bluuebunny/crossref_metadata_2025 huggingface dataset:
Metal artifact reduction on MRI images
Authors: Gapon Nikolay V. , Semenishchev Evgenii A. , Balabaeva Oxana S. , Skorikova Arina A. , Tokareva Olga A. , Nadykto Alexey M.
Published: November 2018

This article examines the method of image reconstruction, which aims to restore the exposed areas on MRI images. The algorithm is based on a geometric model for patch synthesis. The lost pixels are recovered by copying pixel values from the source using a similarity criterion. We used a trained neural network to choose the “best similar” patch. Experimental results show that the proposed method outperforms widely used state-of-the-art methods.
The key management method for the system of end-to-end symmetric database encryption
Authors: Galushka Vasily , Marshakov Daniil , Aydinyan Andrey , Tsvetkova Olga , Fathi Denis
Published: November 2018

The article is devoted to the description of ways to manage cryptographic keys for the system of end-to-end symmetric database encryption designed to implement access control mechanisms with the aim of enhancing the capabilities for managing user rights. It describes how to use unique encryption keys for individual database tables, the associated information security risks and approaches to their elimination using cryptography. Separately, the question of implementing the method of managing access to rows of the table by creating a multi-level hierarchy of users using encryption key chains formed through irreversible transformations, as well as the exchange of data by keys. It is proposed to implement it using a crypto container, which is a set of information necessary for the operation of asymmetric encryption algorithms and modified taking into account the peculiarities of the system in question, which allows providing comprehensive information security of user data.
The increase of signal-to-noise ratio in the spatial separation of signals by the curvature of the wavefront
Authors: Okorochkov Aleksandr , Malyutin Bogdan , Khripkov Gleb
Published: November 2018

The article presents the results of the research of the dependence of the signal-to-noise ratio in the focal spot of the reflecting passive phased antenna array (PPAA), made of planar diffraction elements, on the orientation of the PPAA relative to the structure of the interference field, its dimensions and distance from PPAA plane to the focal spot. The results of the research show that the signal-to-noise ratio mainly depends on the horizontal size of the PPAA. The increase of the vertical size of the array leads to the fact that the focal distance corresponding to the maximum of the signal-to-noise ratio increases with the practically unchanged value of this maximum.
Liuwei Dihuang exhibits antidiabetic effects through inhibiting α-amylase and α-glucosidase
Authors: Wang Huafu , Gang Huang , Zhou Shuxin , Liu Lixian , Ding Ting , Gui Zhihong , Chu Weihua
Published: November 2018

Objective: Liuwei Dihuang (LWDH) is a famous traditional herbal medicine formula in China that may regulate the balance of kidney yin yang and has been used to restore functional insufficiency of the kidney for a long time in China.

Methods: In this study, the water extract of LWDH was tested for its α-Amylase and α-Glucosidase inhibitory activities, and its anti-diabetic property in streptozotocin (STZ)-induced diabetic mice was also analyzed.

Results: LWDH extract inhibited α-Glucosidase and α-Amylase activities in a dose- dependent manner. Treatment of streptozotocin-induced diabetic mice with LWDH extract decreased camp, fasting blood glucose, TC, TG, LDL-c, HbA1C, Urine volume levels and Urine sugar, increased HDL-c level when compared to STZ induced diabetic mice.

Conclusion: This study demonstrates that extract of LWDH can inhibit α-amylase and α-glucosidase activities and shows anti-diabetic effect in a mice preclinical model.
Bone and dental abnormalities as first signs of familial Gardner’s syndrome in a Chinese family: a literature review and a case report
Authors: Yu Dan , NG CW Benjamin , Zhu Huiyong , Liu Jianhua , Lin Yi
Published: November 2018

Gardner’s syndrome (GS) is an autosomal dominant disease characterized by the presence of familial adenomatous polyposis (FAP) as well as extraintestinal manifestations such as osteomas, dental anomalies, epidermoid cysts and ocular abnormalities. These intestinal polyps carry a 100% risk of malignant change, so early diagnosis is crucial. As craniofacial osteomas and dental anomalies of GS usually precede gastrointestinal symptoms, otolaryngologists, oral surgeons and dentists play an important role in the diagnosis of GS. GS is extensively reported in literature in the Caucasian race but not in the Mongoloid race. We report a case of a 22-year-old patient with a manifestation of three features of GS - multiple osteomas, soft tissue tumors and dental anomalies in the craniofacial region, with no intestinal polyps at the time of reporting. A family pedigree with our patient as the proband was constructed and revealed 3 consecutive generations in his lineage with GS.
Knock-down of filaggrin influences the mitogen-activated protein kinases signaling pathway in normal human epidermal keratinocytes
Authors: Wang Shumei , Qiu Liyun , Meng Xianguang , Dang Ningning
Published: November 2018

Background: Filaggrin is an essential structural protein of the stratum corneum binding to the keratin intermediate filaments to form a dense protein-lipid matrix. However, the function of filaggrin in epidermal terminal differentiation is not completely understood.

Aim: To evaluate the effects of filaggrin on normal human epidermal keratinocytes (NHEKs) and to investigate the relevant mechanisms.

Methods: Short hairpin RNA (shRNA) technology was used to knock-down filaggrin in normal human epidermal keratinocytes (NHEKs). Western blot and real-time quantitative PCR (qRT-PCR) were performed to detect expression of filaggrin, differentiation-related proteins and MAPK-related proteins.

