Psychiatric Correlates of Snuff and Chewing Tobacco Use

Compared to the association between cigarette smoking and psychiatric disorders, relatively little is known about the relationship between smokeless tobacco use and psychiatric disorders. To identify the psychiatric correlates of smokeless tobacco use, the analysis used a national representative sample from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) wave 1. Smokeless tobacco use was classified as exclusive snuff use, exclusive chewing tobacco, and dual use of both snuff and chewing tobacco at some time in the smokeless tobacco user''s life. Lifetime psychiatric disorders were obtained via structured diagnostic interviews. The results show that the prevalence of lifetime exclusive snuff use, exclusive chewing tobacco, and dual use of both snuff and chewing tobacco was 2.16%, 2.52%, and 2.79%, respectively. After controlling for sociodemographic variables and cigarette smoking, the odds of exclusive chewing tobacco in persons with panic disorder and specific phobia were 1.53 and 1.41 times the odds in persons without those disorders, respectively. The odds of exclusive snuff use, exclusive chewing tobacco, and dual use of both products for individuals with alcohol use disorder were 1.97, 2.01, and 2.99 times the odds for those without alcohol use disorder, respectively. Respondents with cannabis use disorder were 1.44 times more likely to use snuff exclusively than those without cannabis use disorder. Respondents with inhalant/solvent use disorder were associated with 3.33 times the odds of exclusive chewing tobacco. In conclusion, this study highlights the specific links of anxiety disorder, alcohol, cannabis, and inhalant/solvent use disorders with different types of smokeless tobacco use.     

Effect of combinations of immunomodulators on phagocytosis

The effect of levamisole, prodigiozan and lithium carbonate combinations on antimicrobial activity of blood neutrophils and peritoneal macrophages was studied on mice. The combinations were used in single doses. An increase in stimulation of phagocytosis with respect to staphylococci was observed after the use of prodigiozan in combination with lithium carbonate. Levamisole and lithium carbonate were antagonistic with respect to macrophagal phagocytosis. No advantage of the combined use of prodigiozan and levamisole to their use alone was shown.     

SWAT模型参数对土地利用变化的响应及其对不同时间尺度径流模拟的影响

SWAT模型广泛应用于土地利用变化的水文效应评估研究,但土地利用变化是否对模型参数产生影响,进而影响径流模拟效果还有待于进一步分析。以东南沿海福建省山美水库流域为研究区,基于SWAT模型,分别模拟1995年、2005年、2015年土地利用条件下的年、月、日尺度径流过程,采用SWAT-CUP进行参数敏感性分析与自动率定,分别获取1995年、2005年、2015年3种土地利用条件下径流过程模拟的最优参数集,比较参数差异;将3组参数集分别应用到不同土地利用条件,分析参数变化对不同时间尺度径流模拟的影响。结果表明：（1）1995-2015年间,研究区土地利用格局发生了较大变化,主要表现为林地转向园地和建设用地;3期土地利用条件下率定的SWAT模型都能较好地模拟山美水库流域年、月、日尺度径流,其效率系数NS和决定系数R²分别大于0.62和0.78。（2）不同土地利用条件下敏感参数基本一致,敏感参数分别为CN2、SOL_AWC、SOL_K、CANMX、ESCO、GW_DELAY、OV_N,但敏感参数取值随着土地利用变化而变化,其变化规律符合敏感参数的物理意义,变化率基本与土地利用变化强度正相关。（3）由土地利用变化引起的参数变化,对年、月径流模拟的影响较小,对日径流影响显著,且随着土地利用变化强度的增加而增加。     

Effect of the 1983 Mental Health Act on the management of psychiatric patients.

Two principal objectives of the 1983 Mental Health Act were to decrease the use of emergency orders and to give patients on observation orders the right of appeal. Statistics were collected from the 13 hospitals that admit acute psychiatric patients in the Greater Manchester area, and the figures for 1980-1 were compared with those for 1984-5. Changes in use of the different sections were examined in university units, large psychiatric hospitals, and district general hospital units. The use of emergency orders decreased and the use of treatment orders increased; the use of observation orders remained unchanged. Many more patients exercised their right of appeal in 1984-5, but the number discharged by tribunals remained small. The nurses'' holding power was used infrequently. The different types of hospital are now more concordant in their use of these orders than before the 1983 act.     

