bluuebunny/crossref_metadata_2025 huggingface dataset:
Diet of Long-eared Owl and Common Kestrel in an urban landscape (Ukraine)
Authors: Zahorodnyi Ivan , Dubovyk Oleksii , Komarnytskyi Ivan , Dykyy Ihor
Published: June 2021

In the present study we performed a comparative dietary analysis of two predatory birds, the Long-eared Owl (Asio otus) and the Common Kestrel (Falco tinnunculus) in the district of Lviv city. We found that the Long-eared Owl and the Common Kestrel are typical small mammal specialists within the urban ecosystem. Considering the abundance and biomass of prey, small mammals comprise 98.4% of the Long-eared Owl’s diet. The species composition of mammals coincides almost 50% in the food intake comparison of the two birds. It has been established that the main prey of both species is the Common Vole (Microtus arvalis). The diet of the Common Kestrel is more varied, compared to the Long-eared Owl, due to the consumption of different species of insects (families Gryllotalpidae, Tettigoniidae, Carabidae and Scarabaeidae), reptiles and birds. This result suggested that dietary plasticity of the Common Kestrel facilitate successful adaptation to the urban landscape. The Long-eared Owl is more narrowly specialized in feeding on murine rodents, which reduces the trophic competition between the two predatory birds and allows the coexistence of two predators in the urban ecosystem.
Long-term lead intoxication of Griffon Vulture (Gyps fulvus Hablizl, 1783) supposedly the result of illegal shooting
Authors: Stamenov Anton , Lazarova Ivanka , Arkumarev Volen , Dimitrova Stefka , Terziev Nikolay , Delchev Atanas , Dobrev Dobromir
Published: June 2021

The European Griffon Vulture Gyps fulvus is a large-sized scavenger exploiting carcasses of livestock and wild ungulates and thus having a paramount importance in the natural ecosystems. In this study, we report on an adult Griffon Vulture detected with lead levels in the bones over the threshold. After two years of tracking, the bird died. The corpse’s clinical examination and radiography detected the presence of two embedded lead pellets from a healed gunshot wound in its right wing. Quantitative laboratory analysis of lead in bone and liver samples evidencing subclinical/chronic lead intoxication of the Griffon Vulture could potentially be a result of the long-term exposure to the lead originating from the pellets in its wing.
Qualitative and Quantitative Analysis of Housing Indices at the Neighborhood Level: Case Study of Region 6 of Tehran Municipality
Authors: Ghalehteimouri Kamran Jafarpour , Rahimzadeh Azad , Parizadi Taher , Sasanpour Farzaneh
Published: June 2021

Most of the cities in Iran have experienced very rapid development. The urban population in the last decade has been increased by migration, and cities in Iran are faced with many problems. Housing is becoming one of the major problems, and standard housing indices have taken an important place in urban planning to provide good conditions for better urban planning. Region 6 of Tehran municipality is home to a large portion of upper-middle social class people for whom owning a house is more than merely a place to live. The aim of the research was to analyze qualitative and quantitative indices for Region 6 of Tehran municipality. The study is based on analytical and descriptive methods. The secondary data collected from the latest Iran census report in 2016 and composite methods used to measure the special effects of changes in population size, growth rate, and indices of quantitative and qualitative assessment are wide-ranging housing which was analyzed based on the t-test, correlation test and regression with SPSS and GIS software. GIS software is used as an effective tool for generating maps to better understanding the behaviors of residents in a neighborhood. The result shows that Region 6 of Tehran is among the areas of serious urban decline and neighborhoods in the neighboring regions are influenced by the activities of other bordering neighborhoods.
The Profile of Portuguese People when Choosing an Apartment
Authors: Santos Eulália , Tavares Fernando
Published: June 2021

It is important to study and to know the determining factors of the housing purchase business, as this is often the greatest business deal in a family’s life. The purpose of this study is to identify the profile of the Portuguese regarding the determining factors when searching for apartments to acquire. The methodology used is based on a questionnaire that analyzes the determining factors in the choice of apartments to acquire and the sociodemographic profile of Portuguese people looking for an apartment. The sample consisted of 646 individuals who were looking for an apartment in different regions of Continental Portugal. The determining factors in the choice of apartments have quite adequate levels of validity and reliability, and four dimensions are obtained: negative externalities, positive externalities, a business located on the ground floor and rational interest in proximity to public services. Cluster analysis results show the formation of five clusters, classifying individuals into a generic cluster, urban business cluster, urban services cluster, urban citizens cluster and elitist cluster. This study is expected to contribute to increasing scientific knowledge on the topic and to help real estate developers better match their clients’ preferences.
Genetic structure and postglacial recolonization of Pinus sibirica Du Tour in the West Siberian Plain, inferred from nuclear microsatellite markers
Authors: Shuvaev D. N. , Ibe A. A.
Published: June 2021

The total of 257 trees from the ten natural Siberian stone pine populations of West Siberian Plain, Ural Mountains and Kuznetsk Alatau were studied with the eight nuclear microsatellite loci. Differentiation of population groups indicates the possible existence of separate refugia in the past in the Urals and Kuznetsk Alatau. The northern populations of Western Siberia were characterized by a reduced level of genetic diversity, which could be a consequence of the founder effect in the process of P. sibirica migration from the southern regions of Western Siberia and the Urals since the end of the last glacial maximum. The genetic variability distribution among populations shows the uneven dynamics of Siberian stone pine migration from the zones of supposed refugia. The map of the proposed ways of Siberian stone pine migration from the zones of possible refugia was constructed, and it is in a good agreement with the results of palynological investigations.
El paradigma del derecho en Colombia: la constitucionalización del derecho penal
Authors: Calvete León Ivanna , Garces Vasquez Jorge
Published: June 2021

