bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating Second Language Request Strategies by a Chinese Undergraduate Student Majoring in Business English
Authors: Li Qiudong
Published: April 2023

Making requests is one of the most commonplace pragmatic behaviors in daily interactions. This present paper attempts to specifically examine the use of second language (L2) request strategies by a single English major in China. By providing four different role-play scenarios in which relative power (+/–P) and social distance (+/–D) were deliberately designed as the contextual constraints, while low ranking of imposition (–R) was kept constant, this case study elicited and audio-recorded the participant’s conversational data via WeChat. Drawing upon the coding scheme developed by Blum-Kulka and Olshtain (1984), the study showcased that the participant was inclined to chiefly employ conventionally indirect requests and more external modification devices than internal ones in all the role-plays. In addition, the participant’s inappropriate adoption of direct requests in the first and third role-plays and written responses to the follow-up survey questions suggested that he was not conscious of the contextual variables at all when performing requests. In conclusion, some pedagogical recommendations are proposed to enhance L2 learners’ pragmatic competence by integrating pragmatic instruction into English language classes.
PERFIL SOCIODEMOGRÁFICO DE IDOSOS QUE SOFRERAM VIOLÊNCIA NO ESTADO DE SERGIPE
Authors: Oliveira de Góis Rebecca Maria , Fraga Oliveira Fernanda Kelly , Bento Fraga Adhara Shuamme , Leilane Oliveira Andressa , Nogueira Emilia Cervino , De Almeida Maria Isabella , Servo Maria Lúcia Silva
Published: April 2023

A Organização Mundial da Saúde diz que a violência contra idosos é “qualquer ação ou omissão, intencional ou não intencional, que cause dano ou sofrimento aos indivíduos com mais de 60 anos de idade”. Este estudo teve como objetivo principal identificar o perfil sociodemográfico de idosos que sofreram violência no estado de Sergipe entre os anos de 2008 a 2017. Tratou-se de um estudo epidemiológico, descritivo, de série histórica, e de natureza quantitativa. Desenvolvido a partir de dados obtidos por meio de consulta no Sistema de Informações de Agravos de Notificação, disponibilizados no Departamento de Informática do Sistema Único de Saúde. Foram selecionados dados entre os anos de 2008 a 2017, referentes à violência acometida às pessoas com 60 anos ou mais, no estado de Sergipe. Por se tratar de um banco de domínio público, não foi necessário submeter o projeto ao Comitê de Ética em Pesquisa (CEP). O perfil das vítimas de violência foi caracterizado pela predominância de mulheres (54,73%); de cor parda (27,86%) e com baixa escolaridade (9,45%). O grau de parentesco do agressor das vítimas mais predominante foram os filhos (34,58%). Entre os tipos de violência mais notificadas, a maioria dos registros demonstrou que a violência por negligência ou abandono foi mais predominante (59,95%). Neste estudo foi possível identificar o perfil sociodemográfico de idosos que sofreram violência no estado de Sergipe entre os anos de 2008 a 2017, caracterizado por idosos do sexo feminino, indivíduos de cor parda e com baixa escolaridade.
The quality of a protein bar for sports nutrition with fish protein supplements
Authors:   Kaliningrad State Technical University, Nekrasova Yulia O. , Mezenova Olga Ya. ,   Kaliningrad State Technical University, Andreev Mikhail P. ,   Kaliningrad State Technical University
Published: April 2023

The quality of a new protein bar for sports nutrition, enriched with fish protein supplements, obtained by hydrolysis of fish scales, was investigated. The objects of the study were two types of protein supplements and the finished product. The paper explores the main indicators of the bar quality. The mass fraction of moisture, fat, and ash was determined according to GOST 5900-2014, GOST 31902-2012 and GOST 5901-2014, the amino acid composition was determined by ion-exchange chromatography, and the mineral composition was determined by atomic absorption spectrometry. The biological value of the additives’ protein and the finished product was determined by the calculation method, structural and mechanical characteristics – using a Brookfield CT3 texture analyzer, organoleptic indicators – on a 100-point scale, microbiological indicators – by standard methods. The peptide-protein and protein-mineral supplements contained 98.8% and 54.1% protein, respectively. The second supplement contained calcium and phosphorus, respectively, 22% and 12%. The amino acid composition of the bar showed the presence of all essential amino acids and glycine, proline, alanine, which are important for the athletes. The mass fraction of protein in the finished bar was 23.5%, which is adequate to 24% of its total energy value and corresponds to high-protein sports nutrition products according to GOST 34006-2016. It has been proven that a bar weighing 60 g is functional in terms of the content of calcium and phosphorus (satisfaction with the daily norm by 44% and 31.4%, respectively), vitamin E and dietary fiber (satisfaction by 22.4% and 58%). The organoleptic analysis revealed its positive perception in all respects and the absence of a fishy aftertaste; the total scoring of the product was 85.75 points. Rational values of rheological parameters were established: limiting shear stress 20–25 kPa, adhesion 200–220 mJ, penetration number 4.7–5.2 mm, elastic modulus 0.08–0.1. According to the results of microbiological studies, the shelf life of protein bars was 28 days.
Straight Lines and Angles that Move, Students’ Ideas that Touch and Add
Authors: Henrique Marcos Paulo , Bairral Marcelo Almeida
Published: April 2023

