bluuebunny/crossref_metadata_2025 huggingface dataset:
Weakly-supervised Convolutional Neural Networks of Renal Tumor Segmentation in Abdominal CTA Images
Authors: Yang Guanyu , Wang Chuanxia , Yang Jian , Chen Yang , Tang Lijun , Shao Pengfei , Dillenseger Jean-Louis , Shu Huazhong , Luo Limin
Published: November 2019

Background: Renal cancer is one of ten most common cancers in human beings. The laparoscopic partial nephrectomy (LPN) is an effective way to treat renal cancer. Localization and delineation of the renal tumor from pre-operative CT Angiography (CTA) is an important step for LPN surgery planning. Recently, with the development of deep neural networks in medical images, fully supervised deep neural networks can provide accurate pixel-wise organ and lesion segmentation. However, constructing the training dataset with manual labels consumes a lot of time. Methods: Therefore, in this work, we proposed a novel weakly-supervised convolutional neural network for renal tumor segmentation. A new three-stage training strategy was introduced to train a convolutional neural network, which includes group and weighted training phases. Results: We evaluated the proposed method on abdominal CT angiographic images of 200 patients. Extensive experimental results show that the proposed method achieves higher dice coefficient of 0.826 than the other two existing weakly-supervised deep neural networks. Furthermore, the segmentation performance is close to the fully supervised deep convolutional neural networks. Conclusions: The proposed strategy improves not only the efficiency of network training but also the precision of the segmentation.
The Effect of Supplemental High Fidelity Simulation Training in Preclinical Medical Students
Authors: Meyers Lori , Mahoney Bryan , Schaffernocker Troy , Way David , Winfield Scott , Uribe Alberto , Mavarez-Martinez Ana , Palettas Marilly , Lipps Jonathan
Published: November 2019

Introduction : Simulation-based education (SBE) with high-fidelity simulation (HFS) offers medical students early exposure to the clinical environment, allowing development of clinical scenarios, management, and teamwork skills. We hypothesized that supplementation of standard pulmonary physiology curriculum with HFS would improve the performance of first-year medical students on written tests of pulmonary physiology. Methods : This pilot study included SBE with three HFS scenarios of patient care that highlighted basic pulmonary physiology. First-year medical students’ test scores of their cardio-pulmonary curriculum were compared between students who participated in SBE versus only lecture-based education (LBE). A survey was administered to the SBE group to assess their perception of the HFS. Results : From a class of 188 first-year medical students, 89 (47%) participated in the SBE and the remaining 99 were considered as the LBE group. On their cardio-pulmonary curriculum test, the SBE group had a median score of 106 [IQR: 97,110] and LBE group of 99 [IQR: 89,105] (p<0.001). For the pulmonary physiology subsection, scores were also significantly different between groups (p=0.014). Conclusion : Implementation of supplemental SBE with HFS could be an adequate technique to improve learning enhancement and knowledge retention in preclinical medical students.
Intravenous administration of tranexamic acid to reduce blood loss during perioperative period in acetabular fracture surgery
Authors: Wang ZhiDong , Wang ZhenHeng , Yang Huilin , Zhu RuoFu , Chen GuangDong , Zhu Xu , Shi WeiDong
Published: November 2019

Backgroud:Literature have reported that topical use of TXA can reduce perioperative blood loss in acetabular fracture surgery.We aim to investigate the effect of intravenous administration of tranexamic acid (TXA) on perioperative blood loss during acetabular fracture surgery Methods:From January 2016 to October 2019, 85 patients undergoing surgical treatment with intravenous TXA administration for acetabular fractures at our department were retrospectively analyzed. The patients were divided into three groups according to dosage of TXA: Single treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery (n = 33), repeated treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery and intravenous infusion of TXA (10 mg/kg) at 3 h (n = 26), and multiple treatment group: patients receiving intravenous infusion of TXA (15 mg/kg) 20 min before surgery and intravenous infusion of TXA (10 mg/kg) at 3 and 6 h (n = 26). Total blood loss, intraoperative blood loss, postoperative hemoglobin drop, surgery-related transfusion rate, postoperative thrombosis rate, and operation time were compared among these three groups Results:Total blood loss, intraoperative blood loss, postoperative hemoglobin drop, and drainage volume in the single treatment group, repeated treatment group, and multiple treatment group were 932.7.0 ± 181.8 ml, 624.2 ± 138.7 ml, 32.2 ± 5.3 g/l, and 100.1 ± 30.1ml; 843.4 ± 153.0 ml, 567.3 ± 144.1ml, 27.6±3.8 g/l, and 86.1± 42.2 ml; and 748.0 ± 145.2ml, 521.1 ± 98.1ml, 24.4 ± 4.4g/l, and 64.8 ± 29.0 ml, respectively; the values were significantly different between groups (P <0.05). The surgery-related blood transfusion rates in the single treatment, repeated treatment, and multiple treatment groups were 51.5% (17/33), 23.0% (6/26), 19.2% (5/26), respectively. There was no statistically significant difference in surgery-related blood transfusion rates between groups Conclusions:Intravenous administration of TXA in acetabular fracture surgery can reduce total blood loss, intraoperative blood loss, and postoperative hemoglobin drop without increasing the risk of venous thrombosis. Multiple administrations before surgery, and at 3 h and 6 h during surgery are more effective than single and repeated administration
Functional versus functional and anatomical criteria-guided ranibizumab treatment in patients with neovascular age-related macular degeneration – results from the randomized, phase IIIb OCTAVE study
Authors: Staurenghi Giovanni , Garweg Justus G. , Gerendas Bianca S. , Macfadden Wayne , Gekkiev Boris , Margaron Philippe , Dunger-Baldauf Cornelia , Kolář Petr
Published: November 2019

