bluuebunny/crossref_metadata_2025 huggingface dataset:
CO2 or air cholangiography reduces the risk of post-ERCP cholangitis in patients with Bismuth type IV hilar biliary obstruction
Authors: zhang wenhui , Ding Peng peng , liu lei , wang yanling , lai wenhui , han jingjing , han jun , li hanwei
Published: May 2020

Background: Endoscopic biliary stenting by endoscopic retrograde cholangiopancreatography (ERCP) is the most common form of palliation for malignant hilar obstruction. However, ERCP in such cases is associated with a risk of cholangitis. The incidence of post-ERCP cholangitis is particularly high in Bismuth type IV hilar obstruction, and this risk is further increased when the contrast injected for cholangiography is not drained. This study aims to compare the incidence of cholangitis associated with the use of contrast agent, air and CO2 for cholangiography in type IV hilar biliary lesions. Methods: The clinical data of consecutive 70 patients with type IV hilar obstruction, who underwent ERCP from October 2013 to November 2017, was retrospectively analyzed. These patients were divided into three groups based on the agent used for cholangiography: group A, contrast (n=22); group B, air (n=18); group C, CO2 (n=30). These three methods of cholangiography were chronologically separated. Prior to the ERCP, MRCP was obtained from all patients to guide the endoscopic intervention. Results: At baseline, there was no significant difference in the patient’s age, gender, symptoms and liver function tests among the three groups (P>0.05). The complication rates was significantly higher in group A than in groups B and C (63.6% vs. 26.7% and 27.8%, P<0.05). The incidence of post-ERCP cholangitis was significantly higher in group A (P<0.05), while the incidence of post-ERCP pancreatitis and bleeding were similar in the three groups. After ERCP, the mean hospital stay was shorter in groups B and C, when compared to group A (P<0.05). There was no significant difference in the 30-day mortality rate among the three groups (P>0.05). Furthermore, there was no significant difference between group B and C in terms of primary end points. Conclusion: CO2 or air cholangiography during ERCP for type IV hilar obstruction is associated with reduced risk of post-ERCP cholangitis, when compared to conventional contrast agents.
Non-steroidal anti-inflammatory drug-induced enteropathy as a major risk factor for small bowel bleeding: A retrospective study
Authors: Lim Doo-Ho , Jung Kyoungwon , Lee Seung Bum , Park In Kyu , Cha Hee Jeong , Park Jae Ho , Kim Byung Gyu , Jung Seok Won , Du Jeong In , Kim Jae Hyun , Kim Sung Eun , Moon Won , Park Moo In , Park Seun Ja
Published: May 2020

Background: Small bowel (SB) bleeding accounts for 5% of all gastrointestinal (GI) bleeding cases and 80% of obscure GI bleeding cases. Although angioectasia is the common etiology of SB bleeding, nonsteroidal anti-inflammatory drug (NSAID)-induced SB lesions are also reported as a major cause in studies from Eastern countries. Herein, we assessed the frequency of occurrence of NSAID-induced SB lesions in Korean patients with obscure GI bleeding. Methods: We retrospectively analyzed medical records of all consecutive patients aged ≥18 years who underwent capsule endoscopy from March 2018 to February 2019 at Ulsan University Hospital and Kosin University Gospel Hospital. Results: Of the 83 subjects (all Korean; mean age ± standard deviation: 59 ± 18 years; age range: 18–84 years; men: n=52; women: n=31), 55 (66.2%) had stool with clear blood and 28 (33.8%) had normal stool with iron deficiency anemia. The detection rate of SB bleeding and lesions using capsule endoscopy was 72.3% (60 of 83 patients). A significantly higher frequency (40 of 51) of ulcerative/erosive lesions than other causes was observed in patients with inactive bleeding but visible SB lesions. As a result, NSAID-induced enteropathy accounted for 30.1% of 83 patients with obscure GI bleeding (25 of the all 60 SB bleeding cases).Conclusions: Contrary to what is reported for patients in Western countries, this study in Korean patients showed an improved diagnostic yield of capsule endoscopy for obscure GI bleeding and that NSAID-induced enteropathy was the most common etiology of SB bleeding. Aggressive small intestine examination is required for patients with unexplained GI bleeding.
“Universal test and treat” program reduced TB incidence by 75% among a cohort of adults taking antiretroviral therapy (ART) in Gurage zone, South Ethiopia
Authors: Girum Tadele , Yasin Fedila , Dessu Samuel , Zeleke Bereket , Geremew Mulugeta
Published: May 2020

Background: Tuberculosis (TB) remains the leading cause of morbidity and mortality in peoples living with HIV. At least 25% of deaths are attributed to TB. It is believed that, Universal test and treat (UTT) program for HIV reduces incidence of TB and most countries implement the program. However, there is limited study conducted to evaluate the impact of UTT on TB incidence. Therefore, by recruiting a cohort of ART users in the “UTT” and “differed treatment” programs we aimed to measure the effect of the UTT program on incidence of TB.Objective: To measure the effect of “UTT” program on TB incidence among a cohort of adults taking antiretroviral therapy (ART) in Gurage zone, South Ethiopia.Methods: Health facility based retrospective cohort study through record review of 5 year (2014-2019) cohort was conducted in public facilities of Gurage Zone. Randomly selected 384 records were reviewed by using standardized structured checklist. Data was entered by Epi info version 7 and analyzed by STATA. Generalized Linear Model with binomial link function was fitted to measure adjusted incidence density/Incidence rate ratio and identify predictors of incidence difference between the two programs.Results: During the follow up period, 39 incident TB cases were occurred, and making the overall incidence rate of 4.79/100 person-year (PY). It is significantly lower in the UTT (IR=2.10/100 PY) than the differed program (IR=6.23/100 PY). The adjusted Incidence Rate Ratio (AIRR) of TB among patients enrolled in the UTT program was; 0.25 (95% CI=0.08-0.70) compared to patients enrolled in the differed program. Thus, UTT program reduce TB incidence by 75% compared to differed program. In addition to the program, IPT (isoniazid preventive therapy) use (AIRR= 0.35 (95% CI=0.22-0.48)), WHO Stage I and II (AIRR=0.70 (95% CI=0.61-0.94)) and higher Base line CD4 count (AIRR=0.96 (95% CI=.94-0.99)) significantly reduce incidence of TB. Whereas, treatment failure increase the incidence (AIRR=5.8 (95% CI=1.93-8.46)). Conclusion: TB incidence was significantly reduced by 75% after UTT. Therefore, intervention to further reduce the incidence has to focus on strengthening UTT program and IPT.
Rivastigmine improves dual-task gait velocity in patients with Alzheimer’s disease
Authors: Shimura Hideki , Aiba Saiko , Hayashi Akito , Hattori Nobutaka , Urabe Takao
Published: May 2020

