bluuebunny/crossref_metadata_2025 huggingface dataset:
The risk of bronchial asthma exacerbations among smokers with asthma-chronic obstructive pulmonary disease overlap after inpatient treatment
Authors: Gnoevykh V. V. , Smirnova A. Yu. , Shorokhova Yu. A. , Gening T. P. , Abakumova T. V.
Published: June 2020

Aim. To assess the risk of exacerbations of bronchial asthma (BA) in smoking patients with the asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) after inpatient treatment. Materials and methods. 36 smokers with ACO (main group) and 36 non-smoking patients (control group) with severe or moderate exacerbation of bronchial asthma were examined. Assessment of the severity of exacerbation of BA before treatment, levels of control and risk of exacerbations of BA after treatment was determined according to the Federal clinical guidelines for the diagnosis and treatment of BA (2016). Spirometry, monitoring of blood oxygenation using transcutaneous spectral pulse oximetry and enzyme immunoassay for determination of matrix metalloproteinases 9 were performed. Smoking experience, smoking index and pack/years index were taken into account in patients with ACO. The carboxyhaemoglobin level was analyzed by the carbon monoxide fraction in the exhaled air. Results. For the first time in patients with the ACO, the ability of heavy tobacco smoking and associated decrease in blood oxygenation to potentiate the negative impact of other predictors on the risk of exacerbations of the underlying disease was revealed. In smoking patients with the ACO, for the first time, a direct association of higher levels of matrix metalloproteinases 9 (measured before inpatient treatment) with such a predictor of the risk of further exacerbations of the disease as more frequent detection of symptoms of uncontrolled BA was revealed. In non-smoking patients with BA, a direct relationship between increased sputum secretion and eosinophilia of blood and/or sputum (a predictor of exacerbation of BA) and the relative duration of episodes of decreased blood oxygenation was established. Conclusion. It was found that intensive and prolonged smoking increases the duration and reduces the effectiveness of inpatient treatment of patients with ACO, contributing to the preservation of air traps and low (forced expiratory volume in 1 second 60%) ventilation capacity of the lungs with the persistence of moderately reduced blood oxygenation; the risk of further exacerbations of BA in this phenotype of patients is significantly higher than in non-smoking patients with BA without combination with COPD.
Evaluation of the relationship between the parameters of peripheral skeletal and respiratory muscles in patients with chronic obstructive pulmonary disease
Authors: Suleymanova A. K. , Baranova I. A.
Published: June 2020

Chronic obstructive pulmonary disease (COPD) is a group of diseases with high levels of comorbidity. Pathological changes of peripheral skeletal and respiratory muscles in COPD patients, which are often underestimated, occupy a special place.
Aim. To study the relationship between functional and quantitative parameters of the peripheral (limb muscle) and respiratory muscles in COPD patients.
Materials and methods. 127 patients (98 men/29 women, mean age 67.68.2 years) were under observation without acute COPD. All COPD patients were classified according to GOLD (2019) into groups A, B, C, D. The algorithm of the European Working Group on Sarcopenia in Older People (EWGSOP2) was used to diagnose sarcopenia. The muscle mass was measured using dual energy X-ray absorptiometry (DXA) and the appendicular lean mass index (ASM) was estimated. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured by body plethysmograph MasterScreen Body. Quantitative assessment of thoracic muscle cross-sectional areas were performed using the CT scan using Vidar Dicom Viewer software.
Results. Sarcopenia was diagnosed in 43.3% of COPD patients. Respiratory muscle dysfunction was determined in 66.1% of patients with COPD, its probability increased in groups C and D in comparison with groups A and B [chance ratio 6.6 (95% confidence interval 2.915.0); p0.0001]. Correlations between the functional parameters of sarcopenia and respiratory muscle strength as well as between the mass of peripheral skeletal muscles and respiratory muscle area have been established according to the data of computerized tomography (р0.01). Sarcopenia as well as respiratory muscle dysfunction was observed more frequently in persons with severe and extremely severe airway obstruction and in patients with predominantly emphysematic COPD phenotype (p0.01).
Conclusion. Sarcopenia is a frequent comorbidity in COPD and its development is connected with the severity of the course of the main disease. Correlation between parameters of peripheral (limb muscle) and respiratory muscles in patients with COPD has been determined.
Cardiovascular and chronic obstructive pulmonary diseases: pathophysiological processes and treatment tactics
Authors: Ambatiello L. G. , Chazova I. E.
Published: June 2020

Due to the global aging of the population, the deteriorating ecology and lifestyle changes, patients with isolated cardiovascular diseases (CVD) are becoming less common, and the portrait of a comorbid patient comes first in the structure of patients with CVD. Among a number of diseases complicating and concomitant with cardiovascular, a special place is occupied by chronic obstructive pulmonary disease (COPD). The prevalence of COPD among CVD patients can reach 60%. Many of the pathophysiological mechanisms underlying COPD can increase the risk of cardiovascular disease and vice versa. The most common cases of COPD are arterial hypertension, coronary heart disease, heart failure, and atrial fibrillation. Given the close relationship between COPD and CVD, it is clear that treatment for one condition can affect another. This review discusses current positions about the influence of both groups of diseases on each other, and also observes the effects of drug therapy of both diseases.
Myocardial perfusion single-photon emission computer tomography and coronary angiography results in patients with different pretest probability of ischemic heart disease
Authors: Ansheles A. A. , Sergienko I. V. , Denisenko-Kankiya E. I. , Sergienko V. B.
Published: June 2020