Background: Visualisation is a crucial skill for several everyday life activities and conceptual construction and development. Objectives: As it represents a substantial part of Euclidean geometry, this article addresses: the study and analysis of the relationships between angles formed from two parallel lines intersected by a transversal and the role of visualisation in the construction and development of geometric concepts imbricated in the mathematical relationships underlying the theme. Design: The methodological approach adopted was Design Experiments. Settings and participants: A teaching situation is presented, in which students from the 8th grade of elementary school at a state public school in Rio de Janeiro, Brazil, performed manipulations on the smartphone screen while carrying out an activity. Data collection and analysis: To analyse this activity, we selected events from a video obtained from the smartphone used by the students. Results: Through interactions and handlings, students visualised, analysed, and built the concepts of corresponding angles and collateral angles by studying a geometric object on the smartphone screen through the GeoGebra application. Conclusions: The geometric work mediated by mobile devices with touch screens enables the curricular reorganisation of Geometry and the articulation and the breaking of the hierarchy of concepts.
Geometry in Mathematics Teaching in Undergraduate Courses at Brazilian Federal Universities
Authors: Moreira Person Gouveia , Pinto Thiago Pedro
Published: April 2023

Background: Geometry has been an essential point of reflection in Mathematics Education, especially in teaching. Objective: We conducted a numerical calculation to quantify the study load of Euclidean geometry concerning the total course load. From this data, we established different pathways to explore the Geometry subjects of these courses and their approaches. We aimed to outline an understanding of Geometry teaching in Mathematics teaching courses in the selected universities. Design: We consulted the CPPs through the official websites of the universities. We catalogued the total study load, the subjects of Geometry, and a comparison of the Geometry subjects and their occurrence. Finally, we analysed the syllabuses and bibliography of one subject listed. Context and participants: We surveyed 68 Brazilian Federal Universities, all institutions that offer the Mathematics Teaching course. Data collection and analysis: We treated the data through qualitative analysis and presented them in a large table subdivided into smaller tables to present the data. Results: After analysing the tabulated data, its result corroborated the research of Crescenti (2005), Lorenzato (1995), Lovis (2009, 2013), Pavanello (1989, 1993), Perez (1991, 2000), Serralheiro (2007) that Geometry is little taught in educational institutions, be them K-12 or higher education. Conclusions: We have identified a significant variation in each course's study load percentage dedicated to Geometry. Even among those that reached the highest values, it is still possible to question if those numbers are enough to solve the issues pointed out by K12 teachers. We have also identified divergencies in the approach suggested in the syllabuses and bibliographies of the subject Plane Geometry. Such numerical and approach deviations need to be deepened by other works.
[Between] the Paintings of the Ndebele Houses: [Geo]metries and Ragged Curricula
Authors: Machado Paulucci Eric , Tamayo Osorio Carolina , De Godoy Domingues Marcelo
Published: April 2023

The implementation of Law 10.639/2003 on the Teaching of Afro-Brazilian History and Culture in Schools has demanded from Mathematics Education several studies and problematizations about the nature of the [M]mathematical knowledge present in school curricula. This Law prompts dialogues between different epistemologies, whether of Western origin, Afro-Brazilian origin, or in between these epistemologies, in order to produce new debates that fray the disciplinary logic, neutrality, universality, and uniqueness of Mathematics. Thus, based on the practice of painting houses, which is carried out by women from the Ndebele people of Africa, we can consider the curriculum a place of invention. Objectives: Learning from the Ndebele women, what paintings can emerge? Are curricula invented when Stories and practices of African cultures become the focus of study in Mathematics classes? Design: We are guided by an intervention-research, performing a review of ethnographic investigations on the sociocultural practice of painting Ndebele houses. Environment and participants: The research begins with the subjectivity processes that cross three researchers: two mathematical educators in different stages of life and a philosopher. They are all interested in following different paths with Mathematics Education, Ethnomathematics, Philosophy, and..., which make us professors, determining our conceptions of territory and research. Data collection and analysis: The records and data of this research were produced based on the works of Paulus Gerdes on the paintings of Ndebele houses, as well as other authors of African origin, allowing us to be affected by these productions and question the homogeneous curricular models. Results: With this research, we travel to Africa to find strange the mathematicS practiced by the Ndebele community and to make the mathematics curriculum strange; in this sense, contemplating knowledge at the crossroads of the school curriculum, Law 10.639/2003 and Mathematics, entails producing a notion that is closer to the affective field than the field of meanings. Conclusions: The experience of shifting sociocultural practices to the classroom, such as the sociocultural practice of painting Ndebele houses reveals a curriculum as a place of invention in which mathematicS takes place and composes other curricula capable of painting a different use for Law 10.639/2003 fraying Mathematics' neutrality, universality, and uniqueness, and developing a school curriculum that escapes, leaks, and spreads minor, distinct, and unusual knowledge.
Geometric Thinking: Reflections Manifested by Preservice Mathematics Teachers in van Hiele Model Studies
Authors: Vieira Anna Flávia Magnoni , Cyrino Marcia Cristina de Costa Trindade
Published: April 2023

