bluuebunny/crossref_metadata_2025 huggingface dataset:
Technocracy Revisited: the Polish Security Dispositif and Ukrainian Migration to Poland
Authors: Jaroszewicz Marta , Grzymski Jan
Published: June 2021

The article investigates the reaction of the Polish technocratic security dispositif to the arrival of Ukrainian migrants in Poland between 2014-2020. It contributes to the studies on securitisation and on technocracy by proposing to re-conceptualise research on the security practices towards migration, drawing upon the notions of a security dispositif and regime of practices. It is exemplified by migration from Ukraine to Poland. The paper distinguishes three regimes of practices within Polish migration control: state ignorance, technocratic governance and neighbourhood. Contrary to most securitisation practices on migration to the European Union from the South, there have been very few populist ‘speech acts’ by Polish political agents that would have positioned the migration from Ukraine as an existential threat. The article concludes that the Polish security dispositif mainly mobilised state ignorance as a resource in governing migration, since neither new legal nor institutional practices were adopted to address the increased arrivals of Ukrainians. Simultaneously, this was accompanied by an internal logic of technocratic governance and its ubiquitous strategic tendency to widen surveillance and control capacities towards foreigners. The article also highlights the role of local identity and the politics of memory in governing Ukrainian migration to Poland.
The Limits of EUropean Legitimacy: On Populism and Technocracy. Introduction to the Special Issue
Authors: Foster Russell , Grzymski Jan , Brusenbauch Meislová Monika
Published: June 2021

This article introduces the special issue on populism and technocracy in the integration and governance of the European Union (EU), framing these opposing approaches in the context of polarised debate on the (il)legitimacy of the EU. The special issue was conceived as an interdisciplinary approach to questions of the EU’s legitimacy in the aftermath of structural crises (the eurozone, sovereign debt and the election and appointment of governing agents) and spontaneous crises (migration, external state and non-state security challenges, Brexit and Euroscepticism). Since the special issue’s conception the unanticipated Covid-19 pandemic, and responses from the EU and its member states (current and former) starkly illuminated debates on how the EU should operate, the limits of its power and the limits of its popular legitimacy. The era of passive consensus has been replaced by claims of legitimacy based on active expert-informed intervention, alongside populist claims of the EU’s inherent illegitimacy as an undemocratic technocracy. As such the special issue’s objective is to critically analyse manifold ways in which the populist-technocratic divide is narrated and performed in different regions, disciplines, and social and political systems in an era of growing internal and external challenges to the Union. We observe that the EU’s institutions remain highly adaptable in responding to challenges, but that member-states have continued and accelerated a tendency to nationalise success and Europeanise failure, with the EU acting as a perennial scapegoat largely due to the ease with which it can be narrated as a site of projection for mistrust, resentment, and social grievances. We argue that the relationship between populism and technocracy is rapidly evolving from an imagined binary into a much more fluid, overlapping, and reversible set of political narratives. We conclude that despite the changing nature of populist-technocratic debates and the resilience and adaptability of the EU, it faces accelerating challenges to its legitimacy in the new era of ‘politics of necessity’.
The Religious Schizophrenic: Why Spirituality is Crucial for Recovery
Authors: Sweet Emily
Published: June 2021

Up to 80% of schizophrenic patients use religion to cope with their illness. These positive spiritual coping strategies are the primary predictor of mental wellness in patients with schizophrenia. Yet, most medical professionals have no religious training and are often ill-equipped to guide their schizophrenic patients in spiritual matters. Typically, religious institutions and modern medicine are not associated together, but what happens when mental health professionals lack the training to assist 80% of their schizophrenic patients who use religion as a coping strategy? Schizophrenic patients whose beliefs are not respected have a higher rate of suicide, face increased stigma and report a lower overall quality of life. Such patients are more likely to decline mentally and drop out of treatment. Some scholars, psychologists and philosophers are now arguing that ignoring the connection between religion and mental wellness is unethical because practitioners are failing to take patient diversity into account. This paper will attempt to answer the following questions: In an increasingly diverse world, is it the responsibility of mental health professionals to learn about their patients’ religious beliefs, especially when their beliefs are so closely intertwined with their chances at successfully managing their illness, such as the case with schizophrenics? Why is it a good idea to consider combining religion and healthcare? Should the increase in diverse patients require additional training for mental health professionals? Is it unethical for a mental health care professional to be ignorant of diverse cultures and religions? What are the dangers of allowing medical professionals, who largely have no training in religious affairs, to guide mentally ill patients? What are the potential solutions for this problem? Which solutions are more effective and why? Are the current practiced healthcare models, which combine medicine and religion, effective? Keywords: schizophrenia, religion, treatment, therapy, psychosis, stigma
New Assessments and Teacher Accountability: Lessons for Teachers’ Practice
Authors: James Jessalynn
Published: June 2021

