bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic Viral Hepatitis Do Not Affect 2019 Novel Coronavirus Disease-Related Outcomes: An Observational Retrospective Study.
Authors: Turco Elena Rosselli Del , Guardigni Viola , Galli Silvia , Scolz Kristian , Re Maria Carla , Viale Pierluigi , Verucchi Gabriella
Published: November 2020

BACKGROUND: To date, data about prevalence and clinical impact of viral hepatitis in COVID-19 are scarce and conflicting.METHODS: We conducted an observational, retrospective study including all subjects tested positive for SARS-CoV-2 from March to May 2020. We evaluated prevalence of chronic viral hepatitis and we performed a matched cohort analysis of patients with and without chronic viral hepatitis comparing COVID-related outcomes.RESULTS: 980 subjects resulted positive to SARS-CoV-2 on oropharyngeal swabs. Among them 12 (1,2%) were HBsAg positive and 6 (0,6%) had detectable HCV RNA. No one was receiving antiviral therapy. None of these had a documented liver cirrhosis.We identified 80 SARS-CoV-2 positive individuals with negative viral markers for HBV and HCV for the matched analysis. No statistical differences in hospitalization, need for MV and mortality rates (p 0.79, p 0.28 and p 0.8, respectively) were found. Although not statistically significant (p 0.12), a higher rate of those positive for viral hepatitis were admitted to ICU (29% Vs 15%). Median time of virus clearance was 27.5 (IQR 20,38) days, with no difference between the two groups (p 0.39, 95% CI (-12;4.8)). We found older age and male sex as factors associated with worse outcomes.CONCLUSION: Our analysis documented similar rates of chronic viral hepatitis among subjects with SARS-CoV-2 infection and general population. Furthermore, in our population, pre-existing viral liver infection did not have any impact on the clinical and virological course of COVID-19.
Cholera Outbreak Caused by Drinking Unprotected Well Water Contaminated with Feces from an Open Storm Water Drainage — Kampala City, Uganda, January 2019
Authors: Eurien Daniel , Mirembe Bernadette Basuta , Musewa Angella , Kisaakye Esther , Kwesiga Benon , Ogole Francis , Ayen Daniel Okello , Kadobera Daniel , Bulage Lilian , Ario Alex Riolexus , Zhu Bao-Ping
Published: November 2020

Background: Kampala city slums, with one million dwellers living in poor sanitary conditions, frequently experience cholera outbreaks. On 6 January 2019, Lubaga Division notified the Uganda Ministry of Health of a suspected cholera outbreak in Sembule village. We investigated to identify the source and mode of transmission, and recommend evidence-based interventions.Methods: We defined a suspected case as onset of profuse, painless, acute watery diarrhoea in a Kampala City resident (≥2 years) from 28 December 2018 to 11 February 2019. A confirmed case was a suspected case with Vibrio cholerae identified from the patient’s stool specimen by culture or Polymerase Chain Reaction (PCR). We found cases by record review and active community case-finding. We conducted a case-control study in Sembule village, the epi-center of this outbreak, to compare exposures between confirmed case-persons and asymptomatic controls, individually matched by age group. We overlaid rainfall data with the epidemic curve to identify temporal patterns between rain and illnesses. We conducted an environmental assessment, interviewed village local council members, and tested water samples from randomly-selected households and water sources using culture and PCR to identify V. cholerae.Results: We identified 50 suspected case-patients, with three deaths (case-fatality rate: 6.0%). Of 45 case-patients with stool samples tested, 22 were confirmed positive for V. cholerae O1, serotype Ogawa. All age groups were affected; persons aged 5-14 years had the highest attack rate (AR) (8.2/100,000). The epidemic curve showed several point-source outbreaks; cases repeatedly spiked immediately following rainfall. Sembule village had a token-operated water tap, which had broken down one month before the outbreak, forcing residents to obtain water from one of three wells (Wells A, B, C) or a public tap. Environmental assessment showed that residents emptied their feces into a drainage channel connected to Well C. Drinking water from Well C was associated with illness (ORM-H=21, 95% CI: 4.6–93). Drinking water from a public tap (ORM-H=0.33, 95% CI: 0.13–0.86) and drinking boiled water (ORM-H=0.15, 95% CI: 0.036-0.59) were protective. Water from a container in one of eight households sampled tested positive for V. cholerae; water from Well C had coliform counts ˃900/100ml.Conclusions: Drinking contaminated water from an unprotected well was associated with this cholera outbreak. We recommended emergency chlorination of drinking water, fixing the broken token tap, and closure of Well C.
Factors Related to Malondialdehyde (MDA) Levels in Metal Casting Industry Workers
Authors: Suwondo Ari , Mohan Ahmad , Widyawati Melyana Nurul , Mardiyono Mardiyono
Published: November 2020