Aim. To study the relationship between pretest probability (PTP) of ischemic heart disease (IHD), calculated according to the recommendations of the European Society of Cardiology (ESC) of 2013 and 2019, with the perfusion of the left ventricle of the myocardium according to the single-photon emission tomography (SPECT) and the results of the invasive coronary angiography (CAG).
Material and methods. The study included 220 patients with a preliminary diagnosis of ischemic heart disease and planned invasive CAG. All patients underwent rest-stress perfusion myocardial SPECT within 1 month prior to or after CAG, standard quantitative parameters of left ventricular perfusion were assessed. Retrospectively clinical data was analyzed and PTP of IHD was assessed according to ESC recommendations for 2013 and 2019.
Results. Invasive CAG revealed obstructive lesion of one or more coromary arteries in 204 of the 220 patients (92.7%). In a retrospective analysis, taking into account gender, age and nature of the complaints, as recommended by ESC in 2013, PTP was rated as low (15%) in 13 patients (5.9%), as intermediate (1585%) in 207 patients (94.1%). Following the comprehensive survey (SPECT and CAG) 8 patients with low PTP (61.5%) underwent coronary revascularization. Among patients with intermediate PTP significant transient ischemia according to SPECT was detected in 31 (15.0%), initial at 107 (51.7%). According CAG among patients with intermediate PTP obstructive lesion was found in 192 (92.7%), 113 patients (58.8%) underwent revascularization. According to ESC recommendations of 2019, PTP was rated as low (15%) in 117 patients (53.2%), including 514% in 98 (44.5%). According to a survey (SPECT and CAG) 68 of them (58.1%) underwent revascularization.
Conclusion. PTP measurements proposed by ESC can not be applied to patients of the Russian population with suspected ischemic heart disease without significant corrections. 2013 ESC recommendations with higher PTP values for all categories of patients reflect Russian population better, while 2019 recommendations mistakenly attribute patients to low PTP in at least 58% of cases. These results are preliminary and will be expanded in subsequent studies with more detailed analysis of PTP in included patients with suspected IHD.
Rebamipide using in gastroesophageal reflux disease treatment
Authors: Ivashkin V. T. , Trukhmanov A. S. , Gonik M. I.
Published: June 2020

Rebamipide is a mucoprotective drug which was developed in Japan in 1990. The therapeutic effect of rebamipide based on the induction of cyclooxygenase-2 and increasing level of prostaglandins, inhibition of oxygen free radicals production, epidermal growth factor stimulation, vascular endothelial growth factor, nitric oxide, and decreasing of lipid peroxidation and neutrophils migration. The combination of proton pump inhibitors and rebamipide is more effective in relieving of gastroesophageal reflux disease symptoms and reducing recurrence rate of disease. Using rebamipide in the treatment of gastroesophageal reflux disease is justified because this drug has a unique mechanism of action, which eliminating the main stages of pathogenesis of the disease.
The myocardial infarction size measuring using modern methods
Authors: Shigotarova E. A. , Galimskaja V. A. , Golubeva A. V. , Oleynikov V. E.
Published: June 2020

An accurate quantitative assessment of myocardium necrosis area and the viable zone (stunned and hibernating) in patients with myocardial infarction is crucial for the preoperative patient selection and predicting the cardiac surgery effectiveness. Currently, researchers and clinicians are most interested in the problem of determining the viable myocardium zone. However, only the necrosis zone area directly correlates with the patients prognosis and determines the heart pathological remodeling processes. In the distant period, the data obtained can be used to predict the post-infarction period course or for analysis the relationship of the necrosis zone with arrhythmogenesis, and a number of other indicators. Thus, the necrosis zone and the viable myocardium zone are two parameters that need to be monitored in dynamics in all patients after myocardial infarction. The most accurate and reproducible method for determining the necrosis area is contrast magnetic resonance imaging of the heart, however, this technique is still inaccessible in most hospitals. In this regard, it remains relevant to estimate the necrotic myocardium area by ubiquitous non-invasive methods such as electrocardiography and echocardiography.
Comparison of clinical-metabolic efficacy of pre- and probiotics in the conducted optimized protocols of eradication therapy of Helicobacter pylori infection
Authors: Butorova L. I. , Ardatskaya M. D. , Osadchuk M. A. , Kadnikova N. G. , Lukianova E. I. , Plavnik R. G. , Sayutina E. V. , Topchiy T. B. , Tuayeva E. M.
Published: June 2020

