bluuebunny/crossref_metadata_2025 huggingface dataset:
Concepción y dinámica familiar: Análisis desde la percepción de un grupo de niños de cuatro años
Authors: Ortega Pacheco Yesid José , Hernández Bolívar Michael , Barrero Toncel Virginia Isabel
Published: February 2020

Con el objetivo de conocer cuál es la percepción que tiene un grupo de niños y niñas de 4 años de edad sobre su familia en Colombia, se realizó un estudio cualitativo con diseño fenomenológico. La muestra estuvo compuesta por 35 sujetos de estudio pertenecientes a los estratos socioeconómicos 1 y 2 catalogados como bajos recursos que hacen parte del Sistema de Selección de Beneficiarios para Programas Sociales (SISBEN). La recolección de la información se hizo a través de la entrevista semiestructurada, así mismo se diseñaron 14 representaciones ilustrativas animadas con diferentes miembros posibles de una familia como técnica de estímulo visual. Los resultados muestran que el concepto de familia para los niños y niñas está basado en sus propias apreciaciones relacionadas con el estilo de apego y crianza que poseen. Por otra parte, se evidencia que la dinámica familiar es un factor precipitante para que estos elaboren construcciones positivas o negativas de su hogar y sus familiares.
CARACTERIZAÇÃO MORFOLÓGICA DA PLATAFORMA CONTINENTAL DE ICAPUÍ UTILIZANDO DADOS BATIMÉTRICOS
Authors: De Abreu neto João Capistrano , Freire George Satander , Souza Daniel De Ponti , Maia Guilherme Augusto Mendonça
Published: February 2020

Os levantamentos batimétricos se apresentam como uma ferramenta através da qual podemos obter informações morfológicas, como perfis batimétricos, modelos digitais de terreno, declividade e orientação do relevo, possuindo aplicações como a identificação de bancos de areia, obras de engenharia, cartas de navegação e estudos ambientais. Trabalhos anteriores acerca da morfologia da plataforma continental de Icapuí, onde foram realizados levantamentos batimétricos no setor oeste da plataforma interna, identificaram afloramentos rochosos, resultados de variações da linha de costa, testemunhos das falésias que resistiram aos processos costeiros atuantes na região e um campo de dunas submersas. Devido à falta de uma caracterização da plataforma como um todo, este trabalho tem como objetivo a caracterização morfológica da plataforma continental do município de Icapuí com o uso de dados batimétricos para assim, identificar as formas de fundo mais expressivas da área. Assim, foi possível caracterizar a morfologia da área, que se apresenta predominantemente plana com baixa declividade, sendo mais estreita e menos profunda do que média do resto do estado do Ceará, com aproximadamente 45 km de extensão e com a zona de quebra da plataforma com profundidade média de 45 m. Ainda foram identificados na plataforma interna cristas de praia submersas e uma quebra na continuidade do relevo, que possibilita dividir a área em setores leste e oeste. Foram obtidos resultados satisfatórios, tornando possível identificar as estruturas mais expressivas da área, sendo possível relacioná-las com as flutuações do nível mar, tornando a região de interesse para a compreensão de tais eventos.
AVALIAÇÃO GEOESTRUTURAL E CARACTERIZAÇÃO TECNOLÓGICA DO SIENITO MARROM IMPERIAL LOCALIZADO NO MUNICÍPIO DE JOÃO ALFREDO-PE
Authors: Amador Maria Carolina de Albuquerque Feitosa , Barros Márcio Luiz Siqueira , Mendes Vanildo de Almeida
Published: February 2020

Através de avaliações das fraturas de um maciço rochoso é possível compreender as forças agentes dos movimentos que provocaram as suas descontinuidades. Tal entendimento é fundamental para o controle das mesmas, o que resulta numa lavra de rochas ornamentais mais eficiente e de maior aproveitamento mineral, haja vista que as dimensões e qualidade dos blocos obtidos dependem principalmente da natureza e equidistância dos fraturamentos controlados pela distribuição das tensões atuantes, dessa forma reduz-se os passivos ambientais tão comuns neste tipo de extração. Neste trabalho, apresenta-se a análise estrutural do Sienito Marrom Imperial, localizado no distrito de Umari, zona rural do Município de João Alfredo-PE. Os dados coletados durante a visita técnica constituíram um banco de dados utilizado na construção de projeções estereográficas e diagramas de rosetas. Com base nos resultados pode-se concluir que a direção SE-NW é a melhor orientação de corte, para o desenvolvimento dos trabalhos de abertura da pedreira, de modo a provocar o alívio das tensões e evitar o desenvolvimento de fraturas durante os serviços de lavra. Quanto à caracterização tecnológica, os resultados obtidos foram comparados aos estabelecidos pelas normas ABNT NBR 15845:2010, NBR 12042:1992 e ASTM C 615:1992. Os índices físicos e ensaio de desgaste Amsler atenderam satisfatoriamente às referidas normas. Os dados dos ensaios de resistência à compressão simples e resistência à flexão mostram que a rocha suporta uma compressão mediana, levemente inferior ao estabelecido pelas já referidas normas. Com base nos resultados e análise petrográfica, a rocha não pode ser aplicada em locais úmidos e de intenso tráfego, devido ao seu grau de absorção de água e resistência à compressão simples abaixo dos limites estabelecido pela norma ASTM C615 e ABNT NBR 15845.
Complejo Limb-Body Wall en el Hospital Universitario San Ignacio en Bogotá (Colombia). Reporte de caso y revisión de la literatura
Authors: Gómez Ana Milena , Olaya Mercedes
Published: February 2020

