bluuebunny/crossref_metadata_2025_split huggingface dataset:
Principles of diagnosis and treatment of alcohol-induced liver fibrosis
Authors: Garbuzenko D. V. 
Published: May 2022

Alcohol-related liver diseases are one of the leading causes of death worldwide, primarily due to complications of liver cirrhosis (LC). Early detection of alcohol-induced liver fibrosis (LF) is a difficult task, since often alcoholic liver disease (ALD) is clinically manifested only at late stages. Given that not all alcoholic suffer from ALD, the widespread use of liver biopsy to verify the diagnosis is not advisable. Despite the variety of proposed non-invasive methods for assessing the severity of LF in patients with ALD, none of them has sufficient validation and therefore cannot be recommended for widespread use in clinical practice. The most well-studied transient elastography, due to its suboptimal specificity, can be effectively used only to exclude clinically significant LF or LC. The only proven approach to treat ALD is persistent and total alcohol abstinence. While the therapeutic options for patients with severe forms of acute hepatitis remain unchanged since the 70s of the last century and are based mainly on the use of corticosteroids, currently, there are no approaches to antifibrotic therapy of ALD approved by the guidelines. At the same time, modern achievements in understanding the pathophysiological mechanisms of this disease have served as an impetus for the development of ways to solve the problem. In particular, providing intestinal eubiosis may be an important goal for the prevention and treatment of alcohol-induced LF. Randomized controlled multicenter trials involving a large number of patients are needed to confirm this and other hypotheses related to antifibrotic therapy of ALD and to accept them as a standard of medical care.
Real clinical practice of complicated Crohn’s disease treatment with ustekinumab: clinical case presentation
Authors: Makarchuk P. A. , Lomakina E. Yu. , Belousova E. A. , Dubrova S. E. 
Published: May 2022

Crohn’s disease (CD) is a severe immune-mediated disease with segmental transmural inflammation and ulcers in gastrointestinal tract most often in terminal ileum and colon. The disease is often associated with severe complications such as fistulas and strictures that require aggressive treatment or surgery. CD treatment remains the unresolved and one of the most serious problems in gastroenterology. Glucocorticosteroids (GCS) are the essential treatment options for many years but unfortunately the frequency of steroid resistance and steroid dependence are constantly increasing. In the cases of steroid refractory CD treatment options include biologics of different classes: tumour necrosis factor alfa - inhibitors (iTNF-α), α4β7 integrin inhibitor (vedolizumab), IL-12/23 inhibitor (ustekinumab). Any of these drugs can be used in bio-naïve CD patients, however secondary loss of response was noted for all biologics over time.In the cases of the first line treatment failure the problem of correct choice of the second and subsequent lines of biologics appears, since some biologics may show lower efficacy in the second line of treatment. Real clinical practice will allow us to make a more correct choice of next biologic. Ustekinumab, a human interleukin -12/23 monoclonal antibody is one of biologics that is highly effective in the first-line CD therapy and remains effective in the subsequent lines of treatment. We present a clinical case of complicated CD in young female with negative disease prognosis and loss of response to three iTNF-α. In this case the high efficacy of ustekinumab after multiple iTNF-α failure was demonstrated.
Disorders of intestinal microbiocenosis: expanding the application of probiotics
Authors: Trukhan D. I. 
Published: May 2022

The problem of interaction between a person and the intestinal microbiome is surrounded by many secrets and mysteries. The bacterial flora of the gastrointestinal tract has a local and systemic effect not only on the digestive system, but also on the entire body as a whole. Numerous studies have proved the pathogenetic relationship of the state of the intestinal biocenosis not only with diseases of the gastrointestinal tract, but also with pathological processes from other organs and systems of the body. In terms of its role in maintaining homeostasis, the intestinal microflora is not inferior to any other vital organ. In the presented review, the current aspects of the terminology and clinic of disorders of intestinal microbiocenosis are considered. Probiotics occupy an important place in the complex therapy of intestinal microbiocenosis disorders and the corresponding clinical manifestations. The review considers the main mechanisms of probiotic / host interaction, non-immunological and immunological effects of probiotics and the requirements for them, the main directions of use of representatives of the normal microflora Bifidobacterium and Lactobacillus. The data of meta-analyzes and systematic reviews, testifying to the expansion of indications for the appointment of probiotics, are considered the possibilities of probiotics in the complex therapy of Helicobacter pylori infection, syndrome of increased epithelial intestinal permeability, and the prevention of respiratory infections.The review concludes with the results of a search in the PubMed database on the possibility of using probiotics in the prevention and treatment of a new coronavirus infection COVID-19. The availability of modern, effective and safe probiotics in the arsenal of a practical doctor (primarily a general practitioner and general practitioner), and their use, contributes to the optimization of drug therapy not only in gastroenterological patients, but also in patients with other somatic pathologies, including those with new coronavirus infection COVID-19.
Functional gastrointestinal diseases: mechanisms of development and principles of multitarget therapy
Authors: Maev I. V. , Andreev D. N. , Zaborovsky A. V. , Lobanova E. G. 
Published: May 2022

