bluuebunny/crossref_metadata_2025 huggingface dataset:
Até quando prolongar a vida?
Authors: SILVA GALDINO CARDIN VALERIA , MORAES GIL NERY LAIS
Published: January 2021

O prolongamento da vida, a obstinação terapêutica, ou seja, a distanásia lesiona os direitos fundamentais, como a autonomia da vontade, a dignidade humana. Os avanços das práticas médicas, no século XX, geraram inúmeros benefícios para este campo, porém estes avanços permitiram um controle das funções fisiológicas do paciente, o que gerou a possibilidade de prolongar a vida. A distanásia é o prolongamento desnecessário da vida, que gera angustia, dor, sofrimento para o paciente e seus familiares. O objetivo deste trabalho é a compreensão de como a prática da distanásia, a obstinação terapêutica, o tratamento inútil gera uma lesão aos direitos fundamentais, ou seja, como essa prática fere os princípios da dignidade da pessoa humana, da liberdade, da autonomia da vontade. Trata-se de um estudo realizado por meio de revisão bibliográfica e documental, descritivo e explicativo. O fato de quebrar o ciclo natural da morte, prolongando a vida não proporciona uma morte digna, mas sim, uma morte com sofrimento e dor desnecessários. Nesse último momento é essencial o respeito a autonomia da vontade e a preservação da dignidade humana.
A Live Video Mind-Body Treatment to Prevent Persistent Symptoms Following Mild Traumatic Brain Injury: Protocol for a Mixed Methods Study (Preprint)
Authors: Greenberg Jonathan , Singh Tanya , Iverson Grant L , Silverberg Noah D , Macklin Eric A , Parker Robert A , Giacino Joseph T , Yeh Gloria Y , Vranceanu Ana-Maria
Published: January 2021

BACKGROUND

Every year, approximately 42 million people sustain a mild traumatic brain injury (mTBI, also known as concussion), with particularly high rates among college-aged individuals. A substantial proportion of these people (44%-64%) develop persistent symptoms that are challenging to treat, costly, and associated with significant disability. Anxiety has emerged as a risk factor for progression from acute to persistent mTBI symptoms.

OBJECTIVE

This study aims to develop, adapt, and establish the feasibility of the Toolkit for Optimal Recovery after Concussions (TOR-C), an innovative mind-body program aimed at preventing persistent symptoms among young adults with mTBI and comorbid anxiety. Here, we describe the proposed study design, methodology, measurement, and treatment manuals.

METHODS

In phase 1, we will conduct individual, live video qualitative interviews (up to n=20) with college-aged individuals with mTBI and comorbid anxiety to inform adaptation of the intervention and study procedures. In phase 2, an open pilot of the live video TOR-C (n=5) with exit interviews will be conducted to explore the initial feasibility, acceptability, and credibility of the program and to refine the study procedures. Phase 3 will involve conducting a feasibility randomized controlled trial (N=50) of the TOR-C versus a health education control (Health Enhancement for Concussions; HE-C), both delivered via live video, to establish feasibility of recruitment procedures (screening, eligibility, and enrollment) and data collection; feasibility, credibility, and acceptability of the live video TOR-C and HE-C (adherence, retention, fidelity, and satisfaction) following prespecified benchmarks; and a signal of improvement in outcomes.

RESULTS

Phase 1 of the study has been approved by the Massachusetts General Hospital Institutional Review Board. Study completion is anticipated by early 2025.

CONCLUSIONS

We will develop and test the first mind-body intervention focused on prevention of persistent symptoms following mTBI in young adults with comorbid anxiety problems. This will allow us to establish feasibility markers in postconcussive symptoms, anxiety, disability, and fear avoidance to inform a future efficacy trial of the TOR-C versus HE-C.

INTERNATIONAL REGISTERED REPORT

PRR1-10.2196/25746
Using Fear and Anxiety Related to COVID-19 to Predict Cyberchondria: Cross-sectional Survey Study (Preprint)
Authors: Wu Xue , Nazari Nabi , Griffiths Mark D
Published: January 2021

BACKGROUND

Studies have highlighted that fear and anxiety generated by COVID-19 are important psychological factors that affect all populations. There currently remains a lack of research on specific amplification factors regarding fear and anxiety in the context of the COVID-19 pandemic. Despite established associations between anxiety sensitivity, intolerance of uncertainty, and cyberchondria, empirical data investigating the associations between these three variables, particularly in the context of the COVID-19 pandemic, are currently lacking. Urgent research is needed to better understand the role of repeated media consumption concerning COVID-19 in amplifying fear and anxiety related to COVID-19.

OBJECTIVE

This study investigated the associations between fear of COVID-19, COVID-19 anxiety, and cyberchondria.

METHODS

Convenience sampling was used to recruit respondents to participate in an online survey. The survey, which was distributed via social media and academic forums, comprised the Cyberchondria Severity Scale, Fear of COVID-19 Scale, Coronavirus Anxiety Scale, Anxiety Sensitivity Index, and Intolerance of Uncertainty Scale. Multiple mediation analyses were conducted using structural equation modeling.

