bluuebunny/crossref_metadata_2025 huggingface dataset:
Setorização de rotas de coleta de resíduos sólidos domiciliares por técnicas multivariadas: estudo de caso da cidade do Recife, Brasil
Authors: Silva Rodrigo Cândido Passos da , Costa Amanda Rodrigues Santos , El-Deir Soraya Giovanetti , Jucá José Fernando Thomé
Published: November 2020

RESUMO Buscar soluções para a problemática dos resíduos sólidos domiciliares (RSD) é um dos desafios enfrentados pelos gestores municipais. Diante do cenário ascendente de geração desses materiais, principalmente nos centros urbanos, a implantação de um modelo integrado e adequado à realidade da municipalidade torna-se imprescindível. Nesse sentido, a setorização de rotas de coleta a partir da utilização de técnicas multivariadas pode auxiliar o gestor na proposição de modelos setoriais de resíduos sólidos que contemplem as particularidades socioeconômicas das áreas estudadas. Desse modo, o presente artigo utiliza as técnicas multivariadas de análise de componentes principais, para avaliar a correlação entre população, renda, geração e composição gravimétrica dos resíduos, elencando, entre esses indicadores, os mais representativos; e a análise de agrupamento hierárquico, para setorizar 31 rotas de coleta em clusters por similaridade. Verificou-se que a população, a renda domiciliar e per capita, a geração de resíduos per capita e os resíduos recicláveis, alimentares e putrescíveis foram bem representados no estudo. A renda e a geração per capita apresentaram forte correlação positiva. A setorização das rotas gerou dois grupos: A e B, que resultaram em cinco subgrupos por similaridade: A1, A2, B1, B2 e B3. Os subgrupos A1 e A2 contemplaram os setores de classe baixa, ao passo que os clusters B1, B2 e B3 compreenderam os setores de classe alta, média e comercial, respectivamente. A setorização de rotas mediante o grau de similaridade apresenta-se como etapa basilar para a proposição de modelos setoriais de RSD que busquem o entendimento das particularidades elencadas.
The crisis of criminal justice in South Africa
Authors: Cameron Edwin
Published: November 2020

This article builds on two lectures (delivered in 2017 and 2019 at the University of the Western Cape and the University of Cape Town respectively) that addressed a a controversial and often overlooked crisis in the criminal justice system – the minimum sentencing regime.  The paper argues that minimum sentences are no response at all to curbing crime in South Africa and to making our people safe. The minimum sentencing regime is a misdirected, hugely costly and above all ineffective way of punishing criminals and dealing with crime. It has been an extravagant mistake of science, understanding, and policy and social response. The article summarises some of the arguments and considers why we are still stuck with minimum sentences when they are demonstrably useless and counterproductive. The author argues that the reasons lie in our broken history, in incoherent decision-making in our present political leadership, institutional incompetence, and the fact that minimum sentences themselves, through their false promise, divert us from finding more efficient solutions.
INCIDENTAL FINDINGS OF MALIGNANCY OF THE CHEST BY SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY MYOCARDIAL PERFUSION – One YEAR FOLLOW-UP REPORT.
Authors: Tung Robert , Heyns Johannes
Published: November 2020

Background: We recently reported 6 cases of pulmonary/hilar malignancies as the result of incidental findings (IF) on CT attenuation correction (CTAC) during SPECT-CT MPI. In this study, we examined clinical features, diagnostic procedures and clinical outcome on all patients who were had malignancies or significant IF that required further follow-up.  Methods: Of 1098 consecutive patients who underwent cardiac SPECT-CT MPI from 9/1/2017 to 8/31/2018, their MPI and CTAC were reviewed contemporaneously.  Patients with known history of prior pulmonary or chest malignancy were excluded.  Results: A total of 79 (7.2%) patients were identified to have significant IF on CTAC; after diagnostic CT, 47 patients were found to have significant findings that warranted further follow-up and included in this study. Eight patients (0.73%) were found to have malignancy of the chest because of IF on the CTAC.   There was no statistical difference in baseline characteristics and cancer risk factors among patients who were found to have cancer vs those without.  At the time of diagnosis, 4 patients were found to have cancer at advanced stage who all died within 12 months while 3 others had lung cancer of early stage and 1 mantle cell lymphoma were alive at a mean follow-up of 17.5+/-2.1 months. Biopsy for tissue diagnosis were performed safely: with needle biopsy, major complication occurred in 1 patient (1/9 or 11.1%); none with surgical biopsy. Conclusions: This study underscores the importance of reviewing CTAC images obtained during cardiac SPECT-CT MPI to potentially detect clinically important incidental findings.
Ankilozan Spondilitli Hastalarda Nöropatik Bel Ağrısı ve Hastalık Aktivitesi, Fonksiyonel kapasite ve Yaşam kalitesi ile İlişkisi
Authors: YILDIRIM Tülay
Published: November 2020

Amaç: Bu çalışmada Ankilozan spondilit (AS)’li hastalarda bel ağrısının nöropatik komponentinin değerlendirmesi ve nöropatik ağrının; hastalık aktivitesi, fonksiyonel kapasite ve yaşam kalitesi ile ilişkisini araştırması amaçlandı.

Gereç ve yöntemler: Çalışmaya 15 AS tanılı hasta dahil edildi. Hastalık aktivitesini değerlendirmek için Bath Ankilozan Spondilit Hastalık Aktivite İndeksi (BASDAI), fonksiyonel durumu değerlendirmek için Bath Ankylosing Spondylitis Functional Index (BASFI), ve yaşam kalitesini değerlendirmek için Ankylosing Spondylitis Quality of Life (ASQoL), bel ağrısının şiddetinin değerlendirmek için visual analog scale (VAS), nöropatik ağrıyı değerlendirmek için ise painDETECT anketi kullanıldı.

