Руководство по применению внутриматочных контрацептивов

ВНУТРИМАТОЧНЫЕ УСТРОЙСТВАКОНТРАЦЕПТИВНЫЕ СРЕДСТВА ЖЕНСКИ

The ultimate arc: Differential displacement, oroclinal bending, and vertical axis rotation in the External Betic-Rif arc

The External Betic-Rif arc, which lies between the converging African and Iberian plates, is one of the tightest orogenic arcs on Earth. It is a thin-skinned fold and thrust belt formed in Miocene time around the periphery of the Alborán Domain, an older contractional orogen that underwent extensional collapse coevally with the formation of the thrust belt. Restoration of four sections across the thrust belt, together with kinematic and paleomagnetic analysis, allows a reconstruction of the prethrusting geometry of the Alborán Domain, and the identification of the following processes that contributed to the formation of the arc: (1) The Alborán Domain moved some 250 km westward relative to Iberia and Africa during the Miocene. This initiated the two limbs of the arc on its NW and SW margins, closing to the WSW in the region of Cherafat in northern Morocco. The overall convergence direction on the Iberian side of the arc was between 310° and 295°, and on the African side it was between 235° and 215°. The difference in convergence direction between the two sectors was primarily a result of the relative motion between Africa and Iberia. (2) Extensional collapse of the Alborán Domain during the Miocene modified the geometry of the western end of the arc: the Internal Rif rotated anticlockwise to form the present north trending sector of the arc, and additional components of displacement produced by extension were transferred into the external thrust belt along a series of strike-slip faults and shear zones. These allowed the limbs of the arc to rotate and extend, tightening the arc, and creating variations in the amounts and directions of shortening around the arc. The Betic sector of the arc rotated clockwise by 25° during this process, and the southern Rif rotated anticlockwise by ∼55°. (3) Oblique convergence on the two limbs of the arc, dextral in the Betics and sinistral in the southern Rif, resulted in strongly noncoaxial deformation. This had three related effects: (1) large rotations of individual thrust sheets resulted from the oblique propagation of thrusts away from the thrust front, followed by pinning and rotation as the thrust sheets peeled off, (2) continued oblique convergence resulted in distributed shear, particularly in the rear of the thrust wedge, causing rotation of stacks of thrust sheets on the scale of a few tens of kilometers, and (3) distributed shear in the orogen resulted in the rotation of folds as they amplified, the hinges migrating through the rock body, and rotating at a slower rate than the rock. These rotations were substantially larger than the bulk rotations of the limbs of the arc, and they strongly modified the orientations of folds, thrust traces, and the structural indicators of fault slip directions

Serological markers of gluten sensitivity in Border terriers with gall bladder mucocoeles

Objectives To evaluate serological markers of gluten sensitivity in conjunction with cholecystokinin measurement in Border terriers with gall bladder mucocoeles. Materials and Methods Medical records from two referral hospitals were obtained between 2011 and 2019 to identify Border terriers with gall bladder mucocoeles, non‐Border terriers with gall bladder mucocoeles and control Border terriers with non‐biliary diseases. Enzyme‐linked immunosorbent assays were performed on stored fasted serum samples for anti‐gliadin IgG, anti‐canine transglutaminase‐2‐IgA autoantibodies and cholecystokinin. Statistical analysis was performed using the Kruskall‐Wallis test to identify differences between the groups. Results Fifteen Border terriers with gall bladder mucocoeles, 17 non‐Border terriers with gall bladder mucocoeles and 14 control Border terriers with non‐biliary diseases were recruited. Median transglutaminase‐2‐IgA autoantibodies in Border terriers with gall bladder mucocoeles was 0.73 (range: 0.18 to 1.67), which was significantly greater than in control Border terriers at 0.41 (0.07 to 1.14). Median cholecystokinin concentration in Border terriers with gall bladder mucocoeles was 13 pg/mL (6 to 45 pg/mL), which was significantly lower than in control Border terriers at 103 pg/mL (9 to 397 pg/mL). There was no difference in the anti‐gliadin IgG between these groups. There was no difference observed in the non‐Border terriers with gall bladder mucocoeles with either of the other groups. Clinical Significance Reduced cholecystokinin and increased transglutaminase‐2‐IgA autoantibodies was detected in Border terriers with gall bladder mucocoeles; which is in part homologous to gall bladder disease identified in human coeliac disease. The results suggest an immunological disease with impaired cholecystokinin release may be affecting gall bladder motility and possibly contributing to mucocoele formation in Border terriers

