bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of higher arterial ketone body ratio (acetoacetate/β-hydroxybutyrate) with relevant nutritional marker in hemodialysis patients
Authors: Inaba Masaaki , Kumeda Yasuro , Yamada Shinsuke , Toi Norikazu , Hamai Chie , Noguchi Koichi , Yasuda Eikichi , Furumitsu Yutaka , Emoto Masanori , Ohno Yoshiteru
Published: November 2020

Background

An association of higher levels of β-hydroxybutyrate (β-HB) in serum with greater mortality in hemodialysis (HD) patients has been reported. This study examined the significance of arterial ketone body ratio (AcAc/β-HB), a relevant marker of energy state, in HD patients.

Methods

The levels of arterial AcAc and β-HB, and AcAc/β-HB ratio were determined in 49 HD patients just before undergoing an HD session. Additionally, changes in those levels during the session were examined to investigate their associations with clinical nutritional markers.

Results

Arterial β-HB, but not AcAc, was significantly higher at the baseline in 25 patients with type 2 diabetes mellitus (T2DM) as compared to 24 non-DM patients, with a significant reduction in arterial AcAc/β-HB ratio seen in those with DM. Although the arterial AcAc/β-HB ratio before the HD session was significantly higher in the non-DM group, it did not differ significantly after the session between the groups, indicating a faster rate of β-HB disappearance from circulation in non-DM HD patients during the interdialytic period. Multiple regression analysis, which included age, gender, presence/absence of DM, log HD duration, log β-HB, and log AcAc/β-HB ratio as independent variables, revealed an independent and significant association of log AcAc/ β-HB ratio, but not log β-HB, with serum albumin and uric acid.

Conclusion

We found that a decreased AcAc/β-HB ratio resulting from increased β-HB, but not increased β-HB itself, was a significant factor independently associated with decreased levels of serum albumin and uric acid, known to be related to higher mortality in HD patients. Furthermore, it is possible that higher mortality in DM HD patients can be explained by reduced arterial AcAc/β-HB ratio.
Geographical access to point-of-care testing for hypertensive disorders of pregnancy as an integral part of maternal healthcare in Ghana
Authors: Kuupiel Desmond , Adu Kwame Manu , Bawontuo Vitalis , Tabong Philip T. N. , Adogboba Duncan A. , Mashamba-Thompson Tivani P.
Published: November 2020

Background

Hypertensive disorders of pregnancy (HDP) are associated with high maternal mortality in Ghana and globally. Evidence shows that there is poor availability of pregnancy-related point-of-care (POC) tests in Ghana’s primary healthcare (PHC) clinics (health centre or community-based health planning services facilities). Therefore, we employed geographic information systems to estimate the geographical distribution of and physical accessibility to HDP POC testing services in the Upper East Region (UER), Ghana.

Methods

We collected data on 100 out of 365 PHC clinics, public hospitals providing HDP testing, PHC clinic type, ownership, and availability of urine dipsticks and blood pressure (BP) devices. We also obtained the geo-located data of the PHC clinics and hospitals using the global positioning system. We employed ArcGIS 10.4 to measure the distance and travel time from the location of each PHC clinic without HDP POC testing services as well as from all locations of each district to the nearest hospital/clinic where the service is available. The travel time was estimated using an assumed motorised tricycle speed of 20 km/hour. We further calculated the spatial distribution of the hospitals/clinics providing HDP POC testing services using the spatial autocorrelation tool in ArcMap, and Stata version 14 for descriptive statistical analysis.

Results

Of the 100 participating PHC clinics, POC testing for HDP was available in 19% (14% health centres and 5% community-based health planning services compounds) in addition to the 10 hospitals use as referral points for the service. The findings indicated that the spatial pattern of the distribution of the health facilities providing HDP POC testing was random (z-score = -0.61; p = 0.54). About 17% of the PHC clinics without HDP POC testing service were located > 10 km to the nearest facility offering the service. The mean distance and travel time from PHC clinics without HDP POC testing to a health facility providing the service were 11.4 ± 9.9 km and 31.1 ± 29.2 min respectively. The results suggest that if every 19% of the 365 PHC clinics are offering HDP POC testing in addition to these 10 hospitals identified, then the estimated coverage (health facility-to-women in fertility age ratio) in the UER is 1: 3,869.

Conclusions

There is poor physical accessibility to HDP POC testing services from PHC clinics without HDP POC testing in the UER. Mothers who obtain maternal healthcare in about 17% of the PHC clinics travel long distances (> 10 km) to access the service when needed. Hence, there is a need to improve the availability of HDP POC diagnostic tests in Ghana’s rural clinics.
Self-enucleation of the right eye by a 38-year-old woman diagnosed with schizoaffective disorder: a case report
Authors: Chechko Natalia , Stormanns Eva , Podoll Klaus , Stickel Susanne , Neuner Irene
Published: November 2020

Background

Autoenucleation is a rare form of self-mutilation typically associated with psychiatric disorders such as schizophrenia, substance-induced psychosis and bipolar disorder. The act is usually unilateral, although bilateral attempts are also well documented in the literature.

