bluuebunny/crossref_metadata_2025 huggingface dataset:
Regional programs as instrument of reducing of poverty for sustainable development of Russia
Authors: Smirnov Vladimir , Danilina Marina , Selivanova Olga , Botasheva Ludmila , Kabanova Natalia
Published: July 2021

The article is dedicated to the analysis of the regional programs as an instrument of diminishment of poverty level in the regions of Russia. On the basis of the examination of 14 regional programs, in accordance with the methodology, developed by VNII of Labour, it was found that the goals of all regional programs are aimed at a steady increase in the income of citizens and a decrease in the proportion of the population with incomes below the subsistence level. Despite the existing variability of formulations, according to the semantic load, the tasks of all regional programs can be combined into four blocks: increase in the level of income of citizens and an excess of the growth rate of income of citizens, including average wages, over the rate of growth of inflation; development of a system of social assistance to citizens in need; development of the social contract system; organization of social adaptation of low-income citizens.
Reorganization of industrial zones as a factor of sustainable development of urban areas
Authors: Baranova Inna , Vlasenko Maria , Dzholdosheva Tamara , Prikhodko Eugenia
Published: July 2021

The reuse of industrial zones is becoming one of the determinants of sustainable urban development, which ensures the effective use of urban areas, taking into account the principle of their integrated development. However, the modern urbanized environment has serious environmental problems, which limits the active use of the redevelopment tool. The conducted research of the implemented redevelopment projects showed that their main share is accounted for the construction of apartments and housing, multinational complexes, creative spaces and offices. The results of the cluster analysis of the territories of Russia allowed the authors to identify the most promising regions for redevelopment.
Methodological aspects of the institutional analysis of the level of regional infrastructure development
Authors: Komarova Oxana
Published: July 2021

The development of the region’s infrastructure is one of the goals of territorial sustainable development. Regional infrastructure improves the quality of life. The article provides a theoretical analysis of methods for assessing the level of infrastructure development. The development of infrastructure is determined by the interests of many stakeholders. This determines the need for taking into consideration the institutional conditions of its development. The goal of the study is to analyze methods for assessing the development of regional infrastructure and substantiate the need for an institutional analysis of infrastructure development. To achieve this goal, methods of analysis, generalization and synthesis of studies on measuring and assessing the level of development of regional infrastructure were used. To form a methodology for assessing regional infrastructure, we used the methods of institutional analysis, comparison and generalization of scientific research. To ensure an increase in the efficiency of regional infrastructure development, the methodology for assessing the institutional conditions for infrastructure development is proposed. The methodology is based on the following indicators: regulatory framework for infrastructure development, assessment of infrastructure development forms in projects for interaction between business and the state, infrastructure development tools, availability of a system for coordination and monitoring of infrastructure development, technological level of the region’s infrastructure. Further research involves testing the methodology for assessing the level of development of regional infrastructure. In general, a systematic approach to the development of the region’s infrastructure is fully consistent with the goals of sustainable development and allows us to identify markers of infrastructure development that correspond to the level of territorial development.
Managing the empathic culture of client-oriented personnel in the system of human resource development in the Russian regions
Authors: Salamatina Yulia
Published: July 2021

The article is devoted to a study on the management of an important professional and personal quality of any employee of a customer-oriented company - empathic culture. The relevance of this research is due to the low level of human resource development in Russian regions. Having conducted an in-depth analysis on the research problem, the author has come to the conclusion that it is the empathic culture of personnel that has a huge impact on efficiency and profitability of any Russian client-oriented company. The author identified the main components of empathic culture of front liners and selected methods to determine the level of formation and development of each of the components. Based on the data following this research, which was conducted on the basis of three client-oriented organisations, the author proposed the most effective ways to manage the empathic culture of staff in order to successfully operate the companies.
Environmental safety in the framework of sustainable development of the region (on the example of the Siberian Federal District)
Authors: Zhidkova E.A. , Dymova I.A.
Published: July 2021

A statistical analysis of public opinion on environmental safety issues was carried out. The Siberian Federal District was chosen as the object of the study. Special attention is paid to the development of environmental safety in the Krasnoyarsk Territory and the Kemerovo Region (Kuzbass). The main criterion for determining the coordinates of “critical” points was the results of a social survey conducted by the Special Communications and Information Service of the Federal Security Service of Russia. The reasons for the negative impact on the state of the environment of the Siberian Federal District are revealed. It is established that when preventive measures are not so effective to maintain a high level of environmental safety, the compensation of environmental damage can pass through the organization of the institute of environmental insurance.
Treating acute bronchitis with a plant based dietary supplement: properties and efficacy assessment
Authors: Poznyakovsky Valery , Shamova Maria , Vyalykh Elena , Tokhiriyon Boisjoni , Lapina Valentina
Published: July 2021

