Антицитрулінові антитіла в діагностиці артритів у дітей

Віходячи з проведеного дослідження, описаного в роботі, можна дійти висновку, що серед дітей із різними формами артритів тільки 4,8% пацієнтів були серопозитивними за РФ, та 23,8% дітей – за рівнем АЦЦП. Прогнастичне значення підвищеного рівня АЦЦП у дітей із РеА полягає в високій вірогідності розвитку ЮРА, що обумовлює більш ретельне їх спостереження із застосуванням індивідуальних схем профілактичного лікування. При цитуванні документа, використовуйте посилання http://essuir.sumdu.edu.ua/handle/123456789/1128

An impact assessment methodology for small scale renewable energy projects in developing countries funded under Dutch policies defined to contribute to the millennium development goals

Vulnerable groups, such as poor people in developing countries, are often hit hard by the effects of climate change since they lack the resources needed to cope or adapt to the changing environment. To conduct poverty reduction without compromising on the environment, the Dutch government defined a variety of policy measures. One is the so‐called Daey Ouwens Fund, established to implement small scale renewable energy projects in the poorest countries of the world. This Fund aims to contribute to Millennium Developing Goal 1, eradication of extreme poverty, and MDG 7, ensuring environmental sustainability. This paper describes the methodology developed to get a better understanding of the socioeconomic and environmental impact of projects to be implemented under the Daey Ouwens Fund. This methodology uses the multi level “Strategic Niche Management (SNM)” framework to systematically assess drivers and barriers crucial in process of innovation. For three selected projects, indicators are defined within this SNM framework, based on the MGD 1 and MGD 7 and the local socio‐economic situation as well as the existing energy system and the innovative renewable energy technology of the project. These indicators are translated into sets of questions to be quantified through a limited number of semi‐structured interviews with key persons and questionnaire inquiries of a large number of potential end‐users. The data of the conducted baseline study will be presented in this paper to provide an overall picture of the current socio‐economic situation and the energy consumption in the areas were the three selected project are going to be implemented. Based on these data and the SNM framework, an overview will be provided of drivers and barriers for the projects and the expected contribution to MDG 1 and 7. The methodology will be assessed and adapted for the impact monitoring assessment that will be held in 2013

Low-value home-based nursing care:A national survey study

Aims: To explore potential areas of low-value home-based nursing care practices, their prevalence and related influencing factors of nurses and nursing assistants working in home-based nursing care. Design: A quantitative, cross-sectional design. Methods: An online survey with questions containing scaled frequencies on five-point Likert scales and open questions on possible related influencing factors of low-value nursing care. The data collection took place from February to April 2022. Descriptive statistics and linear regression were used to summarize and analyse the results. Results: A nationwide sample of 776 certified nursing assistants, registered nurses and nurse practitioners responded to the survey. The top five most delivered low-value care practices reported were: (1) ‘washing the client with water and soap by default’, (2) ‘application of zinc cream, powders or pastes when treating intertrigo’, (3) ‘washing the client from head to toe daily’, (4) ‘re-use of a urinary catheter bag after removal/disconnection’ and (5) ‘bladder irrigation to prevent clogging of urinary tract catheter’. The top five related influencing factors reported were: (1) ‘a (general) practitioner advices/prescribes it’, (2) ‘written in the client's care plan’, (3) ‘client asks for it’, (4) ‘wanting to offer the client something’ and (5) ‘it is always done like this in the team’. Higher educational levels and an age above 40 years were associated with a lower provision of low-value care. Conclusion: According to registered nurses and certified nursing assistants, a number of low-value nursing practices occurred frequently in home-based nursing care and they experienced multiple factors that influence the provision of low-value care such as (lack of) clinical autonomy and handling clients' requests, preferences and demands. The results can be used to serve as a starting point for a multifaceted de-implementation strategy. Reporting Method: STROBE checklist for cross-sectional studies. Patient or Public Contribution: No Patient or Public Contribution. Implications for the Profession and/or Patient Care: Nursing care is increasingly shifting towards the home environment. Not all nursing care that is provided is effective or efficient and this type of care can therefore be considered of low-value. Reducing low-value care and increasing appropriate care will free up time, improve quality of care, work satisfaction, patient safety and contribute to a more sustainable healthcare system.</p