Background: To evaluate the efficacy and safety of two individualized ranibizumab retreatment schemes in neovascular age-related macular degeneration.
Methods: Patients (N=671) were randomized (1:1) to receive three initial monthly ranibizumab 0.5 mg injections, then retreatment guided by either best-corrected visual acuity (BCVA) loss (Group I) or BCVA loss and/or signs of disease activity on optical coherence tomography (OCT; Group II). The study was terminated prematurely and the decision to discontinue the study was made by the sponsor. Efficacy analyses were performed on patients who completed 12 months of the originally planned 24-month study. Safety analyses are presented for all safety analyzable patients.
Results: Of 671 randomized patients, 305 completed 12 months of the study. For the 12-month completers, baseline mean (standard deviation) BCVA and reading-center evaluated central subfield thickness (CSFT) were comparable [Group I: 60.9 (13.10) letters and 517.7(201.79) µm; Group II: 60.2 (12.21) letters and 515.3 (198.37) µm]. The change from baseline at Month 12 in BCVA was 6.7 (13.48) letters in Group I and 8.3 (13.53) letters in Group II and the change in CSFT was −161.3 (163.48) µm and −175.3 (170.45) µm, respectively. The mean number of ranibizumab injections was 8.2 in Group I and 8.4 in Group II.
Conclusion: Ranibizumab treatment resulted in visual and anatomic gains at 12 months for both retreatment strategies, with a trend in favor of OCT-guided vs BCVA loss guided retreatment. No new safety signals were seen.
A Joint Segregation Analysis of the Inheritance of Fertility Restoration for Cytoplasmic Male Sterility in Pepper
Authors: Wei Bingqiang , Wang Lanlan , Bosland Paul W. , Zhang Gaoyuan , Zhang Ru
Published: November 2019

A cytoplasmic male sterility (CMS) system is one of the most efficient ways to produce F1 hybrid seeds in pepper (Capsicum annuum). Restorer-of-fertility (Rf) genes are a critical component within the CMS/Rf system. The inheritance of Rf genes in pepper by joint segregation analysis was examined. The inheritance of Rf genes in the two progenies was controlled by two major additive-dominant epistatic genes and additive-dominant epistasis polygene. The two major genes had high additive effects and dominant effects. In addition, there existed significant epistatic effects between the two major genes. The major genes had high heritability in F2, BC1, and BC2 generations. Also, the fertility restorer characteristic can be selected during early generations of the breeding cycle.
Histopathologic Concordance of Mohs Micrographic Surgery: A Systematic Review
Authors: Highsmith James T. , Highsmith M. Jason , Brown Brandon , Weinstein David A. , Etzkorn Jeremy R. , Monheit Gary D.
Published: November 2019

Mohs micrographic surgery is dependent upon accurate interpretation of frozen section slides to ensure complete tumor removal and high cure rates. The objective of this study was to determine an aggregate concordance of histologic frozen section interpretation between the Mohs surgeon
and dermatopathologists as available in the literature. The study sought to assess the bias risk, applicability, and level of evidentiary support for studies of histologic accuracy between these two provider groups. A systematic literature review of three medical databases was conducted. The
Quality Assessment of Diagnostic Accuracy Studies instrument was used to determine bias risk and applicability. The level of evidence was then determined by using the Center for Evidence-Based Medicine (CEBM) model. According to the literature, the concordance rate for frozen slide interpretation
between fellowship-trained Mohs surgeons and dermatopathologists was 99.4% after reviewing 5,566 cases with CEBM Level 2 evidence. This study confirms a high level of correlation of histologic frozen section slide interpretation between fellowship-trained Mohs surgeons and dermatopathologists,
which is supported by Level 2 evidence with low bias risk and low applicability concerns.
Cheating and Its Dangers
Authors: Martin Dean F.
Published: November 2019

Theses (dissertations and masters' theses) can be particularly important resources because they represent sources of detailed information that may not be included in a communication of an article in a highly popular journal, owing to space limitations. In addition, a thesis is a document
presumably prepared under supervision of an experienced faculty member with the aid of a committee of faculty peers. The supervisory committee constitutes an in-house group of experts who can prevent mistakes from being disseminated, as editors and reviewers do for articles sent to journals.
Unfortunately, the value of a thesis may be limited when committee members do not perform their traditional functions, when students cheat, or when students commit plagiarism. Examples of these problems are presented as case studies and as cautionary examples. In addition, suggestions are
made to limit damage that can be caused by those guilty of less than exemplary behavior.
The case of rare genetic mutation in a child with the Wolf–Hirschhorn syndrome from the family irradiated during the Chernobyl accident
Authors: Safonova M. P. , Sipyagina A. E. , Baleva L. S. , Kanivets I. V.
Published: November 2019