BackgroundMDA, as a sign of oxidative stress, was increasing as a factor that changes the toxicity of responses in the workplace and causes male infertility etiology. This study aims to measure the MDA levels of workers in the casting industry metal.MethodsThis type of research was analytical explanatory research with a cross-sectional design. This study's variables include the variables taken are MDA levels while the independent variables were age, years of service, type of work, BMI, marital status, and smoking habits. A saturated sampling technique took the research sample of 34 workers. Data analysis used univariate and bivariate methods.ResultsThe results determined that respondents had MDA hormone levels below the average of 24 or 70.6%, while respondents who had MDA levels above an average of 10 or 29.4%.ConclusionsMDA levels relating to the length of work and marital status, while the type of work, BMI, and smoking habits are not associated with MDA levels in metal casting industry workers in the CV. Bonjor Jaya Klaten.First part title: Text for this section: expose, age, MDA, Metal Castin.The study was conducted in accordance with Ethical Clearance No: 264/EC/FKM/2017.
Survival Status and Its Predictors Among Adult Human Immunodeficiency Virus Infected Patients Attending Their Antiretroviral Treatment at Health Centers in Kirkos Sub City, Addis Ababa, Ethiopia. A Retrospective Cohort Study
Authors: Amha Selam Tesfayohannes , Moges Sisay , Shine Sisay , Dagnaw Abinet
Published: November 2020

BackgroundBurden of HIV/AIDS is high in low- and middle-income countries including Ethiopia. In resource-poor countries like Ethiopia, the survival of patients with AIDS treated with ART depends on a variety of factors, which may also vary greatly with economic, demographic, behavioral risk, and health factors. Unlike other previous studies, this study was done at health centers since some of the clinical factors may differently affect the survival of the patients under ART. ObjectivesThe main aim of this study is to estimate the mortality rate and survival predictors among adult HIV infected patients under ART at health centers in Kirkos sub city.MethodA retrospective cohort study was conducted at the health centers found in Kirkos sub-city, Addis Ababa. All adult HIV positive patients under follow-up between Dec. 1, 2014, and Oct. 30, 2019 were the source population. A total of 665 samples were taken using the lottery method. Data were extracted from the patient card and electronic database by trained data collectors. Kaplan-Meier and Cox-proportional hazard regressions were used. Resulta total of 55(8.5%) of death has occurred with the incidence death of 3.25/100 person-years. Majority of deaths occurring within 6 months of ART initiation. Predictors mortality were patients with age category above 50 years (AHR = 4.90, 95% CI: 2.00, 11.98), TB comorbidity (AHR= 3.46, 95% CI: 1.52,7.91), WHO stage IV (AHR = 4.55,95% CI: 1.72,12.02), lack of dug adherence (AHR=1.76, 95% CI: 1.23, 3.33), co-trimoxazole therapy (AHR=2.56, 95% CI: 1.25,5.24),BMI of less than 18.5 (AHR= 2.59, 95% CI: 1.37,4.90) and CD4 cell count, below 200/dl (AHR =22.77, 95% CI: 1.30,5.92).ConclusionThe majority of deaths occurring within six months of ART initiation. Factors directly or indirectly affects immunity were associated with poor survival. Prevention of TB infection, enhancing feeding and early screening of nutritional status of patients’ needs great attention.
Reasons for Missed Visits and Influence of Phone Call Reminders on Retention of HIV-Infected and Uninfected Children Followed in Cameroon: The ANRS-PEDIACAM Cohort
Authors: SEPTOH Francis Jaudel YUYA , Tchatchueng Jules Brice , Ndongo Francis Ateba , Penda Ida Calixte , Guemkam Georgette , Tetang Suzie , Gweha Derboise , Bense Angèle , Moukoko Astrid , Sofeu Casimir Ledoux , Faye Albert , Warszawski Josiane , Tejiokem Mathurin Cyrille
Published: November 2020

BackgroundAs many longitudinal studies, follow-up in the ANRS-PEDIACAM study is disrupted by repeated absences of participants to scheduled visits. This lead to missing data which influence the quality of results. We describe reasons for participants absence or non-compliance (NC) and assess the influence of phone call reminders (CR) on retention in care.MethodsFrom November 2007 to 2011, 611 infants divided in three groups were included and followed in three referral hospital in Cameroon: HIV-infected children followed from the first week of life or not but diagnosed before seven month of life (n=210), HIV-uninfected children born to HIV-infected (HEU) (n=205) mothers or not (HUU) (n=196). From 2014 to 2017, CR were reinforced to record reasons of missing visits. we used frequency, chi-square or Fisher test for categorical variables; means, median (IQR) and non-parametric Kruskal Wallis test for continuous variables. A multistate transition modelling approach was used to analyse the retention care cascade. The R software was used to perform all statistical analysis.ResultsDuring the study period, 45.1% (246/546) of children were NC at least once of ​​which 16.3% (25/153), 58% (116/200), 54.4% (105/193) respectively among HIV-infected, HEU and HUU-children. Among NC, 69.5% (171/246) has been reachable at least once and 22.2% (38/171) of them returned to follow-up after a median delay of 32 days (IQR: [2.0 – 110]); 44.4% (109/246) were not seen throughout the study period (HIV-infected: 12/153, HEU-children: 57/200, HUU-children: 40/193). A total of 276 reasons have been reported among 54%(115/213) of the NC, mainly related to delocalisation (30.4%), lack of time (23.6%), wish to stop follow-up (11.6%), travelling (9.8%), schooling (9.4%), forgetting (7.2%). Comparing before and after period, CR allowed to divided by three adjusted relative risk ratio to miss one clinical visit (RRR [CI]: 0.35[0.24 – 0.52]), However CR effect was not significant among children who are non-compliant.ConclusionOur finding suggest that maternal HIV and socio-economic status are related to attendance of children in HIV care. Also, the CR are an effective strategy to improve attendance. However, to make this strategy effective for children who are non-compliant, it needs to be strengthened by community monitoring.
Distributed Energy Systems and Energy Communities Under Negotiation
Authors: Palm Jenny , Kojonsaari Anna-Riikka
Published: November 2020

