bluuebunny/crossref_metadata_2025 huggingface dataset:
Three-Dimensional Nonlinear Integral Operator with the Modelling of Majorant Function
Authors: Hameed Hameed Husam , Al-Saedi Hayder M
Published: January 2021

In this paper, the process for finding an approximate solution of nonlinear three-dimensional (3D) Volterra type integral operator equation (N3D-VIOE) in R3 is introduced. The modelling of the majorant function (MF) with the modified Newton method (MNM) is employed to convert N3D-VIOE to the linear 3D Volterra type integral operator equation (L3D-VIOE). The method of trapezoidal rule (TR) and collocation points are utilized to determine the approximate solution of L3D-VIOE by dealing with the linear form of the algebraic system. The existence of the approximate solution and its uniqueness are proved, and illustrative examples are provided to show the accuracy and efficiency of the model.
Mathematical Subject Classification (2010):  45P05, 45G10, 47H99
The Dominant Metric Dimension of Corona Product Graphs
Authors: Adirasari Rembulan Putri , Suprajitno Herry , Susilowati Liliek
Published: January 2021

The metric dimension and dominating set are the concept of graph theory that can be developed in terms of the concept and its application in graph operations. One of some concepts in graph theory that combine these two concepts is resolving dominating number. In this paper, the definition of resolving dominating number is presented again as the term dominant metric dimension. The aims of this paper are to find the dominant metric dimension of some special graphs and corona product graphs of the connected graphs  and , for some special graphs  . The dominant metric dimension of  is denoted by  and the dominant metric dimension of corona product graph G and H is denoted by .
Child Perception Questionnaire in Iranian Elementary Schoolers: A Psychometric Study
Authors: Faghani Maryam , Mehdipour Aida , Akbari Elaheh , Amini-Tehrani Mohammadali , Armaki Atefeh Salehi , Lajevardi Seyed Mohammad Hossein , Ghazvinian Leila , Zamanian Hadi
Published: January 2021

Background: Child perception questionnaire (CPQ) assessing the oral health-related quality of life (OHQoL) of children is a widely-used instrument in the field. However, the instrument has not undergone validation and psychometric evaluation in Iranian population of children. The study aimed at examining the construct validity and testing the reliability of CPQ-16 in 7-12-year-old Persian-speaking elementary schoolers.Methods: From two main cities in 2018, Iran, 708 mother-child dyads were enrolled in this cross-sectional study. Questionnaires were executed via interviewer-administered method. DMFT and dmft indexes were examined for divergent validity. Two built-in indexes of overall oral health (OOH) and overall well-being (OW) were used for concurrent validity. Exploratory factor analysis (EFA) with Geomin rotation, Cronbach’s alpha, and Spearman’s correlation were executed. Results: Overall, 695 data entered the analysis. Children’ mean age was 9.72 (1.36) years. EFA indicated 11 items to compose three eligible factors, including oral problems, emotional problems, and social problems. Except for social well-being and emotional well-being, all OHQoL variables were correlated. CPQ-16, CPQ-11, and the subscales indicated significant relationships with overall oral health, except for social wellbeing. CPQ-11 compared to CPQ-16 showed a slightly higher correlation with OOH index. Only CPQ-11 and emotional well-being indicated significant associations with OW index. Whereas only emotional well-being indicated high DMFT, the CPQ-16, CPQ-11 and oral problems were associated with dmft. Cronbach’s alpha was 0.66. Conclusions: Further research on clinical sample is needed. Practitioners are suggested employing CPQ to multi-dimensionally examine the children’s’ oral health needs.
Risk Factors For Traumatic Open Fracture in Children and Adolescents Presenting With Traumatic Fractures
Authors: Wang Hongwei , Liu Jun , Wu Deluo , Ou Lan , Li Changqing , Yu Hailong
Published: January 2021

Background: To investigate the risk factors for open fractures in children and adolescents (≤18 years old) presenting with traumatic fractures.Methods: We retrospectively reviewed the records of 2418 children and adolescents who presented with traumatic fractures and were admitted to our university-affiliated hospitals, among which 206 patients (8.5%) presented with open fractures.Results: This study enrolled 1789 males (74.0%) and 629 females (26.0%) with an average age of 11.2±5.0 years. There were 206 patients (8.5%) who presented with open fractures. The five most common fracture sites were the tibia (31.1%, 64/206), fibula (20.9%, 43/206), phalanx (15.5%, 32/206), humerus (11.2%, 23/206) and ulna (9.7%, 20/206). Univariate logistic regression analysis showed that the aetiology (P﹤0.001) and fracture site (P﹤0.001) were risk factors for open fracture. Multivariate logistic regression analysis indicated that mechanical trauma (OR=64.229, P﹤0.001), being hurt/cut by others (OR=26.757, P﹤0.001), and being struck by an object (OR=15.345, P﹤0.001) were stronger risk factors for open fracture than were low falls; additionally, lower limb fractures (OR=5.970, P﹤0.001), upper limb fractures (OR=5.865, P﹤0.001) and multiple fractures (OR=5.414, P﹤0.001) were stronger risk factors than craniofacial fractures for open fractures.Conclusions: Aetiology (especially being injured by a machine or being hurt/cut by others) and the fracture site (including lower limb fractures, upper limb fractures and multiple fractures) were independent risk factors for open fractures.
Overexpression of Thermophilic α-amylase in Bacillus Licheniformis using a High Efficiency Chromosomal Integration and Amplification Strategy
Authors: Shen Peili , Niu Dandan , Liu Xuelian , Tian Kangming , Kugenthiren Permaul , Singh Suren , Wang Zhengxiang
Published: January 2021