Wolf – Hirschhorn syndrome is a rare genetic disease caused by the deletion of the end of the short arm of the 4th chromosome; it is manifested by numerous congenital malformations, delayed physical and psychomotor development. The article describes clinical experience of managing a patient with Wolff – Hirschhorn syndrome born to exposed parents who lived in a territory contaminated with radionuclides after the Chernobyl accident. The article describes pathogenetic aspects of the development of the disease and the need for timely diagnostics.
The role of the pediatrician in the treatment of children with congenital cataracts
Authors: Egiyan N. S. , Katargina L. A. , Kruglova T. B. , Arestova N. N.
Published: November 2019

The purpose of the report is to acquaint obstetricians-gynecologists, neonatologists and pediatricians with the etiological and clinical manifestations, tactics and results of treatment for timely diagnosis and referral to an ophthalmologist. The article presents modern data on the etiology and clinical manifestations of congenital cataracts in children, the particularities of the development of the visual analyzer. The article substantiates the need for the removal of full forms of congenital cataracts in the sensitive period of the child’s development – in the first six months of life for high functional results. The authors note an important role of the pediatrician in the early detection of pathology and timely visit to ophthalmologist to determine treatment tactics.
Analysis of the respiratory therapy in newborns with extremely low body weight at birth
Authors: Bayalieva A. Zh. , Ziganshin I. M. , Babintseva A. A.
Published: November 2019

Respiratory therapy is the main component of intensive care for premature newborns, it has a great influence on nursing outcomes.

Characteristics of children and research methods. The authors carried put a retrospective analysis of the intensive care effectiveness in 44 infants with extremely low body mass at birth.

Results. They found the cases of bronchopulmonary dysplasia and evaluated the treatment effectiveness depending on the weight and gestational age. The children with birth weight of 500–699 grams demonstrated low efficiency of intensive care and adverse course of bronchopulmonary dysplasia. This group of premature infants was characterized by a prolonged stay in the intensive care unit, mechanical ventilation, low body mass dynamics, and, as a result, had a high mortality rate in the late neonatal period compared to the group of children born with a birth weight of more than 700 g (p <0.05).

Conclusion. Effective nursing of preterm infants with a birth weight less than 700g requires a combination of an individual approach to the auxiliary ventilation methods and a non-invasive ventilation regimen along with pharmacotherapy that stimulates the respiratory center of the newborn and promotes the maturation of surfactant to prevent complications of respiratory therapy.
The features of nutritional status in children with congenital heart disease
Authors: Sadykova D. I. , Khabibrakhmanova Z. R. , Shakirova A. R. , Safina L. Z.
Published: November 2019

Malnutrition is a common problem in children with congenital heart defects, regardless of the type of defect and the presence / absence of cyanosis. Children born with heart defects form a high-risk group of nutritional deficiency. Surgical treatment of congenital heart defects is often accompanied by metabolic changes and increased needs of energy and protein. Correction of nutritional status in children with congenital heart diseases improves the condition of patients after cardiac surgery. The purpose of our study was to assess the nutritional status of children with congenital heart defects hospitalized to the cardiac surgery department, and to correct their enteral nutrition. The authors analyzed anthropometric data on the Z-score (weight – age) of children admitted to the department for examination and correction of heart disease. The authors concluded that there is need for further studies to assess the impact of changes in nutritional status on the incidence and mortality of patients with congenital heart defects and the possibility of optimal correction of nutritional status.
Evaluation of anthropometric parameters and body composition in children with cerebral palsy
Authors: Rakhmaeva R. F. , Kamalova A. A. , Ayupova V. A.
Published: November 2019

Children with cerebral palsy (CP) often develop nutritional disorders, their incidence reaches 80% (according to the literature data).

Purpose. To analyze the frequency of nutritional disorders and features of nutritional status in children with CP.

Characteristics of children and research methods. We studied the anthropometric indicators (weight, height, body mass index, triceps and subscapular skin fold thickness), physical development characteristics depending on the motor abilities of the child according to the Gross Motor Function Classification System scale and body composition by bioelectrical impedance.

Results. Nutritional status disorders were detected in 88.8% of patients, while the diagnostic was based on a reduced physical development in 55.5% of patients. 22.2% of patients had protein-energy deficiency of the first degree, 15.5% of patients had protein-energy deficiency of the second degree, 6.7% of patients had protein-energy deficiency of the third degree, 11.1% of patients suffered from overweight. Besides, nutritional disorders were diagnosed in 33.3% of patients with normal physical development, but with altered body composition, namely, with the imbalance of fat and lean body weight, the isolated increase of the percentage of fat mass, the decrease of active cellular and musculoskeletal weight. These patients also require nutritional correction.

