Laparoscopic vs open hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a meta-analysis of the long-term survival outcomes

Background In patients with hepatocellular carcinoma (HCC) and cirrhosis, laparoscopic hepatectomy (LH) confers short-term benefits over open hepatectomy (OH) but the long-term outcomes of this procedure are unclear. This systematic review aims to compare the long-term survival outcomes of LH and OH for patients with HCC and underlying cirrhosis. Methods EMBASE, MEDLINE and Scopus databases were searched from date of inception to 7th October 2016. Controlled clinical studies comparing LH to OH for HCC in cirrhotic patients, which reported long-term overall and disease-free survival were included. The studies were evaluated using the MOOSE guidelines and Newcastle-Ottawa Scale. Data were extracted and analysed using a fixed-effects model. Results Five non-randomised, retrospective observational studies representing 888 patients were included. LH was associated with significantly lower tumour recurrence [OR: 0.65, 95% CI: 0.48, 0.89]. LH conferred greater overall survival at 1- [HR: 0.41, 95% CI: 0.25, 0.68], 3- [HR: 0.63, 95% CI: 0.46, 0.87] and 5-years [HR: 0.60, 95% CI: 0.45, 0.80]. With LH, there was higher disease-free survival at 1-year [HR: 0.71, 95% CI: 0.53, 0.96], but not at 3- [HR: 0.89, 95% CI: 0.70, 1.14]; and 5-years [HR: 0.85, 95% CI: 0.70, 1.04]. Conclusions Laparoscopic surgery is associated with comparable postoperative and survival outcomes in patients with HCC and underlying cirrhosis. With careful selection of patients, this approach is safe, feasible and advantageous

The role of joint distraction in the treatment of knee osteoarthritis: a systematic review and quantitative analysis

Introduction: Knee osteoarthritis is a major cause of pain and disability for which joint distraction is a potential treatment to delay the need for knee arthroplasty. This systematic review aims to assess the short- and long-term clinical and structural outcomes following knee joint distraction (KJD). Methods: MEDLINE, EMBASE, Scopus and Web of Science databases were searched from the date of inception to 26th June 2019. Clinical studies investigating joint distraction for knee osteoarthritis with outcomes including ∆WOMAC index, ∆VAS pain score and ∆joint space width were included. The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) – CRD42018087032. Results: Nine studies comprising a total of 507 patients were included. There were four randomised controlled trials (RCTs), five open prospective cohort studies and one case series. Overall, there were significant improvements in WOMAC index, VAS pain score and joint space width following KJD, which persisted up till nine years. KJD also demonstrated comparable clinical outcomes with HTO and TKA. Conclusion: There is moderate quality evidence supporting the beneficial outcomes of joint distraction for knee osteoarthritis. Larger RCTs with longer follow-up (>1 year) are necessary to establish the true effect size of this procedure

Joint distraction for knee osteoarthritis: protocol for a systematic review and meta-analysis

Background Osteoarthritis is a degenerative joint disease that is highly prevalent worldwide. Knee osteoarthritis is the most common form of osteoarthritis and is a major cause of pain and disability. However, there remains a lack of treatments available that have demonstrated effectiveness in stopping or reversing the degenerative process. Joint distraction has emerged as a viable alternative in the treatment of knee osteoarthritis to delay the need for knee arthroplasty. Methods An electronic search will be conducted on MEDLINE, EMBASE, Web of Science, CINAHL, Cochrane and EBSCO databases. Clinical studies investigating joint distraction for knee osteoarthritis, which reported clinical or structural outcomes including ∆WOMAC index, ∆VAS pain score and ∆joint space width will be included. Risk of bias will be assessed using the Newcastle-Ottawa Scale for observational studies and Cochrane Collaboration tool for randomised controlled trials. Quality of studies will be assessed using the modified Coleman methodology score. Discussion This systematic review will summarise the short- and long-term clinical and structural outcomes following joint distraction for knee osteoarthritis. The findings from this review will establish the quality of currently available evidence, which will determine the need for further studies to establish the true effect size of this procedure

Heuristically enhanced dynamic neural networks for structurally improving photovoltaic power forecasting

Among renewable generators, photovoltaics (PV) is showing an increasing suitability and a lowering cost. However, integration of renewable energy sources possesses many challenges, as the intermittency of these non-conventional sources often requires generation forecast, planning and optimal management. There exists scope to improve present PV yield forecasting models and methods. For example, the popular dynamic neural network modelling method suffers from the lack of a selection mechanism for an optimal network structure. This paper develops an enhanced network for short-term forecasting of PV power yield, termed a `focused time-delay neural network' (FTDNN). The problem of optimizing the FTDNN structure is reduced to optimizing the number of delay steps and the number of neurons in the hidden layer alone and this problem is conveniently solved through heuristics. Two such algorithms, a genetic algorithm and particle swarm optimization (PSO) have been tested and both prove efficient and can improve the forecasting accuracy of the dynamic network. Given the success of the PSO in solving this discontinuous structural optimization problem, it is expected that PSO offers potential in optimizing both the structure and parameters of a forecasting model

