bluuebunny/crossref_metadata_2025_split huggingface dataset:
Activated Hepatic Stellate Cells (Ito Cells) - Marker of Advanced Fibrosis in Chronic Viral Hepatitis C: A Pilot Study
Authors: Sufletel Rada Teodora , Stanca Melincovici Carmen , Orășan Olga Hilda , Zaharie Toader , Gheban Bogdan Alexandru , Istrate Alexandru , Constantin Anne-Marie , Mihu Carmen Mihaela 
Published: June 2023

Background and Aims: The aim of this study is to determine whether activated hepatic stellate cells (HSCs) may represent a prognostic marker of progressive liver fibrosis in chronic viral hepatitis C (VHC) before antiviral therapy. The possible correlation between HSCs immunohistochemical features, histopathological aspects and clinical data before therapy were also studied.
Methods: This retrospective pilot study was conducted on 27 liver biopsies from VHC patients before antiviral therapy. HSCs’s immunohistochemical analysis used the antibodies alpha-smooth muscle actin (α-SMA), glial fibrillary acidic protein (GFAP) and vinculin. We correlated immunopositive HSCs with HCV load, liver stiffness (LS), fibrosis stage and necro-inflammatory degree before treatment. Also, we assessed the association between liver fibrosis after therapy, the sustained virological response at 12 weeks after therapy (SVR 12) and the type of therapy.
Results: HSCs were increased in VHC patients compared to controls, mainly in the intermediate and periportal lobular regions. α-SMA and vinculin HSCs correlated positively with fibrosis stage (p=0.044), (p=0.028). Furthermore, α-SMA and vinculin HSCs were associated with LS (p=0.027), (p=0.002) and viral load (p=0.021), (p=0.006), but not with necro-inflammation degree. GFAP HSCs inversely correlated with fibrosis stage (r= -0.475), LS (r= -0.422) and HCV load (r= -0.517), but positively with necro-inflammation degree (p=0.038). Liver fibrosis post therapy correlated positively with SVR12 (p<0.001) and the type of therapy (p=0.006) and SVR12 correlated positively with treatment’s type (p=0.002).
Conclusions: Activated HSCs may represent a marker of increased liver fibrosis in VHC. Different immunohistochemical markers can detect various HSCs subpopulations involved in the evolution of VHC and liver fibrosis.
Endoscopic Mucosal Resection of Non-pedunculated Colorectal Polyps ≥20mm: Outcome in a Self-taught Skills Environment
Authors: Casper Markus , Krawczyk Marcin , Lammert Frank 
Published: June 2023

Background and Aims: Endoscopic mucosal resection (EMR) of non-pedunculated colorectal polyps ≥20mm is technically demanding and should preferentially be performed by specialist endoscopists in referral centres. Little is known about the outcome in institutions establishing this competency. Here, we report the learning curve on 100 consecutive large non-pedunculated polyps resected by a single endoscopist with self-taught acquisition of skills.
Methods: We analysed data on 100 non-supervised EMR procedures performed at our academic endoscopy centre (2016-2021), representing a single endoscopist’s learning curve beginning with the first polyp ≥20 mm.
Results: The median polyp size was 30 mm (20-70mm), and 61% of all polyps were ≥30 mm. Predominant polyp morphology was 0-Is (34%) or 0-IIa (47%), and most polyps developed in the ascending colon (36%). In total, 20% of polyps showed high-grade intraepithelial neoplasia, and 8% included pT1 carcinoma. Adenoma recurrence rate after piecemeal resection was 21%. All but one recurrent adenoma were treated endoscopically. Deep mural injury, intra-procedural bleeding and post-procedural bleeding were detected and managed endoscopically in 3%, 21%, and 4% of procedures, respectively. Overall, surgery could be avoided in 91% of all and 98% of non- malignant polyps. Results for the first 50 polyps did not differ from results for the following polyps.
Conclusions: Structured training is advisable to acquire advanced EMR skills. Our data show that autonomous acquisition of skills after finishing a training course represents an acceptable alternative with good results in the setting of an open error culture. Continuous review of outcome parameters and complication rate is mandatory during the learning process.
A Rare Cause of Abdominal Pain: IgG4-Related Sclerosing Mesenteritis
Authors: Archer Sara , Pereira-Guedes Tiago , Fonseca Tomás , Carvalho Sá Diogo , Pedroto Isabel 
Published: June 2023

