bluuebunny/crossref_metadata_2025 huggingface dataset:
Small RNA Mcr11 requires the transcription factor AbmR for stable expression and regulates genes involved in the central metabolism of Mycobacterium tuberculosis
Authors: Girardin Roxie C. , McDonough Kathleen A.
Published: November 2019

Mycobacterium tuberculosis (Mtb), the etiologic agent of tuberculosis, must adapt to host‐associated environments during infection by modulating gene expression. Small regulatory RNAs (sRNAs) are key regulators of bacterial gene expression, but their roles in Mtb are not well understood. Here, we address the expression and function of the Mtb sRNA Mcr11, which is associated with slow bacterial growth and chronic infections in mice. We found that stable expression of Mcr11 requires multiple factors specific to TB‐complex bacteria, including the AbmR transcription factor. Bioinformatic analyses used to predict regulatory targets of Mcr11 identified 7–11 nucleotide regions with potential for direct base‐pairing with Mcr11 immediately upstream of Rv3282, fadA3, and lipB. mcr11‐dependent regulation of these genes was demonstrated using qRT‐PCR and found to be responsive to the presence of fatty acids. Mutation of the putative Mcr11 base‐pairing site upstream of lipB in a promoter reporter strain resulted in significant de‐repression of lipB expression, similar to that observed in mcr11‐deleted Mtb. These studies establish Mcr11’s roles in regulating growth and central metabolism in Mtb. Our finding that multiple TB‐complex‐specific factors are required for production of stable Mcr11 also emphasizes the need to better understand mechanisms of sRNA expression and stability in TB.
Cultural nationalism of the interwar period: Latvian visual art and folklore
Authors: Ķencis Toms
Published: November 2019

The interwar period in Europe marks a tendency towards authoritarian leaders in politics as well as the classicizing practices of the visual arts. However, the extent and modality of both tendencies vary from state to state: mapping differences and similarities leads towards greater understanding of each national history. The particularity of Latvian art life is a comparatively substantial use of folklore motifs and representation of pagan mythology, going hand in hand with overall ethnolinguistic nationalism agenda and related state cultural policy. Despite the coexistence of various artistic styles, in regard to content and intentions of artworks, the interwar period can be characterized by the turn from National Romanticism to Romantic Nationalism. The historical outline and theoretical discussion of folklore representations are illustrated by three case studies, analysing the biographies, ideas, and works of Latvian artists Ansis Cīrulis, Jēkabs Bīne, and Niklāvs Strunke.
Symptom variability throughout the day in patients with gastroparesis
Authors: Shahsavari Dariush , Yu Daohai , Jehangir Asad , Lu Xiaoning , Zoll Bryan , Parkman Henry P.
Published: November 2019

Background

Symptoms of gastroparesis (Gp) can fluctuate at different times of the day. Our aims are (1) To characterize Gp symptom variability throughout the day and in relation to meals and (2) to compare the daily symptom variability in subtypes of Gp—diabetic gastroparesis (DGp) and idiopathic gastroparesis (IGp).

Methods

Patients with Gp filled Patient Assessment of Gastrointestinal Symptoms (PAGI‐SYM) and completed a modified GCSI‐DD seven times a day (GCSI‐Throughout the Day [GCSI‐TTD]; before and after meals, and before going to bed) over a 2‐week period.

Key Results

A total of 44 patients participated (86% females), including 29 (66%) with IGp, 13 (30%) with DGp, and 2 (4%) with postsurgical Gp. Using the GCSI‐TTD, patients with Gp reported significant postprandial worsening of overall symptom severity, as well as severities of nausea, early satiety, stomach fullness, and abdominal pain. Patients also had progressive worsening of the overall symptom severity, early satiety, stomach fullness, and abdominal pain during the day; however, nausea severity did not differ during the day. Number of vomiting and retching episodes did not show significant variations postprandially or during the day. Patients with IGp had greater symptom severity throughout the day and greater postprandial increase in symptoms compared to patients with DGp.

Conclusions and Inferences

Patients with Gp experience postprandial worsening of overall symptom severity, as well as severities of nausea, early satiety, stomach fullness, and abdominal pain. These symptoms also progressively worsen during the day, except for the severity of nausea which persists throughout the day. Understanding the symptom variability in patients with Gp throughout the day and postprandially may be useful in treatment of patients with Gp.
Shape shifting by amphibious plants in dynamic hydrological niches
Authors: van Veen Hans , Sasidharan Rashmi
Published: November 2019

Amphibious plants thrive in areas with fluctuating water levels, partly as a result of their capacity to make specialized leaves when submerged or emerged. The tailor‐made leaves improve gas exchange underwater or prevent aerial desiccation. Aquatic leaves are thin with narrow or dissected forms, thin cuticles and fewer stomata. These traits can combine with carbon‐concentrating mechanisms and various inorganic carbon utilization strategies. Signalling networks underlying this plasticity include conserved players like abscisic acid and ethylene, but closer inspection reveals greater variation in regulatory behaviours. Moreover, it seems that amphibious leaf development overrides and reverses conserved signalling pathways of their terrestrial counterparts. The diversity of physiology and signalling makes plant amphibians particularly attractive for gaining insights into the evolution of signalling and crop improvement.
Goals and Strategies to Solve Peer Conflict: Comparison by Aggression Trajectories
Authors: Douglas Brooke , Orpinas Pamela
Published: November 2019

