bluuebunny/crossref_metadata_2025 huggingface dataset:
THE FEATURES OF MEDICAL CARE TO FOREIGN CITIZENS STUDYING IN RUSSIAN UNIVERSITIES
Authors: Khodorovich Maxim A. , Fomina A. V
Published: March 2020

This article discusses the main issues of legislative and legal aspects of the provision of primary health care, emergency, including specialized medical care to foreign citizens who are studding in state, municipal and non-state organizations of higher education of the Russian Federation on various programs. The paper comprehensively analyzes the legal nuances of medical support for foreign students compared to their Russian counterparts. The rights and obligations of foreign citizens studying in Russian universities, as well as the possibilities for them to receive full medical care in the Russian Federation are described in detail and step by step. According to the results of the analysis, the authors propose a number of measures for the possibility of equal medical care for foreign students in relation to their Russian colleagues. The analysis was based on regulatory documentation on this topic.
POSSIBILITIES FOR RISK ASSESSING IN PATIENTS WITH ACUTE CORONARY SYNDROME OLDER THAN 75 YEARS
Authors: Zubova E. A , Brazhnik V. A , Minushkina Larisa O. , Zateyshchikov D. A
Published: March 2020

The aim of the study was to assess the possibility of using risk assessment scales for adverse outcomes in patients with acute coronary syndrome (ACS) of older age groups. Materials and methods. The study included 988 patients with ACS who were followed up within 1 year after discharge from the hospital as part of the ORACLE II study. The average age of patients was 61.7±4.22 years, 582 (58.9%) men, 405 (40.1%) women. Results of the study: Within 1 year of observation, death from any causes was recorded in 52 (8.2%) patients younger than 75 years old and in 89 (26.6%) patients older than 74 years; coronary outcomes - in 80 patients (12.4%) under the age of 75 years and in 80 patients (23.3%) aged 75 years and older. Any adverse outcome, including atherothrombotic events and bleeding, was recorded during the year in 148 (43.1%) patients of the older age group and in 211 (32.7%) patients under 75 years of age. In patients younger than 75 years, when predicting the risk of death using the GRACE risk score, the area under the ROC curve was 0.794, in the group of patients over 75 years old it was only 0.575, which indicates a low diagnostic value. Similar data were obtained regarding the risk of coronary events. The Russian RECORD scale had the best predictive ability with respect to the prognosis of mortality in patients older than 75 years. the area under the ROC curve was 0.691, as well as in predicting repeated ischemic events in both subgroups. Conclusions: widely used scales for assessing the prognosis of mortality and recurring ischemic events, which well predict the prognosis in patients under 75 years of age in a group of patients older than 75 years have low prognostic value. The highest score in the older age group may have a risk score scale RECORD.
EFFECT OF AMINOGUANIDINE ON CATARACTOGENESIS IN EXPERIMENTAL DIABETES MELLITUS
Authors: Spasov A. A , Govorova Yulia A. , Naumehko L. V , Babkov D. A , Taran A. S , Smirnov A. B , Velikorodnaya Yu. I
Published: March 2020

Nonenzymatic glycosylation of lens proteins in diabetes mellitus is one of the pathogenetic mechanisms of cataract formation. According to the results of this study, aminoguanidine, which has anti-glycation activity, inhibits cataractogenesis in experimental diabetes. Laboratory animals with streptozotocin-induced diabetes mellitus treated with aminoguanidine showed less clouding in the lenses, and the content of advanced glycation end products, in particular, carboxymethyllysine, in the lenses was found to be reduced compared to the same parameters in animals from the control diabetic group.
AN INDIRECT PATHWAY FOR GENETIC INFLUENCE ON THE FORMATION OF THE CEREBRAL PALSY PHENOTYPE: GENOME AND HYPOXIA TOLERANCE
Authors: Sokolov P. L , Prityko A. G , Chebanenko Natal’ya V. , Romanov P. A.I
Published: March 2020

The incidence of cerebral palsy is increasing. In 70% of cases, the disease develops as a result of exposure to known pathogenesis factors, such as hypoxia-ischemia, infectious, toxic, and traumatic damage to the fetus. In 30% of cases of the disease, the effect of pathogenetic factors is absent. This determines the relevance of the search for genetic anomalies responsible for the formation of this phenotype. Many genome disorders associated with the development of the cerebral palsy phenotype have been identified. Of particular interest is the indirect influence of genetic factors of pathogenesis, affecting the formation of the disease indirectly, through the mechanisms of formation of hypoxic-ischemic brain damage. Such factors affect almost all stages of the “ischemic cascade”: the formation of a “glutamate shock”, the realization of a “glutamate shock” by cytokines, the defect of the antioxidant defense of a neuron, the realization of the cytotoxic effect of nitric oxide (NO), and the stimulation of apoptosis of neurons and microglia. This makes it possible to identify genome variants that determine the tolerance of the child’s brain to hypoxic-ischemic damage. The combination of carriers of such anomalies into risk groups will make it possible to differentiate the tactics of their observation in the natal and postnatal periods in order to reduce the likelihood of the formation of severe hypoxic-ischemic lesions of the central nervous system and cerebral palsy. Today, a large amount of scientific data has been accumulated on the molecular genetic mechanisms of the pathogenesis of perinatal brain lesions. Such as epigenetic, transcriptome gene expression control mechanisms via micro-RNA. The available information allows us to experimentally develop new methods for protecting the fetal brain from hypoxia-ischemia and stopping the effects of hypoxia-ischemia in the neonatal period.
Enseñanza de la(s) lengua(s) en Colombia desde una perspectiva glotopolítica
Authors: Cisneros Estupiñan Mireya , Mahecha Miguel Ángel
Published: March 2020

