bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcriptome-wide Characterization of Novel WRKY Family Genes Engaged in Crocin Biosynthesis in Crocus sativus
Authors: Gao Guangchun , Li Jun , Wang Ping , Wu Jiming , Xu Jinbiao , Mao Lisa
Published: August 2024

Crocins comprise a family of hydrophilic carotenoids with pharmacological properties that are produced in significant quantities in stigma of Crocus sativus. Although the biosynthesis pathway of crocins has been sufficiently elucidated, there is a paucity of information regarding how transcription factors (TFs) regulate crocin biosynthesis in various stigma developmental stages. WRKY TFs play a role in modulating carotenoid/apocarotenoid metabolism. To provide an overview of the WRKY family in Crocus sativus (CsWRKY) and characterize candidate CsWRKY TFs involved in the biosynthesis of crocins, CsWRKY genes were identified from RNA-sequenced stigma at different developmental stages. A phylogenetic analysis was performed to characterize their evolutionary interrelatedness. A coexpression analysis of CsWRKY genes and crocin biosynthesis-related genes was performed. A quantitative real-time polymerase chain reaction was used to corroborate the expression level of CsWRKY TFs in various tissue and at different developmental stages. A total of 34 CsWRKY TFs were identified from the stigma of C. sativus. The CsWRKY TFs, together with their orthologs from Arabidopsis, were clustered into group I, II, or III following phylogenetic analysis. A correlation analysis revealed that the expressions of the TFs CsWRKY1, CsWRKY2, CsWRKY8, CsWRKY10, CsWRKY15, and CsWRKY28 were strongly related to the expression of crocin biosynthesis-related genes CsBCH, CsCCD2L, CsALDH, and CsUGT. CsWRKY2, CsWRKY15, and CsWRKY28 exhibited identical motifs and were stratified into group IId. Transcript levels of candidate CsWRKY genes were higher in stigma than in other tissues and were proportional to the crocin content.
Black hole mergers in holographic space time models of cosmology
Authors: Suresh Anish , Banks Thomas
Published: August 2024

Holographic space-time, a theory of quantum gravity that generalizes string theory and quantum field theory, predicts black holes in the early matter-dominated era of its models of inflation. Before these black holes can decay, there is a chance that enough of these particles merge to produce radiation visible today in the Cosmic Microwave background. To discover if this is the case, we perform a rudimentary computer simulation. We show that no problematic black holes are formed by mergers in the Holographic Space-time models of inflation. However, we conclude that tiny bound structures containing black holes remnants form in this theory unconditionally. Since black hole decay products are mostly massive standard model particles, and perhaps their superpartners, the fate of these structures is a complicated dynamical problem that requires further study. It suggests the possibility of primordial structures on the order of the horizon size at the beginning of the radiation dominated era. This is about 10^9 L_P109LP in the current model.
Corporate governance dynamics in financial institution performance: A panel data analysis
Authors: Masrick Hasan Shaikh , Taleb Tawfiq Tawfiq , Mahedi Hasan Md. , M. Anwarul Islam K.
Published: August 2024

The study aims to identify the effect of corporate governance factors on financial institution performance in Bangladesh. This study employs annual data for 20 financial institutions, including banks, NBFIs, and insurance companies, data is collected from 2011 to 2022. Here, three corporate governance indicators are utilized – board size, board independence, and director’s ownership. The performance of the financial institutions is measured using return on assets (ROA), return on equity (ROE), and net asset value (NAV). Apart from the corporate governance variables, three company-specific factors, i.e., firm age, financial leverage, and firm size, are used as the control variables. Panel data analysis is conducted through the dynamic Feasible Generalize Least Square (FGLS) method, and the robustness is performed using the random effect model. The results show that corporate governance parameter such as board size has a significant positive influence on financial institution performance in Bangladesh, where board independence and director ownership do not have a significant influence on the performance of financial institutions. Thus, the performance of financial institutions increases when board size increases. This indicates that board members are actively engaged in strategic decision-making and ensure the rights of all stakeholders, which helps improve financial institutions’ overall performance. Therefore, financial institutions may increase their board size to the maximum level to ensure better corporate governance practices in the organizations, which ultimately increases performance.
Building Personality from Al-Ghazalī’s Perspective: Critical Study of Freud's Psychoanalytic Theory
Authors: Arroisi Jarman , Putri Diana Aristika , Amrullah Muhammad Fahmi
Published: August 2024

The issue of human behaviours is still engaging to discuss as human behaviour constantly changes. This study aims to reveal the problem of the psychoanalytic theory of Sigmund Freud, which has been the primary reference in the discussion of modern psychology. Modern psychologists tend to neglect the role of religion due to secularization in various aspects of life. This paper is library-based research that employs a comparative-analysis method. This study reveals that personality studies in modern psychology disregard the role of God. Humans deny God's power outside themselves, leading to modern man's spiritual crisis. In addition, the psychoanalytic theory does not deal with the spiritual aspect, so this theory is no longer relevant as a solution to modern human personality problems. Third, the concept of tazkiyat an-nafs and insān kāmil in the Islamic tradition can guide human life amid a spiritual crisis and guide humans to return to their God.  Contribution: This article reveals that the most effective solution in dealing with modern humans' personality and spiritual crises is to return to the initial nature of humans as creatures of God who are always obedient to Him.
Fault diagnosis of rolling bearing based on hierarchical discrete entropy and semi-supervised local Fisher discriminant analysis
Authors: Zhang Tao , Chen Yongqi , Sun Zhongxing , Huang Liping , Dai Qinge , Shen Qian
Published: August 2024

