bluuebunny/crossref_metadata_2025_split huggingface dataset:
Engineering a replication-incompetent viral vector for the delivery of therapeutic RNA in crustaceans
Authors: Alenton Rod Russel R , Mai Hung N , Dhar Arun K 
Published: August 2023

Abstract
Viral disease pandemics are a major cause of economic losses in crustacean farming worldwide. While RNA interference (RNAi)-based therapeutics have shown promise at a laboratory scale, without an effective oral delivery platform, RNA-based therapy will not reach its potential against controlling viral diseases in crustaceans. Using a reverse-engineered shrimp RNA virus, Macrobrachium rosenbergii nodavirus (MrNV), we have developed a shrimp viral vector for delivering an engineered RNA cargo. By replacing the RNA-dependent RNA polymerase (RdRp) protein-coding region of MrNV with a cargo RNA encoding green fluorescent protein (GFP) as a proof-of-concept, we generated a replication-incompetent mutant MrNV(ΔRdRp) carrying the GFP RNA cargo resulting in MrNV(ΔRdRp)-GFP. Upon incorporating MrNV(ΔRdRp)-GFP in the diet of the marine Pacific white shrimp (Penaeus vannamei), MrNV(ΔRdRp) particles were visualized in hemocytes demonstrating successful vector internalization. Fluorescence imaging of hemocytes showed the expression of GFP protein and the MrNV capsid RNA (RNA2) as well as the incorporated GFP RNA cargo. Detection of cargo RNA in hepatopancreas and pleopods indicated the systemic spread of the viral vector. The quantitative load of both the MrNV RNA2 and GFP RNA progressively diminished within 8 days postadministration of the viral vector, which indicated a lack of MrNV(ΔRdRp)-GFP replication in shrimp. In addition, no pathological hallmarks of the wild-type MrNV infection were detected using histopathology in the target tissue of treated shrimp. The data unequivocally demonstrated the successful engineering of a replication-incompetent viral vector for RNA delivery, paving the way for the oral delivery of antiviral therapeutics in farmed crustaceans.
Characterizing restrictions on commercial advertising and sponsorship of harmful commodities in local government policies: a nationwide study in England
Authors: McKevitt Sarah , White Martin , Petticrew Mark , Summerbell Carolyn , Vasiljevic Milica , Boyland Emma , Cummins Steven , Laverty Anthony A , Millett Christopher , de Vocht Frank , Junghans Cornelia , Vamos Eszter P 
Published: August 2023

Abstract

Background
Commercial advertising and sponsorship drive the consumption of harmful commodities. Local authorities (LAs) have considerable powers to reduce such exposures. This study aimed to characterize local commercial policies across all English LAs.

Methods
We conducted a census of all English LAs (n = 333) to identify local commercial policies concerning advertising and sponsorship of tobacco, alcohol, less healthy foods and gambling, through online searches and Freedom of Information requests. We explored policy presence, commodity frequency and type, and associations with LA characteristics (region, urban/rural and deprivation).

Results
Only a third (106) of LAs in England had a relevant policy (32%). These included restrictions on tobacco (91%), gambling (79%), alcohol (74%) and/or less healthy foods (24%). Policy prevalence was lowest in the East of England (22%), North East (25%) and North West (27%), higher in urban areas (36%) than rural areas (28%) and lower in the least (27%) compared with the most (38%) deprived areas. Definitions in policies varied, particularly for alcohol and less healthy foods.

Conclusions
English LAs currently underutilize their levers to reduce the negative impacts of harmful commodity industry marketing, particularly concerning less healthy foods. Standardized guidance, including clarity on definitions and application, could inform local policy development.
The Effects of Dexamethasone versus Potassium Chloride as Additives to Local Anesthetic in Supraclavicular Brachial Plexus Block
Authors: El Said Kamel Amr Mohamed , Thabet Wael Reda Hussen , Michael Hany Victor Zaki , El Din Saad Assem Ahmed Galal 
Published: August 2023

Abstract

Background
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. Regional anesthesia of the trunk and the extremities an alternative to general anesthesia in many situations. It avoids the unwanted effects of the anesthetic drugs used during general anesthesia and the stress of laryngoscopy and tracheal intubation.

Aim of the Work
To compare the clinical efficacy of addition of dexamethasone or potassium chloride to local anesthetic solution of bupivacaine and lignocaine on the onset, duration, quality of analgesia, and quality of sensory and motor blockade in supraclavicular brachial plexus block in patients undergoing upper extremity surgeries.

