bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of vineyard ‘potential’ and grape maturation on the aroma-volatile profile of Grenache wines
Authors: Escudero Ana , Arias Ignacio , Lacau Blanca , Astraín Jesús , Barón Cristina , Fernandez-Zurbano Purificación , Ferreira Vicente
Published: November 2019

Background and aims: Wine is a beverage characterized by its pleasant aromatic features. These sensory notes are determined by the specific concentrations of odorous chemical compounds in each wine. Many of these aroma compounds arise directly or indirectly from the grapes, and their formation is affected by both grape metabolism and the viticultural ecosystem. Two studies were done with the 2015 vintage of Vitis vinifera L. cv. Grenache in Denominación Origen Somontano, a wine region of northern Aragon, Spain. In one study, we analysed wine from vineyards with different potentials: high potential, defined by balanced yield and high exposed leaf area (surface foliaire exposée, SFE, expressed in square metres) relative to production (P, expressed as kilograms of grapes) (i.e. high SFE:P ratio); and low potential, defined by unbalanced yield and low SFE:P ratio. In the other study, we analysed wine produced from grapes harvested at different times and therefore at different stages of ripening. The aim was to determine the effects of these variables on the aromatic compound profile of the wines.
Methods and results: Concentrations of major aroma compounds were determined by gas chromatography (GC) with flame ionization detection, those of minor and trace aroma compounds by GC–mass spectrometry (MS), and those of pyrazines by thermal desorption–GC coupled with GC–MS. In the first study, wines from high-potential vineyards had higher concentrations of some compounds, such as esters of fermentative origin (isoamyl acetate, ethyl lactate and diethyl succinate), esters of varietal origin (ethyl dihydrocinnamate, methyl vanillate and ethyl vanillate), and terpenols (linalool and geraniol). In contrast, wines from low-potential vineyards had higher concentrations of 3-isopropyl-2-methoxypyrazine, γ-nonalactone and volatile phenols. In the second study, concentrations of varietal compounds such as rotundone and linalool increased with extended maturation. Furthermore, as ripening progressed, the ester to acid ratio for linear fatty acid ethyl esters generally increased while that for branched fatty acid ethyl esters tended to decrease. Acetaldehyde concentration was decreased in wines produced from grapes harvested at the latest date, a result that may be related to increased polyphenol content.Conclusions: The results of these studies provide an approximation of how the aromatic compound profile of a Grenache wine may differ between vineyards with different characteristics.Significance and impact of the study: We suggest explanations for these differences, which may guide the choice of harvest date.
Possibilities of Combination of Beta-blockers and Ivabradine in Patients with Stable Angina Pectoris
Authors: Kashtalap V. V. , Barbarash O. L. , Sedykh D. Yu. , Krivoshapova K. E. , Tsygankova D. P. , Tsygankova O. V.
Published: November 2019

Aim. To evaluate the therapeutic efficacy of a combination of ivabradine and beta-blockers (BAB) in patients with stable angina, initially taking only BAB and not reaching the target heart rate (HR) due to the risk of hypotension.

Material and methods. A prospective observational post-registration study was performed at the Research Institute for Complex Issues of Cardiovascular Diseases. The study included 50 patients with stable angina pectoris (diagnosed by coronary angiography in combination with clinical manifestations of angina of functional class II-III according to the Canadian classification) and an initial sinus rhythm with a heart rate of more than 70 beats per minute. These patients have already taken BAB. Heart rate, the number of angina attacks, nitrate intake and quality of life indicators according to the questionnaire were evaluated as criteria for therapeutic efficacy.

Results. Taking the study drug in combination with BAB led to a significant decrease the average heart rate at rest by 20%, as well as after a six-minute walk test (TLC) in most patients (p<0.050), and a decrease in the total number of angina attacks per week from 5 to less than 1 (p<0.050) and the frequency of nitrate intake for the relief of angina attacks from 58% to 20% (p=0.001). Therapy with ivabradine (Bravadin) was well tolerated by patients: there were no adverse events in the observed sample of patients, patients had a high adherence to treatment (100% of the contents of handed out blisters were used). During the 3 months of follow-up, according to the EQ-5D-5L quality of life questionnaire, patients improved their perception of their own health level (p<0.050), the number of patients experiencing mild (p=0.034) and strong (p=0.041) mobility limitations decreased; strong (p=0.024) restriction in self-care, mild (p=0.041) and strong (p=0.024) restriction of daily activities, mild manifestation of pain (p=0.009) and mild anxiety (p=0.027) also were reduced compared with the initial questionnaires.

Conclusion. Ivabradine (Bravadin) in addition to BAB is an effective and safe antianginal therapy for the prevention of angina attacks by reducing the initially high heart rate in patients with angina pectoris of functional class II-III.
Comparative Study of the Results of a Three-year Observation of Cardiologists and Surgeons in Patients with Peripheral Atherosclerosis
Authors: Barbarash L. S. , Sumin A. N. , Medvedeva Yu. D. , Korok E. V.
Published: November 2019

Aim.To compare the results of 3-year follow-up of patients with peripheral atherosclerosis (PA) in two patient cohorts: during outpatient monitoring by cardiologists and when observed by surgeons.