Case presentation

It is a case study involving a female patient (NN) diagnosed with schizoaffective disorder who self-enucleated her right eye following sexual intercourse with a fellow patient, and was forcefully prevented by staff from enucleating the second eye. We report recurrent episodes of her illness culminating in this severe act of self-mutilation. The motivational reasons behind this form of self-harm along with differential diagnosis and potential treatment options are discussed in the context of the available literature.

Conclusion

Autoenucleation is commonly associated with religious and sexual delusions, and patients are thought to be at a greater risk of further self-harm. Timely antipsychotic treatment is likely to reduce the risk of such extreme forms of self-harm, although they can occur despite robust therapeutic intervention and treatment attempts. While self-inflicted eye injuries are rare, their prevention in what is typically a difficult patient group is fraught with challenges.
Significantly delayed polyglactin 910 suture-related pseudoinfection in a Yucatan pig
Authors: Collins Dalis , Simons Brian
Published: November 2020

Background

Polyglactin 910 is a synthetic braided, absorbable suture commonly used in surgery. Though polyglactin 910 suture-related pseudoinfection is well documented in the human literature, it has not been previously reported in the veterinary literature.

Case description

A 3-year-old female, ovariectomized but otherwise experimentally naïve Yucatan pig was evaluated for a several week history of bilateral multifocal abscesses in the area of the paralumbar fossa, which continued to worsen despite oral antibiotics and non-steroidal anti-inflammatory medications. The multi-focal abscesses continued to worsen and additional diagnostics were pursued including cytology, culture (aerobic, anaerobic and fungal), and bloodwork. All supported a non-infectious etiology. Biopsy results indicated a suture-related pseudoinfection. Despite treatment including parenteral antibiotics, pain medications and superficial surgical debridement, the dermatologic lesions worsened. Euthanasia was elected. Post-mortem necropsy demonstrated a suture-related pseudoinfection with extrusion of suture material from the ovarian pedicle ligatures through the body wall and skin leading to numerous sterile abscesses in the bilateral paralumbar fossa.

Conclusions

This is the first published report of a significantly delayed polyglactin 910 suture-related pseudoinfection in a Yucatan pig. While likely an isolated incident, it supports further research into this area. Additionally for critical research studies using Yucatan pigs, pre-surgical assessment with hypersensitivity patch testing may be appropriate.
Factors affecting the use of clinical practice guidelines by hospital physicians: the interplay of IT infrastructure and physician attitudes
Authors: Sasaki Noriko , Yamaguchi Naohito , Okumura Akiko , Yoshida Masahiro , Sugawara Hiroyuki , Shin Jung-ho , Kunisawa Susumu , Imanaka Yuichi
Published: November 2020

Background

Compliance with clinical practice guidelines (CPGs) remains insufficient around the world, despite frequent updates and continuing efforts to disseminate and implement these guidelines through a variety of strategies. We describe the current status of young resident physician practices towards CPGs and investigate the multiple factors associated with the active use of CPGs, including the physician’s knowledge, attitudes, behaviours, CPG-related education received, and the hospital’s IT infrastructures. The aim is to identify a more effective point for intervention to promote CPG implementation.

Methods

We conducted a questionnaire survey among resident physicians working at 111 hospitals across Japan in 2015 and used results with hospital IT score data collected from a prior survey. Multivariable logistic regression analysis was performed to examine the determinants of frequent use of CPGs (defined at least once per week). The independent variables were selected based on physician demographics, clinical speciality and careers, daily knowledge and behaviour items, CPG-related education received, digital preference, and hospital IT score (high/medium/low), with and without interaction terms.

Results

Responses from 535 resident physicians, at 61 hospitals, were analysed. The median hospital IT score was 6 out of a possible 10 points. Physicians who had learned about CPGs tended to work at hospitals with medium to high IT scores, had easier access to paywalled medical databases, and had better knowledge of the guideline network ‘Minds’. In addition, these physicians tended to use CPGs electronically. A physician’s behaviour towards using CPGs for therapeutic decision-making was strongly associated with frequent use of CPGs (odds ratio [95% CI] 6.1 [3.6–10.4]), which indicated that a physician’s habit strongly promotes CPG use. Moreover, CPG-related education was associated with active use of CPGs (OR1.7 [1.1–2.5]). The interaction effects between individual digital preferences and higher hospital IT score were also observed for frequent CPG use (OR2.9 [0.9–8.8]).

Conclusions

A physician’s habitual behaviours, CPG-related education, and a combination of individual digital preference and superior hospital IT infrastructure are key to bridging the gap between the use and implementation of CPGs.
Effects of Cnidium monnieri (L.) Cuss. fruit extract on sexual behaviors in male rats
Authors: Dau Thuy Duong , Le Minh Ha , Nguyen Tran Thi Giang Huong , Dang Thi Ngoc Mai , Do Thi Nguyet Que , Tran Quynh Trang
Published: November 2020

Background

Cnidium monnieri (L.) Cuss. has been used for a long time according to the traditional experiences and documentation in order to treat male sexual disorders. Osthole is one of the main bioactive components in Cnidium monnieri (L.) Cuss. In this study, we aimed to evaluate the effect of Cnidium monnieri (L.) Cuss. fruit extract of which osthole content was 35% (determined by HPLC method) on sexual behaviors in adult male rats.

