Mitral Annular Forces and Their Potential Impact on Annuloplasty Ring Selection

Objectives: To provide an overview that describes the characteristics of a mitral annuloplasty device when treating patients with a specific type of mitral regurgitation according to Carpentier's classification of mitral regurgitation.Methods: Starting with the key search term “mitral valve annuloplasty,” a literature search was performed utilising PubMed, Google Scholar, and Web of Science to identify relevant studies. A systematic approach was used to assess all publications.Results: Mitral annuloplasty rings are traditionally categorised by their mechanical compliance in rigid-, semi-rigid-, and flexible rings. There is a direct correlation between remodelling capabilities and rigidity. Thus, a rigid annuloplasty ring will have the highest remodelling capability, while a flexible ring will have the lowest. Rigid- and semi-rigid rings can furthermore be divided into flat and saddled-shaped rings. Saddle-shaped rings are generally preferred over flat rings since they decrease annular and leaflet stress accumulation and provide superior leaflet coaptation. Finally, mitral annuloplasty rings can either be complete or partial.Conclusions: A downsized rigid- or semi-rigid ring is advantageous when higher remodelling capabilities are required to correct dilation of the mitral annulus, as seen in type I, type IIIa, and type IIIb mitral regurgitation. In type II mitral regurgitation, a normosized flexible ring might be sufficient and allow for a more physiological repair since there is no annular dilatation, which diminishes the need for remodelling capabilities. However, mitral annuloplasty ring selection should always be based on the specific morphology in each patient.

Tenecteplase vs. alteplase for acute ischemic stroke: a systematic review

Introduction Thrombolysis for acute ischemic stroke (AIS) with alteplase is the currently approved therapy for patients who present within 4.5 h of symptom onset and meet criteria. Recently, there has been interest in the thrombolytic tenecteplase, a modified version of alteplase, due to its lower cost, ease of administration, and studies reporting better outcomes when compared to alteplase. This systematic review compares the efficacy of tenecteplase vs. alteplase with regard to three outcomes: (1) rate of symptomatic hemorrhage, (2) functional outcome at 90 days, and (3) reperfusion grade after thrombectomy to compare the efficacy of both thrombolytics in AIS Methods The search was conducted in August 2021 in PubMed, filtered for randomized controlled trials, and studies in English. The main search term was “tenecteplase for acute stroke.” Results A total of 6 randomized clinical trials including 1675 patients with AIS was included. No one’s study compared alteplase to tenecteplase with all three outcomes after acute ischemic stroke; however, by using a combination of the results, this systematic review summarizes whether tenecteplase outperforms alteplase. Conclusions The available evidence suggests that tenecteplase appears to be a better thrombolytic agent for acute ischemic stroke when compared to alteplase.

Neologismen in Coronatijd – een steekproef

In times of crisis language is often enriched with new words called neologisms. After all, extraordinary circumstances call for new words. This also applies to the corona crisis. For example, the Dutch have had to deal with the anderhalvemetersamenleving and other corona measures. Moreover, the crisis has caused a lot of “corona damage”, both economically, psychologically and physically. The vaccination campaign has set the stage for a return to normality. This route also provides necessary neologisms. This article takes a look at which neologisms were used on one day in a particular newspaper. Since most neologisms consist of compound nouns, the sample will focus on these only. The De Volkskrant online edition, dated 16 April 2021, will be used for this purpose, using the articles obtained after entering the search term corona. After a short introduction to neologisms and the different types of compositions, the neologisms obtained are then categorised according to different composition categories and according to corona themes. Finally, a conclusion is drawn based on the results obtained.

Targeted therapy of irritable bowel syndrome with anti-inflammatory cytokines

Irritable bowel syndrome (IBS) is a multifactorial disease of which infection, as well as inflammation, has recently been considered as an important cause. Inflammation works as a potential pathway for the pathogenesis of IBS. In this review, we have discussed the targeted therapy of IBS. We used the search term “inflammation in IBS” and “proinflammatory” and “antiinflammatory cytokines and IBS” using PubMed, MEDLINE, and Google Scholar. The literature search included only articles written in the English language. We have also reviewed currently available anti-inflammatory treatment and future perspectives. Cytokine imbalance in the systematic circulation and the intestinal mucosa may also characterize IBS presentation. Imbalances of pro-and anti-inflammatory cytokines and polymorphisms in cytokine genes have been reported in IBS. The story of targeted therapy of IBS with anti-inflammatory cytokines is far from complete and it seems that it has only just begun. This review describes the key issues related to pro-inflammatory cytokines associated with IBS, molecular regulation of immune response in IBS, inhibitors of pro-inflammatory cytokines in IBS, and clinical perspectives of pro- and anti-inflammatory cytokines in IBS.