Patients and Methods
This study is a prospective double – blinded, randomized trial After obtaining approval from the Research Ethical Committee of faculty of medicine Ain shams University, this study was conducted in the operating theaters of Ain shams University Hospital.

Results
In the current study, it was obvious that: addition of Dexamethasone to bupivacaine in supraclavicular nerve block shortened the onset times of both sensory and motor blocks than add. Addition of Dexamethasone to bupivacaine significantly prolongs both sensory and motor block durations than injecting dexamethasone intravenously. Addition of Dexamesthasone to bupivacaine prolongs the analgesia of brachial plexus block with subsequent consumption of less amount of analgesics than adding Potassium Chloride.

Conclusion
The use of ultrasonography in performing the supraclavicular nerve block, decreased significantly the incidence of complications such as pneumothorax or intravascular injection and hence, lowered the incidence of systemic toxicity of local anesthetics.
Role of Neutrophil to Lymphocyte Ratio in Risk Stratifying Patients with Unstable Angina and NSTEMI
Authors: Hinnawy Abeir Ramadan El , Abdul-Wahab Sameh Mosaad , Fekky Ehab Mohamed El , Ahmed El Abd Ali 
Published: August 2023

Abstract

Background
A well-known fact about acute myocardial infarction is its association with leukocytosis. The differential analysis of white blood cells gives additional benefit of assessing ACS severity by clinical outcomes. Obtaining peripheral leukocyte count is a cheap and widely available mode.

Aim of the Work
The aim of the study was to test the value of neutrophil to lymphocyte ratio in risk stratifying patients with acute coronary syndromes and its early outcomes.

Patients and Methods
A total of 100 patients with UAP and NSTEMI were prospectively evaluated at Ain Shams University Hospital (63% UAP and 37% NSTEMI).The patients were followed for clinical outcomes for 48 hours in-hospital and 1 month after discharge.

Results
The median (IQR) NLR was 8.4 (5.3 to 9.7) in NSTEMI group versus 1.8 (1.2 to 2.8) in unstable angina group, NLR &gt; 3.9 had a sensitivity of 100%, specificity of 92% as a diagnostic value. All patients were divided into “low risk,” “intermediate risk” and “high risk” groups according to TIMI score. In unstable angina group, the quartiles of NLR in “low risk,” “intermediate risk” and “high risk” groups were 3.01 (2.01, 4.33), 3.39 (2.36, 5.10) and 5.49 (3.44, 9.65). In NSTEMI group, the quartiles of NLR in “low risk,” “intermediate risk” and “high risk” groups were 5.08 (3.07, 8.14), 5.17 (2.98, 9.05) and 6.49 (3.86, 11.68). Meaning that there is positive correlation, as NLR were found to be significantly higher in high risk groups.

Conclusion
Admission NLR is the strong and independent predictor of cardiovascular outcomes in patients with NSTEMI and UAP. Consequently, given the advantages of NLR, it may be the ideal marker for risk stratification in patients with NSTEMI and UAP. Despite the science of inflammatory biomarkers having been described decades ago, NLR appears to be enjoying a renaissance as a cost-effective biomarker with immediate clinical predictability and prognostication. The ease and rapidity of performing these tests make them an independent, simple, inexpensive and accurate early predictor of high-risk TIMI score patients in ACS.

Abbreviations
ACS: Acute coronary syndrome; AMI: Acute myocardial infarction; CAD: Coronary artery disease CK: Creatine kinase cTnI: Cardiac troponin I cTnT: Cardiac troponin T; EDTA: Ethylene-diamine-tetra-acetic acid; MI: Myocardial infarction; NLR: Neutrophil-to-lymphocyte ratio; NSTEMI: Non-ST-elevation myocardial infarction; SCD: Sudden cardiac death; STEMI: ST-elevation myocardial infarction; TLC: Total leucocyte count; UA: Unstable angina; UAP: Unstable angina pectoris; VF: Ventricular fibrillation; WBC: White blood cell count
Assessment of Extent of Myocardial Injury in Patients Undergoing Transvenous Implantation of Pacemaker Using Cardiac Troponin I (cTnI) as a Marker of Structural Heart Damage and It’s Relation to Different Sites of RV Implantation
Authors: Ramadan M , Effat E , Badran H , El Damanhoury H 
Published: August 2023

Abstract

Aim and objectives
The aim of the study is to assess the extent of myocardial injury in patients undergoing trans-venous implantation of pacemaker using cardiac troponin I (cTnI) as a marker of myocardial injury and it’s relation to different sites of RV pacing and number of screwing.