Methods

Cnidium monnieri (L.) Cuss. fruit extract was administered orally at the dose of 150 mg/kg b.w and after 30 min, male rats were coupled with receptive adult female rats to evaluate sexual behaviors, including mounting and intromission.

Results

Cnidium monnieri (L.) Cuss. fruit extract at the dose of 150 mg/kg b.w increased the percentage of rats that mounted and intromitted; increased the intromission frequency and decreased mounting latency and intromission latency.

Conclusion

Cnidium monnieri (L.) Cuss. fruit extract increased the ability to mount and intromit in rats, and scientifically support the traditional use of Cnidium monnieri (L.) Cuss. in treatment of male sexual disorders.
The impact of alternative environmentally differentiated fairway dues systems in Sweden
Authors: Vierth Inge , Johansson Magnus
Published: November 2020

The Swedish system for determining fairway dues at the national level is acknowledged as being unique in attempting to consider the environmental performance of vessels. Between 1998 and 2014, vessels could get a SOX discount and between 1998 and 2017 a NOx discount, both based on certificates. In 2018, the Swedish government initiated a new system comprising more environmental impacts requiring operators that want to benefit from it, to register their vessels for a score in the Clean Shipping Index (CSI). The CSI covers performance in five categories: NOX, CO2, SOX/PM, Chemicals and Waste. Based on received scores, vessels can get 10%, 30% or 90% discount. In this paper, the short-term outcome of the new system is analysed and compared to the old NOX-based system. The comparison is based on revealed preferences of the involved vessel operators. Vessel specific data about the discounts and scores are analysed as well as the regional distribution of discounts and impacts on different vessel types. The paper shows that the Swedish Maritime Administration has succeeded in creating a system that attracts more vessel types and encompasses more environmental categories, but that the incentives to reduce NOX emissions have been reduced. Ex-post cost-benefit analyses of the earlier certificate-based systems have proven them beneficial to society. However, it is unclear how the outcome of the new system will be. The paper suggests that there are efficiency gains in harmonising the system SMA has introduced with the different systems for environmentally differentiated port fees in Sweden.
Influences of changes in obesity-related parameters on progression of arteriosclerosis in hemodialysis patients: a prospective cohort study
Authors: Iida Takeshi , Morimoto Satoshi , Okuda Hidenobu , Amari Yoshifumi , Yurugi Takatomi , Nakajima Fumitaka , Ichihara Atsuhiro
Published: November 2020

Background

Hemodialysis patients have a greater risk of cardiovascular disease, their major cause of death. Obesity is a risk factor for arteriosclerosis, cardiovascular disease, and mortality in the general population. Conversely, an increased body mass index (BMI) is known to be associated with better survival of hemodialysis patients. However, the influences of changes in parameters associated with obesity on arteriosclerosis in these patients have not been evaluated. Here, we evaluated the relationship between changes in parameters associated with obesity and brachial-ankle pulse wave velocity (baPWV), as an index of arteriosclerosis, in hemodialysis patients.

Methods

Two hundred and fifty-eight subjects were selected from patients undergoing stable hemodialysis. BMI, abdominal circumference (AC), visceral fat area (VFA) and subcutaneous fat areas (SFA), and baPWV were assessed at baseline and 4 years later. Ankle-brachial index and baPWV were measured on a non-dialysis day using volume-plethysmographic apparatus. Abdominal circumference was measured at the level of umbilicus by computed tomography (CT). Body fat distribution was determined using CT. All CT scans were performed on a non-dialysis day with the subject in a supine position.

Results

Sixty-one patients died during the 4-year period. Abdominal circumference, BMI, VFA, and SFA were higher, and baPWV was lower in patients who survived than in those who died. During the study period, baPWV increased and was positively correlated with the change in visceral plus subcutaneous fat area in patients whose initial VFA was > 100 cm2. There were negative correlations between the change in baPWV and changes in AC, and SFA in individuals whose VFA was < 100 cm2.

Conclusions

These data suggest that patients with a large VFA should adopt strategies aimed at reducing body weight, while patients with a small VFA should avoid undernutrition.
Occurrence, sociodemographic, and clinical correlates of eating disorders among a sample of secondary school students in Egypt
Authors: Sabry Walaa , ElMahlawy Naglaa , Essawy Heba , Al-Saleet Gamalat , Saad Mohamed , Morsy Mahmoud
Published: November 2020

Background

Eating disorders are common in adolescents. Data on occurrence rates, sociodemographic correlates, and risk factors in Egyptian population are needed along with better screening tools to inform future research and service development. We aimed to estimate the occurrence of eating disorders in a representative sample of Egyptian adolescent students and to examine the sociodemographic and clinical risk factors associated with eating disorders. So, a multistage random selection of 407 adolescent students from public and private secondary schools in Eastern Tanta, Egypt, was carried out. All participants were subjected to screening using the Eating Attitude Test (EAT) and the eating disorders section of the clinician version of the Structured Clinical Interview for DSM-IV axis-I disorders

Results

Occurrence estimates of anorexia nervosa and bulimia nervosa were 6.1% and 3.2%, respectively. Being female, overweight (BMI = 25–29.9 kg/m2), low self-esteem, and high body shape preoccupation were significantly associated with eating disorders risk among adolescents.