Highly efficient preparation of industrially important enzymes depends on development of the genetically stable and high-yield microbial cell factories, which is often a challengeable laboratory hard work. In aims to simplify strain development with high efficiency for enzyme overproduction, a new strategy based on chromosomal integration and amplification in Bacillus sp . was developed. A pair of plasmids, an integrated expression plasmid pUB'-Ex1 and a thermosensitive replicable plasmid pUB-MazF, were constructed. pUB'-Ex1 conditionally self-replicated in Bacillus sp . when the RepF in pUB-MazF expressed. pUB-MazF thermosensitively self-replicated in Bacillus sp . , which was easily cured from the host by inducing MazF expression with IPTG. Bacillus licheniformis BL-UBM that integrated with pUB-MazF was then transformed with pUB'-amyS derived from pUB'-Ex1 by in-frame cloning of amyS encoding a thermophilic α-amylase from Geobacillus stearothermophilus ATCC 31195. The transformant of B. licheniformis BL-UBM with pUB'-amyS was cultivated at 42 o C with the existence of 1 mmol/l IPTG and 500 μg/ml kanamycin and the recombinants with high α-amylase activities were selected. All tested recombinants were extremely high genetic stability. One of which, recombinant BLiS-002, carried five copies of amyS and produced the highest yield of α-amylase. It could yield 50,753 U/ml of α-amylase in a 50-l bioreactor. The strategy developed in this study is of application potential for convenient and quick strain development for industrially important enzyme overexpression.
Effectiveness of Reverse Total Shoulder Arthroplasty for Primary and Salvage Fracture Care - Clinical and Radiological Outcome in Mid-term Follow-up in a Single-Center Experience
Authors: Schwarz Angelika , Hohenberger Gloria , Sauerschnig Martin , Niks Milan , Lipnik Georg , Mattiassich Georg , Zacherl Maximilian , Seibert Franz Josef , Plecko Michael
Published: January 2021

Background The introduction of reverse total shoulder arthroplasty (RSA) as a treatment option in complex proximal humeral fractures, including patients with poor bone quality, has significantly extended the surgical armamentarium.The aim of this study was to investigate the mid-term outcome following fracture RSA (FRSA) in acute or sequelae, as well as salvage procedures. It was hypothesized that revision FRSA (SRSA) leads to similar mid-term results as primary fracture treatment by RSA (PRSA).Methods This retrospective case-series study describes the radiological and clinical mid-term outcome in a standardized single-center and one-material Inlay design. Patients who underwent FRSA between 2008 and 2017 were matched (minimum follow-up: two years, minimum age at the time of operation: 60 years).The assessment tools used for functional findings were range of motion (ROM), Visual Analogue Scale, absolute (CS) plus normative Constant Score, Quick DASH, and Subjective Shoulder Value. All adverse events and the radiological results and their clinical correlations were analyzed statistically (using α = 5% and 95% confidence intervals).Results Following FRSA, 68 patients were included (mean age: 72.5 years, mean FU: 46 months). Forty-two underwent primary RSA (PRSA), 26 revision RSA (SRSA). Adverse advents were observed in 13% (n = 9/68).No statistically significant results were found in PRSA and SRSA in effect sizes by scores, whereby the failed osteosynthesis SRSA subgroup obtained significantly negative values in ROM subzones (flexion: p = .046, abduction: p = .037). Decreased tubercle healings in PRSA relative to SRSA were observed (p = .006). A missing bony healing of the tubercles was related to significant negative clinical outcome (all scores: p < .05, external rotation: p = .019). In SRSA, significant postoperative improvements could be stated (CS: 23 to 56 at mean, p = .001), the time from index surgery to operative revision revealed no associations in functional findings.Conclusions RSA is an effective option in severe shoulder fracture management with predictable results as salvage as well as first-line treatment. Promising mid-term functional results, reasonable implant survival rates, and a high patient satisfaction could be achieved.Trial RegistrationNot applicable, level of evidence III.
Energy Efficiency Of National Economy: Social, Economic And Ecological Indicators
Authors: Ziabina Yevheniia , Pimonenko Tetyana , Starchenko Luidmyla
Published: January 2021

The paper aimed to formalise the relationship between the level of Ukrainian energy efficiency from 30 indicators of social, ecological and economic development of the country. The main purpose of the study is to identify the impact and dependence of socio-ecological and economic indicators on the level of energy efficiency using multiple correlation-regression analysis. The systematisation of the analysed results allowed identifying the core directions to overcome the issues of the slow pace of energy efficiency improvement and the development of carbon neutrality of the country. The relevance of this scientific solution to the problem is that the level of energy efficiency is influenced by a large number of socio-ecological and economic factors sometimes independent of each other. The authors analysed the relationship between the level of energy efficiency and socio-ecological and economic indicators of country development. The investigation consisted from the following stages: conducting polynomial-regression analysis of energy efficiency development in Ukraine; development of correlation-regression multiple models of relationships between energy efficiency indicator and socio-ecological-economic indicators; explaining the conclusions and providing recommendations considering the findings. The object of the study was the processes of energy efficiency relationships with 30 indicators of socio-ecological and economic development, namely how much they affect the energy development of the country. The conclusions were theoretical and practical in terms of the impact on the level of energy efficiency of interdisciplinary indicators. The conclusions which proved by the empirical findings allowed identifying weaknesses in the development of the national economy, as well as to improve and increase the energy potential of the country through energy efficiency development strategies due to the studied determinants that have a strong impact on the level of energy efficiency.

