bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequency and Risk of Occupational Health and Safety Hazards for Home Healthcare Workers
Authors: Suarez Rassull , Agbonifo Noma , Hittle Beverly , Davis Kermit , Freeman Andrew
Published: April 2017

Given the increased prevalence of chronic disease and health care costs, more individuals are treated in the home, which has augmented the demand for more Home Healthcare Workers (HHCWs) in the field. HHCWs face multiple hazards with injury rates being more than double the national average; however, current studies on HHCWs have provided limited understanding of their occupational safety & health experiences and exposures. The aim of this study was to assess the frequency and risk of exposures through perceptions of HHCWs. The results of this study provide an initial picture of the different risks that HHCWs face daily. These findings show that studies involving HHCWs occupational safety need to be job-specific, and the proposed interventions will also likely need to be tailored by HHCWs type.
A Long-Term, Open-Label, Safety Study of Triple-Bead Mixed Amphetamine Salts (SHP465) in Adults With ADHD
Authors: Adler Lenard A. , Frick Glen , Yan Brian
Published: April 2017

Objective: The aim of this study was to evaluate the long-term safety of triple-bead mixed amphetamine salts (MAS) in adults with ADHD. Method: Adults meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) ADHD criteria and satisfying study criteria from one of two antecedent studies were enrolled in this 52-week (dose titration, 4 weeks; dose maintenance, 11 months) open-label extension. The protocol included 12.5- to 75-mg triple-bead MAS but was amended to a maximum of 50-mg triple-bead MAS. Safety evaluations included treatment-emergent adverse events (TEAEs) and vital signs. Clinical outcome measures included ADHD Rating Scale–IV (ADHD-RS-IV) total score changes. Results: Of 505 enrolled participants, 266 completed the study; the M ± SD daily dose during the study was 48.0 ± 15.96 mg. The most frequent TEAEs were insomnia (initial insomnia, insomnia, early morning awakening, middle insomnia; 38.2%), headache (25.7%), and dry mouth (20.2%). Study discontinuations were more frequent with higher doses of triple-bead MAS (37.5-75 mg) than with lower doses (12.5 and 25 mg). Blood pressure and pulse increases were observed at end-of-study. Mean ADHD-RS-IV total score decreases from antecedent study and open-label baselines at end-of-study were −23.3 ± 11.44 and −7.9 ± 13.19, respectively. Conclusion: Triple-bead MAS exhibited a long-term safety profile comparable with previous reports and demonstrated evidence of continued symptom control for up to 12 months.
Triple-Bead Mixed Amphetamine Salts (SHP465) in Adults With ADHD: Results of a Phase 3, Double-Blind, Randomized, Forced-Dose Trial
Authors: Frick Glen , Yan Brian , Adler Lenard A.
Published: April 2017

Objective: Evaluate the efficacy and tolerability of triple-bead mixed amphetamine salts (MAS) in ADHD. Method: Adults with ADHD Rating Scale IV (ADHD-RS-IV) total scores ≥32 were randomized to 6 weeks of triple-bead MAS (25, 50, or 75 mg) or placebo. The primary endpoint was ADHD-RS-IV total score change from baseline at end of study (EOS). Results: Least squares mean (95% confidence interval [CI]) treatment differences for ADHD-RS-IV total score changes from baseline to EOS significantly favored triple-bead MAS (all doses combined: −10.6 [−13.2, −8.0]; p < .0001); there were no significant differences between triple-bead MAS dosages. The most frequently reported TEAEs with triple-bead MAS (all doses combined) included insomnia, decreased appetite, and dry mouth. Mean ± SD pulse and systolic blood pressure increases at EOS were 3.5 ± 10.33 bpm and 0.3 ± 10.48 mmHg with triple-bead MAS (all doses combined). Conclusion: Triple-bead MAS significantly reduced adult ADHD symptoms; the safety profile was consistent with previous triple-bead MAS studies.
Bone Marrow Lesion: Image, Clinical Presentation, and Treatment
Authors: Bonadio Marcelo Batista , Ormond Filho Alipio Gomes , Helito Camilo Partezani , Stump Xavier MGRG , Demange Marco Kawamura
Published: April 2017

In this article, the cause, histology, imaging characteristics, clinical presentation, and treatment of these lesions are thoroughly discussed. Bone marrow edema is the generic term classically used to describe the high-signal-intensity alterations detected on magnetic resonance fluid-sensitive sequences. The significance of bone marrow edema for the patient’s clinical condition and the prognosis of the affected joint is being increasingly investigated and discussed, and situations characterized by subchondral insufficiency are receiving increasing attention. More recent studies found some important correlations between bone marrow lesions and patient’s pain and osteoarthritis progression. Conservative treatment is based on anti-inflammatory and analgesic uses according to the patient’s pain, combined with reduced load on the affected limb. Regarding surgical treatment, subchondroplasty is an option still in development, albeit with promising initial results.
The role of self-disgust in eating psychopathology in overweight and obesity: Can self-compassion be useful?
Authors: Palmeira Lara , Pinto-Gouveia José , Cunha Marina
Published: April 2017

