bluuebunny/crossref_metadata_2025 huggingface dataset:
Musculo-skeletal problems of the hand in haemophilia
Authors: Bravo Elena , Barco Raul , Rodríguez-Merchán E. Carlos
Published: June 2020

Musculo-skeletal complications of the hand in the haemophilia patient are rare, and they include synovitis, arthropathy, pseudotumours, carpal tunnel syndrome and vascular aneurysms and pseudoaneurysms. The best way to prevent the aforementioned musculo-skeletal complications is early continuous haematological primary prophylaxis (intravenous infusion of the deficient coagulation factor, ideally from cradle to death). There is a wide range of procedures that a hand surgeon treating these patients should be able to manage, including synovectomy, prosthetic replacement of small joints, removal or curettage of pseudotumours, release of carpal tunnel and, occasionally, vascular reconstruction of aneurysms. The treatment of these patients should be made at an institution with close collaboration between haematologists and hand surgeons (all surgical procedures must always be performed under cover of the deficient coagulation factor).

Cite this article: EFORT Open Rev 2020;5:328-333. DOI: 10.1302/2058-5241.5.190078
Prognostic factors in ankle sprains: a review
Authors: Ferreira José Nuno , Vide João , Mendes Daniel , Protásio João , Viegas Rui , Sousa Manuel Resende
Published: June 2020

Ankle sprains are one of the most common musculoskeletal injuries, being the most frequent musculoskeletal trauma among athletes. Most of these injuries are successfully treated conservatively; however, up to 70% of patients can develop long-lasting symptoms. Therefore, understanding prognostic factors for an ankle sprain could help clinicians identify patients with poor prognosis and choose the right treatment. A suggested approach will be presented in order to positively identify the factors that should warrant a more aggressive attitude in the initial conservative treatment. There are some prognostic factors linked to a better recovery and outcome; nevertheless, prognostic factors for full recovery after initial ankle sprain are not consistent.

Cite this article: EFORT Open Rev 2020;5:334-338. DOI: 10.1302/2058-5241.5.200019
From past to present: children’s exposure of intimate partner violence and subsequent experience of IPV in adulthood among women
Authors: Chernyak Elena , Ceresola Ryan , Herrold Morgan
Published: June 2020

The objective of this research is to analyse the prevalence of physical intimate partner violence (IPV) in ten developing countries in four regions as identified by the Demographics and Health Survey (DHS): Sub-Saharan Africa with Mali and Nigeria; North Africa/West Asia with Egypt and Jordan; South and Southeast Asia with Cambodia, Pakistan and the Philippines; and Latin America and the Caribbean with Haiti, the Dominican Republic and Peru. These countries are all tested with one primary research question: whether witnessing physical IPV in family-of-origin is associated with women’s experience of physical IPV in adulthood. Past research has shown reason to believe witnessing parental violence is a significant risk factor in IPV in many nations, but the influence of IPV in these developing countries has not been examined.

The results indicate that having witnessed physical IPV in one’s family-of-origin significantly increases the likelihood of experiencing later physical abuse, for respondents in all countries. By controlling for other factors, this finding provides robust support for the intergenerational transmission of violence theory, which explains the link between interparental aggression and physical IPV in subsequent relationships as a result of learned models of behaviour observed in childhood. Implications of this research for developing countries are also discussed.
Multi-pitch self-calibration measurement using a nano-accuracy surface profiler for X-ray mirror metrology
Authors: Huang Lei , Wang Tianyi , Nicolas Josep , Polack François , Zuo Chao , Nakhoda Kashmira , Idir Mourad
Published: June 2020

For high accuracy X-ray mirror measurement, the analysis and corrections of minute systematic errors of the measuring instrument are required. As an X-ray mirror metrology tool, the nano-accuracy surface profiler (NSP) consists of two autocollimators (AC) serving its reference and sample beams, in which the sample-beam AC maintains a fixed distance from the mirror. In this work, the multi-pitch self-calibration method is applied to an NSP instrument to reconstruct both the mirror slope and the instrument error of the sample-beam AC through a series of x scans and pitch angle scans. It is more technically sound to apply this multi-pitch self-calibration method to a working-distance-fixed slope scanner, such as the NSP. First of all, we introduce the principle of the multi-pitch self-calibration method, discuss its ambiguities, and provide our regularization illustrated with simulations. Second, some real measurements of a spherical mirror with 10-mrad total slope are demonstrated to verify the effectiveness of the multi-pitch self-calibration technique with an NSP. Furthermore, the experimental reconstruction of the low- and high-frequency signals of the instrument error with different settings in x and pitch steps are addressed and studied in terms of repeatability, reproducibility, self-consistency, and effectiveness in compensation for single-pitch scans.
CW demonstration of SHG spectral narrowing in a PPLN waveguide generating 2.5 W at 780 nm
Authors: Carpenter Lewis G. , Berry Sam A. , Gray Alan C. , Gates James C. , Smith Peter G. R. , Gawith Corin B. E.
Published: June 2020

