bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of GMI Snowfall Observations by Using a Combination of Weather Radar and Surface Measurements
Authors: von Lerber Annakaisa , Moisseev Dmitri , Marks David A. , Petersen Walter , Harri Ari-Matti , Chandrasekar V.
Published: December 2017

Currently, there are several spaceborne microwave instruments suitable for the detection and quantitative estimation of snowfall. To test and improve retrieval snowfall algorithms, ground validation datasets that combine detailed characterization of snowfall microphysics and spatial precipitation measurements are required. To this endpoint, measurements of snow microphysics are combined with large-scale weather radar observations to generate such a dataset. The quantitative snowfall estimates are computed by applying event-specific relations between the equivalent reflectivity factor and snowfall rate to weather radar observations. The relations are derived using retrieved ice particle microphysical properties from observations that were carried out at the University of Helsinki research station in Hyytiälä, Finland, which is about 64 km east of the radar. For each event, the uncertainties of the estimate are also determined. The feasibility of using this type of data to validate spaceborne snowfall measurements and algorithms is demonstrated with the NASA GPM Microwave Imager (GMI) snowfall product. The detection skill and retrieved surface snowfall precipitation of the GPROF detection algorithm, versions V04A and V05A, are assessed over southern Finland. On the basis of the 26 studied overpasses, probability of detection (POD) is 0.90 for version V04A and 0.84 for version V05A, and corresponding false-alarm rates are 0.09 and 0.10, respectively. A clear dependence of detection skill on cloud echo top height is shown: POD increased from 0.8 to 0.99 (V04A) and from 0.61 to 0.94 (V05A) as the cloud echo top altitude increased from 2 to 5 km. Both versions underestimate the snowfall rate by factors of 6 (V04A) and 3 (V05A).
Breakdown of the Relationship between Australian Summer Rainfall and ENSO Caused by Tropical Indian Ocean SST Warming
Authors: Zhu Zhiwei
Published: December 2017

The relationship between El Niño–Southern Oscillation (ENSO) and Australian summer rainfall (ASR) during 1960–2015 experienced an interdecadal change around the mid-1980s. Before the mid-1980s, ASR was significantly correlated with tropical central Pacific (TCP) sea surface temperature (SST), whereas after that it was not. While El Niño was always independent from ASR, La Niña had a close relationship with ASR. However, this relationship was weakened after the mid-1980s. The Indian Ocean SST warming might contribute to the weakening relationship between La Niña and ASR. For La Niña events before the mid-1980s, the negative SSTA over TCP and the southern tropical Indian Ocean induced a large-scale lower-level cyclonic anomaly over Australia, leading to nearly uniform positive precipitation over Australia. In this manner, a significant relationship between ASR and La Niña was established. On the contrary, for the La Niña events after the mid-1980s, because of the Indian Ocean SST warming, the equatorial eastern Indian Ocean and Maritime Continent presented positive SSTAs and enhanced moisture, favoring enhanced rainfall anomalies over the equatorial Maritime Continent. This enhanced rainfall condensation heating induced a lower-level cyclonic anomaly to the west of Australia. The northerly anomalies at the eastern flank of this cyclonic anomaly counteracted the southerly anomalies at the western flank of the cyclonic anomaly over eastern Australia induced by the negative TCP SSTA, leading to insignificant circulation and rainfall anomalies over Australia. As such, being interfered with by the equatorial Maritime Continent heating, the relationship between ASR and La Niña was weakened.
Statistical Assessment of the OWZ Tropical Cyclone Tracking Scheme in ERA-Interim
Authors: Bell Samuel S. , Chand Savin S. , Tory Kevin J. , Turville Christopher
Published: December 2017

The Okubo–Weiss–Zeta (OWZ) tropical cyclone (TC) detection scheme, which has been used to detect TCs in climate, seasonal prediction, and weather forecast models, is assessed on its ability to produce a realistic TC track climatology in the ERA-Interim product over the 25-yr period 1989 to 2013. The analysis focuses on TCs that achieve gale-force (17 m s−1) sustained winds. Objective criteria were established to define TC tracks once they reach gale force for both observed and detected TCs. A lack of consistency between storm tracks preceding this level of intensity led these track segments to be removed from the analysis. A subtropical jet (STJ) diagnostic is used to terminate transitioning TCs and is found to be preferable to a fixed latitude cutoff point. TC tracks were analyzed across seven TC basins, using a probabilistic clustering technique that is based on regression mixture models. The technique grouped TC tracks together based on their geographical location and shape of trajectory in five separate “cluster regions” around the globe. A mean trajectory was then regressed for each cluster that showed good agreement between the detected and observed tracks. Other track measures such as interannual TC days and translational speeds were also replicated to a satisfactory level, with TC days showing limited sensitivity to different latitude cutoff points. Successful validation in reanalysis data allows this model- and grid-resolution-independent TC tracking scheme to be applied to climate models with confidence in its ability to identify TC tracks in coarse-resolution climate models.
Doppler Lidar Observations of the Mixing Height in Indianapolis Using an Automated Composite Fuzzy Logic Approach
Authors: Bonin Timothy A. , Carroll Brian J. , Hardesty R. Michael , Brewer W. Alan , Hajny Kristian , Salmon Olivia E. , Shepson Paul B.
Published: December 2017

