bluuebunny/crossref_metadata_2025 huggingface dataset:
Interrelation of regulatory legal acts regulating professional functions of the labor protection specialist
Authors: Sevastyanov B V , Lisina E B , Selyunina N V , Shadrin R O , Shalamova A V
Published: January 2020

The work shows the history of the development of the profession of a specialist in the field of labor protection. For the first time in the Russian Empire the training of specialists in the field of labor protection took place in the beginning of the 20th century at the Peter the Great Institute, St. Petersburg. In this paper the professional duties of a specialist in the field of labor protection specified in current regulatory legal acts are considered, including working in commissions on labor protection, accident investigation, drafting documents, orders, plans and reports relating to labor protection and providing advice to heads of departments and enterprises about issues in labor protection. It is indicated they have organizational, managerial and supervisory content. The analysis of the content of professional competencies of the Federal State Educational Standard of Higher Education “Technospheric safety” and the labor functions of a specialist in the field of labor protection is presented. It is indicated that some of the academic disciplines included in educational programs are very distantly related to the activities of a labor protection specialist. At the same time, academic disciplines arising from the professional duties of a labor protection specialist are not included in the curricula, which indicates the need for a substantial adjustment of the content of the educational standard for technospheric safety and, above all, towards a more complete account of those functions that are imposed by current regulatory legal acts on specialists of labor protection services organizations. The list of professionally orienteering disciplines that should be included in the curriculum for preparing students in the “Technospheric safety” training area is presented.
Study of Occupational Health Risks in the Irkutsk Region
Authors: Podkorytova A M , Khamidullina E A
Published: January 2020

The aim of this article is to study the statistical patterns of changes in the level of industrial risks in the Irkutsk Region and to identify the factors that have the greatest influence on these changes. In the paper, we used statistical analysis methods, such as retrospective analysis, construction of Shewhart control charts, and regression analysis. The retrospective analysis included the period of 2011-2017 and was carried out in the Irkutsk Region in general and by separate industries. The Shewhart control charts were constructed by type of injury in order to identify the randomness/systemic nature of the causes of damage to workers’ health. The linear regression analysis was used to identify dependencies of the level of industrial injuries on the costs of labor protection measures. It was shown that, in the Irkutsk Region in general, the risks of injury and death of workers in the workplace tended to decrease during 2011-2017. But only since 2014 there has been an increase in the ratio of injuries to deaths, which indicates a real reduction in the severity of injuries. Statistical modeling using the construction of Shewhart control charts showed that there were systematic causes in respect to non-fatal injuries and, accordingly, the need to identify them. In terms of fatal injuries, we noted statistical risk controllability and natural variability inherent in random processes. Models of the linear dependency of the level of industrial injuries on the costs of labor protection measures revealed a high reverse causality between the risk of industrial injuries and the costs of training in labor protection. The results obtained indicate the need to increase the interest of employers in quality training in labor protection, as well as the importance of optimizing the costs to ensure occupational safety.
Ecogeochemical evaluation of soils under conditions of technogenesis
Authors: Sarapulova G I
Published: January 2020

The distribution of total forms of heavy metals Cu, Cd, Ni, Pb, Zn, Co, Hg, and As in technogenic soils has been evaluated using geochemical research methods. Diagnostic indicators of damage of soil natural properties in the area of technogenesis are revealed. Statistically significant empirical dependences toxic elements migration on the buffer properties of soils (pH, N, Corg) and salinity factor of the territory are obtained. It is shown that in the zone of industrial objects in the soil surface layer, lateral technogenic geochemical pollution modules can be formed at depth down to 30-50 cm. This should be taken into account when evaluating the environmentalrisk of a territory and in the environmental control of soil pollution.
Occupational safety training in the process of knowledge assessment
Authors: Sevastyanov BV , Lisina E B , Selyunina N V , Shadrin R O , Shalamova A V
Published: January 2020

The article is devoted to the occupational safety training using the exercise system formed as a test: chain and test, as well as matrix test tasks, which can be included in the structure of these systems. The ability of testing to diagnose competencies is also addressed to in this article.
Composite sorbents based on waste from the crystalline silicon production and biochar
Authors: Timofeeva S S , Leonova M S , Gorlenko N V , Chang Jih-Hsing , Cheng Shu-Fen
Published: January 2020

The aim of this paper was to create a composite porous material based on waste from the crystalline silicon production and biochar from agricultural waste for sorption wastewater purification from copper. In the paper, we proposed a method for pelletizing fine crystalline silicon (gas treatment waste) and biochar from agricultural waste using liquid glass. The choice of liquid glass is due to the fact that this substance has high adhesive properties for the formation of durable composites, as well as an excess of alkali, which contributes to the exothermic reaction and the evolution of hydrogen gas upon the addition of finely divided silicon, as a result of which the composite material acquires a porous structure. Using the optical emission research method, we found that the samples of the prepared sorbents mainly consist of both macropores and meso- and micropores, the dimension of which depends on the ratio of components. In the course of research, we identified the optimal ratios and studied the mechanical and sorption properties of composite materials.
Specialized alarm-initiating device for early detection of coal self-ignition
Authors: Timofeeva S S , Smirnov G I , Timofeev S S , Latysheva S V
Published: January 2020

