Rubin

Genitourinary syndrome of menopause (GSM) describes the symptoms and physical changes that result from declining estrogen and androgen concentrations in the genitourinary tract during the menopausal transition. This guideline provides information to clinicians regarding identification, diagnosis, counseling, and treatment for patients with GSM to optimize symptom control and quality of life while minimizing adverse events. The systematic review used in the creation of this guideline is based on research conducted by the Minnesota Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality and funded by the Patient Centered Outcomes Research Institute. The EPC synthesized effectiveness and/or harms outcomes from 68 publications. An additional 66 articles evaluating 46 nonhormonal interventions were described in an evidence map. Clinicians diagnose GSM based on symptoms, with or without related physical findings, and after ruling out other etiologies or co-occurring pathologies. There is a large body of evidence examining the use of hormonal and nonhormonal treatment options to manage the symptoms of GSM; however, the local low-dose vaginal estrogen has the most robust evidence base. The strategies defined in this document were derived from evidence-based and consensus-based processes. Given that there is insufficient information to recommend one hormonal therapy over another, this guideline is not meant to support a stepwise progression through different hormonal approaches. The clinician should make treatment decisions in the context of shared decision-making, considering patient goals and preferences, using the evidence of efficacy and adverse events of each possible intervention as a guide.

In this article, using the example of developing a technique for non-destructive testing of a fireclay product («asterisks») using the natural vibrations of the object of control, a mathematical model is presented that allows us to specifically describe the process of converting an external dynamic effect into the natural vibrations of the part. The peculiarity of the model is that, firstly, it is a carrier of the free energy of elastic deformation and the process of natural oscillations is formed in it. Secondly, the model is a Riemannian space in which all dynamic parameters are constant and reduced to zero, i.e. the model does not exist physically, but only as a functional space. The proposed model can serve as an effective tool for analyzing the processes observed during non-destructive testing and vibration diagnostics. Ill. 7. Ref. 22.

Tendo como referência o conceito sexo/gênero de Rubin (2017), o presente artigo tem com objetivo elaborar procedimentos didáticos para a educação infantil com base nas compreensões teóricas e metodológicas sobre diversidade de gênero. Para isto em um primeiro momento será apresentado o debate histórico sobre o conceito de gênero e sua articulação social como padrão para os indivíduos com base no sexo biológico. Na sequência serão discutidos os argumentos teóricos sobre Educação para a diversidade de Gênero e o seu debate nas orientações para a educação infantil contidas no documento final da Base Nacional Comum Curricular (BNCC). Em um terceiro momento através de uma busca na Biblioteca Digital Brasileira de Teses e Dissertações (BDTD) com o descritor “diversidade de gênero” será possível verificar as contribuições da temática no campo da pesquisa e de propostas metodológicas para a educação. A partir de tais contribuições teóricas será possível articular as orientações didáticas sobre gênero para a educação infantil com jogos que problematizem as relações cotidianas como brincadeiras, cores, atividades, entre outras.

We examined the relationship between comorbid medical conditions and changes in cognition over the course of rehabilitation following acquired brain injury. In particular, we compared outcomes between traumatic brain injury (TBI) and non-TBI using a retrospective inpatient rehabilitation dataset. We hypothesized that differences by diagnosis would be minimized among subgroups of patients with common comorbid medical conditions. We used the Functional Independence Measure (FIM)-cognition subscale to index changes in cognition over rehabilitation. A decision tree classifier determined the top 10 comorbid conditions that maximally differentiated TBI and non-TBI. Ten subsets of patients were identified by matching on these conditions, in rank order. Data from these subsets were submitted to repeated-measures logistic regression to establish the minimum degree of commonality in comorbid conditions that would produce similar cognitive rehabilitation, regardless of etiology. The TBI group demonstrated a greater increase in ordinal scores over time relative to non-TBI, across all subscales of the FIM-cognition. When both groups were matched on the top 3 symptoms, there were no significant group differences in rehabilitation trajectory in problem-solving and memory domains (Cohen's d range: 0.2-0.4). Comorbid medical conditions explain differences in cognitive rehabilitation trajectories following acquired brain injury beyond etiology.