Pharmacological Effects of Grifolin: Focusing on Anticancer Mechanisms

Grifolin is a volatile compound contained in essential oils of several medicinal plants. Several studies show that this substance has been the subject of numerous pharmacological investigations, which have yielded interesting results. Grifolin demonstrated beneficial effects for health via its multiple pharmacological activities. It has anti-microbial properties against bacteria, fungi, and parasites. In addition, grifolin exhibited remarkable anti-cancer effects on different human cancer cells. The anticancer action of this molecule is related to its ability to act at cellular and molecular levels on different checkpoints controlling the signaling pathways of human cancer cell lines. Grifolin can induce apoptosis, cell cycle arrest, autophagy, and senescence in these cells. Despite its major pharmacological properties, grifolin has only been investigated in vitro and in vivo. Therefore, further investigations concerning pharmacodynamic and pharmacokinetic tests are required for any possible pharmaceutical application of this substance. Moreover, toxicological tests and other investigations involving humans as a study model are required to validate the safety and clinical applications of grifolin

RaKUn: Rank-based Keyword extraction via Unsupervised learning and Meta vertex aggregation

Keyword extraction is used for summarizing the content of a document and supports efficient document retrieval, and is as such an indispensable part of modern text-based systems. We explore how load centrality, a graph-theoretic measure applied to graphs derived from a given text can be used to efficiently identify and rank keywords. Introducing meta vertices (aggregates of existing vertices) and systematic redundancy filters, the proposed method performs on par with state-of-the-art for the keyword extraction task on 14 diverse datasets. The proposed method is unsupervised, interpretable and can also be used for document visualization.Comment: The final authenticated publication is available online at https://doi.org/10.1007/978-3-030-31372-2_2

Sustainable Engineering higher education in Oman-lessons learned from the pandemic (COVID-19), improvements, and suggestions in the teaching, learning and administrative framework

This research study has investigated the challenges faced due to the pandemic (COVID-19). This paper further provides recommendations that can be adopted by academics, learners, and administrators to make the education system more robust and sustainable. The impact of the COVID-19 pandemic can be felt in various fields across the world including higher education. The closure of face-to-face (FtF) learning in educational institutions worldwide has impacted over 95% of the world's student population. Therefore, in wake of this, many institutions have quickly adopted to offer complete online teaching and learning in a very short period. However, such a quick transition has raised several challenges. 1) What are the challenges encountered by academics and their readiness to adapt to the rapid remote learning transition? 2) What are the challenges encountered by learners (students), and their readiness to adapt to the rapid remote learning transition? 3) What are the recommendations for strategic planners or high-level administrators in institutions to tackle such pandemic risks effectively in the future? To address research questions mixed methods are used. A qualitativequestionnaire survey is framed by an extensive literature review to understand the perceptions of academics and learners. A total of (n=525) academician samples and (n= 1460) student samples have been collected. The academic and learner's perceptions are analyzed by estimating the Pearson correlation coefficients. The mean and SD values based on academic rank stood at 3.01±0.96, and by experience stood at 2.96±0.98. Similarly, learner's perceptions stood at 2.67±0.95

Economic Impact of Dyspepsia in Rural and Urban Malaysia: A Population-Based Study

Background/Aims : The economic impact of dyspepsia in regions with a diverse healthcare system remains uncertain. This study aimed to estimate the costs of dyspepsia in a rural and urban population in Malaysia.Methods Economic evaluation was performed based on the cost-of-illness method. Resource utilization and quality of lifedata over a specific time frame, were collected to determine direct, indirect and intangible costs related to dyspepsia. Results The prevalences of dyspepsia in the rural (n = 2,000) and urban (n = 2,039) populations were 14.6% and 24.3% respectively. Differences in socioeconomic status and healthcare utilisation between both populations were considerable. The cost of dyspepsia per 1,000 population per year was estimated at USD14,816.10 and USD59,282.20 in the rural and urban populations respectively. The cost per quality adjusted life year for dyspepsia in rural and urban adults was USD16.30 and USD69.75, respectively.Conclusions The economic impact of dyspepsia is greater in an urban compared to a rural setting. Differences in socioeconomic status and healthcare utilisation between populations are thought to contribute to this difference

Air gap membrane distillation: A detailed study of high saline solution

An experimental study is used to examine the effect of high concentration of several salts, i.e., NaCl, MgCl2, Na2CO3 and Na2SO4 on permeate flux and rejection factor by air gap membrane distillation (AGMD). A comparative study involving three different membrane pore sizes (0.2, 0.45 and 1.0 μm) were performed to investigate the influence of pore size on energy consumption, permeate flux and rejection factor. The permeate flux decline is higher than that predicted from the vapour pressure reduction. Furthermore, the energy consumption was monitored at different membrane pore size and was found to be increased when the concentration increased

Recapitulation of Human Retinal Development from Human Pluripotent Stem Cells Generates Transplantable Populations of Cone Photoreceptors

Transplantation of rod photoreceptors, derived either from neonatal retinae or pluripotent stem cells (PSCs), can restore rod-mediated visual function in murine models of inherited blindness. However, humans depend more upon cone photoreceptors that are required for daylight, color, and high-acuity vision. Indeed, macular retinopathies involving loss of cones are leading causes of blindness. An essential step for developing stem cell-based therapies for maculopathies is the ability to generate transplantable human cones from renewable sources. Here, we report a modified 2D/3D protocol for generating hPSC-derived neural retinal vesicles with well-formed ONL-like structures containing cones and rods bearing inner segments and connecting cilia, nascent outer segments, and presynaptic structures. This differentiation system recapitulates human photoreceptor development, allowing the isolation and transplantation of a pure population of stage-matched cones. Purified human long/medium cones survive and become incorporated within the adult mouse retina, supporting the potential of photoreceptor transplantation for treating retinal degeneration