bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptoms and problems reported by patients with non-cancer diseases through open-ended questions in specialist palliative care: A national register-based study
Authors: Rojas-Concha Leslye , Hansen Maiken Bang , Groenvold Mogens
Published: July 2023

Purpose
Since 2010, a comprehensive symptom/problem (S/P) assessment has been carried out in Danish specialist palliative care using the EORTC QLQ-C15-PAL questionnaire and the open-ended “Write In three Symptoms/Problems” (WISP) instrument. On WISP patients can report up to three S/Ps not included in the EORTC QLQ-C15-PAL. However, little is known about which S/Ps patients with non-cancer diseases report using WISP. Therefore, we investigated the prevalence and severity of S/Ps reported on WISP by non-cancer patients in specialist palliative care and compared these S/Ps with those previously reported by cancer patients.
Methods
This register-based study collected data from the Danish Palliative Care Database. We included adult patients with non-cancer diseases answering the EORTC QLQ-C15-PAL at admittance to specialist palliative care between 2016–2021. WISP responses were qualitatively categorized, and their prevalence and severity calculated.
Results
Of the 2,323 patients with non-cancer diseases answering the EORTC QLQ-C15-PAL, 812 (34.9%) reported at least one S/P using WISP. A total of 1,340 S/Ps were reported on WISP, of which 56.7% were not included in the EORTC QLQ-C15-PAL (i.e., were new). Edema, existential problems, dizziness, cough, and dysphagia were the most prevalent new S/Ps. Overall, 88.7% of the S/Ps were scored as moderate-severe. The prevalence of S/Ps reported on WISP did not significantly differ between cancer and non-cancer patients, except for existential problems, dysphagia, myoclonus, speaking problems, sweats and vomiting.
Conclusion
The similarities and differences in the prevalence of the most common S/Ps reported on WISP, confirm that WISP improves symptom assessment regardless of patient diagnosis.
ABS: Adaptive Bounded Staleness Converges Faster and Communicates Less
Authors: Tan Qiao , Zhu Feng , Zhang Jingjing , Liu Shengyun
Published: July 2023

The convergence time and communication rounds are critical performance metrics in distributed learning with a parameter-server (PS) setting. Local stochastic gradient descent (SGD) is a widely used method for improving communication efficiency in distributed learning. However, synchronous local SGD can experience substantial slowdowns, forcing stragglers to perform multiple local updates and the other nodes to keep waiting. Asynchronous methods are immune to these slowdowns but can suffer from gradient staleness, leading to suboptimal results or even divergence. To address these challenges, we propose a novel asynchronous strategy named adaptive bounded staleness (ABS). ABS leverages two key enablers. Firstly, the number of workers that the PS waits for per round for gradient aggregation is adaptively selected to strike a balance between straggling and staleness. Secondly, workers with relatively high staleness are prompted to initiate a new round of computation, alleviating the negative effects of staleness. Simulation results demonstrate that ABS outperforms state-of-the-art schemes in terms of wall-clock time and communication rounds.
Unraveling the Impact of SNAP on Household Non-Food Expenditure: An Instrumental Variables Approach
Authors: Almada Lorenzo , Nam Jaehyun
Published: July 2023

This study investigates the causal effects of SNAP participation on household expenditures, with a central focus on non-food related expenditures. We examine total non-food spending as well as six subcategories of non-food expenditures using the 2000–2011 waves of the Consumer Expenditure Survey (CE). Selection into SNAP is addressed by employing an IV approach that exploits variation in state-level policies and program administration to instrument for SNAP participation, conditional on household and state-level characteristics. Respondent misreporting is addressed by adopting an approach based on parametric methods for misclassified binary dependent variables that produces consistent estimates when using instrumental variables. The analyses reveal that, after adjusting for misreporting, SNAP participation among low-income households increases expenditure on non-food by 27 percent, while increasing expenditure on food by nearly 41 percent per year. The results indicate that SNAP participation significantly increases most of the non-food subcategories. The results are generally similar but measured less precisely when separately examining households with and without children. Overall, the findings of this study indicate that SNAP is serving its intended purpose of increasing household expenditures on food, while also allowing households to allocate some of their income to various non-food spending categories.
Preferential disruption of HLA-A/B enhances allogeneic CAR-T cell expansion and antitumor capacity in B cell malignancies
Authors: Chen Xinfeng , Tan Binghe , Xing Haizhou , Zhao Xuan , Ping Yu , Zhang Zhen , Huang Jianmin , Shi Xiujuan , Zhang Na , Lin Boxu , Cao Weijie , Li Xin , Zhang Xudong , Li Ling , Jiang Zhongxing , Zhang Mingzhi , Li Wei , Liu Mingyao , Du Bing , Zhang Yi
Published: July 2023

