bluuebunny/crossref_metadata_2025 huggingface dataset:
Manipulation of Host Cell Organelles by Intracellular Pathogens
Authors: Omotade Titilayo O. , Roy Craig R.
Published: April 2019

In this article, we explore the unique adaptations of intracellular bacterial pathogens that manipulate conserved cellular pathways, organelles, and cargo to convert the phagosome into a pathogen-containing vacuole (PCV). The phagosome is a degradative organelle that rapidly acidifies as it delivers cargo to the lysosome to destroy microbes and cellular debris. However, to avoid this fate, intracellular bacterial pathogens hijack the key molecular modulators of intracellular traffic: small GTPases, phospholipids, SNAREs, and their associated effectors. Following uptake, pathogens that reside in the phagosome either remain associated with the endocytic pathway or rapidly diverge from the preprogrammed route to the lysosome. Both groups rely on effector-mediated mechanisms to meet the common challenges of intracellular life, such as nutrient acquisition, vacuole expansion, and evasion of the host immune response.
Mycobacteria
,
Salmonella
, and
Coxiella
serve as a lens through which we explore regulators of the canonical endocytic route and pathogens that seek to subvert it. On the other hand, pathogens such as
Chlamydia
,
Legionella
, and
Brucella
disconnect from the canonical endocytic route. This bifurcation is linked to extensive hijacking of the secretory pathway and repurposing of the PCV into specialized compartments that resemble organelles in the secretory network. Finally, each pathogen devises specific strategies to counteract host immune responses, such as autophagy, which aim to destroy these aberrant organelles. Collectively, each unique intracellular niche and the pathogens that construct them reflect the outcome of an aggressive and ongoing molecular arms race at the host-pathogen interface. Improving our understanding of these well-adapted pathogens can help us refine our knowledge of conserved cell biological processes.
Improving patient portal enrolment in an academic resident continuity clinic: quality improvement made simple
Authors: Rhudy Courtney , Broxterman Jane , Stewart Sara , Weaver Victoria , Gibson Cheryl , Shankweiler Caylin , Comfort Branden , Lowry Becky
Published: April 2019

Electronic health record patient portal usage has been associated with improvement in chronic disease parameters, patient functional status and patient satisfaction. Our institution’s patient portal is a secure, online health management tool that connects patients to portions of their electronic health record.

Our quality improvement project aimed to increase patient portal enrolment significantly in our Internal Medicine resident patient panels.

This study was conducted in a large, multisite health system in Kansas City, Kansas that serves a diverse patient population. Our clinic includes 65 resident patient panels. We followed a subset of 16 resident patient panels in this quality improvement project. A baseline audit showed that 35% of the 1628 patients in these panels were enrolled in the patient portal system. A standardised, nurse-initiated portal sign-up process following patient rooming was implemented. Initial results indicated a 9.6% increase in patient portal sign-up at the end of the first 4-week cycle. We then implemented educational sessions for our clinic nurses as well as attending physicians, and achieved a 15.1% increase from baseline to the end of the second 4-week cycle, resulting in 86 patient portal activations (p<0.01).

Resident physicians worked with clinic nurse partners in two formats for this project. Nurses assigned to patient rooming for residents during the clinic sessions being studied (rooming nurses) initiated the portal sign-up process. Nurses assigned to partner with the resident for longitudinal patient care management, anchor nurses, worked with residents on items such as phone messages or portal messages. Semi-structured interviews of the four anchor nurses aligned with the 16 residents were conducted at the end of the study and revealed that nursing staff perceived increased patient portal activity to be associated with a decrease in nursing workload and an increase in patient engagement.
HPV vaccination of gay, bisexual and other men who have sex with men in sexual health and HIV clinics in England: vaccination uptake and attendances during the pilot phase
Authors: Checchi Marta , Mesher David , McCall Mark , Coukan Flavien , Chau Cuong , Mohammed Hamish , Duffell Stephen , Edelstein Michael , Yarwood Joanne , Soldan Kate
Published: April 2019

Background

Human papillomavirus (HPV) vaccination for gay, bisexual and other men who have sex with men (GBMSM) aged up to 45 years attending sexual health clinics (SHC) and HIV clinics began in England as a pilot in June 2016, with national roll-out from April 2018. The recommended course is three doses of the quadrivalent HPV vaccine over one to 2 years. We present the methodology and results of monitoring vaccination uptake (initiation and completion), and attendance patterns, during the pilot phase.

Methods

Total numbers of eligible GBMSM receiving HPV vaccine doses were extracted from routine datasets from pilot start to end of March 2018. Numbers of attendances since January 2009 were extracted and tested for trends before and after introduction of HPV vaccination.

Results

Overall, first dose uptake was 49.1 % (23 619/48 095), with clinics with highest data completeness achieving close to 90% uptake during the pilot period. Refusals were very low (3.5%). There was no evidence of increases in the number of GBMSM attendances at pilot SHC.

Conclusions

HPV vaccination has not caused important deviations to expected attendance patterns of GBMSM at SHC throughout the pilot phase. Overall, recorded initiation has been encouraging given known issues with data recording, as is current status of second and third dose completion. Attendances, vaccination initiation and completion will continue to be monitored alongside surveillance of anogenital warts diagnoses and of rectal HPV prevalence.
Crossbow bolt injury to the heart
Authors: Jacobs Deanne , Hardman Claire , Zaman Syed A , Ekeh Akpofure Peter
Published: April 2019

Case summary

A 33-year-old woman was transferred from an outside hospital with a penetrating injury to her right chest. The patient was shot with a crossbow with the entry site to the right breast/chest and a transmediastinal trajectory. She was intubated prior to arrival due to difficulty breathing. Her vital signs remained stable and within normal limits, with good breath sounds, and no evidence of pneumothorax on chest X-ray. The tip of the bolt was palpable at the patient’s left midaxillary line. Chest X-ray in trauma bay showed the transmediastinal trajectory, and the bolt appeared to have a field point (not a broadhead point) (figure 1). A CT of the chest was obtained to assist with surgical planning. Images showed the bolt penetrating the right chest, right ventricle and inferior aspect of the left ventricular muscle, through the stomach, and ending near the tip of the spleen with a fracture of the left seventh rib (figure 2).