Objective. Prior research identified three trajectories of adolescent aggressive behavior from Grades 6 to 12:Low, Medium Desisting, and High Desisting Aggression. This study examined whether youth in these trajectories differed in their goals and strategies to solve conflict. Method. The sample consisted of 620 randomly selected students participating in the Healthy Teens Longitudinal Study. Participants attended schools in Northeast Georgia, USA. Mean scores were plotted for the seven years, and analysis of variance was used to examine whether student endorsement of goals and strategies differed by aggression trajectories. Results. Self-reported student goals and strategies were stable over time. At Grade 6 and 12, significantly more students in the Low Aggression trajectory endorsed positive goals and strategies to resolve peer conflict, and significantly more students in the two more aggressive trajectories endorsed aggressive goals and strategies. Youth in the two more aggressive trajectories did not differ in goals or strategies. Seeking help from a teacher did not vary by aggression trajectory or grade level. Conclusion. Given the stability of goals and strategies, school should implement programs early to enhance social-cognitive factors affecting students’ behavior in peer conflict situations, and thus prevent violence and enhance a positive school climate.
Operacionalización psicodinámica del eje estructura en un paciente drogodependiente
Authors: Vanegas Osorio Jorge Humberto , Zapata-Patiño Daniel Alejandro , Castrillón-Osorio Leidy Carolina
Published: November 2019

Objetivo. Comprender la relación entre el perfil psicodinámico y la adicción a las drogas en pacientes internos en una comunidad terapéutica, considerando la operacionalización del eje estructura según el Diagnóstico Psicodinámico Operacionalizado (OPD-2). Método. Se implementó el estudio cualitativo de cuatro procesos individuales de psicoterapia psicodinámica. Cada caso fue analizado por separado y se operacionalizaron los ejes diagnósticos del OPD-2; instrumento validado internacionalmente para la investigación, evaluación, focalización e indicación del tratamiento. Resultados. El análisis de caso permitió concluir que las limitaciones en las capacidades cognitivas, emocionales y vinculares corresponden a un nivel estructural medio-bajo. Conclusión. Para la intervención psicoterapéutica es importante comprender la dinámica psíquica que sostiene la conducta adictiva con base en un acertado diagnóstico dimensional.
El programa EQUIPAR para Educadores: sus efectos en el pensamiento y la conducta social
Authors: Van der Meulen Kevin , Granizo Laura , Del Barrio Cristina , De Dios María José
Published: November 2019

Objetivo. EQUIPAR para Educadores (EpE; DiBiase et al., 2010) es un programa educativo cuyo objetivoes equipar a los jóvenes con habilidades y conocimientos para su vida diaria, a fin de prevenir conductasantisociales. El presente estudio se propone analizar los efectos de la aplicación del programa en lasdistorsiones cognitivas, el clima de aula y las actuaciones del alumnado en situaciones de acoso escolar.Método. Participaron 123 estudiantes de 3º y 4º de ESO. Se utilizó un diseño cuasi-experimental pretest/postest con un grupo control (128 estudiantes). Resultados. Se observaron cambios positivos en las actuaciones ante el acoso escolar, pero las distorsiones cognitivas y el clima de aula percibido no mostraron cambios después de la aplicación del programa. Conclusión. Una percepción muy positiva del clima de aula y el bajo nivel de distorsiones cognitivas antes de la intervención podrían explicar la falta de efectos, junto a aspectos relacionados con la implantación del programa EpE.
Mutual control of coherent spin waves and magnetic domain walls in a magnonic device
Authors: Han Jiahao , Zhang Pengxiang , Hou Justin T. , Siddiqui Saima A. , Liu Luqiao
Published: November 2019

Toward magnonic devices

The field of magnonics aims to use spin waves (SWs) and their associated quasiparticles—magnons—as carriers of information. Compared with the movement of charge in conventional electronics, a major advantage of SWs is reduced Joule heating. However, SWs are trickier to direct and control. Two groups now go a step further toward magnon-based devices. Han
et al.
show that in multilayer films, domain walls can be used to change the phase and magnitude of a spin wave. Wang
et al.
demonstrate how magnon currents can be used to switch the magnetization of an adjacent layer.

Science
, this issue p.
1121
, p.
1125
Immunology taught by vaccines
Authors: Pulendran Bali
Published: November 2019

Systems analysis of vaccine responses reveals the impact of the microbiota on human immunity
Watching helical membrane proteins fold reveals a common N-to-C-terminal folding pathway
Authors: Choi Hyun-Kyu , Min Duyoung , Kang Hyunook , Shon Min Ju , Rah Sang-Hyun , Kim Hak Chan , Jeong Hawoong , Choi Hee-Jung , Bowie James U. , Yoon Tae-Young
Published: November 2019

A pathway for helical membrane proteins

Membrane proteins are inserted into cell membranes while they are being translated and may fold concurrently into their secondary and tertiary structures. Choi
et al.
describe a single-molecule force microscopy technique that allowed them to monitor folding of helical membrane proteins in vesicles and bicelles. Two helical membrane proteins, the
Escherichia coli
rhomboid protease GlpG and the human β
2
-adrenergic receptor, both folded from the N to the C terminus, with structures forming in units of helical hairpins. In the cell, this would allow these proteins to begin folding while being translated.

