bluuebunny/crossref_metadata_2025 huggingface dataset:
Performing laparoscopic sleeve gastrectomy in an obese patient with systemic lupus erythematosus undergoing long-term steroid therapy: a case report
Authors: Gakuhara Atsushi , Miyazaki Yasuhiro , Kurokawa Yukinori , Takahashi Tsuyoshi , Yamasaki Makoto , Makino Tomoki , Tanaka Koji , Nakajima Kiyokazu , Mori Masaki , Doki Yuichiro
Published: October 2019

Background

Systemic lupus erythematosus (SLE), an autoimmune disease characterized by systemic inflammatory lesions, is often associated with obesity. Obesity aggravates symptoms of SLE; however, these symptoms can be improved by weight loss through diet therapy and bariatric surgery. However, there are only a few reports regarding the effectiveness of bariatric surgery in obese patients with SLE. Herein, we discuss the laparoscopic sleeve gastrectomy (LSG) performed in an obese patient with SLE while undergoing long-term steroid therapy.

Case presentation

A 36-year-old female, suffering from SLE for 10 years with effects on the central nervous system, developed diabetes mellitus (DM) triggered by the steroid therapy for SLE. The patient was undergoing steroid therapy (6 mg/day) for SLE since a long time. For DM management, her HbA1c level was maintained at 7.4%. She was 158 cm tall and 91.6 kg in weight. Her body mass index was 36.7. She could not work and depended on welfare services. To improve her obesity and DM, physicians suggested that she should undergo bariatric surgery in our hospital. Eventually, she underwent LSG, which lasted for 185 min, with minimal blood loss and without complications. Her blood glucose level stabilized immediately after the surgery; hence, her antidiabetic medication was discontinued. She was discharged 8 days after surgery, and her weight decreased steadily. In the first year after surgery, her weight was 54.4 kg, and she had lost approximately 37 kg from her initial weight. Her steroid requirement had also reduced to 4 mg/day. Through weight loss, she could begin to work and became a part of society again.

Conclusion

LSG was safely performed in an obese patient with SLE undergoing long-term steroid therapy. We noted substantial weight loss, improved DM condition, and reduced requirement of SLE therapy after surgery. Hence, surgical risks must be carefully examined before patients undergo bariatric surgery.
A randomised controlled feasibility trial and qualitative evaluation of an early years language development intervention: study protocol of the ‘outcomes of Talking Together evaluation and results’ (oTTer) project
Authors: Bowyer-Crane Claudine , Nielsen Dea , Bryant Maria , Dharni Nimarta , Heald Rebecca , Storr Chloe , Dickerson Josie
Published: October 2019

Background

Problems with oral language skills in childhood have been linked with poor educational, employment, and mental health outcomes. In the UK, there is increasing concern about the oral language skills of children, particularly children from areas of social disadvantage. Research emphasises the importance of the home language environment as a fundamental bedrock for the development of oral language skills. It is vital, therefore, that support is available to help families in need to provide the optimal language environment for their child. Talking Together is a 6-week home visiting programme recently commissioned by Better Start Bradford to develop parents’ knowledge of the importance of a good language environment and help to improve parent-child interactions. This study represents the initial steps in developing a definitive trial of the Talking Together programme.

Method

This study is a two-arm randomised controlled feasibility study in which families referred into the Talking Together programme and consent to participate in the trial will be randomly allocated to either an intervention group or a waiting control group. We will assess the recruitment and retention rates, the representativeness of our sample, the appropriateness of our measures, and the sample size needed for a definitive trial. We will also carry out a qualitative evaluation to explore the acceptability of trial procedures for families and service providers, fidelity of delivery, time and resources for training, and barriers and facilitators to engagement with the programme. Clear progression criteria will be used to assess suitability for a definitive trial.

Conclusion

This feasibility study will inform the development of a definitive trial of this home-based visiting programme, which will add to the sparse evidence base on which practitioners can draw when supporting families in need. The lessons learnt from this feasibility study will also inform the wider evaluation work of the Better Start Bradford Innovation Hub.

Trial registration

The trial is registered with the ISRCTN registry: study ID ISRCTN13251954. Date of registration: 21 February 2019 (the trial was retrospectively registered).
Transnational migration, health and well-being: Nigerian parents in Ireland and the Netherlands
Authors: White Allen , Dito Bilisuma B. , Veale Angela , Mazzucato Valentina
Published: October 2019

The phenomenon of families separated across continents is a result of migratory flows in a globalised world. Transnational families occur because one or both parents migrate internationally requiring children to be raised in transnational child-raising arrangements, with the help of caregivers. This study examines the health and the emotional well-being of Nigerian migrant parents living in Ireland and the Netherlands, using comparative analyses based on a survey of close to 300 migrant parents in each host country. Half of the sample in each country is living in transnational families the other half are not. This paper adds to the existing literature on transnational families by including control groups (migrants who are not separated from their children) and comparing migrant parents from the same origin country who live in different host countries, allowing us to identify the significance of migratory context and legal regimes in shaping the emotional well-being and health of parents.

The results indicate that the factors that drive the health and emotional well-being of migrant parents are not solely related to their separation from their children but rather to other mediating variables such as legal status, socio-economic status, and the normative contexts. While Nigerian child fostering norms ease the influence of separation in both contexts, separate analyses of the Irish and the Netherlands sample show the more pronounced consequences of the mediating factors in the Irish sample, highlighting the differences in the migratory trajectories of Nigerian parents in Ireland and the Netherlands.
Anesthetic management of a surgical patient with an acute aortic dissection complicated by hemoglobin Kansas
Authors: Kobayashi Takashi , Suzuki Kenji
Published: October 2019

Background

Hemoglobin Kansas (Hb Kansas) is a rare disease with cyanosis.