Patients and Methods
This study included 50 patients undergoing Trans-venous Implantation of single or dual chamber permanent pacemakers at Ain Shams University Hospitals during the period from February 2020 to August 2020, divided into 2 equal groups according to the site of RV lead implantation, 25 patients RV lead implanted in the Apex and 25 patients RV lead implanted in the Septum.

Results
All patients had rise in Troponin I after implantation of pacemaker indicating that there is significant relationship between trans-venous implantation of permanent pacemaker and incidence of myocardial injury. Comparing the RV septal pacing group to the RV apical pacing group, results showed that septal RV pacing caused more rise in cardiac troponin I after implantation than in apical pacing group indicating that there is a significant relationship between site of RV pacing and extent of myocardial injury being more in septal RV pacing than apical RV pacing. Furthermore, our study showed that regarding active fixation of RV lead into the myocardium, increasing number of trials of screwing the lead in different sites to achieve the best pacing threshold causes more rise in cardiac troponin I. So, there is a significant relationship between number of screwing and extent of myocardial injury.

Conclusion
We conclude that trans-venous implantation of permanent pacemakers is associated with an increased incidence of myocardial injury and septal RV pacing is associated with more extent of myocardial injury than apical RV pacing. Also, increasing number of trials of active fixation by screwing the RV leads into the myocardium is associated with more extent of myocardial injury.
Registry for the Safety and Success of Percutaneous Coronary Intervention of Chronic Total Occlusion in Ain Shams University Hospitals
Authors: Ayman Elbaz M , Sallam Walid , Rashid Tarek , Okasha Nireen 
Published: August 2023

Abstract

Aim and Objectives
The aim of this registry was to develop an electronic registry for all patients who had Percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) at Ain Shams University Hospitals (ASUHs) over a period of eight months. To collect data on treatment strategies and the outcomes of the procedure and analyze it to determine the frequency of CTO PCI performed, examine the procedural strategies utilized, determine patients „comorbidities, risk factors, the predictors of in-hospital mortality and the outcomes regarding technical and procedural success during the hospital stay.

Patients and Methods
This study is an electronic Registry implementation study on all patients who had Coronary Angiography that shows viable CTO vessel and underwent CTO PCI at Ain shams University Hospitals during eight months of activity since the first of July 2020 till the end of February 2021.

Results
Our registry was conducted on 62 patients. overall procedural success was achieved in 57 lesions (91.9%). The rate of success among re-attempts following a previous failure was slightly lower and not significant (28.1%) (p = 0.573). An ante-grade approach was undertaken in 42 lesions (67.7%), while a retrograde approach was used in 20 lesions (32.2%); the switch of the initial approach strategy in the same procedure was observed in 4 cases (6.4%): in one case (1.6%), retrograde was switched with antegrade, while in the remaining 3 procedures (4.8%) antegrade was changed into the retrograde approach. Procedural success according to the approaches were (88.1%) for anterograde and (100%) for retrograde with no statically significant relation with (p &lt; 0.108). In-hospital adverse event rates were very low (death 1.6% and stroke 1.6%). Potential disadvantages of these procedures, including a large amount of a contrast volume (median 400 ml) and long fluoroscopic time (median 55 min), were not associated with serious clinical sequelae (contrast induced nephropathy 3.2%).

Conclusion
Most CTO lesions can be safely and successfully treated with PCI. Invasiveness and potential risks of these strategies, which have been the greatest concerns of CTO treatment, may be acceptable in the majority of cases considering the actual incidences of related major adverse cardiac events and the procedural success rates. Such outcomes should become the standard of care that all centers undertaking CTO PCI should aspire to.
Evaluation of Efficiency and Reliability of Teledermatology
Authors: Abdel-Aal Sherine Mohamed El-Mustafa , Lotfy Rania Adel , El-Khateeb Ekramy Ahmed 
Published: August 2023

Abstract

Background
Teledermatology (TD) is one of the most rapidly evolving branches of telemedicine. It uses the information and communications technologies to diagnose, monitor, treat, prevent, research, and educate over a distance. It was demonstrated to be more efficient and cost effective in certain settings, such as travel times. It was reported to be reliable and diagnostically accurate for a variety of dermatologic complaints and was shown to reduce wait times, increase access, and improve patient satisfaction and quality of life.