Low patient compliance due to the development of adverse events in the form of antibiotic-associated diarrhea (AAD) is considered as the main reason for the failure of the eradication of optimized anti-Helicobacter therapy regimens. A key mechanism for the development of AAD is to reduce the number and species diversity of bacteria that form butyric acid.
Aim. The purpose of this study was to study the comparative effect on the clinical effectiveness of eradication therapy (ET) of Helicobacter pylori infection and metabolic changes in the colon microbiota of additional inclusion in the optimized treatment regimen of the combined prebiotic Zakofalk (inulin + butyrate) with probiotics (lacto- and bifidobacteria in an amount of at least 1017 СFU).
Materials and methods. 120 patients with chronic gastroduodenal diseases and infected H. pylori were еxamined. A comparative analysis of the effect of a combined prebiotic and lacto-bifid-containing probiotics on improving the effectiveness of the optimized ET scheme and improving its tolerability, as well as on the quantitative and qualitative content of short-chain fatty acids (SFA) in feces. The success of eradication was controlled by a 13C urease breath test.
Results. According to the results of the study in randomized groups of patients, an excellent percentage of eradication (95%) was achieved in patients who performed ET with the addition of the prebiotic Zakofalk. In the same group of patients, there was an increase in the absolute content of SFA and a significant increase in the concentration of butyric acid. In the group of patients who received ET with the addition of probiotics, an acceptable level of eradication was achieved (85.7%), but no changes in SFA were found indicating an increase in the number or activity of the butyrate-producing flora. Patients who performed ET without the addition of pre-probiotics did not achieve the target percentage of successful eradication (83.3%), and a significant quantitative decrease in SFA was found with a significant decrease in the proportion of butyric acid.
Conclusion. The inclusion of Zakofalk in the ET scheme, in comparison with probiotics, significantly increases the probability of successful eradication, more effectively restores the metabolic potential of the microbiota, and prevents the development of AAD.
Frequency of sarcopenia and factors associated with lean mass in women with rheumatoid arthritis
Authors: Toroptsova N. V. , Dobrovolskaya O. V. , Nikitinskaya O. A. , Demin N. V. , Feklistov A. Yu.
Published: June 2020

Aim. To evaluate the frequency of sarcopenia (SP) according to EWGSOP2 criteria and factors associated with low lean mass in women with rheumatoid arthritis (RA).
Materials and methods. 79 women (aged 4075 years) with RA were enrolled in the study. We analyzed clinical data: age, body mass index (BMI), disease duration, methotrexate use, glucocorticoid use, anthropometric measurements, C-reactive protein level, disease activity score in 28 joints-erythrocyte sedimentation rate, bone mineral density (BMD) of the lumbar spine, femur neck, total hip and body composition by Dual energy X-ray absorptiometry. Also, muscle strength and functional tests were performed. We analyzed the correlation between disease parameters and low lean mass with the Spearman method.
Results. 73 (92%) patients had low muscle strength, 20 (25%) patients had low muscle strength and low lean mass, among them 9 (11%) also had functional disability. There was no correlation between the age of patients and the presence of SP, while the duration of RA in women with SP was significantly greater (p=0.006). There were significant correlations between lean mass and body mass index, glucocorticoids used, methotrexate doses, creatinine and urea acid serum concentration, bone mineral density and falls number.
Conclusion. According EWGSOP2 confirmed sarcopenia was found in 25% RA patients, among them 11% women had severe sarcopenia. Lean mass correlated with the factors related to the disease itself and some general clinical parameters, which requires further study.
Possibility of complex medicamental and endovascular treatment of pulmonary hypertension in Takayasu arteritis with predominant pulmonary arteries’ lesion
Authors: Маrtynuk T. V. , Aleevskaya A. M. , Gramovich V. V. , Danilov N. M. , Korobkova I. Z. , Matchin U. G. , Solodovnikova L. V. , Beketova T. V.
Published: June 2020

Takayasu arteritis (TA) is a systemic vasculitis with predominatly lesions of aorta and its large branches. In some cases pulmonary arteries (PA) are involved in the pathological inflammatory process and lead to the formation of pulmonary hypertension and significantly worse the prognosis. Timely development of lesion of PA, appointment of adequate therapy and surgical treatment can prevent irreversible damage of blood vessels and improve the prognosis. Perioperative administration of interleukin-6 inhibitor inhibitor (tocilizumab) in at patients with indications for vascular surgery, including angioplasty PA, should be considered as a promising approach to control the inflammatory activity of TA, reduce the dose of glucocorticoids and the risk of postoperative complications. We present the clinical experience of significant improvement in the patients condition was achieved by using two-stage balloon angioplasty on the background of control of the disease activity with interleukin-6 tocilizumab intravenously and specific therapy with riociguat and iloprost.
Depression and severity of articular destruction in patients with rheumatoid arthritis
Authors: Abramkin A. A. , Lisitsyna T. A. , Veltishchev D. Yu. , Seravina O. F. , Kovalevskaya O. B. , Glukhova S. I. , Nasonov E. L.
Published: June 2020

Aim. To assess the influence of anxiety and depressive disorders on joint destruction in patients with rheumatoid arthritis (RA).
Materials and methods. 128 RA-patients were included, 87% were women with a mean age of 47.411.3 years and a median of RA duration 96 [48; 228] months. At the inclusion most patients had moderate (n=56, 43.7%) and severe (n=48, 37.5%) disease activity according to DAS28. Joint destruction was classified as maximal in patients with radiographic stage III, IV and/or osteonecrosis) and minimal in patients with stage I, II and no osteonecrosis. Pain intensity was measured with the BPI (Brief Pain Inventory) scale, severity of fatigue with fatigue severity scale (FSS), clinically important fatigue was diagnosed in patients with FSS4. Anxiety and depressive disorders (ADD) were diagnosed by a licensed psychiatrist in 123 (96.1%) of RA-patients in accordance with ICD-10 in semi-structured interview. Severity of depression and anxiety was evaluated with Montgomery-Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating Scale (HAM-A). RA-patients with ADD were divided into the following treatment groups: 1 сDMARDs (n=39), 2 сDMARDs+PPT (sertraline or mianserine), n=43, 3 сDMARDs+bDMARDs (n=32), 4 сDMARDs+bDMARDs+PPT (sertraline or mianserine), n=9. Biologics treatment duration varied from 1 to 6 years, antidepressants from 6 to 96 weeks. 83 (67.5%) RA patients were assessed at five-years follow-up. Linear regression analysis was conducted to determine factors associated with maximal join destruction.
Results. According to linear regression analysis, maximal joint destruction at 5 years follow-up was associated with higher baseline BPImax, longer RA and ADD duration, clinically important fatigue at baseline, baseline extraarticular RA manifestations, recurrent depressive disorder at 5-years follow-up and treatment with cDMARDs only.
Conclusion. Recurrent depressive disorder without antidepressant treatment is an important predictor of progression of joint destruction in patients with rheumatoid arthritis.
Mental disorders and cognitive impairment in patients with antiphospholipid syndrome
Authors: Borisova A. B. , Lisitsyna T. A. , Veltishchev D. Yu. , Reshetnyak T. M. , Seravina O. F. , Kovalevskaya O. B. , Krasnov V. N. , Nasonov E. L.
Published: June 2020

