Liver cirrhosis and left ventricle diastolic dysfunction: Systematic review

BACKGROUND Liver cirrhosis is a chronic hepatic disease which is associated with cardiovascular abnormalities.Hyperdynamic circulation in liver cirrhosis causes functional and structural cardiac alterations.The prevalence of left ventricle diastolic dysfunction(LVDD)in cirrhotic patients ranges from 25.7%to as high as 81.4%as reported in different studies.In several studies the severity of diastolic dysfunction(DD)correlated with a degree of liver failure and the rate of dysfunction was higher in patients with decompensated cirrhosis compared with compensated.Future directions of comprehensive assessment of cardiac function in cirrhotic patients might provide a better prognosis for these patients.AIM To clarify the correlation between the severity of liver cirrhosis and left ventricle diastolic dysfunction in the existing literature.METHODS Through January and February of 2019 at Vilnius University we conducted a systematic review of the global existing literature on the prevalence of left ventricle diastolic dysfunction in patients with liver cirrhosis.We searched for articles in PubMed,Medline and Web of science databases.Articles were selected by using adequate inclusion and exclusion criteria.Our interest was the outcome of likely correlation between the severity of cirrhosis[evaluated by Child-Pugh classes,Model For End-Stage Liver Disease(MELD)scores]and left ventricle diastolic dysfunction[classified according to American Society of Echocardiography(ASE)guidelines(2009,2016)],as well as relative risk of dysfunction in cirrhotic patients.Subgroup analyses were performed to evaluate the ratio and grades of left ventricle diastolic dysfunction with respect to cirrhosis severity.RESULTS A total of 1149 articles and abstracts met the initial search criteria.Sixteen articles which met the predefined eligibility criteria were included in the final analysis.Overall,1067 patients(out of them 723 men)with liver cirrhosis were evaluated for left ventricle diastolic dysfunction.In our systemic analysis we have found that 51.2%of cirrhotic patients had left ventricle diastolic dysfunction diagnosed and the grade 1 was the most prevalent(59.2%,P<0.001)among them,the grade 3 had been rarely diagnosed-only 5.1%.The data about the prevalence of diastolic dysfunction in cirrhotic patients depending on Child-Pugh Classes was available from 5 studies(365 patients overall)and only in 1 research diastolic dysfunction was found being associated with severity of liver cirrhosis(P<0.005).We established that diastolic dysfunction was diagnosed in 44.6%of Child-Pugh A class patients,in 62%of Child B class and in 63.3%of Child C patients(P=0.028).The proportion of patients with higher diastolic dysfunction grades increases in more severe cirrhosis presentation(P<0.001).There was no difference between mean MELD scores in patients with and without diastolic dysfunction and in different diastolic dysfunction groups.In all studies diastolic dysfunction was more frequent in patients with ascites.CONCLUSION This systemic analysis suggests that left ventricle diastolic dysfunction is an attribute of liver cirrhosis which has not received sufficient attention from clinicians so far.Future suggestions of a comprehensive assessment of cardiac function in cirrhotic patients might provide a better prognosis for these patients and give hint for better understanding of the left ventricle diastolic dysfunction pathogenesis in liver cirrhosis.

Meru University of Science and Technology Research Ethics Review System: A SWOT Analysis

