Solutions to housing problems of the homeless in Ukraine against the situation in Poland

In this article approaches toward solving housing problems of the homeless in Ukraine and in Poland are compared. Particular attention is paid to the types of housing objects and their location. The report on the situation in Poland became a basis to formulate recommendations for new Ukrainian housing policy concerning the homeless. In the group of almost several hundred thousand homeless people in Ukraine, the majority are citizens of working age and with secondary education. Although single people largely prevail in this group, the numer of those with families is increasing. According to the official estimates, in Poland there are 30–40 thousand homeless people. This group consists mainly of middle-aged unqualified men, mostly single ones. It is observed that the period of being homeless is extending each year. Similarly, the share of highly educated homeless is increasing. Both in Poland and Ukraine, people deprived of their homes concentrate in urban agglomerations and big cities. The authors conclude that shaping Ukrainian housing policy ought not focus on shelters, which are oriented towards chronic homeless, but on dwellings which enable rehabilitation, socialisation and re-integration of the excluded people with the society. Social rehabilitation should consist of 2–4 stages depending on individual cases. For each of the stages a type of dwelling is suggested. The article provides also some remarks on location of dwellings for the homeless. They are aimed at minimizing tensions between the homeless and the community where the institution is supposed to operate.W artykule podjęto się porównania podejść do rozwiązywania problemów mieszkaniowych osób bezdomnych na Ukrainie i w Polsce. Szczególną uwagę poświęcono rodzajom obiektów mieszkaniowych oraz ich lokalizacji. Omówienie aktualnej sytuacji w Polsce stało się podstawą do sformułowania rekomendacji odnośnie kształtowania nowej polityki mieszkaniowej w zakresie lokalizacji i projektowania obiektów mieszkaniowych dla bezdomnych na Ukrainie

Predicting keratinocyte carcinoma in patients with actinic keratosis: development and internal validation of a multivariable risk-prediction model

Background: Patients with actinic keratosis (AK) are at increased risk for developing keratinocyte carcinoma (KC) but predictive factors and their risk rates are unknown. Objectives: To develop and internally validate a prediction model to calculate the absolute risk of a first KC in patients with AK. Methods: The risk-prediction model was based on the prospective population-based Rotterdam Study cohort. We hereto analysed the data of participants with at least one AK lesion at cohort baseline using a multivariable Cox proportional hazards model and included 13 a priori defined candidate predictor variables considering phenotypic, genetic and lifestyle risk factors. KCs were identified by linkage of the data with the Dutch Pathology Registry. Results: Of the 1169 AK participants at baseline, 176 (15·1%) developed a KC after a median follow-up of 1·8 years. The final model with significant predictors was obtained after backward stepwise selection and comprised the presence of four to nine AKs [hazard ratio (HR) 1·68, 95% confidence interval (CI) 1·17–2·42], 10 or more AKs (HR 2·44, 95% CI 1·65–3·61), AK localization on the upper extremities (HR 0·75, 95% CI 0·52–1·08) or elsewhere except the head (HR 1·40, 95% CI 0·98–2·01) and coffee consumption (HR 0·92, 95% CI 0·84–1·01). Evaluat

Discrete Generation of Superoxide and Hydrogen Peroxide by T Cell Receptor Stimulation: Selective Regulation of Mitogen-Activated Protein Kinase Activation and Fas Ligand Expression

Receptor-stimulated generation of reactive oxygen species (ROS) has been shown to regulate signal transduction, and previous studies have suggested that T cell receptor (TCR) signals may involve or be sensitive to ROS. In this study, we have shown for the first time that TCR cross-linking induced rapid (within 15 min) generation of both hydrogen peroxide and superoxide anion, as defined with oxidation-sensitive dyes, selective pharmacologic antioxidants, and overexpression of specific antioxidant enzymes. Furthermore, the data suggest the novel observation that superoxide anion and hydrogen peroxide are produced separately by distinct TCR-stimulated pathways. Unexpectedly, TCR-stimulated activation of the Fas ligand (FasL) promoter and subsequent cell death was dependent upon superoxide anion, but independent of hydrogen peroxide, while nuclear factor of activated T cells (NFAT) activation or interleukin 2 transcription was independent of all ROS. Anti-CD3 induced phosphorylation of extracellular signal–regulated kinase (ERK)1/2 required hydrogen peroxide generation but was unaffected by superoxide anion. Thus, antigen receptor signaling induces generation of discrete species of oxidants that selectively regulate two distinct redox sensitive pathways, a proapoptotic (FasL) and a proliferative pathway (ERK)

