bluuebunny/crossref_metadata_2025 huggingface dataset:
Yerel yönetimlerde stratejik planlama uygulamalarının kurum performansına etkisi
Authors: Karğın Çakar Öznur , Esen Ayla
Published: September 2023

Stratejik yönetim faaliyetleri, kurum kaynaklarının verimli kullanılması ve kurumların uzun vadede sürdürülebilirliğinin sağlanması açısından önemli role sahiptir. Ülkemizde kamu kurumlarında stratejik yönetim, kamu reformları çerçevesinde 5018 sayılı Kamu Mali Yönetimi ve Kontrol Kanunu’nun yürürlüğe girmesi ile birlikte daha fazla zaman ve kaynak ayırılan bir süreç haline gelmiştir.  Kamu reformları sonucunda kurumların faaliyetlerini gerçekleştirirken stratejik planlama uygulamaları ile kıt kaynaklarını daha etkili ve verimli kullanmaları amaçlanmaktadır. Bu araştırmanın amacı, belediyelerin yürüttükleri stratejik planlama uygulamalarının etkinliğini değerlendirmek ve bu uygulamaların yerel yönetim kurumlarında topluma katkı ve verimlilik düzeylerine ne derece etki ettiğini ortaya koymaktır. Bu bağlamda, belediyelerdeki stratejik planlama uygulamalarının belirleyici alt boyutlarının, kurum performansı alt boyutlarına etkisinin ölçülmesi hedeflenmiştir. Araştırma kapsamında İstanbul’daki yerel yönetim kurumlarında çalışan orta ve üst kademe yöneticilerden toplam 100 adet anket formu toplanmıştır. Gerçekleştirilen analizlerin sonucunda, “belediyelerde kurumsal yapının stratejik planlamaya uygunluğu” ve “stratejik planlama sürecinde karşılaşılan sorunları çözme becerisi” boyutlarının, belediyelerin “topluma katkı performansını” pozitif etkilediği görülmüştür. “Stratejik plan hazırlama ve uygulama süreci etkinliği” ile “stratejik plan uygulamalarında karşılaşılan sorunları çözme becerisi” boyutları da kurumların verimliliğini olumlu etkileyen unsurlar olarak ortaya çıkmıştır. Çalışmada, yerel yönetimlerde stratejik planlama uygulamaları, Planlama Okulu’nun öne sürdüğü normatif stratejik planlama yaklaşımı ile ele alınmış olup, stratejik planlama ile kurum performansı arasındaki ilişki Planlama Okulu bakış açısı çerçevesinde de değerlendirilmiştir.
OECD ülkelerinde sürdürülebilir kalkınma politikalarının ARAS metodu ile performans analizi
Authors: Alpdoğan Hilal
Published: September 2023

İlk kez 1972 Birleşmiş Milletler (BM) Konferansı’nda kavramsallaştırılan “sürdürülebilir kalkınma”, 2016 yılına gelindiğinde BM tarafından “2030 Sürdürülebilir Kalkınma Amaçlarının” ilanı ile ülkelerin kalkınma politikalarının merkezine yerleşmiştir. 2030 yılı sonuna kadar ulaşılması hedeflenen Sürdürülebilir Kalkınma Amaçları (SKA) Ocak 2016 tarihi itibariyle yürürlüğe girmiştir. 17 temel amacı kapsayan Sürdürülebilir Kalkınma Amaçları, ülkelerin kalkınma planlarına da yansımış ve hedeflenen politikalarda sürdürülebilirlik kavramı öne çıkmıştır. Bu bağlamda çalışma OECD ülkelerinin ekonomik, sosyal ve çevresel politikalarının sürdürülebilirlik çerçevesinde etkinliğini ortaya koymayı hedeflemektedir. Bu amaç doğrultusunda, çok kriterli karar verme tekniklerinden biri olan ARAS Metodu kullanılarak performans analizi gerçekleştirilmiştir. Analizde beş ekonomik kriter, altı sosyal kriter ve sekiz çevre kriteri üç ayrı kategoride ve birlikte değerlendirilmiştir. Bu yöntem, ülkelerin farklı politika alanlarındaki performansını objektif bir şekilde değerlendirmek için kullanılmıştır. Ayrıca 19 kriterin birlikte değerlendirildiği analiz sonuçlarına göre sürdürülebilir kalkınma politikalarında en etkin üç ülkenin Yeni Zelanda, Kore ve İzlanda olduğu görülmektedir. Bu ülkeler, ekonomik, sosyal ve çevresel alanlarda sürdürülebilirlik hedeflerine daha yakın performans gösteren ülkeler olarak öne çıkmaktadır. Diğer yandan, analiz sonuçlarına göre en başarısız üç ülke ise ABD, Kanada ve Türkiye olarak belirlenmiştir. Bu ülkeler, sürdürülebilir kalkınma politikalarını uygulama konusunda daha fazla çaba sarf etmeleri gereken ülkeler olarak değerlendirilmiştir.
The relationship between brand awareness and purchase intention: A meta-analysis study
Authors: Kerse Yağmur
Published: September 2023

This study aimed to determine the relationship between brand awareness and purchase intention through meta-analysis. The scope of the study was limited to the data set of studies conducted in Turkey. For this purpose, relevant studies were accessed using the National Thesis Centre (Türkiye), Kafkas University Database, and Google Scholar search engine. Twelve studies, seven theses and five articles, were deemed appropriate for inclusion in the analyses. CMA 4.0 (Comprehensive Meta-Analysis 4.0) program was used for the analyses in the study. In the analyses, it was determined that there was a heterogeneous distribution and there was no publication bias. As a result of the analyses, it was determined that the effect size (according to Pearson r) between brand awareness and purchase intention was 0.627 (in the fixed effect model) and 0.610 (in the random effect model). Therefore, according to the data obtained from the studies included in the meta-analysis, it was revealed that brand awareness positively affects purchase intention.
Sağlık kurumlarında algılanan hizmet kalitesinin ve hasta memnuniyetinin ölçülmesine yönelik bir araştırma
Authors: Bora Semiz Buket , Semiz Tarık , Güneş Kâmil
Published: September 2023

