bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of a surface magnet in the extraction of another magnet aspirated into the bronchus of a 7-year-old girl
Authors: Narang Sumeet , Joshi Jayateertha , Vasudevarao Sunil Baikadi , Rao Suchetha
Published: August 2019

A 7-year-old girl presented to the emergency room (ER) with alleged history of aspiration of a toy magnet. The challenge was to safely extract the foreign body. A bronchoscopic approach with forceps, or Dormia basket, or Fogarty catheter, was considered, but these approaches had disadvantages, such as slipping or impaction of the object, and oxygen desaturation. Applying principles of removal of intraocular metallic objects in ophthalmologic surgery using magnetism, the object was removed with the help of another larger surface magnet. The location of the foreign body was confirmed by bronchoscopy. A Fogarty catheter was introduced distal to the object, under bronchoscopic guidance. A strong surface magnet was then placed on the surface of the chest and under C-arm guidance, the object was moved from the bronchus to the trachea. Once at the vocal cords, the Fogarty catheter was inflated to prevent it from slipping back and the magnet was extracted using forceps.
Responsive Asthma Care for Teens (ReACT): development protocol for an adaptive mobile health intervention for adolescents with asthma
Authors: Cushing Christopher C , Fedele David A , Patton Susana R , McQuaid Elizabeth L , Smyth Joshua M , Prabhakaran Sreekala , Gierer Selina , Koskela-Staples Natalie , Ortega Adrian , Fleming Kandace K , Nezu Arthur M
Published: August 2019

Introduction

Asthma is a leading cause of youth morbidity in the USA, affecting >8% of youth. Adherence to inhaled corticosteroids (ICS) can prevent asthma-related morbidity; however, the typical adolescent with asthma takes fewer than 50% of their prescribed doses. Adolescents are uniquely vulnerable to suboptimal asthma self-management due to still-developing executive functioning capabilities that may impede consistent self-regulation and weaken attempts to use problem solving to overcome barriers to ICS adherence.

Methods and analysis

The aims of this project are to improve adherence to ICS as an important step towards better self-management among adolescents aged 13–17 years diagnosed with asthma by merging the efficacious behaviour change strategies found in behavioural health interventions with scalable, adaptive mobile health (mHealth) technologies to create the Responsive Asthma Care for Teens programme (ReACT). ReACT intervention content will be developed through an iterative user-centred design process that includes conducting (1) one-on-one interviews with 20 teens with asthma; (2) crowdsourced feedback from a nationally representative panel of 100 adolescents with asthma and (3) an advisory board of youth with asthma, a paediatric pulmonologist and a behavioural health expert. In tandem, we will work with an existing technology vendor to programme ReACT algorithms to allow for tailored intervention delivery. We will conduct usability testing of an alpha version of ReACT with a sample of 20 target users to assess acceptability and usability of our mHealth intervention. Participants will complete a 4-week run-in period to monitor their adherence with all ReACT features turned off. Subsequently, participants will complete a 4-week intervention period with all ReACT features activated. The study started in October 2018 and is scheduled to conclude in late 2019.

Ethics and dissemination

Institutional review board approval was obtained at the University of Kansas and the University of Florida. We will submit study findings for presentation at national research conferences that are well attended by a mix of psychologists, allied health professionals and physicians. We will publish study findings in peer-reviewed journals read by members of the psychology, nursing and pulmonary communities.
Long-term psychological recovery process and its associated factors among survivors of the Great Hanshin-Awaji Earthquake in Japan: a qualitative study
Authors: Tanaka Eizaburo , Tennichi Honami , Kameoka Satomi , Kato Hiroshi
Published: August 2019

Objectives

The 1995 Great Hanshin-Awaji Earthquake had an enormous negative impact on survivors’ health. Many survivors experienced psychological distress and their long-term psychological recovery process remains unclear. Our objective was thus to explore this long-term psychological recovery process.

Design

Qualitative study.

Setting

From January to December 2015, face-to-face interviews were conducted in Kobe, Japan.

Participants

20 affected survivors (55% female; ages ranged from 7 to 60 at the time of the disaster)—10 volunteer storytellers, six first responders (firefighters/public health nurses) and four post-traumatic stress disorder patients.

Outcome measures

We asked participants about their experiences and psychological distress relating to the earthquake and what facilitated or hindered their psychological recovery. We analysed interview data using constructivist grounded theory.

Results

Participants experienced diverse emotional reactions immediately after the disaster and often hyperfocused on what they should do now. This hyperfocused state led to both mental and physical health problems several months after the disaster. Months, and sometimes years, after the disaster, guilt and earthquake narratives (ie, expressing thoughts and feelings about the earthquake) played key roles in survivors’ psychological recovery: guilt suppressed their earthquake narrative; conversely, the narrative alleviated feelings of distress about the earthquake. In time, participants reconsidered their earthquake experiences both alone and through social interaction. This alleviated their emotional reactions; however, participants still experienced attenuated emotional reactions, and some hid their feelings of distress even 20 years postdisaster. Interpersonal relationships modified this psychological process both positively and negatively.