Material and methods. The first group included 131 patients with PA who sought medical attention in outpatient clinic in 2013-2014 and then were observed by a surgeon. The second group is represented by 454 patients with PA who sought medical attention in outpatient clinic in 2010- 2012 and then underwent observation by a cardiologist as a part of a pilot project. The average follow-up duration in the studied groups was three years. The groups were compared according to the main demographic, anthropometric indicators, the presence of risk factors for atherosclerosis, comorbidity, the prevalence of atherothrombotic events in history, laboratory and instrumental examination data. Additionally, after 3 years of observation the incidence of deaths and amputations was assessed in groups.

Results. Patients of the second group were older than these in the first group (p<0.001). Patients of the group 1 compared to the group 2 were more often overweight (p=0.005), suffered from diabetes mellitus (p<0.001), had a disability (p<0.001). Among patients of the group 2 compared with the group 1, the clinical picture of angina pectoris (p=0.001), rhythm disorders (p=0.058) were more often observed, they had a greater number of myocardial infarctions (p<0.001) and myocardial revascularization operations in the history: coronary bypass surgery (p=0.029), percutaneous coronary interventions (p<0.001), and underwent coronary angiography (p<0.001). Patients in group 2 were more likely to receive statins (p<0.001), β-blockers (p<0.001), angiotensin-converting enzyme inhibitors, and calcium channel blockers, angiotensin II receptor blockers, and antiarrhythmics (p<0.001). Pentoxifylline was prescribed more often in the first group (p<0.001). With a three-year observation of PA patients a fatal outcome occurred in 8.2% of cases, amputation – in 1.4%. In the first group, compared with the second one, there were more often observed deaths in general (p=0.023), death from cardiac causes, stroke, disability (p=0.005) and amputations (p=0.003). The risk of adverse outcomes (death and amputations) was increased in the presence of signs of chronic lower limb ischemia of stage III, a history of amputation, more than 70% stenosis and occlusions of lower limb arteries, chronic lung disease, and angina symptoms. The risk of adverse outcomes was decreased in outpatient observation by cardiologist, taking statins, aspirin, and performing exercise therapy.

Conclusion. Observation of PA patients by a cardiologist results in more frequent optimal drug therapy (due to the better adherence of cardiologists to clinical recommendations for the treatment of such patients) and improves the prognosis of these patients.
Prediction of the Possibility of Hemorrhagic Syndrome during Combined Antiplatelet Therapy According to the Krasnodar Region Registry
Authors: Tatarintseva Z. G. , Kosmacheva E. D. , Kruchinova S. V. , Akinshina V. A. , Khalafyan A. A.
Published: November 2019

Background. According to the literature data, acute coronary syndrome (ACS) in 2-20 % of cases is combined with atrial fibrillation (AF). According to the current guidelines of the European Society of Cardiology (ESC), patients with coexisting AF and ACS should receive dual antiplatelet therapy for the prevention of recurrent cardiovascular events and anticoagulant therapy for the prevention of thromboembolic complications. However, this combination is fraught with the development of hemorrhagic syndrome.

Aim. To develop a model and software module for predicting possible bleeding in patients with ACS combined with AF taking three-component antithrombotic therapy.

Materials and Methods. To build prognostic models for the development of hemorrhagic syndrome, a statistical method was used for classification trees and the neural network procedure implemented in the STATISTICA package. To build prognostic models, a sample was used consisting of 201 patients with a combination of ACS and AF with and without fatal outcome, the state of which was described by 42 quantitative and qualitative clinical indicators. The control group included 205 patients with ACS and intact sinus rhythm.

Results. To identify predictors of predictive models of the possible development of hemorrhagic syndrome in patients with triple antithrombotic therapy, the Spearman correlation coefficient was used. The study of correlations allowed to reveal clinical indicators – predictors of prognostic models. After analyzing the predictive ability of the developed models, a software module was created in the Microsoft Visual C # 2015 programming environment that allows determining the possibility of hemorrhagic syndrome in patients with a combination of ACS and AF using classification trees and neural networks.

Сonclusion. A classification model and a software module were developed to predict possible bleeding in patients taking three-component antithrombotic therapy. Models contain both quantitative and qualitative (categorical) clinical indicators. The current level of development of data analysis technologies opens up broad horizons for medicine in solving problems on real medical data, without translating them into scoring risk scales, including prediction of the diagnosis of the disease, stage of the disease, treatment outcome, possible complications, etc. High reliability of such systems can be provided by large volumes of medical data accumulated on servers.
Prenatal sFlt-1/PlGF value for prediction of adverse neonatal outcome of isolated ultrasonic small-for-gestational-age fetus in normotensive pregnant women: A prospective cohort study
Authors: Shim So Hyun , Jeon Haeng Jun , Ryu Hye Jin , Kim So Hyun , Min Seung Gi , Kang Min Kyu , Park Hee Jin , Cha Dong Hyun
Published: November 2019

Background: Not only preeclampsia but also small-for-gestational-age (SGA) neonates in the absence of preeclampsia are at increased risk of morbidity and mortality. Early recognition of fetuses at increased risk of being growth-restricted enables more appropriate surveillance and optimization of management for reduced risk of adverse neonatal outcomes. We investigated potential value of soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio, estimated in late-second and early-third trimester respectively, for prediction of SGA neonates with poor neonatal outcome in the absence of preeclampsia. Methods: Included in this case control study were 530 singleton pregnant women who had attended the prenatal screening program at single institution between January 2011 and March 2012. Demographic and clinical information of maternal and neonatal data were collected. The sFlt-1/ PlGF value at 24 to 28+6 weeks and 29 to 36+6 weeks of gestation were analyzed for comparing appropriate for gestational age control group, SGA and SGA with poor neonatal group. Results: After excluding 22 preeclampsia cases, 47 SGA group and 461 control-group were included. Among SGA group, 17 neonates had adverse neonatal outcome (36.1%, 17/47). Mean gestational age at delivery in SGA group was 37.76±2.05 weeks, which showed no significant difference comparing to control group (38.43±2.1 weeks, p=0.122). The sFlt-1/PlGF ratios at late-second trimester were both higher in the SGA group and poor neonatal SGA group than control group (3.74±2.52 vs 6.73±8.22 vs 7.62±15.2, p=0.63) and especially sFlt-1/PlGF ratio at early-third trimester was significantly higher (14.41±12.5 vs 28.62±37.2 vs 109.12±83.96, p=0.002). As gestational age advances, rapid increase in sflt-1/PlGF ratio detected in poor SGA group comparing to SGA group with no adverse outcome. A cutoff value of 28.15 for the sFlt-1/PlGF ratio at 29 to 36+6weeks significantly predicted SGA neonates who had adverse outcome, with sensitivity and specificity of 76.9% and 88%, respectively. Conclusion: In this study, sFlt-1/PlGF ratio of SGA with adverse neonatal outcome group was significantly higher than control group. This study suggests the feasibility of the sFlt-1/PlGF ratio as helpful objective measurement for predicting the adverse SGA neonatal outcome by providing sFlt-1/PlGF cutoff value, besides ultrasound biometry measurement.
Reduced risk of prostate cancer in a cohort of Lithuanian diabetes patients
Authors: Kincius Marius , Ausvydas Patasius , Donata Linkeviciute-Ulinskiene , Stukas Rimantas , Lina Zabuliene , Giedre Smailyte
Published: November 2019

Background: The aim of this study was to determine whether type 2 diabetes mellitus and treatment with metformin is associated with prostate cancer risk. Methods: Male patients with diagnosis of type 2 diabetes during the period of 2000 – 2016 were identified in the National Health Insurance Fund database. The prostate cancer cases were identified by pooling these records from the national Cancer Registry. The calculation of prostate cancer stardardized incidence ratios (SIRs) was composed as a ratio of observed number of cancer case in people with diagnosis of diabetes to the expected number of cancer cases in the underlying general population. Results: Overall, 64,000 males diagnosed with diabetes in Lithuania between 2000 and 2016 were included in the final cohort. 2,754 prostate cancers were observed versus 3,111.26 expected within the period of observation entailing an SIR of 0.89 (95% CI: 0.85–0.92). Significantly lower risk of prostate cancer was found in diabetes patients in all age groups, there were no differences in prostate cancer risk by time since diagnosis of diabetes. Significantly lower risk of prostate cancer also was found in both metformin users and never-users’ groups, with higher risk reduction in metformin users (SIR 0.71, 95% CI: 0.68–0.75) than in diabetes patients never-users (SIR 0.88, 95% CI: 0.80–0.96). Conclusions: In this large population-based study we found a significantly decreased risk of prostate cancer among men with diabetes and metformin users. However, the risk of prostate cancer showed no clear trend with diabetes duration and cumulative metformin dose.
A Prospective, Randomized, Placebo Controlled Study of a Combination of Simvastatin and Chemotherapy in Metastatic Breast Cancer
Authors: Alarfi Hiba , Youssef Lama , Salamoon Maher
Published: November 2019

Background: Preclinical studies support anticancer activity of statins, however, the existing clinical evidence are inconsistent and not definitive. Our study aimed at evaluating a postulated cancer chemo sensitizing effect of statin (simvastatin) in a cohort of metastatic breast cancer (MBC) patients.Methods: We designed a prospective, single-centered, randomized, double blinded, and placebo controlled trial that encompassed MBC patients with an ECOG Performance Status scale ≤2 and undergoing a chemotherapy course consisting of carboplatin and vinorelbine at Al-Baironi Hospital, Damascus, Syria. Patients were enrolled between August 2011 and July 2012, and randomly allocated to receive a 15-day course of either simvastatin (40 mg) or placebo at the day -7 of each chemotherapy cycle. Primary endpoints were objective response rate (ORR) and toxicity, and secondary endpoint was overall survival (OS).Results: Eighty-Two patients met the inclusion criteria and consented. ORR (35% vs. 32.5%) and predominant toxicity; grade≥3 neutropenia (occurred in 30% vs. 40% of the patients) were not significantly different between simvastatin and placebo groups, respectively. Over a median follow-up of 44 months (range, 10-60), median OS was 15 months in simvastatin group and 17 in placebo group (Hazard ratio (HR)=1.16, 95% CI (0.70-1.91), P =0.57). Elevated baseline values of high-sensitivity C-reactive protein (hsCRP >10 mg/l), lactate dehydrogenase (LDH >480 U/L) and chemotherapy being ≥2 nd line significantly associated with shorter OS for the total cohort in both univariate and multivariate analyses. Conclusions: Our data prove a safe profile of simvastatin at 40 mg per day combined with carboplatin and vinorelbine in MBC patients, but without any beneficial increase of tumor sensitivity to chemotherapy. Moreover, we demonstrated a strong clinical advantage of baseline values of hsCRP and LDH as useful prognostic tools in MBC patients. Trial registration: Damascus University / 15073/. Registered on December 28, 2010.
Metabolite and transcriptome analyses provide new insights into the generation of the blue supramolecular pigment in cornflower
Authors: Deng Chengyan , Wang Jiaying , Lu Chenfei , Li Yanfei , Hong Yan , Dai Silan
Published: November 2019

