bluuebunny/crossref_metadata_2025 huggingface dataset:
The therapeutic effects of microRNAs in preclinical studies of acute kidney injury: a systematic review protocol
Authors: Zankar Sarah , Rodriguez Rosendo A. , Vinas Jose Luis , Burns Kevin D.
Published: October 2019

Background

Acute kidney injury (AKI) causes significant morbidity and mortality in humans, and there are currently no effective treatments to enhance renal recovery. MicroRNAs (miRNAs) are short chain nucleotides that regulate protein expression and have been implicated in the pathogenesis of AKI. Recently, preclinical studies in vivo have uncovered a therapeutic role for administration of specific miRNAs in AKI. However, the overall benefits of this strategy in preclinical studies have not been systematically reviewed, and the potential for translation to human studies is unclear.

Aim

The primary aim is to conduct a systematic review of the therapeutic properties of miRNAs in preclinical studies of AKI. The secondary aim is to determine potential adverse effects of miRNA administration in these studies.

Methods

A comprehensive search strategy will identify relevant studies in AKI in vivo models, using the MEDLINE, EMBASE, OVID, PUBMED, and Web of Science databases. The search strategy will include terms for mammalian (non-human) AKI models, including injury related to ischemia/reperfusion, nephrotoxicity, sepsis, contrast agents, cardio-pulmonary bypass, and hemorrhagic shock. Interventions will be defined as direct administration of exogenous miRNAs or antagonists of miRNAs, as well as maneuvers that alter expression of miRNAs that are mechanistically linked to AKI outcomes. The primary outcomes will be indices of kidney function and structure, and there will be no restriction on comparator interventions. Two independent investigators will initially screen abstracts, and selected articles that meet eligibility criteria will be reviewed for data abstraction and analysis. The SYRCLE RoB tool for animal studies will determine risk of bias, and meta-analysis will be performed as appropriate. The GRADE methodology will assess the quality of evidence.

Discussion

The administration of selective miRNA mimics or antagonists exerts beneficial effects in mammalian models of AKI, although multiple obstacles must be addressed prior to translation to human clinical trials. The proposed systematic review will document key miRNA candidates, and determine effect size estimates and sources of outcome bias. The review will also identify gaps in knowledge and guide future directions in AKI research.

Systematic review registration

PROSPERO CRD42019128854
Neurocognitive outcome of school-aged children with congenital heart disease who underwent cardiopulmonary bypass surgery: a systematic review protocol
Authors: Feldmann Maria , Ullrich Cinzia , Bataillard Célina , Knirsch Walter , Gosteli-Peter Martina A. , Latal Beatrice , Held Ulrike
Published: October 2019

Background

Over the past decades, survival rates of children born with congenital heart disease (CHD) have increased dramatically. Progress in prenatal diagnosis, less-invasive catheter techniques and perioperative intensive care as well as surgical techniques have led to an increased focus on extracardiac comorbidities, including potential neurodevelopmental sequelae associated with CHD. A growing body of literature reports impairments in early and school-age developmental outcome; however, there is a substantial variability in the spectrum of examined CHD types, assessment ages and applied test batteries. Furthermore, little information is available on executive function impairments in this population. Therefore, the aim of this systematic review is to determine the impact of CHD on intellectual outcome and executive functioning at school age and to determine risk factors for impaired outcomes by means of a systematic search.

Methods

A systematic review of literature that reports neurodevelopmental outcome in children with CHD undergoing cardiopulmonary bypass surgery. Intelligence quotient or executive function scores will be considered primary outcomes. Databases such as Cochrane, EMBASE, MEDLINE and PsycINFO will be searched.

Discussion

The results of this systematic review will summarize the current evidence on intellectual and executive function outcome after cardiopulmonary bypass surgery in school-age children with CHD. This review will thus be the basis for better patient and parental counselling and the establishment of tailored follow-up programmes and interventional trials.

Systematic review registration

In accordance with the guidelines, our systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on January 9, 2019 (CRD42018086568). PROSPEROCRD42019118736.
The existence of sign-changing solution for a class of quasilinear Schrödinger–Poisson systems via perturbation method
Authors: Chen Lizhen , Feng Xiaojing , Hao Xinan
Published: October 2019

This paper is concerned with the existence of a sign-changing solution to a class of quasilinear Schrödinger–Poisson systems. There are some technical difficulties in applying variational methods directly to the problem because the quasilinear term makes it impossible to find a suitable space in which the corresponding functional possesses both smoothness and compactness properties. In order to overcome the difficulties caused by nonlocal term and quasi-linear term, we shall apply the perturbation method by adding a 4-Laplacian operator to consider the perturbation problem. And then, by using the approximation technique, a sign-changing solution with precisely two nodal domains is derived.
Some new inequalities for generalized fractional conformable integral operators
Authors: Nisar Kottakkaran Sooppy , Rahman Gauhar , Khan Aftab
Published: October 2019

The present paper aims to establish certain new classes of integral inequalities for a class of n ($n\in \mathbb{N}$
n
∈
N
) positive continuous and decreasing functions by utilizing the generalized fractional conformable integral operators (FCIO) recently defined by Khan and Khan. From these results, we also derive several particular cases.
‘Remark or retake’? A study of candidate performance in IELTS and perceptions towards test failure
Authors: Pearson William S.
Published: October 2019