Introducción: las alteraciones del cordón umbilical están asociadas con diversas complicaciones de la gestación a corto y a largo plazo, algunas con pocas probabilidades de sobrevida y relacionadas con lesiones fetales múltiples. El complejo Limb-Body Wall (LBWC), compuesto por defectos de la pared corporal lateral y anomalías por acortamiento de miembros, es una de tales complicaciones, cuyas aún discutidas etiologías, pobre pronóstico y posibilidad de recurrencia hacen que cobre importancia en el diagnóstico ecográfico, la atención neonatal y el abordaje de la autopsia.Objetivos: reportar un caso de LBWC y revisar la literatura publicada sobre su etiología, características clínicas y diagnóstico, en el contexto de las complicaciones asociadas con las alteraciones del cordón umbilical.Materiales y métodos: se presenta el caso clínico de una recién nacida de primer embarazo de madre adolescente quien consultó a una entidad de nivel referencia y alta complejidad, recién nacida que falleció a los pocos minutos de nacer; presentaba defecto de la pared abdominal, escoliosis y esbozo de miembro superior izquierdo, asociado con cordón umbilical de 6 cm. Se realizó una revisión de la literatura publicada en las bases de datos Medline vía PubMed, Ovid e Hinari.Conclusión: el LBWC se asocia con un índice importante de morbimortalidad y con la expresión de un cordón excesivamente corto; por tanto, cobra gran relevancia hacer un diagnóstico oportuno y brindar asesoría genética adecuada a las familias.
Iniencefalia: primer caso reportado en Colombia y revisión de la literatura
Authors: Saldarriaga-Gil Wilmar , Ruiz-Murcia Fabián Andrés , Isaza Carolina
Published: February 2020

Introducción: la iniencefalia es un defecto del tubo neural, de baja frecuencia, del cual no hay valores de prevalencia establecidos. Esta patología se caracteriza por un ensanchamiento del foramen magno, raquisquisis y retroflexión marcada de la cabeza. El objetivo de este artículo es reportar un caso con los hallazgos clásicos de iniencefalia, y revisar la literatura.Materiales y métodos: se presenta el caso de un recién nacido de sexo femenino, producto de madre primigestante de 14 años, que consultó a institución de tercer nivel de complejidad, que atiende pacientes en su mayoría de la red pública del suroccidente colombiano, con ecografía prenatal que mostró feto con defecto a nivel de vértebras cervicales y torácicas. Al recién nacido se le realizó autopsia y radiografías, en los que se evidenciaron anomalías clásicas de iniencefalia. Se realiza búsqueda en las base de datos Medline vía PubMed por medio de la palabra claveiniencephaly.Conclusión: la importancia de este reporte radica en sumar a la literatura un nuevo caso de iniencefalia asociado con meningocele e hipoplasia de radio y ulna, adicionalmente es el primero reportado en Colombia.
PENGAJARAN GURU PENDIDIKAN DASAR DI ERA MILLENIAL DALAM MEMBENTUK MORAL SISWA
Authors: Susandi Ari
Published: February 2020

Elementary education is the first step to build student moral in introducing and basic teaching are needed a figure of teacher that ca be able to build whole student identity in this era state situation is getting more sophistiaced, aduance and do changes by creating something new that have a strong function in IPTEK development. At the bracelet III public elementary school institutions new sources there are still many students who are less active and focused in following the learning given by the teacher as well as the lack of learning innovation, hereby researcher interested to conduct research at education institution that have run at 1,2,3 August 2019 by open and close interview to teachers class I to VI it will be tested and result will be analysed in descriptively and qualitatively to answer the main case and qualitative data to know the score or percentage of the education proses that done by teacher class I to VI at SDN Gelang III Sumberbaru have they applied the best five indicator learing they are in personal approachement, meaning full learning, giving the feed back, sregthen the learning and also learning evaluation and taking the data by documenting of learning and also learning evaluation of elementary school teacher in era in building the student moral on 29-30 August at SDN Gelang III Sumberbaru Jember school year 2019-2020.the best five indicator learning is personal approachment meaningful learning.
EFFECTIVENESS OF EARLY WARNING MODELS: A CRITICAL REVIEW AND NEW AGENDA FOR FUTURE DIRECTION
Authors: Padhan Rakesh , Prabheesh K. P.
Published: February 2020

This paper suggests a new agenda for constructing early warning models (EWMs) toenhance their effectiveness in predicting financial crises. The central argument of thenew agenda aims to eradicate the weaknesses of existing EWMs, since their failure topredict the global financial crisis of 2007–2008 demonstrates the need to improve theirefficiency. We document the history of EWMs and propose a new agenda as follows:1) the accurate measurement of a financial crisis, 2) implementation of a fourthgenerationcrisis model to capture the dynamic nature of the financial crisis, and 3) theinclusion of interconnectedness/contagion variables as explanatory variables for thefinancial crisis.
STRATEGI KOMUNIKASI PEMASARAN INTERAKTIF CIEWIE BATIK DALAM CUSTOMER ENGAGEMENT
Authors: Marsudi Marsudi
Published: February 2020