A Halo Photonics Stream Line XR Doppler lidar has been deployed for the Indianapolis Flux Experiment (INFLUX) to measure profiles of the mean horizontal wind and the mixing layer height for quantification of greenhouse gas emissions from the urban area. To measure the mixing layer height continuously and autonomously, a novel composite fuzzy logic approach has been developed that combines information from various scan types, including conical and vertical-slice scans and zenith stares, to determine a unified measurement of the mixing height and its uncertainty. The composite approach uses the strengths of each measurement strategy to overcome the limitations of others so that a complete representation of turbulent mixing is made in the lowest km, depending on clouds and aerosol distribution. Additionally, submeso nonturbulent motions are identified from zenith stares and removed from the analysis, as these motions can lead to an overestimate of the mixing height. The mixing height is compared with in situ profile measurements from a research aircraft for validation. To demonstrate the utility of the measurements, statistics of the mixing height and its diurnal and annual variability for 2016 are also presented. The annual cycle is clearly captured, with the largest and smallest afternoon mixing heights observed at the summer and winter solstices, respectively. The diurnal cycle of the mixing layer is affected by the mean wind, growing slower in the morning and decaying more rapidly in the evening with lighter winds.
Hard drug use in Norway
Authors: Amundsen Ellen J. , Bretteville-Jensen Anne Line
Published: December 2017

E.J. Amundsen & A. Bretteville-Jensen: Hard drug use in Norway

Background

Hard drug use has a variety of heavy personal, social and economic costs. Knowing the size of the hard drug use population, the types of drugs consumed and modes of consumption can help policy makers design better policies and facilitate decision making. Intravenous drug users constitute one subgroup of hard drug users. The aim of this article is to describe 1) how the prevalence of intravenous drug use is estimated in Norway and 2) how available data sources give insight about other types of hard drug use even though we can not estimate the true extent of such use. Some policy consequences are outlined.

Methods/Materials

Overdose deaths and the mortality multiplier method were used to estimate the prevalence of intravenous drug users. Other materials were used to supply the picture of hard drug use in Norway.

Results/Findings

The prevalence of intravenous drug users in Norway increased steadily from the early 1980s, peaked in 2001, decreased until 2003 and then stabilized. Heroin is the substance of choice of most hard drug users in Norway and injection is the preferred means of intake. Amphetamines are also injected or consumed in other ways, while heavy use of cocaine in the treatment population is low. The use of more than one substance is common.

Conclusion

Preventing and reducing heroin injection is the main challenge facing Norwegian policy makers. Other drugs pose a problem as well. Wide availability of substitution treatment has a successful record of helping many former heroin users avoid heroin. The risk of relapsing remains high, however, and of dying after drop out or completion. Current knowledge of hard drug use is fragmented and improved monitoring of this high risk group should be prioritized.
Artikel
Authors: Babor Thomas F.
Published: December 2017

Alcohol and Public Policy Group: Alcohol: No ordinary commodity – a summary of the second edition

This article summarizes the contents of Alcohol: No Ordinary Commodity (2nd edn). The first part of the book describes why alcohol is not an ordinary commodity, and reviews epidemiological data that establish alcohol as a major contributor to the global burden of disease, disability and death in high, middle and low income countries. This section also documents how international beer and spirits production has recently been consolidated by a small number of global corporations that are expanding their operations in Eastern Europe, Asia, Africa, and Latin America. In the second part of the book, the scientific evidence for strategies and interventions that can prevent or minimize alcohol-related harm is critically reviewed in seven key areas: pricing and taxation, regulating the physical availability of alcohol, modifying the drinking context, drink-driving countermeasures, restrictions on marketing, education and persuasion strategies, and treatment and early intervention services. Finally, the book addresses the policy making process at the local, national, and international levels and provides ratings of the effectiveness of strategies and interventions from a public health perspective. Overall, the strongest, most cost-effective strategies include taxation that increases prices, restrictions on the physical availability of alcohol, drink-driving countermeasures, brief interventions with at risk drinkers, and treatment of drinkers with alcohol dependence.
Research Report
Authors: Kollom Kersti
Published: December 2017

K. Kollom: Estonian nongovernmental organisations in alcohol policy planning

Unlike other Northern European countries, Estonian non-governmental organisations have, until now, been fairly passive in shaping alcohol policy and alleviating alcohol problems. More generally, there has been little systematic analysis of alcohol policy in Estonia. This article starts with a short overview of the problems associated with alcohol abuse and the current state of alcohol policy in Estonia. I will then examine how non-governmental organisations (NGOs) see their role in the formation of alcohol policy and whether contributing to the dialogue on alcohol policy is even among their priorities. Finally, I will investigate the readiness of governmental agencies to involve organisations in shaping alcohol policy. One of the conclusions is that the state and NGOs are currently caught in a policy loop: third-sector organisations expect the state to put projects out to tender and to invite them to alcohol policy discussions, while government institutions would like the NGOs to show more initiative – at least on the level of rhetoric. Furthermore, because alcohol policies involving injunctions and prohibitions are associated with the former occupation regime of the Soviet Union, frowned on in the new liberal society, prominence is rather given to opinion formation and education work than prohibitive measures, which by their nature are more controversial.
Effects of Increasing Availability of Wine and Spirits in Norway
Authors: Nordlund Sturla
Published: December 2017