Science
, this issue p.
1150
Incoherent strange metal sharply bounded by a critical doping in Bi2212
Authors: Chen Su-Di , Hashimoto Makoto , He Yu , Song Dongjoon , Xu Ke-Jun , He Jun-Feng , Devereaux Thomas P. , Eisaki Hiroshi , Lu Dong-Hui , Zaanen Jan , Shen Zhi-Xun
Published: November 2019

A sharp boundary in the cuprates

Many physicists working on cuprate superconductors believe that the so-called strange metal phase in the cuprate phase diagram is associated with a quantum critical point. Within this picture, the quantum critical point gives rise to a V-shaped region in the doping-temperature phase diagram of the cuprates: the strange metal phase. Chen
et al.
used angle-resolved photoemission spectroscopy in the cuprate family Bi2212 to challenge this view. By taking comprehensive measurements as a function of doping and temperature—and making sure that the signal was not affected by environmental conditions—they found an incoherent strange metal phase that was sharply separated from a conventional phase by a temperature-independent vertical line in the phase diagram.

Science
, this issue p.
1099
Human cohesin compacts DNA by loop extrusion
Authors: Kim Yoori , Shi Zhubing , Zhang Hongshan , Finkelstein Ilya J. , Yu Hongtao
Published: November 2019

Cohesin extrudes DNA loops

DNA is folded into loops in eukaryotic cells by a process that depends on a ring-shaped adenosine triphosphatase complex called cohesin. Davidson
et al.
and Kim
et al.
now show that in the presence of the NIPBLMAU2 protein complex, the human cohesin complex can function as a molecular motor that extrudes DNA loops with high speed in vitro. In contrast to how it mediates sister chromatid cohesion, cohesin does not appear to entrap DNA topologically during loop extrusion. The results provide direct evidence for the loop extrusion model of chromatin organization and suggest that genome architecture is highly dynamic.

Science
, this issue p.
1338
, p.
1345
An even bigger climate problem
Authors: Schmidt Carolina
Published: November 2019

Holding a major international summit on climate change against a backdrop of civil discontent like the kind that has rocked Chile might have given the world the impression that issues like clean energy can be addressed without also confronting problems of social justice. So last month, in the midst of massive protests on cost-of-living burdens and other inequalities, Chile withdrew as the host nation of the United Nations Climate Change Conference (COP25). Instead, COP25 will convene next week in Madrid, Spain. Despite this decision, Chile's commitment to maintain its presidency of COP25 through next year hopefully signals a turning point in climate action—one that further steers Chile and the rest of the global community to recognize connections between social and climate crises, and to support climate policies that do not leave anyone behind.
Влияние синхротронного и фоторекомбинационного излучений на поглощение альфвеновской волны диссипативной плазмой
Authors: Гавриков Михаил Борисович , Gavrikov Mikhail Borisovich , Таюрский Алексей Александрович , Tayurskiy Aleksei Aleksandrovich
Published: November 2019

Предложена математическая модель затухания альфвеновской волны, в основу исследования которой положены уравнения двухжидкостной электромагнитной гидродинамики с полным учeтом инерции электронов и их тормозного излучения. Особое внимание уделено изучению дополнительного влияния фоторекомбинационного и синхротронного излучений. Исследование выявило, в частности, конечность глубины проникновения альфвеновской волны в плазму. Другим важным эффектом является установление параметров поглощаемой альфвеновской волны и выход их на квазистационарный режим.
О сходимости и точности метода итерируемой приближенной факторизации операторов многомерных высокоточных бикомпактных схем
Authors: Рогов Борис Вадимович , Rogov Boris Vadimovich , Чикиткин Александр Викторович , Chikitkin Alexander Viktorovich
Published: November 2019

Исследована сходимость и точность метода решения высокоточных бикомпактных схем, имеющих четвертый порядок аппроксимации по пространственным переменным на минимальном шаблоне, для многомерного неоднородного уравнения переноса. Метод основан на приближенной факторизации разностных операторов многомерных бикомпактных схем. Кроме того, в нем используются итерации для сохранения высокого (выше второго) порядка точности бикомпактных схем по времени. С помощью спектрального метода удалось доказать сходимость этих итераций как для двумерных, так и для трехмерных бикомпактных схем для линейного неоднородного уравнения переноса с постоянными положительными коэффициентами. Проведено сравнение эффективности двух параллельных алгоритмов решения уравнений многомерных бикомпактных схем. Первый из них есть пространственный маршевый алгоритм счета нефакторизованных схем, а второй основан на итерируемой приближенной факторизации разностных операторов схем.
Initiative for Promoting Affordable and Quality Tuberculosis Tests (IPAQT): a market-shaping intervention in India
Authors: Dabas Harkesh , Deo Sarang , Sabharwal Manisha , Pal Arnab , Salim Sachin , Nair Lakshmi , Chauhan Kaartikeya , Maheshwari Prateek , Parulkar Aparna , Singh Ritu , Chitalia Manasi , Kadam Rigveda , Kaur Manjot , Oghor Collins , Ponnudurai Nirros , Kumta Sameer , Small Peter , Dewan Puneet , Pai Madhukar
Published: November 2019