Dokument Papieskiej Komisji Biblijnej Interpretacja Biblii w Kościele 2 wymienia kilka metod stosowanych w badaniach biblijnych, m.in.historyczno-krytyczną, retoryczną, narracyjną i semiotyczną, a także różne podejścia.Współcześnie pojawiają się próby stosowania w analizie tekstów biblijnych metody intertekstualnej, a przynajmniej jej pewnych elementów.Metoda ta oparta jest na zjawisku intertekstualności, identyfikowanym i stosowanym współcześnie w wielu badaniach

Since Ecuador has determined that it wants to be fully bilingual in ten years, this paper describes the experience of a Fulbright Scholar at a university Language Center in Quito; one helping language teachers improve the language learning skills of their students. The theoretical framework for this work comes from Learner Self-Management (LSM) or Self-Regulation. The scholar details her experience teaching LSM concepts such as SMART goal setting, Task Analysis, Cognitive and Affective Strategies. She provides descriptions of what these language teachers consider the roles of the teacher and that of the learner to be and also what their most critical teaching issues were. She also briefly elaborates the history of the development of learner strategies and the value of metacognitive strategies and knowledge.

Introduction: The Hypertension Control Program in Argentina (HCPIA), a cluster-randomized trial of a community health worker-led multicomponent intervention on blood pressure (BP) control in low-income patients in Argentina, previously reported a significant reduction in systolic BP in the intervention compared to the control group over 18 months (6.6 mm Hg net difference; p<0.001). Understanding which elements of a multicomponent intervention are important contributors to its success is critical for future BP control efforts. We conducted a mediation analysis to determine the contributions of seven measured intervention targets to the systolic BP intervention effect. Methods: HCPIA randomized 18 primary healthcare clinics treating uninsured patients to either a multicomponent intervention, consisting of health coaching, home blood pressure monitoring, blood pressure audit and feedback, physician education, and a mobile health intervention, or usual care. A total of 1,357 hypertensive participants completed the trial and are included in the mediation analyses. Changes in seven potential mediators over the 18-month intervention were assessed: medication adherence score, medication adjustments (addition of new medication or dose titration), waist circumference, physical activity, fruit and vegetable consumption, sodium consumption, and alcohol consumption. Generalized estimating equations were used to compare changes in potential mediators between intervention groups. Path analytic models were used to test single-mediator and multiple mediator indirect intervention effects using the Lavaan package in R statistical software. Mediation was considered significant at p<0.10. Results: All potential mediators were significantly improved in the intervention group compared to the control group. Fruit and vegetable consumption, medication adherence, physical activity, and salt consumption are each significant mediators accounting for 4.3, 3.8, 3.3, and 3.2%, respectively, of the intervention effect in single-mediator models. The multiple mediation model explained 15.5% (1.3 mm Hg) of the total intervention effect. Changes in fruit and vegetable consumption and medication adherence remained significant mediators in multiple mediation analysis, responsible for 3.8% and 4.3% of the net reduction in systolic BP, respectively. Other potential mediators did not account for a significant proportion of the intervention effect. Conclusions: Increases in medication adherence and fruit and vegetable consumption were responsible for the largest proportions of the explained intervention effect.

The purpose of the research is to increase the effectiveness of information and measurement and control systems of vibration testing equipment by introducing automated processing of experimental data allowing to extract with the required accuracy resonant bursts in the investigated amplitude-frequency characteristic section of the developed sample of a technical tool. To achieve this goal, a new method for processing experimental data by linear functions of variable length has been developed. The proposed method is based on the elements of the classical least squares method used to construct single approximating linear functions. The proposed method for processing experimental data differs from the known ones in that the number of linear approximating functions and their lengths vary depending on the required accuracy of approximation. The authors developed a mechanism for the formation of a sequence of linear functions on the considered segment, taking into account the given accuracy of approximation. The proposed mechanism is implemented in the form of algorithms, the description of which is presented in the work. Practical significance of the application of the developed method consists in reducing the processing time of the experimental data and obtaining the information necessary for the development engineers to provide a given level of strength and stability to external vibrational influences of the developed technical tools.

The normal distribution of a random variable is usually used in studies of the probabilistic characteristics of information systems. However, the approximation by the normal distribution of distributions determined on a limited interval distorts the physical meaning of the model and the numerical results, and it can only be used as an initial approximation. The aim of the work is to improve the methods for calculating the probabilistic characteristics of information systems. The object of the study is an analytical method for calculating the processing time of the query in the system. The subject of the study are formulas for calculating the duration of sequential processing of the query by elements of the system with uniformly distributed random processing times. In deriving the formulas for calculating the probability characteristics of a sum of independent uniformly distributed random variables, the methods of the theory of probability and statistics are applied. It is proposed for random variables, determined only on the positive coordinate axis, to use finite-interval distribution laws, for example, beta distribution. Density formulas and probability functions for sums of two, three and four independent uniformly distributed random variables are derived.