20‐year follow‐up study of physical morbidity and mortality in relationship to antipsychotic treatment in a nationwide cohort of 62,250 patients with schizophrenia (FIN20)

Antipsychotics are effective in preventing relapses of schizophrenia, but it is generally believed that their long‐term use is harmful for patients’ physical well‐being. However, there are no long‐term studies which have verified this view. This nationwide, register‐based cohort study aimed to assess the risk of hospitalization due to physical health problems, as a marker for severe physical morbidity, and the risk of all‐cause mortality, as well as of cardiovascular and suicidal death, associated with antipsychotic use in all patients treated for schizophrenia in inpatient care between 1972 and 2014 in Finland (N=62,250), with up to 20 years of follow‐up (median: 14.1 years). The use of antipsychotic drugs (i.e., use of any antipsychotic compared with non‐use) and the use of specific antipsychotics were investigated, and outcomes were somatic and cardiovascular hospitalization, and all‐cause, cardiovascular and suicide death. Hospitalization‐based outcomes were analyzed by a within‐individual design to eliminate selection bias, comparing use and non‐use periods in the same individual by stratified Cox model. Mortality outcomes were assessed by traditional between‐individual Cox multivariate models. The adjusted hazard ratios (aHRs) for any somatic hospitalization and cardiovascular hospitalization were 1.00 (95% CI: 0.98‐1.03) and 1.00 (95% CI: 0.92‐1.07) during use of any antipsychotic compared to non‐exposure periods within the same individual. The aHRs were 0.48 (95% CI: 0.46‐0.51) for all‐cause mortality, 0.62 (95% CI: 0.57‐0.67) for cardiovascular mortality, and 0.52 (95% CI: 0.43‐0.62) for suicide mortality during use vs. non‐use of any antipsychotic. The most beneficial mortality outcome was associated with use of clozapine in terms of all‐cause (aHR=0.39, 95% CI: 0.36‐0.43), cardiovascular (aHR=0.55, 95% CI: 0.47‐0.64) and suicide mortality (aHR=0.21, 95% CI: 0.15‐0.29). The cumulative mortality rates during maximum follow‐up of 20 years were 46.2% for no antipsychotic use, 25.7% for any antipsychotic use, and 15.6% for clozapine use. These data suggest that long‐term antipsychotic use does not increase severe physical morbidity leading to hospitalization, and is associated with substantially decreased mortality, especially among patients treated with clozapine.     

Pathomorphological picture of the liver in mice administered antitumor antibiotics intraperitoneally and its comparative assessment]

A single administration of carminomycin, ribomycin or olivomycin in LD50 or treatment of the experimental animals with these antibiotics for 10 days in the therapeutic doses equal to 10 per cent of the LD50 induced distrophic and necrobiotic changes in the liver. The use of bruneomycin in the equivalent doses induced sclerotic process in addition to the above doses resulted in a decrease in the colour intensity of DNA, RNA and protein as compared to the control, the content of glycogen and a marked increase in the amount of lipids in the hepatocyte cytoplasm. The most pronounced shifts were observed with the use of carminomycin, rubomycin and especially bruneomycin in single doses. With the use of olivomycin in a single dose the shifts were less pronounced. It should be noted that with the use of carminomycin and rubomycin the damages were of the same character by their intensity. The changes in the liver on the use of carminomycin, rubomycin and olivomycin in single doses or during the treatment course were reversible, while on the use of bruneomycin they preserved to the end of the experiment.     

赣江中上游地区土地利用变化空间分异与驱动因素

赣江中上游地区是东南丘陵重要的水土保持功能区,分析不同时空尺度下该区域土地利用变化及其驱动力,对维持与优化本地生态功能具有重要意义。本研究基于1 km空间分辨率的土地利用数据,分析1980—2018年赣江中上游地区的土地利用结构与土地利用动态度;并利用主成分分析法(PCA)、普通最小二乘法(OLS)和地理加权回归(GWR)分析土地利用变化的空间分异驱动力。结果表明: 1980—2018年,研究区主要土地利用类型是林地(面积占比69.4%～71%)和耕地(占比20.8%～20.9%);建设用地、未利用地的土地利用动态度较大,研究区综合土地利用动态度逐渐增加,尤其是2010—2018年明显增加。GWR模型对研究区土地利用变化驱动因素分析的拟合效果更好,在98.6%的区域内都比较理想。在土地利用变化空间分异的影响因素中,自然环境因素对研究区土地利用变化空间分异的影响最明显,起制约作用;社会经济因素的影响居次位,主要起促进作用;自然-社会因素综合影响较弱且复杂。     

