bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Carnitine on the Quality of Life and Sleep-Wake Disturbance in Patients With Liver Cirrhosis
Authors: Miyaaki Hisamitsu , Haraguchi Masafumi , Miuma Satoshi , Fukushima Masanori , Sasaki Ryu , Miyazoe Yuri , Shigeno Masaya , Nakao Kazuhiko
Published: October 2020

Background: Some patients with liver cirrhosis have sleep-wake disturbance and reduced quality of life (QOL). However, the effects of L-carnitine on QOL and sleep-wake disturbance have not been extensively studied. Thus, we aimed to examine the effects of L-carnitine on the sleep quality and QOL in cirrhotic patients.Methods: We investigated 19 cirrhotic patients (age: 65.0±10.2 years, male:female=10:9, Child-Pugh score: 6.5±1.8) treated with 1500-mg L-carnitine at Nagasaki University Hospital and its associated hospitals. We used questionnaires to evaluate the patients’ sleep-wake disturbance and QOL at the time of entry and 8 weeks. Results: Cirrhosis-related symptom scores (CSSs), Pittsburgh Sleep Quality Index (PSQI) and General Health (GH) of QOL score improved with L-carnitine treatment (CSS: from 11.5±9.4 to 9.4±3.7, p=0.015; PSQI: from 9.6±5.8 to 7.4±3.3, p=0.035; GH: from 33.5±8.2 to 38.3±9.8, p=0.05). L-carnitine treatment reduced PSQI in 12 out of 14 patients with sleep disturbance (PSQI>5). CSS was improved in 12 cases (63%), and PSQI was improved in 13 cases (68%). However, L-carnitine treatment did not improve daytime hypersomnolence, as evaluated by the Epworth Sleepiness Scale. None of patients had any adverse events related to the L-carnitine treatment.Conclusions: L-carnitine is a safe and useful treatment for cirrhotic patients with reduced sleep quality and QOL.
Factors Influencing Stress, Anxiety, and Depression Among Iranian Pregnant Women: The Role of Sexual Distress and Genital Self-image
Authors: Keramat Afsaneh , Malary Mina , Moosazadeh Mahmood , bagherian Nastaran , Rajabi-Shakib Mohammad-Reza
Published: October 2020

Background: Pregnancy is a unique period with the increased likelihood of psychological changes and emotional disturbances such as depression, anxiety, and stress. In this study, we investigated the factors influencing depression, anxiety, and stress in pregnancy and identify their associations with Sexual Distress (SD) and Genital Self-Image(GSI). Methods: This was a descriptive, correlational, cross-sectional study performed between September 2019 and January 2020. Overall, 295 pregnant women completed a demographics and obstetric information checklist, Depression Anxiety and Stress Scale-21 (DASS-21), Female Genital Self-Image Scale (FGSI), and Female Sexual Distress Scale-Revised (FSDS-R).Results: The mean score of SD was significantly associated with the severity of depression, anxiety, and stress. Also, the mean score of GSI was negatively correlated with the severity of depression and anxiety. Multiple linear regression analysis revealed that the risk factors for depression include SD, fear of fetal abortion, bad experience in previous pregnancy, poor GSI, and advancing age, whereas satisfaction with income was a protective factor. SD, fear of fetal abortion, and increased duration of marriage were found to be associated with the development of anxiety symptoms, whereas satisfaction with income, positive body image, and increased gestational age had a protective effect against this variable. SD, adverse events in previous pregnancies, and advancing age were the risk factors, while planned pregnancy and increased gestational age were the protective factors against developing stress during pregnancy. Conclusion: Many factors influence the development of depression, anxiety and stress in pregnancy, which may be different or common. Some of these factors are avoidable and some are not. Therefore, considering all the factors comprehensively with emphasis on the improvement of preventable factors by screening and counseling can be useful for mothers and their fetuses.
What was the Impact of a Global Pandemic (COVID-19) Lockdown Period on Experiences within an Eating Disorder Service? A Service Evaluation of the Views of Patients, Parents/Carers and Staff.
Authors: Shaw Hannah , Robertson Sarah , Ranceva Nadia
Published: October 2020

Background: The World Health Organization declared the outbreak of COVID-19 as a global pandemic on the 11th March 2020. As a result, the UK Government imposed severe restrictions on working and social contact as part of “lockdown.” Whilst the full extent of the pandemic’s impact on eating disorder patients is unknown, the literature suggests that patients with pre-existing mental illness may be more vulnerable to the mental health impacts. In addition, the restrictions greatly reduced the access to mental health services and presented new challenges to service delivery. A service evaluation was carried out to explore how the COVID-19 global pandemic changed service provision in a young person’s eating disorder service and how this affected patients, family and staff experiences. Methods: Quantitative data was collected in an online survey and qualitative data was collected in two formats: open ended answers as part of the online survey and open-ended focus groups, structured using narrative enquiry. The 43 participants consisted of 12 patients, 19 parents/carers, and 12 staff members. Patients were under the age of 18 and had a diagnosis of an eating disorder. Results: COVID-19 and lockdown increased the pressure on the service and changed service provision significantly. This has impacted the relational experiences for patients and their carers and staff have been faced with new challenges. Patients, parents/carers and staff all preferred face-to-face appointments over virtual options. There was no difference in service satisfaction before and during COVID-19. Conclusions: It is possible to provide a high-quality eating disorder service in lockdown restrictions. Providing face-to-face appointments at the beginning of treatment and including families in the planning should be prioritised. Staff support is crucial to be able to continue delivering high quality services. The key themes are identified, and clinical recommendations are made to guide service delivery.
Up-regulated Endonuclease Regnase-1 Suppresses Osteoarthritis by Forming Negative Feedback Loop of Catabolic Signaling in Chondrocytes
Authors: Yang Jeong-In , Chun Jang-Soo
Published: October 2020

