bluuebunny/crossref_metadata_2025 huggingface dataset:
ПРИХИЛЬНІСТЬ ЖІНОК ДО ДОВГОТРИВАЛОЇ ВТОРИННОЇ ПРОФІЛАКТИКИ ПІСЛЯ ІНФАРКТУ МІОКАРДА
Authors: Hrebenyk M. V. , Levchyk O. I. , Kotsyba O. I. , Mykulyak V. R. , Bydovanets L. Yu. , Dudarenko V. A.
Published: June 2018

Інфаркт міокарда (ІМ) є причиною високої смертності, інвалідизації та значних фінансових витрат в усіх країнах світу. В Україні щорічно реєструють до 50 тис. випадків ІМ, 50 % із цих пацієнтів помирають упродовж наступних 5 років. Тому оптимізація заходів вторинної профілактики (модифікація стилю життя, прихильність до подальшої медикаментозної терапії) має ключове значення у виживаності цих пацієнтів. Однак комплаєнсу при будь-яких захворюваннях вдається досягнути лише у 20–57 % випадків, і за даними літератури, стать має вплив на його рівень.Мета дослідження – багатофакторна оцінка прихильності жінок до лікування у післяінфарктний період.Матеріали і методи. Обстежено 408 жінок із гострим коронарним синдромом віком від 46 до 94 років (середній вік (71,30±0,44) року). Динаміку досліджуваних показників через 6; 12; 24 місяці вдалось простежити у 52 пацієнток. Відповідно до анкети Morisky–Green (D. E. Morisky, L. W. Green, 1986), виділено дві групи: перша (І) – прихильні 27 осіб – середній вік (65,26±0,44) року та друга (ІІ) – неприхильні 25 осіб – середній вік (68,52±1,88) року. Далі проведено аналіз та оцінку клініко-лабораторних та інструментальних показників.Результати досліджень та їх обговорення. В усіх жінок виявлено супутню патологію у поєднанні з артеріальною гіпертензією та цукровим діабетом 2 типу, надмірну масу тіла. Жінок першої групи швидше госпіталізували в стаціонар (через (15,37±4,9) год), ніж другої групи (через (6,45±18,9) год) з більшою часткою реваскуляризації – 28,8 % проти 5,7 %; більшою масою некрозу міокарда; вищими вихідними показниками систолічного (САТ) та діастолічного (ДАТ) артеріального тиску – (160±6,06) і (95,6±2,66) проти (153±6,11) і (89,4±2,37) мм рт. ст. та нижчим рівнем загального холестерину – (5,59±2,99) проти (6,46±2,77) ммоль/л. У динаміці в цій групі виявлялось достовірне зниження частота серцевих скорочень (ЧСС), СА Т та ДАТ та загального рівня холестерину та наближення показників ехокардіоскопії до притаманних для нормальної геометрії міокарда.Висновки. У жінок спостерігається недостатній рівень прихильності до наступної вторинної профілактики на амбулаторному етапі лікування і у більшості з них зберігається лише часткова прихильність, особливо через рік після перенесеного ІМ. Встановлено дуже низьку прихильність до немедикаментозних методів вторинної профілактики та заходів з корекції факторів ризику і модифікації стилю життя. Отримані результати ще раз вказують на необхідність оптимізації організаційно-профілактичних заходів на амбулаторному етапі. Можлива стратегія переходу в роботі з пацієнтами від “комплаєнсу до конкордансу” дозволить покращити вторинну профілактику інфаркту міокарда.
ВУЗЛОВІ УТВОРЕННЯ ЩИТОПОДІБНОЇ ЗАЛОЗИ. СТАН ПРОБЛЕМИ (ОГЛЯД ЛІТЕРАТУРИ)
Authors: Yusupov Sh. A. , Kurbaniyazov Z. B. , Zayniev A. F.
Published: June 2018

Проблема ранньої діагностики та своєчасного адекватного лікування патологічних утворень щитоподібної залози, котрі сьогодні зустрічаються у 4–10 % населення, досі залишається актуальною. спостерігається тенденція до зростання частоти діагностування вузлових новоутворень залози, однак цифри залежать від обраного методу обстеження. Так, при пальпації вузли діагностують у 4–6 % обстежуваних в районах с достатнім вмістом йоду в воді та продуктах харчування, а у зонах ендемічних по зобу – ця цифра вища. При ультразвуковому обстеженні щитоподібної залози частота виявлення раніше недіагностованих вузлів у дорослого населення складає 13–40 %. При аутопсії людей, котрі померли від нетиреоїдних захворювань, вузли знаходять більше ніж у половини. У даному огляді літератури розглядаються питання сучасних можливостей комплексної діагностики вузлових утворень щитоподібної залози. Незважаючи на значну кількість проведених обстежень, не завжди можливо правильно встановити точний морфологічний діагноз, що свідчить про необхідність удосконалення існуючих та пошуку нових більш інформативних методів діагностики. В даному аспекті повідомлення про використання вимірювань тканинного тиску в щитоподібній залозі видаються досить перспективними.
ОКСИДАТИВНИЙ СТРЕС ТА СТАН СТРЕСЧУТЛИВИХ СИСТЕМ: ПАТОГЕНЕТИЧНЕ ПАРТНЕРСТВО ПРИ НЕГОСПІТАЛЬНІЙ ПНЕВМОНІЇ У ДІТЕЙ
Authors: Kibar O. D.
Published: June 2018