Background
Although chimeric antigen receptor T (CAR-T) cells have been proven to be an effective way of treating B cell malignancies, a lot of patients could not benefit from it because of failure in CAR-T cell manufacturing, disease progression and unaffordable price. The study aimed to explore universal CAR-T cell products to extend the clinical accessibility.
Methods
The antitumor activity of CRISPR/Cas9 edited allogeneic anti-CD19 CAR-T (CAR-T19) cells was assessed in vitro, in animal models, and in patients with relapsed/refractory (R/R) acute B cell lymphoblastic leukemia (B-ALL) or B cell lymphoma.
Results
B2M−/TRAC− universal CAR-T19 (U-CAR-T19) cells exhibited powerful anti-leukemia abilities both in vitro and in animal models, as did primary CD19+ leukemia cells from leukemia patients. However, expansion or anti-tumor efficacy of U-CAR-T19 cells was not observed in six patients with R/R B cell malignancies. Accordingly, significant activation of natural killer (NK) cells by U-CAR-T19 cells was proven both clinically and in vitro. HLA-A−/B−/TRAC− novel CAR-T19 (nU-CAR-T19) cells were constructed with similar tumoricidal capacity but resistance to NK cells in vitro. Surprisingly, robust expansion of nU-CAR-T19 cells, along with rapid eradication of CD19+ B cells, was observed in the peripheral blood and bone marrow of three patients with R/R B-ALL. The patients achieved complete remission with no detectable minimal residual disease 14 days after the infusion of nU-CAR-T19 cells. Two patients had grade 2 cytokine release syndrome, which was managed using an IL-6 receptor blocker. Most importantly, no graft-versus-host-disease was observed in any patient, suggesting the safety of TRAC-disrupted CAR-T cells generated using the CRISPR/Cas9 method for clinical application.
Conclusions
The "off-the-shelf" allogeneic nU-CAR-T19 cells showed a strong response in R/R B-ALL. nU-CAR-T19 cells have the potential to be a promising new approach for treating R/R B cell malignancies.
Multi-omics comprehensive analysis of renal clear cell carcinoma to distinguish subtypes with different molecular characterizations and therapeutic strategies
Authors: Ruan Xinjia , Lai Chong , Lu Xiaofan , Zhang Dandan , Lai Maode , Yan Fangrong
Published: July 2023

Purpose
Kidney renal clear cell carcinoma (KIRC) is the most prevalent heterogeneous subtype of malignant renal cell carcinoma and is well known as a common genitourinary cancer. Stratifying tumors based on heterogeneity is essential for better treatment options.
Methods
In this study, consensus clusters were constructed based on gene expression, DNA methylation, and gene mutation data, which were combined with multiple clustering algorithms. We further analyzed the gene differences, pathway enrichment, prognosis, genetic alterations, immunotherapy response and drug sensitivity of each subtype. In addition, we also performed integrated analysis of bulk data and scRNA-Seq data.
Results
Among the two identified subtypes, CS1 (consensus subtype) was enriched in more inflammation-related and oncogenic pathways than CS2, showing a worse prognosis. We found more copy number variations and BAP1 mutations in CS1. Although CS1 had a high immune infiltration score, it exhibited high expression of suppressive immune features. Based on the prediction of immunotherapy and drug sensitivity, we inferred that CS1 may respond poorly to immunotherapy and be less sensitive to targeted drugs. The analysis of bulk data combined with single-cell data further verified that the suppressive immune features were highly expressed in CS1 and the JAK STAT signaling pathway was enriched in CS1. Finally, the robustness of the new subtyping was successfully validated in four external datasets.
Conclusion
In conclusion, we conducted a comprehensive analysis of multi-omics data with 10 clustering algorithms to reveal the molecular characteristics of KIRC patients and validated the relevant conclusions by single-cell analysis and external data. Our findings discovered new KIRC subtypes and may further guide personalized and precision treatments.
Prognosis and Influencing Factors of ER-positive, HER2-low Patients with Residual Diseases after Neoadjuvant Chemotherapy: A Retrospective Study
Authors: Tang Lingfeng , Jiang Linshan , Jin Yudi , Shu Xiujie , Xu Yingkun , Yu Haochen , Liu Shengchun
Published: July 2023

Background
Previously, we found that estrogen receptor (ER)-positive, HER2-low patients is insensitive to neoadjuvant chemotherapy (NACT). And the outcomes of patients with residual diseases were worse than that of patients who achieved pathological complete response (pCR) after NACT. The purpose of this study is to explore the prognosis and influencing factors of these patients .
Methods
A total of 618 ER-positive breast cancer patients who received thrice-weekly standard NACT were enrolled, including 411 ER-positive, HER2-low cases. Clinicopathological features before and after NACT of these patients were collected. Univariate and multivariate COX regression analyses were used to find the independent factors of 5-year disease-free survival (DFS).
Results
Of the ER-positive, HER2-low patients, 49 cases (11.9%) attained pCR after NACT. A significant survival difference was shown in patients with or without residual diseases after NACT. Level changes in immunohistochemical markers and tumor stages before and after NACT were significant. According to univariate and multivariate analyses, we found that significant associations between cN_stage (P = 0.002), ER (P = 0.002) and Ki67 (P = 0.023) expression before NACT with 5-year DFS, while pT_stage (P = 0.015), pN_stage (P = 0.029), ER (P = 0.020) and Ki67 (P ༜0.001) after NACT was related to 5-year DFS in ER-positive, HER2-low patients with residual diseases.
Conclusion
Our study suggested that pre- and post-NACT high proliferation, low ER expression level and advanced stage both were associated with poor prognosis, which provides a reference for developing long-term treatment strategies for ER-positive, HER2-low patients with residual diseases in the future.
Emergency endoscopic interventions in acute upper gastrointestinal bleeding: a cohort study
Authors: Mackiewicz-Pracka Anna , Nehring Piotr , Przybyłkowski Adam
Published: July 2023