P-L09 Pyogenic Liver Abscess: a Retrospective Study of Patients Presenting to a UK Tertiary Liver Centre

Background Pyogenic liver abscess (PLA) carries a significant mortality of between 2-12%. The incidence is higher in East Asia than in Western countries, and recent data looking at PLA in western populations is limited. Increasingly, we find that PLA is primary in the liver rather than from a secondary source, even in the western world. The aim of this retrospective study is to analyse data on presentation and outcomes of PLA at a UK tertiary liver centre. Methods Data was collected on patients diagnosed with a PLA and treated at the University Hospital of Wales, Cardiff between December 2010 and December 2020. Patients were identified by searching the Cardiff Liver Unit surgical database and Radiology database using the search term “liver abscess”. Patients with an abscess secondary to gallbladder perforation into the liver were excluded. Data was gathered using the available electronic health records, including comorbidities, mode of presentation, cause of PLA, microbiology, treatment received (surgical, radiological drainage, or antibiotic therapy), and outcomes. Results There were 86 patients with a median age of 69 (16-91), Male:Female ratio was 2:1. Main symptoms were abdominal pain and fever; 61.6% (n = 53). Treatment was surgical in 49% (n = 42), US guided drainage in 21% (n = 18) and antibiotics only in 30% (n = 26). Mortality was 9.3% (n = 8), with a median age of 76, significantly higher than survivors (p = 0.012). In this group, Male:Female ratio was 7:1; proportion with >2 co-morbidities was 62%, compared with 39% of survivors; and there was a greater delay in diagnosis (average 4 days versus 2 days in survivors), although these factors were not statistically significant. Conclusions PLA is a serious infection that can lead to mortality. Forty percent of patients can present with non-specific symptoms and early imaging in this group is essential for diagnosis. In our cohort, significant number of patients were treated with surgery compared to the literature, with good outcomes. Although the numbers are small to be statistically significant, delayed diagnosis, multiple comorbidities, and male gender confer an increased risk of mortality, as does advanced age. We conclude that early diagnosis and referral to a Liver centre for opinion or management is essential for optimal outcomes.

A Systematic Review of Herbal Medicine in the Treatment of Cirrhotic Ascites

Objectives: The purpose of this study was to investigate the trend in the research on cirrhotic ascites using t herbal medicine.Methods: This review was conducted using six electronic databases(NDSL, KMBASE, Koreantk, KISS, KISTI, KoreaMed) with no restriction in year. The search term was ‘liver cirrhosis’, ‘ascites’, or ‘cirrhotic ascites’, ‘herbal medicine’, ‘traditional Chinese medicine’, and ‘randomized clinical trial’, and there was no restriction in year. The searched studies were analyzed according to the type of research.Results: After scanning the titles and abstracts, 13 articles were ultimately included. Of the outcome measures of 13 studies, effective rate, liver function test, and ascites regression time were included in the meta-analysis, which showed that the effective rate of herbal medicine-supportive treatment combination therapy was 1.27 times higher than that of supportive treatment alone, and the difference was statistically significant.Conclusions: We analyzed the trends of cirrhotic ascites treatment in herbal medicine through this review. It is necessary to conduct further studies, such as well-designed clinical trials based on the results from experimental research.

The effect of classroom acoustic conditions on literacy outcomes for children in primary school: A review

Literacy skills are essential for success in today’s society. However, classrooms often have suboptimal acoustic conditions for learning. The goal of this review was to synthesize research assessing the effect of different classroom acoustic conditions on children’s literacy. A comprehensive search of four online databases was conducted in August 2021. The search term was classroom AND (noise OR reverberation OR acoustics) AND (reading OR spelling OR writing OR literacy). Eighteen papers were deemed relevant for the review plus an additional seven from their references. The types of acoustic conditions that have been assessed, the types of measures used to assess literacy, and the effect of the acoustic conditions on children’s reading, writing, and spelling outcomes are discussed. Suggestions for the classroom acoustic conditions needed to ensure appropriate literacy development and areas for future research are also considered.

