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The efficiency of systems for converting wind energy into electricity to a large extent depends on the ratio of the speed of rotation of the shaft of the wind turbine to the speed of the wind driving the wind turbine. In this paper, the dependence of the efficiency of a wind energy conversion system on wind speed is determined when using the mode of maintaining the maximum power point tracking, which allows maximum power to be extracted from wind energy. The provision of the optimal turbine rotation speed calculated using the maximum power mode is carried out using the vector control system of the permanent magnet synchronous generator. The mechanical losses in the gearbox and in the synchronous machine are determined, the losses in the steel of the synchronous machine and the switching losses in an autonomous voltage inverter are taken into account.

With alcohol and cannabis remaining the most commonly detected drugs in seriously and fatally injured drivers, there is a need to understand their combined effects on driving. The present study examined the effects of combinations of smoked cannabis (12.5% THC) and alcohol (target BrAC 0.08%) on simulated driving performance, subjective drug effects, cardiovascular measures, and self-reported perception of driving ability. In this within-subjects, double-blind, double-dummy, placebo-controlled, randomized clinical trial, cannabis users (1–7 days/week) aged 19–29 years attended four drug administration sessions in which simulated driving, subjective effects, cardiovascular measures, and whole blood THC and metabolite concentrations were assessed following placebo alcohol and placebo cannabis (

Purpose. Finding out the frequency and structures posterior vitreous detachment (PVD), the proportion of local vitreoretinal adhesion in topographical zones of large retinal vessels of posterior pole of the eye in patients of different age groups with axial myopia. Material and methods. Clinical material was 82 eyes (41 patients). The age of patients ranged from 18 to 70 years. According to the age category, which is determined by the WHO classification, all patients were divided into 3 groups. The 1st group (18-44 years old) included 12 people (24 eyes); the 2nd group (45–59 years old) included 14 people (28 eyes); the 3rd group (60–74 years old) included 15 people (30 eyes). Results. In the 1st group PVD was not detected in 11 eyes (45.8%); in 13 eyes there were various variants of PVD (54.2%). In the 2nd group PVD was not detected in 9 eyes (32.1%); in 19 eyes there were various variants of PVD (67.9%). In the 3rd group PVD was not detected in 5 eyes (16.7%); in 25 eyes (83.3%) there were various variants of PVD. In this group, there was statistically significant predominance of partial PVD with fixation of the posterior hyaloid membrane to inner limiting membrane (PHM to ILM). Conclusion. In the group of elderly patients with axial myopia (60– 75 years), statistically significant increase in incidence of local adhesion of PHM to ILM in the projection of large retinal vessels was revealed in comparison with young and middle-aged groups (10 cases versus 1 and 2, respectively, p

New options of the design of a vapor-compressor refrigerator with cold thermal energy storage are proposed. A comparative analysis of the performance of the considered systems is carried out. Results on the effectiveness of using various methods of cold thermal energy storage in the vapor-compression refrigerator circuit have been obtained. Recommendations regarding the field of application of these systems and the volume of cold thermal energy storages are given.

Information on the characteristics of the growth and development of plants of large snapdragon, hybrid petunia, sparkling sage, elegant zinnia, depending on the depth of planting is provided. Characteristics of the main morphological signs are given, data on the height of plants, the number of lateral axes, buds, flowers, fruits, leaves, weight and number of roots of deeply planted and control plants are presented; provides information on vegetation periods; ways to improve the agricultural technology of transplants of indicated plants are identified. It is shown that deep planting is an economically viable rational agricultural method that helps to increase the decorativeness of plants, their earlier, long and plentiful flowering, and to improve the aesthetic expressiveness of flower beds without additional labor and material costs.

The conclusion of the Expert Council reports an agreement on the place of the P2Y 12 receptor blocker prasugrel in the early invasive treatment of patients with acute coronary syndrome ACS, according to the results of the multicenter randomized controlled study ISAR-REACT 5. Prasugrel should be considered the preferred P2Y 12 receptor blocker in the planned primary percutaneous coronary intervention and early invasive management of patients with ST segment elevation ACS. Herewith, prasugrel intake in patients with non-ST segment elevation ACS is preferable after coronary angiography and decision for coronary stenting.

The technique and results of the study of optical and microphysical characteristics of contrails with the use of the unique high-altitude polarization lidar of the National Research Tomsk State University are described. The microstructure parameters of ensembles of crystalline particles were estimated by comparing elements of light backscattering matrices calculated theoretically and obtained experimentally. It is shown that the condensation trail appearing in the atmosphere behind the plane 30–40 min after the emission of fuel combustion products from the engines consists of small chaotically oriented ice particles, mostly of the column shape.

Various technologies and equipment complexes for associated petroleum gas (APG) stripping are analyzed and modeled to develop a universal technology and mobile modular complexes for getting liquid products from APG. The selection of a schematic design of an APG stripping plant that includes a refrigerating machine operating with a multicomponent mixed refrigerant and a fractionating column is validated.