Hizmet sektörünün önemli bir aktörü olan sağlık hizmetlerinde algılanan hizmet kalitesinin ve hasta memnuniyetinin ölçümü her geçen gün artan rekabetle birlikte daha da önem kazanmaya başlamıştır. Bu bağlamda bu çalışmanın amacı da sağlık kurumlarında algılanan hizmet kalitesinin hasta memnuniyeti üzerindeki etkisini incelemektir. Bu bağlamda Bilecik Eğitim Araştırma Hastanesi’nden acil hizmetler dahil gerek yatarak gerek ayaktan gerekse her iki durumda da en az bir kez hizmet alan 376 hastadan kolayda örnekleme yöntemi uygulanarak 1-20 Mart 2022 tarihleri arasında anket ile veri toplanmıştır. Öncelikle araştırmada kullanılan ölçeklerin geçerlilik ve güvenilirlik analizleri yapılmıştır. Sonrasında ise araştırma sorularına cevap bulabilmek adına frekans analizlerinden, araştırma hipotezlerini test edebilmek adına ise basit ve aşamalı regresyon analizlerinden yararlanılmıştır. Araştırma sonucuna göre, algılanan hizmet kalitesinin tüm boyutlarının hizmet kalitesi üzerinde etkisinin olduğu sonucuna ulaşılmıştır. Ayrıca, katılımcıların Bilecik Eğitim ve Araştırma Hastanesi’nde en çok acil servis olmak üzere, dahiliye ve cildiye birimlerinden hizmet aldıkları görülmüştür. Bunun yanı sıra katılımcılar hastanenin tuvalet ve lavabolarının temizliğini, genel kullanım alanlarının hijyenini ve bekleme alanlarının yeterliliğini olumlu olarak değerlendirirken, personel ve çalışan sayılarını yetersizliğini, otopark hizmetlerini ve personelin ilgi ve alakasını olumsuz olarak değerlendirmişlerdir. Çalışma sonunda elde edilen bulgular bağlamında sağlık kurumlarına çeşitli önerilerde bulunulmuştur.
A hybrid machine learning approach in predicting smoking behaviour: The case of Turkey
Authors: Tezcan Nuray , Karahan Adalı Gökçe , Özyurt Serim Anıl Burcu
Published: September 2023

This study aims to analyze the smoking behaviour of people aged 15 and older in Turkey using supervised and unsupervised machine learning methods. In this study, C4.5 and Random Forest (RF) were trained to predict smoking behaviour, and an apriori algorithm was used to detect associations. Sensitivity, specificity, accuracy, positive predicted value (PPV), and f-measure were used to compare the performances of the supervised models. The Turkey Health Interview Survey 2019 was used with a sample size of 17084 to predict smoking behaviour and determine the factors affecting smoking. Data analysis and performance evaluation were performed with R programming language by RStudio. By association rules, gender, age, and alcohol consumption are the most representative attributes of smoking behaviour. Associations were determined on smoking, non-smoking and quit-smoking behaviour. Also, it has been seen that the RF algorithm has better results than the C4.5 algorithm. It’s preferred to use the RF model, which had better performance with an accuracy of 0.909, a specificity of 0.965, a sensitivity of 0.782, a PPV of 0.908, and an f-measure of 0.840 for predicting smoking behaviour. This study contributes to the literature covering the most comprehensive national health survey data and using machine learning methods on this data in Turkey. Also, it indicates that machine learning methods can be used to analyze such datasets.
Systematic review on consumer forgiveness: Clarifying the domain and future research agenda
Authors: Özdemir Neslişah
Published: September 2023

Consumer forgiveness has gained prominence in marketing literature, particularly in investigating service failure and recovery. In this vein, this study aims to systematically review the consumer forgiveness literature and provide valuable suggestions for future research endeavours based on the discovered gaps in the existing literature. The present study thoroughly examined 77 peer-reviewed journal articles on consumer forgiveness from the Scopus database. The findings are discussed under the headings of descriptive overview (year and journal) and content analysis that consists of theoretical background, methodological trends (research design, data collection method, sample size, industry, analysis techniques, measurement) and thematic issues (antecedents, consequences, mediators and moderators) subtitles. This study contributes to the body of knowledge by clarifying the literature on consumer forgiveness, identifying gaps, and making suggestions for future research. This study also contributes to the literature by proposing a comprehensive framework that aligns with the variables investigated in previous research on consumer forgiveness.
Investigating the Impact of Physiological and Neuromuscular Performance in Highly Trained Judo Athletes of Different Weight Categories
Authors: Manar Bouzoualegh , Adel Belkadi , Lalia Cherara , Saddak Benhammou
Published: September 2023

Background and Study Aim This study aimed to investigate the physiological and neuromuscular aspects influencing the performance of highly trained judo athletes across different weight categories.

Material and Methods: A total of twenty-one male judokas with an average age of 20.6 ± 1.8 years participated in the study. The participants had an average body mass (MC) of 77.3 ± 13.4 kg and an average height (SH) of 176.5 ± 8.4 cm. The study employed various assessments to evaluate muscle power, judogi strength endurance, special judo fitness, fight simulation, and incremental treadmill tests. Statistical analyses, such as the Shapiro-Wilk test, Pearson's linear correlation, "t" test for dependent samples, and one-way ANOVA, were used.