Low-value home-based nursing care:A national survey study

Aims: To explore potential areas of low-value home-based nursing care practices, their prevalence and related influencing factors of nurses and nursing assistants working in home-based nursing care. Design: A quantitative, cross-sectional design. Methods: An online survey with questions containing scaled frequencies on five-point Likert scales and open questions on possible related influencing factors of low-value nursing care. The data collection took place from February to April 2022. Descriptive statistics and linear regression were used to summarize and analyse the results. Results: A nationwide sample of 776 certified nursing assistants, registered nurses and nurse practitioners responded to the survey. The top five most delivered low-value care practices reported were: (1) ‘washing the client with water and soap by default’, (2) ‘application of zinc cream, powders or pastes when treating intertrigo’, (3) ‘washing the client from head to toe daily’, (4) ‘re-use of a urinary catheter bag after removal/disconnection’ and (5) ‘bladder irrigation to prevent clogging of urinary tract catheter’. The top five related influencing factors reported were: (1) ‘a (general) practitioner advices/prescribes it’, (2) ‘written in the client's care plan’, (3) ‘client asks for it’, (4) ‘wanting to offer the client something’ and (5) ‘it is always done like this in the team’. Higher educational levels and an age above 40 years were associated with a lower provision of low-value care. Conclusion: According to registered nurses and certified nursing assistants, a number of low-value nursing practices occurred frequently in home-based nursing care and they experienced multiple factors that influence the provision of low-value care such as (lack of) clinical autonomy and handling clients' requests, preferences and demands. The results can be used to serve as a starting point for a multifaceted de-implementation strategy. Reporting Method: STROBE checklist for cross-sectional studies. Patient or Public Contribution: No Patient or Public Contribution. Implications for the Profession and/or Patient Care: Nursing care is increasingly shifting towards the home environment. Not all nursing care that is provided is effective or efficient and this type of care can therefore be considered of low-value. Reducing low-value care and increasing appropriate care will free up time, improve quality of care, work satisfaction, patient safety and contribute to a more sustainable healthcare system.</p

The Color Red Is Implicitly Associated With Social Status in the United Kingdom and China

Research and theorizing on human societies have shown that the color red plays a large role in human psychological functioning. The aim of the present study was to test the association between red and high-status symbols across cultural contexts. Using the Implicit Association Test (IAT) paradigm, across seven experiments (N = 357), we demonstrated that participants exhibited a faster association of red color and logos of high-status stimuli compared to red color and logos of low-status stimuli. The effect was shown among both males and females, with two different types of status symbols (car logos and university logos), and with four different contrast colors (white, gray, green, blue). Moreover, this association was observed in both United Kingdom and China. These findings provide compelling evidence for the implicit association between the color red and high social status across two different cultural contexts

Left ventricular mass increases with deteriorating glucose tolerance, especially in women: Independence of increased arterial stiffness or decreased flow-mediated dilation - The Hoorn Study

OBJECTIVE - Type 2 diabetes and impaired glucose metabolism (IGM) are associated with an increased cardiovascular disease (CVD) risk. Increased left ventricular mass (LVM) is thought to increase CVD risk through several unfavorable cardiac changes. Type 2 diabetes and IGM are associated with increased LVM, but the underlying mechanism is unclear. We investigated the association between glucose tolerance status (GTS) and LVM and explored whether any such association could be mediated through increased arterial stiffness, impaired endothelial function, or the presence of atherosclerosis. RESEARCH DESIGN AND METHODS - We used ultrasound to measure LVM, carotid and femoral stiffness, carotid-femoral transit time, and flow-mediated vasodilation (FMD) and tonometry to estimate compliance and augmentation index. The study population (n = 780) consisted of 287 individuals with normal glucose metabolism (NGM), 179 with IGM, and 314 with type 2 diabetes, and the mean age was 68.4 years. RESULTS - In women, after adjusting for age, height, BMI, and mean arterial pressure, LVM increased significantly with deteriorating GTS (LVM 157 g in NGM, 155 g in IGM, and 169 g in type 2 diabetes, P for trend <0.018). Additional adjustment for arterial stiffness, FMD, or the presence of atherosclerosis did not materially alter the results, even though these variables were significantly associated with both GTS and LVM. Indexes of hyperglycemia/-insulinemia or insulin resistance explained at most 7% of the association between GTS and LVM. In men, no statistically significant associations were observed. CONCLUSIONS - Our data expand the conceptual view of the pathogenesis of GTS-related changes in LVM because we show that the increase in LVM in women is independent of increased arterial stiffness, impaired FMD, or the presence of atherosclerosis. In addition, we show that this increase in LVM is only minimally explained by indexes of hyperglycemia/-insulinemia or insulin resistance. Our data may, in part, explain the increased CVD risk seen in women with deteriorating GTS

Nanoparticles in cigarette smoke; real-time undiluted measurements by a scanning mobility particle sizer