This study explores the relationship between self-disgust and eating psychopathology and whether self-compassion plays a mediator role on this relationship. Participants were 203 adults, from both genders, with overweight and obesity ( MBMI = 31.17, standard deviation = 5.43). Women reported higher levels of self-disgust and eating psychopathology and lower levels of self-compassion than men. Path analysis results suggested that the effect of self-disgust on eating psychopathology occurred partially through one’s inability to be self-compassionate. The results highlight the damaging role of self-disgust on eating psychopathology and the importance of developing a more compassionate attitude towards the self to promote healthy eating behaviors.
Dealing with digital intermediaries: A case study of the relations between publishers and platforms
Authors: Kleis Nielsen Rasmus , Ganter Sarah Anne
Published: April 2017

The rise of digital intermediaries such as search engines and social media is profoundly changing our media environment. Here, we analyze how news media organizations handle their relations to these increasingly important intermediaries. Based on a strategic case study, we argue that relationships between publishers and platforms are characterized by a tension between (1) short-term, operational opportunities and (2) long-term strategic worries about becoming too dependent on intermediaries. We argue that these relationships are shaped by news media’s fear of missing out, the difficulties of evaluating the risk/reward ratios, and a sense of asymmetry. The implication is that news media that developed into an increasingly independent institution in the 20th century—in part enabled by news media organizations’ control over channels of communication—are becoming dependent upon new digital intermediaries that structure the media environment in ways that not only individual citizens but also large, resource-rich, powerful organizations have to adapt to.
The Problem of Words in the Eighth Moment
Authors: Lapadat Judith C.
Published: April 2017

This poem addresses the limitations of language for representing experience and shaping political action at this historical moment of inquiry. Words have the power to name or to silence. Who owns a particular narrative, and who has a right speak for whom? As worldwide political, social, and environmental issues become ever more pressing, we need pragmatic tools to bridge the gap between naming and doing, and strategies to move from fear and passivity to collective agency.
The second life of Kowloon Walled City: Crime, media and cultural memory
Authors: Fraser Alistair , Li Eva Cheuk-Yin
Published: April 2017

Kowloon Walled City (hereafter KWC or Walled City), Hong Kong has been described as ‘one of history’s great anomalies’. The territory remained under Chinese rule throughout the period of British colonialism, with neither jurisdiction wishing to take active responsibility for its administration. In the postwar period, the area became notorious for vice, drugs and unsanitary living conditions, yet also attracted the attention of artists, photographers and writers, who viewed it as an instance of anarchic urbanism. Despite its demolition in 1993, KWC has continued to capture the imaginations of successive generations across Asia. Drawing on data from an oral and visual history project on the enclave, alongside images, interviews and observations regarding the ‘second life’ of KWC, this article will trace the unique flow of meanings and reimaginings that KWC has inspired. The article will locate the peculiar collisions of crime and consumerism prompted by KWC within the broader contexts in which they are embedded, seeking out a new interdisciplinary perspective that attends to the internecine spaces of crime, media and culture in contemporary Asian societies.
DUSP-1 gene expression is not regulated by promoter methylation in diabetes-associated cardiac hypertrophy
Authors: Singh Gurinder Bir , Khanna Sanskriti , Raut Satish K. , Sharma Saurabh , Sharma Rajni , Khullar Madhu
Published: April 2017

Background:

The exact mechanism causing decreased expression of the dual specific phosphatase-1 ( DUSP-1) gene in diabetes-associated cardiac hypertrophy is not known. DNA promoter methylation is often associated with decreased gene expression in many diseases including cardiovascular diseases. So, we investigated whether epigenetic silencing via promoter methylation is involved in the decreased expression of DUSP-1 in diabetes-associated cardiac hypertrophy.

Methods:

Real-time polymerase chain reaction (PCR) and Western blotting confirmed the down regulation of the DUSP-1 gene at transcriptional and translational levels. Bisulfite-converted DNA samples from myocardium of rat model of diabetic cardiomyopathy (DCM), high glucose (HG)-treated neonatal rat cardiomyocytes (NRCMs) and cardiac tissues from archived human myocardial DCM autopsies along with their respective controls were analyzed for methylation in the promoter region of the DUSP-1 gene.

Results:

We observed no methylation in the promoter regions of the DUSP-1 gene in DCM rat hearts, in HG-treated NRCMs (between −355 bp and −174 bp) and in cardiac tissues from archived human myocardial DCM autopsies (between −274 bp and −73 bp).

Conclusion:

Methylation-mediated silencing of the DUSP-1 promoter does not appear to be associated with reduced expression, indicating the involvement of other factors in specific suppression of DUSP-1 in diabetes-associated cardiac hypertrophy.
Renal cell carcinoma with inferior vena cava thrombus extending to the right atrium diagnosed during pregnancy
Authors: Ghanney Efe C. , Cavallo Jaime A. , Levin Matthew A. , Reddy Ramachandra , Bander Jeffrey , Mella Maria , Stone Joanne , Schwartz Myron , Haines Kenneth , Gidwani Umesh , Mehrazin Reza
Published: April 2017

Only one case of renal cell carcinoma (RCC) with inferior vena cava (IVC) tumor thrombus diagnosed and treated during pregnancy has been reported in the literature. In that report, the tumor thrombus extended to the infrahepatic IVC (level II tumor thrombus).

In the present case, a 37-year-old woman with lupus anticoagulant antibodies was diagnosed with RCC and IVC tumor thrombus extending to the right atrium (level IV tumor thrombus) at 24 weeks of pregnancy. The fetus was safely delivered by cesarean section at 30 weeks of gestation. At 4 days later, an open right radical nephrectomy and IVC and right atrial thrombectomy were performed on cardiopulmonary bypass (CPB) once the patient’s hemodynamic status had been optimized.