Results: there was significant correlations between the number of throws in the Special Judo Fitness Test (SJFT) and factors such as ANV, PV, and CMJ. However, no significant correlations were observed between Fmax and TMFmax on the dominant and non-dominant sides, as well as LACmax. %FCmax did not show a significant correlation with ANV and DLS. A significant inverse correlation was found between LACmax and VLAn, while no correlation was observed between DLS and VLAn. LACmax values were significantly higher in the medium/medium-heavy category compared to the light/medium-heavy category, and the CMJ was significantly lower in the medium/medium-heavy category compared to the other categories.

Conclusion: conclusion, this study determined that muscle power, capacity, and aerobic power were the primary factors influencing the number of throws in the SJFT among highly trained judo athletes. Maximum strength, strength resistance, and glycolytic capacity did not significantly contribute to the number of throws. Athletes with greater aerobic capacity exhibited lower glycolytic demand during fights. these factors can contribute to the development of effective training programs and strategies to optimize performance in judo athletes of various weight categories.
Comparative analysis of physical development and body composition of kickboxing athletes with different training experience
Authors: Podrigalo Leonid , Ke Shi , J. Cynarski Wojciech , Perevoznyk Volodymyr , Paievskyi Volodymyr , Volodchenko Olexandr , Kanunova Liudmyla
Published: September 2023

Background and Study Aim. Comparative analysis of physical development and body composition using the index method in kickboxing athletes with different training experience.

Material and Methods. Participants: 30 kickboxing athletes, group 1 – 15 people, (13.20±0.60) years old, training experience (0.71±0.13) years. Group 2 - 15 people, (15.20±1.14) years old, training experience (6.80±1.16) years. 18 anthropometric indicators were determined. 21 indices were calculated based on them. The median (Me), 1 (25%) and 3 (75%) quartiles were determined. The somatotype was determined by the bioimpedance method using the OMRON BF-511 body composition monitor (Japan). The significance of differences in the groups was assessed by the nonparametric Rosenbaum test (Q).

Results. A significant excess of indicators of the 2nd group in terms of Erisman's index (Q=10), Pignet's index (Q=7), Livy's index (Q=12), Isakson's body surface area (Q=11) and relative body surface (Q=21) was established , relative length of arm (Q=11) and leg (Q=14), index of arm circumference (Q=15) and leg (Q=6), shoulder index (Q=10), indices of massiveness of segments of the forearm (Q=11) and shoulder (Q=30), conditional moments of force of the forearm (Q=30), shoulder (Q=30), lower leg (Q=30) and thigh (Q=30). A trend towards a decrease in fat content and an increase in muscle tissue in more trained athletes has been confirmed.

Conclusions. A comparative analysis of the physical development and body composition of kickboxing athletes with different training experience confirmed certain differences. More trained kickboxers had better indicators of the shoulder index, which reflects the posture of the athletes. The Erisman index illustrated the increase in the muscles of the torso under the influence of training loads. The increase in body surface area and relative body surface reflects the greater adaptive potential of more trained kickboxers. The large relative length of the arms and legs, the indices of the ratio of the segments of the limbs, the indices of massiveness and the conditional moments of the segments' strength reflect the best technical capabilities of more trained athletes, the ability to blow at a greater distance and with greater force. The adequacy of using the method of indices as more informative than anthropometric indicators is shown. It is proposed to use these indices in monitoring the state of kickboxing athletes.
Formation of the structure of psychophysiological features of elite basketball players
Authors: Xu Xiang-Qian , Korobeinikova Lesia , Li Xu , Diana Mischuk , Korobeynikov Georgiy , Han Wei , Sergienko Uriy
Published: September 2023

Among coaches and scientists, one of the main topics is the improvement of the system for training elite athletes. Traditional studies in basketball devoted to the actual connection of study with a long training process. Training and competitive activity in basketball includes neurodynamic, psychomotor, cognitive and psychoe-motional characteristics. Modern research devoted to the characteristics of the functional states of athletes in various training and competitive conditions. But among the modern studies of team sports, there are no data on the psychophysiological states of elite athletes for different types of monitoring.

Purpose: Development of the system of psychophysiological support of elite basketball players as an actual scientific direction in the theory and methodology of sports training

Materials and methods: The 13 elite basketball players, age 19-23 (sport experience more than 8 age) were examined. The sensory-motor response, mobility and balance of nervous process, verbal memory, operative thinking and general intelligence were studied. All of tests include the complex of computer diagnostic “Multipsychometer 05”. Also, in battery were include tests: estimates of actual psychical state (by color test Lusher), field independence (by Stroop test), motivation (by Mehrabian test) and aggressive (by Bass-Darki test). With the factors analysis the main components of psychophysiological characteristics of basketball players were obtained.

Results: The factor’s structure of psychophysiological state of elite basketballs included 4 factors: neurodynamics, cognitive resources, energy-information and emotional-cognitive.

Conclusion: The factor structure of psychophysiological state of elite basketball players was revealed. The identified factors can be used to correct the training process of elite athletes.
Assessment of the functional state of the cardiovascular system of students during a mountain hiking trip
Authors: Skaliy Alexander , Mulyk Kateryna , Ban Zhijing , Ostrowski Andrzej , Anosova Olena
Published: September 2023

Background and Study Aim. In the conditions of hiking trip, a particularly important role is played by the high adaptive abilities of the body, based on the reactivity and lability of functional systems. Of particular importance is the assessment of the functional state of the cardiovascular system of students when participating in a mountain hike. The purpose of the study is to evaluate the effect of physical activity on the state of the cardiovascular system of students in the process of overcoming a mountain hiking trip.

Material and Methods. The study involved 30 students aged 18-22 years old who were involved in various sports at the amateur level. The hiking trip lasted six days and covered 114 km. Canyon SportMaster hand-held heart rate monitors were used to determine the power of the students' cardiovascular system. When overcoming climbs during a mountain hike, the rate of heart rate recovery after physical activity was determined (heart rate indicators were recorded before the climb, at the end of the climb, and two minutes after the climb).