Background Randomized trials of complex interventions are increasingly including qualitative components to further understand factors that contribute to their success. In this paper, we explore the experiences of health care practitioners in a province wide smoking cessation program (the Smoking Treatment for Ontario Patients program) who participated in the COMBAT trial. This trial examined if the addition of an electronic prompt embedded in a Clinical Decision Support System (CDSS)—designed to prompt practitioners to Screen, provide a Brief intervention and Referral to Treatment (SBIRT) to patients who drank alcohol above the amounts recommended by the Canadian Cancer Society guidelines—influenced the proportion of practitioners delivering a brief intervention to their eligible patients. We wanted to understand the factors influencing implementation and acceptability of delivering a brief alcohol intervention for treatment-seeking smokers for health care providers who had access to the CDSS (intervention arm) and those who did not (control arm). Methods Twenty-three health care practitioners were selected for a qualitative interview using stratified purposeful sampling (12 from the control arm and 11 from the intervention arm). Interviews were 45 to 90 min in length and conducted by phone using an interview guide that was informed by the National Implementation Research Network’s Hexagon tool. Interview recordings were transcribed and coded iteratively between three researchers to achieve consensus on emerging themes. The preliminary coding structure was developed using the National Implementation Research Network’s Hexagon Tool framework and data was analyzed using the framework analysis approach. Results Seventy eight percent (18/23) of the health care practitioners interviewed recognized the need to simultaneously address alcohol and tobacco use. Seventy four percent (17/23), were knowledgeable about the evidence of health risks associated with dual alcohol and tobacco use but 57% (13/23) expressed concerns with using the Canadian Cancer Society guidelines to screen for alcohol use. Practitioners acknowledged the value of adding a validated screening tool to the STOP program’s baseline questionnaire (19/23); however, following through with a brief intervention and referral to treatment proved challenging due to lack of training, limited time, and fear of stigmatizing patients. Practitioners in the intervention arm (5/11; 45%) might not follow the recommendations from CDSS if these recommendations are not perceived as beneficial to the patients. Conclusions The results of the study show that practitioners’ beliefs were reflective of the current social norms around alcohol use and this influenced their decision to offer a brief alcohol intervention. Future interventions need to emphasize both organizational and sociocultural factors as part of the design. The results of this study point to the need to change social norms regarding alcohol in order to effectively implement interventions that target both alcohol and tobacco use in primary care clinics. Trial registration ClinicalTrials.gov NCT03108144. Retrospectively registered 11 April 2017, https://www.clinicaltrials.gov/ct2/show/NCT03108144

mathematical model of a wind turbine is investigated, which includes mathematical descriptions of a horizontal axis small- scale power wind turbine with permanent magnet synchronous generator with vector control and a three-phase rectifier connected to a stand-alone voltage source inverter. The maximum power point tracking of the wind turbine, which calculates the optimal rotation turbine speed for each wind speed is used. Vector control system provides the calculated optimal rotation turbine speed. The mechanical losses in the gearbox and in the synchronous machine are determined, as the iron losses and copper losses in the permanent magnet synchronous machine and commutation losses (switching and conduction losses) in stand- alone voltage source inverter are taken into account.

The technique and results of a complex experiment on studying the effect of high-level clouds (HLCs) on the scattered solar radiation flux are described. Optical characteristics of clouds (backscattering phase matrix, optical depth, and scattering ratio) and their geometric characteristics (altitudes of the cloud base and top and vertical extent) were determined based on lidar data, and the scattered solar radiation flux over the lidar point of view was measured by a zenith pyranometer. It is shown that specular HLCs, i.e., clouds consisting of predominantly horizontally oriented ice crystals, significantly decrease the flux of scattered solar radiation incident on the Earth’s surface from the near-zenith sky as compared to HLCs with the same optical depth but a chaotic orientation of particles.

BACKGROUND AND AIMS Parallels between the persistent overconsumption of food and addictive drugs have given rise to the notion of food addiction. In a large community sample of Canadian adults, the current study examined the prevalence of food addiction and its relationship with obesity, quality of life and multiple indicators of impulsivity. A secondary goal was to analyze differences between obese and non-obese individuals with and without food addiction. DESIGN Cross-sectional in-person assessment. SETTING Hamilton, Ontario, Canada. PARTICIPANTS A total of 1432 community adults (age = mean ± standard deviation = 38.93 ± 13.7; 42% male) recruited from the general community using print, bus and internet advertisements. MEASUREMENTS Yale Food Addiction Scale 2.0, anthropometrics (including body mass index), body composition (e.g. body fat, muscle mass, body water), World Health Organization Quality of Life scale and impulsivity measures, including impulsive personality traits, delay discounting and behavioral inhibition. FINDINGS The prevalence of food addiction was 9.3% and substantially below that of obesity (32.7%), although food addiction was significantly more common among obese individuals (18.5%, P

The article analyses the essence of Smart technologies in the context of educational mobility and mobile education. Examples of elements implementation of Smart-cities concepts in China, England, Czech Republic, Finland, Great Britain and Denmark are presented. Smart-technology structure components are revealed. The research has practical value - it allows using the revealed essence and separate elements of Smart-technology structure for realization of particular models in open education system of new generation.