The limitations of assessing impacts of land use changes on runoff with a distributed hydrological model: case study of the Hron River

A distributed hydrological model was applied for estimating changes in a runoff regime due to land use changes. The upper Hron river basin, which has an area of 1766 km² and is located in central Slovakia, was selected as the pilot basin. A physically-based rainfall-runoff model with distributed parameters was used for modelling runoff from rainfall and melting snow. The parameters of the model were estimated using climate data from 1981–2000 and from three digital map layers: a land-use map, soil map and digital elevation model. Several scenarios of changes in land use were prepared, and the runoff under the new land use conditions was simulated. Long-term mean annual runoff components and the design maximal mean daily discharges with a return period from 5 to 100 years under the previous and changed land uses were estimated and compared. The simulated runoff changes were confronted with expert judgments and estimates from the literature. Limitations of the use of distributed models for estimating land use changes are discussed.     

中国西南岩溶区水分利用效率变化及其对气象要素的响应

水分利用效率（WUE,Water use efficiency）是衡量水资源利用率的重要指标,对气候变化有明显响应,中国西南岩溶区生态缺水严重,水资源利用问题亟需解决,但该区域水分利用效率对气象要素的响应仍不明晰。利用MODIS总初级生产力（Gross primary productivity,GPP）和蒸散发（Evapotranspiration,ET）数据集计算中国西南岩溶区的水分利用效率,结合气象数据和归一化植被指数（NDVI,Normalized difference vegetation index）数据,采用Theil-Sen Median趋势分析和Pearson相关分析,揭示了其水分利用效率的时空变化特征及对气象要素的响应。结果表明：2000-2014年中国西南岩溶区年水分利用效率与植被生长期水分利用效率（AGS-WUE）时间序列变化趋势相近,春、秋季水分利用效率呈上升趋势,夏季呈下降趋势;年水分利用效率呈上升趋势,与降水呈负相关,喀斯特地区与气温呈正相关,非喀斯特地区呈负相关,NDVI增长是主要驱动因素;年水分利用效率和AGS-WUE从东南到西北逐渐升高;非喀斯特地区水分利用效率高于大部分喀斯特地区;总体上高海拔地区水分利用效率高于低海拔地区。气温、海拔及喀斯特发育程度综合影响喀斯特地区水分利用效率。本研究结果能为提高喀斯特生态系统水分利用效率提供理论参考。     

Location and agricultural practices influence spring use of harvested cornfields by cranes and geese in Nebraska

Millions of ducks, geese, and sandhill cranes (Grus canadensis; hereafter cranes) stop in the Central Platte River Valley (CPRV) of Nebraska to store nutrients for migration and reproduction by consuming corn remaining in fields after harvest. We examined factors that influence use of cornfields by cranes and geese (all mid-continent species combined; e.g., Anser, Chen, and Branta spp.) because it is a key step to efficient conservation planning aimed at ensuring that adequate food resources are available to migratory birds stopping in the CPRV. Distance to night-time roost site, segment of the CPRV (west to east), and agricultural practices (post-harvest treatment of cornfields: idle, grazed, mulched, mulched and grazed, and tilled) were the most important and influential variables in our models for geese and cranes. Probability of cornfield use by geese and cranes decreased with increasing distance from the closest potential roosting site. The use of cornfields by geese increased with the density of corn present there during the early migration period, but field use by cranes appeared not to be influenced by early migration corn density. However, probability of cornfield use by cranes did increase with the amount of wet grassland habitat within 4.8 km of the field. Geese were most likely to use fields that were tilled and least likely to use fields that were mulched and grazed. Cranes were most likely to use fields that were mulched and least likely to use fields that were tilled, but grazing appeared not to influence the likelihood of field use by cranes. Geese were more likely to use cornfields in western segments of the CPRV, but cranes were more likely to use cornfields in eastern segments. Our data suggest that managers could favor crane use of fields and reduce direct competition with geese by reducing fall and spring tilling and increasing mulching. Moreover, crane conservation efforts would be most beneficial if they were focused in the eastern portions of the CPRV and in fields as close as possible to both known roosting and large amounts of wet grassland habitats. © 2011 The Wildlife Society.     