Background Gait impairments are common in patients with Alzheimer’s disease. Cholinesterase inhibitors are used to treat the symptoms of patients with Alzheimer’s disease, but they have not been shown to reduce Alzheimer’s disease-related gait disorders.Methods The aim of the present study was to determine the effect of the acetylcholinesterase inhibitor rivastigmine on gait in 21 newly diagnosed patients with mild to moderate Alzheimer’s disease. The outcome variables were velocity, stride length, and cadence during single-task and dual-task gait trials. The subjects were also assessed with the Mini-Mental State Examination, Alzheimer’s Disease Cooperative Study Activities of Daily Living, Functional Assessment Staging, and Geriatric Depression Scale.Results After 12 weeks of treatment with rivastigmine, gait velocity was significantly improved in dual-task gait trials; gait velocity was increased from 40.59 ± 13.59 m/min at baseline to 46.88 ± 12.73 m/min when counting backward from 100 in steps of 7 while walking, and gait velocity was increased from 37.06 ± 15.57 m/min at baseline to 42.03 ± 14.02 m/min when naming animals while walking. In the single-task gait trials, which consisted only of walking at their usual pace or at a fast pace, gait velocity was not increased by rivastigmine administration.Conclusion Our findings indicated that rivastigmine improved gait in subjects with mild to moderate Alzheimer’s disease. The observed enhancement of dual-task gait might be caused by an improvement of cognitive function rather than motor function.
Cartilage degeneration is associated with activation of the PI3K/AKT signaling pathway in a growing rat experimental model of developmental trochlear dysplasia
Authors: Lin Wei , Dai Yike , Niu Jinghui , Fan Chongyi , Feng Xunkai , Wang Fei
Published: May 2020

Background: Trochlear dysplasia is a commonly encountered lower extremity deformity in humans. However, the molecular mechanism of cartilage degeneration in trochlear dysplasia is unclear thus far. The PI3K/AKT signaling pathway is known to be important for regulating the pathophysiology of cartilage degeneration. This study investigated the relationship of the PI3K/AKT signaling pathway with trochlear dysplasia cartilage degeneration. Materials and methods: In total, 120 female Sprague-Dawley rats (4 weeks of age) were randomly separated into control and experimental groups. Distal femurs were isolated from the experimental group at 4, 8, and 12 weeks after surgery; they were isolated from the control group at the same time points. Micro-computed tomography and histological examination were performed to investigate trochlear anatomy and changes in trochlear cartilage. Subsequently, expression patterns of PI3K/AKT, TGFβ1, and ADAMTS-4 in cartilage were investigated by immunohistochemistry and quantitative polymerase chain reaction. Results: In the experimental group, the trochlear dysplasia model was successfully established at 8 weeks after surgery. Moreover, cartilage degeneration was observed beginning at 8 weeks after surgery, with higher protein and mRNA expression levels of PI3K/AKT, TGFβ1, and ADAMTS-4, relative to the control group. Conclusions: Patellar instability might lead to trochlear dysplasia in growing rats. Moreover, trochlear dysplasia may cause patellofemoral osteoarthritis; cartilage degeneration in trochlear dysplasia might be associated with activation of the PI3K/AKT signaling pathway. These results provide insights regarding the high incidence of osteoarthritis in patients with trochlear dysplasia. However, more research is needed to clarify the underlying mechanisms.
Neutrophil-to-lymphocyte ratio predicts diagnosis and prognosis of patients with hepatocellular: A systematic review and meta-analysis
Authors: Lin Shan , Hu Shiping , Ran Yun , Wu Fenfang
Published: May 2020

Background: Neutrophil-to-lymphocyte ratio (NLR) is one of the poor prognostic factors of Hepatocellular carcinoma (HCC) in patients. As contradictory data are seen concerning the predictive ability of NLR, a meta-analysis is performed for the determination of its prognostic value in patients with HCC in this study.Methods: We systematically searched several databases including PubMed, EMBASE, and Cochrane Library with the updated date of January 21, 2020. Pooled estimates of odds ratio (OR) and diagnostic odds ratio (DOR) were used to assess the prognostic performance of NLR in HCC patients.Results: Nine studies containing a total of 3,862 HCC patients were included. High baseline NLR was correlated with poor prognosis or recurrence significantly. The patient-based analysis of pooled estimates was as follows: sensitivity 0.68 [95% confidence interval (CI), 0.58-0.77], specificity 0.73 (95% CI, 0.61-0.82), and DOR 6.347 (95% CI, 5.450-7.391), respectively. The pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLHR) were 2.5 (95% CI, 1.8-3.6) and 0.43 (95% CI, 0.33-0.57). Furthermore, the area under the curve (AUC) of summary receiver operating characteristic (SROC) reflecting the diagnostic accuracy was 0.76 (95% CI, 0.72-0.80). Results obtained from subgroup meta-analyses and overall meta-analyses were accordingly consistent with each other.Conclusions: Our findings suggested that NLR is an efficient prognostic factor for patients with HCC, especially for those from East Asian with high incidence. In the future, trails with larger sample sizes and more high-quality evidence are needed to further enhance the patient outcomes.
Induction of IRG1 following ischemic stroke promotes HO-1 and BDNF expression to alleviate neuroinflammation and restrain ischemic brain injury
Authors: Kuo Ping-Chang , Weng Wen-Tsan , Scofield Barbara A. , Furnas Destin , Paraiso Hallel C. , Yu I-Chen , Yen Jui-Hung
Published: May 2020