Background Generally, cyanidin facilitates pink to red petal colours, whereas it causes the expression of a vivid blue colour in cornflower. Previous chemical studies show that the pure blue colour in cornflower petals originates from a blue supramolecular pigment composed of cyanidins, apigenins and metal ions in a stoichiometric ratio, suggesting that the generation of this blue pigment complex is precisely regulated. However, the potential molecular mechanism remains unclear, restricting the innovation of blue cultivars in flowers originally accumulating cyanidin derivatives.Results In the present study, we traced the dynamic changes in petal colour from white to violet and, finally, to blue on the same petal in cornflower. Pigment analysis showed that apigenin biosynthesis started in the white region and peaked in the violet and blue regions, while cyanidin accumulated in the blue region to almost 2.5-fold higher than that in the violet region, suggesting that the content ratio of the two flavonoids plays a key role in blue colour development. Nine libraries from the above three colour regions were constructed for RNA-Seq, and 105,506 unigenes were obtained by de novo assembly. The differentially expressed genes among the three colour regions were significantly enriched in the phenylpropanoid biosynthesis and flavonoid biosynthesis pathways, leading to the excavation and analysis of 46 structural genes. Moreover, the R2R3-MYB and IIIf bHLH proteins were identified as cyanidin biosynthetic activators by both the dual luciferase reporter assay and transient over-expression in tobacco leaves. Moreover, eight differentially expressed unigenes possibly involved in metal ion transport, storage, tolerance and chelating processes were screened out.Conclusion The co-existence as well as the appropriate ratio of cyanidin and apigenin directly influence the blue colour development in cornflower. CcMYB6-1 and CcbHLH1 are identified as activators in regulating cyanidin biosynthesis and metal ion related gene resources that may be involved in chelating with flavonoids are also mined. These obtained results provide new insights into the generation of the blue supramolecular pigment in cornflower.
Effects of a nurse-led medication self-management programme in cancer patients: a mixed-method randomised controlled trial
Authors: Komatsu Hiroko , Yagasaki Kaori , Yamaguchi Takuhiro , Mori Ayako , Kawano Hiromi , Minamoto Noriko , Honma Orie , Tamura Kenji
Published: November 2019

Background : Despite patient convenience and better tolerability, treatment challenges have become evident compared with conventional chemotherapy. This study evaluated the effects of a patient-centred medication self-management support programme in patients with metastatic breast cancer undergoing oral anticancer treatment. We also evaluated the programme’s effectiveness based on the perceptions of intervention nurses.
Methods: This trial was a two-phased mixed-method approach, with a prospective randomised, parallel-group, two-arm, open-label, four-centre study, followed by a qualitative study using a focus-group interview. Eligible participants were 155 patients with metastatic breast cancer who had been newly prescribed an oral chemotherapy or a targeted therapy agent. The intervention group received the patient-centred medication self-management support programme conducted by trained nurses. Primary outcome was adherence to medication at three months after the commencement of oral chemotherapy or target therapy, calculated as Medication Possession Ratio (MPR). Patients were defined as being adherent if MPR was equal to or greater than 90%. Secondary outcomes included the Japanese version of the General Self-Efficacy (GSE) Scale, Functional Assessment of Cancer Therapy-Breast (FACT-B), Kessler 6 (K6), M.D. Anderson Symptom Inventory (symptom severity and symptom interference), and patient satisfaction score.　
Results:
Primary outcome (MPR ≥ 0.9 at three months) was not significantly different in the intervention group (59/64 patients: 92%) and control group (54/59 patients: 92%). There was no significant difference in secondary outcomes except for GSE (p = 0.026). In the qualitative study, comments about the intervention programme of 20 participating nurses were positive. They also felt a patient’s enhanced self-efficacy by reassurance or endorsement.
Conclusions: The patient-centred medication self-management support programme in patients with metastatic breast cancer undergoing oral anticancer treatment did not improve medication adherence because the adherence rate was high in both groups. Nevertheless, this study offers suggestions to design future studies for optimal adherence to oral medication therapy, including focusing on patients with high risk of non-adherence and the effect of involvement of other healthcare providers.
Pulmonary microbiome patterns correlate with the course of the disease in patients with sepsis-induced ARDS
Authors: Schmitt Felix Carl Fabian , Lipinski Anna , Hofer Stefan , Uhle Florian , Nusshag Christian , Hackert Thilo , Dalpke Alexander H. , Weigand Markus A. , Brenner Thorsten , Boutin Sébastien
Published: November 2019