Introduction: Acute upper gastrointestinal bleeding frequently leads to emergency department admissions. The standard approach for diagnosing and treating acute upper gastrointestinal bleeding involves endoscopy of the upper gastrointestinal tract. While daytime emergency endoscopy has been well-studied, there is limited evidence regarding its effectiveness during nighttime procedures
Patientes and Methods: We conducted a retrospective cohort study at a single center, analyzing adult patients referred for emergency endoscopy outside of regular hospital hours due to AUGIB. Endoscopic hemostatic methods were employed, and patients were categorized into day-hours and night-hours groups based on the timing of their procedures. The primary clinical endpoint was 120-day all-cause mortality, with secondary endpoints including haemostasis and recurrence.
Results: Among the 752 enrolled patients with acute upper gastrointestinal bleeding symptoms, 592 underwent endoscopy during the day, while 160 had procedures performed at night. In the day-hours group, the median time from symptom onset to endoscopy was 10 hours (IQR 6-15h), compared to 6 hours (IQR 4-16h) in the night-hours group. Intervention times were significantly shorter during the night hours (P < 0.001). In both groups, endoscopic intervention after the 6th hour from symptom onset yielded improved outcomes, while treatment before the 5th hour resulted in poorer outcomes. Although the night-hours group had higher 120-day all-cause mortality, the difference was not statistically significant.
Conclusion: Our findings indicate that emergency endoscopic intervention for acute upper gastrointestinal bleeding is similarly effective during both day and night hours, particularly when performed after the 6th hour from symptom onset.
An Auto-Encoder of Inscription Character Inpainting based on Branch Convolutional Channel Attention Module
Authors: Zhao Long , Yuan Zonglong , Lou Yuhao , Xu Qingyu , Qiao Xinxiao
Published: July 2023

Many inscriptions suffer severe damage as a result of artificial or natural causes, necessitating computer repair and protection. There isn’t a publicly accessible dataset of inscriptions, and the majority of character inpainting algorithms that are currently in use are directly derived from common image inpainting algorithms , which have insufficient feature extraction capabilities for the character of inscriptions and don’t have metrics for the weights of obscured and unobscured regions. We developed a Character Auto-Encoder (CAE) to improve the inpaint-ing capabilities of inscription characters and solve the aforementioned issues. The down-sampling module is replaced by the Branch Convolutional Channel Attention Module (BCCAM), which employs a branching structure to enhance the model’s capacity for representation and weights various areas of the character. First, we compared other inpainting models using the inscription dataset, and the CAE’s peak signal-to-noise ratio (PSNR) and structural similarity (SSIM) increased by 0.82 and 0.016, respectively, compared to the baseline model. Next, we compared the Handwritten Chinese Character Inpainting Generative Adver-sarial Network (HCCI-GAN) with the handwritten Chinese character dataset, and the CAE’s design was relatively more ingenious and simpler.
Realities of modern urate-reducing therapy for gout
Authors: Krasivina I. G. , Dolgova L. N. , Dolgov N. V. , Bakhvalova D. Yu.
Published: July 2023

Introduction. In the treatment of a patient with gout, it is important to achieve the target level of uric acid (UA) < 360 μmol/l, which reduces the frequency of acute attacks of arthritis and improves the prognosis of comorbid diseases. Relief of acute gouty arthritis causes much less difficulty compared with the appointment of urate-l owering therapy (UST). The reasons for not achieving the target level of MC can be both objective and subjective.

Aim. To analyze the objective and subjective components of the activity and effectiveness of UST in real outpatient practice.

Material and methods. A cross- sectional study of 117 randomly selected outpatient records of patients diagnosed with gout. Mean age 58.6 ± 13.1, mean UA level 423.7 ± 122.4 μmol/L. Additionally, an anonymous survey of doctors and patients with gout was conducted on the issues of UST.

Results. Patients with gout in the analyzed group were characterized by a high degree of polymorbidity: women and men, respectively, had arterial hypertension in 100 and 79%, type 2 diabetes mellitus in 39 and 23%, osteoarthritis in 73 and 57%. With inevitable polypharmacy, UST was prescribed in 37.6% of patients. Achievement of target levels of UA was registered in 23.8% of men and 39.4% of women. Failure to achieve the target sUA was associated with diuretics, elevated creatinine, and body mass index. Physicians were more than 70% active in prescribing UST, but knowledge of a single target UA level was demonstrated by 6 to 13%, depending on work experience, with an excessive assumption of UST use during an acute gout attack (19 to 36.5%). 

Conclusion. All components of the diagnostic and therapeutic process of curing a gouty patient need to be improved.
Potential for sustaining remission in ankylosing spondylitis patients upon netakimab discontinuation
Authors: Lapshina S. A. , Garaeva A. R. , Gabdullina Z. N. , Sukhorukova E. V. , Abdulganieva D. I.
Published: July 2023

Introduction. Biological disease modifying drugs (bDMARD) in the treatment of ankylosing spondylitis (AS) have shown good results with the achievement and long-term preservation of remission. There is a discussion about the withdrawal of drugs without loss of effect in order to reduce the economic burden, drug load, adverse events, the possibility of interrupting therapy during surgical treatment.

Aim. To evaluate the potential for sustaining the therapeutic effect of netakimab (NTK) after its discontinuation in patients with AS who have achieved remission.