S. Nordlund: Effects of increasing availability of wine and spirits in Norway

During the 1990s the monopoly on wine and spirits sales in Norway lost popular support. In 1998 the management of the monopoly therefore launched a plan for regaining popularity by increasing the number of retail outlets and introduce self service in the shops. Surveys since 1990 show that the negative trend really changed around the turn of the millennium, and the monopoly system has regained most of its popular support since then. A crucial question is then: Has the increased availability of wine and spirits resulted in increasing alcohol consumption? Data from two surveys, one in 1999 and one in 2004, are used to answer this question. According to these data the total alcohol consumption increased during this period, but only in the municipalities that had a monopoly shop before 1999, i.e. in municipalities that were not expected to be influenced by the increasing availability. This increase was mainly due to increased consumption of beer and spirits. In the municipalities that were influenced by the new monopoly shops during this period, there was a decrease in consumption of spirits. This was due to a sharp decrease in the consumption of “moonshine”, while the consumption of spirits from the monopoly shops increased. These results are in accordance with previous studies of short term (one year) effects in particular municipalities where a new monopoly shop was opened.
Kommentar
Authors: Karlsson Patrik
Published: December 2017

P. Karlsson: Inherent problems in universal information-based prevention interventions

This paper discusses inherent problems in universal information-based drug prevention interventions which in part may explain why such interventions often fail. The discussion centers around three main points: (1) that there must be room for change in people's risk perceptions for information interventions to be potentially effective, (2) that the recipients must trust the information for it to have effect, and (3) that there are variations in risk perception levels at baseline among recipients. While the first two criteria must be satisfied for an intervention to be potentially effective, they often stand in a contradictory relationship with each other. Recipients with low risk perceptions often do not trust the information (i.e., only the first criterion satisfied), whereas those who trust the information often already have high risk perceptions (i.e., only the second criterion satisfied). Variations in risk perception levels among recipients further suggest there exist no optimal level at which the risk message may be set. If the risk message is set high many will dismiss it; if it is set low it may decrease risk perceptions in some groups. It is concluded that information interventions targeting specific groups may overcome some of these problems.
Alcohol and Economics. Research, Politics or Industry?
Authors: Horverak Øyvind
Published: December 2017

The article reviews the history of the discussion concerning the effect of alcohol consumption on the national economy. The point of departure is a discussion prompted by the prohibitionists in the Nordic countries and US who succeeded in bringing a ban on alcohol into reality. It made sense in those circumstances to ask the question. Two different situations were compared, a society where alcohol was forbidden and one where it was not. After the prohibitionists’ hope of an alcohol-free society became a lost cause in the 1930s, interest in these calculations waned for a spell. Interest was re-ignited in Finland, Norway and Sweden in the 1960s and ‘70s, however, spreading to North America and Australia in the 1980s and ‘90s. A set of international guidelines was issued on how to estimate the social costs attributable to alcohol consumption. In practice, there was a heavy bias in favour of costs, while the income side, with the exception of alcohol's presumed beneficial effect on cardiovascular diseases, was left out. Cost-of-illness studies were employed here, in which a contemporary society was compared with a fictive one, where alcohol had never existed. This article argues that such studies are not very meaningful in a research context and represent a capitulation to the desire of politicians to give political decisions a semblance of neutrality based on a common-sense approach to economics.
The Puzzle of Italian Drinking
Authors: Allamani Allaman , Beccaria Franca , Voller Fabio
Published: December 2017

During the recent decades, a significant process of change in alcohol consumption patterns is currently ongoing in Italy. This is especially obvious in the decreased wine consumption during the last 40 years, which parallels the decrease in deaths from liver cirrhosis. The drinking patterns of younger people have also changed during the last two decades, even if traditional values and practices are still retained. There is no evidence to suggest that planned public health policies had any substantial impact on these changes.
Challenges in an Affluent Society
Authors: Rossow Ingeborg
Published: December 2017

Over the past two decades recorded alcohol sales in Norway have increased by almost 50%. Although control policy measures are somewhat weakened over this period, the increase should also be viewed in light of the significant increase in purchase power, implying that alcohol has become relatively cheaper for the consumers. Most of the increase in alcohol sales is due to the more than doubled sales of wine, and the possible importance of wine journalism and bag-in-box wine is discussed in this respect. Despite the significant increase in consumption indicators of alcohol related harms do not show consistently increasing trends. Several possible explanations for this are discussed. Finally the current status of policy initiatives, the public opinion and some future challenges are outlined.
Addiction Treatment Ultimatums and U.S. Health Reform: A Case Study
Authors: Weisner Constance , Hinman Agatha , Lu Yun , Chi Felicia W. , Mertens Jennifer
Published: December 2017

■ AIMS

Increased access to health care, including addiction treatment, has long been a goal of health reform in the U.S. An unanswered question is whether reform will change the way people get to addiction treatment; when treatment is easily accessible, do individuals self-refer, or do they still enter treatment via ultimatums, and if so, from which sources? To begin examining this, we used a single case study of a U.S. health plan that provides access similar to that called for in health reform.

■ METHOD

Using a case study method of data from studies conducted in a large, private non-profit, integrated managed care health plan which includes addiction services, we examined the prevalence and source of ultimatums to enter treatment, and the characteristics of those receiving them. The plan is highly representative of changes to U.S. health care and other countries due to health reform.

