bluuebunny/crossref_metadata_2025 huggingface dataset:
Neurotransmission to parasympathetic cardiac vagal neurons in the brain stem is altered with left ventricular hypertrophy-induced heart failure
Authors: Cauley Edmund , Wang Xin , Dyavanapalli Jhansi , Sun Ke , Garrott Kara , Kuzmiak-Glancy Sarah , Kay Matthew W. , Mendelowitz David
Published: September 2015

Hypertension, cardiac hypertrophy, and heart failure (HF) are widespread and debilitating cardiovascular diseases that affect nearly 23 million people worldwide. A distinctive hallmark of these cardiovascular diseases is autonomic imbalance, with increased sympathetic activity and decreased parasympathetic vagal tone. Recent device-based approaches, such as implantable vagal stimulators that stimulate a multitude of visceral sensory and motor fibers in the vagus nerve, are being evaluated as new therapeutic approaches for these and other diseases. However, little is known about how parasympathetic activity to the heart is altered with these diseases, and this lack of knowledge is an obstacle in the goal of devising selective interventions that can target and selectively restore parasympathetic activity to the heart. To identify the changes that occur within the brain stem to diminish the parasympathetic cardiac activity, left ventricular hypertrophy was elicited in rats by aortic pressure overload using a transaortic constriction approach. Cardiac vagal neurons (CVNs) in the brain stem that generate parasympathetic activity to the heart were identified with a retrograde tracer and studied using patch-clamp electrophysiological recordings in vitro. Animals with left cardiac hypertrophy had diminished excitation of CVNs, which was mediated both by an augmented frequency of spontaneous inhibitory GABAergic neurotransmission (with no alteration of inhibitory glycinergic activity) as well as a diminished amplitude and frequency of excitatory neurotransmission to CVNs. Opportunities to alter these network pathways and neurotransmitter receptors provide future targets of intervention in the goal to restore parasympathetic activity and autonomic balance to the heart in cardiac hypertrophy and other cardiovascular diseases.
An Unusual Course of Segmental Renal Artery Displays a Rare Case of Hilar Nutcracker Phenomenon
Authors: Sawant Devendra A. , Moore Thomas F.
Published: September 2015

Nutcracker phenomenon or renal vein entrapment is classically seen as a compression of renal vein in between abdominal aorta and superior mesenteric artery with patients being asymptomatic or clinically manifested in the form of nutcracker syndrome as proteinuria, hematuria, flank pain, pelvic congestion in women, and varicocele in men. In this report, we are presenting a case of rare variant of nutcracker phenomenon along with brief review of anatomy, pathophysiology, public health, and clinical significance of nutcracker syndrome. On a routine dissection of an adult male cadaver, we noticed an unusual arrangement of the structures at the hilum of the left kidney showing entrapment of renal vein between left anterior inferior and posterior segmental renal arteries. The variation in the course of left anterior inferior segmental renal artery leads to compression of left renal vein at renal hilum. Therefore, we have named this rare abnormal anatomical entity as hilar nutcracker phenomenon. The structures in the right renal hilum are normal. The objective of this paper is to report an unusual but important variant of nutcracker phenomenon and also give collective knowledge of such anatomical variations in renal vasculature that will help in diagnosing and treating such rare renal disorder.
Apoptosis Induction in Human Leukemia Cell Lines by Gold Nanoparticles Synthesized Using the Green Biosynthetic Approach
Authors: Namvar Farideh , Rahman Heshu Sulaiman , Mohamad Rosfarizan , Rasedee Abdullah , Yeap Swee Keong , Chartrand Max Stanley , Azizi Susan , Tahir Paridah Mohd
Published: September 2015

Gold nanoparticles were grown on Sargassum muticum water extract (S‐GNPs) using the green biosynthetic approach. The nanoparticles were characterized using UV‐visible spectroscopy, zeta potential, and transmission electron microscopy (TEM). The resulting S‐GNPs were spherical and crystalline with a size of <10 nm. The in vitro anticancer activity was demonstrated in human leukemia cell lines. The cancer cells were treated with different concentrations of S‐GNPs, and calorimetric (MTT) assay used for the cytotoxicity test, which resulted in an IC50 value of 4.22 ± 1.12, 5.71 ± 1.4, 6.55 ± 0.9, and 7.29 ± 1.7 μg/mL for each of the K562, HL‐60, Jurkat, and CEM‐ss cells, respectively. Thus, the K562 was selected for the next experiments. Furthermore, apoptosis induction was confirmed by Hoechst 33342, annexin V staining, and caspase‐3/‐9 activity tests. The cell cycle analysis exhibited a significant increase in the accumulation of S‐GNPs treated cells at the sub‐G1 phase, demonstrating the induction of apoptosis by S‐GNPs. The nature of the inhibition of cancer cell growth by S‐GNPs could open the way for further research in the design of green synthesis therapeutic agents, particularly in nanomedicine, for the treatment of cancer.
The Likelihood Ranking Methods for Interval Type-2 Fuzzy Sets Considering Risk Preferences
Authors: Zhao Meng , Qin Song-song , Li Qi-wang , Lu Fu-qiang , Shen Zhe
Published: September 2015