The transition to new assessments aligned to the Common Core State Standards was a significant turning point in the standards’ implementation. Concerns about the transition led districts to suspend the use of value-added scores for evaluating teachers, but changes to other measures, such as classroom observations, were rare. Using data from the Washington, DC Public Schools, I evaluate the effect of the assessment transition on teachers’ practice. I find substantial declines in instructional practice, ranging from 13% to 20% of a standard deviation, for teachers in tested grades and subjects when the new exam was introduced. These results suggest that policymakers should consider the ramifications of testing changes on a wider array of teaching outcomes than value-added scores alone.
Experience of using Neurouridine® in various types of peripheral neuropathy
Authors:   South Kazakhstan Medical Academy, Shymkent, Republic Of Kazakhstan, Zharkinbekova Nazira , Khamidulina Aiganym ,   South Kazakhstan Medical Academy, Shymkent, Republic Of Kazakhstan, Barat Zhazira ,   South Kazakhstan Medical Academy, Shymkent, Republic Of Kazakhstan, Rustemova Botagoz ,   South Kazakhstan Medical Academy, Shymkent, Republic Of Kazakhstan
Published: June 2021

The quality of life of patients with chronic pain syndrome remains one of the most pressing issues. Pain is considered chronic if it lasts or recurs for more than 3-6 months. This contributes to disability, depression, sleep disorders, poor quality of life, and what is important in this situation, the cost of treatment. According to statistics, the average prevalence of chronic pain in the adult population is 20%. Practitioners everywhere are in search of new methods of pain relief. Purpose of research. The quality of life of patients with chronic pain syndrome has traditionally remained a topical issue. Given the permanent nature of pain and the completeness of approaches to its relief, the modern Clinician is constantly looking for new treatment methods that meet the principles of evidence-based medicine and safety. Material and methods. This paper presents the results of using Neurouridine® in 30 patients with peripheral neuropathy. 30 patients were randomized for a 3-week treatment period. Average age: 47.5±1.5 years. All patients received standard symptomatic therapy, and an oral combination drug containing b vitamins, folic acid, choline, and Uridine was added to the treatment in the 150 mg mode once a day. Patients made three visits to the outpatient neurological office: visit 1-to evaluate pre-treatment, visit 2-after 10 days of treatment, and visit 3-after 20 days of treatment. Each patient was presented with two performance evaluations at each study visit: pain assessment on the CRS NRS scale, and the fps Face scale. Results and discussion. Analysis of the results of the treatment showed improvement in the form of reduced pain, improved quality of life in 65.90%, rapid recovery of performance in 32.10%, reduced need for analgesics in 59.90% and complete disappearance of symptoms in 25.30% of patients. Pain was assessed using the HI NRG scale, the AZA Face scale, and the frequency of analgesics at the patient's first, second, and third visits. Conclusion. The use of Neurouridine® for analgesic purposes has shown a positive effect on reducing symptoms in patients with peripheral neuropathy. The results confirm that this therapy provides a clear regeneration of the nerves, relieving pain, and reducing the soreness characteristic of nerve damage. Keyword: peripheral neuropathy, Neurouridine®, pain assessment, quality of life.
ISO and Lean Quality Management Systems in Healthcare
Authors:   Pavlodar Branch of the KDL “Olymp”, Pavlodar, Republic of Kazakhstan, Magauov Tolegen
Published: June 2021

