bluuebunny/crossref_metadata_2025 huggingface dataset:
The problem of choice of optimal technological decisions on harvester control
Authors: Dimitrov Valery P. , Borisova Lyudmila V. , Nurutdinova Inna N. , Pakhomov Viktor I. , Maksimov V.P.
Published: November 2018

The paper considers the problem of determining optimal technological decisions on a harvester control which includes the choice of the harvester adjustable parameters at presetting and also their updating in the process of operation. To solve this problem, an information system of decision making support based on fuzzy expert knowledge is used. The expedience of this approach is stipulated by the data fuzziness about the factors of the environment in which the harvester is operating and also by complex and system of uncertain interrelations among external factors, adjustable parameters and harvesting quality indices. For the case of harvesting grain crops an expert knowledge base has been made which makes it possible to formalize empirical knowledge about the dependencies of the harvester adjustable parameters on the environment factors such as crop yield, stand of grain humidity, stand of grain dockage rough straw. The most essential adjustable parameters have been considered: speed of the harvester motion, rotational speed of a threshing drum and rotor speed of a separator fan. Fuzzy logic inference has been performed with the help of Fuzzy Logic Toolbox application package (Matlab). The examples of technological decisions of the harvester preliminary adjustment at different environmental conditions have been presented, accurate values of the adjustable parameters were calculated by the «barycentre» method.
The dynamics of impurity distribution in marine systems
Authors: Sidoryakina Valentina V. , Protsenko Sofya V.
Published: November 2018

The system of Navier-Stokes equations, which includes three equations of motion in regions with a dynamically varying geometry of the computational domain was used to describe the wave processes. The velocity vector field is used as input information for calculating the dynamics of impurity propagation in marine systems. The article considers construction and investigation of parallel algorithms for the numerical realization of 3D models of suspended matter transportation and deposition and 2D models of bottom sediment transportation in sea coastal systems on the basis of explicit schemes with regularization terms that provide improved stability quality. The developed models take into account coastal currents and stress near the bottom caused by wind waves, turbulent spatial-three-dimensional motion of the water medium, particle size distribution and porosity of bottom sediments and hydraulic size of suspended particles, complicated shoreline shape and bottom relief and other factors. The practical significance of numerical algorithms and the complex of programs that realize them consists in the possibility of their application in the study of processes in coastal water systems, as well as in constructing the velocity and pressure field of the aquatic environment.
The application of the artificial neural network in analysing the spread quality
Authors: Petkovic Marko , Blagojevic Marija , Mladenovic Vladimir
Published: November 2018

In this paper, we introduce a new approach in food processing using an artificial intelligence. The main focus is simulation of production of spreads and chocolate as representative confectionery products. This approach aids to speed up, model, optimize, and predict the parameters of food processing trying to increase quality of final products. An artificial intelligence is used in field of neural networks and methods of decisions.
Images denoising in case impulse noise using spline approximation
Authors: Bezuglov Dmitriy A. , Voronin Viacheslav V. , Krutov Vladimir A.
Published: November 2018

Analytical equations of a new spline approximation method for filtering impulse noise in images are obtained. The proposed method differs from the known ones: when filtering images, one-dimensional sequential spline functions are used for direct and inverse transformations, and the processing is performed in rows and columns. In this work, experimental studies based on computer simulation using special test images on the background of impulse noise were conducted. Experimental studies have shown the operability and high efficiency of the developed method, which allow to improve the quality of image filtering by up to 10 dB. In this case, the properties of spline functions make it possible to abandon the use of various masks, that is, to abandon inefficient linear methods of image filtering. The method can be used to create digital image processing systems in the industry, to create autonomous robots, under observation conditions that complicate the registration process, and in the absence of a priori information about the form of background noise.
Conditions for fixing violations of traffic rules do not pass pedestrians on unregulated pedestrian crossings in automatic mode
Authors: Ibadov Samir R. , Kalmykov Boris Y. , Ibadov Ragim R.
Published: November 2018

The article presents the urgency of developing systems for fixing violations of traffic rules in automatic mode. Describes the verification of conditions for determining the violation of pedestrians’ nonadmission on unregulated pedestrian crossings by drivers of vehicles.
Artificial intelligence and cyber-physical mechanical processing systems in digital industry
Authors: Kabaldin Yuri , Shatagin Dmitrii
Published: November 2018

The article suggests new approaches to the creation and control of cyber-physical machining systems in the digital industry. Features of the use of artificial intelligence and the possibilities of big data for analyzing the current and future state of CNC machines are considered. A specialized neuromorphic chip is proposed, with the possibilities for deep learning, for control and sharing knowledge between CNC machines as part of a technology group. The features of the use of blockchain technology in digital industry with the use of the industrial Internet of things are shown.
Incidence and risk factors of the temporomandibular joint disorders in the patients without condylar fractures
Authors: Junjie Yan , Weidong Liu , Ren Lin , Min Ye
Published: November 2018

Objective: To evaluate the incidence and risk factors of the temporomandibular joint disorders (TMD) in the patients suffering from maxillo-facial injury without condylar fractures.

Methods: sixty patients without condylar fractures were recruited from Feb 2014 to Nov 2015 in the department of stomatology, Lishui people’s hospital. The incidence of TMD was recorded at 1, 3, 6, 9 and 12 months after injury through MRI examination. The risk factors for TMD were evaluated by logistic regression analysis.