■ RESULTS

Many individuals entering addiction treatment had received an ultimatum stemming from employment, legal, medical, and family sources. Having more employment problems, an occupation with public safety concerns, being older, male, and ethnicity predicted an employment ultimatum. Higher legal problem severity predicted a legal ultimatum. More men (and younger people) had family ultimatums, and more women (and older people) had medical ultimatums. Being younger, male, married, having higher employment and family problem severity, and being drug or combined drug/alcohol dependent rather than dependent on alcohol-only predicted an ultimatum from one's family. On the whole, an ultimatum from one source was not related to having one from another source. Those most likely to receive ultimatums from multiple sources were women, those separated/divorced, and those having higher psychiatric and legal problem severity.

■ CONCLUSIONS

Even in an insured population with good access to addiction treatment, individuals often receive ultimatums to enter treatment rather than being self-referred. Understanding the treatment entry process, and how it is affected by health care systems, could benefit from international and other comparative research.
The World Health Organization Substance Abuse Instrument for Mapping Services
Authors: Babor Thomas F. , Poznyak Vladimir
Published: December 2017

This paper describes the rationale for and development of the World Health Organization Substance Abuse Instrument for the Mapping of Services (WHO-SAIMS), a new procedure for assessing, monitoring, and evaluating treatment systems for substance use disorders in all UN Member States. The paper begins with a description of the information needed to understand the structure and function of drug and alcohol service systems. A conceptual model is presented to show how service system policies and characteristics impact on population health. Five kinds of research are then reviewed to suggest how the nature and impact of alcohol and drug services can be evaluated: 1) systems mapping studies; 2) assessments of service needs; 3) monitoring system development; 4) analysis of system performance; and 5) comparative studies. Although the WHO-SAIMS has a primarily descriptive function that will allow for gaps in service delivery and areas for system improvement to be identified, it can also be used for monitoring and process evaluation to allow countries to identify changes in the system over time and to assess the extent to which system improvement strategies have been implemented.
Replacing mouse BAFF with human BAFF does not improve B-cell maturation in hematopoietic humanized mice
Authors: Lang Julie , Zhang Bicheng , Kelly Margot , Peterson Jacob N. , Barbee Jacob , Freed Brian M. , Di Santo James P. , Matsuda Jennifer L. , Torres Raul M. , Pelanda Roberta
Published: December 2017

Key Points

Expression of full-length hBAFF from cDNA in the endogenous murine locus does not improve maturation of human B cells in hu-mice. mBAFF is not limiting the maturation of human B cells in hu-mice.
An autonomic hierarchical reliable broadcast protocol for asynchronous distributed systems with failure detection
Authors: Jeanneau Élise , Rodrigues Luiz A. , Arantes Luciana , Duarte Elias P.
Published: December 2017

Reliable broadcast is a fundamental building block in fault-tolerant distributed systems. It consists of a basic primitive that provides agreement among processes of the system on the delivery of each broadcast message, i.e., either none or all correct processes deliver the message, despite failures of processes. In this work, we propose a reliable broadcast solution on top of VCube, assuming that the system is asynchronous. VCube is an autonomic monitoring layer that organizes processes on a hypercube-like overlay which provides several logarithmic properties even in the presence of processes failures. We consider that processes can fail by crashing, do not recover, and faults are eventually detected by all correct processes. The protocol tolerates false suspicions by sending additional messages to suspected processes but logarithmic properties of the algorithm are still kept. Experimental results show the efficiency of the proposed solution compared to an one-to-all strategy.
Surgical management of inverted papilloma; a single-center analysis of 247 patients with long follow-up
Authors: Bugter Oisín , Monserez Dominiek André , van Zijl Floris Vincent Willem Joseph , Baatenburg de Jong Robert Jan , Hardillo Jose Angelito
Published: December 2017

Background

Our aim was to review our management of inverted papilloma (IP), perform a recurrence analysis, and review the literature.

Methods

A retrospective analysis of 247 patients treated for an IP. Patients were grouped according to surgical approach, tumor presentation (primary, residual and recurrence) and Krouse-stage.

Results

Recurrence was observed in 20.3%, 28.6% and 35.1% ( p = 0.017) of the patients who underwent endoscopic, external and combined surgery, respectively. Recurrences occurred more often in residual than primary IP (36.9% vs. 22.3%, p = 0.021). Primary endoscopic surgery had a recurrence rate of 12.5%, which was comparable to the recent literature (11.2%, 161/1433).

Conclusions

The relatively high number of recurrences in this cohort is explained by the long follow-up and previous (incomplete) surgery in 61.5% of the cases. The inferior outcome of residual IP underscores the importance of having a low threshold for preoperative biopsy in unilateral and atypical sinonasal disease.
Continuous Noninvasive Arterial Pressure Monitoring Using the Vascular Unloading Technique (CNAP System) in Obese Patients During Laparoscopic Bariatric Operations
Authors: Rogge Dorothea E. , Nicklas Julia Y. , Haas Sebastian A. , Reuter Daniel A. , Saugel Bernd
Published: December 2017

BACKGROUND:

Increasing rates of obesity create new challenges for hemodynamic monitoring in the perioperative phase. Continuous monitoring of arterial pressure (AP) is important in severely obese patients who are at particular risk for cardiovascular complications. Innovative technologies for continuous noninvasive AP monitoring are now available. In this study, we aimed to compare continuous noninvasive AP measurements using the vascular unloading technique (CNAP system; CNSystems, Graz, Austria) compared with invasive AP measurements (radial arterial catheter) in severely obese patients during laparoscopic bariatric surgery.