Conclusions

Eating disorders are prevalent in the general adolescent population. The unmet treatment needs in the adolescent population place these disorders as important public health concerns.
Trans-thoracic versus trans-hiatal resection for oesophageal carcinoma: a retrospective comparative study of a single-centre case series
Authors: Baram Aram , Sherzad Hiwa
Published: November 2020

Background

Oesophageal carcinoma (EC) is the eighth most common cancer. Surgery is the cornerstone of management for resectable EC. Trans-thoracic oesophagectomy (TTE) and trans-hiatal oesophagectomy (THE) are the two most widely practised procedures. Most of the related controversies are centred on both early and late post-operative complications and mortality (in terms of overall survival and cancer-free survival).

This was a single-centre, retrospective, comparative study analysing the outcomes of two EC resection methods. All 87 patients underwent surgery by the same surgical team over 13 years. Consequently, 87 oesophagectomies with curative intent were performed and divided into the TTE group (group A = 47) and the THE group (group B = 40).

Results

The mean patient age was 65.60 ± 6.30 years in the TTE group and 63.48 ± 9.34 years in the THE group. No significant difference was found in operative time, blood loss or duration of stay in the intensive care unit. The duration of hospital stay was significantly different between the THE and TTE groups (17.25 ± 5.92 vs. 12.93 ± 3.44, respectively; P ≤ 0.001). In-hospital mortality was higher in the TTE group (9/47, 19.14%) than in the THE group (5/40, 12.5%) (P = 0.400). The mean survival rate from our series showed the superiority of group A (TTE) (65.56 months) over group B (THE) (45.01 months), with P = 0.146.

Conclusion

No high level of evidence suggests the superiority of one surgical procedure over another. The THE procedure is less time-consuming concerning care and follow-up, and most patients were more satisfied and experienced less pain than with the TTE procedure. Both THE and TTE have comparable post-operative anastomotic complications, and they have no significant long-term survival differences.
Voice problem in a patient with chronic renal failure
Authors: Zaky Effat Ahmed , Mamdouh Haytham , Esmat Olivia , Khalaf Zeinab
Published: November 2020

Background

Chronic kidney failure is an irreversible medical condition that impairs the kidney’s ability to function. When CRF reaches a sophisticated stage, dangerous levels of fluid, electrolytes, and wastes can accumulate within the body. Dysphonia detected within the CRF patients was due to affection of the chronic kidney failure on the system and phonatory system. Patients with CRF treated by hemodialysis are exposed to continuous pulmonary insults of multifactorial origin: Fluid retention predisposes them to pulmonary edema which occurs more frequently within the presence of concomitant cardiovascular disease. Also, the spirit of the kidney failure patients can induce psychogenic dysphonia. The aim of this work is to see and analyzed voice problems in patients with chronic kidney failure to ascertain baseline data about the scale and distribution of the probable voice disorder in these patients for early detection and proper management.

Results

The results obtained from this study showed that there have been statistically significant differences between chronic kidney failure patients G1 and control G2 regarding first harmonic, jitter %, shimmer dB and noise harmonic ratio dB, presence of dysphonia, and also the total score of VHI. The results of the study revealed statistical correlation between the quantity of years of hemodialysis and total acoustic measures.

Conclusion

The results of our study revealed that subjects with chronic failure exhibit a clinical evidence of voice disorders and proving that there is interplay of different body systems and the larynx. The voice problems can vary between CRF patients depending on duration of hemodialysis and leading causes of chronic kidney failure.
A case report of unilateral conductive hearing loss as a consequence of malignant sinonasal melanoma: the importance of completing a full clinical history and examination
Authors: Blackabey Victoria , Kenyon Olivia , Talwar Rishi
Published: November 2020

Background

Sinonasal melanoma is a rare head and neck tumour. It is associated with a poor prognosis, high rates of loco-regional recurrence and distant metastasis. Treatment of the disease is therefore complicated, and because of limited data regarding the cancer, management is frequently tailored to the individual patient. We describe an unusual presentation of sinonasal melanoma with relevant histology, radiology and clinical photography.

Case presentation

The case report describes the presentation of a 64-year-old man to the Ear, Nose and Throat department with progressive right-sided hearing loss. A thorough history highlighted other clinical symptoms including unilateral nasal obstruction and epistaxis. Clinical examination showed a right middle ear effusion with a polypoidal lesion in the right nasal cavity. Relevant imaging demonstrated a destructive process that required further assessment. An endoscopic sinus procedure was performed to obtain histological diagnosis as well as providing symptomatic relief. Histology confirmed malignant mucosal melanoma. The patient underwent maxillectomy and orbital exenteration (due to further progression of disease) at a tertiary centre with a plan for subsequent immunotherapy. This however has been delayed due to further surgery to excise a metastatic lesion to the right femur.