A 67-year-old man with previous cardiovascular disease was referred to our consultation due to a 5-month history of recurrent epigastric pain. Esophagogastroduodenoscopy and full blood workup presented no alterations. CT scan showed an irregularly shaped mass at the root of the mesentery, measuring 40x25x47mm, with spiculated contours and retractile behaviour (a). Simultaneous densification of the adjacent fat and infracentimetric ganglionic formations scattered throughout the mesentery were shown. Surgical biopsy revealed extensive storiform fibrosclerosis, with the presence of interstitial lymphoplasmocytic infiltrate and obliterative phlebitis (b); the plasma cells had mostly IgG expression, with IgG4:IgG ratio >40% (c), accounting for more than 30- 40 IgG4 plasma cells per field. The serum IgG4 level was 137mg/dL. A diagnosis of IgG4-related sclerosing mesenteritis was made, without other organ involvement. Prednisolone (0.6mg/kg/d) improved partially the abdominal pain, so steroid sparing strategy with off-label rituximab was associated.
Due to its low prevalence, the understanding of this entity is scarce, and its diagnosis is challenging. Unlike other manifestations of IgG4-related disease, the intra-abdominal disease is identified in later stages, due to unspecific symptoms. This case aims to raise awareness about this condition as a differential diagnosis of abdominal pain.
The Influence of Intravenous Lidocaine Infusion on Postoperative Outcome and Neutrophil-to-Lymphocyte Ratio in Colorectal Cancer Patients. A Pilot Study
Authors: Alexa Alexandru Leonard , Ciocan Andra , Zaharie Florin , Valean Dan , Sargarovschi Sergiu , Breazu Caius , Al Hajjar Nadim , Ionescu Daniela 
Published: June 2023

Background and Aims: In the last years increasing scientific evidence drew attention on the potential effects of anesthetic drugs on postoperative outcome in cancer patients. Local anesthetics, especially lidocaine, have been intensively studied in relation with postoperative outcome in colorectal cancer patients. Our study objectives were to investigate the effects of perioperative intravenous lidocaine infusion on neutrophil-to-lymphocyte ratio and short-term postoperative outcome. Additionally, we also looked at 1 year outcome after intended radical colorectal cancer surgery.
Methods: 150 patients scheduled for colorectal cancer surgery were randomized to receive sevoflurane anaesthesia with or without 48 hours lidocaine infusion.
Results: 73 patients were included in the group A (sevoflurane) and 77 in the group B (sevoflurane with lidocaine). Lidocaine infusion did not modify neutrophil-to-lymphocyte ratio at 24 hours after surgery (p=0.58). Patients receiving intravenous lidocaine had significantly lower morphine consumption (p=0.04), faster mobilization time (p=0.001) and fewer days spent in the hospital (p=0.04). Moreover, at 1 year follow- up, patients in group B had a significant decreased rate of recurrences (p=0.03). There was no significant difference in 1 year survival (p=0.22).
Conclusions: In our study, intravenous lidocaine infusion hastened the postoperative recovery of patients in terms of mobilization, hospital discharge and opioid consumption and reduced 1 year recurrence rate. Further studies on larger groups of patients are needed.
Individualized Education Programs and Transition Planning for Adolescents With Autism
Authors: Hughes Michelle M. , Kirby Anne V. , Davis John , Bilder Deborah A. , Patrick Mary , Lopez Maya , DaWalt Leann S. , Pas Elise T. , Bakian Amanda V. , Shaw Kelly A. , DiRienzo Monica , Hudson Allison , Schwenk Yvette D. , Baroud Thaer M. , Washington Anita , Maenner Matthew J. 
Published: June 2023

OBJECTIVES
The study objectives were to examine the contents of individualized education programs (IEPs) of adolescents with autism spectrum disorder (ASD), including postsecondary transition goals, services, and changes in special education classification over time.