It is becoming increasingly important for individuals for whom English is a second language to demonstrate their linguistic credentials for academic, work and employment purposes. One option is to undertake International English Language Testing System (IELTS), which involves attempting to meet the linguistic entrance criteria set by a gatekeeping institution in the skills of listening, reading, writing, and speaking. Yet limited information is available in the public domain concerning the success of test-takers in meeting cut-off criteria set by the 10,000 or so organisations that utilise IELTS. The present study analyses the relationship between the test results and stated band score objectives of a cohort of 600 IELTS candidates, who shared their results on a social networking platform. It was uncovered that more test-takers failed to meet their band score goals (n = 281) than achieved them (n = 245), with many requiring high level linguistic goals to maximise their prospects in immigration systems. Thematic analysis was employed to explore the seldom-heard perspectives of the test-takers who missed their targets, and thereby ‘failed’ the IELTS test. Far more candidates held perspectives that constituted a rejection of their overall or sub-test score in comparison with those who were accepting of their results. Candidates’ incredulity was notably acute concerning the accuracy of Speaking and Writing assessment, likely fuelled by a mistrust in single examiner marking and a lack of detailed test performance feedback to explain what went wrong.
Epanorin, a lichen secondary metabolite, inhibits proliferation of MCF-7 breast cancer cells
Authors: Palacios-Moreno Juan , Rubio Cecilia , Quilhot Wanda , Cavieres M. Fernanda , de la Peña Eduardo , Quiñones Natalia V. , Díaz Hugo , Carrión Flavio , Henríquez-Roldán Carlos F. , Weinstein-Oppenheimer Caroline R.
Published: October 2019

Background

Epanorin (EP) is a secondary metabolite of the Acarospora lichenic species. EP has been found in lichenic extracts with antimicrobial activity, and UV-absorption properties have been described for closely related molecules; however, its antiproliferative activity in cancer cells has not yet been explored. It has been hypothesized that EP inhibits cancer cell growth. MCF-7 breast cancer cells, normal fibroblasts, and the non-transformed HEK-293 cell line were exposed to increasing concentrations of EP, and proliferation was assessed by the sulforhodamine-B assay.

Results

MCF-7 cells exposed to EP were examined for cell cycle progression using flow cytometry, and DNA fragmentation was examined using the TUNEL assay. In addition, EP’s mutagenic activity was assessed using the Salmonella typhimurium reverse mutation assay. The data showed that EP inhibits proliferation of MCF-7 cells, and it induces cell cycle arrest in G0/G1 through a DNA fragmentation-independent mechanism. Furthermore, EP’s lack of overt cytotoxicity in the normal cell line HEK-293 and human fibroblasts in cell culture is supported by the absence of mutagenic activity of EP.

Conclusion

EP emerges as a suitable molecule for further studies as a potential antineoplastic agent.
Total joint reconstruction using computer-assisted surgery with stock prostheses for a patient with bilateral TMJ ankylosis
Authors: Rhee Seung-Hyun , Baek Seung-Hak , Park Sang-Hun , Kim Jong-Cheol , Jeong Chun-Gi , Choi Jin-Young
Published: October 2019

Backgrounds

The purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses.

Case presentation

A 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication.

Conclusion

For a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.
Management of NK/T-Cell Lymphoma, Nasal Type
Authors: Allen Pamela B. , Lechowicz Mary Jo
Published: October 2019

Extranodal natural killer (NK)/T-cell lymphoma, nasal type, is a rare peripheral T-cell lymphoma associated with Epstein-Barr virus. It most often presents as limited-stage disease in patients of East Asian descent with a palatal deformity caused by erosion of the tumor through the hard palate. Limited-stage disease is often curable with the use of l-asparaginase–based chemotherapy and high-dose radiation therapy. Obtaining an accurate diagnosis is essential, because treatment with standard lymphoma regimens and omission of radiation severely compromise the likelihood of long-term survival. Conversely, patients with advanced disease have a poor prognosis and are recommended for asparaginase-based chemotherapy followed by consolidation with autologous transplantation as a potentially curative approach. Progress often has been hampered by the rarity of this disease. However, discovery of common genetic alterations in pathways that promote growth and inhibit apoptosis, and actionable markers such as CD30 (among others), have begun to broaden the availability of novel drugs (eg, targeted therapies). There is also cautious optimism about immunotherapies, such as checkpoint blockade and novel cellular therapies that target Epstein-Barr virus. Advances in treatment and understanding of the genetic landscape of this disease offer hope for improved treatment outcomes.
The Walk and the Talk
Authors: Dover Daniela
Published: October 2019

It is widely believed that we ought not to criticize others for wrongs that we ourselves have committed. The author draws out and challenges some of the background assumptions about the practice of criticism that underlie our attraction to this claim, such as the tendency to think of criticism either as a social sanction or as a didactic intervention. The author goes on to offer a taxonomy of cases in which the moral legitimacy of criticism is challenged on the grounds that the critic him- or herself engages in the behavior that he or she criticizes in others. The author argues that, in each type of case, the would-be critics should not constrain their participation in moral discourse on the grounds that they are not themselves innocent of the wrongdoing they criticize in others.
Algorithm and Parameters: Solving the Generality Problem for Reliabilism
Authors: Lyons Jack C.
Published: October 2019