Results: Filaggrin was successfully knocked down in NHEKs (99% efficiency). We found that the lack of filaggrin significantly decreased the expression of some differentiation-related proteins, including Cytokeratin 5 protein, Cytokeratin 14 protein, ST14 protein and SPRR3 protein (P<0.05). In addition, filaggrin knock-down significantly decreased expression of p-p38, p-ERK1/2, p-JNK, p-Akt, and p-NF-κB in NHEKs.

Conclusion: Our study shows that filaggrin regulates epidermal terminal differentiation and impairs MAPK signaling pathway in normal human epidermal keratinocytes.
UNBS5162 inhibits colon cancer growth via suppression of PI3K/Akt signaling pathway
Authors: Zhang Fan , Lv Hui-zeng , Liu Ji-ming , Ye Xiao-yong , Wang Cun-chuan
Published: November 2018

Colon cancer is a common cause of cancer-related death worldwide. However, the underlying mechanism of tumor progression of colon cancer remains far from being elucidated. In the present study, we report the role of UNBS5162 in colon cancer. UNBS5162 is a naphthalimide that can intercalate into DNA and suppress the expression level of CXCL chemokines. Here, we investigated its effect on cell proliferation, mobility and apoptosis in HCT116 cells, and explored the underlying mechanism. A CCK8 assay revealed that UNBS5162 can block the proliferation of colon cancer cells. Base on a Transwell assay, we showed that cell migration and invasion ability of HCT116 cells are inhibited by UNBS5162. In addition, Annexin V-FITC/PI assay and Western blot analysis were performed to detect whether UNBS5162 could induce cell apoptosis. The results indicated that UNBS5162 increases the number of apoptotic cells remarkably. Furthermore, Western blot analysis demonstrated that UNBS5162 down-regulates the expression level of Bcl2, and up-regulates that of Bax as well as the level of activated Caspase-3. Moreover, we examined the impact of UNBS5162 on PI3K/Akt signaling pathway. UNBS5162 substantially inhibited the phosphorylation of Akt and its downstream effector mTOR, and reduced the expression of p-70. Taken together, these results suggest that UNBS5162 should be considered as a potent therapeutic anticancer agent that targets the PI3K/AKT signaling pathway.
Relationship between depression and blood cytokine levels in lung cancer patients
Authors: Liu Wen-Juan , Wang Xiao-Dan , Wu Wei , Huang Xiao
Published: November 2018

Objective: To study the correlation between depression and blood cytokine levels in lung cancer patients.

Methods: 92 patients with advanced lung cancer were evaluated for depression using the scoring index of depression self-rating scale. Lack of depression (n=24), mild depression (n=45), and moderate depression (n=23) were found in the cohort. Meanwhile, 40 healthy subjects were selected as the control group. The levels of IL-10, IL-6, IL-8, and TNF-α in each group were detected by sandwich enzyme-linked immunosorbent assays, and their correlation with the degree of depression was analyzed.

Results: The levels of IL-10, IL-6, IL-8, and TNF-α were all higher than those in the control group (P<0.05). Moreover, the depression statuses of patients with lung cancer were positively correlated with IL-10, IL-6, and TNF-α levels (r = 0.705, 0.301, and 0.446, P<0.01); however, the level of IL-8 was not relevant (r=0.136, p>0.05).

Conclusion: Serum levels of IL-10, IL-6, and TNF-α are associated with depression scoring in patients with lung cancer.
Complement protein C5a enhances the β-amyloid-induced neuro-inflammatory response in microglia in Alzheimer’s disease
Authors: An Xiao-qun , Xi Wei , Gu Chen-yun , Huang Xiao
Published: November 2018

Objective: The dysregulation of neuro-inflammation is one of the attributes of the pathogenesis of Alzheimer’s disease (AD). Over-expression of complement proteins co-localizes with neurofibrillary tangles, thereby indicating that a complement system may be involved in neuro-inflammation. Here, we report the influence of complement activation on the neuro-inflammation using a microglial cell line.

Methods: first, we performed a cytotoxic assay using the microglial cells BV-2. Second, after treatment of BV-2 cells with Aβ42 and/ or C5a, the anaphylatoxin derived from C5, we determined the expression levels of the pro-inflammatory factors TNF-α, IL-1β, and IL-6. Finally, we explored whether this neuroinflammatory response was mediated by JAK/ STAT3 signaling.

Results: C5a had an enhanced effect on the neural cell viability of BV-2 cells treated with Aβ42. In addition, C5a also increased the Aβ-induced neuro-inflammatory response, and these effects were blocked by the C5aR antagonist, PMX205. Finally, we demonstrated that the neuro-inflammatory responses induced by Aβ and C5a were mediated through JAK/STAT3 signaling. By blocking this pathway with an antagonist, AG490, the expression of TNF-α, IL-1β, and IL-6 was alleviated.