Background: Ribonucleases (RNases) play central roles in the post-transcriptional regulation of mRNA stability. Our preliminary results revealed that the endonuclease Regnase-1 is specifically up-regulated in osteoarthritic chondrocytes. We herein explored the possible functions and regulatory mechanisms of Regnase-1 in a mouse model of osteoarthritis (OA).Methods: The expression and target genes of Regnase-1 were identified by microarray analysis in primary-culture mouse articular chondrocytes. Experimental OA in mice was induced by destabilization of the medial meniscus (DMM). The function of Regnase-1 in DMM-induced post-traumatic OA mice was examined by adenovirus-mediated overexpression or knockdown in knee joint tissues, and also by using Regnase-1 heterozygous knockout mice (Zc3h12a+/-). Results: Among the RNases, Regnase-1 was exclusively up-regulated in chondrocytes stimulated with OA-associated catabolic factors. Adenovirus-mediated overexpression or knockdown of Regnase-1 alone in joint tissues did not cause OA-like changes. However, overexpression of Regnase-1 in joint tissues significantly ameliorated DMM-induced post-traumatic OA cartilage destruction, whereas knockdown or genetic ablation of Regnase-1 exacerbated DMM-induced cartilage destruction. Mechanistic studies showed that Regnase-1 appears to suppress cartilage destruction by modulating the expression of matrix-degrading enzymes in chondrocytes. Conclusion: Our results collectively suggest that up-regulated Regnase-1 in OA chondrocytes may function as a chondro-protective effector molecule during OA pathogenesis by forming negative feedback loop of catabolic signaling such as expression of matrix-degrading enzymes in OA chondrocytes.
Can Brain Natriuretic Peptide Be Used as an Indicator of Over-infusion in Patients with Acute Sepsis? : A Pilot Study Evaluating Correlation Between Brain Natriuretic Peptide and Global End-diastolic Volume Index
Authors: Kishihara Yuki , Yasuda Hideto , Morisawa Kenichiro , Fujitani Shigeki , Homma Yosuke , Shigemitsu Kazuaki , Saito Nobuyuki , Hayakawa Katsura , Hifumi Toru , Rinka Hiroshi , Mayumi Toshihiko , Fujiwara Shinsuke , Murao Yoshinori , Taira Yasuhiko
Published: October 2020

Background: Recently, for patients with sepsis, under-infusion, that hastens the progression to multiple organ failure and death, has been avoided; however, the rate of over-infusion and resulting complications, such as mortality has increased. There are few indicators of over-infusion, such as transpulmonary thermodilution; therefore, minimally invasive, simple, and quick indicators of over-infusion are needed. This pilot study aimed to determine the association between brain natriuretic peptide (BNP) and global end-diastolic volume index (GEDI).Methods: This was a post-hoc analysis of a multicenter prospective randomized controlled study, performed in the intensive care units (ICU) of 10 separate hospitals in Japan from September 2013 to March 2016. Patients with sepsis who were expected to require mechanical ventilation for more than 48 hours were included. We measured BNP and GEDI every 24 hours from ICU admission until next 72 hours. The primary outcome was the correlation between BNP and GEDI that was assessed in two ways: 1) GEDI considered a continuous variable, and 2) GEDI divided into two groups based on a cutoff of 850 ml/m2, which is the upper limit of normal GEDI. We used a univariable generalized linear mixed-effects model in which patients are considered as a random effect.Results: Fifty-seven patients were analyzed. GEDI remained under the upper limit of normal GEDI (850 ml/m2) from ICU admission to 72 h, and there were no significant changes in the trends of BNP and GEDI over time. BNP tended to be higher in group 1 (GEDI >850 ml/m2) from ICU admission to 72 h, but there was no significant difference in the BNP values. The regression coefficient and 95%CI of BNP for GEDI were 2.5 and 1.3 to 3.7 when considered as a continuous variable, and 166 and -273 to 605 when divided into two groups based on GEDI cutoff of 850 ml/m2. Conclusion: There could be a weak but significant correlation between GEDI and BNP considering GEDI as a continuous variable. Using BNP as an indicator of over-infusion may be possible; however, further studies are needed.Trial registration: None.
γ-Cyclodextrin Metal-Organic Framework as a Carrier to Deliver Triptolide for the Treatment of Hepatocellular Carcinoma
Authors: Li Zhe , Yang Gang , Wang Rong , Wang Yuanyuan , Wang Jing , Yang Meng , Gong Chunai , Yuan Yongfang
Published: October 2020

Triptolide (TPL) has been employed to treat hepatocellular carcinoma (HCC). However, the poor water-solubility of TPL restrict its applications. Therefore, we prepared TPL loaded cyclodextrin-based metal-organic framework (TPL@CD-MOF) to improve the solubility and bioavailability of TPL, thus enhancing the anti-tumor effect on HCC. The BET surface and the pore size of TPL@CD-MOF were 1134.5 m2·g−1 and 1.6 nm, respectively. The results of XRD indicated that TPL in TPL@CD-MOF was encapsuled. TPL@CD-MOF showed a slower release than free TPL in vitro. Moreover, the CD-MOF improved the cell internalization and bioavailability of TPL. TPL@CD-MOF also showed higher anti-tumor efficacy in vitro and in vivo compared to free TPL. As a carrier, CD-MOF improved the solubility and bioavailability of TPL. In addition, TPL@CD-MOF exhibited improved anti-tumor effects in vitro and in vivo, indicating great potential as a carrier for insoluble anti-tumor drugs.
H19 contributes to aerobic glycolysis, proliferation and immune escape of gastric cancer cells via the miR-519d-3p/LDHA axis
Authors: Sun Linqing , Li Juntao , Yan Wenying , Yao Zhendong , Wang Ruoqin , Zhou Xiaojun , Wu Hongya , Zhang Guangbo , Shi Tongguo , Chen Weichang
Published: October 2020