The objectives of this article are as follows: 1) to propose a university research ethics system framework, 2) to provide a brief anatomy of the Meru University of Science and Technology (MUST) Institutional Research Ethics Review Committee (MIRERC), 3) to perform a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis of MIRERC, and 4) to make recommendations for improving its performance. The 13-member multi-disciplinary MIRERC was established in April 2017 to provide effective ethical oversight of research undertaken by the University’s scholarly community. Strengths of the MUST research ethics review system include a functional MIRERC, a pertinent national law and ethical guidelines, an Innovation and Enterprise Centre that could house a dedicated MIRERC Secretariat, and a supportive University Management Board. The weaknesses include lack of graduate schools to assure scientific rigor of proposals before submission to the MIRERC, lack of research ethics training in most school’s curricula, absence of a dedicated MIRERC Secretariat, undergraduate research proposals being not ethically reviewed, dearth of faculty trained in research ethics, and lack of an operating budget for MIRERC work. The opportunities include existence of about 22 accredited Institutional Research Ethics Review Committees (IRERC) in Kenya, existence of international standards and operational guidance for ethics review, availability of guidelines and codes of best ethical practices in research, existence of a free automated platform called Research for Health Innovation Organizer (RHInnO) Ethics for managing the ethics review process, and availability of external resources for strengthening IRERCs. In order to improve the performance and sustainability of the MUST research ethics system, there is need to include research ethics training in all undergraduate and post-graduate curricula, create a dynamic database of potential research ethics reviewers, allocate a percentage of the annual MUST research budget for MIRERC operations, charge a graduated fee for proposal ethics review, require all students’ and faculties’ internal and external research proposals be cleared by the MIRERC, and use the RHInnO Ethics platform to manage the ethics review process.

The Definition of Sustainable Development of Private University- Based on the Method of Literature Review and Cluster Analysis

The sustainable development of private university has become the focus of the academia and the private higher education after an approximately golden period.Through the method of literature review and cluster analysis,this paper studies the concept of sustainable development of private university from the perspective of the connotation definition and epitaxial recognition,in order to effectively reveal the essence of the sustainable development of private university,hoping to provide some certain support for the theory and practice of sustainable development of private university.

Left lateral decubitus sleeping position is associated with improved gastroesophageal reflux disease symptoms: A systematic review and meta-analysis

BACKGROUND A limited number of studies have demonstrated that sleeping in the left lateral decubitus(LLD)decreases nocturnal reflux in patients with gastroesophageal reflux disease(GERD)compared to right lateral decubitus(RLD)and supine.AIM This systematic review summarizes the association between sleeping in the LLD position and nocturnal reflux in patients with GERD.METHODS Studies published up to July 17,2023,in MEDLINE,EMBASE,and CENTRAL were searched.Eligible studies were randomized and nonrandomized studies assessing the effect of sleeping in LLD compared to RLD and supine in reducing nocturnal reflux in GERD patients.Outcomes include the acid exposure time(AET)(%time in pH<4),acid clearance time(ACT)(in sec/episode),number of reflux episodes,and improvement in N-GSSIQ scores.RESULTS Two nonrandomized studies showed decreased AET and ACT in LLD sleep position in comparison to RLD(mean difference[MD]-2.03[95%CI:-3.62 to-0.45];-81.84[95%CI:-127.48 to-36.20],respectively)and supine position(MD-2.71[95%CI:-4.34 to-1.09];-74.47[95%CI:-116.26 to-32.69],respectively).There was no difference in AET and ACT between RLD sleep position and supine.Furthermore,one randomized controlled trial investigating the use of electronic sleep positional therapy,which increased the duration of LLD sleep and decreased the duration of RLD sleep compared to sham,showed nocturnal symptoms improvement(improved N-GSSIQ score,increased reflux-free nights,and resolution of nocturnal reflux symptoms).CONCLUSION Current evidence suggests that sleeping on the left side could reduce nocturnal reflux and improve GERD-related quality of life,therefore warranting interventions that promote LLD sleep position.

On the Parliament Participation in the Universal Periodic Review of the United Nations Human Rights

Whether, and if so how, parliaments should participate in the Universal Periodic Review mechanism of the UN Human Rights Council is emerging. Due to their unique contributions to human rights protection and promotion, parliaments should participate in the process. Furthermore, some parliaments are already involved in this mechanism, including drafting national reports, engaging in interactive dialogues, and the implementation of review recommendations. In the past two rounds of reviews, China’s National People’s Congress has a positive record in this regard, but it should play a more active role in ratifying or acceding to international human rights conventions.