This paper addresses challenges in extracting effective information from rolling bearing fault signals and handling strong correlations and information redundancy in high-dimensional feature samples post-extraction. A rolling bearing fault diagnosis method is proposed on the basis of hierarchical discrete entropy (HDE) combined with semi-supervised local Fisher discriminant analysis (SELF). Firstly, hierarchical discrete entropy is extracted from signals preprocessed via variational mode decomposition. We assess entropy stability under different parameters using the coefficient of variation and select optimal parameters accordingly. Secondly, we employ the SELF method to remap the multidimensional feature sample set extracted, performing dimensionality reduction. Finally, a fault diagnosis model classifies the dimensionality-reduced feature samples for fault identification. Experimental results demonstrate that entropy samples extracted via HDE achieve higher diagnostic accuracy after dimensionality reduction with the SELF method. Specifically, accuracy rates of 100 % and 98.2 % are achieved for two types of fault samples, respectively, validating the feasibility and effectiveness of our approach.
Estado actual de la investigación sobre etnoturismo
Authors: Diaz Arzate Gerardo , Sánchez Valdés Arlen , Delgado-Cruz Alejandro , Vargas Martínez Elva Esther
Published: August 2024

El etnoturismo es una actividad en la que los visitantes buscan experiencias en comunidades originarias; es un turismo sustentable y respetuoso de los pueblos ancestrales. No obstante, su estudio ha sido limitado en los últimos años. Por lo tanto, el presente artículo de revisión tiene como objetivo analizar las categorías temáticas que guían las investigaciones en torno al etnoturismo en las últimas décadas exponiendo su estado actual, así como futuras líneas de investigación. Para lograrlo, se efectuó una revisión sistemática de literatura en la base de datos Scopus publicada de 2000 a 2022. El proceso consideró las etapas del Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA): identificación, cribado, elegibilidad e inclusión. Se realizaron dos tipos de análisis: bibliométrico y de contenido. Los resultados develaron cuatro categorías temáticas: a) elementos de desarrollo etnoturístico; b) segmento turístico; c) desarrollo local, y d) función de la comunidad receptora. En conclusión, se denota el potencial turístico basado en cultura, costumbres y tradiciones, la incidencia de este en el desarrollo local, el papel de la comunidad receptora y la percepción de los turistas étnicos.
Mechanisms Underlying the Therapeutic Effects of Nicotinamide Mononucleotide in Treating High-fat Diet-induced Hypertrophic Cardiomyopathy based on GEO Datasets, Network Pharmacology, and Molecular Docking
Authors: Han Yuan-chun , Wang Li , Zhang Yi-dan , Zhou Ao-jia , Wang Zi-ping , Dong Wen-huan , Wang Jian-peng , Wang Ting , Zou Jun
Published: August 2024

Background:

The beneficial effects of nicotinamide mononucleotide (NMN) on heart disease have
been reported, but the effects of NMN on high-fat diet-induced hypertrophic cardiomyopathy (HCM) and its
mechanisms of action are unclear. In this study, we systematically explored the effects and mechanism of action
of NMN in HCM using network pharmacology and molecular docking.

Methods:

Active targets of NMN were obtained from SWISS, CNKI, PubMed, DrugBank, BingingDB, and
ZINC databases. HCM-related targets were retrieved from GEO datasets combined with GeneCards, OMIM,
PharmGKB, and DisGeNET databases. A Protein-Protein Interaction (PPI) network was built to screen the
core targets. DAVID was used for GO and KEGG pathway enrichment analyses. The tissue and organ distribution
of targets was evaluated. Interactions between potential targets and active compounds were assessed by
molecular docking. A molecular dynamics simulation was conducted for the optimal core protein-compound
complexes obtained by molecular docking.

Results:

In total, 265 active targets of NMN and 3918 potential targets of HCM were identified. A topological
analysis of the PPI network revealed 10 core targets. GO and KEGG pathway enrichment analyses indicated
that the effects of NMN were mediated by genes related to inflammation, apoptosis, and oxidative stress, as
well as the FOXO and PI3K-Akt signaling pathways. Molecular docking and molecular dynamics simulations
revealed good binding ability between the active compounds and screened targets.

Conclusion:

The possible targets and pathways of NMN in the treatment of HCM have been successfully
predicted by this investigation. It provides a novel approach for further investigation into the molecular processes
of NMN in HCM treatment.
Effect of Salbutamol on the Disposition Kinetics of Levofloxacin in the Plasma and Lung of Rats
Authors: Cicekler Murat Ali , Oguz Halis , Corum Orhan
Published: August 2024

Background:

Antibiotics and bronchodilator drugs can be used together in respiratory distress
caused by bacterial infections. Levofloxacin (LVX) and Salbutamol (SLB) can be used simultaneously in respiratory
distress. However, there have been no investigations on how the concurrent use of SLB can affect the
pharmacokinetics of LVX in rats.

Objective:

The purpose of this study was to investigate the influence of SLB on the plasma and lung pharmacokinetics
of LVX in rats.

Methods:

A total of 132 rats were randomly assigned to two groups: LVX (n=66) and LVX+SLB (n=66).
LVX (intraperitoneal) and SLB (oral) were administered to rats at doses of 50 and 3 mg/kg, respectively. The
concentrations of LVX in the plasma and lungs were determined through the utilization of high-performance
liquid chromatography along with UV. Pharmacokinetic parameters were assessed by non-compartmental analysis.