METHODS:

In 29 severely obese patients (mean body mass index 48.1 kg/m2), we simultaneously recorded noninvasive and invasive AP measurements over a period of 45 minutes and averaged the measurements using 10-second episodes. We compared noninvasive (test method) and invasive (reference method) AP measurements using Bland-Altman analysis and 4-quadrant plot/concordance analysis (2-minute interval).

RESULTS:

We observed a mean of the differences (±SD, 95% limits of agreement) between the AP values obtained by the CNAP system and the invasively assessed AP values of 7.9 mm Hg (±9.6 mm Hg, −11.2 to 27.0 mm Hg) for mean AP, 4.8 mm Hg (±15.8 mm Hg, −26.5 to 36.0 mm Hg) for systolic AP, and 9.5 mm Hg (±10.3 mm Hg, −10.9 to 29.9 mm Hg) for diastolic AP, respectively. The concordance rate was 97.5% for mean AP, 95.0% for systolic AP, and 96.7% for diastolic AP, respectively.

CONCLUSIONS:

In the setting of laparoscopic bariatric surgery, continuous noninvasive AP monitoring with the CNAP system showed good trending capabilities compared with continuous invasive AP measurements obtained with a radial arterial catheter. However, absolute CNAP- and arterial catheter–derived AP values were not interchangeable.
Extracorporeal Membrane Oxygenation Appropriateness: An Interdisciplinary Consensus-Based Approach
Authors: Nurok Michael , Warsh Jonathan , Griner Todd , Kharabi Mayumi , Castongia Joseph , Overbeck Cali , Krueger Lisa , Coleman Bernice , Ramzy Danny , Chung Joshua , Chan Alice , Ley Eric , Kubendran Sindhu , Parrish Neil , Yu Zhe , Langberg Michael , Finder Stuart , Rosen Bradley T. , Kaplan Robert S. , Sax Harry , Arabia Francisco
Published: December 2017

We describe a quality improvement initiative aimed at achieving interdisciplinary consensus about the appropriate delivery of extracorporeal membrane oxygenation (ECMO). Interdisciplinary rounds were implemented for all patients on ECMO and addressed whether care was consistent with a patient’s minimally acceptable outcome, maximally acceptable burden, and relative likelihood of achieving either. The rounding process was associated with decreased days on venoarterial ECMO, from a median of 6 days in 2014 (first quartile [Q1]–third quartile [Q3], 3–10) to 5 days in 2015 (Q1–Q3, 2.5–8) and in 2016 (Q1–Q3, 1–8). Our statistical methods do not allow us to conclude that this change was due to our intervention, and it is possible that the observed decreases would have occurred whether or not the rounding process was implemented.
Misaligned Feeding May Aggravate Pain by Disruption of Sleep–Awake Rhythm
Authors: Xu Fangxia , Zhao Xin , Liu Huan , Shao Xueming , Chu Shuaishuai , Gong Xiangdan , Ma Zhengliang , Gu Xiaoping
Published: December 2017

BACKGROUND:

Increasing evidence suggests that patients with eating disorders are more likely to develop chronic pain. A misaligned diet has been reported to disrupt the sleep–awake rhythms. Combined with our previous investigation on circadian pain, we aimed to investigate the role of misaligned diet in the pain sensitivity and the underlying mechanisms.

METHODS:

Two-month-old C57BL/6J male mice were administered chronic constriction injury (CCI) surgery to establish neuropathic pain models. CCI mice were randomized to scheduled food access throughout the whole day (CCI-free), during the daytime (CCI-misaligned), and at night (CCI-aligned), respectively. The paw withdrawal mechanical threshold, indicating pain behavior, was measured by Von Frey. The gross motor activity pattern indicating the sleep–awake rhythm was monitored by Mini-Mitter. Melatonin (Mel) was administered to ameliorate the sleep–awake rhythm (CCI-free + Mel and CCI-misaligned + Mel). The expressions of circadian pain–related proteins were detected by quantitative polymerase chain reaction and western blot. The primary outcome is the pain threshold and the secondary outcome is the sleep–awake rhythm.

RESULTS:

Misaligned diet during the peri-CCI surgery period significantly decreased the paw withdrawal mechanical threshold compared with the CCI-free mice (day 14: 0.40 ± 0.09 vs 0.64 ± 0.15; P = .03;) and altered the sleep–awake rhythm. Mel pretreatment alleviated the increased pain (day 14, CCI-misaligned + Mel versus CCI-misaligned: day 14: 0.60 ± 0.13 vs 0.35 ± 0.12; P = .022) and the disrupted sleep–awake rhythm caused by misaligned feeding. The mRNA levels of N-methyl-d-aspartate receptor subtype 2B (NR2B), Ca2+/calmodulin-dependent protein kinase II (CaMKII), and cyclic adenosine monophosphate-response element binding protein (CREB) in the spinal dorsal horn increased in CCI-misaligned mice compared with the CCI-free mice. The phosphor-NR2B, phosphor-CaMKII, and phosphor-CREB also increased in CCI-misaligned mice compared with the CCI-free mice. However, the expressions of NR2B, CaMKII, and CREB were decreased in CCI-misaligned + Mel mice compared to CCI-misaligned mice at both transcriptional and translational levels.

