bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrating animal protection criteria into conservation management: a case study of the management of Eastern Grey Kangaroos in the ACT
Authors: Ben-Ami Dror , Mjadwesch Ray
Published: September 2018

Compassionate conservation is an emerging field in conservation that seeks to integrate animal protection and conservation to achieve either improved conservation outcomes, particularly where conservation priorities and human-wildlife conflict, or the same outcomes, but with less pain and suffering for wildlife. In the Australian Capital Territory (ACT), Eastern Grey Kangaroos (EGKs) are culled to reduce grazing pressure on threatened native grasslands and woodlands. We integrate decision-making criteria about animal protection into planning of wildlife-management to formulate a compassionate conservation management case study. The management criteria include a series of guiding questions: Is management necessary? Will intervention (management of EGKs) achieve the desired conservation outcomes? And, if intervention is necessary, is killing necessary? We found that kangaroos can be managed without culling. The conflict between conservation goals and kangaroo abundance is likely to be accentuated during extended drought. In the short-term, methods for improving rates of habitat recovery can include fencing of threatened grassland communities and reduction of kangaroo density via translocation. Human activity must also be monitored as multiple human-caused biotic and abiotic disturbances are known to have a strong impact on biodiversity of the native grassland habitats. In the medium to long-term, Eastern Grey Kangaroos have the potential for maintaining stable populations, and their herbivory is necessary for grassland function and nutrient cycling. Finally, we suggest that compassionate conservation and adaptive management can work well together as social values shift towards greater emphasis on animal protection.
Retrospective Review of Clinical and Chest X-Ray Findings in Children Admitted to a Community Hospital for Respiratory Syncytial Virus Infection
Authors: Niles Denver , Larsen Brett , Balaji Arvind , Delaney Dana , Campos Elizabeth , Bhattarai Bikash , Shoshan Dor , Connell Mary , Ostovar Gholamabbas Amin
Published: September 2018

Introduction. We performed a retrospective study to evaluate demographics, clinical course, outcome, and radiological findings of children with respiratory syncytial virus (RSV) infection. Methods. Four hundred patients admitted between October 2013 and May 2016 were enrolled. Clinical and radiographic trends were evaluated for association with severity of RSV presentation. Severity was defined as hospitalization >2 days, pediatric intensive care unit admission, or need for mechanical ventilation. Results. Common clinical findings included fever (78.5%), coughing (97%), rhinorrhea/congestion (93%), and hypoxia (44.8%). Hypoxia was seen in 64.7% of the severe group compared with 32.0% in the nonsevere group ( P < .001). Airspace opacification was seen in 49.2% of chest X-rays of the severe group compared with 26.4% in the nonsevere group ( P < .001). Conclusion. Higher incidence of hypoxia or airspace opacification on chest X-ray may be predictors of poorer outcomes for patients with RSV infection.
Modified Schema-Based Instruction to Develop Flexible Mathematics Problem-Solving Strategies for Students With Autism Spectrum Disorder
Authors: Cox Sarah K. , Root Jenny R.
Published: September 2018

The Common Core State Standards in Mathematics outline both the content and practices students must engage in at each grade level to become mathematically proficient. Mathematical processes include problem solving, reasoning and proof, communication, and procedural fluency, which includes flexible thinking. The purpose of this study was to evaluate the effectiveness of modified schema-based instruction (MSBI) on the acquisition and maintenance of math content and practices by middle school students with autism spectrum disorder (ASD). Two middle school students with ASD learned to solve proportional word problems containing extraneous information. Specifically, we measured mathematical problem-solving flexibility and communication using a 4-point rubric. Results of the reversal design found a functional relation between MSBI and the students’ ability to flexibly solve the mathematical word problems and explain their answer, suggesting MSBI may be a useful strategy for some students with ASD.
Increasing Sepsis Rates in the United States: Results From National Inpatient Sample, 2005 to 2014
Authors: Rubens Muni , Saxena Anshul , Ramamoorthy Venkataraghavan , Das Sankalp , Khera Rohan , Hong Jonathan , Armaignac Donna , Veledar Emir , Nasir Khurram , Gidel Louis
Published: September 2018

Objectives:

To examine the trends in hospitalization rates, mortality, and costs for sepsis during the years 2005 to 2014.

Methods:

This was a retrospective serial cross-sectional analysis of patients ≥18 years admitted for sepsis in National Inpatient Sample. Trends in sepsis hospitalizations were estimated, and age- and sex-adjusted rates were calculated for the years 2005 to 2014.

Results:

There were 541 694 sepsis admissions in 2005 and increased to 1 338 905 in 2014. Sepsis rates increased significantly from 1.2% to 2.7% during the years 2005 to 2014 (relative increase: 123.8%; P trend < .001). However, the relative increase changed by 105.8% ( P trend < .001) after adjusting for age and sex and maintained significance. Although total cost of hospitalization due to sepsis increased significantly from US$22.2 to US$38.1 billion ( P trend < .001), the mean hospitalization cost decreased significantly from US$46,470 to US$29,290 ( P trend < .001).