Periodically poled lithium niobate (PPLN) waveguides are a proven and popular means for efficient wavelength conversion. However, conventional PPLN waveguides typically have small mode field diameters (MFD) (≲6 µm) or significant insertion and/or propagation losses, limiting their ability to operate at multi-watt power levels. In this work we utilise zinc indiffused PPLN ridge waveguides that have a larger MFD, favourable pump/SHG modal overlap, and low insertion losses. Here for the first time, we have demonstrated continuous wave (CW) spectral narrowing from a PPLN waveguide, both with high efficiency and multi-watt second harmonic generation (SHG). 2.5 W of 780 nm has been produced by SHG of an amplified 1560 nm telecom laser with a device efficiency of 58% in a 4.0-cm long ridge waveguide. We have modelled conversion efficiency and applied experimentally measured waveguide parameters to show excellent agreement to the SHG spectra. Spectral narrowing of the full width half maximum (FWHM) of 35.7% has been measured as the nonlinear drive is increased. This work demonstrates that single-pass, multi-watt, CW SHG at 780 nm is feasible from our PPLN waveguide in the large conversion regime.
All-optical logic gates using dielectric-loaded waveguides with quasi-rhombus metasurfaces
Authors: Yao Chaonan , Kotb Amer , Wang Bin , Singh Subhash C. , Guo Chunlei
Published: June 2020

Nanostructure and nanoantenna-based all-optical (AO) devices have attracted significant research interests in recent years due to their small size, high information capacity, ultrafast processing, low power consumption, and overall practicality. Here, in this Letter, we propose a novel metasurface having quasi-rhombus-shaped antennas to modulate optical modes in a dielectric-loaded waveguide for the realization of a complete family of logic gates including NOT, AND, OR, XOR, NAND, NOR, and XNOR. These logic operations are realized using destructive and constructive interferences between the input optical signals. The high contrast ratios of about 33.39, 27.69, and 33.11 dB are achieved for the NAND, NOR, and XNOR logic gates, respectively, with the speed as high as 108 Gb/s.
Mueller matrix ellipsometer using dual continuously rotating anisotropic mirrors
Authors: Ruder Alexander , Wright Brandon , Peev Darin , Feder Rene , Kilic Ufuk , Hilfiker Matthew , Schubert Eva , Herzinger Craig M. , Schubert Mathias
Published: June 2020

We demonstrate calibration and operation of a single wavelength (660 nm) Mueller matrix ellipsometer in normal transmission configuration using dual continuously rotating anisotropic mirrors. The mirrors contain highly spatially coherent nanostructure slanted columnar titanium thin films deposited onto optically thick gold layers on glass substrates. Upon rotation around the mirror normal axis, sufficient modulation of the Stokes parameters of light reflected at oblique angle of incidence is achieved. Thereby, the mirrors can be used as a polarization state generator and polarization state analyzer in a generalized ellipsometry instrument. A Fourier expansion approach is found sufficient to render and calibrate the effects of the mirror rotations onto the polarized light train within the ellipsometer. The Mueller matrix elements of a set of anisotropic samples consisting of a linear polarizer and a linear retarder are measured and compared with model data, and very good agreement is observed.
Separação e colaboração do Estado e da Igreja no tempo de Salazar: o caso dos feriados
Authors: Torgal Luís Reis
Published: June 2020

Tomando como base as investigações inacabadas de Luís Oliveira Andrade, falecido em 2005, Luís Reis Torgal publicou na Imprensa da Universidade de Coimbra, no ano de 2012 (duas edições), em coautoria e em sua homenagem, o livro Feriados em Portugal. Tempos de memória e de sociabilidade. Nunca mais abandonou o tema, tendo em 2018 apresentado em Bolonha, no colóquio anual promovido pela REFAT (Rede de Estudo dos Fascismos, dos Autoritarismos, dos Totalitarismos e das Transições para a Democracia), desta vez intitulado Fascismo, chiese e religioni, a comunicação “O caso dos feriados no contexto da Concordata entre o Estado Novo e a Santa Sé”. O frutuoso diálogo que teve então com outros investigadores, entre eles Paula Borges Santos, que apresentou como tese de doutoramento, orientada por Fernando Rosas, o estudo A Segunda Separação. A política religiosa do Estado Novo (1933-1974), publicada em 2016, levou-o a escrever um longo texto, que depois sintetizou num mais curto, que será publicado nas atas do encontro de Itália. Todavia, entendeu que o primeiro texto que escreveu não deveria perder-se, pelo que se propôs publicar a presente obra, intitulada Separação e Colaboração do Estado e da Igreja no tempo de Salazar. O caso dos feriados, que considerou uma espécie de “terceira edição” da obra de coautoria Feriados em Portugal, que agora o autor dedica a Luís Oliveira Andrade. Na verdade, o tema dos feriados foi uma “descoberta” de Luís Andrade e é um dos mais curiosos na questão mais vasta das relações entre o Estado e a Igreja que agora é abordada fundamentalmente no tempo de Salazar, embora não perdendo de vista (antes pelo contrário) a época que vai de 1910 a 2016 e mesmo, de certo modo, até aos nossos dias. De resto, os anexos transcrevem os principais documentos sobre o tema. Ver-se-á que a questão da laicidade dos feriados não foi abandonada pelo Estado salazarista senão em 1948 e, sobretudo, em 1952, por pressão de alguns políticos católicos, tendo à frente o patriarca de Lisboa, cardeal Cerejeira. A Concordata de 1940 marcou a mudança de rumo do “fascismo à portuguesa” (como o autor chama ao Estado Novo), embora o processo de luta pela catolicização do Estado seja obviamente anterior e aproveitado politicamente por Salazar.
Visões da Luz
Authors: Gil Francisco , Catarino Lídia
Published: June 2020

