA (+ve) among patients with gastric cancer: an Egyptian study
Authors: El Mazny Ahmed N. , Hishmat Tarek , Hussein Ahmed , Gaith Doaa 
Published: September 2023

Abstract
Introduction and aims
Gastric cancer is currently the second most common cause of cancer-related death in the world and the fifth most common cancer and the fourth leading cause of cancer-related death in Europe. It has been evident for more than the past 20 years that Helicobacter pylori is involved in the development of gastric adenocarcinoma. The cagA gene of H. pylori is the main virulence factor that leads to the development of gastric adenocarcinoma through the derangement of cellular architecture and signaling. The objective of our work is to study the prevalence of cagA among patients with gastric cancer.

Patients and methods
This descriptive study was done on 60 patients with gastric cancer underwent serum anti-H. pylori IgM and anti-cagA IgG assessment, computed tomography, upper endoscopy, and biopsy taking, and if needed, computed tomography-guided biopsy, followed by histopathological examination.

Results
A total of 34 (56.67%) patients were cagA +ve and 26 (43.33%) patients were cagA -ve, with no statistically significant difference regarding sex or age.

Conclusion
H. pylori cagA plays a significant role in development of gastric cancer, so we recommend not only H. pylori screening but also cagA virulence strain.
Tumor necrosis factor-alpha and alpha-fetoprotein as biomarkers for diagnosis and follow-up of hepatocellular carcinoma before and after interventional therapy
Authors: Elrabat Amr , Eletreby Shahera , Zaid Ahmed M. Ali , Zaghloul Mohammed H. Eldeen 
Published: September 2023

Abstract
Introduction
Up to 90% of the hepatocellular carcinoma (HCC) cases in Egypt were attributable to hepatitis C virus (HCV) infection. The absolute positive and negative markers for HCC are still deficient. Alpha-fetoprotein (AFP), the most widely used biomarker for early detection and clinical follow-up of patients with HCC, has a sensitivity and a specificity of 41–65% and 80–94%, respectively, even with low cutoff value at 20 ng/ ml. High plasma levels of tumor necrosis factor-alpha (TNF-α) are associated with some cancers, and it has an important central role in hepatocarcinogenesis and involved in cancer invasion with or without metastasis.

Aim
To evaluate the diagnostic accuracy of TNF-α versus AFP as biomarkers for detection of HCC on top of HCV-related cirrhosis and to assess treatment response by using TNF-α and AFP after locoregional intervention of HCC.

Patients and methods
A total of 27 normal control, 51 cirrhotic patients, and 69 cirrhotic patients with HCC were studied in two phases. Radiofrequency ablation and transarterial chemoembolization were done, and patients were followed up for response and tumor marker values.

Results
TNF-α in the diagnosis of Egyptian patients with HCC related to HCV cirrhosis had a sensitivity of 100% and a specificity of 94.1% at a cutoff value of more than or equal to 30 pg/ml. Moreover, more than or equal to 15.2% decrement is a good predictor of complete ablation versus partially or failed ablation with a sensitivity of 78.6%, a specificity of 83.3%, and overall accuracy of 80.77%.

Conclusion
Combined use of TNF-α in addition to AFP increases sensitivity and specificity for early diagnosis of HCC rather than the use of each tumor marker alone. Moreover, TNF-α could be a better noninvasive tumor marker than AFP for assessment of response after locoregional therapy of HCC.
ENHANCING THE PERFORMANCE OF SMEs POST COVID-19: THE ROLE OF STRATEGIC LEADERSHIP CAPABILITIES
Authors: Peter Fred Ojochide , Adeniyi Mojisola Mubo , Sajuyigbe Ademola , Peter Adeshola Oluwaseyi , Adeoti Sarah Bunmi 
Published: September 2023