Незважаючи на значні успіхи, досягнуті у вивченні патогенезу, діагностики та лікування пневмонії у дітей, до теперішнього часу не вдалося досягти суттєвих змін в рівнях захворюваності та смертності цієї патології. Це веде до пошуку нових маркерів тяжкості перебігу пневмонії, виявлення коморбідних станів, вивчення їх впливу на організм дитини.Мета дослідження – вивчити взаємозв’язок між змінами стану стресчутливих систем і антиоксидантного захисту при оксидативному стресі у дітей із позалікарняною пневмонією.Матеріали і методи. Обстежено 70 дітей із позалікарняною пневмонією. Оцінювали стани системи антиоксидантного захисту, стресзалежних систем, апоптозу і рівень молекулярних ушкоджень.Результати досліджень та їх обговорення. При обстеженні пацієнтів із пневмонією середнього ступеня тяжкості й тяжким виявлено достовірно значимі зміни систем глутатіону і вільно-радикального окиснення, що характеризуються зниженням вмісту GSH на 6,01 і 12,27 % відповідно і збільшенням вмісту GSSH на 24,12 65, 52 % відповідно. При тяжкому перебігу пневмонії одночасно спостерігали зниження активності СОД (2,04 (1,61; 3,51) ум.од./мг білка)) і зменшення редокс-індексу глутатіону до 0,817 (0,805–0,829) ум. од., на тлі збільшення вмісту оксирадикалів, каспази-3, інтенсивного утворення окисної модифікації білків і посилення фрагментації ДНК. Виявлені зміни мають тенденцію до зменшення залежно від ступеня тяжкості пневмонії.Висновки. Коливання показників окиснювального стресу, рівень молекулярних ушкоджень й інтенсивність апоптозу в дітей із позалікарняною пневмонією корелюють з тяжкістю захворювання.
ЗАХВОРЮВАНІСТЬ НА ХРОНІЧНИЙ ГЕПАТИТ С В СТРУКТУРІ ІНШИХ ХРОНІЧНИХ ВІРУСНИХ ГЕПАТИТІВ В ДНІПРОПЕТРОВСЬКОМУ РЕГІОНІ ТА УКРАЇНІ
Authors: Shevchenko-Makarenko O. P. , Shostakovich-Koretskaya L. R. , Velychko S. O. , Shtepa O. P. , Reznyh V. G.
Published: June 2018

За даними ВООЗ, витрати, пов’язані з боротьбою із хронічними хворобами та подоланням факторів ризику, складають значну частку внутрішнього валового продукту кожної країни. При цьому пацієнти та їх близькі часто стикаються зі значними витратами на лікування, зниженням доходів унаслідок хвороби, інвалідизацією, передчасним виходом на пенсію і підвищеною залежністю від послуг соціальної підтримки.Мета дослідження – вивчити та проаналізувати рівень захворюваності на хронічний вірусний гепатит С (ХВГС) у структурі хронічних вірусних гепатитів (ХВГ) у багаторічній динаміці за 2010–2017 рр. у Дніпропетровському регіоні, порівняно з показниками в Україні, та визначити тенденції і подальший прогноз розвитку епідемічного процесу.Матеріали і методи. Аналіз захворюваності проведено за епідеміологічним методом. Для визначення основних тенденцій і прогнозування захворюваності ХВГ і ХВГС використовували методи розрахунку ланцюгових темпів зростання, згладжування часових рядів методом ковзних (змінних) середніх, а також побудова регресійних моделей.Результати досліджень та їх обговорення. Питома вага ХВГС щорічно у структурі захворюваності на хронічні вірусні гепатити (В, С, D) в Дніпропетровській області становить (82,83±1,15) %, в Україні загалом – (75,76±0,79) %. Динаміка цих хвороб у Дніпропетровському регіоні й в Україні має хвилеподібний характер, з більш вираженою тенденцією до збільшення показників в Україні. Середній показник захворюваності в області склав (16,31±0,91) на 100 тис. населення проти (12,94±0,31) на 100 тис. населення в Україні (p<0,05).Висновки. За прогнозними даними у 2018–2020 рр. можна очікувати рівень захворюваності на ХВГС в Україні у середньому (6215,7±43,4) випадка на рік, захворюваність на ХВГ – (7976,5±44,4) випадка. Для імплементації глобальної стратегії ВООЗ за вірусними гепатитами необхідно впровадити широку скринінгову програму для уточнення рівня захворюваності та поширеності парентеральних гепатитів, у тому числі ХВГС, серед різних верств населення і створити реєстр хворих на хронічні вірусні гепатити як в регіоні, так і в Україні у цілому.
ЕПІДЕМІОЛОГО-КЛІНІЧНІ ПАРАЛЕЛІ УРОДЖЕНИХ ВАД ТОНКОЇ КИШКИ В НОВОНАРОДЖЕНИХ
Authors: Shamsiev А. М. , Oripov F. S. , Shamsieva D. А.
Published: June 2018

Вплив певних пестицидів та інших хімічних сполук може збільшити ризик народження немовлят з уродженими аномаліями. Проблеми різноманітних клініко-анатомічних варіантів розвитку мальформацій, вибору тактики та тривалості хірургічного лікування часткової кишкової непрохідності, як наслідку вроджених аномалій, залишаються невирішеними на сьогодні.Мета дослідження – вивчити структуру стінки тонкої кишки та визначити морфологічні та епідеміологічні критерії її уродженої обструкції у немовлят; розробити рекомендації для попередження розвитку вроджених аномалій тонкої кишки.Матеріали і методи. Досліджували зразки тонкої кишки прооперованих новонароджених немовлят з уродженими патологіями тонкої кишки, які перебували на лікуванні у відділенні дитячої хірургії СамМІ клініки № 2.Результати досліджень та їх обговорення. Дані, які ми отримали, показують, що структура тонкої кишки новонароджених дітей та експериментальних тварин мають ідентичні морфологічні зміни. Частота розвитку вроджених мальформацій чітко корелювала із рівнем забруднення водних ресурсів пестицидами у досліджуваних регіонах (R²=0,8894).Висновки. Ризик розвитку вродженої патології тонкої кишки новонароджених чітко корелює з проблемами водопостачання та високим рівнем забруднення пестицидами водних ресурсів. Таким чином, для ефективного вирішення проблеми та профілактики мальформацій кишки необхідний цілий ряд профілактичних заходів.
ПЕРЕВАГИ ВИКОРИСТАННЯ ОНЛАЙН-ФОРМ ЯК ЗАСОБУ ВИКЛАДАННЯ В ІНТЕРНАТУРІ
Authors: Krivenko V. I. , Kachan I. S. , Nepryadkina I. V. , Fedorova O. P. , Kolesnik M. Yu. , Pakhomova S. P. , Radomskaya T. Yu.
Published: June 2018