Currently, in the healthcare of the Republic of Kazakhstan and many other countries, ISO standards are mandatory, and also in some countries the Lean Production System is used. In the Republic of Kazakhstan, the Ministry of Health issued guidelines for the implementation of lean technologies in healthcare organizations in 2017. However, the introduction of Lean technologies is not yet mandatory and has not become widespread in medical organizations in our country. In this regard, information on Lean technologies, experience of their application and effectiveness in healthcare organizations is useful for our medical managers and workers. Goal. Analysis of literature data on ISO and Lean quality management systems, their comparison, experience of application in healthcare organizations and efficiency. Material and methods. For this analysis, we searched for information on the issue with a depth of up to 20 years. Search for publications on the topic of the review was carried out in the databases of PubMed / MEDLINE, PMC, EMBASE, Web of Since, as well as a broad search through the browsers Google.com and Yahoo.com. The search criteria were combinations of terms: quality management system, healthcare, and lean production. Results and discussion. The description of the main features of the quality management systems ISO and Lean, as well as their comparison have been made. Information on the use of these systems in healthcare organizations is given. Currently, the Lean manufacturing system has been implemented in all healthcare organizations in the province of Saskatchewan (Canada), and a large-scale implementation has begun in the Russian Federation. Many medical organizations are implementing Lean system on their own initiative. Most publications have positive feedback on the Lean application. However, there are also several critical articles that the published positive reports lack a strong evidence base. In addition, it is impossible to compare the reports of different organizations due to the lack of a unified system for evaluating the effectiveness of Lean. Conclusion. The Lean manufacturing system is increasingly being used in healthcare organizations. Mostly positive results of Lean application are reported. However, the issue of its effectiveness in healthcare requires further research, since most of the reports cannot be considered as hard evidence. Keywords: quality management system, quality of care, lean management, customer satisfaction
Assessment Of Thyroid Cancer Incidence In Kazakhstan
Authors:   Astana Medical University, Nur-Sultan, Republic of Kazakhstan, Yerlankyzy Moldir ,   Central Asian Cancer Institute, Nur-Sultan, Republic of Kazakhstan, Sakhanov Sauirbay ,   Astana Medical University, Nur-Sultan, Republic of Kazakhstan; Central Asian Cancer Institute, Nur-Sultan, Republic of Kazakhstan, Turebayev Dulat ,   Astana Medical University, Nur-Sultan, Republic of Kazakhstan, Kulmirzayeva Dariyana ,   National Center of Neurosurgery, Nur-Sultan, Republic of Kazakhstan; Central Asian Cancer Institute, Nur-Sultan, Republic of Kazakhstan, Urazova Saltanat ,   Astana Medical University, Nur-Sultan, Republic of Kazakhstan, Amanshayeva Akmaral ,   Central Asian Cancer Institute, Nur-Sultan, Republic of Kazakhstan, Bilyalova Zarina ,   Central Asian Cancer Institute, Nur-Sultan, Republic of Kazakhstan, Igissinov Nurbek ,   Astana Medical University, Nur-Sultan, Republic of Kazakhstan; Central Asian Cancer Institute, Nur-Sultan, Republic of Kazakhstan; Eurasian Institute for Cancer Research, Bishkek, Kyrgyz Republic
Published: June 2021

Thyroid cancer (TC) is the most wide spread malignant tumor of the endocrine glands. According to the International Agency for Research on Cancer, more than 586,200 new cases of TC were registered in the world in 2020. However spatial arrangement of this disease indicates a different distribution of this pathology all over the world. The aim to assess the peculiarities of the incidence of TC in Kazakhstan. Materials and methods. The study was retrospective – the study period was 10 years (2009-2018). The material for the study was data of new cases of TC. In the research were used descriptive and analytical methods of oncoepidemiology. Results and discussion. We found out that the average age of patients with TC in women (51.8±0.2 years) were less than in men (53.2±0.5 years). The crude rate and standardized incidence rates in women (5.4±0.40/0000 and 5.1±0.370/0000, respectively) were higher than in men (0.9±0.10/0000 and 1.1±0.10/0000, respectively). Age-related indicators of the incidence of TC were characterized by a peak in 60-69 years – 4.21±0.200/0000 in men and 15.37±1.210/0000 in women. Trends in morbidity tended to increase in both women (Tg=+7.8%) and men (Tg=+5.0%). Conclusion: Age and gender features of TC incidence were established in the whole country. The obtained data are recommended for use in planning anti-cancer activities. Key words: thyroid cancer, incidence, Kazakhstan.
Autologous hematopoietic stem cell transplantation in HIV-associated plasmablastic lymphoma: a case report
Authors:   National Research Oncology Center, Department of Oncohematology and Bone Marrow Transplantation, Nur-Sultan, Republic of Kazakhstan, Zhunis Guljanat , Kemaykin Vadim ,   National Research Oncology Center, Department of Oncohematology and Bone Marrow Transplantation, Nur-Sultan, Republic of Kazakhstan, Saparbay Jamilya ,   National Research Oncology Center, Department of Oncohematology and Bone Marrow Transplantation, Nur-Sultan, Republic of Kazakhstan
Published: June 2021

Plasmablastic lymphoma (PBL) is a disease that was originally described in 1997 as a distinct subtype of diffuse large B-cell lymphoma (DLBCL), which is more common in patients with HIV infection. It is characterized by extranodal lesions, the most common of which are the oral cavity, digestive tract, and skin3. No generally accepted chemotherapy protocol for the treatment of HIV-associated PBL has been developed. Early consolidation through autologous hematopoietic stem cell transplantation (auto-HSCT) may be a treatment option for advanced patients with concurrent use of highly active antiretroviral therapy (HAART). Disease history. Patient B., 44 years old, with HIV-associated PBL-IV-stage according to AnnArbor with lesions of the alveolar process of the upper jaw, lymph nodes of the neck on the left, bronchopulmonary lymph nodes, and the lower lobe of the right lung, who after 6 courses of chemotherapy according to the standard CHOP regimen, autotransplantation of hematopoietic stem cells was performed in the first remission. Conclusion. Our clinical experience correlates with the few studies on this issue. The patient received stem cell-supported high-dose chemotherapy (HDCT) and his life expectancy is 36 months. Keywords: plasmablastic lymphoma, HIV-associated lymphomas, autologous hematopoietic stem cell transplantation.
The Impact of IMPACT: How instruction in critical thinking has a beneficial impact on standardised test performance
Authors: Ellerton Peter
Published: June 2021

