bluuebunny/crossref_metadata_2025 huggingface dataset:
Perspectivas de terapia ocupacional na atenção aos usuários com doenças do aparelho circulatório no contexto hospitalar de média complexidade
Authors: Hein Daniele Tatiane , Toldrá Rosé Colom
Published: April 2021

Resumo Introdução As Doenças do Aparelho Circulatório têm se configurado ao longo dos anos como as maiores causas de mortalidade e hospitalização de adultos e idosos em todo o mundo. Tal realidade foi observada na prevalência de usuários internados em um Hospital Universitário. Objetivo Descrever e analisar as estratégias terapêuticas ocupacionais desenvolvidas com adultos e idosos hospitalizados com Doenças do Aparelho Circulatório. Método A pesquisa tem caráter qualitativo exploratório e retrospectivo, realizada entre junho e setembro de 2019, com base em pesquisa documental referente aos registros dos prontuários de terapia ocupacional e o resumo de alta hospitalar de usuários acompanhados no Hospital Universitário da Universidade de São Paulo, no período de 2014 e 2018. Resultados Dos 200 prontuários selecionados, foram analisados 46 registros de usuários com Doenças do Aparelho Circulatório, sendo a maioria do sexo masculino e acima de 60 anos, e cerca da metade, 22 registros, apontaram doenças relacionadas ao Acidente Vascular Cerebral. Quanto ao Índice de Barthel Modificado, todos apresentaram algum grau de dependência. Os temas e as estratégias terapêuticas ocupacionais se mostraram diversificados e voltados para funcionalidade, aspectos subjetivos dos usuários, multiprofissionalidade e seguimento na rede de serviços e cuidado extra-hospitalar. Conclusão A terapia ocupacional favoreceu o desenvolvimento de estratégias terapêuticas centradas nas demandas dos usuários na perspectiva da humanização e da integralidade do cuidado em consonância com os princípios e diretrizes do SUS e colaborou para a ampliação do conhecimento sobre a contribuição da terapia ocupacional na atenção de pessoas que possuem DAC no contexto de hospitalização.
Coverage for the cost of outpatient nursing procedures by the Unified Health System: a percentage analysis
Authors: Sportello Elisabete Finzch , Castilho Valéria , Lima Antônio Fernandes Costa
Published: April 2021

ABSTRACT Objective: To analyze the percentage of the coverage of transfers from the Brazilian Unified Health System regarding nursing procedures conducted in the Outpatient facility of a University Hospital. Method: Quantitative, exploratory, descriptive case study. The sample for calculating the mean total direct costs was composed of non-participant observations of 656 procedures. The obtained costs were compared to transfers from the Unified Health System by multiplying the amount of procedures agreed upon by the unit cost in the Unified Table of Procedures in 2016 and 2017. Results: The Unified Health System transferred a percentage corresponding to 11.13% of the actual cost in 2016 and to 16.02% in 2017. In these two years, transfer values covered only a mean of 13.4%, resulting in a percentage difference in revenue significantly smaller than the actual cost. Conclusion: The higher the productivity of the performed procedures, the higher was the hospital deficit and, consequently, the higher were the costs not covered by the Unified Health System.
Nurses' attitudes and knowledge regarding patient rights: a systematic review
Authors: Mpouzika Meropi , Karanikola Maria , Panayiotou Elena , Raftopoulos Vasilios , Middleton Nicos , Papathanassoglou Elizabeth
Published: April 2021

ABSTRACT Objective: To synthesize current evidence on nurses' attitudes and/or knowledge on the entire spectrum of patient rights. Method: A systematic search of the literature was performed in Web of Science, PubMed, Scopus and CINAHL. Studies were selected according to pre-defined inclusion/exclusion criteria. The Cochrane and PRISMA guidelines, including templates for systematic reviews, were applied. For rigor assessment, the Critical Appraisal Skills Program Qualitative Research Checklist, and the Center for Evidence-Based Management tool were employed. Results: Thirteen studies were included, that exhibited important methodological limitations, such as convenience sampling, mediocre response rates and inadequate instrument validity. Findings indicated: a) low level of awareness regarding patient rights among nurses, b) knowledge discrepancies on specific aspects of patient rights, c) low priority ascribed to a patient's right to access information, and d) insufficient evidence on formal educational sources of knowledge on the topic of patient rights. Conclusion: Narrow geographical localization, heterogeneity and methodological limitations render generalizability of the conclusions difficult. Further research based on robust methodology is proposed.
COVID-19 em Instituições de Longa Permanência para Idosos: um inquérito epidemiológico
Authors: Lima Nereida , Viana Jaciara , Bellissimo-Rodrigues Fernando , Moriguti Julio , Ferriolli Eduardo , Santos Jair
Published: April 2021

