bluuebunny/crossref_metadata_2025 huggingface dataset:
Catastrophic Health Expenditure Incidence and Its Equity in China: A Study on the Initial Implementation of the Medical Insurance Integration System
Authors: liu huan , zhu hong , wang jiahui , qi xinye , zhao miaomiao , shan linghan , gao lijun , kang zheng , jiao mingli , pan lin , chen ruohui , liu baohua , Wu Qunhong , ning ning
Published: July 2019

Introduction: By 2013, several regions in China have introduced health insurance integration policies. However, few studies have addressed the impact of medical insurance integration in China. This study investigates catastrophic health expenditure and equity in the incidence of catastrophic health expenditure by addressing its potential determinants in both integrated areas and non-integrated areas in China in 2013.
Methods: The primary data are drawn from the fifth China National Health Services Survey in 2013. The final sample comprises 19,788 households (38.4%) from integrated areas and 31,797 households (61.6%) from non-integrated areas. A probit model is employed to decompose the inequality of the incidence of catastrophic health expenditure in line with the methodology used for decomposing the concentration index.
Results: The incidence of catastrophic health expenditure in integrated areas is higher than in non-integrated areas (13.87% vs. 13.68%, respectively). The concentration index in integrated areas and non-integrated areas is -0.071 and -0.073, respectively. Average household out-of-pocket health expenditure and average capacity to pay in integrated areas are higher than in non-integrated areas. However, households in integrated areas have lower out-of-pocket expenditures share in capacity to pay than households in non-integrated areas. The majority of the observed inequalities in catastrophic health expenditure can be explained by differences in the health insurance and householders’ educational attainment both in integrated areas and non-integrated areas. However, compared with non-integrated areas, the inequity caused by integrated medical insurance has been significantly reduced in integrated areas.
Conclusions: The medical insurance integration system in China is still at the exploring stage; hence, its effects are of limited significance. Regardless of the area, catastrophic health expenditure is associated with pro-poor inequality. Medical insurance, urban-rural disparities, the elderly population, and the use of health services significantly affect the equity of catastrophic health expenditure incidence.
Keywords: Catastrophic health expenditure, Medical insurance integration system, Equity, Influencing factors
Characterization of B-box proteins and their contribution to plant development in Arachis duranensis
Authors: Jin Hanqi , Xing Mengge , Cai Chunmei , Li Shuai
Published: July 2019

Background

B-box (BBX) proteins are important factors involving in the regulation of plant growth and development, and have been identified in many plant species. However, the characteristics and transcription patterns of BBX genes in wild peanut are limited.

Results

In the present study, we identified and characterized 24 BBX genes in a wild peanut Arachis duranensis. The AdBBX members distributed on 9 of the 10 chromosomes and chromosome 3 contained the most AdBBX members, with 6 AdBBXs. 16 AdBBX proteins had two distinct BBX domains, 11 members contained one CCT domain, and 7 genes had both BBX and CCT domains. Protein structure analysis revealed that AdBBX were classified into five clades: I (3 genes), II (4 genes), III (4 genes), IV (9 genes) and V (4 genes), on the basis of the diversity of conserved BBX and CCT domains. Moreover, 15 distinct motifs were found in these 24 AdBBX proteins and motif 1 and 5 existed in all the AdBBX proteins. Duplication analysis revealed that 4 interchromosomal duplicated gene pairs were obtained and all of them belonged to group IV. In addition, 95 kinds of cis-acting elements were found in the promoter regions of AdBBXs and 53 types were predicted to have putative functions. The numbers and types of cis-acting elements varied in these AdBBX promoters, as a result, AdBBX genes exhibited distinct expression levels in different tissues. The transcription investigation combined with synteny analysis suggested AdBBX8 might be the key factor involving in flowering time regulation in Arachis duranensis.

Conclusion

Overall, this study provides a genome-wide identification of BBX genes in a wild peanut Arachis duranensis. Characteristic and transcription pattern analysis revealed their critical roles in plant growth and development. Our study will provide essential information for further functional characteristic investigation of AdBBX genes.
Comprehensive influences of overexpression of a MYB transcriptor regulating anthocyanin biosynthesis on transcriptome and metabolome of tobacco leaves
Authors: Zong Yuan , Li Shiming , Xi Xingyuan , Cao Dong , Wang Zhong , Wang Ran , Liu Baolong
Published: July 2019

Background

Overexpression of MYB transcription factors can induce the expression of structural genes for anthocyanin biosynthesis and increase the anthocyanin content of plant tissues. However, it remains unclear whether MYB transcription factor overexpression effects the activation of other genes and the concomitant accumulation of chemical compounds.

Results

Overexpression of LrAN2 promoted anthocyanin accumulation in a variety of tissues in tobacco cultivar Samsun. Only 185 unigenes, from total of 160,965, were expressed differently in leaves and 241 chemical compounds exhibited differences in accumulation. Four anthocyanins, including apigeninidin chloride, cyanidin 3-O-malonylhexoside, pelargonidin 3-O-beta-D-glucoside, and cyanidin 3,5-O-diglucoside were detected only in transgenic lines, which could explain the purple leaf phenotype. Beside anthocyanins, the phenylpropanoids, polyphenols (catechins), flavonoids, flavones, and flavonols were also upregulated. Overexpression of LrAN2 activated the basic helix-loop-helix transcription factor AN1b, and the MYB transcription factor MYB3. Additionally, structural genes associated with the phenylpropanoid biosynthetic pathway were activated, which lead to the upregulated accumulation of phenylpropanoid, polyphenol (catechin), flavonoid, flavone, flavonol, and anthocyanin. The MYB transcription factor CPC, a negative regulator of anthocyanin biosynthesis, was also expressed at increased levels in transgenic lines, which implie that a negative regulation mechanism existed in the anthocyanin biosynthesis pathway. The relative contents of all 19 differently accumulated amino groups and derivatives were decreased in transgenic lines, which meant that the phenylalanine biosynthesis pathway used other amino acids as substrates. Interestingly, the expression of acetylalkylglycerol acetylhydrolase was suppressed in transgenic lines, which caused the accumulation of 19 lyso-phosphatidylcholine derivatives and a decrease in production of eight octodecane derivatives.