We report a case of anesthetic management for a patient with an acute aortic dissection complicated by Hb Kansas.

Case presentation

We encountered a 62-year-old male, surgical patient with an acute aortic dissection complicated by postoperative Hb Kansas. During anesthesia, his arterial oxygen saturation was low, while the partial pressure of arterial oxygen was within the normal range. The patient underwent ascending aortic replacement under hypothermic circulation arrest with a bladder temperature of 22 °C after introducing cardiopulmonary bypass. The patient was then referred to the hematology department for detailed examination and was diagnosed as having Hb Kansas through genetic analysis at 2 months after surgery.

Conclusions

Except for apparent cyanosis, Hb Kansas causes no clinical problems because the delivery of oxygen to peripheral tissues may be enhanced for such patients. When we perform anesthetic management for cyanosis patients with unknown causes, it is necessary to consider the oxygen supply-demand balance.
Treatment failure and associated factors among first line patients on highly active antiretroviral therapy in Ethiopia: a systematic review and meta-analysis
Authors: Assemie Moges Agazhe , Alene Muluneh , Ketema Daniel Bekele , Mulatu Selishi
Published: October 2019

Background

Antiretroviral therapy (ART) restores immune function and reduces human immunodeficiency virus (HIV) related adverse outcomes. The results of previous studies in Ethiopia were replete with inconsistent findings; nonexistence of national representative figures and determinant factors are found as significant gap. The aim of this systematic review and meta-analysis was to assess the existing evidence on ART treatment failure and associated factors in Ethiopia.

Methods

Relevant studies on ART treatment failure were retrieved from international databases: PubMed, Google Scholar, Scopus, and Science Direct systematically prior to March 14, 2019. All identified studies reporting the proportion of first line treatment failure among HIV patients in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. A random-effects model was used to calculate pooled estimates and associated factors in Stata/se Version-14. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the studies.

Results

From 18 articles reviewed; the pooled proportion of first line treatment failure among ART users in Ethiopia was 15.3% (95% CI: 12, 18.6) with (I2 = 97.9%, p < 0.001). The subgroup analysis by World Health Organization (WHO) treatment failure assessment criteria were carried out, accordingly the highest prevalence (11.5%) was noted on immunological and the lowest (5.8%) was observed virological treatment failure. We had found poor adherence (OR = 8.6, 95% CI: 5.6, 13.4), not disclosed (OR = 2.1, 95% CI: 1.5, 3.0), advanced WHO clinical stage III/IV (OR = 2.4, 95% CI: 1.5, 3.8), change in regimen (OR = 2.5, 95% CI: 1.6, 3.9) and being co-infected (OR = 2.56, 95% CI: 2.2, 3.0) were statistically significant factors for treatment failure.

Conclusion

In this study, treatment failure among ART users in Ethiopia was significant. Adherence, co-infection, advanced WHO clinical stage, regimen change, and disclosure are determinant factors for treatment failure. Therefore, improve drug adherence, prevent co-infection, close follow up, and prevent HIV-drug resistance are required in future remedial efforts.
Comprehensive evaluation model of wind power accommodation ability based on macroscopic and microscopic indicators
Authors: Li Gengyin , Li Guodong , Zhou Ming
Published: October 2019

This article explores and establishes comprehensive evaluation index system of wind power accommodation ability considering microscopic index and macroscopic index, and the index system includes conventional evaluation indexes such as forecast deviation, simultaneity factor and anti-peak rate, also newly introduced evaluation indexes such as installed capacity, power adequacy and accommodation space. Bayesian weight modified method is used for solving index weights of 8 wind power accommodation indexes. The paper puts forward a comprehensive evaluation model of wind power accommodation ability based on improved radar chart method, and this model changes traditional radar chart fan-shaped sector to quadrilateral evaluation region, and increasing angle bisector can solve the problem that evaluation results are not unique. It constructs new area and perimeter vectors of radar chart, which make the evaluation results give consideration to level of aggregation and balance degree of evaluation objectives, and case study results show that this model has a certain practical value.
Bone Mineral Density After Transitioning From Denosumab to Alendronate
Authors: Kendler David , Chines Arkadi , Clark Patricia , Ebeling Peter R , McClung Michael , Rhee Yumie , Huang Shuang , Stad Robert Kees
Published: October 2019

Context

There are few studies on patients transitioning from denosumab to bisphosphonates.

Objective

To investigate patient characteristics and changes in bone mineral density (BMD) after transitioning from denosumab to alendronate.

Design

Randomized, open-label, 2-year crossover Denosumab Adherence Preference Satisfaction (DAPS) study (NCT00518531).

Setting

25 study centers in the US and Canada.

Patients

Treatment-naïve postmenopausal women with BMD T-scores from −2.0 to −4.0.

Interventions

This post hoc analysis evaluated women randomized to subcutaneous denosumab 60 mg every 6 months in year 1 followed by once-weekly oral alendronate 70 mg in year 2.

Main Outcome Measure

A 3% BMD threshold identified participants who lost, maintained, or gained BMD in year 2 on alendronate.