Mental disorders (mainly anxiety and depressive disorders) and cognitive impairment are often found in patients with antiphospholipid syndrome (APS), but their prevalence, structure, and mechanisms of occurrence are not well researched. The review provides literature data on the frequency, spectrum and possible causes of mental disorders and cognitive impairment in patients with APS, the pathogenetic mechanisms of these disorders (in particular, the important role of antiphospholipid antibodies, stress factors, chronic inflammation), the relationship between APS, mental disorders and as well as cognitive impairment is examined. Special attention is paid to the influence of mental disorders and cognitive impairment on patients adherence to treatment, their quality of life, as well as the particularities of psychopharmacotherapy of mental disorders in patients with APS. The aim of the review is to actualize the interdisciplinary problem of mental disorders and cognitive impairment in patients with APS and the need to introduce a partnership model of care.
Survival of bDMARDs in bionaive patients with rheumatoid arthritis: data from a retrospective 12-month follow-up
Authors: Aronova E. S. , Lukina G. V. , Glukhova S. I. , Gridneva G. I. , Kudryavtseva A. V.
Published: June 2020

Aim. Analysis of survival on biological therapy in previously bionaive patients with rheumatoid arthritis (RA) during the first year of therapy in real clinical practice.
Materials and methods. The retrospective study included 204 adult patients with RA. In the hospital, patients were first prescribed therapy with various biological disease-modifying antirheumatic drugs (bDMARDs): infliximab, adalimumab, etanercept, certolizumab pegol, tocilizumab, abatacept (ABA), rituximab (RTM). Patients were divided by age in accordance with the classification adopted by WHO. Clinical forms of RA were presented: RA, seropositive for rheumatoid factor, RA, seronegative for rheumatoid factor, RA with extra-articular manifestations, adult-oneset Stills disease, juvenile RA. The reasons for the cancellation of bDMARD during the first year of treatment were: insufficient effectiveness (including primary inefficiency), adverse events, administrative reasons, clinical and laboratory remission, death.
Results. A year after being included in the study, treatment was continued in 92 (45%) patients and was discontinued in 112 patients. The average time of treatment amounted to 0.750.33 years. The longest duration of treatment was in the RTM and ABA groups (0.920.22 and 0.830.29 years, respectively). In 56 (50%) patients, bDMARD was canceled due to insufficient effectiveness (including primary inefficiency), 28 patients (25%) due to the development of adverse reactions, 19 (17%) patients for administrative reasons, 7 (6.25%) patients due to drug remission. During the first year of therapy, there were 2 (1.75%) deaths due to severe comorbid conditions in patients, one of whom received RTM, the other tocilizumab.
Conclusion. Study showed that 45% of patients with RA continue treatment with first-time bDMARD for more than 12 months. The most common reason for discontinuation of therapy was its lack of effectiveness. The best survival rate of bDMARDs was observed in RTM and ABA. When selecting bDMARD in each case, it is necessary to take into account the continuity at all stages of treatment.
IgG4-related disease: what do we know after 20 years
Authors: Sokol E. V.
Published: June 2020

IgG4-related disease is immunomediated fibroinflammatory condition, characterized by tumefective lesions in different organs with distinctive pathomorphological features and IgG4 hypersecretion in serum and tissues in the majority of patients. IgG4-RD has been established as a separate clinical in the early 2000s. In the review we focus on the evolution of views on ethiopathogenesis of the disease, therapeutic and diagnostic options and classification of the disease.
Advantages of therapy with sodium glucose cotransporter type 2 inhibitors in patients with type 2 diabetes mellitus in combination with hyperuricemia and gout
Authors: Panevin T. S. , Eliseev M. S. , Shestakova M. V. , Nasonov E. L.
Published: June 2020

Currently, only two drugs for reducing uric acid (UA), allopurinol and febuxostat, are registered in the Russian Federation, but their use does not allow to achieve the target level of UA in all cases. According to the results of numerous randomized trials, hyperuricemia and gout are associated with the corresponding components of the metabolic syndrome, including diabetes mellitus. The influence of factors is due to the need to search for new drugs that have a complex effect on several components of metabolic syndrome at once. Potentially attractive in this regard is a new group of drugs for the treatment of type 2 diabetes mellitus inhibitors of the sodium-glucose cotransporter of type 2, which, in addition to the main hypoglycemic actions, showed positive effects on the cardiovascular system, kidneys, as well as lowering UA.
From Schönlein-Henoch purpura to IgA-vasculitis: pathogenetic aspects of the disease
Authors: Guliaev S V , Strizhakov L A , Moiseev S V , Fomin V V
Published: June 2020