Conclusions

This case report highlights the importance of a thorough clinical history and examination. An unusual presentation of a sinonasal tumour can easily be missed leading to a significant delay in treatment. The case report also describes the use of functional endoscopic sinus surgery in order to obtain histological diagnosis and to debulk the tumour, providing symptomatic relief. The current literature regarding management will be discussed as well as current developments guiding future treatment.
Adult Gliomas
Authors: Colman Howard
Published: November 2020

PURPOSE OF REVIEW

This article highlights important aspects of the evaluation, diagnosis, and treatment of adult gliomas, including lower-grade astrocytomas and oligodendrogliomas, glioblastomas, and ependymomas.

RECENT FINDINGS

The appropriate initial evaluation and accurate diagnosis of gliomas require an understanding of the spectrum of clinical and radiographic presentations. Recent advances in the understanding of distinct molecular prognostic subtypes have led to major revisions in the diagnostic classification of gliomas. Integration of these new diagnostic and molecular classifications is an important part of the modern management of gliomas and facilitates better understanding and interpretation of the efficacy of different therapies in specific glioma subtypes.

The management of adult gliomas is a multidisciplinary endeavor. However, despite recent molecular and treatment advances, the majority of diffuse gliomas remain incurable, and efforts aimed at the development and testing of new therapies in clinical trials are ongoing.
Metastasis to the Central Nervous System
Authors: Boire Adrienne
Published: November 2020

PURPOSE OF REVIEW

Management of metastasis to the central nervous system (CNS) has evolved, and molecular characterization of metastatic disease is now routinely done. Targeted therapies, once few in number with limited penetration into the CNS, have multiplied in number and increased in CNS coverage. This article addresses recent advances in the evaluation and clinical management of patients with CNS metastasis.

RECENT FINDINGS

Metastasis of cancer to the CNS can be diagnosed and characterized with novel techniques, including molecular analyses of the spinal fluid, so-called liquid biopsies. Resected parenchymal CNS metastases are now routinely subjected to genomic sequencing. For patients with CNS metastases displaying targetable mutations, a wide variety of treatment options are available, including deferral of radiation therapy in favor of a trial of an orally bioavailable targeted therapy or immunotherapy. For patients without a molecularly targetable lesion, local treatment in the form of radiation therapy, now most often stereotactic radiosurgery, is supplanting untargeted whole-brain radiation therapy.

Technologic advances in diagnosis and management have resulted in new diagnostic and therapeutic approaches to patients with metastasis to the CNS, with resulting improvements in progression-free and overall survival.
Neurotoxicity of Cancer Therapies
Authors: Dietrich Jorg
Published: November 2020

PURPOSE OF REVIEW

This article reviews neurologic complications associated with chemotherapy, radiation therapy, antiangiogenic therapy, and immunotherapy.

RECENT FINDINGS

Cancer therapies can cause a wide range of neurologic adverse effects and may result in significant patient morbidity and mortality. Although some treatment-associated neurologic complications manifest acutely and are often reversible and transient, others occur with delayed onset, can be progressive, and are uniquely challenging to patient management. With an increase in multimodality and combination therapies, including targeted therapies and immunotherapies, and prolonged patient survival, novel and unique patterns of neurologic complications have emerged.

Both conventional and novel cancer therapies can adversely affect the nervous system, thereby producing a wide range of neurologic complications. Increased awareness among neurologists and early recognition of cancer therapy–induced neurotoxic syndromes is critically important to minimize patient morbidity, prevent permanent injury, and improve patient outcomes.
Evaluation and Management Codes for Outpatient Neurology Services in 2021: Changes to 99202-99215
Authors: Cohen Bruce H. , Busis Neil A. , Villanueva Raissa , Ciccarelli Luana
Published: November 2020

Medical services can be conceptualized as falling into two categories: procedures and cognitive care. A procedure is defined as a surgical, medical, or diagnostic test performed on a patient, such as an x-ray, wound suture, surgery, or physical therapy treatment. Cognitive care, also known as Evaluation and Management (E/M) services, involves performing a medical history along with a physical examination and possibly ordering or reviewing diagnostic tests before formulating a medical opinion and initiating a care plan. The uniform language and categorization of all medical services is contained in the Current Procedural Terminology (CPT) manual by the American Medical Association, which precisely describes all medical services using non-overlapping definitions and descriptions. The codes defined by CPT are the most commonly accepted set of codes used to file medical claims. In 2000, the US Department of Health and Human Services designated CPT to be the national reporting standard used in conjunction with the Health Insurance Portability and Accountability Act (HIPAA). CPT codes used today for E/M services were established in 1995 and define the components of history, examination, and medical decision making necessary to determine the level of each cognitive care service as delivered by a physician or other qualified health care professionals (eg, advanced practice providers). E/M rules were modified in 1997 and allowed some specialty services, such as neurology, to substitute a single system examination for a general, multisystem physical examination. Although new E/M codes were added over the years, the code descriptions and documentation guidelines for E/M services for outpatient and inpatient care remained essentially unchanged from 1997 through 2020. Most of the work performed by neurologists is E/M services, and the rules for coding outpatient care will change dramatically on January 1, 2021. This article discusses the rationale for these coding changes and explains how they are to be applied in the clinical setting.
Pediatric Brain Tumors
Authors: Partap Sonia , Monje Michelle
Published: November 2020

PURPOSE OF REVIEW

This article focuses on primary brain tumors in the pediatric population with an emphasis on molecular classifications and treatment strategies.

