Humanism in the Age of COVID-19: Renewing Focus on Communication and Compassion

The global COVID-19 pandemic has become one of the largest clinical and operational challenges faced by emergency medicine, and our EDs continue to see increased volumes of infected patients, many of whom are not only ill, but acutely aware and fearful of their circumstances and potential mortality. Given this, there may be no more important time to focus on staff-patient communication and expression of compassion.However, many of the techniques usually employed by emergency clinicians to provide comfort to patients and their families are made more challenging or impossible by the current circumstances. Geriatric ED patients, who are at increased risk of severe disease, are particularly vulnerable to the effects of isolation.Despite many challenges, emergency clinicians have at their disposal a myriad of tools that can still be used to express compassion and empathy to their patients. Placing emphasis on using these techniques to maximize humanism in the care of COVID-19 patients during this crisis has the potential to bring improvements to ED patient care well after this pandemic has passed

Trade and interdependence in the economic growth process: a multiplier analysis for Latin America

This paper illustrates alternative methodological approaches to the issue of trade and interdependence in the economic growth process with a focus on the countries of Latin America, drawing inspiration from earlier contributions by Machlup, Goodwin and Miyazawa. The world economy is divided into two main blocks ofcountries (Latin America and a selection of developed economies) with the rest of the world forming an aggregated third block. A time series of trade matrices for the period 1978-1991 has been constructed to explore the degree to which changes in one country spillover to the rest ofthe world and the degree to which the changes are symmetric or asymmetric. The approaches reveal that important insights into trade structure can be obtained, insights that will prove of value in the rapidly changing trade regimes of the current and next decades

Семинар «Комплексная судебно-баллистическая и судебно-медицинская экспертиза» (Москва)

The paper presents the outcomes of the seminar «Integrated Forensic Ballistics and Medical Examinations» hosted October 16–20, 2017 by the RFCFS of the Russian Ministry of Justice in MoscowПредставлены итоги семинара «Комплексная cудебно-баллистическая и судебно-медицинская экспертиза», прошедшего с 16 по 20 октября 2017 года в Москве на базе ФБУ РФЦСЭ при Минюсте Росси

Salen Mn Complexes Mitigate Radiation Injury in Normal Tissues

Salen Mn complexes, including EUK-134, EUK-189 and a newer cyclized analog EUK-207, are synthetic SOD/catalase mimetics that have beneficial effects in many models of oxidative stress. As oxidative stress is implicated in some forms of delayed radiation injury, we are investigating whether these compounds can mitigate injury to normal tissues caused by ionizing radiation. This review describes some of this research, focusing on several tissues of therapeutic interest, namely kidney, lung, skin, and oral mucosa. These studies have demonstrated suppression of delayed radiation injury in animals treated with EUK-189 and/or EUK-207. While an antioxidant mechanism of action is postulated, it is likely that the mechanisms of radiation mitigation by these compounds in vivo are complex and may differ in the various target tissues. Indicators of oxidative stress are increased in lung and skin radiation injury models, and suppressed by salen Mn complexes. The role of oxidative stress in the renal injury model is unclear, though EUK-207 does mitigate. In certain experimental models, salen Mn complexes have shown “mito-protective” properties, that is, attenuating mitochondrial injury. Consistent with this, EUK-134 suppresses effects of ionizing radiation on mitochondrial function in rat astrocyte cultures. In summary, salen Mn complexes could be useful to mitigate delayed radiation injury to normal tissues following radiation therapy, accidental exposure, or radiological terrorism. Optimization of their mode of delivery and other key pharmaceutical properties, and increasing understanding of their mechanism(s) of action as radiation mitigators, are key issues for future study

Immune checkpoint inhibitors in cancer therapy: Review of orofacial adverse events and role of the oral healthcare provider

