bluuebunny/crossref_metadata_2025 huggingface dataset:
MRI evaluation of nerve root avulsion in neonatal brachial plexus palsy: understanding the presence of isolated dorsal/ventral rootlet disruption
Authors: Smith Brandon W. , Chang Kate W. C. , Parmar Hemant A. , Ibrahim Mohannad , Yang Lynda J. S.
Published: March 2021

OBJECTIVE

The evaluation, treatment, and prognosis of neonatal brachial plexus palsy (NBPP) continues to have many areas of debate, including the use of ancillary testing. Given the continued improvement in imaging, it is important to revisit its utility. Nerve root avulsions have historically been identified by the presence of pseudomeningoceles or visible ruptures. This “all-or-none” definition of nerve root avulsions has many implications for the understanding and management of NBPP, especially as characterization of the proximal nerve root as a potential donor remains critical. This study examined the ability of high-resolution MRI to more specifically define the anatomy of nerve root avulsions by individually examining the ventral and dorsal rootlets as they exit the spinal cord.

METHODS

This is a retrospective review of patients who had undergone brachial plexus protocol MRI for clinical evaluation of NBPP at a single institution. Each MR image was independently reviewed by a board-certified neuroradiologist, who was blinded to both established diagnosis/surgical findings and laterality. Each dorsal and ventral nerve rootlet bilaterally from C5 to T1 was evaluated from the spinal cord to its exit in the neuroforamen. Each rootlet was classified as avulsed, intact, or undeterminable.

RESULTS

Sixty infants underwent brachial plexus protocol MRI from 2010 to 2018. All infants were included in this study. Six hundred individual rootlets were analyzed. There were 49 avulsed nerve rootlets in this cohort. Twenty-nine (59%) combined dorsal/ventral avulsions involved both the ventral and dorsal rootlets, and 20 (41%) were either isolated ventral or isolated dorsal rootlet avulsions. Of the isolated avulsion injuries, 13 (65%) were dorsal only, meaning that the motor rootlets were intact.

CONCLUSIONS

A closer look at nerve root avulsions with MRI demonstrates a significant prevalence (approximately 41%) of isolated dorsal or ventral nerve rootlet disruptions. This finding implies that nerve roots previously labeled as “avulsed” but with only isolated dorsal (sensory) rootlet avulsion can yet provide donor fascicles in reconstruction strategies. A majority (99%) of the rootlets can be clearly visualized with MRI. These findings may significantly impact the clinical understanding of neonatal brachial plexus injury and its treatment.
The minimally invasive interbody selection algorithm for spinal deformity
Authors: Mummaneni Praveen V. , Hussain Ibrahim , Shaffrey Christopher I. , Eastlack Robert K. , Mundis Gregory M. , Uribe Juan S. , Fessler Richard G. , Park Paul , Robinson Leslie , Rivera Joshua , Chou Dean , Kanter Adam S. , Okonkwo David O. , Nunley Pierce D. , Wang Michael Y. , Marca Frank La , Than Khoi D. , Fu Kai-Ming , _ _
Published: March 2021

OBJECTIVE

Minimally invasive surgery (MIS) for spinal deformity uses interbody techniques for correction, indirect decompression, and arthrodesis. Selection criteria for choosing a particular interbody approach are lacking. The authors created the minimally invasive interbody selection algorithm (MIISA) to provide a framework for rational decision-making in MIS for deformity.

METHODS

A retrospective data set of circumferential MIS (cMIS) for adult spinal deformity (ASD) collected over a 5-year period was analyzed by level in the lumbar spine to identify surgeon preferences and evaluate segmental lordosis outcomes. These data were used to inform a Delphi session of minimally invasive deformity surgeons from which the algorithm was created. The algorithm leads to 1 of 4 interbody approaches: anterior lumbar interbody fusion (ALIF), anterior column release (ACR), lateral lumbar interbody fusion (LLIF), and transforaminal lumbar interbody fusion (TLIF). Preoperative and 2-year postoperative radiographic parameters and clinical outcomes were compared.

RESULTS

Eleven surgeons completed 100 cMISs for ASD with 338 interbody devices, with a minimum 2-year follow-up. The type of interbody approach used at each level from L1 to S1 was recorded. The MIISA was then created with substantial agreement. The surgeons generally preferred LLIF for L1–2 (91.7%), L2–3 (85.2%), and L3–4 (80.7%). ACR was most commonly performed at L3–4 (8.4%) and L2–3 (6.2%). At L4–5, LLIF (69.5%), TLIF (15.9%), and ALIF (9.8%) were most commonly utilized. TLIF and ALIF were the most selected approaches at L5–S1 (61.4% and 38.6%, respectively). Segmental lordosis at each level varied based on the approach, with greater increases reported using ALIF, especially at L4–5 (9.2°) and L5–S1 (5.3°). A substantial increase in lordosis was achieved with ACR at L2–3 (10.9°) and L3–4 (10.4°). Lateral interbody arthrodesis without the use of an ACR did not generally result in significant lordosis restoration. There were statistically significant improvements in lumbar lordosis (LL), pelvic incidence–LL mismatch, coronal Cobb angle, and Oswestry Disability Index at the 2-year follow-up.