Background Patients with sepsis-induced Acute Respiratory Distress Syndrome (ARDS) are hallmarked by high mortality rates. An early and goal directed antibiotic therapy is crucial for patients’ survival. The clinical use of a Next Generation Sequencing (NGS)-based approach for pathogen identification might lead to an improved diagnostic performance. Therefore, the objective of this study was to examine changes in the pulmonary microbiome and resulting influences on patients’ outcome in septic ARDS, but also to compare NGS- and culture-based diagnostic methods for pathogen identification.Results In total, 30 patients in two groups were enrolled in the study: (1) 15 septic ARDS patients and (2) 15 patients undergoing oesophageal resection serving as controls. In the ARDS group, blood samples were collected at ARDS onset as well as 5 days and 10 days afterwards. At the same timepoints, bronchoalveolar lavages (BAL) were performed to collect epithelial lining fluid for culture-, as well as NGS-based analyses and to evaluate longitudinal changes in the pulmonary microbiome. In the control group, only one BAL and one blood sample were collected immediately prior to the surgical procedure. ARDS patients showed a significantly decreased α-diversity (p=0.003**) and an increased dominance (p=0.005**) in their pulmonary microbiome. The α-diversity index revealed a good correlation with the length of stay in the intensive care unit (ICU) (p-value=0.027) and the need for mechanical ventilation (p-value=0.027). In 42.9% of all ARDS patients, culture-based results were not concordant with NGS-based findings. Moreover, culture-based results remained negative in 5 cases where NGS-based diagnostics revealed signs of bacterial colonisation.Conclusion Sepsis-induced ARDS is associated with a significant dysbiosis of patients’ pulmonary microbiome, which is closely correlated with the clinical course of the disease. Furthermore, an NGS-based diagnostic approach was shown to be promising for pathogen identification in septic ARDS.
A Study on the Perimenopausal Symptoms and Its Relevant Factors
Authors: Liang Wenjing , Zhao Chongbang , Wang Xianglan , Guan Nianhong , Wang Jihui , Zhang Guican , Zhu Qi , Zhang Ming , Xu Sebao
Published: November 2019

Objective: To explore the relevant factors of perimenopausal symptoms. Method: Community female subjects conforming to perimenopausal criteria were recruited through advertising. Modified Kupperman Index(KI) was used for evaluation of perimenopausal symptoms, Zung Self-Rating Depression Scale (SDS)for depressive symptoms and Zung Self-Rating Anxiety Scale (SAS)for anxiety symptoms. Eysenck Personality Questionnaire(EPQ) is used to evaluate the individual mental characteristics of subjects,including Extraversion(E), Neuroticism (N),Psychoticism(P),and Lie(L). Metacognition Questionnaire-30 (MCQ-30) is used to evaluate the metacognitive levels of subjects in the 5 important factors, including cognitive confidence(F1), positive beliefs about worry(F2), cognitive self-consciousness(f3), negative beliefs about uncontrollability of thoughts and danger(F4), and beliefs about the need to control thoughts (F5). Meanwhile, the levels of plasma gonadal hormones such as diol, testosterone and progesterone, are monitored. Pairwise correlation and linear regression are used to analyze the relevance between perimenopausal symptoms and the aforementioned factors. Results: Among 66 perimenopausal female subjects, 40 (60.4%) showed perimenopausal symptoms, with the most frequent being fatigue, joint and muscle pain , headache, dizziness, hypersensitivity and agitation. N score(β’=0.419，P<0.001), SDS anxiety factor (β’=0.363，P<0.001)and BMI （β’=0.244，P=0.001） are significantly correlated with KI total score. Age（β’=0.482，P<0.001）, SDS anxiety factor（β’=0.276，P=0.006）, SDS core depressive factor（β’=0.287，P=0.010）and SDS anxiety factor（β’=0.287，P=0.010）are significantly correlated with psychological symptoms. SAS standard score (β’=0.277，P=0.029) and SDS (β’=0.254，P=0.045) are significantly correlated with somatic symptoms. Conclusion: Emotional symptoms such as depression and anxiety are apparent. Perimenopausal females with Neuroticism personality, of elder age and higher BMI suffer from perimenopausal symptoms more severely.
Characteristics of Psychiatric Patient's Use of One Emergency Department and Crisis Services and Comparison of Models of Care for Patients with Borderline Personality Disorder in the Frequency of Use of Emergency Services
Authors: Veluri Ramamohan , Roles Stacey , Heale Roberta , Nguyen Vicky P. K. H. , Renouf M. Elizabeth
Published: November 2019