In recent years, acute bronchitis has become one of the most widespread lung diseases. Therefore, there is a need for effective prevention and treatment procedures, with nutrition being one of the important factors to be taken into account. The present paper discusses the properties and efficacy of a new plant based dietary supplement that contains ingredients with synergistic properties and can be successfully applied to regulate metabolism when treating bronchopulmonary pathology. The plant based dietary supplement was administered to enhance the traditional treatment. One capsule was taken by the patients of the experimental group three times a day at breakfast, lunch and dinner for the period of 30 days. While the control group did not receive the plant based dietary supplement and undertook the standard form of treatment. By comparing all the data collected during the clinical trial, positive impact of the new plant based dietary supplement was observed, i.e. the exacerbation phase was shortened by two or three days, the period of the hospital treatment was reduced by five and a half days. Alongside the ease of the shortness of breath, improved lung function and lung vital capacity, were the increased volume of forced inhalation, the rallied mucociliary apparatus, and bronchial mucosal swelling reduction. The experimental group patients demonstrated both the increased tocopherol level and the growth in oxygen concentration. The positive changes were observed in metabolic process, i.e. lipid peroxidation, which in turn provides better exercise capacity. The data collected during the clinical trial is of huge importance and can help improve the life of the patients with acute bronchitis. Active ingredients of the new plant based dietary supplement influence both the chemistry of lipid peroxidation and antioxidant protection process against free-radical damage. This influence is particularly notable in the early stages of the disease. The clinical trial findings indicate that administering the new plant based dietary supplement as a part of a standard treatment is justified and effective. Moreover, the supplement can be successfully taken to prevent the acute bronchitis.
Formation of breakthrough competencies for bachelors of tourism
Authors: Plotnikova Victoria , Glushanok Tamara , Dmitrieva Tatiana
Published: July 2021

The relevance of the study of breakthrough competencies is due to the growth of competitiveness in the international and Russian markets for services of young specialists. The rapidly changing economic conditions in which the modern tourism industry operates are associated with the development of digital technologies in tourism, the improvement of the transport system, hotel chains, the globalization of the tourism business, the massive exit of companies working in the tourism industry online, the transformation of consumer behavioral characteristics, new practices, and consumption patterns services. This article is aimed at identifying breakthrough competencies that representatives of the tourism industry and the institutions and communities interacting with it designate as significant for the formation and implementation of a development strategy aimed at anticipating and forming new markets and niches in the tourism industry that contribute to its sustainable development. The aim of the study is to study breakthrough competencies that form the general competence of a graduate of a tourism university. The main method in the study of this problem is the method of questioning, carried out among specialists in the tourism industry and students studying in this area. The sample also included teachers who work at the Department of Tourism. The experimental base of the study was the Petrozavodsk State University.
Methodological approach to the assessment of ecological tourism as a direction of sustainable development of the tourism industry
Authors: Antamoshkina Elena , Korabelnikov Ivan , Daeva Tatyana , Nazarova Tatjana , Morozova Natalia
Published: July 2021

The article recommends a methodological approach, that includes the analysis of natural and recreational, cultural, historical, and socio-economic factors to assess the potential of ecotourism development. The indicators and parameters of the assessment are established, qualitative and quantitative values are determined, they enable evaluation of the impact of each criterion on the assessment of the potential for ecotourism development in points. The authors identified organizational and economic factors of ecotourism development in the region: insufficient funding for natural parks improvement activities; lack of equipped ecological trails and routes; insufficient information and personnel support. On the basis of the proposed methodology, the potential for ecotourism development in natural parks of the Volgograd region was assessed. The article highlights risks of ecological tourism development in the Volgograd region: the lack of a unified system of state accounting and monitoring of the state of natural resources; low efficiency of control and supervisory activities; the spread of environmentally non-adaptive forms of nature management in the region; the low level of ecological culture of the population. The potential for ecotourism development determines opportunities for the implementation of main functions of specially protected natural areas: ecological, scientific and educational, socio-economic, which together forms a system of conditions for sustainable development of rural areas.
Critical evaluation of competitiveness in international receipt of tourism amongst BRICS nations
Authors: Singh Jagjit , Sharma Shikha
Published: July 2021

We are living in the world of globalization where competition is inseparable part of every business. It is possible to devolved countries to survive in this competition because of access to various economic resources. Purpose-This study focuses on one of such economic integration i.e. BRICS and has compared international Receipt of tourism among BRICS nations. This research has also appraised India‘s position among BRICS Nations in connection with international receipts of tourism. Research Methodology-To accomplish objectives of the research data gathering has been done form official website of Organization for Economic Cooperation and Development. A panel of data of BRICS nations from the year 2008-2019 has been built and various research tools were employed for analyzation of data. Finding-Statistics evaluation performed by utilizing the tool of ANOVA shows a statistically significant difference between the International receipts of tourism of BRICS nations. Also, apart from Brazil and South Africa, all other groupings of BRICS are displaying a statistically significant variance in terms of international receipt of tourism. Originality/Value-Data collection has been done from official website of OECD and all implications are from published research papers of authors from tourism domain.
Features of sustainable economic development in the Central Asian countries
Authors: Brovko Natalia , Borbugulov Malik
Published: July 2021