RESULTS

A total of 694 respondents (males: n=343, females: n=351) completed the online survey. The results showed that fear and anxiety generated by COVID-19 predicted cyberchondria (fear: β=.39, SE 0.04, P<.001, t=11.16, 95% CI 0.31-0.45; anxiety: β=.25, SE 0.03, P<.001, t=7.67, 95% CI 0.19-0.32). In addition, intolerance of uncertainty and anxiety sensitivity mediated the relationship between fear and anxiety generated by COVID-19 with cyberchondria. In a reciprocal model, the standardized total effects of cyberchondria on fear of COVID-19 (β=.45, SE 0.04, P<.001, t=15.31, 95% CI 0.39-0.51) and COVID-19 anxiety (β=.36, SE 0.03, P<.001, t=11.29, 95% CI 0.30-0.41) were statistically significant, with moderate effect sizes. Compared to males, females obtained significantly higher scores for cyberchondria (t1,692=–2.85, P=.004, Cohen d=0.22), COVID-19 anxiety (t1,692=–3.32, P<.001, Cohen d=0.26), and anxiety sensitivity (t1,692=–3.69, P<.001, Cohen d=0.29).

CONCLUSIONS

The findings provide a better understanding of the role of COVID-19 in amplifying cyberchondria. Based on these results, cyberchondria must be viewed as a significant public health issue. Importantly, increasing awareness about cyberchondria and online behavior at both the individual and collective levels must be prioritized to enhance preparedness and to reduce the adverse effects of current and future medical crises.
Risk Assessment of Importation and Local Transmission of COVID-19 in South Korea: Statistical Modeling Approach (Preprint)
Authors: Lee Hyojung , Kim Yeahwon , Kim Eunsu , ‍Lee Sunmi
Published: January 2021

BACKGROUND

Despite recent achievements in vaccines, antiviral drugs, and medical infrastructure, the emergence of COVID-19 has posed a serious threat to humans worldwide. Most countries are well connected on a global scale, making it nearly impossible to implement perfect and prompt mitigation strategies for infectious disease outbreaks. In particular, due to the explosive growth of international travel, the complex network of human mobility enabled the rapid spread of COVID-19 globally.

OBJECTIVE

South Korea was one of the earliest countries to be affected by COVID-19. In the absence of vaccines and treatments, South Korea has implemented and maintained stringent interventions, such as large-scale epidemiological investigations, rapid diagnosis, social distancing, and prompt clinical classification of severely ill patients with appropriate medical measures. In particular, South Korea has implemented effective airport screenings and quarantine measures. In this study, we aimed to assess the country-specific importation risk of COVID-19 and investigate its impact on the local transmission of COVID-19.

METHODS

The country-specific importation risk of COVID-19 in South Korea was assessed. We investigated the relationships between country-specific imported cases, passenger numbers, and the severity of country-specific COVID-19 prevalence from January to October 2020. We assessed the country-specific risk by incorporating country-specific information. A renewal mathematical model was employed, considering both imported and local cases of COVID-19 in South Korea. Furthermore, we estimated the basic and effective reproduction numbers.

RESULTS

The risk of importation from China was highest between January and February 2020, while that from North America (the United States and Canada) was high from April to October 2020. The R0 was estimated at 1.87 (95% CI 1.47-2.34), using the rate of α=0.07 for secondary transmission caused by imported cases. The Rt was estimated in South Korea and in both Seoul and Gyeonggi.

CONCLUSIONS

A statistical model accounting for imported and locally transmitted cases was employed to estimate R0 and Rt. Our results indicated that the prompt implementation of airport screening measures (contact tracing with case isolation and quarantine) successfully reduced local transmission caused by imported cases despite passengers arriving from high-risk countries throughout the year. Moreover, various mitigation interventions, including social distancing and travel restrictions within South Korea, have been effectively implemented to reduce the spread of local cases in South Korea.
Vaccines for All: Challenges and Potential Solutions for Equitable COVID-19 Vaccine Distribution (Preprint)
Authors: Bae Joseph , Blumenthal Susan , Dhaliwal Jagjit , Bergin Shirley , Sarma Sanjay , Raskar Ramesh
Published: January 2021

UNSTRUCTURED

As several COVID-19 vaccine candidates are being approved for human use, governments around the world are preparing comprehensive frameworks and protocols to address potential obstacles for equitable distribution. In this paper, we identify challenges for vaccine distribution in four core areas - supply chain logistics, monitoring of health outcomes, recipient engagement, and public health communication. Inequitable vaccine allocation, variation in vaccine efficacy and the duration of immunity, barriers to multi-dose adherence, and widespread misinformation are among the most critical issues that must be addressed. While many of these challenges have been previously identified and planned for, some have not been thoroughly addressed to target the needs of diverse population groups for which significant health disparities have been identified.
To address these challenges, governments and private sector corporations have partnered to develop public health policies, vaccine administration frameworks, and technological solutions. In this paper we describe both traditional and modernized solutions to challenges in vaccine distribution and compare the merits of each approach. We firmly believe that privacy-oriented, interoperable digital solutions can help ensure the equitable distribution of vaccines for all.
Exploring the Associations Between Self-reported Tendencies Toward Smartphone Use Disorder and Objective Recordings of Smartphone, Instant Messaging, and Social Networking App Usage: Correlational Study (Preprint)
Authors: Marengo Davide , Sariyska Rayna , Schmitt Helena Sophia , Messner Eva-Maria , Baumeister Harald , Brand Matthias , Kannen Christopher , Montag Christian
Published: January 2021

BACKGROUND

Social communication via instant messaging (IM) and social networking (SN) apps makes up a large part of the time that smartphone users spend on their devices. Previous research has indicated that the excessive use of these apps is positively associated with problematic smartphone use behaviors. In particular, image-based SN apps, such as Instagram (Facebook Inc) and Snapchat (Snap Inc), have been shown to exert stronger detrimental effects than those exerted by traditional apps, such as Facebook (Facebook Inc) and Twitter (Twitter Inc).