El texto propone un análisis de las categorías de paradigmas del derecho que Ferrajoli en sus obras propone, para entender históricamente cómo el derecho se ha desarrollado y cuáles son las implicaciones que conllevan los cambios a través del tiempo en la manera cómo se estudian y aplican las normas jurídicas. Se explica brevemente cada uno de los paradigmas propuestos por Ferrajoli, partiendo del paradigma jurisprudencial, posteriormente el paradigma legalista y por último el paradigma constitucional, que a su vez se divide en paradigma constitucional garantista y paradigma constitucional principialista. Así mismo, una vez se expongan cada uno de los paradigmas, el texto pretende analizar Colombia, con la Constitución de 1991, a cuál paradigma aduce en su estudio y aplicación del derecho, reconociendo argumentativamente su relación con el paradigma principialista. Para finalizar se exponen algunos de los argumentos que permiten identificar la relación entre el paradigma principialista y el derecho penal. Algunos de estos argumentos son: el papel preponderante del juez constitucional dentro del marco de acción del juez de control de garantías; la vinculación de valores, derechos fundamentales y principios como marco para la comprensión y aplicación de las normas jurídico-penales; y los criterios de relevancia de las normas constitucionales frente a las reglas penales. Esto en aras de concluir con la coherencia del derecho penal con el paradigma constitucional principialista.
Calidad de vida en el trabajo y aspectos sociodemográficos en trabajadores reintegrados en una empresa de bus de rápido tránsito
Authors: Galarza Iglesias Ana Milena , Gómez Salazar Lessby , Ordóñez Hernández Cecilia Andrea
Published: June 2021

Cuando un trabajador se reincorpora a su trabajo después de una incapacidad médica puede presentar restricciones laborales que ameritan ajustes al interior de la organizacional, los cuales pueden impactar la calidad de vida laboral y productividad de dicho trabajador. Con el objetivo de determinar la calidad de vida laboral y su relación con los aspectos sociodemográficos y ocupacionales en trabajadores reincorporados en una empresa de bus de rápido tránsito, se llevó a cabo un estudio con diseño cuantitativo de tipo observacional, transversal; usando el instrumento CVT-GOHISALO. Este instrumento mide la calidad de vida en el trabajo en términos de satisfacción a partir del análisis de 7 dimensiones: soporte institucional para el trabajo, seguridad en el trabajo, integración al puesto de trabajo, satisfacción por el trabajo, bienestar logrado a través del trabajo, desarrollo personal y administración del tiempo libre. Participaron el total de trabajadores reincorporados en la empresa (N=75). A partir de los datos obtenidos se realizaron análisis estadísticos , pruebas Chi2 y Fisher. Como resultados de esta investigación, se evidencia que de las 7 dimensiones de calidad de vida en el trabajo, 5 obtuvieron nivel bajo de satisfacción: integración al puesto de trabajo (60%), satisfacción por el trabajo (62,7%), bienestar logrado a través del trabajo (53,3%), desarrollo personal del trabajador (56%) y administración del tiempo libre (93,3%). Las 2 dimensiones con nivel de satisfacción alta fueron soporte institucional (58,7) y seguridad en el trabajo (66,7%). Así mismo se encontró relación entre la edad con el bienestar logrado a través del trabajo (p=0.028) y con el desarrollo personal del trabajador (p=0,025), relación entre la escolaridad con la integración al puesto de trabajo(p=0.043) y con la administración del tiempo libre (p= 0.004). respectivamente). En general, esta investigación evidencia que los trabajadores manifiestan baja calidad de vida laboral relacionada con factores personales, historia laboral y condiciones organizacionales; aunque manifiestan alta satisfacción en las dimensiones que valoran el papel del supervisor o jefe inmediato visibilizando el rol de facilitador que tienen en el proceso de reincorporación.
Grupos de Investigación contable y sus características de acuerdo con el modelo del Ministerio de Ciencia y Tecnología al año 2019 en Colombia
Authors: Patiño-Jacinto Ruth Alejandra , Juan Carlos  , Burgos Rolón Samuel David , Valero Zapata Gloria Milena , Macías-Cardona Hugo A.
Published: June 2021

El objetivo de este trabajo es identificar el estado actual de los grupos de investigación contable colombianos y considerar los cambios con respecto a estudios previos. Para ello se llevó a cabo un análisis sistemático de la información oficial registrada por los grupos en las plataformas del Ministerio de Ciencia y Tecnología. En los resultados se diferencian los grupos contables de aquellos que tienen solo un componente contable, es decir, los que incluyen distintas disciplinas. Se analizan los investigadores activos, las líneas de investigación, las publicaciones y la concentración de las actividades dentro de la geografía nacional. La metodología utilizada es cualitativa, a partir de la revisión documental de las bases de datos de Minciencias para grupos GrupLac e investigadores CvLac. El principal resultado es que los grupos de investigación contable se han incrementado de forma significativa, lo cual genera producción relevante para el contexto colombiano. La limitación principal corresponde a que únicamente se analizó la información registrada en Minciencias y se omiten otras dinámicas que podrían ser relevantes para algunos integrantes de la comunidad que no registran su información en estas bases.
Una mirada a los procesos de inclusión laboral de excombatientes a la dinámica empresarial
Authors: Ortiz Silva Sandra Milena , Quintero Salgado Milena , Restrepo Escobar Francisco Eladio
Published: June 2021