Background Medications for smoking cessation are currently only effective in helping a minority of smokers quit. Drug development is slow and expensive; as such, there is much interest in optimizing the effectiveness of existing treatments and medications. Current standard doses of nicotine replacement therapy are not effective for many smokers, and in many cases, the amount of nicotine provided is much less than when a smoker is smoking their usual number of cigarettes. The proposed study will test if titrating the dose of the nicotine patch (up to 84 mg) will improve quitting success compared to those receiving a 21-mg nicotine patch with increasing doses of placebo patch. Methods This is a multicenter, pragmatic, two-arm, placebo-controlled, block randomized controlled trial. We will recruit participants who smoke at least 10 cigarettes daily and are interested in making a quit attempt. After 2 weeks of usual treatment with a 21-mg patch, participants who fail to quit smoking (target n = 400) will be randomized to receive escalating doses of a nicotine patch vs matching placebo patches for an additional 10 weeks or up to a maximum dose of 84 mg per day. Those who stop smoking during the first 2 weeks of usual treatment will continue with 21 mg patch treatment for 10 weeks and will form an additional comparison arm. In addition to the medication, participants will receive brief behavioral counseling at each study visit. The primary outcome will be biochemically confirmed continuous abstinence from smoking during the last 4 weeks of treatment (weeks 9 to 12). Discussion Research evidence supporting the effectiveness of personalized doses of nicotine replacement therapy could change current practice in a variety of healthcare settings. Given the evidence that quitting smoking at any age diminishes the risk of tobacco-related morbidity and mortality, even small increases in absolute quit rates can have a substantial population-level impact on reducing smoking-related disease, mortality rates, and associated healthcare costs. Trial registration ClinicalTrials.gov, NCT03000387. Registered on 22 December 2016.

The development of measures to preserve the population of Atlantic salmon has been carried out on the basis of the results of studying the state of its habitat and the conditions of reproduction. During the survey of the habitat conditions of this species in the River Ura (the Murmansk region, Russia), the area of spawning and nursery fund has been determined, the qualitative and quantitative distribution of salmon in the river basin has been established, and the migration barrier (waterfall) and the bypass for this obstacle have been described. The data obtained during the calibration of spawning and nursery plots and juveniles fishing have indicated that Atlantic salmon Salmo salar L. is widely distributed in the River Ura and runs along the main watercourse, three tributaries of the 1st order and one inflow of the 2nd order. The waterfall located on the River Ura at the distance of 28 km from its mouth does not limit the distribution of salmon which has the ability to make spawning migration along the creek bending the waterfall. The total area of the spawning and nursery fund is 69.4 ha, 83 % of which are located in watercourses below the waterfall. Spawning and nursery habitat of the Atlantic salmon is represented by a variety of habitat conditions with various longitudinal relief of the lake - river system, and the fractional composition of the bottom substrate. During the studies it has been noted a relatively high content of gravel and cobble fractions forming the most important types of spawning and nursery grounds, most suitable for Atlantic salmon spawning. "Spawning-nursery" grounds (42 %), as well as "spawning-nursery grounds with spawning grounds predominance" (35 %) constitute the bulk of spawning and nursery fund of the Atlantic salmon in the River Ura basin. Nursery grounds play a smaller role in its formation. The role of the latter is more noticeable in the river reaches above the waterfall where their share reaches 50 %.

Objectives The efficacy of brief interventions for cannabis use was assessed in a systematic review and meta-analyses. Methods Systematic searches in academic databases were conducted, and reference lists of included studies were reviewed. Randomized trials were included that compared brief interventions with minimal control interventions for improving cannabis-specific outcomes among participants recruited from healthcare settings. Mean differences (MDs) based on change-from-baseline measurements were pooled using random-effects meta-analyses, with stratification by short term (≤3 months) and long term (>3 months). Results Ten reports from 9 studies were included. Most studies were conducted in the United States, including participants who were adults and were recruited from primary care or emergency departments. There were no significant effects of brief interventions on cannabis-specific Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) scores in the short term (MD -1.27 points; 95% confidence interval [CI] -3.75, 1.21; I 84.40%). The null pattern of findings was also observed for number of days of cannabis use in the past 30 days in the short term (MD -0.22 days; 95% CI -2.27, 1.82; I 60.30%) and long term (MD -0.28 days; 95% CI -2.42, 1.86; I 60.50%). The evidence base for other outcomes not subjected to meta-analyses was limited and mixed. Conclusions Brief interventions did not result in reductions in cannabis-specific ASSIST scores or number of days of cannabis use, whereas the evidence base for other outcomes was limited and mixed. As such, brief interventions in healthcare settings may not be efficacious for cannabis use.

Background In 2013, an Integrated Care Pathway (ICP) for concurrent Major Depressive (MDD) and Alcohol Use (AUD) Disorders was developed at the Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada. The ICP was further implemented at 8 other clinical sites across Ontario (the DA VINCI Project) in 2015–2017. The goal of this study was to systematically describe and analyze the main clinical outcomes of the project. Methods Data on a non-randomized cohort of patients receiving ICP-based treatment were collected prospectively at nine clinical sites in a variety of clinical settings. Statistical methods: descriptive statistics, t-test, chi-square, ANOVA, generalized linear models. Results Two hundred forty-six patients were enrolled, 58.8% males, mean age was 45.6 years, 170 patients received treatment at academic health centres (AHC), 49 – at community hospitals (CH) and 27 – in family health teams (FHT). There were no major differences in anamnestic parameters and depression severity between the three settings, but there were differences in baseline drinking patterns between subgroups (F = 4.271, df = 2, p = 0.015). Overall completion rate was 70.7% with no significant variation between settings (χ2 = 3.35, df = 2, p = 0.19). Treatment duration in AHC was the longest, and completion rates were the highest. There was a statistically significant and clinically meaningful reduction in the number of drinking days per week (1.81, t = 8.78, p