Esta obra junta várias contribuições de especialistas em áreas muito diversas do saber, para discutir o tema ‘Luz’ de vários pontos de vista. Os temas reunidos nesta obra provêm das áreas de Física, Filosofia, Transcendência, Química, Ótica, Geologia, Literatura, História das Ciências, História, Geografia, Relações Internacionais, Biologia, Psicologia, Arte, Cinema e Fotografia, Medicina e Museologia. Os textos reflectem parcialmente os conteúdos apresentados no colóquio interdisciplinar ‘Visões da Luz’ realizado em Outubro de 2015, por ocasião do Ano Internacional da Luz de 2015, sob a égide do III-UC e aberto ao meio académico e à sociedade, em particular, a professores dos Ensinos Básico e Secundário.
Comunicación y Educación en los Museos, espacios de interacción en la Zona de Desarrollo Próximo en España
Authors: Ortega-Mohedano Félix , García-Martín Inma , Pérez-Peláez María Esther
Published: June 2020

La interactividad con el público en los museos fruto del desarrollo de las Tecnologías de la Información y Comunicación ha revolucionado las posibilidades divulgativas en estos espacios culturales: digitalización de contenidos, visita virtual, pantallas interactivas y aplicaciones sociales, entre otros, por lo que más museos han comenzado a integrarlas en sus estrategias de comunicación. El objetivo de la presente investigación es analizar los hábitos de uso y consumo digitales de los usuarios de los museos de Castilla y León, y desvelar el impacto de las aplicaciones digitales en Internet en el público de estos espacios culturales en un contexto de aprendizaje. Se trata de un estudio de carácter estadístico-descriptivo donde se presentan los resultados de un cuestionario realizado a 619 visitantes del Museo de La Evolución Humana y El Museo Art Nouveau y Art Decó – Casa Lis. Entre los principales resultados destaca el escaso interés mostrado por el público joven ante los recursos de la página web de los museos de la muestra; el gran valor que los encuestados otorgan a la tarea divulgativa de las herramientas digitales para la adquisición de nuevos conocimientos; y un mayor impacto de uso e interacción entre web y visitantes adultos respecto a los públicos más jóvenes que puede deberse a la falta de adaptabilidad de los museos estudiados a las nuevas formas de consumo cultural de las nuevas generaciones.
How Teaching Affects Student Attitudes towards the Environment and Sustainability in Higher Education: An Instructors’ Perspective
Authors: Misseyanni Anastasia , Marouli Christina , Papadopoulou Paraskevi
Published: June 2020

In the rapidly changing, 21st century globalized world, with increasing environmental pressures and challenges, education for the environment and sustainability is a priority at all levels; from  kindergarten to higher education. It is the education that will create the environmentally aware and socially responsible individuals, capable of addressing existing and future environmental challenges. Courses on the environment and/or sustainability are now an essential element of all Higher Education Institutions with a sustainability vision. But, does teaching about the environment and sustainability lead to a change in student attitudes? What teaching and learning methods seem to have a more significant effect on attitudes and behaviors and what are the challenges for instructors? In this study, instructors reflect on which educational methods seem most effective in promoting change in student attitudes and behaviors towards the environment and sustainability. This reflection is based on instructor experiences from selected courses or course activities (learning objects) and it focuses on the goals, teaching methods and effect on student learning and attitudes; changes in student attitudes in the course of the last years are also discussed. Suggestions are offered and implications for higher education institutions are outlined. Keywords: education for the environment, education for sustainability, higher education, active learning, student behaviors, emotional engagement
The Concept of an Eco-Efficient Regional Development Strategy: A Case of the Baikal Region
Authors: Gunzenova Karina
Published: June 2020

The transition to sustainable development requires a comprehensive systematic state policy and suggests a change in existing cultural characteristics that determine the nature of the economic development of society. It assumes reliance on effective mechanisms that can minimize the time and risks of possible destructive processes of such a transition. As a mechanism for institutionalization, we propose using the concept of ecological efficiency as a criterion for the compliance of strategic development plans and relevant regulatory legal acts with the selected course of sustainable development. This work aims to disclose the concept of eco-efficiency through understanding the benefits of focusing on qualitative development criteria. The methodological basis of the study was the provisions of dialectical realism, which determines the variability of the content of quantitative development indices with the constancy of qualitative guidelines, thus ensuring balanced development of civilization for an indefinitely long term. Keywords: sustainable development, ecological efficiency, sustainable development strategy, Baikal region, dialectical realism
Water-Education as a Promoter of Education for Sustainable Development: Three Studies in Portuguese-Speaking African Countries
Authors: Leitão Mafalda Franco , Cunha Albino , Ferreira Manuela Malheiro
Published: June 2020

