Who are the 3 Per Cent? The Connections Among Climate Change Contrarians

Despite 97 per cent of scientists agreeing on anthropogenic global warming, the remaining 3 per cent play a critical role in keeping the debate about climate consensus alive. Analysis of climate change contrarians from multi-signatory documents reveals 3 per cent of signees to be climate experts, while the remaining 97 per cent do not meet expert criteria and are also involved with organizations and industries who make up the climate change countermovement. The data also reveal most contrarians to be aged sixty-five or older. As a result, we explore other factors (for example, collective memories and ideological views) that may have also contributed to expert and non-expert views.

To the Question of Terminology, Expert Criteria for Evaluating the Effectiveness of Antiangiogenic Therapy and the Prevalence of Refractory Forms of Neovascular Age-Related Macular Degeneration. Review

The authors presented a review of studies aimed at assessing the effectiveness of antiangiogenic therapy in patients with neovascular form of age-related macular degeneration. The purpose of this review was to clarify the prevalence of true refractory forms of WMD on literary data. The vast majority of experts consider the marker of “refractory” the exit of the dye from the vessels on fluorescent angiography (FAG), fibrovascular detachment of pigment epithelium with intraretinal and/or subretinal fluid on optical coherent tomography, an increase in hemorrhage on the eye compared to the initial level of post-loading phase therapy. The analysis showed a wide corridor of indicators, due to different approaches and timing of the assessment of the respondent’s status, as well as expert criteria for the effectiveness of antiangiogenic therapy. In addition, the authors drew attention to the different understanding of the terms tahiphylaxis and tolerance, presented by the researchers. Many papers are replacing these perceptions. The our work presents the fundamental differences of these biological phenomena in the clinic and morphometric data, as well as the timing of development. Meanwhile, overcoming resistance involves an accurate diagnosis of the pharmacological cause and a subsequent differentiated approach to solving the problem. An overview of the work on overcoming refractory to antiangiogenic drugs in various ways is presented.

Primary care physician perspectives on screening for axial spondyloarthritis: A qualitative study

Background Many patients with axial spondylarthritis (axSpA) experience lengthy diagnostic delays upwards of 14 years. (5–14 years). Screening tools for axSpA have been proposed for use in primary care settings, but whether this approach could be implemented into busy primary care settings remains unknown. Objective To solicit feedback from primary care physicians regarding questions from the Inflammatory Back Pain Assessment: the Assessment of Spondyloarthritis International Society (ASAS) Expert Criteria and gain insight about barriers and facilitators for implementing axSpA screening in primary care. Methods Guided by Consolidated Criteria for reporting Qualitative Research (COREQ-criteria), we recorded, transcribed, and analyzed in-depth interviews with eight family medicine physicians and ten internists (purposeful sampling) using immersion/crystallization techniques. Results Few physicians reported awareness of existing classification criteria for axSpA, and many reported a lack of confidence in their ability to distinguish between inflammatory and mechanical back pain. From three domains, 10 subthemes emerged: 1) typical work-up of axSpA patients in primary care, with subthemes including the clues involved in work-up and role of clinical examinations for axSpA; 2) feedback on questions from the Inflammatory Back Pain Assessment: ASAS Expert Criteria, with subthemes to evaluate contents/questions of a potential screening tool for axSpA; and 3) implementation of the screening tool in primary care settings, with subthemes of perceived barriers including awareness, time, other conditions to screen, rare disease, and lack of structured questionnaire for back pain and perceived facilitators including workflow issues and awareness. Conclusions Primary care physicians believed that an improved screening instrument and a strong evidence-base to support the need for screening for axSpA are required. The implementation of axSpA screening into a busy primary care practice requires integration into the practice workflow, with use of technology suggested as a possible way to improve efficiency.

Preparación física especial en los nadadores del estilo crawl

Este trabajo surge como una necesidad social, que se debe solucionar con la mayor brevedad posible, por lo que implica el desarrollo de la preparación física especial para la obtención de buenos resultados deportivos en los nadadores del estilo Crawl. Es por ello que el autor de la investigación se propuso como objetivo diseñar una metodología para el desarrollo de la preparación física especial de los nadadores del estilo Crawl. Para dar cumplimiento a este objetivo se utilizarán los siguientes métodos de investigación: análisis-síntesis e inducción deducción y la revisión de diferentes fuentes documentales relacionadas con la preparación especial de los nadadores del estilo Crawl, además se utilizará el método del criterio de expertos para la validación teórica de la metodología que será diseñada por el autor. PALABRAS CLAVE: nadadores del estilo Crawl; preparación física especial; metodología. Special physical preparation for crawl style swimmers ABSTRACT This work arises as a social need, which must be solved as soon as possible, which implies the development of special physical preparation to obtain good sports results in Crawl style swimmers. That is why the author of the research set out to design a methodology for the development of the special physical preparation of Crawl style swimmers. To fulfill this objective, the following research methods will be used: analysis-synthesis and induction deduction and the review of different documentary sources related to the special preparation of Crawl swimmers, in addition, the method of expert criteria will be used for the Theoretical validation of the methodology that will be designed by the author. KEYWORDS: swimmers of the Crawl style; special physical, preparation; methodology.

Performance of Different Criteria Sets for Inflammatory Back Pain in Radiographic and Nonradiographic Axial Spondyloarthritis

Introduction: It is important to recognise inflammatory back pain (IBP) for early diagnosis of ankylosing spondylitis (AS). The aims of this study were to develop a valid, reliable Bengali IBP tool and to assess the performance of different IBP criteria sets, including Calin, Berlin set 8a and 7b, and new Assessment of SpondyloArthritis International Society (ASAS) expert criteria, in radiographic axial spondyloarthritis (axSpA) and nonradiographic axSpA. Method: This case-control study was performed in three phases. The first phase involved development of an IBP tool by adding the fifth parameter of ASAS expert criteria to the National Health and Nutrition Examination Survey (NHANES) 2009–2010 arthritis questionnaires; the second phase assessed reliability by test-retest statistics among 87 participants at a 5-day interval. Finally, according to the imaging arm of ASAS axSpA classification criteria, 50 patients with axSpA were included as cases while 50 patients with chronic mechanical back pain (MBP) were included as a control. Results: The presence of IBP with SpA versus patients with MBP, detected by Calin criteria, were 76.0% versus 10.0%, by Berlin 8a were 72.0% versus 6.0%, by Berlin 7b were 58.0% versus 12.0%, and by ASAS were 64.0% versus 18.0%, respectively. Results suggested the Calin criteria set has the highest sensitivity (76.0%) and Berlin set 8a has the highest specificity (78.9%) in the differentiation of IBP from MBP. Conclusion: The performance of the new ASAS criteria was analogous to the other existing criteria sets. The highest positive likelihood ratio and odds ratio were found for Berlin set 8a criteria. The Berlin set 8a criteria can still be used in primary care practice at the first screening because of high sensitivity.