Background Long non-coding RNAs (lncRNAs) have been investigated in multiple human cancers including gastric cancer (GC). Our research aims to explore the role of H19 in aerobic glycolysis, proliferation, and immune escape of GC cells.Methods The expression of H19 in GC samples were analyzed using Gene Expression Profiling Interactive Analysis (GEPIA), Gene Expression Omnibus (GEO) data, and real-time quantitative polymerase chain reaction (RT-qPCR) analysis. Glucose consumption and lactate production were applied to assess the aerobic glycolysis of GC cells. Subcellular fractionation, luciferase reporter, and western blot assays certified the binding between genes. CCK-8 and colony formation assays were used to determine GC cell proliferation. Flow cytometry, ELISA, and RT-qPCR assays were applied to analyze the immunosuppressive effect of H19. Results H19 was highly expressed in samples of patients with GC, and associated with tumor growth in vivo. H19 knockdown suppressed glucose consumption, lactate production, proliferation of GC cells by regulating miR-519d-3p/LDHA axis. Both miR-519d-3p depletion and LDHA overexpression could reverse the H19 knockdown-induced decrease in aerobic glycolysis and proliferation. Moreover, conditioned medium (CM) from stable knockdown H19 GC cells modulated the activity of immune cells including γδT cells, Jurkat cells, and tumor-associated macrophages (TAMs) in a lactate dependent manner.Conclusions The H19/miR-519d-3p/LDHA axis mainly contributed to aerobic glycolysis, proliferation, and immune escape of GC cells.
Circular RNA hsa_circ_0006401 promotes proliferation and metastasis in colorectal carcinoma
Authors: Zhang Chenjing , Zhou Xiaolu , Geng Xiaoge , Wang Jingya , Zhang Yu , Jing Jiyong , Pan Wensheng
Published: October 2020

Background: Dysregulation of circular RNA (circRNA) expression is involved in the progression of cancer. Here, we aimed to study the potential function of hsa_circ_0006401 in colorectal cancer (CRC).Methods: CircRNA hsa_circ_0006401 expression levels in CRC and adjacent nontumor tissues were analyzed by real-time quantitative PCR (qRT-PCR) and circRNA in situ hybridization (RNA-ISH). Two siRNAs were designed according to the splice junction of hsa_circ_0006401, and both effectively downregulated the hsa_circ_0006401 expression level. Then, CRC cell proliferation was assessed by cell counting. Wound-healing and transwell assays were utilized to detect the effect of hsa_circ_0006401 on CRC migration. A circRNA-ORF-GFP construct was created, and a specific antibody against the splice junction of hsa_circ_0006401 was prepared.Results: Hsa_circ_0006401 was closely related to CRC metastasis and exhibited upregulated expression in metastatic CRC tissue samples. Proliferation and migration were inhibited in vitro when hsa_circ_0006401 expression was silenced. Downregulation of hsa_circ_0006401 expression decreased CRC proliferation and liver metastasis in vivo. A 198-aa peptide was encoded by sequences of the splice junction absent from col6a3. Hsa_circ_0006401 promoted CRC proliferation and migration by encoding the hsa_circ_0006401 peptide. Hsa_circ_0006401 peptides decreased the protein level of the host gene col6a3 but did not alter its gene expression level.Conclusion: Our study revealed that circRNAs generated from col6a3 that contain an open reading frame (ORF) encode a novel 198-aa functional peptide and hsa_circ_0006401 peptides transcriptionally regulates the host gene col6a3 to promote CRC proliferation and metastasis.
MicroRNA-138-1-3p sensitizes sorafenib to hepatocellular carcinoma by targeting PAK5 mediated β-catenin/ABCB1 signaling pathway
Authors: Li Tong-tong , Mou Jie , Pan Yao-jie , Huo Fu-chun , Du Wen-qi , Liang Jia , Li Lin , Wang Yang , Pei Dong-Sheng
Published: October 2020

Background: Kinase inhibitor sorafenib is the first-line targeted drug for advanced hepatocellular carcinoma (HCC) patients. However, the appearance of anti-cancer agents’ resistance has limited its therapeutic effect. Methods: In this study, quantitative real-time PCR (qPCR) and Western Blot were utilized to detect the levels of PAK5 in HCC sorafenib-resistant cells and their parental cells. The biological functions of miR-138-1-3p and PAK5 in sorafenib-resistant cells and their parental cells were explored by cell viability assay, plate colony formation assay and flow cytometric analysis. The potential mechanisms of PAK5 were evaluated via co-immunoprecipitation (co-IP), immunofluorescence, dual luciferase reporter assay and chromatin immunoprecipitation (ChIP). The effects of miR-138-1-3p and PAK5 on HCC sorafenib chemoresistant characteristics were investigated by a xenotransplantation model. Results: We detected significant down-regulation of miR-138-1-3p and up-regulation of PAK5 in HCC sorafenib resistance cell lines. Mechanical studies revealed that miR-138-1-3p reduced the protein expression of PAK5 by directly targeting the 3′-UTR of PAK5 mRNA. In addition, we verified that PAK5 elevated the phosphorylation and nuclear translocation of β-catenin that enhanced the transcriptional activity of multidrug resistance protein ABCB1. Conclusions: PAK5 contributed to the sorafenib chemoresistant characteristics of HCC by activity β-catenin/ABCB1 signaling pathway. Our findings identified the correlation between miR-138-1-3p and PAK5 and the molecular mechanisms of PAK5-mediated HCC sorafenib resistance, which provided a potential therapeutic target for advanced HCC patients.
Trauma In Children During Lockdown For SARS-CoV-2 Pandemic
Authors: Dibello Daniela , Salvemini Marcella , Colella Antonio , Amati Carlo , Pederiva Federica
Published: October 2020

