Dynamics of the serum bilirubin level during bile ducts drainage in patients with hilar tumor stenosis and jaundice

Palliative bile duct decompression with various modifications are currently performed in 75-80% of patients with hilar stenosis caused by the tumor. The main goal of palliative care is to reduce the manifestations of jaundice, intoxication, pain syndrome, prolong life period and improve patient’s conditions for chemotherapy.Objective: to evaluate the effectiveness of bile ducts antegrade drainage methods by bilirubin reducing in the palliative treatment of patients with jaundice due to hilar stenosis caused by the tumor.Materials and methods. In a prospective study included 78 patients with hilar obstructive jaundice, who were underwent of palliative antegrade draining of bile ducts: percutaneous transhepatic cholangiostomy (group PTC) - n = 24, externally-internal suprapapillary cholangiostomy (group EISC) - n = 26, percutaneous transhepatic antegrade endobiliary stenting (group PTAES) - n = 28. Endpoints of the study: total serum bilirubin before the procedure, after 3, 7 days and every 10 days for two months. The mean values of bilirubin and the average percentage of decrease in its value at each of the control periods were evaluated in relation to the initial level. Also, at the same time, the cumulative percentage of patients in which bilirubin had a value of ≤34.2 μmol / L (2 mg / dL) or ≤ 85.5 μmol / L (5 mg / dL) was assessed - the threshold values at which a certain type of chemotherapy is possible.Results. In all groups, there was a decrease in the average values of bilirubin levels with an increase in the time passed after the procedure. At all control periods, the mean bilirubin values and the percentage of decrease in the mean bilirubin values did not differ statistically between groups (all p < 0.05). The highest rates of decrease in the level of bilirubin were observed during the first 10 days (about 60.0%). From the 10th to the 60th day, the decrease in the level of bilirubin was approximately 20% from the initial one. The cumulative percentage of patients with the bilirubin level on the 60th day ≤ 34.1 μmol / l (2 mg / dl) was 45.8% in the EISC group, 64.5% in the PTC group, and 63.9% in the PTAES group (p = 0.257) in a month these indicators were 11.7%, respectively; 12.5% and 17.9% (all p <0.05). The decrease in the level of bilirubin ≤ 85.5 μmol / L (5 mg / dL) was more rapid. So, already after 10 days, the cumulative percentage of such patients in the groups exceeded 50.0%: 58.3% in the EISC group, 63.6% in the PTC group, 57.7 % in the PTAES group (p = 0.26) in a month these indicators were respectively 83.3%; 77.3% and 80.8%, after two months, respectively 91.7%, 86.4 and 100% (p = 0.80).Conclusions. The methods of transcutaneous bile ducts drainage/stenting effectively reduce the level of total bilirubin in patients with obstructive jaundice due to hilar stenosis caused by tumor and have no statistically significant differences in the dynamics of bilirubin level within two months of observation

Long-term Annual Aerial Surveys of Submersed Aquatic Vegetation (SAV) Support Science, Management, and Restoration

Aerial surveys of coastal habitats can uniquely inform the science and management of shallow, coastal zones, and when repeated annually, they reveal changes that are otherwise difficult to assess from ground-based surveys. This paper reviews the utility of a long-term (1984–present) annual aerial monitoring program for submersed aquatic vegetation (SAV) in Chesapeake Bay, its tidal tributaries, and nearby Atlantic coastal bays, USA. We present a series of applications that highlight the program’s importance in assessing anthropogenic impacts, gauging water quality status and trends, establishing and evaluating restoration goals, and understanding the impact of commercial fishing practices on benthic habitats. These examples demonstrate how periodically quantifying coverage of this important foundational habitat answers basic research questions locally, as well as globally, and provides essential information to resource managers. New technologies are enabling more frequent and accurate aerial surveys at greater spatial resolution and lower cost. These advances will support efforts to extend the applications described here to similar issues in other areas

Influence of Reservoir Infill on Coastal Deep Water Hypoxia

Ecological restoration of the Chesapeake through the Chesapeake Bay total maximum daily load (TMDL) requires the reduction of nitrogen, phosphorus, and sediment loads in the Chesapeake watershed because of the tidal water quality impairments and damage to living resources they cause. Within the Chesapeake watershed, the Conowingo Reservoir has been filling in with sediment for almost a century and is now in a state of near‐full capacity called dynamic equilibrium. The development of the Chesapeake TMDL in 2010 was with the assumption that the Conowingo Reservoir was still effectively trapping sediment and nutrients. This is now known not to be the case. In a TMDL, pollutant loads beyond the TMDL allocation, which are brought about by growth or other conditions, must be offset. Using the analysis tools of the Chesapeake TMDL for assessing the degree of water quality standard attainment, the estimated nutrient and sediment loads from a simulated dynamic equilibrium infill condition of the Conowingo Reservoir were determined. The influence on Chesapeake water quality by a large storm and scour event of January 1996 on the Susquehanna River was estimated, and the same storm and scour events were also evaluated in the more critical living resource period of June. An analysis was also made on the estimated influence of more moderate high flow events. The infill of the Conowingo reservoir had estimated impairments of water quality, primarily on deep‐water and deep‐channel dissolved oxygen, because of increased discharge and transport of organic and particulate inorganic nutrients from the Conowingo Reservoir