A majority of patients with tuberculosis (TB) in India are diagnosed and treated in the private sector. Yet, most private providers do not use most recent WHO-endorsed microbiological tests such as liquid cultures, line probe assays and Xpert MTB/RIF due to a combination of factors such as lack of awareness, misaligned incentives and high prices that are unaffordable for patients. We designed a market-based approach to transform a high-price, low-volume market equilibrium into a low-price, high-volume equilibrium to improve the uptake of these tests. Toward this end, a non-profit consortium of private laboratories, called Initiative for Promoting Affordable and Quality Tuberculosis Tests (IPAQT) was formed in India in March 2013. It negotiated lower pricing on equipment and reagents with manufacturers, closer to that offered to the public sector. In return, IPAQT assured that this discount was passed on to patients, who typically paid for these tests out of their pockets, through an informally agreed on retail ceiling price. IPAQT also invested in demand generation activities that complemented the supply-side effort. IPAQT membership grew from 56 laboratories in 2013 to 211 in 2018. During this period, the initiative resulted in a 10-fold increase in the uptake of Xpert and a 30%–50% reduction in price. This initiative is planned to be expanded to other South Asian countries with similar TB epidemic and private market structure and dynamics. However, long-term sustainability of the initiative would require developing more cost-effective marketing activities and integration with broader private sector engagement agenda of the national TB programme.
Evaluation of the increased risk of spine fracture in patients with mood disorder compared with matched controls: a longitudinal follow-up study using a national sample cohort in Korea
Authors: Kim So Young , Min Chanyang , Park Bumjung , Kim Miyoung , Choi Hyo Geun
Published: November 2019

Objective

To evaluate the risk of spine fracture in patients with mood disorder using a nationwide cohort.

Design

A longitudinal follow-up study.

Setting

Claims data for the population ≥20 years of age were collected from 2002 to 2013 for the Korean National Health Insurance Service-National Sample Cohort.

Participants

A total of 60 140 individuals with mood disorder were matched with 240 560 individuals (control group) for age, sex, income, region of residence and osteoporosis.

Interventions

In both the mood disorder and control groups, the history of spine fracture was evaluated. The International Classification of Diseases 10th Revision codes for mood disorder (F31–F39) and spine fracture (S220 and S320) were included.

Primary and secondary outcome measures

The univariable and multivariable HRs and 95% CIs of spine fracture for patients with mood disorder were analysed using a stratified Cox proportional hazards model. Subgroup analyses were conducted according to the history of osteoporosis, age and sex.

Results

Approximately 3.3% (2011/60 140) of patients in the mood disorder group and 2.8% (6795/240 560) of individuals in the control group had spine fracture (p<0.001). The mood disorder group demonstrated a higher adjusted HR for spine fracture than the control group (multivariable HR=1.10, 95% CI 1.04 to 1.15, p<0.001). The participants without osteoporosis showed a higher HR of mood disorder for spine fracture than the control participants (multivariable HR=1.25, 95% CI 1.14 to 1.37, p<0.001). According to age and sex, this result was consistent in subgroups of women aged 20–39 and 40–59 years and men aged ≥60 years.

Conclusion

The risk of spine fracture was increased in patients with mood disorder. The potential risk of spine fracture needs to be evaluated when managing patients with mood disorder.
Association of acculturation with cardiac structure and function among Hispanics/Latinos: a cross-sectional analysis of the echocardiographic study of Latinos
Authors: López Lenny , Swett Katrina , Rodriguez Fátima , Kizer Jorge R , Penedo Frank , Gallo Linda , Allison Matthew , Arguelles William , Gonzalez Franklyn , Kaplan Robert C , Rodriguez Carlos J
Published: November 2019

Objective

Hispanics/Latinos, the largest immigrant population in the USA, undergo the process of acculturation and have a large burden of heart failure risk. Few studies have examined the association of acculturation on cardiac structure and function.

Design

Cross-sectional.

Setting

The Echocardiographic Study of Latinos.

Participants

1818 Hispanic adult participants with baseline echocardiographic assessment and acculturation measured by the Short Acculturation Scale, nativity, age at immigration, length of US residence, generational status and language.

Primary and secondary outcome measures

Echocardiographic assessment of left atrial volume index (LAVI), left ventricular mass index (LVMI), early diastolic transmitral inflow and mitral annular velocities.

Results

The study population was predominantly Spanish-speaking and foreign-born with mean residence in the US of 22.7 years, mean age of 56.4 years; 50% had hypertension, 28% had diabetes and 44% had a body mass index >30 kg/m2. Multivariable analyses demonstrated higher LAVI with increasing years of US residence. Foreign-born and first-generation participants had higher E/e′ but lower LAVI and e′ velocities compared with the second generation. Higher acculturation and income >$20K were associated with higher LVMI, LAVI and E/e′ but lower e′ velocities. Preferential Spanish-speakers with an income <$20K had a higher E/e′.

Conclusions

Acculturation was associated with abnormal cardiac structure and function, with some effect modification by socioeconomic status.
Moving 2 Mindful(M2M) study protocol: testing a mindfulness group plus ecological momentary intervention to decrease stress and anxiety in adolescents from high-conflict homes with a mixed-method longitudinal design
Authors: Lucas-Thompson Rachel , Seiter Natasha , Broderick Patricia C , Coatsworth James Douglas , Henry Kimberly L , McKernan Charlotte J , Smyth Joshua M
Published: November 2019

Introduction

Interparental conflict exposure places adolescents at risk for problems with stress and anxiety; existing prevention/intervention strategies focus on reducing interparental conflict. Mindfulness-based programmes may be a promising treatment strategy for this population, but studies have not yet tested whether they are effective in this high-conflict context. In addition, evidence suggests that extensions to traditional treatments, such as delivering components in daily life that are tailored to moments of need, can increase treatment efficacy, particularly when combined with in-person treatments and particularly for adolescents. However, there are no such extensions to mindfulness interventions available. TheMoving 2 Mindfulstudy aims to (1) develop an ecological momentary intervention (EMI) supplement to Learning to BREATHE (L2B), an evidence-based mindfulness intervention for adolescents; (2) refine the EMI programme and determine the best delivery plan; (3) examine the feasibility and acceptability of L2B Plus (L2B plus the developed supplement) and (4) examine the potential for L2B Plus to reduce stress and anxiety for adolescents from high-conflict homes.