Conclusion: The complement protein C5a could exaggerate the Aβ-induced neuroinflammatory response in microglia, and C5aR may be a potential therapeutic tool for AD treatment.
The youth in the European labour market. Is it lost generation?
Authors: Markovic Daniel
Published: November 2018

Young people, school leavers, graduates and those who have not completed education, belong in many countries of European Union among the disadvantaged in the labour market. Because of that, they often face serious social situation. This paper focuses on the situation of young people in the labour market in the European Union, for whom the term lost generation is used in the media. It is investigated whether the concept of a Lost Generation is an adequate name for the situation or it is just journalistic hyperbole. The paper is a systematic review. It includes a meta-analysis component which involves using statistics. The methods of analysis of statistical data, synthesis of researched findings and monitoring of press and media are used.
The civil procedure principles as the essential basis for undisputed enforcement of obligations
Authors: Pesudovs Andris
Published: November 2018

Not always are a legal transaction and the legal consequences thereof limited to complete and voluntary fulfilment of the mutual obligations of the parties. In cases when a commitment has not been fulfilled, there is an option for a creditor to request for judicial protection in order to prove substantiality of his claim and to receive confirmation to his right to recover the debt in a form of court judgment. However, in the civil legal relationship such impairment of a right is possible which exists outside the dispute regarding the right. A debtor fails fulfilling his obligation and not denies doing it. In such circumstances, notwithstanding recognition of the debt, in order to achieve compulsory execution of the obligation, a document to be enforced is also needed. Provided the type of transaction allows establishing of such type of legal consequences, simplified procedural arrangements may be applied, and restricted principle of contest may result in the possibilities of procedural economy being exercised. Admissibility of such procedural possibility also inevitably activates the discussion regarding what the preconditions of the simplified procedure are and how the simplified procedure of establishing the debtor's obligation can be consistent with protection of his rights. The article focuses on the procedural legal principles, which are involved in the alternative to claim proceedings action of the expedited proceedings and the mutual coherency thereof. Attention is also paid to the form of the transaction and significance thereof in the simplified proceedings.
Price of human life: Medical, legal and social aspects
Authors: Vilks Andrejs
Published: November 2018

The author of the article turns attention to the phenomenon of human life, recognizing it as the value which is hard and complicated to define. The price of a human life comprises philosophical, political, sociological and legal issues. From the legal and philosophical aspect the price of a human life is practically impossible to determine, since it is worth the highest price. Determination of the price of human life means admitting that a human is the measure of value in a certain community under appropriate socially economic conditions. Different approaches and methodologies are applied in determination of a materialized price of a human life, therefore the rating of the price is varied. In determining the price of a human life, the legal aspect is important, since it deals with the fixation of the amount of compensations in cases of an individual's loss of life and calculations of the insurance costs.
Multi-criteria decision analysis as a tool for evaluation of unmet needs in health care
Authors: Araja Diana
Published: November 2018

The United Nations Sustainable Development Goals appoint that all Member States have agreed to try to achieve Universal Health Coverage by 2030. This includes financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines for all. The World Health Organisation has defined the Universal Health Coverage as a priority, which means that all people can use the preventive, curative, rehabilitative and palliative health care services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship. The classic approach of the unmet medical needs is defined as the total self-reported unmet needs for medical care for the following three reasons: financial barriers, waiting times, too far to travel. According to the Eurostat data, overall range of unmet medical needs in Latvia is the highest of the European Union countries, however, the accessibility of health services depends on a multitude of factors that relate to the health system and also to the patients themselves. Therefore the Multi-criteria decision analysis approach could be acceptable for assessment of the unmet medical needs. The data on unmet medical needs for Latvia should be additionally evaluated, taking into account the “therapeutic need”, which refers to the need for a better treatment than the treatment currently reimbursed, from the perspective of the patient. Apart from therapeutic need, the concept of societal need should be investigated, which refers to the need for a better treatment than the currently available treatment for societal reasons.
Well-being and functional abilities in nursing home and home living seniors in Latvia
Authors: Balode Aija , Stolarova Anda , Villerusa Anita , Vetra Janis
Published: November 2018

The society in developed countries is aging. 1.5% of seniors live in nursing homes in Latvia.Aim: to compare functional abilities and well-being between nursing home and home living Latvian seniors.Methods:280 home living seniors and 285 from nursing homes, age ≥ 65 years able to respond to questions and stand up were included in the study based on availability. They were asked to describe their well-being from very bad to very good. The functional abilities were assessed by hand grip strength, the ability to stand up without assistance, the dependence on caregivers (1 – independent, 2 – partly dependent, 3 – fully dependent), the use of walking device assistance devices.Results:The home living seniors could stand up without assistance of hands more often than nursing home residents (60.4% vs. 38.2%,p< 0.001). The handgrip strength was higher in the elderly community-dwelling women (0.3 (0.2–0.3) vs. 0.2 (0.15–0.2) Ba),p< 0.001. The nursing home residents were less often independent (62.8% vs. 83.9%,p< 0.001), more often partly dependent (30.2% vs. 14.6%,p< 0.001) and independent (7.0% vs. 1.4%,p= 0,001) while performing activities of daily living. The nursing home residents had higher walking device assistance needs (mean rank 345.7 vs. 219.2,p< 0.001) and described their well-being as “good” more often (28.4% vs. 16.8%,p= 0.001) and less often as “bad” or “very bad” (18.9% vs. 26.8%,p= 0.048). Conclusion. The subjective well-being of elderly nurse home residents is better than of home living seniors despite having less functional abilities.
Measuring the technophobia among middle-aged and older adults in Latvia: A pilot study
Authors: Zarina Ilona , Circenis Kristaps , Erts Renars
Published: November 2018