Background

Inflammatory stimuli induce immunoresponsive gene 1 (IRG1) expression that in turn catalyzes the production of itaconate through diverting cis-aconitate away from the tricarboxylic acid cycle. The immunoregulatory effect of IRG1/itaconate axis has recently documented in LPS-activated mouse and human macrophages. In addition, dimethyl itaconate, an itaconate derivative, was reported to ameliorate disease severity in the animal models of psoriasis and multiple sclerosis. Currently, whether IRG1/itaconate axis exerts an immunomodulatory effect in ischemic stroke is unknown. Thus, we investigated whether IRG1 plays a role in modulating brain injury in ischemic stroke. In addition, the molecular mechanisms underlying the protective effects of IRG1 in ischemic stroke were elucidated.
Methods

Wild type (WT) C57BL/6 and IRG1−/− mice were subjected to 40 minutes middle cerebral artery occlusion (MCAO). Ischemic brain injury, microglia (MG) activation and peripheral immune cell infiltration of the ischemic brain were assessed. Furthermore, the expression of HO-1 and BDNF in the ischemic brain was measured. Finally, IRG1−/− MCAO mice were administered with D3T, an Nrf2/HO-1 pathway inducer, to determine its effects on cerebral BDNF expression and ischemic brain injury.
Results

We observed IRG1 was highly induced in the ischemic brain of WT but not IRG1−/− MCAO mice. Strikingly, IRG1−/− MCAO mice exhibited exacerbated brain injury with enlarged cerebral infarct, enhanced MG activation, and elevated immune cell infiltrates compared to WT MCAO controls. Further analysis of molecular mechanisms underlying the protective effects of IRG1 in ischemic stroke revealed that IRG1 promoted HO-1 and BDNF expression to restrain ischemic brain injury, as IRG1−/− MCAO mice exhibited reduced HO-1 and BDNF expression in the ischemic brain compared to WT MCAO controls. Notably, D3T, an Nrf2/HO-1 pathway inducer, promoted BDNF expression and lessened ischemic brain injury in IRG1−/− MCAO mice.
Conclusions

We demonstrate that the induction of IRG1 following ischemic stroke may serve as an endogenous protective mechanism to restrain ischemic brain injury, and that may be mediated through the protective effect of IRG1 on the induction of HO-1 and BDNF expression in the ischemic brain. Thus, our study suggests that targeting IRG1 may represent a novel approach for the treatment of ischemic stroke.
Genome-Wide Identification and Analysis of Class III Peroxidases in Betula pendula
Authors: Cai Kewei , Chen Song , Zhao Xiyang , Chen Su
Published: May 2020

Background: Class III peroxidases (POD) proteins are widely present in the plant kingdom that are involved in a broad range of physiological processes including stress responses and lignin polymerization throughout the plant life cycle. However, little is known about the POD genes in Betula pendula, although it has been characterized in Arabidopsis, rice and maize. The POD genes remain to be determined in Betula pendula.Results: A total of 90 nonredundant POD genes were identified in Betula pendula. (designated BpPODs). These POD genes were divided into twelve groups based on their phylogenetic relationships. The BpPODs are unevenly distributed on the 14 chromosomes. In addition, some BpPOD genes were located sequentially in tandem on chromosomes, inferred that tandem duplication contributes to the expansion of the POD genes family in Betula pendula. Analysis of the distribution of conserved domains of BpPOD proteins showed that all these proteins contain highly conserved motifs. We also investigated their expression patterns in different tissues, the results show that some BpPOD genes might play significant roles in root, xylem, leaf and flower. Furthermore, under low temperature conditions, some BpPOD genes showed different expression patterns at different times.Conclusions: Comprehensive study of the POD genes suggests that their functional diversity during Betula pendula growth and development. Our findings provide a basis for further functional analysis on POD genes family in Betula pendula.
Transcriptome analysis reveals that multiple metabolic pathways operate in Zea mays roots subjected to graphene
Authors: Chen Zhiwen , Zhao Jianguo , Song Jie , Han Shenghua , Du Yaqin , Qiao Yuying , Liu Zehui , Qiao Jun , Li Weijia , Li Jingwei , Wang Haiyan , Xing Baoyan , Pan Qiliang
Published: May 2020