El presente trabajo de investigación tiene como objetivo analizar las estrategias de inclusión laboral de excombatientes en proceso de reintegración a la dinámica empresarial implementadas por tres empresas colombianas. El estudio es de carácter descriptivo con enfoque mixto (cualitativo y cuantitativo). La población estuvo constituida por setenta y un empleados (autodefensas y guerrilleros desmovilizados) a quienes se les aplicó una encuesta y por tres directivos de gestión humana a quienes se les entrevistó. Se indagó por las dimensiones: Inclusión laboral sostenible, equidad en la contratación, el trato y herramientas administrativas; Clima laboral, satisfacción con la organización y experiencias y sentidos del trabajo. Los resultados obtenidos en términos generales, permitieron establecer que los excombatientes experimentan satisfacción con las políticas implementadas por las empresas para generar programas de inclusión laboral sostenibles, para que cada vez más personas puedan reintegrarse a la vida civil. Esta investigación cobra relevancia por los aportes que brinda a la agencia para la reincorporación y normalización, a las empresas y en general a todas las organizaciones públicas o privadas interesadas en contratar personas desmovilizadas que pertenecieron a grupos al margen de la ley.
Collective Memory and Nation-Building in Africa
Authors: Iroanya Obinna , Ndapulamo Salomo , Nguluwe Gabriella
Published: June 2021

Based on documentary analysis, this article argues that lessons of violent conflicts are rarely appropriated positively for nation-building in the context of post-conflict African societies. The article further stresses that the reasons often projected as causes of ineffective nation-building, such as multiple ethnicity and neo-colonialism, are unjustifiably projected as causal factors. It argues that diverse ethnicity remains a dormant destructive force until operationalised for political gains through misappropriation and deployment of collective memories. In the African context, post-conflict societies adopt the mixed approach of selective amnesia which emphasises amnesty, reconciliation, rehabilitation and reintegration as necessary for nation-building. Experience, however, suggests that the operationalisation of this approach is always marred by inconsistencies and repression. Consequently, repressive mechanisms suppress violence and achieve relative stability. True reconciliation which is critical for nation-building is never achieved. Among loser ethnic groups (hereafter loser groups), resistance to selective amnesia and simultaneous preoccupation with collective memory of victimisation, discrimination and injustice continue to reinforce sentiments of group exceptionality and separatist impulses rather than national consciousness. Therefore, cautious expression of citizenship among segments of the loser groups continues to attract mutual suspicion and distrust from leadership of post-conflict states. It is concluded that the challenge of social contradictions in post-conflict societies is serious because neither the state nor loser groups positively deploy memory of conflict for nation-building. A new reconciliatory approach drawn largely from lessons of history is recommended for post-conflict nation-building efforts in post-conflict African states. Positive appropriation and deployment of memory for nation-building ensures amnesty and restoration without repercussions; and remembrance without resentment.
Evaluation of complications of the late postoperative period in patients with diabetes mellitus after drainage surgery of neovascular glaucoma
Authors:   RUDN University, Moscow, Biletskaya V.A. , Lipatov D.V. ,   RUDN University, Moscow,   Endocrinology Research Centre, Moscow, Frolov M.A. ,   RUDN University, Moscow
Published: June 2021

Today diabetes mellitus (DM) is one of the leading medical and social problems. Its complications lead to terrible concomitant pathologies that qualitatively affect the lives of patients. At the end of 2019, there were more than 463 million people with diabetes in the world and this number is increasing every year. Diabetic retinopathy (DR) is one of the most severe complications of DM on the organ of vision. Secondary neovascular glaucoma (NG) is a manifestation of the end-stage proliferative DR. This is a relatively rare but difficult-to-treat pathology that often leads working-age patients to disability and impaired social adaptation. The main objective of treatment for NG is to compensate for intraocular pressure (IOP), but conservative (drug) therapy is often ineffective. Therefore, doctors are forced to use surgical methods of treatment. At the same time, do not forget about the multiple complications during the operation, as well as in the early and late postoperative periods. A special feature of the course of NG in patients with DM is its combination with the failure of the ligamentous-capsular apparatus of the lens, iris bombage, anterior and posterior synechiae, traction retinal detachment and various hemorrhagic complications. All this allows us to talk about the so-called diabetic glaucoma (DG). Currently, drainage devices have become the standard in the treatment of refractory NG. The effectiveness of such operations according to various sources is about 70-80% of success. Purpose. To assess the condition of patients with DM in the late (10-15 years) postoperative period after performing NG drainage surgery, to analyze the effectiveness of the intervention by studying the dynamics of IOP, the presence or absence of pain syndrome and various intraocular complications. Material and methods. During the period 2006-2020, 150 patients with NG and DM were operated on in the Department of Diabetic Retinopathy of the Federal State Budgetary Institution «Endocrinology Research Centre» of the Ministry of Health of the Russian Federation. Results. In 100% of the postoperative period, the pain syndrome was stopped. And also, in 59.7% of cases, the presence of late complications: vascular thorn, EED, subatrophy and anophthalmos. Conclusion. Despite the presence of complications, drainage surgery in patients with DM continues to be an effective method of choosing surgical treatment for patients with uncompensated NG. Key words: diabetes mellitus; diabetic retinopathy; neovascular glaucoma; drainage surgery.
The effectiveness of treatment of partial optic nerve atrophy in children
Authors:   Federal State Budgetary Educational Institution of Higher Education «Kemerovo State Medical University» of the Ministry of Health of the Russian Federation, Goncharenko V.A. , Gromakina E.V. ,   Federal State Budgetary Educational Institution of Higher Education «Kemerovo State Medical University» of the Ministry of Health of the Russian Federation, Basova G.G. ,   Federal State Budgetary Educational Institution of Higher Education «Kemerovo State Medical University» of the Ministry of Health of the Russian Federation
Published: June 2021