The existing methods of fire detection are based on the registration of physical phenomena associated with the processes of combustion or smouldering, such as elevated temperature, the release of combustion products, changes in the chemical composition of the air, thermal radiation. Sensor elements of the devices detecting those features stay at a distance from the source of ignition. This result in postponed time of fire registration in comparison with its occurrence. Accordingly, the more time it takes, the more significant damage a fire can cause. The work studies the design of alarm-initiating device developed at Irkutsk National Research Technical University. The device is to detect the evidence of incipient self-ignition at the stage of self-heating before a fire starts, and it is applicable to coal and other substances that a likely to ignite spontaneously. The main feature of the invention is that the temperature measurement and air sampling are carried out directly in the places that are at more risk of self-ignition. In addition, the device is energy-independent due to the original design of the power supply element. Moreover, the measurement of several parameters of the fire environment significantly increases the reliability and credibility of the self-ignition detector.
Current assumptions of characteristics for different-type Siberian water objects in modeling and forecasting of their aquatic-ecological state
Authors: Tskhai A A
Published: January 2020

The application of mathematical estimates and models for different types of Siberia water objects in extrapolation cases is discussed. The anthropogenic component of hydrochemical runoff of the Ob river is assessed for different time periods. A prediction algorithm for reservoir ecosystem state consists of the determination of input data sets, the use of internal model parameters for the reservoir - analogue and simulation. Developed for the water bodies of the Upper Ob basin, this algorithm is used in assessment of ecological consequences under river regulation.
Justification of underground gold placer development parameters for the Konevinsky deposit
Authors: Vasilyev D S , Pavlov A M
Published: January 2020

The Konevinsky deposit is located in the Eastern Sayan highlands in a poorly developed area of the Far North. The deposit is being developed by Khuzhir Enterprise LLC. The deposit is a thin steeply dipping vein characterized by the extremely irregular metal content and a low ore-bearing coefficient. Ore is extracted using the underground method at a depth of 300 m in the permafrost zone. Steeply dipping ore deposits with a complex morphology and a discrete distribution of metal are developed using the ore shrinkage system which involves longwall stoping without supporting enclosing rocks. Longwall stoping with a small extraction space eliminates rock cleavage along the cracking system that results in high dilution of ore (up to 67%). Due to this fact, the existing mining geotechnology of balance reserves development has become unprofitable and production has been suspended. The purpose of this article is to identify new parameters of the balance reserve extraction method that will improve quality of ore and increase profitability of metal production. Studies of geological environment and analysis of causes of ore quality deterioration showed that along with the excessive sticking of wall rocks under the minimal excavation width of 1m, ore dilution is affected by inrushes from block sides with an increased rock fracturing and an internal chocking with low-grade ores. These disadvantages can be eliminated using sublevel drifts, the breast-and-bench method and a descending order of reserves excavation. The article substantiates and develops parameters of the system which can increase ore production quality without increasing production costs.
Processing of agricultural waste in the Penza region
Authors: Goryachev V , Golobokov S , Brostilova T
Published: January 2020

Annotation

In this work we considered the impact of uncontrolled waste of the agricultural sector on the biosphere. We estimated assessment of the energy potential of the Penza region and its technologically utilization. We compared the obtained data with the volumes of energy supplies. We carried out the analysis of existing technologies of processing and utilization of agricultural waste. In this work we studied the influence of various operational factors on the efficiency of processing different types of waste and the utilization of the resulting fuel. We issued recommendations for the introduction of new technologies and effective utilization.
Problems of environmental management on Russia’s coasts in the context of global sea level rise
Authors: Kholoptsev A V , Podporin S A
Published: January 2020

This study addresses some issues related to environmental management on Russia’s coasts in the context of ongoing global warming and subsequent sea-level rise. The attention to this problem is drawn due to the great extent of Russia’s coastline and high economic potential of certain coastal zones, inundation of which would be detrimental for the economy and the population dwelling there. The research seeks to answer the question as to how seriously global warming contributes to sea-level rise in Russia’s seas and whether or not highly developed coastal zones may be threatened. The study is primarily aimed at identification of statistical correlation between sea-surface temperatures, influenced by global warming, and variations in sea topography that can possibly lead to inundations. As a secondary goal, the areas exhibiting highest sea-level rise rates in the modern period are revealed. The results obtained show that most of the economically developed coastal zones are unlikely to face serious risks of inundation in the near future, however certain areas do need close attention, among them being the seacoasts of Kaliningrad Oblast due to high rates of mean sea-level rise and northeastern coasts of the Sea of Azov due to possible intensification of surge effects. Based on the findings, measures to deal with the potential inundation risks are discussed.
Structural forms, paragenesis and tectonophation of exozone
Authors: Kochnev A P , Kononov E E , Ivanova R N
Published: January 2020