En este artículo se presentan reflexiones glotopolíticas en relación con el plurilingüismo y el bilingüismo en Colombia, así como las particularidades de una aproximación tanto sociolingüística como glotopolítica. También se plantea la necesidad de implementar en nuestro país una política y una planificación lingüísticas fundamentadas en criterios glotopolíticos que permitan el desarrollo equitativo de las lenguas que forman parte de la realidad social, cultural y cotidiana en Colombia.
Cerrahi olarak menopoz oluşturulmuş sıçanlarda melatonin tedavisinin östrojen, progesteron ve vitamin D’nin serum düzeylerine etkisi
Authors: GÜRLER Esra Bihter , ÇAĞLAYAN YEĞEN Berrak
Published: March 2020

Amaç: Bifosfonatlar menopoz sonrası osteoporozda kemik kütlesinin korunması amacıyla sıklıkla kullanılmaktadır. Melatonin kemik metabolizmasında da düzenleyici rolü olduğu düşünülen bir antioksidan hormondur. Ancak seks hormonları ve Vitamin D düzeylerine etkisi daha önce çalışılmamıştır.
Gereç ve Yöntem: Anestezi altında, Sprague-Dawley sıçanlara (n=40) bilateral overektomi (OVT) ve taklit cerrahi (n=8) uygulanmıştır. Cerrahiden dört hafta sonra OVT’li sıçanlar serum fizyolojik (1 ml/kg/gün), melatonin (25 mg/kg/gün), alendronat (70 μg/kg/hafta) veya melatonin + alendronat ile sekiz hafta tedavi edilmişlerdir. Sıçanlar dördüncü (n=8) ve 12. haftanın (n=12) sonunda kalpten kan alınarak sakrifiye edilmiştir.
Bulgular: Overektomiden sonraki dördüncü ve 12. haftalarda serum östrojen seviyelerindeki düşüş (p<0,05) melatoninle kontrol düzeyine dönmüştür (p<0,001). Ancak melatonin+alendronatla tedavi edilen gruplarda bir değişiklik görülmemiştir. Öte yandan, 12. haftanın sonunda OVT grubunda progesteron düzeylerinde bir değişiklik görülmezken, melatonin, alendronat veya kombine tedavi yapılan gruplarda anlamlı bir artış saptanmıştır (p<0,05-0,001). Seks hormon bağlayıcı globülin düzeylerinde OVT gruplarının hiçbirinde farklılık oluşmamış, fakat melatonin grubunda anlamlı olmayan bir yükseliş eğilimi gözlenmiştir. Benzer olarak, yalnızca melatonin tedavili grupta Vitamin D düzeylerinde anlamlı bir artış bulunmuştur. (p<0,01-0,001).
Sonuç: Bulgularımız melatoninin over-dışı seks hormonlarının ve Vitamin D’nin sentezinde bir rolü olduğunu düşündürmektedir. Melatoninin hormon replasman tedavisinde yeni bir terapötik ajan olarak kullanılabilmesi için klinik araştırmalara gereksinim vardır.
La creciente interacción entre la seguridad nacional y el comercio internacional: hacia una concreción del significado y alcance del artículo XXI GATT en tiempos de cambios tecnológicos y competencia geopolítica = National security and international trade: approaching the meaning and extent of article XXI GATT in times of technological changes and geostrategic competence
Authors: Esplugues Mota Carlos
Published: March 2020

Resumen: Tras años de fomento del libre comercio y de la globalización, las posiciones nacionalistas y unilateralistas comienzan a ganar terreno en la realidad internacional. En este entorno, el recurso a la noción de intereses esenciales de la seguridad del Estado y conceptos similares es usado de forma creciente para avalar la adopción de medidas proteccionistas frente a bienes y servicios provenientes del exterior. El artículo XXI GATT gana, así, un protagonista que le ha sido negado desde su redacción en la década de los cuarenta del siglo pasado. Carente de una práctica amplia y consistente, el precepto ha sido ahora objeto de interpretación por al órgano de resolución de controversias de la OMC. El presente artículo aborda la naturaleza y significado de este artículo, referente indiscutible para muchas de las cláusulas de excepción presentes en los distintos Tratados de Libre Comercio, y sus perspectivas de futuro en un entorno marcado por la crisis de la OMC.Palabras clave: Artículo XXI GATT, Intereses esenciales de la seguridad del Estado, Seguridad nacional, Comercio internacional, Guerra comercial.Abstract: International free trade and globalization have been heavily supported during the last decades. Nevertheless, nationalist and unilateralist positions are gaining ground in the international arena and free trade is currently under attack. Notions like “essential interests of state security” or “national security” are increasingly used to support the adoption of protectionist measures against goods and services coming from abroad. In this scenario, article XXI GATT is raising an increasing protagonist. The provision has historically lacked a broad and consistent practice but currently it has been interpretated by the WTO dispute resolution body. This article addresses the nature and meaning of article XXI GATT and its future role in an international trade environment characterized by the WTO crisis.Keywords: Article XXI GATT, Essential Security Interests of the State, National Security, International Trade, Trade War
La crisis de identidad del Derecho societario de la Unión Europea. Comentario al asunto Polbud y a cuestiones derivadas = The identity crisis of the European Union’s Corporate Law. A review on the Polbud case and derivated matters
Authors: González López José Antonio
Published: March 2020