Purpose. To evaluate the effectiveness of early treatment in patients with partial optic nerve atrophy, nystagmus and albinism. Material and methods. A study of case histories and outpatient records of 265 patients with partial optic nerve atrophy was carried out. Among them, 219 children received a single course of treatment and 46 children received two or more courses of treatment at different periods of initiation of therapy. Results. After a single course of treatment, 54% of children had no dynamics of visual acuity. After regular complex treatment, visual acuity increased by 0.2 and higher in 58.3% of children at the beginning of treatment under 3 years of age. In cases of isolated lesions of the optic nerve and with a combination of partial atrophy of the optic nerve with nystagmus, an increase in visual acuity by 0.2 and higher was noted in 50% and 60%, respectively, at the start of treatment for children under 3 years of age. Conclusion. Treatment of partial atrophy of the optic nerve is effective in children with regular courses of therapy. An increase in visual acuity by 0.2 and higher was observed twice as often at the start of complex treatment up to 3 years. Key words: optic nerve atrophy, children, visual acuity
Characteristic of the central cornea thickness in healthy children and in patients with congenital glaucoma
Authors:   FGBOU VO «Saint-Petersburg state medical pediatric university» of the Ministry of Health of the Russian Federation, Baranov A.Y. , Brzheskii V.V. ,   FGBOU VO «Saint-Petersburg state medical pediatric university» of the Ministry of Health of the Russian Federation, Chistyakova M.N. ,   FGBOU VO «Saint-Petersburg state medical pediatric university» of the Ministry of Health of the Russian Federation, Sadovnikova N.N. ,   FGBOU VO «Saint-Petersburg state medical pediatric university» of the Ministry of Health of the Russian Federation, Zertsalova M.A. ,   FGBOU VO «Saint-Petersburg state medical pediatric university» of the Ministry of Health of the Russian Federation
Published: June 2021

Background. Ophthalmic hypertension is one of the most important diagnostic criteria for congenital glaucoma. The «gold standard» for measuring intraocular pressure (IOP) is the applanation tonometry (Maklakov and Goldmann methods). However, the thickness of the central corneal zone has a significant effect on the value of IOP measured by these methods. The aim of this study was to compare the central corneal thickness (CCT) in children with congenital glaucoma and in healthy children. Material and methods. We examined 15 children aged from 7 months to 14 years (22 eyes) with congenital glaucoma. In the healthy children group, 26 subjects from 7 to 17 years old (51 eyes) were examined. CCT was measured in all subjects using the optical coherence tomograph Carl Zeiss Cirrus HD-OCT 5000 with an external lens for cornea scanning. The examination was carried out in pachymetry mode; the average thickness of the central ring having a diameter of 2 mm was evaluated. Results. Central corneal thickness in children with glaucoma ranged from 471 to 771 microns, the average value was 561.5±72.26 microns. In the group of healthy children, CCT was in the range of 480-597 microns with an average value of 529.88±29.33 microns. Thus, we noted a higher average value of the central corneal thickness and its higher variability in children with glaucoma in comparison with the group of healthy children. Conclusion. All children with glaucoma and suspected glaucoma should routinely perform pachymetry prior to applanation tonometry. One should consider the central corneal thickness when assessing intraocular pressure. Key words: congenital glaucoma, pachymetry, optical coherence tomography, central corneal thickness, applanation tonometry, intraocular pressure.
Analysis of COVID-associated posterior eye segment lesions for the period from may 2020 to april 2021 in the Budgetary institution of the Chuvash Republic «Republican clinical ophthalmological hospital» of the Ministry of healthcare of the Chuvash Republic
Authors:   The Budgetary Institution of the Chuvash Republic «Republican Clinical Ophthalmological Hospital» of the Ministry of Healthcare of the Chuvash Republic, Cheboksary, Leonteva M.Y. , Arsiutov D.G. ,   The Budgetary Institution of the Chuvash Republic «Republican Clinical Ophthalmological Hospital» of the Ministry of Healthcare of the Chuvash Republic, Cheboksary,   The State Independent Institution of Additional Professional Education «Institute for Advanced Medical Studies» of the Ministry of Healthcare of the Chuvash Republic, Cheboksary,   The Federal State Budgetary Educational Institution of Higher Education «The Chuvash State University named after I.N. Ulyanov», Cheboksary
Published: June 2021