ABSTRAKPenelitian ini ingin menganalisis Strategi komunikasi pemasaran Interaktif Ciewie Batik dalam customerengagement. Penelitian ini bertujuan untuk menunjukkan pemahaman tentang Strategi dan bentukbentukkomunikasi pemasaran Interaktif Ciewie Batik dalam melaksanakan bisnisnya. Penelitian inimenggunakan metode deskriptif kualitatif dengan studi melalui dokumentasi dan wawancara mendalamBerdasarkan hasil wawancara dan dokumentasi, dapat disimpulkan bahwa Strategi komunikasi pemasaran Interaktif  yang dipergunakan Ciewie Batik dalam melaksanakan rutinitas bisnisnya meliputi : memaksimalkan serta mengintensifkan akun Instagram Ciewie Batik, mengintegrasikan prosespelayanan pelanggan dengan aplikasi Android, mengintensifkan layanan keluhan dan pertanyaanpelanggan yang express, aktif dalam Fanpage Facebook, dan senantiasa update di website CiewieBatik termasuk aktif merekrut web-reseller.This research eagers to analyse Ciewie Batik Interactive Marketing Communication Strategy in customerengagement. This research intends to show the meaningful of Ciewie Batik Interactive MarketingCommunication Strategy in Business dealing. Research runs the qualitative descriptive method usingdocumentation study and indepth interview. According to documentation study and indepth interview,can be concluded that Ciewie Batik Interactive Marketing Communication Strategy in dealing Businessconsist of : maximizing and intensified the Ciewie Batik Instagram Account, integrating the servicingcustomer process with Android Application, intensified customer question and complaint expressly,active in Facebook fanpage, dan keep on updating Ciewie Batik website including actively hire webreseller.Kata kunci: Komunikasi Pemasaran, Social Information Processing Theory, Strategi    Komunikasi Interaktif, Customer Engagement, Ciewie Batik
Pengenalan Perencanaan Program Desa Berbasis Bukti: Studi Di Desa Murtajih Kecamatan Pademawu Kabupaten Pamekasan
Authors: Adriansyah Agus Aan , Firdausi Nurul Jannatul , Wulan Tri Deviasari
Published: February 2020

Pembangunan desa memerlukan dukungan dari dana desa. Dana desa yang dikelola haruslah diimbangi dengan penyusunan perencanaan yang baik dan mempertimbangkan prioritas masalah yang ada di desa, sehingga efektivitas program yang dijalankan dapat sesuai dengan tujuan dan harapan pemerintah dalam mendukung pembangunan nasional. Desa Murtajih merupakan desa di Kecamatan Pademawu, Pamekasan yang masih menghadapi kesulitan dalam pelaksanaan manajemen perencanaan desa. Disebabkan karena keterbatasan perangkat desa dalam mengoperasikan komputer, perangkat desa belum mendapatkan pelatihan tentang perencanaan, dan penyusunan dokumen planning of action (POA) dalam perencanaan desa. Pengabdian masyarakat ini menyasar perangkat desa, kader, pengurus pokja PKK dan bidan desa. Penelitian dilakukan dengan menganalisis pengetahuan perangkat desa dan pihak lainnya tentang penyusunan perencanaan, intervensi dengan pemberian materi pengenalan perencanaan program desa berbasi bukti dan memperkaya wawasan dalam menggunakan data untuk menyusun perencanaan. Target kegiatan penelitian ini adalah peningkatan pengetahuan peserta tentang perencanaan program berbasis bukti. Pengukuran pengetahuan meliputi peran perencanaan terhadap anggaran, proses dan sumber data untuk perencanaan program serta pelaksanaan perencanaan dan evaluasi. Hasil pengukuran pengetahuan peserta pengabdian kepada masyarakat melalui pre-test dan post-test menunjukkan informasi, hasil pre-test terbanyak adalah dalam kategori pengetahuan cukup baik (61,11%) dan post-test dalam kategori pengetahuan baik (94,44%). Terjadi peningkatan pengetahuan pada 15 responden (83,33%), hal ini menunjukkan bahwa mayoritas responden mengalami peningkatan pengetahuan mengenai dana desa setelah pelaksanaan kegiatan sosialisasi. Pengetahuan responden terkait proses dan sumber data perencanaan program meningkat hingga 92,2% dengan efektivitas sosialisasi yang menunjukkan nilai signifikansi sebesar 0,001 ( nilai α), yang menunjukkan adanya efektivitas sosialisasi dalam meningkatkan pengetahuan.
Eduardo Reyme Wendell Lección de las aves
Authors: Cavalier Gonzales Jossimar
Published: February 2020

En la siguiente reseña se presenta un poema sobre aves. Aquí un extracto Nosotros no amamos como las aves Si amáramos como las aves, holgaríamos nuestras alas y realizaríamos el respectivo baile de cortejo. Si tan solo amáramos como ellas, nuestras palabras serían pequeños susurros que remecerían constelaciones y surcarían aires no tan lejanos. El amor nos hace volar y la poesía solo es ese instrumento para alzar el vuelo. Pero nos hemos alejado de las coordenadas correctas y nos hemos convertido en el pájaro en el ojo de la bestia: «...el pájaro / impreso en el ojo del cazador / se vuelve el cazador mismo en el ojo de la bestia» (Saint-John Perse): epígrafe que da inicio a la primera parte del poemario Las aves y el amor.
Vibiro vulnificus hemolysin associates with gangliosides.
Authors: KASHIMOTO Takashige , Sugiyama Hiroyuki , Kawamidori Keigo , Yamazaki Kohei , Kado Takehiro , Matsuda Kaho , Kodama Toshio , Mukai Takao , Ueno Shunji
Published: February 2020

Background: Vibrio vulnificus hemolysin (VVH) is a pore-forming toxin secreted by Vibrio vulnificus . Cellular cholesterol was believed to be the receptor for VVH, because cholesterol could bind to VVH and preincubation with cholesterol inhibited cytotoxicity. It has been reported that specific glycans such as N-acetyl-D-galactosamine and N-acetyl-D-lactosamine bind to VVH, however, it has not been known whether these glycans could inhibit the cytotoxicity of VVH without oligomer formation. Thus, to date, binding mechanisms of VVH to cellular membrane, including specific receptors have not been elucidated. Results: We show here that VVH associates with ganglioside GM1a, Fucosyl-GM1, GD1a, GT1c, and GD1b by glycan array. Among them, GM1a could pulldown VVH. Moreover, the GD1a inhibited the cytotoxicity of VVH without the formation of oligomers. Conclusion: This is the first report of a molecule able to inhibit the binding of VVH to target cells without oligomerization of VVH.
A novel carcinogenic PI3Kα mutation suggesting the role of helical domain in transmitting nSH2 regulatory signals to kinase domain
Authors: Ghalamkari Safoura , Alavi Shahryar , Mianesaz Hamidreza , Khosravian Farinaz , Bahreini Amir , Salehi Mansoor
Published: February 2020