Results. Analysis of the data obtained showed that the power of the cardiovascular system changed during the hiking trip. The third day turned out to be the most difficult day; the level of power of the cardiovascular system on this day was 76% of the maximum. In all subsequent days, the tourists’ cardiovascular system coped with the stress much better. The indicators obtained on the last day of the hike indicate the adaptive changes that occurred in the athletes’ bodies.

Conclusions. It was found that on the first day of the hike the cardiovascular system worked at a sufficient level. In the next two days, there was a decrease in recovery rates and a deterioration in the performance of the cardiovascular system. This is explained by fatigue after the first day, and the fact that the body has not yet had time to work and adapt to unusual loads. Analysis of the last three days of the hike clearly indicates that the body systems have adapted to the stress and environment. Heart rate recovery indicators went up sharply, and the heart rate system worked at only 65% of maximum power. Also, important factors that also need to be taken into account: the weight of the backpacks, the length of the distance, weather conditions, temperature conditions, the psychological atmosphere in the group, equipment, etc.
Commissioning of 6 and 10 MV Beams for Total Body Irradiation (TBI)
Authors: Garcia Joel Charles , De Arruda Botelho Marina , Baptista Delano Valdivino Santos , Viegas Cláudio , Santos Fortes Saulo
Published: September 2023

The objective of the TBI treatment is the ablation of the bone marrow and the destruction of the circulating leukemia cells, once they are widely distributed throughout the body. Using beam parameters acquired under conventional SSD in TBI treatments may add non-negligible uncertainties in the monitor units calculation or in the beam profiles. The study, aims to commission the 6 and 10 MV photon beams, of the Varian accelerator CX model. A slab phantom and dosimetric assembly were used under TBI conditions. The accuracy of the TPS was evaluated against the experimental data. A set of data were acquired, highlighting the TPR table and methodology for calculating MU has been implemented. The TPS has presented a statistical uncertainty of ± 2.7 % compared to the experimental data for monitor unit calculation. The use of an acrylic spoiler has been shown to be clinically advantageous where, for a 6 MV beam, the entrance PDD was 75 % without a spoiler and  99.5 % with a spoiler. For a 10 MV beam, it was verified that without a spoiler, the entrance PDD was about 55 %, but with a spoiler, it was about 93 %. For medium Heterogeneous the TPS underestimated dose values by up to - 3.5 % with a mean deviation of – 2.9 %, for 6 MV and for 10 MV, the TPS overestimated the dose values by up to 1.1 %, with an average deviation of 1.0 % using the acrylic thorax phantom. The data obtained can be used clinically.
Growth differentiation factor-15 — a new indicator of unfavorable prognosis in uncomplicated myocardial infarction
Authors: Sabirzyanova A. S. , Galyavich A. S. , Baleeva L. V. , Galeeva Z. V.
Published: September 2023

Aim. To evaluate the role of growth differentiation factor-15 (GDF-15) in long-term prognosis in patients with uncomplicated myocardial infarction (MI).

Material and methods. The study included 118 patients with uncomplicated ST-elevation and non-ST-elevation MI. In addition to the routine examination, all patients were analyzed for GDF-15, as well as the N-terminal pro-brain natriuretic peptide (NT-proBNP) by enzyme immunoassay in the first 48 hours from the onset of MI symptoms. The changes in the patients' condition were assessed by questioning after 1, 3, 6, 12 months, as well as the analysis of medical records in the event of repeated cardiovascular events and deaths. The endpoints were cardiovascular death, hospitalization for recurrent MI, and/or unstable angina. To assess the value of quantitative variables in predicting recurrent cardiovascular events, the ROC analysis was used. The survival function of patients was assessed using the Kaplan-Meier method.

Results. Twelve-month follow-up revealed 29 recurrent cardiovascular events, including 2 deaths and 8 recurrent MIs. GDF-15 was predictive of recurrent cardiovascular events with a sensitivity of 77,3% and a specificity of 56,2% (ROCAUC, 0,7±0,065 (95% confidence interval (CI), 0,572-0,827), p=0,004). Patients with GDF-15 ≥2,075 ng/mL had a higher risk of recurrent cardiovascular events (hazard ratio (HR), 3,4 (95% CI, 1,342-8,613), p=0,005). Another prognostic factor influencing the rate of recurrent cardiovascular events was NT-proBNP. An NTproBNP level ≥578 pg/mL was associated with an increased risk of cardiovascular death and rehospitalization for unstable angina and recurrent MI (HR, 4,3 (95% CI 1,828-10,239), p=0,00019).

Conclusion. The combined increase in GDF-15 ≥2,075 ng/mL and NT-proBNP ≥578 pg/mL in patients with uncomplicated MI increases the risk of recurrent cardiovascular events over the next 12 months (HR, 4,5 (95% CI, 2,087-9,736), p=0,00018).
Diagnostic criteria for proximal left bundle branch block and their significance in predicting the success of cardiac resynchronization therapy
Authors: Rimskaya E. M. , Kashtanova S. Yu. , Salami Kh. F. , Kukharchuk E. V. , Malkina T. A. , Gaman S. A. , Komlev A. E. , Mironova N. A. , Stukalova O. V. , Imaev T. E. , Akchurin R. S. , Golitsyn S. P.
Published: September 2023

Aim. To develop diagnostic criteria for proximal left bundle branch block (LBBB) based on non-invasive methods and to determine the significance of these criteria in predicting the effect of cardiac resynchronization therapy (CRT).