Objetivo: Mapear a ocorrência da infecção por SARS-CoV-2 nas Instituições de Longa Permanência para Idosos (ILPIs) da cidade de Ribeirão Preto, SP, incluindo idosos e funcionários, identificando fatores associados, visando adoção oportuna de medidas preventivas.Metodologia: Inquérito epidemiológico realizado em cidade de médio porte para identificar a infecção por SARS-CoV-2 em residentes e funcionários, identificando fatores associados. Houve amostragem estratificada, sendo coletados dados demográficos, de saúde, sintomas atuais ou recentes comuns à infecção, além de avaliadas as atividades básicas de vida diárias (ABVD) e a cognição com aplicação do Mini Exame do Estado Mental (MEEM). Foi realizado teste sorológico em todos os sorteados.Resultados: Os idosos da amostragem tinham 80,2±9,7 anos e funcionários 37,4 ±12,2 anos. A positividade no teste sorológico foi de 13,3% entre idosos e 25,9% em funcionários. Idosos apresentavam 2,9±1,5 doenças crônicas, com uso de 5,7±2,8 medicamentos, somente 11,1% com rastreio para demência negativo e 20% independentes. Os funcionários tinham SARS-CoV-2 detectada previamente em apenas 6,9%, com 30% sem vacinação contra influenza e sem checagem sistemática de sintomas.Conclusões: Regras rígidas de comportamento devem ser instituídas, pois todo funcionário é potencialmente um transmissor da doença e, por isso, devem ser rastreados quanto a sintomas antes de cada dia de trabalho. Houve elevada prevalência de alterações cognitivas que podem dificultar o cumprimento das medidas de proteção individual dentro das ILPIs.
Examining the Relationship between Production, Trade and Consumption Using Hierarchical Analysis Methods
Authors: Timiryanova Venera M.
Published: April 2021

Reproduction is a continuous process of production, distribution and consumption of products in the hierarchy of economic space. Simultaneously, local production depends on both domestic demand and wholesale promotion of products to international markets. The study determines the influence of the wholesale, defining the distribution and trade stages, on the shipping volume, characterising the production stage. The research aims to correlate territorial hierarchy (country → region → municipality) with the reproduction sequence (production → distribution/trade → consumption). Additionally, it attempts to decompose the observed variation of the shipping volume in accordance with the hierarchy of economic space using the hierarchical linear modelling (HLM). The differences between municipalities are analysed in the context of two territorial levels: municipal (population income, determining consumption) and regional (wholesale trade, characterising the distribution) ones. The research examined the data for 2017 on 331 municipalities of 7 constituent entities of the Russian Federation. The study results show that hierarchical analysis methods can be used to analyse the relationship between production, distribution and consumption. In the considered territory, the shipping volume was mostly influenced by domestic consumption and to a much lesser extent wholesale trade. The application of hierarchical analysis methods enhances the analysis of reproduction. Moreover, it allows the government to create favourable conditions for implementing the programmesof infrastructure development and assessing supply capabilities of trade and production enterprises
Company Mobility in the Modern Economy
Authors: Vazhenin Sergey G. , Vazhenina Irina S.
Published: April 2021

While the modern economy demonstrates an increase in company mobility, neither economists nor company managers pay due attention to this developing socio-economic phenomenon. Therefore, we analysed how new organisations enter the market of companies and old enterprises leave it after losing their viability, noting the specific features of these processes. We examined the market of companies in Russia in general and in the Federal Districts of the Russian Federation in particular. We used the data from 1 January 2001 to 1 January 2020 published in the Statistical Register of Organisations of Federal State Statistics Service (Rosstat). The research methodology includes synthesis, analysis, comparison methods, and systemic-structural approach. The obtained results showed that, since 2016, the share of officially liquidated companies in the Russian Federation and most of its regions exceeds the birth rate of organisations. This is inextricably linked to the worsening economic situation in Russia, including the business environment. We noted that privately owned companies and organisations with joint Russian and foreign ownership have the highest turnover. The average annual turnover of organisations in Russia amounted to 16.8% in the period 2001–2019. Among the federal districts of the Russian Federation, organisations of the Siberian and Ural Federal Districts have demonstrated the greatest dynamics of the market of companies over the 19-year period (18.1 % and 17.4 %, respectively). Corresponding changes have taken place in the structure of organisations in the market of Russian companies. The share of companies providing various services has sharply increased, including transport and communication companies, and real estate organisations. New organisations with an established business reputation are mostly registered in the regions with higher competitive immunity, characterised by a favourable business environment for small- and medium-sized enterprises. The research results can be used by authorities for managing the spatial development of territories, and determining the support for certain types of business activities in a particular region or municipality.
The impact of mobile money, remittances, and financial development on innovative growth in sub-Saharan Africa
Authors: Alhassan Tijani F. , Guryanov Sergey A. , Kouadio Ahou J.
Published: April 2021

Mobile money has become a mode of banking for the unbanked residents and the system has been gaining patronage among citizens of developing countries. This trend especially refers to sub-Saharan Africa, where the level of financial inclusion is low. Thus, the expansion of the mobile money as well as easy access to it promotes the development of the financial sector in the region. To define the role of the financial elements in innovation growth in sub-Saharan African countries, we examined the relationship between mobile money activities, remittance, financial development, and innovation growth in sub-Saharan Africa (SSA). Using partial least squares (PLS), we conducted a comprehensive analysis to econometrically establish the nexus between innovation development and financial activities in sub-Saharan African region. The results show that significant positive relationship exists between all the independent variables and innovation growth (the dependent variable). Thus, this study indicates that mobile money services, financial development and remittances have significant impact on economic growth. However, mobile money services are the most influential variable. Hence, these results can be used by policymakers to encourage and improve mobile money payment and banking system as this could facilitate the pooling of resources and their effective allocation to productive sectors, thus leading to the promotion of innovative growth in the region.
Revisiting the Dynamics of the Fiscal Deficit and Inflation in India: the Nonlinear Autoregressive Distributed Lag Approach
Authors: Sharma Vishal , Mittal Ashok
Published: April 2021