Keywords: energy efficiency, carbon-free economy, sustainable development, energy sector, green energy, energy security.
Assessing The Level Of Macroeconomic Stability Of EU Countries
Authors: Zolkover Andrii , Renkas Jurij
Published: January 2021

This article is devoted to the development of methods for assessing the integrated level of macroeconomic stability of the country. Systematization of literature sources and approaches to determining the factors influencing macroeconomic stability and methods of its assessment showed that this problem is still unresolved and needs attention, given the epidemiological threats as additional factors destabilizing the world economy. The urgency of solving this scientific problem lies in need of an adequate and timely response to changes in the development of the national economy to prevent them from escalating into crisis phenomena. The study of assessing the integrated level of macroeconomic stability in the country was carried out in the article in the following logical sequence: 1) the formation of the statistical base of the study in terms of three groups of indicators: stimulants, disincentives and nominators; 2) bringing the indicators of the statistical input base of the study to a comparable form; 3) determining the priority of the impact of the components of the indicator in the integrated indicator; 4) assessment of the integrated level of macroeconomic stability, considering both the ranking of input indicators and the strength of their impact on the formation of the desired integrated indicator; 5) conducting a qualitative interpretation of the integrated level of macroeconomic stability. The methodological tools of the study were the following methods: minimax approach to the normalization of the statistical base of the study; sigma-limited parameterization method and Pareto method for determining the priority of the impact of the components of the indicators of the integrated level of macroeconomic stability; Erlang’s formula for estimating the integrated level of macroeconomic stability. The study period was 2006-2019. The countries selected for the study were the following: Poland, the Czech Republic, Lithuania, Latvia, Hungary and Slovakia. The article presents the results of the assessment of the integrated indicator, which showed that Lithuania, Latvia, the Czech Republic and Poland achieved macroeconomic stability on average from 2014 at 84%, Slovakia – 65%, while Hungary had relative stability from 2010 to 2016, at the level of 76-82%, but in 2017-2018 there is a destabilization of economic development to 45%. The results of the study can be useful for public authorities in determining macroeconomic stability as an element of national economic management, the use of which will protect against financial and economic crises by taking a set of preventive measures. Keywords: Pareto diagram, macroeconomic stability, minimax approach, ranking, sigma-limited parameterization, Erlang’s formula.
Agritourism Development Issues In Rural Places: Evidence From Armenia
Authors: Tovmasyan Gayane , Avetisyan Samvel , Galustyan Inga , Tatosyan Kristine , Mirijanyan Lusya , Rushanyan Argine
Published: January 2021

The following paper summarizes the arguments and counterarguments within the scientific discussion on the issues of agritourism development issues in rural places. Agritourism development is a good source for rural development, as it will contribute to the investments in villages, increase rural income, emlpoyment, etc. The main purpose of the article is to analyze agritourism development opportunities and issues in Armenian rural places. The analysis was carried out in Armenian two regions: Lori and Tavush. The investigation of the topic and the results of the analysis state that Armenian regions Lori and Tavush have opportunities to develop different types of tourism based on existing resource potential: historical-cultural, eco, agro, gastronomic, adventure, etc. The research empirically confirms and theoretically proves the existing problems that hinder agritourism development. For the analysis a survey and observation methods were used. Survey was done among village heads and local population-hosts. The main results of the research are then analyzed via SWOT analysis, based on which some suggestions were made. The main conclusion is that it is necessary to implement various actions for agritourism development, such as: involving investments, improving roads and infrastructures, improving legislation and statistics, organizing trainings for hosts and farmers, improving marketing, etc. The development of agritourism will contribute to the development of the community and the whole country, will increase incomes, spread and preserve culture, increase motivation to live in villages, will form a civil society, as constant contact with tourists, continuous development of business skills and aspirations, will enlarge the worldview of population and will contribute to their understanding of the most important problem of preserving the Armenian culture. The results of the research can be useful for the state and municipal organs, private sector, also for researchers of tourism sphere.