Fetal and maternal concerns included the risk of a thromboembolic event (due to increased hypercoagulability from pregnancy, active malignancy, and lupus anticoagulant), intraoperative hemorrhage risk (due to extensive venous collaterals and anticoagulation), and fetal morbidity and mortality (due to fetal lung immaturity). Standardized guidelines for treatment of RCC with or without IVC tumor thrombus during pregnancy are unavailable due to the infrequency of such cases. Treatment decisions are therefore individualized and this case report may inform the management of future patients diagnosed with RCC with level IV tumor thrombus during pregnancy.
Isolated Gastrocnemius Recession for the Treatment of Achilles Tendinopathy
Authors: Smith Kenneth S. , Jones Caleb , Pinter Zachariah , Shah Ashish
Published: April 2017

Background: Various treatment modalities have been described for Achilles tendinopathy with varying degrees of success. The rationale for the gastrocnemius recession procedure is to decrease the mechanical overload of the Achilles tendon arising from an equinus contracture. Methods: We retrospectively reviewed 25 patients who underwent an isolated gastrocnemius recession procedure at our institution between May 2013 and April 2015 by a single surgeon. Clinical outcome was evaluated on the basis of pain, utilizing visual analog scale (VAS) scores and the Foot Function Index (FFI) by telephonic interview. Student’s t test and one-way analysis of variance were used for statistical analysis. Results: The average age of patients was 53.2 years with an average body mass index of 35.8 kg/m2. The average follow-up was 13.1 months. All 25 patients had a decrease in VAS scores from an average of 8.9 preoperatively to 2.0 at the 6-week visit. The average FFI went from 73.5 preoperatively to 27.4 at final follow-up. Two out of 25 patients had a postoperative sural neuritis with a total complication rate of 12%. Twenty-one of 25 patients (84%) reported total or significant pain relief. Conclusion: The medium-term results of our study suggest that an isolated gastrocnemius recession is a simple, effective, and safe surgical procedure for the treatment of Achilles tendinopathy.

Levels of Evidence: Therapeutic, Level IV: Retrospective
Rapid Expansion of Oil Palm Is Leading to Human–Elephant Conflicts in North Kalimantan Province of Indonesia
Authors: Suba Rachmat B. , Ploeg Jan van der , Zelfde Maarten van’t , Lau Yee Wah , Wissingh Thomas F. , Kustiawan Wawan , de Snoo Geert R. , de Iongh Hans H.
Published: April 2017

Crop raiding by Bornean elephants ( Elephas maximus borneensis) is increasing rapidly in North Kalimantan, mainly due to a rapid conversion of swiddens and secondary forest into oil palm plantations. In the Tulin Onsoi subdistrict, the area used by oil palm plantations has grown from 3,302.71 ha in 2001 to 21,124.93 ha in 2014. Particularly from 2006 to 2010, the area covered by oil palm plantations increased rapidly (418%). Preventing further encroachment of oil palm plantations in elephant habitat and regulating land use change are keys to stop further population declines and make way for the reestablishment of a viable elephant population in Kalimantan. Crop raiding is a strong determinant of the local people’s perceptions of elephants and risks eroding cultural values that enabled people to coexist with elephants. People’s perception and attitude toward elephants are generally negative. Nevertheless, negative attitudes have not led to cases of retaliation in the Tulin Onsoi subdistrict. Public education at the community level could strengthen cultural values and foster coexistence between humans and elephants.
Hapax Legomena in Esther 1.6: Translation Difficulties and Comedy in the Book of Esther
Authors: Lees David
Published: April 2017

Containing one of the highest counts of hapax legomena for the length of text in the Hebrew Bible, the book of Esther has posed certain challenges to translators. Three of these hapax legomena (טהב, רד, תרחס) have been particularly difficult and unsatisfactorily translated as kinds of stone as adornments to the banquets in the palace in Susa. Various commentaries offer differing translations of different kinds of stone, whilst arguing such translations. This paper argues that these hapax legomena describe royal carpets that, in line with motifs from Greek literature, function as a comedic device in the Hebrew text of Esther. Translating טהב, רד, and תרחס to refer to carpets best fits the etymological evidence and literary style of the banquet scenes.
The Financial Impact of Advanced Kidney Disease on Canada Pension Plan and Private Disability Insurance Costs
Authors: Manns Braden , McKenzie Susan Q. , Au Flora , Gignac Pamela M. , Geller Lawrence Ian ,   for the Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network
Published: April 2017

Background:

Many working-age individuals with advanced chronic kidney disease (CKD) are unable to work, or are only able to work at a reduced capacity and/or with a reduction in time at work, and receive disability payments, either from the Canadian government or from private insurers, but the magnitude of those payments is unknown.

Objective:

The objective of this study was to estimate Canada Pension Plan Disability Benefit and private disability insurance benefits paid to Canadians with advanced kidney failure, and how feasible improvements in prevention, identification, and early treatment of CKD and increased use of kidney transplantation might mitigate those costs.

Design:

This study used an analytical model combining Canadian data from various sources.

Setting and Patients:

This study included all patients with advanced CKD in Canada, including those with estimated glomerular filtration rate (eGFR) <30 mL/min/m2 and those on dialysis.

