bluuebunny/crossref_metadata_2025 huggingface dataset:
Interventions to improve antimicrobial prescribing of doctors in training: the IMPACT (IMProving Antimicrobial presCribing of doctors in Training) realist review
Authors: Wong Geoff , Brennan Nicola , Mattick Karen , Pearson Mark , Briscoe Simon , Papoutsi Chrysanthi
Published: October 2015

Introduction

Antimicrobial resistance has been described as a global crisis—more prudent prescribing is part of the solution. Behaviour change interventions are needed to improve prescribing practice. Presently, the literature documents that context impacts on prescribing decisions, yet insufficient evidence exists to enable researchers and policymakers to determine how local tailoring should take place. Doctors in training are an important group to study, being numerically the largest group of prescribers in UK hospitals. Unfortunately very few interventions specifically targeted this group.

Methods and analysis

Our project aims to understand how interventions to change antimicrobial prescribing behaviours of doctors in training produce their effects. We will recruit a project stakeholder group to advise us throughout. We will synthesise the literature using the realist review approach—a form of theory-driven interpretive systematic review approach often used to make sense of complex interventions. Interventions to improve antimicrobial prescribing behaviours are complex—they are context dependent, have long implementation chains, multiple non-linear interactions, emergence and depend on human agency. Our review will iteratively progress through 5 steps: step 1—Locate existing theories; step 2—Search for evidence; step 3—Article selection; step 4—Extracting and organising data; and step 5—Synthesising the evidence and drawing conclusions. Data analysis will use a realist logic of analysis to describe and explain what works, for whom, in what circumstances, in what respects, how and why to improve antimicrobial prescribing behaviour of doctors in training.

Ethics and dissemination

Ethical approval was not required for our review. Our dissemination strategy will be participatory and involve input from our stakeholder group. Tailored project outputs will be targeted at 3 audiences: (1) doctors in training; (2) clinical supervisors/trainers and medical educators; and (3) policy, decision makers, regulators and royal societies.
Evaluating the effectiveness of a home-based exercise programme delivered through a tablet computer for preventing falls in older community-dwelling people over 2 years: study protocol for the Standing Tall randomised controlled trial
Authors: Delbaere K , Valenzuela T , Woodbury A , Davies T , Yeong J , Steffens D , Miles L , Pickett L , Zijlstra G A R , Clemson L , Close J C T , Howard K , Lord S R
Published: October 2015

Introduction

In order to prevent falls, older people should exercise for at least 2 h per week for 6 months, with a strong focus on balance exercises. This article describes the design of a randomised controlled trial to evaluate the effectiveness of a home-based exercise programme delivered through a tablet computer to prevent falls in older people.

Methods and analysis

Participants aged 70 years or older, living in the community in Sydney will be recruited and randomly allocated to an intervention or control group. The intervention consists of a tailored, home-based balance training delivered through a tablet computer. Intervention participants will be asked to complete 2 h of exercises per week for 2 years. Both groups will receive an education programme focused on health-related information relevant to older adults, delivered through the tablet computer via weekly fact sheets. Primary outcome measures include number of fallers and falls rate recorded in weekly fall diaries at 12 months. A sample size of 500 will be necessary to see an effect on falls rate. Secondary outcome measures include concern about falling, depressive symptoms, health-related quality of life and physical activity levels (in all 500 participants); and physiological fall risk, balance, functional mobility, gait, stepping and cognitive performance (in a subsample of 200 participants). Adherence, acceptability, usability and enjoyment will be recorded in intervention group participants over 2 years. Data will be analysed using the intention-to-treat principle. Secondary analyses are planned in people with greater adherence. Economic analyses will be assessed from a health and community care provider perspective.

Ethics and dissemination

Ethical approval was obtained from UNSW Ethics Committee in December 2014 (ref number HC#14/266). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conferences.

Trial registration number

Australian New Zealand Clinical Trials Registry (ACTRN)12615000138583.
IMPROVING CARE FOR PEDIATRIC URINARY TRACT INFECTION: RELATIONSHIP BETWEEN IMPLEMENTATION OF A CLINICAL PATHWAY AND PRESCRIBING PATTERNS IN THE ED
Authors: Caglar Derya , Poole Nicole , Migita Russ , Kronman Matthew , Zerr Danielle , Rutman Lori
Published: October 2015

Background

Urinary tract infections (UTIs) are the most common serious bacterial infection in children; nearly 10% of girls and 2% of boys are affected during their first 8 years of life. Broad-spectrum antibiotics are popular first-line treatment agents; however, these medications can lead to resistant organisms and more severe infections over time. In July 2010, our institution implemented a clinical pathway for children presenting to the ED with UTI based on national guidelines and local consensus regarding the need for antimicrobial stewardship. A goal of the pathway was to increase narrow spectrum (cephalexin) and decrease broad spectrum (cefixime) antibiotic use for children with uncomplicated UTI presenting to the ED.

Objectives

To determine the impact of a UTI clinical pathway on provider antibiotic prescribing patterns.

Methods

We used statistical process control (p-charts) to analyze the percentage of patients receiving each antibiotic over time. Data were analyzed over a 6-year period; 1.5 years before and 4.5 years after pathway implementation.

Results

2292 patients were included. The percentage of patients receiving targeted narrow spectrum antibiotics increased from an average of 19% to 73% (figure 1). There was a concomitant decrease in the percentage of patients receiving broad-spectrum antibiotics (cefixime) from 46% to 3% (figure 2). Special cause variation was noted twice during the study period; immediately following pathway implementation and again 6 months later when the pathway was revised to increase provider education regarding appropriate antibiotic use.