Results:

The area under the curve from 0 to 16 h (AUC0−16), terminal elimination half-life, volume of distribution,
total body clearance, and peak concentration of LVX in the plasma were 42.57 h*μg/mL, 2.32 h, 3.91
L/kg, 1.17 L/h/kg, and 23.96 μg/mL, respectively. There were no alterations observed in the plasma and lung
pharmacokinetic parameters of LVX when co-administered with SLB. The AUC0−16 lung/AUC0−16 plasma ratios of
LVX were 1.60 and 1.39 after administration alone and co-administration with SLB, respectively.

Conclusion:

The concentration of LVX in lung tissue was higher than that in plasma. SLB administration to
rats did not affect the plasma and lung pharmacokinetics and lung penetration ratio of LVX. There is a need to
reveal the change in the pharmacokinetics of LVX after multiple administration of both drugs and after administration
of SLB by different routes.
Green Synthesis of Carbon Quantum Dots Using Barks of Ficus religiosa and their Application as a Selective Fluorescence Chemosensor
Authors: Meghal Balabadra Krishna , Sridharan Gokul , Ganapathy Dhanraj , Sundramoorthy Ashok K.
Published: August 2024

Background:

Green synthesis refers to the environmentally friendly methods of producing
materials, typically using sustainable and non-toxic reagents. Carbon Quantum Dots (CQDs) are
a new class of carbon nanomaterials composed of discrete, quasi-spherical carbon nanoparticles
with sizes below 10 nm.

Objective:

The CQDs were made from the bark of the Ficus religiosa (FR) tree. Barks collected
from the FR served as a sustainable source for the synthesis process due to its unique bioactive
composition.

Methods:

FR tree barks were collected, completely washed using ethanol and DI H2O, and dried at
50°C in a hot air oven. After that, the bark was cut into small pieces and ground well. The bark
powder (200 mg) was mixed in 100 mL of DI H2O and heated at 60°C for 60 min. and transferred
into an autoclave and heated at 175°C for 12 h.

Results:

UV-Vis, FT-IR, FE-SEM, EDS, elemental mapping, and fluorescence spectroscopy were
used for the characterization of CQDs. Moreover, CQDs showed a wide emission spectrum ranging
from 280 to 400 nm by adjusting the excitation wavelengths. Fe3+ ions had a higher fluorescence
quenching impact on CQDs compared to other heavy metal ions. Fluorescence measurements
showed that this CQD-based method could detect Fe3+ ions with the lowest limit of detection
(LOD) of 2.07 μM and a linear detection from 0-70 μM Fe3+.

Conclusion:

This novel fluorescent CQDs-based method could be used for selective detection of
Fe3+ ions in real-world water samples.
İhracatta Uzmanlaşma (ES) Endeksi Kapsamında Türkiye ile Ürdün Serbest Ticaret Anlaşması Ülkelerin Karşılıklı Dış Ticaretini Nasıl Etkiledi?
Authors: Almasri Shatha , Şimdi Halil
Published: August 2024

Ticaret anlaşmalarının amacı temelde ülkeler için dış ticarette çeşitli kolaylıkların sağlanması olarak ifade edilebilir. İlgili kolaylıkların neticesinde ülkeler arasındaki ticaret hacminde artış olması beklenmektedir. Serbest ticaret anlaşmaları da bu kolaylıkları sağlayan ekonomik entegrasyon modelleri arasında sayılmaktadır. Her ne kadar ülkelerin uyguladığı serbestleşme süreci ülkelerin ticaret hacmi açısından pozitif etkilere sahip olsa da kimi durumlarda bu anlaşmaların faydalı olmadığını savunan taraflar da bulunmaktadır. Nitekim Ürdün ve Türkiye arasında imzalanmış olan serbest ticaret anlaşmasının yürürlükten kaldırılma sebebi de bu sav olmuştur. Taraflar arasında 2011 yılında yürürlüğe giren anlaşma, 2018 yılında Ürdün ekonomisine zarar verdiği ifade edilerek tek taraflı olarak iptal edildi. Bu kapsamda çalışma Ürdün ve Türkiye arasında imzalanan serbest ticaret anlaşmasının ülke ihracatları üzerindeki etkisini ele almaktadır. Ülkelerdeki serbest ticaret anlaşmasının etkisini bulabilmek adına ülkelerin ihracatta uzmanlaşma endeksleri 2002:Ç1 – 2023:Ç4 dönemi kapsamında üçer aylık dönemler dâhilde hesaplanmış ve endeksler serbest ticaret anlaşması öncesi, serbest ticaret anlaşması dönemi ve serbest ticaret anlaşması sonrası olmak üzere üç dönemde karşılaştırılmıştır. Çalışmanın sonucunda Türkiye ve Ürdün arasında imzalanan anlaşmanın Ürdün’e olumlu açıdan fayda sağlayarak ihracat uzmanlaşma endeksini yükselttiği diğer taraftan Türkiye için ihracatta uzmanlaşma endeksini düşürdüğü bulunmuştur. Sonuç olarak Ürdün’ün ileri sürdüğü anlaşmanın Ürdün ekonomisine zarar verdiği iddiası ihracatta uzmanlaşma endeksi skorlarına göre doğru olmadığı ifade edilebilir.
Cystatin C and Kidney Function Recovery in Patients Requiring Continuous KRT for Acute Kidney Injury
Authors: Haeger Sarah M. , Okamura Kayo , Li Amy S. , He Zhibin , Park Bryan D. , Budnick Isadore M. , Foulon North , Kennis Matthew , Blaine Rachel E. , Miyazaki Makoto , Campbell Ruth , Jalal Diana I. , Colbert James F. , Brinton John T. , Griffin Benjamin R. , Faubel Sarah
Published: August 2024

Key Points

Plasma cystatin C is decreased in participants with AKI requiring continuous KRT (CKRT) with early kidney function recovery.