Investigation’s history and nomenclature’s evolution of the IgA-vasculitis are presented in the article. Pathogenesis of the renal and skin damages is discussed in details, particularly abnormalities of the IgA-immunity and systemic endotoxemia. Relevant world’s literature is cited.
Influence of visceral obesity on the secretion of adipokines with epicardial adipocytes in patients with coronary heart disease
Authors: Gruzdeva O V , Borodkina A D , Akbasheva O E , Dileva Yu A , Antonova L V , Matveeva V G , Uchasova E G , Ivanov S V , Belik E V , Fanaskova E V , Karetnikova V N , Kokov A N , Barbarash O L
Published: June 2020

Aim. To study adipokine-cytokine profile of epicardial adipocytes (EAT) and subcutaneous adipose tissue (SAT) in conjunction with the area of visceral adipose tissue (VAT), biochemical and clinical characteristics of patients with coronary heart disease. Materials and methods. Examined 84 patients (70 men and 14 women) with coronary artery disease. In fact the presence of visceral obesity (VO) the patients were divided into two groups. Patients VO the sampling of adipocytes of EAT and SAT, with subsequent cultivation and evaluation of adipokine and provospalitelna activity. Carried out the determination of carbohydrate and lipid metabolism, adipokine and pro-inflammatory status in the blood serum. Results and discussion. It was found that adipokine-cytokine profile of adipocytes of EAT and SAT differ. Adipocytes art of the disease on the background characterized by an increase IL-1, TNF-α, leptin-adiponectin relationships and a decrease in the content of protective factors: adiponectin and anti-inflammatory cytokine IL-10. While the SAT adipocytes was characterized by a decrease in the concentration of soluble receptor for leptin and the more pronounced leptinresistance, and the increase in proinflammatory cytokines was offset by the increase in the concentration of IL-10. The presence associated with multi-vessel coronary bed lesion, multifocal atherosclerosis, insulin resistance, atherogenic dyslipidemia, an imbalance of adipokines and markers of inflammation. So the value of the square VAT determined higher concentrations of leptin, TNF-α in adipocytes and serum, lipid and carbohydrate metabolism and a lower content of soluble receptor for leptin. Conclusion. Thus, the disease on the background of the status of the adipocytes of EAT characterized as a "metabolic inflammation", and may indicate the direct involvement of adipocytes in the pathogenesis of coronary artery disease, due to the formation of adipokine imbalance and the activation of proinflammatory reactions.
Functional insufficiency of the pancreas and the metabolic activity of the microbiota in cystic fibrosis adults patients
Authors: Vinokurova L V , Baimakanova G E , Krasovsky S A , Silvestrova S Yu , Dubtsova E A , Varvanina G G , Bordin D S
Published: June 2020

In order to optimize the therapy, the functional state of the pancreas (P) and the peculiarities of metabolic activity of intestinal microbiota in adults with cystic fibrosis (CF) were assessed. Materials and methods. 14 CF patients (20-34 years, 7 men, 7 women) were enrolled. In 8 patients, the diagnosis was confirmed in the first year of life on the basis of clinical data, positive sweat test, 5 had genetic confirmation. In 4 patients, the diagnosis was confirmed at the age of 8-13 years and 2 patients aged 18, 27 years. In this group, genetic confirmation was in 4 subjects. In addition to general clinical studies, the level of C-peptide in blood, elastase and the concentration of short chain fatty acids in feces was determined. Results and discussion. Of elastase feces in 9 patients was 5.5±4.7 icg/g, that is revealed severe exocrine insufficiency of the pancreas and in 5 patients the elastase level was normal and amounted to 402±124 icg/g. Deployed the clinical picture of diabetes mellitus was observed in 3 patients. Metabolic activity of the colon microflora as a whole was reduced, the sum of the concentration of short-chain fatty acids (ΣCn) was 6.03±4.11 mg/g at a rate of 10.61±5.11 (p
Development of opportunistic lesions in patients with HIV infection in the absence of pronounced immunodeficiency
Authors: Ermak T N , Kravtchenko A V , Shakhgildyan V I , Peregudova A B , Goliusova M D , Yadrikhinskaya M S
Published: June 2020

Research objective. Statistical data concerning patients with opportunistic infections depending on parameters of immunity and the description of a number of clinical cases of development of opportunistic lesions in patients with HIV infection in the absence of the expressed immunodeficiency. Materials and methods. Medical records of the patients with HIV infection hospitalized in 2012-2015 in the Infectious Diseases Clinical Hospital No. 2 of Moscow, and the clinical cases of patients with development of opportunistic lesions with satisfactory indicators of the immune status. Results. The distribution of patients with HIV infection who had opportunistic infections, depending on the number of CD4+ lymphocytes at the time of development of the disease revealed a significant group of patients with a sufficiently large number of CD4+ cells. Statistical data on the development of various opportunistic lesions with different parameters of the immune status are presented. The authors describe a number of relevant clinical cases. Discussion. The possible causes of the development of opportunistic diseases and their recurrence in patients with HIV infection with a satisfactory amount of CD4+ lymphocytes are discussed. In the pathogenesis of this phenomenon are important not only quantitative but also qualitative parameters of immunity, as well as the characteristics of the causative agents of opportunistic lesions.
Efficacy of 13-valent pneumococcal conjugate vaccine in healthcare workers
Authors: Shpagina L A , Kotova O S , Shpagin I S , Loktin E M , Rukavitsyna A A , Kuznetsova G V , Kamneva N V , Laletina M A
Published: June 2020