The article deals with the results of the analysis of the effectiveness of using online forms in the process of mastering the discipline «internal diseases». A pedagogical experiment was conducted with the inclusion of 46 interns who were engaged in the department during the period 2016-2017. It was found that the use of online forms to improve the efficiency of the educational process at the expense of, firstly, reducing the time spent on processing of the survey results, and, secondly, the optimization of the material assimilation level and «survival» knowledge of medical interns using a visual representation the results of the initial test and the substantive discussion on problematic issues. The combination of the online interviewing as a form of testing with the traditional way of control, and with self-control, can lead to a real system of objective assessment of the knowledge and realization of the main task of the educational process — the formation of strong knowledge and provide high-quality training of future specialists.
A exposição entre Curadoria e Públicos: problemas da Arte Contemporânea para a Ciência da Informação
Authors: Crippa Giulia
Published: June 2018

Resenha de: SCOTINI, Marco. Artecrazia: macchine espositive e governo dei pubblici. Roma: DeriveApprodi, 2016.
Comparative Effects of PCSK9 (Proprotein Convertase Subtilisin/Kexin Type 9) Inhibition and Statins on Postprandial Triglyceride-Rich Lipoprotein Metabolism
Authors: Chan Dick C. , Watts Gerald F. , Somaratne Ransi , Wasserman Scott M. , Scott Rob , Barrett P. Hugh R.
Published: June 2018

Objective—

Inhibition of PCSK9 (proprotein convertase subtilisin/kexin type 9) and statins are known to lower plasma LDL (low-density lipoprotein)-cholesterol concentrations. However, the comparative effects of these treatments on the postprandial metabolism of TRLs (triglyceride-rich lipoproteins) remain to be investigated.

Approach and Results—

We performed a 2-by-2 factorial trial of the effects of 8 weeks of subcutaneous evolocumab (420 mg every 2 weeks) and atorvastatin (80 mg daily) on postprandial TRL metabolism in 80 healthy, normolipidemic men after ingestion of an oral fat load. We evaluated plasma total and incremental area under the curves for triglycerides, apo (apolipoprotein)B-48, and VLDL (very-LDL)-apoB-100. We also examined the kinetics of apoB-48 using intravenous D3-leucine administration, mass spectrometry, and multicompartmental modeling. Atorvastatin and evolocumab independently lowered postprandial VLDL-apoB-100 total area under the curves (
P
<0.001). Atorvastatin, but not evolocumab, reduced fasting plasma apoB-48, apoC-III, and angiopoietin-like 3 concentrations (
P
<0.01), as well as postprandial triglyceride and apoB-48 total area under the curves (
P
<0.001) and the incremental area under the curves for plasma triglycerides, apoB-48, and VLDL-apoB-100 (
P
<0.01). Atorvastatin also independently increased TRL apoB-48 fractional catabolic rate (
P
<0.001) and reduced the number of apoB-48–containing particles secreted in response to the fat load (
P
<0.01). In contrast, evolocumab did not significantly alter the kinetics of apoB-48.

Conclusions—

In healthy, normolipidemic men, atorvastatin decreased fasting and postprandial apoB-48 concentration by accelerating the catabolism of apoB-48 particles and reducing apoB-48 particle secretion in response to a fat load. Inhibition of PCSK9 with evolocumab had no significant effect on apoB-48 metabolism.
Gomphosphenia plenkoviciae sp. nov. A new species from Crveno jezero, Croatia
Authors: UDOVIČ MARIJA GLIGORA , ŽUTINIĆ PETAR , PILTAVER IVNA KAVRE , KULAŠ ANTONIJA , OZIMEC ROMAN , TOFILOVSKA SLAVICA
Published: June 2018

Crveno jezero (Red Lake) is one of the largest karstic sinkhole lakes in the Europe. Diatom flora of this lake was unknown due to difficulties in collecting samples. Recently, samples were collected by speleodivers in the frame of systematical natural sciences research, during the cave diving expedition “Crveno jezero 2017” and observations revealed the existence of a new species, Gomphosphenia plenkoviciae Gligora Udovič & Žutinić sp. nov. The species is described herein as new to science based on light and scanning electron microscopy. Gomphosphenia plenkoviciae is characterized by having narrowly clavate to linear valves, which are slightly heteropolar in larger specimens to clavate in smaller specimens, thus differing from the closest taxon by the valve outline and shape of the central area. Smaller valves of G. plenkoviciae differ from other small-sized Gomphosphenia species by valve outline, striae morphology and the shape of axial and central areas.
First record of Hiroshiinoueana Kawabe, 1978 from China (Lepidoptera: Tortricidae: Olethreutinae), with descriptions of two new species
Authors: FEI YAO , ZHAO JINGXIA , LIU KAILI
Published: June 2018

The genus Hiroshiinoueana Kawabe, 1978 is recorded from China for the first time. Two new species, H. wuzhishanica sp. nov. and H. inequivalva sp. nov., are described and illustrated. A key to the species of Hiroshiinoueana is provided. Cytochrome oxidase subunit I (COI) sequences of the new species are deposited in GenBank.
‘It’s not like it used to be’: Respect and nostalgia in the policing of nightlife
Authors: Wadds Phillip
Published: June 2018