The present study is based on research in teacher self-training in Education for Sustainable Development (Leitão, 2012). Water was the motivating theme. The priority of a fair distribution of water, guaranteeing the consumption, in quality and quantity, to all mankind and living beings is urgent. To respond to water-related sustainability challenges, people worldwide need to acquire "water literacy" about various aspects of water use and management in order to ensure safer water consumption and to contribute to Disaster Risk Reduction (DRR). Three case studies were carried out in schools in three African countries: Angola, Guinea-Bissau and Mozambique. A model of skills in education for sustainable development was applied (Sleurs, 2008). From the analysis of these case studies the theoretical assumptions of research were strengthened by the effective professional practice. But, on contrary, the results that the pillars of sustainable development presented in the basic research should be reviewed, placing the political dimension as transversal, thus strengthening education for sustainable development as fundamental for critical and responsible citizens of the present and of the future. This experience paves the way for future water-education and education for sustainable development projects; such as the follow-up of these three schools.  Keywords: Sustainable Development; Education for Sustainable Development; Water-education and Water Literacy; Case Study
Methodology for Assessing the Harmony of Economic Relations Between Participants of the Agrofood Market
Authors: Kravchenko Olha , Kucher Anatolii , Yanchuk Tetiana , Stavska Yuliia
Published: June 2020

The purpose of the paper is to summarize the principles of harmonization of economic relations between participants of the agrofood market of Ukraine, in particular, the livestock products market, and to create a system of criteria for socio-ecological and economic assessment of the level of harmony of these relations with adherence to the principle of inclusivity. The results of a systematic review convincingly show that the basic principles of harmonization of economic relations between the livestock market participants shall be as follows: the principle of inclusivity, maximizing the mutual benefit of all parties to relationship, the consistency of their economic interests (or the principle of consensus), the principle of systematization, controllability, social fairness, openness and scientific validity. With the help of three indicator systems, namely: (1) criteria for assessing the socio-economic conditions of the livestock market entities, (2) criteria for assessing the development effectiveness and efficiency of the specified market entities, (3) criteria for assessing the harmonious relations of agricultural producers with other participants in relations on the product market animal husbandry, it is possible to systematically explore the economic environment in which modern economic relations between the livestock production market participants are formed, developed and transformed, and to find mechanisms for harmonizing such relations. Key words: economic relations, sustainable development, agrarian policy, harmonization, livestock products market, inclusivity, agrofood sector, Ukraine
Innovative Forms of Realization of Regional Social Policy by Organizing Public Dialogue and Communication in Conditions of Post-conflict Transformation in Eastern Ukraine
Authors: Halhash Ruslan , Semenenko Inna , Ovcharenko Ievgen , Borova Ganna
Published: June 2020

The current socio-economic situation in Eastern Ukraine, complex processes of economic recovery, internal displacement cause numerous conflicts between local and displaced population and institutions. In these circumstances the issues of implementation of effective regional social policy instruments, integration of internally displaced persons into local communities, strengthening social cohesion and peacebuilding become important. The purpose of the article is to substantiate innovative forms of implementation of regional social policy by organizing public dialogue and communication in conditions of post-conflict transformation in Eastern Ukraine, which would ensure sustainability of conflict resolution. The article shows the experience of implementing the results of experimental studies on organizational support for interaction of institutions on conflict prevention and resolution in the project "Geoinformation system for monitoring, analysis, assessment and resolution of conflicts in communities". The essence, basic principles, components and tasks of the geoinformation system, which is realized through creation of the online resource and the network of regional experts working under support of the international community, were presented. Keywords: conflict, regional social policy, organization, dialogue, communication, interaction, institution, geoinformation system, network of mediators.
Conceptual and Legal Framework for Promotion of Education for Sustainable Development: Case Study for Ukraine
Authors: Tetiana Hudima , Malolitneva Vesta
Published: June 2020

Promoting the sustainable development is currently a key global issue posing a challenge to all of us on personal, professional and political levels. The education plays a major role in this path, in particular the education for sustainable development (ESD). The traditional one-way transfer of knowledge is no longer sufficient to inspire the students to behave as responsible citizens. This article suggests a number of competencies, which must serve as a basis for ESD, as well as application of the multiple intelligence theory as a mechanism for implementing the competencies derived by students from ESD at the basic education level. It is proved that security competencies in the broadest sense (covering all levels, from personal to the global space) should also be included in the modern educational process. As for the university education, it is required to explain the concept of "sustainability" to all specialties without exception, including the political scientists, engineers and others. This is particularly important for training of experts dealing with the economic law issues. A lack of economic analysis in modern legal studies and development of regulations results in writing and adoption of idle laws hazardous for the country. To upgrade the education system in Ukraine, it is appropriate to develop the National Strategy on Education for Sustainable Development and its implementation plan based on the global Sustainable Development Goals. It is required to switch from traditional education to the model focused on sustainable development with the underlying extensive interdisciplinary knowledge based on an integrated approach to the development of society, economy, and environment. Implementation of this strategy should consider the adaptive nature of the regional education component, in particular the economic features of a relevant region. It is important to focus on the learning processes underlying the circular economy. Keywords: sustainable development, society, economy, environment, circular economy, education for sustainable development, sustainability, economic law.
Evaluation of the Convergence of International Markets for Agricultural Enterprises of Ukraine under International Diversification Conditions
Authors: Tanasiichuk Alona , Kovalchuk Svetlana , Hromova Olha , Inna Hryhorenko , Olena Fedortsova
Published: June 2020

It is proposed the classification of indicators of convergence assessment of international markets for determining their marketing attractiveness for the enterprise, which includes absolute and relative indicators of measurement of general statistical data, evaluation of factors of production, information on products and services, dynamic indicators and convergence indicators used by enterprises for the search of new international markets. In the expert assessment of convergence indicators, the markets of foreign countries, the indicators of which are as close as possible to the Ukrainian economy, are distinguished, the result of the assessment allowed to draw conclusions about the marketing opportunities of domestic enterprises in the conditions of the export of goods to the markets of these countries. As the analysis of practical aspects of the functioning of agricultural enterprises and their associations results, a scientific and methodical approach to a comprehensive convergence of agricultural enterprises activities of Ukraine assessment under the conditions of international diversification has been developed. The proposed approach is based on the method of summing up the ranks to rank foreign markets according to the system of dynamic indicators application, which allowed to determine the marketing attractiveness of new international markets for the domestic enterprises activity in these markets and to assess their convergence. As the application of the proposed approach result, foreign markets have been identified which demonstrate favorable conditions for doing business on them, indicating the convergent conditions existence, which is a prerequisite for domestic agricultural enterprises to the markets of these countries release, and also determines the factors and criteria for making managerial decisions regarding realization of domestic agrarian enterprises activity under international diversification conditions. It is proved that the markets of Belgium, Italy, Ireland, Switzerland, and Japan have demonstrated favorable conditions for doing business with them, indicating a significant convergence of markets in these countries. It is determined that the markets of Greece and China are promising for domestic enterprises in the presence of opportunities to overcome a significant margin of discretion. Keywords: convergence, international diversification, international markets marketing attractiveness, convergence evaluation of international markets
Information Component of the Environmental Policy of Ukraine: Current Status and Development Potential
Authors: Haraschuk Volodymyr , Zelinska Yana , Spasenko Viktoriia , Shulga Ievgenii
Published: June 2020

The article emphasizes the importance of the role of the information component of the environmental policy of the modern state within the context of the reorientation of human-nature relations towards sustainable development. The existing approach of the Ukrainian lawmaking body to the determination of environmental information, the features of environmental information relations and the state-regulatory mechanism of its control are analyzed. The emphasis is placed on the existing ineffective system of collecting, analyzing, processing and transmitting information, which actually brings to naught the fairly broad rights of citizens in the environmental information sphere. A new differentiated approach is proposed to determine the structural elements of the information component of the environmental policy in Ukraine, based on which the main existing gaps of the modern state policy of Ukraine in this field are emphasized. Their solutions are proposed, among which are: the creation and organizational support of the automated information and analytical systems and other objects (sources) of providing access to environmental information; optimization of the existing procedural order for obtaining environmental information by contacting the public authorities and local governments in obtaining environmental information by the interested parties; responsibility tightening of public officials of executive and local authorities for failure to comply with the requirements of the law, for the timely provision and reliability of environmental information; adaptation of the national regulatory framework to international standards for environmental management and environmental labelling of products, etc. Keywords: information, ecology, environmental information relations, environmental policy of Ukraine, information policy of Ukraine.
Conceptual Principles of Education for Sustainable Development
Authors: Karpan Iryna , Chernikova Nataliia , Motuz Tetiana , Bratanich Boris , Lysokolenko Tetiana
Published: June 2020

Education has an important place in transitional strategy of society to sustainable development that is proved by many international acts. In the outlines of modern approaches, education for sustainable development is characterized as innovative concept of changes to educational activity, as mechanism of realization of strategy of sustainable development, as instrument of modernization of educational practice, as one of the basis of modern educational quality and continuity standards. National system of global aims for consolidation of society of sustainable development with an accent on the significance of educational matter was created in Ukraine. Education for sustainable development is characterized by being part to structure creating social institutes of modern society, transversality, subjective direction, integrativity, forward-looking character. This vector of education research is same with global man’s intentions of civilization development – increase in human’s value in all spheres of life, developing of democratic management, constructive cooperation and communication, etc. Among multidimensional potential of researched phenomenon the most practical value has environmental education. As for today, environmental education is a practical mechanism of transformation of educational system on the principles of sustainable development. Environmental education is seen as an instrument for systematic formation of man’s basic attributes for being part of education for sustainable development field – critical thinking, environmental worldview, subjective-value approach to environment, eco-cultural values. Cumulative result of environmental education is formation of environmental culture.  Key words: education, sustainable development, environment, ecology, synergetic, culture, humanism.
Response to a Book Report
Authors: Response Book Report
Published: June 2020

