bluuebunny/crossref_metadata_2025 huggingface dataset:
Hospitales: ¿habrá futuro?
Authors: Redondo-Gómez Herman
Published: February 2020

La crisis de los hospitales públicos es un resultado de la crisis del sistema y no su causa. En el modelo de aseguramiento vigente no es claro el futuro para los hospitales públicos en Colombia, debido a que está basado en un modelo de libre mercado de la salud, manejado por empresas privadas con ánimo de lucro (Entidades Promotoras de Salud EPS); además de la competencia desleal existente entre los hospitales y las clínicas que pertenecen a las EPS, y las entidades públicas y privadas que han generado una especie de guerra del centavo ya experimentada en otros renglones de la economía, con resultados desalentadores.A menos que se realicen correctivos de fondo, los hospitales públicos no podrán continuar con la extraordinaria función que han venido cumpliendo hasta el momento. Un ejemplo es la atención que estas instituciones prestan a sectores específicos de la población con patologías que representan una baja rentabilidad económica pero con una muy alta rentabilidad social, cuya oferta siempre ha estado presente y debe continuar siendo suministrada en el futuro.
Metaplasia ósea endometrial: reporte de casos y revisión de la literatura
Authors: Mondragón-Cedeño Alba Lucía , Miranda-Cruz Ángel David , Parra-Duarte Sergio Augusto , Paredes-Becerra Eliana , Zúñiga-Chávez Ana María
Published: February 2020

Objetivo: presentar dos casos y revisar la literatura acerca de la etiología de la enfermedad y los métodos utilizados para su diagnóstico.Casos clínicos: los casos fueron atendidos en el Hospital de San José, Hospital Universitario de referencia de tercer nivel de atención, a donde llegaron remitidas, por infertilidad y dolor pélvico crónico, dos pacientes. Sus ecografías mostraban imágenes hiperecogénicas en endometrio. Se les realizó histeroscopia, encontrando múltiples formaciones óseas flotantes en cavidad endometrial, extraídas con pinza grasper, cuyos cortes histológicos confirmaron el diagnóstico de metaplasia ósea endometrial. La primera mujer quedó en estado de embarazo 8 meses después de la intervención, finalmente tuvo un recién nacido a término sano. La segunda mujer inició dos embarazos que terminaron en abortos tempranos completos.Materiales y métodos: se realizó una búsqueda electrónica en las bases de datos Medline vía PubMed, SciELO y Ovid, en donde se incluyeron artículos publicados en los últimos 15 años.Conclusión: la metaplasia ósea es un problema de diferenciación celular, de las células madre estromales del endometrio secundario, a raíz de una deficiencia de superóxido dismutasa. Esta entidad se sospecha por ecografía transvaginal y se debe diagnosticar y tratar con histeroscopia.
COMPARATIVE ANALYSIS OF METHODS EFFICIENCY OF VIRIFICATION OF THE TICK-BORNE ENCEPHALITE VIRUS
Authors: Leonova Galina N.
Published: February 2020

Based on experimental studies with 10-fold dilutions of two the strains TBEV of the Far Eastern subtype, different in molecular-genetic characteristic complex data of simultaneously taking into account three indicators of their verification (virus titer, ELISA and PCR-RT) were obtained. The efficiency of detecting a genetic marker in PCR compared with ELISA for a weakly pathogenic strain with defects in the genetic structure was higher by a factor of 10, and for a highly pathogenic strain by a factor of 5,000. At the same time, positive results in both reactions with respect to two strains were detected with a virus titer of not less than 1-1.5 log TCID50, i.e. this level of virus in the sample is defined as epidemically significant. An algorithm for conducting research on the verification of TBEV is proposed: 1) Ticks collected from vegetation can be examined by ELISA or by PCR. All positive results can be summarized and considered viral ticks; 2) All samples with positive results only in PCR or ELISA must be investigated in two reactions in order to obtain confirmation of the possible infectivity of the pathogen; 3) To obtain a fast complex result of infection of the removed ticks from patients or blood after a tick bite, studies should be carried out simultaneously in two reactions simultaneously in ELISA and PCR; 4) Isolation virus should be carried out in biological samples (ticks collected from vegetation, ticks removed from patients, the blood of patients with suspected TBE, mammals) only with the same results in PCR and ELISA. Thus, such an approach to verifying TBEV in a tick or in the blood of patients will improve the reliability of laboratory diagnostics, identifying not only markers of TBEV, but also determining the infectivity of the pathogen, which may be the basis for the appointment of early intensive antiviral therapy.
Clinical value of comorbidity of affective disorders and alcohol dependence
Authors: Roshchina O. V. , Rozin A. I. , Schastnyy E. D. , Bokhan N. A.
Published: February 2020

The aim was to study the clinical-psychopathological, clinical-follow-up, clinical-dynamic features of mood disorders (MD) and alcohol use disorder (AUD) with their comorbidity combinations.

Materials and methods. The study included 88 people with AUD and MD: 33 women (37.5%) and 55 (62.5%) men. The first group was 31 patients (35,0%) with AUD without comorbid affective symptoms, the second was 29 patients (33.0%) with MD without alcohol dependence, and the third was 28 patients (32.0%) with comorbid AUD and MD. There were no statistically significant differences between the groups by age and sex composition, by the level of statistical significance of differences (p = 0.115 – by sex, ð = 0.248 – by age). The study used clinical, psychopathological, clinical and follow-up, clinical, dynamic and statistical methods. Statistical processing was performed using Pearson’s χ2, Mann – Whitney U-test for comparing independent samples and Spearman’s correlation analysis (r).