The increasing need for the development of new solutions for older adults in order to support the independent living at home is perspicuous. The rapid development of information and communication technology will provide capable solutions for maintaining of life quality. Computerized technology is devoted to improving our quality of life. By the way, here is a segment of the population who do not have access to the technology in any way or form because technophobia. The aim of the pilot study was to translate measurement instrument of technophobia “Technophobia test” and collect data needed for analysis and adaptation process. The following research tasks were completed: upon examination of the available literature, the most accepted instruments for measuring technophobia are the Computer Anxiety Rating Scale (Form C), the Computer Thoughts Survey (Form C) and the General Attitudes towards Computers Scale (Form C). In Latvia, up to now such research has not been carried out. Participants (62) were middle-aged and older persons, aged from 45 to 87 years. The descriptive statistic parameters of Technophobia test subscales and the reliability statistical parameter Cronbach's alpha were calculated and average level of technophobia was assessed.
Postural state of preschoolers on territory of Ružomberok and Martin, Slovakia
Authors: Kolarova Marina
Published: November 2018

Postural disorders are the current problems of the present time and can be monitored in each age group and today they are not rare even among pre-schoolers. Untreated postural disorders can cause spinal deformity, pain, neurological symptoms or disorders of movement patterns. It is therefore extremely important to monitor and assess their occurrence as early as in pre-school age, when posture is still developing and taking the form and, if irregularities are found, take relevant preventive measures. This is the reason we conducted the assessment of posture among pre-schoolers. Within the project Healthy little back carried out in Ružomberok and Martin we examined 111 pre-schoolers aged 5–6. Their posture was assessed using aspexia. The aim of the examination was to determine the posture of body parts and then assess the overall posture. To assess the posture we used a modified methodology of Napoleon Wolanski. Results: 48.65% pre-schoolers with physiologic posture, 36.94% with initial postural disorder and 14.41% with serious postural disorders. Less than half of pre-schoolers have physiological posture and it is therefore necessary to implement preventive measures and programs in kindergartens to avoid the situation to worsen.
Influence of high physical load endurance exercises on the anthropometric parameters and health status of military personnel
Authors: Plavina Liana , Vellere Natalija , Umbrasko Silvija
Published: November 2018

Military personnel are in high-risk group for health disorders, musculoskeletal pathology and psychological overload. We provide evaluation of the anthropometric parameters and health status of military personnel, Cadets, who have participated in ten days duration Combat training course. Combat training course is associated with life-style change – social, environmental, climate and geographical conditions, biorhythms, nutrition etc., with an increase in physical and psych emotional loads. It is characterized with transition from daily routine of military study process in National Defence academy to military exercise in external environment. Cadets faced to feeding limitation, sleeping deprivation intensive and continuous training, strict discipline etc. We provided analysis of anthropometric parameters before, and in time of Combat training course, summarized data of health statement and health problems that were fixed in the medical cards. The proper body mass supports good health capacity and we provided assessment of it. Physical fitness and body composition have adverse effect on military performance. Body composition undergoes changes during higher physical load performance. Military personnel have high risk to health, concerning impact of external and internal factors. According the review of medical cards of cadets group, we indicated main problems, which are fixed after the Combat training course.
Perinatal outcomes of multiple births conceived through in vitro fertilization compared with spontaneous multiple births
Authors: Zile Irisa , Jefremova Inga , Gavare Iveta
Published: November 2018

Pregnancies that occur after assisted reproduction procedures constitute high-risk pregnancies. There is a lack of sufficient epidemio-logically based data on this issue in Latvia. The aim of this study was to compare the maternal and perinatal outcomes of multiple pregnancies conceived by in vitro fertilization (IVF) in comparison with spontaneous multiple pregnancies. This retrospective cohort study (2007–2014) analysed data from population-based Medical Birth Register (MBR). There is a statistically significant increase of multiple births from IVF pregnancies – an average 2% per year (p< 0.01). Newborns of IVF multiple births have higher odds of low birth weight (OR = 1.2) and congenital anomalies (OR = 1.6). Maternity characteristics showed that mothers in the IVF group were significantly older than those in the control group (≥35 years) (OR = 2.1) and primipara births (OR = 4.1). Multiple births conceived by IVF have similar outcomes as spontaneously conceived multiples in the perinatal period, although the rates of congenital anomalies after IVF are just slightly higher than in control group.
Subjective perceptions of life among women after hysterectomy
Authors: Banovcinova Lubica , Jandurova Sona
Published: November 2018

Hysterectomy is the most commonly performed gynaecological surgery, which can influence woman's life in sexual, psychological, hormonal and social sphere. The aim of this study was to examine the subjective perceptions of life among women after hysterectomy (positive and negative effects of surgery, sources of social support, satisfaction with support, satisfaction with life and health). 70 women who underwent hysterectomy (mean age was 47.66 ± 9.47 y.; 29–72) were assigned for this study. The Multidimensional scale of perceived social support (MSPSS) and additional questions were used to gain information on social support, positive and negative effects of surgery, satisfaction with support, satisfaction with life and health. The majority (68.6%) of respondents prefer husband or partner as a source of support and were subjectively satisfied with this support (81.4%). 20% sought support outside family and friends network and priest, psychologist and support groups were their preferred supporters. The most cited positive aspects of hysterectomy were the disappearance of symptoms and reduced fear of uterine cancer. Most women did not see any negative consequences of surgery (45.7%) and were subjectively satisfied with their life (90%). Since the social support is one of the important factors affecting women's life, healthcare professionals should also focus on building and strengthening patient's support network when working with these groups of women.
Development of the Russian version of the Work Rehabilitation Questionnaire. Preliminary evaluation of the social and vocational status of patients with traumatic spinal cord injury
Authors: Vasilchenko Elena , Zoloyev Georgy , Karapetian Karine
Published: November 2018