Results: the TMD incidence rates were 25.0%, 30.0%, 35.0%, 41.7% and 48.3% at 1, 3, 6, 9 and 12 months after injury with no statistical difference between male and female (P>0.05). Logistic regression indicated that disorder of occlusal relationship (OR=1.84,95%CI:1.36-2.78) and hemi-mastication (OR=1.56, 95% CI:1.23- 2.24) were independent risk factors for the development of TMD.

Conclusion: there was a high incidence of temporomandibular joint disorders in the patients suffering from maxillo-facial injury without condylar fractures. The disorder of occlusal relationship and hemi-mastication were independent risk factors for the development of post-injury TMD.
Analysis of the association betweenCDH2gene polymorphism and osteoarthritis risk
Authors: Zhao Guanglei , Shi Jingsheng , Xia Jun
Published: November 2018

Objective: to define the cadherin 2 (CDH2) gene polymorphism in Chinese osteoarthritis and control populations and to explore the correlation betweenCDH2gene polymorphism and the risk of osteoarthritis.

Method: a total of 476 patients with osteoarthritis were collected and 380 control subjects were included in the study. Clinical data such as gender, age and functional score were collected. The blood and tissue samples were collected and genotyped by PCR. Data analysis was performed using SPSS 19.0, Hapioview 4.2 and SNPstats softwares.

Results: the association of rs11083271 and osteoarthritis was initially validated in this study population (P = 0.016, OR = 1.43 (1.07- 1.93)]. The risk of OA was significantly higher in heterozygous T/C than in homozygous T/T and C/C in rs11083271. By adjusting the age, according to gender stratification analysis, the heterozygous T/C genotype in rs11083271 significantly increased the risk of OA incidence in males [p = 0.011, 3.40 (1.55-7.43)]. The remaining rs sites were not significantly associated with OA. Notably, the association of rs11564299 with OA, regardless of genotyping, gene frequency and RNA expression levels in the study population, was not confirmed.

Conclusion: in this study, we have analyzed the association betweenCDH2gene polymorphism and OA in Chinese population. We found that rs11083271 heterozygous T/C genotype significantly increases the risk of OA and the severity of the disease. By contrast, the rs11564299 locus and OA have no significant correlation in the Chinese population. The role of rs11083271 in the regulation of CDH2 expression levels and the mechanisms by which it impacts OA remain to be further studied.
Exploring the dynamic changes between pulmonary and cutaneous sarcoidosis based on gene expression
Authors: Sheng Youyu , Yang Yuxin , Wu Yun , Yang Qinping
Published: November 2018

Sarcoidosis is a disease involving the growth of abnormal inflammatory granulomas and affecting multisystems. It has an unknown etiology. The lung and the skin are the most commonly involved organs. Although large amounts of research have focused on the pathogenesis of sarcoidosis, little is known about the link between cutaneous sarcoidosis and pulmonary sarcoidosis. Moreover, the gene expression profiles provide a novel way to find diagnostic or prognostic biomarkers. Therefore, the aim of this study was to analyze the differentially expressed genes (DEGs) in pulmonary sarcoidosis and cutaneous sarcoidosis patients and to compare them to healthy individuals. DEGs and their biological functions are dynamically dysregulated, and several common disease-related genes and mutual disease progression-related genes were identified which linked pulmonary sarcoidosis and cutaneous sarcoidosis together. The biological functional pathways regulated by these DEGs may allow to define the common mechanism shared by different type of sarcoidosis, providing novel insight into the common pathogenesis of sarcoidosis and opening the way to the development of new therapeutic strategies.
“Student as a consumer” in Latvian higher education
Authors: Stankevics Aivars , Zivarts Juris
Published: November 2018

The authors felt it necessary to update the discussion, which is associated with higher education, as one of the forms, which operates under free market conditions, and the relationship that is established between the higher education institutions and the students. Higher Education Institutions is a “service provider”, but the student recipient of the service – “consumer”. Both the Latvian and international higher education area is very different and there are conflicting views on the issue. Consequently, the authors wanted to analyze the current situation in Latvia, look at the legal framework relating to the above problem and to provide their views.
Shaping of personality of Russian youngsters during the pre-perestroika and post-perestroika periods of development of society
Authors: Uryvaev Vladimir , Subbotina Larisa , Karpov Anatoliy , Senin Ivan , Karpov Aleksandr
Published: November 2018

Introduction – socio-political and socio-economic changes in society largely define a developing personality. Goal – to conduct a psycho-diagnostic evaluation of the changes in basic personal characteristics of young students in the context of Russian society development. Results: the comparison of two groups of medical student (both groups are identical: the second course, the department of general medicine, Yaroslavl State Medical University). Testing of 1992 (n = 243) and 2016 (n = 197) using the 16-PF Questionnaire and the POI reveals two main tendencies. The first tendency is the increase of the general level of tension (the 16-PF scales: C, I, O, Q4 – all the quantitative indices have increased, p < 0.01, Student's t-test). The second tendency is a significant growth of the efficiency of personal characteristics providing self-regulation and voluntary behaviour (the 16-PF scales: E, G, H, Q3 are analogous to the first tendency; the SAV scale of the POI also reports a growth with high statistical values). Discussion: the respondents from the first group were born in 1972–1973. Prenatal maturation, babyhood, junior school, and early adolescent age took place in the epoch of a high degree of stability and succession in the development of society. The respondents from the second group were born in 1998–1999. The samples are separated by a generation. The second group (2016 testing) reports a high level of neuro-psychic tension during socio-psychological adaptation and, consequently, the growth of efforts in developing voluntary regulation of social behavior. Evidently, there is value of self-actualization in the new reality.
Gender as a recruitment criterion in the parliamentary political elite of Latvia (1993–2016)
Authors: Metla-Rozentale Lelde
Published: November 2018