The paper offers a solution to the generality problem for a reliabilist epistemology, by developing an “algorithm and parameters” scheme for type-individuating cognitive processes. Algorithms are detailed procedures for mapping inputs to outputs. Parameters are psychological variables that systematically affect processing. The relevant process type for a given token is given by the complete algorithmic characterization of the token, along with the values of all the causally relevant parameters. The typing that results is far removed from the typings of folk psychology, and from much of the epistemology literature. But it is principled and empirically grounded, and shows good prospects for yielding the desired epistemological verdicts. The paper articulates and elaborates the theory, drawing out some of its consequences. Toward the end, the fleshed-out theory is applied to two important case studies: hallucination and cognitive penetration of perception.
Genetic study in a family with dopa-responsive dystonia revealed a novel mutation in sepiapterin reductase gene
Authors: Froukh Tawfiq
Published: October 2019

Dopa-responsive dystonia due to sepiapterin reductase deficiency (OMIM#612716) is caused by recessive mutations in the gene encoding sepiapterin reductase (SPR), which plays an important role in the biosynthesis of tetrahydrobiopterin (BH4). One Jordanian patient to first cousin parents is reported in this study. The parents of the proband have recognized the symptoms of their daughter at six months old with motor developmental delay. The symptoms were progressed after-then to include speech delay, seizure, ataxia, oculomotor apraxia, dysarthia and choreoathetosis. Despite of these symptoms, the clinicians in Jordan were unable to diagnose the case. In August 2018, the proband (8 years old) was presented to the department of biotechnology and genetic engineering at Philadelphia University in Jordan for the purposes of performing whole exome sequencing (WES). Analysis of WES data has revealed novel homozygous frameshift variant in the gene SPR (NM_003124.4:c.40delG,p.Ala15Profs*100). The variant is heterozygous in the parents and in the healthy male siblings. Therefore, the studied case was diagnosed with sepiapterin reductase deficiency. Because this disease is likely to be treated recommendations were given to the family immediately to start treatments trials. The case in this study illustrates the difficulties of diagnosing sepiapterin reductase deficiency based on clinical symptoms only and thus renders the possibilities of early management. Also, this study reinforces the importance of running WES to undiagnosed neurodevelopmental cases.

doi: https://doi.org/10.12669/pjms.35.6.1181

How to cite this:Froukh T. Genetic study in a family with dopa-responsive dystonia revealed a novel mutation in sepiapterin reductase gene. Pak J Med Sci. 2019;35(6):1736-1739. doi: https://doi.org/10.12669/pjms.35.6.1181

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Anatomical predicting factors of difficult spinal anesthesia in patients undergoing cesarean section: An observational study
Authors: Atashkhoei Simin , Samudi Saeed , Abedini Naghi , Khoshmaram Nahid , Minayi Masoumeh
Published: October 2019

Objectives: Although Spinal anesthesia is the most common and safe anesthetic method for patients undergoing cesarean section, difficult access to it is a frequent problem in operating theaters. The predictive factors for the difficulty of spinal anesthesia in patients undergoing cesarean section were investigated.

Methods: A total of 110 pregnant women, single-stranded, aged 18-40 years old and ASA class I or II candidates for elective cesarean section with spinal anesthesia were studied. Demographic information, body appearance, ability to bend the back of the patient was recoded. Also the position of the anatomical landmarks of the lumbar spine, the presence or absence of deformity in the spinal column lumbar was recorded for all patients. 

Results: The correlation coefficient of age, weight, body mass index, general body appearance, retention ability, anatomical signs of the spinal column (touching the spinous process) and the interval between the vertebra with the difficulty of spinal anesthesia were statistically significant (p<0.05). Complications after spinal anesthesia had a statistically significant relationship with the difficulty of performing spinal blockade (p: 0.006).

Conclusion: Increasing age, weight, body mass index, reducing the ability to bend the waist, the non-touching of the spinous process and interstitial space causes the difficulty of performing spinal anesthesia in patients undergoing cesarean section. The results can contribute to determining and designing a spinal blockade scoring system based on the patient’s characteristics and effective factors before the surgery, to facilitate the technique by anesthesiologist. 

doi: https://doi.org/10.12669/pjms.35.6.1276

How to cite this:Atashkhoei S, Samudi S, Abedini N, Khoshmaram N, Minayi M. Anatomical predicting factors of difficult spinal anesthesia in patients undergoing cesarean section: An observational study. Pak J Med Sci. 2019;35(6):1707-1711.   doi: https://doi.org/10.12669/pjms.35.6.1276

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Multi-level barriers & priorities accorded by policy makers for Neonatal Hearing Screening (NHS) in Pakistan: A thematic analysis
Authors: Mumtaz Nazia , Babur Muhammad Naveed , Saqulain Ghulam
Published: October 2019