Keywords: agritourism, infrastructures, marketing, rural places, tourism, villages.
The Observational Socio-Economic Study and Impact on the International Innovative Leadership in the United States
Authors: Kasztelnik Karina , Brown Damon
Published: January 2021

This paper summarizes how socio-economic study has impact on the international innovative leadership in the United States. This article includes the review will focus and examine literature and theories related to public policy organizational effectiveness as well as diversity leadership. Online databases including search engines located relevant books, journals, articles, and dissertations. The search terms used were descriptive of various themes such as diversity, diversity leadership, public policy and public policy leadership, organizational leadership, public policy and leadership, cultural diversity, organizational effectiveness, and public policy effectiveness. Additionally, measurements of public policy organizations effectiveness have been narrowly focused on past practice failing to include multiple organizational aspects similar to other professional organizations. Prior studies have been conducted in relationship to the effects of diversity leadership and leadership although related solely to the individual officer or the public policy organization. Notwithstanding, studies have been sparse which suggest that diversity leadership initiatives or enhanced leadership, increase public effectiveness, let alone collectively. Limited studies are not the case concerning public policy. This study attempted to fill this gap by examining if leadership of public policy outcomes of diversity leadership initiatives and the level of leadership predicts public policy organizational effectiveness. All of these terms have assisted in locating contemporary and relevant research. The results of the critical review article with analysis both authors can be useful for any leaderships around the World to support social-economics changes.

Keywords: socio-economic, innovation, leadership, education, public policy.
The introduction of new technologies for out-patient care for tuberculosis patients during the COVID-19 pandemic in the Republic of Sakha (Yakutia)
Authors: Kravchenko A. F. , Prokopiev E. S. , Yakovleva L. P. , Lukina A. M. , Luginova E. F. , Val N. S.
Published: January 2021

During the COVID-19 pandemic in the Russian Federation associated with restrictions and quarantine, in order to ensure the quality and availability of tuberculosis medical care to the population of the Republic of Sakha, it became necessary to improve and search for new organizational forms of out-patient care.

The objective of the study: to analyze the use of new technologies in out-patient care for tuberculosis patients in the Republic of Sakha (Yakutia) during the COVID-19 pandemic.

Result: Scientific Practical Phthisiology Center introduced the following information and digital technologies to ensure the availability and quality of medical services to the population of the republic during the COVID-19 pandemic: Cloud Polyclinic, Telemedical Consultations, Radiological Information System of APK ArchiMed , Video-Controlled Treatment at Home, and Hospital at Home.

All technologies have demonstrated their efficacy for remote medical consultations and contacting patients online. Based on practical experience, these technologies provided the following: improvement of medical care provided to the population through consultations, maintaining good contact with the patient, monitoring patients' well-being, and drug in-take. They assured compliance with general federal and regional anti-epidemic recommendations to prevent the spread of the new coronavirus infection.
ETHANOMEDICINAL PLANTS WITH ANTI-INFLAMMATORY EFFECT FROM SOUTHERN HARYANA, INDIA: A REVIEW
Authors:   Department of Pharmaceutical Sciences, Guru Jambheshwar University of Science and Technology, Hisar-125001 Haryana(India)., Singh Sumitra , Devi Bhagwati ,   Department of Pharmaceutical Sciences, Guru Jambheshwar University of Science and Technology, Hisar-125001 Haryana(India).
Published: January 2021

Inflammation is a physiological host response to external challenges or cellular injury such as pathogens, damaged cells or irritants leading to the release of a complex array of inflammatory mediators and aiding the recovery of tissue structure and function.All inflammatory processes develop along a known sequence: locally increased blood supply, leakage of fluid, small molecule or proteins and infiltration of cells.Inflammation is not a synonym for infection, even in case where inflammation is caused by infection, response includes clinical signs of erythema, edema, hyperalgesia and pain. Since the ancient Greek and Roman era five basic symptoms of inflammation have been known i.e, redness, swelling, heat, pain and deranged function are produced by inflammatory agents such as nitric oxide, prostaglandins, bradykinin, serotonin, leukotrienes and histamine. The inflammatory process is a series of events that can be elicited by numerous stimuli such as infectious and thermal or physical injury through years of ingenious synthesis and structural modifications.
THE ROLE OF EXTERNAL PARTIES IN INFLUENCING THE CONFLICT IN LIBYA
Authors:   Phd Student,Department of Political Science Management and Science University., Naser Ahmed Khlifa Abubakr
Published: January 2021

Some countries and international organizations took advantage of the events that occurred in many Arab countries, or the so-called Arab Spring, to bring down the dictatorial regime, including what happened in the Libyan state, where the Libyan regime suppressed the popular uprising demanding change, and the transition to a democratic system establishes social justice and protects freedom and human rights. This gave the justification for these countries to intervene as a third party in the crisis, which complicated the crisis and made the events take a violent turn that ultimately led to the collapse of the state and the fall of Muammar Gaddafis regime, with the help of foreign countries for the uprising through international decisions that led to the military intervention. This resulted in a civil war raging between the Libyan parties with external funding, and the inability of the internationally recognized government to play its role within the borders of the Libyan state. We seek here to find out the role that these parties played in the Libyan state and its impact on the course of events and the existing conflict.
EXTENSIVE ANTERIOR WALL ST ELEVATED MYOCARDIAL INFARCTION FOLLOWING STEERING WHEEL IMPACT AND BLUNT CHEST TRAUMA IN A ROAD TRAFFIC ACCIDENT: A RARE CASE REPROT
Authors:   Consultant Emergency Medicine, Ramkrishna Care Hospital, Raipur, Chhattisgarh, India., Banerjee Sayani , Anil Jain Pranay ,   Consultant Cardiologist, Ramkrishna Care Hospital, Raipur, Chhattisgarh, India., Kumar Singh Santosh ,   Consultant Emergency Medicine, Ramkrishna Care Hospital, Raipur, Chhattisgarh, India.
Published: January 2021