Bulgular: PainDETECT skoru hastaların % 13'ünde kesin nöropatik ağrı, % 33'ünde ise olası nöropatik ağrı saptandı. PainDETECT skorları ile bel ağrısı VAS değerleri, BASFI ve CRP düzeyleri arasında anlamlı düzeyde pozitif korelasyon saptandı (p
The Silk Road of Social Partnership
Authors: Zaitseva Larisa , Racheva Svetlana
Published: November 2020

The article discusses the prospects and impediments of collective bargaining legislation’s harmonization of six participants (China, Kazakhstan, Russia, Belarus, Poland, and Germany) in the railway project that has linked China and Europe and has become an integral part of the New Silk Road global initiative. To this effect, the authors have analyzed transnational companies’ experience in making collective contracts and have assessed the degree of the impact of international treaties on the aforementioned countries’ legislation in terms of their involvement in various international organizations’ activities and ratification of the most significant international acts. Based on a comparative analysis of a collective contract’s legislation, the authors have singled out some key features influencing transnational companies’ collective bargaining practices. The analysis revealed the norms and practices that impede and/or boost the extraterritorial application of transnational companies’ collective contracts. Since the countries are members of various international organizations, the international acts on freedom of collective bargaining made it possible to identify legal grounds for distinctions between the social partnership’s legal policies. A meticulous study of individual transnational companies’ collective bargaining agreements and practices enabled the authors to identify systemic links and the Transnational Companies’ (hereinafter – TNCs) practice of determinism due to international regulation and the laws of the country of origin. The research revealed the principal steps forward which should be taken to resolve the issues of extraterritorial application of TNCs’ collective agreements.
Characteristics of Crimes Against the Interests of Service in Commercial and Other Organisations in Russia and Germany
Authors: Markuntsov Sergey , Wassmer Martin Paul
Published: November 2020

The comparative study focuses on corruption in commercial organisations, which has received considerable attention in both Russia and Germany in recent years. In both countries anti-corruption law has been harmonised by several international conventions to reflect the growing importance of world trade and increasing globalisation. The authors analyse the current criminal offences and the criminological characteristics in both countries. Whereas in Russia special criminal provisions were created under Chapter 23 (Articles 201, 202, 203, 204, 204.1 and 204.2 of the Criminal Code of the Russian Federation), in Germany the relevant corrupt conduct is covered by the traditional general criminal offence of embezzlement (§ 266 of the German Criminal Code (StGB)) and by newly created special corruption offences (§§ 299, 300 and 301 StGB). The authors show that in each of the two countries, Russia and Germany, corruption in commercial organisations is now considered a grave form of corruption, so that the international conventions are taken into account to some extent. In Germany, however, not only are the sanctions foreseen for corruption in commercial organisations considerably lower than those for corruption in the public sector, but the offences are only prosecuted on criminal complaint. In the practice of German criminal prosecution, these types of bribery offences have therefore so far had little significance. Nevertheless, a high number of undetected cases and large economic losses can be expected. Furthermore, the comparative legal study shows that there are not only considerable differences in the design of the criminal provisions as well as in the legal reality, but that there are also several common elements in Russia and Germany.
Analysis on the Definition of Japanese Territory After World War II in Terms of International Law: the Southern Kurils, the Diaoyu Islands and Tok Islet
Authors: Pak Hui-Chol , Son Hye-Ryon
Published: November 2020

Geopolitical tensions have periodically risen in the Asia-Pacific region due to territorial disputes between Japan and its neighbours over the Southern Kurils (the Northern Territories), the Diaoyu Islands (the Senkaku islands) and Tok Islet (Tok Islet (Dokdo)/ Takeshima). There is, of course, great discrepancy between the disputes over the Southern Kurils, the Diaoyu Islands and Tok Islet (Dokdo) in terms of their respective origin and legal nature, and effective control over them, and the historical and legal grounds on which the disputing states rely in their claims over the disputed territories vary widely. But what is consensual and definite is the fact that the islands in dispute were already excluded from the Japanese territory under the international legal acts deciding Japanese territory after World War II. The paper examines and analyzes Japanese reasoning behind its claim over the disputed territories in terms of relevant international legal acts relating to the delimitation of Japanese territory after World War II.
Role of microRNAs in neuroendocrine neoplasms of the stomach
Authors: Peregorodiev I. N. , Vinokurova S. V. , Bohyan V. Yu. , Delektorskaya V. V. , Malikhova O. A. , Gorbunova V. A. , Sakibov B. I. , Elkin D. S. , Stilidi I. S.
Published: November 2020

Neuroendocrine neoplasms (NENs) are a heterogeneous group of rare epithelial tumors that arise from cells with a neuroendocrine phenotype. NENs are found in the gastrointestinal tract and pancreas – 60 % of all localities. The incidence of gastric NENs is about 9 % of all neuroendocrine tumors of the gastrointestinal tract and 0.3 % of all stomach tumors. Stomach neuroendocrine tumors (NETs) are classified into three clinico-pathological types, based on etiology, pathogenesis and morphology. There are also separate neuroendocrine cancers: small- and large-cell. The prognosis and approach to treatment of various types of gastric NENs differs significantly. Modern methods of instrumental diagnostics, immunohistochemical methods of morphological research, along with light microscopy, do not always allow us to accurately assess the malignant potential of a tumor and individualize the treatment process. One of the promising directions in the study of NETs is to determine the molecular mechanism underlying their development, in particular the role of microRNAs. This direction can open a new vector of understanding the pathogenesis, determining the prognosis of the disease, as well as finding new application points for the drug treatment of NETs. MicroRNAs are a class of short non-coding RNA molecules (18–25 nucleotides). MicroRNAs can be involved in the regulation of all major cellular processes, including proliferation and differentiation, metabolism, signaling pathways, and apoptosis. A study of microRNA expression in tissues revealed tumor-specific microRNAs. In contrast to a number of other malignant tumors, microRNA expression in patients diagnosed with NENs is poorly understood. MicroRNA-222 and microRNA-202 are among the few microRNAs that have been demonstrated in the NETs of the stomach.
Analysis of genetic aberrations in pediatric high-grade gliomas
Authors: Zaytseva M. A. , Shekhtman A. P. , Papusha L. I. , Valiakhmetova E. F. , Yasko L. A. , Druy A. E.
Published: November 2020