The globalization process has transformed substantially understanding of the issue of border. Revising borders is also seen in political science – in the area of political elite recruitment. Recruitment criteria and their importance are changing, including the importance of gender. In 1981 the United Nations General Assembly adopted the Convention on the Elimination of All Forms of Discrimination Against Women, which provides equal rights of genders in the political elite, the so-called “mirror representation”, i.e., in the political elite men and women should be represented proportionally according to their number in society [4]. It should be particularly stressed that the purpose of “mirror representation” is not only to ensure equal rights of genders, but first of all to improve the quality of politics. As soon as Latvia regained its independence in 1990, the complicated process of formation (recovery) of the democratic governance model started. In 1993 the first parliamentary elections were held, and by 2016 elections for eight parliamentary terms had been held [3]. In view of the complex political history of Latvia, it is interesting and important to clarify the role of gender in the Latvian parliamentary political elite recruitment process – what correlations can be observed with regard to the male and female share in the parliament during the period from 1995 till 2016, and the extent to which it complies with the sex ratio breakdown of the society.
Criminological characteristics of sexual violence
Authors: Kipane Aldona
Published: November 2018

The aim of the current article is to analyse the criminological aspect of sexual violence. Nowadays sexual assault has become a major social issue in many contemporary cultures. Sexual violence is a complex interdisciplinary issue, which includes several aspects psychological, judicial, medical, and other aspects. Sexual crime is an urgent problem with a high level of latency, most part of such crimes are not reported in crime statistics. Particularly, sexual violence against children is a serious problem for Latvia and the world. At present, there is a sharp increase in such crimes as a human trafficking or commercial sexual exploitation; as well as the number of sexual crimes against boys is rising. Expansion of criminal activity in the cyberspace has also increased.
The right to health in context of ensuring the best interests of the child
Authors: Kudeikina Inga , Palkova Karina
Published: November 2018

The right to health is one of the human fundamental rights. In present socio-legal area in health security issues, the human as an unconditional obedient patient, transforms into medical practitioner's associate, actively participating in all discussions of issues, which affect his health and executable medical manipulations. The human from medical object has turned into the medical subject. As exceptions can be mentioned persons who, for objective reasons, are not able to exercise their rights in full. One of such person group is children. Children have no capability to exercise their rights themselves. Therefore it is important to understand whether the volume of child's right is equal to the volume of adult's rights. Conditionally, we can say that in the stage of exercising the right, children depend on their representatives. The article will provide information on the issues, which affect child's right to health in context of ensuring the best interests of the child in Latvia according to the local and the European Union legal documents. In addition, the article will show the mechanism for dispute resolving, which may occur between a medical institution (doctor) and a person, who represents the child in Latvia. Both international and national legal acts stipulate that a child requires a special care, which includes ensuring the best interests of the child. It is essential that the concept “best interests of the child” is not defined in legislation and in all cases it is subject to interpretation of the adopter of the law (the user). On the fact, how fully the child's natural or legal guardians will defend the interests of the child, depends observation of the child's fundamental right – right to health. To find the answers to the current research questions descriptive, analytical, deduction-induction methods, etc. are used.
The understanding of the text and images by teenagers with different levels of intelligence with eye tracking using
Authors: Zashchirinskaia Oksana V. , Nikolaeva Elena
Published: November 2018

The aim of this study was to identify and compare the characteristics of the recognition and understanding of verbal and nonverbal stimuli in the form of a text and drawing images of various degrees of definition applicable to students with mild mental retardation. The objects of the comparative study were graduates of schools with a varying degree of the intelligence decline (F83 – mixed specific disorders of psychological development and F70 – mild mental retardation). 85 subjects were participants. There were 49% boys and 51% girls. The study revealed specific features of perception and understanding of the texts and images of different degree of visual complexity by students with mild mental retardation. In the analysis of the visual information, they preferred to focus on the emotional aspect of the content both of the texts and pictures. Students with mild mental retardation demonstrated a lower level of cognitive development and volitional activity when viewing a stimulus of a high degree of visual complexity. A specific feature in the perception and understanding of the texts and images by these students is the lack of cognitive orientation on the procedural side event analysis.
Motivating factors of infection control in nurse practice
Authors: Platace Diana , Millere Inga
Published: November 2018