Despite being cleared by CKRT, plasma cystatin C in the first 3 days of CKRT may be a useful clinical tool to help predict the prognosis of AKI requiring CKRT.

Background

Plasma cystatin C is a reliable marker to estimate kidney function; however, it is unknown whether this remains true in patients receiving continuous KRT (CKRT). In this study, we tested the hypothesis that lower concentrations of plasma cystatin C during the first 3 days of CKRT would predict kidney function recovery.

Methods

We performed a retrospective observational study of 72 patients from a 126-patient, single-center CKRT study. We studied two a priori defined cohorts of patients without advanced CKD who had AKI requiring CKRT: (1) with early kidney function recovery defined as liberation from KRT within 7 days of CKRT initiation versus (2) with delayed kidney function recovery defined as receipt of KRT for >21 days or death while on KRT. Subsequent analysis included patients with advanced CKD and intermediate kidney function recovery (liberation between 8 and 21 days). Cystatin C was then measured on stored plasma, urine, and dialysis effluent collected before CKRT initiation and on days 1, 2, and 3 of CKRT.

Results

Plasma cystatin C was significantly lower in patients with early kidney function recovery in comparison with patients with delayed kidney function recovery on days 1 (1.79 versus 2.39 mg/L), 2 (1.91 versus 2.38 mg/L), and 3 (2.04 versus 2.67 mg/L) of CKRT. Sieving coefficient and CKRT clearance of cystatin C were similar for patients with early and delayed kidney function recovery. The lowest plasma cystatin C concentration on days 1–3 of CKRT predicted early kidney function recovery with an area under the receiver operating curve of 0.77 (P=0.002), positive likelihood ratio of 5.60 for plasma cystatin C <1.30 mg/L, and negative likelihood ratio of 0.17 for plasma cystatin C ≥1.88 mg/L.

Conclusions

Lower plasma cystatin C concentrations during the first 3 days of CKRT are associated with early kidney function recovery.
Interrupción de los estudios universitarios en mujeres indígenas de Calakmul: violencias epistémicas en espacios de reciente colonización
Authors: Rafael Riveros Landy Edith , Evangelista García Angélica Aremy , Benítez López Jazmín
Published: August 2024

Desde un enfoque decolonial, en este artículo se analiza la interrupción de los estudios universitarios en jóvenes mujeres indígenas originarias del municipio de Calakmul (Campeche, México). Con una metodología cualitativa se aplicaron técnicas como la observación y la entrevista a profundidad para producir narrativas con 10 jóvenes que ingresaron a la Universidad Tecnológica de Calakmul entre 2015 y 2021. Los hallazgos muestran que la colonialidad configuró el territorio de Calakmul y las dinámicas de sus instituciones. Así, en un área de reciente colonización y con profundas desigualdades estructurales, la interrupción de los estudios universitarios se gestó a lo largo de la trayectoria educativa, en la que las colaboradoras enfrentaron violencia institucional, epistémica y relacionada con sus derechos lingüísticos. Las jóvenes destacan por su capacidad de agencia, pero sus redes de apoyo fueron insuficientes para concluir con sus estudios universitarios.
Hubungan antara Karakteristik Calon Pengantin Wanita dengan Pengetahuan tentang Kesehatan Reproduksi di Puskesmas Tunjung Kecamatan Randuagung Kabupaten Lumajang Jawa Timur
Authors: Alya Kirana Deifa Syaldillah , Sukarya Wawang Setiawan , Pudyastuti Erlina
Published: August 2024

The maternal mortality rate in Indonesia is still high at 4,400/100,000 births, likewise in Lumajang Regency at 97/100,000 live births. Various factors that influence the high maternal mortality rate include knowledge about reproductive health. In Lumajang Regency there is a regent's regulation about prospective bride and groom must report to the Puskesmas to obtain reproductive health information. Until now, in the coverage area of Tunjung Health Center, Lumajang Regency are not known about the connection between characteristics of the prospective bride and groom with knowledge about reproductive health, this research was conducted to find out. An observational analytic survey with cross sectional approach are used in this research. Fifty research samples were determined by the Lemeshow formula and total sampling technique. Data were collected using questionnaire that was created and validated. The results showed that most of the prospective brides were aged 20 to 35 years (63.64%), while the risk group in terms of age <20 years was 36.36%. Most of education of the bride-to-be is in junior high school (52.73%) and 12.73% are elementary school. The highest income for prospective brides is under 2 million (69.09%) with 14.55% of them earning below 1 million. Sourcemost reproductive health information from teachers (47.27%) and parents (21.82%), the respondent group of prospective brides with less knowledge are only 5.45%. The results of statistical analysis with Pearson chi-square test showed there is a significant relationship between age and the level of knowledge of reproductive health.
Keywords: age, education, income, reproductive health
Gambaran Tingkat Kecemasan Pada Penderita Diabetes Melitus Tipe-II di RSUD Pesanggrahan,Jakarta Selatan
Authors: Winarso Rizka Suhartini , Darwin Prasilia , Indriyati Leli Hesti
Published: August 2024