Background. High-grade gliomas are characterized by a wide range of genetic abnormalities. The heterogeneous genomic landscape of pediatric high-grade gliomas allows identifying distinct subgroups of the disease in children and young adults. Most importantly, these subgroups differ by clinical course and prognosis, as well as treatment response to standard therapy.

Objective: to assess the profile of molecular genetic markers of high-grade gliomas in children.

Materials and methods. In the current study, we examine the frequency of H3F3A, Hist1H3B, BRAF, IDH1 / 2 mutations, the copy number alterations of CDKN2A / 2B genes and the expression of ETV6‑NTRK3 fusion gene in a cohort of 53 pediatric high-grade gliomas.

Results. Driver mutations and CDKN2A / 2B deletions were observed in 24 (45 %) and 15 (28 %) of 53 tumors, respectively. Overall, the studied high-grade gliomas harbored 41 genetic aberrations including 24 (58.5 %) somatic missense mutations, 1 (2.4 %) genetic variant of unknown clinical significance, 1 (2.4 %) oncogenic fusion gene and 15 (36.6 %) deletions of the tumor suppressor genes.

Conclusion. These findings point to the importance of molecular profiling of tumors for the optimal clinical care and development of new approaches to treatment aimed at molecular targets for personalized anticancer therapies.
The role of extracellular vesicles in the diagnosis of glioblastoma progression
Authors: Ryabova A. I. , Novikov V. A. , Yunusova N. V. , Ponomareva A. A. , Spirina L. V. , Gribova O. V.
Published: November 2020

The article reviews studies highlighting the role of extracellular molecules in non-invasive diagnosis of glioblastoma recurrence. Glioblastoma is the most common malignant tumor of the brain characterized by fatal outcome prognosis. Current treatment of tumor recurrence allows to increase patient survival, improve functional outcome and decrease caregivers» load. The standard method of recurrence diagnosis is neuroimaging which at early stages cannot distinguish between tumor recurrence and post-radiation changes. Currently in oncology, liquid biopsy and marker detection in circulating extracellular vesicles are considered promising approaches allowing to obtain early and differential tumor diagnosis, determine dynamic molecular and genetic status of the tumor, diagnose tumor recurrence at early stages. In this context, the most promising approach to glioblastoma diagnosis is associated with studying of expression of glial fibrillary acidic protein (GFAP), epidermal growth factor receptor (EGFR), its mutant variant EGFRvIII, podoplanin (PDPN) and isocitrate dehydrogenase 1 (IDH1) in extracellular vesicles; for primary glioblastoma diagnosis and early recurrence: studying of microRNA-210, -301a, -222, -123-3p, -21; for control of immunotherapy effectiveness in patients with recurrent forms of glioblastoma after standard treatment: evaluation of СD9+ / GFAP+ / survivin+ exosomes in plasma.
DEVELOPMENT OF MAP-BASICS AND SEMIOTIC COMPONENTS OF SOME SYNTHETICS ELEMENTS OF CONTENTS FOR INTERACTIVE ATLAS UNIVERSITY EDUCATIONAL-MANAGERIAL TYPE
Authors: Molochko N. , Yatsenko O. , Molochko A. , Pampukha I.
Published: November 2020

The issue of cartosemiotics, support for the development of Interactive Atlas of Higher Education Institution (HEI), its mathematical basis-to display the Semitic components of the table of contents: a syntactic (space-defined) and of the semantic (meaningful) sides and their other components: signaling, coloro-thematic, pragmatic and stylistic, and also construction of characterizing elements of synthesized figures, which are distinguished in comparison with reflection of analytical Indicators Cartographic modeling in satin work educational and managerial type. The issues discussed are based on tracking the development stages of the general theory of cartographic from the period of its post-war prosperity (1940-1990), the period of the establishment of the technical development trend (visualization in geoinformatics) (1990-2010), to the consideration of the conceptual environment of the modern (up to 2020) the trend of the formation of the general theory of cartography. It is due to the definition of six (required, minimum necessary and sufficient) components of the normalized structure of the semiotic sides of the map. Due to this, the language of the map began to function, revealing the semiotic aspects of the content of any objects of study, cartosemiotics sides through the completed form as a perfect theory of the object language of the map. Considered methodological approaches, regarding the development of the interactive atlas of the university, reveal the essence of the cartosemiotic positions of cartographic modeling in education at the local level.
Küllî Fıkıh Tasavvuru ve Fıkıh, Ma'rifet, Ubûdiyyet İlişkisi
Authors: KORUCU Bünyamin
Published: November 2020