Hospitals in developed countries for more than 170 years have been studying and validating a variety of methods for staff motivation: education at work, distributed leaflets, seminars and lectures, provided the necessary equipment and personal protective equipment as well as surveillance and control provided by the hospital epidemiological service. No less important role nurses play in the motivation of psychological factors, such as attitudes, habits, stress and tolerance. Aim – to explore the motivating factors of infection control in nurse practice. The study used qualitative research method – structured interview (n = 36) and a quantitative study – questionnaires (n = 230). Questionnaires engaged 98 intensive care nurses and 132 surgical nurses. Results – most of the nurses (62.2%) regularly improved their knowledge of infection control. Infection control rules in their work regularly used 86.1% of respondents, while 13.9% of respondents irregularly applied infection control within the patient care process, posing a threat to their own health as well as to patient's health. Nurses noted several motivating factors for infection control, for example, the importance of the rules in patient care (94.3%), availability of infection control rules in the ward (92.6%), regular supervision provided by head nurse (84.8%), positive attitude of colleagues (80.4%), availability of the necessary equipment and personal protective equipment, understandable and simple rules for infection control, sufficient time for infection control in patient care, adequate infection control and surveillance in high risk units, provided by the hospital epidemiological service. The most frequently mentioned reasons for breaking the infection control rules were increased workload and burnout, as well as the lack of understanding of the importance of infection control in patients’ health maintenance and inappropriate attitude. Conclusions – the study suggests that in high-risk units there are different motivating factors of infection control, such as the necessary equipment and personal protective equipment, comprehensibility and accessibility of infection control rules, infection control and surveillance provided by the hospital epidemiological service. And at the same time, there are factors that disturb nurses’ motivation, such as an increased workload, lack of awareness of infection control in practice and inappropriate attitude.
How hardiness and the quality of life relate to the parameters of autonomic balance
Authors: Nikolaeva Elena , Elnikova Oksana , Vergunov Eugeny , Perevoskina Yulia
Published: November 2018

The purpose of the research was to evaluate the prognostic significance of the two tests most often used by psychologists for describing of the subject's quality of life: the Short Form-36 Health Status Survey (SF-36) and the Hardiness Test (Maddi, 1998). As an indicator of the state of internal control, the activity of the sympathetic nervous system (SNS) and the parasympathetic nervous system (PSNS) was chosen. Our study sample consisted of 59 students and office workers (mean age of 25.1 ± 11.0 years). The study was conducted in two successive stages. During each of the stages, the heart rate was recorded, the slow and the fast waves on the cardiogram were assessed. During the first stage, the R-R intervals were recorded with the subject in a state of quiet wakefulness; during the second, while the subject's health was being discussed. A second recording was done for further elaboration (once again while the test subject was in the process of describing the state of their health). The only correlation between a person's own description and the actual inner state arises when they are describing their real responsibilities and how they carry them out.
Development, adaptation and application of a rehabilitation technology – art-based assessments of art therapy: An overview of the current situation in Latvia
Authors: Strazdina Elza
Published: November 2018

The aim of this study is to give an overview on the current situation of art-based assessment in Latvia, focusing on the adaptation and its results of The Bridge Drawing (TBD) assessment tool. The study consisted of two stages – the adaptation of TBD in Latvian and examination of its content validity and psychometric data; the use of adapted instrument in order to investigate any differences in TBD drawings between clients with symptomatic eating disorders and those without. In the first stage of the study, 40 respondents participated, while in the second stage 50 participants (25 respondents with symptomatic eating disorders and 25 without such diagnosis) were selected. It was concluded that the psychometric data generally shows adequate results in most of the quantitative TBD scales. Statistically significant correlation between a number of TBD and COPE-LV scales was detected, suggesting that TBD can be used to determine problem-solving strategies. This research also revealed various differences in TBD drawings of clients with symptomatic eating disorders.
Social worker intervention performance in work with unemployed adults
Authors: Dmitrijeva Natalja , Razgale Ilvija
Published: November 2018

This article is based on the survey of scientific articles and results of practical research in effectiveness of social worker's intervention in work with adults having employment problems in Social service office of Riga. Research in effectiveness of social worker's intervention is important and topical issue nowadays, especially because there is no data on current practice in social service. The research revealed that there are no common methods for following up the work with adults having employment problems. Assessment of effectiveness of social worker's intervention is particularly aimed at intervention process and its results, such as planned and actual ones. Whereas effectiveness of social worker's intervention is determined by various factors, for example, social worker's and client's relations, support from colleagues etc. Feedback between managers and social workers plays a very important role in case of questions about practice. Author of this article analyses this and other factors that impact effectiveness of social worker's intervention.
Fixationsoptionen des Receivers/Stimulators bei
Cochlea-Implantation begutachtet
Authors: Tisch Matthias
Published: November 2018

Pamuk AE et al. The effect of cochlear implant bed preparation and fixation
technique on the revision cochlear implantation rate. J Laryngol Otol 2018;
11:1–6

Zur Prävention einer Migration des Receivers/Stimulators bei der
Cochlea-Implantation ist seine Einbettung entscheidend. Türkische Ärzte der
Klinik für Hals-, Nasen- und Ohrenheilkunde der Universität von Istanbul
verglichen zwei Techniken der Einbettung.
Fingeramputationen und -replantationen bei
unterschiedlichen Kostenträgern: Ist die Vergütung
kostendeckend?
Authors: Sacher Maxi , Auhuber Thomas , Sauerbier Michael , Arsalan-Werner Annika
Published: November 2018

Hintergrund Fingeramputationen sind ein in berufsgenossenschaftlichen
Unfallkliniken häufig behandeltes Verletzungsbild und werden entweder durch
Fingerreplantation oder Stumpfbildung therapiert. Die Kosten beider
Therapieoptionen unterscheiden sich dabei erheblich. Ob eine kostendeckende
Vergütung von Fingeramputationsverletzungen insbesondere mit nachfolgender
Fingerreplantation erfolgt und inwiefern dies vom Kostenträger abhängt, ist
Gegenstand dieser Untersuchung.