Results

Of 126 participants randomized to denosumab, 115 (91%) transitioned to alendronate in year 2. BMD increased by 3% to 6% with denosumab in year 1 and by 0% to 1% with alendronate in year 2. After transitioning to alendronate, most participants maintained or increased BMD; 15.9%, 7.6%, and 21.7% lost BMD at the lumbar spine, total hip, and femoral neck, respectively. Few participants fell below their pretreatment baseline BMD value; this occurred most often in those who lost BMD in year 2. Women who lost BMD with alendronate in year 2 also showed a greater percent change in BMD with denosumab in year 1. The BMD change in year 2 was similar regardless of baseline characteristics or adherence to oral alendronate.

Conclusion

Alendronate can effectively maintain the BMD gains accrued after 1 year of denosumab in most patients, regardless of baseline characteristics.
Real-world Comparison of Afirma GEC and GSC for the Assessment of Cytologically Indeterminate Thyroid Nodules
Authors: San Martin Vicente T , Lawrence Lima , Bena James , Madhun Nabil Z , Berber Eren , Elsheikh Tarik M , Nasr Christian E
Published: October 2019

Context

Molecular tests have improved the accuracy of preoperative diagnosis of indeterminate thyroid nodules. The Afirma Gene Sequencing Classifier (GSC) was developed to improve the specificity of the Gene Expression Classifier (GEC). Independent studies are needed to assess the performance of GSC.

Objective

The aim was to compare the performance of GEC and GSC in the assessment of indeterminate nodules.

Design, Settings, and Participants

Retrospective analysis of Bethesda III and IV nodules tested with GEC or GSC in an academic center between December 2011 and September 2018. Benign call rates (BCRs) and surgical outcomes were compared. Histopathologic data were collected on nodules that were surgically resected to calculate measures of test performance.

Results

The BCR was 41% (73/178) for GEC and 67.8% (82/121) for GSC (P < .001). Among specimens with dominant Hürthle cell cytology, the BCR was 22% (6/27) for GEC and 63.2% (12/19) for GSC (P = .005). The overall surgery rate decreased from 47.8% in the GEC group to 34.7% in the GSC group (P = .025). One GEC-benign and 3 GSC-benign nodules proved to be malignant on surgical excision. GSC had a statistically significant higher specificity (94% vs 60%, P < .001) and positive predictive value (PPV) (85.3% vs 40%, P < .001) than GEC. While sensitivity and negative predictive value (NPV) dropped with GSC (97.0% vs 90.6% and 98.6% vs 96.3%, respectively), these differences were not significant.

Conclusions

GSC reclassified more indeterminate nodules as benign and improved the specificity and PPV of the test. These enhancements appear to be resulting in fewer diagnostic surgeries.
Human Endometrial Transcriptome and Progesterone Receptor Cistrome Reveal Important Pathways and Epithelial Regulators
Authors: Chi Ru-pin Alicia , Wang Tianyuan , Adams Nyssa , Wu San-pin , Young Steven L , Spencer Thomas E , DeMayo Francesco
Published: October 2019

Context

Poor uterine receptivity is one major factor leading to pregnancy loss and infertility. Understanding the molecular events governing successful implantation is hence critical in combating infertility.

Objective

To define Progesterone Receptor (PGR)-regulated molecular mechanisms and epithelial roles in receptivity.

Design

RNA-sequencing and PGR-ChIP-seq were conducted in parallel to identify PGR-regulated pathways during the Window of implantation (WOI) in endometrium of fertile women.

Setting

Endometrial biopsies from the proliferative and mid-secretory phases were analyzed.

Patients or Other Participants

Participants were fertile, reproductive aged (18–37 years) women with normal cycle length, and without any history of dysmenorrhea, infertility, or irregular cycles. In total, 42 endometrial biopsies obtained from 42 women were analyzed in this study.

Interventions

There were no interventions during this study.

Main Outcome Measures

Here we measured the alterations in gene expression and PGR occupancy in the genome during the WOI, based on the hypothesis that PGR binds uterine chromatin cycle dependently to regulate genes involved in uterine cell differentiation and function.

Results

653 genes were identified with regulated PGR binding and differential expression during the WOI. These were involved in regulating inflammatory response, xenobiotic metabolism, epithelial mesenchymal transition, cell death, interleukin/Signal Transducer And Activator Of Transcription (STAT) signaling, estrogen response, and Mammalian target of rapamycin complex 1 (MTORC1) response. Transcriptome of the epithelium identified 3052 differentially expressed genes, of which 658 were uniquely regulated. Transcription factors Interferon Regulatory Factor 8 (IRF8) and Myocyte Enhancer Factor 2C (MEF2C) were found to be regulated in the epithelium during the WOI at the protein level, suggesting potentially important functions that are previously unrecognized.

Conclusion

PGR binds the genomic regions of genes regulating critical processes in uterine receptivity and function.
Increases in Bioactive IGF do not Parallel Increases in Total IGF-I During Growth Hormone Treatment of Children Born SGA
Authors: Wegmann Mathilde Gersel , Jensen Rikke Beck , Thankamony Ajay , Frystyk Jan , Roche Edna , Hoey Hilary , Kirk Jeremy , Shaikh Guftar , Ivarsson Sten-A , Söder Olle , Dunger David B , Juul Anders
Published: October 2019

Background

Some children born small for gestational age (SGA) experience supra-physiological insulin-like growth factor-I (IGF-I) concentrations during GH treatment. However, measurements of total IGF-I concentrations may not reflect the bioactive fraction of IGF-I which reaches the IGF-I receptor at target organs. We examined endogenous IGF-bioactivity using an IGF-I kinase receptor activation (KIRA) assay that measures the ability of IGF-I to activate the IGF-IR in vitro.