Öz
Fıkhı insanın nihâî hedefini gerçekleştirmek üzere tasarlanmış bir araç olarak tasavvur etmeyi teklif eden bu çalışmada mezkur yaklaşımın tabi bir uzantısı olarak sözkonusu araç-amaç ilişkisine dikkat çekmek amaçlanmış, fıkıh ilminin varlık amacı, insanın varoluş amacı ekseninde ele alınmıştır. Makalede varlıktaki ortak gâye, gâyesel ilişkiler ve ortak nihâî amaç uğrunda varlığın örgütlenme tarzına dikkat çekilmiş ve fıkhın amaçlar hiyerarşisi içindeki yeri tespit edilmeye çalışılmıştır. Çalışmada “kişinin itikadi, ahlâkî ve davranışsal edimlerinin ölçüye uygunluğunu araştırma konusu yapan ilim dalı” olarak fıkhın erken devirlerdeki bu küllî anlamına vurgu yapılmış ve bu bağlamda fıkıh, özellikle insanın varlık amacı olarak marifet ve ubûdiyyetle gâyesel anlamdaki irtibatı bakımından konu edilmiştir. Sözü edilen ilişkiler ağı içinde fıkıh ve onu kuşatan üst yapı vasfıyla din, bu amaçları gerçekleştirmek için işlev gören araçlar olarak konumlandırılmıştır.
Örtü Altı Sebze Yetiştiriciliğinde Kullanılan Bilgi Kaynaklar: Samsun İli Çarşamba İlçesi Örneği
Authors: KURT Yasin Alparslan , BOZ İsmet
Published: November 2020

Bu çalışma; Samsun İli Çarşamba İlçesinde örtü altında sebze yetiştiriciliği yapan üreticilerin üretim ve pazarlama konularına yönelik bilgi kaynaklarını tespit etmek ve bu bilgi kaynaklarının tarımsal yayım açısından değerlendirilmesi amacıyla yapılmıştır. Araştırmanın materyali, Tesadüfi Tabakalı Örnekleme Yöntemine göre sebze üretimi yapılan 37 köyden seçilen 104 üreticiyle, 2019 yılının sonbaharında yapılan anket çalışmasından elde edilen verilerden oluşmaktadır. Üreticilerin kullanmış oldukları bilgi kaynakları modern ve geleneksel olmak üzere iki gruba ayrılarak bu iki grup arasında sosyoekonomik özellikler ve iletişim davranışları bakımından herhangi bir farkın olup olmadığı bağımsız iki örnek t-testi ve ki-kare testi ile kontrol edilmiştir. Bulgulara göre; modern bilgi kaynaklarını daha çok kullanan üreticilerin sosyoekonomik özelliklerden örtü altı alanı büyüklüğü, örtü altı üreticilik deneyimi, traktör varlığı, gelir kaynağı ve sosyal güvence durumu; iletişim davranışlarından radyo dinleme sıklığı, tarım kuruluşlarıyla görüşme sıklığı ve il merkezine gitme sıklığı bakımından daha avantajlı oldukları tespit edilmiştir. Araştırmada üreticilerin modern bilgi kaynaklarını kullanmaları ve tarımsal kuruluşlarla iletişim halinde olmaları için eğitim ve yayım faaliyetleri önerilmektedir.
THE EFFECT OF COLEMANITE ADDITION ON THE MICROSTRUCTURAL AND MECHANICAL CHARACTERISTICS OF IPP
Authors: SOYKAN Uğur , VALİYEVA Fidan
Published: November 2020

The objective of this study was to investigate the effect of the addition of the colemanite having 45µm size on the significant characteristic features of the isotactic polypropylene (IPP). The microstructural properties (diffraction pattern, a,b and c unit cell parameters and grain size) and mechanical behaviors (tensile strength, Young's Modulus, impact strength and percent elongation of the samples relative to the colemanite content (5, 10, 15, 20 and 30 wt.%) were studied in details. The optimum amount of colemanite was determined in order to obtain IPP based composites having the improved properties. The obtained samples were characterized by using XRD and conventional mechanical tests. The results showed that the content level of the colemanite considerably affected to the fundamental properties of IPP. As for microstuructural properties, it was observed from the XRD patterns that all composite samples mainly showed only α form (monoclinic arrangement) in the crystalline domains without any β form (hexagonal arrangements). Moreover, the finding revealed that a and b the unit cell parameters of IPP based composites increased initially, reached the maximum values with the products containing 10% of colemanite, and then the consistent decrement trend was observed with the further increasing of the colemanite content in the products. Conversely, c unit cell parameter almost remained relatively unchanged. Furthermore, the mechanical test measurements depicted that the reinforcements were achieved in the tensile, Modulus and impact strengths of the composite materilas, while the percent elongation of the products decreased with the increasing of the colemanite content. 7.4%, 24.9% and 6.7% increases were recorded in the tensile strength, Modulus and impact strength at the product with 10% colemanite, respectively. The improvements was probably stemmed from that the presence of micro size colemanite particles gave rise to increment in the orientations and alignments of IPP chain in the matrix.
Aktivitas berjalan meningkatkan bone mineral density pada perempuan pascamenopause
Authors: Savitri Evita Peninta Dwi , Herwana Elly
Published: November 2020

LATAR BELAKANGOsteoporosis merupakan penyakit tulang yang ditandai dengan rendahnya bone mineral density (BMD) disertai perubahan pada mikroarsitektur tulang. BMD yang rendah menandai adanya penurunan kepadatan pada tulang dan meningkatkan risiko terjadinya fraktur. Penurunan kadar estrogen pada kondisi pascamenopause, gaya hidup yang meliputi aktivitas fisik dan kebiasaan berjalan  sangat berperanan dalam progresivitas osteoporosis. Penelitian ini bertujuan menilai hubungan antara aktivitas berjalan dengan kepadatan tulang pada perempuan pascamenopause.