Within the research of efficiency of Atlantic salmon the artificial reproduction, feeding rate, distribution and growth of farm-raised one-year-old Atlantic salmon have been examined. The fish has been released into nursery areas with different hydrological characteristics located in the Rivers Kola, Umba, Srednyaya and Akkim in the Murmansk region. The observations have being conducted for 1–5 months since the moment of fish release. In natural habitat, juveniles rapidly distribute downstream and upstream regardless of water temperature, depth and current velocity. In all examined nursery areas adapting one-year-old juveniles prefer to stay at weak current sites close to the shore, hiding in the gravel. In all the cases farmed parr shows high feed rate, but qualitative composition of their food differs significantly from food composition of wild juveniles. Revealed peculiarities of adapting parr's distribution and qualitative food composition indicate the impact of long-term rearing at hatcheries on fish behavior. Growth rate of one-year-old juveniles is arcwise connected with fraction composition of gravel and the level of bottom fouling: the bigger bottom rocks are and the thicker the fouling is, the more intensive fish growth is. The revealed correlations have been described with equations of linear regression. Connections between juvenile growth and water temperature, current velocity and depth of the area have not been detected. The research outcomes could provide a basis for scientific advice for planning release sites and number of released one-year-old Atlantic salmon by hatcheries in the Murmansk region.

Background Major Depressive Disorder (MDD) and Alcohol Use Disorder (AUD) are highly prevalent, comorbid, and have significant impact on morbidity, mortality, and socioeconomic burden in Canada. Combined psycho- and pharmacotherapies for both conditions promise better outcomes than treatment as usual (TAU). At the Centre for Addiction and Mental Health, Toronto, Canada, we developed and implemented an Integrated Care Pathway (ICP) specifically for treatment of concurrent MDD and AUD. The goal of the study is to assess the clinical effectiveness of the ICP approach in comparison to TAU. Materials and Methods Non-randomized design, clinical chart review, Chi-square and t-tests, Cohen's d, Linear Mixed Effects Models, Kaplan–Meier, and log-rank analyses. Results Eighty-one ICP patients were included, matched to 81 controls by age, sex, severity of depressive symptoms, and patterns of drinking. ICP cohort had a significantly lower dropout rate (18.5% vs 69.1%, p

Background and aims Alcohol use is a major contributor to injuries, mortality and the burden of disease. This review updates knowledge on risk relations between dimensions of alcohol use and health outcomes to be used in global and national Comparative Risk Assessments (CRAs). Methods Systematic review of reviews and meta‐analyses on alcohol consumption and health outcomes attributable to alcohol use. For dimensions of exposure: volume of alcohol use, blood alcohol concentration and patterns of drinking, in particular heavy drinking occasions were studied. For liver cirrhosis, quality of alcohol was additionally considered. For all outcomes (mortality and/or morbidity): cause of death and disease/injury categories based on International Classification of Diseases (ICD) codes used in global CRAs; harm to others. Results In total, 255 reviews and meta‐analyses were identified. Alcohol use was found to be linked causally to many disease and injury categories, with more than 40 ICD‐10 three‐digit categories being fully attributable to alcohol. Most partially attributable disease categories showed monotonic relationships with volume of alcohol use: the more alcohol consumed, the higher the risk of disease or death. Exceptions were ischaemic diseases and diabetes, with curvilinear relationships, and with beneficial effects of light to moderate drinking in people without heavy irregular drinking occasions. Biological pathways suggest an impact of heavy drinking occasions on additional diseases; however, the lack of medical epidemiological studies measuring this dimension of alcohol use precluded an in‐depth analysis. For injuries, except suicide, blood alcohol concentration was the most important dimension of alcohol use. Alcohol use caused marked harm to others, which has not yet been researched sufficiently. Conclusions Research since 2010 confirms the importance of alcohol use as a risk factor for disease and injuries; for some health outcomes, more than one dimension of use needs to be considered. Epidemiological studies should include measurement of heavy drinking occasions in line with biological knowledge.

The article shows how to simulate the activities of a travel agency in the SimEvents environment and how to calculate the system load. This model allows you to optimally load the system by regrouping services. The considered example of building the architecture of the system model, taking into account the logistics of moving the groupings of objects, can be generalized to the tasks of planning the optimal workload of work centers and other production management tasks. In our case, the agency operates mainly through the Internet. The object of the study is the process of servicing several types of clients of a travel agency. The distribution of various types of tourist destinations is under study. A simulation of a deterministic system, including a servicing device (server) with a discrete time for servicing applications and a request generation unit, which also has a constant arrival time, was carried out. The intelligence of the model was achieved by creating a program code that ensured full automation of the modelling process. The simulation results indicate the quality of the constructed model.

Differential optical absorption spectroscopy (DOAS) gas-analyzer was successfully tested. Ultraviolet light emitting diodes and high pressure Xe arc lamp were employed as a light sources. Recent developments in fibre-coupling telescope technology and the availability of UV LEDs allowed us to construct a portable instrument. The DOAS system consisted of a coaxial telescope, a spectrometer, and retroreflector. Gas analyzer spectral data bank includes more than 40 molecules absorbed in UV spectral region. Minimally detected concentration is the unit of ppb on paths up to 500 m. The results of the field test measurements of pollutants in Tomsk are presented

The software complex for automation of processing the results of the experiments on sensing of high-level clouds with the high-altitude polarization lidar developed at National Research Tomsk State University is described. The software performs the following operations: preliminary processing and visualizing experimental data; calculating optical and geometrical characteristics of the observed aerosol layers; downloading meteorological data corresponding to the place, date, and time of the lidar experiment; as well as forming summary report on the performed processing.