METHODS
This study involved a longitudinal population-based surveillance cohort from the Autism Developmental Disabilities Monitoring Network from 2002 to 2018 in 3 catchment areas in the United States. The sample included 322 adolescents who were born in 2002, identified with ASD, and had an IEP available for review at ages 15–16 years.

RESULTS
We found that 297 (92%) adolescents with ASD had an IEP including a transition plan. Those without intellectual disability (ID) were more likely to have postsecondary education and employment goals and have those goals be to pursue higher education or competitive employment compared with those with ID. Forty-one percent of adolescents with ASD had a postsecondary living arrangement goal. Although 28% of adolescents with ASD received school-based mental health services, none of these adolescents were Black; additionally, 15% of those with ID received mental health services compared with 34% without ID. The percentage of adolescents with ASD served under an autism classification increased from 44% at age 8 years to 62% by age 16.

CONCLUSIONS
We identified gaps and disparities in school-based postsecondary transition planning. Working with education partners, families, and adolescents will be important to identify what challenges contribute to these findings and what supports are needed to improve the equity and quality of the transition planning process for adolescents with ASD so they are prepared for adulthood.
Global value chains and knowledge spillover to local economy in Visegrad 4 countries
Authors: Otsuka Kozo , Natsuda Kaoru , Csonka Laszlo 
Published: June 2023

AbstractThis study empirically examines knowledge spillover in Visegrad Four (V4) countries, with an emphasis on global value chains (GVCs). Using patent statistics, the study aims to estimate the knowledge production function, including domestic and foreign knowledge stocks, and found that international knowledge spillover does not contribute much to the innovation of the local economy in the V4 countries because of three factors: i) multinational corporations' (MNCs) strategy to locate a low-cost production base, ii) MNCs' strategy to locate supporting (process, production or non-core product related) research and development (R&D) activities and iii) limited technology spillover effect from MNCs to local firms. Local firms in the V4 countries became dependent on the peripheral products and technologies provided by MNCs, and as a result, local R&D activities in the V4 countries were diverted from patentable innovation.
A hazai cigányság területitársadalmi megjelenítése a tankönyvekben.
Authors: Cserti Csapó Tibor 
Published: June 2023

„A roma kultúra reprezentációja a tartalomszabályozók, tartalomhordozók körében,
valamint ezek fejlesztési lehetőségei” című kutatás során azt vizsgáltuk, hogy a
közoktatásban a környezetismeret, a természetismeret és a földrajz tanításához a
választható tankönyvek listáján szereplő tananyaghordozók a hazai
nemzetiségekről, fókuszáltan a cigány, roma népességről tartalmaznak-e olyan
releváns információkat, amelyek a Nemzeti alaptanterv (NAT), a Kerettantervek,
illetve az ezekre épülő helyi tantervek előírásai szerint kötelező elemei
lennének az egyes évfolyamok ismeretanyagának. (Ld. még Orsós 2015,
2016; Cserti Csapó 2016; Andl–Cserti 2017.) Áttekintettük a
témakörben született korábbi eredményeket is (Terestyéni 2005; Balázs et
al. 2014; Binder–Pálos 2016).
A tankönyvek első vizsgálata nagyon negatív tapasztalatokkal zárult. A
választható tankönyvek elvétve tartalmaztak a nemzetiségekről információkat, a
cigánysággal kapcsolatban még inkább érezhető volt ez a negligálás. Bár
mindegyik tantárgy alkalmas arra, hogy a nemzeti kisebbségekkel szembeni
tartalmi és érzékenyítési elvárásoknak eleget tegyen.
A tankönyvek közül néhányban jelentek meg tartalmak, de ezek kivétel nélkül vagy
pontatlanok, vagy inkább a sztereotipikus gondolkodás veszélyét rejtették.
Az is világossá vált, mennyire nehéz feladat a tankönyvszerző számára, hogy
egyszerre feleljen meg minden elvárásnak. (Ld. Dárdai 2002; Balázs et
al. 2017.) A tanulmány reflektál arra, mit és hogyan lehet tanítani
abból a „megrendelői csomagból”, amit a hazai oktatáspolitika előír a hazai
nemzetiségek – köztük a roma, cigány népesség – társadalmi-gazdasági-területi
megközelítésével kapcsolatban.
Comprehensive analysis of clinical and paraclinical parameters of coronary blood flow in patients with acute types of coronary artery disease and type 2 diabetes
Authors: Kokozheva M. A. , Kutsenko V. A. , Mardanov B. U. , Akhundova H. R. , Mamedov M. N. 
Published: June 2023