Currently, functional dyspepsia (FD) and irritable bowel syndrome (IBS) are among the most common nosological units in the structure of functional gastrointestinal diseases in adults. An important problem of treatment of these diseases at the current stage of medicine is low efficiency of monotarget drugs, which is determined by multicomponent pathogenesis. Indeed, the currently available methods of drug treatment of FD and IBS have suboptimal efficacy, as illustrated by recent meta-analyses demonstrating high rates of NNT (the average number of patients who need to be treated to achieve a certain favorable outcome). In addition, the frequent “overlap” of these diseases forces clinicians to prescribe several drugs with different pharmacological actions to the patient, which inevitably leads to a decrease in compliance. The optimal strategy for managing patients with FD and IBS is the tactics of multitarget drugs that act on several links in the pathogenesis of these pathologies and have a significant evidence base in the effectiveness and safety of use. STW 5 (Iberogast®), included in the clinical guidelines of the Russian Gastroenterological Association on the diagnosis and treatment of patients with FD, published in 2017, has the above-mentioned characteristics, as well as the clinical guidelines of the Russian Gastroenterological Association in collaboration with the Russian Association of Coloproctologists on the diagnosis and treatment of IBS, published in 2021. The clinical effectiveness of Iberogast in the treatment of FD and IBS has been demonstrated in a number of randomized trials, the results of which showed high efficacy of the drug and its good tolerability.
Mechanisms of impact on the soil environment of drip irrigation applying treated sewage effluent: a review in China
Authors: Qiu Zhenjie , Sun Mengying 
Published: May 2022

Abstract
Due to the severe shortage of water resources, more than 33.3% of treated sewage effluent (TSE) is used for agricultural irrigation in China. There are significant advantages of using drip irrigation of TSE. However, it is still not known how TSE drip irrigation influences the soil environment. It is known that drip irrigation technical parameters determine the distribution of TSE in soil and have a substantive effect on the soil environment, while the magnitude of these impacts depends on the TSE quality. Since the application of conventional water resources is limited, TSE is expected to be used more frequently for agricultural irrigation. The growing concern of soil environmental risk due to TSE drip irrigation requires further study of the interaction and coupling of drip irrigation and TSE. This summary will help understand TSE drip irrigation in China, and guide the practice of reclaimed water utilization in the future.
Comprehensive Analysis of Epigenetic Associated Genes with Differential
Gene Expression and Prognosis in Gastric Cancer
Authors: Li Yan , An Songlin , Li Xinbao , Li Bing 
Published: May 2022

Background:
Gastric cancer (GC) is the most common malignancy of the human digestive
system and represents the second leading cause of cancer-related deaths. As early GC is generally
mild or asymptomatic and advanced GC is commonly diagnosed, early detection has a significant
impact on clinical outcomes. This study aimed to identify epigenetic factors (EFs) as potential
GC biomarkers.

Methods:
We identified 3572 differential expressed genes (DEGs) from 436 GC tissues and 41
non-tumor adjacent samples through The Cancer Genome Atlas (TCGA) datasets. Among them, a
total of 57 overlapped genes were identified as differentially expressed EFs (DE-EFs), including 25
up-regulated DE-EFs and 32 down-regulated DE-EFs.