This paper proposes a ranking method that considers the risk preferences of decision makers for multiple-attribute decision-making problems in a multiple-interval type-2 trapezoidal fuzzy set environment. First, decision makers are classified according to the risk preferences and a measurement method of risk preferences is proposed. Second, a risk preference decision matrix is obtained and a new calculation formula of likelihood is defined. Finally, we obtain the ranking results of alternatives by calculating the signed distance. Our example analysis shows that the proposed method is scientific and reasonable, and different risk preferences influence the results of decision making. Comparison with previous methods shows that the proposed algorithm is more feasible; it is applicable for decision making on both risk preferences and risk conservation.
Operative Exposure of a Surgical Trainee at a Tertiary Hospital in Kenya
Authors: Ojuka Daniel Kinyuru , Macleod Jana , Nyabuto Catherine Kwamboka
Published: September 2015

Background. Psychomotor domain training requires repetitive exposure in order to develop proficiency in skills. This depends on many training factors in any training institution.Objective. This study sought to look at the operative exposure of surgical trainees in a tertiary hospital in a developing country.Design and Setting. This was a six-month retrospective study performed in one surgical firm at Kenyatta National Hospital.Patients and Methods. The files of all patients admitted to the unit at that time were retrieved. The demographics, diagnosis at admission, need for surgery, and cadre of operating surgeon among others were recorded. Scientific Package for Social Sciences (SPSS) version 17.0 was used for data entry and analysis.Results. The study cohort was 402 patients of the 757 patients admitted in the study period. The average age was 36.7 years, a female to male ratio of 1 : 2.5. The majority (69.7%) of patients required surgery. Trauma was the most common reason for admission (44.5%). Year 2 residents received the most clinical exposure. Consultant was available in only 34.5% of the cases.Conclusion. The junior residents performed the vast majority of procedures with an unsatisfactory amount of supervision from the senior residents and faculty.
Serum Ferritin Is Associated with Metabolic Syndrome and Red Meat Consumption
Authors: Felipe Avila , Guadalupe Echeverría , Druso Pérez , Carlos Martinez , Pablo Strobel , Oscar Castillo , Luis Villaroel , Diego Mezzano , Jaime Rozowski , Inés Urquiaga , Federico Leighton
Published: September 2015

Background and Aims. Hyperferritinemia has been related with a wide spectrum of pathologies, including diabetes, cardiovascular disease, neurodegenerative disorders, and metabolic syndrome. The aim of this study was to investigate the association between hyperferritinemia and iron consumption.Methods and Results. Serum ferritin concentration was evaluated in 66 presumed healthy men, along with other clinical and biochemical markers of chronic diseases. A three-day food questionnaire was applied for nutrition information. Hyperferritinemia was a condition found in 13.4% of the volunteers analyzed. Significant correlations were found between serum ferritin concentration and metabolic syndrome parameters (HDL cholesterol, triglycerides, and fasting glucose) as well as an increase of the serum ferritin mean value with the number of risk factors of metabolic syndrome. Also, oxidative stress markers (carbonyl groups, AOPP, and glycated hemoglobin), hepatic damage markers (GGT, SGOT), and parameters related to insulin resistance (HOMA, blood insulin, and blood glucose) correlate significantly with serum ferritin. Volunteers had an excessive iron intake, principally by bread consumption. Analyses of food intake showed that red meat consumption correlates significantly with serum ferritin.Conclusion. Red meat consumption, metabolic syndrome, and chronic disease markers are associated with hyperferritinemia in a population of Chilean men.
Interaction between Common Breast Cancer Susceptibility Variants, Genetic Ancestry, and Nongenetic Risk Factors in Hispanic Women
Authors: Fejerman Laura , Stern Mariana C. , John Esther M. , Torres-Mejía Gabriela , Hines Lisa M. , Wolff Roger K. , Baumgartner Kathy B. , Giuliano Anna R. , Ziv Elad , Pérez-Stable Eliseo J. , Slattery Martha L.
Published: September 2015

Background: Most genetic variants associated with breast cancer risk have been discovered in women of European ancestry, and only a few genome-wide association studies (GWAS) have been conducted in minority groups. This research disparity persists in post-GWAS gene–environment interaction analyses. We tested the interaction between hormonal and lifestyle risk factors for breast cancer, and ten GWAS-identified SNPs among 2,107 Hispanic women with breast cancer and 2,587 unaffected controls, to gain insight into a previously reported gene by ancestry interaction in this population.

Methods: We estimated genetic ancestry with a set of 104 ancestry-informative markers selected to discriminate between Indigenous American and European ancestry. We used logistic regression models to evaluate main effects and interactions.

Results: We found that the rs13387042–2q35(G/A) SNP was associated with breast cancer risk only among postmenopausal women who never used hormone therapy [per A allele OR: 0.94 (95% confidence intervals, 0.74–1.20), 1.20 (0.94–1.53), and 1.49 (1.28–1.75) for current, former, and never hormone therapy users, respectively, Pinteraction 0.002] and premenopausal women who breastfed >12 months [OR: 1.01 (0.72–1.42), 1.19 (0.98–1.45), and 1.69 (1.26–2.26) for never, <12 months, and >12 months breastfeeding, respectively, Pinteraction 0.014].

Conclusions: The correlation between genetic ancestry, hormone replacement therapy use, and breastfeeding behavior partially explained a previously reported interaction between a breast cancer risk variant and genetic ancestry in Hispanic women.

Impact: These results highlight the importance of understanding the interplay between genetic ancestry, genetics, and nongenetic risk factors and their contribution to breast cancer risk. Cancer Epidemiol Biomarkers Prev; 24(11); 1731–8. ©2015 AACR.
Understanding Microbiome Data: A Primer for Clinicians
Authors: Seksik Philippe , Landman Cécilia
Published: September 2015

The human gut contains 1014 bacteria and many other micro-organisms such as Archaea, viruses and fungi. This gut microbiota has co-evolved with host determinants through symbiotic and co-dependent relationships. Bacteria, which represent 10 times the number of human cells, form the most depicted part of this black box owing to new tools. Re-evaluating the gut microbiota showed how this entity participates in gut physiology and beyond this in human health. Studying and handling this real ‘hidden organ' remains a challenge for clinicians. In this review, we aimed to bring information about gut microbiota, its structure, its roles and the way to capture and measure it. After bacterial colonization in infant, intestinal microbial composition is unique for each individual although more than 95% can be assigned to 4 major phyla. Besides its biodiversity, the major characteristics of gut microbiota are stability over time and resilience after perturbation. In pathological situations, dysbiosis (i.e. imbalance in gut microbiota composition) is observed with a loss in overall diversity. Dysbiosis associated with inflammatory bowel disease was specified with the reduction in biodiversity, the decreased representation of different taxa in the Firmicutes phylum and an increase in Gammaproteobacteria. Beyond depicting gut microbial composition, metagenomics allows the description of the combined genomes of the microorganisms present in the gut, giving access to their potential functions. In fact, each individual overall microbial metagenome outnumbers the size of human genome by a factor of 150. Besides a functional core in which there is redundancy for mandatory functions assuring the robustness of the ecosystem, human gut contains an important diversity and high number of non-redundant bacterial genes. Clinical data, treatment and all the factors able to influence microbiome should enter integrated big data sets to put in light pathways of interplay within the supra organism composed of gut microbiome and host. A better understanding of dynamics within human gut microbiota and microbes-host interaction will allow new insight into gut pathophysiology especially regarding resilience mechanisms and dysbiosis onset and maintenance. This will lead to description of biomarkers of diseases, development of new probiotics/prebiotics and new therapies.
Bowel Ultrasonography in Inflammatory Bowel Disease
Authors: Kucharzik Torsten , Petersen F. , Maaser C.
Published: September 2015

Background: The diagnosis of inflammatory bowel disease (IBD) is based on a combination of endoscopic, clinical and biochemical investigations as well as cross-sectional imaging. The applications of cross-sectional imaging in IBD are manifold. Ultrasonography has emerged as an important imaging modality in the diagnosis of Crohn's disease (CD) as well as for monitoring disease progression and in the therapeutic response to CD and ulcerative colitis (UC). Key Messages: Ultrasonography is non-invasive, radiation free, cheap, easy to use and well tolerated and accepted by patients. Bowel ultrasonography can be used for the primary diagnosis of CD as it has a similar sensitivity and specificity like that of MRI and CT, particularly in the case of CD. Ultrasonography can also be used to monitor treatment response to therapy and to detect disease recurrence of CD as well as UC. In CD, ultrasonography can also be used to detect complications such as strictures as well as extramural complications, including abscesses and fistulas. Contrast-enhanced ultrasonography is a useful tool that might be helpful to detect certain indications in CD, in particular the differentiation between abscesses and inflammation. Conclusion: A variety of advantages of bowel ultrasonography over other imaging modalities suggest the more frequent use of this method to manage IBD patients in daily practice. Bowel ultrasonography should be a standard tool in IBD centers.
Gastroenterology, Academic Medicine and a Changing Landscape
Authors: Podolsky Daniel K.
Published: September 2015

The forces that are reshaping the delivery of health care through much of the developed world are especially acute within academic centers that carry the responsibility for delivering that care while advancing medical knowledge and ensuring well-trained physicians. Gastroenterology will not be spared any of those forces, and in some ways represents the leading edge of their impact. Though the dynamics vary within the context of the health-care delivery and scientific enterprise of individual countries, common elements are demands for greater accountability and transparency in how academic medical centers demonstrate their value while assuring broad access to their expertise. In the United States, underlying many forms of change in the payment scheme are the common elements that will increasingly place the risk for the cost of care on providers rather than on the payers, be it government or private, as has historically been true. At the same time, academic medical centers, with gastroenterology responsible for addressing the burden of digestive diseases, must remain the stem cells for health care integrating all their missions and providing the foundation of medical advances which will ultimately improve human welfare. What will academic gastroenterology units look like if they are able to effectively respond to these forces? Gastrointestinal (GI) divisions and faculty will own new roles including responsibility for system success in caring for patients. They will evolve their training programs to provide the next generation with skills needed to succeed, including the discipline of system improvement, team leadership and others. And there will be new models that will drive the organization of research that are not as conventionally self-contained within the gastroenterology units, but fostering research teams that have hubs and spokes. The vitality of GI divisions will depend on the willingness to seize ownership of the new value proposition of disease management ensuring that each patient achieves the best outcome with the most effective use of resources and endeavor within their systems to capture some of that value to invest in their training and research missions. In the course of that evolution, gastroenterology will be well served by rebalancing the dependence on existing modalities. If procedural gastroenterology becomes the sole value proposition, it will lead to an increasingly narrow view of the field.
Postsurgical Prophylaxis in Crohn's Disease: Which Patients, Which Agents?
Authors: Michetti Pierre
Published: September 2015