Conclusions

Implementation of clinical pathways for UTI can result in sustained improvements in antimicrobial stewardship among children seen in ED settings.

Figure 1

Percent of UTI Patients Receiving Narrow-Spectrum Antibiotic (cephalexin).

Figure 2

Percent of UTI Patients Receiving Broad-Spectrum Antibiotic (cefixime).
IDENTIFYING ACTIONABLE INFORMATION: PREVENTABLE 30-DAY NEUROSURGICAL READMISSIONS.
Authors: Laurans Maxwell , Tyrtova Evgeniya , Semlow Melani
Published: October 2015

Background

Hospital readmissions within 30 days after discharge are increasingly recognized as markers of inpatient quality of care and significant contributors to rising healthcare expenditures. Identifying potentially preventable readmission causes and developing targeted interventions is a national priority.

Objectives

To determine rate, reasons, and potential for prevention for 30-day unplanned neurosurgical readmissions at Yale-New Haven Hospital.

Methods

Over a 6-month period, all patients who had been discharged from YNHH after receiving care from the Department of Neurosurgery and readmitted within 30 days were retrospectively identified. In-depth chart analysis was performed to uncover relevant medical/social history and admission/readmission details.

Results

During 6 months, 84 (6.6%) of 1,279 patients were readmitted within 30 days. Reasons for readmission were categorized into miscellaneous (34%), non-surgical site infections (15%), postoperative wound complications (14%), intracranial hemorrhage (13%), neurological deficits: brain (10%), CSF device malfunction (8%), neurological deficits: spine (4%), and ischemic CNS events (2%). Most complications were moderate (54%) or mild (31%). Overall, 17% of readmissions were determined to be likely preventable, 10% – potentially preventable, 73% – not preventable. Notably, 42% of postoperative wound complications and 32% of brain-related neurological deficits could have been prevented. 49% of readmissions were related to initial hospitalization and 12% resulted from inappropriate post-discharge care; 34% and 88% of those, respectively, were preventable.

Conclusions

Overall, 27% of 30-day neurosurgical readmissions were determined to be potentially preventable. Underlying reasons were identified and will be used to design targeted interventions. Preventing postoperative wound complications and providing appropriate discharge arrangements/instructions are the most promising areas of improvement.
IMPROVING THE TRANSFER OF MEDICALLY COMPLEX PATIENTS FROM THE CARDIAC INTENSIVE CARE UNIT TO THE CARDIOLOGY INPATIENT WARD
Authors: Storey Jean , Mustin Laurie , Madsen Nicolas , Kimball Melissa , Schoenling Gina , Brown James , Byrnes Jonathan , Cooper David
Published: October 2015

Background

Readmission to the cardiac intensive care unit (CICU) increases LOS and cost, negatively impacts patient experience, throughput and resource allocation. A review of unplanned readmissions to the CICU identified that transfer of care and monitoring practices were not differentiated based on patient specific risk.

Objectives

To increase days since last readmission to the CICU within 48 hours of transfer by defining patients at increased risk and standardizing key transfer processes.

Methods

A standardized care process was developed and tested for patients at increased risk of readmission to CICU within 48 hours of transfer. Bundle components included: Patients identified 24 hours prior to transfer; Face to face nurse handoff in the CICU; Standardized team huddle on arrival to ward and prior to overnight hand-off; VS every 2 hours, I/O every 4 hours for 24 hours and RN staffing ratio of 2:1. Statistical process control charts were used to monitor progress.

Results

Transfer bundle compliance reached a median of 100%. Days between 48 hour readmissions to CICU increased from an average of 12 days to 45 days. Process control charts demonstrate 3 data points considered special cause after bundle compliance reached 100%.

Conclusions

Transfer of care processes and outcomes for patients at increased risk of CICU readmission have improved. These interventions can be spread to other hospital units with the hopes of achieving similar results.

Figure 1Figure 2Figure 3
Nurse led venesection: a quality improvement project
Authors: Patel Chandni , Morgan Dafydd
Published: October 2015

Venesection is a widely practised procedure, involving the removal of a unit of blood in order to treat haemochromatosis and polycythaemia. It is still well regarded due to a lack of better alternatives and a small side effect profile. At Barnet General Hospital, venesection has recently been a physician led service, unlike its neighbouring hospital at Chase Farm Hospital, which has a well run nurse led service. The current service being run at Barnet Hospital was beset with problems, including delays in service provision and discharge, using junior doctors who may not be comfortable with or have knowledge of pre and post procedure checks. Furthermore, the medical day treatment unit is comprised of highly skilled nurses. 100% of nursing staff felt comfortable gaining venous access, but none had any formal training. Following a practical tutorial, followed by formal teaching, the nurses now run the venesection service. This has been done at no cost to the hospital, has sped up discharges and this has subsequently led to the capacity of the unit to venesect patients to increase by 100%.
Budd–Chiari syndrome: investigation, treatment and outcomes
Authors: Goel Rishi M , Johnston Emma L , Patel Kamal V , Wong Terence
Published: October 2015