Materials and methods. A cohort of 11 patients diagnosed with ankylosing spondylitis (AS) who had achieved remission was included in this study. The patients were closely observed for 52 weeks after discontinuing NTK treatment. AS exacerbations, pain intensity, disease activity scores (BASDAI, ASDAS), enthesitis evaluations (MASES), functional impairments (BASMI and BASFI), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were documented, as well as radiographic and MRI assessments of the sacroiliac joints and spine were performed.

Results. Out of the 11 patients, 5 (45.5%) experienced AS exacerbations within the 12-month observation period. Patients who developed flare-ups had higher baseline levels of BASDAI, ASDAS, BASMI, and CRP at the time of NTK discontinuation. They also had a longer disease duration and were older compared to patients without relapse (p < 0.05). The presence of flare-ups was significantly associated (p < 0.05) with a history of peripheral arthritis, previous treatment with IFN-alpha, and the number of comorbidities. By week 52 of the observation period, patients demonstrated a deterioration in both activity and functional limitations (p < 0.05). Elevated ASDAS-CRP levels were found to be correlated (p < 0.05) with higher radiographic stages of sacroiliitis, the presence of syndesmophytes, functional limitations based on BASMI at the time of drug discontinuation, and the absence of continuous NSAID use. Significant prolongation of remission was associated with a substantial decline in ASDAS-CRP under NTK treatment (rSp = 0.996; p < 0.05), especially among younger patients (rSp = 0.607; p < 0.05).

Conclusions. Approximately half of the patients who discontinued NTK therapy after achieving clinical and laboratory remission were able to sustain it. Maintenance of remission for 1 year was more prevalent in younger patients with shorter duration of AS, achieving inactive disease status based on ASDAS-CRP, fewer functional limitations, absence of peripheral arthritis, and comorbidities. Nevertheless, regular patient monitoring is necessary to promptly identify disease recurrence.
Management of patients with mild cognitive impairment: the possibility of using nitric oxide
Authors: Parfenov V. A. , Starchina Yu. A. , Grinyuk V. V.
Published: July 2023

Cognitive impairment (CI) is one of the leading causes of disability in the elderly, most often caused by neurodegenerative disease (NDD) and/or cerebrovascular disease (CVD). Mild CI (MCI) represents an intermediate state between normal cognitive functions (CF) and dementia and occurs in a significant proportion of the elderly. Patients with MCI have a higher risk of developing dementia than in the general population; therefore, prevention of the progression of MCI is an important area of modern neurology. Currently, no drugs have been found that can slow the progression of CI caused by CVD or NDD; drugs effective for dementia do not have a significant effect at the stage of MCI. In the prevention of dementia at the stage of MCI, an important role is noted for non-drug methods (regular physical activity, rational nutrition, mental activity, smoking cessation and alcohol abuse) and drug interventions (antihypertensive therapy, antithrombotic therapy, statins). In recent years, the use of nitric oxide in CVD and NDD has been discussed in order to attenuate the processes of oxidative stress, the release of cytokines, and the processes of apoptosis. In our country, there is a positive experience of inhaled use of nitric oxide with the help of an apparatus synthesized from the air for pulmonary, cardiovascular diseases and CVD. The effectiveness of inhaled nitric oxide using an apparatus synthesized from air is currently being studied in patients with MCI due to CVD and NDD. A clinical observation of a patient with MCI is presented, in which a month after the inhalation use of nitric oxide, an improvement in CF was noted according to neuropsychological examination.
Blepharospasm: an analysis of typical medical practice and the effectiveness of therapy
Authors: Tolmacheva V. A. , Romanov D. V.
Published: July 2023

Introduction. Blepharospasm (BS) is a form of focal dystonia in which botulinum therapy (BT) has been used successfully, however, data on typical practice of patient management and the effectiveness of long-term BT in BS in our country are insufficient.

Aim. To analyse the typical medical practice of management of patients with BS and the effectiveness of long-term BT.

Materials and methods. A total of 50 patients with idiopathic BS, mean age 58 years (of which 37 were women) were included in the study. All patients were treated with botulinum toxin type A. Typical medical practice, erroneous diagnosis, time required to reach a correct diagnosis, severity of dystonia, and quality of life before BT and during a three-year prospective observation were analysed. The severity of dystonia was determined using the BS Disability Index (BSDI), and the quality of life was measured using the EQ-5D questionnaire.

Results. The correct diagnosis was reached, on average, in 3 years. Upon onset of symptoms the majority of patients (84%) visited an ophthalmologist. Eye diseases and myasthenia gravis were the most common primary erroneous diagnosis in BS, which were treated with inadequate symptomatic therapy. After one-month BT, it was noted that the disability index decreased from an average of 13.6 ± 5.1 to 2.7 ± 2.3 scores (p < 0.001) according to BSDI and the quality of life increased from 59.9 ± 8.2 to 82.6 ± 6.4 scores (p < 0.001) according to the results of EQ-5D. Repeated BT injections (2–6 times a year) conducted for 3 years also resulted in essentially positive effect without significant adverse events. At the end of three years, the disability index decreased to 10.7 ± 4.7 scores, and the improvement in the quality of life reached 81.8 ± 5.9 scores according to the results of EQ-5D (p < 0.001).