Critical and creative thinking are fundamental 21st century skills and ‘general capabilities’ or ‘core competencies’ of many educational systems around the world, and yet there is much confusion and indeed some doubt about whether explicit instruction in critical thinking is either necessary or desirable. Standardised testing, meanwhile, is under fire for encouraging teachers to ‘teach to the test’ in a way that, for many teachers, undermines their capacity to create opportunities for students to engage in critical and creative learning. This study, based on an examination of standardised test (NAPLAN) performance data from students enrolled in courses dedicated to the teaching of critical thinking through the Queensland Government Department of Education’s IMPACT Centre shows that explicit instruction in critical thinking is correlated with significant relative gains when those students are compared with students whose exposure to critical thinking was secondary to domain-specific knowledge. This promises (a) to provide reasons for thinking that explicit instruction in critical thinking is beneficial for students in supporting the core areas of the curriculum measured within standardised tests, and (b) to provide an antidote to the idea that the existence of standardised testing militates against inquiry-based, critical thinking pedagogical practices.
Post-LGM glacial retreat drives aggradation in the interiors of the Kashmir Himalaya
Authors: Dey Saptarshi , Chauhan Naveen , Vashistha Anushka , Jain Vikrant
Published: June 2021

Understanding the response of glaciated catchments to climate change is fundamental for assessing sediment transport from the high-elevation, semi-arid to arid sectors in the Himalaya to the foreland basin. The fluvioglacial sediments stored in the semi-arid Padder valley in the Kashmir Himalaya record valley aggradation during ~19-11 ka. We relate the valley aggradation to increased sediment supply from the deglaciated catchment during the glacial-to-interglacial phase transition. Previously-published bedrock-exposure ages in the upper Chenab valley suggest ~180 km retreat of the valley glacier during ~20-15 ka. Increasing roundness of sand-grains and reducing mean grain-size from the bottom to the top of the valley-fill sequence hint about increasing fluvial transport with time and corroborate with the glacial retreat history. Our result also correlates well with late Pleistocene-early Holocene sediment aggradation observed across most Western Himalayan valleys. It highlights the spatiotemporal synchronicity of sediment transfer from the Himalayas triggered by climate change.
Failure to show robust noun-referent associations in German-learning infants
Authors: Steil Jessica Naomi , Friedrich Claudia , Schild Ulrike
Published: June 2021

Work with the looking-while-listening paradigm suggested that six-month-old English-learning infants associated several common nouns with pictures of their referents. This was evidenced by systematic fixations towards the named target picture (while one distractor picture was present). However, Norwegian-learning infants did not systematically fixate the target pictures until they were 8- to 9-months old, suggesting a cross-linguistic difference in the onset of noun comprehension. Moreover, their success in this task appeared to be modulated by aspects of stimulus pairing, specifically frequency differences between target and distractor: High (resp. low) frequent targets attracted more fixations if they were paired with low (resp. high) frequent distractors. In the present eye-tracking study, we tested 42 monolingual German-learning infants aged six to 14 months by means of a looking-while-listening paradigm. Infants saw two pictures side-by-side on a screen, whilst an unfamiliar male talker named one of both. Overall, infants did not fixate the target picture more than the distractor picture. In line with previous results, infants’ performance on the task was higher when the target and distractor word differed within their word frequency operationalized by the parental rating of word exposure. Therefore, our results further emphasize cross-linguistic differences in early word learning and strengthen the view that infants might use extra-linguistic cues within the stimulus pairing, such as frequency imbalance, to disambiguate between two potential referents.
Exploring the Role of Enforcement in Promoting Adherence with Protective Behaviours During COVID-19
Authors: Mills Freya , Symons Charles , Carter Holly
Published: June 2021