Based on a field study of structural forms, formational, comparative geological, morphotectonic, and structural paragenetic analyzes and generalization of materials available in publications, a systematic analysis was made of the structural features of material complexes for the upper section of the unshared crust exozone. The results obtained made it possible to distinguish typomorphic structural paragenesis, which are exozonal. In the accepted genetic systematics, three groups of structural forms are distinguished: exogenous, endogenous, and cosmogenic, which are divided into nine subgroups. The forms of exogenous or non-tectonic origin, which to a large extent are formed as a result of the activity of underground and surface waters, or in connection with the economic activities of humans, are predominantly developed. Structural forms of endogenous and cosmogenic origin are observed in a subordinate amount within the exozone.
Methodological aspects of operational cartographic and space environmental monitoring of the impact zone of the Angara river reservoir cascade
Authors: Plastinin L A , Stupin V P , Olzoev B N
Published: January 2020

The necessity of organizing environmental monitoring of the zone of influence of the cascade of Angarsk reservoirs is substantiated. The goals, objectives and stages of its practical implementation on a systematic methodological basis using the operational data of remote sensing of the Earth and the capabilities of geographic information mapping.
The rational use of mica as a priority for the mining industry of Irkutsk region
Authors: Shishelova T I , Fedchishin V V , Khramovskikh M A
Published: January 2020

Mica is one of the most widespread minerals. Muscovite and phlogopite whose large reserves are located in Irkutsk region have various industrial applications. Due to the crisis, a large amount of mica remained unclaimed. There are mining dumps of raw materials and production waste. The use of mica and the disposal of industrial waste are urgent problems. One of the ways to solve them is to produce mica-based composite materials. The use of such materials will improve technical and economic indicators of production processes and contribute to the development of low-waste and non-waste technologies, protection of the environment. The article aims to establish fundamental laws of production of mica-based composite materials. The article provides recommendations on production technologies. Samples of muscovite, phlogopite mica, mine scraps and mica waste were studied. The methods of physicochemical analysis were used to study the samples. Thermodynamic and quantum chemical calculations were made. Based on the experimental studies and scientific generalizations, the theoretical foundations of the production technology for temperature-resistant mica-based materials and effective heating elements based on mica composite materials were developed. They are based on the integrated and rational use of mineral raw materials.
Non-traditional hydrocarbon deposits
Authors: Shulga V V
Published: January 2020

The article describes results of the study of non-traditional hydrocarbon deposits. Reservoir properties of rocks with various types of pores, the dependence of quality of raw materials on the natural conditions of rock formation were analyzed. Problems of exploration and exploitation of non-traditional deposits were identified.
Contribution of forest and peat fires to atmospheric pollution in the Irkutsk region
Authors: Timofeeva S S , Timofeev S S , Garmyshev V V
Published: January 2020

Smoke and toxic combustion products emitted as a result of natural fires are among the most hazardous factors, as they lead to poisoning and death of people, as well as environmental pollution. Only one hectare of a burning forest accounts for 80 to 100 tons of smoke particles and 10-12 tons of a mixture of gases such as carbon monoxide, carbon dioxide, sulfur and nitrogen oxides, acetaldehyde, acetone, acrolein that are emitted into the atmosphere. The smoke of forest fires consists of tar drops, water vapor, gaseous substances and soot. Bulk emissions of ecotoxicants into the atmosphere generated during natural fires make an additional contribution to environmental pollution. The aim of the paper was to assess the contribution of forest and peat fires to atmospheric pollution in the Irkutsk Region. Based on statistical data as well as monitoring the consequences of forest and peat fires, studying procedural documents for investigating and describing fires, we calculated quantitative indicators of burnt natural materials in the territory of the Irkutsk Region for 2011-2018. When comparing pollution indices from stationary sources (the calculation was made according to the annual reports on the state of the environment in the Irkutsk Region) as well as forest and peat fires, it was found that the contribution of forest and peat fires reached 23.0-9.6%, the average value for 8 years was 16.8%. We found that for the period 2011-2018 as a result of forest and peat fires on average up to 259.12 thousand tons of pollutants were released into the atmosphere annually. Forest and peat fires make a significant contribution to atmospheric pollution in the Irkutsk Region. In addition to atmospheric pollution, other unfavorable environmental consequences are realized. In particular, during peat fires, burning is slow due to the lack of oxygen and fire does not propagate as fast as on the surface, it forms burnt voids and there is a chance of falling into burnt peat. Forest and peat fires lead to the destruction of forests in vast territories and may be one of the possible causes of the catastrophic flood in the Irkutsk Region in June 2019.
Assessing the environmental risk of mining enterprises by the integral indicator of dust emission
Authors: Timofeeva S S , Murzin M A
Published: January 2020