Small and medium enterprises had difficulty coping with the Covid-19 pandemic as very few SMEs have made it through it, particularly in Nigeria. Strategic leadership has been acknowledged as a crucial asset and one of the driving forces of success among SMEs. This study examined the impact of strategic leadership on the performance of SMEs in Lagos, Nigeria, adopting a mixed-method approach. A total of 400 complete responses from SME managers were analyzed. While simple regression was applied for the analysis of the returned copies of the questionnaire, the qualitative interview results were obtained through thematic analysis. The results indicate that innovation capabilities significantly impact organizational performance. Hence, the study recommends that focusing on innovative capability of strategic leadership such as new product development, innovation activities, marketing intelligence, value creation and new ideas with radical changes are germane for enhancing performance.
PERAN MODEL KEPEMIMPINAN TRANSFORMASIONAL DALAM KESIAPAN BERUBAH KARYAWAN TERHADAP EFEKTIVITAS KINERJA KARYAWAN
Authors: Fransisco Fransisco , Sutikno Arron Yonas , Adriana Erica 
Published: September 2023

This study aims to analyze the role of the transformational leadership model in increasing the readiness to change employees and the effectiveness of employee performance in a company. Transformational leadership is a leadership style that focuses on developing and empowering employees, so that they contribute optimally and can reach their full potential. Transformational leadership is a leadership model that is carried out by inspiring and motivating employees with the aim that they can destroy the boundaries within themselves by exceeding their own abilities in completing their work. This can happen if there are signs, namely: giving ideal influence, motivating inspirationally, providing intellectual stimulation and giving individual consideration. Research has provided evidence that transformational leadership has a positive impact on the performance of employees in companies.
There are several ways in transformational leadership to increase the effectiveness of employee performance, one of which is to process the handling of employees to change. Improvements in performance can occur when employees can be ready to change, because they can quickly get new ideas and challenges that can improve the performance of these employees. There are several ways to get employees ready to change. The trick is to provide a high sense of concern about the need for change. It is also necessary for a leader to convey the usefulness of the change and what the risks are if you don't make the change. Another way that can be applied is by listening to the urgency of its employees, which then the leader must be able to provide support and encouragement. This support and encouragement can be done by providing training and development to employees and rewarding them for their performance in the company. A transformational leader can make the goals of the organization quickly achieved by increasing the readiness of its employees to change. By increasing employees' readiness for change, transformational leaders can help organizations achieve their goals.
So, transformational leadership is a tool that can be used to increase the effectiveness of employee performance. With us being able to understand the models and behaviors of transformational leadership, the book of Isa creates a positive work environment.
IDENTIFIKASI QUASI-LINEAR CONVECTIVE SYSTEM MENGGUNAKAN RADAR C-BAND DI WILAYAH MAKASSAR
Authors: Siregar Muhammad Arief Rahman 
Published: September 2023

Quasi-Linear Convective System (QLCS) merupakan suatu fenomena sistem cuaca konvektif yang berpotensi menyebabkan terjadinya hujan lebat, petir, dan angin kencang yang sifatnya merusak. Penelitian ini mengambil kasus kejadian QLCS Desember 2018 – Mei 2019 di cakupan radar cuaca Makassar yang memiliki jaringan pengamatan radar cuaca berbasis C-Band dengan produk CMAX, Central Tracking, Combined Moment, dan Vertical Shear. Pengamatan dilakukan untuk mengetahui pola sebaran spasial, temporal, profil angin QLCS dan dampak QLCS terkait kejadian petir. Hasil penelitian menunjukkan bahwa pola QLCS di wilayah cakupan radar cuaca Makassar teridentifikasi 32 kasus QLCS dengan durasi terbanyak pada 30-60 menit. Lokasi pembentukan QLCS dominan di Coastal Ocean dengan waktu inisiasi terbanyak saat malam hari pada rentang waktu 18.00-23.59 Local Time. Arah propagasi terbanyak ke arah timur-tenggara sebanyak 47% dengan kecepatan propagasi sel QLCS didominasi oleh slow moving sebesar 47%. Kecepatan angin Vertical Wind Shear (VWS) ditemukan 3 dari 4 jenis pembentukan QLCS yaitu broken line, back building, broken areal, embedded areal, bahwa kecepatan VWS maksimum saat fase matang. Dampak QLCS yang dikaitkan dengan terjadinya petir, hanya 10 dari 32 kasus (31.25%) yang dapat menimbulkan petir.

Kata kunci: QLCS, Radar cuaca, VWS, Petir