Conclusion. The low awareness of doctors, especially ophthalmologists, about the symptoms of BS and the widespread use of ineffective drugs was noted. The long-term regular (2–6 times a year) use of BT reduces the symptoms of the disease, improves the quality of life of patients and has no significant side effects.
A young patient at a neurologist’s appointment: features of diagnostics and therapy
Authors: Putilina M. V.
Published: July 2023

Outpatient neurological appointments in most cases consist of patients older than 45 years. The novel coronavirus pandemic has changed this statistic. Young patients began to turn to polyclinics more often with complaints of headache, feeling of weakness, decreased physical activity, forgetfulness, and changes in concentration. COVID-1 9 provoked the development of coagulopathy in patients with genetic mutations and signs of dysplasia. The percentage of patients with acquired or congenital thrombophilia has increased. Most of them had certain manifestations of undifferentiated dysplasia, with signs of impaired venous outflow with a characteristic cephalgic syndrome. The peculiarity of which is polymorphism, inconstancy, the absence, in most cases, of connection with specific vascular and hemodynamic factors (excluding headache in venous thrombosis), a decrease in the frequency of occurrence as the disease progresses. The presence of certain complaints (headache, asthenia, cognitive impairment) requires the appointment of specific therapy. Monotherapy with one drug, even if it has a pleiotropic effect, does not always achieve therapeutic goals, since one or another mechanism of pharmacological action prevails, and the rest are secondary, requiring enhancement or other drugs, or non-drug methods. Given the poor adherence of young patients to treatment, the way out of this situation is the use of combined drugs. Combination drugs can be used as multifunctional drugs, potentiating or summarizing their effects, while reducing the risk of polypharmacy and unwanted side reactions. One of the most promising combinations is Picamilon Ginkgo (Ginkgo biloba leaf extract + Nicotinoyl gamma-a minobutyric acid), which has established itself as an effective corrector of asthenia and cognitive impairment in patients of any age.
Predictors of repeated and first-time low-energy fractures in patients with rheumatoid arthritis
Authors: Kovalenko P. S. , Dydykina I. S. , Postnikova P. S. , Glukhova S. I.
Published: July 2023

Introduction. Low-energy fractures in patients with rheumatoid arthritis (RA) occur more often than in the general population, reduce the quality and life expectancy of patients. Establishment of predictors of fractures will allow to personalize treatment and preventive measures.

Aim. To study the frequency, structure, predictors of new and repeated low-energy fractures that occurred in patients with RA during long-term prospective follow-up.

Materials and methods. 123 women with RA, aged 63.7 ± 8.3 years, were included in an open, prospective, non-interventional study, the follow-up period was 9.4 ± 1.8 years. Initially and in dynamics, laboratory and X-ray examinations were performed (X-ray morphometry of the spine, X-ray densitometry of the lumbar spine (L1-4) and femoral neck (SB)).

Results. During the follow-up period, 101 low-energy fractures occurred in 63 (51%) patients: in 33 (52%) people – for the first time, in 25 (48%) – again. Two or more fractures occurred in 25 (39%) patients. There were 32 (32%) peripheral fractures, 69 (68%) vertebral fractures. A direct relationship was established between fractures and a longer duration of RA course (r = 0.231, p < 0.05), with X-ray stage of RA at baseline (r = 0.280, p < 0.05) and over time (r = 0.819, p < 0.05), intake of glucocorticoids (GC) initially (r = 0.202, p < 0.05) and over time (r = 0.308, p < 0.05), cumulative dose of GC initially (r = 0.239, p < 0.05) and over time (r = 0.268, p < 0.05), duration of GC use (r = 0.270, p < 0.05), history of low-energy fractures (r = 0.291, p < 0.05), and feedback with OP in SB (r = -0.190, p < 0.05).

Conclusions. А high frequency of repeated and first-time low-energy fractures was established in patients with RA, among which fractures of the vertebrae, distal forearm, humerus and lower leg bones predominated. Fracture predictors: GC intake, history of low-energy fractures, baseline radiological stage of RA. A mathematical model for assessing the risk of fractures with good predictive ability has been developed.
The choice of a modern neuroprotective drug as a basic strategy in the treatment of chronic cerebrovascular diseases
Authors: Shishkova V. N. , Prikhodko V. A. , Okovityi S. V.
Published: July 2023

The topicality of the issues of effective treatment and prevention of cerebrovascular diseases (CVD) is not doubtful in view of their leadership in the top ranked causes of high mortality and disability in the general population almost all over the world, including Russia. The pathogenetic aspects of chronic CVD caused by hypoperfusion, which triggers a chain of successively developing metabolic disorders, represent a potential therapeutic target for the development of new dosage forms. The enormous clinical experience has been accumulated and evidence of therapeutic benefits in patients with various types of vascular and metabolic disorders accompanied by ischemia, including cerebrovascular disease, has been obtained over almost thirty years of active clinical use of ethylmethylhydroxypyridine succinate (6-methyl-2-ethylpyridin-3-ol butanedioate, EMHPS). It proved that EMHPS has such important effects as antioxidant, membrane-protective, antihypoxic, and anti-ischemic properties, as well as confirmed its hypoglycemic, hypolipidemic, antiplatelet and antithrombotic actions, which makes it an important component of the complex therapy of CVD. Progress in the development of innovative drugs is the result, on the one hand, of the availability of highly active pharmacological substances and, on the other hand, of the creation or selection of new dosage forms. The use of matrix tablets as a modern dosage form allowed us to efficiently optimize the pharmacokinetics of EMHPS, which led to the creation of a drug with a high predictive efficacy and safety. Thus, the developed new prolonged dosage form of EMHPS enables a constant-rate daily release of the active substance for 20 hours and reduces the likelihood of not only side effects, but also skipped intake during the day. The new dosage form of EMHPS is available at 375 and 750 mg doses, which makes it possible to take just 1 tablet per day and get all the therapeutic benefits while staying compliant.
Anxiety disorders in clinical practice: from development mechanisms to differentiated therapy
Authors: Vasenina E. E. , Gankina O. A. , Levin O. S.
Published: July 2023