In this study there is an attempt to consider not only the consequences of climatic and technogenic changes in the Kyrgyz Republic, but also to develop some directions for solving these problems, taking into account the natural, economic and geopolitical capabilities of this country at the present stage. Within the framework of the study the issues of the impact of climate change associated with the reduction of fresh water, agricultural and crop production, as well as the problems of further use of traditional energy sources have been studied. These aspects are deeply covered as the Sustainable Development Goals under the auspices of the UN. According to the author, it is vitally important for the countries of the post-Soviet area to simultaneously find independent and nationally oriented directions and approaches to solve these problems, but without fail using the developments of the institutional base, the experience of the world community, as well as the advantages of regional integration. The main results consist in the development of a green development model related to the use of renewable energy sources at the present stage of development. The field of application of the results obtained is determined by the possibilities of including the main indicators of green development in strategic plans for socio-economic development and increasing the competitiveness of the national economy. The approach proposed by the authors allows, as a replenishment of lost energy sources in connection with climate warming and a decrease in water resources: proposals for the development of alternative sources of energy supply, the creation of solar and wind farms is proposed.
The impact of man-made accidents and catastrophes in the stable functioning of industrial enterprises on the quality of life of the population and socio-economic development
Authors: Kamdina Lyudmila , Simchenko Olga , Grakhov Valery , Suntsov Alexander , Chazov Evgeny
Published: July 2021

The article considers the quality of life of population and the impact of man-made accidents and disasters during stable functioning of industrial enterprises. The author offered to take into account the influence of anthropogenic factors, the source of which is industrial production, provoking man-made accidents and catastrophes, when assessing the quality of life of population. To fully take into account the factors affecting the quality of life of population, a comprehensive methodology created by the Council for the Study of Productive Forces by order of the Ministry of Economic Development of the Russian Federation that contains 19 indicators for diagnosing the quality of life of the population of the region, grouped by seven main areas, was chosen. Changes in the system of indicators of the consolidated index of the quality of life of the population under the influence of man-made accidents and catastrophes in the context of 7 spheres are shown. As an example, the impact on the main components of the quality of life of the population of the largest man-made disaster in the history of mankind and the nuclear industry - the Chernobyl accident - is considered.
Directions of wage optimization in construction
Authors: Yamshchikovа I.V. , Doroshenko T.G. , Mikheeva N.B.
Published: July 2021

The article analyses the method proposed by the Government of the Russian Federation for adjusting the principle of determining the minimum subsistence level, based on the median salary. The article shows the result of the analysis of changes in wages in construction when calculating, using the median salary in relation to the “absolute” principle of calculating the minimum subsistence level, the calculation of the size of the minimum subsistence level in Russia as a whole, and on the territory of the Irkutsk region is analysed. It is shown that the transition to the calculation of the median salary in the Irkutsk region will decrease the subsistence level in relation to the existing one. Based on our analysis, the conclusion is made that in order to calculate the minimum subsistence level for medial salary, it is necessary to revise the calculation methodology.
Features for making decisions in the interests of organizing transport processes
Authors: Moskvitin G.I. , Pismennaya A.B. , Abroskin P.N. , Korsakova V.V.
Published: July 2021

The practice of management activities suggests that the experience and knowledge of managers alone cannot always provide an optimal or even rational solution without additional scientifically grounded methods for assessing the effectiveness of possible options for organizing transport processes. All this generated a need for the development of scientific methods for making (developing, supporting, justifying) decisions that would make it possible to develop specific recommendations for the head who manages the facility in difficult situations. These methods included the formation of effectiveness measures in the form of maximum or minimum of a single indicator — the target function with or without constraints and various algorithms for finding the values of arguments that provide the required value of this function. Subsequently, mathematical methods for solving multi-criteria problems involving different goals of the operation and using, respectively, a lot of alternative effectiveness measures began to develop.
Asset management of transportation companies: Analysis and methods
Authors: Zharikov Michael V. , Shatskaya Irina I.
Published: July 2021

The article deals with gaining some ideas and skills that an investor might use to choose the best opportunities in the market from among the thousands of options concentrated in the transport industry. The authors are also trying to build up a standard set of tools that make up the core of every stock analyst’s tool box. From the practical perspective, the ideas and techniques in the discussion part will be useful for analysing just every possible investment. A special focus in the article has been made on the transportation companies struggling with the consequences of the corona-crisis of 2020.
Potential of digital solutions in the conditions of sustainable economic development of industrial enterprise: concept and performance indicators
Authors: Golovina Alla , Peshkova A.
Published: July 2021