Pharmacogenetics of Biological Agents Used in Inflammatory Bowel Disease: A Systematic Review

Inflammatory Bowel Disease (IBD) comprises a group of disorders, in particular Crohn’s disease (CD) and ulcerative colitis (UC), characterized by chronic inflammation affecting the gastrointestinal tract. The treatment of these conditions is primarily based on anti-inflammatory drugs, although the use of biological drugs with lower side effects quickly increased in the last decade. However, the presence of certain polymorphisms in the population may determine a different outcome in response to therapy, reflecting the heterogeneity of the efficacy in patients. Considering that several studies showed important correlations between genetic polymorphisms and response to biological treatments in IBD patients, this systematic review aims to summarize the pharmacogenetics of biologicals approved for IBD, thus highlighting a possible association between some polymorphisms and drug response. With this purpose, we reviewed PubMed papers published over the past 21 years (2000–2021), using as the search term “drug name and IBD or CD or UC and polymorphisms” to underline the role of pharmacogenetic tests in approaching the disease with a targeted therapy.

Earth Observation Systems and Pasture Modeling: A Bibliometric Trend Analysis

An Earth observation system (EOS) is essential in monitoring and improving our understanding of how natural and managed agricultural landscapes change over time or respond to climate change and overgrazing. Such changes can be quantified using a pasture model (PM), a critical tool for monitoring changes in pastures driven by the growing population demands and climate change-related challenges and thus ensuring a sustainable food production system. This study used the bibliometric method to assess global scientific research trends in EOS and PM studies from 1979 to 2019. This study analyzed 399 published articles from the Scopus indexed database with the search term “Earth observation systems OR pasture model”. The annual growth rate of 19.76% suggests that the global research on EOS and PM has increased over time during the survey period. The average growth per article is n = 74, average total citations (ATC) = 2949 in the USA, is n = 37, ATC = 488, in China and is n = 22, ATC = 544 in Italy). These results show that the field of the study was inconsistent in terms of ATC per article during the study period. Furthermore, these results show three countries (USA, China, and Italy) ranked as the most productive countries by article publications and the Netherlands had the highest average total citations. This may suggest that these countries have strengthened research development on EOS and PM studies. However, developing counties such as Mexico, Thailand, Sri Lanka, and other African countries had a lower number of publications during the study period. Moreover, the results showed that Earth observation is fundamental in understanding PM dynamics to design targeted interventions and ensure food security. In general, the paper highlights various advances in EOS and PM studies and suggests the direction of future studies.

Deep learning—a first meta-survey of selected reviews across scientific disciplines, their commonalities, challenges and research impact

Deep learning belongs to the field of artificial intelligence, where machines perform tasks that typically require some kind of human intelligence. Deep learning tries to achieve this by drawing inspiration from the learning of a human brain. Similar to the basic structure of a brain, which consists of (billions of) neurons and connections between them, a deep learning algorithm consists of an artificial neural network, which resembles the biological brain structure. Mimicking the learning process of humans with their senses, deep learning networks are fed with (sensory) data, like texts, images, videos or sounds. These networks outperform the state-of-the-art methods in different tasks and, because of this, the whole field saw an exponential growth during the last years. This growth resulted in way over 10,000 publications per year in the last years. For example, the search engine PubMed alone, which covers only a sub-set of all publications in the medical field, provides already over 11,000 results in Q3 2020 for the search term ‘deep learning’, and around 90% of these results are from the last three years. Consequently, a complete overview over the field of deep learning is already impossible to obtain and, in the near future, it will potentially become difficult to obtain an overview over a subfield. However, there are several review articles about deep learning, which are focused on specific scientific fields or applications, for example deep learning advances in computer vision or in specific tasks like object detection. With these surveys as a foundation, the aim of this contribution is to provide a first high-level, categorized meta-survey of selected reviews on deep learning across different scientific disciplines and outline the research impact that they already have during a short period of time. The categories (computer vision, language processing, medical informatics and additional works) have been chosen according to the underlying data sources (image, language, medical, mixed). In addition, we review the common architectures, methods, pros, cons, evaluations, challenges and future directions for every sub-category.