Budd–Chiari syndrome is a rare disorder characterised by hepatic venous outflow obstruction. It affects 1.4 per million people, and presentation depends upon the extent and rapidity of hepatic vein occlusion. An underlying myeloproliferative neoplasm is present in 50% of cases with other causes including infection and malignancy. Common symptoms are abdominal pain, hepatomegaly and ascites; however, up to 20% of cases are asymptomatic, indicating a chronic onset of hepatic venous obstruction and the formation of large hepatic vein collaterals. Doppler ultrasonography usually confirms diagnosis with cross-sectional imaging used for complex cases and to allow temporal comparison. Myeloproliferative neoplasms should be tested for even if a clear causative factor has been identified. Management focuses on anticoagulation with low-molecular-weight heparin and warfarin, with the new oral anticoagulants offering an exciting prospect for the future, but their current effectiveness in Budd–Chiari syndrome is unknown. A third of patients require further intervention in addition to anticoagulation, commonly due to deteriorating liver function or patients identified as having a poorer prognosis. Prognostic scoring systems help guide treatment, but management is complex and patients should be referred to a specialist liver centre. Recent studies have shown comparable procedure-related complications and long-term survival in patients who undergo transjugular intrahepatic portosystemic shunting and liver transplantation in Budd–Chiari syndrome compared with other liver disease aetiologies. Also, the optimal timing of these interventions and which patients benefit from liver transplantation instead of portosystemic shunting remains to be answered.
Veterinary team interactions, part one: the practice effect
Authors: Kinnison T. , May S. A. , Guile D.
Published: October 2015

Veterinary practices have evolved since the era of solo practitioners working on one site. Today veterinary practices tend to include veterinary surgeons, veterinary nurses, receptionists and business managers, leading to the notion of the veterinary team and the rise of interprofessional working. In addition, practices have grown in size and frequently include several branches, creating a distributed team. Research regarding veterinary teamwork is lacking. This paper uses Social Network Analysis (SNA) to address this issue. SNA measures interactions between members of a network. The types of interactions in practice and the effects of practice size and location (branches) are considered. Information sharing and asking for advice are straightforward, lower order interactions. Problem solving and being influenced by another are complex, higher order interactions. Smaller practices have higher densities of interactions, implying a more cohesive team. However, individuals in smaller practices still do not interact with everyone and therefore actively choose with whom to interact. Practices with little staff rotation across branches experience limited interactions across locations. The results of this study have implications for practices aiming to expand their team, either in a single site or by acquiring more branches. Suggestions for ways to maintain and improve interactions are made.
Gravitational crystal inside the black hole
Authors: Nikolić Hrvoje
Published: October 2015

Crystals, as quantum objects typically much larger than their lattice spacing, are counterexamples to a frequent prejudice that quantum effects should not be pronounced at macroscopic distances. We propose that the Einstein theory of gravity only describes a fluid phase and that a phase transition of crystallization can occur under extreme conditions such as those inside the black hole. Such a crystal phase with lattice spacing of the order of the Planck length offers a natural mechanism for pronounced quantum-gravity effects at distances much larger than the Planck length. A resolution of the black hole information paradox is proposed, according to which all information is stored in a crystal-phase remnant with size and mass much above the Planck scale.
Axion electrodynamics in the duality perspective
Authors: Tiwari S. C.
Published: October 2015

Axion electrodynamics is deduced from the local duality invariant electrodynamics (LDIE) with a new perspective on both formalism and the physical interpretation. First, the delicate issue of duality rotation symmetry in the Maxwell action is critically reviewed and the generalized Maxwell field equations invariant under local duality rotation are derived. In the alternative approach, a generalization is made to Sudbery’s pseudo-vector action such that it is local duality invariant. Variational principle is used to derive the Euler–Lagrange equations of motion. The gauge potential for local duality rotation, termed duroton, under the assumption that it is a gradient of the axion field leads to the dual symmetric axion electrodynamics. The absence of the magnetic monopole in Maxwell equations motivates to impose a natural condition to deduce the standard axion electrodynamics. The present derivation offers the possibility for new physical interpretation of the axions and the monopoles.
Design for Test and Diagnosis of Power Switches
Authors: Valka Miroslav , Bosio Alberto , Dilillo Luigi , Girard Patrick , Virazel Arnaud , Debaud Philippe , Guilhot Stephane
Published: October 2015

Power gating techniques have been adopted so far to reduce the static power consumption of integrated circuits (ICs). Power gating is usually implemented by means of several power switches (PSs). Manufacturing defects affecting PSs can lead to increase in the actual static power consumption and, in the worst case, they can completely isolate a functional block in the IC. Thus, efficient test and diagnosis solutions are needed. In this paper, we present a novel Design for Test and Diagnosis (DfTD) solution able to increase the test quality and diagnosis accuracy of PSs. The proposed approach has been validated through SPICE simulations on ITC’99 benchmark circuits as well as on industrial test cases.
Prof. François Englert
Authors:   APPN Editorial Team
Published: October 2015

The Belgian theoretical particle physicists François Baron Englert is the 2013 Nobel Prize Laureate in Physics and is currently Professor emeritus at the Université libre de Bruxelles in Brussels, Belgium. He is also affiliated with the School of Physics and Astronomy of Tel Aviv University, Israel and the Institute for Quantum Studies at Chapman University, USA. Prof. Englert was awarded many notable awards, such as the J. J. Sakurai Prize for Theoretical Particle Physics in 2010, the Wolf Prize in Physics in 2004 and the High Energy and Particle Prize of the European Physical Society in 1997. Peter W. Higgs and he were jointly awarded the Nobel Prize in Physics 2013 for "the theoretical discovery of a mechanism that contributes to our understanding of the origin of mass of subatomic particles."
A Conversation with Prof. Chen-Ning Yang
Authors:   APPN Editorial Team
Published: October 2015

For an hour on 27 May 2015, six C.N. Yang scholars from Nanyang Technological University had the privilege of conducting an informal discussion with Prof. Yang. Coming from different faculties and subject groups, the students represented the spectrum of subject areas that were influenced by Prof Yang's work. Centring on the topics of inspiration and research, Prof. Yang, accompanied by Prof. Choo Hiap Oh (Professor, Department of Physics, National University of Singapore) and Prof. Kok Khoo Phua (Director, Institute of Advanced Studies, Nanyang Technological University), dispensed advice with some humour.
Aliyun and Chinese Academy of Sciences Sign MoU for Quantum Computing Laboratory
Authors:   APPN Editorial Team
Published: October 2015

Alibaba Group's cloud computing subsidiary, Aliyun, and the Chinese Academy of Sciences (CAS) signed a memorandum of understanding on 31 July 2015 in Shanghai to co-found the Chinese Academy of Sciences – Alibaba Quantum Computing Laboratory. The aim of the new research facility is to advance the study and applications of quantum theory, thereby creating new technologies and platforms for information security, connectivity and computing.
Alpha Magnetic Spectrometer (AMS) Releases New Results on Dark Matter Detection
Authors: Chang Yuan-Hann
Published: October 2015

It is known that the majority (about 80%) of the matter in the universe is not visible, but rather a hypothetical "Dark Matter". The existence of Dark Matter has been postulated to explain the discrepancies between the estimated mass of visible matters in the galaxies, and their gravitational effects. Although it has been postulated for over 70 years, and has been commonly accepted by most scientists, the essence of the Dark Matter has not yet been understood. In particular, we still do not know what constitutes the Dark Matter. Direct detection of the Dark Matter is therefore one of the most important issues in physics.
IAS Hosts the 8th Joint Meeting of Chinese Physicists Worldwide
Authors:   APPN Editorial Team
Published: October 2015

This summer, the International Organization of Chinese Physicists and Astronomers (OCPA), held their 8th Joint Meeting of Chinese Physicists Worldwide (OCPA8) at the Nanyang Technological University in Singapore. Participants included Nobel Laureates Prof Chen-Ning Yang (Nobel Laureate in Physics 1957) and Prof Carlo Rubbia (Nobel Laureate in Physics 1984), as well as distinguished speakers from leading institutions in Asia, Australia, Europe, and the United States. The theme of the conference was Physics Education and Frontier Physics.
Quantum Walks of Photons on a Nonlinear Chip
Authors: Solntsev A. S. , Setzpfandt F. , Clark A. S. , Wu C. W. , Collins M. J. , Xiong C. , Schreiber A. , Katzschmann F. , Eilenberger F. , Schiek R. , Sohler W. , Mitchell A. , Silberhorn C. , Eggleton B. J. , Pertsch T. , Sukhorukov A. A. , Neshev D. N. , Kivshar Y. S.
Published: October 2015

Quantum entanglement underpins the realization of quantum simulators and computers, which can be used for unbreakable cryptography and powerful computational algorithms. Entangled photons are an ideal medium for creating and manipulating quantum states due to the low noise and ease of transmission. A qubit encoded into a photon can be easily sent between different photonic elements along an optical fiber, in analogy with the transmission of classical bits along electrical wires. Furthermore, logic operations can be performed on entangled photons by exploiting the nonlinearity inherent to quantum measurements [1]. The practical implementation of complex applications requires the minimization of coupling losses, as well as stable quantum interference. Low losses and interferometric stability allow strong entanglement between output photons. One of the biggest milestones in achieving these requirements is the integration of photon sources together with optical circuits on the same photonic chip.
From Vassar to the Discovery of the Higgs Particle
Authors: Wu Sau Lan
Published: October 2015

President Hill, Professor Feroe, the Board of Trustees, the eminent faculty, proud parents, grandparents and Vassar graduates of the class of 2014: Thank you for giving me this great honor and wonderful opportunity to address today's 150th commencement ceremony.
Arthur Smith Woodward's fossil fish type specimens
Authors: Bernard Emma Louise , Smith Mike
Published: October 2015

Four years after joining the Natural History Department of the British Museum in 1882, Arthur Smith Woodward published his first taxonomic paper erecting three new species based on sharks’ teeth. He retired from the Natural History Museum in 1924 but continued to publish until his death in 1944 at the age of 80. In total he named 321 new fossil fishes, a remarkable achievement, marking him out as the most influential palaeoichthyologist of his time. For the first time brief details of all his type specimens are brought together, accompanied in many cases by high-quality photographic images, in an online format readily available to anyone with access to the Internet.

Supplementary material:

Details of all the Smith Woodward type specimens, including images, are available at
http://www.geolsoc.org.uk/SUP18874
Cephalic phase secretion of insulin and other enteropancreatic hormones in humans
Authors: Veedfald Simon , Plamboeck Astrid , Deacon Carolyn F. , Hartmann Bolette , Knop Filip K. , Vilsbøll Tina , Holst Jens J.
Published: October 2015