Contemporary debates regarding criminal justice, law and order, and also the occupational consciousness of policing itself, are often concerned with a mythical period of heightened ‘respect’ for authority that is contrasted with the decline of such respect in contemporary work patterns and interaction with the public. This nostalgia features most prominently in discussions about spaces and work practices where officers feel threatened, challenged or ‘under-siege’. One such site is the night-time economy, where expansion of drinking-based leisure and a long-term liberalisation of regulatory controls have exerted more pressure on police and produced urban spaces where this ‘lack of respect’ is keenly felt. This paper analyses themes that emerged from 15 interviews conducted with current and former members of the New South Wales Police Force to argue that the emergence and growth of urban nightlife have played a key role in promoting a nostalgic discourse that reflects ambivalence about historical efforts to lift police–community relations and the more formal regulation of interaction with the public. Such nostalgia also serves as a personal, social and existential resource that helps fortify shared meaning and a sense of solidarity in the working lives of officers.
Institutional procedural justice and street procedural justice in Chinese policing: The mediating role of moral alignment
Authors: Sun Ivan Y , Wu Yuning , Liu Jianhong , Van Craen Maarten
Published: June 2018

Although the process-based model of policing has been widely tested, research on how procedural justice works within police agencies, particularly its impact on officer willingness to engage in procedurally fair behavior on the street, is relatively scant. Based on survey data collected from Chinese police officers, this study assessed the linkages between internal procedural justice and external procedural justice through the mechanisms of moral alignment with both supervisors and citizens and perceived citizen trustworthiness. Greater internal procedural justice was directly related to higher external procedural justice. Fair supervision helped build up moral alignment between officers and supervisors and between officers and citizens, which in turn led to stronger commitment to fair treatment of the public. Internal procedural justice and moral alignment with citizens also cultivated officers’ perceptions of public trustworthiness, which further strengthened officers’ fair treatment toward the public.
Operational risk, omissions and liability in policing
Authors: Heaton Robert , Bryant Robin , Tong Stephen
Published: June 2018

Recent decades have seen the sensitisation of UK society towards harm and policing ‘failures’ become increasingly significant. This paper is intended to stimulate thought and debate by analysing some consequences of these developments. It reviews literature in relation to risk-taking in UK operational policing, identifying increased criminal and disciplinary liability, particularly in respect of alleged omissions. Hindsight is found to be a potentially powerful influence. The article concludes that it is unlikely that public culture will be changed readily. However, police and other bodies should be able to reach a common approach towards operational risk, omissions and hindsight.
Anticipating Industry Arguments: The US Food and Drug Administration’s Authority to Reduce Nicotine Levels in Cigarettes
Authors: Berman Micah L. , Zettler Patricia J. , Ashley David L.
Published: June 2018

The US Food and Drug Administration has announced that it is considering lowering nicotine levels in cigarettes to “minimally addictive or nonaddictive levels.” This could be a transformative public health measure, but the tobacco industry is likely to challenge such an action in court. This article reviews some of the key legal arguments that industry is likely to advance and considers possible responses. As we demonstrate, there are strong arguments that the US Food and Drug Administration has the authority to implement a policy to reduce nicotine in cigarettes to nonaddictive levels.
De Novo DNM1L Variant in a Teenager With Progressive Paroxysmal Dystonia and Lethal Super-refractory Myoclonic Status Epilepticus
Authors: Ryan Conor S. , Fine Anthony L. , Cohen Alexander L. , Schiltz Brenda M. , Renaud Deborah L. , Wirrell Elaine C. , Patterson Marc C. , Boczek Nicole J. , Liu Raymond , Babovic-Vuksanovic Dusica , Chan David C. , Payne Eric T.
Published: June 2018

Background:

The dynamin 1-like gene ( DNM1L) encodes a GTPase that mediates mitochondrial and peroxisomal fission and fusion. We report a new clinical presentation associated with a DNM1L pathogenic variant and review the literature.

Results:

A 13-year-old boy with mild developmental delays and paroxysmal dystonia presented acutely with multifocal myoclonic super-refractory status epilepticus. Despite sustained and aggressive treatment, seizures persisted and care was ultimately withdrawn in the context of extensive global cortical atrophy. Rapid trio-whole exome sequencing revealed a de novo heterozygous c.1207C>T (p.R403C) pathogenic variant in DNM1L. Immunofluorescence staining of fibroblast mitochondria revealed abnormally elongated and tubular morphology.

Conclusions:

This case highlights the diagnostic importance of rapid whole exome sequencing within a critical care setting and reveals the expanding phenotypic spectrum associated with DNM1L variants. This now includes progressive paroxysmal dystonia and adolescent-onset super-refractory myoclonic status epilepticus contributing to strikingly rapid and progressive cortical atrophy and death.
Additive-manufactured microporous polymer membranes for biomedical in vitro applications
Authors: Düregger Katharina , Trik Sina , Leonhardt Stefan , Eblenkamp Markus
Published: June 2018

Microscale porous membranes are used in a wide range of technical and medical applications such as water treatment, dialysis and in vitro test systems. A promising approach to control membrane properties and overcome limitations of conventional fabrication techniques is given by additive manufacturing (AM). In this study, we designed and printed a microporous membrane via digital light processing and validated its use for biomedical in vitro applications based on the example of a cell culture insert. A multi-layer technique was developed, resulting in an eight-layer membrane with an average pore diameter of 25 µm. Image analyses proved the printing accuracy to be high with small deviations for an increasing number of layers. Permeability tests with brilliant blue FCF (E133, triarylmethane dye) and growth factors comparing the printed to track-etched membranes showed similar transfer dynamics and confirmed sufficient separation properties. Overall, the results showed that printing microporous polymer membranes is possible and highlight the potential of AM for biomedical in vitro applications such as cell culture inserts, scaffolds for tissue engineering or bioreactors.
Cellulitis caused by the Burkholderia cepacia complex associated with contaminated chlorhexidine 2% scrub in five domestic cats
Authors: Wong Jessica K. , Chambers Lara C. , Elsmo Elizabeth J. , Jenkins Tiffany L. , Howerth Elizabeth W. , Sánchez Susan , Sakamoto Kaori
Published: June 2018