Aim. To study clinical and paraclinical parameters and lesions of the coronary bed in patients with acute types of coronary artery disease (CAD) and type 2 diabetes (T2D).Material and methods. The study included 102 patients of both sexes with acute CAD. Patients were analyzed in two following groups: the first (mean age, 56,6±0,96 years, men/women 34/16) consisted of 50 patients with acute coronary syndrome (ACS) and type 2 diabetes, the second (mean age, 58,7±1,01 years, men/women 37/15) — 52 patients without T2D. Along with the assessment of behavioral and biological risk factors for CVD, clinical and hemodynamic parameters and the results of coronary angiography were analyzed.Results. In patients with ACS and T2D, the duration of T2D was 5,6±3,7 years. Somatic comorbidities were registered in 74% in the first group, and in 53,8% in the second. According to echocardiography, in the group of people with ACS and T2D, the left ventricular ejection fraction was lower, and the mean pulmonary artery pressure was higher compared to the group without T2D. Stenosis of the distal coronary artery third in patients with T2D occurred in 78% of cases, and in patients without T2D — in 42%; the differences were significant (p<0,001). Diffuse CAD also prevailed in the first group and amounted to 58%, and in the second — 27%. The SYNTAX score was higher in patients with T2D compared with the group of people without T2D — 29,2 and 22%, respectively (p<0,001).Conclusion. In patients with ACS and T2D, the prevalence of pulmonary hypertension and left ventricular systolic dysfunction was revealed. The features of the coronary flow in patients with T2D with ACS were predominantly the distal type of lesion, as well as an increased risk of angioplasty complications, assessed using the SYNTAX score.
Prognostic significance of troponin I in assessing cardiovascular risk in the Russian population. Data from ESSE-RF1 and ESSE-RF2 multicenter studies
Authors: Drapkina O. M. , Shalnova S. A. , Kontsevaya A. V. , Kutsenko V. A. , Kapustina A. V. , Balanova Yu. A. , Evstifeeva S. E. , Ivanova A. A. , Imaeva A. E. , Makogon N. V. , Metelskaya V. A. , Muromtseva G. A. , Filichkina E. M. , Yarovaya E. B. 
Published: June 2023