Conclusions:

Hospitalizations for sepsis increased during the years 2005 to 2014. Our study paradoxically found declining rates of in-hospital mortality, length of stay, and mean hospitalization cost for sepsis. These findings could be due to biases introduced by International Classification of Diseases, Ninth Revision, Clinical Modification coding rules and increased readmission rates or alternatively due to increased awareness and surveillance and changing disposition status. Standardized epidemiologic registries should be developed to overcome these biases.
Social Impact Bonds and Institutional Investors: An Empirical Analysis of a Complicated Relationship
Authors: Del Giudice Alfonso , Migliavacca Milena
Published: September 2018

Over the past 8 years, social impact bonds (SIBs) have attracted increasing attention from scholars, policy makers, and investors. Notwithstanding good intentions and policy makers’ enthusiasm, SIBs have failed to attract significant private capital. Considering the SIBs issued worldwide until December 2017, we look for the critical success factors of SIB funding by investigating both the financial and contractual characteristics of SIB contracts. We find that institutional investors are more likely to participate in an SIB funding when there are fewer agency problems.
A Framework for Rigorous Qualitative Research as a Component of Mixed Method Rapid-Cycle Evaluation
Authors: Skillman Megan , Cross-Barnet Caitlin , Friedman Singer Rachel , Rotondo Christina , Ruiz Sarah , Moiduddin Adil
Published: September 2018

As federal, state, and local governments continue to test innovative approaches to health care delivery, the ability to produce timely and reliable evidence of what works and why it works is crucial. There is limited literature on methodological approaches to rapid-cycle qualitative research. The purpose of this article is to describe the advantages and limitations of a broadly applicable framework for in-depth qualitative analysis placed within a larger rapid-cycle, multisite, mixed-method evaluation. This evaluation included multiple cycles of primary qualitative data collection and quarterly and annual reporting. Several strategies allowed us to be adaptable while remaining rigorous; these included planning for multiple waves of qualitative coding, a hybrid inductive/deductive approach informed by a cross-program evaluation framework, and use of a large team with specific program expertise. Lessons from this evaluation can inform researchers and evaluators functioning in rapid assessment or rapid-cycle evaluation contexts.
Association Between Cognitive Tests and Antiretroviral Medication Adherence in Older Adults With HIV
Authors: Caballero Joshua , Ownby Raymond L. , Jacobs Robin J. , Thomas Jennifer E. , Schweizer Mark S.
Published: September 2018

Background: One of the fastest growing populations living with HIV is older adults especially those 65 years of age or older. Current antiretroviral therapy (ART) has prolonged life expectancy of persons with HIV. However, for therapy to be effective, patients need to be adherent. Over time, older persons with HIV may experience HIV-associated neurocognitive disorders or other factors that could affect ART adherence. The use of expedient cognitive tests that help measure medication adherence may be useful for the optimal care of these patients. Objective: To investigate the association between cognitive tests and ART adherence. Methods: This was a prospective study evaluating patients 65 years of age or older with HIV. Cognitive tests used included the Executive Clock-Drawing Task (CLOX) 1 and 2, Trail Making Test parts A and B, and Grooved Pegboard Test (GPB). The medication event monitoring system cap over 1 month was used as the primary measure for adherence. Results: CLOX 1 and GPB were significantly related to adherence ( P < 0.05). Comparison of the magnitude of each measure’s relation to adherence suggests that the GPB is a better indicator of ability to adhere ( R = 0.514 vs R = 0.381). Conclusion and Relevance: CLOX 1 and GPB demonstrated an association with adherence in patients 65 years of age or older with HIV. Although the use of these tests to measure adherence in older persons with HIV seems promising, more research is needed to ascertain their ultimate utility.
Impact of Knee Scooter Flexion Position on Venous Flow Rate
Authors: Ciufo David J. , Anderson Michael R. , Baumhauer Judith F.
Published: September 2018

Background:

The knee scooter is a commonly used mobility device in the setting of unilateral below-knee immobilization. The bent-knee posture has been shown to decrease venous flow in a seated position, but the knee scooter differs as the patient is weightbearing through the affected extremity. Our goal was to investigate the effects of knee scooter positioning on popliteal venous flow.

Methods:

Duplex ultrasonography was performed to obtain venous diameter and flow velocity of the popliteal vein on healthy subjects over the age of 18 without immobilization. Measurements were performed on the left knee of each subject while standing and with the same knee flexed on the knee scooter, by 2 physicians trained in ultrasound techniques. Mean velocity, peak velocity, vessel diameter, and volumetric flow rate were calculated and t tests were performed for each variable. A power analysis was performed, determining that 9 subjects would provide 80% power with an alpha of 0.05. A total of 13 subjects participated in the study. Mean age was 33 (range 20-56) years, with 6 females and 7 males.

Results:

Measurements of subjects while standing and on the knee scooter demonstrated a significant decrease in mean velocity (6.5 vs 3.2 cm/s, P < .01) and volumetric flow rate (227.8 vs 106.2 mL/min, P < .01) while subjects were using the scooter. Vessel diameter (0.82 vs 0.78 cm, P = .15) and peak velocities (19.8 vs 14.7 cm/s, P = .19) were not significantly different between standing and kneeling positions.

Conclusion:

Our findings demonstrated a statistically significant decrease in volumetric flow rate in subjects using a knee scooter device with a flexed knee. Although venous stasis is a known risk factor for DVT, flow rate thresholds for increased thrombus formation are not well defined. The duration of scooter use, or flexed knee positioning, may have some effect on the degree of stasis. This finding should caution orthopedists to consider the risk attributed to the knee scooter as part of their overall patient assessment.