Resumen: La regulación de la vida y muerte de las sociedades es una cuestión que corresponde a cada uno de los Estados miembros de la UE. Ante un quizás interesado desinterés armonizador, ha sido el TJUE el encargado de solventar en la medida de lo posible los problemas que, a la luz de la libertad de establecimiento, ha suscitado la mencionada falta de interés. En este trabajo se comenta de manera crítica la jurisprudencia del mencionado Tribunal y los problemas que evidencia. Tales problemas son, en esencia, las contradicciones entre las regulaciones societarias laxas y estrictas de los diferentes Estados miembros y la gran contradicción: las dos teorías contrapuestas para la determinación de la lex societatis que conviven en territorio europeo.Palabras clave: domicilio social, traslado, sede real, incorporación, empresa, compañía.Abstract: The regulation of life and death of companies is a competence of each EU member states. Due to a lack of interest in harmonizing, the CJEU has been in charge of solving the conflict between the freedom of establishment and the mentioned lack of interest. This paper contains a critical commentary of the case law of the CJEU and the problems that it shows. Such problems are basically the contradictions between the lax and strict corporate regulations of the different Member States and, also, the great contradiction: the two opposed theories for the regulation of the lex societatis that coexist in European territory.Keywords: registered office, transfer, real seat, incorporation, enterprise, company.
Building Capacity for Quality Assurance in Global Higher Education
Authors: E. Waller Robert , A. Lemoine Pamela , G. Mense Evan , D. Richardson Michael
Published: March 2020

As a result of changing missions, quality assurance in global higher education has ascended to the top of the higher education policy agenda in many nations. In order to hold universities accountable despite limited governmental support, many nations have adopted performance-based university funding strategies. Increasingly citizens and bureaucrats in many countries are asking more frequently what tangible benefits the society is receiving for the revenues being spent on higher education. The marketing, selling and financing of higher education has had both positive and negative effects on the future of global higher education because stakeholders are increasingly asking whether students are learning and whether institutions are providing a quality of service that justifies their cost. How do global higher education institutions develop and initiate techniques and programs to promote quality assurance for teaching and learning? Globalization and accountability create an atmosphere in higher education where knowledge and information are more vastly prized and more highly globalized than are localized economic concerns. Can quality assurance provide the framework for the implementation and development quality higher education in a climate of change and ambiguity?
The Development of Student Worksheets Based on Simulation Methods
Authors: Mispandi Mispandi , Mulyani Endang
Published: March 2020

This study aims to determine, the process of development, eligibility and student responses to student worksheets based on simulation methods. This type of research is Research and Development (R&D), using the Borg & Gall development model. The subjects of the study were students of class XI of SMA Negeri 1 Sambelia. The results showed that the results obtained were validated material, language, and design 3.44 with the appropriate category, and the students' response was 4.16 with the appropriate category. The results showed that the development of student worksheets based on simulation methods was feasible to use and influenced student learning outcomes in economic subjects. The contribution of research as a tool in the learning process for teachers and students in schools.
A Field Case Study of Managed Pressure Drilling in Offshore Ultra High-Pressure High-Temperature Exploration Well in the South China Sea
Authors: Yin Qishuai , Yang Jin , Li Zhong , Huang Yi , Luo Ming , Wang Bin , Tyagi Mayank , Xu Guoxian , Zhao Xin
Published: March 2020

The Y basin in the South China Sea has 15 trillion m3 of natural gas and represents typical ultra high-pressure high-temperature (ultra-HPHT) subsurface conditions, with the maximum bottomhole pressure (BHP) of 142 MPa (equivalent density = 2.38 sg), the highest bottomhole temperature (BHT) of 249°C at a depth of 5638 m, and an extremely narrow drilling mud density window. Therefore, there are several kinds of technical challenges during drilling operations. In recent years, managed pressure drilling (MPD) has been successfully applied in the basin with reduction of risks and well cost. Presented research focuses on a successful field case study of MPD in the Y basin.

The case study consisted of two parts: MPD operational designs and MPD operational procedures. MPD operational designs included two steps: the precise calculation of drilling fluid equivalent circulating density (ECD) and the optimization of operational parameters. Four models were used in calculating drilling fluid ECD: wellbore heat transfer model, drilling fluid equivalent static density (ESD) model, drilling fluid rheological property model, and incorporating the effects of cuttings in the pressure loss model. The second step included two key operational parameters: mud weight (MW) and surface backpressure (SBP). MPD operational procedures were performed in three steps: roles and responsibilities of key personnel during MPD operations, wellsite training program and emergency procedures. Emergency procedures included unexpected drilling events, downhole equipment failures, and surface equipment failures.