The chronic government deficit (fiscal deficit) and increase in the price level (inflation) have become major concerns for economists and policymakers. While numerous studies have examined the twin problems of the fiscal deficit and inflation for both developed and developing economies, their results are inconclusive due to different estimation techniques, chosen time periods, selection of variables, etc. Therefore, we examined the fiscal deficit-inflation nexus in India for the period from 1980–81 to 2016–17 by employing the Autoregressive Distributed Lag (ARDL) and Nonlinear Autoregressive Distributed Lag (NARDL) approaches. The results of the ARDL approach found no evidence of linear relationship between fiscal deficit and inflation in the Indian context. Further, the empirical findings of the NARDL model confirmed the nonlinear relationship between fiscal deficit and inflation in the long run and no association between money supply and inflation, supporting the ideas of the Fiscal Theory of the Price Level (FTPL) in the case of India. FTPL postulates that public debt and taxation policies drive price level; monetary policy has an indirect role only. Therefore, fiscal policymakers should focus on reducing fiscal deficits. Simultaneously, the Reserve Bank of India (RBI) should regulate lending interest rate so that a mix of fiscal and monetary policies can be applied for controlling inflation in India.
ÇOCUKLARDA COVİD-19 ENFEKSİYONUNDA KALP TUTULUMU,
Authors: KESKİN Mahmut
Published: April 2021

ÖZET

Dünya Sağlık Örgütü (DSÖ) tarafından 11 Mart 2020 tarihinde salgın olarak ilan edilen ve “Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2)” olarak isimlendirilen “Coronavirus Disease 2019 (COVID-19)” çocuklarda genellikle hafif seyretmektedir. Nisan 2020'de Birleşik Krallık'taki Pediatrik Yoğun Bakım Derneği, belirgin gastrointestinal semptomları ve miyokardiyal tutulum da dahil olmak üzere toksik şok sendromu ve atipik Kawasaki hastalığı ile örtüşen olağandışı bir klinik tablo ile başvuran çocuklar hakkında bir uyarı yayınladı. Bu tarihten sonra Avrupa’da çeşitli merkezlerde buna benzer vakalar bildirilmeye başlandı. DSÖ 14 Mayıs 2020 tarihinde bu olguları pediatrik multisistemik inflamatuvar sendrom (MIS-C) olarak tanımlamıştır. Çocuklarda hafif seyretmekle birlikte COVID-19 hastalığı MIS-C tablosuna yol açtığında ölümcül olabilmektedir. Özellikle kalp tutulumu MIS-C hastalarının çoğunda görüldüğünden erken tanı ve tedavisi önem arz etmektedir. Bu derlemede COVID-19'u literatür ışığında kardiyak tutulum açısından değerlendirmek istedik.
Growth Arrest Specific Gene 6 Improved in vitro Maturation of Oocytes and the Development Potential of Porcine Embryo after Parthenogenetic Activation
Authors: Li Zhi-Peng , Shafique Laiba , Rehman Saif ur , Cui Kui-Qing , Lei Xiao-Can , Lu Xing-Rong , Shi De-Shun , Liu Qing-You
Published: April 2021

In this study, expression pattern-and function of growth arrest specific gene 6 (Gas6) during porcine oocyte maturation and early embryonic development were systemically investigated. The expression of Gas6 in the process of follicular development was studied by immunohistochemical staining, immunofluorescence, QRT-PCR and western blot. Immunohistochemical staining results showed that Gas6 was expressed in the oocytes, especially the nucleus, from the primary to preovulatory stages. The further immunofluorescence results showed that Gas6 was expressed thoughout the in vitro matured porcine oocytes, and the staining signal decreased in the first 12 h but then increased during the process of oocyte maturation. QRT-PCR analysis revealed that Gas6 mRNA was continuously expressed during the process of oocyte maturation, disappeared after parthenogenetic activation, re-appeared and elevated in the blastocysts stage. The following western blot analysis revealed a similar expression pattern with QRT-PCR and immunofluorescence. In conclusion, the expression pattern of Gas6 gene is closely related to oocytes maturation and embryo development. Gas6 may play a crucial role in the process of oocytes maturation and improve the development potential of early embryos by promoting the cytoplasmic maturation.
A Fuzzy Logic-Based System for Controlling the Temperature of Steam Exiting a Superheater for the Purpose of Preemptive Perturbation Compensation
Authors: Ryabchikov M. Yu. , Ryabchikova E. S. , Filippov S. A.
Published: April 2021

This paper discusses the issue of adjusting the temperature of steam exiting a superheater in an environment that is affected by perturbations due to the sudden and significant fluctuations in the inlet steam temperature. Using the superheater at the Magnitogorsk Iron & Steel Works as an example, we highlight that a slow response to the aforementioned perturbations in the systems that adjust for deviations leads to undesired rises and drops in the outlet steam temperature. We review the current suggestions on adjusting the temperature of steam exiting a superheater and determine the main reasons behind the drop in adjustment quality. These reasons are related to a significant lag and the variability of the control object’s features, which make preemptive perturbation control difficult. In order to control such environments, we propose a system with two degrees of freedom, which combines a proportional-integral controller and a fuzzy logic-based controller. In the system that we are proposing, the changes in the controlled parameter (depending on the input value) are adjusted within the main loop that has a standard controller and negative feedback, while the perturbations are removed by using a secondary loop, which also has negative feedback, a fuzzy logic-based controller, and a simulation of the object without the component that accounts for the lag. For situations when the information on the object’s features is precise, we describe the specifics of the loops’ interaction, specifically in cases when the task processing loop does not respond to the perturbations in the inlet steam temperature, thus allowing for setting up the loops’ controllers separately. In situations when the inlet steam temperature is experiencing perturbations, the impact of the lag on adjustment quality only becomes evident when the trajectory of the transition process shifts along the time scale by a lag value, which is completely in line with the Smith predictor principles. The system is focused on synthesizing the fuzzy logic rules and refining the parameters of the simulation used for adjustment purposes, based on the results of automated computer-aided control simulation. We propose a structural modification of the control system that makes it possible to compensate for any residual control errors caused by the non-linear structure of the fuzzy controller; this reduces the number of requirements for those set-up parameters where the value selection is based on the needs of simulation modeling, which requires a lot of computing resources. We demonstrate the results of simulation experiments that compare the efficiency of control using the system suggested and the efficiency of control using a system with a standard controller only. The computer simulation was performed in the MATLAB Simulink environment. We reaffirm that a combined control system performs better when adjusting the steam temperature.
Sources of Harmonic Force and Speed in Mechatronic Automatic Systems
Authors: Popov I. P.
Published: April 2021