Background: To explore the effects and molecular mechanism of graphene on the growth and development of Zea mays L., the seeds were randomly divided into the control and experimental groups in this study, the roots of Zea mays L. seedlings were watered by different concentrations (0~100 mg/L) graphene. Results: By evaluating the root growth indices of maize, 50 mg/L graphene increased significantly the total root length, root volume, the number of root tips and root forks of maize seedlings compared with the control group. The contents of nitrogen and potassium in the soil around the roots were elevated after the treatment of 50 mg/L graphene. Then, we compared the transcriptome changes of Zea mays roots in response to 50 mg/L graphene treatment. Transcriptional factor regulation, plant hormone signal transduction, nitrogen and potassium metabolism as well as secondary metabolism in maize roots subjected to graphene showed significant up-regulated expressions, all of which might be related to mechanisms underlying graphene response. Based on qPCR validations, we proposed several candidate genes that might be responded to the graphene treatment in maize roots. Conclusion: The transcriptional profiles presented here provide a foundation for deciphering the mechanism between the graphene and maize roots interaction.
Unilateral Biportal Endoscopic Lumbar Interbody Fusion. Technical Note and Surgical Comparison with Conventional MIS TLIF.
Authors: Gatam Asrafi Rizki , Luthfi Omar , Mahadhipta Harmantya , Gatam Luthfi , Ajiantoro Ajiantoro
Published: May 2020

Backgrounds : Minimally invasive surgery develops very extensively in past few decades, not only in the scope of decompression but until fusion surgery. Surgeon has been trying to reduce the damage to the normal anatomical structure. In this study we performed unilateral biportal endoscopic lumbar interbody fusion (ULIF) as one of the fusion option which is readily available without sophisticated minimal invasive instrument. The purpose of this study is to introduce unilateral biportal endoscopic surgery and comparing the result with conventional minimal invasive lumbar interbody fusion (MIS-TLIF) Methods : This is a retrospective cohort study of 145 lumbar spondylolisthesis patient underwent conventional MIS-TLIF or ULIF procedure. All patient were followed up until 12 months to evaluate the VAS of back pain and leg pain, ODI, SF-36 and fusion rate. Results : Back pain VAS were a little higher compared with the endoscopic group, but the VAS of leg pain were the same. Both group had improvement in ODI score and SF-36 which shows both of the procedure were quite effective in managing such cases. Conclusion : Full endoscopic fusion offer benefit of minimal invasive surgery with better visualization of decompression and endplate preparation. Long term follow up is still needed to evaluate the result of the procedure.
BNIP3 relieves the LPS-induced inflammation and apoptosis of chondrocytes by promoting the development of autophagy
Authors: Ma Zetao , Wang Deli , Weng Jian , Zhang Sheng , Zhang Yuanshi
Published: May 2020

Background: Inflammation and apoptosis of chondrocytes are the pathological basis of osteoarthritis. Autophagy could alleviate the symptoms of inflammation and apoptosis. Previous study has shown that BCL2/adenovirus E1B 19 kDa protein-interacting protein 3 (BNIP3) could induce the occurrence and development of autophagy. However, it is unknown whether autophagy induced by BNIP could alleviate the inflammation and apoptosis of chondrocytes. Methods: We used the lentivirus to construct the overexpression BNIP3 chondrocytes. Next, the lipopolysaccharide (LPS) was used to stimulate these cells to simulate the physiological environment of osteoarthritis. After that, the enzyme-linked immunosorbent assays (ELISA) were performed to determine the levels of tumor necrosis factor-α (TNF-α), interleukin-1 beta (IL-1β) and interleukin-6 (IL-6) and the flow cytometry was performed to detect the apoptosis rates of chondrocytes. At last, the expression of autophagy related proteins was detected with the western blotting. Results: The expression of BNIP3 was suppressed after the stimulation of LPS. However, overexpression of BNIP3 inhibited the secretion of proinflammatory factors (TNF-α, IL-1β and IL-6) and relieved the apoptosis of chondrocytes. Furthermore, overexpression of BNIP3 led to the upregulation of autophagy related proteins including little computer 3 (LC3), autophagy-related protein 7 (ATG7) and Beclin-1. Application of autophagy inhibitor recovered the expression of proinflammatory factors and apoptosis rates of chondrocytes. Conclusions: BNIP3 alleviated the LPS induced inflammation and apoptosis of chondrocytes by activating the autophagy.
An Intelligent Parallel Method for Automatic Production of the Human Bronchial Tree Fulfilling Bronchopulmonary Segmental Isolation Based on Stochastic Parametric L-system
Authors: Abbasi Zeinab , Boozarjomehry Ramin Bozorgmehry
Published: May 2020

In the human lung, air is transported from the environment to the respiratory zone by conducting airways containing ~60000 airways with different scales. An accurate model of this complicated structure is crucial for studying transport phenomena in the human lung. In the present study, the parametric Lindenmayer System (L-System) has been used to produce the human bronchial tree in the bronchopulmonary segments whose shapes have been obtained based on the medical image processing techniques. The airways propagate into the host segments simultaneously similar to what happens in real life using multi-threads parallelism method. Each module in rewriting rules of the formulated L-System plays the role of an airway with its characteristic properties that have been found almost independently based on an intelligent procedure. This feature enables the method to be less sensitive to change in the host shape and size of the lungs. In addition, the stochastic behavior of the proposed procedure generates slightly different structures with the same statistical properties. Furthermore, the dimensions of the terminal branches are functions of age, which make the proposed method capable of generating the tree structure for the subjects with various ages fulfilling almost all anatomical and physiological requirements. The morphometric characteristics of the generated structure are in good agreement with the corresponding experimental data reported in the literature. The results show that the proposed method outperforms the previously reported models. The accurate three-dimensional model proposed by this study can be used for simulation of fluid distribution, mass and heat transfer, drug delivery, and particle deposition in the human respiratory system.
A Meta-Analysis of Acute Kidney Injury in Patients Undergoing Hip Fracture Surgery: Prevalence and Risk Factors
Authors: Zhang Yan-Li , Pu Yan-Chuang , Wang Jin , Li Zi-Cai , Wang Hu-Lin
Published: May 2020