Introduction:spinal cord injury is a damaging event that affects person's wellbeing and represents a significant societal problem. Traumatic spinal cord injury (TSCI) occurs mostly among young adults and causes severe impairments in daily living activities and functioning. The Work Rehabilitation Questionnaire (WORQ) based on the International Classification of Functioning, Disability and Health was developed recently as an instrument to evaluate functioning in vocational rehabilitation. The evidence of work activities and vocational status of disabled persons in Russia remains almost unstudied, Therefore, the need for Russian version of WORQ has emerged to investigate the social and vocational status of TSCI-patients.Objectives:cross-cultural adaptation of WORQ into Russian; preliminary evaluation of the social and vocational status of patients with TSCI.Material and methods:Russian WORQ (self-reported version) was used to investigate the social and vocational status of the patients with TSCI.Results:more than 80% of participants are not vocationally active;Conclusions:the most severe degree of impairment is not associated with lower rates of employment; female patients with TSCI are more likely to have an active working status.
The phenomenon of social risk families and its dynamics in Lithuania
Authors: Gudzinskiene Vide , Augutavicius Rimvydas
Published: November 2018

Families at risk are definitely the urgent public concern that requires immediate solutions in Lithuania. It is important to mention that the children growing within the families at risk are in the centre of concern as their social and physical environment is not stimulating enough, leading to a number of different problems the families and children themselves are facing. In general, the number of such children makes about 4 percent of the total number of children in the country and this rate has remained stable for many years. Scientific problem – the problems experienced by children growing within social risk families and the impact of social risk factors on children's socialization and integration. Object – phenomenon of families at risk in Lithuania. Task of the article – to analyze the phenomenon of social risk families and its trends in Lithuania.
Educational activities for older people as a part of social work
Authors: Zemaitaityte Irena , Petrauskiene Alina
Published: November 2018

The article is an attempt to highlight the value of the educational activities for the quality of human life and educational practices of social workers in gerontology. The article introduces the research results obtained from the focus group. 10 social workers with the experience of organizing educational activities in social care institutions for older people participated in the research. Organising of social events for social workers means implementation of leisure, culture, art related activities through utilizing inner resources of the organisation and by outsourcing of educational activities. Organizing educational activities for social workers is a creative process. It offers learning experience and, while dealing with limitations of resources, allows for collaboration with organisations that are involved in cultural and art activities.
The perspective of Gestalt therapy in social work practice
Authors: Petrauskiene Alina , Zemaitaityte Irena , Grigaliene and Vida
Published: November 2018

The paper analyzes social work integrating the principles of Gestalt therapy, such as dialogue and phenomenological approach, internalization, responsibility and creative adaptation. The main perspectives of Gestalt therapy, which are related to the cases of social work, contexts and possibilities of therapeutic work, are highlighted. The article also reveals obstacles (e.g. dominant, patronizing, controlling and expert model of client assistance, isolated and restricted by directives the reality of social work, institutionalized social work practices and bureaucratic dependence of social security) that impede the development of therapeutic social work in Lithuania. It can be argued that the perspective for Gestalt therapies is available to social workers who seek therapeutic social work practice methodologies, help relationships, and empower clients for change.
Down syndrome – a challenge for Latvian health care and education system
Authors: Cirule-Galuza Julija , Ilze Strale , Jegorenko Solvita , Priedena Liga , Gintere Erika , Muceniece Aija , Durneva Ilze , Cirulis Sandris , Jansone Liga
Published: November 2018

Down syndrome (DS) is a genetic disorder. From 1997 to 2015, 473 DS patients were born in Latvia. Prenatal diagnosis allows terminating pregnancies with high risk of DS. The aim of our research was to assess the impact of environmental quality (family and extra-familial care) on the child's development, range of services for DS patients, and to identify the optimal early support system. Families and specialists were interviewed to analyze differences between children in families and institutional care clients. State financial support for a DS child in the family is less than to a child in institutional care, and does not provide adequate rehabilitation services. Conclusion: the environment (family/institution, available resources, and rehabilitation services) where the child grows up after the birth, determines both their quality of life and level of independence development. If the somatic problem-solving path is clear, then social integration needs to be improved. Support of inter-professional teams for the families is necessary immediately after the diagnostic statement in order to ensure a more favourable family environment and to reduce the risk of institutionalization. Despite the potentially higher early intensive rehabilitation costs, in the course of time we can predict that it will provide an economic effect on the state and improve the patient and their family's quality of life.
Quality of life of men and women using drugs in Western Slovakia
Authors: Zakova Martina , Krajcirova Martina
Published: November 2018