Aim

To compare responses of bioactive IGF and total IGF-I concentrations in short GH treated SGA children in the North European Small for Gestational Age Study (NESGAS).

Material and method

In NESGAS, short SGA children (n = 101, 61 males) received GH at 67 µg/kg/day for 1 year. IGF-I concentrations were measured by Immulite immunoassay and bioactive IGF by in-house KIRA assay.

Results

Bioactive IGF increased with age in healthy pre-pubertal children (n = 94). SGA children had low-normal bioactive IGF levels at baseline (-0.12 (1.8 SD), increasing significantly after one year of high-dose GH treatment to 1.1 (1.4) SD, P < 0.01. Following high-dose GH, 68% (n = 65) of SGA children had a total IGF-I concentration >2SD (mean IGF-I 2.8 SDS), whereas only 15% (n = 15) had levels of bioactive IGF slightly above normal reference values. At baseline, bioactive IGF (SDS) was significantly correlated to height (SDS) (r = 0.29, P = 0.005), in contrast to IGF-I (SDS) (r = 0.17, P = 0.10). IGF-I (SDS) was inversely correlated to delta height (SDS) after one year of high-dose GH treatment (r = -0.22, P = 0.02).

Conclusion

In contrast to total IGF-I concentrations, bioactive IGF stayed within the normal reference ranges for most SGA children during the first year of GH treatment.
Time to Diagnosis in Cushing’s Syndrome: A Meta-Analysis Based on 5367 Patients
Authors: Rubinstein German , Osswald Andrea , Hoster Eva , Losa Marco , Elenkova Atanaska , Zacharieva Sabina , Machado Márcio Carlos , Hanzu Felicia Alexandra , Zopp Stephanie , Ritzel Katrin , Riester Anna , Braun Leah Theresa , Kreitschmann-Andermahr Ilonka , Storr Helen L , Bansal Prachi , Barahona María-José , Cosaro Elisa , Dogansen Sema Ciftci , Johnston Philip C , Santos de Oliveira Ricardo , Raftopoulos Christian , Scaroni Carla , Valassi Elena , van der Werff Steven J A , Schopohl Jochen , Beuschlein Felix , Reincke Martin
Published: October 2019

Context

Signs and symptoms of Cushing’s syndrome (CS) overlap with common diseases, such as the metabolic syndrome, obesity, osteoporosis, and depression. Therefore, it can take years to finally diagnose CS, although early diagnosis is important for prevention of complications.

Objective

The aim of this study was to assess the time span between first symptoms and diagnosis of CS in different populations to identify factors associated with an early diagnosis.

Data Sources

A systematic literature search via PubMed was performed to identify studies reporting on time to diagnosis in CS. In addition, unpublished data from patients of our tertiary care center and 4 other centers were included.

Study Selection

Clinical studies reporting on the time to diagnosis of CS were eligible. Corresponding authors were contacted to obtain additional information relevant to the research question.

Data Extraction

Data were extracted from the text of the retrieved articles and from additional information provided by authors contacted successfully. From initially 3326 screened studies 44 were included.

Data Synthesis

Mean time to diagnosis for patients with CS was 34 months (ectopic CS: 14 months; adrenal CS: 30 months; and pituitary CS: 38 months; P < .001). No difference was found for gender, age (<18 and ≥18 years), and year of diagnosis (before and after 2000). Patients with pituitary CS had a longer time to diagnosis in Germany than elsewhere.

Conclusions

Time to diagnosis differs for subtypes of CS but not for gender and age. Time to diagnosis remains to be long and requires to be improved.
GLP-1 Analog Modulates Appetite, Taste Preference, Gut Hormones, and Regional Body Fat Stores in Adults with Obesity
Authors: Kadouh Hoda , Chedid Victor , Halawi Houssam , Burton Duane D , Clark Matthew M , Khemani Disha , Vella Adrian , Acosta Andres , Camilleri Michael
Published: October 2019

Purpose

Obesity is associated with alterations in appetite, gastrointestinal hormone levels and excessive fat mass. We previously published a double-blind, placebo-controlled, randomized, 16-week trial on effects of once-daily glucagon-like peptide-1 (GLP-1) analog, liraglutide on weight, satiation, and gastric functions in obese volunteers. The aim of this substudy is to compare to placebo the effects of liraglutide on appetite, taste preference, regional body fat stores, and anthropometric measurements.

Methods

Forty obese adults received standard instruction for weight management, monthly behavioral intervention utilizing motivational interviews, and 16-week treatment of once-daily liraglutide (escalated to 3 mg SQ daily). At baseline and 16 weeks, the following were measured: appetite and taste preferences rated every 30 min for 5 h after ingesting 300 mL Ensure®; maximal tolerated volume (MTV) with a nutrient drink test; fasting and postprandial bioactive GLP-1 (7–36) and peptide YY (PYY) levels; total and regional body fat with dual-energy X-ray absorptiometry, and waist and hip circumference.

Results

Thirty-five participants (17 liraglutide; 18 placebo) completed the trial. Compared to placebo group, liraglutide group had significant reductions in MTV; prospective food consumption score; desire to eat something sweet, salty, savory or fatty; and an increase in perceived fullness. Postprandial plasma levels of GLP-1 decreased and PYY levels increased with liraglutide relative to baseline. Significant reductions in total body, trunk, and upper and lower body fat without reduction in lean body mass were observed.

