bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomized Controlled Trials for Comparison of Laparoscopic Versus Conventional Open Catheter Placement in Peritoneal Dialysis Patients: A Meta-Analysis
Authors: Sun Mei-lan , Wang Bo , Zhang Piao , zhang yong 
Published: August 2019

Abstract
Aim

The application of laparoscopic catheterization technology in peritoneal dialysis (PD) patients has recently increased. However, the advantages and disadvantages of laparoscopic versus conventional open catheterization are still controversial. The aim of this meta-analysis is to assess complications of catheterization in PD patients and to provide a reference for the clinical choice of PD catheter placement technique.

Methods

We searched numerous databases, including Embase, PubMed, CNKI and the Cochrane Library, for published randomized controlled trials (RCTs).

Results

Eight relevant studies (n=646) were included in the meta-analysis. The pooled results showed a lower incidence of catheter migration (P: 0.03, OR: 0.42, 95% CI: 0.19 to 0.90) and malfunction (P: 0.008, OR: 0.41, 95% CI: 0.21 to 0.79) but a higher incidence of bleeding (P: 0.02, OR: 3.25, 95% CI: 1.18 to 8.97) with a laparoscopic approach than with a conventional approach. There was no significant difference in the incidence of obstruction (P: 0.24, OR: 0.32, 95% CI: 0.05 to 2.10), hernia (P: 0.20, OR: 0.38, 95% CI: 0.09 to 1.68), leakage (P: 0.23, OR: 0.69, 95% CI: 0.38 to 1.26), mechanical dysfunction (P: 0.90, OR: 0.96, 95% CI: 0.48 to 1.91), malfunction (P: 0.008, OR: 0.41, 95% CI: 0.21 to 0.79), perforation (P: 0.97, OR: 0.95, 95% CI: 0.06 to 15.42), peritonitis (P: 0.13, OR: 0.95, 95% CI: 0.42 to 1.12) or tunnel or exit-site infections (P: 0.49, OR: 0.95, 95% CI: 0.71 to 2.02).

Conclusion

Laparoscopic catheterization and conventional open catheter placement in PD patients have unique advantages, but laparoscopic catheterization may be superior to conventional open catheter placement. However, this conclusion needs to be confirmed with further large-sample-size, multi-centre, high-quality RCTs.
Comparing the accuracy and reliability of detecting intensity of spinal inflammation on STIR sequence with ADC values in axial spondyloarthritis
Authors: Chung Ho Yin , Cheung Tommy Tsang , Lau Vince Wing Hang , Lee Kam Ho , Chan Florence King Pui , Tsang Helen Hoi Lun , Chan Shirley Chiu Wai , Lau Chak Sing 
Published: August 2019

Abstract
Objective

To compare the accuracy and reliability of detecting the intensity of spinal inflammation on short tau inversion recovery (STIR) with the apparent diffusion coefficient (ADC) values of the active MRI lesions in axial spondyloarthritis (axSpA).

Materials and methods

Fifty active lesions in STIR sequence of spinal MRI were identified. With reference to sites of active lesions in STIR, the corresponding region of interest (ROI) on ADC map was drawn to determine the maximum ADC (ADCmax), mean ADC (ADCmean), normalized maxium (nADCmax) and mean (nADCmean). Four independent readers scored the identified active lesions as “intense” or “non-intense” according to the SPARCC MRI index. They were compared to various ADC parameters for assessment of accuracy and reliability. Regression analyses were used to adjust potential factors that could affect ADC.

Results

Significant differences were found in ADCmax between “intense” and “non-intense” lesions scored by 3 of the 4 readers (1405.7±271.4 vs 1165.8±223.8, p=0.01; 1420.7±272.1 vs 1209.0±248.5, p=0.01; 1438.0±307.2 vs 1213.6±231.0, p=0.01). Only 1 reader could differentiate a difference in “intense” and “non-intense” lesions with respect to ADCmean (899.2±248.3 vs 711.0±222.6, p=0.01) and nADCmean (4.4±2.1 vs 3.4±1.4, p=0.05). Inter-reader agreements were slight to moderate (Kappa=0.07-0.45). Reliability substantially improved when only the lowest and highest 25th percentiles of ADC values were included (Kappa=0.17-0.75). Regression analyses showed the “intense” lesions were associated with higher ADC values after adjustment for confounders.