Background: Blunt trauma chest may rarely lead to acute myocardial infarction. Shear force generated from trauma causes tearing, laceration of coronary vascular intima and results in intraluminal thrombosis. Left anterior descending (LAD) artery is the most common to be involved secondary to its proximity to anterior chest wall. Case Presentation: We report a case of 38year old hypertensive male presented in emergency room with complaints of left sided chest pain & diaphoresis for one hour following trauma to his chest from steering wheel following a collision between two four wheeler. During primary survey as per ATLS guideline 12 ECG revealed acute extensive anterior wall STEMI. Other associated injuries were left frontal non hemorrhagic contusion, bilateral minimal pneumothorax, multiple bilateral rib fractures, mild hemoperitoneum with small hematoma in retroperitoneum and serosal surface of stomach. Urgent coronary angiography done by cardiologist on call and patient was diagnosed with single vessel coronary artery disease involving LAD with severe systolic LV dysfunction. Percutaneous transmural coronary angioplasty (PTCA) was done by a drug eluting stent in LAD. Conclusion: An emergencyphysician should consider cardiac complications in patients with chest trauma including myocardial infarction, early diagnosis of which is critical to save the myocardium.Any delay in diagnosis can be detrimental. What we already know? There are quite a few case reports that already mentioned about possibility of acute myocardial infarction after blunt chest trauma following road traffic accident secondary to intimal laceration of coronary artery and intraluminal thrombosis. Most coomonly left anterior descending artery is involved. What this paper adds?This is rare case report of acute & extensive anterior wall myocardial infarction secondary to single vessle coronary artery involvement after blunt chest trauma by steering wheel in a road traffic accident. We specifically points towards the fact that noobvious Clinical guideline to manage these kind of cases mentioned in literature.Hence proper clinical guidelines to manage such kind of cases. Also, in acute myocardial infarction post blunt trauma chest, PCI seems to be a better option than thrombolysis keeping in mind of other injuries.
LEADERSHIP BEHAVIOR OF HEALTH WORKERS IN PROVIDING HEALTH SERVICES THROUGH HOMECARE ONLINE WWW.EXCELLENTCARE.ID DURING THE COVID-19 PANDEMIC
Authors:   STIKes Nurul Hasanah Kutacane., Andriani Dina , Arma Nuriah ,   Institut Kesehatan Helvetia., Ramini Novy ,   Institut Kesehatan Helvetia., Syahradesi Yessy ,   STIKes Nurul Hasanah Kutacane., Lestari Fika ,   Akademi Kebidanan Nurul Hasanah., a Desrina ,   Akademi Keperawatan Teungku Fakinah., b Yusnaini ,   STIKes Nurul Hasanah Kutacane., Madani Ultra ,   STIKes Nurul Hasanah Kutacane.
Published: January 2021

The Covid-19 pandemic demands changes in health services that focus on social restrictions. The use of digital technology is key in efforts to combat the Covid-19 virus through online homecare. Health workers play an important role as leaders in supporting the optimal implementation of online homecare. The leadership of health workers is identified through the behaviors shown during homecare services to patients. The purpose of this study is to analyze the leadership behavior of health workers in providing health services through the online homecare www.excellentcare.id during the Covid-19 pandemic. This type of research is quantitative with a descriptive survey method.The population in this study were all online homecare health workers www.excellentcare.id.com with a sampling technique in the form of a total sampling of 43 health workers. The results showed that most of the health workers with adults, most of the health workers were female, most of the health workers with a nurse professional education level and almost all health workers had good leadership behavior. Based on the results of this study, it is hoped that health workers will demonstrate and continuously improve leadership behavior through education and training in order to show exemplary, inspire patients to be able to face challenges, cooperate among health workers and provide support for patients and families.
USAID’S Assured Assistance: USAID’s Humanitarian Aid in Latin America and the Caribbean 2001- 2019
Authors: Carpenter Carolyn Louise
Published: January 2021

The United States Agency for International Development (USAID) is the largest donor of humanitarian assistance to Latin America and the Caribbean (LAC). A quantitative analysis of USAID’s disaster relief funding for LAC from 2001- 2019 was conducted to determine trends and effectiveness of its contracting. The findings demonstrate that USAID provides billions in assistance to increase foreign trade, but project results are ambiguous. The United States views short-term assistance programs as investments for long-term growth in globalized economies. It is recommended that LAC for-profit and non-profit organizations follow a similar strategy and capitalize on the assured assistance of USAID.
Keywords: Foreign aid; foreign policy; disaster relief; NGO; GO; contracting.
Indicador de captación del programa de control de tuberculosis: reto del ente territorial frente a los Objetivos de Desarrollo Sostenible
Authors: Martelo Salazar German , Bohorquez Moreno Cristina , Hernandez Escolar Jacqueline
Published: January 2021

Teniendo en cuenta que la tuberculosis es una meta del tercer Objetivo de Desarrollo Sostenible, se propuso a través de un estudio transversal descriptivo, evaluar el estado del indicador de captación del programa de control de tuberculosis del departamento de Bolívar, se revisaron 334 fichas de notificación de 2016 a 2018, el porcentaje de captación fue menor al 80%, y solo se cumplió la meta de concentración de BK en el año 2017 con un promedio de 2,5%.  Se concluye que no existe cumplimiento de la búsqueda de sintomáticos respiratorios, sin embargo, la concentración de baciloscopias reportó en el programa un mantenimiento adecuado.
Unique strain of Bifidobacterium longum and its efficacy in irritable bowel syndrome
Authors: Plotnikova E. Yu.
Published: January 2021