OBJECTIVE

In this study, we investigated the correlation between individuals’ tendencies toward smartphone use disorder (SmUD) and objective measures of the frequency of smartphone usage. Additionally, we put to test the hypothesis that the pathway linking the frequency of actual smartphone usage to self-reported tendencies toward SmUD was mediated by the increased frequency of IM and SN app usage.

METHODS

We recruited a sample of 124 adult smartphone users (females: 78/124, 62.9%; age: mean 23.84 years, SD 8.29 years) and collected objective information about the frequency of smartphone and SN app usage over 1 week. Participants also filled in a self-report measure for assessing the multiple components of tendencies toward SmUD. Bivariate associations were investigated by using Spearman correlation analyses. A parallel mediation analysis was conducted via multiple regression analysis.

RESULTS

The frequency of smartphone usage, as well as the use of IM apps (Messenger, Telegram, and WhatsApp [Facebook Inc]), Facebook, and image-based apps (Instagram and Snapchat), had significant positive associations with at least 1 component of SmUD, and the cyberspace-oriented relationships factor exhibited the strongest associations overall. We found support for an indirect effect that linked actual smartphone usage to SmUD tendencies via the frequency of the use of image-based SN apps.

CONCLUSIONS

Our novel results shed light on the factors that promote SmUD tendencies and essentially indicate that image-based SN apps seem to be more strongly associated with problematic smartphone behaviors compared to IM apps and traditional SN apps, such as Facebook.
BEES AND WASPS VENOM TOXINS, ITS IMMUNE-ALLERGIC RESPONSES, DIAGNOSIS AND THERAPEUTICS
Authors: PRAJAPATI KRISHNA KUMAR , UPADHYAY RAVI KANT
Published: January 2021

Present article explains insect toxins, its immune allergic, pharmaceutical and therapeutic effects. Insect venom glands generate enzymatic and non-enzymatic toxins and are inflicted by the stings. Insect’s envenomation are highly painful, inflamed and life-threatening. It causes breathing difficulties, bronchospasm, hypotension and arrhythmia, cardiopulmonary problems, and imposes allergic reactions. Wasp venom toxins generate strong T-cell responses in hypersensitivity patients and stimulate the production of IgE antibody molecules. Massive envenomations causes the death of victims due to the toxic effects of the venom toxins if clinical treatment is delayed. This article also emphasizes the role of natural and recombinant toxins for the development of highly sensitive immune-assays for diagnosis of allergen-specific tolerance, its early and delayed effects in patients to avoid fatal anaphylactic reactions. It also directs about the essentiality of immune diagnostics, vaccines and antiserum therapy in high population density regions where incidences of wasp and bee envenomations are more frequently occur. Venom immunotherapy can restore normal immunity against venom allergens and may also provide lifetime tolerance against venoms. This article highlights the major effects of insect venom allergens, its diagnosis and venom immunotherapy.
Network meta-analysis of nivolumab plus ipilimumab in the second-line setting for advanced hepatocellular carcinoma
Authors: Parikh Neehar D , Marshall Alexander , Betts Keith A , Song Jinlin , Zhao Jing , Yuan Muhan , Wu Aozhou , Huff Keith D , Kim Richard
Published: January 2021

Aims:
To compare the efficacy of nivolumab 1 mg/kg + ipilimumab 3 mg/kg with regorafenib 160 mg, cabozantinib 60 mg and nivolumab 3 mg/kg monotherapy for second-line treatment of advanced hepatocellular carcinoma.
Materials & methods:
Indirect comparison using network meta-analysis and propensity score weighting.
Results:
 Nivolumab 1 mg/kg + ipilimumab 3 mg/kg had significantly higher objective response rate (median 31.2% [95% credible interval: 19.6–44.5%]) than cabozantinib (4.2% [2.0–6.5%]) and regorafenib (4.8% [1.1–8.3%]), and significantly longer overall survival (cabozantinib: hazard ratio: 0.46 [95% credible interval: 0.27–0.79]; regorafenib: 0.56 [0.32–0.97]). Nivolumab 1 mg/kg + ipilimumab 3 mg/kg had significantly better objective response rate (difference 21.0% [4.5–37.5%]) and overall survival (hazard ratio: 0.58 [0.35–0.96]) than nivolumab monotherapy.
Conclusion:
 Nivolumab 1 mg/kg + ipilimumab 3 mg/kg had a superior efficacy versus cabozantinib 60 mg, regorafenib 160 mg and nivolumab 3 mg/kg monotherapy as second-line therapy for advanced hepatocellular carcinoma.
Cuando la vocación no te permite la sana distancia
Authors: Nicolás Nicolás Lesly Marissa
Published: January 2021

Este testimonio presenta un panorama de algunos de los retos docentes enfrentados a raíz del confinamiento por covid-19, en un Sistema de Educación de Nivel Superior. Se resalta el importante papel del docente en esta contingencia y el hecho de que no por trabajar desde casa todo es comodidad, pues la enseñanza requiere de vocación de servicio, empatía y preparación constante para la atención de necesidades no sólo académicas sino formativas en nuestros estudiantes.
¿Nativos o zombis digitales?
Authors: Ávila García Guillermina
Published: January 2021