Crohn's disease (CD) evolution is characterized by increasing proportions of patients developing complications such as strictures, abscesses and fistulas that require surgical management. After resection of a diseased intestinal segment, CD recurrence concerns up to 60% of patients within a year post surgery. The mucosa just above the site of the intestinal anastomosis is at particularly high risk of relapse. Prophylactic medical therapy to prevent recurrence has been shown to be effective with a variety of medications, but the recurrence rate remains high, demanding that a better risk stratification of patients be achieved. Recognized risk factors for postsurgical CD recurrence include young age at diagnosis and at surgery, smoking, need for repeated surgeries and penetrating disease. These patients require full dose immunosuppressive or anti-tumor necrosis factor (anti-TNF) therapy, which should be initiated in the immediate postoperative period, to prevent the onset of an inflammatory activity in the bowel. Systematic follow-up by endoscopy to monitor treatment benefit should also be part of the management, as endoscopic recurrence heralds clinical relapse in these patients. The role of noninvasive markers of mucosal inflammation, such as stool calprotectin levels, show promise to complete this monitoring. Although the efficacy of mesalazine and imidazole antibiotics has been long recognized, more aggressive approaches, such as thiopurines and anti-TNF antibodies, have shown higher efficacies in direct comparison trials. The potential place of anti-homing agents is not yet defined, but these agents should in principle be of interest for this prophylactic indication due to their mode of action and interesting side-effect profile. The current recommendations are based on a step-up approach that includes immunosuppressors and/or imidazole antibiotics, followed by an anti-TNF agent, such as infliximab and adalimumab, both already tested in randomized trials in this indication. When endoscopic recurrence is identified during follow-up, upscaling to anti-TNF or dose escalation is advocated.
Tailoring Treatment to the Individual Patient - Will Inflammatory Bowel Disease Medicine Be Personalized?
Authors: Fiocchi Claudio
Published: September 2015

Personalized medicine is variably defined as a new system aimed at providing optimal medical care by using comprehensive pathophysiology-based information on all aspects and components of a disease process to prevent, diagnose and treat in ways that are custom-made for the individual patient. The need for personalized medicine derives from the realization that today's most challenging medical conditions are chronic complex diseases with multiple pathogenic components that interact with each other. Complexity and interaction together create unique molecular pathways that are only relevant to certain disease subtypes, but not to the entire population of patients with the same diagnosis. Thus, complex diseases cannot be properly controlled, and much less cured, by modulating single components at sporadic time points in the course of the disease or administering the same treatment to all patients, as we currently do in the management of inflammatory bowel disease (IBD). The implementation of personalized medicine requires entirely novel and methodologically sophisticated bioinformatics-based approaches that use comprehensive and detailed information on the various components (‘omes') of the disease process. This requires identifying the key controllers (‘hubs') of pathogenic pathways in a totally unbiased fashion and discovering highly specific agents that can selectively block or even revert pathogenic events. IBD is a perfect example of a condition with multiple causes and multiple mechanisms, and IBD patients will unquestionably benefit from the adoption of personalized medicine in the near future.
Upward Translation of Cerebellar Tonsils following Surgical Expansion of Supratentorial Cranial Vault: A Unified Biomechanical Explanation of Chiari Type I
Authors: Winston Ken R. , Stence Nicholas V. , Boylan Arianne J. , Beauchamp Kathryn M.
Published: September 2015

Cerebellar tonsils moved significantly upward in 3 patients with Chiari type I who underwent supratentorial cranial vault expansion to alleviate intracranial pressure related to multisutural craniosynostosis. The Chiari type I deformities in these patients were the biomechanical consequence of posterior fossa-cerebellar disproportion caused by supratentorial craniocerebral disproportion secondary to multisutural craniosynostosis. The authors postulate that all cases of Chiari type I deformity share the sine qua non feature of posterior fossa-cerebellar disproportion.
Selective Retina Therapy in Acute and Chronic-Recurrent Central Serous Chorioretinopathy
Authors: Framme Carsten , Walter Andreas , Berger Lieselotte , Prahs Philipp , Alt Clemens , Theisen-Kunde Dirk , Kowal Jens , Brinkmann Ralf
Published: September 2015

Purpose: Selective retina therapy (SRT), the confined laser heating and destruction of retinal pigment epithelial cells, has been shown to treat acute types of central serous chorioretinopathy (CSC) successfully without damaging the photoreceptors and thus avoiding laser-induced scotoma. However, a benefit of laser treatment for chronic forms of CSC is questionable. In this study, the efficacy of SRT by means of the previously used 1.7-µs and shorter 300-ns pulse duration was evaluated for both types of CSC, also considering re-treatment for nonresponders. Material and Methods: In a two-center trial, 26 patients were treated with SRT for acute (n = 10) and chronic-recurrent CSC (n = 16). All patients presented with subretinal fluid (SRF) in OCT and leakage in fluorescein angiography (FA). SRT was performed using a prototype SRT laser system (frequency-doubled Q-switched Nd:YLF-laser, wavelength 527 nm) with adjustable pulse duration. The following irradiation settings were used: a train of 30 laser pulses with a repetition rate of 100 Hz and pulse durations of 300 ns and 1.7 µs, pulse energy 120-200 µJ, retinal spot size 200 µm. Because SRT lesions are invisible, FA was always performed 1 h after treatment to demonstrate laser outcome (5-8 single spots in the area of leakage). In cases where energy was too low, as indicated by missing FA leakage, energy was adjusted and the patient re-treated immediately. Observation intervals were after 4 weeks and 3 months. In case of nonimprovement of the disease after 3 months, re-treatment was considered. Results: Of 10 patients with active CSC that presents focal leakage in FA, 5 had completely resolved fluid after 4 weeks and all 10 after 3 months. Mean visual acuity increased from 76.6 ETDRS letters to 85.0 ETDRS letters 3 months after SRT. Chronic-recurrent CSC was characterized by less severe SRF at baseline in OCT and weaker leakage in FA than in acute types. Visual acuity changed from baseline 71.6 to 72.8 ETDRS letters after 3 months. At this time, SRF was absent in 3 out of 16 patients (19%), FA leakage had come to a complete stop in 6 out of 16 patients (38%). In 6 of the remaining chronic CSC patients, repeated SRT with higher pulse energy was considered because of persistent leakage activity. After the re-treatment, SRF resolved completely in 5 patients (83.3%) after only 25 days. Conclusion: SRT showed promising results in treating acute CSC, but was less effective in chronic cases. Interestingly, re-treatment resulted in enhanced fluid resolution and dry conditions after a considerably shorter time in most patients. Therefore, SRT including re-treatment if necessary might be a valuable CSC treatment alternative even in chronic-recurrent cases.
ДИНАМІКА ЗАХВОРЮВАНОСТІ ТА ПОШИРЕНОСТІ ІНФЕКЦІЙНИХ ХВОРОБ В УКРАЇНІ
Authors: Маркович І.Г.
Published: September 2015