RECENT FINDINGS

Pediatric brain tumors are a heterogeneous group of tumors that differ from adult brain cancers despite similar nomenclature. With the added complexity of the developing brain, treatment regimens are tailored to protect neurocognitive outcomes without sacrificing long-term survival. The 2016 World Health Organization’s classification incorporated molecular characteristics to aid in defining the diagnosis and prognosis of these tumors. These changes have enabled providers to stratify patients, thus intensifying therapies in those with high-risk diseases and modifying treatments to reduce morbidity for children and to provide better outcomes. Recent published findings from clinical trials have been especially helpful for gliomas, embryonal tumors, and ependymomas. By using this new information, molecular factors that correlate with survival have been identified in patients. In addition, genetic findings in tumor tissue have also led to revelations in predisposing germline mutations.

New findings from clinical trials and molecular stratification will shape the next generation of therapies in hopes of improving overall outcome, identifying pathways in tumorigenesis, and aiding in genetic counseling for children and their families.
Making Space
Authors: Cobb Jasmine Nichole
Published: November 2020

In this interview, artist and scholar Deborah Willis describes the work of excavating and organizing the history of Black photography. Willis’s groundbreaking scholarship helped to formally establish an archive of Black visual practice before libraries and cultural institutions began to purposely catalogue such materials. Across projects, she has engaged questions of beauty, citizenship, Black culture, and family history from the nineteenth century to the present by closely examining the camera practices of legendary photographers and the cultural contexts surrounding iconic images. In this interview, Willis describes her research as a student relying on periodical records as well as on the support of Black artists such as Roy DeCarava, Carrie Mae Weems, Gordon Parks, and James VanDerZee. This conversation with the author intertwines Willis’s personal history and the history of creating a visual archive to offer a look back and a look forward at the practice of Black photography.
The Unicorn and the Larva
Authors: Vaidya Anuj , Shah Tejal
Published: November 2020

In this performative co-interview, the unicorn (Tejal Shah) and the larva (Anuj Vaidya) reflect on their artistic practice, and the trajectory of their work from addressing issues of queer sexuality to those of queer ecology. Anuj and Tejal met at the School of the Art Institute of Chicago, where they collaborated on Chingari chumma (Stinging Kiss, 2000)—a short video that turns a cliched Bollywood ending into a queer fairy-tale phantasy— as an experiment in post-pornography. In this conversation, the artists reflect on the beginnings of their collaboration, giving special attention to their process, their shared love for drag and camp, and to the complicated reception to their work. While Tejal returned to India soon after, the pair continued to remain in conversation over the decades, even as their own practices meandered into questions of gender performance, nation-state politics, activism, and eventually into concerns about the environment and the nonhuman. In their most recent works, the artists confront the legacy of human exceptionalism and invoke the forgotten wisdom of interspecies dependence and desire as a way through the sixth extinction. Will we emerge on the other side? They dare not hope, but they do dare to wonder.
Maxillofacial lymphomas
Authors: MacDonald David , Martin Montgomery , Savage Kerry
Published: November 2020

Lymphomas affecting the bones of the jaws, although less frequent than carcinomas, can both present radiologically as carcinomas in addition to the more frequent “periapical-radiolucencies-of-inflammatory-origin” (PRIOs). Certainly those lymphomas arising within the maxillary alveolus have a short period of prior awareness before presentation, denoting an aggressive process. Half are provisionally diagnosed as carcinomas and the other half as PRIOs. Failure of the latter to respond to appropriate treatment, compels prompt and appropriate investigation for a malignancy. Further distinction of the malignancy into carcinoma and lymphoma is necessary, because the treatment of carcinomas is radical, achieved mainly by resection plus radiotherapy, whereas treatment of lymphomas relies on chemotherapy and in some cases, radiotherapy. The few reported cases that have been subject to cross-sectional imaging and reporting by radiologists has only appeared relatively recently. These cases reveal roles for cone-beam computer tomography, computed tomography and magnetic resonance (MR). Ultimately the diagnosis is dependant on a biopsy from the most representative area/s and the treatment plan upon the diagnosis and extent of the disease defined by the imaging.
Comparing second cancer risk for multiple radiotherapy modalities in survivors of hodgkin lymphoma
Authors: Timlin Claire , Loken James , Kruse Jon , Miller Robert , Schneider Uwe
Published: November 2020

Objectives:

To assess if excess absolute risk (EAR) of radiation-induced solid cancer can be used to rank radiotherapy plans for treatment of Hodgkin lymphoma (HL) in a statistically significant way.

