bluuebunny/crossref_metadata_2025 huggingface dataset:
PADRÕES DE BELEZA: OS EFEITOS DA MÍDIA NOS JOVENS
Authors: Piñol Susana , Esmeraldino Amanda da Silva , Klaus Kauany Raissa , Estrazulas Luiza Severo , Silva Sarah Isabele Hoeft da
Published: October 2019

Os padrões estéticos mudam de uma cultura para outra. Desde os tempos antigos existe um padrão que as pessoas consideram atraente e que vai mudando com o passar dos anos. (MALDONADO, 2006, p. 61)Na opinião do site portal da juventude (2017), o conceito de belo e de beleza é muito subjetivo. Ele varia de pessoa para pessoa e, também, de época para época. Aquilo que é desagradável para um pode ser altamente sedutor e encantador para outro. Conforme relata Damasceno et al. (2006) apud Frois et al.(2011, p.73), a insatisfação com a imagem corporal aumenta na medida em que a mídia expõe belos corpos, um fato que nas últimas décadas têm impulsionado a busca pelo corpo ideal.Para o site Adolescência e Saúde (2010), embora a identidade de um indivíduo seja estruturada ao longo da vida, é durante a adolescência que diversas características, como sexualidade, crenças, desejos e objetivos de vida, se exteriorizam maisintensamente. A maneira como o adolescente percebe seu corpo é condição fundamental na formação de sua identidade. Segundo o site Portal do Professor (2010), a grandeinsatisfação com o corpo tem levado um número crescente de jovens (mulheres e homens) a desenvolverem transtornos alimentares que podem em casos extremos, gerar um quadro de anorexia nervosa.O tema deste trabalho foi escolhido no intuito de verificar por que os padrões de beleza impostos pela mídia causam tantos conflitos em relação à imagem corporal do adolescente. Pretende-se apurar os motivos que levam muitos adolescentes a se importarem tanto em mudar o seu corpo devido a estes padrões observados nas mídias.Para tanto estabeleceu-se como objetivo geral verificar os padrões de beleza veiculados pela mídia e o quanto eles que interferem no comportamento dos adolescentes durante oprocesso de formação da sua opinião sobre si e o meio em que vive. Como objetivos específicos formulou-se: a) averiguar como o adolescente elabora uma opinião sobre seu corpo em relação aos padrões impostos pela mídia e a de um grupo em que ele convive; b) conhecer os meios de mídia que mais interferem nospadrões de beleza entre os adolescentes e c) analisar os efeitos das influências da mídia no comportamento do adolescente.
GUT E LAYOUT: FERRAMENTAS DE GESTÃO DA QUALIDADE APLICADAS A UMA EMPRESA DE TRANSPORTE COLETIVO
Authors: Piñol Susana , Corrêa Andressa Cristina , Corrêa Maria Eduarda , Pereira Maysa da Silva , Corrêa Vitória de Assis
Published: October 2019

Empresas prestadoras de serviços, sobremaneira, as prestadoras de transporte coletivo pelo alto contato com o usuário durante o processo de execução do serviço devem manter-se sistematicamente atentas à qualidade dos serviços prestados. Aaplicação de ferramentas de gestão de qualidade torna-se uma forte aliada dos gestores organizacionais que buscam entender para atender da melhor forma seus públicos. Dentro desta perspectiva, este artigo apresenta a aplicação das ferramentas Análise de Layout e GUT junto a uma organização de transporte coletivo.O termo Layout vem do inglês e na área das artes gráficas é usado para se referir a um rascunho, um esboço inicial de um projeto, um esquema, um arranjo (MEUS DICIONARIOS, 2017). Nas organizações é utilizada como objetivo de otimizar osrecursos disponíveis, ganhando agilidade, facilitando as atividades e diminuindo os custos nos processos. Descreve o estudo, a disposição e alocação das pessoas, móveis,ferramentas, maquinários ou áreas. (MARKETING FUTURO, 2017)Por sua vez, “a matriz GUT, é uma ferramenta bastante utilizada pelas empresas, principalmente, com o intuito de priorizar os problemas e consequentemente tratá-los, levando em conta suas Gravidades, Urgências e Tendências”. (PORTALADMINISTRAÇÃO, 2014). GUT é um acrônimo para Gravidade, Urgência e Tendência. Conforme esclarece Portal Administração (2014), no caso desta ferramenta, gravidade: representa o possível dano ou prejuízo que pode decorrer de uma situação;urgência: representa a questão do tempo que existe para resolver um problema, ou uma determinada situação; e tendência: representa a probabilidade do problema se tornarmaior.O objetivo deste estudo foi aplicar ambas ferramentas junto a uma empresa prestadora de serviços com vistas a verificar qual a prioridade junto aos aspectos de layout a melhorar. Trata-se de uma prática extensionista porque amplia para a comunidade empresarial uma aplicação do que foi aprendido no componente curricular Gestão de Serviços ofertado no primeiro ano do Curso Técnico Integrado ao Ensino Médio do Instituto Federal Catarinense - Campus São Francisco do Sul. Para alcançar o objetivo geral atendeu-se os seguintes objetivos específicos: obtenção do consentimento da empresa para realização da atividade de consultoria; realização do diagnóstico do layout atual da sede da empresa; análise do layout atual;proposição de melhorias no layout atual; e aplicação de GUT para identificar priorizações.
Transcriptomic Profiling of Cotton Leaves in Response to Cotton Aphid Attack
Authors: Zhang Jianmin , Zhong Xiao , Feng Pei , Ma Qiqi , Su Qi , phD Xiangping , Yang Yazhen
Published: October 2019

Main conclusion The molecular mechanism of the interaction between cotton and cotton aphids remains unclear currently. The RNA-Seq study of cotton leaves was performed in response to cotton aphid damage at different time points. The transcriptome analysis revealed that a lot of cotton gene transcripts were regulated by cotton aphid damage. Cotton aphids (Aphis gossypii Glover) are regarded as one of the most harmful insect pests for cotton production. They are usually capable of causing severe yield loss through sucking cotton liquids, secreting honeydews and transmitting plant viral diseases. However, the molecular mechanism of the interaction between cotton and cotton aphids remains unclear currently. Therefore, the RNA-Seq study of cotton leaves was performed in response to cotton aphid damage at different time points (0 h,6 h,12 h, 24 h, 48 h and 72 h). A total of 9, 103 new genes were identified, and 7, 510 of them were annotated functionally. Based on the comparison results, the gene expression was analyzed according to the expression amount of genes in different samples. 24,793 differentially expressed genes were authenticate in all and their functional annotation and enrichment analysis were conducted. Compared with 0 h (without aphid damage, CK), the amount of down-regulated DEGs was largely more than that of the up-regulated genes at different time points under cotton aphid attack except for 48h. As revealed by the functional annotation of DEGs, these genes were involved in all kinds of plant biological process, including various resistance to abiotic and biotic stress, hormone metabolism, signaling transduction and transcriptional regulation. These results established a firm foundation for the study of the molecular mechanism of the interaction between cotton and cotton aphids and would facilitate the development of plant aphid resistant cultivars.
Efficacy and safety of prophylactic use of ketamine for prevention of postanesthetic shivering: A system review and meta analysis
Authors: Zhou Yang , Mannan Abdul , Han Yuan , Liu He , Guan Hui-Lian , Gao Xing , Dai Ming-Sheng , Cao Junli
Published: October 2019

Background
Postanesthetic shivering is a common complication of anesthesia, which accounts for much discomfort in postoperative patients and may increase postoperative complications in high-risk patients. Due to the lack of high-quality evidence, it is difficult to draw a conclusion about optimal anti-shivering medication. The main purpose of this meta-analysis was to analyze and evaluate the efficacy and safety of prophylactic use of ketamine for preventing postanesthetic shivering.
Methods
We used a systematic approach, also known as meta-analysis, to further address postoperative shivering. We searched the following databases: Medline, EMBASE, and the Cochrane Central Register of Controlled Trails for randomized controlled trials. The primary outcome observed was the incidence rate of postanesthetic shivering. The secondary outcomes were the sedation score and incidence of the side effects caused by drugs utilized in the studies.
Results
In this meta-analysis, we analyzed a total of 16 trials including 1485 patients. Ketamine reduced the incidence rate of postanesthetic shivering compared to a placebo (odds ratio [OR]: 0.13, 95% confidence interval [CI]: 0.06 to 0.26, P＜0.01). Regarding side effects, there was no evident variability of the incidence of nausea and vomiting. Usage of ketamine was associated with a lower rate of hypotension and bradycardia when compared to a placebo. Hallucinations were more frequently observed in patients who received higher doses of ketamine. No significant difference was found in the incidence of postanesthetic shivering with ketamine versus other pharmacological interventions.
Conclusions
Ketamine can prevent postanesthetic shivering without severe side effects. However, ketamine shows no advantage over other anti-shivering drugs.
Working Well: Strategies to Strengthen the Workforce of the Indigenous Primary Healthcare Sector
Authors: Jongen Crystal , McCalman Janya , Campbell Sandy , Fagan Ruth
Published: October 2019

Background

The capacity of the Indigenous primary healthcare (PHC) sector to continue playing a crucial role in meeting the health needs of Aboriginal and Torres Strait Islander Australians is in large part reliant on the skills, motivation and experience of its workforce. While exhibiting many workforce strengths, the sector faces significant challenges in building and maintaining a strong and stable workforce. Drawing on data from one Aboriginal Community Controlled Health Service (ACCHS), this study reports what is working well and what could be improved to strengthen the Indigenous PHC sector workforce.Methods

Using grounded theory methods, interviews with 17 ACCHS staff from a range of organisational positions were transcribed, coded and analysed. This paper focuses on the strategies identified that contribute towards strengthening the Indigenous PHC workforce.Results

Four overarching strategies for Indigenous PHC workforce strengthening were identified. These were Strengthening Workforce Stability, Having Strong Leadership, Growing Capacity, and Working Well Together . A range of enabling factors at the macro, community, organisational and individual levels were also identified.Conclusion

Indigenous PHC services are already implementing many important workforce-development strategies that are having a positive impact on the sector. There are also several persistent challenges which need to be addressed through action at organisational and structural levels. Approaches to workforce strengthening in Indigenous PHC should be tailored to local needs to ensure they address the unique workforce challenges experienced in different contexts.
Burden of Relapsing-Remitting Multiple Sclerosis on Workers in the US: A Cross-sectional Analysis of Survey Data
Authors: Nicholas Jacqueline , Electricwala Batul , Lee Lulu K. , Johnson Kristen M
Published: October 2019

Background: Multiple sclerosis (MS) is prevalent among working age individuals (20-60 years), leading to high burden on work productivity. Few data are available about the absenteeism and presenteeism in employed individuals with MS in comparison to non-MS personnel. This study aimed to quantify the burden of illness of employed US adults with relapsing-remitting multiple sclerosis (RRMS) and examine burden by levels of work impairment.
Methods: A retrospective cross-sectional analysis was conducted using patient-reported responses from the US National Health and Wellness Survey (NHWS). Data from NHWS 2015-2016 were analyzed from 196 employed RRMS respondents who were matched 1:4 to employed respondents without MS based on demographic and general health characteristics. Demographic and general health characteristics for employed RRMS individuals were analyzed by levels of work impairment (none, 1-30%; 31-68%; 69-100%). Work productivity (absenteeism, presenteeism, and work impairment), decrements in health-related quality of life (HRQoL) (short form-36, EQ-5D), and healthcare resource utilization (HCRU) were compared to determine the burden of RRMS.
Results: After propensity score matching, the levels of absenteeism and presenteeism were 2 and 1.8 times higher in the employed RRMS population than the employed non-MS population, respectively (P<0.001 for both). HRQoL was significantly lower in employed respondents with RRMS than those without MS (P<0.001 for all). Employed respondents with RRMS had significantly more HCRU over 6 months compared to those without MS (P<0.001). Furthermore, among employed RRMS respondents, greater levels of impairment were associated with increasing disease severity, greater healthcare resource use, fatigue, and cognitive impairment and inversely associated with mental and physical HRQoL (P<0.0001 for all).
Conclusions: Among employed individuals, respondents with RRMS had lower, work productivity, HRQoL, and higher HCRU as compared with those without MS. Given the large impact RRMS has on work impairment, a need exists to manage individuals on therapies that improve HRQoL, reduce symptoms, and improve their ability to perform in the workforce.
Keywords: Absenteeism, presenteeism, healthcare resource utilization, relapsing-remitting multiple sclerosis, work impairment.
Comparison of bilateral versus unilateral total knee replacement on pain levels and functional recovery
Authors: Alghadir Ahmad H , Iqbal Zaheen A , Anwer Shahnawaz , Anwar Dilshad
Published: October 2019

Background: Total knee replacement (TKR) is a common operative procedure to improve pain, function, and quality of life in patients with severe grade knee osteoarthritis. The current study aimed to compare bilateral versus unilateral total knee replacement (TKR) on pain intensity and recovery of function.Methods: A total of 80 patients (bilateral 50, unilateral 30) aged 63.28 (9.4) years undergone TKR participated in the current study. The participants were admitted for 5-7 days in the hospital. Participants in both the group received similar inpatient and outpatient physiotherapy sessions. Pain intensity and function capacity were assessed at baseline, day 7, and day 30 postoperatively using visual analogue scale (VAS) and lower extremity functional scale (LEFS), respectively. Repeated measures analysis of variance was used to analyze the data. Results: Both the group showed a significant reduction of pain intensity and improvement in the functional capacity following TKR at 30 days post-operatively (p<0.001). However, there was a non-significant difference noted between bilateral versus unilateral TKR on the reduction of pain intensity and improvement in the functional capacity at 30 days postoperatively (p>0.05).Conclusion: Bilateral TKR was associated with a similar reduction of pain intensity and recovery of function compared to unilateral TKR, suggesting the use of Bilateral TKR in patients with bilateral knee osteoarthritis to reduce costs and co-morbidity related to staged bilateral TKR.
Associations of Mitochondrial DNA 3777-4679 region mutations with maternally inherited essential hypertensive subjects in China.
Authors: Zhu Ye , You Jia , Xu Chao , Gu Xiang
Published: October 2019

Background: Nuclear genome or family mitochondrial screening system has become the hot focus of studies into essential hypertension. The role of mitochondrial DNA (mtDNA) in sporadic Chinese patients with hypertension has not been fully understood. The study was to evaluate the associations of mtDNA mutations with maternally inherited essential hypertensive (MIEH) subjects in China. Methods: From June 2009 to June 2016, a total of 800 gender-matched Chinese patients with maternally inherited essential hypertension (MIEH) and control group were 1:1 enrolled in this case-control study. Genomic DNA was extracted from each person's peripheral blood cells. The main mtDNA locations for MIEH were screened with oligodeoxynucleotides 3777-4679bp, analyzed and compared with the updated consensus Cambridge Sequence. Pathogenic mtDNA mutations were identified from the mitochondrial map. Results: MIEH subjects presented significantly higher values than those of control group in abdominal circumference(AC), waist circumference(WC), body mass index(BMI), fasting blood glucose(FBG), triglyceride(TG), low-density lipoprotein cholesterol (LDL) and renal function ( P <0.05). MIEH subjects carried more amino acid changes and coding sequence variants ( P <0.01) than control group. The allele frequencies of the eight single nucleotide polymorphisms(SNPs) were significantly different between the two groups, including C3970T, G4048A, C4071T, C4086T, A4164G and T4248C in ND1 gene, and T4386C and C4394T in tRNA Gln gene( P <0.001). Fifty-five homoplasmic or heteroplasmic mutations were detected in 5 genes: ND1, tRNA Ile , tRNA Met , tRNA Gln and ND2 gene. The ND1 gene was the main mutation site, where the most mtDNA mutation was C3970T. Conclusions: The results convincingly proved that mtDNA mutations were involved in the process of MIEH. We identified mitochondrial genetic characteristics in MIEH patients in China. The present research serves as a solid foundation for further detailed research on the association between MIEH and mitochondrial dysfunction, and their causal relationship in Chinese and other populations with a similar lifestyle.
Exploring the Roles of Fecundity-related mRNAs and Long Non-coding RNAs in the Adrenal Glands of Small-tailed Han Sheep
Authors: Xia Qing , Li Qiuling , Gan Shangquan , Guo Xiaofei , Zhang Xiaosheng , Zhang Jinlong , Chu Mingxing
Published: October 2019

Background Long non-coding RNAs (lncRNAs) can play important roles in uterine and ovarian functions. However, little researches have been done on the role of lncRNAs in the adrenal gland of sheep. Herein, RNA sequencing was used to compare and analyze gene expressions in adrenal tissues between FecB ++ (WW) and FecB BB (MM) sheep in the follicular and luteal phases and key lncRNAs and genes associated with reproduction were identified.Results In MM sheep, 38 lncRNAs and 545 mRNAs were differentially expressed in the adrenal gland between the luteal and follicular phases; In WW sheep, 30 differentially expressed lncRNAs and 210 mRNAs were identified. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses indicated that differentially expressed lncRNAs and their target genes are mainly involved in the circadian rhythm, the mitogen activated protein kinase, thyroid, ovarian steroidogenesis and transforming growth factor beta signaling pathways. Key lncRNAs can regulate reproduction by modulating genes involved in these signaling pathways and biological processes. Specifically, XLOC_254761 , XLOC_357966 , 105614839 and XLOC_212877 targeting CREB1 , PER3 , SMAD1 and TGFBR2 , respectively, appear to play key regulatory roles.Conclusion These results broaden our understanding of lncRNAs in adrenal gland of sheep and provide new insights into the molecular mechanisms underlying sheep reproduction.
A modified approach Pancreaticoduodenectomy feasible for recurrent cancer in No. 13 lymph node following gastrectomy
Authors: Feng Yechen , Zhang Hang , Qin Renyi
Published: October 2019

Background In a proportion of patients with recurrence of gastric cancer after surgery, that recurrence is in the No. 13 lymph node group. The treatment of these patients are still controversal and challenging. Here we used a modified ‘Artery-first’ approach technique and retrospective analysis the data to examined the efficacy and feasibility of reoperative pancreaticoduodenectomy for recurrent cancer in this lymph node group after initial subtotal gastrectomy.
Methods From January 2011 to December 2015, 24 patients underwent pancreaticoduodenectomy with a modified ‘Artery-first’ approach technique for recurrent gastric cancer in the No. 13 lymph node group at Tongji Hospital, Wuhan, China. Their medical records were retrospectively reviewed for relevant clinical characteristics, type of first and second surgical procedures, TNM stage, adjuvant treatments, complications, and survival. Kaplan–Meier curves were used to analyze survival.
Results The median interval between the first and second operations was 7.5 (range 4.5–13.5) months and the median duration of follow-up 20.1 (range 5–58) months. The median operation time was 6.5 (range 5.0–9.9) hours, and median blood loss 448 (range 110–1200) mL. The median intensive care unit stay was 1.5 (range 1–4) days and the median postoperative hospital stay 31.6 (range 15–55) days. No patient died. Two had serious complications. The median survival after pancreaticoduodenectomy was 28 (range 5–58) months. 13 patients had subsequent recurrence. T stage, N stage, and adequacy of resection influenced survival.
Conclusion s Pancreaticoduodenectomy with a modified ‘Artery-first’ approach technique is a reasonable treatment option for recurrent remnant gastric cancer following unexpanded lymphadenectomy, particularly for patients with no distant metastases. Additionally, D2+ lymphadenectomy may be more effective than D2 lymphadenectomy in patients with locally advanced gastric cancer.
Reform of health-care payments for Chinese medical insurancepractices in Luohu District, Shenzhen City, Guangdong Province
Authors: Gong Fangfang , Sun Xizhuo , Li Wenhai , Zhang Zou , Li Yanan
Published: October 2019

