Дневниковая проза как исторический источник о средневековом обществе Японии

Дневниковая проза средневековой Японии рассмотрена в качестве исторического источника, содержащего подробнейшую информацию о нравах и мировоззрении общества Японии X-XIIIвв. На материале анализа дневниковой прозы описаны особенности менталитета и раскрыто содержание особой эстетической философии аристократии хэйанской эпохи. Акцентируется ведущее место любовных отношений в жизни аристократов, показано своеобразие их изображения в литературе. Раскрывается сущность проявления эстетизации культуры в бытовой и художественной сферах жизни. Выявлены ключевые темы дневниковой прозы

Cost-effectiveness of bivalent, quadrivalent, and nonavalent HPV vaccination in South Africa

Background and Objectives: In South Africa, the prevalence of human papillomavirus (HPV) and associated diseases, such as cervical cancer and genital warts, is among the highest in the world. This study evaluates the cost-effectiveness of bivalent, quadrivalent, and nonavalent HPV vaccination for 9- to 14-year-old girls from the South African healthcare system perspective. Methods: A Markov model portraying the natural HPV disease progression from high-risk infection to cervical intraepithelial neoplasia (CIN) I, CIN II/III, or cervical cancer and from low-risk infection to genital warts was built. Transition probability, utility, and efficacy data were sourced from peer-reviewed literature. Vaccination costs were calculated based on the World Health Organization (WHO) guidelines. The model was populated with a cohort of 520,000 9-year-old girls to calculate incremental cost-effectiveness ratios (ICER) in South African Rand (R) per quality-adjusted life-years (QALYs) gained for each vaccination strategy. Results: All HPV vaccination strategies dominate the no vaccine strategy. Compared with the bivalent vaccine, the nonavalent strategy increases QALYs by 0.14 and costs by R1793 (ICER: R13,013 per QALY) per person, while the quadrivalent vaccination provides −0.02 incremental QALYs and R1748 costs (ICER: −R116,397 per QALY). Consequently, at the South African willingness-to-pay threshold of R23,630 per QALY, nonavalent vaccination is the preferred strategy, with a probability of 90.2%. Scenario analysis demonstrated that results are influenced by vaccine coverage, efficacy, and duration of efficacy. Conclusions: The introduction of nonavalent for bivalent HPV vaccination is a cost-effective intervention in South Africa. HPV vaccination should be part of a multifaceted public health strategy entailing screening, condoms, and education of all stakeholders to reduce the significant burden of sexual transmitted diseases in South Africa. Sex-neutral and catch-up vaccinations are subjects for further research

Initial and supplementary indication approval of new targeted cancer drugs by the FDA, EMA, Health Canada, and TGA

Background. Previous research focused on the clinical evidence supporting new cancer drugs’ initial US Food and Drug Administration (FDA) approval. However, targeted drugs are increasingly approved for supplementary indications of unknown evidence and benefit. Objectives. To examine the clinical trial evidence supporting new targeted cancer drugs’ initial and supplementary indication approval in the US, EU, Canada, and Australia. Data and Methods. 25 cancer drugs across 100 indications were identified with FDA approval between 2009–2019. Data on regulatory approval and clinical trials were extracted from the FDA, European Medicines Agency (EMA), Health Canada (HC), Australian Therapeutic Goods Administration (TGA), and clinicaltrials.gov. Regional variations were compared with χ 2-tests. Multivariate logistic regressions compared characteristics of initial and supplementary indication approvals, reporting adjusted odds ratios (AOR) with 95% confidence intervals (CI). Results. Out of 100 considered cancer indications, the FDA approved 96, the EMA 92, HC 86, and the TGA 83 (83%, p < 0.05). The FDA more frequently granted priority review, conditional approval, and orphan designations than other agencies. Initial approvals were more likely to receive conditional / accelerated approval (AOR: 2.69, 95%CI [1.07–6.77], p < 0.05), an orphan designation (AOR: 3.32, 95%CI [1.38–8.00], p < 0.01), be under priority review (AOR: 2.60, 95%CI [1.17–5.78], p < 0.05), and be monotherapies (AOR: 5.91, 95%CI [1.14–30.65], p < 0.05) than supplementary indications. Initial indications’ pivotal trials tended to be shorter (AOR per month: 0.96, 95%CI [0.93–0.99], p < 0.05), of lower phase design (AOR per clinical phase: 0.28, 95%CI [0.09–0.85], p < 0.05), and enroll more patients (AOR per 100 patients: 1.19, 95%CI [1.01–1.39], p < 0.05). Conclusions. Targeted cancer drugs are increasingly approved for multiple indications of varying clinical benefit. Drugs are first approved as monotherapies in rare diseases with a high unmet need. Whilst expedited regulatory review incentivizes this prioritization, indication-specific safety, efficacy, and pricing policies are necessary to reflect each indication’s differential clinical and economic value