Methods and analysis

TheMoving 2 Mindfulstudy proposes a mixed-methods approach to developing and refining a multimethod adaptive supplement to L2B. Feasibility, acceptability and potential effectiveness will be tested in a sample of 38 families, who will be randomly assigned to receive L2B Plus or an active health and wellness control condition and followed until 3 months postintervention. A range of psychosocial and physiological factors will be assessed at multiple time points. This study is registered with clinicaltrials.gov (IDNCT03869749; pre-results).

Ethics and dissemination

The Institutional Review Board at Colorado State University has approved this study. Findings will be disseminated in scientific journals and conferences, whether they are positive, negative or inconclusive.
Social and spatial inequalities in allostatic load among adults in China: a multilevel longitudinal study
Authors: Mao Fan , Astell-Burt Thomas , Feng Xiaoqi , Liu Yunning , Dong Jianqun , Liu Shiwei , Wang Lijun , Jiang Yingying , Dong Wenlan , Zhou Maigeng , Wang Limin
Published: November 2019

Objectives

To investigate potential geographical and socioeconomic patterning of allostatic load (AL) in China.

Design

Multilevel longitudinal study of the 2010 Chronic Disease Risk Factor Surveillance linked to the National Death Surveillance up to 31 December 2015.

Setting

All 31 provinces in China, not including Hong Kong, Macao or Taiwan.

Participants

96 466 ≥ 18 years old (women=54.3%).

Exposures

Person-level educational attainment and mean years of education in counties.

Outcome

AL was measured using clinical guidelines for nine biomarkers: body mass index; waist circumference; systolic blood pressure; diastolic blood pressure; fasting blood glucose; total cholesterol; triglycerides; high-density lipoprotein cholesterol; low-density lipoprotein cholesterol.

Results

Multilevel logistic regressions adjusted for sex, age, marital status, person-level education, county mean years of education and urban/rural reported ORs of 1.22 (95% CI 1.08 to 1.38) for 5-year all-cause mortality (n=3284) and 1.20 (1.04–1.37) for deaths from non-communicable diseases (n=2891) among people in AL quintile 5 (high) compared with quintile 1 (low). The median rate ratio estimated from unadjusted multilevel negative binomial regression showed AL clustered geographically (province=1.14; county=1.12; town=1.11; village=1.14). After adjusting for aforementioned confounders, AL remained higher with age (rate ratio 1.02, 95% CI 1.02 to 1.02), higher in women compared with men (1.17, 1.15 to 1.19), lower among singletons (0.83, 0.81 to 0.85) and widowers (0.96, 0.94 to 0.98). AL was lower among people with university-level compared with no education (0.92, 0.89 to 0.96), but higher in counties with higher mean education years (1.03, 1.01 to 1.05). A two-way interaction suggested AL was higher (1.04, 1.02 to 1.06) among those with university-level compared with no education within counties with higher mean years of education. Similar results were observed for alternative constructions of AL using 75th and 80th percentile cut-points.

Conclusions

AL in China is patterned geographically. The degree of association between AL and person-level education seems to be dependent on area-level education, which may be a proxy for other contextual factors that warrant investigation.
Influence of government price regulation and deregulation on the price of antineoplastic medications in China: a controlled interrupted time series study
Authors: Guan Xiaodong , Wushouer Haishaerjiang , Yang Mingchun , Han Sheng , Shi Luwen , Ross-Degnan Dennis , Wagner Anita Katharina
Published: November 2019

Background

In October 2012, the Chinese government established maximum retail prices for specific products, including 30 antineoplastic medications. Three years later, in June 2015, the government abolished price regulation for most medications, including all antineoplastic medications. This study examined the impacts of regulation and subsequent deregulation of prices of antineoplastic medications in China.

Methods

Using hospital procurement data and an interrupted time series with comparison series design, we examined the impacts of the policy changes on relative purchase prices (Laspeyres price index) and volumes of and spending on 52 antineoplastic medications in 699 hospitals. We identified three policy periods: prior to the initial price regulation (October 2011 to September 2012); during price regulation (October 2012 to June 2015); and after price deregulation (July 2015 to June 2016).

Results

During government price regulation, compared with price-unregulated cancer medications (n=22, mostly newer targeted products), the relative price of price-regulated medications (n=30, mostly chemotherapeutic products) decreased significantly (β=−0.081, p<0.001). After the government price deregulation, no significant price change occurred. Neither government price regulation nor deregulation had a significant impact on average volumes of or average spending on all antineoplastic medications immediately after the policy changes or in the longer term (p>0.05).

Conclusion

Compared with unregulated antineoplastics, the prices of regulated antineoplastic medications decreased after setting price caps and did not increase after deregulation. To control the rapid growth of oncology medication expenditures, more effective measures than price regulation through price caps for traditional chemotherapy are needed.
Intradermal thumbtack needle buried Neiguan (P6) point for prevention of postoperative nausea and vomiting in patients undergoing craniotomy: study protocol for a randomised controlled trial
Authors: Lv Jian-qin , Wang Chengwei , Yang Yi , Li Yu , Xu Tian-hao , Jian Ling-qi
Published: November 2019

Introduction

Postoperative nausea and vomiting (PONV) is among the most common adverse reactions following anaesthesia and surgery. Recent clinical studies have reported that the average incidence is about 30%, while in patients specifically undergoing neurosurgery, the incidence can be as great as 73%. Studies also suggest that its occurrence increases the risk of intracranial haematoma and haemorrhage. The objective of this study is to evaluate the effectiveness of intradermal thumbtack needle buried Neiguan (pericardium 6 (P6)) point therapy in the prevention of PONV in patients undergoing craniotomy under general anaesthesia.