BackgroundNew decentralized energy-generation technologies have turned economies of scale upside down while becoming more economically viable. The increased penetration of information technologies has led to new opportunities to manage infrastructure in a less hierarchical, more flexible way. Together with citizen demands for control over energy, this has put energy communities (ECs) on the agenda, potentially advancing the transition towards more sustainable energy systems, despite hindrances encountered on the way.This paper presents a case from Sweden, using participatory observations and interviews conducted during the planning of a sustainable city district built around sharing. We examined the discussions between stakeholders concerning smart energy systems and the establishment of a microgrid.ResultsWe found that the discussions of the microgrid comprised two parallel discourses, coexisting but seldomly explicitly confronted. The distribution system operator in the area promoted its solutions, while the property developers opted for a microgrid organized more as an EC. We discuss why the EC proponents apparently lost the battle in this smart grid case.ConclusionsThis paper described the energy planning process in a case study in Sweden, where two different models for building an electric microgrid can be identified: distributed energy systems and energy community perspectives. We suggest that these perspectives have different values. We conclude that interest in microgrids could shift the transition pathway towards a more decentralized system involving a variety of owners.
WITHDRAWN: First Case of Ductal Adenocarcinoma of the Prostate with MAP3K1 Homozygous Deletion: A Case Report and Literature Review
Authors: Shojo Kazunori , Kosaka Takeo , Nakamura Kohei , Hongo Hiroshi , Mikami Shuji , Nishihara Hiroshi , Oya Mototsugu
Published: November 2020

Background: Ductal adenocarcinoma of the prostate is a rare prostate cancer variant and associated with higher stage and greater risk of recurrence and mortality. Optimal systemic therapy for metastatic ductal adenocarcinoma is not known. Many case reports are needed for further understanding of clinical and molecular features about it. Herein we report the first case of a man who was diagnosed with ductal adenocarcinoma of the prostate with mitogen-activated protein kinase 1 (MAP3K1, MEKK1) homozygous deletion.Case Presentation: A 67-year-old man presented with ductal adenocarcinoma of the prostate accompanied by multiple lung metastases and advanced bone metastases. We performed channel transurethral resection of the prostate and confirmed the diagnosis of ductal adenocarcinoma of the prostate. DNA sequencing identified a TP53 somatic point mutation (p.Gly245Ser) as the pathogenic variant. Furthermore, a homozygous deletion was observed in MAP3K1 (MEKK1). The patient received enzalutamide but deceased five months after presenting to our institution.Conclusion: To our knowledge, this is the first report of ductal adenocarcinoma of the prostate with a MAP3K1 homozygous deletion. Accumulation of whole-exome sequencing data is expected to inform future advances in therapy development.
Prone Positioning of Non-intubated Patients with COVID-19 - A Systematic Review and Meta-analysis
Authors: REDDY Mallikarjuna Reddy PONNAPA , SUBRAMANIAM Ashwin , LIM Zheng Jie , ZUBAREV Alexandr , AFROZ Afsana , BILLAH Baki , BLECHER Gabriel , TIRUVOIPATI Ravindranath , RAMANATHAN Kollengode , WONG Suei Nee , BRODIE Daniel , FAN Eddy , SHEKAR Kiran
Published: November 2020

Purpose: Several studies have reported adopting prone positioning (PP) in non-intubated patients with COVID-19-related hypoxaemic respiratory failure. This systematic review and meta-analysis evaluated the impact of PP on oxygenation and clinical outcomes.Methods: We searched PubMed, Embase and the COVID-19 living systematic review from December 1, 2019 to July 23, 2020. We included studies that reported using PP in hypoxaemic, non-intubated adult patients with COVID-19. Primary outcome measureed was the weighted mean difference (MD) in oxygenation parameters (PaO2/FiO2, PaO2 or SpO2) pre and post-PP. Results: Fifteen single arm observational studies reporting PP in 449 patients were included. Substantial heterogeneity was noted in terms of, location within hospital where PP was instituted, respiratory supports during PP, and frequency and duration of PP. Significant improvement in oxygenation was reported post-PP: PaO2/FiO2 (MD 37.6, 95% CI 18.8-56.5); PaO2 (MD 30.4 mmHg, 95% CI 10.9 to 49.9); and SpO2 (MD 5.8%, 95% CI 3.7 to 7.9). Patients with a pre-PP PaO2/FiO2 ≤150 experienced greater oxygenation improvements compared with those with a pre-PP PaO2/FiO2 >150 (MD 40.5, 95% CI -3.5 to 84.6) vs. 37, 95% CI 17.1 to 56.9). Respiratory rate decreased post-PP (MD -2.9, 95% CI -5.4 to -0.4). Overall intubation and mortality rates were 21% (90/426) and 26% (101/390) respectively. There were no major adverse events reported. Conclusions: Despite the significant variability in frequency and duration of PP and respiratory supports applied, PP was associated with improvements in oxygenation parameters without any reported serious adverse events. The results are limited by lack of control arm and adjustment for confounders. Clinical trials are required to determine the effect of awake PP on patient-centred outcomes.Systematic review registration: Registration/protocol in PROSPERO (CRD42020194080).
Early Effects of Unfractionated Heparin on Clinical and Radiological Signs and D-dimer Levels in Patients With COVID-19 Associated Pulmonary Embolism: an Observational Cohort Study
Authors: Wal Lea Imeen van der
Published: November 2020