Irritable bowel syndrome (IBS) is one of the most prevalent gastrointestinal disorders affecting between 5 and 15% of the general adult population worldwide. Over the course of many years altered intestinal motility, visceral hypersensitivity, immune changes and, as it has recently been found, impaired epithelial barrier function were meant to explain the origin of symptoms in the IBS. We have come to realize now that the IBS warrants serious clinical and scientific study. Not that long ago, the connections between the gut and the brain have been expanded to include a new entrant, the microbiota, resulting in the creation of a new concept of a microbiota-gut-brain axis.

Microbiota is a risk factor for the irritable bowel syndrome. Probiotics are defined as live microorganisms, which can alter the intestinal flora and regulate intestinal functions such as reduction of visceral hypersensitivity, improvement of mucosal barrier function, modulate immune responses and chronic inflammation, affect the central nervous system, gastrointestinal motility, etc. The correctness of this approach is confirmed by several studies of the probiotic Bifidobacterium longum subsp. longum 35624, which is widely used in the treatment of symptoms of irritable bowel syndrome. The dietary supplement Bifidobacterium longum subsp. longum 35624 contains 1 × 109 colony-forming units, which provides a clinically effective level of these beneficial bacteria. Bifidobacterium longum subsp. longum 35624 also reduces inflammation in the gastrointestinal tract and has positive results in reducing abdominal symptoms (e.g. abdominal pain / discomfort and bloating) associated with the irritable bowel syndrome and other conditions.
The role of regulatory T cells in autoimmune thyroiditis
Authors: Zhukova S. I. , Kanner I. D. , Mamontova T. M. , Shelomentceva E. M. , Maximov M. L.
Published: January 2021

Autoimmune thyroiditis is an organ-specific autoimmune disease caused by the activation of self-reactive CD4+ T cells. Regulatory T (Treg) cells are a population of T cells that play a central role in immunological tolerance by suppressing selfreactive cells. CD4+ Tregs are divided into thymic (tTreg) and peripheral (pTreg). tTregs perform their functions through cytokine-independent mechanisms, pTregs – through IL-10, TGF-β and IL-35. Tregs perform a protective function against AIT. Studies of Treg level in AIT show different results, in most cases Treg level is increased, and their function is impaired. Treg function in AIT is affected by many factors, such as the level of thyroglobulin, vitamin D etc. Apart from the Treg level itself, the Th17/Treg ratio is also crucial in AIT. Activation of Tregs and modification of the Th17/Treg ratio can be used in AIT treatment.
Vasomotor menopausal symptoms: is it just hot flashes? Alternative non-hormonal methods of treatment with proven effectiveness (literature review)
Authors: Kasyan V. N. , Adamyan L. V.
Published: January 2021

Taking into account the modern life expectancy, a third of their lives, on average, women live in conditions of estrogen deficiency, which negatively affects the quality of life and the level of morbidity in older people. For doctors of other specialties, besides ObGyn, the climacteric period is strongly associated exclusively with hot flashes. However, early menopausal symptoms include sleep disturbances, mood changes, the risk of depression and decrease in self-esteem, sexual dysfunction. The predominance of vegetative symptoms makes the patient seek help not only from the gynecologist, but also from other specialists, however, the lack of knowledge in menopause medicine leaves them unsatisfied. In this regard, a therapeutic approach requires a comprehensive understanding of the problem.

The “gold standard” for managing patients with climacteric complaints is menopausal hormone therapy. However, there are women with contraindications to this group of drugs or the predominance of vegetative symptoms, when only hormonal correction is not enough. Among alternative non-hormonal agents, inhibitors of serotonin reuptake, in particular the most popular drug venlafaxine, hold a strong leadership with proven efficacy against a complex of symptoms. Also, other medications have been studied that can stop both vasomotor and vegetative symptoms of menopause. The review presents the literature data on the role of alternative agents in the correction of vasomotor symptoms of menopause, along with the known efficacy against autonomic complaints for increasing the effectiveness of counseling for older women.
Comparative characteristics of osmolarity, tear production and state of the corneal epithelium after instillations of the preparations Visomitin and hypromellose
Authors: Safonova T. N. , Surnina Z. V. , Zaitseva G. V.
Published: January 2021

Introduction. Dry eye syndrome (DES) is a multifactorial disease of the ocular surface, characterized by changes in its homeostasis and accompanied by ocular symptoms, the etiology of which is associated with destabilization of the tear film, hyperosmolarity, inflammation, damage to the structures of the ocular surface and neurosensory disorders.

Objective. To study the effect of a drug containing plastoquinonyldecyltriphenylphosphonium bromide (PDTP, SkQ1) on dynamics of osmolarity and reparative properties of the cornea.

Materials and methods. The study included 23 patients (46 eyes) aged 23 to 49 years. All patients presented complaints of dryness, burning sensation, cramps and discomfort in the eyes, increased sensitivity with instillation of drops, periodic blurred vision. Patients underwent standard and special ophthalmic examinations. The patients were divided into two groups comparable in gender and quantitative composition.

