bluuebunny/crossref_metadata_2025 huggingface dataset:
Iranian relatives’ attitudes towards culturally profiled nursing homes for individuals living with dementia
Authors: Kiwi Mahin
Published: December 2017

This article discusses Iranian family members’ attitudes towards the culturally profiled nursing home, their relationships with the staff, the obstacles, their hopes and their fears. This study is based on qualitative research using 29 semi-structured interviews with family members who had previously been informal caregivers, as well as using fieldwork, all in the same nursing home. The interviews were analysed by the three steps of content analysis. The results show the identification of three main categories with nine main subcategories. The categories and subcategories in the table clarify and explain how the interviewees tended to compare the situation in Iran with that in Sweden, how they perceived the situation in Sweden and finally how they also saw the culturally profiled nursing home.
Frames for the Future: Developing Continuing Education & Professional Development Programs for Spiritual Care Practitioners: A Perspective from Victoria, Australia
Authors: Wong Shinen , Tan Heather
Published: December 2017

This article examines the educational issues in ongoing professional education for spiritual care practitioners. A meta-evaluation of registration and evaluation data over four years (between 2013 and 2016) of one such monthly program conducted by Spiritual Health Victoria (Australia) will be examined. Recommendations are made to support healthcare managers and spiritual care educators in designing and developing continuing education programs for spiritual care practitioners in a variety of other professional health and care contexts.
Church Services in a Complex Continuing Care Hospital: Why Bother?
Authors: Fisher Elizabeth , Kraus Jan , Kuluski Kerry , Allatt Peter
Published: December 2017

This research aimed to explore patient motivation for attending hospital-run church services in a complex continuing care hospital setting, as well as the perceived spiritual benefits as categorized by Fitchett’s 7 × 7 Model for Spiritual Assessment. Invitations to participate in one-to-one interviews were offered to all patient attendees at both an ecumenical and a Roman Catholic service over the course of several weeks. We collected 20 interviews before performing a qualitative analysis, at which point we determined that saturation of content had been reached. The key findings were that participants identified the strongest perceived benefits in Experiences and Emotions, and Rituals and Practice, suggesting that access to the ritual of Sunday church services contributes meaningfully to participants’ coping strategies and overall quality of life.
Curative, regenerating, redemptive and liberating? The systematic production of ignorance in Michael Gove’s rhetoric on prison reform at a time of crisis
Authors: Peacock Chloe
Published: December 2017

Prisons are in a moment of crisis, with a number of recent high-profile scandals receiving substantial media attention and threatening to undermine the hegemony of the institution. At the same time, the work of the current Conservative Government on criminal justice policy as a whole, and on prisons in particular, has been seen by many as a marked departure from their previous penal policy agenda, heralding a new, progressive and broadly liberal direction. Focusing on Michael Gove’s rhetoric on prison reform during his term as Justice Secretary (May 2015 to July 2016), this article uses critical discourse analysis (CDA) to examine how Gove employed a variety of discursive strategies to create an impression of a liberal, progressive reform agenda, while simultaneously reinforcing the need for an expansive and punitive prison system. Building on recent work on agnotology, it shows that Gove strategically selected, deflected, distorted and ignored the available evidence on prisons. In doing so, he effectively legitimized and reinforced the central role of the prison in the criminal justice system despite increasing evidence of its inefficacy, foreclosing discussion of genuinely radical alternatives.
Global Currents, Musical Streams: European Opera in Colonial Southeast Asia
Authors: yamomo meLê
Published: December 2017

The advancement of the new transportation and communications technologies in the nineteenth century changed the landscape of the trade between Asia and Europe. Steam transportation, the telegraph, and the opening of the Suez Canal in 1869 heightened the pace of material trade and labour migrations (including cultural workers), along with commercial transactions of cultural goods and performance cultures. These steamships that carried the raw products from East to the West also carried musical instruments, musical scores, and opera and theatre companies from Europe to Asia. This article surveys primary archival sources and recent literature on the itinerant European opera companies that arrived in Southeast Asia in the nineteenth century and analyses the economic and sociological aspects of this phenomenon. This article also examines the local responses to the travelling theatre troupes which took residencies in the different Southeast Asian cities.
Between Policy Intent and Practice: Negotiating Access to Land and Other Resources in Tanzania's Wildlife Management Areas
Authors: Moyo Francis , Funk Sharissa , Pretzsch Jürgen
Published: December 2017

This article analyses how states and nonstate actors' efforts at sustaining natural resource lead to the exclusion of those who are most dependent on access to it. An access lenses review of Burunge Wildlife Management Area unravels the paradox between policy promise and practice. Situating our case in the context of neoliberal conservation that offers opportunities of patronage, rent-seeking, and capital accumulation to various state and private investors, we show that Wildlife Management Areas concentrate licit benefits to a few elites, while excluding the majority of rural peoples in accessing their customary lands and natural resources. This leads people to rely on illicit access mechanisms, and consequently, leading to violent confrontations between game scouts and people and protests and struggles to regain legal access. These conflicts erode rural peoples' trust and willingness to support conservation. The widely overlooked socioeconomic and political contextualization in conservation policy formation, often framed in apolitical and normative terms, acts as a vehicle for different meanings and practices that are mobilized by different actors to promote their own interests. Thus, state and nonstate actors, whose interests override ideals of an apolitical conservation vision, jointly produce an austere conservation regime that strips local people from access to resources.
Exploring the microbiome in health and disease
Authors: Scotti Elena , Boué Stéphanie , Sasso Giuseppe Lo , Zanetti Filippo , Belcastro Vincenzo , Poussin Carine , Sierro Nicolas , Battey James , Gimalac Anne , Ivanov Nikolai V , Hoeng Julia
Published: December 2017