Immune checkpoint inhibitors (ICIs) are a revolutionary class of antineoplastic therapy that restore anti-tumor immunity. Consequences of this enhanced immune response include a multitude of immune related adverse events (irAEs) that can affect any body system, including the mouth. Orofacial irAEs reproduce features of numerous immune-mediated conditions, including oral lichen planus, mucous membrane pemphigoid, and Sjögren syndrome, among others. The aim of this review is to summarize known orofacial irAEs and to familiarize oral healthcare providers with how to identify and manage these toxicities as part of the care team for patients treated with ICIs

Разъяснение некоторых положений методики установления принадлежности объекта к огнестрельному оружию

The paper clarifies some of the provisions of the «Methodology for matching objects to specific firearms» that lend themselves to varying interpretations or lack explicit requirements regarding examination conditions. A newly proposed algorithm is easy to apply in forensic practice and can be recommended as a supplement to the methodology in question.Разъясняются некоторые положения «Методики установления принадлежности объекта к огнестрельному оружию», допускающие неоднозначное толкование или нечеткие требования к условиям проведения исследования. Предложен алгоритм, легко применимый в экспертной практике и рекомендованный в качестве дополнения к указанной методике

Key sectors and structural change in the Brazilian economy: a comparsion of alternative approaches and their policy implications

Attempts to identify key sectors in an economy with input output models have been a source of considerable debate. in this paper; several old and new approaches to the problem are evaluated with reference to the Brazilian economy using the input-output models for 1959, 1970 and 1975. Two alternative approaches are suggested in this paper. The first of these focuses on key coefficients through the identification of fields of influence associated with changes in these coefficients, including the effects of simultaneous changes in more than one coefficient. The second approach decomposes the interindustry transactions into a set (hierarchy) of flows. It is claimed that the flows associated with the higher levels of the hierarchy can be considered as the key flows or most important transactions. These new approaches are compared to earlier techniques to examine the degree to which important changes in the economy could be detected

Key sectors and structural change in the Brazilian economy: a comparsion of alternative approaches and their policy implications

Attempts to identify key sectors in an economy with input output models have been a source of considerable debate. in this paper; several old and new approaches to the problem are evaluated with reference to the Brazilian economy using the input-output models for 1959, 1970 and 1975. Two alternative approaches are suggested in this paper. The first of these focuses on key coefficients through the identification of fields of influence associated with changes in these coefficients, including the effects of simultaneous changes in more than one coefficient. The second approach decomposes the interindustry transactions into a set (hierarchy) of flows. It is claimed that the flows associated with the higher levels of the hierarchy can be considered as the key flows or most important transactions. These new approaches are compared to earlier techniques to examine the degree to which important changes in the economy could be detected

Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis

Numerous guidelines have been developed over the past decade regarding treatments for Posttraumatic stress disorder (PTSD). However, given differences in guideline recommendations, some uncertainty exists regarding the selection of effective PTSD therapies. The current manuscript assessed the efficacy, comparative effectiveness, and adverse effects of psychological treatments for adults with PTSD. We searched MEDLINE, Cochrane Library, PILOTS, Embase, CINAHL, PsycINFO, and the Web of Science. Two reviewers independently selected trials. Two reviewers assessed risk of bias and graded strength of evidence (SOE). We included 64 trials; patients generally had severe PTSD. Evidence supports efficacy of exposure therapy (high SOE) including the manualized version Prolonged Exposure (PE); cognitive therapy (CT), cognitive processing therapy (CPT), cognitive behavioral therapy (CBT)-mixed therapies (moderate SOE); eye movement desensitization and reprocessing (EMDR) and narrative exposure therapy (low-moderate SOE). Effect sizes for reducing PTSD symptoms were large (e.g., Cohen's d ~-1.0 or more compared with controls). Numbers needed to treat (NNTs) were <4 to achieve loss of PTSD diagnosis for exposure therapy, CPT, CT, CBT-mixed, and EMDR. Several psychological treatments are effective for adults with PTSD. Head-to-head evidence was insufficient to determine these treatments' comparative effectiveness, and data regarding adverse events was absent from most studies