Determinants of contraceptive use in Nepal

This 1981 study is the 1st of its kind in Nepal. Analysis using a logit-linear model showed that contraceptive use in Nepal depends on many factors. Women aged 35-49 are 3 times more likely than women aged 15-24 to use contraceptives. Women with 4 or more children are 8 times more likely to use contraceptives than women with 1 or no children, and 2.5 times more likely than women with 2 or 3 children. The use of contraceptives is greatest among women whose offspring includes more sons than daughters, and least among women whose offspring are all daughters. Women who desire no more children are 5 to 6 times more likely to use contraceptives than women who desire more children. Women who have discussed desired family size with their husbands are more than 4 times more likely to use contraceptives than women lacking this type of communication. Women with some schooling are twice as likely to use contraceptives as women with no schooling. Contraceptive use is higher among women who do nonfarm work than farm work, and higher still among women who do not work. Urban women were almost twice as likely to use contraceptives as rural women. Women with less than 1 hour access to a family planning service outlet were 2 to 3 times more likely to use contraceptives than women whose access to these facilities was greater than 1 hour. The number of previous child losses per woman had no significant effect in contraceptive use. Conclusions are based on analysis of data from the Nepal Contraceptive Prevalence Survey, 1981.     

The Impact of WHO Essential Medicines Policies on Inappropriate Use of Antibiotics

Background

Inappropriate overuse of antibiotics contributes to antimicrobial resistance (AMR), yet policy implementation to reduce inappropriate antibiotic use is poor in low and middle-income countries.

Aims

To determine whether public sector inappropriate antibiotic use is lower in countries reporting implementation of selected essential medicines policies.

Materials and Methods

Results from independently conducted antibiotic use surveys in countries that did, and did not report implementation of policies to reduce inappropriate antibiotic prescribing, were compared. Survey data on four validated indicators of inappropriate antibiotic use and 16 self-reported policy implementation variables from WHO databases were extracted. The average difference for indicators between countries reporting versus not reporting implementation of specific policies was calculated. For 16 selected policies we regressed the four antibiotic use variables on the numbers of policies the countries reported implementing.

Results

Data were available for 55 countries. Of 16 policies studied, four (having a national Ministry of Health unit on promoting rational use of medicines, a national drug information centre and provincial and hospital drugs and therapeutics committees) were associated with statistically significant reductions in antibiotic use of ≥20% in upper respiratory infection (URTI). A national strategy to contain antibiotic resistance was associated with a 30% reduction in use of antibiotics in acute diarrheal illness. Policies seemed to be associated with greater effects in antibiotic use for URTI and diarrhea compared with antibiotic use in all patients. There were negative correlations between the numbers of policies reported implemented and the percentage of acute diarrhoea cases treated with antibiotics (r = -0.484, p = 0.007) and the percentage of URTI cases treated with antibiotics (r = -0.472, p = 0.005). Major study limitations were the reliance on self-reported policy implementation data and antibiotic use data from linited surveys.

Conclusions

Selected essential medicines policies were associated with lower antibiotic use in low and middle income countries.     

Influence of Caffeine on Physiological and Cognitive Functions of Humans

The review is devoted to the analysis of the effect of caffeine on physiological and cognitive functions of humans. The methodological aspects of experiments with the use of caffeine are discussed, in particular, the dosage, the frequency of use, and in combination with other products. The possibilities of the use of caffeine for studying physiological and mental phenomena, as well as age-related and individual psychological differences in reactions to caffeine, were shown.     