Background: The study of geometric thinking in the preservice education of mathematics teachers is an emerging theme that can reverberate in the teaching of geometry in basic education. Objectives: To analyse reflections manifested by prospective mathematics teachers (PMTs), working with tasks supported by van Hiele theoretical model to develop geometric thinking. Design: The nature of this study is qualitative and interpretative. Setting and participants: Twenty-four PMTs members of a geometry teaching subject were investigated in a mathematics degree course at a public university in Paraná - Brazil. Data collection and analysis: The data was collected from the video-recorded training sessions, the written production of the PMTs promoted by the tasks and the registers kept on the field diary. The analysis focused on the reflections expressed by PMTs regarding the work with tasks involving geometric thinking, considering the levels of reflection proposed by Muir and Beswick (2007). Results: The results show descriptive, deliberate, and critical reflections, with different levels of incidence, associated with (I) the levels of thought proposed in the van Hiele model; (II) the teacher’s role in classroom practice; and (III) the geometric concepts and properties of flat figures. Conclusions: The promotion of formative actions that privilege discussions and reflections on geometric thinking can allow PMTs to seek connections between knowledge of geometry, geometric thinking, and their future teaching practice.
Efeitos hipoglicêmicos do feijão (Phaseolus vulgaris L.) em roedores com diabetes mellitus
Authors: Silva Araújo Danielle , Ramos Silva Tamiris , Emilly de Sousa Rodrigues Bárbara , Morais de França Maria Cássia , Douglas Dias Barros Francisco , Jucielma Araújo Luz Maria , Pereira Sousa Ana Cibele
Published: April 2023

Introdução: O feijão é uma leguminosa que apresenta alto teor de proteínas, carboidratos complexos, minerais e vitaminas. Pesquisas epidemiológicas apontam que sua ingestão contínua associa-se a um extenso número de melhorias à saúde, dentre elas a diminuição do risco de desenvolvimento de doenças crônicas não-transmissíveis, como o diabetes mellitus (DM). Objetivo: Verificar na literatura o efeito hipoglicêmico do feijão em roedores diabéticos. Métodos: Trata-se de uma revisão integrativa realizada nas bases de dados Science Direct, PubMed e Scopus utilizando os descritores “Phaseolus vulgaris” e “diabetes mellitus”. Foram incluídos artigos originais publicados nos anos de 2015 a 2020 em português, espanhol e inglês. Adicionalmente, publicações que não apresentaram o assunto proposto no resumo do artigo, artigos de revisão, pesquisas que não utilizaram experimentação em roedores e publicações duplicadas foram excluídas. Resultados: A utilização do feijão ou preparações a base desse alimento em roedores diabéticos diminuíram a glicemia e hemoglobina glicosada, os triglicerídeos, colesterol, lipoproteínas de baixa densidade, os níveis de albumina e ureia na urina, e aumentaram a insulina no sangue e a depuração de creatinina. Além disso, observou-se eliminação de grupos de amônio, a regulação da inflamação, resposta oxidativa, sinalização celular e apoptose. Conclusão: Os estudos apresentados mostram a eficácia do uso do feijão na diminuição dos níveis glicêmicos em roedores diabéticos. Ressalta-se que mais estudos devem ser realizados visando testar seu benefício em seres humanos, já que a utilização desse alimento seria um método alternativo no tratamento dessa patologia.
Yoga and Mindfulness Intervention for Concussion Recovery
Authors: Devore Elizabeth , Morgenlander Andrea , Krucoff Carol , Morgenlander Joel
Published: April 2023

Concussion imposes a substantial global health burden, and few evidence-based treatments that approach concussion treatment holistically are available. Moreover, early intervention is important before concussion symptoms become chronic and more refractory to treatment. In this pilot study, we evaluated the tolerability of a protocol called Mindfulness and Yoga for Treatment After Concussion (MYTAC), which was specifically designed for individuals with concussion. We also explored the possible benefit of the MYTAC protocol for concussion recovery. Participants were 15–60 years old with recent concussion and had presented to selected practices within a university health system. Participants used the video-based MYTAC protocol for 5 consecutive days and reported concussion symptoms on an abbreviated version of the Sports Concussion Assessment Tool version 3 (SCAT3). We compared the abbreviated SCAT3 scores across the intervention period, including immediately before and after each yoga session, using standard statistical methods for paired data. Of 25 participants enrolled in the study, 15 completed the MYTAC protocol and 1 completed 2 days of the protocol before withdrawing due to worsening symptoms; the remaining 9 participants did not complete the protocol. On average, total abbreviated SCAT3 scores decreased by 9.9 ± 7.6 points, or approximately 50%, over the intervention period (from an initial value of 18.8 ± 6.7 points prior to the yoga protocol).