Conclusions

Overexpression of LrAN2 activates the pathway of anthocyanin synthesis and metabolism in tobacco. Four anthocyanins lead to the purple leaf phenotype The main pathways of flavonoid biosynthesis were up-regulated. This research provides more information about the function of MYB transcription factors in anthocyanin biosynthesis and the production of other chemical compounds. This work will help breeders to obtain new plant cultivars with high anthocyanin contents using biotechnology.
PpNAC187 enhances lignin synthesis in ‘Whangkeumbae’ pear (Pyrus pyrifolia) ‘hard-end’ fruit
Authors: Li Mingtong , Cheng Chenxia , Zhang Xinfu , Zhou Suping , Wang Caihong , Ma Chunhui , Yang Shaolan
Published: July 2019

Background: A disorder in pears known as ‘hard-end’ fruit affects the appearance, edible quality, and market value of pear fruit. To explore the mechanism underlying the formation of hard-end, RNA-Seq was carried out on the calyx end of ‘Whangkeumbae’ pear fruit with and without the hard-end symptom.
Result: Results indicated that genes in the phenylpropanoid pathway affecting lignification were up-regulated in hard-end fruit. An analysis of differentially expressed genes (DEGs) identified three NAC transcription factors, and RT-qPCR analysis of PpNAC138, PpNAC186 and PpNAC187 confirmed that PpNAC187 gene expression was correlated with the hard-end disorder in pear fruit. A transient increase in PpNAC187 was observed in the calyx end of ‘Whangkeumbae’ fruit when they began to exhibit hard-end symptom. Concomitantly, the higher level of PpCCR, Pp4CL and PpCOMT transcripts was observed; which are the key genes in lignin biosynthesis. Notably, lignin content in the stem and leaf tissues of transgenic tobacco overexpressing PpNAC187 was significantly higher than in control plants transformed with an empty vector. Furthermore, transgenic tobacco overexpressing PpNAC187 had a larger number of xylem vessel elements.
Conclusion: The results of this study confirmed that PpNAC187 functions in inducing lignification in pear fruit during the development of the hard-end disorder.
The gene regulatory network in different brain regions of neuropathic pain mouse models
Authors: Li Xia , Xu Long-Sheng , Xu Yu-Fen , Yang Qi , Fang Zhi-Xian , Lv Xiao-Dong , Yao Ming , Chen Wen-Yu
Published: July 2019

Neuropathic pain is the direct result caused by lesions or somatosensory nervous system diseases that are associated with emotional regulation. The incidence of neuropathic pain in the general population is 7-10% and the mechanisms of neuropathic pain are largely unknown. It is often related to structural and functional abnormalities in multiple brain regions. The forebrain, including nucleus accumbens (NAc), medial prefrontal cortex (mPFC) and periaqueductal gray (PAG) have been shown to correspond with the regulation of neuropathic pain. To investigate the molecular mechanism of neuropathic pain across different brain regions, we identified the differentially expressed genes between the spared nerve injury model (SNI) mice of neuropathic pain and the control Sham mice in NAc, mPFC and PAG and mapped these genes onto comprehensive functional association network. With Random Walk with Restart (RWR) analysis, we identified more novel neuropathic pain genes in NAc, mPFC and PAG, such as Asic3, Cd200r1 and MT2, beside well known Capn11 and CYP2E1. What’s more, we discovered their interactions or cross talks. Our results provided novel insights of neuropathic pain and provided therapeutic targets for treating neuropathic pain.
Phytochemical and comparative transcriptome analysis reveals different regulatory mechanisms in terpenoids pathways between Matricaria recutita L. and Chamaemelum nobile L
Authors: Tai Yuling , Hou Xiaojuan , Liu Chun , Sun Jiameng , Guo Chunxiao , Su Ling , Jiang Wei , Ling Chengcheng , Wang Chengxiang , Wang Huanhuan , Pan Guifang , Si Xiongyuan , Yuan Yi
Published: July 2019

Background

Matricaria recutita (German chamomile) and Chamaemelum nobile (Roman chamomile) belong to the botanical family Asteraceae. These two herbs are not only morphologically distinguishable, but their secondary metabolites – especially the essential oils in flowers are also different, especially the terpenoids. The aim of this project was to preliminarily reveal differential regulatory mechanisms in terpenoids biosynthetic pathway between German and Roman chamomile by performing comparative transcriptomic and metabolomics analyses.

Results

We determined the content of essential oil in disk florets and ray florets in these two chamomiles, and found that the terpenoids content of German chamomile is greater than that of Roman chamomile. In addition, comparisons between German and Roman chamomile were studied by RNA-Seq, which showed that 54% of genes shared >75% sequence identity between the two species. In particular, more highly expressed DEGs (differentially expressed genes) and TFs (transcription factors), different regulation of CYPs (cytochrome P450 enzymes) and rapid evolution of the downstream enzymes in terpenoids biosynthetic pathways in German chamomile, and maybe the reasons result to differences in the types and levels of terpenoids compounds in these two chamomiles. In addition, the phylogenetic tree of single copay genes showed that German chamomile and Roman chamomile had a high identity to C. nankingense.