Conclusions

Future psychosocial support plans for disaster survivors may need to (1) include both mental and physical care in the transition from the acute phase to the recovery phase; (2) facilitate supportive interpersonal relationships for survivors during the mid-term recovery phase and (3) provide long-term psychological support to the most traumatised survivors, even if they appear to be functioning normally.
The Portrait Depiction of the Market Members Based on Data Mining
Authors: Guan Jinlan , Tang Cuifang , Ou Jiequan
Published: August 2019

Aiming at the problem of portrait of members in shopping malls, this paper analyzes the similarities and differences of consumption behaviors between member groups and nonmember groups, and constructs the LRFMC model with [Formula: see text]-means algorithm to analyze the value of membership. Second, active states of members are divided according to the consumption time interval, and KNN algorithm model is established to predict member states and used to predict the membership status. Finally, it discusses which types of goods are more suitable for promotional activities and can bring more profits to the shopping mall.
A Nordhaus–Gaddum bound for Roman domination
Authors: Rad Nader Jafari , Rahbani Hadi
Published: August 2019

A Roman dominating function of a graph [Formula: see text] is a labeling [Formula: see text] such that every vertex with label [Formula: see text] has a neighbor with label [Formula: see text]. The Roman domination number, [Formula: see text] of [Formula: see text], is the minimum of [Formula: see text] over such functions. Let [Formula: see text] be an [Formula: see text]-vertex graph. Chambers et al. [E. W. Chambers, B. Kinnersley, N. Prince and D. B. West, External Problems for Roman domination Siam J. Discrete Math. 23 (2009) 1575–1586.] proved that if [Formula: see text] is a connected graph of order [Formula: see text], then [Formula: see text], with equality if and only if [Formula: see text] or [Formula: see text] is [Formula: see text] or [Formula: see text]. In this paper, we construct a specific family of graphs [Formula: see text], and prove that if [Formula: see text] and [Formula: see text], then [Formula: see text], and this bound is sharp.
Transpression and the build-up of the Cordillera: the example of the Bucaramanga fault (Eastern Cordillera, Colombia)
Authors: Siravo Gaia , Fellin Maria Giuditta , Faccenna Claudio , Maden Colin
Published: August 2019

Widespread wrench tectonics have been described along the northern Andes. The Bucaramanga fault, described as sinistral strike-slip, bounds the high Santander Massif. We combine structural and thermochronological data from the central-southern portion of the fault to investigate the vertical displacement. The structural survey data show old phases of activity preserved in the host rocks along the fault trace, with the superimposition of different generations of slickenlines, and both strike-slip and dip-slip kinematics indicators. New and previous thermochronological data show that differential exhumation of the fault walls has been ongoing for the last 50 Ma. The hanging wall, the Santander Massif, records, in the central portion, decreasing exhumation rates from the early Miocene to the mid- to late Miocene and, in the southern portion, constant rates from the Late Oligocene to the Pliocene. Combining such observations, the thermochronological offset resulting from the relative motion of the two fault walls is comparable with the observed drop in elevation across the fault, suggesting that the present topography of the Santander Massif is related to vertical movement along the Bucaramanga fault. We infer that the fault has a significant Neogene reverse component, consistent with the present day horizontal global positioning system vector data, long-term exhumation rates and the structural assemblage.

Supplementary Material:
The Supplementary Materials contain methodological information on the thermochronological procedures, a compilation of the previously published data used in this study and the structural geology dataset,
https://doi.org/10.6084/m9.figshare.c.4620140
Data Transparency with Blockchain and AI Ethics
Authors: Bertino Elisa , Kundu Ahish , Sura Zehra
Published: August 2019

Providing a 360° view of a given data item especially for sensitive data is essential toward not only protecting the data and associated privacy but also assuring trust, compliance, and ethics of the systems that use or manage such data. With the advent of General Data Protection Regulation, California Data Privacy Law, and other such regulatory requirements, it is essential to support data transparency in all such dimensions. Moreover, data transparency should not violate privacy and security requirements. In this article, we put forward a vision for how data transparency would be achieved in a de-centralized fashion using blockchain technology.
LINC00319 acts as a microRNA-335–5p sponge to accelerate tumor growth and metastasis in gastric cancer by upregulating ADCY3
Authors: Zou Jun , Wu Kun , Lin Chao , Jie Zhi-Gang
Published: August 2019

Gastric cancer (GC) is one of the most common cancers in the world and remains a heavy burden of health worldwide. Adenylate cyclase 3 ( ADCY3) is a widely expressed membrane-associated protein in human tissues and has been identified to be a new molecular target of GC. Long noncoding RNAs have a substantial influence on tumorigenesis and progression of tumors by binding to microRNAs. Therefore, this study is to clarify the mechanism by which LINC00319 sponges micro RNA-335–5p ( miR-335–5p) to influence the development of GC. Initially, microarray analysis identified GC-related differentially expressed LINC00319 and ADCY3 for this study. The interaction was confirmed that LINC00319 interacted with miR-335–5p to regulate ADCY3. Next, SGC-7901 cells presenting with the lowest LINC00319 expression and the highest miR-335–5p expression were transfected with LINC00319, miR-335–5p inhibitor, or ADCY3 vector to examine their roles in growth and metastasis of GC cells, which was further ascertained by in vivo experiments. LINC00319 was upregulated and miR-335–5p was downregulated in GC cells. LINC00319 overexpression, miR-335–5p inhibitor, or ADCY3 overexpression was shown to significantly elevate the expression of cyclin-dependent kinase 4 and metastasis associated 1, decrease that of growth arrest-specific 1, and promote tumor growth and metastasis by increasing proliferation and migration and reducing cell apoptosis. Importantly, it was found that overexpressed miR-335–5p exerted its tumor suppressive role in GC through downregulating ADCY3. Collectively, LINC00319 expedited growth and metastasis of GC by upregulating miR-335–5p-mediated ADCY3.