Objectives: To explore the Barriers and Priorities accorded to neo-natal hearing screening at government health policy level.
Methods: This exploratory descriptive study design employed qualitative parameters with purposive sampling and was conducted at Capital Administration & Development Division (CADD) and Ministry of National Health Services, Regulations & Coordination (MoNHSR&C) from June 2015 to January 2017 over a period of 18 months. Sample included stakeholders concerned with healthcare planning and policy making in Pakistan. Research included in depth interviews using a self-structured interview guide from three policy makers’ fulfilling the selection criteria. Data recorded was transcribed and thematic analyses drawn manually and verified using two separate coders.
Results: Outcomes from thematic analysis drawn were Planning, Funding, Governance, Awareness, Medical and technical capacity building, Policy development, Evaluation and Sustainability. Lack of financial resources allocation due to policies and legislation top the list of barriers. The lack of research and reliable data as to the number of persons suffering from hearing loss (HL) from birth and its economic cost to the state and individual remains a policy barrier.
Conclusion: The barriers to NHS are lack of financial resource allocation by the federal government, and lack of research and reliable statistics about Hearing Impairment (HI) and its economic cost.
doi: https://doi.org/10.12669/pjms.35.6.703
How to cite this:Mumtaz N, Babur MN, Saqulain G. Multi-level barriers & priorities accorded by policy makers for Neonatal Hearing Screening (NHS) in Pakistan: A thematic analysis. Pak J Med Sci. 2019;35(6):1674-1679. doi: https://doi.org/10.12669/pjms.35.6.703
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Screening tuberculosis patients for diabetes mellitus in a routine program setting in Kampala, Uganda: a cross-sectional study
Authors: Nsonga Joseph , Dongo John Paul , Mugabe Frank , Mutungi Gerald , Walyomo Richard , Oundo Christopher , Zalwango Sarah , Okello Daniel , Muchuro Simon , Dlodlo Riitta A , Lin Yan
Published: October 2019

Background: Uganda is located in East Africa and is among the countries with the lowest income globally. The ten health centres in this project serve populations in the under-privileged communities of Kampala. The objective of the study was to implement diabetes mellitus (DM) screening among tuberculosis (TB) patients in a routine program setting with limited resources and high human immunodeficiency virus (HIV) prevalence.

Methods: A descriptive cross-sectional observational study was conducted in ten health centres in Kampala, Uganda. As part of a project to implement DM screening in a routine setting, TB patients were screened for DM by trained health workers. A fasting blood glucose (FBG) value ≥7.0mmol/l was considered to indicate DM. For this study, aggregate data was collected and analysed using SPSS for Windows, version 13.0.

Results:  Among 4,590 TB patients registered, 4,016 (88.0%) were screened with random blood glucose (RBG). Of those with RBG ≥6.1mmol/l, 1,093 (83.3%) were screened with FBG. In total, 92 (2.3%) patients were diagnosed with DM and 66 (71.8%) of them were newly diagnosed. The proportion of TB patients screened with FBG in the health centres varied from 58.2% to 100%. The proportion of patients screened with FBG and the prevalence of DM were significantly higher in private health centres compared with public health centres. The health centres in peri-urban areas screened more patients with RBG than those in urban areas. These health centres without DM services screened a larger number of patients with RBG and FBG than those with DM services.

Conclusions: It appears feasible to implement screening TB patients for DM in routine program settings with limited resources and high HIV prevalence. Its introduction requires close collaboration between TB and DM services. The challenges identified need government attention and certain institutional and service-related factors need to be better managed at times
Creation of a rectal cancer registry in Italy by the Advanced International Mini-Invasive Surgery (AIMS) academy clinical research network
Authors: Mari Giulio M. , Achilli Pietro , Maggioni Dario , Crippa Jacopo , Costanzi Andrea T.M. , Scotti Mauro A. , Giardini Vittorio , Garancini Mattia , Cocozza Eugenio , Borroni Giacomo , Benzoni Ilaria , Martinotti Mario , Totaro Luigi , Origi Matteo , Mazzola Michele , Ferrari Giovanni , Ziccarelli Antonio , Petri Roberto , Bagnardi Vincenzo , Pugliese Giacomo , Forgione Antonello , Pugliese Raffaele ,   AIMS Academy Clinical Research Network
Published: October 2019

Background: The management of rectal cancer is multimodal and involves a multidisciplinary team of cancer specialists with expertise in medical oncology, surgical oncology, radiation oncology and radiology. It is crucial for highly specialized centers to collaborate via networks that aim to maintain uniformity in every aspect of treatment and rigorously gather patients’ data, from the first clinical evaluation to the last follow-up visit.

The Advanced International Mini-Invasive Surgery (AIMS) academy clinical research network aims to create a rectal cancer registry. This will prospectively collect the data of patients operated on for non-metastatic rectal cancer in high volume colorectal surgical units through a well design pre-fashioned database for non-metastatic rectal cancer, in order to take all multidisciplinary aspects into consideration.

Methods/Design: The protocol describes a multicenter prospective observational cohort study, investigating demographics, frailty, cancer-related features, surgical and radiological parameters, and oncological outcomes among patients with non-metastatic rectal cancer who are candidates for surgery with curative intent. Patients enrolled in the present registry will be followed up for 5 years after surgery.