The analysis of human microbiome is an exciting and rapidly expanding field of research. In the past decade, the biological relevance of the microbiome for human health has become evident. Microbiome comprises a complex collection of microorganisms, with their genes and metabolites, colonizing different body niches. It is now well known that the microbiome interacts with its host, assisting in the bioconversion of nutrients and detoxification, supporting immunity, protecting against pathogenic microbes, and maintaining health. Remarkable new findings showed that our microbiome not only primarily affects the health and function of the gastrointestinal tract but also has a strong influence on general body health through its close interaction with the nervous system and the lung. Therefore, a perfect and sensitive balanced interaction of microbes with the host is required for a healthy body. In fact, growing evidence suggests that the dynamics and function of the indigenous microbiota can be influenced by many factors, including genetics, diet, age, and toxicological agents like cigarette smoke, environmental contaminants, and drugs. The disruption of this balance, that is called dysbiosis, is associated with a plethora of diseases, including metabolic diseases, inflammatory bowel disease, chronic obstructive pulmonary disease, periodontitis, skin diseases, and neurological disorders. The importance of the host microbiome for the human health has also led to the emergence of novel therapeutic approaches focused on the intentional manipulation of the microbiota, either by restoring missing functions or eliminating harmful roles. In the present review, we outline recent studies devoted to elucidate not only the role of microbiome in health conditions and the possible link with various types of diseases but also the influence of various toxicological factors on the microbial composition and function.
Interventions to Address Sexual Problems in People With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Adaptation of Cancer Care Ontario Guideline
Authors: Carter Jeanne , Lacchetti Christina , Andersen Barbara L. , Barton Debra L. , Bolte Sage , Damast Shari , Diefenbach Michael A. , DuHamel Katherine , Florendo Judith , Ganz Patricia A. , Goldfarb Shari , Hallmeyer Sigrun , Kushner David M. , Rowland Julia H.
Published: December 2017

Purpose

The adaptation of the Cancer Care Ontario (CCO) guideline Interventions to Address Sexual Problems in People With Cancer provides recommendations to manage sexual function adverse effects that occur as a result of cancer diagnosis and/or treatment.

Methods

ASCO staff reviewed the guideline for developmental rigor and updated the literature search. An ASCO Expert Panel ( Table A1 ) was assembled to review the guideline content and recommendations.

Results

The ASCO Expert Panel determined that the recommendations from the 2016 CCO guideline are clear, thorough, and based upon the most relevant scientific evidence. ASCO statements and modifications were added to adapt the CCO guideline for a broader audience.

Recommendations

It is recommended that there be a discussion with the patient, initiated by a member of the health care team, regarding sexual health and dysfunction resulting from cancer or its treatment. Psychosocial and/or psychosexual counseling should be offered to all patients with cancer, aiming to improve sexual response, body image, intimacy and relationship issues, and overall sexual functioning and satisfaction. Medical and treatable contributing factors should be identified and addressed first. In women with symptoms of vaginal and/or vulvar atrophy, lubricants in addition to vaginal moisturizers may be tried as a first option. Low-dose vaginal estrogen, lidocaine, and dehydroepiandrosterone may also be considered in some cases. In men, medication such as phosphodiesterase type 5 inhibitors may be beneficial, and surgery remains an option for those with symptoms or treatment complications refractory to medical management. Both women and men experiencing vasomotor symptoms should be offered interventions for symptomatic improvement, including behavioral options such as cognitive behavioral therapy, slow breathing and hypnosis, and medications such as venlafaxine and gabapentin.Additional information is available at: www.asco.org/survivorship-guidelines and www.asco.org/guidelineswiki .
Genomic Resistance Patterns to Second-Generation Androgen Blockade in Paired Tumor Biopsies of Metastatic Castration-Resistant Prostate Cancer
Authors: Han G. Celine , Hwang Justin , Wankowicz Stephanie A.M. , Zhang Zhenwei , Liu David , Cibulskis Carrie , Gaviola Glenn C. , Ghazikhanian Varand , McKay Rana R. , Bubley Glenn J. , Carter Scott L. , Balk Steven P. , Hahn William C. , Taplin Mary-Ellen , Van Allen Eliezer M.
Published: December 2017

Purpose

Patients with castration-resistant prostate cancer (CRPC) receive second-generation androgen-deprivation therapy, but frequently experience relapse or do not respond. Understanding the genetic mechanisms of resistance will help to identify strategies and biomarkers that are essential for the next line of therapy.

Patients and Methods

We analyzed whole exomes of patient-matched pre- and post-treatment tumors from patients with CRPC. These patients had received the secondary androgen-deprivation therapy agent, abiraterone, which suppresses androgens to below castration levels, or enzalutamide, which competitively inhibits the key androgen signaling effector, androgen receptor.

Results

We observed that abiraterone-resistant tumors harbored alterations in AR and MYC, whereas enzalutamide-resistant tumors gained alterations in cell-cycle pathway genes, such as mutation in cyclin-dependent kinase N2A ( CDKN2A) or amplification of CDK6. Experimentally, overexpressing cell-cycle kinases promoted enzalutamide resistance in androgen-sensitive LnCAP cells that was mitigated via CDK4/6 blockade—palbociclib and ribociclib.

Conclusion

CDK4/6-mediated resistance observed in preclinical experiments suggests that CDK4/6 amplifications may sufficiently promote enzalutamide resistance in CRPC, and that these patients may respond to palbociclib or ribociclib. The overall observations suggest that, in genomically selected advanced CRPC, clinical strategies against abiraterone- or enzalutamide-resistant tumors may require treatment strategies that are tailored to the resistance mechanisms that are specific to those patient subpopulations.
Draft genome of tule elk Cervus canadensis nannodes
Authors: Mizzi Jessica E. , Lounsberry Zachary T. , Brown C. Titus , Sacks Benjamin N.
Published: December 2017

This paper presents the first draft genome of the tule elk (Cervus elaphus nannodes), a subspecies native to California that underwent an extreme genetic bottleneck in the late 1800s.  The genome was generated from Illumina HiSeq 3000 whole genome sequencing of four individuals, resulting in the assembly of 2.395 billion base pairs (Gbp) over 602,862 contigs over 500 bp and N50 = 6,885 bp. This genome provides a resource to facilitate future genomic research on elk and other cervids.
The decision to delivery interval in emergency caesarean sections: Impact of anaesthetic technique and work shift
Authors: Hein Anette , Thalen David , Eriksson Ylva , Jakobsson Jan G.
Published: December 2017

Background: One important task of the emergency anaesthesia service is to provide rapid, safe and effective anaesthesia for emergency caesarean sections (ECS). A Decision to Delivery Interval (DDI) <30 minutes for ECS is a quality indicator for this service. The aim of this study was to assess the DDI and the impact of chosen anaesthetic technique (general anaesthesia (GA), spinal anaesthesia (SPA) with opioid supplementation, or “top-up” of labour epidural analgesia (tEDA) with local anaesthesia and fentanyl mixture) and work shift for ECS at Danderyds Hospital, Sweden.

Methods: A retrospective chart review of ECS at Danderyds Hospital was performed between January and October 2016. Time between decision for CS, start of anaesthesia, time for incision and delivery, type of anaesthetic technique, and time of day, working hours or on call and day of week, Monday – Friday, and weekend was compiled and analysed. Time events are presented as mean ± standard deviation. Non-parametric tests were used.

Results: In total, 135 ECS were analysed: 92% of the cases were delivered within 30 minutes and mean DDI for all cases was 17.3±8.1 minutes. GA shortened the DDI by 10 and 13 minutes compared to SPA and tEDA (p<0.0005). DDI for SPA and tEDA did not differ. There was no difference in DDI regarding time of day or weekday. Apgar <7 at 5’ was more commonly seen in ECS having GA (11 out of 64) compared to SPA (2/30) and tEDA (1/41) (p<0.05).

Conclusion: GA shortens the DDI for ECS, but the use of SPA as well as tEDA with opioid supplementation maintains a short DDI and should be considered when time allows. Top-up epidural did not prolong the DDI compared to SPA. The day of week or time of ECS had no influence on the anaesthesia service as measured by the DDI.
Single-cell heterogeneity and cell-cycle-related viral gene bursts in the human leukaemia virus HTLV-1
Authors: Billman Martin R , Rueda David , Bangham Charles R M
Published: December 2017

Background: The human leukaemia virus HTLV-1 expresses essential accessory genes that manipulate the expression, splicing and transport of viral mRNAs.  Two of these genes,taxandhbz, also promote proliferation of the infected cell, and both genes are thought to contribute to oncogenesis in adult T-cell leukaemia/lymphoma.  The regulation of HTLV-1 proviral latency is not understood. tax,on the proviral plus strand, is usually silent in freshly-isolated cells, whereas the minus-strand-encodedhbzgene is persistently expressed at a low level.  However, the persistently activated host immune response to Tax indicates frequent expression oftaxin vivo. 

Methods: We used single-molecule RNA-FISH to quantify the expression of HTLV-1 transcripts at the single-cell level in a total of >19,000 cells from five T-cell clones, naturally infected with HTLV-1, isolated by limiting dilution from peripheral blood of HTLV-1-infected subjects. 

Results: We found strong heterogeneity both within and between clones in the expression of the proviral plus-strand (detected by hybridization to thetaxgene) and the minus-strand (hbzgene). Both genes are transcribed in bursts;taxexpression is enhanced in the absence ofhbz, whilehbzexpression increased in cells with hightaxexpression. Surprisingly, we found thathbzexpression is strongly associated with the S and G2/M phases of the cell cycle, independent oftaxexpression.  Contrary to current belief,hbzis not expressed in all cells at all times, even within one clone.  Inhbz-positive cells, the abundance ofhbztranscripts showed a very strong positive linear correlation with nuclear volume.