NEW & NOTEWORTHY This study is carried out based on in vivo and in vitro studies in mice and gastric cancer (GC) cells with the aim of clarifying the role of LINC00319 on GC growth and metastasis, which associated with micro RNA-335–5p-mediated adenylate cyclase 3. Altogether, we identified LINC00319 to be a potential therapy to treat GC.
Entropy Generation Analysis of Peristaltic Flow and Heat Transfer of a Jeffery Nanofluid in a Horizontal Channel under Magnetic Environment
Authors: Bibi Aneela , Xu Hang
Published: August 2019

A mathematical model is developed to examine the behaviors of a peristalsis flow with nanoparticles in a symmetric channel under the magnetic environment. Here, the nanofluid is electrically conducted through an external magnetic field. Thermal radiation and Joule heating effects are also retained in the present analysis. Under the lubrication approach, the reduced nonlinear systems are obtained. Then, they are solved very efficiently by means of a homotopy analysis method‐based package BVPh 2.0. The influences of important physical parameters on the flow behaviors are presented. Analysis of the entropy generation is illustrated. It is found that the Brownian diffusion and the thermophoresis are the two most important nanoparticle slip mechanisms in the Jeffery fluids as well. Besides, the Hartman number, the type of the Jeffery fluid, the Brinkman number, and the thermal radiation parameter play important roles on flow behaviors. Results show that the temperature profile enhanced but the nanoparticles’ volume fraction profiles lowered with increase in the Hartman number. However, using the Jeffery nanofluid induces effect on the velocity distribution that decreases with the increase in the Jeffery fluid parameter. It is also found that the generated total entropy increases with an increase in the Brownian motion parameter but with a decrease in the thermophoresis parameter.
Hairy Cell Leukemia Masquerading as Pancytopenia in Pregnancy
Authors: Shackleton Louisa , Langabeer Stephen E. , O’Brien David , McCarron Sarah L. , Byrne Bridgette , Barry Rupert , Flavin Richard , Bacon C. Larry , Flynn Catherine M.
Published: August 2019

Thrombocytopenia is one of the most common hematological abnormalities observed during pregnancy, and in rare cases, this may be the first indicator of an underlying hematological malignancy. Hairy cell leukemia (HCL) is an uncommon B-cell lymphoproliferative disorder of which thrombocytopenia is a recurrent presenting feature. A case of pancytopenia presenting in pregnancy is described in which the thrombocytopenia persisted postpartum coincidental with a vesicular, pustular rash characterised as Sweet’s syndrome. Hematological, histological, immunophenotypic, and molecular investigations confirmed the presence of HCL. The patient was treated with cladribine resulting in resolution of Sweet’s syndrome, hematological remission from HCL, and achievement of a normal platelet count. This case highlights the need to maintain a wide differential diagnosis for presentations of pancytopenia or thrombocytopenia in pregnancy and the requirement for follow-up investigation of unusual cases with a lack of response to steroids or immunoglobulin.
Central Tendon-Splitting Approach and Double Row Suturing for the Treatment of Insertional Achilles Tendinopathy
Authors: Zhuang Ze , Yang Yang , Chhantyal Kishor , Chen Jianning , Yuan Guohui , Ni Yirong , Liu Dezhao , Shi Dehai
Published: August 2019

Background. To assess the clinical outcomes of central tendon-splitting approach and double row anchor suturing for the treatment of insertional Achilles tendinopathy. Methods. 28 patients (28 feet) diagnosed with insertional Achilles tendinopathy were included in this study. The inclusions were symptom of hindfoot pain around the insertion of the Achilles tendon, radiographic demonstration of calcification, or degeneration of the Achilles tendon, showing no symptom improvement even after standard nonsurgical treatment for more than six months. The X-ray revealed that patients had obvious posterior superior calcaneal exostosis with the possibility of friction with the Achilles tendon or intratendinous calcification. Surgical correction by the central tendon-splitting approach and double row Achilles tendon suturing was performed. The ankles were immobilized with plaster for four weeks postoperatively. The American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue score (VAS) were assessed preoperatively and at 2 years postoperatively. At final follow-up, the Manchester-Oxford Foot Questionnaire (MOXFQ) as patient-reported outcome measures (PROMs) was also evaluated. Results. No complication, including postoperative wound infection and tendon rupture, was not found. All the patients resumed their daily activities with no high level of daily activities, such as jumping and jogging after 6 weeks postoperatively. 27 patients were available for follow-up for at least 2 years, while only one patient was lost to follow-up. At postoperative 2 years, the postoperative AOFAS score increased significantly, while the VAS score decreased statistically when compared with preoperative values. At final follow-up, 24 patients had complete alleviation of pain, whereas the remaining 3 patients complained of mild heel pain after walking for a long time. The MOXFQ score showed obvious relief of previous symptoms for all included cases. Conclusions. Central tendon-splitting approach and double row Achilles tendon suture provide excellent intraoperative visual field, larger tendon-bone contact area, and stronger pullout strength and, thus, facilitate early rehabilitation. It can be a safe and effective method for the treatment of insertional Achilles tendinopathy.
Identifying a Novel DPYD Polymorphism Associated with Severe Toxicity to 5-FU Chemotherapy in a Saudi Patient
Authors: Bukhari Nedal , Azam Faisal , Alfawaz Mohammed , Zahrani Mohammed
Published: August 2019

Dihydropyrimidine dehydrogenase (DPD) is the major enzyme in the catabolism of 5-Fluorouracil (5-FU) and its prodrug capecitabine. We report a 65-year-old female with rectal adenocarcinoma who experienced severe toxicities secondary to standard dose 5-FU based chemotherapy. She was found to be heterozygous for rs371313778, c.2434G>A. This finding prompted restarting 5-FU at 50% dose reduction with further titration in subsequent cycles. We herein report the first case of rs371313778, c.2434G>A (p.Val812lle) DPYD polymorphism leading to severe 5-FU toxicities. The patient eventually completed a 6-month course of adjuvant treatment with modification of 5-FU dose.
Triggering WORM/SRAM Memory Conversion by Composite Oxadiazole in Polymer Resistive Switching Device
Authors: Zhao Enming , Liu Xiaodan , Liu Guangyu , Zhou Bao
Published: August 2019