Conclusion. These data confirm the dependence of physical development and body composition on the patient’s motor activity and demonstrate the need for complex comprehensive study of nutritional status in children with CP.
Idiopatic fibrosing alveolitis in a newborn
Authors: Gabitova N. Kh. , Cherezova I. N. , Cherezova K. A.
Published: November 2019

The article describes a clinical case of idiopathic fibrosing alveolitis – a rare antenatal disease of a newborn. The disease began with the clinical manifestations of transient tachypnea in a full-term child born in the operative way. Chest X-ray was used for dynamic control of lung tissue damage. Due to the absence of specific clinical symptoms of interstitial lung damage, the disease was considered as a course of congenital pneumonia. The researchers used antibacterial and symptomatic therapy. Despite treatment, the respiratory failure progressed, resulting in fatal outcome.
The health of children born to mothers who have had a threat of abortion
Authors: Smirnova A. V. , Borzova N. Yu. , Sotnikova N. Yu. , Malyshkina A. I. , Kharlamova N. V.
Published: November 2019

The risk of preterm labor is one of the leading complications of gestation which determines the high level of perinatal morbidity and mortality. Receptor for advanced glycation end product RAGE is considered to be an important participant of congenital and adaptive immunity and it can regulate the production of pro-inflammatory cytokines and chemokines. TNFa is a leading pro-inflammatory cytokine, it is produced in response to endotoxin. TGFß1 is the main mediator providing anti-inflammatory effect.

Purpose. To identify the features of the health status of newborns after the threat of termination of pregnancy in 22–27 weeks, the content of sRAGE and cytokines in women at risk of preterm labor depending on perinatal pathology in children.

Materials and methods. We examined 120 pregnant women at 22–27 weeks of gestation, they were divided into 2 groups: the main group (80 women at risk of preterm labor) and the control group (40 women with uncomplicated pregnancy). We determined the content of sRAGE, TGFβ1 и TNFα cytokines, and antibodies to Chlamydia trachomatis, Mycoplasma hominis и Ureaplasma urealyticum, simple herpes virus, cytomegalovirus, the virus of Epstein–Barr in the venous blood serum by ELISA.

Results. The threat of preterm labor at 22–27 weeks increases the risk of perinatal hypoxic lesions of the CNS in newborn 1,5 times (relative risk (RR) 1.43; 95% confidence interval – CI 1.14–1.78). A premature birth, after the threat of preterm labor at 22–27 weeks, increases the risk of perinatal damage to the CNS more than five times (RR 5.13; 95% CI 2.47–10,69), and the risk of intrauterine infection is increased four times (RR 4.08; 95% CI 2.54–6.54). Low content of sRAGE in patients with threat of premature labor at 22–27 weeks is a predictor of development of perinatal hypoxic lesions of the CNS.

Conclusion. Low content of sRAGE in the blood serum of patients at risk of premature labor at 22–27 weeks is a predictor of development of perinatal hypoxic lesions of the CNS. A decreased concentration of TGFβ1 cytokine in the blood of women at risk of premature birth is associated with intrauterine infection in newborns.
Association of polymorphisms of NO synthases and arginase genes, clinical, laboratory and functional indicators with the level of nitrogen oxide in exhaled air in children with bronchial asthma
Authors: Batozhargalova B. T. , Diakova S. E. , Petrova N. V. , Mizernitsky Yu. L. , Zinchenko R. A.
Published: November 2019

The article presents the results of a study of the associations of NO synthase and arginase genes in children with bronchial asthma with clinical, laboratory and functional parameters depending on the level of nitrogen oxide in exhaled air (FeNO). We examined 107 children with bronchial asthma, they were divided into 2 groups depending on the level of FeNO. We found a number of associations in the group of patients with an elevated level of FeNO (≥20 ppb): carriage of alleles and genotypes containing short tandem repeats of S (9–11) NOS1(AAT)n gene, with an early debut and severe course of the disease, an increased level of total IgE in blood serum; carriage of alleles and genotypes containing long tandem repeats L (12–16) of the NOS2A(CCTTT) n gene, with a moderate course of the disease, with an increased level of IgE; carriage of the allele *A of the ARGII gene (rs3742879) with a moderate course of the disease; carriage of the *G allele and heterozygous *AG genotype of the ARGII gene (rs3742879) with a decreased level of FEV1/FVC; carriage of L alleles and a combination of the SL and LL genotypes of the NOS1(AAT)n gene with elevated blood eosinophils (eosinophilia); a combination of S/L + L/L genotypes of the NOS1(AAT)n gene with fungal sensitization. The authors established the correlations between disease severity and NOS1(AAT)n; the age of the manifestation of the disease and NOS1(AAT)n; FEV1/FVC and ARGII (rs3742879); feedback between blood eosinophilia and NOS1(AAT)n. The authors also determined a number of associations in the group of patients with low level of FeNO (<20 ppb): carriage of alleles and genotypes containing short tandem repeats of S (9–11) gene NOS1(AAT)n, with fungal sensitization; carriage of alleles and genotypes containing long tandem repeats of L (12–16) gene NOS2A(CCTTT)n, with reduced FEV1 and FEV1/FVC; carriage of the homozygous genotype of *GG gene ARGII(rs3742879) with epidermal sensitization. With a reduced level of FeNO, the study determined a relationship between the severity of bronchial asthma and NOS1(AAT)n; degree of effectiveness of anti-inflammatory basic therapy and NOS1(AAT)n; fungal sensitization and NOS1(AAT)n; feedback between FEV1 and NOS2(CCTTT)n; FEV1/FVC and NOS2(CCTTT)n.
Experience in using povidone-iodine to treat superficial and full-thickness burns
Authors: Vladimirova O. V. , Lavreshin P. M. , Vladimirov V. I. , Rybalko A. E. , Zybinskiy I. A.
Published: November 2019