Conclusions: The occurrence of intense, intermittent plus-strand gene bursts in independent primary HTLV-1-infected T-cell clones from unrelated individuals strongly suggests that the HTLV-1 plus-strand is expressed in burstsin vivo.  Our results offer an explanation for the paradoxical correlations observed between the host immune response and HTLV-1 transcription.
Using mitoribosomal profiling to investigate human mitochondrial translation
Authors: Gao Fei , Wesolowska Maria , Agami Reuven , Rooijers Koos , Loayza-Puch Fabricio , Lawless Conor , N. Lightowlers Robert , Chrzanowska-Lightowlers Zofia M. A.
Published: December 2017

Background: Gene expression in human mitochondria has various idiosyncratic features. One of these was recently revealed as the unprecedented recruitment of a mitochondrially-encoded tRNA as a structural component of the large mitoribosomal subunit. In porcine particles this is mt-tRNAPhe whilst in humans it is mt-tRNAVal. We have previously shown that when a mutation in mt-tRNAVal causes very low steady state levels, there is preferential recruitment of mt-tRNAPhe. We have investigated whether this altered mitoribosome affects intra-organellar protein synthesis.

Methods: By using mitoribosomal profiling we have revealed aspects of mitoribosome behaviour with its template mt-mRNA under both normal conditions as well as those where the mitoribosome has incorporated mt-tRNAPhe.

Results: Analysis of the mitoribosome residency on transcripts under control conditions reveals that although mitochondria employ only 22 mt-tRNAs for protein synthesis, the use of non-canonical wobble base pairs at codon position 3 does not cause any measurable difference in mitoribosome occupancy irrespective of the codon. Comparison of the profile of aberrant mt-tRNAPhe containing mitoribosomes with those of controls that integrate mt-tRNAVal revealed that the impaired translation seen in the latter was not due to stalling on triplets encoding either of these amino acids. The alterations in mitoribosome interactions with start codons was not directly attributable to the either the use of non-cognate initiation codons or the presence or absence of 5’ leader sequences, except in the two bicistronic RNA units, RNA7 and RNA14 where the initiation sites are internal.

Conclusions: These data report the power of mitoribosomal profiling in helping to understand the subtleties of mammalian mitochondrial protein synthesis. Analysis of profiles from the mutant mt-tRNAVal cell line suggest that despite mt-tRNAPhe being preferred in the porcine mitoribosome, its integration into the human counterpart results in a suboptimal structure that modifies its interaction with mt-mRNAs.
The valuation of geometric characteristics of products: a modern approach
Authors: Вячеславова Ольга , Vyachyeslavova Olga , Парфеньева Ирина , Parfen'eva Irina , Зайцев Сергей , Zaycev Sergey
Published: December 2017

Discusses issues related to the modification of national standards in the field of basic norms of interchangeability. Analyzes the current approach to the valuation of geometric characteristics of products: tolerances on linear dimensions and geometric tolerances. Sets out the approach to the assessment and description of the microgeometry of the surface regulating new indicators microgeometry of the surface profile, harmonized with the experience of foreign countries
State and municipal procurement. In 2 h H. 1.: Evolution of procurement methods in the Russian Federation
Authors: Мельников Владимир , Mel'nikov Vladimir
Published: December 2017

The tutorial provides an assessment of the external environment of state regulation and characteristics of the formation mechanisms for the implementation of procurement for state and municipal needs in the economic conditions in post-Soviet Russia. Analyzes the stages of evolution of methods of public procurement from a planned economy to the formation of a national contract system of the Russian Federation.
Recommended for graduate students of economic and legal specialties of higher educational institutions, as well as for training programmes of retraining state and municipal employees.
Book Reviews
Authors: Shen Wenjing
Published: December 2017

In Book Reviews, we review an extensive and diverse range of books. They cover theory and applications in operations research, statistics, management science, econometrics, mathematics, computers, and information systems. In addition, we include books in other fields that emphasize technical applications. The editor will be pleased to receive an email from those willing to review a book, with an indication of specific areas of interest. If you are aware of a specific book that you would like to review, or that you think should be reviewed, please contact the editor. The following books are reviewed in this issue of Interfaces, 47(6), November–December: The End of Theory: Financial Crises, the Failure of Economics, and the Sweep of Human Interaction, Richard Bookstaber; Working on the Dark Side of the Moon: Life Inside the National Security Agency, Thomas Reed Willemain.
Exploring Online Travel Reviews Using Data Analytics: An Exploratory Study
Authors: Miguéis Vera L. , Nóvoa Henriqueta
Published: December 2017

The information provided by online traveler reviews is becoming a key element in the decision-making process of hotel customers, reducing the uncertainty and the perceived risk of a traveler. Therefore, a careful analysis of the content provided by online customers’ reviews might give invaluable information concerning the key determinants, from a user’s perspective, of the quality of the service provided, justifying the attributed service rating. The objectives of this study are twofold: (1) use text-mining techniques to analyze the user’s generated content automatically collected from hotels in Porto in a certain period of time and, from this analysis, derive the most frequent terms used to describe the service; (2) understand whether it is possible to predict the aggregated rating assigned by reviewers based on the terms used and, at the same time, identify the terms showing high predictive capacity. Our study attempts to support hotel service managers in achieving their strategic and tactical goals by using innovative text- and data-mining tools to explore the wealth of information provided by user generated content in an easy and timely way.
Metacompetition: Competing over the Game to Be Played
Authors: Barnett William P.
Published: December 2017