The aim of our research was to determine the quality of life of men and women who are current drug users in terms of their own perception. We decided to focus on gender because it can also interfere with quality of life. In particular, we aimed to investigate the main dimensions of quality of life such as health, economic situation and social ties. We used a standardized questionnaire WHOQOL BREF. The fieldwork phase of the research was realized from September 2015–December 2015. We used a snowball sampling for collecting data. We investigated that all four domains (physical health, psychological, social relationships and the environment) were evaluated worse by women than men. Women showed in relation to the fair value population the highest standard deviation in the area of psychological domain and men in social relatioships domain. The highest deviation in the areas between men and women was in the physical area. The results showed that quality of life of drug users was dimished, but not as much as we expected in terms of knowledge that literature states.
Comparison of outcomes for supine vs. prone position ERCP: a systematic review and meta-analysis
Authors: Mashiana Harmeet Singh , Jayaraj Mahendran , Mohan Babu Pappu , Ohning Gordon , Adler Douglas G.
Published: November 2018

Background While endoscopic retrograde cholangiopancreatography (ERCP) is usually performed in the prone position, some studies have advocated for ERCP in the supine position. Studies comparing the technical success and safety outcomes have shown variable results. We performed a systematic review and meta-analysis of studies reporting the comparison between the two positions for ERCP outcomes.

Methods We conducted a search of electronic databases and conference proceedings including PubMed, EMBASE, and Web of Science databases (from inception through October 2016) to identify studies that reported the comparison of technical success and safety outcomes between supine and prone ERCP. The primary outcome was to estimate the pooled rates of technical success. The secondary outcome was to estimate the risks of complications, such as cardiopulmonary and post-ERCP pancreatitis (PEP).

Results Six studies reporting on 309 supine and 1415 prone ERCPs were identified. The pooled technical success rates for completion of ERCP in supine and prone positions were 89.1 % (95 %CI = 80.9 – 94.0) and 95.6 % (95 %CI = 91.5 – 97.7), respectively. The pooled rates for complications (cardiopulmonary and PEP) in the supine position were 37.5 % (95 %CI = 19.1 – 60.3) and 3.5 % (95 %CI = 1.6 – 7.3), respectively. The pooled rates for complications (cardiopulmonary and PEP) in the prone position were 41.0 % (95 %CI = 20.9 – 64.8) and 3.9 % (95 %CI = 2.4 – 6.4), respectively. The mean time required for the procedure was 30 minutes and 29.8 minutes for supine and prone positions, respectively. Substantial heterogeneity was noted in the analysis.

Conclusion Prone ERCPs have a higher technical success rate with a slightly lower mean duration but a higher number of adverse events. The decision with regard to patient position should be made after evaluating the overall clinical scenario.
Recurrent esophagogastric variceal bleeding due to portal vein thrombosis caused by protein S deficiency
Authors: Zhou Haoxiong , Xuan Jieying , Lin Xianyi , Guo Yunwei
Published: November 2018

Background and study aims Esophagogastric variceal bleeding (EGVB) is common in patients with portal vein thrombosis (PVT). Hereditary deficiencies in natural anticoagulant proteins, such as protein S, might contribute to PVT. However, recurrent EGVB caused by PVT in patients with protein S deficiency is seldom reported. Herein, we present the case of a 38-year-old man with protein S deficiency complicated with PVT. The patient suffered recurrent EGVB for 7 years. He underwent splenectomy plus pericardial revascularization and sequential endoscopic therapy, including one gastric variceal obturation (GVO) procedure and two esophageal variceal ligations (EVL) to eradicate the varices. Rivaroxaban was administrated to reduce risk of thrombotic events. The patient is currently well without rebleeding after 1 year of follow-up. To our knowledge there is no consensus on management of recurrent EGVB on the basis of thrombophilia complicated with PVT. According to our practice, sequential endoscopic therapy combined with anticoagulant appears to be effective and safe.
Exclusively endoscopic approach to treating gastric perforation caused by an intragastric balloon: case series and literature review
Authors: Barrichello Junior Sérgio Alexandre , Ribeiro Igor Braga , Fittipaldi-Fernandez Ricardo José , Hoff Ana Carolina , de Moura Diogo Turiani Hourneaux , Minata Mauricio Kazuyoshi , de Souza Thiago Ferreira , Galvão Neto Manoel dos Passos , de Moura Eduardo Guimarães Hourneaux
Published: November 2018

Background and study aims Obesity is a serious disease, resulting in significant morbidity and mortality. Intragastric balloons (IGBs) have been in use since the 1980s. After the insertion of an IGB, complications such as migration of the device and even severe gastric perforation can occur, requiring laparoscopic surgery. Here, we report three cases of gastric perforation after IGB insertion. In all three cases, the perforation was successfully repaired through an exclusively endoscopic approach.
Risk Factors of Carpal Tunnel Syndrome for Male Patient
Undergoing Carpal Tunnel Release
Authors: Lee Jun-Ku , Lee Soo-Hyun , Kim Banghyun , Jung Kyunghun , Park Inkeun , Han Soo-Hong
Published: November 2018

Introduction Although the major cause of carpal tunnel syndrome (CTS)
remains idiopathic, many male CTS patients are clinically different from female
patients and often have specific risk factors associated with their conditions.
An accurate analysis of such propensity has yet to be established. The purpose
of this study is to compare male and female patients by analyzing the risk
factors associated with CTS patients who underwent surgical treatment, with
focus on their occupation.