Discrete charging of metallic grains: Statistics of addition spectra

We analyze the statistics of electrostatic energies (and their differences) for a quantum dot system composed of a finite number $K$ of electron islands (metallic grains) with random capacitance-inductance matrix $C$, for which the total charge is discrete, $Q=Ne$ (where $e$ is the charge of an electron and $N$ is an integer). The analysis is based on a generalized charging model, where the electrons are distributed among the grains such that the electrostatic energy E(N) is minimal. Its second difference (inverse compressibility) $\chi_{N}=E(N+1)-2 E(N)+E(N-1)$ represents the spacing between adjacent Coulomb blockade peaks appearing when the conductance of the quantum dot is plotted against gate voltage. The statistics of this quantity has been the focus of experimental and theoretical investigations during the last two decades. We provide an algorithm for calculating the distribution function corresponding to $\chi_{N}$ and show that this function is piecewise polynomial.Comment: 21 pages, no figures, mathematical nomenclature (except for Abstract and Introduction

Indications for traditional surgical treatment (classic) in choledocholithiasis

Catedra chirurgie nr.1 “Nicolae Anestiadi”, Univeritatea de Stat de Medicină și Farmacie “Nicolae Testemitanu”, Chișinău, Republica Moldova, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica MoldovaIntroducere: Tratamentul chirurgical tradițional al litiazei CBP este un procedeu de referință; are șanse sporite de a fi înlocuit de tratamentul celioscopic/endoscopic, care se extinde inexorabil. Materiale și metode: Studiul retrospectiv între anii 1998-2019 a vizat 201 pacienți cu icter mecanic cauzat de litiaza coledociană. Tabloul clinic sugestiv în concordanță cu investigațiile imagistice (EUS, CT, RMN, ERCP) au dictat atitudinea chirurgicală. Rezultate: 93 pacienți (46,2%) s-au tratat prin papilosfincterotomie endoscopică asociata sau nu cu litextracție și colecistectomie laparoscopică. Tratamentul chirurgical tradițional s-a impus la 108 pacienți (53,7%), având indicație: sindrom de icter mecanic- 66 cazuri; coledocolitiază asociată cu pancreatită cronică – 7 cazuri; cu ulcer duodenal stenozant- 2 cazuri; hemoragie -1 caz; colecistită acută 12 cazuri. Dimensiunile CBP a depășit în toate cazurile 1,5 cm. Coledocolitotomia s-a efectuat în toate cazurile, urmată de : drenaj biliar extern în 68 cazuri, de anastomoză biliodigestivă în 36 cazuri; asociată cu rezecție gastrică - 3 cazuri; DPC-1 caz. Morbiditatea: fistulă biliară 2 cazuri; hemoragie erozivă masivă- 1 caz, pancreatită acuta – 1 caz. În 2 cazuri procese purulente intrahepatice extensive au cauzat decesul (1,8%) Concluzie: Actualmente continuă să persiste indicațiile pentru tratamentul chirurgical în icterul mecanic, când diagnosticul etiologic nu progresează. Coledocolitiaza complicată este rezolvată prin coledocolitotomie completată cu drenaj biliar sau anastomoză coledocoduodenală. Coexistența altor afecțiuni înrudite ce necesită gest chirurgical combinat și laborios se rezolva printr-o intervenție chirurgicală clasică.Introduction: The traditional surgical treatment of CBD lithiasis is a reference procedure and has increased chances of being replaced by celioscopic / endoscopic treatment that expands inexorably. Materials and methods: The retrospective study between 1998-2019 targeted 201 patients with mechanical jaundice caused by cholestatic lithiasis. The suggestive clinical picture in accordance with the imaging investigations (EUS, CT, MRI, and ERCP) have dictated the surgical treatment. Results: 93 patients (46.2%) were treated with endoscopic sphincterotomy associated with or without litextraction and laparoscopic cholecystectomy.Traditional surgical treatment was established in 108 patients (53.7%), of which: mechanical jaundice syndrome - 66 cases; choledocholithiasis associated with chronic pancreatitis - 7 cases; duodenal stenosis ulceration - 2 cases; haemorrhage -1 case; acute cholecystitis 12 cases. The CBD dimensions in all cases exceeded 1.5 cm. Choledocholithotomy was performed in all cases, followed by: external biliary drainage in 68 cases, biliodigestive anastomosis in 36 cases; associated with gastric resection -3 cases; DPC-1 case. Morbidity: biliary fistula- 2 cases; massive erosive haemorrhage - 1 case, acute pancreatitis - 1 case. In 2 cases extensive intrahepatic purulent processes caused death (1.8%). Conclusion: Currently there are persistent indications for surgical treatment in mechanical jaundice, when the etiological diagnosis is not progressing. Complicated choledocholithiasis is solved by complicated choledocholithotomy with biliary drainage or coledocoduodenal anastomosis. The existence of other related diseases requiring combined and hard treatment is resolved through a classic surgery