To study resonance and near-resonance phenomena, a symbolic (complex) method was used, which makes it possible to significantly increase productivity, simplify and formalize mathematical transformations. Parallel and sequential connections of elements of a mechanical system with a source of harmonic force or a source of harmonic speed as a source of external mechanical harmonic action are considered. The analytical descriptions of resonance in theoretical mechanics courses correspond to parallel connection. There are devices, in a satisfactory approximation, capable of performing the functions of sources of force and sources of speed. The source of harmonic speed can be a crank-yoke drive and a flywheel with a large moment of inertia. The source of the harmonic force can be the rod of the pneumatic cylinder, the cavity of which communicates with the cavity of another pneumatic cylinder, the diameter of which is immeasurably higher than that of the first, and the piston performs harmonic oscillations. The mechanical harmonic influences described in the courses of theoretical mechanics correspond to the source of the force. Four modes are described — resonances and antiresonances of forces and velocities. The use of the symbolic (complex) method has significantly simplified the study of resonance and near-resonance phenomena, in particular, it has made it possible to deeply unify and formalize the consideration of various mechanical systems. The cumbersome and time-consuming operations associated with the preparation and solution of differential equations have been replaced by simple algebraic transformations. Resonance and antiresonance of forces, resonance and antiresonance of velocities are determined.
Occurrence of intestinal and urinary parasites among Alkhalawi students, Sudan: A cross-sectional study
Authors: NAG Ali , HA Bakhit , MBEA Saad , MMAZ Alabeden , AA Alsadig , YMY Ballal , AB Ahmed
Published: April 2021

Background: Parasitic diseases were some of the leading causes of global mortality with higher burdens of prevalence in developing countries, especially regions of the world where the contaminated water and poor personal hygiene. The purpose of this study to determine the prevalence rate of intestinal and urinary parasites among Alkhalawi students in Rabak city, White Nile State, Sudan. Materials and methods: In this study, 150 stool and 150 urine samples were collected from Alkhalawi students (all were males). The stool samples were processed by wet preparation, formal ether concentration technique and the urine samples were processed by the sedimentation technique. Results: The results revealed that out of the 150 stool and 150 urine samples, 37 were found positive for intestinal and urinary parasites, this constituted an overall prevalence rate of 12.3%. The highest prevalence rate (28%) was reported among the 11-15 years age groups, while the lowest prevalence rate (0%) was reported among the 21-25 years age groups. The prevalence rate of different parasites was as follow: Giardia lamblia (11.3%), Entamoeba histolytica (8%), Hymenolepis nana (2.7%), Schistosoma haematobium (3.3%). The prevalence of intestinal parasites (21.3%) was higher than urinary parasites (3.3%). The study showed that 24% were infected with single infection and 0.6% were infected with mixed infection. Conclusion: From the result we concluded the intestinal and urinary parasites are highly prevalent among the Alkhalawi students in Rabak city. Giardia lamblia is more likely to occur among the Alkhalawi students followed by Entamoeba histolytica. The highest infection rate was reported among the 11-15 years age groups. Formal ether concentration technique proved to be as efficient more than the wet preparation technique.
Non-traumatic lesions of clavicle – A pictorial essay
Authors: S Kakarla
Published: April 2021

The aim of this paper is to illustrate the various pathological lesions encountered in clavicle other than traumatic. Clavicle is not a common structure for investigation, except when trauma is suspected. However, whenever a pathological lesion is to be studied, conventional radiology is the first modality to adopt. There are no standard radiographic techniques to study the clavicle. Often it is seen on a conventional chest radiograph. Many systemic disorders reflect on clavicles. Cross sectional imaging helps very little except in neoplastic conditions. The imaging appearances are described in most of the lesions that are found in clavicle.
Russia and Spain, Fatal Attraction? Brief History of Encounters and Disagreements
Authors: López González H.
Published: April 2021

The article that is presented, responds to a series of still images experienced by the author throughout the years of youth and maturity, before and after his multiple visits to the Russian Federation, on the occasion of his responsibility in the RR. Internationals of the University of León. It also involves an approach to the changes that take place in the mind of a person who has lived in very special circumstances, in order, especially the encystment of the different countries of Europe, in this case, a product of the Second World War. It serves, at the same time, as an approach to diplomatic relations between Spain and Russia, especially at the beginning of them.
Genetic Determination as a Source of Cultural Clashes Between Civilizations
Authors: Boterashvili D.B.
Published: April 2021