Purpose The purpose of the work is to evaluate the differences between the routine accesses to Pediatric Emergency Room in a second level Children’s Hospital and the ones during an extraordinary event as the first month of the lockdown due to the Sars CoV 2 Pandemic in relation to types, sites and severity of Orthopaedic trauma, age, sex, and place in which the trauma occurred.Methods Authors compared retrospectively all children who had an access to the Emergency Room of Children Hospital Giovanni XXIII of Bari and then to Pediatric Orthopedic Unit during the first month of lockdown due to the Sars CoV 2, from March 10th 2020 to April 10th 2020, with the children that had an access to the same hospital from March 10th 2019 to April 10th 2019 for the sites, the types and the severity of the Orthopedic injuries.Results In 2019 there were 261 accesses to Emergency Room, in 2020 69: during lockdown the reduction was of 75%.The data were statistically significant about: the age, lower in 2020 during lockdown, (p<0.0001) and the worst prognosis of the lesions in the same period, 42.65% of fractures versus 28.05% (p<0003). No statistical evidence about sex, anatomical site of trauma and kind of lesion.Conclusions The volume of the accesses for trauma during lockdown decreased by 75%; this means that to avoid the potential risk of Covid’s infection in Hospital, only children with major trauma were brought there by parents, while the ones with contusions and sprains remained at home.
Serum lncRNA XIST has the Capacity to Serve as a Diagnostic Biomarker for Nasopharyngeal Carcinoma
Authors: Wang Lili , Song Hongguang , Yang Shiming
Published: October 2020

BackgroundLncRNA XIST (X-inactive specific transcript) is involved in various tumors. In this study, we aimed to investigate the diagnostic performance of serum lncRNA XIST in NPC.MethodsSerum samples were collected from 117 NPC patients and 80 gender and age matched healthy individuals. The relative expression of serum lncRNA XIST was detected by qRT-PCR. Chi-square test was applied to evaluate the relationship between lncRNA XIST expression and clinical characteristics. ROC analysis was performed to identify the feasibility of serum XIST as a diagnostic biomarker for NPC.ResultsSerum lncRNA XIST was higher in NPC patients than that in healthy volunteers (P<0.001). Furthermore, its elevated expression showed positive link with clinical stage (P=0.013), TNM stage (P=0.024), and lymph node metastasis (P=0.003). ROC curve demonstrated that lncRNA XIST could discriminate between NPC patients and healthy individuals, with the AUC value of 0.827. The cut-off value of serum XIST for NPC diagnosis was 3.735, with the sensitivity of 75.2% and specificity of 83.7%.ConclusionLncRNA XIST as an oncogene plays promoting roles in aggressive progression of NPC. Serum lncRNA XIST may be employed as a diagnostic biomarker for NPC.
Protein-Protein Interaction Analysis Reveals A Novel Cancer Stem Cell Related Target TMEM17 in Colorectal Cancer
Authors: Yu Zhaoliang , Chen Yu-feng , Zheng Bin , Cai Ze-rong , Zou Yi-feng , Ke Jia , Lan Ping , Gao Feng , Wu Xiao-jian
Published: October 2020

Background Cancer stem cells (CSCs) have been increasingly reported for tumour recurrence and chemoresistance in colorectal cancer (CRC). However, it is still lack of effective therapy on CSCs. Methods Here we describe a two-step strategy to generate CSC targets with high selectivity for colon stem cell markers, consisting in first step to generate specific proteins interacted CSC markers and second step to validate in survival analysis. TMEM17 was found and further investigated its biological functions in CRC cells. Finally, we utilized the Gene Set Enrichment Analysis (GSEA) to dig the potential mechanisms of TMEM17 in CRC.Results By combining protein-protein interaction (PPI) database and high-throughput gene profiles, network analysis revealed a cluster of colon CSCs related genes. In the cluster, TMEM17 was identified as a novel CSCs related gene. In vitro functional study, our results show that TMEM17 depletion can suppress cell proliferation and sensitize chemotherapy drugs to CRC cells. Enrichment analysis of differentially expressed genes was conducted using GSEA algorithm, Wnt/β-catenin pathway was found to be associated with TMEM17 expression. Further validation in clinical samples revealed TMEM17 expression was much higher in tumour than normal tissue and it was associated with poor survival in CRC patients. Conclusion Collectively, our finding unveils the critical role of TMEM17 in CRC and targeting TMEM17 is potential effective therapeutic for CRC patients.
Restless legs syndrome is a risk factor for major depressive disorder: a systematic review and meta-analysis
Authors: Zhang Haiwang , Zhou Changxi , Jin Shuai , Liu Xingde , Li Song , Zablah Youssif Ben , Merovitch Neil , Xia Kaide , Li Peng , Xia Guangyuan , Wang Junwen , Kang Xiaohong , Wang Yiming
Published: October 2020

A significant association between major depressive disorder (MDD) and restless legs syndrome (RLS), but RLS prevalence is dramatically different among MDD individuals across studies. Our present work aimed to comprehensively evaluate available evidences to determine the role of RLS in MDD. PubMed, Web of Science, Embase, Science Online, Wip Chinese Biomedical Journal, Wanfang and Chinese National Knowledge Infrastructure were searched to identify observational and case-control studies relevant to RLS and MDD. Stata 12.0 software was used for meta-analysis. RLS individuals exhibited a higher risk of MDD than non-RLS controls (OR 2.05, 95%CI 1.80–2.33; p<0.05). No significant differences were found in MDD prevalence between young RLS patients (OR 2.10, 95%CI 1.72–2.56) and older RLS patients (OR 2.02, 95%CI 1.70–2.39). In addition, no significant difference in MDD prevalence was evident between between Asian (OR 1.98, 95%CI 1.66–2.37) and European or American (OR 1.76, 95%CI 1.54–2.01) RLS patients. Our meta-analysis provides evidence that the risk for MDD is higher among RLS patients compared to non-RLS individuals suggesting that RLS may play an important role in MDD patheogenesis.
Risk of Major Bleeding by Ethnicity and Socioeconomic Deprivation among 488,107 People in Primary Care: A Cohort Study
Authors: Tse Wai Chung , Grey Corina , Harwood Matire , Jackson Rod , Kerr Andrew , Poppe Katrina , Mehta Suneela , Pylypchuk Romana , Wells Sue , Selak Vanessa
Published: October 2020