Purpose. To evaluate COVID-associated lesions of the posterior segment of the eye and analyze them in terms of severity. Material and methods. The study was carried out at the Republican Clinical Ophthalmological Hospital of the Ministry of Healthcare of Chuvashia, Cheboksary. For the period from May 2020 to April 2021, 58 complaints were registered from patients with a sharp deterioration in vision against the background of a confirmed coronavirus infection. All patients underwent a standard ophthalmologic examination. After the examination and verification of the diagnosis, the patients were divided into two groups. The first group: COVID - associated vascular diseases of the posterior segment of the eye, and the second group - COVID - associated inflammatory diseases of the posterior segment of the eye. Results. In the first group, when macular edema was detected using OCT, intravitreal instillation of ranibizumab (the average number of injections was 3) followed by paravasal laser coagulation of the retina. In the second group, patients received pathogenetic therapy - glucocorticosteroids, non-steroidal anti-inflammatory, desensitizing drugs both locally and systemically, cycloplegia. We noted that COVID-associated inflammatory diseases of the posterior eye segment are distinguished by the severity of the course, a tendency to relapse and, often, an unfavorable outcome. Conclusions. Coronavirus infection tends to affect the posterior segment of the eye. COVID-associated diseases of the posterior segment of the eye are distinguished by the severity of the course, a tendency to relapse and, often, an unfavorable outcome. In young patients, inflammatory manifestations of coronavirus infection in the posterior segment of the eye predominate. It can be assumed that coronavirus infection is neurotropic according to the frequent involvement of the optic nerve in the pathological process. Key words: coronavirus infection, posterior segment of the eye, COVID-associated vascular diseases of the posterior segment of the eye, COVID-associated inflammatory diseases of the posterior segment, neurotropicity.
Analysis of keratopographic and biomechanical corneal indicators with evaluation of the impact of diagnostic results on myopic refraction patient management tactics
Authors:   S.N. Fedorov NMRC «MNTK «Eye Microsurgery», Volgograd Branch, Sibakin D.D. , Breev V.A. ,   S.N. Fedorov NMRC «MNTK «Eye Microsurgery», Volgograd Branch, Solodkova E.G. ,   S.N. Fedorov NMRC «MNTK «Eye Microsurgery», Volgograd Branch
Published: June 2021

Purpose. To analyse keratopographic and biomechanical corneal indicators with the diagnostic results assessment of the influence on the treatment tactics of myopic refraction patient. Materials and methods. Keratotopographic and biomechanical parameters of the cornea in a patient with mild myopia were evaluated. Results. The Belin/Ambrosio (Enchanced Ectasia Display) - BAD keratoconus screening program was used on Pentacam HR, which did not reveal corneal pathology. According to the results of CBI (Corvis biomechanical index) on Corvis ST (OD - 0.61, OS - 0.48), that was indicating poor corneal biomechanical properties and a high risk of keratectasia development. Conclusion. Ophthalmic examination, using The Corvis ST (Oculus, Germany) biomechanical measurements, makes possible to reveal with greater sensitivity subclinical signs of a keratectatic process at the pre-clinical stage of development. Key words: keratotopography, corneal biomechanics, keratoconus.
Experimental evaluation of antifibrotic effect of pirfenidone in dacryocystorhinostomy
Authors:   Research Institute of Eye Diseases, Moscow, Rein D.A. , Atkova E.L. ,   Research Institute of Eye Diseases, Moscow
Published: June 2021

One of the main reasons of failure in surgical treatment of dacryocystitis is cicatrical closure of the ostium. Considering controversial data on efficacy and safety of antifibrotic methods currently employed during dacrycystorhinostomy, searching for new ways to prevent fibrosis remains one of the main directions of research in dacryology. Pirfenidone, a small-molecule agent, was demonstrated to have a pronounced antifibrotic effect in experiments both in the eye and various other organs. Aim. To experimentally evaluate the antifibrotic effect of pirfenidone in dacryocystorhinostomy. Material and methods. 18 shinshilla rabbits were used in the current study. Subjects underwent modified dacryocystorhinostomy followed by 0,15 or 0,3 mg/ml pirfenidone injection circumostially. Animals were divided into groups based on pirfenidone dosage used. Control group animals received no injection. Rabbits were killed on the 7th (6 rabbits), 14th (6 rabbits) and 28th day (6 rabbits) following surgery. Ostium patency was evaluated using lacrimal irrigation and morphologically once the animal was killed. Ostium tissue samples were analyzed histologically. Results. Cicatrical closure of the ostium was observed in 4 subjects from control group on days 14 and 28 following surgery. The most pronounced fibrotic changes were also noted in tissue specimens obtained from these rabbits. Fibrotic changes in groups 1 and 2 were notably less severe than in control group. Conclusion. Data obtained in the current study evidences high antifibrotic efficacy of pirfenidone. This necessitates further research of pirfenidone use in dacryocystorhinostomy. Key words: dacryocystorhinostomy, ostium closure, dacryostoma, pirfenidone, antifibrotic therapy.
Comparative evaluation of the results of simultaneous and two-stage surgical treatment of patients with advanced proliferative diabetic retinopathy and complicated incipient cataract.
Authors:   N. Pirogov's National Medical Surgical Center, Moscow, Konovalova K.I. , Shishkin M.M. ,   N. Pirogov's National Medical Surgical Center, Moscow
Published: June 2021

Aim. Undertake a comparative analysis of the results two-stage or simultaneously vitreoretinal surgery with phacoemulsification of PDR patients. Material and methods. 52 cases of surgery treatment of patients with PDR and complicated primary cataract were analyzed. These patients were divided into three groups. In the 1st group patients were subjected to a two–step surgical procedure: vitreoretinal surgery with gas tamponade performed as the 1st step in their treatment; followed by the 2d step, phacoemulsification surgery and the IOL implantation. In the 2d group phacoemulsification performed simultaneously with vitreoretinal surgery: phacoemulsification, IOL implantation, vitreoretinal surgery with gas tamponade. Results. Outcomes of the preliminary studies suggest that it is more viable to perform phacoemulsification surgery sometime later along on PDR patients with complicated primary cataract. Conclusions. This sequence of treatment procedure ensures a more gentle approach to the anatomic structures of the eye during the first stage (vitreoretinal surgery) and contributes to the reduction in the number of intraoperative and postoperative complications. Key words: diabetic retinopathy, cataract, vitreoretinal surgery.
Treatment of Coates retinitis in both eyes in a 5-year-old girl
Authors:   V.F. Voyno-Yasenetsky Scientific and Practical Center for Specialized Medical Care for Children, Department of Healthcare, Moscow, Nazarenko A.O. , Sidorenko E.E. ,   V.F. Voyno-Yasenetsky Scientific and Practical Center for Specialized Medical Care for Children, Department of Healthcare, Moscow,   Pirogov Russian National Research Medical University, Moscow, Suhanova I.V. ,   V.F. Voyno-Yasenetsky Scientific and Practical Center for Specialized Medical Care for Children, Department of Healthcare, Moscow, Shavaleeva A.R. ,   Pirogov Russian National Research Medical University, Moscow
Published: June 2021