Background Mutations in PIK3CA, which encodes p110 subunit of PI3K class IA enzyme, are highly frequent in breast cancer. Here, we aimed to probe mutations in exon 9 of PIK3CA and computationally simulate their function. Method PCR/HRM and PCR/sequencing were used for mutation detection in 40 breast cancer specimens. The identified mutations were queried via in silico algorithms to check the pathogenicity. The molecular dynamics (MD) simulations were utilized to assess the function of mutant proteins. Result Three samples were found to harbor at least one of the E542K, E545K and L551Q mutations of which L511Q has not been reported previously. All mutations were confirmed to be pathogenic and MD simulations revealed their impact on protein function and regulation. The novel L551Q mutant dynamics was similar to that of previously found carcinogenic mutants, E542K and E545K. A functional role for the helical domain was also suggested by which the inhibitory signal of p85α is conducted to kinase domain via helical domain. Helical domain mutations lead to impairment of kinase domain allosteric regulation. Interestingly, our results show that p110α substrate binding pocket of helical domain in mutants may have differential affinity for enzyme substrates, including anit-p110α drugs. Conclusion The novel p110α L551Q mutation could has carcinogenic feature similar to previously known mutations.
The Influence of Job Satisfaction, Resilience and Work Engagement on Turnover Intention among Village Doctors in China：a cross-sectional study
Authors: Zhang Xuewen , Bian Liyan , Bai Xue , Kong Dezhong , Liu Li , Chen Qing , Li Ningxiu
Published: February 2020

Background: As the gatekeepers of rural residents’ health, teams of village doctors play a vital role in improving rural residents’ health. However, the high turnover of village doctors – both individually and collectively – threaten the stability of village medical teams. This research evaluated the influence of job satisfaction, resilience , and work engagement on the turnover intention of village doctors, and explored the mediating role of resilience and work engagement between job satisfaction and the turnover intention of village doctors in China.
Methods: A quantitative study using a self-administered questionnaire containing mostly structured items was conducted among village doctors with a sample size of 2693 from 1345 rural clinics in Shandong province, China, during May and June 2019. All variables including demographic characteristics, job satisfaction, resilience, work engagement and turnover intention were based on available literature, and measured on a 5- or 6-point Likert scale. Such statistical methods as one-way ANOVA, bivariate correlation, exploratory factor analysis (EFA), and Structural Equation Modelling (SEM) were used.
Results: As high as 46.9% of participants had a high turnover intention and no less than 26.3% of participants had a medium turnover intention. Job satisfaction not only has a direct negative effect on turnover intention(β=-0.37, p < 0.001), but also an indirect effect through work engagement(β= -0.04, p < 0.001), which has a direct negative impact on turnover intention (β= -0.13, p < 0.002) , and resilience had an indirect negative effect on turnover intention through the mediating effect of work engagement(β= -0.09, p < 0.001). The results of this study strongly verified that job satisfaction, resilience, and work engagement were early, powerful predicators of turnover intention.
Conclusion: According to the results, the following should be taken seriously to improve job satisfaction: reasonable and fair income, effective promotion mechanism, fair social old-age security, reasonable workload, and strong psychological coping mechanisms for work stress. The turnover intention of village doctors could be reduced through improving job satisfaction, resilience and work engagement.
Silencing of microRNA-210 inhibits the progression of liver cancer and Hepatitis B virus-associated liver cancer via targeting EGR3
Authors: Li Xiaojie , Yuan Mei , Song Lu , Wang Yan
Published: February 2020

Background: This study was aimed to investigate the regulatory role of microRNA-210 (miRNA-210) on the progression of liver cancer and Hepatitis B virus (HBV)-associated liver cancer.
Methods: The expression of miRNA-210 was detected in liver tissues of HBV-associated cirrhosis and liver cancer, and in HepG2 and HepG2.2.15 cells by qRT-PCR. MiRNA-210 was silenced in HepG2 and HepG2.2.15 cells by the transfection of miRNA-210 inhibitor. The cell viability and apoptosis was detected by MTT assay and Annexin V-fluorescein isothiocyanate/propidium iodide staining, respectively. The protein expression of EGR3 was detected by Western blot. The regulatory relationship between EGR3 and miRNA-210 was predicted by TargetScan and identified by Dual luciferase reporter gene assay.
Results: MiRNA-210 was overexpressed in the liver tissues of HBV-associated cirrhosis and liver cancer, and in HepG2 and HepG2.2.15 cells ( P < 0.05). Silencing of miRNA-210 inhibited the viability and promoted the apoptosis of HepG2 and HepG2.2.15 cells ( P < 0.05). EGR3 was a target of miRNA-210, which was down-regulated in the liver tissues of HBV-associated cirrhosis and liver cancer, and in HepG2 and HepG2.2.15 cells ( P < 0.05). Silencing of miRNA-210 increased the mRNA and protein expression of EGR3 ( P < 0.05). Silencing of EGR3 reversed the anti-tumor effect of miRNA-210 inhibitor on HepG2 and HepG2.2.15 cells ( P < 0.05).
Conclusions: Silencing of miRNA-210 inhibits the progression of liver cancer and HBV-associated liver cancer via up-regulating EGR3.
Distribution and antimicrobial resistance profiles of bacterial species in stray cats, hospital-admitted cats, and veterinary staff in South Korea
Authors: Jung Woo Kyung , Shin Sook , Park Young Kyung , Lim Suk-Kyung , Moon Dong-Chan , Park Kun Taek , Park Yong Ho
Published: February 2020