Electrical characterization indicates that the nonvolatile write once read many (WORM) times/volatile static random access memory (SRAM) conversion was triggered by the composite of the oxadiazole small molecule. FTO/PMMA/Ag device possesses nonvolatile WORM memory behavior, while the FTO/PMMA+oxadiazole/Ag device shows vastly different volatile SRAM feature. The FTO/PMMA/Ag and FTO/PMMA+oxadiazole/Ag memory devices both exhibit high ON/OFF ratio nearly 104. The additive oxadiazole small molecule in the polymethyl methacrylate was suggested to form an internal electrode and serve as a channel during the charge transfer process, which is easy to both the charge transfer and back charge transfer, as a consequence, the WORM/SRAM conversion upon oxadiazole small molecule complexation was triggered. The results observed in this work manifest the significance of oxadiazole small molecule to the memory effects and will arouse the research interest about small molecule composite applied in memory devices.
Analysis of a Stochastic SIR Model with Vaccination and Nonlinear Incidence Rate
Authors: El Koufi Amine , Adnani Jihad , Bennar Abdelkrim , Yousfi Noura
Published: August 2019

We expand an SIR epidemic model with vertical and nonlinear incidence rates from a deterministic frame to a stochastic one. The existence of a positive global analytical solution of the proposed stochastic model is shown, and conditions for the extinction and persistence of the disease are established. The presented results are demonstrated by numerical simulations.
Targeting Autophagy in Cancer: Recent Advances and Future Directions
Authors: Amaravadi Ravi K. , Kimmelman Alec C. , Debnath Jayanta
Published: August 2019

Autophagy, a multistep lysosomal degradation pathway that supports nutrient recycling and metabolic adaptation, has been implicated as a process that regulates cancer. Although autophagy induction may limit the development of tumors, evidence in mouse models demonstrates that autophagy inhibition can limit the growth of established tumors and improve response to cancer therapeutics. Certain cancer genotypes may be especially prone to autophagy inhibition. Different strategies for autophagy modulation may be needed depending on the cancer context. Here, we review new advances in the molecular control of autophagy, the role of selective autophagy in cancer, and the role of autophagy within the tumor microenvironment and tumor immunity. We also highlight clinical efforts to repurpose lysosomal inhibitors, such as hydroxychloroquine, as anticancer agents that block autophagy, as well as the development of more potent and specific autophagy inhibitors for cancer treatment, and review future directions for autophagy research.

Significance:

Autophagy plays a complex role in cancer, but autophagy inhibition may be an effective therapeutic strategy in advanced cancer. A deeper understanding of autophagy within the tumor microenvironment has enabled the development of novel inhibitors and clinical trial strategies. Challenges and opportunities remain to identify patients most likely to benefit from this approach.
A Case Report of Clear Cell Chondrosarcoma (CCC) Sparing the Epiphysis and Literature Review of CCC
Authors: Hindiskere Suraj , Kim Yong Sung , Kim Han-Soo , Han Ilkyu
Published: August 2019

Clear cell chondrosarcoma (CCC) is a rare subtype of chondrosarcoma with a relatively low malignant potential, mainly diagnosed by its characteristic location in the epiphysis of long bones. We report the case of a 33-year-old gentleman who presented with pain, difficulty in walking and restricted range of motion of the right hip joint, with a lesion located in the proximal femoral metaphysis and completely sparing the epiphysis. Needle biopsy was consistent with CCC, which was extremely unusual considering the location of the tumour. The patient was treated by “en bloc” resection of the tumour along with femoral head and reconstruction with hemiarthroplasty. The final histopathology report confirmed the diagnosis with clear surgical margins. The aim of this case report and literature review was to highlight the unusual location of this rare tumour, as such an isolated case of CCC completely sparing the epiphysis has never been reported.
СУЧАСНІ ПОГЛЯДИ НА ІМУНОПАТОГЕНЕЗ ВІЛ-ІНФЕКЦІЇ ТА ТУБЕРКУЛЬОЗУ
Authors: Kolotylo T. R.
Published: August 2019

Мета роботи – базуючись на останніх світових дослідженнях, оцінити імунопатогенез ВІЛ-інфекції та туберкульозу (ТБ).

Наведено основні імунопатогенетичні механізми розвитку і прогресування ВІЛ-інфекції та туберкульозу, а також пояснені шляхи посилення ефекту їх поєднаної дії. З прогресуванням ВІЛ-інфекції зменшується кількість і порушується функціональна активність СD4+Т-лімфоцитів. У кістковому мозку посилюється синтез лімфоцитів і компенсаторно активується гуморальний імунітет. Хронічні хвороби або інфекції зумовлюють виснаження компенсаторних механізмів, унаслідок чого поступово знижується кількість лімфоцитів, ще більше порушується клітинний імунітет, а з порушенням функції В-лімфоцитів змінюється і гуморальна імунна відповідь.

Приєднання інтеркурентних захворювань у ВІЛ-інфікованих і хворих на ВІЛ-інфекцію залежить від стану клітинного і гуморального імунітету, рівня СD4+Т-лімфоцитів, зниження якого до 300 кл./мкл крові є визначальним фактором приєднання вторинної патології.