Although this pilot study had significant methodological limitations, we concluded that the MYTAC protocol had fair tolerability and possibly a beneficial effect on concussion recovery. However, future interventions should evaluate this protocol in larger, more rigorously designed studies.
Historical aspects of aortic valve replacement using autologous pericardium: do we know everything?
Authors: Komarov R. N. , Tkachev M. I. , Savina V. A. , Chernyavsky S. V. , Drakina O. V. , Ismailbayev A. M. , Lenkovets M. S. , Noginov V. K.
Published: April 2023

Highlights. The article describes the contribution of foreign and Russian surgeons to the development of aortic valve replacement using autologous tissue, and presents the evolution of the technique. The authors tried to answer the question whether the Japanese professor S. Ozaki actually developed something new or the discovery was already made 40 years ago. At the end of the article, the technique developed by a Russian cardiac surgeon is presented, casting doubt on the use of templates in this procedure.

Abstract. Aortic valve replacement using autologous pericardium (neocuspidalization) is becoming an increasingly attractive option that can be applied to a wide range of aortic valve diseases. This technique avoids the need for lifelong administration of anticoagulant drugs, and provides the maximum effective orifice area, resulting in a low transvalvular gradient. The new technique, introduced by Shigeyuki Ozaki, has made the procedure more reproducible with promising medium- and longterm results. But is Ozaki the predecessor of this technique or is “all new is well forgotten old”? This review focuses on the historical aspects of the development of neocuspidalization of the aortic valve using autologous pericardium, the first interventions for valve reconstruction are mentioned, the evolution in the technique of preparation and fixation of the leaflets is reflected.
Dural sinus thrombosis: pre- and postnatal MRI observation
Authors: Korostyshevskaya A. M. , Gornostaeva A. M. , Makogon A. V. , Khalikov A. D.
Published: April 2023

Highlights. The clinical case report describes the important role of MRI in the perinatal diagnosis of dural sinus thrombosis, timely verification of the diagnosis, differential diagnosis with other vascular and tumor formations of the brain.

Abstract. Dural sinus thrombosis (DST) is a rare congenital anomaly. Ultrasound findings usually mimic intracranial tumors. As a result, the condition is often misdiagnosed and its frequency in general population is underestimated. According to literature data, the progression of DST is a favorable prognosis in case of absence of other concomitant pathologies of the fetal brain. We present a case of DST that was detected with ultrasound, and verified by numerous pre and postnatal MRI starting from 22 weeks of gestation till 4 years of life. A case with a favorable neurological outcome, postnatal ventriculosubgaleal shunting, and ventriculoperitoneal shunting was followed with MRI and CT before and after interventions. The aspects of differential diagnosis, factors determining prognosis are presented. The presented case demonstrates a significant role of fetal MRI in DST diagnosis, depiction of the internal structure of the expanded sinus, and exclusion of concomitant pathology of the brain. These MRI data are integral in determining the appropriate perinatal management, and can be used as predictors of the favorable neurological outcome despite of the severity and size of prenatally diagnosed DSТ.
Outcome of implementation of the project aimed to prevent cardiovascular diseases in the regional vascular center
Authors: Panteleev O. O. , Demyanov S. V. , Vyshlov E. V. , Ryabov V. V.
Published: April 2023

Highlights. The article presents an analysis of the outcome of the project dedicated to cardiovascular disease prevention in the Regional Vascular Center, the analysis involved the assessment of changes in the characteristics of deceased patients. The study made it possible to identify changes in mortality rate, the impact of new diagnostic and treatment techniques and administrative decisions on the change in mortality, as well as aspects that prevent further reduction in mortality.

Aim. To assess the results of the implementation of new methodological approaches to cardiovascular diseases prevention, myocardial infarction in particular, in the Regional Vascular Center.

Methods. The study involved the analysis of the data (entered in real time) from the Emergency Cardiac Care Department of the Сardiology Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, and data from the Department`s database containing anamnestic and clinical characteristics of patients, and recording of deaths in the period from 2014 to 2019. Statistical data processing was performed using the StatSoft Statistica software (ver. 10.0).

Results. From 2014 to 2019, percutaneous coronary intervention (PCI) in myocardial infarction (MI) increased from 48 to 67.4% (p˂0.05); the primary PCI in MI with ST segment elevation (STEMI) increased from 24% to 32% (p˂0.001), the overall frequency of PCI in STEMI (primary + rescue + delayed) increased from 59.6% to 73% (p˂0.05); PCI in MI without ST segment elevation (NSTEMI) increased from 23.9% to 43.9% (p˂0.001), the frequency of intra-aortic balloon counterpulsation increased from 0.6% to 1.5% (p˂0.05), the frequency of mechanical ventilation did not change (8,3 and 8,5%), moreover the widespread use of ticagrelor and prasugrel was noted. At the same time, hospital mortality of patients with MI decreased from 9.8 to 8.0% (p>0,05): in patients with STEMI it decreased from 10.7% to 7.7% (p = 0.047), in patients with NSTEMI there was no change in mortality, it remained equal to 8–9%. Implementation of coronary reperfusion strategies that do not involve streptokinase is associated with a decrease in hospital mortality of patients with STEMI.