Background: Antithrombotic medication (antiplatelets and anticoagulants) reduce the risk of cardiovascular disease (CVD), but with the disadvantage of increasing bleeding risk. Ethnicity and socioeconomic deprivation are independent predictors of major bleeds among patients without CVD, but it is unclear whether they are also predictors of major bleeds among patients with CVD or atrial fibrillation (AF) after adjustment for clinical variables. Methods: Prospective cohort study of 488,107 people in New Zealand Primary Care (including 64,420 Māori, the indigenous people of New Zealand) aged 30-79 years who had their CVD risk assessed between 2007 and 2016. Participants were divided into three mutually exclusive subgroups: (1) AF with or without CVD (n=15,212), (2) CVD and no AF (n=43,790), (3) no CVD or AF (n=429,105). Adjusted hazards ratios (adjHRs) were estimated from Cox proportional hazards models predicting major bleeding risk for each of the three subgroups to determine whether ethnicity and socioeconomic deprivation are independent predictors of major bleeds in different cardiovascular risk groups . Results: In all three subgroups (AF, CVD, no CVD/AF), Māori (adjHR 1.63 [1.39-1.91], 1.24 [1.09-1.42], 1.57 [95% CI 1.45-1.70], respectively), Pacific people (adjHR 1.90 [1.58-2.28], 1.30 [1.12-1.51], 1.62 [95% CI 1.49-1.75], respectively) and Chinese people (adjHR 1.53 [1.08-2.16], 1.15 [0.90-1.47], 1.13 [95% CI 1.01-1.26], respectively) were at increased risk of a major bleed compared to Europeans, although for Chinese people the effect did not reach statistical significance in the CVD subgroup. Compared to Europeans, Māori and Pacific peoples were generally at increased risk of all bleed types (gastrointestinal, intracranial and other bleeds). An increased risk of intracranial bleeds was observed among Chinese and Other Asian people and, in the CVD and no CVD/AF subgroups, among Indian people. Increasing socioeconomic deprivation was also associated with increased risk of a major bleed in all three subgroups (adjHR 1.07 [95% CI 1.02-1.12, 1.07 [1.03-1.10], 1.10 [1.08-1.12], respectively, for each increase in socioeconomic deprivation quintile). Conclusion: Ethnicity and socioeconomic status should be considered in bleeding risk assessments to guide the use of antithrombotic medication for the management of AF and CVD. Primary Funding Source: The Health Research Council of New Zealand
Use of Quantitative CT Analysis to Evaluate the Degree of Lung Destruction in Lymphangioleiomyomatosis
Authors: Song Xixi , Wang Jian , Cai Hui , Yang Chengyu , Zhu Mengchan , Zhu Guiping , Ye Ling , Jin Meiling
Published: October 2020

Background: Lymphangioleiomyomatosis (LAM) is a multisystem disease that mainly presents with cystic damage in the lungs. The purpose of this study was to quantify the degree of pulmonary cystic damage in CT and to compare its correlation with pulmonary function tests (PFTs) and serum levels of vascular endothelial growth factor (VEGF-D). Subjects and methods: 21 patients were included and 36 CT scans and PFTs were analyzed. The correlation of serum VEGF-D levels of 17 patients and their 24 CT scans were studied. Cystic areas were identified by the software. The volumetric percentage of cystic regions of the total lung volume was calculated to get a cyst score. A ROC curve was calculated to select the threshold at which the cyst scores could predict the lung impairment best.Results: The cyst scores correlated best with FEV1%pred (r = -0.72, p<0.01) and DLCO%pred (r = -0.82, p<0.01). The correlation with serum VEGF-D levels (r = -0.143, p = 0.506) was not obvious. The Youden Index is max (0.667) when cyst score is 15.80%. Conclusion: The pulmonary cyst scores on CT is strongly correlated with FEV1%pred and DLCO%pred. However, the association with serum levels of VEGF-D is not obvious. Cyst score >15.80% might indicate an abnormal lung function and patients are recommended a sirolimus treatment.
Characteristics, Treatment Patterns, Healthcare Resource Use, and Costs among Pediatric Patients Diagnosed with Neurofibromatosis Type 1 and Plexiform Neurofibromas: A Retrospective Database Analysis of a Medicaid Population
Authors: Yang Xiaoqin , Desai Kaushal , Agrawal Neha , Mirchandani Kirti , Chatterjee Sagnik , Sarpong Eric , Sen Shuvayu
Published: October 2020

Background: Neurofibromatosis type 1 (NF1)-related plexiform neurofibromas (PN) can cause substantial morbidity by disfigurement and compression of vital structures. Real-world data on the burden and cost of disease among pediatric patients with NF1 and PN is limited. The objectives of this study were to describe the characteristics, treatment patterns, healthcare resource use (HCRU), and costs of these patients.Results: A total of 383 patients were included in the retrospective analysis of patients aged ≤18 with at least 1 ICD-10-CM diagnosis code for both NF1 and PN enrolled in the MarketScan® Multistate Medicaid database from October 1, 2014 to December 31, 2017. The mean follow-up was 448 days. The mean age was 11.4 years and 52.0% of patients were male. Most patients were diagnosed by a specialist (63.5%). During the follow-up period, pain medications were used by 58.5% of patients, 25.1% were treated with chemotherapy, 7.1% received surgery for PN, 1.6% received MEK inhibitors, and 0.8% received radiation. Mean per patient per year inpatient, outpatient, emergency room, pharmacy, and other visits were 1.4, 17.3, 1.6, 13.6, and 25.8, respectively. Mean ±SD (median) total per patient per year healthcare costs (2018 USD) were $17,275 ±$61,903 ($2,889), with total medical costs of $14,628 ±$56,203 ($2,334) and pharmacy costs of $2,646 ±$13,303 ($26). Inpatient costs were the largest drivers of medical cost, with a mean per patient per year cost of $6,739.Conclusions: This study showed that many pediatric patients diagnosed with NF1 and PN were treated with supportive care only, highlighting a substantial unmet medical need. This study also highlights the considerable economic burden among patients with NF1 and PN.
Triglycerides to High-density Lipoprotein Cholesterol Ratio is the Best Surrogate Marker for Insulin Resistance in Non-obese Middle-aged and Elderly Population: A Cross-sectional Study
Authors: Yang Yumei , Wang Baomin , Yuan Haoyue , Li Xiaomu
Published: October 2020