Наростання ураження імунної системи врешті-решт призводить до розвитку опортуністичних інфекцій. У цих умовах імунна система не може стримувати персистенцію мікобактерій туберкульозу (МБТ), що і спричинює розвиток клінічних форм ТБ. Значне пошкодження і зниження кількості СD4+Т-лімфоцитів у хворих з поєднаною ВІЛ/ТБ-інфекцією супроводжується значним ослабленням активності альвеолярних макрофагів, посиленим розмноженням в легенях МБТ, що сприяє їх дисемінації.
CИСТЕМА ДИСТАНЦІЙНОЇ ФОРМИ НАВЧАННЯ НА КАФЕДРІ ЗАГАЛЬНОЇ ХІМІЇ
Authors: Burmas N. I. , Boyko L. A.
Published: August 2019

Дистанційне навчання – інтерактивна взаємодія як між викладачем та студентами, так і між ними та інтерактивним джерелом інформаційного ресурсу (web-сторінки), яка відображає всі компоненти навчального процесу, що здійснюється в умовах реалізації засобів інформаційно-комп’ютерних технологій (комп’ютерна візуалізація навчальної інформації, інформаційно-пошукової діяльності, автоматизація процесів інформаційно-методичного забезпечення). У статті розглянуті основні поняття і характерні особливості дистанційного навчання в університеті, яке передбачає застосування двох форм: синхронної та асинхронної. Проводиться обґрунтування актуальності використання дистанційних технологій у навчанні. У статті виділено переваги дистанційного навчання для студентів: вільний графік проведення занять; одночасне проведення навчання з декількох дисциплін, можливо, в різних навчальних закладах; використання аудіо- та відеоматеріалів, мультимедіа. Основний акцент зроблений на особливостях організації дистанційного навчання на кафедрі за допомогою сучасних технологій та мультимедіа, що реалізується через такі компоненти, як: лекції (презентації та відеозаписи); практичні заняття (тестування в системі Moodle); спілкування викладача зі студентом.

Успішне створення і використання дистанційної освіти на кафедрі загальної хімії сприяє значному розширенню потенційних студентів, впровадженню нових технологій для передачі навчальної інформації та вдосконаленню педагогічної майстерності співробітників кафедри.
ШЛЯХИ ПІДВИЩЕННЯ ЯКОСТІ НАВЧАННЯ ІНОЗЕМНИХ СТУДЕНТІВ ВИЩОГО МЕДИЧНОГО НАВЧАЛЬНОГО
Authors: Кrytskyi I. O.
Published: August 2019

Якість вищої освіти є національним пріоритетом і передумовою національної безпеки України, додержання міжнародних норм і вимог законодавства Української держави щодо реалізації права громадян на освіту. На забезпечення якості вищої освіти спрямовують матеріальні, фінансові, кадрові та наукові ресурси суспільства й держави. Висока якість вищої освіти передбачає взаємозв’язок освіти і науки, теорії та практики. У статті оцінено результати впровадження нових методів для покращення якості навчання іноземних студентів у вищому медичному навчальному закладі. Використання цих технологій сприяє встановленню  особистості майбутнього лікаря та веде до  вдосконалення змісту, структури, форм і методів професійної підготовки студентів до виконання лікарської діяльності, визначення психолого-педагогічних умов підвищення якості їх навчання. Теоретичний аналіз дозволив нам використати  нову модель і включити в неї всі необхідні, на нашу думку, методи навчання для покращення навчання студентів.
ФОРМУВАННЯ КОМУНІКАТИВНОЇ КОМПЕТЕНТНОСТІ ЯК ФУНДАМЕНТАЛЬНОЇ СКЛАДОВОЇ ПРОФЕСІЇ ЛІКАРЯ
Authors: Haliyash N. B. , Bilkevych N. A. , Petrenko N. V.
Published: August 2019

У статті сформульовано сучасну концепцію професійної (медичної) комунікативної компетентності та запропоновано підходи для її ефективної імплементації в систему підготовки медичних кадрів.
Комунікативна компетентність медика розглядається як інтелектуально й мотиваційно обумовлена соціально-професійна характеристика, що базується на комунікативних здібностях, вміннях і знаннях та дозволяє лікарю самостійно й відповідально реалізовувати ефективні й адекватні комунікативні дії в конкретних ситуаціях міжособистісної взаємодії. Оволодіння комунікативною компетентністю в медицині передбачає засвоєння таких складових елементів, як ініціація спілкування, збір інформації, роз’яснення та планування діагностичних і лікувальних процедур, завершення розмови, застосування різних комунікативних методик тощо. Традиційно засвоєння навичок спілкування відбувалося після вивчення низки розрізнених теоретичних предметів на практиці за механізмом наслідування стилю поведінки лікарів-викладачів, які слугували взірцем. Втім, на сьогодні такий підхід має низку недоліків. Сучасний міжнародний досвід показує, що оволодіння даною компетентністю повинно починатися ще до початку роботи в клініці та вимагає виділення окремого циклу занять для формування початкових навичок спілкування, що і було впроваджено в 2018–19 навчальному році в ДВНЗ «Тернопільський державний медичний університет імені І. Я. Горбачевського МОЗ України», а також видано посібник «Комунікативні навички в медицині» для забезпечення теоретичної та методичної бази формування комунікативної компетентності студентів.
У сучасних умовах висококваліфікований фахівець, задля конкурентоспроможності на ринку праці, повинен досконало володіти комунікативними навичками. Здатність до ефективної комунікації є набутою, тому її необхідно розвивати та тренувати. Для досягання відповідності зростаючим вимогам щодо рівня володіння комунікативними навичками необхідна оптимізація навчальних програм та використання спеціальних педагогічних підходів при підготовці фахівців медичного профілю як на додипломному, так і на післядипломному рівні. Доцільним є розробка та впровадження наскрізної програми з медичної комунікації, що забезпечить методичний та системний підхід для трансформації теоретичних знань та початкових навичок спілкування у повноцінну комунікативну компетентність майбутнього фахівця медичного профілю.
ПРОБЛЕМИ ВИКОРИСТАННЯ ДОСВІДУ США З ОРГАНІЗАЦІЇ ПРОФЕСІЙНОЇ ПІДГОТОВКИ МАЙБУТНІХ ЛІКАРІВ: УКРАЇНСЬКИЙ КОНТЕКСТ
Authors: Horpinich T. I.
Published: August 2019