Discussion: Standardization and centralization of data collection for neoplastic diseases is a virtuous process for patient care. The creation of a register will allow the control of the quality of treatments provided and permit prospective and retrospective studies to be carried out on complete and reliable high quality data. Establishing data collection in a prospective and systematic fashion is the only possibility to preserve the enormous resource that each patient represents.
Case Report: Germ cell tumor presenting as cecal mass
Authors: Pendela Venkata Satish , Munoz Anisleidys , Warner JulieAnn , Yarlagadda Roopa
Published: October 2019

Extra gonadal germ cell tumors most frequently occur in the anterior mediastinum, retro-peritoneum, and pineal and suprasellar regions. The infrequency of its occurrence inside gastrointestinal tract makes it an arduous diagnostic challenge.

A 23 year old male with no significant past medical history presented to the emergency department with increasing abdominal pain, diarrhea, episodic vomiting for 3 weeks. Review of systems was positive for melena and shortness of breath on exertion. Fullness and irregularity along with tenderness was noted around the right iliac region.

CT scan (computed tomography) of the abdomen revealed a cecal mass with multiple metastases to liver, lungs and abdominal lymph nodes.  Colonic endoscope was performed but it could not be advanced beyond the cecal mass. Biopsies from the mass were reported as poorly differentiated metastatic carcinoma. During the course of hospitalization, he developed symptomatic small bowel obstruction with perforation. Colonic resection was performed and histology showed Germ-Cell Tumor. Beta HCG level was 118789 IU/L suggestive of a non-seminomatous germ cell tumor. Ultrasound of the scrotum, MRI brain (magnetic resonance imaging) and CT scan of the chest did not reveal a primary tumor. Chemotherapy was started with Bleomycin, Etoposide and Cisplatin after which beta human chorionic gonadotropin (HCG) levels dropped dramatically. His hospital course got complicated with neutropenic sepsis with shock which progressed to multi-organ dysfunction and unfortunately, he succumbed to the disease burden.

This case demonstrates one of the rare presentations of extragonadal germ cell tumors and the diagnostic challenges associated with it. Very few cases have been reported in the literature, and none of them presented as a cecal mass. Early recognition of this presentation will help in reducing the tumor burden and the mortality associated with it, as germ cell tumors are highly susceptible to chemotherapy.
Topical issues of aerotechnogenic safety of industrial zones: factor of greening
Authors: Крупина Надежда , Krupina Nadyezhda , Киприянова Елена , Kipriyanova Elena
Published: October 2019

From the position of interdisciplinary approach the monograph discusses the state, problems and prospects of development of green areas of industrial zones of industrial cities. The functions and role of barrier territories in the framework of the modern city from the standpoint of the tasks of the national project "Clean air", methods of planning organization and approaches to the assessment of the complex of ecosystem effects are outlined. New estimations of spatial factor of localization of damage from aerotechnogenic influence and rationalization of construction of a network of posts of monitoring of air quality in a situation of heterogeneity of pollution and imposing of streams of emissions from simultaneously working numerous sources of industrial zones are offered. Methodological aspects of innovative modernization of barrier territories are considered.
It will be of interest to specialists in the field of urban planning, industrial ecology and sanitation, urban management, aerotechnological safety, students, graduate students and teachers of relevant disciplines, as well as all those interested in the management of ecosystem services of green areas.
Effectiveness of autologous platelet-rich plasma gel in the treatment of hard-to-heal leg ulcers: a randomised control trial
Authors: Rainys Domantas , Cepas Adas , Dambrauskaite Karolina , Nedzelskiene Irena , Rimdeika Rytis
Published: October 2019

Objective:

Regenerative medicine products such as autologous platelet-rich plasma (autologous PRP) gel may speed up the process of healing. Clinical studies show promising results in the treatment of diabetic foot ulcers (DFUs), however there is lack of scientific evidence of autologous PRP effectiveness in treating leg ulcers of other aetiology. This study evaluates the effectiveness of autologous PRP gel in the treatment of hard-to-heal leg ulcers compared with existing conventional treatment.

Method:

A prospective, randomised controlled, open-labelled clinical trial was carried out between 2014 and 2018. An eight-week study protocol was chosen or until 100% wound re-epithelialisation was observed. Wound size reduction, granulation tissue formation, microbiological wound bed changes and safety were evaluated.

Results:

A total of 69 patients (35 in the autologous PRP group and 34 in the control group) were included in the study; 25.71% of the autologous PRP group and 17.64% of control group had ulcers completely re-epithelialised (p>0.05). Wound size reduction in the autologous PRP group was 52.35% and 33.36% in the control group (p=0.003). The autologous PRP group showed superiority over conventional treatment in wound bed coverage with granulation (p=0.001). However, more frequent wound contamination was observed at the end of treatment in the autologous PRP group (p=0.024). No severe adverse events were noted during the study. Both treatment methods were considered equally safe.