Enteropancreatic hormone secretion is thought to include a cephalic phase, but the evidence in humans is ambiguous. We studied vagally induced gut hormone responses with and without muscarinic blockade in 10 glucose-clamped healthy men (age: 24.5 ± 0.6 yr, means ± SE; body mass index: 24.0 ± 0.5 kg/m2; HbA1c: 5.1 ± 0.1%/31.4 ± 0.5 mmol/mol). Cephalic activation was elicited by modified sham feeding (MSF, aka “chew and spit”) with or without atropine (1 mg bolus 45 min before MSF + 80 ng·kg−1·min−1 for 2 h). To mimic incipient prandial glucose excursions, glucose levels were clamped at 6 mmol/l on all days. The meal stimulus for the MSF consisted of an appetizing breakfast. Participants (9/10) also had a 6 mmol/l glucose clamp without MSF. Pancreatic polypeptide (PP) levels rose from 6.3 ± 1.1 to 19.9 ± 6.8 pmol/l (means ± SE) in response to MSF and atropine lowered basal PP levels and abolished the MSF response. Neither insulin, C-peptide, glucose-dependent insulinotropic polypeptide (GIP), nor glucagon-like peptide-1 (GLP-1) levels changed in response to MSF or atropine. Glucagon and ghrelin levels were markedly attenuated by atropine prior to and during the clamp: at t = 105 min on the atropine (ATR) + clamp (CLA) + MSF compared with the saline (SAL) + CLA and SAL + CLA + MSF days; baseline-subtracted glucagon levels were −10.7 ± 1.1 vs. −4.0 ± 1.1 and −4.7 ± 1.9 pmol/l (means ± SE), P < 0.0001, respectively; corresponding baseline-subtracted ghrelin levels were 303 ± 36 vs. 39 ± 38 and 3.7 ± 21 pg/ml (means ± SE), P < 0.0001. Glucagon and ghrelin levels were unaffected by MSF. Despite adequate PP responses, a cephalic phase response was absent for insulin, glucagon, GLP-1, GIP, and ghrelin.
Cardioprotective adaptation of rats to intermittent hypobaric hypoxia is accompanied by the increased association of hexokinase with mitochondria
Authors: Waskova-Arnostova Petra , Elsnicova Barbara , Kasparova Dita , Hornikova Daniela , Kolar Frantisek , Novotny Jiri , Zurmanova Jitka
Published: October 2015

Chronic hypoxia increases the myocardial resistance to acute ischemia-reperfusion injury by affecting the mitochondrial redox balance. Hexokinase (HK) bears a high potential to suppress the excessive formation of reactive oxygen species because of its increased association with mitochondria, thereby inhibiting the membrane permeability transition pore opening and preventing cell death. The purpose of this study was to determine the effect of severe intermittent hypobaric hypoxia (7,000 m, 8 h/day, 5 wk) on the function and colocalization of HK isoforms with mitochondria in the left (LV) and right ventricles of rat myocardium. The real-time RT-PCR, Western blot, enzyme coupled assay, and quantitative immunofluorescence techniques were used. Our results showed significantly elevated expression of HK isoforms (HK1 and HK2) in the hypoxic LV. In addition, intermittent hypoxia increased the total HK activity and the association of HK isoforms with mitochondria in both ventricles. These findings suggest that HK may contribute to the cardioprotective phenotype induced by adaptation to severe intermittent hypobaric hypoxia.
Bortezomib Improves Adoptive T-cell Therapy by Sensitizing Cancer Cells to FasL Cytotoxicity
Authors: Shanker Anil , Pellom Samuel T. , Dudimah Duafalia F. , Thounaojam Menaka C. , de Kluyver Rachel L. , Brooks Alan D. , Yagita Hideo , McVicar Daniel W. , Murphy William J. , Longo Dan L. , Sayers Thomas J.
Published: October 2015

Cancer immunotherapy shows great promise but many patients fail to show objective responses, including in cancers that can respond well, such as melanoma and renal adenocarcinoma. The proteasome inhibitor bortezomib sensitizes solid tumors to apoptosis in response to TNF-family death ligands. Because T cells provide multiple death ligands at the tumor site, we investigated the effects of bortezomib on T-cell responses in immunotherapy models involving low-avidity antigens. Bortezomib did not affect lymphocyte or tissue-resident CD11c+CD8+ dendritic cell counts in tumor-bearing mice, did not inhibit dendritic cell expression of costimulatory molecules, and did not decrease MHC class I/II-associated antigen presentation to cognate T cells. Rather, bortezomib activated NF-κB p65 in CD8+ T cells, stabilizing expression of T-cell receptor CD3ζ and IL2 receptor-α, while maintaining IFNγ secretion to improve FasL-mediated tumor lysis. Notably, bortezomib increased tumor cell surface expression of Fas in mice as well as human melanoma tissue from a responsive patient. In renal tumor-bearing immunodeficient Rag2−/− mice, bortezomib treatment after adoptive T-cell immunotherapy reduced lung metastases and enhanced host survival. Our findings highlight the potential of proteasome inhibitors to enhance antitumor T-cell function in the context of cancer immunotherapy. Cancer Res; 75(24); 5260–72. ©2015 AACR.
СТРАТЕГІЯ СТВОРЕННЯ ТА ОЦІНЮВАННЯ ФУНКЦІОНУВАННЯ СИСТЕМ УПРАВЛІННЯ ЯКІСТЮ МЕДИЧНОЇ ОСВІТИ. ПЕРШЕ ПОВІДОМЛЕННЯ. ПОСТАНОВКА ПРОБЛЕМИ
Authors: Mintser O. P. , Tolstanov О. K. , Zagoriy G. V. , Kalyta T. P.
Published: October 2015

The article is devoted to functioning of the quality management by ISO 9001 standard. The problem of inefficient and non-working systems is pointed out, the causes of their inefficiency are investigated. The phenomenon of simultaneous existence of two parallel management systems: formal quality management system and living systems of managerial decisions making is studied. To study this situation the measure of «efficiency of quality management system» is introduced; further tasks for creating indicators and mechanisms for its evaluation are defined.
ЗАХИСТ ПЕРСОНАЛЬНИХ ДАНИХ ІНФОРМАЦІЙНО-ОСВІТНЬОГО ПРОСТОРУ
Authors: Yaremenko N. V.
Published: October 2015