Background : Antimicrobial resistance is becoming increasingly important in both human and veterinary medicine. According to the One Health concept, an important step is to monitor the resistance patterns of pathogenic bacteria. In this study, the antimicrobial susceptibility patterns and trends of bacteria isolated from stray cats, hospital-admitted cats, and veterinary staff in South Korea between 2017 and 2018 were investigated. Results : The minimum inhibitory concentrations of different antibiotics for Staphylococcus spp., Enterobacteriaceae , and Enterococcus spp. were determined to establish representatives of different antibiotic classes relevant for treatment or surveillance. For Coagulase-positive and Coagulase-negative Staphylococci, resistance to fluoroquinolones was below 13%, but resistance to ampicillin and penicillin was high (20–88%). A total of 9.5%, 12.1%, and 40.3% of staphylococcal isolates from stray cats, hospital-admitted cats, and veterinary staff, respectively, were confirmed to be mecA positive. For Enterobacteriaceae , resistance to carbapenems, fluoroquinolones, and 3 rd generation cephalosporins was low (0–11.1%). The Enterococcus spp. isolates showed no resistance to vancomycin. The antimicrobial resistance rates of the Staphylococcus spp. and Enterobacteriaceae isolates from stray cats were usually lower than those of isolates from hospital-admitted cats and veterinary staff, but the Enterococcus spp. isolates revealed the opposite. Thus, the antimicrobial resistance varied across bacterial species according to the source from which they were isolated. Conclusions : Resistance to critically important compounds were low. However, the presence of antimicrobial resistance in cat isolates is of both public health and animal health concern.
Specific humoral response in cancer patients treated with a VEGF-specific active immunotherapy procedure within a compassionate use program.
Authors: Ramírez Javier Sánchez , Díaz Yanelys Morera , Bequet-Romero Mónica , Hernández-Bernal Francisco , Bauta Yenima Martín , Bernal Katty-Hind Selman-Housein , Santos Ana Victoria de la Torre , Iglesia Mariela Pérez de la , Lorenzo Lian Trimiño , Program Team of Investigators of Compassionate use , Avila Marta Ayala
Published: February 2020

Background: CIGB-247 is a cancer therapeutic vaccine that uses as antigen a variant of human vascular endothelial growth factor (VEGF) mixed with the bacterially-derived adjuvant VSSP. CIGB-247 has been already evaluated in two phase I clinical trials (CENTAURO and CENTAURO-2), showing to be safe and immunogenic in advanced cancer patients selected under well-defined and controlled clinical conditions. Surviving patients were submitted to monthly re-immunizations and some of them showed objective clinical benefits. Based on these results, a compassionate use program (CUP) with CIGB-247 was initiated for patients that did not meet the strict entry criteria applied for the CENTAURO and CENTAURO-2 clinical trials, but could potentially benefit from the application of this cancer therapeutic vaccine. Results: Polyclonal IgM, IgA and IgG antibodies specific for VEGF were detected by ELISA in serum samples from patients vaccinated with 400 µg of antigen combined with 200 µg of VSSP. Polyclonal antibody response showed no cross reactivity for other VEGF family member molecules like VEGF-C and VEGF-D. Serum from immunized individuals was able to block the binding of VEGF to its receptors VEGFR2 and VEGFR1. IgG fraction purified from immune sera shared the aforementioned characteristics and also inhibited the interaction between VEGF and the therapeutic recombinant antibody bevacizumab, an anti-angiogenic drug approved for the treatment of different tumors. No serious adverse events attributable to CIGB-247 have been documented yet in participants of the CIGB-247 CUP.The present paper is a first report of our findings concerning the humoral response and safety characteristics in treated CIGB-247 CUP cancer patients. The study has provided the unique opportunity of not only testing CIGB-247 in a broader clinical spectrum sample of Cuban cancer patients, but also within the context of the day-to-day clinical practice and treatment settings for these diseases in Cuban medical institutions. Conclusions: The CIGB-247 CUP has demonstrated that immunization and follow-up of a variety of cancer patients, under day-to-day clinical practice conditions in several Cuban medical institutions, replicate our previous findings in clinical trials: CIGB-247 is safe and immunogenic.
Finite Elements Analysis of the Temporomandibular Joint Disc in Patients with Intra-articular Disorders
Authors: Lai Linfeng , Xiong Guofeng , Huang Chenyao , Zhou Fan , Xia Fujian
Published: February 2020

Background： Anterior and/or medial displacement of the temporomandibular joint disorder(TMJ) disc or intra-articular disorders( ID) is the most common form of TMJ dysfunction(TMD).TMD cause change of friction coefficient during TMJ movement. In the present study, We provided a 3D finite elements models(FEM) including the maxilla, disc and mandible and evaluated the stress distribution with different friction coefficient. Methods: 14 volunteers without TMD and 20 TMD patients,who were diagnosed by MRI, were selected.CT and MRI data were collected to build 3D FEA model of mandibular and TMJ disc.Stress distribution with different friction coefficient was measured. Result: In the normal model, stress distribution on TMJ disc was 2.07±0.17,1.49±0.14,1.41±0.14MPa with 0.001 0.3 and 0.4 friction coefficient.In TMD model,stress distribution is 3.87±0.15,7.23±0.22,7.77±0.19MPa respectively. Conclusion: When the friction coefficient of the side with anterior displacement increased, stress on the disc, condyle and mandible of the opposite side increased. Simultaneously, stress values of the disc, condyle and mandible were higher than those of the normal lateral joint.
A cross-sectional study of the relationships between different components of sarcopenia and brachial ankle pulse wave velocity in community-dwelling elderly
Authors: Rong Yu-Dong , Bian Ai-Lin , Hu Hui-Ying , Ma Yue , Zhou Xin-Zi
Published: February 2020