Objective: Acute kidney injury(AKI) was a frequent complication following hip fracture surgery, but recent studies reported inconsistent findings. The purpose of our study was to systematically clarify the prevalence and risk factors of AKI after hip fracture surgery. Methods: Pubmed, Embase, and Web of Science were searched from the inception to March 2020 to identify observational studies investigating the prevalence and risk factors of AKI in patients undergoing hip fracture surgery. Pooled prevalence and odds ratios(ORs) with 95% confidence intervals(CIs) were estimated using random-effect model. Publication bias was evaluated with a funnel plot and statistical test. All the statistical analyses were performed using STATA version 12.0. Results: A total of 11 studies with 16,421 patients were included in the current meta-analysis. The pooled prevalence of AKI in patients undergoing hip fracture surgery was 17%(95%CI, 14%-21%). Postoperative serum albumin(OR 1.80; 95%CI, 1.38–2.36) was a significant predictor for AKI. Age(OR 1.01; 95%CI, 0.95–1.07) and ACE inhibitors(OR 1.38; 95%CI, 0.92–2.07) were also associated with increased risk of AKI, but the results were not statistically significant. No significant publication bias was identified through statistical tests(Egger’s test, p = 0.258 and Begg’s test, p = 0.087). Conclusions: The pooled AKI following hip fracture surgery was approximately 17%. Postoperative serum albumin was a potential significant risk factor for AKI.
Benchmark examination of blood amino acids patterns in phenylketonuric neonates and young children on phenylalanine-restricted dietary treatment
Authors: Wan Zhihui , Rosenbaum Eric , Liu Wei , Song Boyan , Yue Xiaofei , Kong Yuanyuan , Li Tianhe , Zhai Yanhong , Ma Zhijun , Cao Zheng
Published: May 2020

Background

Phe-restricted diets have been the basis of therapy for phenylketonurics; however, little is known how this treatment effects homeostasis of other important amino acids. This study aimed to describe blood amino acid patterns in neonates with phenylketonuria (PKU) and identify any effects of Phe restriction on these patterns in young children.
Methods

Neonate group (age 0–4 weeks): 45 PKU patients, 45 age-/sex-matched controls without PKU; 1–4 year-old group: 27 diet-treated PKU patients, 27 age-/sex-matched children without PKU. Concentrations of 11 amino acids were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS) performed on dried blood spots.
Results

Elevated blood phenylalanine (Phe), arginine (Arg), citrulline (Cit), valine (Val) and methionine (Met) concentrations were observed in PKU neonates relative to controls (Phe, Arg, Cit, Val: P < 0.001; Met: P < 0.05), of which Phe, Arg, and Met levels could be either partially or completely restored with dietary intervention. Diet had no effect on elevated Cit and Val. Decreased blood tyrosine (Tyr) and proline (Pro) concentrations were observed in PKU neonates compared to controls (P < 0.001). Both amino acids could be near completely restored to normal with dietary treatment. No significant differences in alanine (Ala), leucine (Leu), ornithine (Orn) and glycine (Gly) concentrations were found in the PKU neonates and 1–4 year-old groups (P > 0.05).
Conclusions

Blood amino acid homeostasis is disrupted in neonates and young children with PKU. Although dietary intervention adjusts amino acid homeostasis in the direction of a healthy equilibrium, complete restoration is not achieved. This persistent disruption may represent a clinically significant barrier to achieving the best possible therapy for those with PKU. Use of laboratory technologies such as LC-MS/MS enable characterization of persistent blood amino acid disequilibrium in the treated phenylketonuric. Testing of this kind presents opportunity for customized treatment feedback that may allow even greater optimization of therapy for neonates and children with PKU.
Long-lasting Insecticide-Treated Mosquito Nets in the Democratic Republic of the Congo: Knowledge, Attitudes and Practices among households in Bonzola Health Zone in Mbuji-Mayi.
Authors: Kaniki Chrys Promesse Kabuya
Published: May 2020

Malaria is the most widespread parasitic disease in the world. It is a major risk of morbidity and mortality for more than two billion human beings worldwide. In the Democratic Republic of the Congo (DRC), it is one of the three leading causes of death among the most vulnerable groups - children under five and pregnant women. The impregnated mosquito net is currently one of the best ways to prevent malaria.The purpose of this study is to assess the knowledge, attitudes and practices of households related to the use of long-lasting insecticide-treated net in Bonzola Health Zone in the City of Mbuji-Mayi .This is a cross-sectional descriptive study conducted with 360 households. Our statistical unit was the household. The interview technique was used to collect data that were encoded, processed and analyzed using Excel 2007 software. In our statistical analyses, we used the calculation of frequencies, mean, standard deviation and proportions. The Chi-square test was used for association research.Overall, 93.83% of respondents have a good knowledge of the long-lasting insecticide-treated net (LLITN) and its benefits, 96.94% have a positive attitude towards its use and only 61.39% have good practices. The LLITN use rate the night before the survey is 90.28% and the availability rate of LLITNs in households is estimated at 94.44%.Certain factors limit the effective use of LLINs by households. Although population knowledge and attitude are good enough, the utilization of LLITNs did not much progress comparing to the proportion of pregnant women sleeping under an ITN (60%) revealed in the 2013 MICS-DRC Report.These results reflect what the last free distribution of LLITNs carried out in August 2015 by the Government (through the National Malaria Control Programme, in partnership with ASF/PSI) has largely produced as impact to the beneficiary population.
Patterns of sucker development in cuttlefishes
Authors: Kimbara Ryosuke , Nakamura Mayuko , Oguchi Kohei , Kohtsuka Hisanori , Miura Toru
Published: May 2020