The article deals with the concept of information and educational space, analyzes the advantages and disadvantages of it in modern terms. There is presented the issue of creating a regulatory and legal framework for the protection of personal data information and educational portal.
МЕХАНІЗМИ ПЕРВІСНОЇ РЕЦЕПЦІЇ ЕЛЕКТРОМАГНІТНИХ ХВИЛЬ ОПТИЧНОГО ДІАПАЗОНУ ЯК БІОФІЗИЧНА ОСНОВА ТЕРАПІЇ ПОЛЯРИЗОВАНИМ СВІТЛОМ
Authors: Hulyar S. O.
Published: October 2015

An existence of separate functional system of electromagnetic balance regulation has been substantiated and a working conception of light puncture has been formulated. As a basis, there is a possibility to use the acupuncture points for input of biologically necessary electromagnetic waves into the system of their conductors in a body that might be considered as a transport facility for energy ofthe polarized electromagnetic waves. Zones-recipients are organs having an electromagnetic disbalance due to excess of biologically inadequate radiation and being the targets for peroxide oxidation, foremost, a body has the neurohormonal and immune regulatory systems. Electromagnetic stimulation or modification of functions of the zones-recipients determines achievement of therapeutic and useful effects, and their combination with local reparative processes allows attaining a clinical goal. We represent own and literary experimental data about development of physiological responses (analgesia, bronchospasm control, immune stimulation and inhibition of peroxide oxidation of lipids) to BIOPTRON-light exposure on the acupuncture points or biologically active zones. We show the experimental facts in support of a hypothesis that a living organism can perceive an action of the electromagnetic waves of optical range not only via the visual system, but also through the off-nerve receptors (specific energy-sensitive proteins detecting critical changes of energy in cells and functioning as the "sensory" cell systems), as well as via the acupuncture points. This confirms an important role of the electromagnetic waves of optical range in providing normal vital functions of living organisms. A current approach to BIOPTRON light therapy consists in combined (local and system) exposure of the electromagnetic waves within the biologically necessary range.
ОГЛЯД ОКРЕМИХ МАТЕМАТИЧНИХ МЕТОДІВ ТА АЛГОРИТМІВ ОПРАЦЮВАННЯ МЕДИЧНИХ ЗОБРАЖЕНЬ НА ПРИКЛАДІ ТЕХНОЛОГІЇ ВОЛЬФРАМ МАТЕМАТИКА (MEDICAL IMAGE PROCESSING)
Authors: Prokopchenko О. E.
Published: October 2015

The article analyzes the basic methods and algorithms of mathematical processing of medical images as objects of computer mathematics. The presented methods and computer algorithms of mathematics relevant and may find application in the field of medical imaging - automated processing of images; as a tool for measurement and determination the optical parameters; identification and formation of medical images database.

Methods and computer algorithms presented in the article & based on Wolfram Mathematica are also relevant to the problem of modern medical education. As an example of Wolfram Mathematica may be considered appropriate demonstration, such as recognition of special radiographs and morphological imaging. These methods are used to improve the diagnostic significance and value of medical (clinical) research and can serve as an educational interactive demonstration.

Implementation submitted individual methods and algorithms of computer Wolfram Mathematics contributes, in general, the optimization process of practical processing and presentation of medical images.
ІНФОРМАТИЗАЦІЯ ЗАКЛАДІВ ОХОРОНИ ЗДОРОВ'Я ЯК ОСНОВА ЕФЕКТИВНИХ КОМУНІКАЦІЙ В СИСТЕМІ ОХОРОНИ ЗДОРОВ'Я
Authors: Znamenska M. A. , Slabkiy G. O.
Published: October 2015

A low level of computerization of primary and secondary health care and a higher level in tertiary health care is shown. At the same time a low level of Internet access in primary health care institutions and much higher - in institutions of secondary and tertiary levels of health care is shown. The current level of informatization does not allow health care institutions to implement an effective system of communication in healthcare.
ПРОГРАМНИЙ КОМПЛЕКС ДЛЯ ОБРОБКИ СИНХРОННО ЗАРЕЄСТРОВАНИХ БІОСИГНАЛІВ У ПОЛІГРАФАХ
Authors: Sverstyuk A. S. , Kravets N. O. , Kasyanyuk V. P.
Published: October 2015

The work described a software package, which provides the compatible statistical processing simultaneously registered in the polygraph biosignals based on a model vector cyclical rhythm associated random processes.
ПРО ПЕРСПЕКТИВИ ШИРШОГО ВИКОРИСТАННЯ ПОНЯТЬ КОМПЛЕМЕНТАРНОСТІ ТА КОНГРУЕНТНОСТІ В ПРАКТИЧНІЙ МЕДИЦИНІ
Authors: Mintser O. P. , Babintseva L. Yu.
Published: October 2015

It was discussed the possibility of widespread use of the complementarity and congruence concepts in medicine. It is proposed to use a simple functional to formalize therapeutic strategy is a reflection of the diagnostic and follow-conformal mapping conclusion of the insurance operations.
ДОСЛІДЖЕННЯ АВТОНОМНОЇ РЕГУЛЯЦІЇ СЕРЦЕВОГО РИТМУ МОЛОДИХ ЩУРІВ ПРИ ПОЄДНАНОМУ ВПЛИВІ ГІПОКСИЧНОЇ АТМОСФЕРИ Й МЕЛАТОНІНУ
Authors: Volkova N. M.
Published: October 2015

The combination of a number of adverse factors as the effect of hypoxic atmosphere, mental work and emotional stress, creates conditions for the development of maladaptive changes in the regulatory systems of the body. changes in autonomic regulation of cardiac cycle of rats under hypoxic atmosphere combined influence and melatonin were studied. The aim of the study was to identify the role of melatonin as factor of biorhythms synchronization in the impact on autonomous regulation of heart rate in young and adult rats with hypoxic incubation environment under conditions of low atmospheric pressure.