Mi trabajo docente se distingue por el diseño de una secuencia didáctica que permite guiar el proceso de aprendizaje de los estudiantes en modalidad escolarizada. La tecnología la utilizaba como un complemento para el apoyo de dicho proceso. Sin embargo, el primer semestre del año 2020, debido a la pandemia, tomó un rumbo distinto. Se suspendió la educación presencial del cotidiano académico y la tecnología se volvió un parteaguas en el proceso de enseñanza-aprendizaje para las materias que imparto: física y matemáticas.
Saliendo de la zona de comodidad
Authors: Delgado Quiñones Edna Gabriela
Published: January 2021

En este relato describo los cambios que he pasado como docente, los obstáculos que he debido enfrentar para no perder las clases con mis alumnos, las preguntas y reflexiones que me he formulado durante este tiempo y, finalmente, las actividades que he desarrollado. Sin duda, esta contingencia ha sido una oportunidad para aprender, para que alumnos y docentes utilicemos la tecnología a nuestro favor, brinquemos obstáculos y, principalmente, desarrollemos habilidades propias como el autoconocimiento y la autorregulación, para llevar a cabo una metacognición.
El aula virtual y la olla exprés
Authors: Fortoul van der Goes Teresa I.
Published: January 2021

No es lo mismo emplear la computadora como editor de textos que como herramienta para armar un aula para un curso en línea. Además, durante esta pandemia, me he dado cuenta de que, a pesar de las diferencias generacionales, siempre hay algo que compartir entre madre e hija, como emplear la olla exprés.
Reconstrucciones de la identidad en El espíritu de mis padres sigue subiendo en la lluvia
Authors: Tornero Salinas Angélica
Published: January 2021

Los hijos de los desaparecidos y supervivientes de la dictadura argentina, a quienes no les corresponde ya atestiguar y cuya motivación es expresar sus dificultades para asumir una identidad propia, han optado por explorar formalmente las posibilidades literarias de las escrituras del yo desde un lugar de enunciación distinto del de sus padres. Es el caso de El espíritu de mis padres sigue subiendo en la lluvia (2011) de Patricio Pron, novela que para alcanzar este propósito utiliza como estrategias principales: la ficcionalización del yo, la memoria y la fotografía. En este artículo, sostenemos que con el uso de estas estrategias, la identidad se configura como proceso de deconstrucción y reconstrucción que va del yo alienado de sí mismo al reconocimiento de sí mismo como otro. En el primer inciso, hemos desarrollado una breve genealogía de las escrituras del yo en Argentina y su relación con la memoria con el fin de ofrecer elementos que permitan ubicar a la literatura de los hijos. En segundo término, analizamos la puesta en escena del yo autoral. Finalmente examinamos el desarrollo de la interpretación de las fotografías, que, a la vez, desvela el proceso de memoria y de constitución de la identidad.
Innovación: una perspectiva sociológica
Authors: Fernández-Esquinas Manuel
Published: January 2021

Este artículo ofrece un marco de análisis de la perspectiva sociológica sobre la innovación. Presenta una serie de herramientas que son útiles para estudiar la relación de la innovación con dimensiones sociales fundamentales.  Realiza una contribución al campo interdisciplinar de los estudios sobre la innovación a través de una serie de conceptos y mecanismos explicativos expuestos de manera sistemática. El artículo discute algunas limitaciones en los estudios sobre innovación para tratar fenómenos de naturaleza social y especifica el significado de la innovación desde los principios del canon sociológico. Aborda las relaciones de la innovación con algunos aspectos de la cultura  (normas, valores, repertorios cognitivos e instituciones) y de la estructura social (clases sociales, ocupaciones, redes y organizaciones).
Jóvenes boomerang en Andalucía; quiénes son y por qué regresan
Authors: Donat López Marta , Martín-Lagos López María Dolores
Published: January 2021

Ciertos jóvenes regresan al hogar familiar una vez emancipados, fenómeno conocido como boomerang. El fenómeno boomerang hace referencia al retorno al hogar familiar de los jóvenes tras haber vivido un periodo de emancipación. En este artículo se pretenden analizar los factores que influyen en la decisión de retornar, los modos en que se produce y los perfiles en el caso de jóvenes andaluces que vuelven al hogar familiar. Se ha analizado una encuesta de la juventud andaluza (2017) elaborada para el Diseño del III Plan Integral de Juventud de Andalucía. Los resultados muestran que determinadas variables y situaciones vividas aumentan la probabilidad de retornar -ser mujer, la intención de seguir estudiando, haber sido víctima de violencia o consumir ciertas sustancias estupefacientes de forma habitual-, mientras que otras la disminuyen -el aumento de edad, el mayor nivel de estudios, tener un contrato fijo, tener pareja estable o tener descendencia-.
¿Por qué se han organizado las camareras de piso? Algunas claves e interpretaciones desde la revitalización sindical
Authors: Moral-Martin David
Published: January 2021

Este artículo analiza la creación de asociaciones de camareras de piso en un complejo contexto sindical. Este hecho matiza las interpretaciones sindicales sobre su desaparición, al tiempo que señala la dificultad de participar en un contexto altamente institucionalizado. La metodología se basa en la realización de entrevistas y en la revisión bibliográfica y documental. Los elementos explicativos surgen del análisis de varios factores que condicionan el comportamiento sindical. Como aportaciones, la utilización de estrategias de revitalización, basadas en tácticas de afiliación múltiple y flexible y en el intento de institucionalizarse sobre la base de sus condiciones materiales de trabajo, junto a una táctica comunicacional han ubicado su relato junto al de otras luchas salariales.
Desafiando las reglas: articulaciones políticas del activismo menstrual
Authors: Gómez Nicolau Emma , Marco Arocas Elisabet
Published: January 2021