Patients/Material and Methods retrospective chart review of 818 patients
with CTS was performed to identify the associated risk factors. Patients were
stratified by gender: female (n = 707, 86.4 %) and male (n = 111, 13.6 %). The
mean patient age was 54.5 (range: 16–85 yr.) for all groups. The medical history
and risk factors of each patient was thoroughly reviewed by medical charts and
telephone survey. We categorized the risk factors of CTS into 7 categories:
anatomic, neuropathic, inflammatory, alteration of fluid balance, distal radius
fracture associated, occupational risk factor related, and idiopathic.
Occupations of CTS patients were divided into high risk occupations (vibratory
tools, assembly jobs, and food processing and packaging jobs, and other
occupations of repetitive wrist motion and forceful gripping) and nonrisk
occupations. All variables were analyzed with chi-square or Fisher’s exact test
for differences between men and women.

Results The number of individuals with known risk factors of CTS was
greater in male, compared to that of female patients; 97 (87.4 %) male patients
had the risk factors of CTS, while 361 (51.1 %) female patients (p < 0.001)
did. In subgroup analysis of risk factors, male patients had frequent risk
factors in neuropathic, inflammatory, and alteration of fluid balance
(p < 0.001). Occupational risk was strongly associated with male gender
(p < 0.001).

Conclusion Male CTS patients who underwent surgery are more likely to have
a reason and have many occupational risk factors than women.
Karpaltunnelsyndrom und ATTR-Amyloidose
Authors: Hahn Katharina , Urban Peter , Meliß Rolf Rüdiger , Axmann Hans-Detlef , Siebert Frank , Röcken Christoph
Published: November 2018

Hintergrund Das Karpaltunnelsyndrom ist das häufigste Kompressionssyndrom
eines peripheren Nervs. Unter anderem wird es durch Transthyretin-Amyloid
verursacht, das sich in Karpaltunnelgeweben ablagert. Die meisten Betroffenen
sind älter als 50 Jahre. Das Karpaltunnelsyndrom stellt häufig das erste Symptom
einer Transthyretin-Amyloidose dar, die im schlimmsten Fall zur
Amyloid-Kardiomyopathie mit den Symptomen einer Herzinsuffizienz führt und die
Lebensqualität und Lebenszeit einschränkt. Für diesen Artikel wurden alle
histologischen Gewebeproben von Karpaltunnelgewebe aus den Jahren 2010 bis 2018
nach den klinischen Patienteneigenschaften Alter und Geschlecht ausgewertet.
Durch die gezielte Auswertung des Transthyretin-Amyloidgehalts in verschiedenen
Regionen des Karpaltunnels konnte eine Empfehlung zur Resektion für die optimale
histologische Diagnostik herausgearbeitet werden.

Material und Methoden Im Amyloidregister Kiel werden alle Fälle unter
anderem nach Amyloidart und vorliegendem Gewebe archiviert. Für die Auswertung
lagen 582 Resektate von Patientinnen und Patienten mit Transthyretin-Amyloid im
Karpaltunnelgewebe aus den Jahren 2010 bis Anfang 2018 vor. Ergänzend wurde der
Transthyretin-Amyloidgehalt aus zwei verschiedenen Regionen des Karpaltunnels
(Synovialisgewebe und Retinaculum flexorum) miteinander verglichen.

Ergebnisse Es lagen mehrheitlich Resektate von Frauen vor (53 %). Das
mediane Alter betrug 78 Jahre für das gesamte Kollektiv, 77 Jahre für Männer und
79 Jahre für Frauen. Die Resektate des Retinaculum flexorum enthielten
signifikant mehr Amyloid (9,66 % Amyloid) als die Resektate aus dem
Synovialisgewebe des Karpaltunnels (2,10 % Amyloid). Die Prävalenz der durch
ATTR-Amyloid-bedingten Karpaltunnelsyndrome beträgt 11,66 %.

Schlussfolgerungen Sowohl Männer als auch Frauen erkranken an einem
Karpaltunnelsyndrom, das durch Transthyretin-Amyloid verursacht wird.
Insbesondere im Alter von über 50 Jahren sollte im Rahmen der ätiologischen
Abklärung des Karpaltunnelsyndroms an Amyloidablagerungen als Auslöser gedacht
werden. Die frühzeitige histologische Diagnostik ist in Hinblick auf das Risiko
einer kardialen Amyloidose von hoher Relevanz. Für eine frühzeitige und korrekte
Diagnose der Transthyretin-Amyloidose im Karpaltunnelgewebe eignet sich vor
allem die histologische Untersuchung des Retinaculum flexorum, so dass von
diesem immer eine Probe-Exzision entnommen und histologisch untersucht werden
sollte.
Synthesis of Perylene-Tagged Internal and External Electron Donors for Magnesium Dichloride Supported Ziegler–Natta Catalysts
Authors: Voskoboynikov Alexander , Guzeev Bogdan , Mladentsev Dmitry , Sharikov Mikhail , Goryunov Georgy , Uborsky Dmitry
Published: November 2018