Purpose. To present a rare clinical case of bilateral Coates retinitis in a 5-year-old girl. Material and methods. A clinical case of a 5-year-old girl with rare Coat's retinitis in both eyes is described. The disease occurred abruptly: the child's parents noted the appearance of leukocoria in the right eye. After the examination Coates ' retinitis was diagnosed. At the time of examination in the clinic, there was a retinal detachment in the right eye, the surgical treatment was performed: lensvitrshvartectomy, plastic surgery of the anterior chamber, with the melting of the retina with perfluoroorganic compounds, drainage of subretinalfluid, endolaser coagulation on the right eye. A month after the first symptoms appeared in the right eye, the patient complained of decreased vision in the left eye. Examination on the pediatric retinal camera showed an increase in vascular activity in the left eye, and signs of Coats' retinitis were revealed. Results. As a therapy for this disease, the patient was twice injected intravitreally inhibitor of vascular endothelial growth factor (VEGF inhibitor) into the left eye with positive dynamics noted as a decrease in the activity of retinal vessels and leveling of the exudative component, as well as with an increase in visual acuity in the left eye. Conclusion. This clinical case demonstrates that intravitreal administration of inhibitor VEGF with traditional methods of treatment can be used as a treatment for patients with Coates retinitis. Key words: Coat's retinitis, Coats' disease, vascular endothelial growth factor inhibitor, aflibercept, intravitreal injection, anti-VEGF, retinal detachment.
Tıp Fakültesi Öğrencilerinin Hekimlik Değer Algıları
Authors: ONCU Selcen , EREL Özlem
Published: June 2021

Amaç: İyi bir hekim olmak ve hekimlik değerlerini kazanmak için mezuniyet öncesi tıp eğitimi büyük önem taşımaktadır. Çalışmamızda, Aydın Adnan Menderes Üniversitesi Tıp Fakültesi öğrencilerinin hekimlik mesleğini nasıl algıladıkları ve bu algıyı etkileyen etmenlerin belirlenmesi amaçlanmıştır. Yöntem: Çalışmamız, Ekim 2019–Ocak 2020 tarihleri arasında Aydın Adnan Menderes Üniversitesi Tıp Fakültesi’nde eğitim görmekte olan öğrencilerle gerçekleştirilmiş, tanımlayıcı tipte bir araştırmadır. Çalışma 751 gönüllü öğrencinin katılımıyla gerçekleştirilmiştir. Veri toplamada kullanılan anket formu; kişisel bilgilerin ve bir adet açık uçlu sorunun yer aldığı ilk bölüm ile Gökler ve ark.ları tarafından 2017 yılında geliştirilen Hekimlik Değer Algısı (HDA) Ölçeğinden oluşmaktadır. Ölçek; 3 alt boyuttan (hekim tutumu, hasta hekim ilişkisi, hekimin empati yeteneği) ve 18 olumlu maddeden oluşan 5’li Likert olarak hazırlanmıştır. Veri analizinde gruplar arası karşılaştırmalarda değişkenler normal dağılım göstermediği için Mann Whitney U ve Kruskall Wallis testleri kullanılmıştır.Bulgular: Yaşları 18-29 yıl (ortalama 20.36 ±0.07) arasında değişmekte olan katılımcıların %47,4’ü kadın; 41,5’i birinci, %18,8 ikinci, %15,4 üçüncü, %7,6 dördüncü, %12,6 beşinci, %4 altıncı sınıftı. HDA ölçeğinden alınan ortalama puan 79.56± 7.2 (27-90); tutum puanı 36.88±3.4 (10-40); ilişki puanı 22.27±2.2 (7-25); empati puanı 15.61±3.0’dır (6-20). Kadın katılımcıların tutum alt boyut puanı 37.25±3.1 (p=0,009), erkeklerin empati alt boyut puanı 15.24±2.9 (p=0,00) anlamlı olarak yüksek bulunmuştur. Sınıflar arası farklılık istatistiksel olarak anlamlı bulunmuştur (p<0,001). HDA puanı 1. sınıflarda yüksek iken 3. sınıfa doğru azalmış, 4. sınıfta yeniden yükselmiştir. Akademik başarı algısı yükseldikçe HDA ortalama puanın anlamlı olarak arttığı (p=0.003) tespit edilmiştir. Katılımcıların “İyi bir hekim nasıl olmalıdır?” sorusuna verdikleri ilk üç yanıt; bilgili (%31,2), iyi iletişim becerilerine sahip (%23,7), sabırlı (%20) olarak belirlenmiştir.Sonuç: HDA ve alt boyutların tümünde en yüksek puanların birinci sınıflara, en düşük puanların ise üçüncü sınıflara ait olduğu saptanmıştır. Akademik başarı algısı yüksek olan öğrencilerin HDA puanları da yüksek bulunmuştur.
Pulmonary Tuberculosis Outbreak in a High School, China
Authors:   National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, China, Zhou Yang ,   National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, China, Zhao Bing ,   National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, China, Li Tao ,   National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, China, Cheng Qian ,   National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, China, Zhao Yanlin ,   National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, China, Tang Yi ,   Hunan Institute for Tuberculosis Control, China, Wang Qiaozhi ,   Hunan Institute for Tuberculosis Control, China, Zhong Liang ,   Hebei Provincial Key Laboratory of Basic Medicine for Diabetes, Shijiazhuang Second Hospital, China
Published: June 2021