Diabetes Mellitus merupakan suatu penyakit kronis yang disebabkan karena pankreas tidak cukup menghasilkan hormon insulin atau saat tubuh tidak mampu menggunakan insulin yang dihasilkan oleh pankreas. Kecemasan merupakan suatu kondisi aprehensi atau kekhawatiran yang merujuk pada sesuatu hal tidak baik yang akan terjadi. Banyak faktor pemicu kecemasan contohnya kondisi kesehatan, masa depan, pekerjaan, dan hubungan sosial. Penelitian ini dilakukan untuk melihat gambaran tingkat kecemasan pada penderita diabetes mellitus tipe-II. Penelitian ini menggunakan desain penelitian analitik dengan pendekatan cross sectional. Instrumen penelitian yang digunakan adalah dengan kuisioner Zung Self-Rating Anxiety Scale (SAS/ZRAS) yang terdiri dari 20 pertanyaan. Hasil penelitian menyatakan bahwa gambaran tingkat kecemasan berpengaruh pada penderita diabetes mellitus tipe-II dengan nilai likelihood ratio sebesar 0.005 < 0.05. Hasil penelitian menunjukkan bahwa kecemasan tingkat ringan lebih banyak dirasakan pada penderita diabetes melitus tipe-II.
PARENTAL SUPPORT FOR ADOLESCENTS WITH BIPOLAR DISORDER SYMPTOMS USING COGNITIVE BEHAVIORAL THERAPHY
Authors: Simbolon Ilham Yunus
Published: August 2024

Adolescents in their development experience symptoms of bipolar disorder that hinder adolescent development. This study presents a critical analysis of previous research findings in the context of developing intervention strategies for adolescents with bipolar disorder symptoms. We evaluated the effectiveness of cognitive-behavioral therapy applied to a group of adolescents with active parental support. This study utilized qualitative-descriptive methods to elucidate the positive impact of the therapy in improving psychological well-being and management of bipolar symptoms. Although the findings indicated the success of the therapy, the limitations of previous research became a focal point for this follow-up study. The results showed that parents' presence and participation played an important role in designing and reinforcing the therapy intervention. Emotional and educative support from parents provides a solid foundation to accelerate the adolescent's healing process. These findings provide insight into the importance of integrating family support in designing effective cognitive-behavioral therapy strategies to manage bipolar disorder symptoms in adolescents.
Los desafíos de la Iglesia católica en contextos de violencia: activismo religioso frente al crimen en Michoacán, México
Authors: Maldonado Aranda Salvador
Published: August 2024

En este artículo exponemos los resultados de un estudio sobre el papel que la Iglesia católica ha jugado en el estado de Michoacán, México, en respuesta a las violencias producidas por las políticas de seguridad y el crimen organizado. Nuestro trabajo etnográfico con varios sacerdotes en sus comunidades e iglesias sugiere que el clero enfrenta grandes retos frente a las violencias y el empoderamiento de actores armados. Fundamentalmente, se debate en una constante tensión entre la justicia, la verdad y el consuelo que parece replantear, otra vez, el lugar de la Iglesia en la sociedad. Un análisis minucioso de la trayectoria histórica de esta institución y sus respuestas a las violencias en espacios altamente conflictivos nos brindará una visión de los actores involucrados en la construcción de una posible paz.
Correction of Thrombocytopenia before Elective Surgery / Invasive Procedures in Patients with Liver Cirrhosis (Experts’ Agreement)
Authors: Maevskaya M. V. , Nadinskaia M. Yu. , Bessonova E. N. , Geyvandova N. I. , Zharkova M. S. , Kitsenko E. A. , Korochanskaya N. V. , Kurkina I. A. , Melikyan A. L. , Morozov V. G. , Khoronko Yu. V. , Deeva T. A. , Gulyaeva K. A. , Ivashkin V. T.
Published: August 2024

Introduction. As a result of portal hypertension (sequestration of platelets in an enlarged spleen) and liver failure (decreased production of thrombopoietin in the liver) in liver cirrhosis, thrombocytopenia develops, which is associated with the risk of periprocedural/perioperative bleeding complications. There are still unresolved questions regarding risk stratification of bleeding complications, the prognostic role of thrombocytopenia, as well as the need for treatment of thrombocytopenia and its methods.

Materials and methods. The Russian Scientific Liver Society selected a panel of experts in the field of therapeutic and surgical hepatology, hematology, transfusion medicine to make reasoned statements and recommendations on the issue of treatment of thrombocytopenia before elective surgery / invasive procedures in patients with liver cirrhosis.

Results. Relevant clinical issues were determined based on the PICO principle (patient or population, intervention, comparison, outcome). The Delphi panel made five questions and gave reasoned answers, framed as ‘clinical practice recommendations and statements’ with evidence-based comments. The questions and statements were based on the results of search and critical analysis of medical literature using keywords in English- and Russian-language databases. The formulated questions could be combined into four categories: bleeding risk stratification, the prognostic value of thrombocytopenia, the necessity and methods of thrombocytopenia drug correction, and bleeding risk reduction.

Conclusions. The results of experts' work are directly related to high-quality management of patients with liver cirrhosis and thrombocytopenia, who have scheduled invasive procedures/surgery. Thus, this recommendations and statements can be used in clinical practice.
Surgical Treatment of Esophagoenteroanastomosis Leakage after Total Gastrectomy
Authors: Peregorodiev I. N. , Zaderenko I. A. , Batyrov K. A. , Nered S. N.
Published: August 2024

Aim: to present the difficulties of the choice of surgical tactics in case of esophagoenteroanastomosis suture failure after gastrectomy.