Conclusion:

Topical application of autologous PRP gel in leg ulcers of various aetiology show beneficial results in wound size reduction and induces the granulation tissue formation. However, it is associated with more frequent microbiological wound contamination.
Convolutional neural networks for wound detection: the role of artificial intelligence in wound care
Authors: Ohura Norihiko , Mitsuno Ryota , Sakisaka Masanobu , Terabe Yuta , Morishige Yuki , Uchiyama Atsushi , Okoshi Takumi , Shinji Iizaka , Takushima Akihiko
Published: October 2019

Objective:

Telemedicine is an essential support system for clinical settings outside the hospital. Recently, the importance of the model for assessment of telemedicine (MAST) has been emphasised. The development of an eHealth-supported wound assessment system using artificial intelligence is awaited. This study explored whether or not wound segmentation of a diabetic foot ulcer (DFU) and a venous leg ulcer (VLU) by a convolutional neural network (CNN) was possible after being educated using sacral pressure ulcer (PU) data sets, and which CNN architecture was superior at segmentation.

Methods:

CNNs with different algorithms and architectures were prepared. The four architectures were SegNet, LinkNet, U-Net and U-Net with the VGG16 Encoder Pre-Trained on ImageNet (Unet_VGG16). Each CNN learned the supervised data of sacral pressure ulcers (PUs).

Results:

Among the four architectures, the best results were obtained with U-Net. U-Net demonstrated the second-highest accuracy in terms of the area under the curve (0.997) and a high specificity (0.943) and sensitivity (0.993), with the highest values obtained with Unet_VGG16. U-Net was also considered to be the most practical architecture and superior to the others in that the segmentation speed was faster than that of Unet_VGG16.

Conclusion:

The U-Net CNN constructed using appropriately supervised data was capable of segmentation with high accuracy. These findings suggest that eHealth wound assessment using CNNs will be of practical use in the future.
Effect of Short-Term Endurance Exercise on COX IV and PGC-1a mRNA Expression Levels in Rat Skeletal Muscle
Authors: Sylviana Nova , Natalia Christina , Goenawan Hanna , Pratiwi Yuni Susanti , Setiawan Iwan , Tarawan Vita Murniati , Nurhayati Titing , Rezano Andri , Juliati Juliati , Purba Ambrosius , Supratman Unang , Lesmana Ronny
Published: October 2019

Endurance exercise induces specific skeletal muscle adaptation by increasing mitochondrial oxidative phosphorylation eficiency and mitochondrial biogenesis. Many previous studies suggesting both PGC-1a and COX IV as a potential biomarker of skeletal muscle adaptation induced by exercise. But most of them only studied the effect of long-term endurance exercise, whereas the effect of short-term exercise remains unclear. To investigate short-term physiological adaptation induced by endurance exercise on expression of COX IV and PGC-1a mRNA in rat skeletal muscle. Twenty healthy male Wistar rats (Rattus norvegicus) aged 10-11 weeks old were used in this experiment. Rats were randomly assigned into 4 groups based on the time period of exercise: 1) control (C; n=5), 2) three days of exercise (E3; n=5), 3) six days of exercise (E6; n=5), 4) fifteen days of exercise (E15; n=5). The exercise groups were run at 20m/s for 30 minutes on the rat treadmill and the stationary control group was only placed inside treadmill with the machines turned off. On the last day of exercise, the rats were sacrificed then RNA from skeletal muscle was extracted. COX IV and PGC-1a mRNA expressions were measured by Reverse Transcriptase PCR. The results showed that there were statistically significant differences of PGC-1a mRNA expression levels in both soleus (F(3,16)=3.740, ps=0.033) and gastrocnemius (F(3,16)=3.969, pg=0.027) muscles. The COX IV mRNA expression levels in soleus (F(3,16)=3.801, ps=0.031) and gastrocnemius (F(3,16)=5.429, ps=0.009) muscles were also significantly increased. There were significant increases of PGC-1a and COX IV expressions in fifteen days of exercise group compared to control group in both muscles. Short-term endurance exercise induced mitochondrial biogenesis marker and mitochondrial activity marker by increasing the PGC-1a and COX IV mRNA expression levels in rat skeletal muscle significantly following the time periods of exercise.
Role of lifestyle intervention programme in regulating brain derived neurotrophic factor in obese children with metabolic syndrome components
Authors: El- Alameey Inas R. , H. Ahmed Hanaa , M. Abushady Mones
Published: October 2019

Brain derived neurotrophic factor (BDNF) is a neurotrophin probably concerned in the pathophysiology of obesity and metabolic syndrome (MS) in adults. The aim was to explore serum BDNF relationship with metabolic syndrome components before and after one-year of the lifestyle intervention program in obese children. Forty obese children and forty age and gender-matched lean controls were studied. Anthropometric parameters, blood pressure, fasting blood glucose, serum insulin, lipid profile, insulin resistance (HOMA-IR), and serum BDNF, before and after one year of diet control and physical activity were measured. At baseline, fasting glucose, insulin, HOMA-IR, cholesterol, LDL, triglycerides were significantly higher in obese children relative to controls (P=0.00). Serum BDNF concentration was significantly lower in obese children than in lean controls (P=0.00), and its mean concentration of the subjects with MS was significantly lower than those without MS, and control group (P< 0.001). Linear regression analysis suggested that high waist: hip ratio, body adiposity index, fat percentage, diastolic BP, fasting blood glucose, LDL and HOMA-IR are good predictors for decreased serum BDNF concentration in obese children. After one-year intervention program, the obese group showed a significant increase in serum BDNF, and HDL, paralleled by a significant decline in fasting glucose, insulin, HOMA-IR, cholesterol, LDL, triglycerides as compared to the baseline (P =0.00). Serum BDNF was lower in obese children than in lean controls, and seemed to be linked with the metabolic syndrome components. One-year lifestyle intervention program succeeded to enhance BDNF serum concentration in these children.
Comparative Efficacy of Syzygium Cumini Seed Extracts in Alleviating Arsenic-Induced Hepatotoxicity and Blood Cell Genotoxicity in Wistar Albino Rats
Authors: Kumar Munesh , Thakur Rajesh , Kumar Sandeep
Published: October 2019