Mineral mining leads to the following negative consequences: disturbance of soil cover and hydrological regime, formation of man-made relief, changes in the quality of land, inhibition of soil formation processes and reduction of soil self-purification capacity and others, and most importantly, pollution of large areas through industrial emissions and, above all, dust emissions. Almost all processing operations, such as blasting, drilling, excavation, transportation of rock mass, storage, performed at mining enterprises are accompanied by dust formation. The aim of this paper was to develop a methodology for the assessment of environmental risks posed by mining enterprises by the integral indicator of dust emission. The objects of research were the largest mining enterprises of the Irkutsk Region engaged in extraction of gold, iron ore, coal and building materials. We analyzed the geoecological situation in the area of industrial activity of the enterprises under study. In our work, we calculated the atmospheric dust pollution indices, the areas of distribution of dust emissions, dust load on personnel of the enterprises, and proposed an integral indicator of dust emission which allows assessing the environmental risks of mining enterprises and their degree of environmental impact. It has been established that coal mining enterprises belong to high-risk facilities and it is necessary to introduce innovative dust suppression technologies at different
Influence of mineral sources on formation of soils in the foothills of Eastern Sayan Mountains (Buryatia)
Authors: Tugarina M A , Lopatovskaya O G
Published: January 2020

The results of studying of unique soils’ genesis and properties in the zone of underground mineral water influence as well as geological conditions are presented on mineral springs sites in the foothills of the Eastern Sayan Mountains. The spatial regularities of soil changes and their dependence on landscape conditions and the composition of mineral water are revealed. It has been established that soils near springs and at a distance of 5 and 20 m are more susceptible to mineral water than distal one at 50 and 200 m. Soil types and its properties change from calcisols that are hydromorphic, thin, gravelly and are formed on travertines, calcites and marbles, to brown soils formed on acidic and ferruginous rocks under the influence of forest vegetation. The salt composition of soils correlates with the mineral water composition and includes ready soluble salts - chlorides, sulfates and bicarbonates of calcium, magnesium and sodium in concentrations from 0.5 to 0.26%, pH changes from acidic to alkaline. The concentration of organic substances varies from 0.5 to 15.0%.
Assessment of the post-pyrogenic water toxicity in the north-eastern part of the Great Vasyugan Mire (Western Siberia)
Authors: Burnashova E N , Kharanzhevskaya Yu A
Published: January 2020

This paper devoted the analysis of the post-pyrogenic water toxicity in the north-eastern part of the Great Vasyugan Mire with a test culture of Daphnia magna Straus. It was found that the water samples of pine-shrub sphagnum bogs have a negative impact on the test organisms D. magna Str. The most toxic effect on test organisms provided by pH value. The chemical composition of waters is determined by the high content of NH+
4, Fetotal, organic matter at all points of the study. The MPC exceeded for NH+
4, Fetotal and COD. The studied post-pyrogenic areas are characterised by an increase in the concentration of heavy metals (Zn, Pb) and Fetotal in waters.
Ecobiotechnology in the process of industrial wastewater treatment of the closed mining enterprise as a guarantee of environment safety
Authors: Gula K E , Krupskaya L T , Rastanina N K
Published: January 2020

The report presents the results of long-term studies of the problem of ecological and chemical assessment of the impact of mineral processing waste in the form of pulp on the ecosphere, including aquatic ecosystems, and the development of bioengineering technologies (bioremediation) aimed at reducing their negative impact on the environment in the Primorsky territory. In the last century at the concentrating plant of the closed Khrustalnensky GOK mining enterprise a chemical method was used to treat industrial wastewater, a degree of which was no more than 75%. It is shown that pollutants discharged into water bodies after chemical treatment, which have a general toxic, carcinogenic and mutagenic effect, still pose a great threat to the ecological balance of natural systems. The studies show that there was intense pollution of ground and surface water, soil and vegetation, exceeding the regional background indicators up to 9 or more times within the boundaries of the anthropogenic system impact. Therefore, in the study area it is necessary to ensure environmental and social safety of industrial effluents by improving their treatment technology. In this regard, the aim of the research was not only to assess the extent of the negative impact of beneficiation mineral toxic wastes in the form of pulp to the ecosphere, but also in the development of ecologically safe biotechnological method of purification industrial wastewater by biodegradation, biooxidation and biosorption from solutions using the metabolic potential of biological systems (hydrophytic plants). Based on the purpose, the following tasks are defined: 1. To analyze and summarize the literature on the problem of industrial wastewater treatment using biological methods; 2. To study the composition and properties of industrial wastewater in the form of pulp and assess their impact on the environment; 3. To investigate ecological and biological features of little Duckweed as a possible concentrator of heavy metal compounds; 4. To develop a biotechnological solution for industrial wastewater treatment using bioremediation (higher aquatic vegetation, Duckweed). Experimental studies have proved the effectiveness of the biological systems metabolic potential (little Duckweed) to ensure the normative quality of treated wastewater by the example of a closed mining enterprise in the Primorsky territory (Khrustalnensky GOK). The scientific novelty of the proposed method is confirmed by a Patent of the Russian Federation (2014).
Bioeconomy of the Irkutsk Region: State and Prospects of Development
Authors: Panasenkova E Yu , Timofeev S S
Published: January 2020