Background Clinical decision support systems (CDSSs) may promote practitioner adherence to evidence-based guidelines. This study examined if the addition of a CDSS influenced practitioner delivery of a brief intervention with treatment-seeking smokers who were drinking above recommended alcohol consumption guidelines, compared with practitioners who do not receive a CDSS prompt. Methods This was a cluster randomized controlled trial conducted in primary health care clinics across Ontario, Canada, implementing the Smoking Treatment for Ontario Patients (STOP) smoking cessation program. Clinics randomized to the intervention group received a prompt when a patient reported consuming alcohol above the Canadian Cancer Society (CCS) guidelines; the control group did not receive computer alerts. The primary outcome was an offer of an appropriate educational alcohol resource, an alcohol reduction workbook for patients drinking above the CCS guidelines, and an abstinence workbook to patients scoring above 20 points in the AUDIT screening tool; the secondary outcome was patient acceptance of the resource. The tertiary outcome was patient abstinence from smoking, and alcohol consumption within CCS guidelines, at 6-month follow-up. Results were analyzed using a generalized estimation approach for fitting logistic regression using a population-averaged method. Results Two hundred and twenty-one clinics across Ontario were randomized for this study; 110 to the intervention arm and 111 to the control arm. From the 15,222 patients that enrolled in the smoking cessation program, 15,150 (99.6% of patients) were screened for alcohol use and 5715 patients were identified as drinking above the CCS guidelines. No statistically significant difference between groups was seen in practitioner offer of an educational alcohol resource to appropriate patients (OR = 1.19, 95% CI 0.88–1.64, p = 0.261) or in patient abstinence from smoking and drinking within the CCS guidelines at 6-month follow-up (OR = 0.93, 95% CI 0.71–1.22, p = 0.594). However, a significantly greater proportion of patients in the intervention group accepted the alcohol resource offered to them by their practitioner (OR = 1.48, 95% CI 1.01–2.16, p = 0.045). Conclusion A CDSS may not increase the likelihood of practitioners offering an educational alcohol resource, though it may have influenced patients’ acceptance of the resource. Trial registration This trial is registered with ClinicalTrials.gov, number NCT03108144, registered on April 11, 2017, “retrospectively registered”. Electronic supplementary material The online version of this article (10.1186/s13012-019-0935-x) contains supplementary material, which is available to authorized users.

Sun trackers are widely used to investigate scattering and absorption of solar radiation in the Earth׳s atmosphere. We present a method for optimization of the optical altazimuth sun tracker model with output radiation direction aligned with the axis of a stationary spectrometer. The method solves the problem of stability loss in tracker pointing at the Sun near the zenith. An optimal method for tracker calibration at the measurement site is proposed in the present work. A method of moving calibration is suggested for mobile applications in the presence of large temperature differences and errors in the alignment of the optical system of the tracker.

Randomized clinical trials have established the efficacy of naltrexone for reducing quantity of alcohol consumption and incidence of relapse to heavy drinking. To evaluate putative treatment mechanisms, human laboratory studies have examined naltrexone's effects on alcohol responses and self-administration during short-term medication protocols. RESULTS from these studies are inconsistent and have yet to be examined in aggregate. This meta-analysis aimed to quantify naltrexone's effects on alcohol self-administration and craving in the context of placebo-controlled human laboratory trials. Potential moderators of medication effects were also examined. Meta-analyses of alcohol self-administration (k = 9, N = 490) and craving (k = 16, N = 748) confirmed that, under controlled experimental conditions, naltrexone reduces the quantity of consumption (Hedges' g = -.277, SE = .074, 95 percent CI = -.421, -.133, p © 2016 Society for the Study of Addiction. Language: en

Objective Substance use disorders (SUD) are frequently comorbid with other psychiatric conditions, but a comprehensive diagnostic assessment is often not feasible clinically. Efficient psychometrically-validated screening tools exist for commonly comorbid conditions, but cutoff accuracies have typically not been evaluated in addiction treatment settings. This study examined the performance of several widely-used screening measures in relation to diagnostic status from a clinical interview to identify and validate cutoff scores in an inpatient SUD treatment setting. Method Participants were 99 patients in a large residential SUD treatment program in Ontario, Canada. Participants completed a screening battery, including the Patient Health Questionnaire – 9 (PHQ-9), Generalized Anxiety Disorder – 7 (GAD-7), and Post-Traumatic Stress Disorder Checklist-5 (PCL-5), and underwent a semi-structured diagnostic clinical interview. Receiver operating characteristic curves were used to determine optimal cutoff scores on the screening tool against the interview-based diagnosis. Results Area under the curve (AUC) was statistically significant for all screens and were as follows: PHQ-9 = 0.70 (95% CI = 0.59–0.80), GAD-7 = 0.74 (95% CI = 0.63–0.84), and PCL-5 = 0.79 (95% CI = 0.66–0.91). The optimal accuracy cutoff scores based on sensitivity and specificity were: PHQ-9 ≥ 16, GAD-7 ≥ 9, the PCL-5 ≥ 42. Conclusions In general, the candidate screeners performed acceptably in this population. However, the optimal cutoff scores were notably higher than existing guidelines for depression and PTSD, potentially due to the general elevations in negative affectivity among individuals initiating SUD treatment. Further validation of these cutoff values is warranted. Public health significance This study provides modified screening cutoff scores for major depression, anxiety disorders, and post-traumatic stress disorder in addiction treatment settings.