Results. Patients of the second and third groups were diagnosed with dysthymia more rarely in statistically significant values by the level of statistical significance of differences (10.4% and 32.1% respectively, p = 0.023) and this testifies to MD taking chronic course in patients with AUD. The average duration of bout of heavy-drinking in the first group was longer than in the third group – 7 (4; 17) and 5,5 (3.5; 9.5) days accordingly (p = 0.043). Duration of the disease in the first and third groups was 10 (6; 18.5) and 14 (10; 19.75) years, respectively (p = 0.036). It confirms the negative impact of comorbidity on the clinicaldynamic features in the case of co-existing of AUD and MD.

Conclusion. The coexistence of alcohol dependence and affective pathology enhances the suicidal risk of certain diseases. A tendency to the early appearance of symptoms of AUD and their rapid dynamics, a shorter duration of light intervals of MD and AUC, a relatively low tolerance to alcohol and pronounced depressogenic effect of alcohol in the case of comorbidity were found.
Clinical and pathophysiological aspects of non-motor manifestations of Parkinson's disease
Authors: Nikitina M. A. , Zhukova N. G. , Bragina E. Yu. , Alifirova V. M. , Zhukova I. A. , Gomboeva D. E. , Kolupaeva E. S. , Zhalsanova I. Zh.
Published: February 2020

Non-motor symptoms are an essential manifestation of the clinical picture of Parkinson's disease (PD). This literature review is devoted to the study of recent advances in the field of clinical and pathophysiological aspects of the non-motor manifestations of Parkinson's disease.

Aim. The aim was to study and generalize the wide range of non-motor manifestations of PD and their features in this pathology, and to reveal the pathophysiological link between motor and non-motor manifestations of the disease and the role of the neurodegenerative process in the clinical picture of PD.

Materials and methods. Keywords (Parkinson's disease, non-motor symptoms, apathy, anxiety, depression, sleep disorder, pain) search in the Web of Science, Core Collection, Scopus, Pubmed databases.

Results. Knowledge about the presence of PD non-motor symptoms, characteristics of their manifestations improve their diagnosis and help to choose the correct treatment strategy. This survey comprises nonmotor manifestations of PD, such as: mood disorders (apathy, anxiety, depression), impulse control disorders (dopamine disregulation syndrome), sleep disorders (insomnia, excessive daytime sleepiness, bouts of sleepiness, conduct disorder in REM phase of sleep), autonomic disorders (constipation, enuresis, thermoregulatory dysfunction, cardiovascular disorders, orthostatic hypotension), and cognitive impairment.
Opsoclonus-myoclonus syndrome (Kinsbourne’s syndrome)
Authors: Alifirova V. M. , Valikova T. A. , Pugachenko N. V. , Kubar N. V. , Azhermacheva M. N. , Vershinina N. B. , Kazakov S. D. , Koroleva E. S.
Published: February 2020

Kinsbourne’s syndrome or opsoklonus-myoclonus syndrome is an autoimmune disease of the central nervous system mainly affecting the cerebellum and its connections. The disease is characterized by progressive course and is rarely observed. There is no accurate data on the prevalence of opsoklonusmyoclonus syndrome in Russia. The etiology and pathogenesis of the disease are being studied. This disease can develop against the background of cancer, infectious diseases and vaccinations. The article presents a ñlinical case of this rare pathology.
A clinical case of neuronal ceroid lipofuscinosis type 2
Authors: Kraeva L. S. , Koroleva E. S. , Alifirova V. M. , Kuzmina A. V.
Published: February 2020

Neuronal ceroid lipofuscinoses (NCL, Batten disease) are a group of inherited neurodegenerative diseases characterized by age-related onset, progressive myoclonus epilepsy, visual impairment and progressive intellectual and motor disorders. In all forms of NCL, the pathological autofluorescent lipopigment accumulates in the brain and other tissues. The diagnosis is made following determination of the activity of specific enzymes in blood leukocytes or cell culture of skin fibroblasts and investigation of biopsy specimens with electron microscopy as well as molecular genetic research. The article presents a patient with the onset of the disease at the age of 3 with epileptic tonic-clonic seizures, with further progression of the disease in the form of myoclonic seizures, motor pyramidal and cerebellar disorders, as well as intellectual, mnestic and speech disturbances. The presented clinical case demonstrates difficulties in the diagnosis of neurodegenerative diseases at onset, as well as the absence of pathognomonic signs of the disease during neurophysiological and neuroimaging examinations, which makes it necessary to conduct additional molecular and genetic research
Toxic encephalopathy in a clinicl case of polycythemia vera
Authors: Kuznetsova P. I. , Tanashyan M. M. , Kornilova A. A.
Published: February 2020

The article deals with a clinical case description of a female patient with toxic encephalopathy against the background of Ph-negative myeloproliferative diseases. The article discusses symptoms and neuroimaging of hepatic encephalopathy developed as a result of a shunt placed after portal vein thrombosis. The issues of etiology and pathogenesis of hepatic encephalopathy, principles of therapy, as well as the unique clinical picture of nervous system damage in this condition are also discussed. Data on the role of manganese in development of toxic encephalopathy, accumulation of paramagnetic substance in the basal ganglia of the brain and development of extrapyramidal symptoms are presented. The pathogenesis of toxic damage to neurons, increase in their sensitivity to hypoxia, and the relationship with the risk of cerebrovascular disorders and development of chronic cerebral ischemia, contributing to reduction of cognitive functions, are described.
A case of anti-NMDA-receptor encephalitis presenting as febrile catatonia
Authors: Shmukler A. B. , Ivashkina A. A. , Murashko A. A.
Published: February 2020