Key points. In patient K., 55 years old, after a planned surgical intervention involving gastrectomy for stomach cancer, leakage of the esophagoenteroanastomosis sutures was noted. An attempt to re-form the esophageal-intestinal anastomosis did not lead to success, despite the early stages of relaparotomy, therefore, in order to relieve purulent complications, it was decided to take the path of “disconnecting” the esophagus, for which the cervical esophagus was transected and brought out in the form of two stomas, and the distal end of the esophagus was sutured tightly. Adequate drainage of the esophageal stump area and disconnection of the esophagus at the cervical level made it possible to avoid purulent complications in the abdominal cavity. The reconstructive stage was performed after 6 months in the amount of a colonic insert between the distal esophagus and the jejunum and plastic surgery of the esophagus using a skin insert in the neck.

Conclusion. The chosen treatment tactics was determined by the impossibility of conservative treatment of the suture failure of the esophageal-intestinal anastomosis due to ischemic disorders and necrosis of the small intestine anastomosed with the esophagus. Disconnection of the esophagus after repeated suture failure of the esophageal-intestinal anastomosis seemed to be the only chance to stop the flow of esophageal contents into the abdominal cavity and thereby eliminate the source of purulent complications. The esophagoplasty option used turned out to be the safest and allowed to save the patient’s life.
Pathogenesis of Disorders of the Motor Function of the Large Intestine in Functional Constipation
Authors: Galagudza M. M. , Uspensky Yu. P. , Fominykh Yu. A. , Butko D. Yu.
Published: August 2024

Aim: to analyze the scientific literature on the role of various factors in the mechanisms of development of functional constipation and to summarize the current data on its leading pathogenetic mechanisms.

Key points. Constipation occurs in 15 % of the adult population in the world and leads to a significant decrease in the quality of life, and in combination with some other symptoms may indicate the presence of an organic pathology of the gastrointestinal tract. The pathogenetic basis of functional constipation (FC) with slow intestinal transit is a decrease in colonic motor function, which is confirmed by the results of high-resolution manometry. FC is characterized by disturbances in such motor patterns of the colon as low and high amplitude propagating contractions, segmental non-propagating contractions, and general increases in pressure. The main FC mechanisms associated with neurogenic dysregulation include impaired function of the gray and white matter of the brain, as well as an increase in the tone of the sympathetic nervous system with a concomitant decrease in the influence of cholinergic nerves innervating the large intestine. A key role in the FC development belongs to a decrease in the pool of interstitial cells, which play the role of an intestinal pacemaker, due to slowing of their self-renewal. FC-associated changes in the enteric nervous system include a relative excess of the contribution of inhibitory influences and a decrease in the activity of cholinergic and serotonergic neurons that stimulate intestinal motility. A certain role in the occurrence of reduced motor function of the colon may have an imbalance in the production of intestinal hormones synthesized by enteroendocrine cells, namely, a deficiency of motility stimulants, which include motilin, gastrin, ghrelin and cholecystokinin, as well as a relative excess of hormones that suppress motility (somatostatin and vasoactive intestinal polypeptide). Changes in the composition of the intestinal microbiota can also contribute to the FC occurrence, which is associated with a dysfunction of the metabolite profile produced by intestinal bacteria.

Conclusions. Functional constipation is a classic multifactorial disease, in the etiology of which the adverse effects of the genotype are combined with multiple acquired risk factors. A more complete understanding of the molecular mechanisms of the FC development can serve as the basis for the emergence of new effective treatments for this common pathology.
Parameters of the Component Composition of the Body and Their Relationship with the Development of Ascites in Liver Cirrhosis
Authors: Zharikov Yu. O. , Zharkova M. S. , Gadjiakhmedova A. N. , Aliyeva A. M. , Nikolenko V. N. , Ivashkin V. T.
Published: August 2024

Aim: to evaluate the relationship of body composition components with the development of ascites in patients with liver cirrhosis.

Materials and methods. One hundred and ten patients (44 men and 66 women) with the established diagnosis of liver cirrhosis were treated at the University Clinical Hospital No 2 of the Sechenov University. The assessment of the component composition of the patients’ body was carried out using the ABC-01 “MEDASS” device  (“MEDASS”, Russia). Ascites diagnosis was performed using ultrasound examination of the abdominal cavity and retroperitoneal space.

Results. The values of body mass index (p < 0.001), fat mass (p = 0.002), active cell mass (p < 0.001), and phase angle (p < 0.001) were lower in patients with ascites than without it. Patients with a lower percentage of body fat mass had a more severe ascites severity and vice versa, and the proportion of fat mass was generally higher in women than in men (r = –0.290; p = 0.002). Patients with lower active cell mass had higher ascites severity (r = –0.380; p < 0.001). However, this indicator was lower in women than in men. Significant negative correlations were revealed between fat mass, active cell mass, phase angle (r = –0.395; p < 0.001) and the severity of ascites.

Conclusion. Our study confirms the importance of body composition parameters in the development of ascites in patients with cirrhosis of the liver. Insufficient amount of fat and muscle mass, as well as low values of the phase angle according to the results of bioimpedance can become predictors of the development of ascites. Evaluation of these components can be used in prognostic models to identify patients with an increased risk of ascites. Further research in this area will help to better understand the mechanisms of ascites development and develop effective methods of prevention and treatment of this complication in patients with liver cirrhosis.
Single Nucleotide Polymorphisms, Associated with Increased Risk of Irritable Bowel Syndrome with Predominant Constipation: A Meta Analysis
Authors: Trush E. A. , Karchevskaya A. E. , Maslennikov R. V. , Poluektova E. A. , Shifrin O. S. , Ivashkin V. T.
Published: August 2024

Introduction. Genetic predisposition in combination with environmental factors and the patient’s psychological and emotional state play a key role in the development of irritable bowel syndrome (IBS). Studies of association between genetic polymorphisms and IBS can help in understanding the key pathophysiological mechanisms. To date, 11 meta-analyses on this issue have been published, however, none of them comprehensively summarize the data on the prevalence of genetic polymorphisms in IBS with predominant constipation (IBS-C).