In this paper, the most important aspect is touched upon - the principle of constructing an individual learning path in the system of open education. At the moment, there is no clear implemented construction method that satisfies both the learner and the teacher. The method proposed in this paper is based on the use of neural network technologies to determine significant input parameters that affect the success rate. At the first stage of determining an individual trajectory, proceeding mainly from theoretical ideas about the diagnosed set, a “draft” version of the list of parameters is formed. This option includes parameters that, according to the expert, should reflect the individual psychological differences of the subjects. The definition of a “draft” version of the initial set of diagnostic features is a difficult formalized task.

Background While inpatient programs are a common setting for addiction treatment, patients' premature termination is a major concern. Predicting premature treatment termination has the potential to substantially improve patient outcomes by identifying high-risk profiles and suggesting care paths that might reduce dropout. The current study examined the predictors of premature termination from an inpatient addiction medicine service. Methods In 1082 patients admitted to a large inpatient addiction medicine service, we used intake assessments of severity of alcohol use disorder, illicit drug use disorder, post-traumatic stress disorder (PTSD), anxiety disorders, and major depressive disorder to predict planned termination (n = 922) or premature termination (n = 160). We used two complementary analytic approaches—traditional binary logistic regression and a data-driven latent profile analysis (LPA). Results Binary logistic regression revealed that alcohol use severity, illicit drug use severity, and PTSD severity significantly predicted termination status, although alcohol use severity notably exhibited an inverse relationship. The LPA revealed four distinct profiles, with one profile exhibiting a significantly higher rate of premature termination and another exhibiting a significantly lower rate of premature termination. The high-risk profile was characterized by high drug severity, high comorbid psychopathology (PTSD, depression, and anxiety symptoms), but low alcohol severity. The low-risk profile was characterized by high alcohol severity, but low drug use and low comorbid psychopathology. Conclusions These results provide converging evidence that illicit drug severity and psychiatric severity, and particularly PTSD, were associated with premature termination. Moreover, the LPA revealed distinct latent subgroups of patients with meaningfully higher and lower risk of premature termination, suggesting that addiction services should develop strategies for identifying high-risk individuals or develop care paths for high-risk symptom clusters. Approaches that are trauma-informed or otherwise focus on the management of comorbid psychiatric conditions may be particularly appropriate for reducing premature termination.

The paper presents the results of numerical simulation of the dispersion properties of surface plasmon-polaritons at the interface between an active composite medium based on metallic nanoparticles and a substrate of the same metals in the visible wavelength range. It is shown that the amplification and dispersion properties of surface plasmon polaritons in these structures can be varied within wide limits by varying the concentration of nanoparticles.

BACKGROUND Little is known about trends in the treatment of problematic cannabis use in Canada. Trends in treatment utilization for problematic cannabis use were examined, as well as trends in the associated sociodemographic characteristics and frequency of cannabis use. METHODS This was a repeated cross-sectional study using data from the Drug and Alcohol Treatment Information System, capturing utilization of all community funded addiction treatment services in Ontario, Canada. Clients in treatment for their own problematic cannabis use from 2010/11 to 2015/16 were included. Two distinct groups were formed: clients with problematic cannabis use only (the cannabis-only group) and clients with problematic use of cannabis and other substances (the cannabis-plus group). Estimates of the number of clients in each of these groups and their cannabis use frequency (past 30 days) were characterized over time by new admissions and total caseload (new admissions plus carryovers). RESULTS There were 152 984 admissions for 83 621 clients over the study period. The number of clients with new admissions in the cannabis-only group decreased from 2954 (95% confidence interval [CI] 2848-3062) in 2010/11 to 2342 (95% CI 2248-2439) in 2015/16. Similar downward trends were observed in the number of clients in the total caseload of this group. The number of clients with new admissions in the cannabis-plus group was stable, but the total caseload increased from 20 139 clients (95% CI 19 862-20 419) in 2011/12 to 21 816 (95% CI 21 527-22 107) in 2015/16. Proportions of daily cannabis use increased among clients in both groups. INTERPRETATION The number of clients in treatment for problematic cannabis use only decreased over the study period, but the frequency of cannabis use increased among clients in both groups. Given the potential reductions in treatment that is unnecessary from a clinical standpoint, alignment of treatment programming with disorder severity may be warranted.

The results of the investigation of radiation characteristics of cirrus consisting of crystalline ice particles with a preferred orientation are discussed. The orientation degree of particles is estimated from the backscattering phase matrices, which are determined with the high-altitude polarization lidar developed at National Research Tomsk State University. It is shown that the orientation of ice crystals in clouds with anomalously high backscattering affects significantly the transmission of solar radiation.

The article considers actual problems of the Internet environment development for master’s degree students. Results of the analysis of university portals and social networks regarding their relevance for organization of research and innovative activity of master’s degree students are cited. The authors conclude that it is necessary to create a special Internet environment for this category of trainees. The structure and implementation of the environment are justified.

High strength or construction bloating clay is widely used in construction operations especially in construction of roads, bridges, airfield pavement. It replaces crushed stone as an aggregate. Technology of high strength bloating clay requires essential changes in its stoving curve in comparison with the production of light bloating clay. It is shown that in order to solve an urgent construction problem of bloating clay release it is necessary to conduct monitoring of temperature pattern in a rotary kiln in several distinctive cross sections and conduct management of a kiln as an object with distributed constants with the use of several, especially three, concentrated control actions. The developed mathematical model of stoving process and methodology of computing experiment, exemplified by the 40×2,5м kiln, allowed to find operating areas of condition and management of an automated object, focused on bloating clay release with assigned strength.