Conclusion

This work provided first insights into the terpenoids biosynthesis of chamomiles, and the candidate unigenes related to terpenoids biosynthesis can serve as important information for molecular breeding approaches to modulate the essential oil composition.
Urinary proteome of dogs with kidney injury during babesiosis
Authors: Winiarczyk Dagmara , Michalak Katarzyna , Adaszek Łukasz , Winiarczyk Mateusz , Winiarczyk Stanisław
Published: July 2019

This study aimed to identify proteins in the urine of dogs with renal dysfunction during the natural course of babesiosis (n=10) and to compare them with proteins in a control group (n=10) to reveal any potential biomarkers of renal damage. Pooled urine samples from both groups were separated by 2D (two-dimensional) electrophoresis, followed by protein identification using MALDI-TOF (matrix-assisted laser desorption ionization time of flight) mass spectrometry. In total, 176 proteins were identified in the urine samples from healthy dogs, and 403 proteins were identified in the urine samples from dogs with babesiosis. Of the 176 proteins, 146 were assigned exclusively to healthy dogs, and 373 of the 403 proteins were assigned exclusively to dogs with babesiosis; 30 proteins were common to both groups. Characteristic analysis of the 373 proteins found in dogs with babesiosis led to the isolation of 8 proteins associated with 10 metabolic pathways involved in immune and inflammatory responses. Furthermore, it was hypothesized that epithelial-mesenchymal transition might play an important role in the mechanisms underlying pathological changes in renal tissue during babesiosis, as indicated by a causal relationship network built by combining 5 of the 10 selected metabolic pathways and 4 of the 8 proteins associated with these pathways; this network included cadherins, gonadotropin releasing hormone receptors, inflammatory responses mediated by chemokine and cytokine signalling pathways, integrins, interleukins and TGF-β (transforming growth factor β) pathways. These pathways were linked by interleukin-13, bone morphogenetic protein 7, α2(1) collagen, and FER tyrosine kinase, which are potential biomarkers of damage during babesiosis in dogs that might indicate early renal injury.
The use of TAP for the primary diagnosis of renal cell carcinoma
Authors: Jiang Linjun , Liu Yili , Qu Hongchen , Dong Fengming
Published: July 2019

Objective

To study the value of TAP expression in peripheral blood for early diagnosis of renal cell carcinoma.

Materials and Methods

TAP expression was analyzed in the peripheral blood of 45 patients with renal cell carcinoma, 32 patients with benign renal lesions and 42 healthy patients. An analysis of the relationship between TAP expression and the clinicopathological features in renal cell carcinoma was performed; the ROC curve was used to evaluate the diagnostic efficacy of TAP detection for renal cell carcinoma diagnosis.

Results

TAP levels were significantly higher in RCC patients than in patients with nonneoplastic diseases. We also found that the rate of positive TAP expression in the peripheral blood of the renal cell carcinoma group showed no significant difference when evaluated by age, sex, histological grade, tumor stage, tumor size or tumor location (P > 0.05). The area under the ROC curve was 0.92 (95% CI: 0.82-0.95), and the sensitivity and specificity in the diagnosis of RCC was 73% and 91%, respectively.

Conclusions

The expression of TAP in peripheral blood of patients with renal cell carcinoma was significantly higher than that in nonneoplastic patients, which may provide an effective means of primary diagnosis for renal cell carcinoma
Surgical Configurations of the Pectoralis Major flap for Reconstruction of Sternoclavicular Defects: A Systematic Review and New Classification of Described Techniques
Authors: Opoku-Agyeman Jude , Matera David , Simone Jamee
Published: July 2019

Objectives

The pectoralis major flap has been considered the workhorse flap for chest and sternoclavicular defect reconstruction. There have been many configurations of the pectoralis major flap reported in the literature for use in reconstruction sternoclavicular defects either involving bone, soft tissue elements, or both. This study reviews the different configurations of the pectoralis major flap for sternoclavicular defect reconstruction and provides the first ever classification for these techniques.

Methods

EMBASE, Cochrane library, Ovid medicine and PubMed databases were searched from its inception to November of 2018. We included all studies describing surgical management of sternoclavicular defects. The studies were reviewed, and the different configurations of the pectoralis major flap used for sternoclavicular defect reconstruction were cataloged. We then proposed a new classification system for these procedures.

Results

The study included 5 articles published in the English language that provided a descriptive procedure for the use of pectoralis major flap in the reconstruction of sternoclavicular defects. The procedures were classified into three broad categories. In Type 1, the whole pectoris muscle is used. In Type 2, the pectoralis muscle is split and either advanced medially (type 2a) or rotated (type 2b) to fill the defect. In type 3, the clavicular portion of the pectoralis is islandized on a pedicle, either the TAA (type 3a) or the deltoid branch of the TAA (type 3b).

Conclusion

There are multiple configurations of the pectoralis flap reported in the English language literature for the reconstruction of sternoclavicular defects. Our classification system will help facilitate communication when describing the different configurations of the pectoralis major flap for reconstruction of sternoclavicular joint defects.
Parvovirus B19 infection and renal injury: report of 4 cases and analysis of immunization and viremia in an adult cohort of 100 patients undergoing a renal biopsy.
Authors: Kauffmann Maëlis , Bobot Mickaël , Daniel Laurent , Knefati Yannick , Moranne Olivier , Burtey Stéphane , Zandotti Christine , Jourde-Chiche Noemie
Published: July 2019