Conclusion. The widespread introduction of modern invasive and medicinal technologies has led to a decrease in mortality of patients with STEMI. Further increasing the number of available invasive procedures – PCI, intra-aortic balloon counterpulsation and mechanical ventilation for the purposes of reducing mortality of patients with MI seems questionable.
Dynamic monitoring of morphological and hemodynamic evolution of small cerebral aneurysms
Authors: Tikhvinskii D. V. , Kuyanova Yu. O. , Bervitskiy A. V. , Obedinskaya N. R. , Tulupov A. A. , Parshin D. V.
Published: April 2023

Highlights. Small cerebral aneurysms (<3 mm), which make up the majority of aneurysms, rupture more frequently, although medium (>3 mm) and giant (>15 mm) aneurysms and have a higher risk of rupture. This article proves for the first time that the rupture risk criteria developed for giant cerebral aneurysms do not work for small aneurysms. The development of small aneurysms in patients was analyzed and measured morphological features of aneurysms were compared with their calculated hydrodynamic characteristics.

Aim. To study the dynamics of development of small cerebral aneurysms, to assess the applicability of existing methods for calculating the risk of rupture, to formulate new clarifying hypotheses for calculating the risk of rupture of small cerebral aneurysms.

Methods. Patient data were provided by the Federal Center for Neurosurgery, Novosibirsk. CT angiography was performed using a Philips Ingenuite CT scanner (Philips Medical Systems, USA, 128 slices). Aneurysm size dynamics was assessed by measuring three main sizes with an accuracy of 0.1 mm using the IntelliSpace Portal Philips software environment. Numerical calculations were carried out using ANSYS CFX 2020R2.

Results. Hemodynamic characteristics change according to the changes of the aneurysm dome. In the case when morphological characteristics of the aneurysm have not changed, a change in the geometry of the patient's circle of Willis (coW) is observed: the curvature of the arteries, the angles of bifurcations (the structure of coW remained unchanged). The PHASES score (absolute risks of rupture for aneurysms) was found to be unusable for the considered aneurysms.

Conclusion. This work formulates and morphologically and hydrodynamically confirms for the first time in the volunteers that the change in risk estimates for such aneurysms is fundamentally affected, even insignificantly, by the change in the circle of Willis: a change in the curvature of individual segments of the cerebral arteries, as well as the angles of their bifurcations. The results obtained are aimed at modifying the existing risk criteria for rupture of cerebral aneurysms.
Evolution of twisting mechanisms in childhood: a modern view on the nature of left ventricular rotational mechanisms
Authors: Pavlyukova E. N. , Kolosova M. V. , Unasheva A. I. , Karpov R. S.
Published: April 2023

Highlights. The hypothesis of the evolution of LV twisting types is proposed, which is based on the gradual transformation of LV twisting types as a prerequisite for postnatal growth and development of heart chambers in healthy children and adolescents. In the future, the transition of one type of LV twist to another will enable us to diagnose the predominance of growth and maturation of the fibrous skeleton, apex, vortex cordis, trabecular apparatus, as well as creating projections of the individual development and growth of the heart in childhood and adolescence.

Abstract. Modern data on the nature of the mechanics of the left ventricle (LV) in postnatal ontogenesis in healthy children and adolescents born full-term are fundamental, since they allow not only to determine ontogenetically conditioned variants of individual development of contractile-rotational mechanisms of LV in the process of growth and development, but also, if necessary, make it possible to identify subclinical dysfunction in the early stages, monitor the effectiveness of complex therapeutic and rehabilitation measures. The article analyzes newly established fact of the absence of static character of the selected various forms of LV twisting into a systole and the ability of their transformation in the process of growth and development. This fact forms the basis of the author's original hypothesis of “the evolution of LV twisting models”, which provides the optimal ontogenetic growth of the child and adolescent heart in the postnatal period. The hypothesis of “evolution of left ventricular twisting types” is based on modern knowledge about multifaceted processes at the tissue level, the mechanics of LV in the individual rate of development and growth of the heart in childhood and adolescence.
Microbial associations in human biotopes as a factor determining the occurrence of polymicrobial infections
Authors: Godovalov Anatoliy P.
Published: April 2023

Annually, data are accumulating on the involvement of opportunistic microorganisms in the development of inflammatory diseases in humans, maintaining a chronic inflammatory response and, thus, adapting to the conditions of existence in the biotopes of the human body. This review provides information on the interactions of microorganisms of medical importance, which affects the virulence of both opportunistic pathogens and classical pathogens, which probably underlie the chronicity of infection and inflammation. Often, opportunistic pathogenic species cannot fully realize their pathogenic potential, which is observed in numerous cases under conditions of microbial symbiosis. Thus, a revision of approaches to interpreting the results of microbiological methods is necessary, which takes into account the functional activity of the total microflora and the search for individual extrachromosomal genetic elements as a marker of the pathogenicity of microorganisms.
Subacute brucellosis: A case report
Authors: Shakhmardanov Murad Z. , Nikiforov Vladimir V. , Tereshkin Nikita A. , Shakhmardanov Shakhmardan E. , Skryabina Anna A. , Tomilin Yuri N.
Published: April 2023