Results:
Then, Gene Ontology (GO) enrichment analysis revealed that the DE-EFs were mainly
associated with histone modification, chromatin remodeling, histone binding, modificationdependent
protein binding, etc. Meanwhile, Kyoto Encyclopedia of Genes and Genomes (KEGG)
analysis results suggested that RNA degradation, thermogenesis, shigellosis, insulin resistance,
AMPK, and FoxO signaling pathways play roles in the progression of GC. Subsequently, Cox
regression and Kaplan-Meier analysis showed that higher expression levels of the three hub EFs,
including BRCC3, USP12, and WAC, were associated with better patients’ OS. We also found that
GC patients in the TCGA dataset with the earlier stage of TNM stage, invasion, depth of tumor,
lymph node metastasis, distant metastasis, and younger age had significantly better GC patients’
OS.

Discussion:
Furthermore, as the pathway enrichment analysis showed that BRCC3 participated in
NOD-like receptors (NLRs)-mediated signaling and the homologous recombination (HR) pathways,
strong and statistically significant positive relationships were found between BRCC3 with
genes in NLRs signaling and HR pathways, including BRCA1, BRCA2, Rad51, BRE, TOPBP1,
HSP90AA1, CASP1, NEK7, and SUGT1, respectively.

Conclusion:
We found three hub EFs, namely BRCC3, USP12, and WAC, which were downregulated
in GC tissues compared to normal tissues, associated with the overall survival of GC patients
and could be used as potential biomarkers to predict prognosis in GC patients. The regulation of
hub genes in GC may promote the exploration of the epigenetic mechanisms associated with tumorigenesis
and provide potential targets for GC diagnosis and treatment.
Tele-Mindfulness for Dementia's Family Caregivers: A Randomized Trial
with a Usual Care Control Group
Authors: Zarei Shadi , Lakhanpal Gita , Sadavoy Joel 
Published: May 2022

Background:
Caring for a family member with dementia is stressful and challenging. Family
caregivers, as a vulnerable marginalized population and invisible backbone of the health care system,
need accessible and effective interventions that are tailored to their particular needs.

Objectives:
The objective of this study was to evaluate the feasibility and effectiveness of a live online
mindfulness-based cognitive therapy (tele-MBCT) intervention for family caregivers of individuals with
dementia.

Method:
Family caregivers were assigned to a tele-MBCT intervention or a usual care control group.
Tele-MBCT participants attended eight weekly live online training and practiced mindfulness practices
at home. All participants completed surveys at baseline, post-intervention, and 4-week follow-up.

Results:
26 participants (age 60±13 years) were enrolled and randomized (14 in the intervention and 12
in the control group), and 92.3% completed the study. 88% of the participants were female, and 70%
were caring for a parent for a mean of 5.12±2.88 years. 84% of the participants in the intervention group
attended at least seven sessions and the average of daily practice was 23.58±45.71 minutes. All participants
were satisfied with the intervention, and 88.8% were satisfied with the online delivery method.
Participants in the intervention group showed Pre-Post improvement in self-compassion (t (11) = -2.49,
p=0.03) and coping strategies (t (11) = 3.62, p=0.004) compared to the control group.

Conclusion:
Tele-MBCT is a feasible intervention and may improve psychological outcomes and adaptive
coping in family caregivers of individuals with dementia. A larger controlled trial is warranted.
Pathophysiology Associated with Diabetes-induced Tauopathy and Development
of Alzheimer’s Disease
Authors: Sur Debjeet , Sarkar Poulami , Banu Sarmin , Bhattacharya Sanchari , Bala Asis 
Published: May 2022

Abstract:
Alzheimer’s disease (AD) is the most common type of dementia that affects the elderly
around the world. Chronic type 2 diabetes (T2DM) has been proven to be closely related to neurodegeneration,
especially AD. T2DM is characterized by the cell's failure to take up insulin as well
as chronic hyperglycemia. In the central nervous system, insulin plays vital regulatory roles, while
in chronic hyperglycemia, it leads to the formation and accumulation of advanced glycation end
products (AGEs). Inflammation plays a crucial role in development of insulin resistance in AD and
T2DM. The microtubule-related protein tau is involved in the pathogenesis of several neurological
diseases known as tauopathies, and is found to be abnormally hyperphosphorylated in AD and accumulated
in neurons. Chronic neuroinflammation causes the breakdown of the blood-brain barrier
(BBB) observed in tauopathies. The development of pro-inflammatory signaling molecules, such
as cytokines, chemokines from glial cells, neurons and endothelial cells, decides the structural integrity
of BBB and immune cell migration into the brain. This review highlights the use of antidiabetic
compounds as promising therapeutics for AD, and also describes several new pathological
molecular mechanisms associated with diabetes that increase AD pathogenesis.
Exophytic Renal Urothelial Carcinoma Versus Renal Clear-cell Carcinoma: Clinical Data and Computed Tomography Findings
Authors: Long Liling , Chen Xin , Chen Yidi , Lei Yiwu , Huang Fuling , Tang Cheng 
Published: May 2022