El activismo menstrual entronca con la reflexión sobre la configuración social del cuerpo que menstrúa en el contexto neoliberal y productivista. La menstruación moviliza un conjunto de percepciones sobre el género, la sexualidad y la feminidad que se encuentran en la base de las relaciones de género. El principal objetivo del artículo es analizar los posicionamientos políticos del activismo menstrual. A través de entrevistas semiestructuradas y técnicas etnográficas nos acercamos a los discursos de un activismo menstrual heterogéneo, conectado a planteamientos feministas en discusión y conflicto. Recorremos entornos del activismo que conectan la crítica al complejo industrial higiénico-farmacológico con la crítica al productivismo y los procesos de explotación y autoexplotación en el marco del mercado laboral, así como a los procesos de apropiación del cuerpo por parte de la cultura biomédica. Finalmente, discutimos el posicionamiento del activismo menstrual con respecto a las políticas feministas neoliberales y las políticas radicales.
Magnetic resonance morphometry of the brain in the advanced stages of Parkinson's disease and vascular parkinsonism
Authors: Iskhakova E. V. , Trufanov A. G. , Efimtsev A. Yu. , Yurin A. A. , Lepekhina A. S. , Fokin V. A.
Published: January 2021

Introduction. MR-morphometry is a method of image processing independent of the researcher, which allows you to get the results of measuring the volume of the brain structures and the thickness of various areas of the cortex and helps in the differential diagnosis in assessing the results of MRI. Our study used MR-morphometry to identify structural markers in the differential diagnosis of vascular parkinsonism in the examination of patients with Parkinson's symptoms. Purpose of research. Visualization of the distribution of atrophic changes in brain structures in vascular parkinsonism and in the advanced stages of Parkinson's disease, as well as the identification of characteristic parts of the brain that undergo a pathological process to increase the accuracy of differential diagnosis. Materials and methods. The results of magnetic resonance morphometry of patients using the postprocessing of native MR images using Freesurfer software are analyzed. We examined 29 patients with vascular parkinsonism and 19 patients with Parknison disease, at stage 4 according to Hyun and Yar. Summary. The application of the method of postprocessing data processing of MR-morphometry allows instrumental confirmation of the clinical diagnosis, as well as to clarify the pathogenesis of neurological syndromes observed in progressive supranuclear paralysis.
Possibilities of small-size glioblastoma visualization by PET-CT with 11C-choline (experimental study)
Authors: Kostenikov N. A. , Dubrovskaya V. F. , Kovan'ko E. G. , Mirolyubova O. Yu. , Ilyushchenko Yu. R. , Stanzhevsky A. A.
Published: January 2021

Introduction. The minimum size of malignant brain tumors detected by positron emission and computed tomography (PET-CT) exceeds 6-7 mm. One of the ways to increase the sensitivity of PET-CT in detecting of malignant brain tumors is to increase the administered activity of the radiopharmaceutical 11C-choline.Purpose & tasks. The aim of the study was to experimentally study the possibility of obtaining a small-size glioblastoma (GB) images (up to 4 mm) by PET-CT with the 11C-choline.Materials and methods. The study was performed on 24 rats with implanted intracerebral tumor «Glioma C6» (glioblastoma). Animals underwent magnetic resonance imaging (MRI) with contrast enhancement (CE) and PET-CT with 11C-choline for 21 days after tumor transplantation.Results. It was shown that using two methods: MRI with CE and PET-CT with 11C-choline, a glioblastoma up to 4 mm can be convincingly visualized.Conclusion. The data obtained can be crucial for early detection of glioblastoma, justification of treatment tactics, evaluation of the treatment effectiveness and prediction the outcome of the disease.
Evaluation of the interchangeability of volumetric lung emphysema quantification: comparative analysis of the evaluation results using different software products
Authors: Gavrilov P. V. , Griva N. A. , Torkatyuk E. A.
Published: January 2021

The aim of this study: to assess the ability of different software products to automated volumetric quantification of lung emphysema and see whether the results can be interconvertible.Materials and methods. This study is based on the results of recognition and analysis of computer tomograms using three different software products.Results: all the programs we used have high sensitivity and specificity in recognition of lung emphysema. However, there are a number of errors that prevent accurate image analysis.Conclusions. The interconvertibility of the results of the automated volumetric quantification of lung emphysema at this stage is not reliably determined and depends on the choice of software products used for analysis.
Diagnostic opportunities of magnetic resonant imagingmri of heart in differential diagnosis of phenotypical forms of hypertrophic cardiomyopathy
Authors: Malov A. A. , Dzhordzhikiya R. K. , Abushayev A. I.
Published: January 2021

Introduction. Phenotype variants of left ventricular (LV) remodeling in patients with hypertrophic cardiomyopathy (HCM) are often associated with abnormalities of the mitral valve (MV), myocardiumstructure, contributing to the development of medium and/or subaortic obstruction. Itcauses the detail visualization of morphological obstruction substrates, tissue characteristics.