CONCLUSIONS:

Misaligned diet might aggravate pain sensitivity through the disruption of the sleep–awake cycle, which could be recovered by Mel. NR2B-CaMKII-CREB may participate in the disruption of sleep–awake rhythm–mediated pain aggravation.
The Effect of High-Frequency, Structured Expert Feedback on the Learning Curves of Basic Interventional Ultrasound Skills Applied to Regional Anesthesia
Authors: de Oliveira Filho Getúlio Rodrigues , Mettrau Francisco de Assis Caire
Published: December 2017

BACKGROUND:

Proficiency in needle-to-ultrasound beam alignment and accurate approach to structures are pivotal for ultrasound-guided regional anesthesia. This study evaluated the effects of high-frequency, structured expert feedback on simulation training of such abilities.

METHODS:

Forty-two subjects randomly allocated as controls or intervention participated in two 25-trial experiments. Experiment 1 consisted of inserting a needle into a bovine muscular phantom parallel to the ultrasound beam while maintaining full imaging of the needle. In experiment 2, the needle aimed to contact a target inside the phantom. Intervention subjects received structured feedback between trials. Controls received a global critique after completing the trials. The slopes of the learning curves derived from the sequences of successes and failures were compared. Change-point analyses identified the start and the end of learning in trial sequences. The number of trials associated with learning, the number of technical errors, and the duration of training sessions were compared between intervention and controls.

RESULTS:

In experiment 1, learning curves departed from 73% (controls) and 76% (intervention) success rates; slopes (standard error) were 0.79% (0.02%) and 0.71% (0.04), respectively, with mean absolute difference of 0.18% (95% confidence interval [CI], 0.17%–0.19%; P = 0). Intervention subjects’ learning curves were shorter and steeper than those of controls. In experiment 2, the learning curves departed from 43% (controls) and 80% (intervention) success rates; slopes (standard error) were 1.06% (0.02%) and 0.42% (0.03%), respectively, with a mean difference of 0.65% (95% CI, 0.64%–0.66%; P = 0). Feedback was associated with a greater number of trials associated with learning in both experiment 1 (mean difference, 1.55 trials; 95% CI, 0.15–3 trials; P = 0) and experiment 2 (mean difference, 4.25 trials; 95% CI, 1.47–7.03 trials; P = 0) and a lower number of technical errors per trial in experiments 1 (mean difference, 0.19; 95% CI, 0.07–0.30; P = .02) and 2 (mean difference, 0.58; 95% CI, 0.45–0.70; P = 0), but longer training sessions in both experiments 1 (mean difference, 9.2 minutes; 95% CI, 4.15–14.24 minutes; P = .01) and 2 (mean difference, 7.4 minutes; 95% CI, 1.17–13.59 minutes; P = .02).

CONCLUSIONS:

High-frequency, structured expert feedback compared favorably to self-directed learning, being associated with shorter learning curves, smaller number of technical errors, and longer duration of in-training improvement, but increased duration of the training sessions.
Accuracy of coronary artery calcium scoring with tube current reduction by 75%, using an adaptive iterative reconstruction algorithm
Authors: Luhur Reny , Schuijf Joanne D , Mews Jürgen , Blobel Jörg , Hamm Bernd , Lembcke Alexander
Published: December 2017

Objective:

To assess the accuracy of an iterative reconstruction (IR) technique for coronary artery calcium scoring with reduced radiation dose.

Methods:

163 consecutive patients underwent twofold scanning by 320-row detector CT at 120 kVp. A low-dose scan at 25% tube current but with standard scan length (14 cm) was followed by a standard dose scan with routine tube current but reduced scan length (10 cm). Reduced dose images were constructed using filtered back-projection (FBP) and IR (adaptive iterative dose reduction in three dimensions). The standard dose scan reconstructed with FBP served as the gold standard for comparisons. Image noise and Agatston coronary calcium scores were determined and compared between the groups.

Results:

Compared with FBP at standard dose, noise at reduced dose increased markedly with FBP but remained low with IR. Mean Agatston score with FBP at reduced dose showed a significant increase as compared with FBP at standard dose. No significant difference was observed when applying IR at reduced dose. At reduced dose, 38 (23.3%) patients were reassigned to a different cardiovascular risk category with FBP but only 8 (4.9%) with IR. Out of 47 patients with a zero Agatston score, 15 patients (31.9%) were false-positive with FBP at reduced dose, but no false positives were found with IR.

Conclusion:

IR allows accurate coronary artery calcium scoring with a radiation dose reduced by 75%.

Advances in knowledge:

The application of adaptive iterative dose reduction in three dimensions allows the maintenance of accurate Agatston scores and risk stratification at significantly reduced tube current, thus reducing the patient’s exposure to ionizing radiation.
Widespread temperature sensitivity and tRNA decay due to mutations in a yeast tRNA
Authors: Payea Matthew J. , Sloma Michael F. , Kon Yoshiko , Young David L. , Guy Michael P. , Zhang Xiaoju , De Zoysa Thareendra , Fields Stanley , Mathews David H. , Phizicky Eric M.
Published: December 2017