Background: Pulmonary embolism is a frequent complication in patients with Coronavirus disease 2019 (COVID-19). The pathogenesis of COVID-associated activation of coagulation is not fully understood and appears to be different from disseminated intravascular coagulation (DIC) in patients with sepsis. As the pathophysiology of coagulation in COVID-patients is unknown, it is uncertain whether unfractionated heparin (UFH), or anticoagulation in general, is effective in the attenuation of the procoagulant state. The aim of this study is to determine the effects of intravenous unfractionated heparin on clinical, radiological and laboratory parameters in patients with COVID-19 and acute pulmonary embolism (PE). Methods: We conducted an observational cohort study in 19 Intensive Care Unit (ICU) patients with COVID-19 and computed tomography (CT) scanning proven pulmonary embolism. According to the local protocol, repeated CT-scanning was indicated if no pulmonary improvement was present after a minimum of 7 days following start of anticoagulant treatment. We defined three endpoints: Laboratory markers (d-dimer at day 0 vs day 2), clinical success (resolution of PE at follow up CT scan or discharged alive from ICU) and radiological response (Qanadli index at follow up CT scan vs CT scan at diagnosis PE). Statistical tests used for analysis were a T-test and Wilcoxon Signed Rank test.Results: Unfractionated heparin resulted in clinical success in at least 14 out of 19 patients. Pulmonary emboli were completely resolved on the follow up computed tomography scans in 5 out of 6 patients and partly resolved in the 6th patient. D-dimer levels decreased on average from 7074 ng/mL to 4347 ng/mL (p=0.001) within 48 hours after start of heparin. Conclusion: In this observational study, we showed a rapid clinical, laboratory and radiological improvement in patients with COVID-19 and proven pulmonary embolism. Standard anticoagulant treatment was effective in this setting, supporting current guideline recommendations.
Comparative Bench Study Evaluation of a Modified Snorkeling Mask Used During COVID-19 Pandemia and Standard Interfaces for Non-Invasive Ventilation.
Authors: FERRONE GIULIANO , Spinazzola Giorgia , Costa Roberta , Piervincezi Edoardo , Gullì Antonio , Scapigliati Andrea , Antonelli Massimo , Conti Giorgio
Published: November 2020

BackgroundCOVID-19 infection has put enormous pressure on the healthcare systems worldwide and especially on Intensive Care Units (ICUs). In this particular situation, a modified snorkeling mask into a mask for non-invasive continuous positive airway pressure (nCPAP) and non-invasive ventilation (NIV), with the help of 3D printers, has been proposed for clinical use. We designed a bench study to compare a Helmet (H), a Full face mask (RFF) and a modified full face snorkeling mask (MFF) for delivering nCPAP and NIV in pressure support mode (PSV).MethodsA mannequin was connected to an active lung simulator. The inspiratory and expiratory variations in airways pressure observed with a high simulated effort (Pmus), were determined relative to the preset CPAP level. NIV was applied in PSV at two simulated respiratory rates and two cycling-off ﬂow thresholds. During the bench study we measured the variables defining patient-ventilator interaction and performance. ResultsDuring nCPAP, the MFF presented significantly lower values of ΔPawi and ∆Pawe compared to the other interfaces tested (H and RFF). During NIV, the MFF demonstrated a better patient-ventilator interaction compared to RFF, as shown by significantly shorter Timepress and Delaytrexp (p<0.01), but no significant differences were found in terms of Delaytrinsp and Timesync between the interfaces tested. At RR 20sim, the MFF presented the shorter ΔPtrigger (p<0.01), moreover during all the conditions tested the MFF showed the longer PTP 200, 300 and 500 compared to RFF (p<0.01). A major limitation of MFF is that during NIV with this interface it is possible to reach at maximum 18 cmH2O of peak inspiratory pressure. Over this pressure value, the presence of air leaks determined important asynchrony phenomena. For this reason, our test was limited to one pressure support and PEEP set (PS 10 cmH2O and PEEP 8 cmH2O).Conclusions﻿The modified full face snorkeling mask can be used as an acceptable alternative to other interfaces for both nCPAP and NIV in emergency situations.
Mesenchymal Stem Cell Conditioned Medium Improves Non-alcoholic Fatty Liver Disease in Type 2 Diabetic Mice by Regulating SIRT1
Authors: Yang Mengmeng , Cui Yixin , Song Jia , Wang Lingshu , Liang Kai , Sha Sha , He Qin , Cui Chen , Hu Huiqing , Guo Xinghong , Zang Nan , Liu Xiaoming , Zhang Yifan , Sun Lei , Chen Li
Published: November 2020