Brucellosis is one of the most common zoonotic diseases worldwide. The epidemiological situation of brucellosis in the Russian Federation is characterized as unfavorable. Brucellosis remains a problem in regions with developed animal husbandry. The variety of clinical manifestations and the absence of specific symptoms of brucellosis make its diagnosis challenging. The clinical case presented in this paper illustrates the delayed diagnosis of brucellosis in a 10-year-old patient presenting with fever and enlarged lymph nodes, liver, and spleen. The failure in the provision of medical care was attributed to the lack of the alertness of doctors regarding brucellosis, insufficient interpretation of epidemiological history data, and incorrect assessment of the totality of the clinical syndrome of the disease and laboratory parameters. As a result, brucellosis was diagnosed only 6 months after disease onset. Subsequent etiotropic therapy led to the stabilization of the patients condition, who was discharged from the hospital with recommendations under the supervision of an infectious disease specialist.
Influence of Atmospheric Air Pollution on Frequency of Congenital Anomalies (on an example of a region)
Authors: Kiryushin Valeriy A. , Bobotina Natal'ya A. , Demchenko Mariya A. , Motalova Tat'yana V.
Published: April 2023

INTRODUCTION: Atmospheric air pollution is the underlying factor of a great number of human diseases in both industrialized and developing countries. Studies show that exposure to atmospheric pollutions in pregnancy can be associated with an increased risk of congenital anomalies (CAs).
AIM: To analyze the impact of atmospheric air pollutants in Ryazan city on the incidence of CAs in newborns.
MATERIALS AND METHODS: The data of monitoring of CAs by Ryazan Regional Perinatal Center; information on atmospheric air pollution of the Federal Service for Hydrometeorology and Environmental Monitoring, of Ryazan Center for Hydrometeorology and Environmental Monitoring, of Rospotrebnadzor of the Ryazan region are presented. The statistical analysis was conducted using free R computing environment (ver. 4.1.2).
RESULTS: In 2019, the prevalence of CAs in Ryazan was 24.09 per 1,000 newborns; in the period 20102021, the absolute number of recorded CAs grew by 244.57%. The most common congenital anomalies were Q21.0 Ventricular septal defects (28.5%, 95% CI: 20.836.2%) and Q62.0 Congenital hydronephrosis (7.3%, 95% CI: 2.911.7%). Correlation was recorded with such air pollutant as sulfur dioxide (SO2) in the second month of pregnancy (AOR 1.39; 95%; CI 1.051.83, p 0.05) and the third month of pregnancy (AOR 1.59; 95% CI 1.172.16, p 0.05). No statistically significant relationship was established between CAs and carbon monoxide (CO), nitrogen dioxide (NO2) and ozone (O3, p 0.05).
CONCLUSION: The study confirms the association between atmospheric air pollution and frequency of CAs. In particular, SO2 has a negative effect in the second and third months of pregnancy. In this context, it is important that the authority bodies of the region and governmental regulatory agencies direct their efforts to reduction of the pollution of the environment which should help reduce the frequency of CAs in children.
Prognosis for Patients after Pulmonary Embolism and its Determining Factors (Results of 12-Month Follow-Up)
Authors: Terekhovskaya Yuliya V. , Akhmedova Nazly E. kyzy , Leonenko Dar'ya I. , Nikulina Natal’ya N.
Published: April 2023