Purpose: To explore the conditions under which enforcement likely is, or is not, an effective strategy to increase adherence to recommended protective behaviours during COVID-19. Design/Methodology/Approach: Relevant search terms were entered into three key databases (Google Scholar, medXriv, psyArXiv) to identify both peer-reviewed and pre-publication articles that reported empirical data relating to the impact of enforcement on adherence with recommended public health behaviours. Findings: Enforcement is less effective when: it is applied inconsistently; rules are ambiguous; behaviours are unobservable. Providing food and financial support, creating social norms and increasing trust are more effective in addressing specific barriers and fostering voluntary adherence. Where enforcement forms part of the strategy for policing COVID-19 regulations, rules must be clear and local responders must be given time and opportunity to plan their response as new rules are implemented. Research limitations/implications: This narrative review was limited to papers published in English and available either via the databases searched, or via reference searching; some relevant studies may therefore not have been identified. Practical implications: Findings inform an understanding of the impact of enforcement on adherence and facilitate the development of recommendations for increasing adherence to protective behaviours during COVID-19. Given the importance of public adherence, these recommendations are not only useful in the context of COVID-19 but also for future public health emergencies. Originality/value: This narrative review is the first to explore the circumstances under which enforcement can increase or reduce adherence with COVID-19 guidelines, generating recommendations for improved public adherence.
Theory of Mind in Nonhuman Primates
Authors: Lewis Laura Simone , Krupenye Christopher
Published: June 2021

Social life demands complex strategies for coordinating and competing with others. In humans, these strategies are supported by rich cognitive mechanisms, such as theory of mind. Theory of mind (i.e., mental state attribution, mentalizing, or mindreading) is the ability to track the unobservable mental states, like desires and beliefs, that guide others’ actions. Deeply social animals, like most nonhuman primates, would surely benefit from the adept capacity to interpret and predict others’ behavior that theory of mind affords. Yet, after forty years of investigation, the extent to which nonhuman primates represent the minds of others remains a topic of contentious debate. In the present chapter, we review evidence consistent with the possibility that monkeys and apes are capable of inferring others’ goals, perceptions, and beliefs. We then evaluate the quality of that evidence and point to the most prominent alternative explanations to be addressed by future research. Finally, we take a more broadly phylogenetic perspective, to identify evolutionary modifications to social cognition that have emerged throughout primate evolutionary history and to consider the selective pressures that may have driven those modifications. Taken together, this approach sheds light on the complex mechanisms that define the social minds of humans and other primates.
Robot Face Memorability is Affected by Uncanny Appearance
Authors: Geiger Allie , Balas Benjamin
Published: June 2021

Human face recognition is influenced by various social and environmental constructs. For example, both age and race can affect the likelihood that a human face will be correctly recalled. Interestingly, general face appearance (i.e. friendly or untrustworthy faces) can also influence memorability. As human-robot interaction (HRI) becomes more commonplace, understanding what factors influence face recognition for non-human social agents is increasingly important. In particular, while there is a growing literature comparing the recognition of real human faces to computer-generated face images, comparisons between human face processing and robot face processing are largely unexplored. Here, we examined how the uncanny/eeriness of robot-faces affects memorability by using a 2AFC old/new task with various robot faces. Participants rated robot and human faces on perceived uncanniness during a study phase and were subsequently given a surprise memory task with only a fraction of the previously-encountered robot faces. Our results suggest that robots who are rated as more uncanny are more memorable than those that do not elicit the eerie feelings that correspond with uncanny faces: The more uncanny the robot face, the more accurately and quickly they were recalled. We discuss these results in the context of the design of social agents for HRI and also vis-a-vis theories of human face recognition and memory.
Attitudes about Paid Parental Leave: Cross-national comparisons and the significance of gendered expectations, family strains, and extant leave offerings
Authors: Knoester Chris , Li Qi , Petts Richard
Published: June 2021

AbstractUsing data on paid parental leave preferences from 35,488 adults situated within 26 different OECD countries, and multilevel modeling, this study examines public opinions about the provision of paid parental leave, some government funding of leave offerings, and preferred lengths of leave offerings. We consider how attitudes may be similar or different across social contexts and then focus upon the extent to which gender, gendered parenting role attitudes, family strains, and country-level institutionalized leave offerings are associated with leave preferences. The findings indicate that the vast majority of respondents are in favor of rather widespread and generous paid parental leave offerings; indeed, there are generally high levels of support for paid leave availability, relatively long paid leave offerings, and government funding of leaves. Gendered expectations and family strains are consistently associated with individuals’ leave preferences—even after accounting for country-level social contexts. Country-level offerings are also associated with leave preferences-- yet we find that the overwhelming majority of respondents express a desire for paid parental leave length offerings that are substantially different than the extant leave offerings in their country. Overall, this research complements previous work by newly documenting widespread public support for the provision of paid leave and some government funding of it. Also, it establishes that gendered expectations, family strains, and country-level practices are consistently associated with paid parental leave preferences in wealthy countries. Yet, substantial dissatisfaction with extant paid leave policies within countries seems to be commonplace.
Algumas possibilidades de cooperação dos leigos no munus regendi segundo a norma de direito
Authors: Parpinelli da Silva Cristiano
Published: June 2021