BACKGROUND: The seroprevalence of human Parvovirus B19 (PVB19) is 70-85 % in adults worldwide. PVB19 is the etiologic agent of the fifth disease, is a cause of aplastic anemia, and can be associated with renal injury. We aimed to describe the cases of 4 patients with renal injury related to PVB19 primary infection, and to evaluate the seroprevalence of PVB19 and the incidence of PVB19 primary infection in patients undergoing a native kidney biopsy.
METHODS: Cases of PVB19 infection with renal injury were reviewed from the archives of the department of Nephrology. A systematic screening of anti-PVB19 IgG and IgM antibodies and viral DNA was performed in sera from 100 consecutive patients with a renal biopsy in 2017-2018.
RESULTS: The 4 patients with PVB19 infection-associated renal disease displayed: one lupus-like glomerulonephritis (GN) without lupus auto-antibodies, one minimal change disease with tubular necrosis, one secondary hemolytic and uremic syndrome and one membrano-proliferative GN. In the 100 patients biopsied, 67 had elevated anti-PVB19 IgG, among whom 8 had elevated IgM, without circulating viral DNA, without any particular renal pathological pattern. One additional patient showed a seroconversion at the time of renal biopsy, which revealed a class V lupus nephritis.
CONCLUSION: PVB19 primary infection can be associated with different renal diseases. The seroprevalence of PVB19 among patients with a renal biopsy is similar to the overall population, and primary infection is rarely documented (1%) after systematic screening. Whether PV19 is nephrotoxic, or triggers renal endothelial injury and immune activation, remains to be elucidated.
Health-related needs and barriers for forcibly displaced women: a systematic review
Authors: Jesuthasan Jenny , Witte Zara , Oertelt-Prigione Sabine
Published: July 2019

Introduction

Women represent a large proportion of the currently internationally displaced individuals. Due to gender roles, care duty, educational and economic imbalance their experiences and vulnerability during flight and relocation differ from that of men and children. The currently available information about their specific health-related needs and barriers to access is scarce and scattered.

Methods

We searched PubMed, Medline, EMBASE, Cochrane Library and Scopus to identify publications that explored the unique experiences of female refugees between 1 January 2008 and 30 June 2018. Publications needed to address the health needs of refugees, asylum seekers or displaced individuals, include at least 50% women in their study and employ a user-centered perspective, i.e. focus on the perspective of displaced individuals themselves and not health care providers. A framework of themes was identified and applied to all publications.

Results

We identified 1945 publications of which 13 could be included in the present review. Twelve of these publications employed qualitative and/or innovative methodology (e.g. ethnographies, index cards, photovoice). We identified five broad categories of health-related needs (immediate healthcare, communication, sultural/spiritual, social, economic), which are further detailed.

Conclusions

A concerted action providing information and culturally-sensitive care, while supporting language acquisition and economic empowerment is essential to improving the health status of female refugees. Transformative interventions need to address multiple axes of unequal access for female refugees to increase participation and overall health.
Attitudes towards early marriage and related factors among adolescent girls in Ethiopia
Authors: Gulema Hanna , Hamdan Ayah , Gingles Jessica , Friedman Lauren E. , Gelaye Bizu , Worku Amare , Worku Alemayehu , Berhane Yemane
Published: July 2019

Background

Early marriage, although it remains a common practice in sub-Saharan Africa, has detrimental effects on women’s sexual and reproductive health, social networks, and educational attainment. We sought to investigate the association between attitudes towards early marriage and marital status among adolescent girls in Ethiopia.

Methods

A cross-sectional study was conducted among 3,013 adolescent girls aged 13-17 years of age, living in four districts of the Oromia region of Ethiopia. Sociodemographic characteristics and were participants’ attitudes towards early marriage were measured using a pre-tested structured questionnaire.

Results

The prevalence of early marriage among adolescent girls was 8.3% and approximately 87.0% of girls had an overall positive attitude towards early marriage. Compared to adolescent girls who were unmarried, those who were married or living with a partner were less likely to believe they should have a say whether they want to marry or not (OR=0.32; 95%CI: 0.18-0.57), believe they should get to decide when to marry (OR=0.52; 0.31-0.88), and believe they should have the final decision over the decision to marry (OR=0.48; 0.32-0.73).

Conclusions

Interventions to prevent early marriage should strengthen women decision-making processes and promote women’s agency.
Recalibration of biochemistry measurements in a multinational cohort study: LIFE course study in CARdiovascular disease Epidemiology (LIFECARE)
Authors: Nang Ei Ei Khaing , Ng Sheryl HX , Shafiq Mahham , Tan Chuen Seng , Sy Rody , Fong Alan , Vathesatogkit Prin , Adam John , Llanes Elmer , Hian Sim Kui , Reganit Paul , Wong Kung Yee , Woodward Mark , Tai E Shyong , Venkataraman Kavita
Published: July 2019

Background

Various cardiovascular biomarkers are used to assess and compare the risk of cardiovascular diseases across populations. However, artefactual variations due to the use of different laboratories may make these comparisons invalid. This work describes the inter-laboratory variations in a multi-country cohort, LIFECARE, and the use of recalibration to a reference laboratory to minimise this variability.

Methods

LIFECARE is a cohort of 10,479 participants recruited from Indonesia, Malaysia, Philippines and Thailand between 2008 and 2011, with blood samples analysed at country-specific laboratories(n=4). Thailand was the designated reference laboratory. The measurements from each laboratory were compared against the reference laboratory using a common set of samples analysed at all laboratories, using the MethComp package in R. Laboratory values for cohort participants were recalibrated using the equation generated by the package, if large, statistically significant differences were observed during the comparison.

Results

Glucose, total cholesterol, HDL cholesterol, LDL cholesterol and triglyceride measurements were reported for all four countries. Cholesterol and HDL from all laboratories required recalibration while glucose did not. Recalibration altered the proportions of the population at risk substantially, with prevalence of high cholesterol changing from 56.3% to 75.0% in Malaysia, 52.1% to 37.5% in Indonesia and 31.3% to 22.7% in Philippines. Prevalence of low HDL was similarly altered.