Equivalent roles of marine subsidies and island characteristics in shaping island bird communities

AimSpecies distributions across islands are shaped by dispersal limitations, environmental filters and biotic interactions but the relative influence of each of these processes has rarely been assessed. Here, we examine the relative contributions of island characteristics, marine subsidies, species traits, and species interactions on avian community composition.LocationCentral Coast region of British Columbia, Canada.TaxonTerrestrial breeding birds.MethodsWe observed 3610 individuals of 32 bird species on 89 islands that spanned multiple orders of magnitude in area (0.0002–3 km$^{2}$). We fit a spatially explicit joint species distribution model to estimate the relative contributions of island physical characteristics, island‐specific inputs of marine subsidies, species' traits, and biotic interactions on species distributions. Biogeographic characteristics included island area, isolation, and habitat heterogeneity, while marine influence was represented by forest‐edge soil δ$^{15}$N, wrack biomass, shoreline substrate, and distance to shore. This approach also allowed us to estimate how much variation in distributions resulted from species' biological traits (i.e. body mass, feeding guild, feeding height, and nesting height).ResultsBird species distributions were determined almost equivalently by island biogeographic characteristics (23.5% of variation explained) and marine influence (24.8%). We detected variation in species‐specific responses to both island biogeographic characteristics and marine influence, but no significant effect of any biological trait examined. Additionally, we found evidence that habitat preferences were a more important driver than competitive interactions.Main ConclusionsAlthough most island biogeographic studies focus only on islands' physical characteristics, we found evidence for an equivalent role of marine subsidy in structuring island bird communities. Our study suggests that for small islands, disentangling the effects of island biogeographic characteristics, marine inputs, and biotic interactions is a useful next step in understanding species distributions

Value CMR: Towards a comprehensive, rapid, cost-effective cardiovascular magnetic resonance imaging

Cardiac magnetic resonance imaging (CMR) is considered the gold standard for measuring cardiac function. Further, in a single CMR exam, information about cardiac structure, tissue composition, and blood flow could be obtained. Nevertheless, CMR is underutilized due to long scanning times, the need for multiple breath-holds, use of a contrast agent, and relatively high cost. In this work, we propose a rapid, comprehensive, contrast-free CMR exam that does not require repeated breath-holds, based on recent developments in imaging sequences. Time-consuming conventional sequences have been replaced by advanced sequences in the proposed CMR exam. Specifically, conventional 2D cine and phase-contrast (PC) sequences have been replaced by optimized 3D-cine and 4D-flow sequences, respectively. Furthermore, conventional myocardial tagging has been replaced by fast strain-encoding (SENC) imaging. Finally, T1 and T2 mapping sequences are included in the proposed exam, which allows for myocardial tissue characterization. The proposed rapid exam has been tested in vivo. The proposed exam reduced the scan time from \u3e1 hour with conventional sequences to \u3c20 minutes. Corresponding cardiovascular measurements from the proposed rapid CMR exam showed good agreement with those from conventional sequences and showed that they can differentiate between healthy volunteers and patients. Compared to 2D cine imaging that requires 12-16 separate breath-holds, the implemented 3D-cine sequence allows for whole heart coverage in 1-2 breath-holds. The 4D-flow sequence allows for whole-chest coverage in less than 10 minutes. Finally, SENC imaging reduces scan time to only one slice per heartbeat. In conclusion, the proposed rapid, contrast-free, and comprehensive cardiovascular exam does not require repeated breath-holds or to be supervised by a cardiac imager. These improvements make it tolerable by patients and would help improve cost effectiveness of CMR and increase its adoption in clinical practice