The use of melatonin drug in therapeutic doses in adults, after the completion of puberty, may be useful for the prevention of meteotropic reactions and improve the efficiency of the organism in adverse weather conditions, type III.
ВИЗНАЧЕННЯ ОСОБЛИВОСТЕЙ ГЕНОТИПІВ У ЖІНОК З ГЕНІТАЛЬНИМ ЕНДОМЕТРІОЗОМ ТА ФІБРОЗНО-КІСТОЗНОЮ МАСТОПАТІЄЮ ТА ЇХ РОЛЬ У ТЯЖКОСТІ ПЕРЕБІГУ ЗАХВОРЮВАННЯ
Authors: Malanchuk L. M. , Martinyuk V. M.
Published: October 2015

The scientific work is devoted to the urgent problem of our time - dishormonal disease of the female reproductive system, namely endometriosis and fibrosis-cystic mastitis. During the last years there has been a steady increase in the dual pathology of genital and breast diseases. According to statistics dishormonal frequency of breast diseases in the population of the female population suffering from various gynecological diseases varies between 76-98 %. It is known that the risk of this disease is closely associated with some alleles detoxification system, glutathione family - S- transferase and proonkogenom p 53, characterized by significant polymorphism. The article presents the results of research on the role of deletion variants of genes GSTT1, GSTM1 and p 53 in the development of endometriosis and fibrosis-cystic mastitis. Screening populations on carriage of alleles reveals women who are likely to develop these diseases and choose the most effective tactics of medical treatment in the event of the disease.
PCSK9 Induces CD36 Degradation and Affects Long-Chain Fatty Acid Uptake and Triglyceride Metabolism in Adipocytes and in Mouse Liver
Authors: Demers Annie , Samami Samaneh , Lauzier Benjamin , Des Rosiers Christine , Sock Emilienne Tudor Ngo , Ong Huy , Mayer Gaetan
Published: October 2015

Objective—

Proprotein convertase subtilisin/kexin type 9 (PCSK9) promotes the degradation of the low-density lipoprotein receptor thereby elevating plasma low-density lipoprotein cholesterol levels and the risk of coronary heart disease. Thus, the use of PCSK9 inhibitors holds great promise to prevent heart disease. Previous work found that PCSK9 is involved in triglyceride metabolism, independently of its action on low-density lipoprotein receptor, and that other yet unidentified receptors could mediate this effect. Therefore, we assessed whether PCSK9 enhances the degradation of CD36, a major receptor involved in transport of long-chain fatty acids and triglyceride storage.

Approach and Results—

Overexpressed or recombinant PCSK9 induced CD36 degradation in cell lines and primary adipocytes and reduced the uptake of the palmitate analog Bodipy FL C
16
and oxidized low-density lipoprotein in 3T3-L1 adipocytes and hepatic HepG2 cells, respectively. Surface plasmon resonance, coimmunoprecipitation, confocal immunofluorescence microscopy, and protein degradation pathway inhibitors revealed that PCSK9 directly interacts with CD36 and targets the receptor to lysosomes through a mechanism involving the proteasome. Importantly, the level of CD36 protein was increased by >3-fold upon small interfering RNA knockdown of endogenous PCSK9 in hepatic cells and similarly increased in the liver and visceral adipose tissue of
Pcsk9
−/−
mice. In
Pcsk9
−/−
mice, increased hepatic CD36 was correlated with an amplified uptake of fatty acid and accumulation of triglycerides and lipid droplets.

Conclusions—

Our results demonstrate an important role of PCSK9 in modulating the function of CD36 and triglyceride metabolism. PCSK9-mediated CD36 degradation may serve to limit fatty acid uptake and triglyceride accumulation in tissues, such as the liver.
Dual Labeling Biotin Switch Assay to Reduce Bias Derived From Different Cysteine Subpopulations
Authors: Chung Heaseung Sophia , Murray Christopher I. , Venkatraman Vidya , Crowgey Erin L. , Rainer Peter P. , Cole Robert N. , Bomgarden Ryan D. , Rogers John C. , Balkan Wayne , Hare Joshua M. , Kass David A. , Van Eyk Jennifer E.
Published: October 2015

Rationale:

S-nitrosylation (SNO), an oxidative post-translational modification of cysteine residues, responds to changes in the cardiac redox-environment. Classic biotin-switch assay and its derivatives are the most common methods used for detecting SNO. In this approach, the labile SNO group is selectively replaced with a single stable tag. To date, a variety of thiol-reactive tags have been introduced. However, these methods have not produced a consistent data set, which suggests an incomplete capture by a single tag and potentially the presence of different cysteine subpopulations.

Objective:

To investigate potential labeling bias in the existing methods with a single tag to detect SNO, explore if there are distinct cysteine subpopulations, and then, develop a strategy to maximize the coverage of SNO proteome.