Conclusion

There was significant variation in serum lipid levels measured by different laboratories, leading to variations in estimates of population at risk. Recalibration to a reference laboratory can overcome this variability and facilitate meaningful comparisons of laboratory data across countries.
Confirmatory factor analysis of the Evidence-Based Practice Attitude Scale in a large and representative sample of Child and Adolescent Mental Health practitioners: Is the use of a total scale score justified?
Authors: Santesson Anna , Jarbin Håkan , Holmberg Robert , Perrin Sean , Bäckström Martin
Published: July 2019

Background: High-quality instruments are essential for implementation practitioners and researcher; only valid and reliable measures can confidently and consistently measure what they are intended to measure. Psychometrically sound and pragmatic measures have the potential to guide the tailoring and evaluation of an implementation program thus contributing to the knowledge base of implementation science. The Evidence-Based Practice Attitude Scale (EBPAS) is one of few implementation instruments with strong psychometric qualities and is widely used to measure attitudes toward Evidence-Based Practice (EBP) in implementation practice and research. The Multidimensionality of the EBPAS has repeatedly been supported. Whether all of the fifteen individual items contribute to the EBPAS total scale beyond their subscales (Appeal, Requirements, Openness and Divergence) has yet to be proven. In addition, the Divergence subscale has been questioned because of low correlation with the other subscales and low inter-item correlations.
Methods: The factor structure of the EBPAS was investigated in a child- and adolescent psychiatry setting (N=925, 62%, n =570) using first- and second-order Confirmatory factor analysis, thus replicating Aarons' initial studies. In addition, the present study is the first to use a bifactor model in a large and representative sample.
Results: The EBPAS was supported as a multifaceted instrument. The EBPAS had a rather strong general factor supporting the use of the inventory as a single measure of attitudes. There were still four dimensions of attitude after the general factor was accounted for. All items, including the items of the Divergence factor, contributed to general attitude as well as to their specific construct.
Conclusions: The present study is the first to show that it is justified to use and interpret the EBPAS as an instrument measuring global as well as specific attitudes toward EBP. Sum score and subscales scores can be used in implementation research and practice.
Dilemma of the differential diagnosis of hilar cholangiocarcinoma and benign diseases:a single-center retrospective study
Authors: Pang Liwei
Published: July 2019

Objective

Hilar cholangiocarcinoma, which lacks specific clinical manifestations, remains very difficult to distinguish from benign disease. This distinction is further complicated by the complex hilar anatomy. We conducted the present study to evaluate the differential diagnosis of these conditions.

Methods

Sixty-five patients underwent resection surgery for suspected hilar cholangiocarcinoma between January 2011 and October 2018. Following a postoperative pathology analysis, all patients were divided into 2 groups: malignant group (54 patients with HCCA) and benign group (11 cases with benign lesions). The patients' clinical data, including general demographics (sex, age), clinical manifestations (jaundice, abdominal discomfort, fever, weight loss), laboratory data [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALKP), total bilirubin (BILT), indirect bilirubin (BILD), carbohydrate antigen (CA) 19-9, carcinoembryonic antigen (CEA)], and imaging findings, were included in a retrospective analysis.

Results

Compared to the benign group, the malignant group had a significantly higher median age and serum CA19-9, CEA, ALT, BILT, and BILD levels (P <0.05). By contrast, the groups did not differ significantly in terms of the sex distribution, clinical manifestations, serum levels of AST and ALKP, and imaging findings. In a receiver operating characteristic curve analysis, we identified a CA19-1 cut-off point of 233.15 U/ml for the differential diagnosis, with a sensitivity of 56% and specificity of 91%. Furthermore, we identified a CEA cut-off point of 2.98 ng/ml for the differential diagnosis, with a sensitivity of 61% and specificity of 90%.

Conclusion

The differential diagnosis of HCCA and benign hilar lesions remains difficult. However, we found that patients with HCCA tended to have an older age at onset and higher serum levels of CA19-9, CEA, BILT, ALT, and BILD. Furthermore, patients with a serum CA19-9 level >233.15 U/ml and CEA level >2.98 ng/ml are more likely to have malignant disease.
Helicobacter pylori infection and increased diabetes prevalence were the risks of colorectal adenoma: a systematic review and meta-analysis
Authors: Wang Horng-Yuan , Lin Ying-Chun , Chen Chieh-Chang , Chen Ming-Jen , Wu Ming-Shiang , Liu Chun-Jen , Huang Chun-Ta , Yang Horng‐Woei , Shih Shou-Chuan , Yu Lo-Yip , Kuo Yang-Che , Hu Kuang-Chun
Published: July 2019

Background

Helicobacter pylori (H. Pylori) infection and hyperglycemia may be associated with an increased risk of colorectal neoplasm. However these two factors affect colorectal neoplasm remain controversial. We aimed to carry out a meta-analysis to evaluate the study population diabetes prevalence rate and H. pylori infection rate with colorectal adenoma risk.

Methods

We conducted a systemic research through English databases for medical reports. We also recorded the diabetes prevalence and H. pylori infection prevalence in each study. We classified these studies into 4 subgroups as their background population diabetes prevalence < 6%(Group 1); between 6 to 8%(Group 2); between 8 to 10%(Group 3) and more than 10%(Group 4). The random effects model had used to calculate pooled prevalence estimates with 95% confidence interval [CI].

Results

Twenty seven studies were finally eligible for meta-analysis. The random-effects model of meta-analysis was chosen, showing pooled odds ratio (OR) equal to 1.51 (95% CI 1.39–1.63). The subgroup meta-analyses showed in Group 1 the H. pylori infection associated colorectal adenoma risk OR was 1.24 (95% CI 0.86–1.78). As diabetes rate exceed 6%, the H. pylori infection became more significant increased risk of colorectal adenoma (Group 2: OR 2.16 (95% CI 1.61–2.91); Group 3: OR 1.40 (95% CI 1.24–1.57); Group 4: OR 1.52 (95% CI 1.46–1.57)).