Conclusion

Liraglutide 3 mg SQ modulates appetite, taste preference, gut hormones, and regional body fat stores in adults with obesity without reduction in lean body mass.
Urine Steroid Metabolomics as a Novel Tool for Detection of Recurrent Adrenocortical Carcinoma
Authors: Chortis Vasileios , Bancos Irina , Nijman Thomas , Gilligan Lorna C , Taylor Angela E , Ronchi Cristina L , O’Reilly Michael W , Schreiner Jochen , Asia Miriam , Riester Anna , Perotti Paola , Libé Rosella , Quinkler Marcus , Canu Letizia , Paiva Isabel , Bugalho Maria J , Kastelan Darko , Dennedy M Conall , Sherlock Mark , Ambroziak Urszula , Vassiliadi Dimitra , Bertherat Jerome , Beuschlein Felix , Fassnacht Martin , Deeks Jonathan J , Biehl Michael , Arlt Wiebke
Published: October 2019

Context

Urine steroid metabolomics, combining mass spectrometry-based steroid profiling and machine learning, has been described as a novel diagnostic tool for detection of adrenocortical carcinoma (ACC).

Objective, Design, Setting

This proof-of-concept study evaluated the performance of urine steroid metabolomics as a tool for postoperative recurrence detection after microscopically complete (R0) resection of ACC.

Patients and Methods

135 patients from 14 clinical centers provided postoperative urine samples, which were analyzed by gas chromatography–mass spectrometry. We assessed the utility of these urine steroid profiles in detecting ACC recurrence, either when interpreted by expert clinicians or when analyzed by random forest, a machine learning-based classifier. Radiological recurrence detection served as the reference standard.

Results

Imaging detected recurrent disease in 42 of 135 patients; 32 had provided pre- and post-recurrence urine samples. 39 patients remained disease-free for ≥3 years. The urine “steroid fingerprint” at recurrence resembled that observed before R0 resection in the majority of cases. Review of longitudinally collected urine steroid profiles by 3 blinded experts detected recurrence by the time of radiological diagnosis in 50% to 72% of cases, improving to 69% to 92%, if a preoperative urine steroid result was available. Recurrence detection by steroid profiling preceded detection by imaging by more than 2 months in 22% to 39% of patients. Specificities varied considerably, ranging from 61% to 97%. The computational classifier detected ACC recurrence with superior accuracy (sensitivity = specificity = 81%).

Conclusion

Urine steroid metabolomics is a promising tool for postoperative recurrence detection in ACC; availability of a preoperative urine considerably improves the ability to detect ACC recurrence.
Surgery as a Viable Alternative First-Line Treatment for Prolactinoma Patients. A Systematic Review and Meta-Analysis
Authors: Zamanipoor Najafabadi Amir H , Zandbergen Ingrid M , de Vries Friso , Broersen Leonie H A , van den Akker-van Marle M Elske , Pereira Alberto M , Peul Wilco C , Dekkers Olaf M , van Furth Wouter R , Biermasz Nienke R
Published: October 2019

Context

The improved remission and complication rates of current transsphenoidal surgery warrant reappraisal of the position of surgery as a viable alternative to dopamine agonists in the treatment algorithm of prolactinomas.

Objective

To compare clinical outcomes after dopamine agonist withdrawal and transsphenoidal surgery in prolactinoma patients.

Methods

Eight databases were searched up to July 13, 2018. Primary outcome was disease remission after drug withdrawal or surgery. Secondary outcomes were biochemical control and side effects during dopamine agonist treatment and postoperative complications. Fixed- or random-effects meta-analysis was performed to estimate pooled proportions. Robustness of results was assessed by sensitivity analyses.

Results

A total of 1469 articles were screened: 55 (10 low risk of bias) on medical treatment (n = 3564 patients) and 25 (12 low risk of bias) on transsphenoidal surgery (n = 1836 patients). Long-term disease remission after dopamine agonist withdrawal was 34% (95% confidence interval [CI], 26-46) and 67% (95% CI, 60-74) after surgery. Subgroup analysis of microprolactinomas showed 36% (95% CI, 21-52) disease remission after dopamine agonist withdrawal, and 83% (95% CI, 76-90) after surgery. Biochemical control was achieved in 81% (95% CI, 75-87) of patients during dopamine agonists with side effects in 26% (95% CI, 13-41). Transsphenoidal surgery resulted in 0% mortality, 2% (95% CI, 0-5) permanent diabetes insipidus, and 3% (95% CI, 2-5) cerebrospinal fluid leakage. Multiple sensitivity analyses yielded similar results.

Conclusions

In the majority of prolactinoma patients, disease remission can be achieved through surgery, with low risks of long-term surgical complications, and disease remission is less often achieved with dopamine agonists.
Endometrial Liquid Biopsy Provides a miRNA Roadmap of the Secretory Phase of the Human Endometrium
Authors: Grasso Alessia , Navarro Roser , Balaguer Nuria , Moreno Inmaculada , Alama Pilar , Jimenez Jorge , Simón C , Vilella F
Published: October 2019

Context

Endometrial liquid biopsy (ELB) is a minimally invasive alternative for research and diagnosis in endometrial biology.

Objective

We sought to establish an endometrial micro ribonucleic acid (miRNA) roadmap based on ELB during the secretory phase of the menstrual cycle in both natural and hormonal replacement therapy (HRT) cycles.