Aim of the Work
to evaluate the efficiency of teledermatology as a patient-doctor communication channel, as well as its reliability to reach a proper diagnosis of variable skin disorders.

Patients and Methods
All patients took photos for their lesions and accompanied them with history in their own words, then the clinic dermatologist carried out history taking and face to face examination as well as taking professional photos. The images and history collected by the patients and the clinic dermatologist were assessed by 10 blinded dermatologists.

Results
of dermatologist presenting cases expectedly showed high percentages of history and photo appropriateness (89.3%, 93.4% respectively) hence high percentage of clue to diagnosis (94.3%). However 35.9% of the cases needed in person evaluation which is still acceptable percent and it could be attributed to the need of further assessment such as clinical, dermoscopic, histopathological examination. On the other hand, the cases presented by the patients were significantly less appropriate than those presented by the dermatologist as regards history and photo appropriateness (31.0%, 31.4% respectively) hence lower percentage of clue to diagnosis (59.1%). And 71.5% of the cases needed FTF consultations.

Conclusion
TD is a leading subspecialty of telemedicine that continues to evolve with advancements in telecommunications and smartphone technology. The evidence to date supports its accuracy, cost effectiveness and ability to facilitate dermatologic care. It should be considered as a valid alternative for face-to-face consultations. And in these days particularly when social distancing is important; TD must be considered as a critical tool to avoid virus transmission and to save both patients’ and physician’s lives. However FTF consultations will remain the gold standard method for diagnosis especilally in diseases which needs clinical, dermoscopic and histopathological examination.
Measurement of Serum Interleukin 24 Specific Immunoglobulin E in Chronic Spontaneous Urticaria and Atopic Dermatitis Patients
Authors: Attia Walaa Abdel Hakim , Elhusseiny Rania Mahmoud , Abdallah Mahmoud Mohamed Abdel Rahim 
Published: August 2023

Abstract

Background
Interleukin-24 is one of the IL-10 cytokine family, it exhibits several functions as autoimmune effect in many diseases of immune origin as chronic spontaneous urticaria. Therefore SP IL24 IgE has been extensively studied for its potential role in the pathogenesis of these diseases, and it hasn’t been studied in AD.

Aim of the Work
To evaluate the presence and percentage of serum IL24 specific IgE in chronic spontaneous urticaria and atopic dermatitis in relation to severity of the diseases.

Patients and Methods
This case control study were done on 20 AD patients, 20 CSU patients, and 20 apparently healthy matched aged and sex controls. Included subjects were subjected to full general and dermatological examination, calculation of AD score for patients using SCORAD and calculation of urticaria activity score seven (UAS7) for CSU patients. Autologous serum skin test and measurement of total serum IgE and IL24 specific IgE in all subjects were performed.

Results
Our results showed that: autologous skin testing revealed significantly higher positive ASST in CSU patients compared to AD patients and control subjects, ASST results were significantly prevalent in CSU female patients compared to males and significantly correlated with increased disease activity. In addition Specific IL24 IgE levels were significantly higher in AD and CSU patients compared to controls being highest in AD patients. Also, specific IL24 IgE discriminated AD and CSU patients from controls with sensitivity and specificity of 90%.

Conclusion
IL24 specific IgE can be considered as a common, specific, and functional auto-antigen of IgE antibodies in patients with CSU and AD.
A Retrospective Study of Management of Gastric Stenosis Post Laparoscopic Sleeve Gastrectomy, Our Institution Experience
Authors: Moustafa Alaa Abbas Sabry , Khalaaf Mohammed Ahmed , Moety Karim Fahmy Abdel , El Qader Matar Ahmed Abd 
Published: August 2023

Abstract

Background
Bariatric surgery is the only obesity treatment with long-term efficacy. Of the various surgical techniques available, laparoscopic sleeve gastrectomy (LSG) is becoming increasingly popular because of its good weight loss results, its ability to correct comorbidities associated with obesity, and its low post-operative complication rate. The early-onset complications of LSG (i.e., those that appear in the first three post- operative months) include gastric fistula (in 2.5 % of cases, according to a recent meta-analysis) and hemorrhage (in fewer than 5 % of cases). Stenosis is a less frequently described early-onset complication of LSG, with an incidence of 0.69 to 3.5%.