As a result of the study the concept of economic potential of digital solutions of the industrial enterprise is developed; the definition of sustainable economic development of the company is clarified; a new indicator of economic efficiency evaluation of the development of digital solutions potential and digital economy is proposed.
Determinants of food security and availability of healthy and safe nutrition - food security of children in rural Punjab, India
Authors: Sharma Kavita , Sharma Sachin , Sood Deepak
Published: July 2021

It is critical to ensure that the availability of food, as well as food safety, are preserved in food security systems. This has substantial consequences on the health of world’s population. Food safety deals with food-borne disease, and it focuses on how, where, and what food is handled, prepared, and stored. The healthiness of a diet depends on the nutritional quality of its food. Food security is a multifaceted concept that takes into account several issues and projects throughout the globe. The findings from this study are intended to provide insight into the food security of children in rural Punjab, India. To study the possibility to establish sustainable programmes that assure hot meals for school students in rural Punjab, the primary goal of the research is to do so. Researchers in Punjab have not done any equivalent scholarly study focusing on food security from an economic standpoint. In-depth nondirective interviews were used to find out what experienced professionals thought. The findings reveal the need to increase family and school food resources to meet the nutritional requirements of children in rural regions. Additionally, offering hot meals in primary schools in impoverished communities is justifiable since poor nutrition among school-aged children has both short-term and long-term impacts on their academic success and development. These findings lead to management implications for policy makers who want to measure the effectiveness of national and state funded educational programmes.
Assessment of accumulated personnel training as an indicator of professional development in the context of the formation of the knowledge economy
Authors: Stepus A.F. , Glavatskikh O.B. , Pushina N.N. , Troyanskaya A.I. , Kharitonova N.N.
Published: July 2021

A variant of the assessment of training and the increment of qualifications is proposed with the aim of further assigning a categoiy for working specialties or a categoiy for specialists and professions of a long training period. The scientific foundations of the increase in the qualifications of domestic and foreign researchers have been worked out for the development of a quantitative calculation of this increase. The practical use of this gain has also been analyzed in learning processes in its various types. This system allows the employee to influence the process of improving their qualifications. It is important that this technique will allow a self-learning organization to create a self-learning system, the personnel of which, among other things, are able to train in third-party organizations, which increases the competitiveness of both the enterprise and employees in the constantly changing modem conditions and the instability of the global economic management system.
The representations of the regional university students about the “gap year” in conditions of the Covid-19 pandemic
Authors: Kremen Sergei , Tsitsikashvili Kseniya
Published: July 2021

The article examines the phenomena of the “gap year” in the conditions of the COVID-19 pandemic. The purpose of this study is to analyze the regional university students’ perceptions of this phenomenon in general and in the context of the pandemic, in particular. The results of the study showed that many students have only a superficial understanding of the “gap year” and most would not want to take a year of gap in education for a number of reasons. The authors conclude that in the Russian reality it is quite difficult to implement the “gap year” due to the low level of awareness about it among schoolchildren and students, weak financial and mobile opportunities for the majority of Russians, and conservative views of most parents.
Environmental education of Z generation students for sustainable development of rural areas (the example of the Russian-Finnish project Luga-Balt-2)
Authors: Kartseva Alexandra , Minin Vladislav , Ranta-Korhonen Tuija , Nurmi Elina , Belyakov Valery
Published: July 2021

In September 2015, the UN General Assembly adopted 17 goals and 169 targets for sustainable development until 2030. The fourth goal provides for the development of inclusive and equitable quality education, and goals 12, 13 and 14 are aimed at protecting the environment and organizing appropriate education for this. When implementing environmental education, it is necessary to take into account the characteristics of a generation of students, in this case, generation Z. For a number of years, Russian-Finnish projects were carried out in the Luga district of the Leningrad region. One of the main objectives of the projects concerned the environmental education of schoolchildren and students. Using international experience, a number of interactive teaching methods have been developed and are still being used. They are focused on fostering student independence and provide his motivation. A student conducts his own research work and participates in a youth team to prepare and to implement their own projects aimed at solving local problems. This approach forms an ecological culture of an ecocentric type among students, and their desire to bear their part of responsibility for the state of the environment.
Ecologization and digitalization of preschool education for sustainable development: problems and prospects
Authors: Vilacheva Maria , Zadorina Mariia , Meshcheryagina Veronika
Published: July 2021

The paper is devoted to the problems of modernization of the preschool education in Russia. The general scientific and private scientific methods formed the methodological basis of the research. There are two directions in the development of the Russian education system over the past few years: ecologization and digitalization. The ideas of the “green economy” are actively entering the field of education. The federal state educational standards provide the opportunity of forming the basics of children’s ecological literacy, ecological culture and ecological intellection in schools, but not in preschool educational organizations. The process of digital transformation is more focused on school and colleges and less on kindergartens. These problems slow down the pace of sustainable development because preschool education is the foundation of a child’s personal development in the future. This paper presents the promising directions for improving the preschool educational system for sustainable development.
Defining “telemedicine services” in the context of large-scale digitalization
Authors: Dvoryadkina Elena , Fechina Alena
Published: July 2021