Level of Evidence:

Level II, therapeutic, comparative study.
Expression Levels of Candidate Circulating microRNAs in Early-Onset Neonatal Sepsis Compared With Healthy Newborns
Authors: Dhas Benet B , Dirisala Vijaya R , Bhat B Vishnu
Published: September 2018

The high mortality rate of neonatal sepsis is directly connected with time-consuming diagnostic methods that have low sensitivity and specificity. The need of the hour is to develop novel diagnostic techniques that are rapid and more specific. In this study, we estimated the expression levels of circulating microRNAs (miRNAs) that are involved in regulating immune response genes and underlying inflammatory responses, which may be used for sepsis diagnosis. The total circulating miRNA was isolated and the candidate miRNAs (miR-132, miR-146a, miR-155, and miR-223) were quantified by real-time polymerase chain reaction technique. Statistical analysis revealed that miR-132 ( P < .01) and miR-223 ( P < .05) were downregulated in septic newborns compared with healthy babies. The decrease in expression of miR-132 and miR-223 may be associated with increased expression of immune-related genes involved in TLR (Toll-like receptor) signaling pathway. Further case-control studies with large sample size are required to identify the potential of miRNAs in neonatal sepsis diagnosis.
Optimising use of rate-of-change trend arrows for insulin dosing decisions using the FreeStyle Libre flash glucose monitoring system
Authors: Ajjan Ramzi A , Cummings Michael H , Jennings Peter , Leelarathna Lalantha , Rayman Gerry , Wilmot Emma G
Published: September 2018

Continuous glucose monitoring and flash glucose monitoring systems are increasingly used by people with diabetes on multiple daily injections of insulin and continuous subcutaneous insulin infusion. Along with real-time updates on current glucose levels, these technologies also use trend arrows to provide information on the direction and rate of change of glucose. Two systems, the Dexcom G5 and the FreeStyle Libre, have recently been approved for use without the need for adjunct capillary blood glucose, and there is a need for practical guidance for insulin dosing which incorporates rate of change in the insulin dosing algorithm. Here, we review the integration of rate of change trend arrow information into daily glucose management, including rapid-acting insulin dosing decisions. Based on the FreeStyle Libre flash glucose monitoring system, we also review a practical decision-support tool for actions to take when using trend arrows in conjunction with current glucose readings.
Post-stroke infections and preventive antibiotics in stroke: Update of clinical evidence
Authors: Vermeij Jan-Dirk , Westendorp Willeke F , van de Beek Diederik , Nederkoorn Paul J
Published: September 2018

This review provides an update of evidence on post-stroke infections and the use of preventive antibiotics in stroke. Infection is a common complication after stroke, affecting between 15% and 30% of the patients. The predictors for post-stroke infection can be divided into three categories: clinical factors, anatomical (stroke related) factors and immunological factors. The relation between the occurrence of a post-stroke infection and functional outcome remained subject of debate, but it seems likely that the occurrence of these infections has a causal relation with poor functional outcome and mortality. In the first meta-analysis on preventive antibiotic therapy, almost a decade ago, its beneficial effect on post-stroke infection rate was clear; however, the effect on functional outcome remained uncertain because included studies were small and heterogeneous. Afterwards, three large phase-3 RCTs were published and a Cochrane meta-analysis was performed. It has now become clear that, despite the finding that overall infections are reduced, preventive antibiotic therapy in the acute phase of stroke does neither improve functional outcome, nor decrease mortality rates. This does not yet mean that further research on preventive antibiotics in stroke is useless: the pathophysiology and etiology of post-stroke infections are unclear and the use of preventive antibiotics in specific subgroups of stroke patients could still be very effective. This is currently being studied. Besides, preventive antibiotic therapy might be cost-effective by increasing quality-adjusted life years. Thirdly, research for the upcoming years might put more emphasis on the effect of stroke on immunological alterations.
Compensated right ventricular function of the onset of pulmonary hypertension in a rat model depends on chamber remodeling and contractile augmentation
Authors: Vélez‐Rendón Daniela , Zhang Xiaoyan , Gerringer Jesse , Valdez‐Jasso Daniela
Published: September 2018

Right‐ventricular function is a good indicator of pulmonary arterial hypertension (PAH) prognosis; however, how the right ventricle (RV) adapts to the pressure overload is not well understood. Here, we aimed at characterizing the time course of RV early remodeling and discriminate the contribution of ventricular geometric remodeling and intrinsic changes in myocardial mechanical properties in a monocrotaline (MCT) animal model. In a longitudinal study of PAH, ventricular morphology and function were assessed weekly during the first four weeks after MCT exposure. Using invasive measurements of RV pressure and volume, heart performance was evaluated at end of systole and diastole to quantify contractility (end‐systolic elastance) and chamber stiffness (end‐diastolic elastance). To distinguish between morphological and intrinsic mechanisms, a computational model of the RV was developed and used to determine the level of prediction when accounting for wall masses and unloaded volume measurements changes. By four weeks, mean pulmonary arterial pressure and elastance rose significantly. RV pressures rose significantly after the second week accompanied by significant RV hypertrophy, but RV stroke volume and cardiac output were maintained. The model analysis suggested that, after two weeks, this compensation was only possible due to a significant increase in the intrinsic inotropy of RV myocardium. We conclude that this MCT‐PAH rat is a model of RV compensation during the first month after treatment, where geometric remodeling on EDPVR and increased myocardial contractility on ESPVR are the major mechanisms by which stroke volume is preserved in the setting of elevated pulmonary arterial pressure. The mediators of this compensation might themselves promote longer‐term adverse remodeling and decompensation in this animal model.
A pilot randomized controlled trial to compare the effectiveness of two 14-day primaquine regimens for the radical cure of vivax malaria in South India
Authors: Saravu Kavitha , Tellapragada Chaitanya , Kulavalli Shrivathsa , Xavier Wilbin , Umakanth Shashikiran , Brahmarouphu Gouthami , Srinivas Navyasree Kola , Channabasavaiah Jagadish Puralae , Bava Anzil , Saadi Abdul Vahab , Guddattu Vasudev , Satyamoorthy Kapaettu , Bhat Krishnamurthy
Published: September 2018