From Country-specific Review to Universal Periodic Review:A Fairer International Human Rights Mechanism

In the Country-specific by the Commission on Human Rights,developed countries lead selective supervision and review the human rights conditions in developing countries,contributing to the inequality in the roles of developed and developing countries and highlighting the unfairness and unreasonableness of the international human rights mechanism.In the Universal Periodic Review by the Human Rights Council,developed countries and developing countries are procedurally equal when evaluating the human rights conditions of other countries,and the evaluation of human rights conditions has transitioned from selective to universal.The development from the Country-specific Review to the Universal Periodic Review system is the result of China and other developing countries working together to optimize the internal governance structure of the Human Rights Council to rationalize its operational logic.Although the Universal Periodic Review system cannot immediately change the predominant status of the Western human rights discourse,it provides a mechanism for all countries to express their human rights values on an equal footing.It is an important manifestation of a fairer and more reasonable international human rights mechanism.

Human Rights NGOs and the United Nations Human Rights Council——Participation by the China Society for Human Rights Studies in the Universal Periodic Review Mechanism

Since its founding in 1993, the China Society for Human Rights Studies （CSHRS） has extensively participated inthe human rights work of the United Nations （UN） and has actively carried out international exchange and cooperation. In May 2012, the UN Human Rights Council （UNHRC） initiated the second round of country reviews on human rights.

A Review of Universal Grammar Concerning Second Language Acquisition Research

Chomsky’s Universal Grammar(UG)theory not only answers"the logical problem of language acquisition",but also provides insights and thoughts for second language acquisition(SLA)research on both theoretical and empirical level.However,there are many problems of UG-based research.On the theoretical aspect,UG-based approach left untouched many areas apart from"core grammar"and the continual development of the theory is problematic to second language researchers.On the empirical aspects,most experiments reveal problems with the design and data collection process.In short,the evaluation of UG concerning SLA should be developmental and comprehensive.

Stem cell mechanisms during left ventricular remodeling post-myocardial infarction:Repair and regeneration

Post-myocardial infarction(MI),the left ventricle(LV)undergoes a series of events collectively referred to as remodeling.As a result,damaged myocardium is replaced with fibrotic tissue consequently leading to contractile dysfunction and ultimately heart failure.LV remodeling post-MI includes inflammatory,fibrotic,and neovascularization responses that involve regulated cell recruitment and function.Stem cells(SCs)have been transplanted post-MI for treatment of LV remodeling and shown to improve LV function by reduction in scar tissue formation in humans and animal models of MI.The promising results obtained from the application of SCs post-MI have sparked a massive effort to identify the optimal SC for regeneration of cardiomyocytes and the paradigm for clinical applications.Although SC transplantations are generally associated with new tissue formation,SCs also secrete cytokines,chemokines and growth factors that robustly regulate cell behavior in a paracrine fashion during the remodeling process.In this review,the different types of SCs used for cardiomyogenesis,markers of differentiation,paracrine factor secretion,and strategies for cell recruitment and delivery are addressed.

Impact of Covid-19 on University Final Year Internship Students

Covid-19 has significantly changed the lives of millions of people worldwide, especially university students. The pandemic has a strong influence on university students, all of whom are concerned about their future. This paper addresses the issue of the impact of the pandemic on final-year internship students. The work’s goal is to illustrate how Covid-19 outbreaks in the last year have influenced final-year internship university students and their internships, internship opportunities, career prospects, psychological well-being, and motivation. The Covid-19 impact is so huge on education. The purpose of this study is to show how it hampers a specific sector, like university final year internship students. In the future, if anybody wants to know the situation of intern students at universities, they will get to know it. The work aims to examine and classify the fundamental problems that final year students have faced in finding an internship during the Covid-19 pandemic period, the obstacles they face in finding an internship, how universities help their students, how students get internships, why internship opportunities are getting limited, and how students overcome obstacles in finding an internship. To complete this research, first, we chose around 25 questions and worked on them to survey different university students in Bangladesh. The research was performed using reviews of different research papers and a survey approach. The survey has been developed using the Google Forms platform. Three hundred students who are currently studying at public and private universities in Bangladesh participated in the study. Students have been asked to answer 25 questions online. The data was evaluated concretely. Most of those students were from the last semester or last year of their university life. And in the end, we finally came to a conclusion about how the research worked. It creates a scenario where over 300 students have shared their thoughts on each aspect of the research questions. Whether they suffer or not, most of them find it pretty difficult to complete their internship because most of the participants were university final year students, and after completing all the research, the results can be written as if there was no situation like this, it would be much easier and more convenient for all the final year university interns.