Background:Previous studies have just found skeletal muscle mass decline is associated with arterial stiffness, but it is unclear whether muscle strength and physical performance as important compositions of sarcopenia are associated with arterial stiffness.The aim of this study was to investigate the relationship between sarcopenia, the components of sarcopenia and arterial stiffness among elderly in the community.Methods:This study enrolled 450 elderly people who received general medical examinations in Tianjin First Central Hospital. Each of the subjects was greater than 65 years old, including 266 male and 184 female subjects. Based on the diagnostic criteria for sarcopenia in older people developed by the Asian Working Group for Sarcopenia (AWGS), 89 subjects were separated into the sarcopenia group. The living habits, disease status, general status and laboratory examinations of all subjects were collected. The body composition (including appendicular skeletal muscle mass and visceral fat area (VFA) of each participant) was measured by bioimpedance analysis. HS, usual gait speed (GS), and brachial ankle pulse wave velocity (baPWV) were measured.Results :Sarcopenia subjects had higher baPWV, nutrition risk and lower appendicular skeletal muscle index(ASMI), Handgrip strength(HS), GS, body mass index(BMI), triacylglycerol(TG), serum albumin(ALB) and creatinine(Cr) than did non-sarcopenia subjects; Sarcopenia subjects also had higher visceral fat area (VFA) than did non-sarcopenia subjects (p<0.05). ASMI and HS were negatively correlated with baPWV (t=-5.807, p=0.000 and t=-3.085, p=0.002), but the relationship between baPWV and GS was not statistically significant (t=-0.862, p=0.389) by multivariable linear regression. After adjusting for confounders, a multivariate logistic regression analysis revealed that sarcopenia was related with age, BMI, sports and baPWV in community dwelling elderly.Conclusions:ASMI and HS were negatively correlated with baPWV in community dwelling elderly in China; and baPWV was a risk factor of sarcopenia.
Dilatation of the Cystic Duct Confluence in Laparoscopic Common Bile Duct Exploration and stone extraction for Patients with Secondary Choledocholithiasis
Authors: Yang Xiao-Bin , Xu An-Shu , Li Jian-Gang , Xu Yong-Ping , Xu De-Song , Fu Chao-Chun , Deng Da-Bo , Li Jie , Zhang Ma-Zhong
Published: February 2020

The advent of endoscopic and laporoscopic techniques changed surgery in many regards. A number of options exist in the management of cholelithiasis and secondary choledocholithiasis. Among them, laparoscopic common bile duct (CBD) exploration with the choledocotomy followed by laparoscopic cholecystectomy (LC) has gained popularity. However, efforts should be made for minimally invasive or non-invasive to the CBD. For this purpose, we modified the surgical modality by laparoscopic transcystic approach with dilatation of the cystic duct confluence in CBD exploration (LTD-CBDE). The aim of this work was to assess the feasibility, safety and effectivity of LTD-CBDE based on our preliminary experience.
Antibiotic prescribing among patients with severe infectious diseases in two private sector hospitals in Central India – A time series analysis over 10 years
Authors: Damlin Anna , Sharma Megha , Marrone Gaetano , Lundborg Cecilia Stålsby
Published: February 2020

Background:Antibiotic resistance is an emerging problem caused due to antibiotic use. In countries with high rates of infectious diseases, antibiotic resistance is a frequent cause of mortality. The aim was to analyse antibiotic prescribing practices between 2008 and 2017 in a teaching (TH) and a non-teaching (NTH) hospital, as typical hospitals of low- and middle-income countries, and to compare antibiotic prescribing for severe infectious indications for which empiric antibiotic treatment is recommended.Methods:Data from adult patients registered at two Indian private-sector hospitals with one of the following indications: epiglottitis, pneumonia, peritonitis, pyelonephritis, cellulitis, erysipelas, septic arthritis, endocarditis, meningitis or sepsis; were included and analysed. Antibiotic prescription data was analyzed using the World Health Organization’s (WHO) Anatomical Therapeutic Chemical classification system and the Defined Daily Doses. Chi-square and t-tests were used to compare the data between groups. Time series analyses were conducted using linear regression. P-values <0.05 were considered significant.Results:In total, 3,766 patients were included, 2,504 inpatients in the NTH and 1,262 in the TH, of which 92% and 89% patients, respectively, were prescribed antibiotics. Sixty-one percent of total prescriptions in the TH and 40% in the NTH comprised theaccesscategory of antibiotics (i.e. the first-choice of treatment according to the WHO). The WHO’s second-choice of treatment, thewatchcategory, comprised 29% and 40% of total prescriptions in the TH and NTH, respectively. Prescribing of fixed-dose combinations (FDCs) of antibiotics was significantly higher in the NTH (18%) than in the TH (8%,P<0.05). Prescribing ofwatchantibiotics and FDCs increased significantly in both hospitals between 2008 and 2017 among patients with pneumonia, cellulitis and peritonitis (P<0.05).Conclusions:Prescribing ofwatchantibiotics and FDCs of antibiotics increased over time at both hospitals, indicating under prescribing ofaccessantibiotics and more prescribing of second-choice antibiotics. The results can be used to highlight the areas of improvement in similar settings. Implementing diagnostic routines and local prescribing guidelines could improve the prescribing practices.
Higher fatty liver index is associated with increased risk of new onset heart failure in healthy adults: A nationwide population-based study in Korea
Authors: Roh Jae-Hyung , Park Jae-Hyeong , Lee Hanbyul , Yoon Yong-Hoon , Kim Minsu , Kim Yong-Giun , Park Gyung-Min , Lee Jae-Hwan , Seong In-Whan
Published: February 2020