The authors analyze the definitions of “telemedicine service” presented in domestic and foreign scientific publications, as well as on the official resources of various departments and healthcare organizations. It is revealed that there is a lack of research on this topic and the concept under study has a controversial nature. The authors carry out comprehensive testing of “telemedicine service” definition, adopted by the World Health Organization, for compliance with digitalization trends. In the course of the research, the incompleteness of the definition generally accepted at the international level was revealed. The authors propose their own interpretation of the “telemedicine service” concept, implying an individualized approach, the use of information and communication technologies in order to increase public health. There are also considered factors affecting the choice of this method of providing medical services, and determining the goals of application, including prevention, identification of causes, diagnosis and treatment of diseases.
Higher education as factor of sustainable development
Authors: Sazanova Larisa
Published: July 2021

The paper analyzes the system at higher education in the context of achieving the goals of sustainable development of modern society. From the point of view of a systemic approach, an attempt is made to identify and classify the factors that can measure the contribution of higher education institutions to achieving the Sustainable Development Goals at the regional level. These factors are correlated with the corresponding tasks, as well as possible problems that are posed by the present unstable situation, and hinder sustainable development of the society. The research uses system-wide methods of analysis and synthesis, generalization and analogy. The analysis of the tasks and problems presented in the article allows us to identify and investigate the cause-effect relationships between the factors that determine the achievement of the Sustainable Development Goals and the complexities that accompany this process, and also contributes to the holistic perception of the concept of sustainable development by university staff members and students. The results of the study can be used in event planning within the framework of implementing the strategies drawn up by universities in the context of the sustainable development paradigm.
Charpy V notch tests – Risks associated with testing with 3 samples
Authors: Huther Michel , Lieurade Henri-Paul
Published: July 2021

To estimate the risk of brittle fracture of a component in service, Charpy tests are generally carried out on 3 samples at the same temperature. Work done over many years on welded joint fatigue using probability and statistics has shown that to have a good assessment of minimum strength, it is clearly necessary to have a larger number of test results. In order to analyse the risks associated with this practice of 3 samples tested at the same temperature, a series of 17 Charpy impact test results of samples of the same steel plate was chosen. From this series, by translation, 2 series were generated, one with a test of 3 specimens showing acceptable steel and one with a test of 3 specimens showing unacceptable steel. The 3-test method was applied to these series leading to a possible simulation of 12 tests each. It was found that the 3-test practice leads to a risk of error of 30 to 40%. It is also found that the determination of the transition curve of a DH36 steel finally shows that its temperature for a CV of 27 J is of the order of −50 °C whereas the regulations require only −20 °C. In conclusion, a possible improvement of the test procedure is indicated, which is the subject of a study within the framework of the “CCRS rupture and fatigue” working groups of the Société des Ingénieurs Soudeurs (SIS).
Symptomkontrolle in der Palliativmedizin (ohne Schmerztherapie)
Authors: Wulf Hinnerk , Volberg Christian , Morin Astrid Marie
Published: July 2021

Patienten in palliativer Erkrankungsphase leiden häufig unter einer Vielzahl belastender Symptome mit deutlicher Einschränkung der Lebensqualität. Die Behandlung gestaltet sich hierbei oftmals schwierig. Zum einen, da die Patienten zumeist mehrere Probleme gleichzeitig mitbringen, und zum anderen, weil die notwendigen Medikamente an anderer Stelle Nebenwirkungen hervorrufen können, die ihrerseits wiederum behandelt werden müssen. Im vorliegenden Artikel erläutern wir einen Großteil dieser Symptome und geben Behandlungsempfehlungen anhand der aktuellen Literatur (ausgenommen Schmerztherapie). Im Speziellen ist der Artikel in folgende Unterpunkte gegliedert: Mukositis/Stomatitis, Atemnot, Übelkeit, Obstipation, Angst, Depression, Schwäche/Fatigue, Delir, Schlafstörungen und terminale Unruhe, Pruritus, Pleuraerguss, Aszites. Nur selten kann man in der Arbeit mit Palliativpatienten nach Lehrbuch vorgehen. Man muss improvisieren, Medikamente abseits ihrer Zulassung
(Off-Label) gebrauchen oder manchmal auch einfach nur da sein. Der wichtigste Grundsatz in der Arbeit mit Palliativpatienten liegt in der Erhaltung oder Wiederherstellung der Lebensqualität. Unsere Therapie sollte immer an die Bedürfnisse des Patienten angepasst sein und es gilt, die Autonomie des Betroffenen zu wahren.
Der Radius und seine funktionelle Bedeutung
Authors: Url Matthias
Published: July 2021

Ob Gelenkflächen-Neigungswinkel, Lister'sches Tuberculum oder funktionelles Bewegungsverhalten: Für die Behandlung distaler Radiusfrakturen ist eine genaue Kenntnis der anatomischen und biomechanischen Besonderheiten des Radius unabdingbar.
Drug-induced Myopathies
Authors: Steinmeyer Jürgen , Flechtenmacher Johannes
Published: July 2021