This study reports an outbreak of Tuberculosis (TB) in a high school in Hunan province, China during January 2017-April 2018. Contact investigation and TB screening were conducted through symptom screening, tuberculin skin testing, chest radiography and smear examination. Identification of positive isolates and drug susceptibility phenotype were assessed by standard method. Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR) and Whole Genome Sequencing (WGS) were performed to investigate the relationships among the positive isolates. A total of 90 students and one teacher were diagnosed active pulmonary TB among 2908 students and 188 staff, with an attack rate of 2.94%. Thirteen positive isolates were identified as drug susceptible Beijing family of Mycobacterium tuberculosis. Results of MIRU-VNTR typing and WGS revealed two clones of Mycobacterium tuberculosis circulating during outbreak. One hundred and twenty-nine Single Nucleotide Polymorphisms (SNPs) discriminated the isolates in two clusters; the maximum number of SNPs between any pair of isolates in each cluster was five or fewer. Our findings highlight the importance of early identification and isolation of the TB cases to prevent spread of TB. WGS provides better resolution than MIRU-VNTR to identify recent transmission in TB outbreak.
Cardiovascular magnetic resonance in myocardial infarction with non-obstructive coronary arteries
Authors: Pershina Ekaterina S. , Shchekochikhin Dmitry Yu. , Shaginyan Georgii M. , Shilova Alexandra S. , Sherashov Andrei V. , Poltavskaya Maria G. , Isaeva Saida Kh. , Gilyarov Mihail Yu. , Svet Alexey V. , Sinitsyn Valentin E.
Published: June 2021

Aim. To analyze diagnostic performance of cardiovascular magnetic resonance (CMR) in patients, presented with myocardial infarction with nonobstructed coronary arteries (MINOCA).
Materials ant methods. 46 consecutives patients presented with myocardial infarction without evidence of obstructive coronary disease on angiography between January, 1 2018 and October 1, 2019 were included in the study. All patients underwent CMR within 10 days after admission. MRI was performed on 1.5 T Magnetic Resonance Imaging (MRI) using comprehensive protocol (T2-images, Cine-CMR, late gadolinium enhancement (LGE)).
Results. CMR revealed myocardial infarction (MI) pattern in 14 patients (30.4%), myocarditis in 12 (26.1%), hypertrophic cardiomyopathy in 6 (13.1%). In 14 patients (30.4%) no LGE was observed. Notably in 2 patients without LGE features of takotsubo syndrome were noted. Mean age was significantly lower in patients with MI versus patient with non-ischemic causes of MINOCA (56.112.3 vs 64.612.8; p=0.04). ST elevation at admission frequency didnt differ between MI and non-ischemic patients (35.7% vs 25.0%; p=0.76). However MI patients had significantly increased troponin level, 0.87 [0.22; 1.85] vs 0.22 [0.07; 0.38]; p=0.008. CMR allowed to establish the prcised clinical diagnosis in 73.9% of the cases.
Conclusion. Clinical data doesnt allow to differentiate ischemic or non-ischemic causes of MINOCA. However, CMR establish the correct diagnosis in most cases.
Analysis of the effectiveness of multiple myeloma treatment based on the clinical experience of European countries
Authors: Ptushkin Vadim V. , Mueller Mario
Published: June 2021

Aim. The main aim of this study was to model the effectiveness of multiple myeloma (MM) therapy using machine learning, which was based on the analysis of various methods of MM treatment, a number of prognostic factors and their results in the daily routine clinical practice of medical centers in European countries.
Materials and methods. The present study was retrospective, non-interventional, multicenter. A structured database of MM patients provided by the Oncology Information service (O.I.s.) was used for the study. Registration took place in medical institutions in eight countries: Austria, Belgium, Switzerland, Germany, Spain, France, Greece and Great Britain.
Results. In total, 57% of men and 43% of women were analyzed in the base of 6074 patients with MM. The median age was 71 years. The median follow-up time along the lines was 387 days. High-risk cytogenetics are represented in 15% of cases. The efficacy endpoint was the best response to each line of therapy, as measured by time to death (TTD) as an indirect indicator of overall survival and time to next treatment (TTNT) as an indirect indicator of progression-free survival. The median TTD and TTNT were 730 and 399 days respectively. After a multi-step selection process, characteristics with the greatest importance for the therapy prognosis were selected: age at the beginning of therapy, line of therapy, time after MM verification, ECOG (Eastern Cooperative Oncology Group), cytogenetic risk, transplant eligibible or not, TTNT after the previous line of therapy, therapy regimen.
Discussion. To continue the study it is necessary to analyze literature data and compare with real practice. Also analysis and comparison with Russian data on the treatment of patients with MM is required.
Conclusion. The analysis of the presented data provides a basis for modeling a tool for assessing the effectiveness of MM therapy (prognosis of TTD and TTNT) for each patient, based on a number of prognostic factors and the results of routine clinical practice in various medical centers in European countries.
Impact of summer heat waves on key parameters of oxidative stress in patients with coronary artery disease
Authors: Osyaeva Mariia K. , Tikhaze Alla K. , Konovalova Galina G. , Heimets Grigorii I. , Martynyuk Tamila V. , Lankin Vadim Z.
Published: June 2021