Taking X-1 Well as an example from the field case study, the following important observations were made. First, the MPD equipment was installed after remodeling of the drilling platform, installation of the wellhead assembly, and pressure testing of the MPD equipment. Next, the MW was set to 2.15 sg and the SBP was maintained at 525 psi while drilling the 8⅜ in. hole section on the basis of the operational design. In addition, the possible risks and corresponding preventive measures were taken into account and the MPD casedhole fingerprinting exercises were carried out. Finally, the MPD was successfully applied to X gas field featuring offshore ultra-HPHT. In addition, the dynamic formation integrity test (DFIT) and stripping out of hole with SBP were conducted. The well was successfully drilled in the narrow drilling mud density window of 0.05 sg without incidents and a sharp drop in the nonproductive time (NPT) was observed. Also, the casing structure was optimized from 7 to 5 strings with a significant reduction in the well cost and drilling time.
Phenotypes of Streptococcus mutans isolates in sound and cavitated tooth surfaces and its relationship to early childhood caries in China
Authors: Liu Shanshan , Li Huihui , Guo Zhenfei , Sun Yu , Zheng Qingwei , Hu Fuyong , Guan Junchang , Zhang Kai
Published: March 2020

The authors have withdrawn this preprint from Research Square.
The determinant of Antenatal Care Visits among Pregnant Women in Ethiopia
Authors: Fenta Setegn Muche
Published: March 2020

The authors have withdrawn this preprint from Research Square.
A tourism preference construction model based on complex network analysis
Authors: Zhong Lina , Deng Baolin , Rong Jackie , Dong Linfeng , Wang Haoyu , Kong Haoyu
Published: March 2020

The travel notes contain a wealth of tourists' behavior information, which provides a new way to study tourists' preferences. How to mine the text of online travel notes accurately and efficiently has become the key to research tourists' preferences. In this paper, the theory and technology of text mining were introduced into the research of tourists' preference through a large number of online travel notes accumulated on the Internet. The main research work of this paper was as follows: (1) The tourists' preference model was constructed by complex network method; (2) The travel notes data of Sanya tourists as an example was crawled and analyzed. In this paper, the theory of network travel data and text mining is introduced into the study of tourists' preferences, which not only improves the data quality of traditional preference research field, but also provides a new method for mastering tourists' preferences more accurately.
Spatial Distributions and Determinants of High-risk Fertility Behavior among Women in Ethiopia: Further Analysis from 2016 Ethiopia Demographic Health Survey
Authors: Tessema Zemenu Tadesse , Tamirat Koku Sisay
Published: March 2020

Background: High-risk fertility behavior associated with numerous unfavorable child and maternal health outcomes such as chronic undernutrition, anemia, and child mortality. Although different studies have been conducted to assess the magnitude and effects of high-risk fertility behaviors, there are limited shreds of evidence about the geographical distributions and determinants in Ethiopia. Therefore, this study aimed to assess the spatial distributions and determinants of high-risk fertility behavior among reproductive-age women in Ethiopia. Method: This study was based on secondary data analysis from the 2016 Ethiopia Demography and Health Survey. Information about 11,022 women who gave birth five years preceding the survey were extracted from the kid’s record (KR) file. For the spatial analysis ArcGIS 10.6 and Sat ScanTM 9.6, were used and for multilevel analysis, STATA 14.1 was used. Mixed effect Multivariable multilevel logistic regression model was fitted to identify determinants of high-risk fertility behavior.Result: More than three fourth (76.5%) with 95%CI (75.1 to 77.1) women had high-risk fertility behavior. From the spatial analysis, high-risk fertility behavior in Ethiopia geographically varies, the eastern and northern parts of the country such as Somalia and Tigray had an increased risk of fertility behavior. Primary education (AOR=0.71, 95% CI: 0.63 to 0.80) and secondary (AOR=0.73; 95% CI: 0.60 to 0.89), not ever used contraceptive (AOR=1.25, 95%CI: 1.12 1.40), unwanted pregnancy (AOR=1.40, 95%CI: 1.23 1.59), no ANC visit (AOR=1.19, 95%CI: 1.05 1.35), rural-dwelling (AOR=1.26, 95%CI: 1.04 1.51), regions of Ethiopia [Somalia (AOR=1.70,95%CI:1.24 2.32) and Amhara (AOR=0.72,95%CI:0.53 0.96)] were determinants of high risk fertility behavior.Conclusion: High-risk fertility behavior was significantly higher and geographical variations also noticed and the eastern and northern parts of the country were the hot spot areas. Education, rural residence, unwanted pregnancies, No ANC visit, and contraceptive use were determinants of high-risk fertility behavior. This suggests that areas with high-risk fertilities need special interventions to avert related complications.
Identification and Validation of an Individualized Autophagy-Clinical Prognostic Index in Gastric Cancer Patients
Authors: Jieping Qiu , Qiu Jieping , Sun Mengyu , Wang Yaoqun , Chen Bo
Published: March 2020

Background: The purpose of this study is to perform bioinformatics analysis of autophagy-related genes in gastric cancer, and to construct a multi-gene joint signature for predicting the prognosis of gastric cancer.Methods: GO and KEGG analysis were applied for differentially expressed autophagy-related genes in gastric cancer, and PPI network was constructed in Cytoscpae software. In order to optimize the prognosis evaluation system of gastric cancer, we established a prognosis model integrating autophagy-related genes. We used single factor Cox proportional risk regression analysis to screen genes related to prognosis from 222 autophagy-related genes in The Atlas Cancer Genome (TCGA) gastric cancer cohort. Then, the generated genes were applied to the Least Absolute Shrinkage and Selection Operator (LASSO). Finally, the selected genes were further included in the multivariate Cox proportional hazard regression analysis to establish the prognosis model. According to the median risk score, patients were divided into high-risk group and low-risk group, and survival analysis was conducted to evaluate the prognostic value of risk score. Finally, by combining clinical features and prognostic gene signatures, a nomogram was established to predict individual survival probability.Results: GO analysis showed that the 38 differently expressed autophagy-related genes was enriched in cell growth, neuron death, and regulation of cell growth. KEGG analysis showed that the 38 differently expressed autophagy-related genes were related to platinum drug resistance, apoptosis and p53 signaling pathway. The risk score was constructed based on 4 genes (GRID2, ATG4D,GABARAPL2, CXCR4), and gastric cancer patients were significantly divided into high-risk and low-risk groups according to overall survival. In multivariate Cox regression analysis, risk score was still an independent prognostic factor (HR = 1.922, 95% CI = 1.573-2.349, P < 0.001). Cumulative curve showed that the survival time of patients with low-risk score was significantly longer than that of patients with high-risk score (P < 0.001). The external data GSE62254 proved that nomograph had a great ability to evaluate the prognosis of individual gastric cancer patients.Conclusions: This study provides a potential prognostic marker for predicting the prognosis of GC patients and the molecular biology of GC autophagy.
Politicking with Health Care and Its Implications for the Attainment of Universal Health Coverage
Authors: Odii Aloysius , Ogbozor Pamela , Orjiakor Charles , Agwu Prince , Onwujekwe Obinna
Published: March 2020