Cigarette smoke is a complex mixture of smoke constituents, often characterised by size-resolved particle distributions. Since descriptions of ultrafine particles <50 nm are absent, our aim was to explore the existence of these nanoparticles in fresh and undiluted cigarette smoke. We measured undiluted smoke particles real-time by a scanning mobility particle sizer with Faraday cup electrometer, integrated in our custom-made smoking machine. Cigarettes were smoked by 2 s puffs, 30 s puff intervals and 50 ml puff volume. We tested six different cigarettes (1–10 mg tar per cigarette) at ten particle size-ranges between 6 and 50 nm, and repeated measurements five times. The formation of nanoparticles in fresh cigarette smoke was observed over the entire range between 6 and 50 nm, and reproduced in all cigarettes. The highest mean yield was 8.8 × 109 (SD = 1.1 × 109) particles per cigarette at the largest particle size range by high-tar cigarettes. Nanoparticle counts appear to increase with particle size, claimed tar values and blocking of filter ventilation holes, and inversely with butt length. Fresh undiluted cigarette smoke contains large amounts of potentially toxic nanoparticles <50 nm. We recommend to further study nanoparticles in the characterisation of cigarette smoke

Improving calculation, interpretation and communication of familial colorectal cancer risk: Protocol for a randomized controlled trial

Contains fulltext : 88114.pdf (publisher's version ) (Open Access)BACKGROUND: Individuals with multiple relatives with colorectal cancer (CRC) and/or a relative with early-onset CRC have an increased risk of developing CRC. They are eligible for preventive measures, such as surveillance by regular colonoscopy and/or genetic counselling. Currently, most at-risk individuals do not follow the indicated follow-up policy. In a new guideline on familial and hereditary CRC, clinicians have new tasks in calculating, interpreting, and communicating familial CRC risk. This will lead to better recognition of individuals at an increased familial CRC risk, enabling them to take effective preventive measures. This trial compares two implementation strategies (a common versus an intensive implementation strategy), focussing on clinicians' risk calculation, interpretation, and communication, as well as patients' uptake of the indicated follow-up policy. METHODS: A clustered randomized controlled trial including an effect, process, and cost evaluation will be conducted in eighteen hospitals. Nine hospitals in the control group will receive the common implementation strategy (i.e., dissemination of the guideline). In the intervention group, an intensive implementation strategy will be introduced. Clinicians will receive education and tools for risk calculation, interpretation, and communication. Patients will also receive these tools, in addition to patient decision aids. The effect evaluation includes assessment of the number of patients for whom risk calculation, interpretation, and communication is performed correctly, and the number of patients following the indicated follow-up policy. The actual exposure to the implementation strategies and users' experiences will be assessed in the process evaluation. In a cost evaluation, the costs of the implementation strategies will be determined. DISCUSSION: The results of this study will help determine the most effective method as well as the costs of improving the recognition of individuals at an increased familial CRC risk. It will provide insight into the experiences of both patients and clinicians with these strategies.The knowledge gathered in this study can be used to improve the recognition of familial and hereditary CRC at both the national and international level, and will serve as an example to improve care for patients and their relatives worldwide. Our results may also be useful in improving healthcare in other diseases. TRIAL REGISTRATION: ClinicalTrials.gov NCT00929097

Design and performance estimation of a photonic integrated beamforming receiver for scan-on-receive synthetic aperture radar

Synthetic aperture radar is a remote sensing technology finding applications in a wide range of fields, especially related to Earth observation. It enables a fine imaging that is crucial in critical activities, like environmental monitoring for natural resource management or disasters prevention. In this picture, the scan-on-receive paradigm allows for enhanced imaging capabilities thanks to wide swath observations at finer azimuthal resolution achieved by beamforming of multiple simultaneous antenna beams. Recently, solutions based on microwave photonics techniques demonstrated the possibility of an efficient implementation of beamforming, overcoming some limitations posed by purely electronic solutions, offering unprecedented flexibility and precision to RF systems. Moreover, photonics-assisted RF beamformers can nowadays be realized as integrated circuits, with reduced size and power consumption with respect to digital beamforming approaches. This paper presents the design analysis and the challenges of the development of a hybrid photonic-integrated circuit as the core element of an X-band scan-on-receive spaceborne synthetic aperture radar. The proposed photonic-integrated circuit synthetizes three simultaneous scanning beams on the received signal, and performs the frequency down-conversion, guaranteeing a compact 15 cm2-form factor, less than 6 W power consumption, and 55 dB of dynamic range. The whole photonics-assisted system is designed for space compliance and meets the target application requirements, representing a step forward toward a deeper penetration of photonics in microwave applications for challenging scenarios, like the observation of the Earth from space