Design

Human ELB samples (n = 58) were obtained from healthy ovum donors undergoing a natural and an HRT cycle consecutively. miRNA profiles were identified using next-generation sequencing (NGS). For functional analysis, messenger ribonucleic acid targets were chosen among those reported in the endometrial receptivity analysis.

Results

The human endometrial secretory phase is characterized by a dynamic miRNA secretion pattern that varies from the prereceptive to the receptive stages. No differences in miRNA profiles were found among natural versus HRT cycles in the same women, reinforcing the similarities in functional and clinical outcomes in natural versus medicated cycles. Bioinformatic analysis revealed 62 validated interactions and 81 predicted interactions of miRNAs differentially expressed in the HRT cycle. Annotation of these genes linked them to 51 different pathways involved in endometrial receptivity.

Conclusion

This NGS-based study describes the miRNA signature in human ELB during the secretory phase of natural and HRT cycles. A consistent endometrial miRNA signature was observed in the acquisition of endometrial receptivity. Interestingly, no significant differences in miRNA expression were found in natural versus HRT cycles reinforcing the functional clinical similarities between both approaches.
From Social Worker to Social Ship Owner
Authors: Metz Alessandro , Hardt Michael , Mezzadra Sandro
Published: October 2019

In this article, Michael Hardt and Sandro Mezzadra interview Alessandro Metz, social worker and “social” owner of the ship Mare Jonio, which seeks to aid and protect migrants during increasingly perilous Mediterranean Sea crossings. Metz explores the relation between social work and political activism, with particular emphasis on the writings of Franco Basaglia.
Death and Life at Sea
Authors: Casarini Luca
Published: October 2019

Luca Casarini, who has served as “chief of mission” on the Mare Jonio, recounts the experience of sailing on the ship and rescuing migrants in distress. He situates his personal experiences in the context of the current plight of migrants in the Central Mediterranean and the Italian government’s attacks against humanitarian organizations.
Octopus insularis as a new marine model for EvoDevo
Authors: Maldonado Ernesto , Rangel-Huerta Emma , González-Gómez Roberto , Fajardo-Alvarado Gabriel , Morillo-Velarde Piedad S.
Published: October 2019

Octopuses are intriguing organisms that, together with squids and cuttlefishes, form the extant coleoid cephalopods. This group includes many species that can potentially be used as models in the fields of biomedicine, developmental biology, evolution, and neuroscience and even for robotics research. The purpose of this work is to first present a simple method for maintaining Octopus insularis embryos under a laboratory setup. Second, we show that these embryos are suitable for detailed analyses of specific traits that appear during developmental stages, including the eyes, hearts, arms, suckers, chromatophores, and Köllikeŕs organs. Similar complex traits between cephalopods and vertebrates such as the visual, cardiovascular, neural and pigmentation systems are generally considered to be a result of parallel evolution. Like other cephalopod models, we propose that O. insularis embryos could be used as a model for evolutionary developmental biology (or EvoDevo) research, where comparisons of the morphogenetic steps in the building of equivalent organs between cephalopods and known vertebrate model systems could shed light on evolutionary convergence.
E2FA and E2FB transcription factors coordinate cell proliferation with seed maturation
Authors: Leviczky Tünde , Molnár Eszter , Papdi Csaba , Őszi Erika , Horváth Gábor V. , Vizler Csaba , Nagy Viktór , Pauk János , Bögre László , Magyar Zoltán
Published: October 2019

The E2F transcription factors and the RETINOBLASTOMA RELATED (RBR) repressor protein are principal regulators coordinating cell proliferation with differentiation, but their role during seed development is little understood. We show that in the fully developed embryos, cell number was not affected either in single or double mutants for the activator-type E2FA and E2FB. Accordingly, these E2Fs are only partially required for the expression of cell cycle genes. In contrast, the expression of key seed maturation genes; LEAFY COTYLEDON 1-2 (LEC1-2), ABSCISIC ACID INSENSITIVE 3 (ABI3), FUSCA 3 (FUS3) and WRINKLED 1 (WRI1) are upregulated in the e2fab double mutant embryo. In accordance, E2FA directly regulates LEC2, and mutation at the consensus E2F-binding site in LEC2 promoter de-represses its activity during the proliferative stage of seed development. Additionally, the major seed storage reserve proteins, 12S globulin and 2S albumin became prematurely accumulated at the proliferating phase of seed development in the e2fab double mutant. Our findings reveal a repressor function of the activator E2Fs to restrict the seed maturation program until the cell proliferation phase is completed.
Non-Electronic Aromatic Ring Activation by Simple Steric Repulsion between Substituents in 1-Methylquinolinium Salt Systems
Authors: Iwai Kento , Yokoyama Soichi , Asahara Haruyasu , Nishiwaki Nagatoshi
Published: October 2019

A systematic study of non-electronic activation of an aromatic ring was performed using a series of 8-substituted 1-methylquinolinium salts. As the 8-substituent became bulkier, the quinoline framework was distorted by steric repulsion between substituents at the 1- and 8-positions. This was accompanied by lack of coplanarity, which brought about dearomatization. Consequently, quinolinium ions possessing a bulky 8-substituent exhibited high reactivity undergoing nucleophilic addition at the 2-position efficiently. We demonstrate that the activation was achieved sterically and not electronically.
The Surge of Economic Nationalism in Western Europe
Authors: Colantone Italo , Stanig Piero
Published: October 2019