Objective
To evaluate different strategies of management of post LSG stenosis and the benefit affecting patient's morbidity and mortality and to describe the mechanism of stenosis and its treatment, suggest a standardized approach to management of post-LSG GS on this basis.

Patients and Methods
This study is a retrospective discreptive study which included patients underwent Laparoscopic sleeve gastrectomy (LSG) at Ain-Shams University El-Demerdash Hospital, Cairo, Egypt and specialized bariatric centers under the supervision of the study modulatrors, Cairo, Egypt From September 2018 to September 2019 with six months of postoperative follow up till January 2020.

Results
In this study we have revised the data of one thousand patients performed laparoscopic sleeve gastrectomy in our bariatric surgery departement and showed a rate of stenosis of 1%, the mean age was 37.5, mean BMI was 47.9, 5 cases were treated by balloon dilatation, two of the were diagnose as stricture and the other three were diagnosed as twist, another two cases were managed by RYGB, and two cases were managed by MGB, finally one case was conservatively managed along with thiamine deficiency support.

Conclusion
Gastric stenosis is a rare but potentially life-threatening complication of LSG. Endoscopic treatment (balloon dilatation in particular) is effective, safe, and avoids the need for revisional surgery. If three attempts at dilatation fail, surgery is necessary. Nutritional support and vitamin supplementation are necessary in cases of poor oral feeding with recurrent vomiting.
Comparative Study between the Effect of the Ultrasound Dissector (the Harmonic) versus Monopolar and Bipolar Electrocautry in Reducing Seroma Formation Post-Conservative Breast Surgery
Authors: El-Anwar Ali Mohamed , Hamid Mohamed Abdel Sattar Abdel , Zaid Mohamed Hamdy , Abuelneel Ahmed Nabil Mohamed 
Published: August 2023

Abstract

Background
Breast cancer, according to national cancer institute, is the commonest cancer in women in Egypt, It represents 37% of all female cancers among Egyptian females cancers, seroma is the most frequent postoperative complication following breast cancer surgery. Our aim was to evaluate the effect of the harmonic focus scalpel versus electrocautery (monoplar and bipolar) in reducing seroma formation post conservative breast surgery.

Patients and Methods
This prospective randomized study was conducted on female patients with breast tumours at the General Surgery Department at Ain Shams University Hospitals starting from November 2020 to May 2021. Approval of the Ethical Committee and written informed consent from all participants were obtained.

Results
Our study included 60 patients, in whom a conservative breast surgery and axillary clearance for breast cancer were performed, were randomly allocated to either harmonic dissection (n = 20) or monopolar electrocautery (n = 20) or bipolar electrocautery (n = 20). Our mean age was 45.47±9.14 years (19-60 years). 10/60 patients (16.6%) had positive family history of mammary cancer, 18/60 patients were diabetic (30%), 23/60 patients were hypertensive (38%), 10/60 patients received neoadjuvant chemotherapy (10%). The mean lesional size was 2.9 ±1.03 cm (1.5-6.2 cm).the mean safety margin was 2.23±0.37 (1.5-3 cm). Operation timing was longer in bipolar electrocautry being (91.90 ± 3.14 minute) than monopolar elctrocautery being (83.35± 3.41 minute), while in harmonic group operation timing being (51.65 ± 5.02 minute).in addition intraoprative blood loss was significant large amount in monopolar electrocautery 75.15 ± 3.12 ml, while in harmonic dissection compared with bipolar electrocautery mean intraoprative blood loss was no significant (52.00 ± 4.18 ml vs 55.80 ± 9.89 ml pvalue =0.055). moreover there was asignificant reduction in the mean time of drain removal (2.90 ± 0.64 day in harmonic dissector), while in bipolar electrocautery 4.95 ± 0.69 day and longest mean time in drain removed in monopolar electrocautery 6.85 ± 0.37 day). And the incidence of seroma formation after drain removal is significant in monopola relectrocautery 58.3%. p-value =0.040, while in harmonic dissection compared bipolar electrocautery incidence of seroma formation after drain removal (16.7% vs 25.0%), this mean that harmonic dissector is low incidence of seroma formation.

Conclusion
Harmonic dissection technique leads to significant decreases in intraoperative blood loss, operative time, mean time of drain removal and postoperative seroma in terms of shorter drain duration and better quality of life. Here, we recommend the use of the harmonic dissection technique in conservative breast surgery.