Background : Morphological novelties have been acquired through evolutionary processes in relation to the acquisition of new life-history strategies together with novel functions of bodyparts. Cephalopod molluscs such as octopuses, squids and cuttlefishes possess novel morphological characteristics such as their overall bodyplans and numerous arms. Among those novel morphologies, in particular, suckers arranged along the oral side of each arm possess multiple functions, such as capturing prey and locomotion, so that the sucker morphology is diversified among species, depending on their ecological niche. However, the detailed developmental process of sucker formation has remained unclear, although it is known that new suckers are formed or added throughout their life-time, including during both embryonic and postembryonic development. In the present study, therefore, focusing on two cuttlefish species, Sepia esculenta and S. lycidas ,in which the sucker morphology is relatively simple, morphological and histological observations were carried out during embryonic and postembryonic development to elucidate the developmental process of sucker formation. Results : The observations in both species clearly showed that the newly formed suckers were added on the oral side of the most distal tip of each arm during embryonic and postembryonic development. On the oral side of the arm tip, the epithelial tissue became swollen to form a ridge along the proximal-distal axis (distal sucker ridge). Next to the distal ridge, there were small dome-shaped bulges that are presumed to be the sucker primordia. Toward the proximal direction, the primordia became functional suckers, in which the inner tissues differentiated to form the complex sucker structures. During postembryonic development, on both sides of the distal sucker ridge, epithelial tissues extended to form a sheath, covering the ridge for protection of undifferentiated suckers. Conclusions : The developmental process of sucker formation, in which sucker primordia are generated from a ridge structure (distal sucker ridge) on the oral side at the distal-most arm tip, was shared in both cuttlefish species.
Omission of Chemotherapy in HR+/HER2- Early Invasive Breast Cancer Based on Combined 6-IHC Score?
Authors: Lin Jiaman , Guo Zihe , Wang Shuo , Zheng Xinyu
Published: May 2020

Background: Previous randomized studies have assessed the possibility of omission of chemotherapy in some hormone receptor (HR)-positive and HER2-negative (HR+/HER2-) breast cancers (BC) based on gene profiling test, e.g., Oncotype DX. The goal of this study was to evaluate if combination of six proliferation related biomarkers by immunohistochemistry (6-IHC) could be a cost-effective option in determining the necessity of adjuvant chemotherapy in HR+/HER2- BC.Methods: A retrospective analysis of HR+/HER2- BC patients was conducted in the First Affiliated Hospital of China Medical University from 2010 to 2016. The expression of 6 BC-related proliferation and invasion genes (Cathepsin L2, MMP11, CyclinB1, Aurora A, Survivin and Ki67) from Oncotype DX were analyzed through IHC (designated as 6-IHC). All the included patients were divided randomly at a 7:3 ratio into training and testing cohorts. The cutoff prognosis index (PI) of 6-IHC was determined by multivariate Cox risk regression analysis after calculating the PI of each patient in training cohort and confirmed in testing cohort. The patients were classified into “Low” and “High” risk groups based on the PI value. Kaplan-Meier (KM) method was used to analyze Disease-free survival (DFS) and overall survival (OS). 6-IHC score and other factors associated with survival benefit of adjuvant chemotherapy were compared with Ki67 index.Results: A total of 330 patients were included and divided into training cohort (n = 231) and validation cohort (n = 99). The receiver operating characteristic (ROC) curve analysis showed that the patients can be divided into 6-IHC score “High” and “Low” risk groups using the cut-off PI of 2.16. The 8-year DFS and OS were 54.6% and 69.2%, respectively in the 6-IHC score “High” risk group; 85.5% and 92.5%, respectively in the 6-IHC score “Low” risk group. The 8-year DFS and OS were 70.8% and 80.9%, respectively in the Ki67 “High” risk group, 77.7% and 87.6%, respectively in the Ki67 “Low” risk group. The KM curves showed that chemotherapy did not significantly improve the DFS in the 6-IHC score “Low” risk group (p = 0.830), but significantly improved the DFS in the 6-IHC score “High” risk group (P = 0.012).Conclusions: Combined 6-IHC score could be a reliable tool in predicting cancer-specific recurrences and survival in HR+/HER2- BC patients and identifying patients who could benefit from adjuvant chemotherapy regardless of the involvement of axillary lymph node (ALN).
Greater trochanteric bone flap grafting with vascular pedicles for the treatment of femoral head osteonecrosis in patients with systemic lupus erythematosus: A retrospective study
Authors: Yang Qiang , Zhou Jixue , Li Lei , Guo Zhaopeng , Tian Xiaolei
Published: May 2020

Background: Osteonecrosis of the femoral head is a complication of systemic lupus erythematosus,that affect the patient's quality of life seriously.This article reviewed the radiographs of osteonecrosis of the femoral head in patients with systemic lupus erythematosus and assessed the effect of using the greater trochanteric bone flap grafting with vascular pedicles.Methods: We retrospectively reviewed 17 patients (26 hips) with systemic lupus erythematosus who underwent the greater trochanteric bone flap grafting with vascular pedicles for the treatment of osteonecrosis of the femoral head. According to Ficat and Arlet classification, 16 hips were in stage II; 10 hips were in stage III. All patients were followed up for a mean of 32 months (ranging 12~48 months) and were assessed clinically and radiologically according to Harris scoring.Results: No hips were treated with total hip arthroplasty in the follow-up. The mean HHS was improved from preoperative 69.1 points (ranging 52–83 points) to postoperative 89.4 points (ranging 56–100 points). At the latest follow-up, of 26 hips, radiographically 21 hips (80.77%) were improved, 3 hips (11.54%) were unchanged and just 2 hips (7.69%) were worse.Conclusion: The greater trochanteric bone flap grafting with vascular pedicles was successful in maintaining joint function and in delaying the need for joint replacement procedure.
Application of artificial intelligence image-assisted diagnosis system in chest CT examination of COVID-19
Authors: Zhang Mengqi , Wang Yangyang , Ding Qianyun , Li Haiwen , Dai Fu , Chao Huimin , Chao Huimin
Published: May 2020