O objetivo deste artigo é o de apresentar algumas possibilidades de cooperação dos leigos no munus regendi segundo a normativa atual do Código de Direito Canônico de 1983. Para tanto, o texto está divido em duas grandes partes. A primeira trata dos princípios norteadores ainda necessários para uma cooperação eficaz do ponto de vista da igualdade, oportunidade e corresponsabilidade dos fiéis leigos. A segunda parte aborda, de modo mais concreto, quais são os canais e os meios para essa cooperação seja em um nível mais amplo de Igreja Particular seja em nível mais restrito como o Paroquial. O texto não apresenta todos os ofícios e encargos que podem ser assumidos por leigos tampouco não irá esgotar o argumento, pois ainda é objeto de muita discussão. A conclusão procura evidenciar o quão importante é a presença e atuação dos leigos na vida da Igreja.
Wolność uprawiania kultu religijnego w Polsce w czasie zarazy – analiza przypadku
Authors: Myszona-Kostrzewa Katarzyna
Published: June 2021

This analysis of freedom of religious worship is associated with a special situation in the world and in Poland caused by the SARS-CoV-2 virus. Restrictions introduced by the Government in Poland enter the constitutional sphere of religious liberty. Under international law and the 1997 Constitution of Poland, the freedom of manifestation of religion may be restricted only by statute and only if it is necessary to protect national security, public order, health, morality or the freedom and rights of others.
Umowy o udzielanie świadczeń opieki zdrowotnej zawierane przez Narodowy Fundusz Zdrowia (leczenie w ramach ubezpieczenia zdrowotnego) a leczenie na zasadach komercyjnych. Implikacje prawne i praktyczne
Authors: Lipowski Paweł
Published: June 2021

The aim of this study is to identify the legal characteristics of contracts for the health care services provided by a public payer, i.e. the National Health Fund (NFZ) as part of treatment covered by universal health insurance, as compared to those provided by the health care providers with public or private legal status. This issue is discussed in relation to the legal conditions for the treatment of patients on a commercial basis in those institutions (private or public) which have contracts for the provision of healthcare services under the general health insurance (so-called contracts). The discussion is presented based on author’s own observations, resulting both from his scientific studies in the field of medical law and his work in various entities operating in the health care system.
Pathogenetical aspects of tubulointerstitial syndrome development in alloxan-induced experimental diabetes mellitus
Authors: Olenovych О. А.
Published: June 2021

Annotation. The aim of our study was to explore the pathogenetical aspects of tubulointerstitial syndrome development in alloxan-induced experimental diabetes mellitus. The experiments were carried out on 20 white non-linear mature male rats, 10 with experimental diabetes mellitus (EDМ) induced by intraperitoneal administration of alloxan at a dose of 160 mg/kg of body weight, 10 intact rats served as the control group. 25 days after administration of the diabetogenic substance, the animals were withdrawn from the experiment. The concentration of sodium and potassium ions in urine and blood plasma samples was determined, followed by calculation (considering water-induced 2-hour diuresis and endogenous creatinine clearance) of glomerular filtration rate, electrolyte excretion, their filtration rate, absolute and relative reabsorption, clearance, their proximal and distal renal transport. Removed after decapitation rats’ kidneys were dissected to 3 parts – renal cortex, medulla and papilla, sodium and potassium content was determined in water-extract of the corresponding part of the renal parenchyma, and papillary-cortical, papillary-medullar and medullary-cortical concentration ion gradients were calculated. Significant suppression of papillary-medullar and papillary-cortical concentration sodium gradients, as well as a slight limitation of its medullary-cortical gradient were established. The concentration potassium gradients were significantly reduced. Statistical processing of the obtained data was carried out with the determination of the average value, standard deviations. To assess the probability of the difference between the study groups used non-parametric Mann-Whitney ranking criterion according to the algorithms implemented in the computer program “Statistica for Windows”, “Version 8.0”. There was a decrease of the sodium-potassium ratio in urine, enhanced urinary excretion of potassium and an increase of its content in urine, as well as intensification of absolute transtubular sodium transport due to equivalent augmentation of the filtration charge of this cation, increase of proximal sodium reabsorption and, to a lesser degree, – of distal one. The distal and proximal sodium reabsorption, reduced to a unit of active nephrons, was found to be decreased, and the relative reabsorption of the cation significantly exceeded the control values, contributing to the limitation of natriuresis. The results of the study suggest that in 26-day alloxan-induced experimental diabetes hemodynamic-hyperperfusion overload on the tubular apparatus of the kidney causes the development of relative insufficiency of the proximal and distal tubules, disorders of hormone-dependent reabsorption of cations, limitation of regulatory influence of aldosterone and ADH with further tubulointerstitial disturbances that unable adequate osmotic concentration of urine.
Clinical and instrumental profile of patients with stage II essential hypertension with different forms of extrasystoles according to the level of apelin-13
Authors: Іvankova А. V. , Кuzminova N. V. , Іvanov V. P.
Published: June 2021