Figure 1

Image A shows the bolt (crossbow arrow) entering the patient’s right breast and chest. Image B is the chest X-ray taken in the trauma bay showing the transmediastinal trajectory and partial visualization of the tip of the bolt with a field point. Image C demonstrates the tip of the bolt after removal.

Figure 2

CT of the chest with intravenous contrast showing a foreign body penetrating the right chest at the fourth intercostal space, right ventricle, left ventricle muscle, left hemidiaphragm, through the stomach, and ending near the tip of the spleen without injury to it. There was also a fracture of the lateral seventh rib and hemopericardium. The tip of the bolt is not clearly demonstrated due to artifact.

What would you do?

Median sternotomy followed by midline laparotomy.

Clamshell thoracotomy in the Emergency Room (ER).

Right anterolateral thoracotomy.

Left posterolateral thoracotomy.
Dietary supplementation of ferulic acid improves performance and alleviates oxidative stress of lambs in a cold environment
Authors: Wang Yuan , Wang Wenwen , Wang Ruifang , Meng Ziqi , Duan Yuanxiao , An Xiaoping , Qi Jingwei
Published: April 2019

Ferulic acid (FA) has been regarded as an antioxidant in domestic animals’ feed. This study was to investigate whether dietary FA supplementation could improve growth performance by decreasing oxidative stress of lambs in cold environment. Thirty-two 3-mo-old crossbred male lambs (Dorper × Small-tail Han sheep; 30.49 ± 0.46 kg) were randomly assigned into one of the following dietary treatments: CON (control, no FA), FA80 (80 mg FA kg−1of diet), FA400 (400 mg FA kg−1of diet), and FA2000 (2000 mg FA kg−1of diet). Lambs fed the FA80 had higher (P < 0.05) average daily gain and lower (P < 0.05) feed efficiency than those fed CON and FA2000. The dry matter, organic matter, and neutral detergent fiber apparent digestibility was lower (P < 0.05) for FA2000 lambs than for lambs from other treatments. Serum total protein and albumin concentrations were greater (P < 0.05) for FA80 group than other groups. Lambs fed FA80 had higher (P < 0.05) plasma glutathione peroxidase and catalase activities and lower (P < 0.05) malondialdehyde (MDA) content than lambs fed CON. However, FA2000 group showed higher (P < 0.05) plasma MDA content than CON group. In conclusion, dietary supplementation of 80 mg FA kg−1diet could improve growth performance by decreasing oxidative stress of lambs in cold environment.
The Role of Chinese Medicine in Health Maintenance and Disease Prevention: Application of Constitution Theory
Authors: Li Lingru , Yao Haiqiang , Wang Ji , Li Yingshuai , Wang Qi
Published: April 2019

Traditional Chinese medicine (TCM) has guided health maintenance and disease treatment for thousands of years and has been widely used in many countries around the world. TCM regards each individual as unique so all corresponding therapeutic and preventive approaches in TCM are personalized. Personalized medicine, also referred to as precision medicine, is an emerging medical paradigm that points toward a new direction for future medical development. TCM constitution studies the holistic body condition, which is affected by both inborn and acquired factors. Body constitution lays the foundation for disease diagnosis, prevention and treatment. Different constitution types predispose individuals to different disease susceptibilities. Examining an individual’s unique body constitution can promote effective health management and benefit the application of personalized medicine significantly. This review will introduce and discuss the application of the TCM constitution for health maintenance and disease prevention. In last decade, a number of modern techniques have been employed in the constitution research to evaluate the health status of individuals. The TCM constitution reflects the current status and future trends of human health in four aspects, i.e., individual differences, life processes, psychological condition and adaptability to natural and social environments. This TCM constitution theory has already been applied in the Chinese public health management at different levels with promising outcome. The constitution theory and practice provide a new approach for health maintenance and disease prevention.
Real-time target moving monitoring algorithm in respiration gating system
Authors: Tuan Chiu-Ching , Lu Chi-Heng , Wu Yi-Chao , Chien Yu-Feng , Lee Tsair-Fwu
Published: April 2019

This study proposes the use of the ScanNet real-time target moving monitoring method that allows the therapist to set up three primary color detection threshold values, the detection range, the automatic compensation of the distance of the device and the angle of the device. Moreover, the real-time images detected are used for reminding the patient to maintain the therapeutic posture. If the displacement exceeds the permitted range, an alert message will be sent out. Moreover, because the operation is simple, and the system requirements are not too demanding, ScanNet, in addition to its use in monitoring displacement during radiation therapy, can be applied to MRI and other treatments that require the patient to maintain a position for a long time or on patients receiving residential respiratory therapy.
Kernel Affine Projection P-norm (KAPP) Filtering under Alpha Stable Distribution Noise Environment
Authors: Dai Shaogang , Jin Mingming , Zhang Xiaofei
Published: April 2019

Aiming at improving the performance of the nonlinear adaptive filtering under the alpha-stable distribution noise environment, Kernel Affine Projection P-norm (KAPP) algorithm based on the minimum dispersion coefficient criterion and the affine projection is deduced. The accuracy of the gradient estimation is enhanced by using the input signals and the error signals at multiple times. The simulation results on Mackey–Glass chaotic time series prediction show that the KAPP algorithm has faster convergence speed, better steady-state performance and stronger robustness under the Gaussian noise and stable distributed noise environment.
Intuitionistic Fuzzy Hybrid Weighted Arithmetic Mean and Its Application in Decision Making
Authors: Wang Weize , Mendel Jerry M.
Published: April 2019

Atanassov’s intuitionistic fuzzy sets (AIFSs), characterized by a membership function, a non-membership function, and a hesitancy function, is a generalization of a fuzzy set. There are various intuitionistic fuzzy hybrid weighted aggregation operators to deal with multi-attribute decision making problems which consider the importance degrees of the arguments and their ordered positions simultaneously. However, these existing hybrid weighed aggregation operators are not monotone with respect to the total order on intuitionistic fuzzy values (AIFVs), which is undesirable. Based on the Łukasiewicz triangular norm, we propose an intuitionistic fuzzy hybrid weighted arithmetic mean, which is monotone with respect to the total order on AIFVs, and therefore is a true generalization of such operations. We give an example that a company intends to select a project manager to illustrate the validity and applicability of the proposed aggregation operator. Moreover, we extend this kind of hybrid weighted arithmetic mean to the interval-valued intuitionistic fuzzy environments.
Certainty Equivalent under Cumulative Prospect Theory
Authors: Chudziak Jacek
Published: April 2019

We consider the relations between some properties of the certainty equivalent and the form of a utility function under Cumulative Prospect Theory.
Isoperimetric deformations of curves on the Minkowski plane
Authors: Park Hyeongki , Inoguchi Jun-ichi , Kajiwara Kenji , Maruno Ken-ichi , Matsuura Nozomu , Ohta Yasuhiro
Published: April 2019

We formulate an isoperimetric deformation of curves on the Minkowski plane, which is governed by the defocusing modified Korteweg-de Vries (mKdV) equation. Two classes of exact solutions to the defocusing mKdV equation are also presented in terms of the [Formula: see text] functions. By using one of these classes, we construct an explicit formula for the corresponding motion of curves on the Minkowski plane even though those solutions have singular points. Another class gives regular solutions to the defocusing mKdV equation. Some pictures illustrating the typical dynamics of the curves are presented.
Exact Algorithms for the Maximum Planar Subgraph Problem
Authors: Chimani Markus , Hedtke Ivo , Wiedera Tilo
Published: April 2019

Given a graph
G
, the NP-hard
Maximum Planar Subgraph
problem asks for a planar subgraph of
G
with the maximum number of edges. The only known non-trivial exact algorithm utilizes Kuratowski’s famous planarity criterion and can be formulated as an integer linear program (ILP) or a pseudo-Boolean satisfiability problem (PBS). We examine three alternative characterizations of planarity regarding their applicability to model maximum planar subgraphs. For each, we consider both ILP and PBS variants, investigate diverse formulation aspects, and evaluate their practical performance.
New Molecular Insights into Immune Cell Development
Authors: Cumano Ana , Berthault Claire , Ramond Cyrille , Petit Maxime , Golub Rachel , Bandeira Antonio , Pereira Pablo
Published: April 2019

During development innate lymphoid cells and specialized lymphocyte subsets colonize peripheral tissues, where they contribute to organogenesis and later constitute the first line of protection while maintaining tissue homeostasis. A few of these subsets are produced only during embryonic development and remain in the tissues throughout life. They are generated through a unique developmental program initiated in lympho-myeloid-primed progenitors, which lose myeloid and B cell potential. They either differentiate into innate lymphoid cells or migrate to the thymus to give rise to embryonic T cell receptor–invariant T cells. At later developmental stages, adaptive T lymphocytes are derived from lympho-myeloid progenitors that colonize the thymus, while lymphoid progenitors become specialized in the production of B cells. This sequence of events highlights the requirement for stratification in the establishment of immune functions that determine efficient seeding of peripheral tissues by a limited number of cells.
Antigen Receptor Function in the Context of the Nanoscale Organization of the B Cell Membrane
Authors: Gold Michael R. , Reth Michael G.
Published: April 2019

The B cell antigen receptor (BCR) plays a central role in the self/nonself selection of B lymphocytes and in their activation by cognate antigen during the clonal selection process. It was long thought that most cell surface receptors, including the BCR, were freely diffusing and randomly distributed. Since the advent of superresolution techniques, it has become clear that the plasma membrane is compartmentalized and highly organized at the nanometer scale. Hence, a complete understanding of the precise conformation and activation mechanism of the BCR must take into account the organization of the B cell plasma membrane. We review here the recent literature on the nanoscale organization of the lymphocyte membrane and discuss how this new information influences our view of the conformational changes that the BCR undergoes during activation.
Differential Effects of Depleting versus Programming Tumor-Associated Macrophages on Engineered T Cells in Pancreatic Ductal Adenocarcinoma
Authors: Stromnes Ingunn M. , Burrack Adam L. , Hulbert Ayaka , Bonson Patrick , Black Cheryl , Brockenbrough J. Scott , Raynor Jackson F. , Spartz Ellen J. , Pierce Robert H. , Greenberg Philip D. , Hingorani Sunil R.
Published: April 2019

Pancreatic ductal adenocarcinoma (PDA) is a lethal malignancy resistant to therapies, including immune-checkpoint blockade. We investigated two distinct strategies to modulate tumor-associated macrophages (TAM) to enhance cellular therapy targeting mesothelin in an autochthonous PDA mouse model. Administration of an antibody to colony-stimulating factor (anti-Csf1R) depleted Ly6Clow protumorigenic TAMs and significantly enhanced endogenous T-cell intratumoral accumulation. Despite increasing the number of endogenous T cells at the tumor site, as previously reported, TAM depletion had only minimal impact on intratumoral accumulation and persistence of T cells engineered to express a murine mesothelin-specific T-cell receptor (TCR). TAM depletion interfered with the antitumor activity of the infused T cells in PDA, evidenced by reduced tumor cell apoptosis. In contrast, TAM programming with agonistic anti-CD40 increased both Ly6Chigh TAMs and the intratumoral accumulation and longevity of TCR-engineered T cells. Anti-CD40 significantly increased the frequency and number of proliferating and granzyme B+ engineered T cells, and increased tumor cell apoptosis. However, anti-CD40 failed to rescue intratumoral engineered T-cell IFNγ production. Thus, although functional modulation, rather than TAM depletion, enhanced the longevity of engineered T cells and increased tumor cell apoptosis, ultimately, anti-CD40 modulation was insufficient to rescue key effector defects in tumor-reactive T cells. This study highlights critical distinctions between how endogenous T cells that evolve in vivo, and engineered T cells with previously acquired effector activity, respond to modifications of the tumor microenvironment.
Rare Concurrence of Two Congenital Disorders: Miller-Dieker Syndrome and T-Cell Lymphopenia
Authors: Chee Siew-Yin , Guo Jiun-Wen , Huang Chi-Jung , Chien Yin-Hsiu , Lee Yu-Chin , Feng Wen-Kan
Published: April 2019

Miller-Dieker syndrome (MDS; OMIM 247200) is a rare contiguous gene deletion syndrome associated with lissencephaly and characteristic facial dysmorphism. T-cell lymphopenia is an immunodeficiency disorder which can be early detected by newborn blood screening, and all live vaccines should be avoided. We report a 2.32-Mb microdeletion at chromosome 17p13.3p13.2 and T-cell lymphopenia in a 6-month-old male infant with MDS. This is, to our knowledge, the first description of these 2 conditions co-occurring in the same patient.
ЕФЕКТИВНІСТЬ МЕТАБОЛІЧНОГО ВПЛИВУ МЕЛЬДОНІЮ ДИГІДРАТУ ПРИ КОМОРБІДНИХ СТАНАХ – АРТЕРІАЛЬНІЙ ГІПЕРТЕНЗІЇ, ОЖИРІННІ ТА ПОДАГРІ
Authors: Vatseba M. O.
Published: April 2019

Артеріальна гіпертензія є актуальною проблемою сучасної охорони здоров'я України з огляду на її поширеність серед різних вікових категорій, несприятливу прогностичну значущість як чинника, що має істотний вплив на показники серцево-судинної захворюваності та смертності.

Мета – оцінити ефективність впливу мельдонію дигідрату на показники ендотеліальної дисфункції та артері­альної жорсткості  у хворих на артеріальну гіпертензію в поєднанні з ожирінням та подагрою.

Матеріал і методи. У дослідження включено 80 хворих на есенціальну атеріальну гіпертензію ІІ стадії 2 ступеня в поєднанні з ожирінням та подагрою. 1 підгрупа – 20 хворих, які отримували стандартну терапію: блокатори кальцієвих каналів – амлодипін 5–10 мг/добу, статин – аторвастатин 10–20 мг/добу, нетіазидний діуретик – індапамід 2,5 мг зранку, алопуринол 100–300 мг/добу. 2 підгрупа – 20 хворих, які, крім стандартної терапії, отримували мельдоній дигідрат («Метамакс», Дарниця, Україна) – 5 мл 10 % розчину розводили в 15 мл 0,9 % розчину натрію хлориду, вводили внутрішньовенно струминно протягом 10 днів з подальшим переходом на капсульну форму – 250 мг 3 рази на день протягом 1 місяця всередину. Здійснили клінічне обстеження хворих та визначили ендотелійзалежну вазодилатацію (ЕЗВД), ендотелійнезалежну вазодилатацію (ЕНЗВД), товщину інтимо-медійного комплексу (ТІМК), швидкість поширення пульсової хвилі (ШППХ), CAVI, індекс жорсткості аорти (ІЖА), рівень ЕТ-1 в крові.

Результати. Через 1 місяць спостерігали позитивну динаміку ЕЗВД на 68,92 % (p<0,001), а через 6 місяців лікування – на 70,81 % (p<0,001). Через місяць застосування мельдонію дигідрату рівень ЕТ-1 знизився на 36,47 % (p<0,001), а через 6 місяців – на 36,69 % (р<0,001). Достовірні зміни ІЖА були відсутні (p>0,05). CAVI знизився вже через 1 місяць лікування – на 6,32 % (p<0,05), а через 6 місяців – на 8,24 % (p<0,05). Зменшилась ТІМК після 1 місяця лікування на 13,46 % (p<0,05), а після 6 місяців – на 16,34 % (p<0,01). ШППХ також достовірно зменшувалась через 1 місяць лікування на 12,54 % (p<0,01), а через 6 місяців – на 18,31 % (p<0,001).

Висновки. Включення до стандартної терапії мельдонію дигідрату сприяє ефективності не тільки антигіпер­тензивної, але й вазопротективної дій.
СТАН КИСЛОТНО-ОСНОВНОЇ РІВНОВАГИ ТА ВʼЯЗКОСТІ КРОВІ У ЩУРІВ ПРИ ГОСТРОМУ І ХРОНІЧНОМУ ОТРУЄННІ АЦЕТИЛСАЛІЦИЛОВОЮ КИСЛОТОЮ ТА ЇХ ВПЛИВ НА СТРУКТУРНУ ОРГАНІЗАЦІЮ ПЕЧІНКИ І НИРОК
Authors: Klantsa M. P. , Herasymiuk I. Ye. , Korytskyy A. G.
Published: April 2019

Оптимальний рівень кислотно-лужної рівноваги є однією з вагомих складових, що формують гомеостаз організму. Відомо також, що метаболічний ацидоз може розвиватися при передозуванні саліцилових препаратів.

Мета – встановити рівень ацидозу та вʼязкості крові у щурів при гострому і хронічному отруєнні ацетил­саліциловою кислотою та їх вплив на морфологічний стан печінки і нирок.

Матеріал і методи. Експерименти проведено на білих лабораторних щурах, яким моделювали гостре і хро­нічне отруєння ацетилсаліциловою кислотою. Дослідження проводили з використанням функціональних (вимірю­вання рН і вʼязкості крові), гістологічних і статистичних методик.

Результати. Встановлено, що гостре отруєння ацетилсаліциловою кислотою у щурів супроводжується суттєвим зниженням рН і вʼязкості крові, що призводить до виражених розладів органного кровообігу, які про­являються у вигляді застійного венозного повнокровʼя, капіляростазів з реактивною висхідною вазоконстрикцією.