INTRODUCTION: Pulmonary embolism (PE) is a cardiovascular disease with high mortality: according to autopsy data, PE is the cause of death in every tenth deceased person. Despite a relatively long history of studying PE, the literature data on this problem are scattered, incomplete and often do not represent the Russian population.
AIM: To evaluate 12-month survival rate of patients after a past episode of PE and to establish predictors of fatal outcome.
MATERIALS AND METHODS: The work was carried out within the Russian SIRENA register. The study included 107 patients (age median and interquartile range 63 (5274) years), who underwent inpatient treatment in Regional Clinical Cardiologic Dispensary of Ryazan (hospitalization from 01.05.2018 to 31.05.2019; inclusion period 13 months). In the period of hospitalization, the information was taken from the data of medical records and objective examinations, and after the discharge through telephone control. Follow-up period from the moment of hospitalization was 12 months; response 84.5%.
RESULTS: The 12-month survival rate of patients with PE was 77.1%; recurrence of venous thromboembolism developed in 6.5% of patients, bleeding in 22.4% of patients. The only statistically significant predictor of the development of a fatal outcome after discharge from hospital was the presence of cancer, including that in history (relative risk (RR) 4.4; 95% confidence interval (CI) 1.414.5; p = 0.014). The leading predictors of death from the moment of hospitalization within 12 months were high risk based on the integral assessment of severity and of early death risk (RR 9.9; 95% CI 1.279.5; p = 0.031), age 65 years (RR 5.1; 95% CI 1.715.2; p = 0.003), hospitalization with other than PE primary diagnosis (RR 4.5; 95% CI 1.910.8; p = 0.001), impaired filtration function of kidneys (RR 4.3; 95% CI 1.711.1; p = 0.003). Besides, a statistically significant increase in the risk of death during this period was associated with history of atherosclerotic diseases, stroke, heart failure, oncology, hemodynamic instability in the acute period, the need for loop diuretics during hospitalization and the presence of S1Q3 syndrome.
CONCLUSION: The mortality rate of patients with PE in one of the regional vascular centers of Ryazan in 20182019 generally agrees with the data of the previous international studies. The leading predictors of fatal outcome within 12 months from the moment of hospitalization include a severe condition of a patient at the time of hospitalization, age 65 years, untimely diagnosis of PE and reduction of filtration function of kidneys.
Achievements and prospects for the application of artificial intelligence technologies in medicine. Overview. Part 2
Authors: Berdutin Vitaly A. , Abaeva Olga P. , Romanova Tatyana E. , Romanov Sergey V.
Published: April 2023

On a global scale, a radical transformation of the healthcare sector is taking place right before our eyes. The last few years have become a turning point in terms of the number of new directions, the emergence of innovative diagnostic and treatment methods, and the introduction of digital platforms. Digital medicine uses information and communication technologies to address the numerous problems associated with ensuring the quality and accessibility of medical care already available today. The rapid development of neural networks and artificial intelligence (AI) provides doctors with ample opportunities to predict the course of diseases and calculate the risks to the health of patients. Manufacturers of medical devices offer consumer a wide range of software and products with AI embedded. Despite the tremendous advances in the application of AI in medicine, the medical community is highly concerned about some of the intractable problems associated with the too rapid and ubiquitous use of these digital platforms. A highly trained neural network is an extremely complex computer program consisting of a large number of internal hidden layers with customizable parameters. The more complex the neural network and the number of computational operations it performs, the more difficult it is to understand the processes in its inner layers. The functioning of AI systems in a black box format makes explaining the results of its work a very non-trivial task. Therefore, in the future, research will certainly be required assessing the reliability of these systems and interpreting their decision-making processes which, will affect the neural networks of the latest generations.
Changes in the availability of medical care to patients with chronic non-infectious diseases during the COVID-19 pandemic: A literature review
Authors: Frolova Irina A. , Abaeva Olga P. , Romanov Sergey V. , Tarlovskaya Ekaterina I.
Published: April 2023

The coronavirus pandemic has caused adjustments to be made to the organization of medical care for the population worldwide. The reorganization of medical institutions to provide emergency, outpatient, and inpatient medical care to infected patients required huge financial and personnel costs and caused a kind of bias towards reducing the medical services provided to patients with chronic non-infectious diseases, which in turn determine the main levels of morbidity, premature mortality, and disability of the population. The availability of medical care to patients with chronic non-infectious diseases has decreased in all the countries that were impacted by COVID-19. This situation has not gone unnoticed by the medical community and as a result, various ways to overcome this problem have been proposed. The proposed article presents an analytical review of various types of Russian and foreign medical sources including articles, orders, statements, interviews, and surveys devoted to the problem of addressing the availability of various types of medical care. The review presents the most obvious and widespread problems in public health during the pandemic. It also analyzes the methods used in various countries, including Russia, to overcome the decline in the availability of medical care. The wide range of problems described that arose in domestic and foreign healthcare during the COVID-19 pandemic, and the variety of ways to solve them, allow us to conclude that this study is relevant. A literary review of articles (reviews, original research, interview data, and telephone surveys) published from March 2020 to March 2022 was conducted on the impact of the COVID-19 pandemic on the availability of medical care for somatic patients in the Russian Federation and several foreign countries. The methods of bibliographic, informational and semantic search for sources in Google Scholar, PubMed and Scopus databases were used. A system analysis of the sources was performed.
Medical and sociological assessment by physicians of the availability of medical care for chronic diseases in rural healthcare in the region: A cross-sectional focus group study
Authors: Yeremina Maria G. , Krom Irina L. , Subbotina Vera G. , Lipchanskaya Tatiana P. , Vlasova Marina V.
Published: April 2023