Results. Based on the results of the examination at the starting visit, all patients were diagnosed with DES mild or moderate study. After one week of therapy, a significant decrease in subjective complaints was noted patients who received the drug with PDTF. All patients tolerated the drug well. In the group of patients who received a tear replacement therapy with hypromellose, in most patients, while complaints of dryness persist, decreased a feeling of pain in the eyes. A month later, complaints persisted only in patients of this group, but their intensity was known significantly reduced compared to the visit after a week. Against the background of therapy with the drug with PDTP, significant improvement of the Schirmer test, Norn test and corneal staining, as well as with the help of a in vivo confocal microscopy shows a decrease in the number of Langerhans cells.

Conclusion. The results obtained indicate a positive effect of PDTP on the structure of the ocular surface even with its short-term use due to its keratoprotective and anti-inflammatory action.
Thrombotic diseases and conditions – diagnosis and monitoring of anticoagulant therapy
Authors: Melkumyan A. L. , Berkovskiy A. L. , Vasiliev S. A. , Sergeeva E. V.
Published: January 2021

Laboratory methods are a very important part of the examination of patients with thrombotic diseases, often putting the final touches on the diagnosis, and in some cases even defining this diagnosis. The present review of thrombotic diseases and conditions, as well as the laboratory methods for their diagnosis, enables the differentiation of these conditions in the laboratory phase of the examination and the selection of the correct specific therapy, especially antithrombotic therapy.

This review reflects the main nosological forms, causes of thrombotic diseases and conditions, as well as methods of their diagnosis using reagents and test systems of the leading domestic manufacturer of reagents for diagnostics of the hemostatic system SPD “Renam” ICPOD “Hemophilia Society”. The mechanisms of conditions and diseases such as deep vein thrombosis (DVT) and pulmonary artery thromboembolism (PATE), hypercoagulability syndrome (HCS), disseminated intravascular coagulation (DIC), hereditary and acquired thrombophilia (deficiency of antithrombin III, proteins C and S, factor Va resistance to activated protein C, etc.) and complications of anticoagulant therapy (heparin-induced thrombocytopenia (HITC), antiphospholipid syndrome (APS), complications of anticoagulant therapy (heparin-induced thrombocytopenia (HIT), coumarin-induced necrosis, etc.) are reviewed. Laboratory criteria for thrombotic conditions are presented. The most commonly used anticoagulant drugs and their control methods are reviewed, including vitamin K antagonists (oral anticoagulants, OAC), unfractionated heparin (UFH), low molecular weight heparins (LMWH), fondaparinux, direct or new oral anticoagulants (DOACs or NOACs). Laboratory criteria for thrombotic conditions are presented. Methods for determining blood D-dimer are described in detail, as well as methods for measuring anti-Xa and anti-IIa heparin activity.

This joint work of the leading employees of the Research and Production Department «Renam» of ICPOD «Hemophilia Society» and FSBI NMRC of Hematology of the Ministry of Health of the Russian Federation reflects the need for scientific and practical cooperation of practitioners, laboratory doctors and manufacturers of reagents and test systems to develop the most sensitive, specific, accurate and convenient methods of disease diagnostics and control of therapy.
Drug-induced arrhythmias
Authors: Leonova M. V.
Published: January 2021

The article provides a scientific review based on the proceedings of the 2020 American Heart Association consensus on drugs that may cause arrhythmias on a risk-sensitive basis and a guidance on strategies for monitoring, prevention methods and therapeutic approaches.

The risk factors for drug-induced arrhythmias are divided into modifiable and non-modifiable. Among the non-modifiable risk factors are congenital anomalies (changes in the conduction system, ion channel polymorphism) and heart diseases (cavity dilatation, myocardial ischemia). Among the modifiable risk factors are various electrolyte disorders (hypo/hyperkalemia, hypo/hypermagnesemia, hypocalcemia). Certain drugs can lead to electrolyte disorders, which require management with potassium and magnesium supplements. The drug-induced arrhythmias can be caused by conditions leading to altered drug pharmacokinetics and increased plasma concentrations and metabolites having proarrhythmogenic effects, as well as drug-drug interactions.

Beta-blockers, non-dihydropyridine calcium channel blockers, other antiarrhythmic drugs, ivabradine, digoxin, anesthetics (bupivacaine, propofol) are the most common culprits in causing drug-induced bradyarrhythmias. The drug-induced atrial fibrillation frequently occurs in patients receiving antiarrhythmics, various sympathomimetics, psychotropic and antineoplastic drugs, anti-inflammatory (NSAIDs, corticosteroids) and immunotropic agents (interleukin-2, fingolimod). Various sympathomimetics and inotropic drugs, some antipsychotic drugs can produce drug-induced atrial and nodal tachyarrhythmias.