Syzygium cumini is well known for its medicinal values in the indigenous Indian system of medicine. This study was designed to evaluate the protective effect of methanolic (SCM), ethanolic (SCE) and aqueous (SCA) extracts of Syzygium cumini seeds on arsenic-induced blood cell genotoxicity and hepatotoxicity in Wistar albino rats. Rats were divided into five groups: (1) control, (2) arsenic, (3) SCM, (4) SCE and (5) SCA. After completion of 60 days treatment period, comet assays were performed on isolated blood lymphocytes and serum marker assays indicative of hepatic toxicity were carried out. Arsenic exposed rats expressed significantly higher DNA damage in their lymphocytes than the unexposed rats. Increased activities of serum alkaline phosphatase (ALP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT), and decreased levels of total proteins were observed in arsenic exposed rats. Simultaneous administration of Syzygium cumini seed extracts significantly decreased the arsenic-induced DNA damage and hepatotoxicity. The amelioration of arsenic toxicity was more pronounced with methanolic extract compared to ethanolic and aqueous extracts of Syzygium cumini seeds.
Effect of Duloxetine Pretreatment on 5-HTP and Dexfenfluramine Induced Behaviours in Albino Rats
Authors: Milind Thorat Vandana , C Khanwelkar Chitra , Mallikarjun Matule Somnath , Satish Salve Pratibha , Ajit Surle-Patil Smita , Sadanandan Seshla
Published: October 2019

Activation of central brain serotonergic receptors viz 5-HT1A and 5-HT2A by serotonin (5-HT) induces the 5-HT behavioural syndrome in rats. 5-HTP and dexfenfluramine produce 5-HT mediated behaviours. We have carried out the experiment with the aim to study the effect of duloxetine pretreatment on 5-hydroxytryptophan and dexfenfluramine induced behaviours in albino rats. Pre-treatment with 20 mg/kg duloxetine, a SNRI was found to potentiate 75 mg/kg 5-HTP mediated behavioural syndrome. However, 5, 10 and 20 mg/kg duloxetine had decreased the intensity of the behavioral syndrome produced by 10 mg/kg dexfenfluramine significantly. Duloxetine at 5, 10 and 20 mg/kg had produced inhibition of serotonin transporter (SERT) and inhibited dexfenfluramine uptake which had significantly antagonised its behavioural syndrome. Duloxetine at 5 and 10 mg/kg did not affect 5-HTP induced behavioral syndrome significantly where as 20 mg/kg duloxetine did significantly potentiate 5-HTP induced behavioral syndrome. This indicates 20 mg/kg dose of duloxetine blocks neuronal reuptake of 5-HT by blocking SERT and effectively increase its concentration to greater level in the synaptic gap which causes synergistic stimulation of the central postsynaptic 5-HT1A and 5-HT2A receptors and potentiation of 5-HTP behavioral syndrome.
Diagnósticos de enfermagem para pacientes com tuberculose na unidade de infectologia
Authors: Neto Vinícius Lino de Souza , Silva Richardson Augusto Rosendo da , Fonseca Ivana de Araújo , Santos Sergilene Fonseca Teixeira , Santos Anzielyson Felix Silva dos , Nascimento Ana Gláucia Lopes do
Published: October 2019

Objetivo: Elencar os diagnósticos de enfermagem em indivíduos com tuberculose em uma unidade de internação em infectologia. Método: Trata-se de um estudo de caso desenvolvido com 02 pacientes em uma unidade de internação de infectologia em um Hospital de Ensino, referência para o tratamento de doenças infectocontagiosas, no Nordeste do Brasil. Para a coleta de dados utilizou-se um formulário estruturado, elaborado pelos pesquisadores seguindo a teoria das necessidades humanas básicas de Wanda Horta. Em seguida, formularam-se as inferências diagnósticas, e assim esquematizados em mapas conceituais. A CIPE® versão 2015 foi a terminologia utilizada, seguindo assim, os preceitos estabelecidos pelo Conselho Internacional de Enfermeiros (ICN). Resultados: Os achados possibilitaram a identificação dos seguintes diagnósticos prevalentes em pacientes com tuberculose: edema periférico, nutrição dietética prejudicada, higiene da cavidade oral prejudicada, padrão de higiene do couro cabeludo comprometida, insônia, abuso de tabaco, baixa autoestima e isolamento social. Conclusões: Os pacientes avaliados apresentaram diagnósticos de enfermagem relacionados às alterações das necessidades psicobiológicas e psicossociais, o que requer o planejamento de ações e cuidados específicos.
MOVIMIENTOS SOCIALES, DEMOCRACIA, EDUCACIÓN Y LOS DERECHOS EN BRASIL: 2013-2018
MOVIMENTOS SOCIAIS, DEMOCRACIA, EDUCAÇÃO E DIREITOS NO BRASIL: 2013-2018
SOCIAL MOVEMENTS, DEMOCRACY, EDUCATION AND RIGHTS IN BRAZIL: 2013-2018
Authors: Gohn Maria Da Glória
Published: October 2019