Measurements:

We combined disability estimates from a provincial kidney care program with the prevalence of advanced CKD and estimated disability payments from the Canada Pension Plan and private insurance plans to estimate overall disability benefit payments for Canadians with advanced CKD.

Results:

We estimate that Canadians with advanced kidney failure are receiving disability benefit payments of at least Can$217 million annually. These estimates are sensitive to the proportion of individuals with advanced kidney disease who are unable to work, and plausible variation in this estimate could mean patients with advanced kidney disease are receiving up to Can$260 million per year. Feasible strategies to reduce the proportion of individuals with advanced kidney disease, either through prevention, delay or reduction in severity, or increasing the rate of transplantation, could result in reductions in the cost of Canada Pension Plan and private disability insurance payments by Can$13.8 million per year within 5 years.

Limitations:

This study does not estimate how CKD prevention or increasing the rate of kidney transplantation might influence health care cost savings more broadly, and does not include the cost to provincial governments for programs that provide income for individuals without private insurance and who do not qualify for Canada Pension Plan disability payments.

Conclusions:

Private disability insurance providers and federal government programs incur high costs related to individuals with advanced kidney failure, highlighting the significance of kidney disease not only to patients, and their families, but also to these other important stakeholders. Improvements in care of individuals with kidney disease could reduce these costs.
Intralesional cryotherapy for hypertrophic scars and keloids: a review
Authors: O’Boyle Ciaran P , Shayan-Arani Holleh , Hamada Maha Wagdy
Published: April 2017

Introduction:

Hypertrophic and keloid scarring remain notoriously troublesome for patients to tolerate and frustratingly difficult for clinicians to treat. Many different treatment modalities exist, signifying the failure of any method to achieve consistently excellent results. Intralesional cryotherapy is a relatively recent development that uses a double lumen needle, placed through the core of a keloid or hypertrophic scar, to deliver nitrogen vapour, which freezes the scar from its core, outwards.

Methods:

This article provides a comprehensive review of the literature on intralesional cryotherapy for hypertrophic scars and keloids. A systematic review or meta-analysis was not possible, since the existing articles did not permit this.

Results:

A search of English language, peer-reviewed literature was carried out. The evidence base was found to be low (level 4). In addition, much of the published evidence comes from a very few groups. Despite this, consistent findings from case series suggest that the technique is safe and achieves good scar reduction with very few treatments. Adverse effects include depigmentation, recurrence and pain. Pain and recurrence appear to be uncommon and depigmentation may be temporary.

Discussion:

Well-constructed, prospectively recruited comparative trials are absent from the literature. These are strongly encouraged, in order to strengthen general confidence in this technique and in the repeatability of outcomes reported thus far.
Identifying Personal Risk Factors for Falls in the Workplace
Authors: Lurati Ann Regina
Published: April 2017

Falls can occur in any occupational setting. Occupational health professionals may focus on creating a safe work environment and training programs to prevent falls. However, an important aspect of safety management is identifying at-risk employees. The purpose of this article is to identify personal risk factors and offer interventions to prevent falls in the workplace.
Screening Commercial Vehicle Drivers for Obstructive Sleep Apnea: Tools, Barriers, and Recommendations
Authors: Evans Kelly A. , Yap Tracey , Turner Barbara
Published: April 2017

Obstructive sleep apnea (OSA) is a disorder characterized by a cessation of breathing during sleep, leading to poor sleep patterns and daytime somnolence. Daytime somnolence is of particular concern for commercial vehicle drivers, whose crash risk increases 50% with untreated OSA. The process of diagnosing and treating OSA in commercial drivers begins with effective and consistent screening. Therefore, the researchers screened drivers with both the STOP-Bang Questionnaire and the Obstructive Sleep Apnea Evaluation Worksheet (OSAEW) and compared the two tools. Drivers screening positive on the STOP-Bang Questionnaire, OSAEW, and both questionnaires were 28%, 23%, and 13%, respectively. Sleep study referrals were made for 50 drivers; 12 drivers were scheduled for sleep tests within 3 months. Health care provider referral rates for drivers screening at high risk (37%) and commercial driver monitoring rates (24%) were both low. Recommendations to improve OSA screening and testing practices include Federal Motor Carrier Safety Administration–mandated screening and referral guidelines, employee-facilitated sleep testing, and OSA awareness campaigns.
The American Association of Occupational Health Nurses: Seventy-Five Years of Education, Practice, and Research
Authors: Wachs Joy E.
Published: April 2017

For the past 75 years, the American Association of Industrial Nurses, and later the American Association of Occupational Health Nurses, has advocated for occupational and environmental health nurses by supporting quality undergraduate and graduate education in the specialty and certification through the American Board of Occupational Health Nurses, Inc., and providing funding for and dissemination of occupational health nursing research as well as by developing occupational health nursing practice standards, competencies, and code of ethics.
Tape Versus Suture in Arthroscopic Rotator Cuff Repair: Biomechanical Analysis and Assessment of Failure Rates at 6 Months
Authors: Liu Rui Wen , Lam Patrick Hong , Shepherd Henry M. , Murrell George A. C.
Published: April 2017

Background:

Rotator cuff retears after surgical repair are associated with poorer subjective and objectives clinical outcomes than intact repairs.

Purpose:

The aims of this study were to (1) examine the biomechanical differences between rotator cuff repair using No. 2 suture and tape in an ovine model and (2) compare early clinical outcomes between patients who had rotator cuff repair with tape and patients who had repair with No. 2 suture.