Background

Radical cure of Plasmodium vivax malaria requires treatment with a blood schizonticide and a hypnozoitocide (primaquine) to eradicate the dormant liver stages. There has been uncertainty about the operational effectiveness and optimum dosing of the currently recommended 14-day primaquine (PQ) course.

Methods

A two centre, randomized, open-label, two arm study was conducted in South India. Patients were randomized to receive either high dose (0.5 mg base/kg body weight) or conventional dose (0.25 mg/kg) PQ for 14 days. Plasma concentrations of PQ and carboxyprimaquine (CPQ) on the 7th day of treatment were measured by reverse phase high performance liquid chromatography. Study subjects were followed up for 6 months. Recurrent infections were genotyped using capillary fragment length polymorphism of two PCR-amplified microsatellite markers (MS07 and MS 10).

Results

Fifty patients were enrolled. Baseline characteristics and laboratory features did not differ significantly between the groups. Mean age of the study population was 42 ± 16.0 years. Recurrences 80–105 days later occurred in 4 (8%) patients, two in each the groups. All recurrences had the same microsatellite genotype as that causing the index infection suggesting all were relapses. One relapse was associated with low CPQ concentrations suggesting poor adherence.

Conclusions

This small pilot trial supports the effectiveness of the currently recommended lower dose (0.25 mg/kg/day) 14 day PQ regimen for the radical cure of vivax malaria in South India.

Trial registration Clinical Trials Registry-India, CTRI/2017/03/007999. Registered 3 March 2017, http://ctri.nic.in/Clinicaltrials/regtrial.php?modid=1&compid=19&EncHid=82755.86366.
KLF4, a miR-32-5p targeted gene, promotes cisplatin-induced apoptosis by upregulating BIK expression in prostate cancer
Authors: Zhang Lu , Li Xiaojie , Chao Yulin , He Ruiping , Liu Junqiang , Yuan Yi , Zhao Wenzhi , Han Chuanchun , Song Xishuang
Published: September 2018

Background

Chemotherapeutic insensitivity remains a big challenge in prostate cancer treatment. Recently, increasing evidence has indicated that KLF4 plays a key role in prostate cancer. However, the potential biological role of KLF4 in Chemotherapeutic insensitivity of prostate cancer is still unknown.

Methods

The role of KLF4 in cisplatin-induced apoptosis was detected by western blotting and a cell counting kit (CCK8). The potential molecular mechanism of KLF4 in regulating prostate cancer chemosensitivity was investigated by RNA sequencing analysis, q-RT-PCR, western blotting and chromatin immunoprecipitation (ChIP). The expression level of KLF4 mediated by miR-32-5p was confirmed by bioinformatic analysis and luciferase assays.

Results

Here, we found that KLF4 was induced by cisplatin in prostate cancer cells and that the increase in KLF4 promoted cell apoptosis. Further mechanistic studies revealed that KLF4 directly bound to the promoter of BIK, facilitating its transcription. Additionally, we also found that the gene encoding KLF4 was a direct target of miR-32-5p. The downregulation of miR-32-5p in response to cisplatin treatment promoted KLF4 expression, which resulted in a increase in the chemosensitivity of prostate cancer.

Conclusion

Thus, our data revealed that KLF4 is an essential regulator in cisplatin-induced apoptosis, and the miR-32-5p-KLF4-BIK signalling axis plays an important role in prostate cancer chemosensitivity.
The effects of AICAR and rapamycin on mitochondrial function in immortalized mitochondrial DNA mutator murine embryonic fibroblasts
Authors: Delic Vedad , Noble Kenyaria , Zivkovic Sandra , Phan Tam-Anh , Reynes Christian , Zhang Yumeng , Phillips Oluwakemi , Claybaker Charles , Ta Yen , Dinh Vinh B. , Cruz Josean , Prolla Tomas A. , Bradshaw Patrick C.
Published: September 2018

Mitochondrial DNA mutations accumulate with age and may play a role in stem cell aging as suggested by the premature aging phenotype of mitochondrial DNA polymerase gamma (POLG) exonuclease-deficient mice. Therefore, E1A immortalized murine embryonic fibroblasts (MEFs) from POLG exonuclease-deficient and WT mice were constructed. Surprisingly, when some E1A immortalized MEF lines were cultured in pyruvate containing media they slowly became addicted to the pyruvate. The POLG exonuclease-deficient MEFs were more sensitive to several mitochondrial inhibitors and showed increased reactive oxygen species production under standard conditions. When cultured in pyruvate containing media POLG exonuclease-deficient MEFs showed decreased oxygen consumption compared to controls. Increased AMP-activated protein kinase (AMPK) signaling and decreased mammalian target of rapamycin (mTOR) signaling delay aging and influence mitochondrial function. Therefore, the effects of 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR), an AMPK activator, or rapamycin, an mTOR inhibitor, on measures of mitochondrial function were determined. Rapamycin treatment transiently increased respiration only in WT MEFs and under most conditions increased ATP levels. Short term AICAR treatment transiently increased ROS production and under most conditions decreased ATP levels. Chronic AICAR treatment decreased respiration and ROS production in WT MEFs. These results demonstrate the context-dependent effects of AICAR and rapamycin on mitochondrial function.
Computer-based automatic classification of trabecular bone pattern can assist radiographic bone quality assessment at dental implant site
Authors: Nicolielo Laura Ferreira Pinheiro , Van Dessel Jeroen , van Lenthe G. Harry , Lambrichts Ivo , Jacobs Reinhilde
Published: September 2018