Around the world there is a transition to a new economic model focused on environmental and social sustainable development. One of the ways for such a transformation is the transition to bioeconomy. The Irkutsk Region has unique forest resources. And it is the forest sector that is a key element for the development of bioeconomy in many countries. Beside major timber resources, the forests of the Irkutsk Region have a high potential for the use of non-timber resources. The aim of the paper was to assess the state of bioeconomy in the Irkutsk Region in terms of the use of renewable forest resources and the prospects for its development. The paper analyzes statistical information on the forest resources of the region in terms of renewability, primarily of non-timber resources, mushrooms, wild plants, etc. Based on the data of the Forestry Plan of the Irkutsk Region, we determined the volumes of non-timber food resources, and considered the contribution of hunting farms, ecotourism and fish husbandry to the economy of the region. It has been shown that the development of bioeconomy will make a significant contribution to the economy of the region, as well as provide an opportunity to create new jobs in rural and remote areas.
Effect of extrusion parameters on primary recycled ABS: mechanical, rheological, morphological and thermal properties
Authors: Kumar Vinay , Singh Rupinder , Ahuja I P S
Published: January 2020

This paper reports the effect of twin screw extrusion (TSE) process parameters on primary (1°) recycled acrylonitrile butadiene styrene (ABS) for possible 3D applications. The ABS (virgin/recycled) is one of the most widely used thermoplastic materials for fused deposition modeling (FDM) based 3D printing of functional prototypes. But hitherto little has been reported on improving the mechanical/rheological/morphological and thermal properties of (1°) recycled ABS while extrusion without any reinforcement (i.e. without secondary (2°) recycling). In this work the granules of 1° recycled ABS have been extruded after ascertaining suitable process parameters of TSE (namely: screw temperature, torque and dead weight). The results of study suggests that screw temperature 210 °C, 0.3Nm torque and dead weight of 13 kg are the best settings for TSE in the present case study. The TSE based extruded 1° recycled ABS has improved crash resistance properties (as modulus of toughness was significantly improved to 3.261 MPa (from 0.191 MPa (for non TSE processed) and 0.081 for virgin ABS).
Enhancing visible light-activated NO2 sensing properties of Au NPs decorated ZnO nanorods by localized surface plasmon resonance and oxygen vacancies
Authors: Chen Chunxu , Zhang Qiuping , Xie Guangzhong , Yao Mingliang , Pan Hong , Du Hongfei , Tai Huiling , Du Xiaosong , Su Yuanjie
Published: January 2020

Increasing light absorption is of crucial importance for optimizing light-activated gas detection. However, the relevant research is still far from sufficient. Herein, a high performance visible light-activated NO2 gas sensor is developed relied on the localized surface plasmon resonance (LSPR) and increased surface oxygen vacancies. Au NPs decorated ZnO nanorod array as sensitive materials was synthesized via a two-step low temperature hydrothermal process. The influences of Au decoration and light wavelength on the sensing behaviors were systematically investigated. It is found that the Au NPs decoration can largely promote the visible light-activated gas sensing properties in comparison with pure ZnO film. In addition, the as-prepared sensors demonstrate excellent repeatability and selectivity as well as moisture stability. Moreover, the sensing mechanism based on LSPR was discussed in detail. This work not only sheds some lights on the fundamental understanding for the LSPR enhanced gas sensing mechanism, but also offers an approach in constructing high-performance light-activated gas sensor.
The American Society for Clinical Pathology’s Job Satisfaction, Well-Being, and Burnout Survey of Pathologists
Authors: Garcia Edna , Kundu Iman , Kelly Melissa , Soles Ryan , Mulder Lotte , Talmon Geoffrey A
Published: January 2020

Objectives

To examine job satisfaction, well-being, job stress, and burnout among pathologists.

Methods

The study utilized a cross-sectional survey design. The survey was administered online via the American Society for Clinical Pathology’s (ASCP’s) survey tool to elicit information about job satisfaction, well-being, job stress, and burnout among pathologists.

Results

Job satisfaction is high and well-being is rated fair to good by most respondents. However, feelings of anxiety or worry about work, high levels of stress, and burnout are prevalent among pathologists. The main contributing factor to job stress, burnout, and work-life balance is quantity of workload.