Висвітлено питання інфекційної захворюваності в Україні за класами хвороб, згідно з Міжнародною класифікацією хвороб Х перегляду (МКХ-10), а також за даними галузевої статистичної звітності санітарно-епідеміологічної служби. Визначені загальні тенденції та регіональні особливості у динаміці найважливіших епідпоказників.
СУЧАСНА КЛІНІКО-ЕПІДЕМІОЛОГІЧНА ХАРАКТЕРИСТИКА БЕШИХИ НА ТЕРНОПІЛЬЩИНІ
Authors: Ніколов В.В.
Published: September 2015

Представлено дані власних клінічних спостережень і вивчення історій хвороб пацієнтів з бешихою, які в 2009-2014 рр. перебували на лікуванні в Тернопільській міській комунальній лікарні швидкої допомоги.
ХАРАКТЕРИСТИКА КОНЦЕПТУАЛЬНОЇ МОДЕЛІ ПОПЕРЕДЖЕННЯ ВТРАТИ НАСЕЛЕНННЯ ПРАЦЕЗДАТНОГО ВІКУ НА РЕГІОНАЛЬНОМУ РІВНІ
Authors: СЕМЕНЮК О.А. , ГРЖИБОВСЬКИЙ Я.Л.
Published: September 2015

Мета: розробити концептуальну модель попередження смертності населення працездатного віку на регіональному рівні.

Матеріали і методи. У ході виконання роботи було використано методи структурно-логічного аналізу та концептуального моделювання. Методичною основою дослідження став системний підхід.

Результати. Розроблено концептуальну модель попередження смертності населення працездатного віку на регіональному рівні. Модель є комплексною, міжсекторальною і ґрунтується на профілактичній спрямованості у діяльності всіх учасників процесу. Модель складається із двох фаз: концептуальної та фази реалізації. Перша спрямована і завершується формуванням загальної концепції дій, друга включає вибір оптимального варіанту з оцінкою ефективності обраної програми.

Висновки. Запропоновані елементи моделі за умов обмеженого бюджету свідчать про їх реальність, персоніфікований характер, економічну доцільність.

КЛЮЧОВІ СЛОВА: населення, працездатний вік, смертність, попередження.
АНТИКОРУПЦІЙНІ ЗАХОДИ ПРИ ПОБУДОВІ НОВОЇ СИСТЕМИ ОХОРОНИ ЗДОРОВ’Я: ДОСВІД РЕСПУБЛІКИ ПОЛЬЩА
Authors: РОГАЛЬСЬКИЙ І.О. , КАЛИНЮК Н.М.
Published: September 2015

Мета: проаналізувати антикорупційне законодавства у сфері медичної діяльності щодо доцільності впровадження медичного страхування при побудові нової національної системи охорони здоров’я.

Матеріали і методи. Вивчалося національне законодавство України, законодавство Республіки Польща; використано порівняльно-правовий метод та інші загальнонаукові та спеціальні методи наукового пізнання.

Результати. Одним із антикорупційних заходів у системі охорони здоров’я є запровадження загальнообов’язкового соціального медичного страхування. Наступними етапами є: встановлення ефективного контролю над фінансуванням системи охорони здоров’я; прийняття Закону України «Про загальнообов’язкове соціальне медичне страхування» та створення умов для його запровадження з відповідними змінами податкового законодавства; стимулювання розвитку державного медичного страхування.

Висновки. Запропонована система заходів, спрямованих на запровадження і розвиток медичного страхування в Україні, дозволить створити умови для найбільш повного задоволення потреб населення в доступній і високоякісній медичній допомозі; суттєво зменшити навантаження на державний та місцеві бюджети; зменшити частку тіньової медицини у системі медичного забезпечення; уникнути необґрунтованих витрат; покращити матеріальну мотивацію працівників.