Strategy research often studies competitions among organizations and defines the winners of these competitions as “great.” But we typically treat as a given the specific formal and informal rules of the game, the logics, that govern these competition. Yet the logics governing competitions themselves are decided through a higher-level “metacompetition” with other possible logics. Metacompetitions determine who can compete, how they can compete, the criteria that will be used to evaluate success and failure, and the payoffs to competition. When we ask “where do great strategies come from” but ignore metacompetition, we take as a given the very process that gives us the rules by which we determine greatness. In this paper I argue that to understand where great strategies come from, we must first understand how metacompetition determines which logics prevail in a market. I develop an ecological model of metacompetition, and I estimate the model using data on metacompetition in the digital music distribution industry.
Effect of patient centredness on health service experience: Mediation of patient satisfaction
Authors: Thomas Bejoy John , JayaKumar David Sam , G Suganya
Published: December 2017

Background:

Hospitals are looking for progressive improvement in quality by refocusing healthcare delivery and organisational policies towards the patient. Patients should receive high quality care whenever it is needed, healthcare staff need to respect and respond to patient choices, needs and values and partnerships need to be formed between the provider, patients, their family and care givers with the core concept of patient centred care. Apart from the quality of care, reduction of cost and many other issues, healthcare executives give more priority to patient experience and satisfaction.

Aim:

The aim of the study is to assess the mediating effect of patient satisfaction between patient centred care and health service experience and to find the effect of patient centred care on health service experience.

Method:

Through a structured questionnaire 454 patients who have visited the leading eye hospitals in South India were selected for the study. Structural equation modeling was used to test the constructs.

Results:

The result suggested that the patient centred care and health service experience has a direct relationship, while patient satisfaction was found to be a partial mediator of patient centred care and experience. Moreover, coordination among the employees will help to deliver centred care for the patient along with a good experience and can result in satisfaction for the patient.

Implication for management:

Managers should emphasise on communication, providing health services in time without any delay and attention to the needs and wants of patients and offer them good reception and treatment.
Mathematical models for predicting final achieved height and its standard deviation rate in children with growth hormone deficiency in the Russian population
Authors: Gavrilova Anna E. , Nagaeva Elena V. , Rebrova Olga Yu. , Shiryaeva Tatiana Yu.
Published: December 2017

Background. Predicting the efficacy of rGH therapy in patients with GH deficiency, based on the final achieved height (FAH) criterion, is an important tool for the clinician. It enables a personalized approach to the treatment of patients with GH deficiency: to recommend careful adherence to the regimen and dosage of the drug, evaluate the efficacy of therapy in different groups of patients, and clearly demonstrate the factors affecting the FAH indicator.
Aim — to develop mathematical models for predicting FAH and its standard deviation score (SDS) in patients with GH deficiency in the Russian population.
Material and methods. For simulation, we used the data of 121 patients diagnosed with GH deficiency who received rGH since the time of diagnosis to the time of final height and were followed-up at the Institute of Pediatric Endocrinology of the Endocrinology Research Centre in the period between 1978 and 2016. As model predictors, we used 11 indicators: the gender, chronological age at the time of GH deficiency diagnosis, puberty status, disease form, regularity of rGH therapy, height SDS at birth, height SDS at the time of GH deficiency diagnosis, bone age at the time of GH deficiency diagnosis, bone age/chronological index, SDS of a genetically predicted height, and maximum stimulated GH level in a clonidine test. To generate models, we used multiple linear regression, artificial neural networks (ANNs), and the Statistica 13 software.
Results. The developed ANNs demonstrated a high accuracy of predicting FAH (the root-mean-square error was 4.4 cm, and the explained variance fraction was 76%) and a lower accuracy of predicting the FAH SDS (the root-mean-square error was 0.601 SDS, and the explained variance fraction was 42%). Linear regression models that were based on quantitative predictors only had a substantially worse quality. Free software implementation was developed for the best produced ANN.
Conclusion. An ANN-based software-implemented model for predicting FAH uses indicators available for any clinician as predictors and can be used for individual prediction of FAH. In the future, the use of larger databases for simulation will improve the quality of predicting the efficacy of rGH therapy.
Comparative pharmacoeconomic evaluation of the treatment of type 2 diabetes mellitus with insulin degludec and insulin glargine in basal-bolus insulin therapy
Authors: Kolbin Alexey S. , Shestakova Marina V. , Galstyan Gagik R. , Zhao Wenlong , Mosikyan Anna A. , Kurylev Aleksey A. , Balykina Yulia E. , Proskurin Maxim A. , Alekseeva Yana G. , Startseva Elena Y.
Published: December 2017