BackgroundMesenchymal stem cells (MSCs), which can be used as a cutting-edge tool in regenerative medicine, release many nutrients into their conditioned medium (CM), which has become a promising acellular treatment tool. There is increasing evidence that stem cells conditioned media can treat metabolic-related diseases (for example, Type 2 diabetes mellitus (T2DM) and diabetic endothelial dysfunction). However, their mechanism of action remains unclear. Here, we studied the potential of MSC-CM in the treatment of diabetes with non-alcoholic fatty liver disease (NAFLD) and its related molecular mechanisms.MethodsTo determine the effects of MSC-CM on NAFLD, MSC-CM was used to treat T2DM mice and palmitic acid (PA)-treated L-O2 cells. To evaluate changes in mitochondrial function and potential signaling pathways, the levels of (i) SIRT1 and PGC1α, (ii) key mitochondrial transcription factors (NRF1, TFAM, and UCP2), (iii) apoptosis-related proteins (BAX, Bcl-2, cleaved caspase-3, caspase-3, cleaved PARP, and PARP), and (iv) inflammation-related proteins (TNF-α, IL-1β, and IL-6) were assessed by western blotting.ResultsMSC-CM improves insulin resistance in diabetic mice, corrects the pathological structure of the liver, enhances the liver’s total antioxidant capacity and mitochondrial function (both in vivo and in vitro), reduces inflammation, and reduces cell apoptosis. In addition, SIRT1 expression may contribute to the effect of MSC-CM treatment. We found that MSC-CM enhanced the expression of SIRT1 and downstream target proteins in the liver of T2DM mice and L-O2 cells treated with PA. At the same time, transfection of SIRT1 siRNA weakened the therapeutic effects of MSC-CM on the liver.ConclusionsOur findings indicate that MSC-CM improves NAFLD in T2DM mice by regulating the expression level of SIRT1, which provides new evidence that MSC-CM has the potential to treat T2DM patients with NAFLD clinically.
Physiological and Histopathological Effects of Electroporation Pulse on Stomach of Rats
Authors: Zhang Yuchi , Han Xuan , Li Zhuoqun , Zhang Yu , Liang Lihong , Ma Xiaoying , Liu Haonan , Gao Yihui , Li Qingshan , Chen Xue , Lv Yi , Ren Fenggang
Published: November 2020

BackgroundElectroporation pulse (EP) is an emerging tissue ablation technique with widespread potential, including in the treatment of multiple cancer types. However, there is a lack of knowledge about its effect on the physiology and histopathology of stomachs. The aim of this study was to investigate biological effects of EP applied to stomachs of healthy rats on digestive function, serum marker levels, and gastric tissue structure.MethodsNinety male rats were divided into nine groups and examined up to 28 days post-treatment. A single burst of electroporation pulses (500 V, 99 pluses, 1 Hz, 100 μs) was delivered to the stomachs of the rats using a forceps electrode. Gastric emptying, small intestinal transit, and gastric secretion were measured to evaluate digestive function. Levels of serum markers were determined using ELISA. Haematoxylin–eosin, Masson trichrome, and immunofluorescence were performed for histopathological analysis.ResultsNo significant effect on gastric emptying or secretion were found post-EP, whereas the small intestinal transit decreased at 4 h and rapidly recovered to normal on 1-day post-EP. Further, levels of serum markers such as TNF-α and IL-1β changed temporarily in the acute term but soon returned to normal within 28 days. Moreover, histopathological analysis revealed that that the cell death in ablation area occurred immediately post-EP, and the gastric wall scaffold in the ablation region remained intact post-EP.ConclusionsThis study demonstrates the safety and efficacy of EP on the physiology and histopathology of the stomach and lays a foundation for the wider use of this technique in future studies.
PREDICTION OF OUTCOME IN PATIENTS WITH FRACTURES OF THE PROXIMAL FEMUR DEPENDING ON MEDICAL AND EPIDEMIOLOGICAL AND ANAMNESTIC CHARACTERISTICS
Authors: Hurbanova T. S.
Published: November 2020

The paper shows the results of a study related to the possibilities of predicting the outcome in patients with fractures of the proximal femur depending on the medical-epidemiological and anamnestic characteristics. It was determined that fractures of the proximal femur are among the most common types of fractures and rank third among the most common types of fractures; they have high relevance and medical and social significance.
Objective: study the possibilities of predicting treatment outcomes in patients with fractures of the proximal femur depending on the medical-epidemiological and anamnestic characteristics.
In order to achieve this purpose, a retrospective study of the treatment outcome in patients with fractures of the proximal femur was conducted using the data of seven medical institutions in Kharkiv for six years (from January 01, 2011 to December 31, 2016).
According to the results of the study, a significant direct correlation of healed fractures and healing fractures with a likelihood of surgical treatment was determined: they were 2.40 and 4.15 times higher, respectively, versus the comparison group. A significant inverse correlation with the conservative treatment of pseudarthrosis and other types of lesions, together with fractures of the proximal femur (reduced likelihood of surgical treatment by 79.50% and 66.90%, respectively) was found. There was a significant inverse correlation between age characteristics and the conservative treatment, with 23.10% increase by every 10 years and a direct correlation between functional characteristics according to the ASA classification and surgical treatment. A significant direct correlation of increased likelihood for operative treatment of fractures of all types according to AO classification in comparison with type 31A1 was defined. Significant correlation with the place of residence was established: increased likelihood of conservative treatment (by 75.00% in patients from other cities of Kharkiv region); increased likelihood of surgical treatment (residents of villages of Kharkiv region – 12.78 times, residents of villages of other regions – 5.20 times, residents of cities of other regions – 7.87 times, persons of no fixed abode – 5.11 times). A significant correlation between the characteristics of patients' admission to the clinic and the use of surgical treatment were recorded: in self-treatment (2.29 times) and in referral to outpatient and inpatient facilities (2.44 times).