Long-term Annual Aerial Surveys of Submersed Aquatic Vegetation (SAV) Support Science, Management, and Restoration

Aerial surveys of coastal habitats can uniquely inform the science and management of shallow, coastal zones, and when repeated annually,theyrevealchangesthatareotherwisedifficulttoassess fromground-basedsurveys.Thispaperreviewstheutilityofalongterm(1984–present)annualaerialmonitoringprogramforsubmersedaquaticvegetation(SAV)inChesapeakeBay,itstidaltributaries, and nearby Atlantic coastal bays, USA. We present a series of applications that highlight the program’s importance in assessing anthropogenic impacts, gauging water quality status and trends, establishing and evaluating restoration goals, and understanding the impactofcommercialfishingpracticesonbenthichabitats.Theseexamplesdemonstratehowperiodicallyquantifyingcoverageofthis important foundational habitat answers basic research questions locally, as well as globally, and provides essential information to resource managers. New technologies are enabling more frequent and accurate aerial surveys at greater spatial resolution and lower cost. These advances will support efforts to extend the applications described here to similar issues in other areas

Студенти-психологи: мотивації до навчання і життєві плани

Батюк, А. В. Студенти-психологи: мотивації до навчання і життєві плани / Анна Вадимівна Батюк, Микола Миколайович Саппа // Особистість, суспільство, закон : тези доп. учасників міжнар. наук.-практ. конф., присвяч. пам’яті проф. С. П. Бочарової (м. Харків, 25 квіт. 2019 р.) / МВС України, Харк. нац. ун-т внутр. справ. – Харків, 2019. – С. 21-24.Наведено результати пілотажного соціологічного дослідження мотивацій до навчання і життєвих планів студентів-психологів ХНУВС.The results of a pilot sociological study of motivations to study and life plans of psychology students of Kharkiv National University of Internal Affairs are given.Представлены результаты пилотажного социологического исследования мотиваций к учёбе и жизненных планов студентов-психологов ХНУВД

Preserving the Chesapeake: Law, Ecology, and the Bay

This event was co-sponsored by the Merhige Center for Environmental Studies, the Allen Chair of Law, the Virginia State Bar, and the Miller Center of Public Affairs. The “Historical Background” session, held from 9:30 - 10:30 a.m., was presented by the Hon. Governor Gerald L. Baliles, Director of the Miller Center of Public Affairs and 65th Governor of the Commonwealth of Virginia; Gerald McCarthy, Executive Director of the Virginia Environmental Endowment; and Russell W. Baxter, Deputy Director of the Virginia Department of Conservation and Recreation. Rodney A. Smolla, Dean of the University of Richmond School of Law, served as moderator. The “Current State of the Bay” session, held on Friday, October 20, 2006 from 10:45 - 11:45 a.m., was presented by Jonathan Z. Cannon, Director of the Center for Environmental and Land Use Law at the University of Virginia School of Law; Erin Ryan, of the Marshall-Wythe School of Law at the College of William and Mary; and Richard Batiuk, Associate Director for Science of the Chesapeake Bay Program Office, United States Environmental Protection Agency. Joel Eisen, University of Richmond School of Law, served as moderator. The Keynote was given from 11:45 a.m. - 1:15 p.m. by L. Preston Bryant, Secretary of Natural Resources of the Commonwealth of Virginia. The “Regulatory Efforts” session, held 1:15-2:15 p.m., was presented by Kathy R. Frahm, Director of the Division of Policy at the Virginia Department of Environmental Quality; Joseph J. Tannery, Virginia Staff Attorney for the Chesapeake Bay Foundation; David E. Evans, Partner at McGuireWoods LLP; and Mark Smith, Environmental Scientist with the Water Protection Division, U.S. Environmental Protection Agency. The “Future and Solutions” session, held from 2:30-3:45 p.m., was presented by Nikki Rovner, Deputy Secretary of Natural Resources for the Commonwealth of Virginia; Timothy G. Hayes, Partner at Hunton & Williams LLP; Clyde Wilbur, Principal of Greeley & Hanson; and Alexandra Dunn, General Counsel for the National Association of Clean Water Agencies. Carl W. Tobias, Williams Professor of Law University of Richmond School of Law, served as moderator

Progress for research of grape and wine culture in Georgia, the South Caucasus

This communication will provide the latest information about the progress of the “Research Project for the Study of Georgian Grapes and Wine Culture”, managed by the National Wine Agency of Georgia since 2014. Local and foreign institutions continue to work together with the aim of stimulating multidisciplinary scientific research activity on Georgian viticulture and viniculture and to reconstruct their development from Neolithic civilizations to the present. The project is multidisciplinary in nature, merging contributions from archaeology, history, ethnography, molecular genetics, biomolecular archaeology, palaeobotany, ampelography, enology, climatology and other scientific fields

The satisfactory growth and development at 2 years of age of the INTERGROWTH-21st Fetal Growth Standards cohort support its appropriateness for constructing international standards.