Affective disorders represent an extremely topical issue in modern healthcare. Prevalence of anxiety disorders in clinical practice increased significantly since 2019 due to various situational causes, and the trend will probably continue in the coming years. Besides, due to aging of the population and significant growth of the number of patients with neurodegenerative diseases, so called secondary affective disorders also increase. These are linked to organic lesion of the zones strategically important for emotional process implementation, and damaging of the key neurotransmitter systems neurons often seen in neurodegenerative pathological process. Development of anxiety is chiefly based on the defect of the “threat-fear” bound, with the reaction developing in the organism not equivalent to the degree of danger. On pathophysiological level this can be explained by disruption of interaction between limbic system structures that provide “fight or flight” reflex response to the threat, and the neocortex responsible for cognitive processing and adaptation of out emotional reactions. Three key theories of anxiety development can be identified: insufficiency of control, generalization of fear, and hypersensibilization to threat. The first mechanism is most often linked to development of generalized anxiety disorder, the second theory reveals most fully the mechanisms of post-traumatic stress disorder development, while the hypersensibilization of prefrontal cortex best allows to explain sociophobia development. An important mechanism of development and chronification of various affective disorders is neuroinflammation, the role of which will also be highlighted in detail in this review. Understanding of the mechanisms of anxiety spectrum disorders development is important for differentiated drug and non-drug therapy and establishing the optimal strategy of treatment for such patients.
Public service motivation research in the Middle East and North Africa (MENA) region: A systematic review of progress and implications for public administration theory and practice
Authors: Alreshoodi Saleh Abdullah
Published: July 2023

The research on public service motivation (PSM) has seen a growing internationalization, necessitating efforts to organize and systematize its findings to assess research progress and enhance the value of PSM theory in various contexts, including public administration. This paper aims to review the progress of PSM research in the Middle East North Africa (MENA) region over the past decade. The primary methodology employed is a systematic literature review, where a total of 20 papers published between 2013 and 2020 were located and analyzed. The assessment of these papers includes an examination of their country of origin, publication source, underlying theory, research design, and lines of study. A critical evaluation of the findings is conducted, focusing on their theoretical and practical contributions to PSM scholarship. The key conclusion drawn from this review is that while PSM research in the MENA region is advancing, it reveals certain methodological limitations and underexplored themes that need to be addressed. Consequently, this paper significantly contributes to public administration research and PSM-specific studies by providing the long-awaited organization, systematization, and integration of regional research. The outcomes of this review enable the identification of relevant contextual factors that can enrich the conceptualization and operationalization of PSM on a regional basis. Additionally, this paper offers a comprehensive overview of existing PSM knowledge in the MENA region, thereby guiding future research in this domain. By acknowledging both the methodological strengths and weaknesses, as well as the thematic aspects of the reviewed studies, specific suggestions are put forth to enhance the quality and depth of future PSM research in the MENA region. This paper thus serves as a valuable resource for researchers seeking to further develop the understanding of PSM within the context of the MENA region.
Effect of various tractor speeds on potato digger performance
Authors: Alkaabi Galib A. A. , S. Al-Ani D. Firas
Published: July 2023

A field experiment was conducted in one of the fields of the Technical Institute in Shatrah in 2022 to study the effect of different tractor speeds, conveyor chain speeds and their type on some performance indicators of a potato digger. Severely scratched tubers and slightly marked tubers and quantitative loss were studied in this research. The hand involved three levels of tractor forward speeds (2.5, 3.20,4.0 km / h), two groups of conveyor chain speeds (43, 49) m/ min and two levels of the type of chain conveyor of iron bars and rubber-coated. The complete random design with three replications was used in the research. The results showed that the tractor speed of 2.5 km/h gets the severely scratched tubers, which amounted to 3.03%, and the slightly scratched amounted to 12.37%, and the lowest quantitative loss was 1.16%. The speed of the chain conveyor, 43 m/min, get the lowest percentage of severely scratched tubers, which amounted to 4.53% and was slightly irritated. It was 14.10%, and the speed of the chain conveyor was 49 m/min. The lowest quantitative loss was 2.09%, and the rubber rods had the lowest percentage of severely scratched tubers, slight marked and quantitative loss.