Tissue Doppler imaging is evolving as a useful echocardiographic tool for quantitative assessment of left ventricular systolic and diastolic function. Over the last 10 years, myocardial deformation imaging has become possible initially with tissue Doppler , and more recently with myocardial speckle-tracking using 2D echocardiography. Unlike simple tissue velocity measurements, deformation measurements are specific for the region of interest. Strain rate or strain measurements have been used as sensitive indicators for subclinical diseases, and it is the most widely used tool to assess mechanical dyssynchrony. Left bundle branch block is a frequent, etiologically heterogeneous, clinically hostile and diagnostically challenging entity. About 2% of patients underwent cardiac stress testing show stable or intermittent left bundle branch block. Presence of left bundle branch block is associated with a lower and slower diastolic coronary flow velocity especially during hyperemia. Stress echocardiography is the best option for the diagnosis of ischemic heart disease, albeit specificity and sensitivity reduce in patients with left bundle branch block in the territory of left anterior descending artery in presence of initial septum dyskinesia.

A differential optical absorption spectroscopy (DOAS) gas-analyzer was successfully tested. A high pressure 150-W Xe arc lamp was employed as a light source. This system consisted of a coaxial telescope, a spectrometer, an analyzer and retroreflector. In order to record the spectra, a monochrometer with a grating and photodiode array was adopted. Gas analyzer spectral data bank includes more than 30 moleculas absorbed in UV spectral region. The measured absorption spectra were evaluated by using a least-squares to determine the average mixing ratio of each species in the atmosphere. A number of air pollutants concentrations: SO2, NO2, O3, etc were trace measured. Minimally detected concentration on pathlength 400 m is the unit of ppb at the time of accumulation of 2 min. The results of the field test measurements of pollutants in Tomsk are presented.

Results of experiments on polarization laser sensing of high-level clouds performed at the high-altitude polarization lidar developed at National Research Tomsk State University are discussed. It is shown that orientation of crystalline ice particles in a cloud leads to different values of the measured depolarization ratio for the same cloud, which depends significantly on the azimuthal orientation of the polarization plane of sensing radiation.

This article considers the results of a survey of the Internet space in order to identify interest and ideas about innovative activities and readiness for it. Understanding of the essence of innovation activity by respondents, its effectiveness, participation in innovation competitions, awareness of leading innovative programs, participation in the registration of intellectual property and other aspects are considered in the article. The results of the survey reveal the preservation of diversity of points of view with the prevalence of a significant change in interest and innovation activity.

Meta-analyses of alcohol use, alcohol dosage and alcohol-related problems as risk factors for tuberculosis incidence were undertaken. The global alcohol-attributable tuberculosis burden of disease was also re-estimated. Systematic searches were conducted, reference lists were reviewed and expert consultations were held to identify studies. Cohort and case-control studies were included if there were no temporal violations of exposure and outcome. Risk relations (RRs) were pooled by using categorical and dose-response meta-analyses. The alcohol-attributable tuberculosis burden of disease was estimated by using alcohol-attributable fractions. 36 of 1108 studies were included. RRs for alcohol use and alcohol-related problems were 1.35 (95% CI 1.09–1.68; I2: 83%) and 3.33 (95% CI 2.14–5.19; 87%), respectively. Concerning alcohol dosage, tuberculosis risk rose as ethanol intake increased, with evidence of a threshold effect. Alcohol consumption caused 22.02 incident cases (95% CI 19.70–40.77) and 2.35 deaths (95% CI 2.05–4.79) per 100 000 people from tuberculosis in 2014. Alcohol-attributable tuberculosis incidence increased between 2000 and 2014 in most high tuberculosis burden countries, whereas mortality decreased. Alcohol consumption was associated with an increased risk of tuberculosis in all meta-analyses. It was consequently a major contributor to the tuberculosis burden of disease., Alcohol use, alcohol dosage and alcohol-related problems are associated with an increased risk of tuberculosis http://ow.ly/CheO30aPqJg

Background Tobacco and alcohol use present multiplicative risk for aerodigestive cancers. Reducing alcohol consumption improves smoking cessation outcomes and reduces cancer risk. Risky alcohol consumption and smoking are often treated separately despite concurrent treatment potentially leading to better outcomes for each. However, no rapidly scalable program exists for combined interventions in primary care clinics spread across wide geographic areas. This cluster randomized trial aims to report on the effects of a novel clinical decision support system (CDSS) on intervention rates by primary care practitioners addressing risky alcohol use in a smoking cessation program. Methods/design We will be implementing a clinical decision support system (CDSS) in 221 primary care sites participating in the Smoking Treatment for Ontario Patients (STOP) program across Ontario, Canada. Sites will be blindly allocated to one of two clinical decision support systems guiding practitioners to provide a risky alcohol use intervention to smokers attempting to quit using nicotine replacement therapy (NRT). Risky alcohol use is defined as drinking above the Canadian Cancer Society’s low-risk drinking guidelines. Primary analysis will measure the proportion of risky drinkers offered an alcohol intervention in each CDSS arm at baseline. Patients will be contacted by phone or email to track smoking cessation and alcohol consumption rates at 6- and 12-month follow-up. Discussion Upon completion of the trial, the effect of different clinical decision support systems on practitioner behaviour, and on client tobacco and alcohol use, will be discussed. If the CDSS successfully promotes SBIRT for risky alcohol use in a primary care setting and/or improves patient-level outcomes, including smoking cessation rates and alcohol use reduction, this tool can be used as a model for other web-based behaviour change interventions integrated into primary care practice. Trial registration ClinicalTrials.gov NCT03108144