Thermal injuries are now ranked number one among injuries, and incidence of injury-related complications, especially infectious and purulent, does not decrease in surgical practice, despite the modern methods for treatment and prevention. Purulent complications depress the speed and quality of wound healing and increase the number of bed-days and treatment costs. Moreover, infection spreading complicates treatment and increases mortality and disability of patients with burn injuries. Choosing the most effective antiseptic agent for burn injuries is crutial both from the perspective of effective local treatment of wounds and wound complications and from the perspective of pharmacoeconomic aspects. At the current time, povidone iodine solution and ointment are one of the leading antiseptics used at all stages of care for burn patients. Its efficacy has been proven by clinical trials and many years’ experience of use by specialists and patients. We have also gained extensive positive experience in using this drug to treat 269 patients with burns of 5 to 35% total body surface area (TBSA) and various thickness without development of resistance and pain in patients and with a pronounced antiseptic effect during its use on the basis of City Clinical Hospital No. 2 of Stavropol, which once again proved high efficacy and feasibility of the widespread use of povidone-iodine in practice due to antimicrobial activity, high bioavailability, ease of use and economic benefits.
Some features of compression therapy for early forms of chronic venous diseases of the lower limbs
Authors: Bogachev V. Yu. , Boldin B. V. , Arkadan N. R. , Lobanov V. N.
Published: November 2019

The current compression garment selection guide is targeted at the earliest clinical stages of chronic venous disease (CVD) and assumes a priori that application of a higher class of compression improves the calf muscle pump function, which is the major mechanism promoting venous return from the lower limb to the heart.Objective of the study: to evaluate the calf muscle pump function in patients with the early forms of CVD using different classes of compression garments.Material and methods: A total of 30 patients (45 lower limbs) with Class 1 CVD (CEAP classification) were enrolled in the study. The calf muscle pump function was evaluated during wearing compression garments using remote cableless photoplethysmography of Bodytronic measurement system (Bauerfeind, Germany) with automatic data processing. The investigators measured venous refilling time (T0) and pump capacity (V0) in patients without compression garments and also in those wearing classes 0, I and II compression garments (RAL standard, Venotrain micro, Bauerfiend socks). All indicators were measured three times with an interval of 30 minutes. The final values of T0 and V0 were calculated as average.Results and discussion: when the indicators were measured without compression and with zero compression, T0 was 26.7 ± 1.2 sec and 25.4 ± 1.1 sec (p = 0.56); V0 - 8.6 ± 0.7% and 8.0 ± 0.4% (p = 0.47). When the calf muscle pump function indicators were measured using class I compression garments, its performance was improved. Thus, T0 and V0 (p <0.01) increased significantly to 38.9 ± 2.1 sec and 12.9 ± 1.4%, respectively. When the calf muscle pump function indicators were measured using class II compression garments, T0 and V0 were 38.1 ± 1.6 sec and 8.1 ± 0.6%. Thus, the use of class I compression garments significantly improved the calf muscle pump function in patients with early manifestations of CVD. The higher level of compression (class II) did not improve T0 and worsened V0. This fact can be explained by excessive compression of the muscular venous sinuses caused by wearing class 2 compression garments, which, apparently, worsened the propulsive ability of the calf pump.Conclusion: the use of class I compression garments is optimal for the management of hemodynamic disorders in patients with early forms of chronic venous diseases (C1 according to CEAP). The higher class of compression does not improve the hemodynamic parameters of the calf muscle pump.
Risk of Kidney Dysfunction IN Nafld
Authors: Mantovani Alessandro , Zusi Chiara , Dalbeni Andrea , Grani Giorgio , Buzzetti Elena
Published: November 2019

Background:

The timely identification of traditional and non-traditional precursors and risk factors for chronic kidney disease (CKD) (a common systemic disease defined as a decreased kidney function documented by reduced glomerular filtration rate, or markers of kidney damage, or both) is relevant in clinical practice, as CKD increases the risk of end-stage renal disease and other serious comorbidities. A possible relationship between non-alcoholic fatty liver disease (NAFLD) (which is to date the most common chronic disease worldwide) and CKD has recently gained significant attention of researchers.

Methods :

A systematic literature search using appropriate keywords was made in order to identify relevant articles that have investigated the association between NAFLD and CKD.

Results:

Several observational studies and meta-analyses have reported the existence of an independent association between NAFLD and risk of CKD in patients with and without diabetes. However, whilst the association between NAFLD and risk of prevalent CKD is strong across various patient populations, whether NAFLD is independently associated with the development and progression of CKD is still debatable. Moreover, emerging evidence now suggests a potential association between patatin-like phospholipase domain-containing protein-3 (PNPLA3) rs738409 genotype (the most important genetic variant associated to NAFLD) and decreasing kidney function, independent of NAFLD.