Aim. To establish the efficacy of 13-valent pneumococcal conjugate vaccine (PCV13) for healthcare workers protection from occupational acquired infection and impact of healthcare staff vaccination on the risk of transmission to patients. Materials and methods. Healthcare personnel (n=157 of whom 105 critical care department staff) and 1770 patients of that critical care department observed. Healthcare workers received PCV13. Infections caused by Str. pneumoniae, respiratory infections regardless of etiology, work absenteeism in healthcare workers during 12 month before and after vaccination assessed. In the same time monitoring of hospital-acquired infections in patients of critical care department performed. Statistical analysis was done using SPSS 24, relationships were assessed by rate ratio, Cox regression, logistic regression and Kaplan-Meier estimator. Results. Healthcare workers' vaccine coverage in critical care department was 97.2%. In healthcare personnel the rate of all pneumococcal infections, asymptomatic carriage of Str. pneumoniae and respiratory pneumococcal infections were decreased after vaccination by 2.1, 2.2 and 2.1 times accordingly. The rate of respiratory infections regardless of etiology was decreased by 30%, р
Research on the Transformation of Teachers' Functions in New Applied Colleges
Authors: Sun Lei
Published: June 2020

With the continuous development of society, the demand for applied talents is becoming more and more urgent, and the new applied undergraduate colleges based on the cultivation of applied talents can effectively solve this contradiction between supply and demand. If we want to realize the cultivation of applied talents, we need to establish a team of teachers with excellent quality. Therefore, this paper gives four ways to solve this problem: strengthening the construction of teachers' ethics, improving teachers' ideological and political ability, strengthening teachers' curriculum practice level, and improving teachers' ability of self-career planning.
Electronic Games to Reduce Child Pain Levels With Injection of Circumcision Anesthesia
Authors: Setyaningsih Tunggul Sri Agus , Wahyuni Hesti
Published: June 2020

Circumcision is an action done by removing the skin that covers the tip of the penis. The pain will be felt during the child is injected circumcision anesthesia. This can make the child uncooperative, making it difficult for the procedure to be performed. Electronic games are one of the non-pharmacological management to reduce pain in children. The purpose of this study was to identify the effect of the use of electronic games on the level of pain in children undergoing circumcision anesthetic injection. This research uses quantitative method, quasi-experimental research with one group pretest-posttest design.  The technique used is an accidental sampling. The study was conducted on 17 children who performed circumcision anesthesia injections in Klinik Kencana Medika Rancaekek Bandung. Pain response is measured using the Faces Pain Rating Scale. These results indicate that there are significant differences with p-value <0.001 and alpha significance value £ 0.05. Based on the results of the study showed the use of electronic games affects the level of pain in children who performed injection circumcision anesthesia. Electronic games can reduce the level of pain in children who undergo injection of circumcision anesthesia. It is hoped that the use of electronic games can be done on factors that affect the level of pain.
TRAINING THE CRITICAL THINKING SKILLS OF STUDENTS USING THE PROBLEM SOLVING LEARNING MODEL IN CHEMICAL EQUILIBRIUM
Authors: Rosa Melysa Pramitha , Azizah Utiya
Published: June 2020

The purpose of its research for  train students' critical thinking with problem solving learning models of equilibrium theory. The research was conducted in XI MIPA 1 class at SMA Negeri 14 Surabaya using the One Group Pretest Posttest Design method. The results obtained in this study were the teacher's implementation of the syntax in accordance with the problem solving learning model obtained by a percentage of ≥61% at each meeting. The student's relevant activity reaches a percentage of 82.78% for meeting 1; 84.44% for meeting 2, and 85% for meeting 3. At the time of the critical assessment of the 4 indicators drilled namely, interpretation, analysis, inference, and increasing understanding of 93.49% respectively; 82.87%; 88.90%; 85.42%. On the learning outcomes of students in the realm of knowledge by 92%. This shows the application of effective problem solving learning models in learning chemical equilibrium in training critical thinking skills.
Presentación
Authors: Gutiérrez Hidalgo Fernando
Published: June 2020

Presentación a cargo del editor, Fernando Gutiérrez
Presentation
Authors: Gutiérrez Hidalgo Fernando
Published: June 2020

Presentation by the editor, Fernando Gutiérrez
Michele Da Colle’s account books (1462-63): the first example of double entry in Portugal?
Authors: Clarinda Cardoso Ana , Sequeira Joana
Published: June 2020

The title of this article puts forward the research question: can the books of the merchant Michele Da Colle be considered as the oldest example of the use of the double entry method in Portugal? Michele was a Tuscan merchant and agent to the Pisan Salviati-Da Colle firm, established in Lisbon as of the second half of the fifteenth century. The first years of his business activity in Portugal are recorded in two account books that are kept today at the Salviati Archive, in the Scuola Normale Superiore of Pisa. To answer the research question, this article thoroughly examines the characteristics of these documents. The aim is to determine if these records follow the general principles of double entry bookkeeping proposed by different scholars. This investigation thus seeks to contribute to the debate on the introduction of double entry in Portugal via Italian influence.
The preliminary analysis of these books shows that we are, indeed, in the presence of double entry records. The example does contain formal imperfections, but it has strong similarities with the context of Tuscan accounting of the time, which can arguably mean that it represents a stage of evolution and development of the double entry method. Since we do not have any other examples, Michele Da Colle’s account books can be considered the earliest records in double entry in Portugal.
Evidence also suggests that Italian merchants exerted influence on Portuguese merchants for the adoption of this method, although it didn’t last in the centuries to come. This explains why several Portuguese works on arithmetic from the sixteenth century fail to mention the double entry system, which was only regularly applied in Portugal as of the mid-eighteenth century.
What is Research Rigor? Lessons for a Transdiscipline [Abstract]
Authors: Gill Grandon , R Gill Tommy
Published: June 2020

[This Proceedings paper was revised and published in the journal "Informing Science: The International Journal of an Emerging Transdiscipline," 23, 47-76.]