Aim. To assess the impact of summer heat waves on key parameters of oxidative stress in patients with coronary heart disease.
Materials and methods. We included 30 male patients aged 5213 years with stable angina pectoris of IIIII functional class with at least one coronary artery stenosis proved by angiography (ischemic group) in comparison with 10 male patients aged 487 years with no angiographic sings of significant coronary stenosis and without angina manifestation (non-ischemic group). The following parameters were studied: activity of superoxide dismutase (Cu,Zn-SOD), catalase (CAT), glutathione peroxidase (GSH-Px), the level of malondialdehyde (MDA) and MDA-modified low-density lipoproteins (MDA-LDL). The analysis of indicators was performed at normal average daily temperature (daytime temperature not higher than 20С) and after a heat wave (daytime temperature above 27C for more than 2 consecutive days).
Results. Our study revealed the decrease of CAT and GSH-Px activities with increased activity of Cu,Zn-SOD in both groups after the heat wave. At the same time we observed accumulation of MDA and increased MDA-LDL level in both groups. Initially ischemic patients showed significantly increased level of CAT and GSH-Px activity compared to the non-ischemic group, while it was no difference in activity of Cu,Zn-SOD and MDA and MDA-LDL level. We observed significant reduce of Cu,Zn-SOD activity in ischemic patients compared to non-ischemic group with no significant differences in all other studied parameters of oxidative stress after heat wave.
Conclusion. Changes in the key parameters of oxidative stress in patients with ischemic heart disease during summer heat waves are comparable to those in patients without ischemia, however significantly greater inhibition of GSH-Px activity and significantly lower increase in Cu,Zn-SOD activity was noted. These results may indicate misregulation of free radical processes in patients with ischemic heart decease
AL-amyloidosis with cardiac involvement. Diagnostic capabilities of non-invasive methods
Authors: Gudkova Alexandra Ya. , Lapekin Sergei V. , Bezhanishvili Tinatin G. , Trukshina Maria A. , Davydova Victoria G. , Krutikov Aleksandr N. , Kulikov Aleksandr N. , Streltsova Anna A. , Andreeva Sofiia E. , Grozov Roman V. , Poliakova Anzhelika A. , Kostareva Anna A. , Salogub Galina N. , Shlyakhto Evgenii V.
Published: June 2021

There are presented the literature data and a description of the clinical course of the disease in isolated/predominant cardiac amyloidosis. Amyloid cardiomyopathy is the most common phenocopy of hypertrophic cardiomyopathy. The modern possibilities of non-invasive diagnostics using osteoscintigraphy for the differential diagnosis between amyloid cardiomyopathy caused by AL- and transthyretin amyloidosis are described in detail.
Exocrine pancreas insufficiency: clinical significance and approaches to correction from evidence medicine
Authors: Maev Igor V. , Kucheryavyy Yury A. , Andreev Dmitry N.
Published: June 2021

Exocrine pancreatic insufficiency (EPI) is a common complication of both benign and malignant diseases of the pancreas, as well as a consequence of radical surgical operations on the pancreas and a whole range of other variable extra-pancreatic causes. In clinical practice in the adult population, most cases of EPI are associated with chronic pancreatitis, while in the pediatric population with cystic fibrosis. The regression of the production of digestive enzymes in EPI mediates the development of the syndrome of maldigestion and malabsorption, leading to the progressive development of malnutrition, the importance of which is often underestimated by practitioners. At the same time, the development of nutritional deficiency is not just a complication of EPI, but also has an important effect on the course of the underlying causative disease, worsening the prognosis and quality of life of the patient, and is also a proven risk factor for osteoporosis and sarcopenia. To date, compensation for the absolute deficiency of pancreatic enzymes using enzyme replacement therapy is the only possible way to correct the EPI and prevent nutritional deficiency.
Peculiarities of Mild Asthma in Russia: the Results of SYGMA2 Study
Authors: Aisanov Zaurbek R. , Avdeev Sergey N. , Arkhipov Vladimir V. , Belevsky Andrey S. , Voznesenskiy Nikolay A.
Published: June 2021

Aim. Patients with mild asthma may experience severe exacerbations. This analysis was conducted to investigate regional peculiarities of mild asthma population in Russia.
Materials and methods. The SYGMA2 is a double-blind multinational study involving adult patients with mild asthma (n=4176). We conducted an open-label descriptive analysis of the baseline characteristics of the Russian group (n=579) of SYGMA2 trial comparing to SYGMA2 population from other countries. The subanalysis was descriptive only, and no hypothesis were tested.
Results. The Russian population of patients with mild asthma was comparable to the rest of countries in terms of demographic characteristics, smoking status and duration of asthma. The spirometric parameters in the Russian group was slightly worse than in the other population. At the study entry 48% of Russian patients had symptom control on maintenance therapy, but 52% were uncontrolled on short-acting bronchodilators. While in other countries this ratio was inverse (55/45%). More patients with mild asthma in the Russian group had at least one severe exacerbation in the previous year (30.1% vs 20.7% in other countries).
Conclusion. We revealed a delayed prescription of controller therapy and overuse of short-acting bronchodilators in the Russian group of mild asthma patients, that may increase risk of asthma non-control and severe exacerbation.