We described a case of anti-NMDA-receptor encephalitis presenting as febrile catatonia in a 22-year-old patient with no somatic burden. We looked into the dynamics of the disease and treatment strategy. In the discussion, we provided analysis of the presented case, as well as issues related to research perspectives in this field.
VIVÊNCIAS ACADÊMICAS E SOFRIMENTO PSÍQUICO EM ESTUDANTES DE MEDICINA
Authors: Moraes Nina Socorro de Fátima , Cruz de Oliveira Rafaela
Published: February 2020

Estudar Medicina acompanha cobranças pessoais e sociais, pois é uma profissão de grande responsabilidade. O curso possui carga horária elevada e exige dedicação, esforço e sacrifício de seus alunos, que muitas vezes precisam abdicar de atividades de lazer e criar novos hábitos de estudo. Portanto, objetiva-se descrever os problemas físicos, psicológicos e sociais identificados como causados pela vida acadêmica como estudante de Medicina. A pesquisa foi realizada com 36 estudantes de todos os períodos do curso, selecionados de forma aleatória. Utilizou-se o Protocolo de Avaliação dos Riscos Psicossociais no Trabalho – PROART, além de entrevista semiestruturada. Os resultados evidenciaram sintomas psicológicos, como mau-humor e vontade de ficar sozinho, e sintomas físicos, como dor de cabeça e nas costas. Além disso, os acadêmicos afirmaram haver necessidade de mudança na grade curricular e demonstraram sofrerem com a falta de tempo e a ansiedade frente às pressões cotidianas. Conclui-se que o curso de Medicina, com sua carga horária extenuante e por exigir dedicação em tempo integral, pode expor os alunos a situações exaustivas e de sofrimento, mostrando a importância de refletir sobre a forma que eles lidam com sua formação e pensar em estratégias para atenuar as vivências que podem levar ao sofrimento.
O ENSINO SUPERIOR E SUAS EXIGÊNCIAS:
Authors: Cristo Fábio de , Farias Isabella Maria Silva Umbelino de , Cavalcante Auralice Carlos , Medeiros Anne Louyse Gomes de , Lima Gyovani Dhieymyson Oliveira , Diogo Wanderley Fernando Quirino
Published: February 2020

As instituições de ensino superior têm se preocupado crescentemente com a saúde mental dos estudantes, importante para o bem-estar e o desempenho acadêmico. Neste artigo, aborda-se a saúde mental a partir de uma experiência de estágio curricular obrigatório em uma instituição de ensino superior. Buscou-se compreender a percepção de pessoas-chave da comunidade acadêmica quanto: à consciência e às expectativas da existência de problemas de saúde mental na instituição, às causas prováveis desse sofrimento e aos principais efeitos/consequências para os envolvidos. Realizaram-se encontros com: diretor e vice da faculdade, coordenadores dos quatro cursos existentes, além do psicólogo, assistente social e representante do diretório e de três centros acadêmicos. Os participantes perceberam que a saúde mental é uma problemática que merece atenção institucional. As causas percebidas dos prejuízos à saúde mental foram, por exemplo: diminuição do contato com familiares, autocobrança, relação opressora/hierárquica entre professor-discente e carga excessiva de estudos. Algumas consequências percebidas: banalização/naturalização do sofrimento, dificuldade de aprendizagem, transtornos de ansiedade e depressivos, uso/abuso de álcool e outras drogas i/lícitas, ideação/tentativa de suicídio. Variáveis associadas também foram identificadas: dificuldades para conciliar trabalho-faculdade, falta de estrutura de lazer da cidade/faculdade, dificuldades financeiras, incertezas sobre o mercado de trabalho e contexto histórico e político.
UNDERSTANDING INDONESIA’S CITY-LEVEL CONSUMER PRICE FORMATION: IMPLICATIONS FOR PRICE STABILITY
Authors: Narayan Paresh Kumar
Published: February 2020

Using the Consumer Price Index (CPI) data of 82 Indonesian cities, we propose thehypothesis of heterogeneity in the cities’ contribution to the aggregate IndonesianCPI. Using a price discovery model fitted to monthly data, we discover that (1) of the23 cities in the province of Sumatera, five contribute 44% and nine contribute 66.7%to price changes, and (2) of the 26 cities in Java, four alone contribute 41.6% to pricechanges. Even in smaller provinces, such as Bali and Nusa Tenggara, one city alonedominates the change in aggregate CPI. From these results, we draw implications formaintaining price stability.
Use of potentially inappropriate medication and polypharmacy in older adults: a repeated cross-sectional study
Authors: Thorell Kristine , Midlöv Patrik , Fastbom Johan , Halling Anders
Published: February 2020

Background: With age, the number of chronic conditions increases along with the use of medications. For several years, polypharmacy has been found to be on the increase in western societies. Polypharmacy is associated with an increased risk of adverse drug events (ADE). Medications called potentially inappropriate medications (PIM) have also been found to increase the risk of ADEs in an older population. In this study, which we conducted during a national information campaign to reduce PIM, we analysed the prevalence of PIM in an older adult population and in different strata of the variables age, gender, number of chronic conditions and polypharmacy and how that prevalence changed over time. Methods: This is a registry-based repeated cross-sectional study including two cohorts. Individuals aged 75 or older listed at a primary care centre in Blekinge on the 31st March 2011 (cohort 1, 15 361 individuals) or on the 31st December 2013 (cohort 2, 15 945 individuals) were included in the respective cohorts. Using a chi2 test, the two cohorts were compared on the variables age, gender, number of chronic conditions and polypharmacy. Use of five or more medications at the same time was the definition for polypharmacy. Results: Use of PIM decreased from 10.60% to 7.04% (p-value <0.001) between 2011 and 2013, while prevalence of five to seven chronic conditions increased from 20.55% to 23.66% (p-value <0.001). Use of PIM decreased in all strata of the variables age, gender number of chronic conditions and polypharmacy. Except for age 80-84 and males, where it increased, prevalence of polypharmacy was stable in all strata of the variables. Conclusions: Use of potentially inappropriate medications had decreased in all variables between 2011 and 2013; this shows the possibility to reduce PIM with a focused effort. Polypharmacy does not increase significantly compared to the rest of the population.
Validation and Modification of Staging Systems for Poorly Differentiated Pancreatic Neuroendocrine Carcinoma﻿
Authors: Wang Haihong , Lin Zhenyu , Li Guiling , Zhang Dejun , Yu Dandan , Lin Qili , Wang Jing , Zhao Ye , Pi Guoliang , Zhang Tao
Published: February 2020