Study Design:

Controlled laboratory study and cohort study; Level of evidence, 3.

Methods:

Biomechanical testing of footprint contact pressure and load to failure were conducted with 16 ovine shoulders using a tension band repair technique with 2 different types of sutures (No. 2 suture [FiberWire; Arthrex] and tape [FiberTape; Arthrex]) with the same knotless anchor system. A retrospective study of 150 consecutive patients (tape, n = 50; suture, n = 100) who underwent arthroscopic rotator cuff repair by a single surgeon with tear size larger than 1.5 × 1 cm was conducted. Ultrasound was used to evaluate the repair integrity at 6 months postsurgery.

Results:

Rotator cuff repair using tape had greater footprint contact pressure (mean ± standard error of the mean, 0.33 ± 0.03 vs 0.11 ± 0.3 MPa; P < .0001) compared with repair using No. 2 sutures at 0° abduction with a 30-N load applied across the repaired tendon. The ultimate failure load of the tape repair was greater than that for suture repair (217 ± 28 vs 144 ± 14 N; P < .05). The retear rate was similar between the tape (16%; 8/50) and suture groups (17%; 17/100).

Conclusion:

Rotator cuff repair with the wider tape compared with No. 2 suture did not affect the retear rate at 6 months postsurgery, despite having superior biomechanical properties.
Surgical Detachment of the Anterior Hyaloid Membrane From the Posterior Lens Capsule
Authors: Chen Yicheng , Shah Vaishali , Jeroudi Abdallah M. , Blinder Kevin J. , Shah Gaurav K.
Published: April 2017

Purpose:

To describe 2 techniques facilitating the potentially challenging removal of the anterior hyaloid during phakic pars plana vitrectomy.

Methods:

Observational surgical series describing the 2 techniques. The hydrodissection technique applies an injection of balanced salt solution into the anterior chamber to displace the anterior hyaloid posteriorly for facile removal. The bubble technique is a novel method that utilizes air bubbles to visualize the anterior vitreous, allowing closer placement of the vitrectomy cutter to facilitate anterior hyaloid removal.

Results:

Both techniques were successful for the safe, efficient removal of the anterior vitreous.

Conclusion:

Removal of the anterior vitreous in a phakic patient is a difficult maneuver which may lead to potential damage to the lens. The hydrodissection and bubble techniques may be used to efficiently and safely remove the anterior vitreous.
Prefrontal Space Ratio—A Novel Ultrasound Marker in the Second Trimester Screening for Trisomy 21: Systematic Review and Meta-Analysis
Authors: Zare Mehrjardi Mohammad , Keshavarz Elham
Published: April 2017

To determine the value of prefrontal space ratio (PFSR) as a novel soft marker in the second-trimester screening for trisomy 21, PubMed and two other databases were searched electronically for the relevant materials published between January 2000 and December 2015. Four studies were included in the mini meta-analysis. All of the studies were retrospective and of high quality. Overall sample size was 293 trisomy 21 and 609 euploid fetuses. The pooled mean PFSR was 0.322 (95% confidence interval [CI], 0.256-0.388) and 1.205 (95% CI, 0.997-1.413) in trisomy 21 and euploid fetuses, respectively. This ratio was found to be significantly lower in trisomy 21 fetuses compared to euploid ones ( P < .0001). The pooled detection rate was 87.2% at a false-positive rate of 5%. Pooled positive and negative likelihood ratios measured 17.2 and 0.146, respectively. In conclusion, PFSR is an efficient marker that may be investigated in the second-trimester ultrasound screening for trisomy 21.
Factors associated with lingual tonsil hypertrophy in Canadian adults
Authors: Harris Matthew S. , Rotenberg Brian W. , Roth Kathryn , Sowerby Leigh J.
Published: April 2017

Background

Hypertrophy of the lingual tonsil tissue in the adult patient is thought to contribute to the pathophysiology of obstructive sleep apnea. The underlying etiology of lingual tonsil hypertrophy (LTH) in the adult patient is unclear and likely multifactorial. Previous studies have suggested that the lingual tonsils may undergo compensatory hyperplasia post-tonsillectomy in children, although it is unknown if this occurs or persists into adulthood. The purpose of this study was to determine what factors are associated with LTH in a population of Canadian adults.

Methods

Adult patients presenting for consultation to an academic Rhinology/General Otolaryngology practice were eligible for enrollment. Demographic data including age, body mass index (BMI), Reflux Symptom Index (RSI), history of allergy, and history of tonsillectomy was collected via questionnaire. Endoscopic photographs of the base of tongue and larynx were captured. These were graded for LTH and Reflux Finding Scale (RFS) by blinded examiners. Statistical analysis was performed by comparing the mean LTH value to the variables of interest using two-tailed T-test. P < .05 was considered significant.

Results

One hundred two subjects were enrolled. Age ranged from 18 to 78. 28 patients had previous tonsillectomy. This was not associated with a significant increase in lingual tonsil tissue ( r = −0.05, p = 0.61). RFS >7 or RSI >13 was considered positive for laryngopharyngeal reflux. There was no difference in LTH based on RSI positivity ( p = 0.44). RFS positivity correlated with increased lingual tonsil tissue ( p < 0.05). BMI >30 was associated with increased lingual tonsil hypertrophy ( p < 0.05).