BackgroundInsulin resistance is closely associated with metabolic profiles, including obesity and dyslipidemia. However, there are few studies to demonstrate a relationship between lipid profiles and insulin resistance, categorized by BMI, especially in Chinese. The aim of the present study was to examine how lipid profiles were associated with insulin resistance in non-obese middle-aged and elderly Chinese population.MethodsThis cross-sectional study included 1608 (596 men and 1012 women) subjects, without prior known diabetes mellitus and lipid regulating therapy history, older than 45 years. Insulin resistance was defined by homeostasis model assessment of insulin resistance (HOMA-IR) of at least 2.5. The areas under the curve of the receiver operating characteristic curves (AROC) were used to compare the power of these serum markers. SPSS 17.0 software was used for the statistical analysis.ResultsIn non-obese subjects (BMI < 25 kg/m2, n= 996), triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (OR = 1.43, 95% CI 1.13-1.81, P = 0.003), and SBP (OR = 1.01, 95% CI 1.00-1.02, P = 0.03) were independently risk factors for the insulin resistance. The best marker for insulin resistance in non-obese subjects was triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio with the AROC of 0.73 (95% CI 0.68-0.77, P < 0.001), and the positive likelihood ratio was greatest for TG/HDL-C ratio in the metabolic profiles including BMI. The optimal cut-off point to identifying insulin resistance for TG/HDL-C ratio was ≥ 1.50 in the non-obese population. The BMI, TG, total cholesterol (TC)/HDL-C ratio and HDL-C also discriminated insulin resistance, as the values for AROC were 0.70 (95% CI 0.66-0.75, P < 0.001), 0.71 (95% CI 0.67-0.76, P < 0.001), 0.70 (95% CI 0.65-0.74, P < 0.001), 0.34 (95% CI 0.29-0.38, P < 0.001), respectively. In overweight subjects (BMI ≥ 25.0 kg/m2, n = 612), BMI was still the best marker for insulin resistance with the AROC of 0.65 (95% CI 0.60-0.69, P < 0.001). ConclusionsTG/HDL-C ratio may be the best reliable marker for insulin resistance in the non-obese population.
Economic Growth and the Optimal Size of the Public sector in Jordan
Authors: Aljaloudi Jameel A. , Warrad Taleb A.
Published: October 2020

The relationship between the size of public sector and the rate of economic growth has been widely examined empirically in different countries. Most applied studies confirmed the validity of the inverse relationship between the increasing role of the state in the economy, measured by the ratio of public spending to gross domestic product and rates of economic growth. These studies estimated the optimum rate that would guarantee achieving the highest economic growth rates. This study aims to analyses this relationship for the case of the Jordanian economy. Using a theoretically justified econometric model, the researchers have utilized an ARDL econometric technique to quantitatively assess this relationship for the period (1970-2018). The study relied on official data related to the gross domestic product published by the Central Bank of Jordan and official data related to public spending and public revenues published by the Jordanian Ministry of Finance. The econometric results of the study confirm the existence of an inverse relationship between the size of public sector and the rate of economic growth in Jordan, which may lend support to the hypothesis of the Armey curve. The optimal size of the government (public sector) is estimated to be about 26 percent, which is much lower than the actual average government size in Jordan. The researchers recommend the need to gradually cutting down the size of public sector through adjusting the real spending structure and restructuring the independent public institutions. The restructuring of independent public institutions requires the abolition of institutions that are not economically feasible and constitute more financial burdens on society on the one hand, and the merging of a number of them into an independent public institution that provides its services to the community in an efficient and effective manner. Researchers also recommend the need to continue privatizing the public sector and activating the role of partnership between the public and private sectors.

Keywords: size of public sector, government spending, economic growth, ARDL, privatization.
ALGORITHM FOR EARLY CANCER DETECTION IN CHILDREN
Authors: Rykov M. Yu. , Manerova O. A. , Turabov I. A. , Kozlov V. V. , Reshetnikov V. A.
Published: October 2020

Background. Over the past decades, there has been a steady increase in the incidence of childhood cancer. The most childhood cancers are detected at advanced stages. The incidence of childhood cancer increased by 12.8 % (from 11.7 per 100,000 in 2007 to 13.2 per 100,000 in 2017) and the prevalence increased by 37.9 % (from 63.9 in 2007 to 88.1 in 2017 per 100,000). The purpose of the study was to develop algorithms for early cancer detection in children.

Material and Methods. In the Arkhangelsk region, the algorithm for referring a patient to a consultation with a pediatric oncologist was introduced into pediatric clinical practice in 2016. To evaluate the effectiveness of the algorithm, we compared two groups of patients with histologically verified solid malignant neoplasms. Group I included 49 patients, who received treatment in 2011–15 (before performing the experiment), and group II consisted of 51 patients, who received treatment in the Department of Pediatric Oncology in 2016–18 (the control group).