BACKGROUND AND AIMS: Unrecorded alcohol constitutes about 30% of all alcohol consumed globally. The aims of this systematic review were to determine the epidemiology (occurrence, types, prevalence) of unrecorded alcohol consumption in different countries/regions, analyze the chemical composition of unrecorded alcohol, and examine health outcomes caused by the consumption of unrecorded alcohol, based on either epidemiology or toxicology. METHODS: A systematic search for, and qualitative analysis of, articles with empirical results on the different categories of unrecorded alcohol, based on PRISMA guidelines. RESULTS: Unrecorded alcohol was widespread in all regions of the world. Artisanal fermented beverages and spirits were the most common categories of unrecorded alcohol globally, and were available on all continents. In India, industrially produced spirits (country spirits) were most prevalent. In Russia and countries of the former Soviet Union, surrogate alcohols complemented artisanal spirits. Cross-border shopping was the most prevalent method of obtaining unrecorded alcohol in parts of Europe. Ethanol was the most harmful ingredient of unrecorded alcohol, and health consequences due to other ingredients found in unrecorded alcohol were scarce. However, since unrecorded alcohol is usually the least expensive form of alcohol available in many countries, it may contribute to higher rates of chronic and irregular heavy drinking. CONCLUSIONS: Very large amounts of alcohol are produced globally that go unrecorded. The primary harm from this kind of alcohol arises from the fact that it is typically much cheaper than licit alcohol. Language: en

SummaryLiver diseases contribute markedly to the global burden of mortality and disease. This paper provides an overview from a global perspective of the contribution of alcohol to liver diseases.The Global Burden of Disease study methodology was used to estimate the burden of alcohol-attributable liver cirrhosis and alcohol-attributable liver cancer in 2010 as measured by deaths and disability adjusted life years (DALYs). This methodology estimates attributable fractions based on alcohol exposure distribution and relative risks associated with different levels of drinking.Globally, in 2010, alcohol-attributable liver cirrhosis was responsible for 493,300 deaths (156,900 female deaths and 336,400 male deaths) and 14,544,000 DALYs (4,112,000 DALYs for women and 10,432,000 DALYs for men), representing 0.9% (0.7% for women and 1.2% for men) of all global deaths and 0.6% (0.4% for women and 0.8% for men) of all global DALYs, and 47.9% of all liver cirrhosis deaths (46.5% for women and 48.5% for men) and 46.9% of all liver cirrhosis DALYs (44.5% for women and 47.9% for men). Alcohol-attributable liver cancer was responsible for 80,600 deaths (14,800 female deaths and 65,900 male deaths) and 2,142,000 DALYs (335,000 DALYs for women and 1,807,000 DALYs for men).The burden of alcohol-attributable liver cirrhosis and liver cancer is high and entirely preventable. Interventions to reduce alcohol consumption are recommended as a population health priority and may range from taxation increases for alcoholic beverages to increases in screening and treatment rates for alcohol use disorders.

Objective: Non-medical prescription opioid use (NMPOU) is a major health problem in North America and increasingly prevalent among First Nations people. More than 50% of many Nishnawbe Aski Nation communities in northern Ontario report NMPOU, resulting in extensive health and social problems. Opioid substitution therapy (OST) is the most effective treatment for opioid dependence yet is unavailable in remote First Nations communities. Suboxone (buprenorphine and naloxone) specifically has reasonably good treatment outcomes for prescription opioid (PO) dependence. A pilot study examining the feasibility and outcomes of a community-based Suboxone taper-to-low-dose-maintenance program for PO-dependent adults was conducted in a small NAN community as a treatment option for this particular setting.Design: Participants (N = 22, ages 16–48 years) were gradually stabilized on and tapered off Suboxone (provided on an outpatient and directly-observed basis) over a 30-day period. Low dose maintenance was offered post-taper to patients with continued craving and relapse risk; community-based aftercare was provided to all participants. Results: Of 22 participants, 21 (95%) completed the taper phase of the program. Fifteen (88%) of 17 participants tested by urine toxicology screening had no evidence of PO use on day 30. No adverse side effects were observed. All but one of the taper completers were continued on low-dose maintenance. Conclusion: Community-based Suboxone taper-to-low-dose-maintenance is feasible and effective as an initial treatment for PO-dependence in remote First Nations populations, although abstinence is difficult to achieve and longer term maintenance may be required. More research on OST for First Nations people is needed; existing OST options, however, should be made available to First Nations communities given the acute need for treatment.

Data of polarization laser sensing of high-level clouds obtained within the year from April, 2011 are processed. Attention is focused on cirrus clouds with anomalous reflection. The optical thickness and average extinction coefficient of cirrus clouds comprising horizontally oriented crystals are estimated for sensing radiation with different polarization states.

Results of observation of the dynamics of evolution and decay of an aircraft condensation jet are described. Polarization lidar is used to determine the upper and lower boundaries of the aerosol layer, its optical thickness, scattering ratio, and backscattering phase matrix.