The drug-induced ventricular tachycardia can be caused by antiarrhythmics, inotropics and various sympathomimetics, antipsychotic and antineoplastic drugs, as well as herbal drugs (aconite, ginkgo biloba). The list of drugs that cause a long QT syndrome includes antiarrhythmics, antimicrobial drugs (macrolides, fluoroquinolones, aminoquinolines, fluconazole), antipsychotics, antineoplastic drugs, antiemetics, etc. For a complete list of drugs that prolong a QT interval, see the CredibleMeds website (Arizona, USA). The drug-induced arrhythmia prevention strategies include rising awareness among doctors about risk factors and potentially dangerous drugs, sufficient monitoring of patients at risk of developing arrhythmias (ECG monitoring, electrolyte balance, kidney and liver function), maintenance of electrolyte balance, primarily potassium and magnesium. The therapeutic approach includes discontinuation of a causative drug; relief and maintenance therapy are carried out based on the modern international clinical guidelines for various forms of arrhythmias.
Tolperisone in the combination treatment of muscular tonic syndrome in individuals with a high level of physical activity
Authors: Gutianskii O. G. , Zarubin A. N.
Published: January 2021

Introduction. Dorsalgia is one of the most common diseases in individuals practising regular physical training and sports Rationale. Because of the growth of the number of physically active individuals expected to rise by 2024, the improvement of drug and physical rehabilitation methods comes into sharp focus.

The objective of the study is to evaluate the clinical efficacy of the use of a centrally acting muscle tolperisone-containing relaxant in the combined treatment of dorsalgia accompanied by a muscular tonic syndrome.

Materials and methods. In the study, two groups of patients (30 people each) with muscular tonic syndrome received therapy that included NSAIDs and a neurotropic vitamin complex (in the comparison group), and additionally a centrally acting muscle relaxant (in the treatment group).

The treatment outcome was assessed by changes in complaints and the objective neurological status of patients, the degree of muscle soreness upon palpation, and the evaluation of pain syndrome using a visual analogue scale.

The shear wave elastography (SWE) of defunct muscles was used as an objective assessment method.

Earlier in clinical practice, muscle tension in patients was usually assessed using manual palpation, i.e., only qualitatively and subjectively. SWE is an operator-independent, relatively reproducible, and quantitative method for assessing tendons and muscles. SWE was used in this study to obtain more objective assessment and comparison of the elasticity of “affected” and “healthy” symmetrical back muscles before and after the use of drugs.

Results. The study showed a high clinical efficacy of tolperisone in the combination therapy of the lower back pain accompanied by muscular tonic syndrome, which was confirmed by a more significant decreased muscle-tonic syndrome based on the evaluation of complaints and the degree of muscle soreness upon palpation, a more pronounced regression of pain syndrome according to VAS in the treatment group of patients vs the comparison group. According to the elastography findings before and after treatment, the group receiving tolperisone showed a more significant decrease in muscular tonic syndrome.

Сonclusion. The study confirmed the clinical efficacy of tolperisone manufactured by Sotex pharmaceutical company. On these grounds we recommend that the drug is used in combination therapy for dorsalgias (dorsopathies) accompanied by a muscular tonic (myofascial) syndrome both in patients without a proper level of physical activity, and in those practising regular physical training and sports.
Pseudo-Univariate Calibration Based on NIR Spectroscopy in the Determination of Anthocyanins and Antioxidant Activity in Grape Juices
Authors: Beltrame Karla , Gonçalves Thays , Março Paulo , Gomes Sandra , Matsushita Makoto , Valderrama Patrícia
Published: January 2021

This work shows an alternative methodology based on a portable near-infrared (NIR) spectroscopy coupled to independent components analysis (ICA) in a pseudo-univariate calibration way to determine total anthocyanins (TA) concentration and antioxidant activity (AA) in whole grape juice. To this, the scores proportions more related to TA and AA were plotted against TA and AA obtained by its respective references methodology to build pseudo-univariate calibration models with correlation coefficients of 0.9699 and 0.9814, respectively. From the results, it is possible the suggestion that NIR spectra coupled to ICA enable to overcome interferences using first-order data and work properly when there is enough selectivity for the analyte profile in the sample data.
Information and Assessment Support for the Management of Region's Social Sphere (Based on the Case of Public Healthcare in Kuzbass)
Authors: Morozova Elena , Pastukhova Elena
Published: January 2021

The importance of information and analytical activities in the management of the region's social sphere can hardly be overestimated since only those decisions will be efficient that rely on reliable and comprehensive data on the condition of the object of influence, trends in its development, possible directions for improvement, and feedback. A competent use of information in management requires that the methodological foundations of analytical and assessment processes be understood, in particular, the corresponding thesaurus. The study aims at systematizing the conceptual apparatus of the information and assessment support for the management of the region's social sphere and analyzing the condition and dynamics of healthcare as one of its key sectors. The paper focuses on the case of Kemerovo Region (Kuzbass). It interprets and systematizes such concepts as information, rate, parameter, indicator, criterion, and assessment. The empirical part of the study showed that the morbidity rate in Kuzbass has been above the nation level for the past 15 years and the data gap for this indicator is gradually increasing. This trend manifests itself against the background of higher values of infrastructure indicators and the load on nursing staff. True, the workload on medical doctors in the region is above the corresponding parameter at the national level. Sociological assessments show an increase in self-esteem of the population's health, but satisfaction with the health care system in the region has been, and remains, low. The data confirm the necessity and expediency of using statistical and sociological assessments in analyzing the current condition and, most importantly, identifying problems and ways to improve the sectors of the social sphere in the region.