Conclusions

Creating targeted interventions based on the results of this survey may help improve the type and quality of wellness programs for pathologists. Trust among team members, managers and clinicians, and institutions can help reduce stress and increase collaboration, engagement, and motivation.
Acute interstitial nephritis associated with immune checkpoint inhibitors: a single-centre experience
Authors: Oleas Diana , Bolufer Mónica , Agraz Irene , Felip Enriqueta , Muñoz Eva , Gabaldón Alejandra , Bury Roxana , Espinel Eugenia , Serón Daniel , García-Carro Clara , Soler María José
Published: January 2020

Background

Checkpoint inhibitors (CPIs) are used to treat solid organ metastatic malignancies. They act by triggering a vigorous immune response against tumoural cells, preventing their proliferation and metastasis. However, this is not a selective response and can cause immune-related adverse events (irAEs). The kidney can potentially be damaged, with an incidence of irAEs of 1–4%. The most frequent type of toxicity described is acute interstitial nephritis (AIN).

Methods

We conducted a study of patients with solid organ metastatic malignancies treated with immunotherapy who developed acute renal injury and underwent kidney biopsy in the last 14 months at the Vall d’Hebron University Hospital.

Results

In all, 826 solid organ malignancies were treated with immunotherapy in our centre, 125 of them (15.1%) developed acute kidney injury (AKI), 23 (18.4% of AKI) visited the nephrology department and 8 underwent kidney biopsy. The most frequent malignancy was lung cancer, in five patients (62%), followed by two patients (25%) with melanoma and one patient (12%) with pancreatic cancer. Four patients (50%) had already received previous oncological therapy, and for the remaining four patients (50%), CPI was the first-line therapy. Five patients (62%) were treated with anti-programmed cell death protein 1, three patients (37%) received anti-programmed death ligand 1 and two (25%) patients were treated in combination with anti-cytotoxic T-lymphocyte antigen 4. The time between the start of CPI and the onset of the AKI ranged from 2 to 11 months. The most frequent urine findings were subnephrotic-range proteinuria, with a mean protein:creatinine ratio of 544 mg/g (standard deviation 147) and eosinophiluria. All patients were biopsied after being diagnosed with AIN. Three patients (37%) received treatment with pulses of methylprednisolone 250–500 mg/day and five patients (62%) received prednisone 1 mg/kg/day. Seven patients (87%) experienced recovery of kidney function and one patient (12%) progressed to chronic kidney disease.

Conclusions

We report on eight patients with CPI-related AIN diagnosed in the last 14 months at our centre. The novel immunotherapy treatment of metastatic solid organ malignancies carries a higher risk of irAEs. The kidney is one of the most commonly affected organs, frequently presenting as an AIN and exhibiting a favourable response to steroid treatment.
Long-term outcomes after conventional surgical repair versus perventricular device occlusion for doubly committed subarterial ventricular septal defects: a propensity score matched study
Authors: Liao ZhenMei , Chen Hang , Lin Li , Chen Qiang , Chen LiangLong , Chen ZhaoYang
Published: January 2020

OBJECTIVES

This study aimed to investigate the long-term outcomes of perventricular device occlusion and surgical repair for doubly committed subarterial ventricular septal defect using propensity score matched analysis because previous comparative studies were limited by differences in the baseline characteristics.

METHODS

We reviewed inpatients with isolated doubly committed subarterial ventricular septal defect aged <18 years who underwent surgical repair or device occlusion between January 2011 and December 2017. Propensity score matching was used to assemble a cohort of patients with similar baseline characteristics.

RESULTS

A total of 336 patients underwent surgical repair; 99 underwent device occlusion. After matching, the repair group included 164 patients, whereas the device group had 91 patients. There were no significant differences in the baseline characteristics. The median follow-up periods were 46 and 58 months for the device and repair groups, respectively. No significant difference was noted in the rates of cumulative adverse events in the 2 groups (7.9% vs 5.5%; P = 0.61). The repair group required longer periods of hospitalization (P = 0.002) and mechanical ventilation (P = 0.016). No grade 3 or higher valvular regurgitation or high-degree atrioventricular block events were observed. All patients were in sinus rhythm at the last follow-up examination.

CONCLUSIONS

In selected patients with doubly committed subarterial ventricular septal defect, compared with conventional repair, perventricular device occlusion has comparable efficacy and safety, less invasiveness in terms of time in the hospital and on mechanical ventilation and avoidance of cardiopulmonary bypass.
Computed tomography-based surgical strategy for total anomalous pulmonary venous connection
Authors: Matsuhisa Hironori , Oshima Yoshihiro , Higuma Tomonori , Matsushima Shunsuke , Hasegawa Shota , Wada Yuson , Matsuoka Michio , Tanaka Toshikatsu
Published: January 2020

OBJECTIVES

We used computed tomographic angiography (CTA)-based surgical planning to clarify the anatomical indications of sutureless repair technique for total anomalous pulmonary venous connection. The mid-term impact of the current surgical strategies was evaluated.

METHODS

One hundred twelve patients underwent repair for total anomalous pulmonary venous connection. The study period was divided into era 1 (1996–2010, n = 56) and era 2 (2011–2018, n = 56). Patients with single ventricular heart (SVH) were included. In era 2, the indications for primary sutureless repair and branch pulmonary vein incision were based on CTA findings.