The subject of this study is intercultural contacts and relationships, the point of view that the logic and rational thinking of fundamentalists are very different from the logic of secularists. The author of the article concludes that the differences between the two main civilizations, archaic-fundamentalist-religious and atheistic-secular, determine the creation of different political structures in human society.
In the Footsteps of the Contexts of the Georgian Renaissance Poem (Shota Rustaveli in Jerusalem)
Authors: Chelidze V.
Published: April 2021

In world literature, Shota Rustaveli is known as a poet of the Renaissance. He brilliantly portrayed free-thinking, spiritually and physically perfect epic characters in the poem "The Knight in the Panther's Skin". An original artistic look, a broad outlook, surprise with the breadth of scale: "The Knight in the Panther's Skin" expresses the new humanistic ideals of the great period. As a Georgian literary monument of verbal art, Rustaveli's poem precedes the works of the European Renaissance. These creative processes, different in time of writing and from different geographic regions, developed independently of each other.
Problems of Teaching a Foreign Language in Professional Activities during the Pandemic
Authors: Ukrainets I.A.
Published: April 2021

The article is devoted to the problems of teaching undergraduates of non-linguistic universities the professional legal and economic language in the new conditions of the coronavirus pandemic. The author analyzes the problems faced by the teachers of universities around the world in completely new conditions, and, in particular, before the teachers who train lawyers and economists, changes in the tasks and methods of teaching. Based on her many years of experience in teaching the subject to lawyers and economists, the author examines and suggests ways and methods of teaching professional English in the new conditions of the pandemic.
Spain and Italy Experience of Digital Education and E-Learning during the Pandemic
Authors: Beletskaya O.S. , Eranova N.A. , Kucheryavenko V.V.
Published: April 2021

Due to the threat of the novel coronavirus infection, most schools, colleges and universities in Italy and Spain followed the recommendation of the Ministries of Science and Healthcare and opted to shift to distance learning mode. Needless to say, that fact had an impact on how the educational process was organized changed the format of communication and implementation of curricula and syllabi. The relevance of this study is conditioned by a growing interest to the problems of distance learning during the pandemic and the scarce research into this subject. The purpose of this paper is to identify and describe computer technologies applied in distance learning in educational institutions of Spain and Italy over the pandemic period. As part of research, we analyzed the data provided by the Spanish and Italian Ministries of Education and Science, as well as over 50 articles published by leading Spanish and Italian printed media, such as Corriere, Repubblica, Ilfattoquotidiano, Varesenews, Agi, OrizzonteScuolat, Udinetoday, El Pais, Expansion, ABC, El Tiempo, etc. The theoretical underpinning for the study is comprised of papers by distance learning experts: I.K. Korneyev, G.N. Ksandopulo, V.A. Mashurtsev [2009], V.L. Uskov [2008], Sharples M., Adams A., Alozie N., Ferguson R., FitzGerald E., Gaved M., McAndrew P., Means B., Remold [2015], Gros B. [2016], Bates A. [2015].
Characteristics of Phraseological Units with the Meaning "Person" in the Avar Language
Authors: Sirazhudinov R.M.
Published: April 2021

At present, new phraseological phrases constantly arise in speech and, being actively used, are included in the phraseological composition of the language, enrich it with new expressive means. From the pages of newspapers and magazines, from radio and television programs, from the theater and variety stages, more and more figurative verbal complexes sound and enter the speech of native speakers. The avalanche of the process of phrase formation requires comprehensive observation, inventory and study on the part of language researchers, since this process is associated with issues of speech culture, problems of language teaching and mastering the rules of behavior, general problems of speech communication.
Multifocal Electroretinography as a Method of Functional Assessment of Retinal Laser Injury in Experimental Studies
Authors: Suetov A. A. , Alekperov S. I. , Odinokaya M. A. , Kostina A. A. , Petrova E. A.
Published: April 2021

Purpose: to investigate local functional changes in the rabbit retina by multifocal electroretinography under pulsed laser radiation.

Materials and methods. Transpupillary applications by single laser pulses (Nd:YAG laser, 532 nm, 50 ms) with the diameter of the laser beam spot on the retina surface of 132 µm (15 eyes) and 200 µm (15 eyes) were performed on 30 eyes of 15 rabbits. In each eye were applied 6 applications of different laser pulse power (15, 30, 50, 100, 150 and 200 mW). The diameter of the injury zone was assessed ophthalmoscopically and histologically. Multifocal electroretinography was performed before and 30 minutes after exposure using a module for multifocal electroretinography Neuro-ERG (Neurosoft, Russia), topographically comparing a pattern of 61 hexagons with an ophthalmoscopic fundus picture. The amplitude (µV) of the P1 peak and the implicit times (ms) of the P1 and N1 peaks were estimated in the first-order response in the hexagons corresponding to the laser damage zones.

Results. When using a laser spot on the retina of 132 microns and 200 microns, the threshold level of laser radiation power for the development of significant local changes in the bioelectric activity of the retina was 50 and 30 mW, respectively (p < 0.05). The minimal diameter of the laser damage at which significant functional changes are recorded by multifocal electroretinography with a pattern stimulator consisting of 61 hexagons was 127.2 ± 6.4 µm (spot 132 µm, energy 50 mW), while a significant relationship was found between changes in the peak amplitude P1 and ophthalmoscopic and histological dimensions of the damage zone (r = 0.73 and r = 0.71, respectively, p < 0.01).