У статті обґрунтовано напрями врахування досвіду професійної підготовки лікарів США в медичній освіті Украї­ни. На основі порівняльного аналізу програмних документів, які регулюють українську й американську систему підготовки майбутніх лікарів, виокремлено такі рекомендації: послідовне впровадження принципу автономії навчальних закладів, стимулювання наукової діяльності в межах університетів через створення науково-дослідних центрів, впровадження обов’язкової дослідницької складової до навчальних планів медичних університетів, створення системи державного освітнього кредитування, субсидування громадян з малозабезпечених сімей для отримання ними професійної освіти; стимулювання співзасновництва і багатоканального фінансування закладів професійної освіти, впровадження чітких правил відбору та зарахування абітурієнтів, започаткування вступних іспитів для вищих медичних навчальних закладів, що включають тести для оцінки психологічних особли­востей та здібностей кандидатів, необхідних для майбутньої професійної діяльності, сприяння кооперації між навчальними і лікувально-діагностичними установами на всіх етапах професійної підготовки лікарів, утвердження концепції безперервного професійного розвитку та контроль за реальним її втіленням.
ESTABLISHMENT AND DEVELOPMENT OF MEDICAL EDUCATION AND SCIENCE IN THE WESTERN UKRAINE (XVIII - XIX CENTURY)
Authors: Prokop I. A. , Savaryn T. V.
Published: August 2019

The research analyses the history of development and organization of medical educational establishments in the Western Ukraine in the second half of XVIII–XIX century.

The article discusses the method of analysing bibliographic catalogues, classification and systematization of primary sources in History of Medicine and Pedagogy, and chronological method that identifies the establishment and development of medical education during different historical periods.

The paper describes the structure of medical education system in the Western Ukraine in the second half of XVIII–XIX century and summarizes available data about professional and scientific activity of the outstanding Ukrainian doctors of this period.

The main characteristics of medical education development in the mentioned historic period are: gradual increase in the number of medical establishments, medical departments, faculties, and students; improvement and transformation of medical personnel education and training.
СУЧАСНІ ТЕХНОЛОГІЇ ДЛЯ ОБ’ЄКТИВІЗАЦІЇ ТА СТАНДАРТИЗАЦІЇ ОЦІНЮВАННЯ ПРАКТИЧНИХ НАВИЧОК ЛІКАРІВ-ІНТЕРНІВ ХІРУРГІВ
Authors: Dolya O. S. , Yareshko N. O.
Published: August 2019

Реформа охорони здоров’я України, яка сьогодні відбувається, інтеграція вітчизняної медичної науки і практики у світову потребують від закладів медичної освіти підготовки сучасних медичних фахівців. Велике значення при цьому відіграє післядипломна медична освіта. Метою роботи було теоретичне обґрунтування методики об’єктивізації оволодіння практичними навичками лікаря-інтерна хірурга за період навчання в інтернатурі, використовуючи сучасні досягнення обігу цифрової інформації. Період навчання після отримання диплома лікаря, на сьогодні, називається інтернатурою і складає 36 міс., з них лише 12 міс. очна форма навчання. У гонитві за засвоєнням різнопланового теоретичного матеріалу відбувається нехтування детальним розглядом питань, з якими частіше стикається молодий спеціаліст. Освоєння практичних навичок більшою мірою зміщене на самостійне опрацювання в період заочної інтернатури. Для вирішення поставленого завдання було проаналізовано ряд англомовних джерел і пропонується використати розгалужені цифрові технології, глобальну мережу «Інтернет» та смартфон, який є у кожного громадянина молодого віку. В основі запропонованої інновації знаходиться «крива навчання», а також розроблений механізм об’єктивізації оцінки набутих навичок та моніторинг їх набуття on-line. Запропоновано змінення формату єдиного документа, що засвідчує зайнятість інтерна, «Щоденник обліку роботи інтерна» на електронний. Висунута ідея не потребує значних фінансових затрат, але зможе підвищити самодисципліну серед молодих спеціалістів, полегшити облік освоєних практичних навичок, а також проводити дистанційний контроль за освоєнням практичних навичок незалежно від місця розташування відділення, в якому лікар-інтерн проходить заочну частину інтернатури. Соціальним наслідком цього буде усунення ряду прихованих проблем у набутті післядипломної освіти інтернами-хірургами і як результат якісно новий формат кваліфікації молодого спеціаліста.
Mudanças de Uso e Cobertura da Terra e Áreas Suscetíveis à Inundação – Estudo de Caso do Município de Duque de Caxias/RJ
Authors: Neves Luciana Viana , Beser de Deus Leandro Andrei , Oscar Júnior Antonio Carlos da Silva , Fernandes Manoel Do Couto
Published: August 2019