Target trial emulation: Do antimicrobials or gastrointestinal nutraceuticals prescribed at first presentation for acute diarrhoea cause a better clinical outcome in dogs under primary veterinary care in the UK?

Target trial emulation applies design principles from randomised controlled trials to the analysis of observational data for causal inference and is increasingly used within human epidemiology. Veterinary electronic clinical records represent a potentially valuable source of information to estimate real-world causal effects for companion animal species. This study employed the target trial framework to evaluate the usefulness on veterinary observational data. Acute diarrhoea in dogs was used as a clinical exemplar. Inclusion required dogs aged ≥ 3 months and < 10 years, presenting for veterinary primary care with acute diarrhoea during 2019. Treatment strategies were: 1. antimicrobial prescription compared to no antimicrobial prescription and 2. gastrointestinal nutraceutical prescription compared to no gastrointestinal nutraceutical prescription. The primary outcome was clinical resolution (defined as no revisit with ongoing diarrhoea within 30 days from the date of first presentation). Informed from a directed acyclic graph, data on the following covariates were collected: age, breed, bodyweight, insurance status, comorbidities, vomiting, reduced appetite, haematochezia, pyrexia, duration, additional treatment prescription and veterinary group. Inverse probability of treatment weighting was used to balance covariates between the treatment groups for each of the two target trials. The risk difference (RD) of 0.4% (95% CI -4.5% to 5.3%) was non-significant for clinical resolution in dogs treated with antimicrobials compared with dogs not treated with antimicrobials. The risk difference (RD) of 0.3% (95% CI -4.5% to 5.0%) was non-significant for clinical resolution in dogs treated with gastrointestinal nutraceuticals compared with dogs not treated with gastrointestinal nutraceuticals. This study successfully applied the target trial framework to veterinary observational data. The findings show that antimicrobial or gastrointestinal prescription at first presentation of acute diarrhoea in dogs causes no difference in clinical resolution. The findings support the recommendation for veterinary professionals to limit antimicrobial use for acute diarrhoea in dogs

Co-ingestion of whey protein with a carbohydrate-rich breakfast boes not affect glycemia, insulinemia or subjective appetite following a subsequent meal in healthy males

We aimed to assess postprandial metabolic and appetite responses to a mixed-macronutrient lunch following prior addition of whey protein to a carbohydrate-rich breakfast. Ten healthy males (age: 24 ± 1 y; body mass index (BMI): 24.5 ± 0.7 kg/m2) completed three trials in a non-isocaloric, crossover design. A carbohydrate-rich breakfast (93 g carbohydrate; 1799 kJ) was consumed with (CHO+WP) or without (CHO) 20 g whey protein isolate (373 kJ), or breakfast was omitted (NB). At 180 minutes, participants consumed a mixed-macronutrient lunch meal. Venous blood was sampled at 15 minute intervals following each meal and every 30 minutes thereafter, while subjective appetite sensations were collected every 30 minutes throughout. Post-breakfast insulinaemia was greater after CHO+WP (time-averaged area under the curve (AUC0-180 min): 193.1 ± 26.3 pmol/L), compared to CHO (154.7 ± 18.5 pmol/L) and NB (46.1 ± 8.0 pmol/L; p &lt; 0.05), with no difference in post breakfast (0-180 min) glycaemia (CHO+WP, 3.8 ± 0.2 mmol/L; CHO, 4.2 ± 0.2 mmol/L; NB, 4.2 ± 0.1 mmol/L; p = 0.247). There were no post lunch (0-180 min) effects of condition on glycaemia (p = 0.492), insulinaemia (p = 0.338) or subjective appetite (p &gt; 0.05). Adding whey protein to a carbohydrate-rich breakfast enhanced the acute postprandial insulin response, without influencing metabolic or appetite responses following a subsequent mixed-macronutrient meal

A multinational survey of companion animal veterinary clinicians: How can antimicrobial stewardship guidelines be optimised for the target stakeholder?