Conclusions

The results of this meta-analysis showed DM prevalence would affect the risk factor of colorectal adenoma with H. pylori infection.
Valstybės skolos rodiklių ir skolos įtakos ekonomikai tyrimas Lietuvoje
Authors: Barkauskaitė Aida , Šimkus Antanas
Published: July 2019

Valstybės skolinimasis tampa svarbiu aspektu, kai šalis susiduria su finansinių išteklių trūkumu. Valstybės skolos ypatumus, jos naudą ir įtaką šalies ekonomikai nagrinėjo daugelis autorių: E. Buškevičiūtė, (2008), F. M. Martin (2009), Ž. Karazijienė ir A. Sabonienė (2009), H. S. Rosen ir T. Gayer (2010), M. Kumar bei J. Woo (2010) ir kiti, tačiau mokslinės literatūros, nagrinėjančios valstybės skolos rodiklių kitimą ir jų įtaką Lietuvos ekonomikai, yra nedaug. Didėjančios išlaidos valstybės skolų aptarnavimui neišvengiamai sukelia didesnį šalies surenkamų pajamų poreikį, kuris tiek gyventojams, tiek verslo subjektams gali pasireikšti mokesčių didinimu ar kitais neigiamais ekonominiais veiksniais.

Straipsnio tikslas – nustatyti Lietuvos valstybės skolos rodiklių kitimo tendencijas ir skolos įtaką Lietuvos ekonomikai. Tyrimo metodai: sisteminė mokslinės literatūros analizė, koreliacinė analizė, lyginamoji ir grafinė analizės. Lietuvos valdžios sektoriaus sumokėtų palūkanų apimtys 2006–2012 m. turėjo tendenciją augti. Teigiamai galima vertinti tik 2013 m., kai sumokėtų palūkanų apimtys Lietuvoje sumažėjo 6,1 proc. Didžioji dalis apskaičiuotų valstybės skolos rodiklių – sumokėtos palūkanos, valstybės skolos ir BVP santykis, biudžeto išlaidų santykis ir kt. – per nagrinėjamą laikotarpį išaugo, o valstybės skolos ir BVP santykis padidėjo daugiau nei du kartus. Tačiau paskutiniais nagrinėjamais 2013 m. valstybės skolos rodikliai Lietuvoje turėjo tendenciją mažėti, lyginant su 2012 m. duomenimis. Lietuvos valstybės skolos įtakos ekonomikai tyrimas parodė, jog nustatyta reikšminga koreliacija tarp valstybės skolos ir šalies BVP, tarp nedarbo lygio ir indėlių sumos buvo nustatyta stipri teigiama koreliacija. Tačiau tarp valstybės skolos ir infliacijos statistiškai reikšmingo tiesinio ryšio nebuvo rasta. Suvokiant valstybės skolos svarbą, priimant sprendimus, susijusius su valstybės skolinimusi, reikia atidžiai įvertinti ir tai, kokią įtaką šie sprendimai gali padaryti visos šalies ekonomikai ir gyventojams.
Research into the Experiences of Physical Activity of Female Students, Enrolled in Vocational Education
Authors: Gulbinas Tadas
Published: July 2019

The benefit of regular physical activity to physical health has been proven. Regular physical activity guarantees better and longer life, physical and emotional wellbeing, reduces the risk of various diseases. If female students’, enrolled in vocational education, experiences of physical activity in schools remain unknown, it will be difficult to promote physically active lifestyle. The aim of the paper is to analyse female students’ experiences in PE lessons and outside of school hours. Research methods: scientific literature overview, qualitative research, analysis of open-ended survey data. The research findings show that female students’ experiences in PE lessons and outside of school hours are bad. The respondents did not emphasise the benefit of physical health at all. Although scientific literature provides many types of barriers to physical activity; only some of them were identified and were mainly related to time management skills.
Socialinių darbuotojų patirtis teikiant paslaugas tėvams, turintiems negalių ir auginantiems vaikus, neturinčius negalių
Authors: Jezerskytė Edita , Stasiulaitienė Andra
Published: July 2019

Pastaraisiais metais daug kalbama apie neįgaliuosius – žmones, turinčius specialiųjų poreikių, jų socialinę integraciją, paramą ir pagalbą jiems, tačiau labai dažnai šeima, kurioje yra neįgalių asmenų, lieka nuošalyje, tarsi jos ta problema neliestų. Neįgalūs tėvai labai dažnai turi specifinių sunkumų: jų pareigos ir atsakomybė dar labiau padidėja, šeima tampa pagrindine, o kartais ir vienintele tiesiogine aplinka tokių tėvų vaikui. Todėl labai svarbu atkreipti dėmesį į visą šeimą, o ne į atskirus jos narius. Straipsnio tikslas – atskleisti socialinių darbuotojų patirtį, teikiant paslaugas tėvams, turintiems negalių ir auginantiems vaikus, neturinčius negalių.Tyrimo metodai: mokslinės literatūros analizė, pusiau struktūruotas interviu, kokybinė turinio analizė.Tyrimo rezultatai atskleidė, kad didžiausios problemos, su kuriomis susiduria neįgalūs tėvai ir jų sveiki vaikai, yra socialinės ir psichologinės. Tyrimo dalyviai akcentuoja, jog neįgaliems tėvams, auginantiems sveikus vaikus, būtinos konsultavimo, informacijos teikimo, materialinės, transporto organizavimo, psichologinės pagalbos, dokumentų parengimo dėl pašalpų ar kompensacinės technikos įsigijimo paslaugos. Informantai nurodo, kad neįgaliems tėvams labai svarbi yra savigalba ir profesinė integracija.
Neformalios edukacinės veiklos raiškos miesto parke prielaidos: Kuršėnų miesto atvejis
Authors: Poškienė Rasa , Gaučaitė Ramutė
Published: July 2019