RESULTS

For patients with biventricular heart, the 5-year survival was 69% and 97% in eras 1 and 2, respectively (P = 0.0024). For patients with SVH, the 5-year survival was 21% and 70% in eras 1 and 2, respectively (P = 0.0007). During the follow-up period, the evidence of post-repair pulmonary vein stenosis (PVS) was observed in 12 patients with biventricular heart [era 1, 8 patients (23%); era 2, 4 patients (13%)], and 14 patients with SVH [era 1, 6 patients (60%); era 2, 8 patients (36%)]. Using multivariable analysis, preoperative CTA was associated with improved survival in both biventricular heart and SVH and associated with post-repair PVS-free survival in SVH. Since 2011, 12 patients with post-repair PVS underwent multiple reintervention with 1 recorded death (5-year survival: 88%).

CONCLUSIONS

CTA-based surgical strategy for total anomalous pulmonary venous connection provided significant survival benefit. Although post-repair PVS could occur in era 2, aggressive reintervention appeared to be associated with improved survival and vein patency.
Number of lung resections performed and long-term mortality rates of patients after lung cancer surgery: evidence from an Italian investigation
Authors: Rea Federico , Ieva Francesca , Pastorino Ugo , Apolone Giovanni , Barni Sandro , Merlino Luca , Franchi Matteo , Corrao Giovanni
Published: January 2020

OBJECTIVES

Although it has been postulated that patients might benefit from the centralization of high-volume specialized centres, conflicting results have been reported on the relationship between the number of lung resections performed and the long-term, all-cause mortality rates among patients who underwent surgery for lung cancer. A population-based observational study was performed to contribute to the ongoing debate.

METHODS

The 2613 patients, all residents of the Lombardy region (Italy), who underwent lung resection for lung cancer from 2012 to 2014 were entered into the cohort and were followed until 2018. The hospitals were classified according to the annual number of pulmonary resections performed. Three categories of lung resection cases were identified: low (≤30), intermediate (31–95) and high (>95). The outcome of interest was all-cause death. A frailty model was used to estimate the death risk associated with the categories of numbers of lung resections performed, taking into account the multilevel structure of the data. A set of sensitivity analyses was performed to account for sources of systematic uncertainty.

RESULTS

The 1-year and 5-year survival rates of cohort members were 90% and 63%. Patients operated on in high-volume centres were on average younger and more often women. Compared to patients operated on in a low-volume centre, the mortality risk exhibited a significant, progressive reduction as the numbers of lung resections performed increased to intermediate (−13%; 95% confidence interval +10% to −31%) and high (−26%; 0% to −45%). Sensitivity analyses revealed that the association was consistent.

CONCLUSIONS

Further evidence that the volume of lung resection cases performed strongly affects the long-term survival of lung cancer patients has been supplied.
Understanding the use of observational and randomized data in cardiovascular medicine
Authors: Bowman Louise , Baras Aris , Bombien René , Califf Robert M , Chen Zhengmin , Gale Chris P , Gaziano J Michael , Grobbee Diederick E , Maggioni Aldo P , Muse Evan D , Roden Dan M , Schroeder Stefan , Wallentin Lars , Casadei Barbara
Published: January 2020

The availability of large datasets from multiple sources [e.g. registries, biobanks, electronic health records (EHRs), claims or billing databases, implantable devices, wearable sensors, and mobile apps], coupled with advances in computing and analytic technologies, have provided new opportunities for conducting innovative health research. Equally, improved digital access to health information has facilitated the conduct of efficient randomized controlled trials (RCTs) upon which clinical management decisions can be based, for instance, by permitting the identification of eligible patients for recruitment and/or linkage for follow-up via their EHRs. Given these advances in cardiovascular data science and the complexities they behold, it is important that health professionals have clarity on the appropriate use and interpretation of observational, so-called ‘real-world’, and randomized data in cardiovascular medicine. The Cardiovascular Roundtable of the European Society of Cardiology (ESC) held a workshop to explore the future of RCTs and the current and emerging opportunities for gathering and exploiting complex observational datasets in cardiovascular research. The aim of this article is to provide a perspective on the appropriate use of randomized and observational data and to outline the ESC plans for supporting the collection and availability of clinical data to monitor and improve the quality of care of patients with cardiovascular disease in Europe and provide an infrastructure for undertaking pragmatic RCTs. Moreover, the ESC continues to campaign for greater engagement amongst regulators, industry, patients, and health professionals in the development and application of a more efficient regulatory framework that is able to take maximal advantage of new opportunities for improving the design and efficiency of observational studies and RCT in patients with cardiovascular disease.
The quantification of the psychiatric revolution: a quasi-natural experiment of the suicide impact of the Basaglia Law
Authors: Ronchetti Caterina , Toffolutti Veronica , McKee Martin , Stuckler David
Published: January 2020

Background

The Italian 180/1978 reform abolishing asylums is one of the most contested mental health programs ever implemented. It aimed to shift care of mental illness into the community improving outcomes and reducing expenditure. It was a model for successive deinstitutionalization initiatives across Europe and North America. However, there were longstanding concerns that, without expansion of community care, it may have deprived patients with mental illness access to support, placing them at increased risk of suicide.