Aim/Purpose: Use of the term “rigor” is ubiquitous in the research community. But do we actually know what it means, and how it applies to transdisciplinary research?

Background: Too often, rigor is presumed to mean following an established research protocol scrupulously. Unfortunately, that frequently leads to research with little or no impact.

Methodology: We identify a sample of 62 articles with “rigor” in the title and analyze their content in order to capture the range of perspectives on rigor. We then analyze how these findings might apply to informing science.

Contribution: This paper offers an approach to defining rigor that is theory based and appropriate for transdisciplinary research.

Findings: Rigor definitions tend to fall into one of two categories: criteria-based and compliance-based. Which is appropriate depends on the research context. Even more variation was found with respect to relevance, which is often used as a catch-all for research characteristics that aren’t associated with rigor.

Recommendations for Practitioners: Recognize that when researchers are referring to rigor and relevance, they often mean these to apply to other researchers rather than to practice. When funding research, it is important to understand who the rigor and relevance are directed towards.

Recommendations for Researchers : When using the term “rigor”, think carefully about which meaning is in-tended and be transparent about that meaning in your writing.

Impact on Society: A great deal of public money is invested in achieving research rigor. Society should be aware of what it is buying with that funding.

Future Research: Developing a better understanding of research fitness and the factors that contribute to it.
THE ROLE OF THE COURT IN OPTIMIZING INTERACTION BETWEEN THE STATE AND CIVIL SOCIETY
Authors: Solyanko Pavel
Published: June 2020

the article substantiates that courts play a special role in optimizing the interaction between the state and civil society. In the framework of administrative and constitutional proceedings, courts resolve public-law disputes between state bodies (officials) and non-state actors, thereby eliminating the risk of confrontation between them, which simultaneously reduces the effectiveness of public administration and the effectiveness of civil society institutions.
Stability of the legislative process in the face of the challenges of Informatization of society
Authors: Usenkov Ivan
Published: June 2020

The aim of the work is to identify the main directions of the transformation of the legislative process in the context of its informatization and development of proposals for the adjustment of such a transformation. The systematic considedring of changes in the legislative process under the influence of its informatization is a complex and multifaceted practical and theoretical problem. This study is an attempt to propose specific optimization options and at the same time inductively determine the general patterns in the field under study. As a result of the study, the limits of informatization of the legislative process as such in which the final decisions are always made by the person are identified, the current trends in the development of individual stages and off-stage elements of lawmaking are identified. The conclusion is made about the spontaneity of informatization of the legislative process, suggestions for its development at each stage are given, the position on the prematureness of the discussion about the emergence of new stages of the process under study as a result of informatization is formulated. The work was supported by Russian Science Foundation (project №18-78-10075).
Reconquista urbana en América Central: acciones del Banco Interamericano de Desarrollo en la producción urbano-territorial en Costa Rica y Panamá
Authors: Jiménez Corrales Andrés
Published: June 2020

En Latinoamérica los gobiernos locales, los organismos internacionales y los inversores tienen un creciente interés en la intervención y la transformación de las áreas centrales de las ciudades. En este artículo se exploran las acciones del Banco Interamericano de Desarrollo a través del estudio de los diagnósticos y los planes de acción para la producción y transformación urbano-territorial de San José, capital de Costa Rica, y Ciudad de Panamá. Se utiliza una metodología de revisión y análisis documental de los productos generados por el BID. Los resultados demuestran cómo la banca multilateral desarrolla un proyecto de producción urbano-territorial que genera condiciones que permiten la atracción de inversiones, siendo esto una expresión de urbanismo neoliberal.
Sonoridades supervivientes
Authors: Campos Fonseca Susan
Published: June 2020

En el presente artículo se emplea un marco teórico que aplica el concepto Umwelt propuesto por el biólogo Jacob von Uexküll, junto al de Pathosformel del historiador Aby Warburg, de quien proviene también la idea de “imagen superviviente”, a través de Georges Didi-Huberman. Esta idea se transforma aquí en “sonoridad superviviente” a partir de los estudios sonoros como posibilidad metodológica. La ciudad se convierte en Umwelt (“mundo vivido”), habitada por Pathosformel (“fórmulas de pathos”), las cuales se manifiestan en “sonoridades supervivientes” que pueden reconocerse como Ethnoepistemes, en este caso, manifiestas en imaginarios estéticos y epistémicos occidentales, acerca de un “saber otro” del pueblo bribri-cabécar, comunidad indígena superviviente en Costa Rica.
Prácticas juveniles rurales e indígenas de producción simbólica. El caso de Santa María Atexcac, Huejotzingo, Puebla
Authors: Pérez Vargas Noel , Méndez Espinoza José Arturo
Published: June 2020