Methods and analysis

This is a single-centre, three-arm, randomised controlled trial. 180 participants are randomly assigned to either an acupuncture, intradermal thumbtack needle or control group in a 1:1:1 ratio. The P6 of the acupuncture group is punctured at both sides perpendicularly to a depth of 20 mm. Needles are retained for 30 min and stimulated every 10 min to maintain the de qi. The therapy includes two treatments; the acupuncture is administered immediately after and 24 hours after surgery. For the intradermal thumbtack needle group, the intradermal thumbtack needle is quickly inserted into the skin and embedded at P6 acupoints bilaterally. Patients and their families are asked to press the needlepoint with the onset of nausea, vomiting, bloating, pain and other reported discomforts. The needle is replaced after 24 hours. The therapy is administered immediately after and 24 hours after surgery. For the control group, no intervention is carried out. The incidence of PONV within 48 hours after craniotomy across the three groups is observed. Other observations include: (1) assessment of nausea score (severity of nausea) and pain score (visual analogue scale) 0–2, 2–6, 6–24 and 24–48 hours after craniotomy under general anaesthesia; (2) assessment of total rescue antiemetic dosage 0–48 hours after craniotomy under general anaesthesia; (3) length of hospital stay and (4) patient satisfaction score with PONV management. We will perform all statistical analysis following the intention-to-treat principle.

Ethics and dissemination

Ethics approval has been granted by the Bioethics Subcommittee of the West China Hospital, Sichuan University: the approval number is 2018 (number 231). Results will be expected to be published in peer-reviewed journals.

Trial registration number

ChiCTR1800017173
Long-term outcomes in patients newly diagnosed with iron deficiency anaemia in general practice: a retrospective cohort study
Authors: Schop Annemarie , Stouten Karlijn , Riedl Jurgen , van Houten Ron , van Rosmalen Joost , Wolfhagen Frank , Bindels Patrick J E , Levin Mark-David
Published: November 2019

Objectives

To describe all iron deficiency anaemia (IDA)–related causes during follow-up of patients newly diagnosed with IDA and to assess whether a delayed colorectal cancer (CRC) diagnosis influences survival.

Design and setting

Retrospective cohort study of patients from general practices in the Dordrecht area, the Netherlands.

Participants

Men and women aged ≥50 years with a new diagnosis of IDA (ie, no anaemia 2 years previously).

Method

From February 2007 to February 2018, all relevant data were collected from the files of the referral hospital. Early IDA-related cause was defined as established within 18 weeks after IDA diagnosis. Cox proportional-hazards regression was used to analyse survival of patients with CRC diagnosis.

Results

587 patients with IDA were included with a median follow-up of 4.6 years. Early and late IDA-related causes could be established in 32% and 8% of patients, respectively. Early and late CRC was found in 8% and 2% of patients, respectively, and were located mainly right sided. After adjustment for age, gender and TNM classification, mortality risk was lower in patients with IDA with early CRC diagnosis, but not significantly (HR 0.30, 95% CI 0.09 to 1.02).

Conclusion

Even with extended follow-up, the cause of IDA remains elusive in the majority of patients with IDA in general practice. However, patients with IDA are at increased risk for in particular right-sided CRC and a late diagnosis of CRC appears to have a detrimental effect on survival in patients with IDA.
Income inequality and social gradients in children’s height: a comparison of cohort studies from five high-income countries
Authors: Bird Philippa K , Pickett Kate E , Graham Hilary , Faresjö Tomas , Jaddoe Vincent W V , Ludvigsson Johnny , Raat Hein , Seguin Louise , Wijtzes Anne I , McGrath Jennifer J
Published: November 2019

Background

Health and well-being are better, on average, in countries that are more equal, but less is known about how this benefit is distributed across society. Height is a widely used, objective indicator of child health and predictor of lifelong well-being. We compared the level and slope of social gradients in children’s height in high-income countries with different levels of income inequality, in order to investigate whether children growing up in all socioeconomic circumstances are healthier in more equal countries.

Methods

We conducted a coordinated analysis of data from five cohort studies from countries selected to represent different levels of income inequality (the USA, UK, Australia, the Netherlands and Sweden). We used standardised methods to compare social gradients in children’s height at age 4–6 years, by parent education status and household income. We used linear regression models and predicted height for children with the same age, sex and socioeconomic circumstances in each cohort.

Results

The total analytic sample was 37 063 children aged 4–6 years. Gradients by parent education and household income varied between cohorts and outcomes. After adjusting for differences in age and sex, children in more equal countries (Sweden, the Netherlands) were taller at all levels of parent education and household income than children in less equal countries (USA, UK and Australia), with the greatest between-country differences among children with less educated parents and lowest household incomes.