Background: The American Joint Committee on Cancer (AJCC) and the European Neuroendocrine Tumor Society (ENETS) staging classifications are two broadly used systems for pancreatic neuroendocrine tumors. This study aims to identify the most accurate and useful tumor–node–metastasis (TNM) staging system for poorly differentiated pancreatic neuroendocrine carcinomas(pNECs).Methods: An analysis was performed to evaluate the application of the ENETS, 7th edition (7th) AJCC and 8th edition (8th) AJCC staging classifications using the Surveillance, Epidemiology, and End Results (SEER) registry (N = 568 patients), and a modified system based on the analysis of the 7th AJCC classification was proposed Results: In multivariable analyses, only the 7th AJCC staging system allocated patients into four different risk groups, although there was no significant difference. We modified the staging classification by maintaining the T and M definitions of the 7th AJCC staging and adopting new staging definitions. An increased hazard ratio (HR) of death was also observed from class I to class IV for the modified 7th (m7th) staging system (compared with stage I disease; HR for stage II =1.23, 95% confidence interval (CI)= 0.73-2.06, P =0.44; HR for stage III =2.20, 95% CI =1.06-4.56, P=0.03; HR for stage IV =4.95, 95% CI =3.20-7.65, P < 0.001).The concordance index (C-index) was higher for local disease with the m7th AJCC staging system than with the 7th AJCC staging system. Conclusions: The m7th AJCC staging system for pNECs proposed in this study provides improvements and may be assessed for potential adoption in the next edition.
Comparative analysis of retrograde intrarenal surgery and modified Ultra-mini percutaneous nephrolithotomy in management of lower pole renal stones (1.5-3.5 cm)
Authors: Li Zhuohang , Lai Cong , Shah Arvind K. , Xie Weibin , Liu Cheng , Huang Li , Li Kuiqing , Yu Hao , Xu Kewei
Published: February 2020

Background：To compare the safety and efficacy of retrograde intrarenal surgery (RIRS) and modified Ultra-mini percutaneous nephrolithotomy (UMP) in semi-supine combined lithotomy position for the management of 1.5-3.5 cm lower pole renal stones (LPSs). Methods: A total of 63 patients with 1.5-3.5 cm LPSs who underwent RIRS (n= 33) or modified UMP (n= 30) in diameter between January 2017 and January 2019 were analyzed retrospectively. Modified UMP was performed in semi-supine combined lithotomy position and a 9.5/11.5 F ureteral access sheath (UAS) was inserted during the procedure in order to maintain low pelvic pressure and to facilitate the removal of stone fragments. Base-line parameters, stone characteristics, illness condition, operation time, postoperative hemoglobin (Hb) drop, postoperative creatinine (Cr) elevation, length of hospital stay, length of postoperative hospital stay, stone-free rate (SFR) and complications were compared between the two groups. Results: There were no significant differences between the two groups in base-line parameters, stone characteristics and illness condition. The mean operating time of RIRS group was longer than UMP group (95.61 ± 21.9 vs. 55.0 ± 16.1 min, p< 0.001). The mean postoperative Hb drop was less in RIRS group (7.42 ± 4.7 vs. 15.70 ± 9.8 g/L, p< 0.001). The length of hospital stay and postoperative hospital stay for RIRS were shorter than UMP (4.76 ± 1.1 vs. 5.83 ± 0.8 d, p< 0.001, 2.97 ± 0.9 vs. 4.07 ± 0.9 d, p< 0.001). The Early SFR was higher in UMP group (54.5 vs. 80.0%, p< 0.050) while SFR at 1-month and 3-months postoperatively was similar in both groups (p= 0.504, p= 0.675). There were no significant differences between the two groups in complications (p= 0.228). Conclusion：For patients with 1.5-3.5 cm LPSs, both modified UMP and RIRS are safe and viable. The modified UMP technique was used in this study, application semi-supine combined lithotomy position and the retention of UAS can improve the surgical efficiency and maintain low pressure perfusion in the kidney, which resulted in superior treatment efficacy. Therefore, we highly recommend this technique for LPSs with heavy stone burdens.
Level of Quality of Option B+PMTCT Service Provision in Public Health Facilities in Mekelle Zone, Northern Ethiopia: Cross-sectional study
Authors: Ajemu Kiros Fenta , Desta Alem
Published: February 2020