Aim: to summarize the published data on the impact of genetic polymorphisms on the risk of IBS-C.

Materials and methods. A literature search was performed in the PubMed and Scopus databases. Identified studies were used for a meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Publications investigating genetic polymorphisms in patients with IBS-C were included in this analysis.

Results. A total of 34 studies met the inclusion criteria. The collected data were sufficient to conduct a meta-analysis on polymorphisms of three of the listed genes: SLC6A4 (10 articles), GNB3 (5 articles), ADRA2A (4 articles). No significant association was found between the SLC6A4 (5-HTTLPR) polymorphism, GNB3 c.825C > T (rs5443) polymorphism and either IBS or IBS-C. It was found that ADRA2A 1291C>G polymorphism was significantly associated with both IBS and IBS-C.

Conclusions. Our meta-analysis revealed that ADRA2A 1291C>G polymorphism was significantly associated with both IBS and IBS-C in the mixed population. Neither homozygous nor heterozygous variants of the SLC6A4 (5-HTTLPR) polymorphism and GNB3 C825T polymorphism were associated with either IBS-C or IBS as a whole.
Diagnosis of Non-Tumor Stenosing Lesions of the Major Duodenal Papilla Using Endoscopic Ultrasonography
Authors: Belozerov V. A. , Okhotnikov O. I. , Korenevskiy N. A. , Prokopov V. A. , Grigoriev S. N. , Shevyakin S. M.
Published: August 2024

Aim: to evaluate the possibilities of endoscopic ultrasonography in the diagnosis of benign stenosis of the major duodenal papilla and improve its results, including by identifying and objectifying the criteria of the disease.

Materials and methods. The results of the examination and treatment of 2146 patients treated at the Kursk Regional Multidisciplinary Clinical Hospital in the period from 2015 to 2022, who underwent transpapillary interventions and/or endoscopic ultrasonography on the basis of the endoscopy department, are presented. A therapeutic and diagnostic algorithm for the management of patients with dilation of the common bile duct has been introduced into clinical practice, based on the developed criteria for stenosis of the major duodenal papilla (MDP), for which endoscopic ultrasonography was used in combination with the methodology of synthesis of hybrid fuzzy decision rules.

The algorithm was implemented in a group of patients, which included 217 people.

Results. Using the developed endosonographic criteria for MDP stenosis and the methodology for the synthesis of fuzzy decision rules, a production decision rule for the diagnosis of MDP stenosis was determined with a decision made according to a threshold set by experts at the level of 0.9. Guided by the selected information sources, 134 (61.7 %) patients with dilated common bile duct were diagnosed with MDP stenosis, requiring minimally invasive treatment aimed at relief of biliary hypertension and indications for endoscopic papillosphincterotomy were determined. In 83 cases of MDP stenosis, it was decided to abandon transpapillary interventions with subsequent follow-up of patients. Minimally invasive treatment using retrograde and antegrade techniques was performed in 134 patients. Complications were noted in 6 (4.4 %) patients, which is comparable to the number of complications with transpapillary interventions performed in patients without MDP stenosis. When monitoring 54 patients for one to three years, 85.2 % of patients showed regression of clinical, laboratory and instrumental symptoms of biliary hypertension.

Conclusions. The combination of endoscopic ultrasonography with fuzzy logic technologies based on hybrid artificial intelligence made it possible to objectify the diagnosis of MDP stenosis and optimize indications for transpapillary interventions.
Implementación de mapas cognitivos difusos con algoritmos genéticos para predecir diabetes mellitus tipo 2
Authors: Hoyos William , Ruíz Rander , Hoyos Kenia
Published: August 2024

La diabetes mellitus tipo 2 es una enfermedad crónica no transmisible, causada por un trastorno en el metabolismo de la glucosa, que provoca un aumento anormal de su concentración en la sangre. El diagnóstico tardío de esta enfermedad contribuye al aumento de las tasas de morbilidad y mortalidad a nivel mundial. El desarrollo de modelos basados en inteligencia artificial para la predicción de diabetes podría acelerar el diagnóstico. Por tanto, el objetivo del presente estudio fue implementar un modelo de predicción de diabetes mellitus tipo 2 basado en mapas cognitivos difusos entrenado con un algoritmo genético. La metodología empleada consistió en utilizar un conjunto de datos del Instituto Nacional de Diabetes y Enfermedades Digestivas y Renales de la población de indios PIMA, que contiene información demográfica y clínica de 768 pacientes. El 70 % de los datos se empleó para el entrenamiento y validación, y el 30 % restante se utilizó para las pruebas de rendimiento. El modelo de mapas cognitivos difusos puede predecir la enfermedad con un 99 % de exactitud, 98 % de precisión y recall de 100 %. Se concluye que el modelo presenta una buena capacidad para predecir y evaluar el comportamiento de las variables de interés en la diabetes mellitus tipo 2, mostrando su valor como herramienta de soporte en la identificación oportuna de la enfermedad y apoyo a la toma de decisiones por parte del profesional médico.
IoT as Audit Evidence: A Reasonable Assurance Framework
Authors: Al-Zamil Zamil S. , Appelbaum Deniz A. , Nehmer Robert A.
Published: August 2024