Conclusion

Reading of STIR MRI is limited by the lack of ability in differentiating subtle differences of spinal inflammation. ADC could be an alternative method.
Clinical outcomes of over-the-scope-clip system for the treatment of acute upper non-variceal gastrointestinal bleeding: a systematic review and meta-analysis
Authors: Zhong Chunyu , Tan Shali , Ren Yutang , Lü MuHan , Peng Yan , Fu Xiangsheng , Tang Xiaowei 
Published: August 2019

Abstract
BackgroundConventional endoscopic treatments can’t control bleeding in as many as 20% of patients with non-variceal gastrointestinal (GI) bleeding. Recent studies have shown that over-the-scope-clip (OTSC) system allowed for effective hemostasis for refractory GI bleeding lesions. So we aimed to conduct a systematic review to evaluate the effectiveness and safety of the OTSC system for management of acute non-variceal upper GI bleeding.MethodA comprehensive literature search was conducted on PubMed, EMBASE, and Cochrane Library covering the period from January 2007 to May 2019. The search terms included “gastrointestinal bleeding” AND “OTSC OR over the scope clip”. The literature was selected independently by two reviewers according to the inclusion and exclusion criteria. The statistical analysis was carried out using Comprehensive Meta-Analysis software version 3.0.ResultsA total of 16 studies including 769 patients with 778 GI bleeding lesions were identified. Pooled technical success was achieved in 761 lesions [95.7%; 95% confidence interval (CI), 93.5%-97.2%], and the pooled clinical success was achieved in 666 lesions (84.2%; 95% CI, 77.4%-89.2%). The incidence of re-bleeding was reported in 81 patients and the post-procedure mortality was 10.9% (n=84). Only 2 (0.3%) patients occurred complications after OTSC system procedure.ConclusionsOur study demonstrated that the OTSC system was a technically feasible modality and highly efficacious in achieving hemostasis in acute non-variceal upper gastrointestinal bleeding.
PS4DR: a multimodal workflow for identification and prioritization of drugs based on pathway signatures
Authors: Emon Mhammad Asif , Domingo-Fernández Daniel , Hoyt Charles Tapley , Hofmann-Apitius Martin 
Published: August 2019

Abstract
Background:
During the last decade, there has been a surge towards computational drug repositioning owing to constantly increasing -omics data in the biomedical research field. While numerous existing methods focus on the integration of heterogeneous data to propose candidate drugs, it is still challenging to substantiate their results with mechanistic insights of these candidate drugs. Therefore, there is an unmet need for more innovative and efficient methods which can enable better integration of the data and knowledge for drug repositioning.

Results:
Here, we present a customizable workflow (PS4DR) which not only integrates high-throughput data such as genome-wide association study (GWAS) data and gene expression signatures from disease and drug perturbations but also takes pathway knowledge into consideration to predict drug candidates for repositioning. We have collected and integrated publicly available GWAS data and gene expression signatures for several diseases and hundreds of FDA-approved drugs in this study. Additionally, different pathway databases were used for mechanistic knowledge integration in the workflow. Using this systematic consolidation of data and knowledge, the workflow computes pathway signatures that assist in the prediction of new indications for approved drugs.

Conclusion:
We showcase PS4DR with applications on how this tool can be used for repurposing drugs as well as to propose drugs that can simulate disease dysregulations. We were able to validate our workflow by demonstrating its capability to predict FDA-approved drugs for their approved indications for several diseases. Further, PS4DR returned many potential drug candidates for repositioning that were backed up by epidemiological evidence extracted from the scientific literature. Source code is freely available at https://github.com/ps4dr/ps4dr.
The diffuse involvement of Anti-N-methyl-D-aspartate receptor encephalitis in brain: a case report
Authors: Jiang Yun , Ma Jianpeng , Gong Tao , Hao Hongjun , Chen Haibo 
Published: August 2019