Aim. To evaluate the possibilities of magnetic resonance imaging (MRI) in the diagnosis of various forms of HCM and combined abnormalities.Materials and methods. 75 patients with suspected HCM were examined. For verification, all patients underwentMRI using protocol: short-pulse T1w-TSE/ T2w-TSE (STIR), gradient echo in cine (CINE), T1-weighted post-contrast images (Inversion Recovery IR-MDE). Results. Patients classified into 4 types according to the anatomical principle (Wiggle E.D. et al., 1985). In addition to the most frequent forms affecting the interventricular septum (IVS) — 64 patients, unusual forms covering the apical zones and papillary muscles — 11 patients. The majority of patients were diagnosed with abnormalities of MV, divided into abnormalities of the number and position of papillary muscles, as well as the ratio of chords and muscles. Myocardial crypts were diagnosed in 12 patients, some combined with areas of non-compact myocardium. Post-contrast visualization using the delayed contrast technique allowed differentiating HCM with accumulation diseases, excluding cavity thrombosis, and evaluating the severity of myocardial fibrosis.Conclusions. MRI allows to estimate in details anatomic picture of LV remodeling, to diagnose features of the mitral valve, tissue characteristics that allows to stratify risk of sudden death, classify the HCM phenotype form and to determine the volume of surgical intervention.
Differential diagnosis of acute and chronic pulmonary thromboembolism according to MSCT data
Authors: Uchevatkin A. A. , Yudin A. L. , Kondakov A. K. , Abovich Yu. A. , Afafnas'eva N. I. , Yumatova E. A.
Published: January 2021

Introduction. One of the important problems of medical imaging is the differential diagnosis of patients with acute and chronic pulmonary embolism. The widely used minimally invasive technique of multispiral computed tomography with intravenous bolus contrast enhancement can serve to solve this problem, in particular, to assess the state of the parenchyma and vascular structures of the lungs.

The purpose. To assess the state of bronchial arteries and parenchymal changes in the lungs in pulmonary thromboembolism based on the results of multispiral computed tomography and their role in the more precise diagnosis of this disease.Materials and methods. An analysis of CT-angiopulmonography of 600 patients with suspected PE was performed. 87 patients with confirmed pulmonary thromboembolism were selected and divided into groups according to the final diagnosis: group 1 — acute pulmonary embolism, group 2 — chronic pulmonary embolism. CT data were analyzed for the presence of pathologically changed bronchial arteries, as well as lung's parenchymal changes (including mosaic perfusion, fibrotic changes, bronchial dilatation with or without wall thickening).Results. Bronchial arteries were assessed in patients with acute and chronic pulmonary embolism and the diagnostic value of the detected changes was determined. Acute pulmonary embolism does not lead to such dilatation of the bronchial arteries as chronic pulmonary embolism. In diagnostically unclear cases, secondary parenchymal signs visible on CT (mosaic perfusion and dilated bronchi without wall thickening) can be useful in the differential diagnosis of acute and chronic pulmonary embolism.

Conclusions. Most patients with chronic pulmonary embolism demonstrated dilated bronchial arteries, in contrast to patients with acute pulmonary embolism. Lung's parenchymal changes (a mosaic perfusion pattern and bronchial dilation without wall thickening) were more common in patients with chronic pulmonary embolism. These CT-signs can help differentiate acute from chronic pulmonary embolism in unclear clinical situations.
Clinical and functional characteristic of adaptation of the cardiovascular system of seafarers during autonomous cruise
Authors: Malinina E. V. , Kondrashova N. M. , Kotelnikov V. N. , Gerashchenko E. V.
Published: January 2021

Purpose. Assessment of functional state of circulatory system in seafarers at different stages independent cruise.Materials and methods. Retrospective analysis of the results of the study of three groups of 180 seafarers on the third, ﬁfth and sixth months of cruise was conducted. The obtained results were subjected to statistical processing according to the rules of variation statistics.Results and its discussion. Functional state of circulatory system in seafarers depends on the kind of military professional activity. Thus, among the staff officers, the number of prehypertensive states is increasing, and for the personnel of surface ships a slightly greater physical working capacity is noted in comparison with divers. At the same time, an increase in the temperature of the skin of the lower extremities was typical for divers, that is deﬁnitely important for the control and early prevention of overheating. At the same time, the most noticeable decrease in working capacity is observed in the command staff, while the indicator was quantitatively correlated with the results of daily monitoring of blood pressure and ECG. In addition, it was revealed that the process of adaptation of the body’s regulatory systems reaches its maximum by the end of the third month of cruise and is determined by an increase in endurance and a decrease in morbidity among seafarers.
Comparative analysis of the parameters of carbohydrate exchange and thiamine security in the crew personnel of the northern water basin depending on the speciﬁcs of work, age and professional experience
Authors: Petrova T. B. , Bichkaeva F. A.
Published: January 2021

Purpose: assessment of carbohydrate metabolism and thiamine supply in the crew, depending on the speciﬁcs of work, age and professional experience.Materials and methods. The researchers examined the crew personnel of the Northern Water Basin (river workers, ﬁshermen and seafarers) aged from 21 to 59 years, with professional experience up to 35 years. In the blood serum, the parameters of carbohydrate metabolism were determined by the spectrophotometric method, and in the blood hemolysate, by the ﬂuorometric method, the content of the thiamine in the body.Results and its discussion. Seafarers have an increased glucose concentration against the background of low thiamine content relative to ﬁshermen and river workers. The frequency of occurrence of marginal states increases with increasing age and experience in river workers, and the frequency of occurrence of pronounced thiamine-deﬁcient states increases with increasing experience in ﬁshermen. Changes in carbohydrate metabolism and thiamine content of the crew depend mainly on the speciﬁcs of the work.
Scientiﬁc basis of the physical training of the navy servicemen
Authors: Zaytsev A. G. , Soshkin P. A. , Zabrodskiy D. S.
Published: January 2021