Conclusions

An elevated body mass index and positive Reflux Finding Score are associated with lingual tonsil hypertrophy in adults. Reflux symptom index, history of allergy and history of childhood tonsillectomy are not associated with LTH.
Alternating first-arrival traveltime tomography and waveform inversion for near-surface imaging
Authors: Sun Mengyao , Zhang Jie , Zhang Wei
Published: April 2017

Near-surface seismic imaging often plays a significant role in producing quality data processing results for the deep subsurface in land and shallow marine environments. First-arrival traveltime tomography is a common approach for near-surface imaging due to its high efficiency and simplicity. However, the method faces issues of missing hidden layers and resolving the structures with low resolution. On the other hand, waveform inversion should offer better solutions for dealing with these issues, but it may suffer from the cycle-skipping problem. We intend to use the advantages and reduce the disadvantages of the two methods by developing a new strategy of alternately applying traveltime tomography and waveform inversion through iterations. First-arrival traveltime tomography applies a wavefront raytracer and a nonlinear inversion approach. Waveform inversion is a multiscale approach in which a wavelet transform is applied in the data domain to better handle the cycle-skipping problem. By alternating the two inversions rather than performing a joint inversion, we reduce the memory requirements and avoid nonphysical scaling problems between the two approaches. Using one synthetic and two real data examples, we determine that alternating inversions minimize two separate objective functions at the same time and constrain the near-surface structures fairly well compared with the waveform inversion method alone. For the field examples, the new method avoids generating the obvious artifacts and provides results consistent with the geology analysis of those areas.
CLINICAL MANIFESTATIONS AND OUTCOMES OF TUBERCULOSIS IN CHILDREN IN THE IRKUTSK REGION
Authors: �����������  , Zorkaltseva Elena , ��������  , Zvonkova Svetlana , ��������  , Pugacheva Svetlana
Published: April 2017

100 children were observed. Tuberculosis of inrathoracic lymph nodes was found in 79 (79,0 %) patients, complicated tuberculosis � in 29 (36,7 %) of 79 patients. The phase of reverse development of tuberculosis was detected in 47,0 % of children with TB. Due to the slow dynamics of the disease, the duration of chemotherapy in 75,0 % of children was 240 days. In the mode of treatment, drug resistance of a patient in lesion of tuberculosis infection is taken into account. As a result of treatment, resorption of infiltration in the lungs was observed in 15,0 %, fibrosis � in 26,0 %, formation of small calcifications � in 39,0 %, formation of multiple large calcifications � in 20,0 % of children. The cause of the formation of calcifications is the late detection of tuberculosis. In children with the formation of calcifications throughout the course of treatment the number of leukocytes decreased, the downward trend in the absolute number of lymphocytes to the 4th month of treatment was traced, the content of leukocytes increased to the end of primary treatment. In children without formation of calcifications the reduction of leukocytes and lymphocytes was not identified during the treatment. The decrease in the content of leukocytes and lymphocytes may explain long-term persistence of endogenous intoxication.
NEED OF THE PEOPLE DISABLED AS A RESULT OF DEPRESSIVE DISORDERS FOR REHABILITATION
Authors: ���������  , Petrunko Olga
Published: April 2017

disorders was analyzed by a continuous method. 24 (20,2 %) of them were recognized as disabled for the first time, 95 (79,8 %) � were recognized as repeatedly disabled; 80,7 % were of working age, but only 10 persons of them (10,4 %) worked. The need for medical rehabilitation was revealed in 100 % of people with disabilities, for professional rehabilitation � in 65,6 %, for social rehabilitation � in 23,5%, for adaptive physical training � in 0,8 %. Full rehabilitation in re-examination was achieved only in 1,3 % of cases, partial rehabilitation � in 1,3 %, employment � in 1 case. Weighting of disability was occurred in 5,2 %. In order to improve the efficiency of complex rehabilitation of disabled people it should include socio-psychological, socio-cultural rehabilitation and adaptive physical education in addition to medical and professional rehabilitation.
PRACTICAL MEASURES TO ENSURE SANITARY AND EPIDEMIOLOGICAL WELFARE OF THE POPULATION OF THE REPUBLIC OF KHAKASSIA
Authors: ���������  , Savchenkov Mikhail , �������  , Ivanova Olga , ��������  , Romanova Tatyana
Published: April 2017

Three emergencies that occurred on the territory of the Republic of Khakassia, their potential influence on sanitary and epidemiological welfare of the population (using water factor as an example) were investigated. We used methods of data collection, analysis and further quality evaluation of fresh water. The results of 2956 analyses of fresh water from centralized sources of drinking water supply and water distribution network of the damaged areas were processed. It was determined that the most substantial deterioration of fresh water quality according to microbiological indicators was recorded in the flood period and upon the liquidation of the consequences of mass fire.
FUNDING OF MEDICAL SCIENCE IN RUSSIA WITHIN AS PART OF STATE PROGRAMS
Authors: ��������  , Nefedova Elena , ������  , Perkhov Vladimir , ����������  , Starodubov Vladimir , ����������  , Kolesnikov Sergey
Published: April 2017

The aim of the research was to reveal main problems associated with the use of state programs funding mechanisms

for basic research in health (medical) sciences in Russia, as main instruments of state policy.

The source of information were �State Academies of Sciences Program of basic investigations for the period of 2013�2020

years� and other normative and legal acts in the sphere of planning and public financing of science and research. A study

completed by using documentary, analytical methods, as well as methods of descriptive statistics and expert estimates.