METODEPenelitian analitik observasional dengan metode cross-sectional dilakukan pada perempuan pascamenopause berusia 45-70 tahun pada periode Agustus-Oktober 2018. Penilaian aktivitas  berjalan dilakukan dengan menggunakan kuesioner dan wawancara. Aktivitas berjalan dinilai dari jumlah langkah berjalan/hari yang dikonversikan dari jarak tempuh subjek berjalan kaki setiap harinya. Pengukuran BMD menggunakan calcaneal quantitative ultrasound (QUS), hasil pengukuran BMD membedakan kepadatan tulang berdasarkan nilai-T. Analisis data dilakukan dengan uji statistik Chi Square dengan tingkat kemaknaan p<0.05.

HASILSebanyak 88 perempuan pascamenopause ikut berpartisipasi sebagai subjek penelitian  dengan usia (rerata ± simpang baku) 57.91 ± 7.25 tahun. Distribusi aktivitas berjalan didapatkan 71 (80.7%) kurang aktif, 12 (13.6%) aktivitas sedang, dan 5 (5.7%) aktif. Distribusi hasil penilaian kepadatan tulang didapatkan sebanyak 18 (20.5%) normal, 49 (55.75%) osteopenia dan 21 (23.9%) osteoporosis. Hasil analisis statistik menunjukkan terdapat hubungan yang bermakna antara aktivitas berjalan dan kepadatan tulang pada perempuan pascamenopause (p=0.009).

KESIMPULANTerdapat hubungan yang bermakna antara aktivitas berjalan dan kepadatan tulang pada perempuan pascamenopause.
Standing in the Chaos: Cross-cultural Competency in Curriculum Materials
Authors: Gray Tamara
Published: November 2020

Many factors influence the success of an educational program. The curric-ulum, represented in the what, how, and who of instruction, is a critical compo-nent of such an achievement. When learning materials and teachers represent a “mainstream” point of view, the educational achievement of minority-identity students can be affected negatively (Horton & Freire, 1990). For students of non-majority communities (whether ethnic, linguistic, religious, tribal, or any other distinguishing identities), the cross-cultural competency of educators has become an important indicator of success for the educational institution that seeks to serve all of its students (Wolff & Booth, 2017).
The effect of topical finasteride in treatment of idiopathic hirsutism
Authors: Ibrahim Yahia Yahia , J. Mohammed Nisreen
Published: November 2020

Hirsutism relatively is a common medical problem and an important influence on about 5-10% of women of reproductive age. Fifty five female shares in the study, seventeen of them did not continue the study, therefore we evaluated 38 females, aged 18-52 years old. In our study we compared pre-treatment and post-treatment for the color of the hairs and the hair removal frequency and the pain during hair removal for four groups which are good response group and moderate response group and mild response group and no response group, by subjective evaluation of all the patients noted a diminished rate of hair growth (fewer times needed for shaving) and a decrement in the density of hairs on the chin area and change in color of the hair but there was no significant difference between groups regarding hair color and there were highly significant difference in hair removal frequency before and after treatment (P<0.001) when we used finasteride cream 1% for 3 months. Six months of topically applied finasteride (0.5%) does not effect on number and thickness of facial hirsutism significantly. Despite lack of objective changes, on questioning, most patients in finastride group perceived a decrease in hair growth with time.
Ways to solve the problem of heart failure statistics in clinical practice
Authors: Boytsov S. A. , Drapkina O. M. , Zayratyants O. V. , Kakorina E. P. , Samorodskaya I. V.
Published: November 2020

For organization of health care, it is important to know the requirement for its individual types, including the number of hospitalizations and the use of expensive technologies. Heart failure (HF) syndrome in patients with cardiovascular diseases often determines their severity and prognosis. However, being a complication of underlying disease, HF is not included into statistical reports and medical bills in the compulsory health insurance system. This article focuses on issues in evaluating HF prevalence and mortality in different countries and provides the authors’ consensus on approaches to HF coding in the informational systems, which record morbidity and mortality.
Management of radio-contrast allergy in radio-contrast allergic patients undergoing coronary angiography and intervention
Authors: Aykan Ahmet Çağrı , Altıntaş Aykan Duygun , Katırcıbaşı Mahmut Tuna , Özgül Sami
Published: November 2020

Objectives Radiocontrast agents (RCA) allergy occurs in 0.04 % – 0.22 % of patients. However, the risk of allergic reaction increases as 16 % to 35 % in patients with prior RCA allergy. Herein we reported our experience in patients with a prior history of RCA induced anaphylaxis who underwent coronary angiography (CAG) and intervention.Methods This retrospective study included 11 patients with prior history of RCA anaphylaxis who underwent CAG and / or intervention at our clinic between May 2016 and September 2019. The mean age of the patients was 61.8±8.99 years, 8 (72.7 %) were female, 9 (81.8 %) had hypertension, 6 (54.5 %) – diabetes mellitus, 11 (100 %) – dyslipidemia, 8 (72.7 %) patients were current smokers, 4 had prior history RCA allergy after i.v. RCA administration in contrast enhanced computed tomography and 7 patients experienced RCA allergy after CAG. All patients had prior severe anaphylaxis reaction. All patients were pretreated with intravenous feniramin maleat 45.5 mg and methylprednizolone 80 mg one hour before the procedure and dexametazon 8 mg after the procedure.Results CAG and intervention was successfully completed in all patients. Two patients had breakthrough RCA induced anaphylaxis, theyhad urticarial, itching, dyspnea and chest tightness, angioedema during coronary artery stenting. Additional dose of i.v. methylpredinisolene 80 mg, salbutamol nebulae and i.v. adrenalin 1 mg administration rapidly stabilize the patients. All patients were successfully treated and uneventfully discharged after percutaneous coronary intervention.Conclusion Management of patients with prior RCA adverse drug reaction may be complex. However when CAG and / or intervention is required in such patients it may be safely performed with premedication.
Asymptomatic Hyperuricemia and Risk Of Cardiovascular and Renal Diseases
Authors: Kobalava Zh. D. , Troitskaya E. A.
Published: November 2020