Material and methods. To develop criteria, 58 patients (21 men, mean age, 76,1±7,1 years) with LBBB occurred immediately after transcatheter aortic valve implantation (TAVI) were included. To assess the significance of the developed criteria, the second group included 22 patients (11 men, mean age, 57,9±9,3 years) with dilated cardiomyopathy (DCM), who had indications for CRT. The effectiveness of CRT was assessed by echocardiography 6 months after implantation. All patients in the DCM group and 15 patients in the TAVI group underwent superficial epiand endocardial non-invasive mapping using Amycard 01C EP Lab (EP Solutions SA, Switzerland). Patients in the DCM group underwent contrast-enhanced cardiac magnetic resonance imaging (MRI) before device implantation.

Results. The criteria for proximal LBBB included 3 electrocardiographic features: QRS complex >130 ms in women and 140 ms in men, QSor rS-configuration in V1 lead, notch in two or more lateral leads (I, avL, V5, V6), and 2 mapping criteria: characteristic location of block line and delayed activation point. In the DCM group, the criteria were positive in 13 of 22 patients (59%). The developed criteria for proximal LBBB showed a relatively strong, significant relationship with the positive effect of CRT (сhi-square test =5,46, p=0,02, Cramer test =0,5, odds ratio (OR)=15,0, 95% confidence interval (CI), 1,32-169,9, p=0,002). An additional analysis showed that both the criteria for proximal block and CRT effect are associated with myocardial fibrosis according to MRI. In particular, intramural stria-shaped contrast accumulation in the interventricular septum leads to a change in characteristic of proximal block mapping phenomena — displacement of delayed activation point (chi-square test =13,9, p<0,001, Cramer test =0,79) and displacement or absence of conduction block lines (chi-square test =6,92, p=0,009, Cramer test =0,56) and prevents the CRT effect (OR =8,67, 95% CI, 1,05-71,57 p=0,03).

Conclusion. Proximal LBBB is only one of the factors determining the effectiveness of CRT. Proximal LBBB may mask significant myocardial structural changes that prevent the CRT success.
Prognostic role of atrial fibrillation in patients with non-compaction cardiomyopathy
Authors: Komissarova S. M. , Rineyskaya N. M. , Melnikova O. P. , Sevruk T. V. , Efimova A. A.
Published: September 2023

Aim. To evaluate the prognostic role of atrial fibrillation (AF) as a predictor of adverse events and outcomes in a cohort of patients with non-compaction cardiomyopathy (NCCM).

Material and methods. We examined 216 patients with NCCM (140 men and 76 women, median age, 39 (30; 50) years). In addition to traditional clinical methods, all patients underwent late gadolinium-enhanced cardiac magnetic resonance imaging (MRI). The endpoints of the study included progression of NYHA class III heart failure (HF) with the need for hospitalization, ventricular tachyarrhythmias, and thromboembolic events (TEEs).

Results. There were 54 out of 216 (23,6%) patients with AF, of which 18 had paroxysmal AF, 16 — persistent AF, and 20 — permanent AF. During the follow-up period (median follow-up, 36 (6; 72) months), 98 out of 216 (45,4%) patients with NCCM had adverse events and outcomes as follows: 16 (7,4%) had ventricular tachyarrhythmias, of which 12 (5,6%) — sudden cardiac death with successful resuscitation and implantation of an implantable cardioverter-defibrillator; 62 (28,7%) patients had NYHA III-IV class HF progression; 20 (9,3%) patients had TEEs. The rate of adverse cardiac events was significantly higher in patients with AF (74,1% vs 35,8%, χ2=23,93, p<0,001) compared with patients without AF, including the incidence of TEEs (20,4% vs 5,6%, χ2=10,58, p=0,002) and HF progression to class III (46,3% vs 22,8%, χ2=10,9, p=0,002).

Multivariate analysis showed that the following most significant predictors of HF progression risk: left ventricular ejection fraction (LVEF) <50% according to cardiac MRI (hazard ratio (HR), 95,8; 95% confidence interval (CI), 10,2 -898,6; p=0,0001), presence of AF (HR, 8,2; 95% CI, 2,2-31,3; p=0,0022) and left atrial volume index (LAVI) >43 ml/m2 (HR, 5,2; 95% CI, 2,1-12,8; p=0,0004); predictors of TEE risk were the presence of AF (HR, 6,5; 95% CI, 2,0-20,8; p=0,0020) and LAVI >43 ml/m2 (HR, 6,0; 95% CI, 1,8-19,7; p=0,036). No association of AF with ventricular tachyarrhythmias was found in the study cohort of patients with NCCM. Predictors of ventricular tachyarrhythmias were LVEF <50% (HR, 4,5; 95% CI, 2,950,4; p=0,0241) and the presence of non-sustained ventricular tachycardia (HR, 3,5; 95% CI, 1,3-9,3 p=0,0139).

Conclusion. The present study shows that, along with the traditional predictor of adverse events in patients with NCCM (LVEF <50%), the identified additional predictors (AF and LAVI >43 ml/m2) can be used to identify patients at high risk of complicated NCCM for the timely prevention and treatment.
Diagnostic value of exercise stress echocardiography on a horizontal cycle ergometer in patients with low-risk non-ST elevation acute coronary syndrome
Authors: Abramenko E. E. , Ryabova T. R. , Yolgin I. I. , Ryabov V. V.
Published: September 2023

Aim. To evaluate the diagnostic accuracy of exercise stress echocardiography on a horizontal cycle ergometer for the detection of obstructive coronary artery disease (CAD) in patients with low-risk non-ST-elevation acute coronary syndrome (NSTE-ACS).

Material and methods. The study included 95 patients aged 53 (46;63) years (men, 58%), hospitalized in the regional vascular center with low-risk NSTE-ACS. Patients with known CAD, impaired resting left ventricular contractility were not included. During hospitalization, standard stress echocardiography on a horizontal cycle ergometer and invasive or non-invasive coronary angiography (CAG) were performed. All values of coronary obstruction ≥70% were verified by invasive CAG. The assessment of myocardial revascularization was observational.