O número de eventos de desastres naturais tem aumentado ao longo do tempo no território brasileiro e no mundo inteiro. No contexto brasileiro, há expressiva ocorrência de eventos de natureza hidrológica a exemplo das inundações, deslizamentos e secas. O presente artigo relaciona as mudanças de uso e cobertura do solo no município de Duque de Caxias, rotineiramente afetado por eventos de inundação, entre 2007 e 2016 (período dentro da vigência do segundo plano diretor municipal), com o resultado do mapeamento das áreas suscetíveis à inundação, realizado pelo CPRM (2013). As mudanças foram inferidas através do modelo Land Change Modeler (LCM), e os insumos de entrada correspondem à mapas de uso e cobertura do solo classificados supervisionadamente com o uso do algoritmo CART, na plataforma Google Earth Engine, através de imagens Landsat 5, sensor TM, bandas 4 (infravermelho próximo), 3 (vermelho) e 2 (verde), e Landsat 8, sensor OLI, Bandas 5 (infravermelho próximo), 4 (vermelho) e 3 (verde), ambas com resolução de 30m x 30m. Analisou-se as classes “urbano”, “vegetação densa”, “vegetação rasteira” e “solo exposto”. Busca-se com este trabalho identificar quais classes obtiveram maiores mudanças no período de análise, se estas tendem a ocorrer em áreas classificadas como alta suscetibilidade à inundação e a probabilidade de uma classe se tornar outra em 2026 (através da matriz de transição de Markov). No intervalo de nove anos, houve mais de 40 km² de perda de vegetação densa, mais de 60 km² de perda de vegetação rasteira e quase 60 km² de expansão da área urbana. Esta última se ampliando para locais com alta suscetibilidade à inundação.
Characteristics, Management, and Outcomes of Patients Hospitalized for Heart Failure in China: The China PEACE Retrospective Heart Failure Study
Authors: Yu Yuan , Gupta Aakriti , Wu Chaoqun , Masoudi Frederick A. , Du Xue , Zhang Jian , Krumholz Harlan M. , Li Jing ,   the China PEACE Collaborative Group
Published: August 2019

Background

Heart failure (HF) is an emerging epidemic in China and accounts for significant healthcare resource utilization in the inpatient setting. To create evidence‐based, life‐saving, and cost‐saving hospitalization systems, the first step is to characterize the contemporary national landscape of inpatient HF care.

Methods and Results

In the China PEACE 5r‐HF study (China Patient‐centered evaluative Assessment of Cardiac Events Retrospective Study of Heart Failure), we used 2‐stage random sampling to create a nationally representative cohort of 10 004 admissions for HF from 189 hospitals in 2015 in China. Data on patient characteristics, management, and outcomes were obtained through centralized medical record abstraction. The median age of the cohort was 73 years (interquartile range, 65–80), and 48.9% were women. More than half (56.2%) of the patients were hospitalized in rural areas. Prevalence of ejection fraction ≥50%, 40% to 50%, and <40% was 60.3%, 17.7%, and 22.0%, respectively. We identified substantial gaps in care, including underutilization of diagnostic tests such as echocardiograms (63.6%), chest imaging (75.2%), and biomarker testing (56.4%), low prescription rates of guideline‐recommended medications during hospitalization and at discharge, suboptimal rates of follow‐up appointments (24.3%), and widespread utilization of traditional Chinese medicine (74.8%). The combined rate of in‐hospital mortality and treatment withdrawal in our study was 3.5%, and median length‐of‐stay was 9 days (interquartile range, 7–13).

Conclusions

Patients admitted with acute HF in China have distinctive epidemiology and receive substandard care, but have low inpatient mortality despite long length of stay. These findings provide opportunities for streamlining efficiencies while improving quality of inpatient HF care in China.

Clinical Trial Registration

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02877914.
Association of Diabetes Mellitus on Cardiac Remodeling, Quality of Life, and Clinical Outcomes in Heart Failure With Reduced and Preserved Ejection Fraction
Authors: Yap Jonathan , Tay Wan Ting , Teng Tiew‐Hwa Katherine , Anand Inder , Richards A. Mark , Ling Lieng Hsi , MacDonald Michael R. , Chandramouli Chanchal , Tromp Jasper , Siswanto Bambang B. ,   ASIAN‐HF (Asian Sudden Cardiac Death in Heart Failure) Registry Investigators, Zile Michael , McMurray John , Lam Carolyn S. P.
Published: August 2019

Background

Diabetes mellitus frequently coexists with heart failure (
HF
), but few studies have compared the associations between diabetes mellitus and cardiac remodeling, quality of life, and clinical outcomes, according to
HF
phenotype.

Methods and Results

We compared echocardiographic parameters, quality of life (assessed by the Kansas City Cardiomyopathy Questionnaire), and outcomes (1‐year all‐cause mortality, cardiovascular mortality, and
HF
hospitalization) between
HF
patients with and without type 2 diabetes mellitus in the prospective
ASIAN
‐
HF
(Asian Sudden Cardiac Death in Heart Failure) Registry, as well as community‐based controls without
HF
. Adjusted Cox proportional hazards models were used to assess the association of diabetes mellitus with clinical outcomes. Among 5028 patients with
HF
and reduced ejection fraction (
HF
r
EF
;
EF
<40%) and 1139 patients with
HF
and preserved
EF
(
HF
p
EF
;
EF
≥50%), the prevalences of type 2 diabetes mellitus were 40.2% and 45.0%, respectively (
P
=0.003). In both
HF
r
EF
and
HF
p
EF
cohorts, diabetes mellitus (versus no diabetes mellitus) was associated with smaller indexed left ventricular diastolic volumes and higher mitral E/e′ ratio. There was a predominance of eccentric hypertrophy in
HF
r
EF
and concentric hypertrophy in
HF
p
EF
. Patients with diabetes mellitus had lower
Kansas City Cardiomyopathy Questionnaire
scores in both
HF
p
EF
and
HF
r
EF
, with more prominent differences in
HF
p
EF
(
P
interaction
<0.05). In both
HF
p
EF
and
HF
r
EF
, patients with diabetes mellitus had more
HF
rehospitalizations (adjusted hazard ratio, 1.27; 95%
CI
, 1.05–1.54;
P
=0.014) and higher 1‐year rates of the composite of all‐cause mortality/
HF
hospitalization (adjusted hazard ratio, 1.22; 95%
CI
, 1.05–1.41;
P
=0.011), with no differences between
HF
phenotypes (
P
interaction
>0.05).