Asymptomatic hyperuricemia (HU) is common in the population and significantly contributes to the general cardiovascular risk. Despite extensive study of this condition there is still no conclusive answers to questions about detection of asymptomatic HU and its effect on the risk for development and progression of cardiovascular and kidney diseases. This review summarizes key information about these issues, which has been accumulated by the present time.
Predictors of Coronary Plaque Vulnerability in Patients with Stable Coronary Artery Disease
Authors: Kochergin N. A. , Kochergina A. M. , Ganyukov V. I. , Barbarash O. L.
Published: November 2020

Aim      To identify new predictors for vulnerability of atherosclerotic coronary plaques in patients with stable ischemic heart disease (sIHD).

Material and methods  This prospective, single-center study included 58 patients with sIHD. Unstable plaques were detected with virtual histology intravascular ultrasound of proximal and medium segments of a coronary artery without significant lesions according to coronarography data. Indexes of inflammation, dyslipidemia and carbohydrate metabolism were considered as candidate predictors for coronary plaque vulnerability.

Results In 56 coronary arteries, 58 plaques were detected, 12 of which (20.7 %) were unstable. Vulnerable plaques differed morphologically from stable ones by a greater size of the necrotic core (35.1±8.5 % vs. 24.0±13.2 %; р=0.008), calcified nodules (2.0 [1.0; 5.0] % vs. 1.0 [0; 2.0] %; р=0.006), and a lower content of fibrous components (54.9±10.2 % vs. 66.4±15.8 %; р=0.02). In addition, vulnerable plaques more frequently narrowed the arterial lumen by >70 % of the lumen area (33.3 % vs. 2.2 %; р=0.0006). Correlation analysis showed a negative correlation between the level of high-density lipoproteins (HDL) and calcium volume (r= –0.4104; р=0.023); a positive correlation between the blood glucose level as determined by the oral glucose tolerance test and the lipid component (r=0.48198; р=0.033); and a negative correlation between the apolipoprotein A level and the calcium volume (r= –0.4297; р=0.008).

Conclusion      The study demonstrated a high prevalence of vulnerable plaques in nontarget coronary arteries in patients with sIHD. In this process, dyslipidemia indexes (LDL, apolipoproteins A) correlate with the calcium volume whereas blood glucose, as measured in the oral glucose tolerance test, correlates with the lipid component of coronary plaque.
Genetic Variants rs1049255 CYBA and rs2333227 MPO are Associated with Susceptibility to Coronary Artery Disease in Russian Residents of Central Russia
Authors: Bushueva O. Yu.
Published: November 2020

Aim      To study association of single-nucleotide polymorphisms rs1049255 CYBA and rs2333227 MPO with development of ischemic heart disease (IHD) in Russian residents of Central Russia.

Material and methods The study material was DNA samples from 436 patients with IHD (265 men, 171 women; mean age, 61 years) and 370 sex- and age-matched arbitrarily healthy volunteers (209 men, 161 women; mean age, 60 years). Genotyping was performed by allelic discrimination with TaqMan probes.

ResultsComparative analysis of genotype frequency (log-additive regression model) showed that SNP rs1049255 CYBA (odds ratio, OR, 0.79 at 95 % confidence interval, CI, from 0.65 to 0.96; p=0.02) and rs2333227 MPO (OR 0.72 at 95 % CI from 0.55 to 0.95; p=0.02) were associated with a decreased risk of IHD adjusted for sex and age. Analysis of sex-specific effects showed that the protective effect of rs1049255 CYBA was evident only in men (OR 0.72 at 95 % CI from 0.55 to 0.94; p=0.16).

Conclusion      The study demonstrated a protective effect of rs1049255 CYBA and rs2333227 MPO with respect of IHD in Russians. The protective effect of rs1049255 CYBA was observed only in men.
Prevention of thromboembolic complications during cardioversion and catheter ablation in patients with atrial fibrillation: review of key randomized trials
Authors: Ionin V. A.
Published: November 2020

This review focuses on the relevance of sinus rhythm control in patients with atrial fibrillation in real-life clinical practice and specific clinical features of patients with this arrhythmia. The authors presented current guidelines on prevention of thromboembolic complications and a review of results from major clinical studies of direct oral anticoagulants. The search for literature and selection of clinical studies for 2009-2020 were performed on websites of the European and Russian Societies of Cardiology, the All-Russian Scientific Society of Arrhythmologists, and in online databases PubMed, EMBASE, eLibrary, and Google Scholar using the key words atrial fibrillation, anticoagulants, ablation, cardioversion, and efficacy and safety.
BALASSA-SAMUELSON HİPOTEZİ: FARKLI GELİR GRUPLARI ÜZERİNE BİR PANEL VERİ ANALİZİ
Authors: YOLCU KARADAM Duygu , GEDİKOĞLU Büşra
Published: November 2020