BACKGROUND: Problems with the organization of medical and medicinal care for populations living in rural and remote areas exist in most countries. In the context of Russia, this problem has been discussed in studies over several decades.The doctor as a subject of medicine more often acts as an object of medical and sociological research in the context of their medical (expert) knowledge about the representatives of different social groups of patients. The uniqueness of the research conducted is determined by the focus of the research interest on the social group of doctors in the context of their health problems, i.e., on the study of the personal patient experiences of rural health doctors.
AIM: To study the problems of access to medical care by rural health professionals in the region.
MATERIALS AND METHODS: Eight heads of departments of district medical organizations of the Saratov region took part in the focus group study. The participants suffered from chronic diseases (for more than 10 years), and two respondents attended a disability group.
Following the guidelines of the focus group study, the discussion covered issues of the accessibility of medical care by physicians with chronic diseases in medical organizations of the region and directions for improving access to medical care by healthcare professionals.
The data obtained were evaluated according to the standard requirements for the analysis of qualitative data with the support of the discourse analysis methodology.
RESULTS: The results highlighted the key issues reflecting the problems of accessibility of medical care to rural healthcare specialists. The empirical material gathered added to the range of problems assumed at the stage of planning and the description of the peculiarities of obtaining medical care by the chosen group of respondentsdoctors in rural healthcare.
CONCLUSION: The analysis of the array of respondents opinions of the focus group research allowed several conclusions to be reached. In the context of rural healthcare, access to medical care for physicians has not only an organizational but also a social and geographical context;moreover,the barriers are the staff deficits in rural healthcare, the lack of necessary infrastructure and material and technological backwardness of rural healthcare, the lack of transport provision in the region, and the mentality of the inhabitants of rural areas. In a situation where physicians with chronic health problems need help, the above list of barriers is supplemented by a high level of workload and the specific self-preservation behaviors of representatives of this group.
Issues and Concerns in the Digital Media Eco-System : Regulation in India
Authors: Bharthur Sanjay
Published: April 2023

Perceptions about Indian media vary and are dependent on where you are located as within the country or part of the Indian diaspora or established media outlets' view quite often described as western media. To Indians, the shrillness of TV news debates and the so-called diverse panellists' perspectives reflects one aspect of how liberal Indian media can be, as well as the tempered variations of the same in the daily newspapers of your choice. Intellectuals are worried and critical about the skewed nature of such debates and their proximity to the ruling polity dispensation. Some express their views or concerns through write-ups in media outlets outside the country. The growth of news media outlets sectoral, as in newspapers, radio, television etc. or converged as in the present digital ecosystem, is imbued within the media's relationship to the formation and sustenance of democratic structures and upheld freedom as an abiding principle. Indian media in the past has always been regarded as relatively accessible when compared to many other developing contexts and is now being debated as the shift from an editorial policy-driven entity to a platform-based content in a free for all user-generated content has occurred not only in India but in other countries as well. The transition from explicit frameworks as laws and ethics to regulating social media platforms is dynamic as well problematic when weighed against conventional notions for freedom of media etc. What, then, are some of the issues and or challenges in the Indian digital ecosystem that will be the focus of this invited article.
Havana Syndrome: New Recommendations and Enrollment Criteria for a Shared Study of Possible Cases
Authors: Posa Franco , Gorini Maurizio , Rondinelli Valeria , Sclavi Francesco , Leone Jessica , Posa Matteo
Published: April 2023

Background: From November 2016 to the summer of 2021, some U.S. diplomats and their family members residing in Havana and other locations, including China, Russia, Colombia, Switzerland, and France, reported the sudden onset of auditory, vestibular, and neurological symptoms. The aim of this study is to define enrollment criteria for patients with a possible diagnosis of Havana Syndrome. Methods: This study, through a review of the scientific literature, proposes the definition of criteria for proper enrollment of patients with a possible diagnosis of "Havana Syndrome" Results: In view of the increasing number of cases, their wide geographic distribution, and the lack of certainty regarding etiopathogenesis, it is essential to propose a strategy for sharing case histories Conclusions: A correct enrollment of patients is crucial since specialists can then disclose new strategies for the study of case histories and for a clear definition of the diagnosis. This way, it will be possible to have a wide discussion of clinical and epidemiological results among specialists in different medical, engineering, and intelligence disciplines.
Long-Term Care Facilities as a Risk Factor for Death Due to COVID-19: Evidence from European Countries and U.S. States
Authors: Gandal Neil , Yonas Matan , Feldman Michal , Pauzner Ady , Tabbach Avraham
Published: April 2023

Background: A large percentage of the deaths from the first wave of COVID-19 in 2020 occurred among residents of long-term care facilities. Objective: There are two competing explanations for this phenomenon. First, the structural features of such settings may lead to death. Alternatively, individuals living in these facilities are in poorer health than those living elsewhere, and they would have died even if they had not been in these facilities. Methods: Using both European and U.S. data, we empirically examine these competing hypotheses, which have very different public policy implications. We collected data on Covid-19 mortality rates and on the number of long-term care beds, in each of (1) thirty-two European countries and (2) the fifty U.S. states. Results: Controlling for other relevant factors, we find that there is a significant positive association between the number of long-term care beds per capita in a country or state and overall COVID-19 mortality rates in countries and states. Conclusions: This finding provides support for the claim that long-term care living arrangements of older people are a significant risk factor for dying from COVID-19. These findings raise policy implications. Efforts should be geared to protecting older adults living in long-term care settings. Policy makers might even consider alternative dwelling options during an epidemic period, such as encouraging residents to live with their families whenever possible.