Background Following the implementation of the Healthy China 2030 strategy, China’s health-care system must shift from being disease-centered to health-centered. Medical insurance funds are the main economic resource for medical health-care service providers in China; therefore, the Chinese medical insurance system has become an important economic lever for adjusting the behavior of medical health-care providers. In the new round of medical reform, substantial progress has been made in the construction of a medical treatment insurance system. The world’s largest medical insurance network has been created in a relatively short period in China and basically achieves universal medical insurance coverage. However, this system mainly provides full coverage to the amount and has yet to fully achieve the principle of “health-care for all” proposed by the Healthy China 2020 strategy. China must promote reform in the medical insurance system and establish a medical insurance guidance mechanism to ensure that medical service providers consider and promote health care. Methods Using Luohu Hospital Group in Shenzhen City, Guangdong Province as the research object, the details of the health maintenance organization’s reform of its medical insurance payment patterns to be more health-oriented are introduced. Comparing the summarized characteristics of the health maintenance organization’s payment patterns, the relevant data for the medical insurance operation and health status of the insured before and after the reform were analyzed statistically. Results The data show that after the reform, the total hospitalization cost of the insured, number of inpatients, and hospitalization rate all decreased. The growth rate of expenditure in the medical insurance fund slowed and initial results were shown in preventive health-care work. The incidence of some infectious diseases and the hospitalization rate of patients with chronic diseases decreased. Conclusions The medical service providers form positive incentives and appropriate medical orientations, while patients demanding health care may form good habits of seeking medical treatment and healthy life, but not pursuing economic benefits through the medical insurance reform.
Time trends analysis of statin prescription prevalence, therapy initiation, dose intensity, and utilization
Authors: Liu Yujuan , Lv Xiaoqun , Xie Ning , Fang Zhonghong , Ren Weifang , Gong Yuan , Jin Yan , Zhang Jun
Published: October 2019

Background Statin remains a mainstay in the prevention and treatment of cardiovascular disease. Statin utilization has evolved over time in many counties, but data on this topic from China are quite limited. This study aimed to investigate the changing trends of statins prescription, as well as detail the statin utilization through a successive longitudinal study. Methods Prescription database was established based on electronic health records retrieved from the hospital information system of Jinshan Hospital, Fudan University from January 2012 to December 2018 in Shanghai, China. The prescription rates and proportions of different statin types and doses among all patients were examined. Sub-analyses were performed by stratified by age, gender, dose intensity, and preventative intervention.Results During the study period, a total of 51,083 patients exposed to statins were included in this study (mean [SD] age, 59.78 [±13.16] years; 53.60% male, n =27, 378). The overall statins prescription rate in patients increased from 2012 (1.24%, 95% CI: 1.21%-1.27) to 2018 (3.16%, 95% CI: 3.11%-3.20%), P <0.001. Over 90% of patients were given a moderate dose of statins. Our study has witnessed a significant rise in statin therapy in primary and secondary prevention. Patients with a history of coronary or cerebrovascular events were more likely to be prescribed with statins for preventative intervention. Conclusions In conclusion, statins were frequently prescribed and steadily increased over time. However, in clinical practice, statins prescription rate in patients may be sub-optimal in local residents. A coordinated effort among the patient, clinical pharmacist, stakeholders and health system is still needed to improve statin utilization accordingly. Keywords: statins, prevalence, cardiovascular disease, initiation, preventative intervention.
Frequency of use of terminal points as an important risk factor for Legionella colonization in hospitals
Authors: Lucas Rafael Manuel Orti , Luciano Eugenio
Published: October 2019

Background: Hospitals have a different structure than domestic buildings. Legionella is a bacterium that can colonize the hospital water causing many outbreaks. It’s a Public Health problem and its prevention and control are essential to avoid nosocomial infections. The aims of this study are to evaluate several risk factors and parameters that can contribute to Legionella colonization in a hospital, thereby improving Legionella risk assessment process. Methods A total of 136 water samples (hot water and cold water) was investigated from different points of a hospital water network. These samples were tested for Legionella sp by three laboratories using different diagnostic tests: culture, polymerase chain reaction (PCR) and a method based on immunomagnetic separation (IMS). The results for these three techniques were combined and interpreted by three microbiologists with the aim of defining a new standard index. A multivariate analysis was performed by logistic regression to estimate the adjusted risk associated with the type of water, length of the pipe, chlorine, temperature, type of terminal point, period of the year, type of health care (ambulatory or hospital) and the frequency of use of the terminal point. Results: There was no statistically significant difference, on the basis of the new standard index, neither between laboratories nor between diagnostic tests. Positive results of this index were significantly correlated with the outpatient medical consultations, shower, frequency of use of the terminal points, and temperature. Logistic regression model revealed that outpatient medical consultations (p=0.058), shower (p=0.007) and the frequency of use of the terminal points (p=0.001) are predictors of Legionella colonization. Conclusions: The inclusion of rapid techniques (IMS, PCR) in the development of a new standard index offer increased sensitivity of Legionella detection improving classical control strategies usually based on the culture method. The proportion of hospital water-system sites testing positive, according to the defined standard index, was well correlated with the frequency of use of terminal points and the temperature, suggesting that the control of these factors may help prevent legionnaires' disease in the hospital.
The level of Bilirubin and the risk of ischemic stroke: a systematic review and dose-response meta-analysis of real-world studies
Authors: Wang Xiao , Zhou Yang , Ye Xiaofei , Liu Fangchen , Zhu Xi , Wu Danhong , Zhong Ping
Published: October 2019

Background: Bilirubin, a marker of hepatic and hematological diseases in clinical practice, is not only a waste end-product but also an antioxidant that may protect against diseases associated with oxidative stress. Numerous epidemiological studies have shown an inverse relationship between the serum total bilirubin (TB) level and the risk of ischemic stroke (IS). However, markedly elevated TB levels may exert neurotoxic effects. Based on this, we conducted a dose-response meta-analysis to quantify the relationship between blood TB and IS as well as between TB and all types of stroke (AS) in the physiological range of bilirubin.Methods: PubMed, Embase, Web of Science, and Cochrane Central databases were searched up to March 2019. Additional studies were identified by reviewing references and contacting authors. Categorical and dose-response meta-analyses were performed to quantify the relationship between TB and IS. The primary outcome was ischemic stroke, and the secondary outcome was all types of stroke.Results: Nine observational studies (seven publications) involving 110,032 participants and 3710 stroke cases were included for analysis. The average OR of IS for every 1 µmol/L increment in TB level was 0.978 (95%CI: 0.957–0.999). The summary OR of AS for every 1 µmol/L increment in TB level was 0.974 (95%CI: 0.956–0.992). Subgroup analysis based on gender showed a negative dose-response relationship between the circulating TB level and IS or AS in males, but not in females.Conclusions: The present study indicates a negative dose-response relationship between the circulating TB level and the risk of IS or AS within physiologic range of serum TB in males. Moderately elevated blood TB levels were associated with a diminished prevalence of IS. Every 1 µmol/L increment in serum TB level was associated with a 2.2% decrease in the risk of IS and a 2.6% decrease in the risk of AS. Large-scaled prospective studies are needed to confirm the conclusion of the current analysis.Trial registration: This study was registered at PROSPERO(https://www.crd. york.ac.uk/PROSPERO/[CRD42017075988]).
Cerebrospinal fluid of chronic osteoarthritic patients induced interleukin-6 release in human glial cell-line T98G
Authors: Liu Weiling , Li Chunmei , Tan Francis Chee Kuan , Neo Hong Jye , Chan Yiong Huak , Low Chian-Ming , Lee Tat Leang
Published: October 2019

Background: Chronic osteoarthritic pain is not well understood in terms of its pathophysiological mechanism. Activated glial cells are thought to play a role in the maintenance of chronic pain. T98G glioblastoma cell line was previously observed to release higher amounts of interleukin-6 (IL-6) when treated with cerebrospinal fluid (CSF) from patients with another chronic pain condition, post-herpetic neuralgia. In this study, we investigated the ability of CSF from patients diagnosed with knee osteoarthritis (OA) suffering from chronic pain, to trigger the release of pro-inflammatory cytokines, IL-6, IL-1beta and tumour necrosis factor alpha (TNF-α) from T98G. Characterization of upstream signalling was also explored. Methods: 15 OA patients undergoing total knee replacement and 15 patients without pain undergoing surgery with spinal anaesthesia were prospectively recruited. CSF was collected during anaesthesia prior to surgery. CSF were added to cultured T98G cells. IL-6, IL-1β and TNF-α release from T98G cells were measured using enzyme immunoassay. Antibody array and western blotting were performed on CSF-triggered T98G cell lysates to identify possible signalling targets. Age, gender and pain scores were recorded. Mann-Whitney U test was used to compare IL-6 release and protein expression between groups. Association between IL-6 and pain score was analysed using linear regression.Results: Compared to CSF of patients without pain, significantly higher IL-6 levels were released by T98G cells when induced by CSF from OA patients. The IL-6 levels showed positive association with pain score (adjusted B estimate= 10.1 (95% Confidence Interval 4.3-15.9); p= 0.001). Array conducted with OA pain patient pooled CSF identified several proteins being upregulated greater than 2-fold including STE20-related kinase adaptor protein and spleen tyrosine kinase. Further validation in western blotting of individual samples was unable to show similar significant increase.Conclusion: IL-6 is a potential biomarker crucial in the maintenance phase of chronic pain in both OA and post-herpetic neuralgia (PHN). Identification of signalling pathways involved in pain using pooled CSF on antibody array yield several protein of interest. However, those targets are inconsistent when individually validated using western blotting. Exploring other protein targets is required to identify the signalling mechanism of chronic pain.
“Too Much to Ask, Too Much to Handle”: Women’s Coping in Times of Zika
Authors: Arias Ana Rosa Linde , Furtado Grace , Tristan-Cheever Elisa , Siqueira Eduardo
Published: October 2019

Background and Objectives Zika virus infection during pregnancy is a cause of congenital brain abnormalities. Its consequences to pregnancies have made governments, national and international agencies issue advice and recommendations to women. This study was designed to develop an initial understanding of the impacts of Zika on women of reproductive age who lived in areas with or without local transmission. The impacts on women who were less directly affected and less vulnerable to Zika were analyzed. The hypothesis was that all women were impacted by the epidemic. Methods A qualitative study was carried out. Women were recruited through the snowball sampling technique from various locations in Brazil, Puerto Rico, and the United States. They were of different nationalities and ethnicities. Data were collected through semi-structured interviews. The data transcripts were analyzed using thematic analysis. Results The social effects of the epidemic affect more women than had been thought before and at deeper emotional levels. Women perceived that the public health systems were placing an unfair responsibility for preventing health complications from Zika onto women who have limited ability. They also stated that the measures recommended to them were invasive, while creating the perception that women were the sole determinant of whether they contracted Zika. The results indicate that women with higher levels of education understood the limitations of the information, government actions, and medical care they received, which ended up producing higher levels of anguish and worry. Conclusions Women appeared to be disproportionately affected by the reproductive implications of the epidemic, even when they were only indirectly affected. Gender inequality and gender discrimination must be recognized and rendered visible in the public health emergency response. It is shown the importance of considering cultural aspects and behaviors when implementing health prevention or protection measures to control epidemics.
Characteristics and risk factors for extrauterine growth retardation in very-low-birth-weight infants
Authors: Zhao Xingli , Ding Li , Chen Xiaoqian , Zhu Xueping , Wang Jian , Cui Ningxun
Published: October 2019