У процесі хронічного отруєння ацетилсаліциловою кислотою через 1 добу експерименту також спостерігалася тенденція до зниження досліджуваних показників крові, проте ступінь її вираження був значно меншим, порівняно із гострим отруєнням. Через 3 доби від початку хронічної інтоксикації відбувалася стабілізація показників і навіть часткова компенсація рН. Проте згодом рівень рН знову продовжував прогресивно знижуватися, не сягаючи, однак, рівня, що був до гострого отруєння. На відміну від цього, вʼязкість крові, навпаки, набувала тенденції до зростання.

Виявлені тривалі розлади органного кровотоку призводили до дистрофічних змін тканин печінки і нирок, які можуть бути причиною розвитку печінкової та ниркової недостатності.

Висновки. 1. Гостре отруєння великими дозами ацетилсаліцилової кислоти призводить до суттєвого зростан­ня рівня ацидозу з одночасним відчутним зниженням вʼязкості крові, які можуть бути важливими ланками пато­генезу розвитку несумісних з життям розладів гемодинаміки.

2. Хронічне отруєння ацетилсаліциловою кислотою також призводить до поступового розвитку ацидозу, ступінь якого менш виражений, ніж при гострому отруєнні, і впливає на динаміку вʼязкості крові.

3. Розлади органного кровотоку, які виникають при хронічному отруєнні ацетилсаліциловою кислотою, менш виражені, ніж при гострому отруєнні, і призводять до дистрофічних змін у печінці й нирках, які можуть бути причиною розвитку печінкової та ниркової недостатності.
ОСОБЛИВОСТІ СУЧАСНОЇ ГЕНДЕРНОЇ ДИФЕРЕНЦІАЦІЇ ПАРАНОЇДНОЇ ШИЗОФРЕНІЇ
Authors: Chernachuk S. V. , Buzdyhan O. H. , Shkrobot S. I.
Published: April 2019

У статті проаналізовано клініко-анамнестичні та клініко-психопатологічні особливості параноїдної шизофренії з урахуванням гендерного фактора.

Мета – вивчення особливостей сучасної  гендерної диференціації клініко-анамнестичних та клініко-психопатологічних особливостей перебігу параноїдної шизофренії.

Матеріал і методи. Проведено клініко-анамнестичне та клініко-психопатологічне обстеження 210 чоловіків та 210 жінок, хворих на параноїдну шизофренію, з використанням шкали PANSS.

Результати. Встановлено, що клінічний патоморфоз депресивних розладів на сучасному етапі характеризується збільшенням поширеності астенічної симптоматики (79,9 % проти 67,4 %, р<0,01), нездатності концентруватися і приймати рішення (71,4 % проти 61,0 %, р<0,05), тривожної симптоматики (81,0 % проти 73,7 %, р<0,05), песимізму (80,4 % проти 79,2 %, р<0,05), суїцидальних думок (70,4 % проти 60,2 %, р<0,05), гастроінтестинальної симптоматики (60,3 % проти 51,7 %, р<0,05), інсомнічних проявів (93,1 % проти 81,8 %, р<0,01), і зменшенням проявів ангедонії (76,2 % проти 84,3 %, р<0,05) і заниженої самооцінки (80,5 % проти 73,0 %, р<0,05). Виявлено, що інтрасиндромологічна структура депресивних розладів на сучасному етапі характеризується зменшенням поширеності вітальної депресії (з 56,8 % до 42,9 %, р<0,05) та анестетичної депресії (з 25,8 % до 18,0 %, р<0,05) при збільшенні поширеності апатичних депресій (24,3 % проти 17,4 %, р<0,05), наявністю тривожно-фобічних та іпохондричних включень (56,1 % проти 47,5 %, р<0,05), інсомнічних порушень у вигляді пресомнічних, інтрасомнічних, постсомнічних проявів з переважанням останніх (93,1 % проти 81,8 %, р<0,01), вегето-соматичних розладів та соматизованих проявів у вигляді гетерогенних поліморфних сенестопатій (77,8 % проти 68,2 %, р<0,05), сенесто-алгічного синдрому (11,6 % проти 6,4 %, р<0,05), а також астенічної депресії (79,9 % проти 66,9 %, р<0,01), ажитованої депресії (38,6 % проти 30,1 %, р<0,05) та депресії зі стрибками ідей (28,0 % проти 20,8 %, р<0,05).

Висновки. Виявлені закономірності враховані при розробці диференційованих схем лікування параноїдної шизофренії.
ДЕЯКІ ОСОБЛИВОСТІ УРАЖЕННЯ ОПОРНО-РУХОВОЇ СИСТЕМИ, АСОЦІЙОВАНІ ІЗ ХВОРОБОЮ ЛАЙМА, У МЕШКАНЦІВ ТЕРНОПІЛЬЩИНИ
Authors: Shkilna M. I. , Popovych D. V. , Diachenko M. M.
Published: April 2019

Цель – изучить особенности клинических проявлений поражения опорно-двигательного аппарата у жителей Тернопольщины, инфицированных Borrelia burgdorferi.

Материал и методы. Под наблюдением находились 58 жителей Тернопольской области в возрасте от 16 до 68 лет с заболеваниями опорно-двигательной системы, инфицированных Borrelia burgdorferi. В зависимости от принадлежности к группам риска Лайм-боррелиоза, обследованных поделили на 2 группы: 30 лиц (1 группа) – работники лесных хозяйств Тернопольской области и 28 лиц (2 группа) – жители Тернопольщины, лечившиеся амбулаторно и стационарно по поводу заболеваний опорно-двигательной системы. Диагноз болезни Лайма уста­нав­ливали на основании серологического исследования сыворотки больных методом иммуноферментного ана­лиза на наличие антител к антигенам комплекса B. burgdorferi sensu lato. Для оценки поражения суставов у жителей Тернопольщины был использован суставной счет (количественный) – суммарное числовое выражение боли и припухлости суставов.