Abstract
Background Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe and most common autoimmune encephalitis in patients under 40 years old. Anti-NMDAR encephalitis has various clinical and neuroimaging findings. Here we report a special case of an anti-NMDAR encephalitis who had diffuse lesions in bilateral hemispheres with mild mass effects in left basal ganglia area.
Case presentations A 28-year-old female anti-NMDAR encephalitis patient mainly presented with headache and fever. Brain magnetic resonance image (MRI) showed slightly contrasted diffuse lesions, involving the left temporal and frontal lobes, left basal ganglia area and splenium of corpus callosum, as well as the right frontal lobe, with mild edema surrounded in the left basal ganglia area. Cerebrospinal fluid (CSF) revealed a moderate pleocytosis with normal protein and glucose levels. Anti-NMDAR antibodies were identified in CSF. Transvaginal ovarian ultrasound did not reveal an ovarian teratoma. The patient was treated with immunoglobulin and steroid, and had a good recovery.
Conclusions Anti-NMDAR encephalitis has no special clinical manifestations and brain MRI is highly variable, which could be unremarkable or abnormal involving white and grey matters. The extensive lesions in frontal and temporal lobes, and basal ganglia area, with mild mass effects, have not been described previously. Recognition of various changes in brain MRI will enable the early detection of anti-NMDAR antibody and then effective treatments.

Key words: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, clinic, brain, magnetic resonance image
A Case Report of two siblings with Alstrom syndrome without hearing loss associated with two new ALMS1 variants
Authors: Shurygina Maria Fedorovna , Parker Maria A. , Schlechter Catie , Chen Rui , Li Yumei , Weleber Richard G. , Yang Paul , Pennesi Mark E. 
Published: August 2019

Abstract
Background

Alström syndrome (AS) is a rare monogenic disorder characterized by progressive multi-organ pathology including retinal degeneration, hearing impairment and type 2 diabetes. Here we present clinical features in two siblings diagnosed with Alström syndrome associated with novel biallelic changes in ALMS1.

Case presentation

Two siblings originally diagnosed as having achromatopsia presented with mild light sensitivity, nonspecific otitis media, and mild developmental delay during the first decade of life with a relatively stable ocular appearance during second decade, late onset of nystagmus and dyschromatopsia (after 20 years) and preserved vision during the third decade of life. One sibling had late onset hearing loss and both siblings had symmetric high myopia, normal stature, and ptosis. Clinical findings revealed structural and functional tests consistent with a cone-rod dystrophy. Novel variants c.9894dupC (p.S3298fs) and c.10769delC (p.T3590fs) in ALMS1 gene were found.

Conclusions

Two North American siblings who presented with a mild clinical phenotype of Alström syndrome were found to have novel mutations in ALMS1. These two frame-shift mutations segregated with the disease phenotype lending evidence to their pathogenicity.
Premedication with dexmedetomidine to reduce emergence agitation: a randomized controlled trial
Authors: Kim Jong Chan , Kim Jihee , Kwak Hayeon , Ahn So Woon 
Published: August 2019

Abstract
Background: Nasal bone fracture is the most common type of facial fracture, and the high incidence of severe emergence agitation occurring after closed reduction of the nasal bone fracture can be challenging to manage. The purpose of this trial was to evaluate whether pre-operative administration of dexmedetomidine is effective in reducing the incidence and severity of emergence agitation in adults undergoing closed reduction of nasal bone fractures.
Methods: In this randomized controlled trial, 90 patients who were scheduled to undergo closed reduction of a nasal bone fracture were prospectively included and were randomly assigned to either the control group (n = 45; 0.9% saline infusion) or the dexmedetomidine group (n = 45; 1 μ/kg over 10 min, pre-operatively). The primary endpoint was Aono's four-point scale scores after anesthesia. The recovery time and numeric rating scale score were assessed as secondary endpoints.
Results: Aono's four-point scale scores were lower in the dexmedetomidine group than in the control group (median: 1 [1-1] vs. 1 [1-2], 95% confidence interval of difference: 0.01 to 0.02, P = 0.02). The number, severity, and duration of agitation episodes were significantly lower in the dexmedetomidine group than in the control group. Furthermore, the number of patients exhibiting intraoperative movement was lower in the dexmedetomidine group.
Conclusions: Pre-operative administration of dexmedetomidine demonstrated several significant benefits, such as a lower incidence of emergence agitation, reduced agitation severity, and a shorter duration of agitation. Additionally, we observed more stable maintenance of intraoperative anesthesia with less movement during the surgery.
Risk factors for viral hepatitis C infection in Rwanda: Results from a Nationwide Screening Program
Authors: Makuza Jean Damascene , Liu Carol Y , Ntihabose Corneille Killy , Dushimiyimana Donatha , Umuraza Sabine , Nisingizwe Marie Paul , Umutesi Justine , Serumondo Janvier , Mugeni Soline Dusabeyesu , Semakula Muhamed , Gupta Neil , Hellard Margaret , Nsanzimana Sabin 
Published: August 2019