Results. All patients had normal structural and functional cardiac parameters at rest. No adverse events were recorded during the tests. The result of stress echocardiography according to impaired local contractility (ILC) criterion was positive in 9 (16%), negative in 28 (49%), incomplete symptom-limited in 20 (35%) patients. Coronary artery stenosis ≥50%/≥70% was detected in 78/78% of cases in the subgroup with a positive result, in 29/11% — with a negative result, 30/10% — with a non-diagnostic result. The association of ILC with stenosis ≥70% was higher, with an odds ratio of 30,1 (4,9; 186,5) vs 8,5 (1,6; 46,1) for stenosis ≥50%. There were following diagnostic accuracy for stenosis ≥70%: sensitivity — 70%, specificity — 93%, positive predictive value — 78%, negative predictive value — 89%, overall accuracy — 86%.

Conclusion. Exercise stress echocardiography on a horizontal cycle ergometer in patients with low-risk NSTE-ACS patients is safe and feasible. The method has moderate sensitivity and positive predictive value and high specificity, negative predictive value and overall accuracy for the detection of anatomically significant coronary artery stenosis. In the structure of results, there is a significant proportion (35%) of symptom-limited tests incomplete due to heart rate, characterized by the lowest incidence of obstructive atherosclerosis.
Severe cardiac AL amyloidosis in an elderly patient with multiple SARS-CoV-2 reinfection: a case report
Authors: Reznik E. V. , Nguyen T.L. , Ettinger O. A. , Lazarev V. An. , Borisovskaya S. V. , Guseva A. I. , Salikov A. V. , Golukhov G. N.
Published: September 2023

Introduction. The relationship between systemic amyloidosis and coronavirus disease 2019 (COVID-19) has not been sufficiently studied to date. This paper presents a case of the persistence of COVID-19 markers in an elderly patient with systemic amyloidosis.

Brief description. A 74-year-old patient with heart failure with preserved ejection fraction and type 2 diabetes was repeatedly hospitalized due to decompensated heart failure. Based on the data of protein electrophoresis with immunotyping, biopsy of subcutaneous fat and bone marrow, echocardiographic data, the patient was diagnosed with systemic AL amyloidosis with cardiac involvement. During hospitalizations in April, August and December 2020, positive polymerase chain reaction test for SARS-CoV-2 were obtained, while there were no clinical manifestations of infection for a long time and adequate antibody production.

Conclusion. A case report demonstrates multiple SARS-CoV-2 reinfection in a severe comorbid elderly patient, as an unfavorable prognostic factor.
Role of radionuclide assessment of global and regional mechanical dyssynchrony of the heart in prognosis of cardiac resynchronization therapy in patients with heart failure
Authors: Mishkina A. I. , Atabekov T. A. , Shipulin V. V. , Batalov R. E. , Sazonova S. I. , Popov S. V. , Zavadovsky K. V.
Published: September 2023

Aim. To determine the prognostic significance of cardiac regional mechanical dyssynchrony (MD), assessed by radionuclide equilibrium ventriculography (REVG) in candidates for cardiac resynchronization therapy (CRT).

Material and methods. The study included 65 patients with indications for CRT according to current guidelines. Prior to CRT, all patients underwent REVG to assess cardiac contractile function and MD. According to the phase analysis, indicators of global and regional cardiac MD were evaluated: phase standard deviation (PSD), histogram band width (HBW), entropy, and interventricular dyssynchrony. The regional assessment included an evaluation of phase histograms obtained from the analysis of the contraction of certain walls: left ventricular (LV) anterior, lateral, posterior wall, right ventricular (RV) free wall, and the interventricular septum. To evaluate the effectiveness of treatment 6 months after CRT, all patients underwent echocardiography, on the basis of which patients were divided into groups of responders and non-responders.

Results. REVG revealed significant differences in the initial regional MD values between the groups of responders and non-responders: in responders, MD values of RV free wall (PSD: 39 (28-67) vs 28 (20-50), p=0,03) and LV anterior wall (PSD: 28,5 (16-40) vs 14 (11-24), p=0,0005) were higher, and the LV lateral wall was lower (PSD: 10 (7-14) vs 15 (9-26), p=0,007) than in non-responders. Multivariate logistic regression found following independent predictors of a positive response to CRT: heart failure of ischemic origin, LV HBW, RV free wall PSD, anterior wall PSD, LV lateral wall HBW (p<0,001). The sensitivity and specificity of the model was 93% and 91%, respectively.

Conclusion. Regional MD scintigraphy parameters increase the predictive value of REVG in CRT candidates. The most informative in this regard are the PSD of RV free wall and LV anterior wall, as well as the HBW of LV lateral wall.
Patients with atrial fibrillation and a low risk of thromboembolic events: prescription rate of anticoagulant therapy according to a retrospective analysis
Authors: Druzhilov M. A. , Kuznetsova T. Yu.
Published: September 2023

Aim. To conduct a retrospective analysis of the prevalence of main risk factors for thromboembolic events (TEEs) and the prescription rate of anticoagulant therapy (ACT) in patients with atrial fibrillation (AF) and a low CHA2DS2-VASc score in certain Russian regions using artificial intelligence technologies.

Material and methods. The information was obtained from the Webiomed predictive analytics platform. The sample included 87601 patients with AF aged 18-74 years (men, 49,5%, mean age, 59,3±12,3 years, mean CHA2DS2-VASc score, 2,3±1,5) who received care in medical organizations in 6 constituent entities of the Russian Federation in the period from 2016 to 2019. CHA2DS2VASc score of 1 and 2 in a man and a woman, respectively, was regarded as a moderate risk, while score of 0 and 1, respectively, as a low risk of TEEs.