Objective:

To develop and validate an automated classification method that determines the trabecular bone pattern at implant site based on three-dimensional bone morphometric parameters derived from CBCT images.

Methods:

25 human cadaver mandibles were scanned using CBCT clinical scanning protocol. Volumes-of-interest comprising only the trabecular bone of the posterior regions were selected and segmented for three-dimensional morphometric parameters calculation. Three experts rated all bone regions into one of the three trabecular pattern classes (sparse, intermediate and dense) to generate a reference classification. Morphometric parameters were used to automatically classify the trabecular pattern with linear discriminant analysis statistical model. The discriminatory power of each morphometric parameter for automatic classification was indicated and the accuracy compared to the reference classification. Repeated-measures analysis of variances were used to statistically compare morphometric indices between the three classes. Finally, the outcome of the automatic classification was evaluated against a subjective classification performed independently by four different observers

Results:

The overall correct classification was 83% for quantity-, 86% for structure-related parameters and 84% for the parameters combined. Cross-validation showed a 79% model prediction accuracy. Bone volume fraction (BV/TV) had the most discriminatory power in the automatic classification. Trabecular bone patterns could be distinguished based on most morphometric parameters, except for trabecular thickness (Tb.Th) and degree of anisotropy (DA). The interobserver agreement between the subjective observers was fair (0.25), while the test-retest agreement was moderate (0.46). In comparison with the reference standard, the overall agreement was moderate (0.44).

Conclusion:

Automatic classification performed better than subjective classification with a prediction model comprising structure- and quantity-related morphometric parameters.

Advances in knowledge:

Computer-aided trabecular bone pattern assessment based on morphometric parameters could assist objectivity in clinical bone quality classification.
Inadequate survivorship care after allogeneic hematopoietic cell transplantation: A retrospective chart review
Authors: Thaw Sunn Sunn , Holtan Shernan , Cao Qing , Franklin Michael , Paye Nyan , Blaes Anne
Published: September 2018

Background: Hematopoietic cell transplant (HCT) survivors are at risk of developing long-term complications. Guidelines for survivorship care of HCT recipients were published in 2012; however, the degree to which these guidelines are incorporated into clinical practice is unknown. The purpose of this study was to determine whether providers utilize the 2012 guidelines and analyze whether survivorship-focused providers, provider gender, or provider year of practice influenced adherence to these guidelines.

Methods: Adult allogeneic HCT recipient’s medical records were reviewed at the University of Minnesota between 2010 and 2012; only patients who survived without relapse to their 2-year follow-up visit after HCT were included. A semi-quantitative scoring system was developed providing 1 point for each of the 13 organ systems assessed by the 2012 survivorship care guidelines. Data was collected on history, clinical exam, laboratory tests, preventive measures, and counseling. The primary endpoint was the overall score for adherence to the survivorship care guidelines. Wilcoxon rank-sum tests for continuous and Chi-square tests for categorical factors were used to compare the overall score between provider groups (survivorship-focused providers vs others), provider gender, and provider year of practice (≥10 years vs <10 years).

Results: Fifteen providers (9 male, 3 survivorship-focused, 7 with <10 years of practice) provided follow-up care to 77 HCT survivors. Survivorship-focused providers had a higher median overall score than other providers (median 10 vs 8, p<0.01).  Female providers had a higher median overall score than male providers (median 9.0 vs 8, p<0.01). There was no difference in median overall score based on provider year of experience (p=0.43).

Conclusions: In conclusion, survivorship-focused providers were more likely to achieve long-term screening recommendations. However, even within this group, adherence to the 2012 screening and preventive practice guidelines was incomplete.  Further efforts to automate and standardize the survivorship assessments in HCT survivors are necessary.
Purchase of medications without prescription in Peru: a cross-sectional population-based study
Authors: Hernández-Vásquez Akram , Alarcon-Ruiz Christoper A. , Díaz-Seijas Deysi , Magallanes-Quevedo Luisa , Rosselli Diego
Published: September 2018

Background: Low availability of medicines in health services, self-medication, inadequate use of medicines, and inadequate dispensing practices in pharmacies are frequent problems in Peru. We aimed to evaluate how frequent the purchase of medications without medical prescription is in Peru, and which factors are associated with this practice.

Methods: We conducted a secondary analysis of the 2016 ENSUSALUD national survey data. Purchase of medicines that require a prescription was measured as a dichotomous coded as bought one or more medicines that requires medical prescription or bought medicines that do not require a prescription. Crude and adjusted prevalence ratios (PR) and their 95% confidence intervals (95% CI) were calculated using Poisson regressions model with robust variance to assess the association of purchasing of medicines that require prescriptions with sociodemographic factors.