Conclusions

In
HF
p
EF
and
HF
r
EF
, type 2 diabetes mellitus is associated with smaller left ventricular volumes, higher mitral E/e′ ratio, poorer quality of life, and worse outcomes, with several differences noted between
HF
phenotypes.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
01633398.
Exploring the Prognostic Value of Novel Markers in Adults With a Systemic Right Ventricle
Authors: Geenen Laurie W. , van Grootel Roderick W. J. , Akman Korhan , Baggen Vivan J. M. , Menting Myrthe E. , Eindhoven Jannet A. , Cuypers Judith A. A. E. , Boersma Eric , van den Bosch Annemien E. , Roos‐Hesselink Jolien W.
Published: August 2019

Background

Adults with a systemic right ventricle (
sRV
) have a high risk of cardiac complications. This study aimed to identify prognostic markers in adults with
sRV
based on clinical evaluation, echocardiography, and blood biomarkers.

Methods and Results

In this prospective cohort study, consecutive clinically stable adults with
sRV
caused by Mustard‐ or congenitally corrected transposition of the great arteries were included (2011–2013). Eighty‐six patients were included (age 37±9 years, 65% male, 83% New York Heart Association functional class I, 76% Mustard transposition of the great arteries, 24% congenitally corrected transposition of the great arteries). Venous blood sampling was performed including N‐terminal pro B‐type natriuretic peptide, high‐sensitive‐troponin‐T, high‐sensitivity C‐reactive protein, growth differentiation factor‐15, galectin‐3, red cell distribution width, estimated glomerular filtration rate, and hemoglobin. Besides conventional echocardiographic measurements, longitudinal, circumferential, and radial strain were assessed using strain analysis. During a median follow‐up of 5.9 (interquartile range 5.3–6.3) years, 19 (22%) patients died or had heart failure (primary end point) and 29 (34%) patients died or had arrhythmia (secondary end point). Univariable Cox regression analysis was performed using dichotomous or standardized continuous variables. New York Heart Association functional class >I, systolic blood pressure, and most blood biomarkers were associated with the primary and secondary end point (galectin‐3 not for primary, N‐terminal pro B‐type natriuretic peptide and high‐sensitivity C‐reactive protein not for secondary end point). Growth differentiation factor‐15 showed the strongest association with both end points (hazard ratios; 2.44 [95%
CI
1.67–3.57,
P
<0.001], 2.00 [95%
CI
1.46–2.73,
P
<0.001], respectively). End‐diastolic basal dimension of the subpulmonary ventricle was associated with both end points (hazard ratio: 1.95 [95%
CI
1.34–2.85],
P
<0.001, 1.70 [95%
CI
1.21–2.38,
P
=0.002], respectively). Concerning strain analysis, only
sRV
septal strain was associated with the secondary end point (hazard ratio 0.58 [95%
CI
0.39–0.86],
P
=0.006).

Conclusions

Clinical, conventional echocardiographic, and blood measurements are important markers for risk stratification in adults with a
sRV
. The value of novel echocardiographic strain analysis seems limited.
Urban Transport Expansions and Changes in the Spatial Structure of U.S. Cities: Implications for Productivity and Welfare
Authors: Baum-Snow Nathaniel
Published: August 2019

Each new radial highway serving large U.S. metropolitan areas decentralized 14% to 16% of central city working residents and 4% to 6% of jobs in the 1960–2000 period. Model calibrations yield implied elasticities of central city total factor productivity to central city employment relative to suburban employment of 0.04 to 0.09, meaning a large fraction of agglomeration economies operates at submetropolitan-area spatial scales. Each additional highway causes central city income net of commuting costs to increase by up to 2.4% and housing cost to decline by up to 1.3%. Factor reallocation toward land in housing production generates the plurality of the population decentralization caused by new highways.
Identity, Place, Space, and Rhymes During a Pilgrimage to the Shrine of Moulay Abdessalam, Morocco
Authors: Gintsburg Sarali
Published: August 2019

The Jbala region in northern Morocco is known for an enormous number of Sufi lodges, shrines of local saints, and the cults of those saints. However, this topic has entirely escaped the attention of modern scholars. This paper focuses on the ziyara, or tradition of pilgrimage to a shrine of a saint, connecting it to the debate on place and space on the one hand, and identity studies on the other. Using a classical ethnographic approach, I analyze one such pilgrimage that took place in 2018, in which I was invited to participate as a guest,. In this paper I understand pilgrimage as a communal spiritual journey and analyze the roles the collective and individual play in it, as well as how and by what means the participants cocreate and experience constructs of place and space.
Some of Them Just Die Like Horses. Contact-Induced Changes in Peripheral Nahuatl of the Sixteenth-Century Petitions from Santiago de Guatemala
Authors: Brylak Agnieszka
Published: August 2019

The aim of this paper is to examine contact-induced changes, visible on lexical and lexico-syntactical levels, in the set of twenty sixteenth-century petitions in Nahuatl from the region of Santiago de Guatemala. They comprise such phenomena as the creation and usage of neologisms, extentions of meaning, the adoption of loans in the morphological system of Nahuatl and the usage of calques. The material is divided in three parts. The first one focuses on specific traits of the Nahuatl language in which the Guatemalan petitions were composed, taking into account an ongoing discussion among researchers concerning the identification of this language or languages. The second part focuses on the presentation of selected lexical and lexico-syntactic changes in Nahuatl due to the influence of the Spanish language, as compared with similar contact-induced phenomena from Central Mexico and attested within the same time span. In the last part of the paper the interdependence of language contact and culture contact is discussed within the perspective of a presumed conceptual equivalency and interchangeability of the Spanish and Nahuatl terms for deer and horse, which appears in one of the studied documents.