Background Heart failure (HF) is relatively common cardiovascular disease with high mortality and morbidity. Although it is associated with many cardiovascular risk factors, the association between nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disease, and HF has not been evaluated in a large-scale cohort study. Thus, we evaluated the ability of the fatty liver Index (FLI), a surrogate marker of NAFLD, to predict the development of HF in healthy individuals. Methods We evaluated 308,578 healthy persons without comorbidities who underwent the National Health check-ups in the republic of Korea from 2009 to 2014. The association between the FLI and HF was analyzed using multivariate Cox proportional-hazards models. Results During a median of 5.4 years’ follow-up, 2,532 subjects (0.8%) were newly diagnosed with HF. Subjects were categorized into quartile groups according to FLI (Q1, 0-4.9; Q2, 5.0-12.5; Q3, 12.6-31.0; and Q4, >31.0). The cumulative incidence of HF was significantly higher in subjects with the highest FLI than in those with the lowest FLI (Q1, 307 [0.4%] and Q4, 890 [1.2%]; P<0.001). Adjusted hazard ratios (HRs) indicated that the highest FLI was independently associated with an increased risk for HF (HR between Q4 and Q1, 2.709; 95% confidence interval=2.380-3.085; P<0.001). FLI was significantly associated with increased risk of new-onset HF regardless of their baseline characteristics. Conclusions Higher FLI was independently associated with increased risk of HF in healthy Korean population.
Different regulation of PARP1, PARP2, PARP3 and TRPM2 genes expression in acute myeloid leukemia cells
Authors: Gil-Kulik Paulina , Dudzińska Ewa , Radzikowska-Büchner Elżbieta , Wawer Joanna , Jojczuk Mariusz , Nogalski Adam , Wawer Genowefa Anna , Feldo Marcin , Kocki Wojciech , Cioch Maria , Bogucka-Kocka Anna , Rahnama Mansur , Kocki Janusz
Published: February 2020

Background Acute myeloid leukemia (AML) is a heterogenic lethal disorder characterized by the accumulation of abnormal myeloid progenitor cells in the bone marrow which results in hematopoietic failure. Despite various efforts in detection and treatment, many patients with AML die of this cancer. That is why it is important to develop novel therapeutic options, employing strategic target genes involved in apoptosis and tumor progression. Methods The aim of the study was to evaluate PARP1, PARP2, PARP3, and TRPM2 gene expression at mRNA level using qPCR method in the cells of hematopoietic system of the bone marrow in patients with acute myeloid leukemia, bone marrow collected from healthy patients, peripheral blood of healthy individuals, and hematopoietic stem cells from the peripheral blood after mobilization. Results The results found that the bone marrow cells of the patients with acute myeloid leukemia (AML) show overexpression of PARP1 and PARP2 genes and decreased TRPM2 gene expression. In the hematopoietic stem cells derived from the normal marrow and peripheral blood after mobilization, the opposite situation was observed, i.e. TRPM2 gene showed increased expression while PARP1 and PARP2 gene expression was reduced. We observed positive correlations between PARP1, PARP2, PARP3, and TRPM2 genes expression in the group of mature mononuclear cells derived from the peripheral blood and in the group of bone marrow-derived cells. In AML cells significant correlations were not observed between the expression of the examined genes. In addition, we observed that the reduced expression of TRPM2 and overexpression of PARP1 are associated with a shorter overall survival of patients, indicating the prognostic significance of these genes expression in AML. Conclusions Our research suggests that in physiological conditions in the cells of the hematopoietic system there is mutual positive regulation of PARP1, PARP2, PARP3, and TRPM2 genes expression. PARP1, PARP2, and TRPM2 genes at mRNA level deregulate in acute myeloid leukemia cells.
Persuasive antimicrobial stewardship intervention in the context of a KPC outbreak: a controlled interrupted time series analysis
Authors: Pereira Nuno Rocha , Dias Paulo Figueiredo , Correia Sofia , Shahriari Shirin , Neves João , Teixeira José , Paiva José Artur , Alves Carlos Lima , Azevedo Ana
Published: February 2020

Introduction: Antimicrobial resistance is a major public health threat. Antimicrobial stewardship (AMS) is one of the key strategies to overcome resistance, but robust evidence on the effect of specific interventions is lacking. We report an interrupted time series (ITS) analysis of a persuasive AMS intervention implemented during a KPC producing Klebsiella pneumoniae outbreak. Methods: A controlled ITS for carbapenem consumption, total antibiotic consumption and antibiotic-free days, between January 2012 and May 2018 was performed, using segmented regression analysis. The AMS intervention was implemented in the Vascular Surgery ward starting on April 2016 in the context of a KPC outbreak. The General Surgery ward was taken as a control group. Data were aggregated by month for both wards, including 51 pre-intervention and 26 intervention points. Results: The AMS intervention produced a level change in carbapenem consumption of -11.14 DDDs/100 patient-days accompanied by a decreasing trend of total antibiotic consumption and stable rate of antibiotic-free days in Vascular Surgery ward. These differences were not apparent in the control group. No differences in mortality or readmission rates between pre-intervention and intervention periods were noticed in any of the groups. Conclusion: Persuasive AMS interventions on top of previously implemented restrictive interventions can reduce carbapenem consumption without increasing total antibiotic consumption. Starting persuasive AMS interventions in an outbreak setting does not compromise the sustainability of the intervention.
Determinants of Isoniazid Preventive Therapy Completion among People Living with HIV Attended Care and Treatment Clinics from 2013 to 2017 in Dar es Salaam Region,Tanzania. A cross-sectional analytical study
Authors: Robert Masanja , Todd Jim , Ngowi Bernard J , Msuya Sia , Ramadhani Angella , Sambu Veryhel , Jerry Isaya , Mujuni Martin R , Mahande Michael J , Ngocho James S , Maokola Werner
Published: February 2020