Background: Substantial improvements have been observed in the coverage and access to maternal health services in Ethiopia. However, quality of care has been lagging behind. Therefore, the aim of this study was to assess quality of Option B+ PMTCT service provision. Methods: Facility based cross sectional study was conducted from February to April 2016 in Northern Ethiopia. The quality of service delivery was assessed in 12 health facilities based on Donabedian input-process-output quality components. It employed mixed method approach involving both quantitative and qualitative data. Facilities were categorized rendering good input service quality if scored 100 % as per national guideline; whilst, 90 % and more for process and output quality components respectively. The emerged themes of factors for good and bad service quality from content analysis were then thematically fitted to donabedian themes. Results: Overall 2 of 12 (16.7%) facilities fulfilled all the three quality components according to predetermined judgment criteria. The input quality was better than their counterpart; in which it was judged as good in 33.3% of facilities. Besides, one fourth of them were realized process and output quality. We identified multiple barriers and facilitators for good and bad service quality in respective quality components influencing quality of care. Conclusion: Only 16.7% of facilities declared the overall quality in all three dimensions according to service delivery guideline. The desired level of quality will be realized if and only if the three quality components would be kept on eye side by side in line with identified facilitators and barriers for good and bad service quality.
The effect of body mass index and creatinine clearance on serum trough concentration of vancomycin in adult patients
Authors: Pan Yuyan , He Xiaomei , Yao Xinyu , Yang Xiaofeng , Wang Fengjiao , Ding Xinyuan , Wang Wenjuan
Published: February 2020

Background: The aim of this study was to evaluate the influence of patient body mass index (BMI) and estimated creatinine clearance (CrCl) on serum vancomycin concentrations to define a possible optimal dosage regimen in overweight patients based on data obtained during therapeutic drug monitoring.Methods: This retrospective study used data collected from January 2017 to January 2019. Adult patients (n=204) received vancomycin treatment at a dose of 1000 mg every 12 h and underwent serum monitoring. Data collected included patient disease category, sex, age, height, weight, vancomycin regimens and concentrations, and serum creatinine. In this study, statistical comparisons were performed on the results of patients according to serum vancomycin concentration.Results: Serum vancomycin concentration was significantly related to BMI (P < 0.001) and CrCl (P < 0.05) in adult patients. Furthermore, the trough serum vancomycin concentration showed a logarithmic correlation with BMI (R = -0.5108, 95% CI: -0.6082 to -0.3982, P < 0.001) and CrCl (R = -0.5739, 95% CI: -0.6616 to -0.4707, P < 0.001). In addition, CrCl was significantly related to BMI (P < 0.01). Moreover, some of the patients with higher BMI (≥ 24 kg/m2) met the goal trough concentration after an adjustment from 1000 mg every 12 h to 1000 mg every 8 h.Conclusions: Serum vancomycin concentration decreases progressively with increasing BMI due to the augmentation in CrCl in adult patients. Therefore, the trough concentration of vancomycin should be continuously monitored for patients with a BMI ≥ 24 kg/m2 while considering the patient CrCl. The dosage regimen should be adjusted in a timely manner to reach the target trough concentration and reduce the impact of BMI.
Concept Analysis of Community Health Outreach
Authors: SHIN Hye Young , KIM Ka Young , Kang Purum
Published: February 2020

Background: The definition of community health outreach, aimed at promoting the health of vulnerable populations, depends heavily on the particulars of the given health project and community. There is no consistency in the definitions attached to the concept itself. Our study aimed to clarify the general definition of community health outreach to facilitate its understanding and use. Methods: Walker and Avant’s (2010) method of concept analysis was used to understand Community Health outreach. A total of 51 articles were included in the analysis after having searched for text on database portals like PubMed, Scopus, CINAHL complete and EMBASE published between 2010 and 2018. Results: The defining attributes of the concept of community health outreach were purposive, temporary, mobile and collaborative. The antecedents were individuals facing health risks and awareness of health risks. The consequences were increased accessibility and health promotion. Conclusion: This study proposed the definition of community health outreach as a temporary, mobile project that involves the collaboration of a community to undertake its purposeful health intervention of reaching a population facing health risks. This definition provides a general understanding of the outreach undertaken by health workers and enables the strong connection between health professionals and community residents.
Loss of FANCD2 and related proteins may predict malignant transformation in oral epithelial dysplasia
Authors: Ho Michael W , Ryan Mark , Gupta Juhi , Triantafyllou Asterios , Risk Janet , Shaw Richard , Wilson James
Published: February 2020

Background: Predicting malignant transformation in oral epithelial dysplasia(OED) is a clinical challenge. The higher rate of malignant transformation in non-smokers supports an endogenous aetiology. Loss of FANCD2 and associated proteins could lead to genomic instability and oncogenesis.
Patients & Methods: Longitudinal archival samples from 40 individuals with OED from time of diagnosis to the most recent review in 23 stable OED; or until excision of the SCC in 17 unstable OED undergoing malignant transformation. Histopathological reassessment, immunohistochemistry for FANCD2 and Western blotting for phosphorylation/monubiquitination status of ATR, CHK1, FANCD2 and FANCG were undertaken on each tissue sample.
Results: Decreased expression of FANCD2 was observed in the diagnostic biopsy of OED lesions which later underwent malignant transformation. Combining the FANCD2 expression scores with histological grading more accurately predicted malignant transformation (p=0.005) than histology alone and correctly predicted malignant transformation in 10/17 initial biopsies. Significantly reduced expression of total FANCD2, pFANCD2, pATR, pCHK-1 and pFANCG were observed in unstable OED.
Discussion: There is good evidence that defects in the DNA damage sensing-signalling-repair cascade are associated with malignant transformation in OED. Loss of post-translational modification in FANCD2 and related proteins, was more predictive of malignant transformation when compared to clinicopathological parameters.
Brain Natriuretic Peptide to Predict Successful Liberation from Mechanical Ventilation in Critically Ill Patients: a Systematic Review and Meta-Analysis.
Authors: Deschamps Jean , Andersen Sarah K. , Webber Jordan , Featherstone Robin , Sebastianski Meghan , Vandermeer Ben , Senaratne Janek , Bagshaw Sean M.
Published: February 2020

Background

Predicting successful liberation from mechanical ventilation (MV) in critically ill patients is challenging. Brain natriuretic peptide (BNP) has been proposed to help guide decision-making for readiness to liberate from MV following a spontaneous breathing trial (SBT).