左室收缩功能评估的超声新方法:心肌做功

心肌做功是一种无创评估左室收缩功能的超声新方法,其通过整合左室整体长轴应变和无创左室收缩压来评估心肌收缩功能。心肌做功能在心血管疾病的早期阶段评估左室整体和局部收缩功能,随访患者病情进展情况以及预后。为了让超声医师更好地理解和应用这一超声新方法,本文就心肌做功的概念、参数、正常参考值及临床应用做一评述。

Health financing for universal health coverage in Sub-Saharan Africa:a systematic review

Background:Universal health coverage(UHC)embedded within the United Nations Sustainable Development Goals,is defined by the World Health Organization as all individuals having access to required health services,of sufficient quality,without suffering financial hardship.Effective strategies for financing healthcare are critical in achieving this goal yet remain a challenge in Sub-Saharan Africa(SSA).This systematic review aims to determine reported health financing mechanisms in SSA within the published literature and summarize potential learnings.Methods:A systematic review was conducted aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)reporting guidelines.On 19 to 30 July 2019,MEDLINE,EMBASE,Web of Science,Global Health Database,the Cochrane Library,Scopus and JSTOR were searched for literature published from 2005.Studies describing health financing approaches for UHC in SSA were included.Evidence was synthesised in form of a table and thematic analysis.Results:Of all records,39 papers were selected for inclusion.Among the included studies,most studies were conducted in Kenya(n=7),followed by SSA as a whole(n=6)and Nigeria(n=5).More than two thirds of the selected studies reported the importance of equitable national health insurance schemes for UHC.The results indicate that a majority of health care revenue in SSA is from direct out-of-pocket payments.Another common financing mechanism was donor funding,which was reported by most of the studies.The average quality score of all studies was 81.6%,indicating a high appraisal score.The interrater reliability Cohen’s kappa score,κ=0.43(p=0.002),which showed a moderate level of agreement.Conclusions:Appropriate health financing strategies that safeguard financial risk protection underpin sustainable health services and the attainment of UHC.It is evident from the review that innovative health financing strategies in SSA are needed.Some limitations of this review include potentially skewed interpretations due to publication bias and a higher frequency of publications included from two countries in SSA.Establishing evidence-based and multi-sectoral strategies tailored to country contexts remains imperative.

开放科学背景下高校科技期刊同行评议优化的探讨

同行评议已经是科技期刊出版过程中的一个极其重要的环节。传统同行评议有其自身无法克服的偏倚。在开放科学的背景下,开放同行评议是传统同行评议的改进模式,其审稿流程更加公开透明,主要包括公开作者和审稿人身份、公开审稿内容、作者与审稿人之间或不同审稿人之间可以直接互相交流、开放公众参与、预印本、开放最终版本评论,以及开放平台。其中公开审稿内容、作者与审稿人之间或者不同审稿人之间可以直接互相交流以及开放最终版本评论可能比较适用于高校科技期刊采用,从而优化同行评议。

移动医疗在左心室辅助装置植入患者延续护理中的应用进展

介绍国内外各种移动医疗干预手段在左心室辅助装置植入患者延续护理中的应用现状、应用形式及内容、局限性及建议,以期为移动医疗在左心室辅助装置植入患者延续护理中的发展提供参考。

左心室辅助装置植入术后病人居家自我管理的研究进展

对左心室辅助装置(LVAD)植入术后居家康复病人的自我管理现状、自我管理症状感知、自我管理理论与模式、自我管理方法以及评估等进行综述,以期为居家康复病人的临床出院指导提供参考。