El objetivo de este trabajo es analizar el escenario político, social y económico de la historia del Brasil contemporáneo, el período de 2013 a 2018. Destaca las formas de participación de la sociedad civil en los movimientos sociales y las manifestaciones colectivas que se han producido, buscando diferencias y similitudes con respecto a los diferentes tipos de cultura y derechos – antiguos y nuevos. Se centra en las redes de activismo que se han construido en las manifestaciones, destacando: ¿Cuáles son los temas en el escenario público, formas de organización, repertorios de acción social y política, formas de movilización, estrategias y demandas? La pregunta central es: ¿Cómo fue el proceso de repolitización de los grupos de protesta de 2013 a 2018? ¿Qué sentido y dirección han tomado en relación con la democracia? Los hallazgos están organizados en cuatro momentos, dentro de un nuevo ciclo de participación social.

O trabalho tem como objetivo analisar no cenário político, social e econômico da história do Brasil contemporâneo o período de 2013 a 2018. Destaca formas de participação da sociedade civil em movimentos sociais e manifestações coletivas ocorridas, buscando as diferenças e semelhanças com respeito a diferentes tipos de cultura e direitos – antigos e novos. Foca as redes de ativismo que se construíram nas manifestações, destacando: quais são os temas no cenário público, formas de organização, repertórios de ação social e política, formas de mobilização, estratégias e demandas. A questão central é: como foi o processo de repolitização dos grupos de protesto de 2013 a 2018? Que sentido e direção eles tomaram em relação à democracia? Os achados são organizados em quatro momentos, dentro de um novo ciclo de participação social.

The objective of this work is to analyze the political, social and economic scenario of the history of contemporary Brazil, in the period of 2013 to 2018. It highlights forms of participation of civil society in social movements and collective manifestations that have occurred seeking differences and similarities with respect to different types of culture and rights – old and new. It focuses on the networks of activism that has been built in the manifestations highlighting: What are the themes in the public scenario, forms of organization, repertoires of social and political action, forms of mobilization, strategies and demands. The central question is: How was the re-politicization process of the protest groups from 2013 to 2018? what sense and direction have they taken in relation to democracy? The findings are organized in four moments, within a new cycle of social participation.
Azathioprin effect on immunologic parameters of patients with newly detected insulin-dependent diabetes mellitus
Authors: Shamkhalova M. Sh. , Abugova I. A. , Shishko P. I. , Dedov I. I. , Kozlov L. V. , Alyoshkin V. A. , Rozina M. N.
Published: October 2019

Azathioprin immunosuppressive therapy prolongs remissions and stimulates residual p-cell function, suppresses insulin antibody production, reduces the activity of the complement and CH50 components, reduces initially increased cellular immunity parameters (total T and В cell counts, T helper to T inductor ratio, and the count of DR carrier cells) in patients with newly detected insulin-dependent diabetes mellitus; this makes this drug effective at the firts stages of the disease. When selecting patients for immunosuppressive therapy the following immunity parameters should be examined: complement status, total counts of T and В lymphocytes, T-helper-in- ductor/T-suppressor-cytotoxic immunoregulation index, DR carrier cell counts. Reduced levels thereof are a contraindication against immunosuppressant therapy. Male patients with insulindependent diabetes mellitus debut at the age of over 25 are particularly susceptible to immunosuppressive therapy with azathioprin.
Some problems in adrenal surgery of patients with endogenic hypercorticism
Authors: Trofimov V. M. , Kalinin A. P. , Nechai A. I.
Published: October 2019

For a long time, the method of choice in the treatment of endogenous hypercorticism was surgery on the adrenal glands. The most reliable in terms of eliminating the manifestations of the disease, they remain to this day. However, with the development of other treatments, they have lost their exclusivity.
Antioxidants (alpha-tocoferol acetate) in therapy of diabetes mellitus
Authors: Kuznetsov N. S. , Abulela Abdel Mohson , Neskoromny V. N.
Published: October 2019

The authors have examined the time course of lipid peroxidation processes and the levels of total lipids in red cell membranes and blood plasma of diabetics administered alpha-tocoferol acetate. Patients with medium-severe diabetes of the first and second types were divided into 2 groups. Group 1 patients were administered only traditional sugar-reducing treatment, in Group 2 alpha-tocoferol acetate in a daily dose 300 mg was added to such therapy. Similar examinations were carried out in both the groups before and after the treatment. Lipid peroxidation levels and the content of total lipids were found significantly increased in the cellular membranes and blood plasma of Group 2 patients, whereas in Group 1 no changes of this kind were detected. Therapy with alpha-tocoferol acetate normalized lipid peroxidation processes in the red cell membranes and the total lipid content in the blood plasma reduced the blood plasma level of lipid peroxidation products and the content of total lipids in red cell membranes. These results permit a conclusion on the favorable effect of alpha-tocoferol acetate on blood plasma lipid peroxidation and total lipid levels in diabetics.