Reel döviz kurunun uzun dönemde satın alma gücü paritesinden sapmalarını ülkelerin göreli verimliliklerindeki değişimle açıklayan Balassa-Samuelson hipotezine göre, ülkelerin göreli verimlilikleri arttıkça reel döviz kuru değer kazanmaktadır. Hipotezin geçerliliği çok sayıda çalışma tarafından incelenmiş ancak farklı ülke ya da ülke grupları için farklı sonuçlar ortaya koyulmuştur. Bu çalışmada, ülkelerin göreli üretkenlikleri ile reel döviz kurları arasında pozitif bir ilişki olup olmadığı 82 ülke ve 1980-2017 dönemini kapsayan geniş bir panel veri seti kullanılarak incelenmektedir. Bunun yanında, farklı gelir düzeyine sahip ülke grupları için reel döviz kuru modelleri tahmin edilerek karşılaştırmalı bir analiz sunulmaktadır. Tüm ülke grubu için yapılan Panel Dinamik OLS tahmin sonuçları, ülkelerin göreli verimliliği arttıkça yerli paranın reel olarak değer kazandığını göstermektedir. Alt gelir grupları için yapılan analizler ise, hipotezin yüksek ve orta-gelir düzeyine sahip ülkelerde güçlü şekilde geçerli iken, düşük-gelirli ülkelerde geçerli olmadığını göstermiştir. Yüksek-gelirli ülkelerde göreli verimliliğin reel döviz kuru üzerindeki pozitif etkisi, orta-gelir düzeyine sahip ülkelere göre daha yüksektir.
EVALUATION OF HEALTH EFFICIENCY OF OECD COUNTRIES WITH DATA ENVELOPMENT AND INVERSE DATA ENVELOPMENT ANALYSES
Authors: DEĞİRMENCİ Nurdan
Published: November 2020

In the present study, the purpose was to evaluate the health effectiveness of the Organization for Economic Development and Co-operation (OECD) countries, including Turkey, with input-oriented DEA and inverse DEA models. The input and output variables were determined by examining the studies in the literature. In this respect, the input variables were identified as the number of physicians per thousand people, the num-ber of hospital beds per thousand people, health expenditure per capita; and output variables were ex-pected life expectancy at birth, and rate of surviving infants. According to the DEA results, only Turkey, Mex-ico and Colombia were found to be efficient. In addition, the input variable which affects at most the health efficiency scores of countries was determined as the number of physicians. According to the findings of the inverse DEA obtained in the study, it was determined that the current number of physicians in Turkey was sufficient, and that the healthcare expenditure per person and the number of hospital beds should be in-creased.
Expanding Higher Education: Does the Open University of Sri Lanka Adequately Provide Distance Education Opportunities?
Authors:   Faculty of Education, Open University of Sri Lanka, Sri Lanka, Hewapathirana Chitrangani
Published: November 2020

In Sri Lanka securing a place in a higher education institute has become more and more competitive and as a solution to the demand on the government for higher education opportunities for qualified students. The Open University of Sri Lanka was built up with a goal to provide an opportunity to enter Higher education to a large number of people. The intention of this research is to find out whether the students who get admitted are really gaining a second chance for higher education through the Open University of Sri Lanka. This research has 3 goals. Study the methods of university entrance in Sri Lanka, look into the methods of admissions practiced by the Open University for distant studying and whether these admissions provide a solution to the problem of entrance to the higher education system in Sri Lanka. In this context the documented data and information are primarily used and for analyzing purposes 15 interviews are conducted. According to this information the Open University currently faces 3 problems on its admissions such as Supply being unable to meet the demand, Supply being unable to win the demand it needs and The decrease in the number of student admissions in both methods. As such the Open University is facing the following problems. The primary goals of the university are challenged. Therefore, to overcome these problems, the Open University should come up with a program to increase its student admissions through its 22 centers throughout the country.
A study of etiology, clinical characteristics, electrocardiographic and echocardiographic findings in patients with cardiac tamponade in a tertiary care hospital in Western Odisha
Authors: Patel Nayan Kumar , Sharma Sunil Kumar , Roy Ayan
Published: November 2020

Background: Cardiac tamponade is a life-threatening condition characterized by elevated intracardiac pressure, limitation of diastolic filling, and reduction of cardiac output and mostly requires urgent therapeutic intervention. Pericardial disease in on the rise attributed to improved survival of malignancy, growing no of cardiac interventions, chronic kidney diseases with dialysis, advent of modern chemo-radiotherapy. Still, there are paucity of data on etiology, clinical characteristics, electrocardiogram (ECG) and echocardiographic features in patients with cardiac tamponade from Odisha. Aim of this study was to emphasize the etiology, clinical characteristics, electrocardiographic and echocardiographic features in patients with cardiac tamponade.Methods: A prospective observational study of 1-year duration was undertaken for patients with cardiac tamponade admitted at VIMSAR, a cardiology unit. Data on etiology, clinical characteristics, Echocardiography, ECG findings were documented. Echo guided pericardiocentesis followed culture, cytological and biochemical analysis done.Results: Most common symptom was dyspnoea (88%), clinical signs were tachypnoea (96%), raised jugular venous pulse (64%), tachycardia (84%), pulsus paradoxus (60%). Classical beck’s triad was seen in 42% cases. X-ray showed cardiomegaly (94%) & pleural effusion (64%). Common ECG findings were sinus tachycardia (84%), low voltage QRS (68%) and electrical alternans (44%). Echocardiography showed 80% and 68% of patients had right atrium collapse and right ventricle collapse respectively. Both inferior vena cava plethora and transmitral flow variation were seen in 88% of cases. 96% had normal left ventricle function. 80% had large effusion. Pericardiocentesis yield was mostly in between 500-1000ml (mean 908 ml) with 72% with haemorrhagic aspirate.  All malignancy cases and 76% tubercular cases had haemorrhagic effusion.  Most common etiology was tubercular (50%), followed by malignancy (28%). 6% remained idiopathic. chronic kidney disease, systemic lupus erythematosus, post MI intervention, hypothyroid were some of the other causes.Conclusions: Initial assessment with investigation and careful follow-up can yield a causal diagnosis in most cases. Early diagnosis and intervention by pericardiocentesis can be lifesaving.
Clinical efficacy of ayurveda treatment modalities in the management of garbhashosh (intrauterine growth restriction): a systematic review
Authors: Shinde Sarika T.
Published: November 2020