基于LDA主题模型的“双一流”高校图书馆用户评论文本数据挖掘

[目的/意义]图书馆用户评论中包含用户对图书馆服务和管理意见的重要信息,对用户评论文本进行深度挖掘,旨在探究用户关心主题及其情感态度、隐含诉求,为高校图书馆建设提供理论依据和数据支持。[方法/过程]以“双一流”高校图书馆为研究对象,收集用户在大众点评网上的评论数据,通过LDA主题建模,得到当前用户评论主要集中在信息资源建设、娱乐休闲服务、馆内设施环境三个维度,进而分别分析三个维度下的关键词共现网络和用户情感态度。[结果/结论]用户对高校图书馆的总体情感态度是积极正向的,但在纸质资源管理、社会化服务、馆内人性化服务等方面表现出负面情绪。

基于评阅意见的中医药院校博士学位论文质量保障的思考与建议

博士学位论文评阅是保障博士学位论文质量的重要手段。本文以浙江中医药大学2022年送审的73篇博士学位论文收到的446份评阅意见为研究对象,通过关键词词频分析等方法,分析中医药院校博士学位论文普遍存在的质量问题,提出改进博士生导师遴选条件及招生指标分配依据、提升博士研究生基本学术规范和科研能力、建立导师组博士生培养模式、重视博士研究生学位论文开题、严格博士学位论文预审、预答辩制度等方面着力保障中医药院校博士学位论文质量。

辨章学术守正本考镜源流求新知——南京中医药大学医史文献学科70年发展回溯与展望

南京中医药大学中医医史文献学科70年来经历了初创期(1954—1958)、成熟期(1959—1977)、发展期(1978—1999)和提升期(2000年至今)4个历史阶段。在一代代学科带头人和学术骨干呕心沥血的努力下,完成了多部具有里程碑意义的划时代中医药文献传世巨著,承担了多项国家级重大与重点项目。学科特色鲜明,以擅长整理编纂大型中医药工具书为成果标志,文献研究以注重实用性为导向,在研究领域以本草和方剂为工作重点,从而为现代临床、科研和教学提供有效信息。未来学科发展将在保持特色的基础上,充分利用新知识和新方法,开展中医药文献的信息化和数智化研究,培养更多优秀的高层次中医医史文献专业人才。

我国高校创新创业教育研究现状与展望——基于北大核心和CSSCI数据库文献的计量学分析

为全面系统地把握我国高校创新创业教育研究现状,采用文献计量分析法对中国知网(CNKI)1999—2023年收录的1166篇有关高校创新创业教育研究的北大核心和CSSCI数据库文献,从发文数量、作者分布、研究机构、期刊来源、基金分布、关键词与研究主题等方面进行深度剖析。研究发现:当前相关研究已进入成熟阶段,成果数量逐年增多;逐步出现核心作者,但未完全形成核心作者群;研究机构以师范类、综合类高校等为主阵地,区域研究力量分布不均;文献刊载期刊分布有向部分核心期刊集中的趋势;国家级和省部级基金项目是研究成果的主要资助来源,构建多元化基金资助体系尤为重要;当前研究主题多元,但仍有广阔视域和拓展空间。未来的研究需要在以下五个方面深化拓展:一是加大政策指引;二是深化研究主题;三是拓宽研究视野;四是注重多维融合;五是突出中国特色,从而提高该领域的研究层次和成果质量。

高校干部人事档案管理工作存在的问题及措施研究

高校干部人事档案管理是高校管理工作的重要组成部分,对于高校的选人用人、人才梯队建设以及教职工的职称晋升等方面都具有重要意义。本文以干部人事档案专项审核工作为视角,探讨高校人事档案管理工作存在的问题,提出改进高校干部人事档案管理工作的措施,旨在提高高等教育领域干部人事档案管理效率,推动高等学校干部人事档案管理工作朝着更加科学的方向发展。