Differential diagnosis of muscle pain and weakness is extensive, including neurological, vertebral, arthrogenic, vascular, traumatic, immunological, endocrine, genetic and infectious
aetiologies, as well as medication or toxin-related causes. Muscles are highly sensitive to a large number of drugs, especially with high doses. Although many drug classes can cause toxic
myopathy, a significant number of cases are caused by lipid-lowering drugs, long-term use of corticosteroids, and, most often, alcohol misuse. Some drug interactions, e.g. those that are
metabolised via the enzyme CYP3A4, can increase the serum levels of the drugs and drug-induced toxicity. A careful history of patientʼs drug and alcohol consumption is therefore vital.
Clinical symptoms depend on the drug, dosage and patientʼs sensitivity. They can vary from asymptomatic increase in serum levels of creatine kinase, mild myalgia and cramps to muscle
weakness, rhabdomyolysis, kidney failure and even death. The pathogenesis is often only partially known and multifactorial. Toxic myopathy is often reversible once the drug is discontinued,
alternative drug therapy is started or a different dosage regimen is chosen. Complications such as acute kidney failure must be avoided, and analgesic therapy may be indicated.
Current Minimally Invasive Surgical Concepts for Sacral Insufficiency Fractures
Authors: Spiegl Ulrich Josef Albert , Schnake Klaus J. , Ullrich Bernhard , Scheyerer Max J. , Osterhoff Georg , Siekmann Holger
Published: July 2021

An increasing incidence of sacral insufficiency fractures in geriatric patients has been documented, representing a major challenge to our healthcare system. Determining the accurate
diagnosis requires the use of sectional imaging, including computed tomography and magnetic resonance imaging. Initially, non-surgical treatment is indicated for the majority of patients. If
non-surgical treatment fails, several minimally invasive therapeutic strategies can be used, which have shown promising results in small case series. These approaches are sacroplasty,
percutaneous iliosacral screw fixation (S1 with or without S2), trans-sacral screw fixation or implantation of a trans-sacral bar, transiliac internal fixator stabilisation, and spinopelvic
stabilisation. These surgical strategies and their indications are reported in detail. Generally, treatment-related decision making depends on the clinical presentation, fracture morphology,
and attending surgeonʼs experience.
Eine Änderung des Rauchverhaltens beeinflusst das Überleben von HNSCC-Patienten
Authors: Fazel Asita , Quabius Elgar Susanne , Fabian Alexander , Gonzales Donate Mireia , Schleicher Thilo , Kress Konstantin , Laudien Martin , Huber Karen , Hoffmann Markus
Published: July 2021

Einleitung Der Einfluss des Rauchens auf das Überleben bei Patienten mit Kopf-Hals-Karzinomen ist in der Literatur gut belegt. Es gibt nur wenige Daten über Änderungen der Rauchgewohnheiten nach Diagnosestellung. Hier wird die Auswirkung der Reduktion der Rauchquantität im Vergleich zur vollen Entwöhnung auf das Überleben untersucht.

Patienten und Methoden Patientenakten und Tumordokumentationen von 643 konsekutiven Kopf-Hals-Karzinom-Fällen des Kopf-Hals-Tumorzentrums der Universitätsklinik Kiel werden retrospektiv ausgewertet: Rauchgewohnheiten vor und nach der Behandlung sowie das Überleben werden dabei ausgewertet.

Ergebnisse Eine Änderung des Rauchverhaltens bei der Erstdiagnose des Karzinoms führt zu signifikant positivem Effekt auf die Prognose im Vergleich zu fortgesetztem Rauchen. Es zeigt sich kein Unterschied zwischen Rauchreduktion und Entwöhnung. Dieser Effekt beruht alleinig auf solchen Patienten, die ausschließlich chirurgisch behandelt werden. Lebenslange Nichtraucher weisen einen signifikanten Überlebensvorteil gegenüber aktiven und ehemaligen Rauchern auf, ohne Unterschied zwischen den beiden letztgenannten Gruppen.

Schlussfolgerung Der positive Einfluss veränderter Rauchgewohnheiten auf die Prognose verläuft parallel zum negativen direkten Effekt des aktiven Rauchens auf die Therapie, was auf peritumorale Hypoxie mit negativer Auswirkung auf die Wirksamkeit der R(C)T zurückgeführt wird. Der positive Effekt der Rauchverhaltensänderung bei ausschließlicher Chirurgie liegt am ehesten in verminderter perioperativer Komplikation begründet. Patienten sollen ermutigt werden, das Rauchen mit der Krebsdiagnose zumindest zu minimieren. Darüber hinaus sollten ehemalige Raucher für Überlebensschätzungen und Therapieplanung als aktive Raucher betrachtet werden.
Medizinprodukteaufbereitung in Klinik und Praxis
Authors: Kollenbach Peter
Published: July 2021