Conclusions :

Convincing evidence now indicates that CKD is increased among patients with NAFLD. For this reason, patients with NAFLD should be regularly monitored for renal function and, on the other hand , NAFLD should be considered in all patients with CKD, especially if they are obese or have type 2 diabetes.
A Review of Ruthenium-catalyzed C-N Bond Formation Reactions for the Synthesis of Five-membered N-heterocycles
Authors: Kaur Navjeet , Ahlawat Neha , Verma Yamini , Grewal Pooja , Bhardwaj Pranshu
Published: November 2019

The field of heterocyclic chemistry has been revolutionized using transition
metal catalysts in recent years. Various research groups have focused on the development
of general protocols to achieve better functional group compatibilities and greater levels of
molecular complexity under mild reaction conditions, using easily available starting substrates.
The methodologies used earlier for their synthesis were less approachable to organic
chemists because of their high cost, highly specified instrumentation and inconvenient
methods. For both stereoselective and regioselective synthesis of five-membered nitrogen-
containing heterocycles, cyclic reactions that are Ru-catalyzed have known to be
very efficient. These methods have many advantages as compared to alternative pathways
involved in the synthesis of heterocyclic compounds. In this review article, we concentrated
on the synthesis of nitrogen-containing five-membered heterocycles in the presence of a ruthenium catalyst.
This review mostly covers the literature published during the period from 1977-2019.
Interleukin-6 and Malondialdehyde in Women with Preterm Birth
Authors: Verma Vinita , Oza Hina , Thaker Riddhi , Kumar Sunil
Published: November 2019

Background:

Preterm Birth (PTB) is one of the main causes of neonatal death and infant
mortality and morbidity. The pro-inflammatory cytokine interleukin-6 (IL-6) is a major proinflammatory
mediator of the host response to infection and malondialdehyde (MDA) is a marker of
oxidative stress.

Objective :

To evaluate potential associations between IL-6 and MDA levels in women with preterm
birth.

Method:

A total of 150 women (66 with full-term and 84 with PTB) were enrolled in this case-control
study. Predesigned performas were filled through questionnaire interviews to collect data on personal,
demographic, occupational, lifestyle and reproductive history. Blood samples were collected within 36
hours of delivery. Serum concentrations of IL-6 and MDA were determined in mothers with full-term
and preterm birth.

Results:

The mean age was marginally higher; whereas BMI was slightly lower in cases (PTB) as
compared to controls (full-term) subjects. Serum IL-6 and MDA levels were significantly higher in
subjects with PTB than full-term birth. The data were further analyzed with respect to underweight,
normal and overweight/obese BMI. In all the BMI categories, the levels of IL-6 and MDA were higher
in PTB cases. Among the PTB categories, the levels of IL-6 and MDA were highest in moderate to late
preterm birth. A significant positive correlation was found between IL-6 and MDA levels. There was a
weak negative correlation between either IL-6 or MDA and the number of gestational weeks.

Conclusion :

Elevated maternal serum levels of Interleukin-6 and Malondialdehyde in preterm as
compared to full-term birth might suggest that inflammation and oxidative stress play a critical role in
PTB.
Convolutional Neural Network-based MR Image Analysis for Alzheimer’s Disease Classification
Authors: Choi Boo-Kyeong , Madusanka Nuwan , Choi Heung-Kook , So Jae-Hong , Kim Cho-Hee , Park Hyeon-Gyun , Bhattacharjee Subrata , Prakash Deekshitha
Published: November 2019

Background:

In this study, we used a convolutional neural network (CNN) to classify
Alzheimer’s disease (AD), mild cognitive impairment (MCI), and normal control (NC) subjects
based on images of the hippocampus region extracted from magnetic resonance (MR) images of
the brain.

Materials and Methods:

The datasets used in this study were obtained from the Alzheimer's Disease Neuroimaging
Initiative (ADNI). To segment the hippocampal region automatically, the patient brain MR
images were matched to the International Consortium for Brain Mapping template (ICBM) using
3D-Slicer software. Using prior knowledge and anatomical annotation label information,
the hippocampal region was automatically extracted from the brain MR images.

Results:

The area of the hippocampus in each image was preprocessed using local entropy minimization
with a bi-cubic spline model (LEMS) by an inhomogeneity intensity correction method.
To train the CNN model, we separated the dataset into three groups, namely AD/NC, AD/MCI,
and MCI/NC. The prediction model achieved an accuracy of 92.3% for AD/NC, 85.6% for
AD/MCI, and 78.1% for MCI/NC.

Conclusion:

The results of this study were compared to those of previous studies, and summarized
and analyzed to facilitate more flexible analyses based on additional experiments. The classification
accuracy obtained by the proposed method is highly accurate. These findings suggest
that this approach is efficient and may be a promising strategy to obtain good AD, MCI and
NC classification performance using small patch images of hippocampus instead of whole slide
images.
Factors Affecting Defects Occurrence in Structural Design Stage of Residential Buildings in Gaza Strip
Authors: Tayeh Bassam A. , Hamad Rami J.A. , Alaloul Wesam Salah , Almanassra Mansour
Published: November 2019

Background:

Residential buildings are an essential and significant satisfaction pillar for the human’s life to ensure a safe and durable residence. In addition, due to the rapid development and population growth in the Gaza Strip, many residential buildings and housing projects are being implemented in a short period of time especially after Gaza conflict during the year 2014. Therefore, various errors and defects are anticipated to rise during the design stage.