Background: Tuberculosis (TB) disease is a common opportunistic infection among people living with HIV (PLHIV). WHO recommends at least six months of isoniazid Preventive Therapy (IPT) to reduce the risk of active TB. It is important to monitor completion of IPT, as a suboptimal dose may not protect PLHIV from TB infection. This study determined IPT completion and its determinants among PLHIV aged 15 years or more in Dar es Salaam region, Tanzania. Methods: A Cross-sectional analytical study was conducted using secondary analysis of routine data from 58 care and treatment clinics in Dar es Salaam region. The study recruited clients who screened negative for TB symptoms and initiated IPT between January 2013 and June 2017. Modified Poisson regression model with robust standard errors were used to estimate prevalence ratios (PR) and 95% confidence interval (CI) for factors associated with IPT completion. Multilevel analysis was used to account the health facility random effects in order to estimate independent factors associated with IPT completion. Results : A total of 29,382 clients were initiated on IPT, with 21,808 (74%) female. Overall 17,092 (58%) completed IPT, increasing from 42% (773/1,857) in year 2013 to 76% (2,929/3,856) in 2017. Multilevel multivariable model accounting for health facility as clusters, found that clients with CD4 counts between 100 to 349 cells/ had 3% lower prevalence of IPT completion as compared to those with 100 cells/ (PR:0.97: 95%CI:0.94-1.01). Patients who were not on ART had 46% lower IPT completion compared to those were on ART (PR: 0.54: 95%CI: 0.45-0.64). There was lower IPT completion among clients who transferred to another clinic compared to those attended the same clinic where they were initiated IPT (PR: 0.63: 95% CI (0.54-0.74). Conclusion: IPT completion is low at care and treatment clinics although it increased over time. Lower IPT completion was seen in PLHIV with CD4 counts between 100 to 349 cells/ , those who transferred to other clinics and those not on ART. Thus it indicates the need for better IPT interventions with greater support PLHIV in those groups.
Peer support for people with severe mental illness versus usual care in high-, middle- and low-income countries: study protocol for a pragmatic multicentre randomised controlled trial (UPSIDES-RCT)
Authors: Moran Galia Sharon , Kalha Jasmine , Mueller-Stierlin Annabel , Kilian Reinhold , Krumm Silvia , Slade Mike , Charles Ashleigh , Mahlke Candelaria , Nixdorf Rebecca , Basangwa David , Nakku Juliet , Mpango Richard , Ryan Grace , Shamba Donat , Ramesh Mary , Ngakongwa Fileuka , Grayzman Alina , Pathare Soumitra , Mayer Benjamin , Puschner Bernd
Published: February 2020

Background: Peer support is an established intervention involving a person recovering from mental illness to support others with mental illness.. Peers are an under-used resource in global mental health. Building upon comprehensive formative research, this study will rigorously evaluate the impact of peer support at multiple levels, including: service user outcomes (psychosocial and clinical); peer support worker outcomes (work role, empowerment); service outcomes (cost-effectiveness, return on investment); and implementation outcomes (adoption, sustainability, organisational change). Methods: UPSIDES-RCT is a pragmatic parallel-group multi-centre randomised controlled trial assessing the effectiveness of UPSIDES at four measurement points over one year (baseline, 4-, 8-, and 12-month follow-up), with embedded process evaluation and cost-effectiveness analysis. Research will take place in a range of high-, middle- and low-income countries (Germany, United Kingdom, Israel, India, Uganda, Tanzania). The primary outcome is social inclusion of service users with severe mental illness (N= 558; N = 93 per site) at 8-month follow-up, measured with the Social Inclusion Scale. Secondary outcomes include empowerment (Empowerment Scale), hope (HOPE scale), recovery (Stages of Recovery), and health and social functioning (Health of the Nations Outcome Scales). Mixed-methods process evaluation will investigate mediators and moderators of effect, and implementation experiences of four UPSIDES stakeholder groups (service users, peer support workers, mental health workers, policy makers). A cost-effectiveness analysis examining cost-utility and health budget impact will estimate the value for money of UPSIDES peer support. Discussion: The UPSIDES-RCT will explore the essential components necessary to create a peer support model in mental health care, while providing the evidence required to sustain and eventually scale-up the intervention in different cultural, organisational and resource settings. By actively involving and empowering service users, UPSIDES will move mental health systems toward a recovery orientation, emphasising user-centeredness, community participation, and the realisation of mental health as a human right.
Metapristone(RU486 derivative) inhibits endometrial cancer cell progress through regulating miR-492/Klf5/Nrf1 axis
Authors: Liu Yun , Chang Yue , Cai Yixuan
Published: February 2020

Background: Endometrial cancer is one of the most common cancers affecting women's health. The pathogenesis of endometrial cancer involves many signaling pathways which are related with transcription factors or microRNAs. Recent studies have reported that endometrial cancer is also related with the sexual-mediated hormones. The purpose of this research is to treat the endometrial cancer with the hormone-related drugs, and find out the specific molecular mechanism. Methods: In this study, RL95-2 cells and Ishikawa cells were used as the endometrial cancer cell models. miR-492 was transfected into RL95-2 cells and Ishikawa cells. The miRNA expression was measured by qRT-PCR. The protein expression was measured by western blot. Cell proliferation was monitored using the MTT assay and cell colony formation assay. Cell apoptosis was monitored using EdU assay. Results: Firstly, the results indicated that metapristone as a kind of hormone-related drugs could significantly inhibit the endometrial cancer cell growth through regulating cell apoptosis-related gene expression. Meanwhile, miR-492 was detected to be highly expressed in the endometrial cancer cell lines. Overexpression of miR-492 could promote the cell proliferation and inhibit the cell apoptosis. Furthermore, the results demonstrated that the downstream target genes of miR-492 were Klf5 and Nrf1, which were inhibited by metapristone. At the animal level, metapristone also inhibited the endometrial cancer cell growth through down-regulating the expression of miR-492 and decreasing the protein level of Klf5 and Nrf1. Conclusion: Taken together, this study indicated that metapristone inhibited the endometrial cancer cell growth through regulating the cell apoptosis related signaling pathway and the expression of miR-492 and its downstream target genes (Klf5 and Nrf1), which provided the theoretical basis of endometrial cancer in clinical treatment.