Keywords
proximal femur fractures, clinical and epidemiological characteristics, concomitant pathology, comorbid burden, age-sexual characteristics, functional status, odds ratio, confidence intervals.
ASSESSMENT AND INFLUENCE OF A FAMILY PHYSICIAN ON THE HEALTH STATUS OF THE POPULATION OF AMALGAMATED TERRITORIAL COMMUNITIES
Authors: Potseluiev V. I.
Published: November 2020

Introduction: Primary health care is the most important part of the health system. Family physicians, as representatives of this link, are key figures who are assigned a number of responsibilities for the prevention, diagnosis, and treatment of both adults and children. An indicator of the effectiveness of their work is the level of satisfaction of citizens with the quality of service. To understand the effectiveness of reform implementation, the authors evaluated the activities of the family physician and its influence on the health of citizens living on the entrusted territory.
The aim of the study is an empirical analysis of the selection criteria, frequency and reasons for the citizens' visits to a family physician in the amalgamated territorial communities of the Sumy region.
Materials and methods: During the research, methods of a systematic approach and comparative analysis were used. The study was conducted in the form of a survey. Calculations and processing of statistical information were carried out using the "OSA" application.
Study results and discussion: The paper shows the condition of primary care as a result of the health system reform. The sociological survey on the work of family physicians in the amalgamated territorial communities concerned the criteria for choosing a family physician, the frequency of requests for medical care, and the reasons for requests, in particular for preventive purposes. The analysis showed that the percentage of signing declarations is relatively high. However, a certain formality of this process was observed, since a significant percentage of citizens who signed the declaration have never met their family physician. The result indicates that citizens often do not seek medical care in outpatient clinics on the territory of the amalgamated territorial community, and they rarely visit the physician for preventive purposes. According to respondents, the reason for not seeking prevention is the lack of need.
Conclusion: A high percentage of residents of the amalgamated territorial communities signed declarations with family physicians. However, having analyzed the survey data, we can note a rather formal attitude to this procedure, since many residents seek medical services in other medical institutions. It is a consequence of the insufficient effectiveness of the reform of primary health care and insufficient attention on the part of local authorities to provide outpatient clinics with qualified specialists. There is a need to raise awareness about the importance of preventive measures.

Keywords
family medicine, family physician, preventive work, declaration, communication.
MEMBRANE-RECEPTOR COMPLEX DYSFUNCTION AS A NEW TARGET FOR THE NEUROTROPHIC THERAPY OF ISCHEMIC STROKE
Authors: Lychko Volodymyr
Published: November 2020

The aim of the study was the β-adrenergic activity of peripheral blood erythrocyte membranes in the acute period of ischemic stroke (IS). Peripheral blood erythrocytes are the most informative biological tissue for studying many pathogenetic mechanisms, and the work of their membrane-receptor complex (MRC) can very well reflect the functional state of the whole organism, one of the most important criteria for assessing is the adrenergic activity of cytoplasmic membranes in the pathogenesis of IS. This study solves the problem of the finding of the features of changes in the adrenoceptors system in the acute period of IS in the dynamics of the treatment of humans cryopreserved cord blood serum (CCBS). The main scientific results: the obtained results indicate a reduced ability of adrenoceptors (ARs) on erythrocyte membranes to bind blockers due to the desensitisation effect, which is observed from the 1st day of the disease. In the onset of IS, there is a significant increase in the values of β-adrenergic activity of membranes (β-ARM) of erythrocytes in 2.4 times compared with the control. Maximum levels of the indicator (42.43±3.64 CU) are observed in patients with initially severe disease, which indicates significant stress of the sympathoadrenal system (SAS) in these patients. On the 10th day of the disease, there was a decrease in β-ARM relative to the values obtained during hospitalisation. Still, comparing the value of the indicator on the 10th day of IS in both groups, there was an apparent, more significant decrease in β-ARM in the 2nd group of patients, which additionally received CCBS. The use of CCBS contributes to a more pronounced degree of recovery in neurological functions (6.9%) and faster stabilisation of the structure of MRCs in erythrocytes in the form of reducing the values of β-ARM to 16.61±2.86 CU (p<0.05). The area of practical use of the research results: the results of the study can be used to diagnose and treat of the IS. An innovative technological product: A comprehensive approach to assess the β-ARM of peripheral blood erythrocytes in patients with IS by determining the degree of changes in osmotic resistance of erythrocytes (ORE) under the action of adrenergic drugs (AD) is informative and can be used to diagnose of IS. The use of neurotrophic factors is a potentially new method of treating this pathology. Scope of application of the innovative technological product: in the clinical practice of neurological departments for the treatment of patients with strokes
EFFICIENCY ASSESSMENT OF IMPLEMENTATION OF THE MECHANISM OF INNOVATIVE RISK MANAGEMENT OF THE FAT AND OIL INDUSTRY IN UKRAINE
Authors: Zhadan Yuliya
Published: November 2020