Background Primary Health Centres (PHCs) are acknowledged key to the achievement of Universal Health Coverage (UHC) owing to their closeness to the grass-root and the constant patronage by low- and middle-income class citizens. An impediment to the efficiency of PHCs is the nature of politics on-going in its operation beginning from its physical construction, employment of staff, among others. This study provides evidence of politicking marring the efficiency of PHCs as well as possible solutions to the issue. Method The study was carried out in eight purposively selected PHC facilities drawn from three local government areas in Enugu State, southeast Nigeria. Data were collected using in-depth interviews (IDIs) and focus group discussions (FGDs). The IDIs involved sixteen participants that cut across frontline health workers, heads and supervisors of health units at the local governments, and chairpersons of the health facility committees (HFCCs). In addition, four FGDs were held with male and female service users of the facilities. Findings It was discovered that certain powerful community members influenced the locations of PHCs, even when the general community is disfavoured by such decision. Powerful group of persons equally influence the recruitment and sanctioning of healthcare staff. The consequences include weak patronage of the facilities and poor healthcare delivery. Of the several solutions, obtaining localised support from powerful persons in the community to enforce fairness featured strongly. Conclusions The politics around primary healthcare is a threat to the achievement of UHC, since it discourages patronage and encourages inefficiency of healthcare staff. To overcome this, there is the need to facilitate genuine participation of community members and implementing local actions and policies in the facilitation of PHCs, and also, rapidly addressing the excesses of powerful groups and individuals. Key words: Primary Health Centre; Politicking; Universal Health Coverage; Power; Politics
Leaky gut potentially leads to bacterial/endotoxin translocation in a rat model of non-ischemic acute kidney injury
Authors: Li Jiangtao , Moturi Krishna Rekha , Wang Lirui , Zhang Kun , Yu Ying , Liu Xi , Zhang Yingying , Yu Chen
Published: March 2020

Background: Emerging evidence indicates that there is a causal relationship between acute kidney injury (AKI) and gut barrier disruption. The aim of our study was to determine whether the translocation of gut-derived bacteria/endotoxin develops in non-ischemic AKI, and, if so, what is the mechanism behind it? Methods: SPF male Sprague-Dawley rats were randomly subjected to bilateral nephrectomy (BNx) or sham-operation and observed for 24 hours. Gut permeability was evaluated in vivo and in vitro. Serum endotoxin and bacterial loads in liver and mesenteric lymph nodes (MLN) were measured. The expression of the key tight junctions (TJs) in ileum, including zonula occluden-1(ZO-1), occludin and claudin-1 were evaluated by Western blot and immunohistochemical staining. The structure of TJs was observed using transmission electron microscopy. Apoptotic changes of ileal mucosa were evaluated by TUNEL staining and ELISA. Results: Non-ischemic AKI rats (rats subjected to BNx) demonstrated marked blunting and shortening of the gut villi. The gut mucosal permeability was increased in non-ischemic AKI rats, evidenced by the elevated serum levels of D-lactate and the increased amount of FITC-Dextran which passed through the ileum wall. Serum endotoxin was significantly elevated in non-ischemic AKI rats. Non-ischemic AKI rats had relatively higher bacterial loads in liver and MLN than sham-operated rats. For non-ischemic AKI rats, apoptosis of ileal mucosa was significantly accelerated. Neither the protein expression and the distribution pattern, nor the structure of the TJs was altered in non-ischemic AKI rats. Conclusion: Non-ischemic AKI results in profound gut barrier disruption and thus favors the subsequent episode of bacterial/endotoxin translocation. In this non-ischemic AKI model, the translocation of bacterial/endotoxin was not most likely due to a TJs mediated paracellular pathway.
Co-culture with leukemia cells decreases proliferation and increases chemoprotective capacity of normal mesenchymal stromal cells
Authors: Hou Ruixia , Yang Wanfang , Zhang Yaofang , Chen Xiuhua , Ren Fanggang , Xu Jing , Tan Yanhong , Xu Zhifang , Chang Jianmei , Wang Hongwei
Published: March 2020