Methoden Anhand der Kosten- und Vergütungsdaten unserer Klinik aus den
Jahren 2014 und 2015 wurde eine Analyse der Vergütung von Fingerreplantationen
und Fingerstumpfbildungen durchgeführt und mit den Kostendaten der bundesweiten
Kalkulationshäuser nach der InEK-Kalkulation verglichen. Anschließend erfolgte
ein Vergleich der Vergütung gesetzlich krankenversicherter Patienten mit der
Vergütung bei gesetzlich unfallversicherten Patienten.

Ergebnisse Im Untersuchungszeitraum wurde bei insgesamt 90 Patienten eine
Fingerreplantation (n = 30) oder -stumpfbildung (n = 60) von einem oder mehreren
Fingern durchgeführt. Für primäre Fingerstumpfbildungen lagen die tatsächlichen
Kosten (ca. 3551 Euro) niedriger als auf Basis der bundesweiten Kostendaten der
Kalkulationshäuser (ca. 3809 Euro, p = 0,442) angenommen. Es konnte ein
positiver Deckungsbeitrag von durchschnittlich 1008 Euro bei gesetzlich
krankenversicherten und 688 Euro bei gesetzlich unfallversicherten Patienten
errechnet werden (p = 0,578). Primäre Replantationen sowie Replantationen mit
nachfolgender Stumpfbildung waren mit im Mittel 260 Euro bei gesetzlich
krankenversicherten Patienten defizitär. Im Gegensatz dazu war die Vergütung der
gesetzlichen Unfallversicherung mit im Mittel 900 Euro Erlös nach Abzug der
Kosten kostendeckend.

Schlussfolgerung Im deutschen DRG-System ist die Vergütung der Behandlung
von Fingeramputationen abhängig vom Kostenträger. Während diese in der
gesetzlichen Unfallversicherung sowohl für Fingerreplantationen als auch für
Fingeramputationen in Berufsgenossenschaftlichen Kliniken kostendeckend ist, war
dies bei gesetzlich krankenversicherten Patienten lediglich bei primären
Stumpfbildungen der Fall. Insbesondere bei Fingeramputationsverletzungen, die
mit einer Replantation versorgt werden, sollte eine Überarbeitung der
Kalkulationsgrundlage in Erwägung gezogen werden, um monetäre Fehlanreize in der
Patientenversorgung zu vermeiden.
Booster medication to achieve capsule excretion in colon capsule endoscopy: a randomized controlled trial of three regimens
Authors: Kroijer Rasmus , Dyrvig Anne-Kirstine , Kobaek-Larsen Morten , Støvring Jens Overgaard , Qvist Niels , Baatrup Gunnar
Published: November 2018

Background and study aims To achieve a complete colon capsule endoscopy, the entire colon must be visualized, clean and filled with clear fluids. The primary aim was to compare three booster regimens in colon capsule endoscopy in achieving capsule excretion within recording time. Secondary aims were quality of bowel cleansing and completion rate (both adequate cleansing and capsule excretion).

Patients and methods Patients scheduled for follow-up colonoscopy due to previous neoplastic findings or familial history of colorectal cancer aged 18 to 70 years were eligible. Bowel preparation was 2-L split doses of polyethylene glycol. Patients were randomized to three booster regimens of either polyethylene glycol (Group A), sulfate-based solution (Group B) or polyethylene glycol with iodine oral contrast (Group C).

Results One hundred eighty participants were included and randomized into three groups of 60. Capsule excretion was 70 % (95 % CI: 58 – 80) in Group A, 73 % (95 % CI: 61 – 83) in Group B and in 68 % (95 % CI: 56 – 79) in Group C, no statistically significant differences. Bowel cleansing grade was statistically significant better in Group B compared to Group A (P = 0.03), but there were no statistically significant differences between Groups C and A (P = 0.40). Complete examination rate was 65 % (95 % CI: 53 – 77), 72 % (95 % CI: 61 – 83) and 62 % (95 % CI: 50 – 74) in Group A, B and C respectively, not statistically significant different.

Conclusions Sulfate-based solution resulted in statistically significant better bowel cleansing compared to polyethylene glycol. Overall the excretion and completion rate was suboptimal. Achieving a high completion rate using patient-tolerable and low-risk compounds is still a challenge.
Efficacy of duodenal bulb biopsy for diagnosis of celiac disease: a systematic review and meta-analysis
Authors: McCarty Thomas R. , O’Brien Corey R. , Gremida Anas , Ling Christina , Rustagi Tarun
Published: November 2018

Background and study aims Although duodenal biopsy is considered the “gold standard” for diagnosis of celiac disease, the optimal location of biopsy within the small bowel for diagnosis remains unclear. The primary aim of this study was to perform a structured systematic review and meta-analysis to evaluate the diagnostic utility of endoscopic duodenal bulb biopsy for celiac disease.

Patients and methods Searches of PubMed, EMBASE, Web of Science, and Cochrane Library databases were performed from 2000 through December 2017. Review of titles/abstracts, full review of potentially relevant studies, and data abstraction was performed. Measured outcomes of adult and pediatric patients included location of biopsy, mean number of biopsies performed, and diagnosis of celiac disease as defined by the modified Marsh-Oberhuber classification.