We document the surge of economic nationalist and radical-right parties in western Europe between the early 1990s and 2016. We discuss how economic shocks contribute to explaining this political shift, looking in turn at theory and evidence on the political effects of globalization, technological change, the financial and sovereign debt crises of 2008–2009 and 2011–2013, and immigration. The main message that emerges is that failures in addressing the distributional consequences of economic shocks are a key factor behind the success of nationalist and radical-right parties. We discuss how the economic explanations compete with and complement the “cultural backlash” view. We reflect on possible future political developments, which depend on the evolving intensities of economic shocks, on the strength and persistence of adjustment costs, and on changes on the supply side of politics.
What They Were Thinking Then: The Consequences for Macroeconomics during the Past 60 Years
Authors: Akerlof George A.
Published: October 2019

This article explores the development of Keynesian macroeconomics in its early years, and especially in the Big Bang period immediately after the publication of The General Theory. In this period, as standard macroeconomics evolved into the “Keynesian-neoclassical synthesis,” its promoters discarded many of the insights of The General Theory. The paradigm that was adopted had some advantages. But its simplifications have had serious consequences—including immense regulatory inertia in response to massive changes in the financial system and unnecessarily narrow application of accelerationist considerations (regarding inflation expectations).
ABOUT SOME PECULARITIES OF CHANGING THE PHYSICAL AND CHEMICAL COMPOSITION OF THE COW BREAST SECRET
Authors: Крупин Евгений , Krupin Evgeniy , Шакиров Шамиль , Shakirov Shamil' , Зухрабов Мирзабек , Zuhrabov Mirzabek , Тагиров Марсель , Tagirov Marsel
Published: October 2019

Studies have shown the effect on the physical and chemical parameters of beestings and milk of metabolic correctors used by animals in accordance with the scheme developed by the authors. The experiment was carried out on 30 cows of the Holstein breed contained in the agricultural factory “Plemzavod im. Lenin” of Atninsky district of the Republic of Tatarstan. The content of the mass fraction of fat, the mass fraction of protein in beestings and milk was determined on “Laktan 1-4” milk quality analyzer, the content of trace elements in milk was determined on “Analist 200” atomic absorption spectrophotometer according to the manufacturer’s method. The use of vitamin-mineral premix P60-3/P in the final 15 days of the dry period in combination with metabolic correctors is accompanied by a maximum content of protein mass fraction in beestings (6.0%), and an increase in the use of this premix to the entire duration of the dry period allows increasing the mass the proportion of fat in beestings is up to 5.41%, however, these changes were not reliable. A significant decrease in the mass fraction of protein in the milk of cows of the control group (P <0.05) and a significant increase in the mass fraction of fat in animals of the third group to 4.13% (P <0.05) on the 30th day of lactation were found. On day 30 of lactation, a significant increase in the content of copper and selenium in the milk of individuals of the second (66.2% (P <0.01) and 65.2% (P <0.05), respectively) and the third (67.2% (respectively P <0.001) and 73.0% (P <0.01)) groups. On the 60th day of lactation in animals of the first group, the increase in the zinc content in milk was reliable and amounted to 6.9% (P <0.05). In cows of the second and third groups, the copper content was significantly higher than in animals of the first group by 60.3% (P <0.01) and 62.6% (P <0.01), respectively. In individuals of the third group, the selenium content was significantly higher than in animals of the first (control) group by 94.2% (P <0.01). This article was prepared as part of the state task AAAA-A18-118031390148-1.
ECOLOGICAL AND BIOLOGICAL EFFECTS OF ELECTROMAGNETIC RADIATION RADIATIONS
Authors: Борисова Ольга , Borisova Ol'ga , Хромушин В. , Hromushin V. , Хадарцев Александр , Hadarcev Aleksandr
Published: October 2019

Mankind has come to a peculiar and very important interaction with the environment. To the existing electricity and magnetic fields of the Earth, atmospheric electricity, radio emissions of the Sun and the Galaxy, electromagnetic radiation (EMR) of artificial origin was added. Biologically significant are the 50 Hz electric fields generated by overhead lines and substations. Genetic effects of EMR in Biosystems are established: induction of various genetic disorders at one modes of influence and modification of gene expression at others.
NONTRIVIAL TECHNIQUES AND MEANS FOR SOLVING THE PROBLEM OF PREVENTING PHYSICAL AND SPIRITUAL DEGRADATION OF A PERSON
Authors: Хадарцев Александр , Hadarcev Aleksandr , Борисова Ольга , Borisova Ol'ga
Published: October 2019

The Body is a unique module that reacts to external natural influences. Disharmonious work of brain structures requires new approaches for health harmonization. The source of creating psychological harmonizing techniques can be the age-old experience of the people, philosophically processed for modern use.
INFLUENCE OF ORGANOMINERAL SUSPENSIONS AND ITS NANO-ANALOGUES ON THE STRUCTURAL ELEMENTS OF OAT CROP
Authors: Суханова Ирина , Suhanova Irina , Газизов Расим , Gazizov Rasim , Ильясов Марс , Ilyasov Mars , Биккинина Лилия , Bikkinina Liliya
Published: October 2019