Results. The use of the algorithm for referring a patient to a consultation with a pediatric oncologist led to the increase in the 3-year survival time from 25.04 ± 2.05 months to 30.3 ± 1.57 months (р=0,045). The time parameters of various stages preceding the start of specialized treatment were statistically significantly reduced: the time from the visit of a pediatric oncologist to verification of the diagnosis decreased from 9.0 (7.0; 14.0) to 7.0 (5.0; 9, 0) days (p˂0.001); the time from diagnosis verification to the beginning of specialized treatment – from 12.0 (8.0; 16.0) to 8.0 (6.0; 10.0) days (p˂0.001); the time from the visit of a pediatrician to referral to a pediatric oncologist – from 11.0 (6.0; 17.0) to 2.0 (1.0; 3.0) days (p˂0.001); the time from the visit of a pediatrician until the beginning of specialized treatment – from 23.0 (17.0; 32.0) to 9.0 (8.0; 12.0) days (p˂0.001).

Conclusion. The introduction of a structural and functional model for organizing medical care for children with cancer was shown to be effective.
NEUROENDOCRINE TUMORS OF THE CERVIX
Authors: Safronova K. V. , Artemieva A. S. , Nuganen A. O. , Kutusheva G. F. , Chuglova D. A. , Mikaya N. A. , Berlev I. V. , Urmancheeva A. F. , Belyaev A. M. , Ulrich E. A.
Published: October 2020

The purpose of the study was to summarize the available data on etiology, diagnosis, clinical symptoms and signs as well as on various approaches to the treatment of neuroendocrine cervical tumors.

Material and Methods. The relevant sources were searched in the PubMed and cochrane Library systems, and publications from 1980 to 2019 were analyzed, 53 of which were used to write this review. We also included 6 case reports from N.N. Petrov National Research Center of Oncology.

Results. Neuroendocrine tumors (NETs) are extremely rare and aggressive malignancies of the female genital tract, among which NETs of the cervix are the most common. Due to the rarity of these tumors, there are currently no treatment standards based on prospective, well-planned clinical trials. For these reasons, NETs present a significant therapeutic challenge for clinicians. Case reports. Six patients ranged in age from 32 to 71 years, with a median age of 46 years, were diagnosed with large-cell neuroendocrine carcinoma (4 patients) and small-cell neuroendocrine carcinoma (2 patients). One patient with stage IIIA dropped out of the follow-up schedule. Out of 5 followed up patients, 2 patients with stage IIIA and IIB died of disease progression after 6 and 11 months, respectively. One patient with stage IB1 is in remission for 16 months. Two patients with stage IIB continue to receive primary treatment.

Conclusion. Neuroendocrine carcinoma of the cervix is a rare variant of cervical cancer. The choice of treatment options is decided only by a multidisciplinary team of doctors, and further research is required.
Balance de la universidad peruana de la segunda mitad del siglo XX
Authors: Zevallos Vera Manuel
Published: October 2020

No tiene
Narcotráfico: la experiencia peruana
Authors: Calderón Navarro Nelly
Published: October 2020

No tiene
El secuestro y el escándalo
Authors: Cáceres Velásquez Artidoro
Published: October 2020

No tiene
Inversión privada bajo concesión en el Perú
Authors: Taquía Gutiérrez Roxana
Published: October 2020

No tiene
Proceso de Elaboración de la Ley de Procedimiento Administrativo General
Authors: Tovar Cerquen Martín
Published: October 2020

No tiene
Los docentes de Derecho de la UAP van camino a la excelencia
Authors: Bonino J. Nieves Ítalo Victorio
Published: October 2020

No tiene
La Reforma constitucional referida a la defensa nacional
Authors: Chanamé Orbe Raúl
Published: October 2020

NO TIENE
La universidad y el abogado
Authors: Peláez Pérez Luis Alberto
Published: October 2020

NO TIENE
La justicia
Authors: Hinojosa Uchofen Carlos
Published: October 2020

NO TIENE
COPER , Un modelo de dirección para liderar el camino organizacional del Perú
Authors: Espinar Torres Fernando Antonio
Published: October 2020

NO TIENE
El derecho desde la perspectiva de la Literatura
Authors: Távara Córdova Francisco
Published: October 2020

NO TIENE
El Hábeas Corpus en el Perú
Authors: Alva Orlandini Javier
Published: October 2020

NO TIENE
Factores para determinar la verosimilitud del derecho invocado en las medidas cautelares
Authors: Salas Villalobos Sergio R.
Published: October 2020

NO TIENE
PRINCIPIO PRECAUTORIO
Authors: Cafferatta Nestor A.
Published: October 2020

NO TIENE
LA SOCIEDAD CONTEMPORANEA Y SU ENEMIGO EL NO-DERECHO PENAL
Authors: Momethiano Santiago Javier Ysrael
Published: October 2020

NO TIENE
UNA BREVE APROXIMACIÓN DEL PRINCIPIO DE OPORTUNIDAD EN EL PROCESO PENAL PERUANO
Authors: Santiago Jimenez Ana María
Published: October 2020

NO TIENE
DEMOCRACIA VIVA Y LIBERTAD DE PRENSA
Authors: Mejía Alarcón Roberto
Published: October 2020

NO TIENE
EL CONTROL DIFUSO DE IA CONSTITUCIONALIDAD DI LAS NORMAS JURÍDICAS
Authors: Pérez Unzueta Karla
Published: October 2020

NO TIENE
DESARROLLO DE LAS COMPETENCIAS EN EDUCACIÓN SUPERIOR
Authors: Del Aguila Riva René
Published: October 2020

NO TIENE
BIOGRAFÍA, ABOGADOS DE AYER Y HOY: HERNANDO DE LA VALLE Y GARCÍA
Authors: Del Solar Rojas Francisco José
Published: October 2020

NO TIENE
El Tribunal Constitucional como poder político
Authors: Häberle Peter
Published: October 2020

NO TIENE
La Integración Supranacional y su Impacto en Estados con Estructura Completa
Authors: Bazán Víctor
Published: October 2020

NO TIENE
Palabras del Rector
Authors: Ramírez Prado Fidel
Published: October 2020

NO TIENE
Palabras del Decano
Authors: Díaz Bazán Ricardo Alfredo
Published: October 2020