BACKGROUND: The World Health Organization recommends that human growth should be monitored with the use of international standards. However, in obstetric practice, we continue to monitor fetal growth using numerous local charts or equations that are based on different populations for each body structure. Consistent with World Health Organization recommendations, the INTERGROWTH-21st Project has produced the first set of international standards to date pregnancies; to monitor fetal growth, estimated fetal weight, Doppler measures, and brain structures; to measure uterine growth, maternal nutrition, newborn infant size, and body composition; and to assess the postnatal growth of preterm babies. All these standards are based on the same healthy pregnancy cohort. Recognizing the importance of demonstrating that, postnatally, this cohort still adhered to the World Health Organization prescriptive approach, we followed their growth and development to the key milestone of 2 years of age. OBJECTIVE: The purpose of this study was to determine whether the babies in the INTERGROWTH-21st Project maintained optimal growth and development in childhood. STUDY DESIGN: In the Infant Follow-up Study of the INTERGROWTH-21st Project, we evaluated postnatal growth, nutrition, morbidity, and motor development up to 2 years of age in the children who contributed data to the construction of the international fetal growth, newborn infant size and body composition at birth, and preterm postnatal growth standards. Clinical care, feeding practices, anthropometric measures, and assessment of morbidity were standardized across study sites and documented at 1 and 2 years of age. Weight, length, and head circumference age- and sex-specific z-scores and percentiles and motor development milestones were estimated with the use of the World Health Organization Child Growth Standards and World Health Organization milestone distributions, respectively. For the preterm infants, corrected age was used. Variance components analysis was used to estimate the percentage variability among individuals within a study site compared with that among study sites. RESULTS: There were 3711 eligible singleton live births; 3042 children (82%) were evaluated at 2 years of age. There were no substantive differences between the included group and the lost-to-follow up group. Infant mortality rate was 3 per 1000; neonatal mortality rate was 1.6 per 1000. At the 2-year visit, the children included in the INTERGROWTH-21st Fetal Growth Standards were at the 49th percentile for length, 50th percentile for head circumference, and 58th percentile for weight of the World Health Organization Child Growth Standards. Similar results were seen for the preterm subgroup that was included in the INTERGROWTH-21st Preterm Postnatal Growth Standards. The cohort overlapped between the 3rd and 97th percentiles of the World Health Organization motor development milestones. We estimated that the variance among study sites explains only 5.5% of the total variability in the length of the children between birth and 2 years of age, although the variance among individuals within a study site explains 42.9% (ie, 8 times the amount explained by the variation among sites). An increase of 8.9 cm in adult height over mean parental height is estimated to occur in the cohort from low-middle income countries, provided that children continue to have adequate health, environmental, and nutritional conditions. CONCLUSION: The cohort enrolled in the INTERGROWTH-21st standards remained healthy with adequate growth and motor development up to 2 years of age, which supports its appropriateness for the construction of international fetal and preterm postnatal growth standards

Novel inhibitors of the calcineurin/NFATc hub - alternatives to CsA and FK506?

The drugs cyclosporine A (CsA) and tacrolimus (FK506) revolutionized organ transplantation. Both compounds are still widely used in the clinic as well as for basic research, even though they have dramatic side effects and modulate other pathways than calcineurin-NFATc, too. To answer the major open question - whether the adverse side effects are secondary to the actions of the drugs on the calcineurin-NFATc pathway - alternative inhibitors were developed. Ideal inhibitors should discriminate between the inhibition of (i) calcineurin and peptidyl-prolyl cis-trans isomerases (PPIases; the matchmaker proteins of CsA and FK506), (ii) calcineurin and the other Ser/Thr protein phosphatases, and (iii) NFATc and other transcription factors. In this review we summarize the current knowledge about novel inhibitors, synthesized or identified in the last decades, and focus on their mode of action, specificity, and biological effects

Educational Programs and Recidivism in Oklahoma: Another Look

Prior research suggests that educational programs are one of the most effective tools in reducing recidivism rates. In this study, however, the authors found that some educational programs administered in Oklahoma may not have an ameliorative effect on criminality. Specifically, they found that completion of a general equivalency diploma program was strongly associated with longer survival times outside of prison, particularly for women. However, for both men and women, completion of vocational-technical training while incarcerated was linked to shorter survival times. This indicates the need to evaluate the types of training offered in prisons.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline