bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic analysis and justification of the directions of innovative development of the Krasnodar region’ agroeconomics
Authors: Bershitsky Yu , Saifetdinov A
Published: June 2019

The analysis of the current state of the agricultural economy of the Krasnodar region is conducted, and the priority directions of its innovative development are substantiated, including the increase in the productivity of livestock and crop production sectors, the level of technical and technological equipment of production and the effectiveness of state support for commodity producers. The necessity of restoration and development of branch science is noted with the intensification of the processes of its integration with private capital, education, and production. A critically high dependence of commodity producers on imported seeds of high-yielding varieties and hybrids of individual crops has been established and recommendations have been formulated to reduce it. It has been established that the most problematic subsectors that hamper the implementation of the import substitution program in the region are the meat and dairy cattle breeding sectors, which require their primary improvement. The necessity of developing the livestock breeding as an important factor of preservation and restoration of soil fertility in the region due to growth of production volumes and application of organic fertilizers, as well as expansion of the area of sowings of perennial and annual grasses, is substantiated in the paper. It is noted that an important direction to improve the efficiency of the agro-economy of the region is to strengthen the system of its state support and the development of small forms of management with deepening the processes of cooperation and integration.
Development models of the cooperative sector in the agro-industrial complex of North American and European countries
Authors: Palatkin I , Pavlov A
Published: June 2019

The research focuses on the characteristic features of the modern development in the cooperative sector in the agro-industrial complex of North American and European countries, taking into account the existing differences in legislation, national traditions, local differences, and the importance of the cooperative movement to search for effective responses to the new challenges of globalization of the economic space. The purpose of the work is to identify the most significant achievements and features inherent in the cooperative sector in the agro-industrial complex of the USA, Canada, France, and Spain. The paper presents quantitative data characterizing the level of development of cooperation in individual countries and the legislative framework for the functioning of agricultural cooperatives. The areas of activity of the largest cooperatives and measures for state support of the development of the cooperative movement in the USA, Canada, France, and Spain are considered. As a result, conclusions were formulated reflecting the significance of the contribution of cooperatives to the economic and financial stability of countries in the context of globalization, to the creation of jobs and increasing the innovative potential of business.
State support for the production of cattle meat: the experience of countries with high levels of self-sufficiency
Authors: Metelkova E , Demishkevich G , Gusev A
Published: June 2019

The relevance of this study is due to the decline in recent years observed in the production of beef and veal, which does not allow to fully ensure food security. The article deals with the use of mechanisms of state support for the development of cattle meat production, as one of the main food products. The purpose of this article is to identify the mechanisms of state support for the development of beef cattle breeding in the most successful countries, which food security index for cattle meat production did not fall below 70% over the period of 2012-2016. Their experience of state support allows for a timely stabilization of the market situation. The leading method for studying this problem is statistical analysis. The study was based on official data of international organizations and foreign organizations. Based on the self-sufficiency assessment, 11 countries were selected to consider the existing state support mechanisms. The results of the study allowed us to identify the main areas of subsidies: research, modernization, support for pedigree cattle breeding, as well as support for developing farmers. Application of the experience of state support for the development of beef cattle through indirect measures will contribute to the prospects for the development of production, both quantitative and qualitative. At the same time, indirect support does not depend on the specifics of ensuring the production of cattle meat, associated with climatic factors and technological development of the country, which allows the application of measures in practice regardless of them.
Features of the market infrastructure of environmentally safe milk
Authors: Nechitaylov A
Published: June 2019

The relevance and novelty of the topic is explained by the increasing role of environmentally safe milk in providing the population with healthy food. The purpose of the work is to show certain features in the formation of the environmentally safe milk market infrastructure. Statistical materials on the work of the dairy market and the dairy industry of the Republic of Tatarstan were used to research the topic. Economic methods were used in the research process. As a result, the conclusions confirming the importance of the correct formation of the infrastructure of the market of environmentally safe milk are formulated. The market of environmentally safe milk of the Republic of Tatarstan has solid potential and good prospects for development, occupies an important place in the agro-food market, is a set of multidimensional organizational and economic relations that regulate the activities of economic entities linked to each other for the production, processing and sale of products. In the infrastructure of the market, special attention should be paid to reducing the cost of moving products from producer to processor and consumer, where nothing is added to the product except a price increase of 40 percent or more, which adversely affects the competitiveness of products.
Conceptual bases for the formation of an effective investment policy of business entities in the agricultural business of Russia
Authors: Sinyavin V , Yanina T , Podrezov A
Published: June 2019

The article considers the sequence of actions proposed by the authors in the framework of planning and subsequent practical implementation of the concept of investment policy of regional economic entities operating in the field of agricultural production. Most agricultural producers in the regions of the Russian Federation face the problem of lack of financial resources. At the same time, the insufficient level of economic efficiency makes them investment unattractive, which prevents the inflow of investor capitals. According to the authors, the concept of a universal (acceptable regardless of industry sector and scale of activity) investment policy that provides for such actions by the management of an economic entity that would help to find hidden corporate reserves, increase productivity and investment attractiveness is able to reverse the current situation. The formation of a similar concept was stated as the purpose of the study. The novelty of the research is determined by the algorithm of formation and implementation of the concept of an effective investment policy of regional agricultural producers.
Factors of competitiveness of domestic livestock products in the international agri-food market
Authors: Tikhomirov A
Published: June 2019

The article considers the current state and possibilities of exporting domestic production of livestock products. The main conditions and factors for the development of the export potential of the industry and the factors influencing its formation are determined. The key countries-importers of Russian food of animal origin and goods supplied to the world market have been established. Reflects trends and macroeconomic conditions for increasing the volume of exports of livestock products. Proposed measures to improve the mechanisms of state support for exporters of livestock products and products of its processing.
Feasibility study of the optimal type of a potato harvester for the conditions of the Moscow region
Authors: Chutcheva Yu , Telegina Zh , Dorokhov A
Published: June 2019

The level of technical equipment of agricultural producers, primarily agricultural machinery, creates the potential aimed at increasing the competitive advantages and efficiency of agricultural production. The consequence of the economic changes that have taken place in the agrarian sector of the Russian economy over the past 30 years has been the physical and moral obsolescence of machinery and equipment, and therefore a significant reduction in the volume of mechanized field work. The observed rates of reproduction of the machine-tractor park neither in terms of quantity nor in terms of energy capacities are sufficient for the full development of the agri-food sector and addressing the issues of food supply of the population. Domestic agricultural producers manage to maintain the technical readiness of the worn-out machine-tractor fleet at the level of 60-62%, which ensures participation in the production of 30-35% of the park of machinery in comparison with the real need. Many years of in-depth study by the authors in the course of scientific research on theoretical approaches to improving the reproduction of the machine-tractor fleet and raising the level of technical equipment for agricultural producers allowed to formulate certain authors’ approaches to solving the existing problems. In particular, as a result of the study, the authors carried out a feasibility study on the use of the optimal type of potato harvester as applied to the conditions of potato cultivation in the Moscow region. That will improve the efficiency of potato cultivation, reduce the losses of producers from injury of tubers in the process of harvesting.
Macromodelling of food and raw material links between large-scale specialized zones for the development of animal husbandry
Authors: Yashina M , Solntseva O
Published: June 2019

One of the ways to improve the efficiency of production is the deepening of specialization and the development of interregional relations. The problems of rational specialization and optimal commodity flows have been troubling the scientific economists over the past two centuries. It is especially important to address the issues of territorial and sectoral division of labor for industries whose production efficiency differs significantly in different regions and is suitable for transportation. The article describes the methodological approaches to the improvement of interregional raw materials and food links in animal husbandry based on the formation of large-scale specialized commodity zones on the example of the Russian Federation. The first task of the study was to identify several large-value zones of specialization in the production of livestock products. As a result of solving the second task, two goals were achieved at the same time: (a) optimization of cattle breeding and (b) the interregional exchange of feed and meat and dairy products. To achieve the goals, we used a combination of statistical and economic-mathematical methods, a combination of several models of optimal linear programming. As a result of the research, five areas of specialization were identified, depending on the level of livestock production and the availability of the natural and economic potential for the development of the subsector, the placement of livestock in those zones has been optimized. In addition, a scheme has been developed for the interregional food exchange and the development of commodity relations. The presented methodological approaches can be used to solve similar problems both at the international level (CIS, EAEU, etc.), and for smaller territorial units, such as federal districts or individual regions.
The mechanism of public-private partnerships in attracting investment in agriculture
Authors: Zeldner A
Published: June 2019

Investment combined with innovation is an essential condition for the growth and development of the socio-economic system. In essence, investments are defined as long-term capital investments in the economy in order to ensure sustainable rates of expanded reproduction. Investments are characterized by the fact that they are always limited, and here it is important to correctly determine the priorities that can maximize the final result. These indisputable priorities include the agro-industrial complex, ensuring the food security of the country. The purpose of the article is determined taking into account the emerging tensions with investment resources of the state, in connection with which it is proposed to intensify the attraction of private investments in the agro-industrial complex, using the experience of economic levers and incentives already approved in the country, aimed at attracting private investments in special economic zones and priority development areas. The analysis of the effectiveness of the special economic zones, including their questioning, conducted by the author and combined with the study of the foreign experience of China and other countries, led to the conclusion about the effectiveness of using the public-private partnership mechanism to attract private investment. The system of economic levers and incentives for attracting investment is proposed in the article.
Strategy and methods of economic evaluation of the quality of technical means of AIC production
Authors: Kovaleva E
Published: June 2019

The paper focuses on the methodological foundations of the economic evaluation of technical means of production and the conceptual positions of the scientific support of the problems being developed to improve economic relations of partners on the basis of mutual interest. A method for the economic evaluation of the quality of technical equipment based on the calculation of compensating costs and equalizing charges, the laws of their change when using aging equipment is proposed. It is shown that equalization charges, reflecting the changing quality of machines, can be used to correct depreciation methods. It is proposed to use the step-wise depreciation method, in which the entire initial cost is transferred to the depreciation fund reflecting the changing quality of the machine.
Trends in state regulation of agrarian relations in Russia: experience, problems, and prospects
Authors: Volkova N , Dorskaya A , Pashentsev D
Published: June 2019

The article discusses the features of the Russian model of legal regulation of agricultural relations. The relevant experience is analyzed in historical retrospect using the historical-comparative method. With the help of the formal legal method, the research shows the feature of the rules of law governing agricultural relations. On the basis of the revealed regularities, the recommendations applicable in contemporary conditions are formulated. The article notes that the agricultural issue in Russia in all ages was among the most acute, which was determined by the traditional agricultural nature of the domestic economy. The article deals with the periodization of the dynamics of state regulation of agricultural relations. The fact of significant changes in approaches to the regulation of agricultural relations on the part of the state is used as the basis of periodization. There are five stages in the development of state-legal regulation of agricultural relations. A brief description of each stage is given, and their features are shown. The main attention is paid to the contemporary stage of development in agricultural relations. The authors’ position on the legality of the allocation of agricultural law as an independent complex branch of law is shown. Contemporary tendencies, problems, and prospects of development of agrarian law in contemporary Russia are discussed. It is concluded that the effective and rational legal regulation of agricultural relations should be aimed at the preservation and development of land and land use as the basis of all economic activity in the agricultural sector. In the context of global turbulence and increasing threats to national security, the effective development of the agricultural sector of the economy is a strong guarantee of Russia’s prosperity.
Theoretical and methodological aspects of designing prospective models for agricultural development
Authors: Ulezko A , Tyutyunikov A , Kurnosov A
Published: June 2019

The article states that the model of rural economy and rural area development formed in the Russian Federation as a result of transition of the economic paradigm is in deep controversy with actual interests and needs of considerable share of rural population and agricultural producers. The need is reasoned for designing prospective models of balanced territorial and sectoral development of regional agro-food complexes taking into account the specific features of agrarian structure of a region, conditions of development level of agricultural production and rural areas, and aimed at creation of the conditions promoting food security of the country, growth of the efficiency of using the rural development potential, mitigation of controversies between the subjects of agrarian relations and balance of their economic interests. The expediency of using such models as part of the deepening the differentiated approach to the development of rural areas, as stated in the “Strategy for the Sustainable Development of Rural Territories of the Russian Federation – 2030,” is pointed out. It is noted that the designed models of balanced territorial-sectoral development of regional agro-food complexes will be a formalized description of the conceptual provisions that determine the evolution of agro-economic systems at the regional level, differentiated according to the structure of the agrarian sector and the development level of agriculture and rural areas, under the conditions of increasing social responsibility of agribusiness, as well as reflecting the state’s place as a natural macro-regulator in the process management system of rural development and allowing assessing the economic and social implications of alternative scenarios for the development of agro-economic systems.
Deeper specialization and development of interstate cooperation in the AIC of the EAEU countries
Authors: Silaeva L , Kulchikova Zh
Published: June 2019

The paper focuses on interstate cooperation of enterprises, networks, and infrastructure in the promising sectors of the agro-industrial complex of the EAEU countries, considering it as an objective process of economic development, which aims to increase the mutually beneficial activities and gain competitive advantages in the agricultural market for the free promotion of goods, technologies, means of labor, capital, etc. The level and dynamics of development of the agrarian sector is also addressed in the paper, which to a large extent determine the growth potential of related industries, resources for the agro-industrial complex, processing industry, and the agri-food market.
State support for the investment development of agricultural producers in conditions of sanctions restrictions
Authors: Kulov A R , Dzusova S S , Dzusov S I
Published: June 2019

The article deals with the issues of state support of investment development on the agricultural sector of the Russian economy. Based on the method of statistical groupings in the study, a disproportion in the distribution of state support for agricultural producers was revealed. The analysis of state support measures in agriculture showed that the mechanism of subsidizing the interest rate on investment loans for the purchase of agricultural machinery and equipment is mainly used. At the same time, subsidizing the interest rate on loans remains insufficient to expand the ability of agricultural producers to acquire innovative technology. The study adopted the methodology of Rosstat for the analysis of investment processes. In the sample of agricultural producers were large, medium, and small farms, which allowed identifying the main problems, the solution of which would contribute to the expansion of state support aimed at ensuring the flow of long-term capital in the industry. And on this basis will give stimulus to the investment development of agriculture. The research recommends to move to the use of measures of uncoupled support for investment development of agriculture. This is especially important in the context of economic sanctions, when limited opportunities to attract long-term capital to the industry from foreign markets of financial resources.
Ecological and economic evaluation of using arable land in the Republic of Bashkortostan
Authors: Askarov A A , Stovba E V , Askarova A A
Published: June 2019

In our country, with the transition to a market-oriented economy, the scientifically based farming systems with their rational crop rotations were violated, which intensified the process of soil fertility depletion. Accordingly, the cumulative damage from non-recoverable soil humus losses is rapidly growing and becomes quite comparable with the cost of crop production received from this land. The article substantiates the necessity of conducting an ecological and economic evaluation of the use of land in agriculture at the regional level. The proposed methodical approach to solving the problem of optimal allocation of crops and cattle-breeding industries is determined by the criterion of the most effective use of the basic means of agricultural production. The analysis of the use of arable land and the structure of cereal crops in all categories farms of the Republic of Bashkortostan was carried out. The results of the economic and environmental damage evaluation caused by the agricultural production of the region were presented. The results of the economic and environmental damage evaluation caused by the agricultural production of the region were presented. The calculation of ecological and economic efficiency of land use in agriculture of the Republic of Bashkortostan is presented in the paper.
Analysis of the current state and prospects for the development of digital agriculture in Russia
Authors: Kozubenko I
Published: June 2019

The article presents approaches to understanding the main problems of the development of digital agriculture in Russia. The author, on the basis of observations on the implementation of the state agrarian policy at the federal level, notes the key problems of digitization of agriculture and presents his view on possible scenarios of digital transformation of agriculture. The author’s interpretation of the concept “Digital agriculture” is also provided in the paper.
A mechanism for developing the professional potential of the professor-teaching composition in the higher school
Authors: Yankovskaya V V
Published: June 2019

This article discusses the relationship of ICT with the need for lifelong learning and the development of the professional potential of the faculty of the Higher School. The goal of the paper is to present a mechanism for developing the professional potential of the faculty of the Higher School.
The role of the high school in the “Triple Loop” model: SCBIN technologies
Authors: Yankovskaya V V , Kukushkin S N
Published: June 2019

Subject / topic: In this paper, a study was conducted of the influence of the “triple loop” model on the Higher School, the university architecture of the organization. The role of convergent technologies in the educational environment and their relationship with the knowledge system, approaches, potential and communication of SCBIN technologies with the knowledge management system is discussed. In particular, the research explores IT and cognitive technologies that form a new space in higher education and provide ways to master it. In the paper, the authors also consider the role and influence of the “triple loop” model on the high school, along with the main tool for implementing SCBIN technologies.
Importance of the formation of environmental consciousness of the personnel for the development of eco-technologies in the hotel enterprise
Authors: Ovcharenko N P , Galenko E V , Orlovskaia Iu V
Published: June 2019

The study focuses on the consideration of the formation methods of ecological consciousness of employees of the hotel enterprise. It is noted that the formation of environmental awareness among the staff is a priority in the implementation of ecotechnologies in the hotel, as they are able to significantly affect the effectiveness of their implementation. The survey shows that a significant part of the staff is not ready to sacrifice their comfort and change the time-fixed sequence of duties for the sake of the implementation of environmental policy. In this regard, a number of recommendations on possible formation methods of ecological consciousness in the management and line staff of hotels. The results of the study may be useful for practical application in hotels planning to implement or introduce eco-technologies.
Natural and resource capacity as a basis for sustainable development of rural areas in the Non-humus zone in the Republic of Bashkortostan
Authors: Stovba E V , Kolonskikh N E
Published: June 2019

The role of the natural resource capacity as a key factor of sustainable development in rural areas is actualized in the article. We point out that the development of a strategy for the sustainable development of rural areas is impossible without comprehensive accounting and assessment of the natural and climatic conditions of the functioning in the considered area. An analysis of the current state and development of the natural resource capacity in rural areas is made on the example of the Non-humus zone in the Republic of Bashkortostan. A detailed description of the climatic conditions at the regional level is given. The actual agricultural specialization and combination of crop and livestock sectors of agro-organizations is established taking into account the differentiation of natural resource and soil-climatic conditions and is caused by regional differences. It is affirmed that the Non-humus zone in the Republic of Bashkortostan has a great natural and resource potential, which, with effective use, makes it possible to ensure sustainable development of rural areas. The main part of the territory under consideration has sufficient bioclimatic and soil resources, which allow creating sustainable premises for the development of agricultural industries, the production of basic types of food. We concluded that natural and soil-climatic factors have a significant impact on the conditions of functioning of modern agriculture, which, in turn, directly affects the sustainable development of agro-organizations. We summarized that the design of the main options of the sustainable development strategy for rural areas of the Non-humus zone in the Republic of Bashkortostan should directly take into account the specific features of the development of the natural and resource capacity of the area.
Assessing the socio-cultural indicators of the population’ quality of life in the transboundary region
Authors: Shchetkina I A
Published: June 2019

Ensuring a high, decent quality of life becomes the goal of socio-economic development of countries and regions, and the formation of a system to ensure a high quality of life leads to ensuring the necessary level of social security. This becomes especially relevant in the territory of transboundary regions. This is determined by the fact that each transboundary region has its own models of ensuring the quality of life of the population, uses its own mechanisms for improving the quality of the social environment and the ecological situation, as well as its own sociocultural living conditions. This article is aimed at identifying the sociocultural conditions for ensuring the quality of life of the population in a cross-border region (using the example of the Trans-Baikal region). The integrative culture-centric approach is the leading approach to the study of socio-cultural indicators of the quality of life of the population. It is based on a set of opposing points of view related both to the subjective perception of life values and to the awareness of the reality and objectivity of the surrounding world. The use of an integrative culture-centric approach made it possible to characterize the objective aspect of the quality of life of a population in a transboundary region in the context of understanding the level of development of the socio-cultural space and the nature of its influence on the lives of citizens. At the same time, this approach made it possible to study the subjective aspect of the quality of life of the population in a transboundary region through the assessment of people’s satisfaction with the quality of their life. As part of the study, a survey of 4,700 residents of municipal areas and urban districts of the Trans-Baikal region was conducted at the age of 18 to 85 years old and indicators are highlighted. They reflect the sociocultural aspects of respondents’ satisfaction with their lives, leisure activities, and the availability of cultural institutions. The materials of the article are of practical value for the authorities and state institutions, public associations, and the world community as a whole. Since they are the basis for developing meaningful social policy measures that expand opportunities for the development of the sociocultural living space of the population, implement social programs and projects aimed at improving the quality of life in different countries, and also develop recommendations for reducing the level of dissatisfaction with the quality of life of people in different countries and regions.
Improving Outcomes
Authors: McBrien Sarah , Bailey Zachary , Ryder Jonathan , Scholer Paige , Talmon Geoffrey
Published: June 2019

Objectives

To determine the strength of study design and outcomes in literature describing pathology education for medical students.

Methods

A search was conducted for articles related to pathology education published over 45 years describing an educational intervention. The primary data collected included phase of education, domain of objectives, number of learners and institutions, type of intervention, use of a comparison/control group, randomization, and strength of statistical analysis.

Results

Of 655 articles, 54 (8%) met inclusion criteria. The majority (65%) reported experiences of 100 learners or fewer, and only one was multi-institutional. Only 46% used a comparison/control group. Statistical significance of results was not reported in 39%. None examined outcomes at a point distant from the educational intervention.

Conclusions

Most studies describing pathology educational interventions are not of strong experimental design. Consumers of educational research should be cognizant of these potential weaknesses in educational studies.
Contemporary Appraisal of Sex Differences in Prevalence, Correlates, and Outcomes of Alcoholic Cardiomyopathy
Authors: Mogos Mulubrhan F , Salemi Jason L , Phillips Shane A , Piano Mariann R
Published: June 2019

Aims

The aims of this study were to: examine differences in alcoholic cardiomyopathy (ACM) prevalence, temporal trends and the distribution of socio-demographic factors and comorbidities by sex; and investigate differences in selected inpatient outcomes between women and men with ACM.

Methods

We used the 2002–2014 Nationwide Inpatient Sample databases. Overall and sex-specific rates of ACM were estimated across sociodemographic, clinical, and hospital characteristics. Joinpoint regression was used to estimate temporal trends (annual percent change [APC]) of ACM-related hospitalization by sex and race/ethnicity. Adjusted odds ratios (AOR) representing associations between sex and selected ACM outcomes were calculated using survey logistic regression.

Results

The rate of ACM among all inpatient men and women was 128 per 100,000 and 17 per 100,000 hospitalizations, respectively. Among women, the rate of ACM remained unchanged during the study period, while for men, there was 1.2% annual reduction from 2002–2010 (APC −1.3, 95% CI: −1.7, −0.8). Women with ACM were more likely than men with ACM to experience depression (AOR=2.24, 95% CI: 2.06–2.43) and anxiety (AOR=1.94, 95% CI: 1.75–2.15), while men with ACM were 21% and 24% more likely than women with ACM to experience ‘any heart failure (HF)’ and HF with reduced ejection fraction respectively. One in 1,471 hospitalizations were related to ACM with a male-to-female ratio of 8:1.

Conclusion

Individuals with ACM are at increased likelihood of adverse outcomes. Women with ACM are at increased risk of depression and anxiety, while men are at increased risk of HF.
Cryptococcal-related Mortality Despite Fluconazole Preemptive Treatment in a Cryptococcal Antigen Screen-and-Treat Program
Authors: Wake Rachel M , Govender Nelesh P , Omar Tanvier , Nel Carolina , Mazanderani Ahmad Haeri , Karat Aaron S , Ismail Nazir A , Tiemessen Caroline T , Jarvis Joseph N , Harrison Thomas S
Published: June 2019

Background

Cryptococcal antigen (CrAg) screening and treatment with preemptive fluconazole reduces the incidence of clinically evident cryptococcal meningitis in individuals living with advanced human immunodeficiency virus (HIV) disease. However, mortality remains higher in CrAg-positive than in CrAg-negative patients with similar CD4+ T-lymphocyte counts.

Methods

We conducted a cohort study to investigate causes of morbidity and mortality during 6 months of follow-up among asymptomatic CrAg-positive and CrAg-negative (ratio of 1:2) patients living with HIV with CD4 counts <100 cells/µL attending 2 hospitals in Johannesburg, South Africa. When possible, minimally invasive autopsy (MIA) was performed on participants who died.

Results

Sixty-seven CrAg-positive and 134 CrAg-negative patients were enrolled. Death occurred in 17/67 (25%) CrAg-positive and 12/134 (9%) CrAg-negative participants (hazard ratio for death, adjusted for CD4 count, 3.0; 95% confidence interval, 1.4–6.7; P = .006). Cryptococcal disease was an immediate or contributing cause of death in 12/17 (71%) CrAg-positive participants. Postmortem cryptococcal meningitis and pulmonary cryptococcosis were identified at MIA in all 4 CrAg-positive participants, 3 of whom had negative cerebrospinal fluid CrAg tests from lumbar punctures (LPs) at the time of CrAg screening.

Conclusions

Cryptococcal disease was an important cause of mortality among asymptomatic CrAg-positive participants despite LPs to identify and treat those with subclinical cryptococcal meningitis and preemptive fluconazole for those without meningitis. Thorough investigation for cryptococcal disease with LPs and blood cultures, prompt ART initiation, and more intensive antifungals may reduce mortality among asymptomatic CrAg-positive patients identified through screening.
Bleeding and ischaemic outcomes in patients treated with dual or triple antithrombotic therapy: systematic review and meta-analysis
Authors: Haller Paul M , Sulzgruber Patrick , Kaufmann Christoph , Geelhoed Bastiaan , Tamargo Juan , Wassmann Sven , Schnabel Renate B , Westermann Dirk , Huber Kurt , Niessner Alexander , Gremmel Thomas
Published: June 2019

Aims

The combination of oral anticoagulation with a P2Y12 inhibitor and aspirin in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) is associated with a high bleeding risk. Dual antithrombotic therapy (DAT) with omission of aspirin is a promising option to reduce bleedings, but carries a yet unknown risk of ischaemic events. We therefore sought to systematically review and analyse randomized controlled trials investigating DAT vs. triple antithrombotic therapy (TAT) in patients with AF following PCI and/or acute coronary syndrome (ACS).

Methods and results

We included four trials with overall 9317 patients (5039 DAT, 4278 TAT) in our analysis. Dual antithrombotic therapy was associated with a significant reduction in thrombolysis in myocardial infarction major bleeding [hazard ratio (HR) 0.52, 95% confidence interval (CI) 0.42–0.65; P = 0.0001], while the composite trial-defined ischaemic endpoint did not differ significantly between DAT and TAT (HR 0.98, 95% CI 0.79–1.22; P = 0.88). There was also no difference regarding the occurrence of myocardial infarction (MI; HR 1.16, 95% CI 0.92–1.46; P = 0.21) or stent thrombosis (HR 1.25, 95% CI 0.69–2.26; P = 0.46). Absolute numbers for MI were 131/4278 (3.1%) with TAT and 182/5039 (3.6%) with DAT, and for stent thrombosis 32/4278 (0.75%) and 52/5039 (1%), respectively. A post hoc power calculation based on the size and event rate of this meta-analysis revealed 80% power to detect a 37% and 100% increase in MI and stent thrombosis, respectively.

Conclusion

Dual antithrombotic therapy significantly reduces bleedings compared with TAT and seems to have a similar effect in preventing ischaemic endpoints in AF patients post-PCI or ACS. Future investigations are needed to determine its applicability specifically in patients at high risk of ischaemic outcomes.
Access to essential cardiovascular medicines for children: a pilot study of availability, price and affordability in Nigeria
Authors: Orubu Ebiowei S F , Robert Faith O , Samuel Mercy , Megbule Daniel
Published: June 2019

Policies to improve access to medicines for children in low- and middle-income countries, such as Nigeria, should consider the growing threat of non-communicable diseases. The aim of this pilot study was to scope availability, price and affordability of essential cardiovascular medicines for children in selected states in Nigeria. The study was a descriptive longitudinal survey conducted in three phases. Availability was determined as percentage of facilities having the medicine on the survey date. Medicines with good availability (>80%) were noted. Prices were cross-referenced against international Reference Prices and the Nigerian National Health Insurance Scheme Prices. Affordability was calculated using the Least-Paid Government Worker method. For medicines compounded to improve availability, a model for calculating affordability was proposed. In Phase I, the availability of all 17 strengths of the cardiovascular medicines or diuretics listed in the Essential Medicines List for Children (2015) were surveyed in two conveniently selected states using the WHO/HAI questionnaire. Data were collected from 17 hospitals and pharmacies. Phases II and III focused on tablet formulations (enalapril, furosemide, hydrochlorothiazide and spironolactone) in three purposively selected state capitals: Lagos, Abuja and Yenagoa. In Phase II, 11 private pharmacies were surveyed in December 2016: Phase III tracked price changes in Abuja and Yenagoa in August 2018. Only furosemide and hydrochlorothiazide tablets had good availability. Oral liquids were unavailable. Prices for four generic oral tablets were 2–16× higher than the International Reference Prices; prices for two of these did not change significantly over the study period. Affordable medicines were generic furosemide and hydrochlorothiazide tablet. Where a fee is charged, compounded medicines were also not affordable. While the small sample sizes limit generalization, this study provides indicative data suggesting that prices for cardiovascular medicines remain high and potentially unaffordable in the private sector in these selected states, and when compounded. Regular systematic access surveys are needed.
Functional muscle recovery following dystrophin and myostatin exon splice modulation in aged mdx mice
Authors: Lu-Nguyen Ngoc , Ferry Arnaud , Schnell Frederick J , Hanson Gunnar J , Popplewell Linda , Dickson George , Malerba Alberto
Published: June 2019

Duchenne muscular dystrophy (DMD) is a rare genetic disease affecting 1 in 3500–5000 newborn boys. It is due to mutations in the DMD gene with a consequent lack of dystrophin protein that leads to deterioration of myofibres and their replacement with fibro-adipogenic tissue. Out-of-frame mutations in the DMD gene can be modified by using antisense oligonucleotides (AONs) to promote skipping of specific exons such that the reading frame is restored and the resulting protein produced, though truncated, is functional. We have shown that AONs can also be used to knock down myostatin, a negative regulator of muscle growth and differentiation, through disruption of the transcript reading frame, and thereby enhance muscle strength. In young mdx mice, combined dystrophin and myostatin exon skipping therapy greatly improved DMD pathology, compared to the single dystrophin skipping approach. Here we show that in aged (>15-month-old) mdx mice, when the pathology is significantly more severe and more similar to the one observed in DMD patients, the effect of the combined therapy is slightly attenuated but still beneficial in improving the disease phenotype. These results confirm the beneficial outcome of the combination approach and support its translation into DMD clinical trials.
Role of Lymphatic Deficiency in the Pathogenesis and Progression of Inflammatory Bowel Disease to Colorectal Cancer in an Experimental Mouse Model
Authors: Daley Sarah K , Witte Marlys H , Washington Jalicia , Bernas Michael , Kiela Pawel , Thorn Jennifer , Tanoue Nathan , Alexander J Steven
Published: June 2019

Background

Inflammatory bowel disease (IBD) is characterized by chronic inflammation, which can progress to colorectal cancer, with duration of disease being the most important risk factor. Although many factors are involved, the pathogenic link between inflammation and cancer and the role played by the lymphatic system have not been fully investigated. This project uses lymphatic-deficient mice (Angiopoietin-2 [Ang2] knockout) to examine the lymphatic system in the progression of IBD to colorectal cancer.

Methods

Angiopoietin-2 wild-type, heterozygote, and knockout mice received a single injection of the procarcinogen azoxymethane and had an IBD-promoting chemical irritant (dextran sodium sulfate) added to their drinking water over a 7-week period. We measured disease activity (weight loss, stool consistency, fecal occult blood) during the study and at sacrifice, collected blood for cytokine/biomarker (Ang2, interleukin [IL] 1-β, IL-6, tumor necrosis factor α [TNFα], and VEGF-C) enzyme-linked immunosorbent assay analysis, measured colon length, and assessed tumor burden.