Isolates of the Burkholderia cepacia complex (BCC) are known as plant and human pathogens. We describe herein BCC infections as the cause of subcutaneous abscesses and purulent cellulitis in 5 cats. All cats were presented with an open wound, and 4 received standard wound care and empiric antibiotic therapy. Despite treatment, clinical signs worsened in 4 cats. Isolates of the BCC were obtained from all 5 cases. Two cats were submitted for postmortem examination. Subcutaneous abscesses with draining fistulas were observed. Histopathology revealed severe, pyogranulomatous cellulitis with intralesional gram-negative bacilli. Based on susceptibility results, the other 3 cats were administered effective antibiotics and recovered without complications. The BCC was cultured from the 2% chlorhexidine surgical scrub solution used in the clinic, suggesting the source of infection for 4 of 5 cats. Given the ability to grow in antiseptic solutions, the extra steps required to culture from antiseptics, and innate multidrug resistance, the BCC poses a challenge to both detect and treat. Although the BCC causes disease almost exclusively in humans with cystic fibrosis or immunodeficiency, the bacteria should also be a differential for nosocomial infections in veterinary patients.
Coupled fields in layered thermomagnetoelectroelastic spheres
Authors: Dinavahi SL Divya , Chen Jiangyi , Heyliger Paul R , Pan Ernian
Published: June 2018

A discrete-layer model is presented and applied to layered anisotropic spheres with coupling among the elastic, electric, magnetic, and temperature fields under static conditions. The governing differential equations that represent these interactions are solved using a combination of one-dimensional finite element approximations in the radial direction with analytic functions over the polar and azimuthal coordinates of the sphere. This allows for an excellent representation of the type of variability in behavior across an interface between two dissimilar materials while keeping computational cost relatively low. Results from this model are in excellent agreement with existing analytic solutions, and the methodology is applied to several new problems with practical applications.
Great expectations
Authors: Eriksson Lena , Edman Johan
Published: June 2018

Background and aims:

Increasingly, efforts to counteract perceived problems in drug treatment at residential rehabilitation centres have come to rely on measures drawing on evidence-based practice (EBP). However, the Swedish media, government inquiries, and international research have identified a number of problems regarding both residential rehabilitation and EBP. This suggests that caution should be exercised when placing expectations on EBP. The aim of this study is to investigate how the responsible authorities have handled increasing demands for EBP with administrative control while facing critical evaluations of their steering and implementation efforts. The study examines the maturation of a widespread treatment ideology, which aims to be based on evidence, in a country known for its restrictive drug policy and its goal of becoming a drug-free society.

Methods:

Through a qualitative textual analysis of 17 years (2000–2016) of inquiries, directives, and authority archives we have traced the interplay between problem descriptions, intended goals, and implemented solutions.

Findings:

The analysis shows that the ambition to provide care and welfare based on EBP is still an ambition. Also, the authorities’ control over the care actually provided still leaves room for improvement. Recurring criticism and the empirical material indicate that the expectations have not been met.

Conclusions:

We would like to suggest that continued frustration can be traced to the misconception that EBP is the opposite of values and ideology, and hence preferable. As drug treatment strives for scientific credibility to give it legitimacy, some types of “evidence” are preferred above others. We would like to suggest that we need to bring ideology to the fore, and openly discuss our restrictive policy goals and choices of “evidence”.
Mental Illness Affects Police Fatal Shootings
Authors: Frankham Emma
Published: June 2018

Emma Frankham on a deadly nexus.
Outcomes of Urinary Tract Infection Management by Pharmacists (RxOUTMAP): A study of pharmacist prescribing and care in patients with uncomplicated urinary tract infections in the community
Authors: Beahm Nathan P. , Smyth Daniel J. , Tsuyuki Ross T.
Published: June 2018

Background:

Pharmacists have the authorization to prescribe medications for the treatment of uncomplicated urinary tract infections (UTI) in some provinces. However, there are limited data on the outcomes of this care by pharmacists. Our objective was to evaluate the effectiveness, safety and patient satisfaction with pharmacist prescribing and care in patients with uncomplicated UTI.

Methods:

We conducted a prospective registry trial in 39 community pharmacies in the Canadian province of New Brunswick. Adult patients were enrolled if they presented to the pharmacy with either symptoms of UTI with no current antibacterial treatment (Pharmacist-Initial Arm) or if they presented with a prescription for an antibacterial to treat UTI from another health care provider (Physician-Initial Arm). Pharmacists assessed patients and if they had complicating factors or red flags for systemic illness or pyelonephritis, they were excluded from the study. Pharmacists either prescribed antibacterial therapy, modified antibacterial therapy, provided education only or referred to physician, as appropriate. The primary outcome was clinical cure at 2 weeks and the secondary outcomes included adverse events and patient satisfaction.

Results:

A total of 750 patients were enrolled (87.4% in the Pharmacist-Initial Arm), average age was 40.9 (SD 16.0) years. Clinical cure was achieved in 88.9% of patients. Of those that did not have sustained symptom resolution, most (5.5% overall) had symptom recurrence after completion of therapy. Adverse events were reported by 7.2% of patients and 88.9% of those continued their medication. Most adverse events were gastrointestinal-related and transient. The patient satisfaction survey reflected very high levels of satisfaction for the care they received, as well as for trust and accessibility of the pharmacist.