Results: There were 3858 participants in the dataset. The prevalence of purchasing medications without prescriptions was 47.2%. History of having previously consumed the same medication (31.6%), and the delay in receiving an appointment at health facilities (26.9%) were the main reasons to buy medications without a prescription. Regarding the recommendation of the medication purchased, the advice of the pharmacy, and remembering a previous old prescription, were the most frequent reasons (38.3%, and 25.9%, respectively). On the multivariable analysis, users that buy medications without prescription were more likely to be of aged 24-45; reside in the Amazon and Highlands regions; and self-consumption of the purchase. Individuals with Seguro Integral de Salud (Comprehensive Health Insurance) were less likely to buy medications without prescription.

Conclusions: There is a high prevalence of prescription requiring medication being bought without one from pharmacies in Peru. It is necessary to include the evaluation of consumer patterns to develop strategies with the aim to regulate the consumption of prescription drugs in the Peruvian population.
Formation of an Engineer Model in the Conditions of Digital Transformation: Interaction of Enterprises and Universities
Authors: Флек Михаил , Flek Mihail , Угнич Екатерина , Ugnich Ekaterina
Published: September 2018

This article is devoted to the study of the content characteristics of the model of a modern engineer. It is shown, that its optimal formation in the conditions of digital transformation is possible only with the interaction of the higher education system and the subjects of the real sector of the economy. It is noted that in the formation of the model of the engineer it is necessary to proceed from the relationship of such components as the requirements for the competence of engineers imposed by enterprises; the necessary knowledge and skills that are provided by universities; effective approaches to training, the implementation of which is possible in the conditions of close cooperation between universities and enterprises. The paper emphasizes the effectiveness of a practice oriented approach to training engineers, which is confirmed by the experience of the specialized departments as a single educational platform of universities and enterprises. On the example of the specialized department of “Aircraft Engineering” of the Don State Technical University, the efficiency of the practice oriented approach to training engineers is evaluated.
Socio-Psychological Climate in the State Authorities
Authors: Рогач О. , Rogach O. , Рябова Т. , Ryabova T. , Фролова Е. , Frolova E.
Published: September 2018

The development of the Institute of public service is connected, fi rst of all, with the improvement of its personnel policy, the fi ght against corruption, the introduction of ethical standards and technologies for managing the career of employees. These problems are the most signifi cant limitations of socio-economic and political development of the state and their solution should pay considerable attention to the socio-psychological well-being and climate of the employees of public authorities in order to minimize the negative eff ects of psychological support for their professional activities. In order to determine the specifi cs of the formation of socio-psychological climate in public authorities, whose employees should be focused on solving signifi cant problems of state construction, the authors conducted a study in the Federal service for fi nancial monitoring of the Russian Federation. By applying the test “Pulsar”, the test of the “Integral job satisfaction”, by A.V. Batashevy, the observation method and personal interview by the authors has been partially refuted the hypothesis that the rigid formalization of the activities of public servants, including the regimentation of action, the pressure of the authorities, routine and emphasis on discipline and high level of personal responsibility, is a dominant factor disturbing the socio-psychological climate in state government. The study revealed that socio-psychological climate in the team of a public authority can be described as favorable and unstable. A team of employees — quite a mature group, able to perform a production job, despite the rather widespread phenomenon: “staff turnover”. According to the results of the tests, the authors characterize a modern civil servant as an effective, purposeful, energetic, constantly increasing his level of knowledge, interested in effective work, which is contrary to the image of a public servant who is tired in society.
Actual Problems of State Support of Small and Medium Entrepreneurship
Authors: Свистунов Василий , Svistunov Vasiliy , Алешина А. , Aleshina A.
Published: September 2018

This article analyzes current problems of state support for small and medium-sized businesses. The state actively participates in the development of this sector of the economy through a difference in the support program. Despite this, the aid system cannot be called perfect. There are many factors preventing the full implementation of existing programs. The analysis of this system makes it possible to clearly identify the actual problems of implementing state programs, as well as to determine the directions of work to eliminate the current shortcomings of the system.
Designing of light industry products: designing of garments
Authors: Махоткина Лилия , Makhotkina Liliya , Никитина Людмила , Nikitina Lyudmila , Гаврилова Ольга , Gavrilova Olga
Published: September 2018

The textbook contains information about the features of obtaining initial information for the purposes of design, construction of structures and patterns of garments, the basics of the process of technical reproduction of clothing parts, the basic methods of designing clothes used in domestic enterprises for the manufacture of clothing. At the beginning of each paragraph new information is presented in the form of a table for its systematization and convenience of perception. After each Chapter there are questions and tasks for repetition and tasks for independent work of students. This publication has a logical relationship with the content of the textbook "Design of light industry products: theoretical basis of design of light industry products", but is an independent publication, allowing to study the sections of the discipline "Design of light industry products" depending on the features of the educational process
Surgeons’ personalities and surgical outcomes
Authors: Lovejoy CA , Nashef SAM
Published: September 2018

Previous studies have found links between personality and exam scores, job satisfaction and burnout. Now, for the first time, we are able to investigate the relationship between surgeon personality and outcomes.
Statin administration is associated with higher IGF-1 levels in patients without diabetes mellitus
Authors: Shpagina Olga V. , Bondarenko Irina Z. , Kolesnikova Galina S.
Published: September 2018