Results A total of 17 studies (n = 4050) were included. Seven studies evaluated adults and 11 studies assessed pediatric populations. Mean age of adults and pediatric patients was 46.70 ± 2.69 and 6.33 ± 1.26 years, respectively. Overall, sampling from the duodenal bulb demonstrated a 5 % (95 % CI 3 – 9; P < 0.001) increase in the diagnostic yield of celiac disease. When stratified by pediatric and adult populations, duodenal bulb biopsy demonstrated a 4 % (95 % CI: 1 to 9; P < 0.001) and 8 % (95 % CI: 6 to 10; P < 0.001) increase in the diagnostic yield of celiac disease. Non-celiac histologic diagnoses including Brunner gland hyperplasia and peptic duodenitis were reported more commonly in the duodenal bulb as compared to the distal duodenum with an increase in diagnostic yield of 4 % (95 % CI 3 – 5; P < 0.001) and 1 % (95 % CI 1 – 2; P < 0.001), respectively.

Conclusions Based upon our results, biopsy and histologic examination of duodenal bulb during routine upper endoscopy increases the diagnostic yield of celiac disease.
Green epithelium revealed by narrow-band imaging (NBI): a feature for practical assessment of extent of gastric cancer after H. pylori eradication
Authors: Yagi Kazuyoshi , Nagayama Itsuo , Hoshi Takahiro , Abe Satoshi , Morita Shin-ichi , Suda Takeshi , Hasegawa Go , Sato Yu-ichi , Terai Shuji
Published: November 2018

Background and study aims Assessment of the extent of gastric cancer detected by endoscopy after successful eradication of H. pylori is often difficult even with narrow-band imaging (NBI)-magnifying endoscopy. Using the latter modality, it has often been noted that the cancerous area has a brownish color surrounded by green epithelium (GE). If the histological origin of this GE could be clarified, it could be of practical use for endoscopic assessment of the extent of cancer.

Materials and methods The endoscopic appearance of gastric cancer after eradication therapy was classified into four types: (A) cancer brownish, surrounding mucosa green; (B) cancer brownish, surrounding mucosa brownish; (C) cancer green, surrounding mucosa brownish; and (D) cancer green, surrounding mucosa green. A histological series of sections taken from tissues in each endoscopic view was stained with HE, and also for CDX2, MUC2, CD10 and MUC5AC. Staining intensity was evaluated by microscopy using a visual analog scale ranging from 0 to 3+: intensities of 0 and 1+ were rated as negative, and those of 2+ and 3+ as positive. Positive or negative immunostaining was examined for each type of endoscopic appearance A – D.

Results Among 42 lesions examined, 16 were type A, 18 type B, 6 type C and 2 type D. MUC2 was positive in the surrounding mucosa in 100 % of type A and D cases, but in only 28 % and 17 % of type B and C cases, respectively.

Conclusions GE observed by NBI-endoscopy corresponds to MUC2-positive mucosa and is thought to be a feature for practical assessment of the extent of cancer.
„Pathway protection“ – Verbesserte Motoneuron-Regeneration
durch additive End-zu-Seit-Koaptation sensorischer Axone
Authors: Györi Eva , Radtke Christine , Gordon Tessa , Borschel Gregory H.
Published: November 2018

Die neuronale Regeneration nach proximaler Nervenverletzung und nach zeitlich
verzögerter Nervenrekonstruktion ist eingeschränkt, was klinisch eine große
Herausforderung darstellt. Experimentelle Studien haben gezeigt, dass die
periphere Nervenregeneration einerseits durch die „chronische Axotomie“ der
neuronalen Zellkörper und der proximalen Axone, welche von ihren Zielstrukturen
getrennt sind und andererseits durch die „chronische Denervation“ des distalen
Nervens beeinträchtigt wird. Der denervierte distale Nerv durchläuft
Veränderungen, die mit der Waller´schen Degeneration assoziiert sind. Es kommt
zu einer Aktivierung der Schwann-Zellen, die mit einwachsenden Axonen
interagieren und deren Regeneration fördern, sowie zu einer Erhöhung der
Konzentration von Wachstumsfaktoren. Diese Veränderungen führen zu der
Entwicklung eines regenerationsfördernden Milieus im distalen Nerven, welches
allerdings zeitlich begrenzt ist und bei lange andauernder Denervation abnimmt.
Dies führt zu einer deutlichen Reduktion der neuronalen Regeneration. In der
klinischen Situation führen proximale Nervenverletzungen, Rekonstruktionen mit
langen Regenerationsdistanzen und verzögerte Nervenrekonstruktionen zu
eingeschränkten funktionellen Ergebnissen. Um die neuronale Regeneration zu
verbessern, wurden verschiedene Techniken der „pathway protection“ entwickelt,
welche die chronische Denervation des distalen Nervens und der Zielorgane
reduzieren sollen. Der Großteil dieser „Babysitter-Techniken“ verwendet
motorische Spendernerven, die meist End-zu-Seit an den denervierten distalen
Nerven koaptiert werden. In experimentellen Studien wurde gezeigt, dass es durch
die einwachsenden Spenderaxone zu einer Erhöhung der Konzentration von
Wachstumsfaktoren kommt und dass die distalen Zielorgane früher reinnerviert
werden können. Durch motorische „Babysitter-Operationen“ wird allerdings ein
motorisches Spendernervdefizit geschaffen. Um dieses zu umgehen wurde in den
letzten Jahren die Möglichkeit der „pathway protection“ mit sensiblen
Spendernerven untersucht. In experimentellen Studien konnte die motorische
Regeneration durch End-zu-Seit-Koaptation sensibler Spendernerven an den
distalen denervierten Nerven, beziehungsweise an lange Nerventransplantate, die
Veränderungen der „chronischen Denervation“ durchlaufen, verbessert werden. Die
sensible „pathway protection“ wurde bereits klinisch eingesetzt, es liegen
allerdings noch keine funktionellen Langzeitergebnisse vor.
Inter-Rater Reliability of Pain Provocation Tests for Painful Lumbar Facet Joints. A Pilot Study
Authors: Thalhamer Christoph , Hahne Julia , Matthijs Omer , Machacek Peter
Published: November 2018