Keyword: qualitative loss, severely scratched, slightly scratched.
Presenting the Model of Using Crowdsourcing in Formulating an Open Strategy
Authors: Shahbandi Mohammadali
Published: July 2023

In terms of the basic practical purpose, in terms of nature, survey research, and in terms of paradigm, combined-exploratory research, sampling in the qualitative part of the research was done in a purposeful way and in the quantitative part in a stratified random manner. In this regard, the project’s first step was to conduct library studies and collect information. In this regard, it was investigated with a review of the theoretical foundations and internal and external research related to the use of crowdsourcing in the development of open strategy. In this research, due to the lack of research based on the use of crowdsourcing in developing an open strategy and the need to know how to explain the phenomenon in a real context, it is inevitable to follow a qualitative paradigm. On the other hand, the need to purify the factors, explain the model, as well as examine the state of the model and its components and relationships descriptively requires the use of quantitative methods, so a mixed approach that includes qualitative and quantitative methods will be used. First is the organization’s semi-structured interview, which includes crowdsourcing in developing an open strategy and how to rank the factors. The research method was carried out purposefully in the qualitative part of the research and stratified randomly in the quantitative part. They are in the qualitative phase of interviews with managers and vice presidents of Cable manufacturing companies in the United States, interviews will continue until theoretical saturation is reached. The research tool in the qualitative part will be determined by using the exploratory method of using the components of crowdsourcing in developing an open strategy and the factors affecting it, the sampling method in the qualitative part is purposeful. The research tool in the qualitative part of the exploratory interview is semi-structured, and in the qualitative part, the analysis of the interviews was done using the foundational data analysis method. And finally, the final model has been presented and fitted.
Percepción sobre la adquisición y el dominio del inglés en profesores universitarios: implicaciones en los procesos de internacionalización en casa
Authors: Solís Navarro José Manuel , González Bello Édgar Oswaldo
Published: July 2023

El dominio del inglés ha sumado valor en la educación superior desde que universidades comenzaron a incorporar procesos de internacionalización en casa, lo cual ha fomentado también la adquisición del idioma por parte de profesores. Por lo tanto, se analiza la percepción del profesorado sobre el dominio del inglés y su relación con los factores socio-académicos, así como del contexto de adquisición del idioma. Se recolectaron respuestas de 670 académicos de una universidad pública de México a través de un cuestionario digital; los datos fueron analizados mediante una regresión lineal múltiple para identificar efectos. Los resultados advierten que la habilidad lectora se percibe con mayor competencia y la capacidad oral con algunas debilidades. Adicionalmente, pertenecer a las áreas STEM y aprender el idioma en ambientes no académicos pueden predecir la percepción del dominio del inglés. Se concluye que, a pesar de los niveles de dominio identificados, las exigencias de ciertas acciones como impartir asignaturas en inglés hacen relevante la planificación institucional y la definición de escenarios estratégicos de capacitación docente en los que se oriente hacia la adquisición del idioma.
Influencia del liderazgo y otras variables críticas en la competitividad de Mipymes chilenas
Authors: Cabana Villca Segundo Ricardo , Rivera Guerra Macarena Belén , Véliz Fernández Rodrigo Patricio , Aguilera Zambra Mauricio Israel
Published: July 2023

Las empresas de menor tamaño son determinantes en la economía chilena. El objetivo de esta investigación es identificar y analizar variables claves en la generación de la competitividad de las empresas de menor tamaño de la Región de Coquimbo – Chile, representadas por las micro, pequeña y medianas empresas (Mipyme). Esto se fundamenta en las percepciones de 384 integrantes del personal operativo de este tipo de empresas y un análisis multivariado, empleando un modelo de ecuaciones estructurales (basado en covarianza - MBC). Se ratifica con confiabilidad estadística que la competitividad en las empresas de menor tamaño, es consecuencia de la influencia de cinco constructos, que deben ser consideradas variables críticas, pues influyen positiva, directa e indirectamente en la competitividad de estas empresas, las cuales son; liderazgo transformacional, liderazgo transaccional, efectividad en el desempeño, esfuerzo extra y satisfacción laboral. Variables que explican en un 69% la varianza de la competitividad.
La intención de compra en la generación Z en el mercado de moda
Authors: Lima-Vargas Alvaro Enrique , Cervantes-Aldana Fernando Javier , Lima-Vargas Suemi
Published: July 2023

Este estudio cuantitativo explora como las actitudes y las normas subjetivas hacia el mercado de la moda por parte de la generación Z influyen en la intención de compra. Se analiza la  inteligencia emocional, la percepción de calidad y el género como variables independientes de las actitudes y la inteligencia emocional de las normas subjetivas. Los hallazgos mostraron que la Teoría de Acción Razonada (TRA) explica la intención de compra en el mercado de la moda por parte de la generación Z. Los hallazgos revelaron que el género no influye en el desarrollo de actitudes, las cuales son generadas por la percepción de calidad y la inteligencia emocional. Por su parte, las normas subjetivas no son inducidas por la inteligencia emocional. Esta investigación contribuirá las empresas del mercado de la moda a generar estrategias de mercado específicas para impulsar la intención de compra por parte de la generación Z.
religiosidad indígena y el pecado original
Authors: Altbach Pérez Daniel
Published: July 2023

Esta reseña del libro Los pecados de la carne en el Nuevo Mundo. La visión española del indio americano de Marialba Pastor busca analizar cómo la autora atiende al proceso intelectual que dio forma y contenido a la taxonomía de los dioses prehispánicos durante la primera mitad del siglo XVI, primero entre los conquistadores y administradores coloniales, y después en las fuentes religiosas (franciscana y dominica). Así mismo, revisa la forma en que el texto presenta la trascendencia de los enfoques parciales atentos a la formación de un orden institucional y del origen de las identidades criollas. De esta manera, mediante esta reseña se mostrará el aporte que tiene la obra de Pastor en los estudios antropológicos e historiográficos relacionados a la visión que tenían, durante la conquista, los españoles sobre los americanos.
Anástasis del diorama de la cacería del mamut
Authors: Rojas Chávez Juan Martín , Medina González José Humberto , Ballester Franzoni Carlos Enrique
Published: July 2023