Purpose The purpose of this study is to evaluate the application efficiency of artificial intelligence (AI) image-assisted diagnosis system in chest CT examination of corona virus disease 2019 (COVID-19). Methods A total of 33 cases of COVID-19 patients who underwent chest CT in Hefei Binhu Hospital between January 2020 and March 2020 were retrospectively included. All patients were tested positive for novel coronavirus nucleic acid by fluorescent reverse transcription-polymerasechain reaction (RT-PCR). The pneumonia screening function of the AI image-assisted diagnosis system was employed for the 103 chest CT examinations of the 33 cases. The diagnosis of four senior radiologists were used as the standard for synchronous under blind state. The sensitivity, specificity, misdiagnosis rate, missed diagnosis rate and other evaluation indexes of the COVID-19 performed by the AI image-assisted diagnosis system were analyzed, and an dynamic evaluation on the CT reexamination was conducted. Results Out of the 103 chest CT examinations, there were 88 cases of true positive, 1 case of false positive, 12 cases of true negative and 2 cases of false negative. The sensitivity was 97.78% (88/90); the specificity was 92.31% (12/13); the positive predictive value was 98.88% (88/89); the negative predictive value was 85.71% (12/14); the accuracy was 97.09% (100/103); the Youden index was 90.09%; the positive likelihood ratio was 12.711 and the negative likelihood ratio was 0.024. There were 790 identified lesions in these CT examinations in total, of which 569 were true positive and 221 were false positive. There were also 64 missed diagnosis markers. The detection rate of all lesions was 89.89% and the rate of false positives was 27.97%. In the last CT scan, the lesion size were smaller and the percentage of lesions in total lung volume along with the mean density of lesions was lower than that of the first CT scan. Conclusion The AI image-assisted diagnosis system has certain clinical application value in the early diagnosis and follow-up evaluation of chest CT examination of COVID-19.
Deep Learning Approach for COVID-19 Diagnosis Using X-Ray Images﻿
Authors: Al-Asfoor Muntasir
Published: May 2020

During the times of pandemics, faster diagnosis plays a key role in the response efforts to contain the disease as well as reducing its spread. Computer-aided detection would save time and increase the quality of diagnosis in comparison with manual human diagnosis. Artificial Intelligence (AI) through deep learning is considered as a reliable method to design such systems. In this research paper, an AI based diagnosis approach has been suggested to tackle the COVID-19 pandemic. The proposed system employs a deep learning algorithm on chest x-ray images to detect the infected subjects. An enhanced Convolutional Neural Network (CNN) architecture has been designed with 22 layers which is then trained over a chest x-ray dataset. More after, a classification component has been introduced to classify the x-ray images into two categories (Covid-19 and not Covid-19) of infection. The system has been evaluated through a series of observations and experimentation. The experimental results have shown a promising performance in terms of accuracy. The system has diagnosed Covid-19 with accuracy of 95.7% and normal subjects with accuracy of 93.1 while it showed 96.7 accuracy on Pneumonia.
SÓ É POSSÍVEL HABITAR O QUE SE CONSTRÓI: UMA COMPREENSÃO CONSTITUCIONALMENTE ADEQUADA DO DIREITO FUNDAMENTAL À MORADIA NO BRASIL CONTEMPORÂNEO
Authors: Costa Débora Laís dos Santos , Filho Edson Vieira da Silva
Published: May 2020

Utilizando de Heidegger como marco teórico, o trabalho tem o intuito de observar a questão do direito à habitação a luz do constitucionalismo. O déficit de concretização dos direitos humano em países de modernidade tardia como o Brasil, especialmente aqueles em que o evento do constitucionalismo contemporâneo se instala com relativo sucesso se torna um problema que vai além do político, administrativo e jurídico, esbarrando antes de mais nada na questão hermenêutica. Antes de pretender-se a realização do novo é necessário compreendê-lo em toda a sua extensão para que as questões a eles relativas tenham respostas adequadas. Se o positivismo normativista moderno oferece respostas insuficientes, contraditórias e precárias há que se buscar o sentido das coisas nelas e em sua mundialidade, único referencial aceitável para que, a partir da compreensão dos entes cheguem a respostas adequadas. Do chão teórico que faz nascer as novas dimensões jurídicas do morar (muito mais complexo que o simples abrigar) à sua compreensão e aplicação constitucionalmente adequada há um longo caminho hermenêutico que será abordado neste artigo.
O NOVO IMPERIALISMO E O NEOLIBERALISMO NAS POLÍTICAS DAS INSTITUIÇÕES DE JUSTIÇA NA AMÉRICA LATINA: UMA ANÁLISE A PARTIR DA REFORMA DO PODER JUDICIÁRIO BRASILEIRO E DA BUSCA PELA CONSOLIDAÇÃO DO ESTADO DEMOCRÁTICO DE DIREITO
Authors: Ramos Edith Maria Barbosa , Miranda Netto Edson Barbosa de
Published: May 2020