Straipsnyje analizuojamos neformalios edukacinės veiklos raiškos miesto parke prielaidos remiantis konkrečiu atveju. Siekiant, kad miestų parkai būtų vertinami kaip priimtiniausias variantas miestų bendruomenės nariams tenkinti edukacinius poreikius ir jų dermę su saviraiškos ir rekreaciniais poreikiais, svarbu tirti parko lankytojų požiūrį į tai, kokios veiklos jiems būtų prieinamos, patrauklios ir skatintų tobulėti. Parkų edukacinės veiklos kontekste aktualizuojama būtinybė tirti parkų lankytojų poreikius ir jais remiantis numatyti siekiamą rezultatą, užtikrinti turinio ir veiklos metodų dermę, ieškoti įžvalgų, leisiančių tobulinti miesto parkų edukacines veiklas. Šiandien vykdoma edukacinė veikla Lietuvos miestų parkuose labiau orientuota į formaliojo ugdymo tikslų siekį ir menkai tekreipia dėmesio į kitus gyvenamosios vietos bendruomenės narių edukacinius poreikius. Miesto parkuose vykdomos veiklos neatliepia skirtingų bendruomenės grupių edukacinių poreikių, jos orientuotos į rekreacinių poreikių tenkinimą, o vietos parkų edukacinis potencialas lieka neišnaudotas. Minėti aspektai leidžia manyti, kad aktualu analizuoti ne tik bendras parkų neformaliosios edukacijos prielaidas, bet tirti ir konkretaus parko edukacinės veiklos patirtį, analizuoti vietos bendruomenės narių požiūrį. Tai ir nulemia straipsnio edukacinę problematiką. Tikslas – remiantis Kuršėnų miesto parko atveju empiriškai ištirti edukacinės veiklos raiškos patirtį ir jos prielaidas miesto parke bei numatyti tobulinimo galimybes.Atliktas tyrimas iliustruoja, kad šiandien miesto parkas, kaip biologinė, socialinė, kultūrinė struktūra, turi praktinę išraišką ir, tobulinant atskirus jos segmentus, gali skatinti bendruomenės narių sociokultūrinį aktyvumą, dalyvaujant įvairiuose renginiuose ar individualiai.
Prasmės (de)konstravimas per aktoriaus ir veikėjo (re)prezentaciją Gintaro Varno režisūroje
Authors: Meilutytė Monika
Published: July 2019

Šio straipsnio tikslas – išanalizuoti ir įvertinti, kaip konstruojama ar dekonstruojama prasmė režisieriaus Gintaro Varno pastatymuose per aktoriaus ir veikėjo (re)prezentaciją. Rašant šį darbą buvo derinta naratologinė analizė ir lyginamasis metodas, o struktūralizmo ir postruktūralizmo teorijos ir jų sampratos buvo pasitelktos formuojant šiam tyrimui teorines prieigas.Tyrimo eigoje išryškėjo, kad Gintaro Varno darbuose aktoriaus funkcija yra tradicinė – jis turi sukurti fikcinį personažą, kuris yra spektaklio prasminio sluoksnio dalis. Tačiau pagrindinis veikėjas šio režisieriaus pastatymuose paprastai vaizduojamas kaip nevienalypė asmenybė. Be to, veikėjo daugialypumą aktoriui kartais padeda išreikšti kitos priemonės, pavyzdžiui, gali būti kuriamas intensyvus dialogas tarp aktoriaus vaidybos ir vaizdo projekcijų.Pastebėta, kad aktoriams Gintaro Varno spektakliuose dažnai tenka manipuliuoti skirtingais pasakojimo lygmenimis ir kurti „teatrą teatre“. Tokiu būdu aktoriai Gintaro Varno pastatymuose pasakojimą konstruoja pasitelkdami ne tik diegetišką mimezę, bet ir jos kaitą. Taip pat aktoriai ir jų personažų vaizdavimas spektakliuose padeda sukurti tikroviškumo ir sapniškumo susilietimus, itin svarbius šio režisieriaus kūryboje.Taigi per aktoriaus ir veikėjo (re)prezentaciją Gintaro Varno spektakliuose kuriami ir spektaklio darnumą palaikantys, ir kartu visumą išardantys elementai.
Retrospective Analysis of Pregnancy Terminations: 9-Years Experience at a Tertiary Hospital in Southeastern Turkey
Authors: Bayramoglu Tepe Neslihan , Gunduz Reyhan , Dizibuyuk Omer Faruk , Ozcan Huseyin Caglayan , Guneyligil Kazaz Tanyeli , Komurcu Karuserci Ozge , Sucu Seyhun , Kutlar Ali Irfan
Published: July 2019

Objective: To determine the indications for termination of pregnancy, and their consistency with autopsy data to offer an insight into termination of pregnancy having regard to conditions in Turkey.Study Design: Three hundred and ninety-one pregnancies terminated before the 24th gestational week were enrolled in this study. Maternal age, gravidity, parity, abortion, the status of folic acid usage, consanguineous marital status, gestational week, anomalies that led to termination and pathological diagnoses were recorded. Anomalies that led to termination were grouped as central nervous system , cardiovascular system, gastrointestinal system, genitourinary system, pulmonary, musculoskeletal, head-neck, chromosomal, genetic, multiple anomalies and others. Four groups were formed based on the consistency of prenatal ultrasound diagnosis with pathological diagnosis.Results: Mean age, gravidity, parity, abortion, and gestational week were 28 years, 3, 1, 1, and 15.7 weeks, respectively. One hundred and thirty-eight (35.2%) patients had consanguineous marriage. Three major causes of termination were central nervous system (45.78%), head-neck (17.4%) and multiple anomalies (14%). One hundred and twenty-eight (71.5%) patients with central nervous system anomalies were not using folic acid. Comparison of prenatal ultrasound findings with pathology results, 275 (70.3%) patients had full consistency, 46 (11.8%) had other findings at autopsy besides the confirmed sonographic findings, 34 (8.7%) had some sonographic findings not confirmed at autopsy, and 4 (1%) had no consistency between the findings.Conclusion: Central nervous system anomalies constitute the most common indication for termination of pregnancy in this retrospective study. Low rate of periconceptional folic acid among those cases is remarkable. First-trimester screening for earlier detection of fetal anomalies may be important in high-risk groups such as those with consanguineous marriages.
Expression and Solution NMR Study of Multi-site Phosphomimetic Mutant BCL-2 Protein
Authors: Song Ting , Cao Keke , Fan Yu dan , Zhang Zhichao , Guo Zong W. , Zhang Min H. , Liu Peng
Published: July 2019

Background:

The significance of multi-site phosphorylation of BCL-2 protein in the
flexible loop domain remains controversial, in part due to the lack of structural biology studies of
phosphorylated BCL-2.