Aim. To assess the significance of troponin I (hs-cTnI) for cardio­vascular risk stratification in a population of Russian working-age men and women of.Material and methods. The data of 13976 men and women aged 25-64 from the ESSE-RF1 and ESSE-RF2 multicenter studies were analyzed. The examination included following points: standard questionnaire, measurements of height, weight, waist circumference, body mass index, blood pressure, pulse rate, biochemical tests. The level of hs-cTnI in blood serum samples stored at -70оC in the Biobank of the National Medical Research Center for Therapy and Preventive Medicine was determined by chemiluminescent immunoassay analysis. Individual cardiovascular risk was calculated using the SCORE scale: values <1% — low risk; 1-4% — moderate, 5-9% — high and ≥10% very high. Similar to the BiomarCaRE study, participants were divided into 3 sex-adjusted cTnI levels: men <6, 6 to 12, and >12 pg/ml; women <4, 4 to 10, and >10 pg/ml. We analyzed following hard endpoints: cardiovascular death or non-fatal myocardial infarction, and composite endpoint: the same and stroke.Results. The prospective analysis of the relationship between troponin levels and endpoints and composite endpoints showed that in participants without prior CVD, hs-cTnI levels >12 pg/ml in men and >10 pg/ml in women are associated with an increased risk of endpoints and composite endpoints by 3,39 (1,91-6,03) and 2,69 (1,6-4,52) times (p<0,001), respectively. Similarly to BiomarCaRE, the SCORE-calculated risk reclassification was validated by adding the hs-cTnI value. The net reclassification improvement index (NRI) for endpoints and composite endpoints was 13% and 11% (p<0,001), respectively. Among men, the reclassification for NRI composite endpoints was more accurate than among women: 19% and 11%, respectively.Conclusion. The hs-cTnI level is an independent predictor of myo­cardial infarction, stroke, and death from CVD in people aged 35-64 years without prior CVD. Adding the hs-cTnI level to the SCORE model makes the risk prediction more accurate.
Interrelation of growth/differentiation factor-15 level with laboratory and clinical and functional parameters of patients with coronary artery disease
Authors: Zakharyan E. A. 
Published: June 2023

Growth differentiation factor 15 (GDF-15) is a circulating protein that is associated with various pathological conditions.Aim. To study the relationship between the level of GDF-15 and labo­ratory, clinical and functional parameters of patients with coronary artery disease (CAD).Material and methods. All patients with coronary artery disease under­went a general clinical examination, coronary angiography, extrac­ranial artery ultrasound examination, echocardiography, deter­mi­nation of the serum level of GDF-15 (ng/ml) and matrix metal­lopro­teinase 9 (ng/ml). Statistical processing of the obtained results was carried out using the Statistica 10.0 software.Results. The study included 88 people (55 men and 33 women), 78 of whom were patients with an established diagnosis of CAD and 10 were healthy volunteers (control group). In the group of CAD patients, the median level of GDF-15 was 4,98 ng/ml [3,15; 8,24], while in the cont­rol group — 1,95 ng/ml [0,01; 2,45]. An association of GDF-15 con­centration with the age of patients was found (r=0,44; p<0,001). There was a direct correlation between the level of GDF-15 and interventricular septal thickness (r=0,33; p<0,05), heart failure stage (Strazhesko-Vasilenko classification) (r=0,23; p<0,05), the concentration of matrix metal­loproteinase 9 (r=0,24; p<0,05), carotid intima-media thickness (r=0,28; p<0,05), the number of coronary arteries that required revas­cularization during coronary artery bypass grafting (r=0,52; p<0,05), and multifocal atherosclerosis (r=0,23; p<0,05). In patients with athero­sclerotic lesions in 2 or 3 vascular beds, the level of GDF-15 was signifi­cantly higher than in patients with CAD (p<0,05).Conclusion. The results obtained demonstrate the value of GDF-15 as a potential marker of atherosclerotic vascular changes, the severity of myocardial hypertrophy, and the severity of heart failure.
Cardiac resynchronization therapy: potential for arrhythmic risk modification
Authors: Ilov N. N. , Boitsov S. A. , Krivosheev Yu. S. , Nechepurenko A. A. 
Published: June 2023