我院专项治理前后抗菌药物使用情况分析

目的:通过分析抗菌药物临床应用专项治理前后住院患者抗菌药的使用情况,以促进合理用药。方法:随机抽取我院2010年1至2011年12月病例1680份,抽取甲状腺/乳腺/疝气/闭合性骨折I类切口手术病历100份,分析治理前后抗菌药物使用率、使用强度、病原送检率、DDDs、DUI及I类切口抗菌药物应用情况。结果:治理前住院患者抗菌药物使用率、使用强度分别为68.50%、49.8DDD;治理后分别为56.2%、37.8DDD,显著降低(P<0.05)。治理前有四种抗菌药物DUI>1,依次为头孢哌酮/舒巴坦钠>头孢噻吩钠=头孢唑啉>头孢呋辛;治理后有两种抗菌药物DUI>1,依次为磺苄西林>头孢哌酮/舒巴坦钠;治理后I类切口手术患者预防使用抗菌药物比例略为下降,疗程符合率、用药合理率明显上升(P<0.05)。结论:我院住院患者抗菌药使用情况基本达到《抗菌药物临床应用专项工作方案》要求。但在某些方面,如I类切口使用率、疗程、用药选择上需要持续改进,应加强对I类切口的监管力度,以确保用药的经济、有效、合理。     

Creation of a non-mycorrhizal control for a bioassay of AM effectiveness

γ -irradiation of soil by 10 and 3 kGy, and the use of a myc⁻ mutant. The methods were examined on clay and loam. Two management histories were included with both soils to study the ability of the methods to differentiate AM effectiveness. For each soil type, two pot experiments were conducted in field soil, one to investigate the effects of the methods on soil nutrient status, and the other to study the effects on mycorrhization and plant response. The test plants, flax (Linum usitatissimum) and pea (Pisum sativum) myc⁺ and myc⁻ mutants, were grown in 1-l pots for 4 weeks in a growth chamber. To test the ability of the bioassay to reflect differences in AM effectiveness in the field, the mutants and benomyl were also studied in the field from which the loam for the pot experiments was obtained. The bioassay accurately represented the situation in the field and the use of benomyl appeared to be the most appropriate method currently available. The advantages were the ability to use a test plant responsive to AM, the use of less elevated nutrient concentrations than with irradiation, and thus the possibility to use untreated soil as the mycorrhizal treatment. The pea mutants proved unresponsive to AM, and reinoculation to irradiated soil resulted in only half the colonization rate in untreated soil. Benomyl may, however, lead to an underestimation of AM effectiveness because the control is not totally non-mycorrhizal. Its use also carries with it health and environmental risks. Received: 9 February 1999 / Accepted: 27 September 1999     

Effect of aspirin and non-steroidal anti-inflammatory drugs on colorectal adenomas: case-control study of subjects participating in the Nottingham faecal occult blood screening programme.

OBJECTIVE--To examine the relation between the use of aspirin and non-steroidal anti-inflammatory drugs and the presence of asymptomatic colorectal adenomas. DESIGN--Case-control study of subjects participating in a randomised controlled trial of faecal occult blood screening for colorectal cancer. Data on analgesics and other drugs were obtained from a questionnaire which was mainly concerned with diet and was administered by an interviewer. SETTING--Nottingham. SUBJECTS--147 patients with positive results in faecal occult blood tests who were found to have colorectal adenomas (cases), 153 age and sex matched control subjects with negative results in such tests (negative controls), and 176 control subjects with positive results in the tests who were found not to have colorectal adenomas (positive controls). MAIN OUTCOME MEASURES--Relative risk of developing colorectal adenomas according to frequency and duration of use of analgesics. RESULTS--Cases reported taking less aspirin and non-steroidal anti-inflammatory drugs than the negative controls, with the estimated relative risk for any use being 0.49 (95% confidence interval 0.3 to 0.8). The inverse association was less strong when cases were compared with the positive controls (0.66 (0.4 to 1.1)). The association was specific for aspirin and non-steroidal anti-inflammatory drugs there being no association with paracetamol or other drugs. Prescribed use of non-steroidal anti-inflammatory drugs for longer than five years was associated with the lowest risk (0.21 (0.1 to 0.8)), although the numbers reporting prolonged prescribed use were small. CONCLUSIONS--These findings support the hypothesis that aspirin and non-steroidal anti-inflammatory drug use protects against the development of colorectal neoplasia.     