Результаты. Среди опрошенных 30 (66,6 %) лесников Тернопольщины и 4 (14,8 %) пациента отметили более 3 укусов клещей, двукратный эпизод укуса имели 8 (26,6 %) пациентов 1-й группы и 2 (7,4 %) 2-й соответственно; 10 (29,6 %) из 58 респондентов двух групп не помнят о случаях укусов клещей в течение жизни. У 15 (48,3 %) из 28 больных заболеваниями опорно-двигательной системы имело место сочетанное поражение больших и мел­ких суставов, тогда как у 15 (50,0 %) из 30 обследованных работников лесных хозяйств преобладали повреждения крупных суставов. Антитела хотя бы одного класса IgM и/или IgG к B. burgdorferi sensu lato (B. burgdorferi sensu stricto, B. afzeliи и B. garinii) выявлены у 14 (46,7 %) из 30 работников лесных хозяйств Тернопольщины и 7 (25,0 %) из 28 пациентов с заболеваниями опорно-двигательной системы.

Выводы. Анализ влияния возбудителей комплекса Borrelia burgdorferi sensu lato на органы опорно-двигатель­ной системы работников лесных хозяйств и жителей Тернопольщины проведен впервые. У 33,3 % пациентов 1-й и 2-й групп, которые не помнили об укусах клещей, лабораторно диагностированы положительные или промежу­точные результаты хотя бы одного класса специфических антител к Borrelia burgdorferi sensu lato и имеются кли­нические признаки поражения органов опорно-двигательной системы. У 50 % работников лесных хозяйств Терно­польской области, инфицированных Лайм-боррелиозом, преобладали поражения крупных суставов, тогда как 53,6 % обследованных нами больных Тернопольщины беспокоило одновременное поражение больших и мелких суставов.
Inteligência artificial e direitos da personalidade
Authors: Tomasevicius Filho Eduardo
Published: April 2019

A inteligência artificial surgiu concomitantemente com a eletrônica e a ciência da computação na década de 1950. Tem sido aplicada cada vez mais em diversas áreas e potencializou-se com a maior capacidade de armazenamento e tráfego de dados pela Internet. Todavia, especialmente em 2018, ampliou-se a percepção da sociedade para os efeitos positivos e negativos do emprego dessa tecnologia, do ponto de vista não apenas político, mas também dos direitos da personalidade, sobretudo o direito à privacidade. Neste artigo, faz-se a apresentação da inteligência artificial, os problemas que esta pode causar às pessoas e os desafios dos direitos da personalidade na defesa da dignidade humana.
O desenvolvimento dos estudos sociojurídicos
Authors: Villas Bôas Filho Orlando
Published: April 2019

Este artigo tem o intuito de ressaltar a importância da pesquisa interdisciplinar para a compreensão da regulação jurídica em um contexto social hipercomplexo. Para tanto, concebe os “estudos sociojurídicos” como um campo interdisciplinar em que contribuições provenientes das mais diversas áreas das ciências sociais podem ser apropriadas pelos juristas para o desenvolvimento de uma compreensão mais consequente da regulação jurídica. Contudo, considerando a especificidade assumida pelos aportes teóricos de outras áreas no âmbito dos estudos jurídicos, procura sublinhar as dificuldades ínsitas à pesquisa interdisciplinar. Assim, em termos ilustrativos, é realizado um contraste da perspectiva dos juristas com a de pesquisadores de outras áreas em quatro domínios: filosofia; sociologia; história; antropologia.
A vocação do nosso tempo para a filosofia do direito... e para a filosofia dos direitos humanos
Authors: Carvalho Felipe Rodolfo de
Published: April 2019

Este ensaio objetiva responder à pergunta quanto ao papel da reflexão filosófica no âmbito do Direito e no âmbito dos Direitos Humanos, explicitando, antes de tudo, por que razão tal indagação necessariamente se coloca. A fim de apresentar uma resposta, busca distinguir as tarefas da Ciência Jurídica e da Filosofia do Direito, ressaltando, ao mesmo tempo, sua complementaridade. Por consequência, propõe-se a identificar não só papéis gerais da Filosofia do Direito, mas também seu papel específico diante do cenário jurídico contemporâneo. É aqui que a busca pelo sentido do Direito se coloca como incumbência da Jusfilosofia, encaminhando-a inexoravelmente para a temática dos Direitos Humanos, os quais demandam também ser ressignificados. Como conclusão, ressalta, então, a vocação do nosso tempo para a Filosofia do Direito e, correlatamente, para a Filosofia dos Direitos Humanos.
Políticas de defesa da concorrência no âmbito internacional
Authors: Cedano Bruno Menoncello
Published: April 2019

O objetivo do presente artigo é analisar a possibilidade de integração entre políticas nacionais de defesa da concorrência e a promoção do antitruste no plano internacional. Defende-se que a convergência regulatória e a celebração de acordos internacionais podem funcionar como instrumento hábil para promover um antitruste mais eficaz e, por esse escopo, se busca conciliar a soberania nacional com a cooperação internacional para um antitruste mais efetivo. Para isso, analisamos as principais vantagens e dificuldades na cooperação internacional para o antitruste, bem como o processo decisório de cada nação na elaboração dessas políticas. Assim, podemos construir uma metodologia que permita que esses acordos sejam negociados. Como conclusão entende-se que essa integração melhor se desenvolve no âmbito dos blocos econômicos, por meio de acordos regionais.
Direito e consequência
Authors: Barros Marco Antonio Loschiavo Leme de
Published: April 2019

Este artigo discute o papel do exame das consequências como uma etapa da adjudicação jurídica. Esse exame é apresentado a partir de duas perspectivas. Primeira, como exame das consequências jurídicas, discute-se o impacto e desdobramento da decisão a partir da dinâmica do sistema jurídico. Tal enfoque enfatiza a evolução do sistema jurídico, bem como recai no debate sobre a compreensão do processo como meio de acesso à justiça e na formação e respeito à cultura dos precedentes. A segunda perspectiva é relacionada ao exame das consequências extrajurídicas, que exige compreender como o direito observa a sociedade. Por meio da Teoria dos Sistemas Sociais, o texto avança sobre o campo de uma sociologia da decisão jurídica orientada para o estudo sobre como juízes e outras autoridades consideram em seus votos as consequências sociais enquanto argumentos para a decisão. No final, o texto indica o desafio metodológico para a articulação entre saberes jurídicos e extrajurídicos subjacente ao enfrentamento das consequências na tomada de decisão. Exige-se do sistema jurídico, em especial das organizações, a observação de mecanismos de tradução e filtragem capazes de lidar com comunicações interdisciplinares, tipo de comunicação envolvida na adjudicação de casos baseados em consequências sociais.
Neoliberalismo e sujeito
Authors: Rossi Helena Costa , Akimoto Júnior Cláudio Kazuo
Published: April 2019