Objectives:

The aim of this paper is to identify and rank the factors affecting the occurrence of the defects in the structural design stage of residential buildings in the Gaza Strip.

Methods:

A survey was conducted for 134 respondents randomly selected as engineers, working for engineering consultant offices as designers, supervisors and projects managers in Gaza Strip.

Results:

The study reveals that the three most effective groups of factors are; the consultant administration and staff group, the drawings preparation group and the structural design group respectively. The most important factors were; ignoring soil investigation or poor soil investigation, poor or lack of engineering supervision or unqualified supervision and conflicts between architectural and structural drawings. These are the most common issues overlooked by the engineers and the contractors in the Gaza Strip.

Conclusion:

The study recommends to apply a strict quality assurance and quality control (QA/QC) program during design phases, providing simple and readable drawings with sufficient details for contractors, raising the awareness of owners towards conducting soil inspections prior to the design process and paying more attention to the informal buildings sector from the related authorities.
Antibiotics in Dentistry: A Narrative Review of Literature and Guidelines Considering Antibiotic Resistance
Authors: Guerrini Luca , Monaco Annalisa , Pietropaoli Davide , Ortu Eleonora , Giannoni Mario , Marci Maria Chiara
Published: November 2019

Background:

Antibiotic resistance is an important issue for public health.

Objective:

The aim of this work is to investigate the clinical situations which require the administration of antibiotics in dentistry.

Methods:

The authors want to do a review of the literature and a comparison of guidelines in dentistry among different countries. The research method was based on the use of Pubmed and the research of indexed articles and documents published by authorities and boards about the antibiotic prescription in dentistry. The paper is an analysis deep inside the physiological and pathological situations that, according to different guidelines, require the use of antimicrobics. The spirit is a clinical one because this paper wants to be a guide for dentists, especially before the administration, in order to moderate the use of antimicrobials. We must remember that the World Health Organisation organizes each year the World Antibiotic Awareness Week, in order to fight against the improper administration of antibiotics in medicine, dentistry, veterinary medicine, and industrial livestock.

Results:

Different guidelines converge on a very calibrate and proper administration of antibiotics. Antibiotics should be used only in recommended situations for risk patients. The authorities and boards should investigate the habits of antibiotic administration, which according to some papers seem to be large and diffused use, not only limited to situations described in guidelines.

Conclusion:

Dentists, together with the General Practitioners and Paediatricians, should be cautious and accurate and should administrate antibiotics only if recommended by guidelines and effective and safe.
Proximal Humerus Fractures in Children: Experience from a Central London Paediatric Orthopaedic Service
Authors: Chae Woojin , Khan Akib , Abbott Sarah , Assiotis Angelos
Published: November 2019

Objective:

Proximal humeral fractures are commonly observed in children who sustain falls whilst running, or from heights. Appropriate and correct treatment is key in order to avoid limb length discrepancy and functional deficiencies. Current treatment methods include non-operative management such as collar and cuff immobilisation, and operative methods such as elastic stable intramedullary nails or Kirschner wires. This paper aims to present the demographics of this patient population and our experience in managing patients with proximal humerus fractures in an urban tertiary referral centre.

Method:

We assessed 41 cases across two sites in central London, identified via hospital electronic notes and our radiology digital system. We analysed patient demographics, mechanism of injury, time to discharge from orthopaedic services taking into account radiological and clinical union, and the treatment methods utilised.

Results:

The mean age of the cohort was 8.6 years old. 70% of the injuries were due to falls and 85% of cases were treated without an operation. The mean time to discharge from our service following radiological and clinical union was 46 days (9 – 161 days). Mean radiological and clinical union were 21.8 and 36.2 days respectively.

Conclusion:

These results support a non-operative approach, especially in cases with patients under 10 years of age. Surgery should only be undertaken in patients who have severe displacement and who have failed attempts at closed reduction. We would advocate a similar approach in institutions dealing with a comparable population of patients, as long as there are provisions for referral of more complex cases that require surgical stabilisation.
Long-Term Outcomes after Colton Type I and II Fractures of the Olecranon
Authors: Schewelov Thord von , Hertervig Fredrik , Josefsson Per-Olof , Besjakov Jack , Hasserius Ralph
Published: November 2019

Background:

It is unclear if the outcomes differ in different subtypes of olecranon fractures.

Objective:

Evaluate the outcomes of different Colton types of olecranon fractures, and if outcomes differ in dominant and non-dominant arms and in men and women.

Methods:

We evaluated primary journals and radiographs in 40 men and 55 women with isolated olecranon fractures and classified fractures according to Colton. Mean 19 years after fracture event, we re-examined subjective, clinical and radiographic outcomes in the former patients, using the uninjured arms as controls.

