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Encyclopedia of caves
Encyclopedia of Caves is a self-contained, beautifully illustrated work dedicated to caves and their unique environments.It includes more than 100 comprehensive articles from leading scholars and explorers in 15 different countries.Each entry is detailed and scientifically sound, yet accessible for students and non-scientists.
eBook
The elements of style
Offers advice on improving writing skills and promoting a style marked by simplicity, orderliness, and sincerity.
Book
Prevalence of the dissociative subtype of post-traumatic stress disorder: a systematic review and meta-analysis
The dissociative subtype of post-traumatic stress disorder (PTSD-DS) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and is characterised by symptoms of either depersonalisation or derealisation, in addition to a diagnosis of post-traumatic stress disorder (PTSD). This systematic review and meta-analysis sought to estimate the point prevalence of current PTSD-DS, and the extent to which method of assessment, demographic and trauma variables moderate this estimate, across different methods of prevalence estimation. Studies included were identified by searching MEDLINE (EBSCO), PsycInfo, CINAHL, Academic Search Complete and PTSDpubs, yielding 49 studies that met the inclusion criteria (N = 8214 participants). A random-effects meta-analysis estimated the prevalence of PTSD-DS as 38.1% (95% CI 31.5–45.0%) across all samples, 45.5% (95% CI 37.7–53.4%) across all diagnosis-based and clinical cut-off samples, 22.8% (95% CI 14.8–32.0%) across all latent class analysis (LCA) and latent profile analysis (LPA) samples and 48.1% (95% CI 35.0–61.3%) across samples which strictly used the DSM-5 PTSD criteria; all as a proportion of those already with a diagnosis of PTSD. All results were characterised by high levels of heterogeneity, limiting generalisability. Moderator analyses mostly failed to identify sources of heterogeneity. PTSD-DS was more prevalent in children compared to adults, and in diagnosis-based and clinical cut-off samples compared to LCA and LPA samples. Risk of bias was not significantly related to prevalence estimates. The implications of these results are discussed further.
Journal Article
Lost before found: A new species of whaler shark Carcharhinus obsolerus from the Western Central Pacific known only from historic records
Carcharhinus obsolerus is described based on three specimens from Borneo, Thailand and Vietnam in the Western Central Pacific. It belongs to the porosus subgroup which is characterised by having the second dorsal-fin insertion opposite the anal-fin midbase. It most closely resembles C. borneensis but differs in tooth morphology and counts and a number of morphological characters, including lack of enlarged hyomandibular pores which are diagnostic of C. borneensis. The historic range of C. obsolerus sp. nov. is under intense fishing pressure and this species has not been recorded anywhere in over 80 years. There is an urgent need to assess its extinction risk status for the IUCN Red List of Threatened Species. With so few known records, there is a possibility that Carcharhinus obsolerus sp. nov. has been lost from the marine environment before any understanding could be gained of its full historic distribution, biology, ecosystem role, and importance in local fisheries.
Journal Article
باتمان والفلسفة : الخوض في روح فارس الظلام
هذا كتاب أعدة وقدم له كل من مارك د. وايت وروبرت آرب ويتناول باتمان وقصصة الشعبية المصورة لإستنباط أمثلة تناقش وتحاور قضايا معرفية وأخلاقية عديدة على منوال ما تقوم به الدراسات الثقافية ودراسات ما بعد الحداثة في الغرب اليوم ويتناول ما الذي يدفع شخصا ما للذهاب إلى هذا الحد وهل ما يفعله بإتمان هو جيد أو صائب أو فاضل وما الذي يقوله هوسه وتفانيه لل \"مهمة\" عمن يكون وكيف يتعامل مع والديه وأصدقائه وأعدائه؟ وكيف هو الحال حين تكون بإتمان حيث أن كل تلك هي أسئلة فلسفية صميمية وعندما نقرأ قصص باتمان فلا يمكننا الإمتناع عن التفكير في هذه الأشياء وفي هذا الكتاب تستكشف قضايا في الأخلاق والهوية والصداقة والسياسة وأكثر من ذلك أيضا.
BOOK
Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER): a phase 2, randomised, double-blind, placebo-controlled trial
Spironolactone is effective at reducing blood pressure in patients with uncontrolled resistant hypertension. However, the use of spironolactone in patients with chronic kidney disease can be restricted by hyperkalaemia. We evaluated use of the potassium binder patiromer to allow more persistent use of spironolactone in patients with chronic kidney disease and resistant hypertension.
In this phase 2 multicentre, randomised, double-blind, placebo-controlled study, we enrolled participants aged 18 years and older with chronic kidney disease (estimated glomerular filtration rate 25 to ≤45 mL/min per 1·73 m2) and uncontrolled resistant hypertension from 62 outpatient centres in ten countries (Bulgaria, Croatia, Georgia, Hungary, Ukraine, France, Germany, South Africa, the UK, and the USA). Patients meeting all eligibility criteria at the final screening visit were stratified by local serum potassium measurement (4·3 to <4·7 mmol/L vs 4·7 to 5·1 mmol/L) and history of diabetes. Participants were randomly assigned (1:1) with an interactive web response system to receive either placebo or patiromer (8·4 g once daily), in addition to open-label spironolactone (starting at 25 mg once daily) and their baseline blood pressure medications. Participants, the study team that administered treatments and measured blood pressure, and the investigators were masked to assigned treatment groups. Dose titrations were permitted after 1 week (patiromer) and 3 weeks (spironolactone). The primary endpoint was the between-group difference at week 12 in the proportion of patients on spironolactone. Efficacy endpoints and safety were assessed in all randomised patients (intention to treat). The study was registered with Clinicaltrials.gov, NCT03071263.
Between Feb 13, 2017, and Aug 20, 2018, we screened 574 patients. 295 (51%) of 574 patients met all inclusion criteria and were randomly assigned to spironolactone in addition to double-blind treatment with either placebo (n=148) or patiromer (n=147). At week 12, 98 (66%) of 148 patients in the placebo group and 126 (86%) of 147 patients in the patiromer group remained on spironolactone (between-group difference 19·5%, 95% CI 10·0–29·0; p<0·0001). Adverse events were mostly mild or moderate in severity and occurred in 79 (53%) of 148 patients in the placebo group and 82 (56%) of 147 patients in the patiromer group.
In patients with resistant hypertension and chronic kidney disease, patiromer enabled more patients to continue treatment with spironolactone with less hyperkalaemia. Persistent spironolactone enablement in this population of patients has clinical relevance for the treatment of resistant hypertension.
Relypsa, a Vifor Pharma Group Company.
Journal Article
Cardiovascular Safety of Febuxostat or Allopurinol in Patients with Gout
Patients with gout and cardiovascular disease were assigned to receive febuxostat or allopurinol. At 32 months, there was no significant between-group difference in a composite cardiovascular end point, but all-cause and cardiovascular mortality were higher with febuxostat.
Journal Article