Background: Research makes it clear that the IGF-1 level correlates with cardiovascular disease, chronic heart failure, and mortality. Yet, little is known about the effect of statins on IGF-1.
Aims: to evaluate the effect of statin treatment on IGF-1 and its association with a cardiovascular risk.
Material and methods: The study included 115 patients (mean age, 55.8±6.1 years) who either were overweight or had mild obesity (body mass index 28.6±3.8 kg/m2) without diabetes. Group 1 consisted of 70 patients with verified coronary artery disease receiving statin therapy; group 2 included 45 healthy subjects. Coronary angiography and treadmill test were used to diagnose coronary artery disease. Impaired glucose tolerance and total cholesterol, triglycerides, LPHD, LPLD, fibrinogen, and IGF-1 levels were evaluated in all the subjects. Heart chamber geometry was assessed by echocardiography.
Results: The IGF-1 level was significantly higher in group 1 compared to the control group (196 and 167 ng/ml, respectively; р=0.014). Serum levels of IGF-1 were associated with duration of statin therapy (R=0.311; p=0.000), stage of hypertension (R=0.187; p=0.04), fibrinogen (R=0.274; p=0.033), TG (R=0.316; p=0.006), total cholesterol (R=–0.213; p=0.016), LPLD (R=–0.184; p=0.038), smoking (R=0.3; p=0.009), ejection fraction (R=0.298; p=0.041), end-diastolic volume (R=0.422; p=0.036), end-systolic volume (R=0.407; p=0.042), end-diastolic dimension (R=0.27; p=0.014), interventricular septal thickness (R=0.247; p=0.02), and left ventricular posterior wall thickness (R=0.258; p=0.019). Rosuvastatin dose positively correlated with the IGF-1 level (R=0.521; p=0.028).
Conclusions: Statin administration is associated with higher IGF-1 levels in patients without diabetes. High IGF-1 level correlates with the risk factors of coronary artery disease: hypertension, lipid profile, and fibrinogen level and has an adverse effect on chronic heart failure by altering the cardiac remodeling.
Expression of transcription and growth factors and the AKT/m-TOR signaling pathway components in papillary thyroid cancer
Authors: Spirina Liudmila V. , Chizhevskaya Sventlana Yu. , Kondakova Irina V.
Published: September 2018

Background: The molecular mechanism of thyroid cancer development is associated with changes in expression of transcription factors and growth factors accompanied by modified level of the AKT/m-TOR components.
Aims. The aim of study was to determine NF-κB p65, NF-κB p50, HIF-1α, HIF-2α, VEGF, CAIX, VEGFR2 expression and mRNA level of the AKT/m-TOR signaling pathway components in papillary thyroid cancer compared to those in benign lesions.
Material and methods: Forty patients aged 33—66 years with T1-4N0-2M0 papillary thyroid cancer (7 males and 33 females) were enrolled in the study. The mean age was 52.0±2.6 years. The comparison group included patients with benign lesions of thyroid tissue (4 males and 18 females) aged 38—66 years (mean age, 53.0±4.4 years). Expression levels of NF-κB p65, NF-κB p50, HIF-1α, HIF-2α, VEGF, CAIX, VEGFR2, and the AKT/m-TOR signaling pathway components were determined by RT-PCR using specific primers.
Results: Increased expression of transcription factors NF-κB and HIF-2α was found in papillary thyroid cancer. The levels of AKT and PTEN mRNA were elevated in transformed tissues. c-Raf expression was reduced 2.1-fold in cancer compared to that in thyroid tissues with benign lesions. Multiple positive correlations were revealed between transcription and growth factors and the AKT/m-TOR signaling pathway components in cancer. An association between PTEN expression and the NF-κB mRNA level was revealed, being a sign of deregulation in the signaling cascade in cancer tissues.
Conclusions: Overexpression of NF-κB, HIF-2α, AKT, PTEN and reduction of c-Raf expression is typical of thyroid papillary cancer.
SOLUSI LEMAH MASALAH DIRICHLET PERSAMAAN DIFERENSIAL PARSIAL LINEAR ELIPTIK ORDER DUA
Authors: Nugraheni Sekar , Indrati Christiana Rini
Published: September 2018

The weak solution is one of solutions of the partial differential equations, that is generated from derivative of the distribution. In particular, the definition of a weak solution of the Dirichlet problem for second order linear elliptic partial differential equations is constructed by the definition and the characteristics of Sobolev spaces on Lipschitz domain in R^n. By using the Lax Milgram Theorem, Alternative Fredholm Theorem and Maximum Principle Theorem, we derived the sufficient conditions to ensure the uniqueness of the weak solution of Dirichlet problem for second order linear elliptic partial differential equations. Furthermore, we discussed the eigenvalue of Dirichlet problem for second order linear elliptic partial differential equations with  respect to the weak solution.
Rusijos geoenergetika ir Baltijos šalių atsakas: integracijos ir bendradarbiavimo iniciatyvų reikšmė
Authors: Molis Arūnas , Česnakas Giedrius , Juozaitis Justinas
Published: September 2018

[straipsnis, santrauka lietuvių kalba; santrauka anglų kalba]