El objetivo principal del texto es comprender el sentido de las prácticas juveniles de las bandas y bailes sonideros de Santa María Atexcac, Puebla, y conocer los factores que inciden en su aparición, así como los intereses que se persiguen con su continuidad. La investigación se basó en el método etnográfico. Se concluye que el sentido de las bandas y bailes sonideros deriva de las tensiones territoriales entre jóvenes y adultos, y que uno de los principales intereses juveniles que generan tal tensión está asociado con la búsqueda de un lugar en el espacio social de Atexcac.
¿Una microhistoria total de Simojovel?
Authors: Barrera Aguilera Óscar Javier
Published: June 2020

Reseña de Espacios sociales en una región agraria del norte de Chiapas (siglos XIX-XXI), de Sonia Toledo Tello. San Cristóbal de Las Casas, Chiapas: CIMSUR-UNAM, 2019.
Religious nature of Duggar graffiti
Authors: Srivastava Aparna
Published: June 2020

The primary goal of art is the feeling of beauty. The creative expression of aesthetics in the arts has been possible due to the creation of religious spiritual artifacts since the beginning of human civilization. Both religion and art make human life orderly and consistent and presents the great truth of human life. Art and religion have acted as inspiration to each other.The Duggar culture of Jammu has special significance in the context of religious manifestation of art, where art has developed a variety of forms for the manifestation of religious expression, of which mural painting is prominent. In the murals of the Duggar culture, the realization of the religious spirit of the people is visible, whose purpose is to propagate the religion and preserve the past. Dogra artists did not originate the art only because of the sublime beauty there, but the power of their inner inspirations and the divine beliefs conferred within them gave color, form, speech and expression to their thoughts and feelings. Presentation of the expression of the religious instincts of Dogra kings is visible to us in the architectural works of these Dogra kings, such as the frescoes built in the cave, temples and palaces, Dogra kalin has various construction under the concept of Hinduism in these murals.

 

कला का प्रधान लक्ष्य सौन्दर्य की अनुभूति है। कलाओं में सौन्दर्यानुभूति की सृजनात्मक अभिव्यक्ति की उत्पत्ति मानव सभ्यता के आदि काल से ही धार्मिक आध्यात्मिक कलाकृतियों की रचना के कारण सम्भव हुई है। धर्म एवं कला दोनों ही मानवीय जीवन को व्यवस्थित एवं संगतिपूर्ण बनाते हैं तथा मानवीय जीवन के महान सत्य को प्रस्तुत करती है। कला तथा धर्म ने एक दूसरे के निहितार्थ प्रेरणा का कार्य किया है।कला की धार्मिक अभिप्यक्ति के सन्दर्भ में जम्मू की डुग्गर संस्कृति का विशेष महत्व है जहाँ कला ने धार्मिक अभिव्यक्ति के प्रकटन हेतु विविध स्वरूपों का विकास किया, जिनमें से भित्ति चित्रण प्रमुख है। डुग्गर संस्कृति के भित्ति चित्रों में लोगों की धार्मिक भावना का साकार रूप दृष्टिगोचर होता है, जिसका उदेश्य धर्म का प्रचार एवं अतीत का सरंक्षण करना है। डोगरा कलाकारों ने वहाँ के बाहय सौन्दर्य के वशीभूत होकर ही कला की उद्भावना नहीं की अपितु उसकी अन्तः प्रेरणाओं और उसके भीतर प्रसुप्त दैवीय विश्वासों के बल ने इनके विचारों व भावों को रंग, रूप, वाणी और अभिव्यक्ति प्रदान की है। डोगरा राजाओं की धार्मिक प्रवृत्ति की अभिव्यक्ति का प्रस्तुतीकरण हमें इन डोगरा राजाओं के वास्तु सम्बन्धी कृतियों यथा-गुफा, मन्दिरों एवं महलों में निर्मित भित्तिचित्रों में दृष्टिगोचर होते हैं डोगरा कालीन इन भित्ति चित्रों में हिन्दू धर्म की अवधारणा के अन्तर्गत विभिन्न निर्माण हुआ है।
SUSTAINABILITY OF WOMEN EMPOWERMENT THROUGH KUDUMBASHREE
Authors: Selvi. C Saravana , Pushpa K.S.
Published: June 2020

Empowerment of women and their participation in the development process has been considered an essential feature of development. Gender equality and empowerment of women is recognized globally as a key element to achieve progress in all areas. Rural women are regarded as voiceless and defenseless. So they are to be empowered to fight against the evils faced by them1. Empowerment of women involves many things economic opportunity, social equality and personal rights. Women are deprived of their human rights, often as a matter of tradition. Kudumbashree plays a vital role in enhancing the financial status of the less privileged women in the State through its thrift and credit societies. These societies facilitate them to save and provide them with cost-effective and easy credit. The savings of the women are pooled together and given out as loans to the most deserving. The programme has 39.97 lakh members and covers more than 50% of the households in Kerala. Today, there are 2.58 lakhs NHGs, over 19,854 ADSs and 1,073 CDSs in Kudumbashree. A total of 100 Kudumbashree members were selected from Devikulam Block, Kerala by using random sampling method. The data was collected through interview schedule and a three point empowerment scale. The study revealed that more than half of the respondents 55 per cent acquired medium level of empowerment while high level is attained by 19 per cent and 26 per cent are in low level empowerment. Kudumbashree Neighbourhood groups (NHG) are considered as the dynamic tools of empowerment as it adopt a participatory approach for empowerment producing credible results since its inception till date. Empowerment of women through Kudumbashree will undoubtedly have long term socio-economic benefits.  It could be concluded that the Kudumbashree programme could bring about radical changes in the lives of the poor sections of the society in the years to come.