Microorganisms have universally adapted their RNAs and proteins to survive at a broad range of temperatures and growth conditions. However, for RNAs, there is little quantitative understanding of the effects of mutations on function at high temperatures. To understand how variant tRNA function is affected by temperature change, we used the tRNA nonsense suppressor SUP4oc of the yeast Saccharomyces cerevisiae to perform a high-throughput quantitative screen of tRNA function at two different growth temperatures. This screen yielded comparative values for 9243 single and double variants. Surprisingly, despite the ability of S. cerevisiae to grow at temperatures as low as 15°C and as high as 39°C, the vast majority of variants that could be scored lost half or more of their function when evaluated at 37°C relative to 28°C. Moreover, temperature sensitivity of a tRNA variant was highly associated with its susceptibility to the rapid tRNA decay (RTD) pathway, implying that RTD is responsible for most of the loss of function of variants at higher temperature. Furthermore, RTD may also operate in a met22Δ strain, which was previously thought to fully inhibit RTD. Consistent with RTD acting to degrade destabilized tRNAs, the stability of a tRNA molecule can be used to predict temperature sensitivity with high confidence. These findings offer a new perspective on the stability of tRNA molecules and their quality control at high temperature.
BONE REMODELING IN WOMEN WITH DIABETES MELLITUS
Authors: Бардымова Татьяна , Bardymova Tatyana , Мистяков Максим , Mistyakov Maksim , Башарина Юлия , Basharina Yuliya , Минаева Елена , Minaeva Elena , Абзаева Александра , Abzaeva Aleksandra
Published: December 2017

Background. It is known that the type 2 diabetes mellitus (DM) and osteoporosis are more often diagnosed in senior
women. The condition of a bone tissue is accompanied by the metabolic violations that are typical for DM. The recent
researches established the multidirectional changes of bone remodeling markers in women with type 2 DM at differ-
ent age periods.
Aims: to study the condition of bone remodeling in women with type 2 DM at different age periods.
Materials and methods. We examined 27 women with type 2 DM, among them 15 were in the post-menopausal period
and 12 with preserved menstrual function. Levels of osteocalcin, N-terminal propeptide of type 1 collagen (P1NP), C-
terminal telopeptide of type 1 collagen (β-Crosslaps), 25-OH vitamin D, the ionized calcium were researched.
Results. The analysis showed that increase in β-Crosslaps levels, P1NP, levels of osteocaltcin were observed in women with
type 2 DM in the post-menopausal period, compared to parameters of women with type 2 DM with preserved menstrual function. Inverse correlation relation of osteocaltcin and 25-OH vitamin D was revealed in women with type 2 DM.
Conclusion. Significant increase in markers of osteosynthesis and osteoresorption in women with type 2 DM was
shown in the post-menopausal period compared with indicators of women with type 2 DM with preserved men-
strual function.
CORRECTION OF MICRONUTRIENT STATUS OF THE POPULATION OF THE IRKUTSK REGION AS A MEANS OF LOWERING INFANT MORTALITY
Authors: Решетник Любовь , Reshetnik Lyubov' , Спасич Татьяна , Spasich Tatiana , Бойко Татьяна , Boyko Tatiana , Григорьева Мария , Grigorieva Maria , Козловская Ирина , Kozlovskaya Irina
Published: December 2017

Aim: to establish a link between the level of folic acid, vitamin D and iodine consumption, and infant and perinatal
mortality, morbidity of childhood tuberculosis in the Irkutsk region.
Consumption of folate in the form of a single-agent preparation increased 3 times in 5 years. Consumption of folic acid
in women at the stage of preconception and pregnancy affected the reduction of perinatal (R = –0.9; p = 0.016) and
infant (R = –0.89; p = 0.04) mortality, including neonatal (R = –0.89; p = 0.039).
Preventive supplementation of vitamin D of people in the region over the past 5 years has increased by 70 %, and infant
mortality fell by 35.5 %. Infant (R = –0.94; p = 0.01) and especially post-neonatal (R = –0.97; p = 0.004) mortality are
controllable and depend on the prevention of hypovitaminosis D. The understanding of the role of vitamin D in trigger-
ing the synthesis of the antimicrobial peptide cathelicidin opens prospects for using it as a medicine for prevention and
treatment of childhood tuberculosis. The incidence of pediatric tuberculosis in the region during this period decreased
by 46 % (R = –0.95; p = 0.01).
Correction of iodine deficiency in pregnant women and children caused the reduction of perinatal (R = –0.99; p = 0.07),
early neonatal (R = –0.99; p = 0.05), neonatal (R = –0.98; p = 0.06) and post-neonatal (R = –0.99; p = 0.002) infant
mortality.
PURPOSE PROPHYLAXIS OF THE INSUFFICIENCY OF VITAMIN D IN THE POPULATION OF THE IRKUTSK REGION
Authors: Спасич Татьяна , Spasich Tatiana , Решетник Любовь , Reshetnik Lyubov' , Жданова Екатерина , Zhdanova Yekaterina , Чубарова Наталья , Chubarova Natalya , Промтов Максим , Promtov Maxim , Румянцев Кирилл , Rumyantsev Kirill , Босхолов Борис , Boskholov Boris
Published: December 2017