Methods

We performed a systematic review and meta-analysis of randomized and prospective observational studies that measured BNP levels at the time of SBT in patients receiving MV. The primary endpoint was successful liberation from MV (absence of re-intubation or non-invasive ventilation at 48h). Statistical analyses include bi-variate and Moses-Littenberg models, and DerSimonian-Laird pooling of areas under ROC curve (AUROC).

Results

A total of 731 articles were screened. After pre-specified inclusion criteria, 18 adult and 2 pediatric studies were included. The measure of the relative variation of BNP during SBT (ΔBNP%) after exclusion of SBT failure by clinical criteria in adults yielded a sensitivity and specificity of 0.889 [0.831-0.929] and 0.828 [0.730-0.896] respectively, with a pooled AUROC of 0.92 [0.88-0.97] for successful liberation from MV. The pooled AUROC for any method of analysis for absolute variation of BNP (ΔBNP), pre-SBT BNP and post-SBT BNP were 0.89 [0.83-0.95], 0.77 [0.63-0.91], and 0.85 [0.80-0.90], respectively.

Conclusion

The ΔBNP during a SBT is an accurate incremental tool after SBT success by clinical indices to predict successful liberation from MV in adults. There is insufficient data to support its use as an alternate test to clinical indices of SBT or the use of ΔBNP, BNP-pre and BNP-post as an alternate or incremental test, or in pediatric patients.
Identification of lncRNA–miRNA–mRNA regulatory network associated with Primary Open Angle Glaucoma
Authors: Zhou Minwen , Lu Bing , Tan Wei , Fu Mingshui
Published: February 2020

Background: Primary open angle glaucoma (POAG) is a multifactorial disorder characterized by a progressive permanent degeneration of retinal ganglion cell (RGCs) death. An increasing number of studies have suggested that long noncoding RNAs (lncRNAs) have the ability to regulate gene expression; however, thus far, the mechanisms and functions of lncRNAs in the development of POAG are still unclear. Methods: Using the data from Gene Expression Omnibus (GEO), differentially expressed lncRNAs and differentially expressed mRNAs between POAG patients and controls were identified. Then, the lncRNA–miRNA–mRNA competing endogenous RNA (ceRNA) network was constructed, and the key lncRNAs in POAG were identified. A Gene Ontology (GO) analysis and a Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed to assess the enriched biological functions of mRNA in the ceRNA network. Results: During this study, a POAG-related ceRNA network with 37 miRNA nodes, 248 lncRNA nodes, 178 mRNA nodes, and 1985 edges was constructed. In addition, four lncRNAs (DNAJC27-AS1, AF121898, OIP5-AS1, and SNX29P2) were established as hub RNAs in this ceRNA network. The functional assay showed that 18 GO terms and 17 pathways were enriched. Conclusion: This study provides novel insights into the lncRNA‑related ceRNA network in POAG, and the four lncRNAs were identified in the development of POAG.
Furosemide stress test as a predictive marker of acute kidney injury progression or renal replacement therapy: a systemic review and meta-analysis
Authors: Chen Jia-Jin , Chang Chih-Hsiang , Huang Yen Ta , Kuo George
Published: February 2020

Background The use of the furosemide stress test (FST) as an acute kidney injury (AKI) severity marker has been discussed in several different trials. However, the diagnostic performance of the FST in predicting AKI progression has not yet been fully discussed. Methods In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the PubMed, Embase, MEDLINE and Cochrane databases up to December, 31 2019. The diagnostic performance of the FST (in terms of sensitivity, specificity, number of events, number of true positives, and number of false positives) was extracted and evaluated. Results We identified nine trials that enrolled a total of 1296 patients, including 432 patients and 864 patients for whom the outcomes in terms of AKI stage progression and renal replacement therapy (RRT), respectively, were reported. The pooled sensitivity and specificity results of the FST for AKI progression prediction were 0.83 (95% CI: 0.76 - 0.89) and 0.87 (95% CI: 0.80 - 0.92), respectively. The pooled positive likelihood ratio (LR) was 5.27 (95% CI: 3.75-7.39), the pooled negative LR was 0.22 (95% CI: 0.15 - 0.32), and the pooled diagnostic odds ratio (DOR) was 29.34 (95% CI: 16.35-52.66). The summary receiver operating characteristics (SROC) with pooled diagnostic accuracy was 0.87. The diagnostic performance of the FST in predicting AKI progression was not affected by different AKI criteria (relative DOR: 1.04, 95% CI: 0.18 - 5.94) or underlying chronic kidney disease (relative DOR: 0.66, 95% CI: 0.08 - 5.70). The pooled sensitivity and specificity results of the FST for RRT prediction were 0.87 (95% CI: 0.76 - 0.93) and 0.71(95% CI: 0.56 -0.83), respectively. The pooled positive LR and pooled negative LR were 2.85 (95% CI: 1.81-4.48) and 0.22(95% CI: 0.11- 0.43), respectively. The pooled diagnostic odds ratio (DOR) was 13.36 (95% CI: 4.79-37.27) and SROC with pooled diagnostic accuracy was 0.87. Conclusion The FST is a simple tool for the identification of AKI populations at high risk of AKI progression, but the diagnostic performance of FST in RRT prediction is suboptimal.
Circulating neutrophil-derived microparticles associated with the prognosis of patients with sepsis
Authors: Chen Hong-Peng , Wang Xiao-Yan , Pan Xiao-Yan , Hu Wang-Wang , Cai Shu-Ting , Deng Lie-Hua , Ma Da-Qing
Published: February 2020