Praėjus 27-eriems nepriklausomybės metams ir 13-ai narystės Europos Sąjungoje metų, elektros energijos srityje Baltijos šalys vis dar veikia iš Maskvos valdomoje sinchroninėje IPS/UPS zonoje, o iki 2014 m. pabaigos buvo visiškai priklausomos ir nuo Rusijoje priimamų sprendimų dėl gamtinių dujų tiekimo ir jų kainos. Vis dėlto priklausymas tai pačiai elektros energetikos sistemai ir Kaliningrado aprūpinimo per Lietuvą veiksnys teisinio abipusiškumo ir pasitikėjimo tarp Baltijos šalių ir Rusijos nesukūrė. Atvirkščiai, Rusijos politika sąlygojo konkrečius neigiamus padarinius Baltijos valstybėms: didesnes didmenines gamtinių dujų kainas, politinių, techninių bei kitų priežasčių sąlygotus energijos tiekimo sutrikimus, politinį šantažą ir pan. Kita vertus, pastarojo meto Lietuvos, Latvijos ir Estijos pažanga, siekiant energetinės nepriklausomybės, nuteikia optimistiškai – Baltijos šalys, regis, atrado Rusijos spaudimui pasipriešinti tinkamas priemones.
Um corpo sem memória? Como se relacionar com alguém com Alzheimer?
Authors: Caretta Flavia
Published: September 2018

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TESTAMENTAL VITAL: CONSIDERAÇÕES ACERCA DE SUA (IM)POSSIBILIDADE NO BRASIL
Authors: Dutra Marcus Vinícius Dellavalle , Araújo Daiane Pereira
Published: September 2018

O presente artigo dedica-se a tecer considerações acerca da Resolução n. 1.995, de 2012, do Conselho Federal de Medicina, que introduziu as diretivas antecipadas de vontade ou testamento vital, como também são conhecidas. Temática que ainda não foi regulamentada por lei específica no Brasil, mas que tem gerado bastante polêmica no meio jurídico. Tratasede possibilidade conferida aos pacientes para, previamente, manifestarem-se acerca de eventuais tratamentos médicos que desejam, ou não, se submeter, quando estiverem impossibilitados de exprimir sua própria vontade. Para melhor compreender a importância do testamento vital para os brasileiros, far-se-á breves considerações sobre as modalidades de testamentos existentes no ordenamento, discorrendo, posteriormente, também sobre as inovações trazidas por esta resolução para ao fim e ao cabo, realizar ponderações sobre a Ação Civil Pública proposta pelo Ministério Público face ao Conselho Federal de Medicina, questionando a sua constitucionalidade.
Reparación a víctimas de violación de derechos humanos y crímenes de lesa humanidad en Ecuador
Authors: Solís María Cristina
Published: September 2018

En mayo de 2007, el ex presidente Rafael Correa creó una Comisión de la Verdad para Ecuador (CVE) a la que encargó esclarecer los hechos de violencia política ocurridos en el país entre los años 1984-2007. En junio de 2010, con la entrega del informe final de la Comisión, el Estado ecuatoriano dio inicio a una serie de acciones con el fin de reconocer su responsabilidad en los hechos y emprender medidas de reparación, judicialización y reformas administrativas. Este artículo busca un acercamiento a la forma en que el “hacer memoria” de los hechos investigados por la CVE se convierte en sustento para la definición y promulgación de políticas de reparación a víctimas y/o sus familiares, así como a la forma en que esas políticas encuentran recepción tanto en las autoridades llamadas a impulsarlas como en sus beneficiarios.
El trabajo político desde una perspectiva cualitativa: aporte para el análisis de las subjetividades
Authors: Bustamante Mauricio
Published: September 2018

Debate "El trabajo político desde una perspectiva cualitativa: aporte para el análisis de las subjetividades"
La interpretación de Emmanuel Lévinas de Ideas I de Husserl
Authors: López Sáenz María Carmen
Published: September 2018

Este artículo describe en un primer momento la herencia que Levinas recibe de Bergson y de la fenomenología de Husserl. Luego, pone el acento en la profundidad con la que captó, desde los años 20, el significado del idealismo trascendental de la obra Ideas I (1913) de Husserl. Ello se suma a su re(con)ducción a lo trascendental, entendida como el sentido de la existencia ignorado por la ontología naturalista. La interpretación levinasiana de la controvertida “reducción” marcará tempranamente tanto sus diferencias con Heidegger como su adhesión a la fenomenología genética, especialmente a la intencionalidad horizóntica y no representativa. En ese orden de ideas, analizaremos la continuación levinasiana de esta fenomenología y su conclusión en la irreductibilidad de la responsabilidad ética.
RISK FACTORS FOR FAILURE TO REACH TOTAL ENERGY VALUE IN AN INTENSIVE CARE UNIT
Authors: Medeiros Louise Carnevali Furtado de , Pádua Cláudia Sena de , Medeiros Irla Maiara Silva , Nascimento Monica Silvina Maia , Amaral Thatiana Lameira Maciel , Prado Patricia Rezende do
Published: September 2018

The objective was identify the risk factors associated with the failure to total energy value. A prospective cohort study was conducted in an intensive care unit with 87 patients receiving exclusive enteral nutrition therapy. The Kaplan-Meier and Cox regression analysis were used to evaluate the results. Regarding the patients, 35.6% were aged between 31 and 50 years, and 58.6% were males. At the end of the third day, 70.8% reached the total recommended energy value. Postoperative patients (HR: 7.09; 95% CI: 2.02-24.81), hemodynamically unstable patients (HR: 5.97; 95% CI: 1.11-31.99) and those who were fasting for the performance of tests (HR: 4.95; 95% CI: 1.01-24.61) presented a greater risk of not reaching the recommended value. The number of patients who achieved the total energy value was adequate, but can be optimized by the evaluation of these identified factors.