Object of research: risk management processes of enterprises of the oil and fat industry in Ukraine. Investigated problem: to assess the efficiency of the implementation of the mechanism of innovative risk management for enterprises of the oil and fat industry in Ukraine Main scientific results: the paper proposes a scientific and methodological approach to quantifying the effectiveness of the implementation of the mechanism of innovative risk management (MIRM) of enterprises of the oil and fat industry in Ukraine, based on comparing the net present value before and after the MIRM implementation and consists of a number of successive interrelated stages, which include: comparative analysis and integrated assessment of unsystematic (financial, production, investment and other types) risks before and after the MIRM implementation at the enterprise; expert assessment of systematic risks that form the environment of the enterprise and can’t be controlled; determination of the total risk value as an arithmetic weighted average non-systematic and systematic component for each type of risk; determination of discount rates taking into account risk before and after the MIRM implementation at the enterprise using the CAPM model (capital assets pricing model) for calculating and comparing the net present value before and after the MIRM implementation at the enterprise (NPV and NPV', respectively). Efficiency assessment of the implementation of the mechanism of innovative risk management (MIRM) was carried out on the example of eleven processing enterprises of the fat and oil industry in Ukraine. The scope of practical use of research results: the risk management system of processing enterprises of the fat and oil industry in Ukraine, which should be the object of constant monitoring of the feasibility of implementation and assessment of the effectiveness of MIRM functioning by management and top management. Innovative technological product: a scientific and methodological approach to quantifying the effectiveness of the implementation of the mechanism of innovative risk management for enterprises of the oil and fat industry in Ukraine, based on comparing the net present value before and after the MIRM implementation (NPV and NPV’, respectively) using the CAPM model (capital assets pricing model) to determine the discount rates taking into account the risk before and after the MIRM implementation (d and d', respectively), which makes it possible to determine the expected amount of reduction in losses at the processing enterprises of the oil and fat industry of Ukraine from the implementation of a set of risk management measures and make informed management decisions on the appropriateness of their application. Scope of application of the innovative technological product: processing enterprises of the oil and fat industry in Ukraine.
ANALYSIS OF THE ROLE OF CENTRAL CHOLINOREACTIVITY IN EXPERIMENTAL TRAUMATIC BRAIN INJURY
Authors: Khudoley Sergey
Published: November 2020

The aim of the research. To study effects of activation and inhibition of the central cholinergic systems (CCS) in traumatic brain injury (TBI). Studied problem. To investigate the influence of the reactivity of the central cholinergic systems on the course of the acute period of traumatic brain injury, in an acute experiment on laboratory animals in vivo. The main scientific results. It was found that in the acute period of TBI (the first three days), both activation and blockade of CCS led to a decrease in mortality, which was statistically confirmed only for their activation. The control group was characterized by the progression of neurological deficit, which was realized due to motor disorders and reflex sphere. Upon activation of the CCS, the degree of neurological deficit was significantly less than in other groups, but, nevertheless, it increased from 48 hours after the injury, as regards behavioral and consciousness disorders. Inhibition of cholinergic systems led to a sharp increase in neurological deficit in all areas immediately after injury, to a greater extent due to reflex disorders. This, together with a high mortality rate, indicated a negative effect of the pharmacological shutdown of CCS in TBI. The area of practical use of the research results. The obtained results will allow a deeper study of the influence of the central cholinergic systems on the course and descent of TBI. To develop effective methods of pharmacological correction in the treatment of patients in the acute period of TBI. Innovative technological product: pathogenetically substantiated medical treatment of the acute period of traumatic brain injury, development of new methods of pharmacological neuroprotection for persons with a priori high risk of injury, development of effective options for reducing mortality and disability from TBI. Scope of the innovative technological product. The important role of CCS in the realization of the response of the central nervous system to TBI was established, and the possibility of using pharmacological stimulation of the central nervous system with cholinomimetics of the central type of action was justified.
Predictive Validity of Entry Level Mathematical on Mathematical Knowledge of Pre-service Teachers for Teaching Basic School mathematics in Ghana
Authors: Kert Millicent Narh
Published: November 2020

Introduction: Knowledge about teaching mathematics remains a contentious issue in the preparation of pre-service teachers in Ghana. This study explored relationships among entry-level mathematical knowledge (ELMK), mathematics content knowledge (MCK) and mathematics pedagogical content knowledge (MPCK) scores of pre-service teachers in colleges of education (CoEs) in Ghana. Methods: The cross-sectional survey design was adopted for this study. A total of 998 pre-service teachers from ten (10) public colleges of education were sampled via multi-stage sampling technique. Structured questionnaire and unstructured observation schedule were used for the survey. College mathematics test results were used as secondary data. The data were analysed using descriptive statistics (frequency count, percentage) and inferential statistics (Pearson’s correlation, paired-samples t-test and regression analysis) with the aid of Statistical Package for Social Sciences software version 22. Results: The majority of pre-service teachers in Ghanaian colleges of education had average but relatively weak grades in ELMCK. ELMCK did not significantly predict pre-service teachers’ MCK statistically (p ≥ 0.05) although a statistically significant positive correlation existed between the variables. Although a negative correlation existed between ELMCK and PMCK, ELMCK significantly predicted pre-service teachers’ PMCK statistically (p ≤ 0.05) but the effect size was statistically negligible. Conclusions: This study concluded that, CoEs in Ghana admit pre-service teachers with average but weak grades in ELMK. Therefore, Ghanaian CoEs should structure and introduce PMCK alongside MCK for pre-service teachers. Mathematics tutors in CoEs should organize remedial lessons for pre-service teachers to scale-up their MCK and PMCK that adequately equip them with MKT. Keywords: Entry-level mathematical knowledge (ELMK), mathematics content knowledge (MCK), mathematics pedagogical content knowledge (MPCK), mathematical knowledge for teaching (MKT), pre-service teachers.
Effect of Inquiry-Based Teaching Method on Students Achievement and Retention of Concepts in Integrated Science in Senior High School
Authors: Issaka Mohammed
Published: November 2020