In analyzing financing from the federal budget for scientific research for civilian use within government programs

calculations section, subsection of the budget classification, reflecting expenditure on scientific research (0110, 0112,

0208, 0313, 0403, 0411, 0504, 0604, 0708, 0803, 0908, 1005, 1104, 1203).

Feature of the current situation is in an indeterminate state basic science after the liquidation of the Russian Academy

of Sciences as a structure that generates through subordinate organizations the bulk of new knowledge and innovation

in the country. Reform of the Russian Academy of Sciences led to the destruction of a coherent system of relations

in science, to the Federal agency of scientific organizations for management of resources, Ministry of Education and

Science and Russian academy of Sciences. Strict rationality and bureaucracy was extremely negatively perceived in

academic science. The analysis of the subject structure of the medical unit actualized in 2015 of the Program of basic

research of the state academies of sciences for the period of 2013�2020 showed that the distribution of the federal

budget for basic research are not consistent with the priorities in the health sector, it does not account for changes in

departmental affiliation Organizations of Medical Sciences.

The authors prove the necessity of functional and managerial integration of academic medical institutions in the

unified system of scientific research, creation and implementation of medical innovations into practical health care.
CHANGE OF APPROACH TO USING INTRA-AORTIC BALLOON COUNTERPULSATION IN COMBINED CARDIAC SURGERY
Authors: Бахарева  , Bakhareva Yuliya , Муравская  , Muravskaya Anna , Надирадзе  , Nadiradze Zurab , Михайлов  , Mikhaylov Aleksey
Published: April 2017

Perioperative acute myocardial dysfunction is an actual problem of cardiac surgery. Rational use of inotropes and

mechanical circulatory support in the postoperative period remains a subject of debate. The outcomes of the combined

coronary artery bypass grafting and heart valve prosthesis were analyzed in Irkutsk Cardiac Surgery Center after 80 patients

were operated on. As a result of the conducted research, authors proposed a method of differentiated approach

to the treatment of acute heart failure in the early postoperative period. Failure to escalate therapy beta agonists in

the absence of adequate response hemodynamics and the transition to a mechanical circulatory support improves

performance of the cardiovascular system and clinical outcomes, reduces hospitalization duration in the department

of intensive therapy. The study showed the superiority of an early beginning of an intra-aortic balloon counterpulsation

before traditional inotropic therapy in the treatment of postcardiotomy heart failure at combined cardiac surgery.
PRIMARY CILIARY DYSKINESIA. CLINICAL OBSERVATION
Authors: Павлова  , Pavlova Tatyana , Шинкарёва  , Shinkareva Vera
Published: April 2017

We give an example of our own clinical observation of primary ciliary dyskinesia showing difficulties of this disease diagnosis. The complexity of this clinical picture is in the absence of situs viscerum inversus of the patient with early symptoms of chronic bronchitis and chronic sinusitis. From birth patient was noticed to have wheezing during acute respiratory viral infection (4 episodes), first year – bilateral pneumonia, and later – 3–4 pneumonias per year. Gastroesophageal reflux disease was diagnosed on third year of life, surgical treatment was used. Year 4 – according to computerized tomography data middle lobe syndrome was detected. We performed middle lobectomy. Then we revealed morphologically-cylindrical bronchiectasis. Severe bronchial asthma and allergic rhinitis were diagnosed in 4,5 years. Despite the fact that baseline inhalation and antimicrobial therapy was done, general condition of the patient did not get better. On year 9 we did bronchoscopy with brush biopsy of bronchial mucosa. The result is sharp decrease of ciliary function. All in all, even though the patient had classical symptoms of primary ciliary dyskinesia and first symptoms showed during the first year of life, right diagnose was stated only when the patient turned nine. Primary ciliary dyskinesia is classified as rare (orphan) diseases, that is why awareness of primary care physicians against this pathology is low, resulting in high disability of patients.
FREQUENCY AND RISK FACTORS OF FRACTURES IN ADOLESCENTS AND YOUNG ADULTS IN THE POPULATION OF IRKUTSK
Authors: Меньшикова  , Menshikova Larisa , Дац  , Dats Lyudmila , Дац  , Dats Andrey
Published: April 2017

The aim of the study was to examine frequency and risk factors of fractures among adolescents and young adults
of Irkutsk aged 14 to 24. The results of the study showed that the frequency of fractures was 23.8 %; and boys have
fractures significantly more often than girls (p = 0.01). Risk factors for fractures are: male gender (OR = 1.25); body
height (> 174 cm for girls (OR = 3.9), > 177 cm for males (OR = 3.5)); body weight (> 60 kg for girls (OR = 2.5), > 66 kg
for boys (OR = 2.1)); tenderness to palpation of spinous processes of vertebra (OR = 3.1 for girls, and OR = 2.4 for boys);
dietary calcium intake < 500 mg/day (OR = 1.5 for girls, and OR = 2.3 for boys). In addition, back pain (OR = 1.9) and
joint hypermobility syndrome (OR = 1.4) were significantly more often found in girls with fractures. There was no statistically
significant connection between fractures in adolescents and young adults and hypodynamia, bone mineral
density, social factors (single-parent or multi-child family), and parental history of fractures.
CLINICAL AND PHARMACOLOGICAL MONITORING OF DRUG SAFETY IN PEDIATRICS
Authors: Охремчук  , Okhremchuk Lyudmila , Кочкин  , Kochkin Aleksandr , Кочкина  , Kochkina Elena , Верлан  , Verlan Nadezhda , Попадюк  , Popadyuk Anna
Published: April 2017