Background To investigate the relationship between plasma neutrophil-derived micro-particles (NDMPs) and sepsis patients’ prognosis. Methods Eighty eligible patients were classified as the sepsis and septic shock group according to the international guidelines. Their demographic data, pro-inflammatory mediators (TNF-α, IL-6 and sTREM-1) and sepsis severity assessment index (PCT, APACHE-II scores, MODS scores, mechanical ventilation time, ICU length of stay (LOS) and total hospital length of stay (LOS)) of the post-admission day 1, 3, 5 and 7 were harvested. Their plasma NDMPs were determined with magnetic bead sorting and nanoparticle tracking analyser (NTA). Survival curve against the circulation NDMPs was constructed. Results The NDMPs level was higher in the septic shock patients than in the sepsis patients on the post ICU admission day 1, 3 and 5 ( P < 0.05). The NDMPs levels were significantly increased with a parallel increase of pro-inflammatory mediators and sepsis severity ( P <0.05) as well as mortality. Conclusions Our data suggested that NDMP may be a biomarker of sepsis severity and mortality but how its role on sepsis prognosis warrants further study.
CReM: chemically reasonable mutations framework for structure generation
Authors: Polishchuk Pavel
Published: February 2020

Structure generators are widely used in de novo design studies and their performance substantially influences an outcome. Approaches based on deep learning models and conventional atom-based approaches may result in invalid structures and did not address their synthetic feasibility issues. Conventional reaction-based approaches result in synthetically feasible compounds but novelty and diversity of generated compounds may be limited. Fragment-based approaches can provide better novelty and diversity of generated compounds but the issue of synthetic complexity of generated structure was not explicitly addressed before. Here, we developed a new fragment-based approach which results in chemically valid structures by design and gives flexible control over diversity, novelty, synthetic complexity and chemotypes of generated compounds. The approach was implemented as an open-source Python module.
Expression of AIM2 in rheumatoid arthritis and its role on fibroblast-like synoviocyte
Authors: qiu fujuan , Yong Chen , Fujuan Qiu , Xiaofeng Zhao , Changhong Xiao
Published: February 2020

Background To determine whether any differences of AIM2 inflammasome expression levels between rheumatoid arthritis (RA) and osteoarthritis (OA) and investigate the effects of AIM2 when transferred into RA fibroblast-like synoviocytes (RA-FLS).Methods Serum AIM2 levels between OA and RA patients were compared by ELISA. Different expression levels of AIM2, ASC, Caspase-1 and IL-1β between RA and OA synovium were semi-quantified by RT-qPCR and immunohistochemical (IHC) staining. IHC staining were recorded by H scores, and determine the correlation with ESR and CRP levels of RA patients. SiRNA AIM2 was transferred to RA-FLS and observe its effects on proliferation and migration by MTT assay and transwell test respectively.Results In RA sera, no significant difference was observed between OA and RA patients. However, in affected knee synovium, AIM2, ASC, Caspase-1 and IL-1β were expressed higher in RA than that of OA. Plus, H score of AIM2, ASC, and IL-1β were positively correlated to ESR and CRP levels in RA patients. After transferred AIM2 siRNA to FLS and incubation for 48 hours, the proliferation of FLS were significantly inhibited, and the apoptosis rate were significantly increased compared to FLS in control group. However, no effect on migration was detected.Conclusions AIM2 participated in the proliferation of FLS, and might be a potential target for therapy.
Cost-effective joint Optimisation of BBU Placement and Fronthaul Deployment in Brown-field Scenarios
Authors: Marotta Andrea , Correia Luis Manuel
Published: February 2020

In this work one proposes a model to evaluate the optimal deployment of Centralised Radio Access Network (C-RAN) architecture elements, i.e. Base Band processing Units (BBUs) and fronthaul links, in a brownfield scenario in which traditional base stations are already deployed and a physical network is present. The proposed optimisation framework jointly optimises BBU placement and access network infrastructures deployment. It clusterises Remote Radio Heads in the scenario through a Multicommodity Flow approach and solves the minimum cost fronthaul network deployment through a Rooted Delay-Constrained Minimum Spanning Tree approach. Optical fibre and microwave links are considered as fronthaul infrastructures. The proposed optimisation framework is validated through a comparison with a theoretical output for a canonical scenario then it is applied to a real scenario. A cost analysis for different scenario configurations is illustrated, and tradeoff and guidelines for a cost optimal deployment of C-RAN are provided. The analysis of results for the real scenario of the city of Lisbon and its surrounding areas shows that the delay budget in the fronthaul network highly impacts on capital expenditures as well as on operational ones. It is shown that a larger delay budget enables an annual cost reduction up to 72% in urban areas and 54% in rural ones.
PTX3 activates classic complement pathway and mediates phagocytosis of cholesterol-induced apoptotic macrophages in atherosclerosis
Authors: guo tang-meng , ke li , cheng bei
Published: February 2020