This study examines the continuing expansion of the Internet of Things (IoT) and its possible development as a source of audit evidence for both internal and external audits. In other words, the auditor checks whether a measure (metric) related to classifying and prioritizing requests and/or incidents is available in the enterprise’s current incident reporting system. This approach uses Design Science Research and is based on the use of auditing standards and frameworks to drive the design of audit plans using metrics available on or derived from the enterprise IoT. This study extends the research on enterprise IoT and its potential application to the enterprise audit process. It provides a framework that illustrates how both internal and external auditors can reasonably assure the provenance and validity of enterprise IoT data while also evaluating the security and controls surrounding its production.
Auditor Use of Benchmarks to Assess Fraud Risk: The Case for Industry Data
Authors: Brazel Joseph F. , Jones Keith L. , Lian Qiyang
Published: August 2024

Auditors perform preliminary analytical procedures to identify unusual or inconsistent relationships between expectations and recorded balances. The results of preliminary analytical procedures help auditors assess the risk that financial statements are materially misstated due to fraud. Via a survey of practicing auditors, we find that auditors rely heavily on prior-year balances and relations within the client’s financial data as benchmarks when developing expectations. Even though auditing standards describe additional benchmarks, which are less susceptible to management manipulation (e.g., industry trends), our survey results indicate that auditors are less apt to employ these benchmarks. Meanwhile, our empirical analyses of revenue frauds reveal that benchmarks derived from industry data, nonfinancial measures, and cash flows outperform both prior-year balances and relations within the client’s financial data. Of the benchmarks we examine, the difference between a company’s revenue growth and the revenue growth of its industry has historically been the best fraud indicator.

Data Availability: Data are available from the authors upon request.

JEL Classifications: M40; M41; M42; M48.
Leptin Activation of Dorsal Raphe Neurons Inhibits Feeding Behavior
Authors: Maxwell Nicholas David , Smiley Cora Erin , Sadek Alia Tereza , Loyo-Rosado Frances Zoe , Giles Daniel Christian , Macht Victoria Alice , Woodruff Jennifer Lynn , Taylor Donzelle Lee , Glass Victoria Marie , Wilson Steven Peter , Reagan Lawrence Patrick , Fadel James Robert , Grillo Claudia Alejandra
Published: August 2024

Leptin is a homeostatic regulatory element that signals the presence of adipocyte energy stores, reduces food intake, and increases energy expenditure. Similarly, serotonin (5-HT), a signaling molecule found in both the central and peripheral nervous systems, also controls food intake. Using neuronal tract tracing, pharmacologic and optogenetic approaches, and in vivo microdialysis, combined with behavioral end points, we tested the hypothesis that leptin controls food intake not only by activating hypothalamic leptin receptors (LepRs) but also through activation of LepRs expressed by serotonergic raphe neurons that send projections to the arcuate (ARC). We showed that microinjection of leptin directly into the dorsal raphe nucleus (DRN) reduced food intake in rats. This effect was mediated by LepR-expressing neurons in the DRN, because selective optogenetic activation of these neurons at either their DRN cell bodies or their ARC terminals reduced food intake. Anatomically, we identified a unique population of serotonergic raphe neurons expressing LepRs that send projections to the ARC. Finally, by using in vivo microdialysis, we showed that leptin administration to the DRN increased 5-HT efflux into the ARC, and specific antagonism of the 5-HT2C receptors in the ARC diminished the leptin anorectic effect. Overall, this study identified a novel circuit for leptin-mediated control of food intake through a DRN-ARC pathway, identifying a new level of interaction between leptin and serotonin to control food intake. Characterization of this new pathway creates opportunities for understanding how the brain controls eating behavior and opens alternative routes for the treatment of eating disorders.

Article Highlights
Diabetes Overtreatment and Hypoglycemia in Older Patients With Type 2 Diabetes on Insulin Therapy: Insights From the HYPOAGE Cohort Study
Authors: Christiaens Antoine , Boureau Anne-Sophie , Guyomarch Béatrice , de Decker Laure , Boland Benoit , Hadjadj Samy , Cariou Bertrand ,   HYPOAGE Study Group, Cariou Bertrand , Hadjadj Samy , Morcel Pierre , Wargny Matthieu , Guyomarch Béatrice , Boureau Anne-Sophie , Chapelet Guillaume , de Decker Laure , Anweiller Cédric , Allix Ingrid , Briet Claire , Gourdy Pierre , Guyonnet Sophie , Paccalin Marc , Saulnier Pierre-Jean , Delabrière Isabelle , Litke Rachel , Cervantes Nathalie , Penfornis Alfred
Published: August 2024

OBJECTIVE

To assess the accuracy of “diabetes overtreatment” proxy definitions in predicting hypoglycemia in older adults with type 2 diabetes (T2D).

RESEARCH DESIGN AND METHODS

Inclusion of patients from HYPOAGE cohort with insulin-treated T2D, aged ≥75 years, and using a continuous glycemic monitoring (CGM) device for 28 days. “Diabetes overtreatment” was defined as HbA1c <7.0% (fixed proxy definition) or as HbA1c <7.0%, 7.5%, and 8.0% according to patient’s health status (individualized proxy definition). The primary outcome was time below range (TBR) ≥1%.

RESULTS

Of the 134 patients included (81.6 ± 5.4 years, 59% male), 25 (19%) and 53 (40%) were overtreated, based on fixed and individualized proxy definitions, respectively. CGM data showed TBR >1% in nearly all patients regardless of overtreatment status. Both proxy definitions had low sensitivity (20% [14; 29] and 41% [32; 50]) and accuracy (27% [20; 35] and 44% [35; 53]) in predicting hypoglycemia.

CONCLUSIONS

A revised definition of diabetes overtreatment is needed to better manage older insulin-treated patients and protect them from hypoglycemia.