Änderungen und Neuerungen in der hygienischen Betrachtung von Operationen und bei der Aufbereitung von Medizinprodukten stellen die Praxen und Krankenhäuser vor zunehmende Herausforderungen. Die föderalistische Umsetzung der Bestimmungen erschwert es zusätzlich, den Überblick über sämtliche Bestimmungen zu behalten. Die zentralen Dokumente für den OP-Betrieb stellen die KRINKO-Empfehlungen zur Vermeidung nosokomialer Infektionen (2018) und die Anforderungen an die Medizinprodukteaufbereitung (2012) dar. Eine Unterscheidung nach ambulanten und stationären Operationen ist aus infektionshygienischer Sicht heutzutage nicht mehr sinnvoll und zielführend. Die Patientenfaktoren, wie Vorerkrankungen, Voroperationen, Adipositas etc. spielen in der Risikobewertung der gesamten operativen Einheit eine zunehmend wichtigere Rolle. Der Betrachtung von Surveillance-Daten wird zunehmende Bedeutung beigemessen.

Für die Aufbereitung der Medizinprodukte (MP) finden sich ebenfalls je nach Konstruktion des MP und dessen Verwendung unterschiedliche Risikobeurteilungen. Die notwendigen Schritte zur Aufbereitung sind durch diese Beurteilung festgelegt. Schwerpunkt in der Aufbereitung wird wohl zunehmend für die Validierung der Prozesse zu erwarten sein. Eine reproduzierbare, hygienisch einwandfreie Aufbereitung zu erreichen und insbesondere zu dokumentieren bedeutet einen hohen organisatorischen Aufwand. Bei manueller, aber auch bei der maschinellen Aufbereitung müssen für jeden Arbeitsschritt Anweisungen erstellt werden, die auch dokumentiert und kontrolliert durchgeführt werden. Bei der maschinellen Aufbereitung ist der Erfüllungsaufwand dabei etwas geringer. Regelmäßige Schulungen und Fortbildungen sind in jedem Fall unerlässlich.

Den betriebswirtschaftlichen Belangen bei der Aufbereitung stehen die Probleme der Finanzierung der mittlerweile hohen hygienischen Anforderungen gegenüber. Verhandlungen über die KBV sind im Gange. Inwieweit Erfolg zu verzeichnen sein wird, bleibt abzuwarten. Derzeit legen die Krankenkassen eine rigide Haltung an den Tag.
Endoscopic Insufflation–Induced Gastric Barotrauma during Percutaneous Endoscopic Gastrostomy: A Report of Three Patients and Review of Literature
Authors: Seth Avnish Kumar , Bansal Rinkesh Kumar
Published: July 2021

Background We report three patients with endoscopic insufflation–induced gastric barotrauma (EIGB) during upper gastrointestinal endoscopy (UGIE) for percutaneous endoscopic gastrostomy (PEG). A definition and classification of EIGB is proposed.

Materials and Methods Records of patients undergoing UGIE over 7 years (April 2013–March 2020) were reviewed. Patients who developed new onset of bleeding or petechial spots in proximal stomach, in an area previously documented to be normal during the same endoscopic procedure, were studied.

Results New onset of bleeding or petechial spots in proximal stomach occurred in 3/286 (0.1%) patients undergoing PEG and in none of the 19,323 other UGIE procedures during the study period. All patients were men with median age 76 years (range 68–80 years), with no coagulopathy. Aspirin and apixaban were discontinued 1 week and 3 days prior to the procedure. Fresh blood was noted in the stomach at a median of 275 seconds (range 130–340) seconds after commencement of endoscopy. At retroflexion, multiple linear mucosal breaks of up to 3 cm, with oozing of blood, were noted in the proximal stomach along the lesser curvature, close to the gastroesophageal junction in two patients. In the third patient, multiple petechial spots were noticed in the fundus. The plan for PEG was abandoned and the stomach deflated by endoscopic suction. There was no subsequent hematemesis, melena, or drop in hemoglobin. One week later, repeat UGIE in the first two patients revealed multiple healing linear ulcers of 1 to 3 cm in the lesser curvature and PEG was performed.

Conclusion Overinsufflation over a short duration during UGIE may lead to EIGB. Early detection is key and in the absence gastric perforation, patients can be managed conservatively.
Morphometry and Contents of the Suprascapular Notch with Potential Clinical Implications: Α Cadaveric Study
Authors: Tsikouris George , Antonopoulos Ioannis , Vasdeki Dionysia , Chrysikos Dimosthenis , Koukakis Athanasios , Tsakotos George , Georgakopoulos Panagiotis , Troupis Theodore
Published: July 2021

Background The suprascapular notch (SN) represents the point along the route of the suprascapular nerve (SSN) with the greatest potential risk for injury and compression. Thus, factors reducing the area of the notch have been postulated for suprascapular neuropathy development.