Background. Type 2 diabetes mellitus (T2DM) and its complications are the major causes of long-term disability, significant performance loss, and premature mortality. Poor glycemic control, diabetes-related complications, and insulin therapy are associated with a significant increase in diabetes costs. The high cost of insulin analogues restricts reimbursement of their costs in some countries. Comprehensive clinical and economic assessments of different insulin analogues are the useful tool that may help policy-makers to set priorities in medicine provision within the existing system of healthcare funding.
Aim — to compare the clinical and economic effectiveness of insulin degludec (100 U/mL) and insulin glargine (100 U/mL) in basal-bolus therapy for T2DM.
Material and methods. Economic evaluation was based on cost effectiveness analysis (CEA), incremental cost-effectiveness ratio (ICER), cost effectiveness modelling (using 5-year time horizon), sensitivity analysis, and economic feasibility assessment. The clinical effectiveness was evaluated based on changes in the HbA1c level, frequency of severe hypoglycemia, and number of patient-years without complications. Only direct medical costs (costs for insulin therapy and treatment of severe hypoglycemia and diabetes-related complications) were analyzed.
Results. The mean total direct medical costs amounted to 783,789 RUR/patient for degludec (of these, the cost of insulin therapy accounted for 68%) and 730,805 RUR/patient for glargine (of these, the costs for treatment of severe hypoglycemia and diabetes complications accounted for 62.58%). Degludec has a higher efficacy (additional HbA1c reduction by 0.52%), lower rate of severe hypoglycemia, and larger number of complication-free patient-years. Incremental costs (ICER) for degludec amounted to 101,236 RUR/patient (based on a decrease in the HbA1c level) and 353,224 RUR/patient (based on an increase in the number of complication-free patient-years); these values were 14.3- and 4.1-fold lower than the threshold of willingness-to-pay, respectively. Additional analysis of costs in patients with severe hypoglycemia rates of 3 and >3 events/patient/year demonstrated that the estimated mean total costs for insulin degludec were lower by 5 and 23%, respectively, than those for insulin glargine.
Conclusion. Our findings demonstrate the clinical and cost benefits of insulin degludec in T2DM patients, which supports its broader use in routine clinical practice for achieving the best glycemic control with minimal adverse effects.
Identification and overcoming of resistance to somatostatin analogues in real clinical practice
Authors: Ilovayskaya Irena A.
Published: December 2017

Resistance to somatostatin analogues (SSAs) is defined as the lack of biochemical and tumor response to the treatment for 12 months. An adequate biochemical response means achieving the target criteria of acromegaly treatment or at least a decrease in the GH and/or IGF-1 levels by >50%. A decrease in the somatotropinoma size by ≥ 20% (when using SSAs as the first line treatment) is considered as the tumor response to treatment. On the basis of treatment efficacy, patients may be classified as non-resistant (biochemical control of acromegaly and tumor response), partially resistant (some degree of biochemical and/or tumor response), and fully resistant (neither biochemical nor tumor response) to SSA therapy. Most patients (up to 60—70%) are partially resistant to the first generation of SSAs. Clinical and biochemical predictors for resistance to SSAs include young age, male gender, high GH/IGF-1 levels, and large invasive sparsely granulated somatotropinoma with high Ki-67 and a hyperintense T2-weighted MRI signal. In recent years, various molecular and genetic predictors for resistance to SSAs have been found; they should be introduced in clinical practice to enable the personalized approach to drug therapy. Treatment options for patients resistant to first-generation SSAs include dose escalation, combined treatment with SSAs and cabergoline, and switching to pasireotide or pegvisomant (not available in Russia); non-drug options include tumor debulking followed by SSA therapy and radiosurgery/radiotherapy.
Clinical, laboratory and instrumental methods of pre-surgical diagnosis of the parathyroid glands cancer
Authors: Mokrysheva Natalia G. , Krupinova Julia A. , Mirnaya Svetlana S.
Published: December 2017

Обоснование. При выявлении у пациента манифестной формы первичного гиперпаратиреоза (ПГПТ) дифференциальная диагностика между доброкачественным и злокачественным новообразованиями околощитовидных желез (ОЩЖ), которые могут быть причиной заболевания, затруднительна. Дифференциальная диагностика злокачественной и доброкачественной опухоли до операции определяет объем хирургического вмешательства и дальнейшую тактику наблюдения.
Цель. Определить клинические и лабораторно-инструментальные предикторы рака ОЩЖ.
Методы. Проведено одноцентровое одномоментное ретроспективное исследование, в которое включено 385 пациентов с ПГПТ (273 с аденомами ОЩЖ, 66 с гиперплазиями и 19 пациентов с раком ОЩЖ), обследованных и прооперированных в ФГБУ “НМИЦ эндокринологии” с 2000 по 2014 г. Первичной конечной точкой исследования стало определение уровня ионизированного кальция (Са++), паратгормона (ПТГ) и объема опухоли ОЩЖ, характерных для злокачественных новообразований ОЩЖ. Уровень Са++ определялся ионоселективным методом, ПТГ – электрохемилюминесцентным методом на анализаторе фирмы Roche Cobas 6000. Объем ОЩЖ рассчитывался по формуле эллипса: V(см3) = (A × B × C) × 0,49 с помощью ультразвукового исследования аппаратом Valuson E8 фирмы GeneralElectric.
Результаты. В группе пациентов с раком ОЩЖ выявлено повышение уровня Са++ более 1,60 ммоль/л (р = 0,004) и ПТГ более 600 пг/мл (p = 0,03). Объем опухоли более 6 см3 встречался чаще в группе раков, чем в группе доброкачественных новообразований ОЩЖ (р = 0,01).
Заключение. В группу высокого риска наличия карциномы ОЩЖ среди пациентов с ПГПТ входят лица с сочетанием гиперкальциемии более 1,6 ммоль/л (Са++), повышением ПТГ более 600 пг/мл и размером опухоли более 6 см3.
Toxicity management of angiogenesis inhibitors: resolution of expert panel
Authors: Rumiantsev Pavel O. , Volkova Maria I. , Podvyaznikov Sergey O. , Romanov Ilya S. , Shavarova Elena K. , Shatokhina Eugenia A.
Published: December 2017