Results

Ang2 knockout (KO) mice exhibited reduced (55%) survival vs wild-type (100%) and heterozygotes (91%; P < 0.01 and P < 0.0001, respectively). Most (>89%) mice developed tumors, and the incidence of colorectal cancer did not differ among the genotypes (P = 0.32). The tumor area was significantly increased in KO mice (P = 0.004). Of the biomarkers measured in the serum, Ang2 and TNF-α concentrations were significantly different among the genotypes (P = 3.35e-08 and P = 0.003 respectively). Disease activity was significantly increased in KO mice compared with wild-type and heterozygote mice (P = 0.033).

Conclusions

Lymphatic deficiency, defective lymphangiogenesis, and impaired lymphatic-generated inflammation did not protect against clinical IBD or progression to colorectal cancer in this experimental model.
Lung cancer photothermal ablation by low-power near-infrared laser and topical injection of indocyanine green
Authors: Hirohashi Kentaro , Anayama Takashi , Wada Hironobu , Nakajima Takahiro , Kato Tatsuya , Keshavjee Shaf , Orihashi Kazumasa , Yasufuku Kazuhiro
Published: June 2019

OBJECTIVES

Surgical treatment is the gold standard for the treatment of early-stage non-small-cell lung cancer. However, minimally invasive tumour ablation can be an alternative treatment for patients not eligible for surgery due to comorbidities. The aim of this study was to evaluate the efficacy of photothermal ablation therapy using low-power near-infrared laser and topical injection of indocyanine green (ICG), a photosensitizer, in a preclinical study using a rabbit VX2 lung cancer model.

METHODS

Six New Zealand white rabbits were used. Five hundred microlitres of a suspension containing 0.5 × 107 VX2 cancer cells with growth factor-reduced Matrigel was inoculated into the right lung using an ultrathin bronchoscope. Three rabbits were treated with laser ablation therapy with topical injection of ICG, whereas another 3 rabbits were treated with laser ablation alone. All tumours were irradiated with a laser with 500-mW output at 808 nm for 15 min. The tumours were examined histopathologically to assess the state of ablation.

RESULTS

The maximum tumour surface temperatures in rabbits treated using ICG/laser and laser alone were higher than 58°C and lower than 40°C, respectively. The ablated areas in the rabbits treated with ICG/laser were significantly larger than those in the rabbits treated with laser alone (0.49 ± 0.27 vs 0.02 ± 0.002 cm2, respectively) (P < 0.05).

CONCLUSIONS

The photothermal treatment using the combination of low-power near-infrared laser and topical injection of ICG can ablate a larger tumour area than laser treatment alone.
Adrenocortical carcinoma arising from an adrenal adenoma in a young adult female
Authors: Rebielak Monica E , Wolf Mary R , Jordan Rebecca , Oxenberg Jacqueline C
Published: June 2019

Adrenocortical carcinoma (ACC) is a rare malignancy that often carries a poor prognosis whereas adrenal incidentalomas are relatively common findings on imaging. Although most adrenal lesions are benign, 15% of patients with ACC are diagnosed based on workup for an adrenal incidentaloma. Continued surveillance or surgical resection may be recommended depending on size. The risk of a benign, non-functional adrenal lesion becoming malignant is low. Therefore, adrenal lesions typically undergo surveillance for no more than 2 years in patients with stable findings and no history of malignancy. This case describes a young adult female with a benign left adrenal adenoma who was found to have high grade ACC 7 years later. Based on interval size increase with indeterminate density, patient underwent surgical resection with adjuvant radiation and medical therapy.
Nutritional strategies to modulate inflammation pathways via regulation of peroxisome proliferator-activated receptor β/δ
Authors: da Cruz Beatriz O , Cardozo Ludmila F M de França , Magliano D’Angelo C , Stockler-Pinto Milena B
Published: June 2019

The peroxisome proliferator-activated receptor (PPAR) β/δ has an important role in multiple inflammatory conditions, including obesity, hypertension, cancer, cardiovascular disease, diabetes mellitus, and autoimmune diseases. PPARβ/δ forms a heterodimer with the retinoic acid receptor and binds to peroxisome proliferator response elements to initiate transcription of its target genes. PPARβ/δ is also able to suppress the activities of several transcription factors, including nuclear factor κB, and activator protein 1, thus regulating anti-inflammatory cellular responses and playing a protective role in several diseases. Recent studies have shown that nutritional compounds, including nutrients and bioactive compounds, can regulate PPARβ/δ expression. This review discusses key nutritional compounds that are known to modulate PPARβ/δ and are likely to affect human health.
Alopecia After Switch to Tenofovir Alafenamide in 6 African American Women
Authors: El Zein Said , Tabaja Hussam , Kanj Amjad , Richmond Deborah , Veltman Jennifer
Published: June 2019

No cases of tenofovir alafenamide (TAF)–induced alopecia have been reported in the literature. We describe 6 cases of hair loss in African American female patients after switching to TAF and aim to raise awareness about this potential adverse effect of TAF, which could predominate in certain patient populations.