This study purposely investigated the impact of using inquiry-based teaching method on students’ academic achievement and retention of concept in integrated science against the traditional method in some selected senior high schools in the Obuasi Municipality. The study also investigated the difference in the mean achievement score between male and female students taught integrated science using inquiry -based method. The sample for the study was 292 students in SHS two from Christ the King Catholic Senior High School and Obuasi Secondary Technical in the Obuasi Municipality. The sample were obtained through random sample technique. The experimental group received instructions in integrated science using inquiry-based method of teaching whereas the control group were taught with the traditional method. The data were collected through the use of pretest- posttest research design and were analyze according to the research question for the study. The main research question for the study was: What is the effect of inquiry-based method of teaching on students’ achievement and retention of concepts in integrated science? The results from the study indicates that the students in the experimental group performed better than the students in the control group. The findings also show that students who were instructed with inquiry-based method have higher retention capacity than their counterpart students who were exposed to traditional method. There was a slightly gender disparity in the achievement and retention capacity of both male and female students taught integrated science with inquiry-based method in favour of the male. This means that inquiry-based method is very rewarding to students in terms of achievement and retention regardless of gender.
Restrictions on the right to distribute information on the Internet in light of countering the spread of drugs
Authors:   St. Petersburg State University, Burlakov Vladimir N. , Plotkina Lilia N. ,   Herzen State Pedagogical University of Russia, Shchurova Anna S. ,   Ural Law Institute of the Ministry of Internal Affairs of the Russian Federation
Published: November 2020

Digitalization has led not only to the expansion of the sphere of people’s communication space, but also to more effective illegal acts with substances that are prohibited from being circulated, in particular, narcotic drugs and psychotropic substances, their analogues, or precursors (hereinafter abbreviated as drugs). Today, drug distribution has “gone online”, and the state is forced to restrict the right to freedom of information in order to make such distribution unsafe for drug traffickers. The article assesses the state of crimes committed in this area and analyzes the problem of the additional criminalization of actions that contribute to the spread of drugs through the use of the Internet. It is emphasized that the Internet’s capabilities contribute to drug trafficking to varying degrees, and specific actions are highlighted that increase drug use among the population. The authors come to the conclusion that the use of the Internet in drug crimes requires stricter responsibility not only for the sale of drugs, but also in relation to persuasion, both by involving a particular person in their consumption and by promoting drug use. Attention is paid to the psychological mechanism of drug dependence, the study of which is important for the prevention of drug related crimes. The conclusion is substantiated that the tendency to use drugs through the use of the Internet generates a combination of addictive behavior, in which there is interaction and complementarity in the quality of the impact on the person from the Internet and drugs. As a result, “Internet addiction” develops as a relatively new area of addiction. This explains why the first victims of the new addiction are teenagers who are firmly “stuck in the Internet web”, and how the negative impact of this web can be reduced.
Waiver of rights in Russian criminal procedure: Issues of theory, legislative regulation, and law enforcement
Authors:   Southwest State University, Chebotareva Irina N.
Published: November 2020

The article discusses the waiver of procedural rights as a particular legal phenomenon. The rationale for studying the waiver of rights in the Russian criminal procedure doctrine arises from the expansion of the spheres of disposition and adversarial nature in present-day Russian criminal procedure. In order to form an overall picture of the ‘waiver of rights’, the article describes its distinctive features and elements that characterize it. Additionally, the theoretical aspects of the waiver of rights in present-day Russian criminal procedures, as well as the legal regulation of a waiver, are analyzed. A waiver of subjective rights is understood as an expression of a legal person’s will in terms of failure to behave as provided for by objective law, which is characterized by voluntariness, awareness, and freedom of choice. It is asserted that any non-realization of rights by a subject is not considered a waiver. The difference is demonstrated in the understanding of the concept ‘waiver of rights’ in the approaches of the European Court of Human Rights, the Constitutional Court of the Russian Federation, as well as in the interpretation of the rules of criminal procedural legislation, which regulates a person’s ability to waive the rights granted to them by the Supreme Court of the Russian Federation. The article states that the disposition principle of legal regulation, applied by the legislator to participants in criminal proceedings defending their personal interests, presupposes the legislatively established possibility of a person to refuse to exercise the right unless it violates the more important public interest. Attention is given in the article to the necessity of guarantees that ensure voluntariness, awareness, and freedom of choice in case of a person’s waiver of their rights.