Background Bone marrow mesenchymal stromal cells (BM-MSCs) are essential structural and functional components of the BM microenvironment and play an important role in acute myeloid leukemia (AML) pathogenesis. BM-MSCs isolated from AML patients (AML-MSCs) show distinct signatures from normal BM-MSCs. However, the exact abnormalities of AML-MSCs and the origin of these abnormalities are still unknown.Methods In this study, we evaluated the proliferative activity of AML-MSCs, and the influence of leukemia cells (LCs) on BM-MSCs. These two cell types were co-cultured using an in vitro co-culture system, and the biological functions of AML-MSCs, healthy donor derived MSCs (HD-MSCs), and LC-treated HD-MSCs (LCtrHD-MSCs) were compared by flow cytometry, and CCK-8 and chemotaxis assays. Student t-test (between two groups) and one-way ANOVA (more than 2 groups) were used to compare differences. Pearson correlation coefficients were used to assess correlations between two factors.Results AML-MSCs display a significant proliferative deficiency, which correlates with primary leukemic blast cell counts but not with patients’ age. Inhibition of BM-MSC proliferation could be induced by leukemia cells through direct contact. Co-cultured leukemia cells also increase expression of several inflammatory cytokines, and chemokines in BM-MSCs. Furthermore, LCtrHD-MSCs reduced apoptosis, and increased migration and chemoresistance in co-cultured AML cells, comparable with AML-MSCs.Conclusions Our results showed that leukemia cells can induce healthy donor derived BM-MSCs to exhibit AML-MSC-like characteristics and indicated that AML-MSC abnormalities may be partly induced by leukemia cells.
The value of TI-RADS combined with superb micro-vascular imagine in distinguishing benign and malignant thyroid nodules:a meta-analysis
Authors: Wang Cong , Hou Xiukun
Published: March 2020

This meta-analysis aimed to evaluate the value of thyroid imaging report and data system (TI-RADS) combined with superb micro-vascular imagine technique(SMI) in distinguishing benign and malignant thyroid nodules. We searched PubMed, Web of Science, Google Scholar, Cochrane Library, EBSCO, and CBM databases from inception through January 1st, 2015 without language restrictions. Meta-analysis was conducted using STATA version 14.0 and Meta-Disc version 1.4 softwares. We calculated the summary statistics for sensitivity(Sen), specificity(Spe), and receiver operating characteristic (SROC) curve. Six studies that met all inclusion criteria were included in this meta-analysis. A total of 408 thyroid malignant nodules and 496 thyroid benign nodules were assessed. All thyroid nodules were histologically confirmed after SMI. The pooled Sen and Spe of TI-RADS were 0.80(95%CI=0.71-0.87) and 0.82(95%CI=0.75-0.87); The pooled Sen and Spe of TI-RADS combined with SMI were 0.88 (95%CI=0.80-0.91) and 0.89 (95%CI=0.85-0.92). The areas under the SROC curve of TI-RADS and TI-RADS combined with SMI were 0.8874(SE=0.0165) and 0.9415(SE=0.0102), between which there was significant difference(Z=2.789; SE=0.0194; p =0.0053). Our meta-analysis indicates that TI-RADS combined with SMI may have high diagnostic accuracy, and is more effective than single TI-RADS in distinguishing benign and malignant thyroid nodules.
Obstetric Fistula: a retrospective study of 413 cases in Haut-Katanga Province, Democratic Republic of Congo
Authors: Nsambi Joseph B. , Mukuku Olivier , Kakudji Prosper L. , Andrianne Robert , Kakoma Jean-Baptiste S.Z.
Published: March 2020

Background: In developing countries, fistulae are generally caused by long obstructed labors. Obstetric fistula (OF) is a severe condition which can have devastating consequences for a woman’s life.This study aims to describe the socio-demographic and delivery characteristics of patients with OF in Haut-Katanga province in the Democratic Republic of Congo.Methods: This is a prospective descriptive study of 413 patients with OF in Haut-Katanga province during the period from September 2009 to December 2018.Results: At fistula occurrence, 53.3% of patients were younger than 20 years (mean age: 21.3 ± 6.7 years) and 65.8% were primiparous. More than half had primary education and 39.7% were illiterate; 70.2% of the patients were separated or divorced. Fistula developed after delivery at home in 239 (57.9%) of 413 women. A total of 393 (95.2%) women developed fistula after vaginal delivery. A total of 387 (93.7%) of the 413 women reported that the fetus did not survive the labor during which fistula developed. 92.3% had a vesico-vaginal fistula and the mean age of fistula was 6.5 years. Surgical repair was successful in 82.9%.Conclusion: Obstructed labor remains the most important cause of OF in Haut-Katanga. It is important to prevent OF arising from obstructive causes. The surgical treatment of OF will depend upon the type, size and location of fistula.
BRCA detection rate in an Italian cohort of luminal early-onset and triple-negative breast cancer patients without family history: when biology overcomes genealogy.
Authors: Toss Angela , Molinaro Eleonora , Venturelli Marta , Domati Federica , Marcheselli Luigi , Piana Simonetta , Barbieri Elena , Grandi Giovanni , Piombino Claudia , Marchi Isabella , Tenedini Elena , Tagliafico Enrico , Tazzioli Giovanni , Cortesi Laura
Published: March 2020