Conclusion. The use of multifocal electroretinography can be used to quantify functional changes in local laser damage to the retina in experimental studies on rabbits.
New Hyaluronic Acid Preparations in the Treatment of Children with Dry Eye Syndrome
Authors: Brzheskiy V. V. , Gorbachevskaya I. N. , Golubev S. Y.
Published: April 2021

The aim of the study was to evaluate the effectiveness of the preparations Optinol® Express Moisture (0.21 %) and Optinol® Deep Moisture (0.4 %) in the treatment of children with dry eye syndrome (DES) and to determine the indications for prescribing these drugs for various etiologies and clinical course of the disease.

Patients and methods. The study involved 56 children aged 4–17 years with DES, which were divided into 3 groups, depending on its pathogenetic type. The first consisted of 24 children with DES, which developed on the basis of chronic blepharitis, the second — 12 children with neuroparalytic keratitis, and the third — 18 children with chronic uveitis, in whom DES was caused by prolonged instillations of eye drops with benzalkonium chloride. Each group was divided into 2 more equal subgroups, the first of which was prescribed the drug Optinol® Express Moisture, and the second — Optinol® Deep Moisture with a frequency of 4 times a day.

Results. In all children, from the very first days of instillation of the studied drugs, a decrease in the severity of subjective signs of DES (OSDI) was noted, as well as a gradual decrease in the degree of xerotic changes in the ocular surface (severity of its staining with vital dyes) and an increase in the stability of the tear film (M.Norn). At the same time, the positive dynamics of the controlled parameters increased with the continuation of therapy, reaching a maximum by the 30th day of treatment. Moreover, the effectiveness of therapy depended on the severity of xerosis of the ocular surface: it was maximal in children with mild, and minimal in children with an extremely severe form of xerosis (with neuroparalytic keratitis). Moreover, the drug Optinol® Express Moisture was more effective in the treatment of children with mild and extremely severe forms of DES, and Optinol® Deep Moisture — with moderate and severe xerosis.

Conclusion. The preparations Optinol® Express Moisture and Optinol® Deep Moisturization are effective in the treatment of children with DES, which has developed on the basis of pathology of the ocular surface of neurotrophic and artifact genesis, as well as increased volatility of the precorneal tear film against the background of chronic blepharitis.
Clinical Course and Results of Anti-VEGF Therapy of Retinopathy of Prematurity
Authors: Katargina L. A. , Demchenko E. N. , Kogoleva L. V.
Published: April 2021

The clinical course of active retinopathy after anti-VEGF therapy, the possibility and timing of recurrence of the disease, anatomical and functional outcomes of treatment are widely discussed in the press, not fully studied and relevant.

Purpose: to study the clinical course of active retinopathy of prematurity after anti-VEGF therapy and clinical and functional outcomes.

Patients and Methods. Children with active retinopathy of prematurity, who turned to the Helmgoltz National Medical Research Centre of Eye Diseases after anti-VEGF therapy, examined by indirect binocular ophthalmoscopy and digital retinal camera (RetcamShuttle). Children were monitored from 1.5 to 6 years (average 2.94 ± 1.47). All children underwent routine examination, 4 children older than 3 years underwent optical coherence tomography.

Results. In all cases, after anti-VEGF therapy, there was a decrease in vascular activity and continued vascularization of the retina. Recurrence of the disease requiring additional treatment, were detected in 11 (42.3 %) eyes within 6–22 weeks (in average 13.33 ± 5.57) after intravitreal anti-VEGF therapy. Laser coagulation of the retina was carried out in 4 children (7 eyes) and repeated administration of anti-VEGF drug — 2 children (4 eyes), which led to regression of the disease. In the long-term period, all 13 (100 %) children had successful outcomes.

Conclusion. Anti-VEGF therapy is effective in plus-zone 1 disease and posterior aggressive retinopathy of prematurity. Its advantages include the ability to treat retinopathy in zone 1 posterior, the absence of “blockade” of the peripheral retina with the possibility of continued growth of blood vessels to the periphery, lower frequency and severity of myopia. The disadvantages include the possibility of recurrence of the disease, which requires long-term regular monitoring.
Comorbid Inflammatory Diseases of Digestive System and Eye
Authors: Bulgakov S. A. , Chernakova G. M. , Kleshcheva E. A. , Simonova S. V.
Published: April 2021

Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases, which are often accompanied by inflammation of other organs. This article presents modern data on etiology, pathogenesis and clinical course of inflammatory bowel diseases, as well as information on extraintestinal eye manifestations of nonspecific ulcerative colitis and Crohn’s disease. The role of microbiota, genetic factors, immune system defects in pathogenesis of intestinal inflammation and extraintestinal eye manifestations is considered. The possibility the development of ophthalmopathology not only against the background of intestinal inflammation, but also as a consequence of therapeutic and surgical methods of treatment of ulcerative colitis and Crohn’s disease is noted. The peculiarities of the course of episcleritis/scleritis, keratitis, uveitis, chorioretinitis, optical neuritis for patients with inflammatory bowel diseases are considered. The presence of these complications may reflect the activity of the underlying disease, which in some cases requires correction of therapy. Anterior uveitis and episcleritis/scleritis are the most common extraintestinal manifestations of inflammatory bowel disease. Inflammation of tissues of the posterior segment of the eye and optic nerve against the background of ulcerative colitis and Crohn’s disease are less common, but are of clinical importance, as they can catastrophically damage the structures of the eye and, as a consequence, lead to complete blindness. Considering the possibility of mild clinical symptoms and asymptomatic course of inflammation in the eye envelopes, the importance of ophthalmological examination of all patients with ulcerative colitis and Crohn’s disease is emphasized. Aspects of modern therapy of ophthalmopathology and background intestinal inflammation are highlighted. Biological preparations — antagonists of pro-inflammatory cytokines — have been identified as the most promising in the treatment of inflammatory intestinal diseases and extraintestinal manifestations. The important role of proper nutrition and biologically active supplements containing omega-3 fatty acids, vitamin D, microelements, was noted as auxiliary therapy of both intestinal and extraintestinal inflammation.
About the Possible Mechanisms of the Influence of Optical Intraocular Implants on the Characteristics of Neurosensory Rehabilitation and Adaptation in Patients with Pseudophakia. Literature Review
Authors: Ramazanova L. Sh. , Napylova O. A. , Shamratov R. Z.
Published: April 2021