Purpose of the study. To determine the influence of climatic and geographical factors of the Irkutsk region on the risk
of hypovitaminosis D in children and adults.
Patients and methods. The contents of 25(OH)D-3 in the blood of children and adults (3261 samples) were evaluated.
The materials were obtained in the Diagnostic Center of the region and the InVitro laboratory. Results of monitoring
of ultraviolet radiation and precipitation in the Irkutsk region for 2014–2015 were analyzed according to ground and
satellite measurements.
Results. The Irkutsk region is in the zone of ultraviolet insufficiency during the period from September-October to
March-May. The status of the metabolite of vitamin D – 25(OH)D3 in the population of the region is low, especially in
adolescents and people older than 70 years. 68 % of children have vitamin D deficiency. Activity of 25(OH)D3 depends
on meteorological factors, especially the level of precipitation and the intake of vitamin D. For each geographical area
of the region, time intervals were calculated for the formation of vitamin D in the skin under the influence of ultraviolet
radiation and time intervals for the intake of vitamin D preparations. The exposure time in the sun was calculated
for the formation of vitamin D for individuals with different skin phototypes, depending on the degree of its openness.
SPECTRUM OF CONDITIONALLY PATHOGENIC MICROFLORA REPRESENTATIVES ISOLATED FROM THE PROSTATE SECRET IN THE COURSE OF CHRONIC BACTERIAL PROSTATITIS
Authors: Туник Татьяна , Tunik Tatyana , Иванова Елена , Ivanova Elena , Григорова Екатерина , Grigorova Ekaterina , Воропаева Наталья , Voropayeva Natalya , Вишневская Вера , Vishnevskaya Vera
Published: December 2017

The article represents a description for microbiocenosis of isolated prostate secret. The initial samples were taken
on the territory of the Irkutsk region from men diagnosed with chronic bacterial prostatitis in the acute stage. 90 %
of samples of isolated prostate secret were tested by cultural method revealed 41 representatives of opportunistic
pathogenic microflora.
Gram-positive microorganisms were found in most samples (86.7 %). Staphylococcus genus representatives formed
the majority in isolated samples of conditionally pathogenic microflora (66.7 %). As for gram-negative representatives
(which role in chronic bacterial prostatitis is proven by multiple research), E. coli and K. pneumoniae were isolated.
In the half of samples, we revealed bacterial associations consisting mostly of two kinds of microorganisms. Staphylo-
coccus epidermidis was isolated in 70 % of such associations.
ALGORITHM OF DIAGNOSTICS AND SURGICAL TREATMENT OF INTERVERTEBRAL DISK HERNIAS IN LUMBAR AND LUMBOSACRAL SPINE
Authors: Кошкарёва Зинаида , Koshkareva Zinaida , Сороковиков Владимир , Sorokovikov Vladimir , Бывальцев Вадим , Byvaltsev Vadim , Калинин Андрей , Kalinin Andrey , Скляренко Оксана , Sklyarenko Oksana , Егоров Андрей , Egorov Andrey , Горбунов Анатолий , Gorbunov Anatoliy , Потапов Виталий , Potapov Vitaliy , Животенко Александр , Zhivotenko Aleksandr
Published: December 2017

The purpose of the research is substantiation of the choice of optimal surgical treatment for intervertebral disc hernias
basing on the complex examination of patients. The authors worked out and introduced into practical healthcare the
diagnostic algorithm for intervertebral disc raptures and constrictive processes of the spinal canal and dural sack. The
algorithm includes clinical neurologic examination, complete blood count and biochemical blood test, electroneuro-
myography, densitometry, standard and functional spinal radiography, weight-bearing radiography, MSCT, MRI, and
multisection CT myelography. The analysis of the obtained data has given the authors the opportunity to establish
precise indications for surgical treatment of intervertebral hernias depending on the localization of the rupture, its
size, degree of compression of neural structures, and the volume of osteo-neural involvement. The work presents three
methods of surgical treatment of intervertebral hernias, optimizing the outcomes of surgical interventions based on
the conducted diagnostic algorithm. 425 patients with intervertebral hernias were operated in different ways: 149
people – by laser-mediated vaporization; 131 people – with the use of video-assisted endoneurosurgery; and 145 pa-
tients were treated by surgical decompression with minimally invasive reconstruction of spinal canal and dural sack.
The suggested methods of surgical treatment of intervertebral raptures are substantiated and confirmed by the patents,
innovative surgical techniques and proved to be highly efficient. The use of said methods allowed to achieve good and
satisfactory outcomes in 89.5 % of cases.
AETIOLOGY OF THE SMALL TORTOISESHELL AT CHILDREN
Authors: Буйнова Светлана , Buynova Svetlana , Шинкарева Вера , Shinkareva Vera
Published: December 2017

Urticaria is a frequent disease in childhood, which almost every child had. Usually, the presence of distinct urticaria
does not present difficulties in nosological diagnosis, but many factors in account for its development cause challenge
for doctors in choosing tactics for therapy. Traditionally the triggers of urticaria in children are food allergens and
drugs, and that is why pediatricians unreasonably eliminate many foods from the baby’s nutrition for a long time. We
analyzed the causes of acute and chronic urticaria in children hospitalized in the department of pediatrics over the
ten-year period. In acute urticaria, in most cases, triggers were food (46.7 % children) and drugs (22.5 % children), in
children with chronic urticaria, food was the cause of rashes only in 20 % of cases, and the infectious etiology of the
disease was confirmed in 8 children. In almost a half of children with chronic urticaria the cause of the rash was not
established. Based on the research, recommendations for the examination of patients with this pathology are suggest-
ed. Except for testing for food allergens and drugs, the diagnostic protocol of a patient with chronic urticaria should
include the laboratory tests for infectious agents, as well as conducting fibrogastroduodenoscopy with biopsy of the
gastric mucosa according to indications.