Durante cincuenta y nueve años (1964–2023) el Diorama de la Cacería del Mamut –que hasta hoy se exhibe en sala “Poblamiento de América” (antes Orígenes)– del Museo Nacional de Antropología de México– es uno de los apoyos museográficos que más han impactado a los miles de visitantes nacionales y extranjeros que año con año visitan este recinto. Esta dramática pieza escultórica creada por la artista Carmen Carrillo de Antúnez y su equipo de escultores puede ser considerada un poderoso icono de cómo pudo ser en la prehistoria del centro de México la práctica de caza de los grandes animales que vivieron en la Edad del Hielo.   El objetivo de este artículo es comprender –con base en la información recuperada hasta los inicios de la segunda mitad del siglo XX por las investigaciones realizadas por la geología, la paleontología y la arqueología en los yacimientos donde se encontraron restos de mamutes en el área de Tepexpan (principalmente Santa Isabel II) y en la Cuenca de México–, cómo se construyó esa imagen de la prehistoria mexicana que quedó plásticamente materializada en este diorama. A partir de una crítica de la narrativa arqueológica que se construyó de esas investigaciones y de la revisión de los datos recuperados de esos yacimientos, el artículo postula contenidos que preponderan el aprovechamiento del mamut más que el de la cacería especializada como se planteaba antes desde una perspectiva que integra a la arqueología, el arte y la museografía. Se propone crear dos nuevos dioramas, que junto con el de la artista Carrillo de Antúnez, dialoguen dentro de la sala “Poblamiento de América” en un solo conjunto llamado “Diorama de Dioramas”.
Estimación del riesgo cardiovascular con herramienta Globorisk en una Unidad de Medicina Familiar
Authors: García-Jiménez Yuliana , Soto-Ávila Dulce A. , Palacios-Tapia Araceli , García-Morales Gabriela
Published: July 2023

Objetivo: estimar el riesgo cardiovascular con la herramienta Globorisk en usuarios de una unidad de medicina familiar. Método: estudio transversal analítico realizado de agosto a diciembre de 2021 mediante muestreo no probabilístico. La muestra estuvo conformada por 750 personas de 40 a 60 años. Se utilizó Globorisk para estimar riesgo cardiovascular. Se utilizó el Cuestionario Internacional de Actividad Física (ipaq), se midió tensión arterial, peso, talla e índice de masa corporal. Se recolectó cifra de triglicéridos, colesterol y glucosa. Se estimó la magnitud del efecto de asociación con Odds Ratio y significancia estadística mediante χ2 de Mantel-Haenszel, con un intervalo de confianza de 95%. Resultados: El riesgo cardiovascular alto a muy alto fue de 27.8% (209/750). 76.3% de participantes presentaron sobrepeso-obesidad (572/750). Entre los factores asociados a presentar riesgo cardiovascular alto a muy alto se encontró: Ser hombre (or 15.8; ic 95% 7.8-32.1), tener educación básica (or 2.9; ic 95% 1.6-5.3), una ocupación sin remuneración (or 3.2; ic 95% 2.0-5.3), vivir sin pareja en hogar (or 2.6; ic 95% 1.6-4.3), padecer diabetes (or 10.8; ic 95% 5.2-22.4), tener una cifra de colesterol mayor a 200 mg/dL (or 2.7; ic 95%1.7-4.5) y realizar actividad física leve (or 2.3; ic 95% 1.4-3.9). Conclusión: tres de cada diez personas analizadas presentaron riesgo cardiovascular alto a muy alto, los factores asociados se relacionaron con el sexo, educación, ocupación y otras variables metabólicas.
El ejercicio como un aliado para el control de las enfermedades
Authors: Hernández-Gálvez Olga Abigail , Hernández-Gálvez Daniela Catherine
Published: July 2023

Comunicación con el paciente
Eritema nodoso
Authors: Domínguez-Gasca Luis Gerardo , Domínguez-Carrillo Luis Gerardo
Published: July 2023

Identifique el caso
An intermediate water gravity wavelength and wave height measurement inside a large wave flume tank
Authors: Aldarabseh Safa Mohammad , Merati Parviz
Published: July 2023

This paper discusses an intermediate water gravity wavelength and wave height measurement method. Three methods were used to obtain wave height, wavelength, and period. Firstly, conventional methods used two Honeywell pressure sensors mounted at the bottom of the wave tank at two different locations. Secondly, using the transfer function of the flap wavemaker (the relationship between wave height and the wave paddle stroke). Thirdly, the Laser Sheet technique (PIV image processing technique). The significant wave height and period from pressure reading sensors of regular gravity waves were obtained from the Raleigh distribution and Zero up crossing technique. Wavelength was obtained indirectly by using a dispersion relationship that was solved by using the Newton Raphson numerical method from both the pressure sensors and the transfer function of the flap wavemaker. This experiment was focused on getting the direct value of wave measurements by developing an image processing technique in a clear large wave flume tank to replace the conventional methods and eliminate the error that may produce by using the numerical methods. The PIV setup with the CCD camera was used to capture wave images. The image processing technique based on Canny edge detection with constant threshold value was used to detect the edge of the waves. The experimental result showed a good agreement between the results obtained from these three methods, with the percent of error up to 8.683%.