Results. There were 22337 (25,5%) patients with AF at moderate risk and 18366 (21,0%) patients at low risk of TEEs. With a moderate risk of TEEs, CHA2DS2-VASc score of 1 in 70,4% of cases was determined by hypertension, while in 15,7% — by age 65-74 years, in 9,0% — by heart failure, in 2,9% — by myocardial infarction and/or peripheral arterial disease, in 2,0% — by type 2 diabetes. In patients with AF and a moderate risk of TEEs, ACT was prescribed in 4927 (22,1%) patients, while with a low risk of TEEs — in 1833 (10,0%). Among patients with AF and a high risk of TEEs (n=46898, 53,5%), 1216 (24,6%) patients with ischemic stroke (IS) did not initially have a high CHA2DS2-VASc risk.

Conclusion. In clinical practice, among patients with AF aged 18-74 years, there are quite often individuals with CHA2DS2-VASc score of 1 not associated with sex. These patients need an individualized approach in ACT, which is the basis for prospective studies in order to optimize the assessment of cardioembolic IS risk, as well as to analyze the efficacy and safety of long-term ACT.
Atrial septal defect. Clinical guidelines 2023
Authors: Bokeria L. A. , Kim A. I. , Zelenikin M. M. , Avramenko A. A. , Alekyan B. G. , Belov V. A. , Bogdanov V. N. , Boriskov M. V. , Borisova N. A. , Brodsky A. G. , Volkov S. S. , Gavrilov R. Yu. , Garmash O. I. , Gladyshev I. V. , Golubova T. F. , Gorbatikov K. V. , Gorbatykh Yu. N. , Gorbachevsky S. V. , Grigoryan A. M. , Eliseeva L. V. , Yevtushenko A. V. , Irtyuga O. B. , Kovalev I. A. , Komissarov M. I. , Krivoshchekov E. V. , Krupyanko S. M. , Kupryashov A. A. , Kurganova A. V. , Levchenko E. G. , Lezhnev A. A. , Lyubchik V. N. , Martynyuk T. V. , Movsesyan R. R. , Nalimov K. A. , Nikiforov A. B. , Petrushenko D. Yu. , Plotnikov M. V. , Podoksenov A. Yu. , Pursanov M. G. , Svobodov A. A. , Semenyak E. G. , Sinelnikov Y. S. , Tataurova V. P. , Teplov P. V. , Trunina I. I. , Chernogrivov A. E. , Shekhmametyev R. M. , Shlyakhto E. V. , Shmalts A. A. , Yakovleva A. N. , Alexandrova S. A. , Baryshnikova I. Yu. , Bergen T. A. , Rychina I. E. , Sinitsyn V. E. , Yurpolskaya L. A.
Published: September 2023

Association of Cardiovascular Surgeons of Russia Russian Society of Cardiology (RSC)

Association of Pediatric Cardiologists of Russia

Russian Scientific Society of Specialists in X-Ray Endovascular Diagnostics and Treatment

All-Russian Public Organization for the Promotion of Radiation Diagnostics and Therapy "Russian Society of Radiologists and Radiologists".

Task Force members declared no financial support/conflicts of interest. If conflicts of interest were reported, the member(s) of the working group was (were) excluded from the discussion of the sections related to the area of conflict of interest.
Potential of anticoagulant therapy in cardiology practice for thrombocytopenia. Literature review
Authors: Pereverzeva K. G. , Yakushin S. S. , Korshikova A. An.
Published: September 2023

The review article discusses the issues of anticoagulant therapy in cardiovascular patients with thrombocytopenia (TP), gives the concept of ethylenediaminetetraacetic acidand heparin-induced TP. The management of patients with heparin-induced TP is analyzed in detail, which consists in the discontinuation of unfractionated and low molecular weight heparin administration with replacement to direct thrombin inhibitors (lepirudin or argatroban), fondaparinux or direct oral anticoagulants.

The authors emphasize that the anticoagulant administration to most patients with platelet count >50×109/l is possible in full prophylactic and therapeutic doses. Reducing the level of platelets to 25-50×109/l in most cases requires a reduction in the anticoagulant dose by 50%. At a platelet level of 20-25×109/l or less, anticoagulant therapy should be avoided in most patients.

In addition to the scope of anticoagulant therapy, TP also determines the choice of anticoagulant as follows: in patients with acute coronary syndrome, bivalirudin or fondaparinux are recommended, while in patients with cancer and stable TP, warfarin or direct oral anticoagulants can be prescribed. In progressive TP (if heparin-induced TP is ruled out), low molecular weight heparins should be used.
Identification of leptin resistance in patients with coronary artery disease and heart defects
Authors: Gorbatovskaya E. Е. , Dyleva Yu. A. , Belik E. V. , Uchasova E. G. , Tarasov R. S. , Gruzdeva O. V.
Published: September 2023

Aim. To compare the incidence of leptin resistance (LR) in patients with acute and chronic coronary artery disease (CAD) and patients with acquired heart defects (AHD).

Material and methods. The study included 234 patients: 114 patients with acute myocardial infarction (MI) and 120 patients with chronic CAD. The comparison group consisted of 48 patients with degenerative non-rheumatic AHD — aortic stenosis (AS). The control group consisted of 40 healthy volunteers. On the 1st day of hospitalization, the concentration of leptin and leptin receptor was measured, and the free leptin index (FLI) was assessed. LR was recorded at leptin >6,45 ng/ ml and FLI >25. Statistical data processing was carried out using the software package Statistica 10.0 and SPSS 17.0 for Windows.

Results. Initially, LR in MI, chronic CAD and non-coronary disease was revealed in 64%, 56,2% and 25%, respectively. Significant differences in the incidence of LR were observed between patients with MI and chronic CAD relative to patients with AHD (p=0,02 and p=0,03, respectively), while no differences were found between patients with coronary pathology (p=0,82). Equation of patients for body mass index (BMI) did not affect the incidence of LR. High incidence of LR remained for patients with acute and chronic CAD, and amounted to 63% and 57,3%, respectively, while for patients with AS — 25%.