Abstract
Background: The epidemiology and risk factors for hepatitis C virus (HCV) infection in Rwanda are not well known; however, this information is crucial to shaping the country’s public health approach to hepatitis C control.
Methods: A HCV screening campaign was conducted in the general population in 24 districts previously identified to have a high HCV disease burden. At the time of sample collection, sociodemographic information and self-reported risk factors were collected. Bivariate and multivariate logistic regressions were conducted to assess risk factors independently associated with hepatitis C antibodies (HCVAb) seroprevalence.
Results: Out of a total of 326,263 individuals screened for HCVAb, 22,183 (6.8%) were positive. In multivariate analysis, risk factors identified as statistically associated with HCVAb Seroprevalence include history of traditional operation or scarification (OR=1.09, 95% CI: 1.05-1.14), presence of viral hepatitis in the family (OR=1.27, 95% CI: 1.15-1.40), widowed or separated/divorced (OR=1.36, 95% CI: 1.26-1.47), Southern province (OR=1.98, 95% CI: 1.88-2.08) and aged 65 years and older (OR=4.86, 95% CI: 4.62-5.11). Ubudehe category 3 (OR=0.97, 95% CI: 0.93-1.01) and participants using RAMA (Health insurances for employees of public and private sectors) insurance (OR=0.76, 95% CI: 0.70-0.85) had lower odds of HCV seroprevalence.
Conclusions: Our findings provide important information for Rwanda’s strategy on prevention and case-finding. Future prevention interventions should aim to reduce transmission through targeted messaging around traditional healing practices and case-finding targeting individuals with a history of exposure or advanced age.
Genome-wide identification of MAPKKK genes and their response to phytoplasma stress in Chinese jujube (Ziziphus jujuba Mill.)
Authors: Liu ZhiGuo , Wang Lixin , Xue Chaoling , Chu Yuetong , Gao Weilin , Zhao Yitong , Zhao Jin , Liu Mengjun 
Published: August 2019

Abstract
Backgrounds

Mitogen activated protein kinase (MAPK) cascades play vital roles in signal transduction in response to various biotic and abiotic stresses. In the previous study we have identified 10 ZjMAPKs and 5 ZjMAPKKs in Chinese jujube genome and found some crucial members of ZjMAPKs and ZjMAPKKs might function importantly in the process of phytoplasma infection. But how these ZjMAPKKs were modulated by ZjMAPKKKs during this process is still elusive and little information is known about the MAPKKKs in Chinese jujube.

Results

In the current study, 56 ZjMAPKKKs were identified in the jujube genome and all of them contain the key S-TKc (serine/threonine protein kinase) domain which distributed in all 12 chromosomes. Phylogenetic analysis showed that these ZjMAPKKKs could be classified into two subfamilies, of which 41 belonged to Raf, and 15 to MEKK subfamily. In addition, the ZjMAPKKKs in each subfamily share the same conserved motifs and gene structures, one pair of ZjMAPKKKs (15/16) was the only tandem duplication event on Chromosome 5. Furthermore, the expression profiles of these MAPKKKs in response to phytoplasma disease were investigated by qPCR. In the three main infected tissues (witches’ broom leaves, phyllody leaves, apparent normal leaves), the ZjMAPKKK26 and 45 were significantly up regulated and the ZjMAPKKK3, 43 and 50 were down regulated. While the ZjMAPKKK4, 10, 25 and 44 were significant highly induced in the sterile cultivated tissues infected by phytoplasma, and the ZjMAPKKK7, 30, 35, 37, 40, 41, 43 and 46 were significantly down regulated.

Conclusions

The identification and classification analysis of ZjMAPKKKs was firstly reported and some key individual ZjMAPKKKs genes might play essential roles in response to phytoplasma infection. This could provide initial understanding for the mechanism that how the ZjMAPKKKs were involved in jujube - phytoplasma infection.
Flipped classroom improves the results in Pathophysiology learning: results of a non-randomized controlled study
Authors: Herrero J. Ignacio , Quiroga Jorge 
Published: August 2019

Abstract
Background

The flipped classroom has become increasingly popular in health professions education. The aim of this study is to analyze its effect on learning in a Pathophysiology course.