Background With a life-time prevalence of 39%, low back pain (LBP) is one of the most common musculoskeletal disorders. Correct diagnosis of underlying causes is commonly seen as a prerequisite for successful therapy of LBP. Currently, there is no useful, non-invasive clinical test to diagnose painful lumbar zygapophyseal joints. Clinical tests with high diagnostic accuracy are therefore desirable. Inter-rater reliability is commonly seen as a prerequisite of test validity. The objective of this pilot study was thus to evaluate inter-rater reliability of new clinical pain provocation tests for diagnosing painful lumbar zygapophyseal joints. If a clinically significant level of inter-rater reliability were to be determined, this study could constitute a first step towards establishing the clinical utility of this new set of tests in the structural diagnosis of low back disorders.

Material and Methods Patients participating in this study were recruited in a specialist hospital throughout June 2015 until September 2016. Both female and male patients with current LBP, with or without buttock or lower extremity symptoms were screened for inclusion. Patients had preferably to be 50 years or older in order to be included in this study. The upper age limit was set at 90 years. They also had to be fluent in German to be able to follow verbal instructions. Exclusion criteria comprised the presence of red flags, surgical spinal fusion at any level of the lumbar spine, discectomy within the past 12 months, radiculopathy and/or radicular pain, interventional treatments for the IVD, SIJs or ZAJs within the past three months, psychiatric disorders, current litigation issues concerning back pain, and central nervous system diseases. Three certified manual therapy instructors tested patients independently. Fleissʼ kappa values and percent agreements were calculated.

Results Subjects included a sample of 48 patients (15 males and 33 females) with a mean age of 66.48 years (range 33 – 90) presenting at a specialist hospital with low back pain. The new pain provocation tests for lumbar zygapophyseal joints showed moderate reliability (Fleissʼ κ = 0.46) and an overall percent agreement of 68.8%. Separate tests for the zygapophyseal joints of L5–S1 showed fair reliability (Fleissʼ κ = 0.37) and an overall percent agreement of 64.6%. Unidimensional tests that were used in the study to exclude the intervertebral disc as a nociceptive generator showed fair reliability as well (average κ of 0.28 and 0.39, respectively). Neither drop outs nor adverse events occurred.

Conclusion The new pain provocation tests for lumbar zygapophyseal joints showed clinically significant levels of inter-rater reliability. Validation of these tests against fluoroscopy-guided medial branch blocks is warranted.
Percutaneous K-wires vs palmar locking plate fixation for
different types of distal radial fractures: a comparison of the outcomes of two
methods to controll our guidelines
Authors: Zyluk Andrzej , Janowski Piotr , Szlosser Zbigniew , Puchalski Piotr
Published: November 2018

The objective of the study was a comparison of the outcomes of K-wire vs plate
fixation for distal radial fractures used according to the proposed
institutional algorithm. Fracture configurations A2, A3, B1, B2, C1 and some C2
were operated on with K-wire pinning, whereas B3 and some B2, C3 and some C2
were with locking palmar-plate fixation.

Patients and Methods: Four hundred and sixty-seven patients were
non-randomly allocated for either K-wire (n = 363) or palmarplate (n = 104)
fixation. The results were assessed at 3 and 12 months by the same outcome
measures.

Results: At the 3-month assessment, statistically significant differences
in grip strength and the DASH scores were noted in favour of the plate-fixation
group. At the 12-month assessment, statistically significant differences were
observed in the wrist palmar and dorsal flexion, favouring the plate-fixation
group. Statistically significant differences were noted in radiological measures
of the palmar tilt and the ulnar variance, both favouring the plate-fixation
method. Meaningful secondary dislocations were noted in ten patients, all in the
K-wire-fixation group.

Conclusion: We conclude that palmar locking plate fixation in even more
severe fractures leads to better radiological and clinical outcomes than K-wire
fixation in less severe fractures.
Die Korrektur intraartikulärer Fehlstellungen am distalen
Radius auf der Basis computergestützter virtueller Planungen
Authors: Pillukat Thomas , Osorio Maria , Prommersberger Karl-Josef
Published: November 2018

Hintergrund Die computerassistierte virtuelle 3D-Planung von
extraartikulären Korrekturen am distalen Radius und die Übertragung der
virtuellen Planung auf den Radius in vivo wurde bereits kürzlich beschrieben. Im
Gegensatz dazu fehlen bisher ähnliche Studien zu intraartikulären Korrekturen.
Unter Berücksichtigung der technischen Schwierigkeiten und potentiellen Risiken
wäre eine Methode, die die Probleme des begrenzten Zuganges und der
Schwierigkeiten von Reposition und Fixation überwindet, wertvoll. Die
vorliegende Studie präsentiert eine Technik für intraartikuläre Korrekturen am
distalen Radius, basierend auf einer computergestützten 3D-virtuellen Planung
und individuell gefertigten patientenspezifischen Instrumenten.

