Диссеминированный мукормикоз у больного острым лимфобластным лейкозом (клинический случай)

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Anime Subculture as Culture and Informational Phenomenon (by Example of Activity of Youth Unions in Irkutsk Region)

The peculiarities of the anime subculture are considered. The scientists’ approaches to determining the features of informal youth unions are studied. Genre variety of media texts typical to anime subculture is noted. It is reported that the study was conducted, which was attended by 307 active users of the Internet, for determining the specificity in the development of the anime subculture in the Irkutsk region. It was found that the membership of those who presents the anime subculture is not heterogeneous: they are between the ages of 12 to 40, with the largest percentage of the audience in the age range from 18 to 21 years. Media preferences of young people for the anime genre are characterised. The part of socially and creatively active people among those who is fond of anime is determined: 78.83 % of the respondents. The conclusions about the preferences of representatives of the subculture in terms of activities in the region of themed events. The activity of organisations associated with the theme of anime in the region is considered, they are examined by the example of a non-profit youth organisation ANIME38. Conclusions are made about the variety of forms of activities aimed at both the creative self-realisation of young people and social cohesion of the groupРассматриваются особенности субкультуры аниме. Изучаются подходы ученых к определению особенностей неформальных молодежных объединений. Отмечено жанровое многообразие медиатекстов, характерных для субкультуры аниме. Сообщается, что для выявления специфики в развитии субкультуры аниме в Иркутской области было проведено исследование, в котором приняло участие 307 активных пользователей сети Интернет. Выяснено, что состав представителей субкультуры аниме неоднороден: среди них есть лица в возрасте от 12 до 40 лет, при этом наибольший процент зрительской аудитории находится в возрастном диапазоне от 18 лет до 21 года. Охарактеризованы медийные предпочтения молодежи в отношении жанров аниме. Определена доля социально и творчески активных людей среди увлекающихся аниме: она составляет 78,83 % респондентов. Сделаны выводы о предпочтениях представителей данной субкультуры в плане проводимых в регионе тематических мероприятий. Рассмотрена деятельность организаций, связанных с тематикой аниме в регионе, раскрыта их суть на примере некоммерческой молодежной организации АНИМЕ38. Сделаны выводы о многообразии форм мероприятий, направленных как на творческую самореализацию молодежи, так и на социальную сплоченность данной групп

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods: The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results: A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion: Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)