Background: The cost of urgent mental health care services is high, both to the system as well as the individual and strategies that prevent these visits are paramount. Frequent users of the emergency department (ED) are a small percentage of ED patients but account for a large percent of visits. In particular, studies show that those patients with borderline personality disorder commonly present to urgent care. Given the rising number of ED visits and the corresponding cost to the health care system, it is important to explore strategies for avoidable or preventable visits to the ED, coupled with directing resources that ensure access to appropriate quality care. Methods: This research was a prospective chart review of the population of frequent users diagnosed with psychiatric illness in the (ED) and crisis (CRI) services at one hospital. Detailed analysis revealed characteristics of the patients who presented to the ED and CRI with a mental health diagnosis. Additional analysis of the subgroup of these patients with borderline personality disorder and/or self-harming behaviour was completed to determine the impact of the model of psychiatric care on subsequent crisis or ED visits in the year after the index visit. Results: The majority of patients presenting for mental health issues did so once. The mean number of subsequent presentations to the ED was 5.00 demonstrating that a small number of patients presented many times. Male patients were trending toward significance for number of ED and CRI visits. Patients with borderline personality disorder and/or self-harming behaviours in a model of care that offered increased access to services were less likely to visit the ED and CRI. Conclusions: Unstable or complex patients with psychiatric issues often present at the ED and CRI. Accessibility to community care services has the potential to reduce the number of ED and CRI visits and is a critical factor when considering this less stable group.
Equations of state, phase relations, and oxygen fugacity of the Ru-RuO2 buffer at high pressures and temperatures
Authors: Armstrong Katherine , Siersch Nicki C. , Boffa-Ballaran Tiziana , Frost Daniel J. , Yu Tony , Wang Yanbin
Published: November 2019

Experimental studies and measurements of inclusions in diamonds show that ferric iron components are increasingly stabilized with depth in the mantle. To determine the thermodynamic stability of such components, their concentration needs to be measured at known oxygen fugacities. The metal-oxide pair Ru and RuO2 are ideal as an internal oxygen fugacity buffer in high-pressure experiments. Both phases remain solid to high temperatures and react minimally with silicates, only exchanging oxygen. To calculate oxygen fugacities at high pressure and temperature, however, requires information on the phase relations and equation of state properties of the solid phases.

We have made in situ synchrotron X-ray diffraction measurements in a multi-anvil press on mixtures of Ru and RuO2 to 19.4 GPa and 1473 K with which we have determined phase relations of the RuO2 phases and derived thermal equations of state (EoS) parameters for both Ru and RuO2. Rutile-structured RuO2 was found to undergo two phase transformations, first at ~7 GPa to an orthorhombic structure and then above 12 GPa to a cubic structure. The phase boundary of the cubic phase was constrained for the first time at high pressure and temperature. We have derived a continuous Gibbs free energy expression for the tetragonal and orthorhombic phases of RuO2 by fitting the second-order phase transition boundary and P-V-T data for both phases, using a model based on Landau theory. The transition between the orthorhombic and cubic phases was then used along with EoS terms derived for both phases to determine a Gibbs free energy expression for the cubic phase. We have used these data to calculate the oxygen fugacity of the Ru + O2 = RuO2 equilibrium, which we have parameterized as a single polynomial across the stability fields of all three phases of RuO2. The expression is log10fO2(Ru – RuO2) = (7.782 – 0.00996P + 0.001932P2 – 3.76 × 10–5P3) + (–13 763 + 592P – 3.955P2)/T + (–1.05 × 106 – 4622P)/T2, which should be valid from room pressure up to 25 GPa and 773–2500 K, with an estimated uncertainty of 0.2 log units. Our calculated fO2 is shown to be up to 1 log unit lower than estimates that use previous expressions or ignore EoS terms.
Self-efficacy parenting and nursing stress: Study on mother from spectrum autism children
Authors: Iskayanti Andini , Hartini Nurul
Published: November 2019

This study aimed to examine parenting self-efficacy especially in mothers who have children with autism spectrum disorder and who suffer from parenting stress. They showed symptoms of anxiety and depression, which indicated parenting stress. Parenting self-efficacy is predicted to be a factor that can decrease anxiety and depression. There were 45 mothers from the city of Surabaya selected through purposive sampling technique to be the participants of this study. The data were collected through a survey using questionnaires concerning Self-efficacy for Parenting Task Index (SEPTI) and Parenting Stress Index Short Form (PSI-SF). The data analyzed using the statistical parametric of the Pearson product-moment correlation coefficient showed that the correlation coefficient was -0.424 and the significance was 0.004. It was concluded that high parenting self-efficacy of mothers who have children with autism spectrum disorder correlates with parenting stress.
Mindfulness-Based Cognitive Therapy (MBCT) in improving quality of life: Case study in Chronic Kidney Disease patients with hemodialysis
Authors: Hasanudin Rini Junita Bakri , Siswandi Ahmad Gimmy Prathama , Wardhani Nurul
Published: November 2019

Chronic Kidney Disease (CKD) not only affects the physical condition but also impacts on psychological conditions, such as feeling down, embarrassed by appearance, feelings of worthlessness, anxiety, to despair which is the cause of decreased quality of life. In improving the quality of life requires a psychological intervention called Mindfulness-Based Cognitive Therapy (MBCT). This study aims to seek the effects of MBCT interventions on improving the quality of life of patients with Chronic Kidney Disease (CKD) with hemodialysis. Research participants were 3 people. This research was a case study research with a mixed method. Data analysis strategy used was a concurrent embedded strategy that compares quantitative and qualitative data. The result showed that MBCT interventions could improve participant’s quality of life. MBCT interventions provide the skills to be aware of clear thoughts, feelings, and events without assessing them so that patients can sort out the things that originate from their thoughts and distinguish them from actual events. This accomplishment of the result can be perceived from the arising of feeling more enjoy life and there is an increase in scores on each aspect of quality of life on the measurement scale used.
Leader-member exchange affects work engagement: The role of psychological well-being mediation
Authors: Permatasari Winny Yus , Suhariadi Fendy
Published: November 2019

Work engagement has a contribution to the success of an organization. Governmental institutions are often criticized for showing less satisfying performance and less effective services due to the misconducts of the civil servants such as coming late to work, leaving at working hours, and being less enthusiastic at work. This study aimed to examine civil servants' working conditions using three variables, namely leader-member exchange, psychological well-being, and work engagement. The measuring tools used referred to the Leader-Member Exchange Multidimensional (Liden & Maslyn, 1998), Psychological Well-being Scale (Ryff, 1989) and Utrecht Work Engagement Scale (Schaufeli & Bakker, 2004). There were 80 civil servants involved in this study as the subjects. They were selected using simple random sampling technique. Statistical techniques used in this study Structural Equation Modeling-Partial Least Square (SEM-PLS) with Warp PLS 5.0 Software. The result indicated that the three variables had a positive correlation with one another, and psychological well-being mediated the influence of leader-member exchange on work engagement.
A multi-model integration method for monthly streamflow prediction: modified stacking ensemble strategy
Authors: Li Yujie , Liang Zhongmin , Hu Yiming , Li Binquan , Xu Bin , Wang Dong
Published: November 2019

In this study, we evaluate elastic net regression (ENR), support vector regression (SVR), random forest (RF) and eXtreme Gradient Boosting (XGB) models and propose a modified multi-model integration method named a modified stacking ensemble strategy (MSES) for monthly streamflow forecasting. We apply the above methods to the Three Gorges Reservoir in the Yangtze River Basin, and the results show the following: (1) RF and XGB present better and more stable forecast performance than ENR and SVR. It can be concluded that the machine learning-based models have the potential for monthly streamflow forecasting. (2) The MSES can effectively reconstruct the original training data in the first layer and optimize the XGB model in the second layer, improving the forecast performance. We believe that the MSES is a computing framework worthy of development, with simple mathematical structure and low computational cost. (3) The forecast performance mainly depends on the size and distribution characteristics of the monthly streamflow sequence, which is still difficult to predict using only climate indices.
Una propuesta de complementariedad entre los estudios de migración y psicoanalíticos en salud mental
Authors: Luna Ángel , Mejia-Arango Silvia
Published: November 2019

El objetivo de este artículo es discutir los fundamentos epistemológicos de los estudios psicoanalíticos y su posibilidad de complementariedad con los estudios de migración basados en la sociología. La metodología utilizada fue la revisión de producción teórica sobre el tema de epistemología en psicoanálisis y la tradición de investigación en sociología, así como sobre estudios de migración enfocados en salud mental. Entre los resultados, se encontraron importantes coincidencias epistemológicas y metodológicas entre ambas disciplinas. A partir de eso, se presenta una breve propuesta que pone en evidencia la viabilidad de generar estudios complementarios sobre migración, específicamente en contextos fronterizos. Se sostiene que el valor de este artículo radica en la exploración de una posibilidad metodológica poco desarrollada en los estudios de migración, la cual profundiza en aspectos subjetivos e intersubjetivos en la experiencia de migrar. Se considera que dicha propuesta puede fungir como guía para estudios posteriores
THE FIRST CASE OF HUMAN GENOME EDITING: CRIMINAL LAW PERSPECTIVE
Authors: Sergeev D.
Published: November 2019

This article analyzes the legal assessment of the human genome modification experiment at the pre-implantation stage conducted by a group of scientists headed by He Jiankui, professor at the Southern University of Science and Technology (SUSTech) in Shenzhen, Guangdong Province, China, by means of the CRISPR/Cas9 technology. Chinese scholars have different opinions concerning He Jiankui’s experiment, but on the whole condemn it as illegal. Though CRISPR/Cas9 has been applied for quite a long time, the legislation of most developed countries is not ready to respond. The author of the article underlines the fact that despite the consolidated opinion of scholars, there is no binding international act which would restrict human genome editing. The author relies on Chinese sources in considering the main approaches to the assessment of He Jiankui’s actions in terms of criminal law (illegal medical activity, forgery of documents or fraud). Based on the analysis of Chinese criminal law doctrine, the author offers possible models of classifying separate actions related to human genome manipulation. The following cases of human genome manipulation are considered by the author as publicly dangerous and criminally liable: (a) when the embryo genome is changed by genetic engineering technologies for the purpose of its further implantation in the situation where the child’s parents are not aware of such intervention and its possible implications; (b) when genetic therapy or any other gene transfer (transgenesis) is applied to a person who is not aware of the nature of such manipulation and the possible implications of the application of the technology.
“BRICS LAW”: AN OXYMORON , OR FROM COO PERATION , VIA CON SOLIDATION , TO CODIFICATION?
Authors: Neuwirth R.
Published: November 2019