КЛЮЧОВІ СЛОВА: корупція, правопорушення, медичне страхування, система охорони здоров’я.
ПЕРСОНАЛІСТИЧНА БІОЕТИКА У ЗАКОНОДАВЧОМУ РЕГУЛЮВАННІ ДОПОМІЖНИХ РЕПРОДУКТИВНИХ ТЕХНОЛОГІЙ В УКРАЇНІ
Authors: ТОЛОКОВА Т.І.
Published: September 2015

Мета: формування знань щодо етичних та законодавчих документів, які захищають індивідуум, суспільство і людство в цілому від небажаних і згубних наслідків упровадження в практику нових медико-біологічних технологій.

Матеріали і методи. За допомогою бібліографічного та герменевтичного методу проведено аналіз нормативних документів та етичних актів.

Результати. Наукові дослідження біологічної природи людського ембріона свідчать про те, що від моменту запліднення ембріон має всі характеристики людської істоти. Це зумовлює необхідність законодавчого регулювання допоміжних репродуктивних технологій та їх альтернативи – НаПроТехнології для вирішення проблем неплідності, ставлення до статусу ембріону людини як до людської особи, наділеної людською гідністю, який від моменту запліднення заслуговує пошани.

Висновки. У сучасній системі охорони здоров’я виникає необхідність перегляду чинного законодавства через усвідомлення основних засад персоналістичної біоетики щодо втручань у людський організм, зокрема щодо вирішення проблем неплідності.

КЛЮЧОВІ СЛОВА: допоміжні репродуктивні технології, статус ембріону, НаПроТехнології, неплідність.
The level of S100b protein in blood serum of patients with hiv/tb co-infectoin as a neurospecific biomarker of neurotoxicity
Authors: Mavrutenkov V. V. , Zhukova N. V. , Kravchuk L. O.
Published: September 2015

There was studied the influence of antiretroviral and antimycobacterial chemotherapy on releasing from the glia
cell marker lesions – S100b protein in the context of possible iatrogenic. It was established that a slight increase in
the concentration of S100b protein in blood serum of patients with co-infection of HIV /TB after starting HAART was
not associated with the occurrence of symptoms of the central nervous system.
Changes of some protein metabolism indices in the conditions of development of experimental allergic alveolitis and their correction
Authors: Sementsiv N. H.
Published: September 2015

There was found out that in the body of experimental animals protein metabolism takes place, which is directly
depends on the term of the experiment. The decrease of albumins level and the increase of globulins and C-reactive
protein were determined. Using the drug “Retabolyl” had a positive correcting influence on experimental indices of
protein metabolism.
Metabolic disorders in liver in late period of cranial-skeletal trauma and their correction by Thiocetam
Authors: Mykhaylyuk I. A. , Hudyma A. A.
Published: September 2015

In the conditions of cranial-skeletal trauma throughout the period of late signs of traumatic disease (14–28 days),
the processes of lipidic peroxidation don’t calm down, the activity of antioxidant protection ferments remains reduced,
the pro-oxidant mechanisms dominate. The use of thiocetam in 250 mg/kg dosage intraperatoneal throughout 14
days after striking of cranial-skeletal trauma essentially lowers the manifestations of free radical oxidation of the
lipids, the activity of superoxide dismutase and catalase increases, the antioxidant mechanisms predominate. By
the 28th day the normalization of the most of the indices occurs.
Modern views on the biosynthesis and mechanism of action of thyroid hormones
Authors: Nechyporuk V. M. , Korda М. М.
Published: September 2015

Among all hormones, which are synthesized in the human body, thyroid hormones have the widest spectrum of
activity. Their effect is not directed at specific target organs but applies to all body's cells and subcellular organelles
(nucleus, mitochondria, ribosomes, cell membranes). They affect the expression of certain genes and regulation
of metabolic rate. Diseases associated with thyroid function are among the most common in clinical practice of
endocrine disorders. At this review the modern data of studies of thyroid function mechanisms regulation, as well
as biosynthesis, secretion and the mechanisms of action of thyroid hormones are shown.
Hemostasis disturbances in patients with acute pancreatitis and the ways of its correction
Authors: Chuklin S. М. , Pidhirnyi B. Ya. , Chuklin S. S.
Published: September 2015

The literature review imposed the experimental and clinical data on the changes in the hemostatic system
at acute pancreatitis. The reasons of hemostatic disorders and possible ways of its correction were identified.
Disturbance in the coagulation is a feature at acute pancreatitis and is associated with disease severity. The
results of experimental studies in animals and clinical studies suggest that modulation of hemostasis can provide a
therapeutic target for the treatment of this disease. Inhibition of the coagulation cascade can prevent intravascular
coagulation and inflammation in the pancreas and distant organs, thereby preventing systemic complications in
patients with acute pancreatitis.
COMENTÁRIOS À LEI Nº. 12.846/2013 – LEI ANTICORRUPÇÃO
Authors: Campos Patrícia Toledo de
Published: September 2015

O presente artigo realiza uma análise pontual sobre a Lei nº. 12.846/2013, publicada no Diário Oficial da União de 02 de agosto de 2013. Inicialmente, apresenta a participação nacional e internacional do Brasil no combate à corrupção. Posteriormente, exibe um panorama geral sobre a lei anticorrupção, abordando as inovações, bem como seus pontos obscuros e polêmicos.
Revision of the Bicyclus ignobilis species-group (Lepidoptera: Nymphalidae: Satyrinae) with descriptions of two new species
Authors: BRATTSTRÖM OSKAR , ADUSE-POKU KWAKU , Collins Steve C. , BRAKEFIELD PAUL M.
Published: September 2015