Background:Distinguishing exophytic renal urothelial carcinoma (ERUC) from exophytic renal clear-cell carcinoma (ERCCC) with collecting system invasion may be difficult as they involve similar locations and collecting system invasion.Objective:The study aimed to characterize the clinical data and computed tomography (CT) features that can aid in differentiating ERUC from ERCCC.Methods:Data from 17 patients with ERUC and 222 patients with ERCCC were retrospectively assessed. CT and clinical features exhibiting significant differences in t-tests/Mann-Whitney U-test and chi-square tests/Fisher’s exact tests were analyzed using receiver operating characteristic (ROC) curves. Variables with an area under the curve (AUC) <0.7 were excluded. Univariate logistic regression analysis was used to analyze the associations of CT and clinical features with ERUC or ERCCC. Variables with odds ratio (OR) values being close to 1 in univariate logistic regression were excluded from multivariate logistic regression. A predictive model was then constructed based on the predictors (p<0 in multivariate logistic regression). Differential diagnostic performance was assessed with AUC values.Results:Multivariate logistic regression analysis identified preserving reniform contour (OR: 45.27, 95% confidence interval [CI]: 4.982–411.39) and infiltrative growth pattern (OR: 21.741, 95% CI: 1.898–249.049) as independent predictors that can be used to distinguish ERUC from ERCCC. AUC values for preserving reniform contour, infiltrative growth pattern, and Model-1 were 0.907 (95% CI: 0.817-0.998), 0.837 (95% CI: 0.729-0.946), and 0.947 (95% CI: 0.874–1), respectively.Conclusion:The independent predictors and predictive model may play an important role in preoperative differentiation between ERUC and ERCCC.
MR Features of Varicella-zoster Myelitis in an Immunocompetent Patient
Authors: Polat Yagmur Basak , Kula Asli Yaman , Balsak Serdar , Oran Zeynep , Alkan Alpay 
Published: May 2022

Background:
Varicella-zoster virus (VZV) is a latent virus that can remain in the central
nervous system. Reactivation of the virus can cause some neurologic manifestations, and myelitis is
one of the rarest of them. In this report, we aimed to present the MRI features of long-segment cervical
myelitis after VZV infection, which is rarely reported in the literature.

Case Presentation:
A 69-year-old patient, who was diagnosed with varicella-zoster two months ago
and treated with valacyclovir, was admitted to our clinic with worsening of his complaints and weakness
in the right upper extremity. Neurological examination was normal in the left upper and bilateral
lower extremities, but the muscle strength in the right upper extremity was evaluated as 4/5 grade.
While rare leukocytes (10 leukocytes/mm³, 50 erythrocytes/mm³, high protein level (46 mg/dl, ref.15-
40 mg/dl)) were seen in the cerebrospinal fluid (CSF) analysis, no microorganisms were seen, and no
growth was observed in the culture. VZV antibody-immunoglobulin G (Ab-IgG) was positive in CSF,
while polymerase chain reaction [PCR] for VZV was negative. On cervical MRI, lesions showing T2
hyperintensity were observed from the C3-4 level to the C7-T1 level, eccentrically located in the right
paramedian spinal cord. On post-contrast images, patchy heterogeneous contrast enhancement was
noted in these regions of the spinal cord. When the patient's history, CSF features and MRI examinations
were evaluated together, the lesions were consistent with VZV myelitis. The patient was started
on valacyclovir treatment, and during the follow-up, the patient's complaints decreased, while no progress
was observed in neurologic symptoms.

Conclusion:
As a result, we aimed to report the MRI features of this rare complication of varicellazoster
and emphasize the necessity of keeping this in mind in the etiology of myelitis, especially in
cases with patchy enhancement, to achieve early diagnosis and treatment.
Evaluation of Fetal Head Circumference (HC) and Biparietal Diameter
(BPD (Biparietal Diameter)) in Ultrasound Images Using Multi-Task Deep
Convolutional Neural Network
Authors: Mohideen Kother , Joharah Fathimuthu 
Published: May 2022

Introduction:
Ultrasound imaging is a standard examination during pregnancy that can measure specific biometric parameters towards prenatal diagnosis and estimating gestational age. Fetal head circumference (HC) is a significant factor in determining fetus growth and health.