Concept of fetal well-being has gained importance in conventional science in recent era, but this concept of ‘supraja janana’ was a prime concern of Ayurveda since old era. Apart from prematurity, intrauterine growth restriction (IUGR) is a major public health problem in most of the developing countries. While going through ayurved classics it is revealed that garbhashosh is one of the disease, which is comparable to intrauterine growth restriction in modern medicine. In Ayurveda various drugs and preparations have been described for treatment of garbhashosh. These drugs are comparatively safe without any unwanted side effects. Aim of this work was to review and meta-analyze the effictiveness of various ayurvedic treatment modalities for garbhashosh with respect to (w.r.t.) IUGR. An attempt to expand the concept of IUGR according to Ayurveda and to yield a flourishing result to this world-wide problem through Ayurveda, this topic has been selected for the study. Going through pathology and main clinical signs and symptoms, garbhashosh can be correlated with IUGR. It is observed that, total 5 clinical studies and 1 case study have been reported on management of IUGR by using classical formulations of Ayurveda. The results and observations obtained through demographical data, effect of therapy observed on the ultrasound parameters as well clinical parameters of garbhashosh w.r.t. IUGR were statistically significant. Results were obtained in favour of most of the ayurvedic formulations. Through this review it can be stated that bruhaniya gana sidha kshirbasti and kshirpan, shatavari kshirbasti, shatavaryadi kshirbasti, yashtimadhu vidari siddha kshirbasti, shatavari ashwagandha phalaghruta kshirbasti, can be given to a pregnant women with IUGR after completion of 28th weeks of gestation, without any complication either in mother or in child. It is cost effective as compared to modern drug.
Endometriosis a brief review: evaluation of crucial risk factors and current treatment regimes
Authors: Ashish Ashish , Kusum Kusum , Rai Sangeeta , Singh Royana
Published: November 2020

Endometriosis is an estrogen-dependent chronic inflammatory disease associated with substantial morbidity, including dyspareunia, dysmenorrhea, pelvic pain, multiple surgery, and infertility. This disease has a high impact on both woman’s physical and mental wellbeing. The etiology of endometriosis is complex and multifactorial. The risk factors associated with the development of endometriosis include family history, menstrual and reproductive cycle, low body mass index (BMI), diet, alcohol uses, smoking, environmental factors, immune system, genetic factors and intrinsic abnormalities in the endometrium. There exist many theories on the initiation and propagation of different types of endometriotic lesions and consequent biological disturbances, of which the most common is the Sampson’s theory according to which the retrograde flow of menstrual blood is linked to the development of endometriosis. Endometriosis affected women have a higher risk than the general female population, for ovarian cancer, coronary heart disease (CHD), and other long-term disease risks as well for autoimmune and atopic disorders. Therefore it becomes a necessity for the clinician not only to attain right diagnosis but also follow up for the other associated disorders.  In this review, we have considered the crucial risk factors and biomarkers of the endometriosis as well as the possible pathogenesis towards the development of endometriosis and its prevention strategies. The currently available therapies for the control and treatment of endometriosis have also been elaborated.
The affected factors of puberty and menstrual disturbances among female students at Al-Andalus university
Authors: Salman Safa K. , Mohammad Marah H. , Mhanna Aya Y. , Saleh Safaa Y.
Published: November 2020

Background: The aim of the study was to determine the pubertal, menarcheal age and menstrual disturbances, and the factors affecting them, during the war in Syria, among AL-Andalus university female students.

Methods: A self-reported questionnaire was answered from 156 students. The questions were about socio-demographic information, reproductive and menstrual patterns, and the participants' lifestyle. Inclusion criteria included girls 17 to 25 years old, no systemic diseases and completed the questionnaire. The questionnaire was answered in the university. The researchers clarified the aim of the study and got the voluntary consent. The data of 148 girls were entered intoSPSS. Exclusion criteria excluded girls (≤17 and ≥25) years and those who did not complete the questionnaire. The study was conducted from 20 January 2020 to 20 March 2020.

Results: 148 cases were analyzed. The mean age of puberty and menarche of our students are 12.38±1.41 and 13.38±1.35 years respectively. Fast food and changing adopted place have a significant association with menstrual disturbances (p<0.05). Blood group, faculty, weight and the mother's menarcheal age have no effects on them (p>0.05).

Conclusions: Not found any change in the age of puberty and menarche, but this does not prevent to make more studies in different places in Syria in the future.
Anaesthesia for a child with glucose-6-phosphate-dehydrogenase deficiency: a case report
Authors: Munasinghe Baththirange Malaka , Nimalan Srisothinathan , Subramaniam Nishanthan , Goonetilleke Sonali
Published: November 2020

Patients with glucose-6-phosphate-dehydrogenase (G6PD) deficiency are prone to acute haemolytic crisis during perioperative period, precipitated by oxidative stress and certain medications, which are common concurrences during this period. Careful peri-operative planning, judicious use of medication and postoperative monitoring plays a pivotal role in preventing complications in these patients. Here, we report a successful case of general anaesthesia in a child with G6PD deficiency.  