In the global arena, the cooperation between the BRICS countries – Brazil, Russia, India, China and South Africa – covers around 42% of the world’s population and some of the world’s most dynamic emerging economies. Initially, the BRICS cooperation was suggested as an idea, and it was later welcomed as a new addition to the global governance debate about the future. The BRICS countries have already held ten consecutive summits of heads of state plus a large number of meetings at the ministerial level. The cooperation describes itself as a “cooperation and dialogue” platform, but it has nonetheless signed a number of binding treaties and, notably, established the New Development Bank (NDB) as a permanent institution headquartered in Shanghai (China).The cooperation has also met with resistance, criticism and problems caused by the overall complexity of global affairs in a rapidly changing world. The diversity and remote locations of the BRICS countries have also been thought of as an obstacle to their successful cooperation and their ability to play an active part in global governance in the twentyfirst century. The main challenge thus lies in their ability to overcome their differences and to make a difference in designing the future global political and economic world order. Against the backdrop of the global governance debate, the present paper therefore asks whether the BRICS cooperation constitutes a novel model of regionalism with multilateral aspirations, and what role law and, notably, the “rule of law” can play in this important task. The paper includes a discussion of the extent to which the BRICS cooperation needs to be upgraded in legal and institutional terms, and possibly to proceed from cooperation via consolidation to the codification of its most important sources of global law.
Prediction of K562 Cells Functional Inhibitors Based on Machine Learning Approaches
Authors: Zhang Yuan , Han Zhenyan , Gao Qian , Bai Xiaoyi , Zhang Chi , Hou Hongying
Published: November 2019

Background:

β thalassemia is a common monogenic genetic disease that is very harmful to human
health. The disease arises is due to the deletion of or defects in β-globin, which reduces synthesis of the β-globin
chain, resulting in a relatively excess number of α-chains. The formation of inclusion bodies deposited on the cell
membrane causes a decrease in the ability of red blood cells to deform and a group of hereditary haemolytic diseases
caused by massive destruction in the spleen.

Methods:

In this work, machine learning algorithms were employed to build a prediction model for inhibitors
against K562 based on 117 inhibitors and 190 non-inhibitors.

Results:

The overall accuracy (ACC) of a 10-fold cross-validation test and an independent set test using Adaboost
were 83.1% and 78.0%, respectively, surpassing Bayes Net, Random Forest, Random Tree, C4.5, SVM, KNN
and Bagging.

Conclusion:

This study indicated that Adaboost could be applied to build a learning model in the prediction of
inhibitors against K526 cells.
Role of in vivo and in vitro Tests in the Diagnosis of Severe Cutaneous Adverse Reactions (SCAR) to Drug
Authors: Bergmann Marcel M. , Caubet Jean-Christoph
Published: November 2019

Severe cutaneous adverse reactions (SCAR) are life-threatening conditions including acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS). Diagnosis of causative underlying drug hypersensitivity (DH) is mandatory due to the high morbidity and mortality upon re-exposure with the incriminated drug. If an underlying DH is suspected, in vivo test, including patch tests (PTs), delayed-reading intradermal tests (IDTs) and in vitro tests can be performed in selected patients for which the suspected culprit drug is mandatory, or in order to find a safe alternative treatment. Positivity of in vivo and in vitro tests in SCAR to drug varies depending on the type of reaction and the incriminated drugs. Due to the severe nature of these reactions, drug provocation test (DPT) is highly contraindicated in patients who experienced SCAR. Thus, sensitivity is based on positive test results in patients with a suggestive clinical history. Patch tests still remain the first-line diagnostic tests in the majority of patients with SCAR, followed, in case of negative results, by delayed-reading IDTs, with the exception of patients with bullous diseases where IDTs are still contra-indicated. In vitro tests have shown promising results in the diagnosis of SCAR to drug. Positivity is particularly high when the lymphocyte transformation test (LTT) is combined with cytokines and cytotoxic markers measurement (cyto-LTT), but this still has to be confirmed with larger studies. Due to the rarity of SCAR, large multi-center collaborative studies are needed to better study the sensitivity and specificity of in vivo and in vitro tests.
Drug-Induced liver Injury Associated with Severe Cutaneous Hypersensitivity Reactions: A Complex Entity in Need of a Multidisciplinary Approach
Authors: Sanabria-Cabrera Judith , Medina-Cáliz Inmaculada , Stankevičiūtė Simona , Rodríguez-Nicolás Antonio , Almarza-Torres Marina , Lucena M. Isabel , Andrade Raúl J.
Published: November 2019

Idiosyncratic drug-induced liver injury (DILI) occasionally occurs in the setting of severe cutaneous
adverse reactions (SCARs), including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and
drug reaction with eosinophilia and systemic symptoms (DRESS). This strengthens the proposed immunologic
mechanism associated with this adverse reaction. DRESS exhibits the most common association with DILI.
SCARs have a wide spectrum of heterogeneous clinical presentations and severity, and genetic predisposition has
been identified. In the context of SCARs, DILI present a different clinical picture, ranging from mild injury to
acute liver failure. Elucidating the role of DILI in the clinical presentation and outcome of SCARs represents a
challenge due to limited information from published studies and the lack of consensus on definitions. The cholestatic
and mixed pattern of liver damage typically predominates in the case of DILI associated with SCARs,
which is different from DILI without SCARs where hepatocellular is the most common injury pattern. Only a few
drugs have been associated with both DILI and SCARs. Is this article, the criteria used for DILI recognition
among SCARS have been revised and discussed, along with the drugs most commonly involved in these syndromes
as well as the outcome, prognostic factors and the need for a multidisciplinary approach to improve the
management of DILI in the context of SCARs.