The ignobilis-group of the genus Bicyclus Kirby 1871 is revised. The species-group contains six species with a distinct wing pattern, but limited intraspecific variation, distributed across tropical African rainforest. We investigate a set of more than 1000 specimens from a range of museum collections, including some type material, and thoroughly update the biogeographical knowledge for the group. We also describe two new species as members of the group. The included species are: Bicyclus ignobilis (Butler 1870) stat. rev., B. rileyi Condamin 1961, B. maesseni Condamin 1971, B. brakefieldi Brattström 2012, B. ottossoni sp. nov. and B. vandeweghei sp. nov. Due to observing a gradual morphological cline within B. ignobilis without any sharp transitions we suppress the previously identified subspecies B. ignobilis eurini Condamin & Fox 1963 syn. nov. and B. ignobilis acutus Condamin 1965 syn. nov.
A new species of Pseudoparaclius Grichanov (Diptera: Dolichopodidae) from Udzungwa Mountains National Park, Tanzania, and a key to Afrotropical species
Authors: KAAE MATHIAS EMIL , GRICHANOV IGOR , PAPE THOMAS
Published: September 2015

Pseudoparaclius udzungwa sp. nov. is described from Udzungwa Mountains National Park, Tanzania, and a key to all known Afrotropical species of Pseudoparaclius Grichanov is provided. Pseudoparaclius udzungwa is morphologically very similar to P. sanjensis (Grichanov) but has a modified male fore tarsus with laterally compressed tarsomeres 4–5, an epandrium with slightly shorter marginal teeth distiventrally, a blunt-tipped sclerotized part of the hypandrium, and an almost straight phallus. Males of P. udzungwa and P. sanjensis share a characteristic, oval, cup-shaped cercus not seen in any other known species of Pseudoparaclius.
Local Finite-Amplitude Wave Activity as a Diagnostic of Anomalous Weather Events
Authors: Huang Clare S. Y. , Nakamura Noboru
Published: September 2015

Finite-amplitude Rossby wave activity (FAWA) proposed by Nakamura and Zhu measures the waviness of quasigeostrophic potential vorticity (PV) contours and the associated modification of the zonal-mean zonal circulation, but it does not distinguish longitudinally localized weather anomalies, such as atmospheric blocking. In this article, FAWA is generalized to local wave activity (LWA) to diagnose eddy–mean flow interaction on the regional scale. LWA quantifies longitude-by-longitude contributions to FAWA following the meridional displacement of PV from the circle of equivalent latitude. The zonal average of LWA recovers FAWA. The budget of LWA is governed by the zonal advection of LWA and the radiation stress of Rossby waves. The utility of the diagnostic is tested with a barotropic vorticity equation on a sphere and meteorological reanalysis data. Compared with the previously derived Eulerian impulse-Casimir wave activity, LWA tends to be less filamentary and emphasizes large isolated vortices involving reversals of meridional gradient of potential vorticity. A pronounced Northern Hemisphere blocking episode in late October 2012 is well captured by a high-amplitude, near-stationary LWA. These analyses reveal that the nonacceleration relation holds approximately over regional scales: the growth of phase-averaged LWA and the deceleration of local zonal wind are highly correlated. However, marked departure from the exact nonacceleration relation is also observed during the analyzed blocking event, suggesting that the contributions from nonadiabatic processes to the blocking development are significant.
Reexamining the Relationship between Climate Sensitivity and the Southern Hemisphere Radiation Budget in CMIP Models
Authors: Grise Kevin M. , Polvani Lorenzo M. , Fasullo John T.
Published: September 2015

Recent efforts to narrow the spread in equilibrium climate sensitivity (ECS) across global climate models have focused on identifying observationally based constraints, which are rooted in empirical correlations between ECS and biases in the models’ present-day climate. This study reexamines one such constraint identified from CMIP3 models: the linkage between ECS and net top-of-the-atmosphere radiation biases in the Southern Hemisphere (SH).

As previously documented, the intermodel spread in the ECS of CMIP3 models is linked to present-day cloud and net radiation biases over the midlatitude Southern Ocean, where higher cloud fraction in the present-day climate is associated with larger values of ECS. However, in this study, no physical explanation is found to support this relationship. Furthermore, it is shown here that this relationship disappears in CMIP5 models and is unique to a subset of CMIP models characterized by unrealistically bright present-day clouds in the SH subtropics. In view of this evidence, Southern Ocean cloud and net radiation biases appear inappropriate for providing observationally based constraints on ECS.

Instead of the Southern Ocean, this study points to the stratocumulus-to-cumulus transition regions of the SH subtropical oceans as key to explaining the intermodel spread in the ECS of both CMIP3 and CMIP5 models. In these regions, ECS is linked to present-day cloud and net radiation biases with a plausible physical mechanism: models with brighter subtropical clouds in the present-day climate show greater ECS because 1) subtropical clouds dissipate with increasing CO2 concentrations in many models and 2) the dissipation of brighter clouds contributes to greater solar warming of the surface.
Response of the Equatorial Pacific Seasonal Cycle to Orbital Forcing
Authors: Erb Michael P. , Broccoli Anthony J. , Graham Neal T. , Clement Amy C. , Wittenberg Andrew T. , Vecchi Gabriel A.
Published: September 2015