Methods

Regression discontinuity models were used to quantify the association between the number of suicides and the introduction of the Basaglia Law, disaggregated by age-group and gender, covering 20 Italian regions during the period 1975–84. Models were adjusted for potential socio-demographic confounding factors, region-specific fixed effects and pre-existing time-trends.

Results

Italian regions implemented the Basaglia Law to varying degrees over time. We observed that, after adjusting for pre-existing time trends, the implementation was associated with a consistent increase in the number of suicides for all the age-groups [incidence rate ratio, age 15–44: 1.29, 95% confidence interval (CI) 1.18–1.41; age 45–74: 1.45, 95% CI 1.37–1.54] and for both genders (males: 1.47, 95% CI 1.41–1.53; females: 1.36, 95% CI 1.25–1.47). Hospital closure appeared to be an important mediating mechanism.

Conclusions

The Basaglia Law was associated with a significant increase in the number of suicides, with evidence of an association with closures of facilities, leaving those with mental illness with nowhere to go, as the envisioned community care structures failed to be developed as originally planned.
Demography and Natural Selection Have Shaped Genetic Variation in the Widely Distributed Conifer Norway Spruce (Picea abies)
Authors: Wang Xi , Bernhardsson Carolina , Ingvarsson Pär K
Published: January 2020

Under the neutral theory, species with larger effective population size are expected to harbor higher genetic diversity. However, across a wide variety of organisms, the range of genetic diversity is orders of magnitude more narrow than the range of effective population size. This observation has become known as Lewontin’s paradox and although aspects of this phenomenon have been extensively studied, the underlying causes for the paradox remain unclear. Norway spruce (Picea abies) is a widely distributed conifer species across the northern hemisphere, and it consequently plays a major role in European forestry. Here, we use whole-genome resequencing data from 35 individuals to perform population genomic analyses in P. abies in an effort to understand what drives genome-wide patterns of variation in this species. Despite having a very wide geographic distribution and an corresponding enormous current population size, our analyses find that genetic diversity of P. abies is low across a number of populations (π = 0.0049 in Central-Europe, π = 0.0063 in Sweden-Norway, π = 0.0063 in Finland). To assess the reasons for the low levels of genetic diversity, we infer the demographic history of the species and find that it is characterized by several reoccurring bottlenecks with concomitant decreases in effective population size can, at least partly, provide an explanation for low polymorphism we observe in P. abies. Further analyses suggest that recurrent natural selection, both purifying and positive selection, can also contribute to the loss of genetic diversity in Norway spruce by reducing genetic diversity at linked sites. Finally, the overall low mutation rates seen in conifers can also help explain the low genetic diversity maintained in Norway spruce.
Genomic Analysis of Wolbachia from Laodelphax striatellus (Delphacidae, Hemiptera) Reveals Insights into Its “Jekyll and Hyde” Mode of Infection Pattern
Authors: Bing Xiao-Li , Zhao Dian-Shu , Sun Jing-Tao , Zhang Kai-Jun , Hong Xiao-Yue
Published: January 2020

Wolbachia is a widely distributed intracellular bacterial endosymbiont among invertebrates. The wStriCN, the Wolbachia strain that naturally infects an agricultural pest Laodelphax striatellus, has a “Jekyll and Hyde” mode of infection pattern with positive and negative effects: It not only kills many offspring by inducing cytoplasmic incompatibility (CI) but also significantly increases host fecundity. In this study, we assembled the draft genome of wStriCN and compared it with other Wolbachia genomes to look for clues to its Jekyll and Hyde characteristics. The assembled wStriCN draft genome is 1.79 Mb in size, which is the largest Wolbachia genome in supergroup B. Phylogenomic analysis showed that wStriCN is closest to Wolbachia from Asian citrus psyllid Diaphorina citri. These strains formed a monophylogentic clade within supergroup B. Compared with other Wolbachia genomes, wStriCN contains the most diverse insertion sequence families, the largest amount of prophage sequences, and the most ankyrin domain protein coding genes. The wStriCN genome encodes components of multiple secretion systems, including Types I, II, IV, VI, Sec, and Tac. We detected three pairs of homologs for CI factors CifA and CifB. These proteins harbor the catalytic domains responsible for CI phenotypes but are phylogenetically and structurally distinct from all known Cif proteins. The genome retains pathways for synthesizing biotin and riboflavin, which may explain the beneficial roles of wStriCN in its host planthoppers, which feed on nutrient-poor plant sap. Altogether, the genomic sequencing of wStriCN provides insight into understanding the phylogeny and biology of Wolbachia.