NO TIENE
Naturaleza jurídica de los Derechos Humanos en el régimen de excepción como una garantía del Estado de Derecho
Authors: Muñoz Pantigoso Wagner
Published: October 2020

NO TIENE
Aportes de la Dactiloscopia en la identificación humana utilizados en la investigación criminal y judicial
Authors: Pebe Pebe Grimaldo Tomás
Published: October 2020

NO TIENE
La libertad de empresa y la Universidad Alas Peruanas análisis de la prohibición de filiales universitarias
Authors: Armas Alvarado Christian
Published: October 2020

NO TIENE
El rol ideológico de los conceptos en la historia conceptual de Reinhart Koselleck
Authors: Serey Aguilera Juan Osvaldo
Published: October 2020

En este artículo analizamos los supuestos de la historia conceptual de Reinhart Koselleck, de cara a la cual se sostiene que el orden conceptual opera a través de la constitución de campos semánticos que obtienen su contenido de los diversos horizontes de expectativas y experiencias en que se encuentran. Sin embargo, esta relación es problemática, pues Koselleck no explora el fundamento ideológico que ejerce presión desde el orden extralingüístico hacia el orden conceptual, mostrando un aspecto que afecta la constitución de la historia conceptual como disciplina que ponga en cuestión sus propios fundamentos. Por ello sostenemos que la noción de control semántico, que es ejercido por las ideologías, que determinan la primacía de ciertos contenidos semánticos sobre otros, permite poner de relieve y solucionar este problema.
La praxeología en los estudios del desarrollo (humano): lineamientos para una visión hegeliana
Authors: Jiménez-Castillo Manuel A.
Published: October 2020

Aceptar la praxeología en Mises como método para predecirel desenvolvimiento del desarrollo humano es profundamentecontrovertido y no está exento de problemas analíticos ynormativos. La incapacidad para sustraerse de los llamados juicios autoevidentes se une al rechazo de aquellos elementos que condicionan como un todo su operatividad. Sometido a un concepto estrecho de bienestar (desautorizado para distinguir entre acción y actuación), queda invalidado para realizar comparaciones interpersonales, por lo que es desacreditado para asumir una teoría de justicia social que sea tanto imparcial como plural. El sistema hegeliano penetra, en cambio, con fuerza, pone orden y perfecciona la interpretación praxeológica de lo económico desde sus dimensiones operativa y normativa.
Sobre un argumento en contra de la combinación de anti-realismo modal de re y realismo sobre objetos
Authors: González Varela José Edgar
Published: October 2020

Algunos filósofos piensan que el anti-realismo sobre la necesidad de re implica anti-realismo sobre la individuación e identidad de objetos. En este trabajo me ocupo de un argumento a favor de esta tesis, debido a Sidelle (2010), según el cual la única manera en que un convencionalista modal de re puede evitar ser refutado por un conocido argumento basado en la contingencia de las convenciones es aceptando también un convencionalismo sobre objetos. Muestro que el argumento de Sidelle no es exitoso y, de esta manera, muestro que la combinación de anti-realismo modal de re y realismo sobre objetos no se ve amenazada, al menos, por esta vía.
CONSTRUCTION OF A LOW-COST POLARIMETER FOR EDUCATIONAL PURPOSES
Authors: Camara Claudio
Published: October 2020

This paper describes the construction of a polarimeter for the identification of chemical substances. The device was built with low-cost materials, measures the phenomenon of optical activity and has educational applicability. The measurement of optical activity is achieved through the measurement of the resulting polarized radiation in a photodiode connected to a voltmeter after passing through polarizing and analyzing filters.
The Life of Hunters in the Chita Region: Effect of Organizational and Technical Problems on Fur Trade (1930s – early 1990s)
Authors: Bespalko D. N.
Published: October 2020

The research featured the effect of household problems of hunters in the Chita region on the fur trade in Soviet Russia. It focused on their everyday life during the hunting season: supply chain, hunting and taiga infrastructure, shared camp property, specialized equipment and food, etc. The study was based on archival sources, reports of hunting expeditions, and memories of hunters. The author defined two stages of organizational and technical arrangement of hunting life in the conditions of the mountain taiga. The first stage lasted from 1930s to early 1950s. The woodlands were socialized, and individual form of exploitation of fishing grounds replaced the group one, which inevitably complicated the organizational and technical issues. The supply system worked intermittently, and no one was in charge of the land development. As a result, the quantitative indicators were low. During the second stage (1950s – early 1990s), the local hunting management improved radically. The hunting areas were officially distributed among collective farms and hunting teams. The newly established chain “procurement – farm – hunter” improved both the living conditions of the hunting population and increased the amount of furs and skins.
Karasor-2 Site in the Upper Tobol
Authors: Podzuban E. V.
Published: October 2020

The present article introduces a collection of prehistoric material culture finds obtained at the Karasor-2 site during a stationary study of the Karasor archaeological site in 1998. A group of Karasor monuments is located near the town of Lisakovsk in the Upper Tobol river valley, which is in the northern Turgai depression. The territory of the Turgai depression connects the West Siberian and Turan plains. The Turgai depression borders on the Trans-Ural Plateau in the west and on the Kazakh hillocky area and the spur of the Ulutau mountains in the east. The local nature and geography destroy the cultural layer on the monuments. Thus, the finds represented by fragments of ceramics and stone products at the Karasor-2 site were collected from the surface, as the cultural layer had been destroyed. The article gives descriptive characteristics of the ceramics, while the stone tools were studied with the technical and typological method. Since the ceramic fragments are too small, the dating and cultural affiliation of the artifacts was based on the results of the technical and typological analysis of the stone tools. Most likely, the stone finds date back to the Mesolithic and Late Eneolithic periods. Most tools are similar to the stone industry of the Tersek culture and belong to the Eneolithic Age. The author believes that the time range of the stone tools and ceramics is from the Late Mesolithic to the Bronze Age.