Methods Thirty-one fresh-frozen shoulders were dissected. The contents of the SN were described according to four types as classified by Polguj et al and the middle-transverse diameter of the notch was measured. Also, the presence of an ossified superior transverse scapular ligament (STSL) was identified.

Results The ligament was partially ossified in 8 specimens (25.8%), fully ossified in 6 (19.35%), and not ossified in the remaining 17 (54.85%). The mean middle-transverse diameter of the SN was 9.06 mm (standard deviation [SD] = 3.45). The corresponding for type-I notches was 8.64 mm (SD = 3.34), 8.86 mm (SD = 3.12) was for type-II, and 14.5 mm (SD = 1.02) was for type III. Middle-transverse diameter was shorter when an ossified ligament was present (mean = 5.10 mm, SD = 0.88 mm), comparing with a partially ossified ligament (mean =7.67 mm, SD = 2.24 mm) and a nonossified one (mean = 11.12 mm, SD = 2.92 mm). No statistically significant evidence was found that the middle-transverse diameter depends on the number of the elements, passing below the STSL.

Conclusion Our results suggest that SSN compression could be more likely to occur when both suprascapular vessels pass through the notch. Compression of the nerve may also occur when an ossified transverse scapular ligament is present, resulting to significant reduction of the notch's area.
Active elements in the form of thin rods of square cross section for multichannel laser amplifiers
Authors: Kuznetsov I.I.
Published: July 2021

We study thermally induced phase distortions of laser radiation in active elements in the form of thin rods of square cross section. The absence of aberrations and beam quality deterioration is demonstrated for these elements, due to which they can be used along with rods having a round cross section, differing from the latter by much higher technological efficiency of fabrication and mounting in the cooling system. A concept of compact and reliable multichannel solid-state amplifier based on such active elements is proposed, which allows one to use a multichannel fibre laser as a master system.
Nonlinear absorption of laser radiation by aluminium particles in a potassium bromide matrix
Authors: Zverev A.S. , Kalenskii A.V. , Ovchinnikov G.E. , Zvekov A.A. , Galkina E.V.
Published: July 2021

Optical properties of a model pressed composite (potassium bromide matrix with incorporated ALEX aluminium powder) are experimentally investigated. It is shown that the spectral dependences of total transmittance and diffuse reflectance can be described with allowance for the presence of both individual aluminium nanoparticles and their aggregates with a characteristic radius of 133 nm in a sample. It is found that irradiation of a composite sample by a 1070-nm cw laser initiates nonlinear absorption of radiation by aluminium particles, which is detected by a change in the sample optical density. A model is proposed to describe the effect, which is based on the sample heating and temperature dependence of the optical characteristics of aluminium particles. The calculation results are in qualitative agreement with the observed changes in optical density; hence, the thermal mechanism of nonlinear absorption of electromagnetic radiation by metal particles is applicable to this model system.
Longer or shorter spines: Reciprocal trait evolution in stickleback via triallelic regulatory changes inStanniocalcin2a
Authors: Roberts Kingman Garrett A. , Lee David , Jones Felicity C. , Desmet Danielle , Bell Michael A. , Kingsley David M.
Published: July 2021

Significance

Across a broad range of species, evolution has modified a common vertebrate body plan to produce endless forms most beautiful. A key unanswered question is whether diverse morphological changes in a common structure arise from modifying different genes or the same genes in different ways. Many natural populations of threespine stickleback have evolved either longer or shorter dorsal and pelvic spines. Here, we identify reciprocal regulatory changes in an ancient enhancer of the bone growth inhibitor,Stanniocalcin2a, as an underlying genetic cause. Many other stickleback loci similarly show three or more major classes of variants across populations; we suggest that diverse alleles at key loci may represent a common mechanism for producing diverse phenotypes from a smaller toolkit of genes.
A Risk Management Solution Designed to Facilitate Risk-Based Qualification, Validation, and Change Control Activities within GMP and Pharmaceutical Regulatory Compliance Environments in the EU—Part II
Authors: O'Donnell Kevin , Greene Anne
Published: July 2021

highlight the need for patient-focused and value-adding qualification, validation, and change control programmes for manufacturing and regulating medicinal products in the EU, which are cost-effective and in-line with current regulatory requirements and guidance. To this end, a formal risk management solution was presented that seeks to demonstrate, in a practical way, how Regulators and Industry in the EU may achieve these goals. This solution represents a formal and rigorous approach to risk management, offering a scientific and practical means for determining and managing, on a risk basis, the scope and extent of qualification and validation, and the likely impact of changes. Based on a ten-step, systematic process, this approach offers a ready-to-use and documented risk management methodology for these activities. This tool is not intended for use in all situations, or to address all risk areas or concerns encountered in GMP and Regulatory Compliance environments. Rather, its use should be commensurate with the complexity and/or criticality of the issue to be addressed, and in many instances, and in-line with ICH Q9 principles, a more informal approach to risk management may be more useful, and indeed proportionate.