Inspirando-se na identificação do neoliberalismo como racionalidade, e como manifestação de uma nova subjetividade, esta pesquisa propõe-se a compreender como o processo de transformação e instituição do sujeito neoliberal é estabelecido e se condiciona sob parâmetros de desempenho. A consequente inadequação a estes parâmetros é inserida no discurso dos diagnósticos psiquiátrico-psicológicos, ensejando uma ressignificação do sofrimento. Em consequência, alteram-se as formas de reconhecimento identitário, determinando-se espaços de exclusão em relação ao diferente. Como resultado de pesquisa bibliográfica (descritiva e exploratória), sujeita ao método interpretativo (descrição, conceituação, caracterização e apontamento de consequências), possibilitou-se, então, compreender como a nova racionalidade neoliberal intervém na construção da identidade e na ressignificação do sofrimento, definindo e estabelecendo espaços de exclusão em relação ao diferente.
The diversity and conservation of mammals in the Dodo Coastal Forest in southwestern Côte d’Ivoire, western Africa: a preliminary study
Authors: Soiret Serge Pacome Keagnon , Kouakou Célestin Yao , Koffi Béné Jean-Claude , Kadjo Blaise , Kouassi Philippe , Gomez Peñate José , Matsuda Goodwin Reiko , Kone Inza
Published: April 2019

To improve the knowledge of non-volant mammal diversity and conservation prospects in the Dodo Coastal Forest (DCF) in southwestern Côte d’Ivoire, we conducted reconnaissance surveys and interviews, and deployed remote cameras.  We calculated visual encounter rates (vER) and sign ER (sER) of mammalian taxa and hunting signs, mapped their locations and tested the hypothesis that sightings and signs of primates occurred closer to the river Dodo in and near the gallery forest.  We sighted nine taxa, including threatened King Colobus (Endangered, EN), Olive Colobus (Vulnerable, VU), Lowe’s Monkey (VU), the Eastern Lesser Spot-nosed Monkey (VU), and White-bellied Pangolin (VU), with vER of 0.04, 0.12, 0.04, 0.12, 0.04, respectively.  We confirmed 14 other taxa with signs including threatened Western Chimpanzee (CR), Pygmy Hippopotamus (Endangered, EN), Bosman’s Potto (VU), and Black-bellied Pangolin (VU), with sER of 0.51, 0.04, 0.08, 0.04, respectively.  The most frequently encountered signs were of the Red River Hog at 1.73 signs/km, and the Bushbuck at 0.63 signs/km.  Remote cameras captured images of these two taxa at image capture rates (ICR) of 0.044 and 0.022, respectively.  Images of the African Buffalo were captured at ICR of 0.044.  The 23 confirmed taxa include seven primates, four rodents, three carnivores, six even-toed ungulates, two pangolins and a Tree Hyrax.  The mean distance from the river Dodo to the sightings and the signs of the primates was significantly shorter than that of other taxa.  This supports our hypothesis.  There was a high level of hunting signs (sER = 0.63) indicating that intensive hunting pressure is menacing the fauna.  We recommend that authorities take actions against poaching, install a surveillance program, and curtail charcoal-making to ensure the conservation of the threatened mammals of the DCF.
Comparison of Patient‐Reported Care Satisfaction, Quality of Warfarin Therapy, and Outcomes of Atrial Fibrillation: Findings From the ORBIT‐AF Registry
Authors: Perino Alexander C. , Shrader Peter , Turakhia Mintu P. , Ansell Jack E. , Gersh Bernard J. , Fonarow Gregg C. , Go Alan S. , Kaiser Daniel W. , Hylek Elaine M. , Kowey Peter R. , Singer Daniel E. , Thomas Laine , Steinberg Benjamin A. , Peterson Eric D. , Piccini Jonathan P. , Mahaffey Kenneth W.
Published: April 2019

Background

Patient satisfaction with therapy is an important metric of care quality and has been associated with greater medication persistence. We evaluated the association of patient satisfaction with warfarin therapy to other metrics of anticoagulation care quality and clinical outcomes among patients with atrial fibrillation (
AF
).

Methods and Results

Using data from the
ORBIT
‐
AF
(Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry, patients were identified with
AF
who were taking warfarin and had completed an Anti‐Clot Treatment Scale (
ACTS
) questionnaire, a validated metric of patient‐reported burden and benefit of oral anticoagulation. Multivariate regressions were used to determine association of
ACTS
burden and benefit scores with time in therapeutic international normalized ratio range (
TTR
; both ≥75% and ≥60%), warfarin discontinuation, and clinical outcomes (death, stroke, major bleed, and all‐cause hospitalization). Among 1514 patients with AF on warfarin therapy (75±10 years; 42% women;
CHA
2
DS
2
‐
VAS
c 3.9±1.7), those most burdened with warfarin therapy were younger and more likely to be women, have paroxysmal
AF
, and to be treated with antiarrhythmic drugs. After adjustment for covariates,
ACTS
burden scores were independent of
TTR
(
TTR
≥75%: odds ratio, 1.01 [95%
CI
, 0.99–1.03];
TTR
≥60%: odds ratio, 1.01 [95%
CI
, 0.98–1.05]), warfarin discontinuation (odds ratio, 0.99; 95%
CI
, 0.97–1.01), or clinical outcomes.
ACTS
benefit scores were also not associated with
TTR
, warfarin discontinuation, or clinical outcomes.