BACKGROUND: NCCN Guidelines recommend BRCA genetic testing in individuals with a probability >5% of being a carrier. This analysis aimed to evaluate the rate of BRCA mutations in triple-negative breast cancer (TNBC) patients diagnosed ≤60 years and luminal-like breast cancer (BC) patients diagnosed ≤35 without breast and/or ovarian family history. METHODS: 159 TNBC patients diagnosed ≤60 years and 109 luminal-like BC patients diagnosed ≤35 years without family history were retrospectively identified. Mutation prevalence and clinical-pathological characteristics associated with mutational status were evaluated. RESULTS: In TNBC patients, BRCA mutation prevalence was 22.6% (21.4% BRCA1 and 1.2% BRCA2). BRCA1-related TNBC patients were younger (p <0.001). Mutation prevalence was 64.2% ≤30 years, 31.8% in patients aged 31-40, 16.1% for those aged 41-50 and 7.9% for those between 51 and 60 years of age. A total of 40% of patients with estrogen receptor (ER) 1-9% were BRCA1 carriers. BRCA detection rate in early-onset BCs was 6.4% (1.8% BRCA1 and 4.6% BRCA2). Mutation prevalence was 0% 0-25 years, 9% 26-30 years and 6% 31-35 years. BRCA2-positive luminal-like early-onset BCs were more likely associated with low progesterone receptor (PR) expression (p = 0.049). CONCLUSIONS: BRCA genetic testing is recommended in TNBC diagnosed ≤ 60 years, regardless of cancer family history, histotype and by using immunohistochemical staining <10% of nuclei for both ER and/PR as a cut-off. In luminal-like early-onset BC patients, a lower BRCA detection rate was observed, suggesting a role for other predisposing genes.
Challenges of clinical chemistry analyzers utilization in public hospitals of selected zones of Oromia region, Ethiopia
Authors: Belete Rebuma Benti , Cheneke Waqtola Gebisa , Getachew Aklilu Mamo , Abdu Ahmedmemewer Seid
Published: March 2020

Background: The modern practice of clinical chemistry relies ever more heavily on automation. Their utilization in clinical laboratories of developing countries is greatly affected by many factors. Thus, identifying the different challenges relating to clinical chemistry automation utilization faced by laboratories is important to work on and resolve. Method: Cross-sectional study was conducted in 15 public hospitals found in Southwest Shoa, Jimma, Ilubabor and Buno-Bedele zones of Oromia region, Ethiopia from January 28 to March 15, 2019. Sixty eight key informants and ninety three laboratorians who were working in the clinical chemistry section were included in the study. Data were collected by self-administered questionnaires, indepth interviews and observation. The quantitative data were analyzed by simple descriptive statistics using SPSS 25.0 whereas qualitative data were analyzed manually. Results: There were 14 different models of clinical chemistry analyzers. More than two-thirds of analyzers were out-of-service. In another way, only 14 (15.1%) of the laboratorians had received user training of clinical chemistry analyzers. Majority of the laboratories were suffered from clinical chemistry reagents shortage. There were also inappropriate procurement processes of the clinical chemistry analyzers, misuse and underuse of clinical chemistry tests. Conclusion: The survey and interviews specified six major challenges that seriously obstruct utilization of clinical chemistry analyzers. Keywords: Challenges; analyzers utilization; clinical chemistry analyzers; automation.
Changes of Three kinds of miRNAs, MALAT1 and PI3K/AKT/mTOR signaling pathway Protein Levels in Her-2 Positive Breast Cancer in neoadjuvant chemotherapy and their relationship with prognosis- -A small sample study report
Authors: Hongcan Zhao , xiping zhang
Published: March 2020

Objective To investigate the roles of three kinds of miRNAs (MiR-99a, MiR-455 and MiR-143), Lnc MALAT1 and related proteins of PI3K/AKT/mTOR signaling pathway in neoadjuvant chemotherapy of patients with Her-2 positive breast cancer (BC) and analysed their related mechanisms. Method The frozen tumor tissue and serum samples before and after neoadjuvant chemotherapy of 14 cases patients with Her-2 positive BC who received neoadjuvant chemotherapy were collected. The relative expressions level of MiR-99a, MiR-455, MiR-143, MALAT1 and related proteins of PI3K/AKT/mTOR signaling pathway in tumor tissue and a part of serum samples were detected by qRT-PCR or western blot. Results MiR-99a level was negatively correlated with RFS and OS before and after chemotherapy. MiR-99a and MiR-455 levels after chemotherapy was negatively correlated with OS. The serum MALAT1 level was negatively correlated with RFS and OS in chemosensitivity group before and after chemotherapy. In chemotherapy resistance group, p-AKT level before chemotherapy was negatively correlated with T stage, p-mTOR level after chemotherapy was positively correlated with lymph node stage and negatively correlated with RFS and OS, PTEN level was negatively correlated with clinical TNM stage. Conclusion Serum MALAT1 and MiR-99a, MiR-455, MiR-143, p-AKT, p-mTOR and PTEN of tumor tissues in Her-2 positive BC patients can be used as markers to judge neoadjuvant chemotherapy sensitivity in Her-2 positive BC. Chemotherapy resistance is may be related to PI3K/AKT/mTOR signaling pathway.
The Tunica vaginalis testis metastasis as the first clinical manifestation of pancreatic adenocarcinoma: a case report and and literature review
Authors: zhang yongrui , guo kaimin , ma dongkai , gao baoshan , an wei , fu yaowen
Published: March 2020

Background: Metastases from pancreas or ampullary malignancies are common, but spread to the testicle and paratesticular tissue is exceedingly rare. To our knowledge, few than 30 cases have been previously reported in the literature. More rarely, it is to be found with tunica vaginalis testis metastasis without involvement of testicle and epididymis. Case presentation: A 65-year-male with complaints of left painless scrotal swellings for over 1 week was referred to the Department of Urology . Scrotal ultrasound demonstrated a left sided hydrocele with paratesticular masses.The chest computed tomography showed lung metastases and left enlarged supraclavicular lymph node. The preoperative diagnosis was left testicular tumor with lung metastasis.Then, a left radical orchidectomy was performed with high ligation of the spermatic cord and postoperative histopathology showed that it was suggestive of metastatic tumors. Abdominal computed tomography revealed the presence of a tumor in the tail of the pancreas. Tumor markers cancer antigen CA 19-9 were elevated almost 6-fold levels. The outcome of this patient was unsatisfactory and died 3 months later. Conclusions: This case highlighted that metastatic carcinoma from the pancreas must be considered in the differential diagnosis of scrotal enlargement. Older patient age is suggestive of a secondary testicular tumor. In addition, careful clinical and radiological examination has become the imaging modality.
Breaking through the barriers to recruit research participants in community settings: a qualitative exploration using the Theoretical Domains Framework and Behaviour Change Wheel
Authors: Rose Jennie , Akister Jane , Maxton Fiona , Redsell Sarah Anne
Published: March 2020