Methods:

EAR models, calibrated with data from the Life Span Study and HL survivors, have been incorporated into a voxelised risk-calculation software, which is used to compare four treatment modalities planned for five virtual HL patients. Organ-specific parameters are generated repeatedly in a Monte Carlo fashion to model their uncertainties. This in turn enables a quantitative estimation of the EAR uncertainties.

Results:

Parameter-driven uncertainties on total EAR are around 13%, decreasing to around 2–5% for relative EAR comparisons. Total EAR estimations indicate that intensity modulated proton therapy decreases the average risk by 40% compared to the intensity modulated radiation therapy plan, 28% compared to the volumetric modulated arc therapy plan whereas the three-dimensional conformal radiation therapy plan is equivalent within the uncertainty.

Conclusion:

Relative EAR is a useful metric for distinguishing between radiotherapy plans in terms of second cancer risk.

Advances in knowledge:

Relative EAR is not dominated by model or parameter uncertainties and can be used to guide the choice of radiotherapy for HL patients.
Mud treatment in the Republic of Crimea
Authors: Golubova Tat'yana , Lyubchik Vera
Published: November 2020

The monograph contains basic information about mud treatment in the Crimea, its history, characteristics and features of the microelement composition, data on the mechanism of action, indications and contraindications to the appointment of mud applications. Clarified and systematized data on the use of therapeutic mud in patients with various diseases, methods are given depending on the nature and severity of the disease, its clinical forms. It is intended for physiotherapists, balneologists, doctors of physical and rehabilitation medicine and other specialties, researchers, as well as for interns, undergraduates and postgraduates of medical specialties.
Latin American models of organization and functioning of the judicial community. The Argentine Republic and the United Mexican States
Authors: Solov'ev Andrey
Published: November 2020

In this publication, the author continues a comparative legal study of the problems of organization and functioning of the judicial community of foreign countries: the Argentine Republic (at the Federal level and at the level of Federal subjects), as well as the United Mexican States. The Appendix contains the author's translations of the current versions Of the law of the Argentine Republic "on the Council of magistracy" and title 6 "governing bodies of the judicial system of the Federation" of the Organic law of the United Mexican States "on the Federal judiciary". It is intended for researchers, teachers, postgraduates, undergraduates and law students who specialize in the theory of law and the state, constitutional, administrative, civil procedure law, as well as problems of the judiciary. It can also be useful for persons involved in law-making activities, judges, employees of the judicial system, lawyers, practicing lawyers, managers and employees of state and local government bodies, as well as for anyone interested in this range of issues.
History of state and law in Russia
Authors: Smykalin Aleksandr , Bazhenova Tat'yana , Zipunnikova Natal'ya
Published: November 2020

The first part of the anthology contains documents reflecting the process of origin and development of the state-legal system of Russia from the X to the XVIII century. The documents are arranged in chronological order.
Control of the Formation of Elements of Functional literacy in the Framework of Natural Science Courses
Authors: Dobrotin Dmitriy
Published: November 2020

The article analyzes the normative documents that serve as the basis for the construction of control measuring materials, discusses current trends in the selection of content for control and evaluation procedures, approaches to the formulation of tasks used in the framework of international monitoring studies of the quality of education and state final certification, provides examples of tasks from various subjects of the natural science cycle; the article describes the current state of natural science education in terms of the results of Russian schoolchildren in international comparative studies of PISA and TIMSS; identifies possible reasons for insufficient results and suggests ways to improve them; analyzes the opinions of various experts on the current state and prospects for the development of school education, and discusses the feasibility of shifting the emphasis in Russian education towards a competence-based approach.
IMPLEMENTATION OF AGILE METHODOLOGY IN THE PROCESS OF DIGITAL TRANSFORMATION OF AGRICULTURE
Authors: Kurakova Chulpan , Safiullin Niyaz
Published: November 2020

Перевод на Английский. The article discusses the specifics of introducing a flexible approach to the management of the digitization of modern agricultural production in the context of the digital economy. As a result of the study of the digital transformation teams of various business processes, it was proposed to introduce Agile's flexible methodology into the digital transformation management system of agricultural organizations in particular and the agricultural sector in general. To do this, the modern Agile frameworks, which define the boundary system that organizes the workflows of the organization, have been adapted. Scrum and Kanban are proposed as the most effective frameworks. This will enable agricultural organizations to explore and identify viable agricultural markets, develop and improve new agricultural information products, produce new products and update them more frequently and with customer opinion in mind, and introduce and support cloud technologies in digital transformation. A scheme has been developed to implement sprints in the Scrum framework and a task organization board in the Kanban framework. The authors highlight the main advantages of the Agile methodology for each interested side of digital transformation, invited to use the experience of digital transformation of foreign and domestic agricultural organizations in the implementation of the Agile methodology. To train agricultural workers, the basics of methodology are offered to be trained in the "CDO- Data-Based Management" program, which will form a digital transformation team and train directors and digital experts. At the same time, the authors highlighted the main shortcomings and problems in the implementation of the Agile methodology, as well as ways to overcome them in the practical activities of agricultural organizations.
EFFECT OF ELECTROHYDRAULIC TREATMENT ON NITRATE NITROGEN CONTENT IN IRRIGATION WATER
Authors: Belov Aleksandr , Vasil'ev Aleksey , Stepanychev Yuriy , Sharko Anton
Published: November 2020