Conclusion. Patients with acute and chronic CAD are characterized by a high LR incidence, in contrast to patients with AHD. The number of LR cases in patients with coronary pathology did not depend on BMI values, which indicates possible alternative leptin sources contributing the development of hyperleptinemia. In addition, studying the mechanisms underlying the leptin receptor decrease in CAD is necessary for adequate leptin effects and the prevention of LR.
Assessment and modification of cardiovascular risk in non-cardiac surgery. Clinical guidelines 2023
Authors: Sumin A. N. , Duplyakov D. V. , Belyalov F. I. , Bautin A. E. , Bezdenezhnykh A. V. , Garkina S. V. , Gordeev M. L. , Zateishchikov D. A. , Irtyuga O. B. , Korok E. V. , Kulagina T. Yu. , Medvedeva E. A. , Menzorov M. V. , Napalkov D. A. , Pavlova T. V. , Petrunko O. V. , Protasov K. V. , Sibagatullina Yu. S. , Cherepanova N. A. , Chomakhidze P. Sh. , Shutov A. M.
Published: September 2023

Russian Society of Cardiology (RCS)
Factors and sex differences associated with intermediate probability of heart failure with preserved ejection fraction in asymptomatic patients working in the Arctic
Authors: Shurkevich N. P. , Vetoshkin A. S. , Simonyan A. A. , Gapon L. I. , Kareva M. A.
Published: September 2023

Aim. To determine additional factors and sex differences associated with the intermediate probability of heart failure (HF) with preserved ejection fraction (HFpEF) in asymptomatic patients working in the Arctic on a rotating basis.

Material and methods. In the polar village of Yamburg (68° 21' 40 "N), 99 men and 81 women with grade 1 and 2 hypertension (HTN) and normal blood pressure, comparable by age (p=0,450), length of service in the north (p=0,956), office systolic blood pressure (BP) (p=0,251), diastolic BP (p=0,579) were simultaneously examined. We performed echocardiography and assessed the risk of HFpEF by H2FPEF score (Heavy; Hypertensive; Atrial Fibrillation; Pulmonary Hypertension; Elder; Filling Pressure). A treadmill test, Baevsky index, 24-hour BP monitoring, and biochemical blood tests were performed.

Results. Depending on H2FPEF score, participants were divided into groups: from 0 to 1 (group 1 — normal), from 2 to 5 (group 2 — intermediate probability of HFpEF). In men with intermediate probability of HFpEF, the Baevsky index (p=0,0048) and the incidence of resting body reserve dysaptation (p=0,0394) were higher, as well as a rapid BP increase during dosed exercise (p=0,0058) and a decrease in chronotropic reserve (p<0,0001) were noted. The presence of HTN in men increased the intermediate probability of HFpEF by 3,6 times, dyspnea at dosed exercise by 10 times, dysaptation to exercise by 5 times, the presence of left ventricular concentric remodeling by 8-10 times. In females with intermediate probability of HFpEF, dysaptation to exercise at rest (p=0,0120) and lower level of oxygen consumption during dosed exercise was more often determined (p=0,0485). The intermediate probability of HFpEF in women increased with autonomic nervous system dysfunction, an increase in the mean 24-hour systolic BP variability, the presence of dyspnea during dosed exercise (10 times), concentric left ventricular remodeling, and an increase in nonspecific inflammation markers (high-sensitivity C-reactive protein, IL-1β, IL-6).

Conclusion. Early identification of additional risk factors for intermediate probability of HFpEF in asymptomatic hypertensive patients has the potential to reduce the risk of subsequent clinical heart failure, allowing focus on prevention and intervention strategies in this group of patients.
The Effect of Death Anxiety on Hedonistic and Utilitarian Consumer Behaviours During the Covid-19 Pandemic
Authors: MERCANOĞLU ERİN Sema , AYHAN GÖKCEK Hande
Published: September 2023

The aim of the research is to determine how the death anxiety felt by individuals during the Covid-19 process affects hedonic consumption and utilitarian consumption.. The original aspect of this research is that it covers the period of the Covid-19 epidemic processively and includes psychology,socioalology,religion and marketing of sciences. Death anxiety, which has been widely reported to have an effect on consumer behavior in the literature, has generally been interpreted later or examined retrospectively in disaster studies. This research was carried out during the Covid-19 pandemic process. Although there are many studies in the literature affecting utilitarian and hedonic consumption, it is thought that its contribution to the literature is to focus on the effect of death anxiety.
E-survey with Google forms was used as the research method. Three different measurement tools were used for the data, namely “Hedonistic Consumption Scale”, “Utilitarian Consumption Scale”, and “Death Anxiety Scale” with demographic variables. In the research, an electronic questionnaire was applied to 403 people in the 18-64 age group residing in Istanbul using the "Snowball Sampling Method" and the data obtained were analyzed and interpreted with licensed SPSS 24 and AMOS 27 statistical programs. According to the results of the structural equation modeling used in the research, the 1st dimension of death anxiety affects (Uncertainty of Death) the 5 dimensions of hedonic consumption( hedonic effect, hedonic adaptation, passiveness, impulsive tendency and the reflection of identity) negatively, and the 2nd dimension affects(Thinking of and Witnessing Death) the 5 dimensions of hedonic consumption (hedonic effect, hedonic adaptation, passiveness, impulsive tendency and the reflection of identity) in a positive way. On the other hand, while the 1st dimension of death anxiety (Uncertainty of Death) is ineffective in 2 dimensions of utilitarian consumption(goal orientation and control orientation), the 2nd dimension( Thinking of and Witnessing Death) negatively affects 2 dimensions of utilitarian consumption (goal orientation and control orientation).