Response by Ihab Amro, dr. jur. to a Book Report
Management of Postcholecystectomy Biliary Complications: A Narrative Review
Authors: Ahmad Dina S. , Faulx Ashley
Published: June 2020

Every year approximately 750,000 cholecystectomies are performed in the United States, most of those are performed laparoscopically. Postcholecystectomy complications are not uncommon and lead to increased morbidity and financial burden. Some of the most commonly encountered complications with laparoscopic cholecystectomy include biliary injury (0.08%–0.5%), bile leak (0.42%–1.1%), retained common bile duct stones (0.8%–5.7%), postcholecystectomy syndrome (10%–15%), and postcholecystectomy diarrhea (5%–12%). Endoscopy has an important role in the diagnosis and management of biliary complications and in many cases can provide definitive management. There is no consensus on the best therapeutic approach for biliary complications. Therefore, biliary complications should be approached by an experienced multidisciplinary team. It is important for the gastroenterologist to be familiar with the management of such complications (Visual Abstract, Supplemental Digital content 1, http://links.lww.com/AJG/B544).
Transformationen. Beobachtungen zur Situation des Religionsunterrichts
Authors: Saß Marcell
Published: June 2020

Religious education is also considerably affected by the current social transformation processes, which appear to be epochal, and is under pressure - varying from region to region. The article analyses this connection under the keywords differentiation, digitisation, diversity and dialogue and offers a brief outlook on future questions of religious education teacher education as well as on international contexts.
Diagnostic value of salivary cortisol in 1-mg dexamethasone suppression test
Authors: Belaya Zhanna E. , Malygina Anastasia A. , Grebennikova Tatiana A. , Il'yin Aleksandr V. , Rozhinskaya Liudmila Ya. , Fadeev Valentin V. , Melnichenko Galina A. , Dedov Ivan I.
Published: June 2020

BACKGROUND: Late-night salivary cortisol and serum cortisol measurements after 1-mg Dexamethasone Suppression Test (1-mg DST) are routinely used to diagnose Cushings syndrome (CS). Measuring morning salivary instead of serum cortisol after 1-mg DST would make the diagnostics of CS fully non-invasive.
AIM: To evaluate the diagnostic accuracy of salivary cortisol in 1-mg DST as measured by electrochemiluminescence assay (ECLIA).
MATERIALS AND METHODS: We combined a cohort diagnostic study, including 164 participants (132 females, 32 males) aged from 18 to 77 years: 110 were overweight or obese as increased BMI is the most common sign of Cushings Syndrome (CS), and 54 healthy volunteers. In each cohort late-night salivary cortisol was measured (at 23:00) followed by 1-mg DST and blood and salivary sampling for cortisol measurement the next morning at 08:00-09:00. Cortisol in saliva and serum were measured on automatic analyzer Cobas е 601 by F. Hoffmann-La Roche Ltd, using ECLIA. The final diagnosis was confirmed by the histological evaluation after surgery or using a follow-up observation in patients with obesity to exclude Cushings syndrome manifestation.
RESULTS: Among 110 patients, 54 subjects were finally confirmed as having Cushing's syndrome. Reference interval for salivary cortisol after 1-mg DST was estimated to be 0,512,7 nmol/l (595 procentile). Maximal salivary cortisol level in 1-mg DST registered in healthy person was 29,6 mmol/l. Areas under the curve (AUC) were as following: for salivary cortisol in 1-mg DST 0,838 (95% СI 0,7720,905), for blood cortisol in 1-mg DST 0,965 (95% CI 0,9390,992) and for late-night salivary cortisol 0,925 (95% CI 0,8820,969). The optimal cut-off point for salivary cortisol after 1-mg DST was estimated as 12.1 nmol/l (sensitivity 60%, specificity 92,9%) among CS versus healthy subjects; 12,6 (sensitivity 58,2%, specificity 96,2%) among patients with obesity and CS; and 12,2 nmol/l (sensitivity 60,7%, specificity 93,4%) among CS and both obese and healthy control subjects. Considering small difference between cut-off points, the recommended cut-off value for salivary cortisol after 1-mg DST is recommended to be 12,0 nmol/l if measured by ECLIA.
CONCLUSION: Although salivary cortisol after 1-mg DST is inferior to serum cortisol after 1-mg DST in the diagnostic performance and diagnostic accuracy, it can be used as a low-invasive screening test with superior specificity.
Antioxidant vitamin status of obese patients in terms of the risk of comorbidities
Authors: Kodentsova Vera M. , Vrzhesinskaya Oksana A. , Kosheleva Olga V. , Beketova Nina А. , Sharafetdinov Khaider Kh.
Published: June 2020