The introduction of mineral fertilizers has a negative impact on the agrobiocenosis. An increase the concentration of nitrate nitrogen in irrigation water in order to use it as a nitrogen fertilizer that does not have a negative impact on the environment seems relevant. The change in the content of nitrate nitrogen was determined in irrigation water, which was used as the flowing water of the city water supply (Moscow); pond water (Moscow region); potassium nitrate solution with a concentration of 50.9 mg/l. Three types of irrigation water were processed using a high-voltage installation. The experimental electrohydraulic installation consisted of a TVI-50/70 transformer with a rectifier unit; DC electric energy storage systems (high-voltage pulse capacitors); arresters designed to generate pulsed spark discharges with a short rise time; controls that allow changing technological modes during experiments; working units. During the research, an ITAN pH meter/ionometer was used according to the RD 52.24.367-2010 method. The technological mode of operation of the electro-hydraulic unit provides for the following characteristics: operating voltage 42 kV; capacitance of capacitors 0.05 μF; number of spark discharges n = 1 ... 5 thousand pieces; forming the gap between the ball arresters FP = 14 mm; working gap between working high-voltage electrodes 10 mm. Electrohydraulic treatment of water increases the concentration of nitrate nitrogen compounds in the running water of city water supply by 3.7 times (from 2.9 to 10.9 mg/l), in pond water - by 7 times (from 1.2 to 8.4 mg/l), in a solution of potassium nitrate - 1.3 times (from 50.9 to 68.4 mg/l). In water treated electrohydraulically, the content of nitrate nitrogen increases, which expands the possibilities for its use when watering plants.
INCREASING THE PROTECTION EFFICIENCY OF 0.4 KV POWER TRANSMISSION LINES WITH BRANCH LINES FROM SINGLE-PHASE SHORT CIRCUITS DUE TO THE USE OF MULTI-CONTACT SWITCHING SYSTEM MSS-2-3
Authors: Vinogradov Aleksandr , Vinogradova Alina , Psarev Aleksandr , Lansberg Aleksandr , Bol'shev Vadim
Published: November 2020

The purpose of the work is to increase the protection efficiency of 0.4 kV power lines with branch lines from single-phase short circuits by means of using the multi-contact switching system MSS-2-3. It can be not possible to provide the necessary sensitivity of protecting 0.4 kV power lines against one-phase short circuits when the power line length is too high and when the wire cross section does not provide the necessary value of the phase-zero loop resistance. Power line sectionalizing helps to solve this problem. It allows dividing power lines into sections, each is protected by its protective device. The settings of the protective devices installed at the beginning of a power transmission line and at the sectioning units (SU) are different. It provides the necessary selectivity of their work. At the same time, many power transmission lines (PTL) have long branch lines. The choice of the installation site of SU in such lines is difficult since a short circuit or other damage can occur both on a trunk line section and on a branch line. When installing SU both before a branch line and behind it, there might be the cases of unjustified power supply outages. Therefore, it is necessary to develop devices allowing for sectionalizing such power lines at the installation site of SU while ensuring the possibility of disconnecting both a trunk line section and a branch line directly. Such a device is a multi-contact switching system having two independent contact groups and three outputs (MSS-2-3). Installing the MSS-2-3 at a branch line point increases the security of the power transmission line against short circuits including single-phase ones and also increases power supply reliability to consumers since only a damaged section is disconnected in case of damage to the power transmission line. The feature of choosing the settings for the operation of switching devices installed in the MKS-2-3 to protect the switched power line sections is the need to take into account the parameters of a trunk line section and a branch line
DEVELOPMENT OF ACCOUNTING, ANALYTICAL AND CONTROL TOOLS BASED ON XBRL TECHNOLOGIES
Authors: Burceva Kseniya
Published: November 2020

Global automation of activity of business entities and wide application of accounting information systems allows to consider them as an analytical platform for compilation of reports and quality control of forming data. The article devoted to consideration of the problematic issue of development of accounting, analytical and control tools using XBRL (eXtensible Business Reporting Language) technologies. The study of the possibilities of implementing XBRL to increase transparency of reporting and optimize procedures for monitoring the activities of economic entities of the Russian Federation was carried out on the basis of a comprehensive analysis of international experience, since the expanded extensible business reporting language provides the opportunity to create documents and further their placement on the Internet for the convenience of use by all stakeholders. The experience of the internationally recognized company Fujitsu has highlighted the advantages of implementing XBRL taxonomies, so its adaptation is recommended to increase transparency of reporting and optimize control procedures of Russian companies. The author proposes to use XRBL taxonomies to develop the functions and control tools used by external and internal supervisory authorities, as well as to form an integrated control system formed on the basis of COSO principles and including a risk and control matrix (RCM). The development of accounting, analytical and control methods based on XBRL taxonomies will ensure transparency of financial and non financial data for investors, creditors, shareholders, suppliers and other interested users (stakeholders) of information data