Annotation. Essential hypertension (EH) is one of the leading causes of disability and mortality among cardiovascular diseases, so today new metabolic markers of cardiovascular risk are being actively studied. One of them is apelin-13. Objective – to evaluate the clinical and instrumental profile of patients with stage II hypertension with different forms of extrasystoles and different neurohumoral background – conditionally high/low serum apelin-13 levels. 156 patients with stage II essential hypertension were examined. 124 of them had frequent symptomatic extrasystoles, 32 patients had no arrhythmias and were considered to the comparison group. 30 practically healthy normotensive persons were considered to the control group. All patients underwent a complete clinical and anthropometric examination, blood pressure measurement, automatic daily blood pressure monitoring, daily electrocardiogram monitoring, echocardiography and the assessment of serum apelin-13 level. For statistical analysis, the procedure of non-linear data estimation was chosen, namely logistic regression or logit model. To form the basic statistical matrix of the analysis, we used clinical-instrumental and laboratory indicators, which passed a preliminary correlation analysis of Spearman with the level of apelin-13 serum and found a significant correlation (p<0.05). In the course of the logistic analysis at the final model, which allowed to predict “background of apelin” in patients with stage II EH entered 4 independent factors that revealed statistically significant (p<0.05) correlations with the initial parameter: the value of the systolic arterial pressure time index in%, the index of the left atrium in mm/m2, the average number of ventricular extrasystoles for 1 hour and the level of total cholesterol in plasma in mmol/l. The last indicator showed the least informativeness in predicting of the apelin-13 serum level. Interpreting the data of the obtained logit regression model, it should be said that in patients with EH of increasing the value of the systolic arterial pressure time index, the index of the left atrium and the average value of ventricular extrasystoles during 1 hour and decrease total cholesterol level in plasma increase the probability of determining relatively low (<920 pg/ml) and at the same time reduce the probability of determining a relatively high (≥920 pg/ml) level of apelin serum. These data also show that the highest informativeness in predicting the level of apelin-13 in patients with EH was the total number of ventricular extrasystole per hour. So, a high “apelin background” (≥920 pg/ml) in patients with EH will be accompanied by a benign course of the disease, so an increase serum apelin-13 in patients with EH should be considered as positive neurohumoral changes that promote cardioprotection, improve prognosis course of the disease and reduce cardiovascular risk.
Comparative analysis of the prevalence complications in the teeth preparation for different types of orthopedic structures using classical and minimally invasive protocols
Authors: Kostenko S. B. , Nakashidze G. N. , Bohdan I. M. , Kostenko O. Ye. , Penzelyk I. V.
Published: June 2021

Annotation. The research analyzes the prevalence of biological and technical complications in orthopedic rehabilitation of dental patients and comparative evaluation of classical and minimally invasive protocols of preparation for different types of orthopedic structures. Study goal - to make a comparative assessment of the prevalence and relative risks of biological and technical complications in the teeth preparation for different types of orthopedic structures using classical and mini-invasive protocols in prosthetic rehabilitation of dental patients. During the study 725 dental patients were comprehensive examined. The patients rehabilitation with the usage of different orthopedic structures types was evaluated, the average term of their functioning was studied and biological and technological complications in orthopedic treatment were registered. Relative risk indicators of biological consequences of iatrogenic interventions in comparison with the vital teeth condition which not covered with orthopedic structures are calculated. The following statistical research methods were used: bootstrap variant of analysis using Duncan's criterion and Pearson's consistency criterion with Yates correction. It is established that minimally invasive design of orthopedic structures (partial ceramic and all-ceramic veneers) is characterized by a statistically lower level of relative risk of complications, including both biological and technical. So, the implementation of minimally invasive protocols for the preparation of teeth for different types of orthopedic structures helps to reduce the relative risk of associated complications (mainly by reducing the risk of adverse effects), preserving more hard tissues of enamel and dentin compared to dentin and dentin. the magnitude of the risk of complications during the classical preparation protocols.
New approaches in providing care to surgical patients under conditions of COVID-19 pandemic on the basis of Military medical clinical center of Central region
Authors: Shaprynskyi V. O. , Verba A. V. , Shaprynskyi Y. V. , Martsynkovskyi I. P. , Shalyhin S. M.
Published: June 2021