22 июня 2017 г. в г. Санкт-Петербурге состоялся совет экспертов по теме “Управление токсичностью ингибиторов ангиогенеза”, в рамках которого обсуждались актуальные вопросы системной терапии прогрессирующего дифференцированного рака щитовидной железы, резистентного к терапии радиоактивным йодом, распространенного рака почки и вопросы эффективности и безопасности новых таргетных препаратов в лечении этих заболеваний. В докладах и дискуссиях экспертов поднимались вопросы: 1. Собственный опыт применения ленватиниба у пациентов с дифференцированным раком щитовидной железы, нечувствительного к терапии радиоактивным йодом, и раком почки. 2. Профиль эффективности и безопасности современной таргетной терапии мультикиназными ингибиторами. 3. Профилактика и контроль прогнозируемой токсичности.
The genus Isoetes from India: An overview
Authors: Patil Sachin , Rajput Kishore S
Published: December 2017

The information regarding the Indian quillwort is reviewed herewith to highlight the taxonomy, history, distribution, phytogeography, morphology, phenology, chromosome count, numerical taxonomy and present taxonomic scenario of Indian species. Authors also reviewed the opinions of different researchers on doubtful species of Indian Isoetes.
Zmienna norma pedagogiczna a postawy ucznia wobec nauki języka obcego
Authors: Lankiewicz Hadrian
Published: December 2017

Referring to critical ecological language awareness (Lankiewicz, 2015), autonomy in language learning (Benson, 2011) as well as the non-fixity of the linguistic code manifested by sociocultural and ecological studies (Harris, 1981; Otsuji and Pennycook, 2010), I put forth the need of applying the idea of a variable pedagogical norm, as postulated by Valdman (1989; 1992). The principal objective of the article is to present research elucidating the fact that the use of classroom activities respecting the pedagogical variable norm may contribute to the raising of students’ language awareness in respect to social and cultural linguistic diversity. Ultimately, this new awareness may contribute to the shift of attitudes towards language learning. The application of the variable pedagogical norm is indicative of critical language awareness of the teacher and helps develop a similar equivalent among students. Concluding, I dare say that developing autonomy in language learning seems impossible without the application of the pedagogical variable norm.
Język a tożsamość. Język pierwszy, drugi i obcy a sukcesy i niepowodzenia szkolne
Authors: Komorowska Hanna
Published: December 2017

The article investigates relationships between national/ ethnic identity and languages used in the school context. The impact of imposed, attributed, regained and selected identities on first and second language proficiency is analyzed on numerous examples drawn from the areas of history, literature and culture. Approaches to bi-and monolingualism and bi and monoculturalism are then presented with special emphasis on the role of stereotypes. Linguistic factors which influence success and failure are discussed vis-à-vis immigration and re-emigration. Attention is given to difficulties encountered by students using restricted L1 codes as well as to problems faced by pupils lacking proficiency in the language of schooling. Implications are sought for language education in the school system.
Evaluación cefalométrica de la longitud y deflexión de la base craneal anterior en pacientes con diferente patrón esquelético
Authors: Flores Angeles Adara , Soldevilla Galarza Luciano
Published: December 2017

Objetivo: Evaluar las diferencias en la longitud y deflexión de la base craneal anterior en pacientes con diferente patrón esquelético. Materiales y método: El diseño del estudio fue observacional, descriptivo y transversal. La muestra fue distribuida en tres grupos y conformada por radiografías cefalométricas de 310 pacientes, cuyo rango de edad fue de 6 a 12 años. Se obtuvieron las radiografías cefalometricas de cada paciente, las cuales fueron evaluadas a través del trazado cefalométrico. Las variables evaluadas fueron: longitud de la línea sella-nasion y el ángulo formado entre la línea sella-nasion y el plano horizontal de Frankfort. Los datos se analizaron estadísticamente utilizando las pruebas Kruskal-Wallis y U Mann-Whitney (p<0,05). Resultados: De acuerdo con el análisis estadístico, se encontraron diferencias significativas en la longitud y deflexión de la base craneal anterior en el grupo con patrón esquelético clase III (60,40+4,31 mm, 7+2,11º) en comparación a la clase I (68,36+3,76 mm, 8,13+2,64º) y clase II (68,76+3,56 mm, 8,63+2,43º). La longitud y deflexión de la base craneal anterior presentaban diferencias significativas según género, sin embargo no se encontraron diferencias significativas en relación a la edad. Conclusiones: La longitud y deflexión de la base craneal anterior es similar en niños con patrón esquelético de clase I y clase II pero diferente en clase III.
El rol del docente investigador en Odontología
Authors: Morales-Chávez Mariana
Published: December 2017

La educación odontológica en la actualidad presenta retos importantes tanto para la universidad como para los docentes ya que debido a los cambios que el mundo afronta, deben cumplirse más que nunca con los tres pilares de la educación universitaria: docencia, investigación y extensión. Ya no es suficiente la simple trasmisión de conocimientos por parte del docente sino la exposición del estudiante a la realidad social a través de la extensión, más aún en carreras científicas como la Odontología. Por último, el docente tiene la obligación de formar al estudiante como investigador para que este sea capaz de generar conocimientos y con ellos dar respuestas a problemáticas sociales. Para ello, el profesor debe contar con ciertos rasgos y desarrollar un perfil que le permita a su vez estar en la capacidad de educar a los estudiantes en el área de investigación, para ello es fundamental que el docente sea un ejemplo de producción intelectual, así como estar al día con el manejo de las nuevas tecnologías como las redes sociales científicas.
Tratamiento ortodóntico con extracción de un incisivo inferior. Reporte de un caso
Authors: Vélez Taboada Luis Carlos , Chávez Sevillano Manuel Gustavo , Luque Luque Hugo Javier
Published: December 2017

Mujer de 22 años de edad con biotipo mesofacial, patrón esquelético de Clase I y buen perfil de labios, presentó una maloclusión de Angle de Clase I con buena intercuspidación de molares y premolares, con apiñamiento moderado superior e inferior, discrepancia de Bolton anterior por exceso inferior y overbite y overjet disminuidos. Se realizó un tratamiento de ortodoncia con la extracción de un incisivo inferior, una de las extracciones atípicas en ortodoncia. El éxito de este tipo de tratamiento requiere de un profundo y minucioso registro diagnóstico en ortodoncia, ya que su elección dependerá de que el caso clínico reúna una serie de requisitos.
The number of articles submitted to the Journal of the Faculty of Medicine experienced a dramatic increase
Authors: Escobar-Córdoba Franklin
Published: December 2017

The Journal of the Faculty of Medicine of Universidad Nacional de Colombia has undergone important changes in the past years; the amount of articles submitted for initiating the editorial process has increased, in the same manner as the amount of articles received in English language, and the rejection rate, which is now around 40%. The number of international authors has also grown, thus demonstrating that the publication has achieved greater visibility and recognition.In this context, the following articles have been selected for the first issue of Volume 69 of the Journal of the Faculty of Medicine:“Is parricide a stable phenomenon? An analysis of parricide offenders in a forensic hospital” (1) is a study written by an important group of Brazilian authors, who demonstrate their expertise in one of the crimes that causes most social upheaval due to its broad implications. Parricide immediately attracts attention as it is easily linked to the presence of a mental disorder, which is actually corroborated by this study, since it shows that most parricides are young adult males, who have a low level of education, are single, with no criminal history and schizophrenic; in addition, few cases show antisocial personality disorders.
Factores de riesgo asociados a la infección por Cystoisospora suis en granjas porcinas de la región central de Venezuela
Authors: Pinilla-León Juan Carlos , Da Silva Borges Natalia
Published: December 2017

It was carried out an investigation in Venezuela with the aim of studying the epidemiological aspects of Cystoisospora suis in intensive swine herds. Sixty-seven intensive swine herds were included. For parasite determination 572 litters with signs of diarrhea, as well as 1,712 faecal samples from mature pigs were selected. Stool samples were cultured in a 2.5% potassium dichromate solution and later processed by copro-parasitological technique. Epidemiological surveys were applied on each farm. The results indicated that C. suis was observed in 55 herds (82.1%) and 210 litters (36.7%). Regarding to litters, oocysts were observed in piglets less than three days of life, which could indicate the existence of alternative infection way. Regarding to mature pigs, there was a significant correlation (rho = 0.35; P < 0.05) among oocysts excretion in piglets and sows, suggesting that sows may act as infection sources. Sows parity was statistically correlated with the prevalence values in litters as in lactating sows (P < 0.05). This might indicate that as parity increase, prevalence decreases in these groups. Probably, ­ these findings are associated with unknown immunologic mechanisms. The herd size did not affect the presence of the parasite, however, farms with plastic floors showed greater control of the infection. It is concluded that non elucidated immunologic mechanisms might be involved in the protozoa transmission cycle and play an important role in the development of Cystoisosporosis Porcina.
Un caso de desorden del desarrollo sexual en un canino mestizo
Authors: Valencia Sarita , Gonzalez Juan Carlos , Rincón Juan Carlos
Published: December 2017

The disorders of sex development can occur in different domestic animals, but they are not very common. They are classified as sex chromosomic disorders, gonadal sex development disorders andphenotypic sex disorders and have different subcategories. The aim of this study was to describe the phenotypic, chromosomal and anatomical traits of the reproductive organs of a canine patient 3-year-old, apparently female with disorder of sexual development, which presented a protuberance into the vagina with bleeding andpus, which anamnesis male behavior report. A general examination was performed by systems, ventral abdominal ultrasound,latero-lateral radiography, blood count and karyotype whit R-replicative bands. After the evaluation found an enlarged clitoris (pseudopene) with urethral opening that showed resistance to placing a catheter. Radiography showed a structure similar to penis bone and the ultrasonography a structure consistent with the cervix in a female and a structure similar to gonadal tissue in the side. The karyotype was typical of a male, compatible with a male pseudo-hermaphrodite, which classifies the individual as XY with a phenotypic disorder of sex development (78, XY) according to the new classification. With the diagnostic tools found in Colombia is possible to make an appropriate differential diagnosis. But nevertheless, lack of availability of specific diagnostic tests such as FISH and serological measurements.