Patienten und Methoden Zwischen 2013 und 2016 unterzogen sich 6 Patienten
(1 weiblich, 5 männlich) einer intraartikulären Korrekturosteotomie am distalen
Radius. Das Durchschnittsalter betrug 48 (38–60) Jahre, das Intervall zwischen
Unfall und Korrektur betrug 10 (4–13) Monate. Alle Patienten waren vorhergehend
auswärts operiert worden. Die computerassistierte Planung wurde in
Zusammenarbeit mit einem industriellen Partner (Materialise NV, 15
Technologielaan, 3001 Leuven, Belgium) durchgeführt. Dazu wurden im eigenen Haus
CT-Schnitte beider Handgelenke und Unterarme anhand eines speziellen Protokolls
angefertigt, aus denen beide distalen Radii virtuell rekonstruiert wurden. Das
Spiegelbild der 3D-Rekonstruktion des unverletzten Radius wurde dem 3-D-Bild des
fehlverheilten Radius überlagert, sodass die Fehlstellung exakt erkennbar war.
Die Korrektur wurde Schritt für Schritt virtuell im Rahmen einer
Online-Konferenz geplant. Die Stabilisierung der Fragmente wurde durch das
Einfügen von Platten und Schrauben in die 3D-Darstellung simuliert. Basierend
auf dieser Planung wurden für jeden Schritt patientenspezifische Bohr- und
Sägeschablonen angefertigt (Fa. Materialise) und an die eigene Einrichtung
ausgeliefert. Das operative Vorgehen und die Technik werden anhand eines
typischen Beispiels dargestellt und variierten mit den individuellen
Gegebenheiten.

Ergebnisse Es traten keine Komplikationen auf. Alle Patienten zeigten eine
knöcherne Heilung. Zusätzliche Eingriffe waren nicht erforderlich. Postoperative
Computertomographien zeigten, dass Stufenbildungen in der Regel gut korrigiert
wurden, hingegen Spaltbildungen oft fortbestanden.
Syntheses of Cyclomarins – Interesting Marine Natural Products with Distinct Mode of Action towards Malaria and Tuberculosis
Authors: Kiefer Alexander , Kazmaier Uli
Published: November 2018

The cyclomarins are cyclic heptapeptides from marine streptomycetes containing four rather unusual amino acids. Interestingly, the cyclomarins address two completely different targets: ClpC1, a subunit of the caseinolytic protease of Mycobacterium tuberculosis (MTB), as well as PfAp3Aase of Plasmodium falciparum. Therefore, the cyclomarins are interesting lead structures for the development of drugs targeting tuberculosis and malaria. As a result, several synthetic protocols towards the synthesis of these unusual building blocks as well as the natural products themselves have been developed, which will be discussed in this review.

1 Introduction

2 Synthesis of the Building Blocks

3 Total Synthesis of Cyclomarin C by Yao and Co-workers

4 Total Synthesis of Cyclomarin A and C by Barbie and Kazmaier

5 Conclusion
‘Heteroaromatic Rings of the Future’: Exploration of Unconquered Chemical Space
Authors: Thorimbert Serge , Botuha Candice , Passador Kevin
Published: November 2018

William Pitt and co-workers have created a virtual exploratory heterocyclic library ‘VEHICLe’ containing over 200 unconquered bicyclic heteroaromatic rings, synthetically feasible with potential medicinal interest. Since the publication of the 22 ‘heteroaromatic rings of the future’ by Pitt in 2009, 15 of them have been successfully synthesized as bicyclic or polycyclic forms and evaluated for applications in both biology and material science. This short review presents the critical synthesis associated with innovative synthetic methodologies of the synthetically conquered ring scaffolds from the list of 22 with a spotlight on the scientific contribution of this fascinating article for the expansion of the chemical diversity.

1 Introduction

2 Heteroaromatic Rings of the Future: The Synthetic challenge?

2.1 4-Pyrido[1,3]oxazin-4-one-P1

2.2 Pyrrolo[2,1-b][1,3]oxazin-4-one-P4

2.3 Furo[2,1-e]pyridazin-4(1H)-one-P5

2.4 Isoxazolo[3,4-c]pyridin-7-one-P6

2.5 5H,6H-[1,2]Thiazolo[5,4-c]pyridin-5-one-P7

2.6 4H,5H-Furo[3,2-b]pyridin-5-one-P8

2.7 1H,5H,6H-Pyrazolo[3,4-c]pyridin-5-one-P9

2.8 Thieno[3,4-c]pyridazine-P10

2.9 Pyrrolo[1,2-c][1,2,3]triazine-P11

2.10 Thieno[3,4-a]oxazole-P12

2.11 2,4-Dihydropyrrolo[3,2-c]pyrazole-P13

2.12 Pyrazolo[1,5-b]isoxazole-P14

2.13 Imidazo[1,5-c]pyrimidin-3(2H)-one-P16

2.14 Cyclopenta[b][1,4]oxazin-5(4H)-one-P17

2.15 2,3-Dihydro-2,6-naphthyridin-3-one-P18

3 Conclusion
Unprecedented Alkene Transposition in Phthalate–Amino Acid Adducts
Authors: Baxendale Ian , Baumann Marcus , Saha Ishika
Published: November 2018

A detailed account on the outcome of the thermal reaction between benzylidene phthalides and various amino acid derivatives is reported. It was discovered that the tricyclic pyrroles as previously described are not the products formed in these reactions. Instead under high-temperature conditions decarboxylated phthalamide adducts are formed within 5-10 minutes. Additionally, an unprecedented alkene transposition mechanism has been identified leading to the final products of these reactions.