Preparations for serodiagnosis of diseases due to causative agents of ixodes tick-borne borreliosis (Lyme disease). Communication 3. Comparative study of enzyme immunoassay test-systems for detection of IgM to Borrelia burgdorferi sensu lato]

Three foreign and one Russian ELISA test-systems for detection of IgM to Borrelia burgdorferi sensu lato were comparatively studied with the use of the clinical material in an encoded experiment. In the foreign ELISA test-systems based on the use of native antigens of borrelia, cross reactions with sera from patients with syphilis, Epstein-Barr infection, cytomegalovirus infection and systemic lupus erythematosus were detected. The Russian recombinant ELISA test-system Borreliosis-ELISA-IgM showed high sensitivity and specificity. The simultaneous use of the test-systems for detecting IgG and IgM significantly increased the efficacy of diagnosis of early borreliosis.     

糖尿病足感染患者病原菌分布和C-肽及视黄醇结合蛋白-4水平分析

目的 探讨糖尿病足感染患者病原菌分布、C-肽和视黄醇结合蛋白-4（RBP4）的水平以及感染相关危险因素。方法 收集乌鲁木齐市友谊医院和新疆生产建设兵团医院2016年2月至2017年6月住院的201例糖尿病足患者临床资料,依据是否发生感染分为感染组（n=63）和未感染组（n=138）。采用ELISA法检测两组患者血清中hs-CRP、PCT、D-二聚体、纤维蛋白原（FIB）、C-肽和RBP4水平并分析感染组患者病原菌分布情况。感染相关危险因素采用Logistic回归分析。结果 感染组患者血清hs-CRP、PCT、D-二聚体、FIB、RBP4、餐后2 h C-肽水平均显著高于未感染组（均P<0.05）。63例糖尿病足感染患者足部分泌物共分离培养出83株病原菌,其中革兰阴性菌46株（55.42%）,以铜绿假单胞菌（24.10%）、大肠埃希菌（13.25%）居多;革兰阳性菌37株（44.58%）,以金黄色葡萄球菌（37.34%）为主。单因素分析显示,两组患者在病程、使用抗菌药物、使用三代头孢、患糖尿病肾病、合并骨髓炎和神经缺损性伤口方面差异有统计学意义（均P<0.05）。多因素分析显示,患者病程、既往使用抗菌药物、使用三代头孢、合并骨髓炎和神经缺损性伤口均是感染发生的独立危险因素。结论 需依据病原菌分布及耐药性情况合理应用抗生素,并针对病程长、既往使用抗菌药物、使用三代头孢、合并骨髓炎和神经缺损性伤口等独立危险因素做好相应预防措施。     

Placebo medication use in patient care: a survey of medical interns

The use of placebo medication, long recognized by clinicians, often has serious practical implications, such as patient deception. Past evidence has suggested that resident physicians tend to misuse placebo medication. Interns from two consecutive years of a residency program were surveyed anonymously to assess their knowledge and use of placebos. Of the 74 interns surveyed, 44 (59%) were familiar with placebo use in patient care. Fifty percent of these interns familiar with placebo use had learned about placebos from another physician. All interns who had learned about placebos during their internships had learned from another physician, whereas interns who had gained their knowledge of placebos as medical students were as likely to have learned from the medical literature as they were to have learned from a physician (P = 0.027). Interns aware of placebo use were more likely to consider placebo administration for suspected, factitious pain (P = 0.022). The present study uncovered no relationship between interns' estimations of placebo efficacy and the utility they attributed to placebos in assessing a complaint of pain. This suggests that conceptual inconsistencies underlie their use of placebos. Interns often learn of placebos as medical students and are influenced by physician-mentors. Placebo use in patient care is an area of attention for medical educators.     

Rapid laboratory detection of antigens of infective agents of infections and technical means for their realization

A system of new accelerated and rapid methods for the detection of the antigens of the infective agents of plague, cholera, tularemia and brucellosis were developed on the basis of solid phase immunosuspension tests: the passive hemagglutination (PHA) test and the latex agglutination (LA) test. The immunological and physico-chemical properties of suspensions in the PHA and LA tests made it possible to use extraneous sources of energy (centrifugal acceleration and the electric field) to accelerate these tests. The results of the PHA and LA tests were registered with the use of a densitometer, model Ultrascan 2202, and a tester, model C 34014.2. To apply centrifugal acceleration and the electric field, a laboratory centrifuge and an electrophoretic microchamber were designed. Densitometry was carried out on modified plates and conductometry, with the use of modified electrodes. The time of obtaining the results of the PHA and LA tests was 15-30 minutes with the use of centrifugation and 2-5 minutes in the electric field, which made it possible to regard these tests as rapid.