Purpose. To conduct structural analysis of physical ﬁtness of the navy servicemen from the position of bioenergetics and development of adaptative potential.Materials and methods. Theoretical analysis and generalization of science literature, structural analysis, developing of theoretical framework.Results and its discussion. The speciﬁcs of the professional activity of the Navy servicemen require maintaining the appropriate aerobic-anaerobic structure of physical ﬁtness. The article presents the physiological laws and pedagogical principles of the consistent development of aerobic and anaerobic human capabilities. It also establishes methodological recommendations for solving related tasks — the formation of the regulatory basis of motor actions, which constitute the biomechanical basis of professional activity, and the development of psychomotor functions.
Required sample size for comparing means in two paired samples
Authors: Grjibovski A. M. , Gorbatova M. A. , Narkevich A. N. , Vinogradov K. A.
Published: January 2021

This paper continues our series of articles for beginners on required sample size for the most common basic statistical tests used in biomedical research. The most common statistical test for comparing means in paired samples is Student’s paired t-test. In this paper we present a simple algorithm for calculating required sample size for comparing two means in paired samples. As in our earlier papers we demonstrate how to perform calculations using WinPepi and Stata software. Moreover, we have created a table with calculated minimal sample sizes required for using Student’s t-tests for different scenarios with the conﬁdence level of 95% and statistical power of 80%.
Инсоляция помещений как средство ограничения распространения COVID-19, гриппа и ОРВИ в городской среде
Authors: Шмаров Игорь , Земцов Виктор , Гуськов Андрей , Бражникова Людмила
Published: January 2021

Инсоляция помещений жилых, общественных зданий и при­легающих территорий регулирует поступление естественного ультрафиолетового излучения и является важным фактором, который необходимо учитывать при проектировании городской застройки. Она способствует ограничению распространения вирусных и бактериальных заболеваний, передающихся как воздушно-капельным аэрозольным путём, так и через общедо­ступные поверхности помещений. В статье проанализировано современное состояние нормирования и расчёта продолжи­тельности инсоляции в национальных и зарубежных нормах. Показано, что ультрафиолетовый свет поступает в помещения через современное энергосберегающее остекление. Сделан вывод о необходимости сохранения данного фактора в обе­спечении безопасности зданий и сооружений.
The State’s Attitude to Cryptocurrency as an Indicator of Its Trust in Society
Authors: Antoncheva O. A. , Apanasenko T. E.
Published: January 2021

It is proposed to justify the applicability of indicators of state confidence in civil society, that is, the state’s faith in the loyalty of society to it and in the ability to maintain its own legitimacy. The first indicator is the legalization of cryptocurrency, the second is the creation of a state cryptocurrency.

There is a direct connection between the degree of legalization of cryptocurrency and the level of state confidence in the loyalty of society to it. The creation of state national cryptocurrency is a signal of a drop in state confidence in its own legitimacy.
Cluster Approach to Strategic Planning on a Regional Level in the Russian Federation
Authors: Musaev R. A. , Pankratov A. A. , Astapov K. L.
Published: January 2021

The article aim is to determine the use of the cluster model of economic modernization in the regional Russian Federation socio-economic development strategies. The following tasks are solved within the article framework: identifying the Russian regions for which the cluster development topic is the most significant and relevant; studying the relationship between the regional strategies approval period and the level of cluster terminology used in them; analyzing the relationship of the cluster concept and other currently used approaches, such as industrial cooperation, «smart specialization» and «lean manufacturing». The main research methods: content analysis and correlation analysis. The study shows a high level of cluster approach use in regional strategies, as well as territorial differentiation of the level of cluster concept use by Russian Federation regions.
Local impedance and ultra-high density 3-dimensional mapping results in improved ablation metrics for cavotricuspid isthmus dependent atrial flutter compared with conventional ablation and contact force-guided ablation with 3-dimensional mapping
Authors: Saraf Karan , Black Nicholas , Garratt Clifford , Muhyaldeen Sahrkaw , Morris Gwilym
Published: January 2021

Introduction Multiple contact-based ablation technologies have been
developed to allow real-time judgement of lesion effectiveness; local
impedance (LI) guided ablation and the role of ultra-high density (UHD)
mapping have not yet been evaluated for cavotricuspid isthmus dependent
atrial flutter (CTI-AFL). Methods This non-randomised observational
study evaluated patients undergoing CTI-AFL ablation using conventional,
contact force (CF) and LI guided strategies. Ablation metrics were
collected, and in the LI cohort, the use of UHD mapping for breakthrough
was evaluated. Results 30 patients were included, 10 in each group. Mean
total ablation time was significantly shorter with LI (3.2±1.3min) vs
conventional (5.6±2.7min) and CF (5.7±2.0min, p=0.0042). Time from start
of ablation to CTI block was numerically shorter with LI (14.2±8.0min)
vs conventional and CF (19.7±14.1 and 22.5±19.1min, p=0.4408). There
were no differences in the number of lesions required to achieve block,
procedural success, complication rates or recurrence. 15/30 patients did
not achieve block following first-pass ablation. UHD mapping rapidly
identified breakthrough in the 5 LI patients, including
epicardial-endocardial breakthrough (EEB) away from the line. Conclusion
The use of LI for real-time assessment of lesion formation resulted in
significantly less ablation requirement. UHD mapping rapidly identified
breakthrough, including EEB, which would likely have been difficult to
identify otherwise and possibly require extensive ablation, contributing
towards shortening of time to CTI block with LI.
Liver and kidney function in patients with Covid-19 treated with remdesivir
Authors: Laar Sylvia van , Boer M De , Gombert-Handoko Kim , Guchelaar HJ , Zwaveling Juliette
Published: January 2021