Methods and Results:

We obtained SNO-modified cysteine data sets for wild-type and S-nitrosoglutathione reductase knockout mouse hearts (S-nitrosoglutathione reductase is a negative regulator of S-nitrosoglutathione production) and nitric oxide–induced human embryonic kidney cell using 2 labeling reagents: the cysteine-reactive pyridyldithiol and iodoacetyl based tandem mass tags. Comparison revealed that <30% of the SNO-modified residues were detected by both tags, whereas the remaining SNO sites were only labeled by 1 reagent. Characterization of the 2 distinct subpopulations of SNO residues indicated that pyridyldithiol reagent preferentially labels cysteine residues that are more basic and hydrophobic. On the basis of this observation, we proposed a parallel dual-labeling strategy followed by an optimized proteomics workflow. This enabled the profiling of 493 SNO sites in S-nitrosoglutathione reductase knockout hearts.

Conclusions:

Using a protocol comprising 2 tags for dual-labeling maximizes overall detection of SNO by reducing the previously unrecognized labeling bias derived from different cysteine subpopulations.
Time-Resolved C-Arm Computed Tomographic Angiography Derived From Computed Tomographic Perfusion Acquisition
Authors: Yang Pengfei , Niu Kai , Wu Yijing , Struffert Tobias , Dorfler Arnd , Schafer Sebastian , Royalty Kevin , Strother Charles , Chen Guang-Hong
Published: October 2015

Background and Purpose—

Multimodal imaging using cone beam C-arm computed tomography (CT) may shorten the delay from ictus to revascularization for acute ischemic stroke patients with a large vessel occlusion. Largely because of limited temporal resolution, reconstruction of time-resolved CT angiography (CTA) from these systems has not yielded satisfactory results. We evaluated the image quality and diagnostic value of time-resolved C-arm CTA reconstructed using novel image processing algorithms.

Methods—

Studies were done under an Institutional Review Board approved protocol. Postprocessing of data from 21 C-arm CT dynamic perfusion acquisitions from 17 patients with acute ischemic stroke were done to derive time-resolved C-arm CTA images. Two observers independently evaluated image quality and diagnostic content for each case. ICC and receiver-operating characteristic analysis were performed to evaluate interobserver agreement and diagnostic value of this novel imaging modality.

Results—

Time-resolved C-arm CTA images were successfully generated from 20 data sets (95.2%, 20/21). Two observers agreed well that the image quality for large cerebral arteries was good but was more limited for small cerebral arteries (distal to M1, A1, and P1). receiver-operating characteristic curves demonstrated excellent diagnostic value for detecting large vessel occlusions (area under the curve=0.987–1).

Conclusions—

Time-resolved CTAs derived from C-arm CT perfusion acquisitions provide high quality images that allowed accurate diagnosis of large vessel occlusions. Although image quality of smaller arteries in this study was not optimal ongoing modifications of the postprocessing algorithm will likely remove this limitation. Adding time-resolved C-arm CTAs to the capabilities of the angiography suite further enhances its suitability as a one-stop shop for care for patients with acute ischemic stroke.
Becoming Visible: The Role of the Internet in Dress Choices among Native-Born Converts to Islam in North America
Authors: Akou Heather
Published: October 2015

Although hijab is just one facet of Islam (and from a theological perspective, not the most important), many native-born converts in North America—especially women—appear to struggle with it: what to wear; what to think about hijab; how to make the transition and how it affects their interactions with non-Muslims, including employers, close friends and family members. How can converts align their appearance with the values of their faith, especially in the context of negative stereotypes following 9/11? Much like patients with rare medical disorders, converts living outside the Dar al-Islam can use the Internet to overcome isolation and a lack of local support. This chapter will consider the kinds of resources available through the Internet, particularly blogs, videos, retail websites and multi-user “boards”. Data for this chapter comes from my own experience with conversion to Islam as well as an ongoing virtual ethnography concerning the growing Islamic fashion industry.
Sexuality, Difference, and American Hijabi Bloggers
Authors: Robinson Rebecca S.
Published: October 2015

This article uses qualitative content analysis to explore some themes associated with perspectives on sexuality and multicultural difference on American hijabi fashion blogs. These themes include tensions within the community, the American Muslim identity and Muslim women’s purposes for veiling and blogging about fashion. This paper frames the American hijabi fashion community as a counterculture movement that focuses on Islamically based objections to the commodification of women’s sexuality in the mainstream fashion and media industries. It also discusses disagreements within Muslim communities such as conceptualizations of awrah and hijab, the connections between veiling and empowerment, the tolerance of the American society and perspectives on the modern-traditional binary. The paper concludes with a discussion of how socioeconomic factors may allow “safe Muslims” such as hijabi fashion bloggers to assimilate into mainstream culture while excluding working class Muslims and how the hijab could create barriers to inclusion within Muslim communities.
Al-Huda International
Authors: Sanyal Usha
Published: October 2015

Al-Huda International was founded in Islamabad in 1994 by Farhat Hashmi and has since spread across several continents. Its rapid spread has been considerably aided by the online classes in English and Urdu from its headquarters in Canada. Its goal is to teach the Qur’an in Arabic to as many women as possible so they can access the sacred text directly without mediation and live in greater harmony with Qur’anic values. One might argue that Al-Huda uses a very “modern” technology, the Internet, to promote “traditional” religious values. But online students’ mastery of Arabic and intensive study of Islamic history and theology, my study argues, simultaneously gives them voice and a sense of empowerment, thereby challenging both traditional Islamic authority structures and Western representations of Muslim women. In this study, based on research grounded in participant observation as a former online student at Al-Huda, I provide an ethnographic portrait of the online learning experience.