Backgrounds/Aims: Apoptotic macrophages are removed by neighboring phagocytes (efferocytosis), which is an important event in advanced atherosclerosis. We reported the long pentraxin 3 (PTX3) located at the membrane of late apoptotic macrophages, mediates efferocytosis in a cell model of advanced atherosclerosis. However, the mechanism underlying PTX3-mediated apoptotic cell clearance in atherogenesis is unclear. Methods: We modeled macrophage apoptosis in advanced plaques by incubating macrophages (peritoneal macrophages isolated from C57 mice) with free cholesterol (free cholesterol-induced apoptotic macrophages, FC-AMs). FC-AMs were added to a monolayer of fresh phagocytes（macrophages） to study the engulfment response. The percentage of phagocytes that ingested FC-AMs was quantified by using confocal microscopy. C1q and C3b were detected by using fluorescence-activated cell sorter (FACS) and the confocal microscopy. Results: We found that PTX3 significantly enhances complement C1q binding on FC-AMs and was correlated with improved activating of classic complement pathway. C3b was the characteristic component of activating of classic complement pathway, displayed the increased deposition on FC-AMs and mediated the phagocytosis of FC-AMs. This study replicated the role of PTX3-mediated efferocytosis, explored the mechanism of PTX3 involving efferocytosis in detail and provided theoretical evidences for PTX3-mediated cardio-protective functions in atherosclerosis. Conclusion: PTX3 activated classic complement pathway and mediated phagocytosis of cholesterol-induced apoptotic macrophages in atherosclerosis.
Traditional Chinese medicine for treating novel coronavirus (2019-nCoV) pneumonia: protocol for a systematic review and meta-analysis
Authors: Li Yuxi , Liu Xiaobo , Guo Liuxue , Li Juan , Zhong Dongling , Zhang Yonggang , Clarke Mike , Jin Rongjiang
Published: February 2020

Background: A new type of coronavirus, 2019 novel coronavirus (2019-nCoV), is causing an increasing number of cases of pneumonia and has been declared a Public Health Emergency of International Concern by the World Health Organization on 30 January 2020. The virus first appeared in Wuhan, China in late December 2019 and traditional Chinese medicine (TCM) is being used for its treatment. This systematic review and meta-analysis will assess studies of the effects of TCM in 2019-nCoV-infected pneumonia (NCIP).Methods: We will search electronic databases including PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP) and Wanfang database using keywords related to NCIP and TCM. Reference lists of relevant trials and reviews will be searched. We will manually search grey literature, such as conference proceedings and academic degree dissertations, and trial registries. Two independent reviewers will screen studies, extract data and evaluate risk of bias. Data analysis will be conducted using Review Manager software (version 5.3.5) and R software (version 3.6.1).Discussion: This study will provide a high-quality synthesis of the effects of TCM for NCIP. The use of TCM for treatment or prevention of these novel viral infections affecting the respiratory tract will be investigated.Systematic review registration: PROSPERO registration number: CRD42020168004
Proximal Gastrectomy with Anti-reflux Anastomosis for Patients with Adenocarcinoma of Esophagogastric Junction: A Simple and Safe Triangle-Valve Technique
Authors: Gao Yongshun , Sun Jiangang , Chen Yuheng , Zhang Yunfei , Chen Peng , Zong Liang , Huang Jingjing , Han Ji , Chen Xiaoping
Published: February 2020

Background A simple and safe triangle-valve technique (TVT) was applied to proximal gastrectomy (PG) in order to prevent post-surgery gastric reflux among patients with adenocarcinoma of the esophagogastric junction (AEG). Its clinical outcomes were evaluated in comparison to those of the canonical total gastrectomy (TG). Method This retrospective study of 74 AEG patients compared two surgical procedures PG-TVT (n = 44) and TG (n = 30) in terms of their surgical outcomes, postoperative complications, and nutritional status. All patients were followed-up for 6 months. Reflux Disease Questionnaire (RDQ) was used to evaluate reflux esophagitis. patients with the RDQ score of ≥12 points were diagnosed with gastroesophageal reflux disease (GERD). Results The mean operation time was significantly shorter in PG-TVT group (242.6 minutes) than in TG group (288.1 minutes). The overall postoperative complication rate was not significantly different between PG-TVT and TG groups. All patients were followed up by 6 months. None of them developed cancer recurrence in distant organs, remnant stomach, or lymph nodes. The GERD incidence was similar between PG-TVT and TG groups. The mean levels of total protein and albumin within the 6 months were significantly higher in PG-TVT group than in TG group after adjusting the time effect and the interaction of time and surgical methods. The level of total protein significantly increased within 6 months in PG-TVT but decreased in TG group. Conclusion PG-TVT provides several advantages including a shorter operating time, better postoperative nutritional status, and similar incidence of GERD over TG for AEG patients.
JUNTS methodology for creating web apps to bridge the gap in doctor-patient communication: the case of COMjuntos application in the field of rare diseases
Authors: Bagò Rosa Estopà i , Ruiz Manuel Armayones
Published: February 2020

Background: The diagnosis or even the suspicion of disease has an emotional impact on the patient and their families and generates a need to acquire relevant knowledge and skills in a short period of time. These patients will sometimes face cognitive barriers in their communication with the professionals. These barriers can have a negative effect on knowledge acquisition and, affect their relationship with clinicians. Results : The JUNTS methodology, helps patients manage the communicative situations they and their family members find themselves by exploiting a polyphonic design that includes different levels of involvement. One of the characteristics that makes this approach unique is that patients and representatives of patient-support associations work jointly with health professionals, in designing the contents of a patient-support application. The methodology exploits a modular structure centred around a series of short challenges with different types of user involvement (visual, textual and hypertextual). For optimal adherence elements of persuasive design have been integrated. Conclusions: In this paper, we outline how the JUNTS methodology has been used to develop the COMjuntos app. This web app has been specifically designed to help families who have a child with a rare disease empower themselves in the main communicative situations with health professionals.