Results:

89% of patients with Colton type I fractures reported at follow-up no subjective differences between the elbows, 84% with type II oblique/transverse fractures and 84% with type II comminuted fractures (p=0.91). The uninjured to former fractured arm differences in elbow range of motion and strength were no different in the 3 fracture types, the proportions of individuals with radiographic elbow degenerative changes were greater in type II than in type I factures (p<0.001), and there were no differences between the proportions of individuals with reduced joint space in the 3 groups (p=0.40). The outcomes were no different if the fractures had occurred in the dominant or non-dominant arms (p=0.43), or in men or women (p=0.43).

Conclusion:

There were no different outcomes after Colton type I, type II oblique/transverse or type II comminuted fractures, no different outcomes between fractures in dominant or non-dominant arms and no different outcomes in men and women.
Crisaborole: Application Pain and Prevention
Authors: Anzelc Madison , Burkhart Craig G.
Published: November 2019

In 2016, a new drug, crisaborole, was developed and approved, for the first time in 15 years, as an effective treatment for Atopic Dermatitis (AD). Crisaborole is a topical phosphodiesterase 4 (PDE4) inhibitor, which alleviates AD symptoms, such as pruritis, inflammation, and flares. Similar to other topical treatments like corticosteroids and calcineurin inhibitors, crisaborole has been found to cause pain during application. The pain felt during a topical application can be attributed to many possible causes, such as increased sensitivity to pain-provoking and itch-provoking stimuli, prior inflammation, prior damage, and hypersensitized skin of the patient to which the topical cream is applied. Crisaborole has been reported to be effective, yet the application site pain is a major road bump in the effective treatment of some patients. Some possible ways to circumvent this pain are letting the epidermis soothe and heal before starting crisaborole, starting this treatment modality before the skin has a chance to become irritated and inflamed, and numbing the area with an ice pack prior to topical crisaborole application. Overall, crisaborole has been an effective treatment modality, but further research is necessary to allow for safe use of this life-changing AD topical medication.
Are Parents Willing to Use Technology to Prevent the Tragedy of Forgetting Children Inside Cars?
Authors: Albert Gila , Kerbis Rivka
Published: November 2019

Background:

Forgetting children inside cars is a tragedy that can happen to anyone, anywhere. Especially on hot summer days, when the temperature inside the car rises quickly, it may lead to a tragic result: vehicular heatstroke. In the U.S, on average, 37 children die this way every year.

Objective:

This paper aims to provide further insights and a deeper understanding of the variables that may affect parents’ willingness to adopt a technology (various systems or smartphone apps) to remind them not to forget a child inside a vehicle.

Methods:

Ninety-two participants, all parents of children under the age of 10 and car owners, participated in an internet survey. The participants completed an internet-based questionnaire, which included socio-economic and personality questions, as well as items pertaining to perceptions, attitudes and behavioral intentions toward using this type of technology. The framework was designed based on the Technology Acceptance Model (TAM).

Results:

The results indicate that the perceived usefulness of such technology is significantly and positively correlated with usage attitudes. Women showed a significantly more positive usage attitude and stronger behavioral intentions compared to men. It was also found that a higher level of stated anxiety implies a more positive usage attitude, and stronger behavioral intentions to use this type of technology.

Conclusion:

More effort should be made to understand how such tragedies can be avoided and what the role of technology is in this regard. The most important challenge is to encourage those parents, who are less reluctant, to try out this technology, in an attempt to prevent the tragedy of forgetting children inside cars.
Kinematic, Coordinative and Efficiency Parameters of Physically Impaired Swimmers at Maximum Aerobic Power Speed
Authors: Feitosa Wellington G. , Correia Ricardo de A. , Barbosa Tiago M. , de Souza Castro Flávio Antônio
Published: November 2019

Background:

In paralympic swimming, the biomechanical parameters related to performance are effectively determined according to the potentialities and peculiarities of each athlete. However, a clear integrated approach to these parameters for swimmers with physical disabilities at the speed of maximum oxygen uptake (vV̇O2max) is still practically non-existent.

Objective:

The purpose of this study was twofold: (i) to assess kinematic, coordinative and efficiency parameters measured at vV̇O2maxin swimmers with physical impairments; and (ii) to correlate these biomechanical parameters with the time for a 200 m maximum test.

Methods:

Eleven swimmers with physical disabilities (seven males and four females) were assessed at vV̇O2maxwith support from a three-dimensional kinematic method. The performance parameters analysed were: (i) kinematic - stroke rate (SR), stroke length (SL), average swimming speed (SS) and intra-cyclic velocity variation (IVV); (ii) coordinative - index of coordination (IdC) and adapted index of coordination (IdCadapt); and (iii) swimming efficiency - propelling efficiency (çp).

Results:

The overall results showed high dispersion and wide confidence intervals for the kinematic and coordinative variables. The mean and standard deviation of vV̇O2maxand V̇O2at the same intensity were 0.90 ± 0.13 m/s and 38.2 ± 8.3 ml/kg/min, respectively.

Conclusion:

Swimmers with less significant impact of physical disability on specific swimming tasks presented higher SL, SS and çp. The IVV was higher in swimmers with a greater impact of disability on conducting specific competitive swimming tasks. In general, the catch-up inter-arm coordination model is adopted.