BACKGROUND: Synchronously optimized concentrations of vitamins C, E, A, carotenoids and their ratios in blood plasma help to prevent or slow down the development of many alimentary-dependent diseases and their complications.
AIMS: to characterize the vitamin status of obese patients from the standpoint of the risk of progression of existing and development of associated diseases.
MATERIALS AND METHODS: An observational single-site cross-sectional study of the sufficiency with antioxidant vitamins in 81 patients (21 men, 60 women) aged 2075 years with body mass index 40,71,2 kg/m2, enrolled for treatment from April to June in Federal Research Centre of Nutrition, Biotechnology had been conducted. The concentration of - and -tocopherols, retinol, ascorbic acid, -carotene was determined in blood serum and their ratios with lipid profile were calculated.
RESULTS: Indicators of vitamin status were determined in 35 patients with obesity, 27 patients with obesity and cardiovascular diseases (CVD), 19 patients with obesity and type 2 diabetes mellitus (T2DM). The concentration of ascorbic acid in more than 50% of patients did not reach the optimal level (50 mol/l). Compared to patients of other groups, patients with T2DM were better supplied with vitamin E, but worse with other vitamins. They have a non-optimal ratio of concentrations of vitamin C and E more often compared with patients of other groups (p0.050). Among them, the combined suboptimal level of vitamin C and -carotene (0.4 mol/l) was detected 1.61.8 fold more often. The lack of antioxidants in patients with T2DM according to simultaneously reduced vitamin C/vitamin E ratio (1.5) and -carotene level was detected 3.3-fold more often, synchronously lowered vitamin C/vitamin E ratio and vitamin C level 2.4-fold. -tocopherol level in serum of patients with T2DM tended to increase compared with that in patients with obesity (p=0.063) and CVD (p=0.081), -tocopherol/triacylglycerides ratio was 1.5-fold higher (respectively р=0.009 и р=0.076). Only in 2 patients with obesity and 2 patients with CVD all serum indicators corresponded to the optimal level of all vitamins. In terms of -tocopherol/cholesterol (5 mol/mol), an increased risk of myocardial infarction was detected in 10.542.9% of the examined patients. Glucose level was positively associated with serum levels of - and -tocopherols, as well as cholesterol-adjusted individual tocopherols; while glycemia was inversely associated with triacylglycerides-standardized individual tocopherols, as well as -carotene and vitamin C/vitamin E ratio.
CONCLUSIONS: In most patients, a non-optimal serum vitamin content was found according to one or several parameters. In order to vitamin C/vitamin E ratio, patients with T2DM need to increase vitamin C intake. Increasing serum -carotene and achieving an optimal C/E ratio will help to prevent an increase in glycemia.
Subclinical hypothyroidism and metabolic syndrome: reasons for drug intervention
Authors: Ruyatkina Lyudmila A. , Ruyatkin Dmitriy S.
Published: June 2020

The high prevalence of metabolic syndrome (MS) and subclinical hypothyroidism (SHypo) creates danger of integral cardio-metabolic risk (CMR). A concept is being developed to increase thyroid-stimulating hormone (TSH) levels as a component of MS with the key role of insulin resistance (IR). To identify groups of active intervention, the definitions of SHypo with age and gender characteristics are analyzed. The results of randomized clinical trials showed a higher incidence of prediabetes and type 2 diabetes mellitus (T2DM) in SHypo, as well as positive associations of autoimmune thyroiditis (AIT) with components of MS, especially in postmenopausal women. The association of SHypo with a systemic inflammatory response is analyzed, which can determine an increase in cardio-metabolic risk. At the same time, most of the thyroid dysfunction and the components of MS are associated with insulin resistance.
The feasibility of SHypo treating with levothyroxine is discussed: the threshold parameters of thyroid-stimulating hormone (TSH) are not determined for initiating treatment; in old age, due to a decrease in the need for thyroid hormones, an increase in the upper reference range of TSH is discussed; there is no evidence of a decrease in cardiovascular risk and mortality. In parallel, data have been accumulated on a decrease in TSH levels in overt and subclinical hypothyroidism in patients with MS and T2DM with metformin therapy. The gender effect of metformin on the activity of the hypothalamus-pituitary-thyroid axis was suggested, its new antihyperglycemic mechanism of action, including the activation of the AMP protein kinase (adenosine monophosphate (AMP) -activated protein kinase) in the pituitary gland, was revealed.
It is possible that metformin is a promising therapeutic agent not only for patients with type 2 diabetes and thyroid disease, but also for MS and obesity. The multifaceted capabilities of metformin, including the correction of peripheral and central insulin resistance and a decrease in TSH levels in patients with SHypo, emphasizes an integrated approach to the prevention of CMR. The prolonged release form of metformin has several advantages: better tolerance, greater efficiency in the correction of IR, lipid and carbohydrate metabolism, additional indication - treatment of prediabetes, the possibility of prescribing for creatinine clearance up to 30 ml/min.
Characteristics of calcium and phosphorous metabolism in patients after bariatric surgery and the role of vitamin d supplementation in the prevention and treatment of postoperative bone and mineral disorders
Authors: Berkovskaya Marina A. , Kushkhanashkhova Dana A. , Sych Yulia P. , Fadeev Valentin V.
Published: June 2020