Conclusions

In a large registry of patients with
AF
taking warfarin,
ACTS
scores provided independent information beyond other traditional metrics of oral anticoagulation care quality and identified patient groups at high risk for dissatisfaction with warfarin therapy.
Review of Epoicocladius Šulc et Zavřel from China (Diptera, Chironomidae)
Authors: YAN CHUNCAI , LIU TING , CAO WEI , ZHANG XINGHUA , LIU WENBIN
Published: April 2019

Epoicocladius Šulc et Zavřel from China is reviewed. Epoicocladius wangi Liu et Yan sp. n. is described and illustrated as male imago from China. The generic diagnosis is amended. Key to the known adult males of the genus and species distribution map worldwide are presented.
Type designations for sap beetles in the subfamily Carpophilinae Erichson (Coleoptera: Nitidulidae) housed in the Natural History Museum, London
Authors: POWELL GARETH S. , MARTIN GAVIN J.
Published: April 2019

The subfamily Carpophilinae, in particular the genus Carpophilus Stephens, represents one of the most speciose lineages within Nitidulidae. The subfamily was first recognized by Erichson (1843) in a much broader sense, including what is now the Cillaeinae. According to Kirejtshuk (2008), there are seven genera and 13 subgenera within Carpophilinae. To date, however, no comprehensive tribal or generic phylogenetic reconstructions have been published for the subfamily. This work constitutes a preliminary stage of a larger project that will address the subfamily in a rigorous taxonomic and systematic framework. A stable taxonomic foundation for Carpophilus species and other Carpophilinae taxa is needed to ensure the validity of future work in the subfamily. Herein we designate lectotypes and paralectotypes and confirm holotypes for 14 species of carpophiline sap beetles following ICZN (1999) articles 73.1 and 74.1.
Coupled Interannual Variability of Wind and Sea Surface Temperature in the Caribbean Sea and the Gulf of Mexico
Authors: Rodriguez-Vera Geidy , Romero-Centeno Rosario , Castro Christopher L. , Castro Víctor Mendoza
Published: April 2019

This work describes dominant patterns of coupled interannual variability of the 10-m wind and sea surface temperature in the Caribbean Sea and the Gulf of Mexico (CS&GM) during the period 1982–2016. Using a canonical correlation analysis (CCA) between the monthly mean anomalies of these fields, four coupled variability modes are identified: the dipole (March–April), transition (May–June), interocean (July–October), and meridional-wind (November–February) modes. Results show that El Niño–Southern Oscillation (ENSO) influences almost all the CS&GM coupled modes, except the transition mode, and that the North Atlantic Oscillation (NAO) in February has a strong negative correlation with the dipole and transition modes. The antisymmetric relationships found between the dipole mode and the NAO and ENSO indices confirm previous evidence about the competing remote forcings of both teleconnection patterns on the tropical North Atlantic variability. Precipitation in the CS and adjacent oceanic and land areas is sensitive to the wind–SST coupled variability modes from June to October. These modes seem to be strongly related to the interannual variability of the midsummer drought and the meridional migration of the intertropical convergence zone in the eastern Pacific. These findings may eventually lead to improving seasonal predictability in the CS&GM and surrounding land areas.
Evaluation of Intraoperative, Local Site Injections of Liposomal Bupivacaine as an Alternative to Standard Local Anesthetics in Patients Undergoing Total Hip Arthroplasty
Authors: Rainville Edward C. , Asche Carl , Ren Jinma , Kim MinChul , Walker Lucas , Maurer B. Ted , Knolhoff Daniel R. , Shick Kyle M.
Published: April 2019

Background: Achieving postsurgical pain control after total hip arthroplasty (THA) is a critical factor for successful recovery because inadequately treated pain may lead to a delay in ambulation and hospital discharge and have an adverse impact on a patient’s quality of life. Objective: This study compares the effectiveness of immediate-release local anesthetics for pain control in THA vs liposomal bupivacaine (LB) related to patient outcomes and costs of care. Methods: This is a retrospective cohort study of consecutive patients undergoing THA at 3 hospitals from January 2013 to July 2016. The control group received plain bupivacaine or ropivacaine while the study group received LB. Generalized linear models were used controlling for several patient factors. Primary measures included length of stay (LOS), hospitalization costs, pain relief, opioid use, and mobility. Secondary outcomes were discharge disposition and 30-, 60-, and 90-day readmissions. Results: One hundred and ninety-six patients were identified, with 103 as controls, 70 receiving LB, and 23 excluded. The LB group showed a decrease in LOS of 0.5 days (2.5 ± 2.6 vs 3.0 ± 2.1 days, P = .010), increased mobility on the day of surgery (27.6 ± 49.3 vs 12.5 ± 48.5 feet, P = .001) and the first day after surgery (186.8 ± 133.8 vs 155.2 ± 135.6, P = .039), and decreased hospital costs ($10 670 vs $11 351, P = .022). There were no significant differences in pain scores, opioid use, adverse events, discharge disposition, or readmissions. Study limitations include retrospective analysis, unblinded participants, and generalizability of results. Conclusions: LB provides an effective alternative to standard local anesthetics in patients undergoing THA based on improvements of inpatient parameters, LOS, and cost measures.
Political Institutions and the Comparative Medicalization of Abortion
Authors: Halfmann Drew
Published: April 2019

Comparative-historical research on medicalization is rare and, perhaps for that reason, largely ignores political institutions, which tend to vary more across countries than within them. This article proposes a political-institutional theory of medicalization in which health care policy legacies, political decentralization, and constitutionalism shape the preferences, discourses, strategies, and influence of actors that seek or resist medicalization. The theory helps explain why abortion has been more medicalized in Britain than the United States. The analysis finds that the American medical profession, unlike its British counterpart, focused on defending private medicine rather than protecting its power to “diagnose” the medical necessity of abortions; that American political decentralization aided the establishment of abortion on request by encouraging strategic innovation and learning that shaped social movement strategies, medical issue avoidance, and the growth of nonhospital clinics; and finally, that constitutionalism promoted rights discourses that partially crowded out medical ones.