Annotation. Nowadays, in coronavirus disease pandemic, the conditions for emergency surgery have changed. The aim of the work was to improve the provision of emergency surgical care under conditions of COVID-19 pandemic by developing and implementing clinical pathway of patients, using the remodeled infectious disease unit with a specially equipped operating room. To improve emergency surgical care under conditions of coronavirus pandemic, clinical pathways have been developed and implemented for management of patients with acute surgical pathology: the pathway of the patient requiring emergency surgery with suspected COVID-19 during self-presentation, the patient delivered by ambulance, in mass admission of patients, in admission of servicemen. Part of the hospital stock was restructured into isolated off-line infectious disease unit for treatment of patients with COVID-19 in a separate two-story building. Specially equipped operating room of the off-line infectious disease unit has separate entrances for patients and medical staff, which ensures the distribution of patient flows in the operating room. Clinical pathways for providing emergency care to patients with acute surgical pathology, developed by the authors, made it possible to divide them into flows and minimize possible risks of coronavirus infection in medical staff and other groups of patients. Under pandemic conditions, restructuring of hospital stock along with creation of off-line units with the use of existing staff seems to be warranted. Appropriate training of medical personnel in the restructured units working with COVID-19 infection as well as the development of rotational system mechanism for medical personnel are urgently required. Clinical results of treatment of patients with acute surgical pathology in the off-line infectious disease unit for patients with COVID-19 will be the object of future studies.
Complex physiological and hygienic assessment of the main regime elements of educational and extracurricular activities of students of institutions of higher medical education in the conditions of distance learning
Authors: Vergeles T. M. , Serheta I. V.
Published: June 2021

Annotation. Physiological and hygienic assessment of the main regime elements of educational and extracurricular activities of young girls and young boys in higher education is an essential component of research, which involves identifying risk factors for the likely development of negative changes in the functionality and adaptive resources of their organism. The research, based on the application of questionnaires and structured interviews, was conducted on the basis of National Pirogov Memorial Medical University, where under supervision during the observation period were 110 students who studied on 1 and 3 courses. The analysis of the obtained data and their prognostic evaluation involved the use of descriptive statistics procedures based on the use of a standardized package of statistical analysis applications “Statistica 6.1 for Windows” (licensed № ВXXR901E245722FA). In the course of the research a comprehensive physiological and hygienic assessment of the main regime elements of educational and extracurricular activities of students of higher medical education in the organization of distance learning and identified their leading differences from similar characteristics when using traditional forms of education. It was found that the share of indicators on the duration of continuous study activities of students, which are considered unfavorable and those that exceed its maximum allowable time range (more than 9 hours, from 8 to 9 hours and from 7 to 8 hours), under the use of distance format was lower than the proportion of similar indicators in the classroom. At the same time, the opposite picture is registered during the analysis of data on the features of educational and meaningful preparation for practical classes carried out at home. Among distance learning students, data that reflected the indicators of the duration of the dynamic component in the structure of the daily time budget had to be considered significantly lower. In the course of a subjectively significant generalized assessment of the daily activities of young girls and young boys, it was found that it should be considered more intense in terms of the use of distance learning technologies. The obtained results should be further used both for the development of methods for comprehensive assessment of the state of adaptive resources of students, taking into account the peculiarities of their daily activities, and during the scientific substantiation of effective use of health technologies in higher medical education.
Medical research and their ethical nature
Authors: Lantukh I. V. , Merkulova N. F. , Ostapenko V. M.
Published: June 2021

Annotation. The article examines the problem of medical researches, which is so relevant and necessary especially today, during the COVID-19 pandemic. It turns out that medical researches have an ethical nature, due to two interrelated aspects – the first aspect relates to professional medical practice, the second – to the patient's personality. Human medical research is based on the "rule of consent". This is necessary to protect the subject of medical research against various threats. The ethical implications of medical research stem from the need to comply with social requirements. The ratio of internal (professional) and external (public) control over medical research is both moral and social problems. Public control over medical research should be limited to such an extent as to leave room for the professional work of scientists. One aspect of this problem is related to the physical well-being of the subject of medical research: an adequate balance between risk and success is determined solely by the physician. The second aspect is related to the well-being of the person being studied as an individual and comes down to the question of who should determine this balance. Physicians attribute this right exclusively to themselves: only they can obtain the necessary information, without putting pressure on their patients. It is important to affirm the "principle of support" for medical research: the only one who can assess the human aspect of research is the subject himself. At first, the patient usually trusts his doctor, but later he must be able to decide how justified this trust was. The scientist-physician must realize that his future as a researcher depends not only on scientific but also moral qualities. On the other hand, fear of the sad consequences of the experiment should not be an obstacle to scientific progress. Important characteristics of the experiment are its reliability and validity. Therefore, medical experiments are an important tool for the development of medical knowledge about a person, about his health.