O presente artigo objetiva analisar as influências das políticas neoliberais e do novo imperialismo norte-americano na Reforma do Poder Judiciário brasileiro promovida por meio da EC n. 45/04. Foram analisadas as reformas políticas e econômicas patrocinadas nos países da América Latina pelos EUA e por organismos financeiros internacionais, sobretudo nas décadas de 80 e 90. Adotou-se a metodologia da revisão sistemática, configurada a partir de estudo bibliográfico e documental. Concluiu-se que, apesar de haver elementos positivos nesse processo de reforma do sistema de Justiça brasileiro, como a busca por maior eficiência e celeridade nos processos, a reforma do sistema judicial brasileiro de 2004 mostrou-se limitada, com a construção insuficiente de mecanismos capazes de efetivamente melhorar a prestação jurisdicional, a exemplo dos meios alternativos de resolução de demandas.
SOSYAL POLİTİKA GELİŞTİRME VE SOSYAL HİZMET UYGULAMALARINDA YERELLEŞME:SAKARYA BÜYÜKŞEHİR BELEDİYESİ SOSYAL GELİŞİM MERKEZİ ÖRNEĞİ
Authors: GENÇ Yusuf , ÇAVUŞOĞLU Oğuzhan , ÇÖPOĞLU Mustafa
Published: May 2020

Modern
dünya düzeni, ekonomik, teknolojik gelişme ve yenilikler bireylerin ihtiyaç
hiyerarşisini değiştirmiş, refah toplumunun ruhunu oluşturan sosyal devlet ve
sosyal belediyecilik anlayışı yaygınlaşmış, yeni yerel sosyal politika üretim
ve uygulamalarına ihtiyaç duyulmuştur. Yerel yönetimlerin bölgesel
farklılıklar, gelişmişlik düzeyi, yerel halkın sosyoekonomik ve kültürel
yapısını daha iyi tanıması, sorunlara hâkim olması ve halka daha yakın olması
sosyal politika üretimi ve uygulamalarında söz sahibi olmasını gerekli
kılmıştır. Bu makalenin amacı; sosyal politika uygulamalarının ve sosyal
hizmetlerin yerelleştirilerek merkezi yönetim yerine yerinden yönetim
tarafından üretilip uygulanmasının önem ve gerekliliğini Sakarya Büyükşehir
Belediyesi Sosyal Gelişim Merkezinin hizmet ve uygulamaları özelinde
açıklamaktır. Araştırma ‘durum çalışması (örnek olay)’ yöntemine dayalı ‘iç içe
geçmiş tek durum deseni’ niteliği taşımaktadır. Verilerin toplanmasında görüşme
tekniği kullanılarak merkez yöneticileri ve çalışanları ile mülakatlar
yapılmış, merkezin hizmet ve faaliyetlerine yönelik dokümanlar incelenmiştir. Çalışmanın
teorik alt yapısında ise sosyal politika, sosyal hizmet, sosyal belediyecilik,
merkezi yönetim ve yerinden yönetim kavramları incelenerek sosyal hizmet ile
ilişkileri ele alınmıştır. Araştırma sonucunda yereldeki sosyal sorunların
çözümü için uygulanabilir yerel sosyal politikalar üretilmesi ve yerel
yönetimler tarafından sosyal hizmet perspektifinde uygulanmasının merkezi
yönetim uygulamalarına göre daha etkin ve verimli olacağı kanaati ortaya
çıkmıştır.
Discovering the Potentials of Medicinal Mushrooms in Combating Depression – A Review
Authors: Lew Sze Yuen , Teoh Seong Lin , Lim Siew Huah , Lim Lee Wei , Wong Kah Hui
Published: May 2020

Depression is the most common form of mental illness and the major cause of disability worldwide. Symptoms of depression, including feelings of intense sadness and hopelessness, may occur after a specific event or in response to a gradual decline in health and functional status, often associated with aging. Current therapies for treating these symptoms include antidepressant drugs, counseling and behavioral therapy. However, antidepressant drugs are associated with mild to severe adverse effects, which has prompted the need for better treatment options. Medicinal mushrooms are valuable sources of food and medicine and are increasingly being used as supplements or as alternative medicines in standard healthcare. Numerous studies have provided insights into the neuroprotective effects of medicinal mushrooms, which are attributed to their antioxidant, anti-neuroinflammatory, cholinesterase inhibitory and neuroprotective properties. In this review, we comprehensively examine the role of these medicinal mushrooms in the treatment of depression. However, to apply these natural products in clinical settings, the therapeutic agent needs to be properly evaluated, including the active ingredients, the presence of synergistic effects, efficient extraction methods, and stabilization of the active ingredients for delivery into the body as well as crossing the blood-brain barrier.
Spectrophotometric Methodologies Applied for Determination of Pharmaceuticals
Authors: Cini Nejla , Gölcü Ayşegül
Published: May 2020

Background:

The development of innovative approaches in drug analysis is a challenging
task for medicine, pharmacy, and engineering sciences. For instance, the requirement of proper dosage
forms in releasing active ingredients is crucial. It is essential to analyze drugs in biological liquids
for early diagnosis and treatment purposes. Drug analysis is also of great importance to control
the quality of pharmaceutical products, test their efficacy, and develop novel drug formulation. The
present review is aimed to highlight the most recent spectrophotometric approaches applied to analyze
various classes of drugs in biological media and/or dosage forms.

Methods:

Direct and derivative UV/UV-Vis spectrophotometry and a combination of various techniques
with spectrophotometry, such as injection analysis and chemometrics, have most widely been
applied in the analysis of dosage forms. In addition, emerging technologies, such as UV imaging allows
to obtain the distribution of drug concentration in time-resolved 2D images based on UV light
absorption, utilization of nanotechnology, self-assembled nanomaterials, and aptamer-based nanoparticles
have gained interests to investigate drug assays and to quantify the proper drug release.

Results:

Due to their high versatility, ease of application, low cost, and fast response, spectrophotometric
methods are one of the most preferable methods providing high accuracy and precision with a
wide linear range in drug analysis.

Conclusion:

Selected examples demonstrating the applicability of spectrophotometric methods in
pharmaceutical assays in this review might contribute to the overall importance of the analytical test
used in modern pharmaceutical analysis.