Methods:
This paper proposes a multi-task deep convolutional neural network for automatic segmentation and estimation of HC (Fetal head circumference) ellipse by minimizing a compound cost function composed of segmentation dice score and MSE of ellipse parameters. Ultrasound-based fetal biometric measurements, such as head circumference (HC) and biparietal diameter (BPD (BIPARIETAL DIAMETER)), are commonly used to evaluate the gestational age and diagnose fetal central nervous system (CNS) pathology. Since manual measurements are operator-dependent and time-consuming, there have been numerous researches on automated methods. However, existing computerized methods still are not satisfactory in terms of accuracy and reliability, owing to difficulties in dealing with various artefacts in ultrasound images.

Results:
This paper focuses on fetal head biometry and develops a deep-learning-based method for estimating HC (Fetal head circumference) and BPD (BIPARIETAL DIAMETER) with a high degree of accuracy and reliability.

Conclusion:
The proposed method effectively identifies the head boundary by differentiating tissue image patterns concerning the ultrasound propagation direction. The proposed method was trained with 102 labelled data set and tested to 70 ultrasound images. We achieved a success rate of 92.31% for HC (Fetal head circumference) and BPD (BIPARIETAL DIAMETER) estimations and an accuracy of 87.14% for the plane acceptance check.
Disposal Practices of Expired and Unused Medications Among Households
in Punjab, Pakistan
Authors: Shah Shahid , Abbas Ghulam , Hanif Muhammad , Ali Mohsin , Rehman Anees Ur , Chand Usman Rashid , Khurram Haris 
Published: May 2022

Background:
The practice of disposing expired or unused medications by different
households is generally not considered and is largely neglected.

Objective:
The study was carried out to determine the disposal practices regarding expired and unused
medications in rural areas of Punjab, Pakistan.

Methods:
The study was conducted by interviewing different households and students (rural areas)
from different universities in Punjab, Pakistan. The sample size was 676 and the questionnaire was
used for data collection.

Results:
Out of 676 members, 552 (81.6%) had medications at the time of the visit. Only 14.5%
(n= 80) were taking medication. Only 14.5% (n = 80) kept medication because the treatment was
still in progress with the patients while 85.5% (n= 472) had medications that should be discarded. The
main reasons for keeping the unused medications at home were completed treatment 34.7% (n= 164) after
recovering from ailment. About 60.57% of female disposed the drugs in domestic trash while majority
of male participants (48.72%) buried the drugs in the ground. Over 80% of respondents (n = 542)
were unaware of the disposal methods. Almost half of the participants (n= 322) had no information
about the impact of improper disposal. Statistically significant variations (p<0.001) were observed in the
disposal practices depending on gender, age, education and occupation.

Conclusion:
Improper disposal of medication is a common practice in rural areas of Punjab, Pakistan.
The launch of public education programs and the development of drug disposal facilities are
very necessary to protect the environment and community health.
Side Effects of Chronic Methadone Use in Opioid Addiction: A Scoping
Review on Hematological Derangements
Authors: Khalid Karniza , Anuar Amalina , Ang Wei Chern , Jamaluddin Ruzita 
Published: May 2022

Background:
Per oral methadone maintenance therapy [MMT] was introduced as part
of harm reduction strategy to manage rising numbers of HIV infections caused by intravenous use
of illicit drugs.

Method:
We aim to review published articles related to the side effects of long-term methadone
therapy, focusing on hematological derangements in human studies published between 1 January
2000 till 31 January 2021.

Results:
Our search databases include Web of Science, Scopus, and Medline. Our search yielded
971 articles, of which 55 articles were related to the effects of MMT on various organ systems:
cardiovascular [n=12], respiratory [n=1], endocrine [n=10], central nervous system [n=12], neurobehavioral
[n=10], gastrointestinal [n=1], and bone [n=1]. There were eight articles specifically related
to the hematological side effects of chronic methadone therapy that include [i] immune system
hyperactivation, [ii] reduced circulating lymphocytes, and [iii] increased blood viscosity.

Conclusion:
In view of all foreseeable health risks seen with prolonged methadone therapy, pharmacological
modulation is warranted to find a better substitute for managing patients with opioid
dependence.