The 95 cases of adverse drug reactions in children were registered in the Centre of Drug Safety Monitoring of Irkutsk Region from 2009 to 2015. In 21.4 % of cases, the coexistent affections developed. Children were allergic three times more often than adults. In 14.7 % of cases severe allergic reactions were registered. Most often allergies occurred after taking immunotropic (62.2 %), antimicrobial (16.2 %) and nonsteroidal anti-inflammatory drugs (10.8 %). 10.5 % of cases concerned inefficient drug use in children under 3 years; and 36.8 % of cases concerned children aged 3 to 18 years. The following risk factors of inefficient antibiotic therapy in children with urinary system infections were determined: the duration of the disease up to 5 years, isolation of two or more infectious agents and concomitant infections of upper and lower urinary tract. Adverse drug reaction occurred more often when more than three drugs were prescribed at the same time. Such cases were generally registered in patients with infectious diseases and epilepsy. Risk of adverse reaction increased with the off-label drug use. Introduction of monitoring methods and prediction algorithms allowing to reveal with high probability and to prevent adverse drug reactions in children improved efficiency and quality of pharmacotherapy.
COMPLICATIONS OF BCG VACCINATION: MODIFICATION OF THE STATISTICAL PROCEDURE
Authors: Баландина  , Balandina Tatyana , Шугаева  , Shugaeva Svetlana , Савилов  , Savilov Evgeniy , Бородина  , Borodina Violetta
Published: April 2017

There is no uniform method to conduct the epidemiological monitoring of BCG complications in the Russian Federation.
Current indicators of BCG complications include the number of complication cases (cases registered within two years
after vaccination) and the total number of the vaccinated children.
Our aim is to discover a new indicator of BCG complications and to compare it with the indicators of the existing methods.
The comparative analysis of new and existing methods of all complication cases (continuous sampling, n = 110) was
conducted in the Irkutsk Region (Eastern Siberia) from 2005 to 2014. The calculating formula included the ratio of the
number of children with complications vaccinated in the analyzed year to 100,000 children vaccinated in the same year.
The new method shows the advantages over the existing methodological approaches. It demonstrates more adequate
assessment, expressed in the highest approximation coefficient of trend model compared to the other methods, and
stability of indicator over the years. The incidence of complications in the Irkutsk Region has a steady decreasing linear
trend and a significant negative growth rate of the indicator (–17.9 %).
The new method offers an adequate assessment and can be used as an epidemiological control system not only in the
Russian Federation but in other high TB-burden countries with massive BCG vaccination of children.
MISMATCH REPAIR AND REPAIR OF INSERTION/DELETION LOOPS IN EUKARYOTIC DNA
Authors: Минакина  , Minakina Liliya , Непомнящих  , Nepomnyashchikh Svetlana , Егорова  , Egorova Irina , Гуцол  , Gutsol Lyudmila , Ясько  , Yasko Mikhail
Published: April 2017

The mismatch repair (MMR) system detects non-Watson – Crick base pairs as well as the defects, appearing in course of DNA replication, and helps to eliminate them by catalyzing the excision of the defect-containing region of daughter DNA and its error-free resynthesis. Thus, MMR remarkably improves the fidelity of replication. After separation, both strands contain non-repairable damages and the mismatches may generate DNA mutation in 50 % of cell progeny after next replication. MMR dysfunction causes surge of mutation rate, abnormal recombination, and cancer in humans and animals. Therefore, the main MMR efficiency parameter is mismatch correction before the next replication cycle. Mismatch detection is made by the MSH2 protein, which forms a heterodimer with either MSH6 or MSH3 (Mut S), depending on the damage (MSH6 is needed for the amendment of single base mispairs, whereas both MSH3 and MSH6 can correct IDLs). A heterodimer of MLH1 and PMS2 (Mut L) controls the interaction between the mismatch-detecting complex of proteins and other proteins essential for MMR, including exonuclease 1, helicase, nuclear antigen of proliferating cells, single-stranded DNA-binding protein and DNA polymerases δ and ε. MLH1 can form a heterodimer with two additional proteins – MLH3 and PMS1. PMS2 is required for the correction of single based mismatches, and PMS2 and MLH3 contribute to the correction of IDLs. The Nobel Prize in Chemistry 2015 was awarded for the studies of DNA repair, i.a. MMR.
ULTRASOUND CASE OF SOLID PSEUDOPAPILLARY TUMOR OF THE PANCREAS
Authors: Ботоева  , Botoeva Marina , Турова  , Turova Svetlana , Козлова  , Kozlova Leokadiya , Конотопцева  , Konotoptseva Anastasiya
Published: April 2017

The clinical case of a rare pancreatic tumor in a 8-year-old child with hypoglycemia (decrease in blood sugar to
1,5 mmol/l) is presented. A sonographic picture of the solid pseudopapillary tumor of the pancreas is shown. The
capability of ultrasound investigation in differential diagnostics of small-size neoplasms at early stages is pointed out.
The role of the Doppler’s effect with color mapping in visualization of the pancreatic vascular pattern normality and
at the verification of pancreatic pathological mass is described. Histological examination which identifies the cellular
structure forms solid and pseudopapillary images.