Conclusions

The study provides preliminary evidence that children across society do better in more equal countries, with greatest benefit among children from the most disadvantaged socioeconomic groups.
Multiple Myeloma-Derived Exosomes Inhibit Osteoblastic Differentiation and Improve IL-6 Secretion of BMSCs from Multiple Myeloma
Authors: Liu Zhaoyun , Liu Hui , Li Yanqi , Shao Qin , Chen Jin , Song Jia , Fu Rong
Published: November 2019

Bone marrow stromal cells (BMSCs) play a critical role in multiple myeloma (MM) pathogenesis by cell contact, and secretion of cytokines, growth factors and extracellular vesicles. Exosomes are secreted by almost all cell types and are recently reported to mediate local cell-to-cell cross-talk by transferring messenger RNAs, LncRNAs, and proteins. Compelling studies have identified BMSC-derived exosomes induce proliferation, migration, survival, and drug resistance of MM cells. However, whether MM cell-derived exosome also plays a role in function in BMSC remains unclear. Here we investigated the effect of MM cell-derived exosomes on the interleukin (IL)-6 secretion and osteoblastic differentiation capability of BMSC from patients with MM. Furthermore we investigated the IL-6 secretion relative regulation protein APE1 and NF-kB and osteoblastic differentiation protein Runx2 (runt-related gene 2), Osterix and osteocalcin (OCN). Our results showed that MM cell-derived exosomes promoted IL-6 secretion and suppressed osteoblastic differentiation and mineralization of BMSCs. Mechanistically, we demonstrated that MM cell-derived exosomes lead to an increase in APE1 and NF-kB and a reduction in Runx2, Osterix and OCN in BMSCs. Taken together, MM cell-derived exosomes induce the secretion of IL-6 and poor osteoblastic differentiation of BMSCs.
A Case of Advanced Gastric Cancer with Folfiri as a Preoperative Chemotherapy
Authors: Nguyen Hieu Van , Nguyen Hung Van , Nguyen Long Thanh , Pham Nga Quynh , Nguyen Hau Xuan , Nguyen Hien Xuan , Nguyen Vuong Thi
Published: November 2019

Introduction. In advanced gastric cancer, preoperative chemotherapy is associated with survival benefit. FOLFIRI has demonstrated promising results in terms of survival and tolerance, especially in patients with poor performance status. Case Presentation. A 59-year-old male, diagnosed with pT4bN2M0 gastric cancer, underwent gastrointestinal anastomosis and three cycles of EOX chemotherapy. Due to disease progression, he was switched to FOLFIRI regimen. After 12 cycles, the patient received a subtotal gastrectomy and D2 lymphadenectomy. Microscopic examination achieved pCR, and the patient has been surviving 34 months without recurrence. No severe toxicities of chemotherapy were recorded. Conclusions. FOLFIRI might be a safe and effective option in neoadjuvant treatment for advanced gastric cancer among patients with poor performance status or progression after first-line chemotherapy.
Correlations of Expression Levels of a Panel of Genes (IRF5, STAT4, TNFSF4, MECP2, and TLR7) and Cytokine Levels (IL-2, IL-6, IL-10, IL-12, IFN-γ, and TNF-α) with Systemic Lupus Erythematosus Outcomes in Jordanian Patients
Authors: Uzrail Amal H. , Assaf Areej M. , Abdalla Shtaywy S.
Published: November 2019

Systemic lupus erythematosus (SLE) is characterized by systemic end-organ damage. We investigated the involvement of IRF5, TLR-7, MECP2, STAT4, and TNFSF4 genes and TNF-α, IFN-γ, IL-2, IL-12, IL-6, and IL-10 cytokines in SLE pathogenesis and in organ damage in Jordanian patients. Blood was collected from 51 patients and 50 controls. Expression levels of SLE genes in PBMCs and cytokine levels were determined using RT-PCR and ELISA, respectively. Expression levels of all genes and levels of TNF-α, IL-12, IL-6, and IL-10 were higher in SLE patients than those in controls (p<0.05), whereas IL-2 level was lower. High STAT4 (α), TNFSF4, and IL-10 levels correlated with cardiovascular damage, and high MECP2 (α) and TNF-α correlated with renal damage. Pulmonary and musculoskeletal damages correlated with high levels of TNFSF4. We concluded that STAT4 and TNFSF4 genes with TNF-α and IL-10 cytokines could be used as biomarkers to assess SLE activity and manage treatment.
Development of New Carbon-Based Electrode Material from Oil Palm Waste-Derived Reduced Graphene Oxide and Its Capacitive Performance Evaluation
Authors: Nasir Salisu , Hussein Mohd Zobir , Zainal Zulkarnain , Yusof Nor Azah
Published: November 2019

This paper is an expansion of our previous work on the synthesis of graphene oxides and reduced graphene oxides from different kinds of oil palm waste-based feedstocks, namely, OPL (oil palm leaf), PKS (palm kernel shell), and EFB (empty fruit bunch). Here, the electrochemical measurements of the resulting reduced graphene oxides derived via mild-temperature annealing reduction of the graphene oxides were accomplished using cyclic voltammetry and galvanostatic charge/discharge processes. The findings put forward their promising features for supercapacitor applications. For instance, the reduced graphene oxide derived using EFB precursor (rGOEFB) which has a BET surface area of 117 m2 g-1exhibits a specific capacitance of 688 F g−1at an applied current density of 0.8 A g-1. This is higher than that observed for reduced graphene oxides derived from oil palm leaf (rGOOPL), palm kernel shell (rGOPKS), and the commercially acquired graphite (rGOCG), which possessed specific capacitance values of 632, 424, and 220 F g−1, respectively. It can be deduced that the specific capacitance of the reduced graphene oxide samples increases in the following order: (rGOCG) < (rGOPKS) < (rGOOPL) < (rGOEFB). In summary, these new classes of carbon-based nanomaterials could be applied as efficient electrode materials for supercapacitor application with potential good performance. With this novel green and sustainable approach, various carbon-based nanomaterials can be fabricated for a broad range of multifunctional applications.
Bond Properties of RAC-Filled Square Steel Tubes after High Temperature
Authors: Zou Wanjie , Liang Jiongfeng , Zhang Guangwu , Yang Haifeng
Published: November 2019