The response of the equatorial Pacific Ocean’s seasonal cycle to orbital forcing is explored using idealized simulations with a coupled atmosphere–ocean GCM in which eccentricity, obliquity, and the longitude of perihelion are altered while other boundary conditions are maintained at preindustrial levels. The importance of ocean dynamics in the climate response is investigated using additional simulations with a slab ocean version of the model. Precession is found to substantially influence the equatorial Pacific seasonal cycle through both thermodynamic and dynamic mechanisms, while changes in obliquity have only a small effect. In the precession experiments, western equatorial Pacific SSTs respond in a direct thermodynamic manner to changes in insolation, while the eastern equatorial Pacific is first affected by the propagation of thermocline temperature anomalies from the west. These thermocline signals result from zonal wind anomalies associated with changes in the strength of subtropical anticyclones and shifts in the regions of convection in the western equatorial Pacific. The redistribution of heat from these thermocline signals, aided by the direct thermodynamic effect of insolation anomalies, results in large changes to the strength and timing of the eastern equatorial Pacific seasonal cycle. A comparison of 10 CMIP5 mid-Holocene experiments, in which the primary forcing is due to precession, shows that this response is relatively robust across models. Because equatorial Pacific SST anomalies have local climate impacts as well as nonlocal impacts through teleconnections, these results may be important to understanding paleoclimate variations both inside and outside of the tropical Pacific.
Near-Ground Rotation in Simulated Supercells: On the Robustness of the Baroclinic Mechanism*
Authors: Dahl Johannes M. L.
Published: September 2015

This study addresses the robustness of the baroclinic mechanism that facilitates the onset of surface rotation in supercells by using two idealized simulations with different microphysics parameterizations and by considering previous results. In particular, the importance of ambient crosswise vorticity relative to baroclinically generated vorticity in the development of near-ground cyclonic vorticity is analyzed. The storms were simulated using the CM1 model in a kinematic base state characterized by a straight-line hodograph. A trajectory analysis spanning about 30 min was performed for a large number of parcels that contribute to near-surface vertical-vorticity maxima. The vorticity along these trajectories was decomposed into barotropic and nonbarotropic parts, where the barotropic vorticity represents the effects of the preexisting, substantially crosswise horizontal storm-relative vorticity. The nonbarotropic part represents the vorticity produced baroclinically within the storm. It was found that the imported barotropic vorticity attains a downward component near the surface, while the baroclinic vorticity points upward and dominates. This dominance of the baroclinic vorticity is independent of whether a single-moment or double-moment microphysics parameterization is used. A scaling argument is offered as explanation, predicting that the baroclinic vertical vorticity becomes increasingly dominant as downdraft strength increases.
An Analysis of the Determinants of Wage and Salary Differentials in Bangladesh
Authors: Hossain Kazi Abrar , Haque Sharjil Muktafi , Haque A.K. Enamul
Published: September 2015

The Gini Index suggests that income inequality is a highly prevalent phenomenon in Southeast Asia (The World Bank, 2012a). As Zaman and Akita (2012) points out, differentials in income is especially prominent in Bangladesh. Our article investigates which factors create differentials in income in Bangladesh. Using data from the Household Income Expenditure Survey published by the Bangladesh Bureau of Statistics, we estimated two separate models—one for daily wage and one for annual salary. We found that education, age (which was used as a proxy for labour market experience), gender and place of work significantly brought about differentials in daily wage rates. We also observed that all four of the above variables, along with different types of occupations, caused differentials in annual salary. We conclude by making several policy recommendations to address these findings.
Early mobilisation in intensive care units in Australia and Scotland: a prospective, observational cohort study examining mobilisation practises and barriers
Authors: Harrold Meg E. , Salisbury Lisa G. , Webb Steve A. , Allison Garry T. ,   on behalf of the Australia and Scotland ICU Physiotherapy Collaboration
Published: September 2015

Introduction

Mobilisation of patients in the intensive care unit (ICU) is an area of growing research. Currently, there is little data on baseline mobilisation practises and the barriers to them for patients of all admission diagnoses.

Methods

The objectives of the study were to (1) quantify and benchmark baseline levels of mobilisation in Australian and Scottish ICUs, (2) compare mobilisation practises between Australian and Scottish ICUs and (3) identify barriers to mobilisation in Australian and Scottish ICUs. We conducted a prospective, observational, cohort study with a 4-week inception period. Patients were censored for follow-up upon ICU discharge or after 28 days, whichever occurred first. Patients were included if they were >18 years of age, admitted to an ICU and received mechanical ventilation in the ICU.

Results

Ten tertiary ICUs in Australia and nine in Scotland participated in the study. The Australian cohort had a large proportion of patients admitted for cardiothoracic surgery (43.3 %), whereas the Scottish cohort had none. Therefore, comparison analysis was done after exclusion of patients admitted for cardiothoracic surgery. In total, 60.2 % of the 347 patients across 10 Australian ICUs and 40.1 % of the 167 patients across 9 Scottish ICUs mobilised during their ICU stay (p < 0.001). Patients in the Australian cohort were more likely to mobilise than patients in the Scottish cohort (hazard ratio 1.83, 95 % confidence interval 1.38–2.42). However, the percentage of episodes of mobilisation where patients were receiving mechanical ventilation was higher in the Scottish cohort (41.1 % vs 16.3 %, p < 0.001). Sedation was the most commonly reported barrier to mobilisation in both the Australian and Scottish cohorts. Physiological instability and the presence of an endotracheal tube were also frequently reported barriers.

Conclusions

This is the first study to benchmark baseline practise of early mobilisation internationally, and it demonstrates variation in early mobilisation practises between Australia and Scotland.