The article presents the results of two summer studies on the use of nanostructured suspensions of sapropel and vermicompost on gray forest medium loamy soil under the conditions of a growing experiment when growing oats of Konkur variety. We see the supply of plants with nutrients in the use of substances created by nature itself, whose chemical composition allows them to be used as fertilizers. In agriculture and crop production, various doses of sapropel and vermicompost in the soil have been studied, but there are no data on the use of their nanostructured components. For the first time in the Republic of Tatarstan, research is underway to develop ways to use sapropel and vermicompost nanomaterials in crop production when growing crops. The nature and degree of influence of macro - and nanostructured suspensions on the main elements of the crop structure during their use for pre-sowing seed treatment and foliar treatment of plants, both in a separate and in a complex application, is revealed. Presowing treatment with suspensions of vermicompost and nanobiohumus increased the height and yield of plant biomass relative to other options by 3.8 ... 26.1% and 8 ... 58.2%, respectively, in terms of structure. The complex use of treatments with nanosuspensions of sapropel and vermicompost positively affected quantitative indicators: mass of 1000 grains, roots and grains. Nanostructured suspensions possessing biologically active properties, particle sizes of 20-30 nm, penetrating unhindered, without damaging the structure and without consequences for the plant organism, stimulating biochemical processes and having a prolonged effect on biological objects, provided better crop structure indicators compared to macro-suspension treatment.
THE STUDY OF VARIETIES AND LINES OF WINTER WHEAT ACCORDING TO ECONOMICALLY VALUABLE SIGNS
Authors: Фадеева Ирина , Fadeeva Irina , Тагиров Марсель , Tagirov Marsel , Газизов Ильяс , Gazizov Ilyas , Никифорова Ирина , Nikiforova Irina , Сайфутдинова Диля , Sayfutdinova Dilya
Published: October 2019

Seventeen varieties and lines of winter soft wheat of Tatar Scientific Research Institute of Agriculture selection were evaluated in comparison with varieties of other breeding centers in the conditions of the northern regions of Volga region in 2016-2018. The purpose of the research is to identify source varieties of stably high yield and technological quality of grain. The soil is gray forest, the predecessor is pure steam. Mineral fertilizers were applied based on the planned productivity of 6.0 tons per hectare. The plot area is 10 m2. The placement is randomized. Replication is 4-fold. The two-factor experiment: factor A - varieties, factor B - years of research. The average productivity of varieties varied from 4.01 to 5.23 tons per hectare. The maximum yield increase over the standard Kazanskaya 560 variety was obtained from Gostianum 2186 line (24.1%) with a variability of 6.1%. The lowest values of the variation coefficient in yield (1.2%) were obtained from Erythrospermum 2200 variety, which forms the grain productivity at the standard level. In contrasting weather conditions, during the years of study, the interaction “genotype × environment” had a significant effect on yield (31.8%). Large-grain varieties were identified - Nadezhda (46.1 grams) and Lutestsens 2164 (45.7 grams) with a slight variation in the trait (0.9% and 7.9%, respectively) by year. Grain with a high natural weight from 788 g/l (Skipetr) to 830 g/l (Universiada) was obtained with a slight variation of this indicator (from 0.3% to 2.3%). Such varieties, as Kazanskaya 560, Nadezhda, Darina, Sultan, Gostianum 2196, Erythrospermum 2197, Gostianum 2199, Erythrospermum 2200 in terms of “mass fraction of protein” can be classified as valuable wheat, and Moscow variety 39 - as strong. It was established, that grain quality indicators are more genetically determined: varietal differences determined the formation of gluten quality to 65.1%; mass of 1000 grains to 52.1%; the full weight of the grain to 38.4%; mass fraction of protein in grain to 49.4%; the mass fraction of gluten in the grain to 48.1%.
CHEMICAL COMPOSITION OF SOD-STRONGLY-PODZOLIC LIGHT-LOAMY SOIL DURING LONG-TERM AGRICULTURAL USE
Authors: Фатыхов Ильдус , Fatykhov Ildus , Бусоргина Нина , Busorgina Nina , Борисов Борис , Borisov Boris , Исламова Чулпан , Islamova Chulpan
Published: October 2019

Mass spectral method with inductively coupled plasma (MS) and atomic emission method with inductively coupled plasma (AES) at ASIC VNIIMS named after N.M. Fedorovskiy 53 chemical elements and 8 oxides in sod-strongly-podzolic light loamy soil were determined. Soil samples were taken from horizons А1 (deposit) and Ап (arable land) during long-term agricultural use in SKhPK named after Michurin of Vavozhskiy district of the Udmurt Republic. Relative to horizon А1 (deposit), in the plow layer there is a higher content of zinc, cadmium and lead - elements of the toxicity class 1, copper - element of the toxicity class 2, barium, strontium and tungsten - elements of the toxicity class 3. In accordance with the requirements of the hygienic standard GN 2.1.7.2041-06, only the arsenic content exceeded maximum permissible concentration. Among the oxides in the arable layer Ап, an increased content of magnesium and iron oxides was noted, compared with their concentration in the А1 horizon (deposit). In the course of the study, it was found that the studied sod-strongly podzolic light loamy soil with long-term agricultural use is characterized by an increase in the content of zinc in the arable layer by 16.8, lead by 0.4, cadmium by 0.11 μg/g, barium by 33.1, strontium by 3.1 and tungsten by 0.11 μg/g relative to their concentration in the А1 horizon (deposit). According to the content in the arable layer of heavy metals sod-strongly podzolic light loamy soil SKhPK named after Michurin of Vavozhskiy district of the Udmurt Republic can be classified as soil with a low level of pollution. According to the total pollution indicator, the soil corresponds to the category of permissible pollution level.