Aim. To evaluate the impact of cardiac resynchronization therapy (CRT) on the risk of sustained ventricular tachyarrhythmias (VT) in patients with heart failure (HF) with a implantable cardioverter-defibrillator (ICD) for the primary prevention of sudden cardiac death.Material and methods. This single-center prospective clinical study included 470 patients (men, 84%) with HF at the age of 57 (51-62) years with a left ventricular ejection fraction (LVEF) of 29 (25-33)%. There were following exclusion criteria: indications for cardiac surgery, known channelopathies, previously registered VT. Depending on intraventricular conduction disorders, dual-chamber ICDs (42%) or CRT-D (58%) were implanted. After ICD implantation, patients were followed up for 24 months to register the end point — a first-time sustained paroxysm of VT detected by the ICD. A positive response to CRT was established in the case of an increase in LVEF by ≥5% of the initial level.Results. A total of 388 patients underwent full postoperative follow-up. The studied arrhythmic endpoint occurred on average 21 (0,6) months after implantation in 104 patients (27%) with higher frequency in the ICD group. However, the differences in the VT rate in the study groups were statistically unreliable (30% in the ICD group versus 24% in the CRT-D group, p=0,142). It was found that the VT rate was reliably lower in CRT-responders (118 patients, 53%): 15% compared to 32% in the group of inefficient CRT. A 5% increase in the LFEF reduced the probability of VT occurrence by 3 times (odds ratio [OR]=0,34; 95% of CI: 0,13-0,86; p=002). Significant modification of arrhythmic risk was verified by increasing LFEF to 36-40% (OR=0,72; 95% CI: 0,63-0,82; p=0,04).Conclusion. The results obtained indicate that effective CRT has the potential to modify arrhythmic risk in patients with HF, especially with an increase in LVEF to the level of 36-40%.
Mortality rates of acute types of coronary artery disease and sudden cardiac death in the Russian regions in 2019-2021
Authors: Samorodskaya I. V. , Bubnova M. G. , Akulova O. A. , Ostroushko N. I. , Drapkina O. M. 
Published: June 2023

Aim. To compare standardized mortality rates (SMR) from acute types of coronary artery disease (CAD) and sudden cardiac death (SCD) with an assessment of their regional variability in the Russian Federation in 2019-2021.Material and methods. Rosstat data on the average annual population and the number of deaths in one-year age groups for 2019-2021 in 82 Russian subjects from acute types of CAD and SCD were analyzed using following ICD-10 codes: I21.0-9 (acute primary) myocardial in­­farction (MI), I22.0-9 (recurrent MI), I20, I24.1-9 (other forms of acute coronary artery disease), I46.1 (SCD). SMR was calculated based on the European standard per 100,000 population. Average regional SMR values (M±SD), coefficients of variation (СV), nonparametric Wilcoxon T-test with Bonferroni adjustment were calculated (differences were considered significant at р<0,05).Results. The average regional values of SMR from the sum of causes (acute types of CAD and SCD for 2019, 2020 and 2021) did not change significantly and amounted to 52,3±33,72; 53,84±36,17; 53,58±34,55, respectively. The annual increase in the average regional SMR for this period was noted from acute MI — 23,59±11,01; 24,85±10,92; 25,73±11,38, and other OF CAD — 19,47±26,17, 19,78±27,45; 20,54±26,79, respectively, in 2019, 2020 and 2021. A significant decrease in SMR occurred only from recurrent MI: from 7,19±5,38 to 6,97±5,97 in 2019-2020 (p=0,048) and to 4,99±4,25 in 2021 (p=0,023 to 2020). In 18 constituent entities of the Russian Federation, an annual decrease in SMR was noted, and in the rest — multidirectional changes. The increase in SMR from acute MI took place in 23 subjects of the Russian Federation with a minimum CV in 2020 and 2021 (44%). The maximum CV for SMD was recorded in 2021 (169%).Conclusion. Mortality from acute types of CAD and SMD for 2019-2021 in the Russian Federation was characterized by a stable level and high regional variability. The problem of improving the criteria for establishing acute types of CAD and SMD as the initial cause of death remains relevant in the absence or insufficiency of data for universal criteria for MI.