We report on the synthesis of three perylene-tagged electron donors representing three major types – phthalates, diethers, and alkoxysilanes – which are of importance for the subsequent studies of MgCl2-supported Ziegler–Natta catalysts by means of laser scanning confocal fluorescence microscopy. The obtained products were unambiguously characterized, including by X-ray crystal structure analysis; their photophysical properties (absorption and emission spectra) were investigated as well. Additionally, a reliable and convenient protocol for the multigram synthesis of the required starting material – 3-bromo­perylene (PerBr) – was developed. The key step of this method was synthesis of trialkylsilyl-substituted perylenes, which were further separated by means of flash chromatography followed by conversion of the isolated 3-trialkylsilyl-substituted product to PerBr.
Diffuse Alveolar Hemorrhage and Pulmonary Vasculitides: Histopathologic Findings
Authors: Scapa Jason , Fishbein Gregory , Wallace W. , Fishbein Michael
Published: November 2018

Vasculitides are a heterogeneous group of disorders in which inflammation of blood vessel walls is present at least some time during the course of the disease. Vasculitides can affect any caliber or type of vessel in many anatomic sites; however, the disease can alter more than just vasculature. Given the diversity of vasculitides, in 2012, a revised classification system was proposed to categorize vasculitides by the type of vessel involved including size, function, and structural attributes. In the lung, vasculitis impacts both the pulmonary vessels and parenchyma. Extrapulmonary involvement, particularly with concomitant kidney involvement, is a frequent occurrence. Pulmonary vasculitides often present with hemoptysis, pathologically manifested as diffuse alveolar hemorrhage (DAH) with or without capillaritis and can be life threatening when diffuse throughout the lungs. Etiologies for DAH include both primary and secondary vasculitides, along with collagen-vascular diseases, infection, and drug toxicity. Therefore, diagnosing the specific vasculitic etiology often relies on comprehensive assessment of all clinical, laboratory/serological, imaging, and histopathologic features that may be present. The most common primary pulmonary vasculitides often affect small vessels and are associated with circulating antineutrophilic cytoplasmic antibodies (ANCAs). In the 2012 classification, these include granulomatosis with polyangiitis (formerly Wegener granulomatosis), eosinophilic granulomatosis with polyangiitis (formerly Churg–Strauss' syndrome), and microscopic polyangiitis. Other less frequent vasculitides that are non-ANCA associated or affect medium- to large-sized vessels can have pulmonary involvement. These entities are usually associated with extrapulmonary disease and include polyarteritis nodosa, Takayasu's arteritis, Behçet's disease, and antibasement membrane antibody disease (formerly Goodpasture's syndrome). Although all vasculitides have vessel wall inflammation at some phase in the disease process, their histopathologic findings are as diverse as the group of diseases themselves. The characteristic histologic findings of the pulmonary vasculitides will be reviewed here.
Antiglomerular Basement Membrane Disease
Authors: Pusey Charles , McAdoo Stephen
Published: November 2018

Antiglomerular basement membrane (anti-GBM) disease is a rare but life-threatening autoimmune vasculitis that is characterized by the development of pathogenic autoantibodies to type IV collagen antigens expressed in the glomerular and alveolar basement membranes. Once deposited in tissue, these autoantibodies incite a local capillaritis which manifests as rapidly progressive glomerulonephritis (GN) in 80 to 90% of patients, and with concurrent alveolar hemorrhage in ∼50%. A small proportion of cases may present with pulmonary disease in isolation. Serological testing for anti-GBM antibodies may facilitate rapid diagnosis, though renal biopsy is often required to confirm the presence of necrotizing or crescentic GN and linear deposition of autoantibody on the glomerular basement membrane. Alveolar hemorrhage may be evident clinically, or detected on imaging, pulmonary function testing, or bronchoscopy. Prompt treatment with plasmapheresis, cyclophosphamide, and steroids is usually indicated to remove pathogenic autoantibodies, to prevent their ongoing production, and to ameliorate end-organ inflammation. Alveolar hemorrhage is usually responsive to this treatment, and long-term respiratory sequelae are uncommon. Renal prognosis is more variable, though with aggressive treatment, independent renal function is maintained at 1 year in more than 80% of patients not requiring renal replacement therapy at presentation. Relapse in uncommon in anti-GBM disease, unless there is a concomitant antineutrophil cytoplasm antibody (present in 30–40%), in which case maintenance immunosuppression is recommended.
Eosinophilic Granulomatosis with Polyangiitis (Churg–Strauss)
Authors: Nguyen Yann , Guillevin Loïc
Published: November 2018

Eosinophilic granulomatosis with polyangiitis (EGPA), formerly called Churg–Strauss syndrome, is a systemic necrotizing vasculitis of small- and medium-size vessels, characterized by asthma and blood eosinophilia. EGPA typically occurs in patients with preexisting asthma, and involves the skin, lungs, and peripheral nerves. Poor-prognosis factors (i.e., involvement(s) of the gastrointestinal tract, heart, and/or kidney) have been assessed with the Five-Factor Score (FFS). One-third of the patients have anti-myeloperoxidase antineutrophil cytoplasm antibodies, and their presence seems to differentiate between two phenotypes, with different clinical characteristics and prognoses. Overall survival has improved markedly since the use of glucocorticoids and immunosuppressants, but relapse rates remain high. All patients require glucocorticoids, and for those with severe/refractory disease and FFS-defined poor prognoses, immunosuppressants should be used (cyclophosphamide for induction and azathioprine for maintenance therapy). Recent advances in EGPA management, including several novel immunomodulatory drugs and targeted biotherapies, were or are being evaluated to improve EGPA patients' prognoses.