This paper presents the results of an experimental study to investigate the influence of high temperatures on the bond properties between the recycled coarse aggregate (RCA) concrete and square steel tubes. A total of 27 pushout recycled aggregate concrete- (RAC-) filled square steel tube specimens are cast and heated under five different temperatures (20°C, 200°C, 400°C, 600°C, and 800°C) for testing. The main parameters considered in the test are temperature, exposure time of heating, RCA replacement ratio, interface length-to-width ratio, and concrete strength. The experimental results indicate that the bond strength for recycled coarse aggregate concrete and square steel tube increases with increasing temperatures.
Exploring the Pharmacological Mechanism of the Herb Pair “HuangLian-GanJiang” against Colorectal Cancer Based on Network Pharmacology
Authors: Gong Benjiao , Kao Yanlei , Zhang Chenglin , Zhao Huishan , Sun Fudong , Gong Zhaohua
Published: November 2019

Since the herb pair Huang Lian-Gan Jiang (HL-GJ) was put forward as conventional compatibility for cold-heat regulation in the middle energizer in the theory of Traditional Chinese Medicine (TCM), their therapeutic effects were observed on the prevention and treatment of intestinal inflammation and tumors including colorectal cancer (CRC). However, the active compounds, crucial targets, and related pathways of HL-GJ against CRC remained unclear. The purpose of this research was to establish a comprehensive and systemic approach that could identify the active compounds, excavate crucial targets, and reveal anti-CRC mechanisms of HL-GJ against CRC based on network pharmacology. We used methods including chemical compound screening based on absorption, distribution, metabolism, and excretion (ADME), compound target prediction, CRC target collection, network construction and analysis, Gene Ontology (GO), and pathway analysis. In this study, eight main active compounds of HL-GJ were identified, including Gingerenone C, Isogingerenone B, 5,8-dihydroxy-2-(2-phenylethyl) Chromone, 2,3,4-trihydroxy-benzenepropanoic acid, 3,4-dihydroxyphenylethyl Alcohol Glucoside, 3-carboxy-4-hydroxy-phenoxy Glucoside, Moupinamide, and Obaculactone. HRAS, KRAS, PIK3CA, PDE5A, PPARG, TGFBR1, and TGFBR2 were identified as crucial targets of HL-GJ against CRC. There were mainly 500 biological processes and 70 molecular functions regulated during HL-GJ against CRC (P<0.001). There were mainly 162 signaling pathways contributing to therapeutic effects (P<0.001), the top 10 of which included DAP12 signaling, signaling by PDGF, signaling by EGFR, NGF signaling via TRKA from the plasma membrane, signaling by NGF, downstream signal transduction, DAP12 interactions, signaling by VEGF, signaling by FGFR3, and signaling by FGFR4. The study established a comprehensive and systematic paradigm to understand the pharmacological mechanisms of multiherb compatibility such as an herb pair, which might accelerate the development and modernization of TCM.
Simultaneous Assay of Dexchlorpheniramine Maleate, Betamethasone, and Sodium Benzoate in Syrup by a Reliable and Robust HPLC Method
Authors: Le Dinh Chi , Ngo Thi Duyen , Hoa Le Thi Huong
Published: November 2019

The simultaneous determination of betamethasone, dexchlorpheniramine maleate, and sodium benzoate in pharmaceutical syrup was done by using a simple validated HPLC method. The chromatographic separation of the three analytes was done in a C18 column maintained at 25°C, using a mixture of acetonitrile and 0.02 M phosphate buffer solution pH 2.70 (35 : 65, v : v) as mobile phase. The isocratic elution was chosen with total flow rate of mobile phase maintained at 1.0 mL per minute. The analytes were detected by a UV-Vis detector set at 254 nm. Injection volume was set at 50 μl. The method was fully validated in terms of specificity, linearity, precision, accuracy, and robustness according to requirements of current guidelines and was proven to be suitable for the intended application.
Assisted Reproductive Technology as a Transcutaneous Route for Bacterial Contamination of Ovarian Endometrioma with Coagulase-Negative Staphylococcus: Case Report and Review of the Literature
Authors: Edelstein Shimon , Ben Shachar Inbar , Ben-Amram Hila , Biswas Seema , Marcus Naama
Published: November 2019

Tubo-ovarian abscess may develop in women with endometrioma following assisted reproductive technology (ART). The infection, though rare, is typically late in onset and may present several months after the procedure, and in pregnancy—with the risks of abortion and premature labor. It is thought that transcutaneous oocyte retrieval during ART is the route for bacterial contamination resulting in infection of the endometrioma. Pathogens reported in the literature includeEscherichia coli(E. coli) and Group B streptococcus (GBS) butStaphylococcus lugdunensis(S. lugdunensis), a coagulase-negative staphylococcus (CoNS), and groin and perineal skin commensal was isolated from the endometrioma in this case. We discuss the challenges in diagnosis and treatment of this rare condition and the implications of the discovery that an organism previously dismissed as a contaminant has emerged as a causative organism in severe, deep-seated infections of soft tissues in recent literature.