Conclusion:

Pharmacist management of uncomplicated UTI is effective, safe, and patient satisfaction appears very high.
Using Benford’s law on the seismic reflectivity analysis
Authors: de Macedo Isadora A. S. , de Figueiredo Jose Jadsom S.
Published: June 2018

Benford’s law (BL) is a mathematical theory of leading digits. This law predicts that the distribution of first digits of real-world observations is not uniform and follows a trend in which measurements with a lower first digit (1, 2, …) occur more frequently than those with higher first digits (…, 8, 9). A data set from earth’s geomagnetic field, the estimated time in years between reversals of earth’s geomagnetic field, the seismic P-wave speed of earth’s mantle below the southwest Pacific, and other geophysical data obey the BL. Although there are other statistical methods for analyzing a data set, we test, for the first time, the analysis of the seismic reflectivity through the Benford distribution point of view. We applied the BL on real reflectivity data from two wells from the Penobscot field and another two from the Viking Graben field. In both data sets, the reflectivity was in conformity with the BL. Moreover, after analyzing the effect of sonic and density logs despiking on Benford’s distribution through the BL, we found an optimum coefficient for the despiking process, which was a common procedure used to edit the well-log data before its use on reservoir studies.
Time-frequency decomposition
Authors: Hall Matt
Published: June 2018

Consider a waveform or signal s as a function of time t. For example, a sine wave with some amplitude a and at some frequency f might be defined by s(t) = asin(2πft).
Surveillance for Late Effects in Childhood Cancer Survivors
Authors: Landier Wendy , Skinner Roderick , Wallace W. Hamish , Hjorth Lars , Mulder Renée L. , Wong F. Lennie , Yasui Yutaka , Bhakta Nickhill , Constine Louis S. , Bhatia Smita , Kremer Leontien C. , Hudson Melissa M.
Published: June 2018

Many childhood cancer survivors carry a significant risk for late morbidity and mortality, a consequence of the numerous therapeutic exposures that contribute to their cure. Focused surveillance for late therapy-related complications provides opportunities for early detection and implementation of health-preserving interventions. The substantial body of research that links therapeutic exposures used during treatment of childhood cancer to adverse outcomes among survivors enables the characterization of groups at the highest risk for developing complications related to specific therapies; however, methods available to optimize screening strategies to detect these therapy-related complications are limited. Moreover, the feasibility of conducting clinical trials to test screening recommendations for childhood cancer survivors is limited by requirements for large sample sizes, lengthy study periods, prohibitive costs, and ethical concerns. In addition, the harms of screening should be considered, including overdiagnosis and psychological distress. Experts in several countries have developed guideline recommendations for late effects surveillance and have collaborated to harmonize these recommendations internationally to enhance long-term follow-up care and quality of life for childhood cancer survivors. Methods used in these international efforts include systematic literature searches, development of evidence-based summaries, rigorous evaluation of the evidence, and formulation of consensus-based surveillance recommendations for each late complication. Alternate methods to refine recommendations, such as cumulative burden assessment and risk prediction and cost-effectiveness modeling, may provide novel approaches to guide survivorship care in this vulnerable population and, thus, represents a worthy objective for future international survivorship collaborations.
Improving communication with older patients with cancer using geriatric assessment (GA): A University of Rochester NCI Community Oncology Research Program (NCORP) cluster randomized controlled trial (CRCT).
Authors: Mohile Supriya Gupta , Epstein Ronald M. , Hurria Arti , Heckler Charles E. , Duberstein Paul , Canin Beverly E. , Gilmore Nikesha , Wells Megan , Xu Huiwen , Culakova Eva , Lowenstein Lisa M. , Flannery Marie Anne , Magnuson Allison , Loh Kah Poh , Mustian Karen Michelle , Hopkins Judith O. , Liu Jijun , Melnyk Nataliya , Morrow Gary R. , Dale William
Published: June 2018

LBA10003

Background: GA includes validated measures that assess age-related health domains (e.g., function, cognition) known to increase adverse outcomes. In this PCORI and NCI funded CRCT, we evaluated if providing a GA summary and recommendations for GA-guided interventions improves communication about age-related concerns for older patients (pts) with cancer. Methods: Pts aged ≥ 70 with advanced solid tumors or lymphoma and at least 1 impaired GA domain were enrolled. Oncology practices were randomized to intervention (oncologists received GA summary) or usual care (no summary provided). The primary outcomes were: 1) number of discussions about age-related concerns (the clinic visit after GA was audio-recorded and transcribed; 2 blinded coders evaluated quality of communication and plan for follow-up interventions) and 2) telephone surveys of patient satisfaction (modified Health Care Climate Questionnaire [HCCQ-age] scored 7-35). Outcomes were analyzed using linear mixed models with arm as the fixed effect, controlling for practice. Results: From 2014-17, 544 pts (295 in GA) were enrolled from 31 practices. There were no differences in demographics by arm (mean age 77 yrs; 49% female). More patients in usual care had impaired physical performance (96% vs 92%, p = 0.03) and social support (33% vs 25%, p = 0.05). In 530 evaluable pts, the overall mean number of discussions was 6.3 (SD: 4.0). The GA arm had 3.5 more discussions about age-related concerns (95%CI: 2.28-4.72, p = 10-6; intraclass correlation coefficient [ICC] = 0.24) compared to usual care; of these, in the GA arm, 2.0 more discussions on average had higher quality communication (95%CI: 1.20-2.69; p = 6x10-6) and 1.9 more led to interventions (95% CI: 1.14-2.73; p = 1.6x10-5). The GA arm had significantly more discussions for almost all GA domains. In 511 pts with HCCQ-age, the mean score was 22.9 (SD 4.5); the score was 1.12 points higher in the GA arm (95%CI: 0.23-2.03; p = .027; ICC = 0.02). Conclusions: Providing a GA summary to oncologists increases the number and quality of discussions about age-related concerns and improves pt satisfaction. Clinical trial information: NCT02107443.
Phase III Randomized Study of Ribociclib and Fulvestrant in Hormone Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative Advanced Breast Cancer: MONALEESA-3
Authors: Slamon Dennis J. , Neven Patrick , Chia Stephen , Fasching Peter A. , De Laurentiis Michelino , Im Seock-Ah , Petrakova Katarina , Bianchi Giulia Val , Esteva Francisco J. , Martín Miguel , Nusch Arnd , Sonke Gabe S. , De la Cruz-Merino Luis , Beck J. Thaddeus , Pivot Xavier , Vidam Gena , Wang Yingbo , Rodriguez Lorenc Karen , Miller Michelle , Taran Tetiana , Jerusalem Guy
Published: June 2018

Purpose

This phase III study evaluated ribociclib plus fulvestrant in patients with hormone receptor–positive/human epidermal growth factor receptor 2–negative advanced breast cancer who were treatment naïve or had received up to one line of prior endocrine therapy in the advanced setting.

Patients and Methods

Patients were randomly assigned at a two-to-one ratio to ribociclib plus fulvestrant or placebo plus fulvestrant. The primary end point was locally assessed progression-free survival. Secondary end points included overall survival, overall response rate, and safety.

Results

A total of 484 postmenopausal women were randomly assigned to ribociclib plus fulvestrant, and 242 were assigned to placebo plus fulvestrant. Median progression-free survival was significantly improved with ribociclib plus fulvestrant versus placebo plus fulvestrant: 20.5 months (95% CI, 18.5 to 23.5 months) versus 12.8 months (95% CI, 10.9 to 16.3 months), respectively (hazard ratio, 0.593; 95% CI, 0.480 to 0.732; P < .001). Consistent treatment effects were observed in patients who were treatment naïve in the advanced setting (hazard ratio, 0.577; 95% CI, 0.415 to 0.802), as well as in patients who had received up to one line of prior endocrine therapy for advanced disease (hazard ratio, 0.565; 95% CI, 0.428 to 0.744). Among patients with measurable disease, the overall response rate was 40.9% for the ribociclib plus fulvestrant arm and 28.7% for placebo plus fulvestrant. Grade 3 adverse events reported in ≥ 10% of patients in either arm (ribociclib plus fulvestrant v placebo plus fulvestrant) were neutropenia (46.6% v 0%) and leukopenia (13.5% v 0%); the only grade 4 event reported in ≥ 5% of patients was neutropenia (6.8% v 0%).

Conclusion

Ribociclib plus fulvestrant might represent a new first- or second-line treatment option in hormone receptor–positive/human epidermal growth factor receptor 2–negative advanced breast cancer.
“The Complexity of Loss Itself”: The Comics Form andFun Home’s Queer Reparative Temporality
Authors: McCullough Kate
Published: June 2018

This article assesses the queer world-making potentiality of the comics form as demonstrated in Alison Bechdel’s 2006 graphic memoir Fun Home. By deploying the temporal openings of the graphic form, Fun Home challenges the putative fixity of heteronormative family time and the temporality of kinship lines more broadly. Bechdel represents this queering of generation and kinship as a constituent part of the young Alison’s coming-of-age as a queer comics artist; this temporal reworking simultaneously makes possible a queer reparative web of affiliation. Building on Eve Kosofsky Sedgwick’s model of reparative reading, I demonstrate how Fun Home’s form produces a version of reparation that emerges from a shared artistry and embraces ambivalent affective responses to the past. Ultimately, Bechdel produces a queer feminist reparative reading that understands futurity’s potential as complex and grounded in both the pain and pleasure of the queer body.
Investment Strategy and Selection Bias: An Equilibrium Perspective on Overoptimism
Authors: Jehiel Philippe
Published: June 2018

Investors implement projects based on idiosyncratic signal observations, without knowing how signals and returns are jointly distributed. The following heuristic is studied: investors collect information on previously implemented projects with the same signal realization, and invest if the associated mean return exceeds the cost. The corresponding steady states result in suboptimal investments, due to selection bias and the heterogeneity of signals across investors. When higher signals are associated with higher returns, investors are overoptimistic, resulting in overinvestment. Rational investors increase the overoptimism of sampling investors, thereby illustrating a negative externality imposed by rational investors. (JEL D82, G11, G31, L26, M13)
Enfranchising Your Own? Experimental Evidence on Bureaucrat Diversity and Election Bias in India
Authors: Neggers Yusuf
Published: June 2018

This paper investigates the effects of polling station administrator diversity on elections in India, using a natural experiment: the random assignment of government officials to teams managing stations on election day, together with surveys conducted with voters and election officers. I demonstrate that changes in the religious and caste composition of officer teams impact voting at the polling station level, causing shifts in coalition vote shares large enough to influence election outcomes. Effects are strongest when officers have greater discretion over the voting process. I also provide evidence suggesting own-group favoritism by election personnel as one relevant mechanism. (JEL C93, D72, D73, J15, O17, Z12)
WATERTOOL™: AN AUTOMATED SYSTEM FOR HYDROLOGICAL INVESTIGATIONS WITH APPLICATION AT THE AREA OF KATO SOULI (NE ATTICA, GREECE)
Authors: Sotiropoulos P. , Tzanis A. , Sideris G.
Published: June 2018

Surface and groundwater resources are important assets for the economic and social welfare of the population of a given area; they are renewable and with proper management, they contribute substantially to sustained development. Unfortunately, the expansion of industrial and agricultural activities lead to increasing withdrawal of water from the aquifers, excessive use of pesticides and fertilizers and (frequently illicit) disposal of industrial waste. This results in rapid reduction in the quantity and quality of water reserves. There's a compelling call for the development of advanced and inexpensive means to monitor the quantitative and qualitative characteristics of water resources. In response to such requirements, as specified by Directive 2000/60 of the European Commission, TerraMentor E.E.I.G. has spearheaded the development of a multi-channel sensor and system to measure up to 15 physical and chemical parameters (pollutant concentration) facilitating the evaluation of water quality in real time (Watertool™). The system uses the Ion-Selective Electrode technology, which is thoroughly described. Its effectiveness is demonstrated with an application in the area of Kato Souli (NE Attica), which suffers from intense salination (seawater intrusion) and pollution of the aquifer. It is shown that the Watertool is an inexpensive, accurate and fast method to map the quality of groundwater reserves and assist aquifer managers in making effective decisions.
PETROLOGY AND PROVENANCE STUDY OF THE QUATERNARY CLASTIC SEDIMENTS FROM HERSO KILKIS (MACEDONIA, GREECE)
Authors: Georgiadis I. K. , Tsirambides A. , Kassoli-Fournaraki A. , Trontsios G.
Published: June 2018

The sediments analysed are generally coarse grained, sand gravels to gravel sands. The silt and clay content of the samples is low and their textural study revealed a fluvial deposition environment. The amounts of quartz, feldspars and lithic fragments range from 33% to 56%, 8% to 18% and 28% to 52%, respectively. The samples studied may be classified as garnet-mica bearing litharenites. Quartz, plagioclases and micas are the predominant constituents. Detritai calcite and pyroxenes are present in small amounts. The samples are texturally and mineralogically immature. Detailed polarized microscopy revealed the presence of garnet, staurolite, kyanite, zoisite, routile, epidote, zircon, apatite and tourmaline, as well as of opaque minerals. These accessory minerals are considered indexes of metamorphic provenance. Geochemically the samples are classified as sublitharenites and subarkoses, all being rich in Si02- The overall percentages of quartz, feldspars and rock fragments designate intense physical weathering and rapid transport and deposition in the Herso Basin which is part of a passive continental margin (recycled orogen).
Multiple Faces of Science in Ethical Environmental Decision-Making
Authors: Greene Herman F
Published: June 2018

This essay concerns the multiple faces of science in ethical environmental decision-making. Environmental crises pose existential threats to human and non-human life. Science is essential to any meaningful response to these crises, but science as it is conventionally understood and practiced is not adequate to the task. Drawing on the work of Bruno Latour in his 2013 Gifford Lectures on ―Facing Gaia: Six Lectures on the Political Theology of Nature,‖1 I will critique this understanding and practice in relation to four faces of science - (i) capacity builder, (ii) informer and guide, (iii) philosophy, and (iv) institution—and propose reforms.
Right and Wrong in the Conduct of Science
Authors: Das Mukunda P , Green Frederick
Published: June 2018

Science, in particular physics, is a collective enterprise and is so because it is, itself, a fruit of the exquisitely social nature of human living. So it is inevitable to encounter ethical issues in the natural sciences, since the contest of differing interests and views is perennial in its practice, indeed essential to its momentum. The crucial ethical question always hangs in the air: How is the truth best served? In this paper we describe some ethical aspects of our own discipline of science: their cultural context and the bounds which they delineate for themselves, sometimes in transgression. We argue that the minimalist ethic espoused in science, namely loyalty to truth, is a bellwether for the much wider, more problematic, and more vital consequences of ethics – and its failure – in human relationships at large.
The rate and predictors of patient satisfaction after total knee arthroplasty are influenced by the focus of the question
Authors: Clement N. D. , Bardgett M. , Weir D. , Holland J. , Gerrand C. , Deehan D. J.
Published: June 2018

Aims

The primary aim of this study was to assess the rate of patient satisfaction one year after total knee arthroplasty (TKA) according to the focus of the question asked. The secondary aims were to identify independent predictors of patient satisfaction according to the focus of the question.

Patients and Methods

A retrospective cohort of 2521 patients undergoing a primary unilateral TKA were identified from an established regional arthroplasty database. Patient demographics, comorbidities, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and 12-Item Short-Form Health Survey (SF-12) scores were collected preoperatively and one year postoperatively. Patient satisfaction was assessed using four questions, which focused on overall outcome, activity, work, and pain. Logistic regression analysis was used to identify independent preoperative predictors of increased stiffness when adjusting for confounding variables.

Results

Using patient satisfaction with the overall outcome (n = 2265, 89.8%) as the standard, there was no difference in the rate of satisfaction for pain relief (n = 2277, odds ratio (OR) 0.95, 95% confident intervals (CI) 0.79 to 1.14, p = 0.60), but patients were more likely to be dissatisfied with activities (79.3%, n = 2000/2521, OR 2.22, 95% CI 1.96 to 2.70, p < 0.001) and work (85.8%, n = 2163/2521, OR 1.47, 95% CI 1.23 to 1.75, p < 0.001). Logistic regression analysis identified different predictors of satisfaction for each of the focused satisfaction questions. Overall satisfaction was influenced by diabetes (p = 0.03), depression (p = 0.004), back pain (p < 0.001), and SF-12 physical (p = 0.008) and mental (p = 0.01) components. Satisfaction with activities was influenced by depression (p = 0.001), back pain (p < 0.001), WOMAC stiffness score (p = 0.03), and SF-12 physical (p < 0.001) and mental (p < 0.001) components. Satisfaction with work was influenced by depression (p = 0.007), back pain (p < 0.001), WOMAC function (p = 0.04) and stiffness (p = 0.05) scores, and SF-12 physical (p < 0.001) and mental (p < 0.001) components. Satisfaction with pain relief was influenced by diabetes (p < 0.001), back pain (p < 0.001), and SF-12 mental component (p = 0.04).

Conclusion

The focus of the satisfaction question significantly influences the rate and the predictors of patient satisfaction after TKA. Cite this article: Bone Joint J 2018;100-B:740–8.