Background Recruitment of pregnant or postnatal women and young families into health research is a challenge. Community midwives and health visitors are well placed to invite service users to participate, but evidence suggests that they do not always invite all potentially eligible service users. Our aim was to use the Theoretical Domains Framework to explore health visitors’ and community midwives’ perceived barriers and enablers to approaching service users about participation in research and to use the Behaviour Change Wheel to suggest theory-based strategies to improve future recruitment. Methods Health visitors and community midwives working in four NHS Trusts and one community partnership in England were invited to complete an anonymous, online survey. The sample comprised health visitors (n=39) and community midwives (n=22). Qualitative data from open-ended questions about recruitment behaviour informed by the Theoretical Domains Framework were analysed using directed content analysis and inductive coding to identify salient Theoretical Domains Framework domains and specific barriers and enablers. Strategies to address these barriers and enablers were identified using the Behaviour Change Wheel. Results Six key Theoretical Domains Framework domains were identified as salient to service user approach: (a) environmental context and resources; (b) social/professional role and identity; (c) social influences; (d) goals; (e) beliefs about capabilities; (f) knowledge. Intervention strategies were identified to address specific barriers (insufficient time and staff capacity, inadequate study materials, rejection of the study’s relevance to practitioners’ role, negative influence of researchers and managers, and competing priorities) and to leverage specific enablers (additional staff resource, the relevance of service user approach to professional role, positive influence of team members, managers and researchers, and a belief in the link between service user approach and improvements in healthcare). Conclusions This study provides new insights into why community midwives and health visitors do, and do not, invite service users to participate in research. Using the Theoretical Domains Framework and the Behaviour Change Wheel we identified that resourcing and social support for staff together with education and communication about the health benefits of approaching service users about research participation are key to improving research recruitment involving these health professionals.
CT scores predict mortality in 2019-nCoV pneumonia
Authors: Xie Yun , Yang Luyu , Dong Hui , Peng Hu , Yu Yuetian , Tu Guowei , Li Qingyun , Fu Shouzhi , Wang Ruilan
Published: March 2020

Background: While 2019-nCoV nucleic acid swab tests has high false positives rate, How to diagnose 2019-nCoV pneumonia and predict prognosis by CT is very important.
Methods: In this retrospective single-center study, we consecutively included suspected 2019-nCoV pneumonia critical cases in the intensive care unit of Wuhan third hospital from January 31, 2020 to February 16, 2020. The cases were confirmed by real-time RT-PCR, and all patients were evaluated with CT, cutoff values were obtained according to the Yoden index, and were divided into high CT score group and low CT score group. Epidemiological, demographic, clinical, and laboratory data were collected.
Results: The major imaging feature of 2019-nCoV pneumonia is the ground glass opacity (GGO). Multivariate regression analysis found that CT score and absolute count of lymphocytes were independent risk factor for death, and CT score predicted mortality AUC-ROC =0.7, cutoff=1.45. When the absolute count of lymphocytes decreased, the patient's CT also deteriorated.
Conclusion: CT score and absolute count of lymphocytes were independent risk factor for death, and patients with high CT score may have a worse prognosis. Lower absolute count of lymphocytes may indicated the patient's CT also deteriorated.
The long non-coding RNA MEG3 plays critical roles in the pathogenesis of cholesterol gallstone
Authors: Qian Changlin , Liu Hua , Qiu Weijing , Zhang Jie , Shen Zhiyong , Zhang Yongjie
Published: March 2020

Background: Cholesterol gallstone (CG) is the most common gallstone disease, which is induced by biliary cholesterol supersaturation. The purpose of this study is to investigate the pathogenesis of CG. Methods: Sixteen mice were equally and randomly divided into model group and normal control group. The model group was fed with lithogenic diets to induce CG, and then gallbladder bile lipid analysis was performed. After RNA-seq library was constructed, differentially expressed mRNAs (DE-mRNAs) and differentially expressed lncRNAs (DE-lncRNAs) between model group and normal control group were analyzed by DESeq2 package. Using clusterProfiler package, enrichment analysis for the DE-mRNAs was carried out. Based on Cytoscape software, the protein-protein interaction (PPI) network and competing endogenous RNA (ceRNA) network were built. Results: The mouse model of CG was successfully established, and then 181 DE-mRNAs and 33 DE-lncRNAs between model and normal groups were selected. For the down-regulated SCP2 , lipid hydroperoxide transport was enriched. Moreover, KDM4A was selected as a hub node in the PPI network, and MEG3 was taken as a key lncRNA in the regulatory network. Additionally, the miR-107-5p/miR-149-3p/miR-346-3p—MEG3 regulatory pairs and MEG3—PABPC4/CEP131/NUMB1 co-expression pairs existed in the regulatory network. Conclusion: These RNAs might be related to the pathogenesis of CG.