Objective:

The purpose of the study is to explore the phosphorylation induced structural changes of
BCL-2 protein.

Methods:

We constructed a phosphomietic mutant BCL-2(62-206) (t69e, s70e and s87e) (EEEBCL-
2-EK (62-206)), in which the BH4 domain and the part of loop region was truncated (residues
2-61) to enable a backbone resonance assignment. The phosphorylation-induced structural change
was visualized by overlapping a well dispersed 15N-1H heteronuclear single quantum coherence
(HSQC) NMR spectroscopy between EEE-BCL-2-EK (62-206) and BCL-2.

Results:

The EEE-BCL-2-EK (62-206) protein reproduced the biochemical and cellular activity of
the native phosphorylated BCL-2 (pBCL-2), which was distinct from non-phosphorylated BCL-2
(npBCL-2) protein. Some residues in BH3 binding groove occurred chemical shift in the EEEBCL-
2-EK (62-206) spectrum, indicating that the phosphorylation in the loop region induces a
structural change of active site.

Conclusion:

The phosphorylation of BCL-2 induced structural change in BH3 binding groove.
Structure - Function Analysis of Peptide Analogs of SQSPA with Respect to α-glucosidase and α-amylase Inhibition
Authors: Ibrahim Mohammed A. , Serem June C. , Bester Megan J. , Neitz Albert W. , Gaspar Anabella R.M.
Published: July 2019

Background:

Peptide-based therapeutics offer a unique avenue for the development of
novel agents for the treatment of diabetes mellitus including α-glucosidase inhibitors. The peptide,
SQSPA, was reported to possess to α -glucosidase inhibitory activity in addition to resistance to
Gastrointestinal Tract (GIT) digestion.

Methods:

In this study, the in silico and in vitro structure-activity analyses of the peptide was conducted
using alanine scanning to identify key amino acid residues.

Results:

The alanine scanning led to four analogs viz; AQSPA, SASPA, SQAPA and SQSAA
which were GIT stable. Initially, the peptides were subjected to molecular docking on human α-
glucosidase and α -amylase where the binding affinities to the enzymes were in the order;
AQSPA>SASPA>SQSPA>SQAPA> SQSAA and AQSPA>SQSAA>SASPA>SQSPA> SQAPA,
respectively. Hydrogen bond were important for the binding of all peptides but SASPA and
AQSPA had the highest hydrogen bonds interactions with the α-glucosidase and α-amylase, respectively.
In vitro analysis revealed that the α -glucosidase and α-amylase inhibitory activities of the
peptides were in the order AQSPA>SQSPA>SQAPA>SASPA>SQSAA and AQSPA>SASPA>
SQAPA>SQSPA>SQSAA, respectively. Using inhibition kinetics, SQSPA was a mixed inhibitor
of α-glucosidase while AQSPA, SQAPA and SQSAA showed non-competitive inhibition. For α-
amylase inhibition, SQSPA was a non-competitive inhibitor while AQSPA and SQSAA were
mixed inhibitors; SASPA and SQAPA showed uncompetitive inhibition.

Conclusion:

The results indicated that P4 and Q2 are important requirements for the α-glucosidase
and α-amylase inhibitory activities of the parent peptide, SQSPA. Furthermore, alanine scanning
has led to the design of a novel α-glucosidase inhibitory peptide, AQSPA, with increased activities.
Human Epididymis Protein 4 Quantification and Interaction Network Analysis in Seminal Plasma
Authors: Kant Krishna , Tomar Anil K. , Sharma Pankaj , Kundu Bishwajit , Singh Sarman , Yadav Savita
Published: July 2019

Background:

A well-known tissue marker of ovarian cancer, Human Epididymis protein
4 (HE4) is the member of whey acidic four-disulfide core proteins family. Purified from human
seminal plasma and characterized as a cross-class protease inhibitor, HE4 was proposed to shield
spermatozoa against proteolytic factors. However, its exact biological function is unknown. Proteins
usually function in conjunction with other proteins in the system and thus, identification and
analysis of protein networks become essential to decode protein functions.

Objective:

This study was performed to explore possible role(s) of HE4 in reproductive physiology
via identification of its interactome in human seminal plasma.

Methods:

HE4 binding proteins were identified through co-immunoprecipitation and MALDITOF/
MS analysis. Also, HE4 was quantified by ELISA in fertile and infertile human seminal
plasma samples.

Results:

Ten HE4 binding proteins were identified, viz. protein phosphatase 1 regulatory subunit
21, protein kinase CLK3, Ankyrin repeat domain-containing protein36A, prostatic acid phosphatase,
KIF5C, Spectrin repeat containing, nuclear envelope 1, isoform CRAf, tropomyosin 4, vezatin,
utrophin and fibronectin1. This interaction network suggests that HE4 plays multiple roles,
specifically in capacitation, sperm motility and maturation. Further, HE4 concentration in human
seminal plasma samples was determined by Elisa. Higher HE4 expression in normozoospermia
compared to azoospermia and asthenozoospermia affirms its importance in fertilization.

Conclusion:

Based on identified interactome, it is plausible that HE4 plays a crucial role in fertilization,
specifically in sperm maturation, motility and capacitation.