This literature review analyzed the possible mechanisms of the influence of the design features and optical characteristics of monofocal intraocular lenses (IOLs) on the characteristics of sensorineural adaptation and visual rehabilitation in patients after cataract phacoemulsification. Bibliographic research of scientific publications was carried out in the following databases: Medline, Pubmed, Cochrane, eLibrary. Languages of publications: Russian and English. The literature review reflects research data on the physicochemical properties, optical surface and color of the IOL filter, spatial contrast sensitivity and wavefront aberrations. Analysis of domestic and foreign literature has demonstrated the absence of a systematic approach to the study of sensorineural adaptation in patients after implantation of monofocal IOLs, which would make it possible to reasonably develop requirements for qualitative and constructive characteristics in the production of intraocular lenses to improve the quantitative and qualitative indicators of their visual functions in order to reduce the terms of rehabilitation and improvement of quality of life indicators in patients with pseudophakia. At the same time, there is an obvious need for research on the influence of the design and quality characteristics of optical intraocular implants on the subjective “quality of vision” of patients with pseudophakia, which is, ultimately, the target indicator of cataract surgery at the present stage. Also, the key mechanisms of neurosensory rehabilitation and adaptation of patients who underwent cataract surgery need to be studied and clarified in order to develop recommendations for the production of intraocular implants.
Clinical and Functional Results of a Combined Surgical Treatment of Pellucid Marginal Degeneration
Authors: Kalinnikov Yu. Yu. , Nevrov D. V. , Kalinnikova S. Yu. , Tkachenko I. S.
Published: April 2021

Purpose: To evaluate the clinical results of a combined approach to the treatment of pellucid marginal degeneration, that includes femtolaser-assisted keratotomy, intrastromal lamellar keratoplasty with a use of refractive lenticule and a simultaneous intracorneal ring segment implantation, followed by a local collagen cross-linking.

Patients and methods. An analysis of the outcomes of the surgical treatment performed in 20 eyes of 15 patients from 36 to 57 years old who were diagnosed with pellucid marginal degeneration in both of their eyes. During the first stage of the treatment patients underwent a femtolaser-assisted keratotomy in a steep meridian, intrastromal lamellar keratoplasty in the zone of corneal thinning and a simultaneous implantation of intracorneal ring segments with an arc-length of 80 to 160 degrees, followed by a local corneal cross-linking during the second stage. Refractive lenticules obtained during the ReLEx® SMILE procedure were used as a lamellar graft.

Results. By the end of the follow-up period of 12 months the UCVA had improved from 0.1 ± 0.07 to 0.33 ± 0.23 and the BCVA from 0.4 ± 0.25 to 0.7 ± 0.28 (p < 0.05). The corneal topography demonstrated a decrease in maximum simulated keratometry values from 49.28 ± 2.57 D to 46.15 ± 1.73 D and an astigmatism reduction from 7.4 ± 3,9 D to 2.1 ± 0,53 D. The corneal thickness increased from 508.0 ± 31.0 μm to 606.0 ± 36.0 μm in the zone of the thinning.

Conclusions. The analysis of the clinical outcomes has demonstrated the high efficacy of the combined approach to the treatment of pellucid marginal degeneration. The ICRS implantation allowed for a significant cylinder reduction and an improvement of visual acuity. The lamellar keratoplasty allowed for a reinforcement of the thinned cornea, and the subsequent local collagen cross-linking ensured corneal stability.
Outcomes of Application Two-Piece Microkeratome-Assisted Mushroom Keratoplasty
Authors: Trufanov S. V. , Budnikova E. A. , Rozinova V. N.
Published: April 2021

Purpose: to evaluate outcomes and to expose possible specific complications of two-piece mushroom keratoplasty.

Patients and methods. A total of 9 patients (9 eyes) with corneal perforations and deep stromal opacities involving the Descemet membrane were undergone surgery. In all cases, preserved hypothermic corneoscleral buttons (in Borzenok– Moroz medium) for up to 5 days were used as donor material. The two-piece mushroom keratoplasty was performed using a microkeratome and vacuum trephines set in the variant proposed by M. Busin.

Results. Success survival was obtained in 78 % of patients (7 out of 9 cases). Best spectaclecorrected visual acuity (BSCVA) 1 year after surgery averaged 0.54 ± 0.20. The average of corneal astigmatism was 3.41 ± 1.89 D. Endothelial cell density in 6 months after surgery was on average 2364 ± 236/mm2, and in 1 year — 2082 ± 228/mm2. A false chamber formation between separate parts of the graft as a specific complication was detected in 2 patients on 1 day after surgery. In one case it was eliminated by air re-injecting into the ocular anterior chamber. The second patient underwent conventional PKP due to the lack of graft adaptation. In addition, 1 patient also underwent conventional PKP as a result of postoperative crystalline infectious keratopathy, which is the non-specific complication of mushroom keratoplasty.