This article provides a review of current literature on the effect of various doses of vitamin D on the parameters of calcium and phosphorus metabolism in patients after bariatric surgery.
The decrease of bone mineral density is one of the most frequent complications of the bariatric surgery, which increases the risk of fractures. There are many different mechanisms for impaired mineral metabolism after bariatric surgery, but a decrease in the absorption of calcium and vitamin D plays a key role in this process. Vitamin D is the most important endocrine regulator of calcium homeostasis in the body, which provides the absorption of 90% of calcium in the gut. Patients with morbid obesity have a high risk of vitamin D deficiency even before surgery, which may worsen after operation and in the absence of timely treatment lead to severe disturbances of calcium and phosphorus metabolism.
It was found that high doses of vitamin D after bariatric surgery can improve parameters of bone metabolism, and, as a result, prevent fractures after surgery, which generally has a beneficial effect on the quality of life and labor prognosis. The results of the studies available to date open up new opportunities for the prevention and treatment of postoperative complications associated with impaired bone metabolism.
Insulin resistance in obesity: pathogenesis and effects
Authors: Lavrenova Evgenia A. , Drapkina Oxana M.
Published: June 2020

The prevalence of obesity in the world is described as the global epidepic. Being not only a chronic recurrent disease but also a serious risk factor, obesity leads to the development and aggravation of many non-communicable diseases. Excessive amount and adipose tissue dysfunction in obesity determines the risk of the development of type 2 diabetes, arterial hypertension, atherosclerosis, non-alcoholic fatty liver disease etc. Secondary insulin resistance often underlies the development of the above mentioned conditions. The mechanisms contributing to the development of insulin resistance in case of excessive adipose tissue accumulation are being intensively investigated over the last decades, however many questions yet remain unsolved. In this article we present the key mechanisms underlying insulin resistance in obesity and diagnostic approaches for insulin resistance as well as the current data in this topic. The authors review the close links between insulin resistance and obesity related diseases, namely disorders of carbohydrate metabolism, dyslipidemia, arterial hypertension, coronary artery disease and reproductive disorders.
Poglądy etyczne Alberta Camusa
Authors: Zapaśnik Stanisław
Published: June 2020

The aim of the paper here presented is to reconstruct the ethical views of Camus and to provide an account of their evolution. Wherever Camus’s axiological convictions closely correspond to his philosophical cogitations, and where the latter appear to present evidence of Camus’s efforts to find theoretical ground for the former the article also supplies information concerning the philosophical ideas of the author of ‚Le Mythe de Sisyphe’.
Aksjologiczna treść pojęcia sprawiedliwości w poglądach Karola Marksa
Authors: Żyro Emilia
Published: June 2020

The article presents an attempt to reconstruct the axiological contents of Marx’s –concept of justice In the broadest terms, the axiological content of Marx’s concept of justice consists, in the author’s opinion, in the eternal conviction of man that it is just to render unto man what is rightfully due to him, while to deprive man of his due rights is a wrong. Accordingly, every man, by reason of his work or merits, rightly deserves the use and enjoyment of the material goods he has produced, or of the good reputation he has won, etc. That formulation, however, does not exhaust the full sense of Marx’s idea of ‚justice’. Man in his capacity as a human being rightfully deserves over and above all that, a chance to draw on the full stock of human achievement, in order to develop and satisfy his manifold needs, inclinations and talents.
Argumentacje moralne stosowane przez prawników
Authors: Ziembiński Zygmunt
Published: June 2020

The article attempts to provide a brief account of the ways in which lawyers carry through their arguments concerning some closed moral evaluations or norms and showing how by reference to those norms and evaluations they argue some legal issues as, e.g., the question of the interpretation of legal norms. The author based his reasoning on examples taken from Polish legal literature.
Socjologiczne aspekty etyki zawodowej: zarys problematyki
Authors: Koralewicz-Zębik Jadwiga
Published: June 2020

The purpose of the article is to collect and arrange considerations and views expressed so far about same aspects of professional ethics. Moreover, the article attempts to give a sociological view of these problems. At this stage the author makes same terminological remarks; for instance, she proposes to distinguish between the concepts of „professional ethics” and „professional morality”, which are often used alternatively. By professional ethics we mean a totality of principles of action formulated by certain individuals or groups, often in a form of tenets which should be obligatory for a profession. The author proposes to split the professional morality into two groups: a) the accepted professional morality which includes all moral norms and evaluations valid among people of a given profession with regard to the fulfilment of their professional functions, b) the represented professional morality, i.e. behaviours which are subject to moral evaluation and actually take place in a certain professional group. The author is primarily interested in the professional ethics and in the specific tenets formulated by professional groups and accepted by them. In this connection the following problems are emphasized:
Etyka zawodowa
Authors: Lazari-Pawłowska Ija
Published: June 2020

By professional ethics I mean written standards which answer the question:
Moralność jako czynnik kształtujący stosowanie prawa
Authors: Ziembiński Zygmunt
Published: June 2020

The application of law means making use of his competence by a subject of law in order to perform in a ”valid” way a definite legal act, basing on a given legal system. The legal act, in a wide meaning of this term, is every act of a conventional character by the adequate performance of which legal obligations of certain subjects, which previously were potentially in force, arise or are actualized. The manner of making use of a granted competence can be unanimously determined, or – and that is of interest in our reasoning – certain limits may be granted to the subject who may decide what use he is willing to make of the awarder competence.