Methods

Flipped classroom was introduced to teach Respiratory Pathophysiology in 2018. The results obtained in the exam were compared with the results of previous year students and with the evolution in Blood Pathophysiology (given by the same teacher, in a traditional way). Comparisons between groups were done with the Student’s T test. A survey was administered to the students after finishing the term.

Results

201 students were examined in 2018 (and 229 in 2017). Gender distribution and the qualifications obtained in General Pathology were comparable between them. The results in Respiratory Pathophysiology were significantly better in 2018 than in 2017 (mean: 48 versus 42 over 100; P=0.004), but the results in Blood Pathophysiology were comparable between both groups. The improvement was significant only in students that obtained scores below the median (mean: 40 versus 33; P=0.009) and was more evident in male than in female students (mean: 52 versus 44; P=0.010) and in those who had the same age (were not older) than the rest of their classmates (mean 51 versus 44; P=0.002). Most students considered that flipped classroom was more attractive and helped them to learn more and with less effort.

Conclusions

Flipped classroom increases medical students’ knowledge acquisitions in Pathophysiology. It benefits more to male students and those with lower qualifications who had not an academic delay.
Efficacy of verum and sham acupoint catgut embedding for treatment of obesity: Study protocol for a randomized controlled trial
Authors: zhou yumei , Yan Bing , Yuan Wei-Qu , Yu Hai-Bo , Yang Zhuo-Xin 
Published: August 2019

Abstract
Abstract
Background: Obesity has become a major public health hazard with epidemic proportions, influencing adults, adolescents and children of both genders. Previous studies suggested that acupoint catgut embedding (ACE) might be a potential therapeutic approach for obesity. The purpose of this study is to conduct a rigorous and normative trial to determine the efficacy of ACE for obesity.
Methods：A total of 99 eligible patients who diagnosed with obesity will be recruited in this study. They will be randomly allocated to either the verum ACE group, sham ACE group, or waiting- list (WL) group with 33 patients for each group. Each patient in the two ACE-based groups will receive 8 sessions of treatment, lasting over 8 weeks. The primary outcomes will the reduction of body mass index (BMI) after treatment. Secondary outcomes will include waist circumference (WC), hip circumference (HC), waist-hip ratio, body fat percentage, blood lipid level, subcutaneous fat area, visceral fat area, and the World Health Organization Quality of Life (WHOQOL). All the outcomes will be evaluated at baseline, ended at 8 weeks of treatments, and 3 months of follow-up. The evaluators and data analyzers will be blinded to group allocation.
Discussion: The findings of this randomized, sham- and waiting-list-controlled trial will help to investigate the influence of ACE on clinical variables as well as visceral fat area of obesity, which will provide high-quality evidence on the efficacy of ACE for obesity.
Trial registration: Chinese Clinical Trial Registry, ID: ChiCTR1800020248. Registered on November 21, 2018.
Keywords: Acupoint catgut embedding, Obesity, Randomized controlled trial, Visceral fat area
El ocaso del paradigma estatocéntrico: la redefinición del Estado a la luz del derecho internacional y las relaciones internacionales contemporáneas
Authors: Cuestas Zamora Edgard Junior 
Published: August 2019

La naturaleza del derecho internacional clásico fue eminentemente pública y se limitó a la regulación de las relaciones entre Estados como únicos actores del sistema internacional. Entre tanto, las relaciones internacionales fueron forjadas como el estudio de la sociedad global, cuya piedra angular fueran los conflictos interestatales y la seguridad internacional. Para mediados del siglo XX, los estudios internacionales ampliaron su espectro de análisis como consecuencia del auge y la diversificación de sujetos internacionales, lo que provocó el desarrollo de nuevas áreas del derecho internacional y la interrelación de las relaciones internacionales con otras disciplinas. Este artículo tiene como finalidad presentar las discusiones teóricas de los últimos cuarenta años, a través de las cuales el paradigma estatocéntrico profesado por ambas disciplinas ha perdido legitimidad. Pese a la proliferación de sujetos internacionales y el proceso de regulación que acompaña su surgimiento, el Estado sigue siendo el actor más poderoso que define la estructura del sistema internacional contemporáneo. Este artículo de investigación es el resultado de una parte del trabajo de grado titulado Aproximaciones al estatus jurídico en derecho internacional público de las provincias separatistas de Abjasia y Osetia del Sur ante la guerra de Osetia de 2008, escrito por el mismo autor.