This study aimed to investigate the characteristics and risk factors for extrauterine growth retardation (EUGR) in very-low-birth-weight infants (VLBWIs). The medical records of 137 VLBWIs admitted to the neonatal intensive care unit between June 2015 and December 2017 were retrospectively reviewed. The patients were divided into EUGR (n = 92) and non-EUGR (n = 45) groups. The data of demographic and clinical characteristics was collected and the risk factors for EUGR were assessed by multivariate logistic regression analysis. Gestational age (OR = 0.573, P < 0.01), SGA (OR = 3.887, P = 0.022), feeding intolerance (OR = 4.632, P = 0.002), and calories supplied by amino acids at the 7 th day (OR = 0.786, P = 0.006) were independent high-risk factors for EUGR. EUGR in VLBWIs may be prevented by strategies including early lactation, providing special formulas to reduce feeding intolerance, and sufficient calorie provision.This study aimed to investigate the characteristics and risk factors for extrauterine growth retardation (EUGR) in very-low-birth-weight infants (VLBWIs). The medical records of 137 VLBWIs admitted to the neonatal intensive care unit between June 2015 and December 2017 were retrospectively reviewed. The patients were divided into EUGR (n = 92) and non-EUGR (n = 45) groups. The data of demographic and clinical characteristics was collected and the risk factors for EUGR were assessed by multivariate logistic regression analysis. Gestational age (OR = 0.573, P < 0.01), SGA (OR = 3.887, P = 0.022), feeding intolerance (OR = 4.632, P = 0.002), and calories supplied by amino acids at the 7 th day (OR = 0.786, P = 0.006) were independent high-risk factors for EUGR. EUGR in VLBWIs may be prevented by strategies including early lactation, providing special formulas to reduce feeding intolerance, and sufficient calorie provision.
The effects of anesthesia induction and positive pressure ventilation on right-ventricular function: An echocardiography-based prospective observational study
Authors: Magunia Harry , Jordanow Anne , Keller Marius , Rosenberger Peter , Nowak-Machen Martina
Published: October 2019

Background:
General anesthesia induction with the initiation of positive pressure ventilation creates a vulnerable phase for patients. The impact of positive intrathoracic pressure on cardiac performance has been studied but remains controversial. 3D echocardiography is a valid and MRI-validated bed-side tool to evaluate the right ventricle (RV). The aim of this study was to assess the impact of anesthesia induction (using midazolam, sufentanil and rocuronium, followed by sevoflurane) with positive pressure ventilation (PEEP 5, tidal volume 6 – 8 ml/kg) on 2D and 3D echocardiography derived parameters of RV function.
Methods:
A prospective observational study on fifty-three patients undergoing elective cardiac surgery in a tertiary care university hospital was designed. Transthoracic echocardiography exams were performed before and immediately after anesthesia induction and were recorded together with hemodynamic parameters and ventilator settings.
Results:
After anesthesia induction TAPSE (mean difference -1.6mm (95% CI -2.6mm to -0.7mm; p=0.0013) as well as the Tissue Doppler derived tricuspid annulus peak velocity (TDITVs’) were significantly reduced (mean difference -1.9% (95% CI: -2.6 to -1.2; p<0.0001), but global right ventricular ejection fraction (RVEF; p=0.1607) and right ventricular stroke volume (RVSV; p=0.1838) did not change.
Conclusions:
This data shows a preserved right ventricular ejection fraction and right ventricular stroke volume after anesthesia induction and initiation of positive pressure ventilation. However, the baso-apical right ventricular function is significantly reduced. Larger studies are needed in order to determine the clinical impact of these findings especially in patients presenting with impaired right ventricular function before anesthesia induction.
Trial registration:
Retrospecitvely registered, 6th June 2016, ClinicalTrials.gov Identifier NCT02820727.
Epidemiology and clinical characteristics of pathogens responsible for the hospitalization of children with segmental/lobar pattern pneumonia
Authors: Yanxia Wang , Liji Ma , Ying Li , Li Yuyun , Zheng Yanfei , Zhang Xiaoyue
Published: October 2019