For the treatment of Covid-19 patients with remdesivir, poor renal- and
liver function were both exclusion criteria in randomized clinical
trials (RCTs) and contra-indication for treatment. Also, nephrotoxicity
and hepatotoxicity are reported as adverse events. We retrospectively
reviewed renal- and liver functions of covid-19 patients who received
remdesivir in the 15 days after treatment initiation. Approximately 20%
of the patient population met RCT exclusion criteria. In total, 11% of
the patients had a decrease in estimated glomerular filtration rate
larger than 10 ml/min/1.73m2. Also, 25% and 35% had increased alanine
transaminase and aspartate transaminase levels, respectively. However,
serious adverse events were limited. Therefore, contra-indications based
on kidney- and liver function should not be absolute for remdesivir
treatment in patients with Covid-19 if these functions are monitored
regularly.
Ethanol resistance in Drosophila melanogaster has increased in parallel cold-adapted populations and shows a variable genetic architecture within and between populations
Authors: Sprengelmeyer Quentin , Pool John E
Published: January 2021

Understanding the genetic properties of adaptive trait evolution is a
fundamental crux of biological inquiry that links molecular processes to
biological diversity. Important uncertainties persist regarding the
genetic predictability of adaptive trait change, the role of standing
variation, and whether adaptation tends to result in the fixation of
favored variants. Here, we use the recurrent evolution of enhanced
ethanol resistance in Drosophila melanogaster during this species’
worldwide expansion as a promising system to add to our understanding of
the genetics of adaptation. We find that elevated ethanol resistance has
evolved at least three times in different cooler regions of the species’
modern range - not only at high latitude but also in two African high
altitude regions - and that ethanol and cold resistance may have a
partially shared genetic basis. Applying a bulk segregant mapping
framework, we find that the genetic architecture of ethanol resistance
evolution differs substantially not only between our three resistant
populations, but also between two crosses involving the same European
population. We then apply population genetic scans for local adaptation
within our quantitative trait locus regions, and we find potential
contributions of genes with annotated roles in spindle localization,
membrane composition, sterol and alcohol metabolism, and other
processes. We also apply simulation-based analyses that confirm the
variable genetic basis of ethanol resistance and hint at a moderately
polygenic architecture. However, these simulations indicate that
larger-scale studies will be needed to more clearly quantify the genetic
architecture of adaptive evolution, and to firmly connect trait
evolution to specific causative loci.
Why Punishment Does Not Fit the Crime: Experimental Evidence That Situational Circumstances Crowd Out Damage Done
Authors: Wall Joseph , Fogarty Timothy J. , Gissel Jodi
Published: January 2021

Regulators desire punishment that restores individuals to monetary positions before the damage and deters future violations. Thus, enforcement effectiveness is partially a function of punishment severity. Under the Securities and Exchange Commission's oversight, the Financial Industry Regulatory Authority provides enforcement and punishment guidelines for securities fraud cases. However, motivation crowding theory suggests extenuating and aggravating circumstances may complicate punishment. We investigate the concern that individuals charged with punishing securities fraud might be excessively tolerant, illustrated by recommended sanctions. Using two samples of participants—compliance examiners and securities arbitrators—in an experimental task that manipulates the fraudster's motivation, history, and personal gain, we find participants may be overly influenced by situational circumstances. Further, participants recommend monetary sanctions that fail to achieve regulators' restoration goals. We discuss practical implications of these findings for regulators. Further, we illustrate the need to extend motivation crowding theory to consider factors associated with non-direct financial benefits.
Basal Cell Carcinoma: Epidemiology, Risk Factors, and Treatment Options
Authors: Farma Jeffrey M , Lamb Elena P
Published: January 2021

Ultraviolent (UV) solar radiation is considered to be the dominant risk factor for development of basal cell carcinoma (BCC). The development of BCC is thought to arise from intense, intermittent sun exposure leading to burns. Identifying patients with high-risk factors for developing BCC includes chronic immunosuppression, exposure to ionizing radiation, and certain genetic syndromes. Primary treatment goals of BCC include cure of tumor with maximal preservation of function. Although rarely metastatic, BCC can produce substantial local destruction. Treatment modalities can be divided into surgical and nonsurgical therapies, although surgical therapy is the mainstay of treatment. Superficial therapies, such as topical imiquimod or 5-fluorouracil, photodynamic therapy, or cryotherapy, may be effective for anatomically challenging locations where surgery or radiation is contraindicated, but the cure rates of these approaches are lower compared with surgery. Recent FDA-approved hedgehog pathway inhibitors include vismodegib and sonidegib for patients who have exhausted surgical and radiation options for treating advanced BCC.
This review contains 4 figures, 5 tables, and 25 references.
Key words: cryosurgery, cutaneous basal cell carcinoma, hedgehog pathway inhibitors, Mohs micrographic surgery, pathologic risk factors, photodynamic therapy, radiation therapy, surgical margins, topical therapies