Conclusion. The two-piece microkeratome-assisted mushroom keratoplasty is an effective method of surgical treatment of corneal perforations and deep stromal opacities involving the Descemet membrane.
Mustafa Kemal Paşa ve İnönü Savaşları
Authors: UCA Alaattin
Published: April 2021

Kurtuluş Savaşındaki cephelerden biri de Batı Cephesidir. 15 Mayıs 1919’da İzmir’de başlayan Yunan işgaline karşı bu cephede Kuva-yı Milliye birlikleri oluşturularak direniş başlatılmıştır. Kuva-yı Milliye birlikleri bu süreçte önemli başarılar kazanmıştır. Fakat bu birliklerin olumsuzlukları da görülmüştür. Yunan ordusu karşısında kesin zafer kazanmak için düzenli ordu kurulmasına karar verilmiştir. Mustafa Kemal Paşa, Umum Kuva-yı Milliye Kumandanı Ali Fuat Paşa’yı Moskova Büyükelçiliğine görevlendirmiştir. Batı Cephesini ikiye bölmüştür. Cephenin Batı kısmına Albay İsmet Bey’i Güney kısmına da Albay Refet Bey’i atamıştır. Böylece düzenli orduya geçilmiştir. Kuva-yı Milliye birlikleri de düzenli orduya katılmıştır. Fakat bu süreçte bazı sorunlar yaşanmıştır. Ethem ve kuvvetleri, düzenli orduya katılmak istememiştir. Bunlar Yunan ordusuyla iş birliği yapmıştır. Buna rağmen I. İnönü Savaşı kazanılmıştır. İtilaf Devletlerinin davetiyle hem İstanbul Hükümeti hem de Ankara Hükümeti temsilcileri Londra Konferansına katılmıştır. Konferans sonuçsuz kalınca Yunan ordusu yeniden saldırmıştır. Türk ordusunun kahramanca mücadelesi sonunda II. İnönü Savaşı kazanılmıştır. Yunan ordusu bir kez daha geri çekilmek zorunda kalmıştır. Mustafa Kemal Paşa, Batı Cephesinde kazanılan bu zaferlerden memnuniyet duymuştur. Bu çalışmada Mustafa Kemal Paşa’nın İnönü Savaşlarıyla ilgili açıklamaları, düşünce ve yorumları ele alınmıştır.
Kuva-yı Milliye’den Düzenli Orduya Geçiş Süreci Gelişmeleri ve Birinci İnönü Savaşı’na Etkileri
Authors: BAL Rıdvan
Published: April 2021

Bu çalışmanın amacı işgale uğrayan Anadolu topraklarında gerçekleştirilen bağımsızlık savaşına giden sürecin başlangıcını incelemektir. Türk halkının mücadelesini, Türk Kurtuluş Savaşını (İstiklal Harbini) anlatan yayınların ve dokümanların analizi, bu çalışmanın araştırma yöntemini oluşturmuştur. Kuva-yı Milliye olarak adlandırılan oluşum, bölgesel kurtuluş için bir araya gelmiş vatansever insanların kurduğu ve merkezî bir komutanlığa bağlı olmayan silahlı direniş gruplarıdır. Bir çeşit gerilla savaşı uygulayan, genellikle kendilerini emir komuta eden liderlerinin ya da yaşadıkları bölgelerin adı ile anılan bu kuvvetler, başlangıçta işgal kuvvetlerine ciddi zararlar vermiştir. Büyük Millet Meclisi’nin açılışından itibaren askerî harekâta yönelik uygulamalar hayata geçirilmeye başlanmış, bu doğrultuda Kuva-yı Milliye’nin sonlandırılıp düzenli orduya geçiş kararı alınmıştır. Düzenli ordu saflarına katılmayı reddeden Çerkez Ethem isyan etmiş, tüm uyarı ve görüşmelere rağmen bu girişimi barış yoluyla çözülememiştir. Batı ve Güney Cephelerine bağlı birliklerden oluşan bir takip kuvveti ile Kuva-yı Seyyare’ye karşı başlatılan harekât, isyancıların saf dışı bırakılmaları, bazılarının teslim olarak düzenli ordu saflarına katılışı ve bir bölümünün de Çerkez Ethem ile beraber Yunan ordusuna sığınmasıyla sonuçlandırılmıştır. Bu gelişmeleri bir fırsata çevirmek isteyen Yunan Küçük Asya ordusu 6 Ocak 1921 günü ileri harekâta geçerek İnönü’ye ulaşmıştır. Şiddetli muharebelerin yaşandığı İnönü’de yer yer Türk mevzilerini ele geçiren Yunan birlikleri, takviye kuvvetlerinin gelmemesi ve Türk askerlerinin savunma hattında güçlü direnişi nedeniyle 10/11 Ocak’tan itibaren eski mevzilerine geri çekilerek savaşı sonlandırmıştır. Batı Cephesinde Yunan ordusuna karşı icra ettiği ilk muharebeden galip çıkan düzenli ordu birliklerinin bu başarısı gelecek savaşlar için umut vermiş ve tüm ulusun moralini yükseltmiştir.