Backgrounds: The occurrence of segmental/lobar pattern pneumonia (S/L-PP) in children has recently increased. The pathogens of the disease may change due to the misuse of antibiotics and the application of vaccines. Therefore, pathogens of S/L-PP in hospitalized children and their association with clinical characteristics may have changed. Objective: To analyze the pathogens of S/L-PP in hospitalized children and their association with clinical characteristics. Methods: The current study analyzed the epidemiological and clinical characteristics of pathogens in children with S/L-PP under 14 years old at a single hospital between 1 st Jan 2014 and 31 st Dec 2018 retrospectively. The pathogens were detected by microbial cultivation, and/or indirect immunofluorescence of the kit (PNEUMOSLIDE IgM), and/or ELISA, and/or realtime PCR in the samples of the patients. Results: A total of 593 children with S/L-PP received treatment at a single hospital during the study period by inclusion criteria. 451 (76.05%) patients were single positive for one pathogen and 83 (14.00%) patients had multiple infections. Mycoplasma pneumoniae ( M.pneumoniae ) (72.34%) was the most frequently identified pathogen, followed by Streptococcus pneumoniae ( S.pneumoniae ) (8.77%). The infection of M.pneumoniae in children with S/L-PP increased with time (p<0.05). The positive rate of M.pneumoniae increased with ages of patients (p<0.05). M.pneumoniae was statistically associated with extrapulmonary manifestations while S.pneumoniae was statistically associated with abnormal white blood cells (WBCs) and C reactive proteins (CRPs) (p<0.05). Conclusion: M.pneumoniae was the most frequently identified pathogen in children with S/L-PP. The positive rate of M.pneumoniae in children with S/L-PP increased with time and the ages of children. M.pneumoniae was associated with extrapulmonary manifestations while S.pneumoniae was associated with abnormal WBCs and CRPs.
Time-series evidence on corporate governance in Thailand: the effect on expected stock returns
Authors: Kakinuma Yosuke
Published: October 2019

This paper presents an empirical evidence of a time-varying relationship between corporate governance and its impacts on stock returns in Thailand. The governance grades assessed by the Thai Institute of Directors are used as governance measurement for the analysis. The parameters estimated by Fama-Macbeth regression indicate that firms with higher governance ratings generate greater expected stock returns in a long run. However, on yearly basis, the positive relationship deteriorates and loses explanatory power in the most of the tested years. The coefficients of governance ratings estimated by fixed effect regression are examined for statistical difference, which confirms that effect of corporate governance on stock returns differs year by year. While there are some distinct years that governance ratings affect stock prices positively, higher governance ratings lead to lower returns in other particular years. The both positive and negative magnitudes of corporate governance’s impact on expected returns do not stay the same over time. Good governance practice at a firm does not always yield positive returns to investors.
Structural Effects of Eurasian Integration
Authors: Migranyan A. A.
Published: October 2019

The article analyzes the achievements, stages of the formation of Eurasian integration and shows the nature of the impact of integration processes on the economic situation of the participating countries. Eurasian integration processes from the moment of the creation of the Customs Union and before its reformatting into the Eurasian Economic Union and the common market of goods and services had a direct impact on the state and dynamics of the main macroeconomic indicators of the member states. The common economic space has led to the rapid transfer of macroeconomic effects, which makes it possible to consider the EAEU as a powerful factor in macroeconomic stabilization during crisis recessions. At the same time, the expectations of positive effects from the functioning of the EAEU were justified only in the initial stages of the formation of a common commodity market due to the effect of trade liberalization. The structure and geography of commodity flows in the EAEU developed inertia, due to the sectoral structure of the national economies of the Union member states. The trade interaction of the countries that make up the integration block is characterized by monocentricity and a higher level of differentiation, which makes it possible to compensate part of the losses while lowering the intensity of foreign trade to stimulate the development of the real sector. Investment cooperation in the EAEU is limited to traditional sectors of the commodity sector and trade finance. The buildup of synergistic effects between the countries of the EAEU has an extensive nature, while a transition to an intensification strategy is needed through the formation of production cooperation platform.
The Eurasian Economic Union Custom – Tariff Regulation of the Trade with the People's Republic of China
Authors: Kovaleva E. V. , Mamysheva J. K.
Published: October 2019

China is the second most important (after the European Union) economic partner of the EAEU. This Partnership has a strategic long-term character. In the early 90s liberalization of economy in China and market reforms in Russia and the other countries of the EAEU affected the increasing commodity turnover between China, Russia and other states. Due to the increasing role of People's Republic of China in a foreign trade turnover of EAEU it would be relevant to consider the features of custom-tariff regulation between China and the EAEU. The article is devoted to the problems of the theoretical and legal framework of the trade and economic cooperation between China and the the манушинаEAEU countries, the problem of the Eurasian Economic Union, custom-tariff regulation system (with the example of The Great Stone) and the analysis of its peculiarities. The key problems of the Eurasian Economic Union custom-tariff regulation system of the trade with the People's Republic of China based on the statistics from the national statistics committees, the ways of its development aimed at improving trade efficiency and also the possible effects are estimated.
World Academic Rankings and Competitiveness of Russian Universities
Authors: Stukalova I. B. , Shishkin A. V. , Stukalova A. A.
Published: October 2019

Advance in the world academic rankings remains one of the priorities of development of the Russian higher education determined by the President and the Government of the Russian Federation.As an axiom authors adopted the provision that the academic ratings are the tool of assessment of level of competitiveness of the national universities, and a rating position of the university – a peculiar integrated indicator of its competitiveness. Authors offered hierarchy of levels of competitiveness of subjects of the higher education system. The results of the analysis of dynamics and the current position of the Russian universities in the world academic rankings (on the example of the rating of QS), analysis of participation in the rating of the QS universities of the countries of EEU and also analysis of perception of a rating position of the university by potential customers and consumers of educational services are given in the article. By an empirical way it is proved that ones the interest of target audience in a rating position of the university as to an indicator of its competitiveness and as to criterion for selection of higher education institution grows. Methodological basis of the research conducted by authors of article were the principles of scientific knowledge: logical and historical. Methods of the structural, comparative and statistical analysis are applied.