The role of idioms in English language learning

The most widely used English idioms are considered in the present paper, their role in English language learning is analyzed as well. The significance of idioms in the modern English language is impossible to underestimate since they make a colloquial speech lively and rich. And, without doubt, idioms are actually used by native speakers in their everyday language. Consequently, it is necessary to pay a particular attention to these lexical units studying a foreign language. Furthermore, some ways of learning idioms individually as well as by means of various communicative types of activity under the guidance of a teacher are also considered in the research. В данной работе рассмотрены наиболее распространенные идиомы в английском языке, проанализирована их роль в изучении английского языка. Выявлено значение идиом в современном английском языке как единиц, обеспечивающих разговорной речи живость и стилистическую выразительность, что обусловило необходимость уделить особое внимание этим лексическим единицам. Рассмотрены некоторые способы изучения идиом как самостоятельно, так и посредством различных коммуникативных видов деятельности под руководством преподавателя

Гірничопрохідницька техніка. Методичні рекомендації до вивчення дисципліни студентами напряму підготовки 6.060101 Будівництво

Подано методичні рекомендації до практичних навчальних занять з дисципліни «Гірничопрохідницька техніка» для студентів напряму підготовки 6.060101 Будівництво. У методичних рекомендаціях розглянуто найбільш загальні підходи до визначення продуктивності й необхідної кількості гірничопрохідницьких машин при будівництві гірничотехнічних об’єктів у міських умовах. Методичні рекомендації до практичних занять передбачають виконання завдань як із викладачем, так і під час самостійної роботи

Medical education and mental health during COVID-19: a survey across 9 countries

Objectives: To investigate students' experience with medical education alongside their mental and physical health since the onset of the COVID-19 pandemic across nine countries. Methods: A cross-sectional online survey was distributed by local collaborators to 2,280 medical students across 148 medical schools in Brazil, Chile, Colombia, Germany, Italy, Japan, Mexico, Spain, and Venezuela using non-probability convenience sampling from June 22 to July 24, 2020. Students answered questions regarding teaching, internet use, COVID-19, physical and mental well-being. A multivariate logistic regression examined factors associated with depressed mood, insomnia, and headache. Results: Academic teaching shifted to a virtual (67%, n=1,534) or hybrid environment (23%, n=531), whilst bedside teaching was suspended or cancelled (93%, n=2,120). Across all countries students were equally satisfied with the teaching modality, quantity, quality, and the evaluation system of in-person, hybrid, and online curricula. Negative changes in mental (40% (n=912) insomnia, 57% (n=1,300) emotional irritability, 47% (n=1,072) emotional instability, 41% (n=935) anhedonia, 40% (n=912) depressed mood) and physical (36% (n=821) headache, 57% (n=1,299) ocular tiredness, 49% (n=1,117) backache) health symptoms were frequently observed. Positive associations between the number of daily screen hours and depressed mood (adjusted odds ratio (AOR)=1.09, 95%CI: 1.05-1.12, p<.001), insomnia (AOR=1.08, 95%CI: 1.05-1.11, p<.001), and headache (AOR=1.11, 95%CI: 1.07-1.14, p<.001) were identified. Conclusions: Students' experience with digital and hybrid medical curricula was diverse during the pandemic. Education modality, quantity, and quality were positively evaluated. However, students' mental and physical health worsened. Besides bedside teaching, faculties ought to digitalize and strengthen social communities and extend support services for students

Pilot Programs for Veterans Transition To Engineering Fields

Veterans, through their active service, frequently receive training in highly skilled technical areas. However, they may lack a theoretical background in underlying engineering principles. They also need additional support with the transition from a highly structured military environment to an environment with more ambiguous time constraints and different sorts of responsibilities. Moreover they are facing challenges which are specific for their student population. Therefore, enabling multiple mechanisms which would support them and provide them necessary guidance are especially important at universities with large veteran populations such as at Old Dominion University in Norfolk, Virginia. Hence, there is a need for programs which build on the specialized training that veterans received and aid in their academic journey. This paper will introduce three pilot programs for advancing engineering education for military veterans focusing on forming a support base for veterans to assist them in overcoming traditional educational barriers

Intravenous fish oil blunts the physiological response to endotoxin in healthy subjects

Objective: To assess the effects of intravenous fish oil fat emulsion on the metabolic alterations induced by lipopolysaccharide (LPS) challenge in healthy volunteers. Design: Two groups of eight healthy subjects were randomized to receive either two pharmacological doses of intravenous FO fat emulsion or no treatment. The FO group received twice 0.5 g/kg 10% emulsion (Omegaven) 48 and 24 h before investigation. LPS (2 ng/kg) was injected as abolus on the investigation day. Systemic parameters, indirect calorimetry, heart rate variability, and platelet membrane phospholipid composition were measured. Results: Basal EPA and DHA content in platelet phospholipids was low (0.28% and 2.54%, respectively) and increased significantly after FO to 1.68% and 3.32%. LPS induced reproducible effects in all subjects. Fever was higher in the FO group than in controls; the difference was significant from t 120 until t 360. FO blunted the neuroendocrine response: the rise in plasma norepinephrine was sevenfold lower at t 120 while the ACTH peak was fourfold lower. Tumor necrosis factor α was significantly lower between t 360 and t 180 in the FO group. Conclusions: Two doses of intravenous FO fat emulsion modified the phospholipid composition of platelets in healthy subjects. FO blunted fever and increased the neuroendocrine and the inflammatory responses to LP