Antimicrobial stewardship initiatives are widely regarded as a cornerstone for ameliorating the global health impact of antimicrobial resistance. Within companion animal health, such efforts have largely focused on development and dissemination of antimicrobial stewardship guidelines (ASGs). However, there have been few attempts to understand veterinarian attitudes towards and knowledge of ASGs or to determine how awareness regarding ASGs might best be increased. An online survey regarding ASGs was formulated for veterinarians who treat companion animals. The survey was distributed across 46 European and associated countries between 12 January and 30 June, 2022. In total, 2271 surveys were completed, with 64.9% of respondents (n = 1474) reporting awareness and usage of at least one ASG. Respondents from countries with greater awareness of ASGs tended to report more appropriate use of antimicrobials (Spearman's rank coefficient = 0.6084, P ≤ 0.001), with respondents from countries with country-specific ASGs tending to score highest across both awareness and appropriate use domains. Respondents prioritised guidance around antimicrobial choice (82.0%, n = 1863), duration of treatment (66.0%, n = 1499), and dosage (51.9%, n = 1179) for inclusion in future ASGs, with 78.0% (n = 1776) of respondents preferring ASGs to be integrated into their patient management system. Awareness of ASGs and their use in companion animal veterinary practice appears to be greater than previously reported, with respondents tending to report antimicrobial prescription decision making broadly in line with current clinical recommendations. However, further initiatives aimed at maximising accessibility to ASGs both within countries and individual veterinary practices are recommended. [Abstract copyright: Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

SpineCreator: a Graphical User Interface for the Creation of Layered Neural Models.

There is a growing requirement in computational neuroscience for tools that permit collaborative model building, model sharing, combining existing models into a larger system (multi-scale model integration), and are able to simulate models using a variety of simulation engines and hardware platforms. Layered XML model specification formats solve many of these problems, however they are difficult to write and visualise without tools. Here we describe a new graphical software tool, SpineCreator, which facilitates the creation and visualisation of layered models of point spiking neurons or rate coded neurons without requiring the need for programming. We demonstrate the tool through the reproduction and visualisation of published models and show simulation results using code generation interfaced directly into SpineCreator. As a unique application for the graphical creation of neural networks, SpineCreator represents an important step forward for neuronal modelling

Is a cooperative approach to seaweed farming effectual? An analysis of the seaweed cluster project (SCP), Malaysia

Seaweed (Kappaphycus spp.) farming has been practised in Malaysia since the late 1970s following government policy incentives (training and farming inputs). However, numerous governance, economic, environmental, technological and sociocultural challenges have limited the industry from achieving its full potential. The Seaweed Cluster Project (SCP) was introduced in 2012 to address some of these challenges. We sought to evaluate the effectiveness of the SCP in delivering its central objectives of increasing seaweed production, optimising the farming area, improving seaweed quality and farming efficiency, raising farmers’ income, and reducing the environmental impact of seaweed farming. Community and industry perceptions of the SCP were obtained from seven communities using a mixed-methods approach based on face-to-face semi-structured interviews, focus group discussions, household surveys, observation and secondary data. Views on the SCP outcomes were generally negative, including low take-up rates by indigenous people, poor stakeholder participation in decision-making, limited acceptance of new technologies, economic vulnerability, a complex marketing system, and low social cohesion of seaweed farming communities. Positive perceptions included recognition that the SCP confers high social status upon a community, reduces operating costs, and facilitates the production of certified seaweed. The SCP’s problems are linked to poor multi-level governance, weak market mechanisms and unintegrated community development. The study concludes with five recommendations to improve the SCP: promote the participation of indigenous people; legalise existing migrant farmers; strengthen local seaweed cooperative organisations; provide entrepreneurship skills to farmers; and fully integrate stakeholders into decision-making