CONCLUSIONS

The use of the MIISA provides consistent guidance for surgeons who plan to perform MIS for deformity. For L1–4, the surgeons preferred lateral approaches to TLIF and reserved ACR for patients who needed the greatest increase in segmental lordosis. For L4–5, the surgeons’ order of preference was LLIF, TLIF, and ALIF, but TLIF failed to demonstrate any significant lordosis restoration. At L5–S1, the surgical team typically preferred an ALIF when segmental lordosis was desired and preferred a TLIF if preoperative segmental lordosis was adequate.
Kauts Ruth. Christianity in the Work of Bakhtin (Ch. 1) Translation from English: Coates Ruth. Christianity in Bakhtin. Cambridge: Cambridge University Press, 1998.
Authors: Барицкий Дмитрий
Published: March 2021

Личность и творчество выдающегося русского мыслителя М. М. Бахтина (1895–1975) в последнее время всё больше и больше становится предметом пристального внимания учёных. Несмотря на существование множества работ, которые посвящены философской, культурологической, эстетической проблематике его произведений, практически совершенно игнорируется вопрос о религиозной составляющей наследия М. М. Бахтина. Английская исследовательница Рут Коутс (Ruth Coates) ставит перед собой задачу восполнить эту лакуну. В своей монографии «Christianity in Bakhtin» («Христианство в творчестве Бахтина») она предлагает нашему вниманию результаты своего анализа как религиозных взглядов самого М. М. Бахтина, так и религиозных мотивов его творчества. Монография была издана в издательстве «Cambridge University Press» в 1998 году. Настоящая публикация открывает серию статей, цель которых — познакомить русскоязычного читателя с содержанием наиболее важных разделов данного исследования.

The personality and work of the outstanding Russian thinker M.M. Bakhtin (1895-1975) have recently become an increasingly important subject of scholarly attention. Despite the existence of many works devoted to philosophical, culturological, aesthetic problems of his works, the question of the religious component of Mikhail Bakhtin's heritage is almost completely ignored. The British researcher Ruth Coates sets herself the task of filling this gap. In her monograph Christianity in Bakhtin, she presents the results of her analysis of both Bakhtin's own religious views and those of Bakhtin. Bakhtin, as well as the religious motifs in his works. This monograph was published by Cambridge University Press in 1998. The present publication opens a series of articles, the purpose of which is to acquaint the Russian-speaking reader with the contents of the most important sections of this study.
Анализ параметров ультразвуковых сигналов при высокоскоростном контроле рельсов
Authors: Марков А.А. , Максимова Е.А.
Published: March 2021

The results of studies of changes in the parameters of ultrasonic (US) signals with an increase in the speed of rail testing are presented. Signals from rail bolt holes were selected as test reflectors. It is shown that the holes closest to the rail joint are not fully sounded, and the signals from them cannot be used as test reflectors. For a full assessment of the decrease in the quality of non-destructive testing of rails with an increase in the scanning speed, it is proposed to use the integral parameter of the analyzed reflector. A noticeable decrease in this parameter at high speeds requires a trade-off when choosing between productivity and quality rail testing. The proposed technique can be used to assess the efficiency of operating and newly created flaw detection systems. The necessity of improving the methods of sounding the first bolt holes of joints and correcting regulatory documents for high-speed testing of rails is substantiated.
Implementation of upselling as a strategy in increasing room sales by guest relation host at Alila Seminyak Hotel
Authors:   Politeknik Negeri Bali, Meliarini Putu Risky , Sudiarta Made ,   Politeknik Negeri Bali, Darlina Lien ,   Politeknik Negeri Bali
Published: March 2021

The purpose of this research is to determine the implementation of upselling as a strategy in increasing room sales at Alila Seminyak hotels and to find out alternative upselling strategies that should be implemented by Guest Relations Hosts in increasing room sales at Alila Seminyak hotels. The analysis technique used is the Sequential Exploratory mixed method design; Internal Factor Summary (IFAS) Matrix, External Factor Analysis Summary (EFAS) Matrix, Internal-External (IE) Matrix, SWOT analysis, and Quantitative Strategic Planning Matrix (QSPM). The analysis result of the IFAS matrix with the main strength is that the Alila Seminyak hotel has ten types of rooms that can support upselling activities to guests and can increase room sales, while the main weakness is the lack of providing special prices for guests who upselling. The analysis result of the EFAS matrix is that the main opportunity is the friendliness of the community, environment, and culture around the Alila Seminyak hotel, while the main threat is the tax policy that applies to tourists who are taken into consideration when wanting to upselling. Based on the results of the IE matrix analysis, the Alila Seminyak hotel is in the position of Growth Strategy (Cell II). The results of the SWOT analysis resulted in nine alternative upselling strategies, where three alternative upselling strategies were prioritized which were calculated by the QSPM matrix with a total TAS 232.64, 225.55, and 216.54.
The application of hotel strategies based on factor analysis to improve the number of events at The Trans Resort Bali
Authors:   Politeknik Negeri Bali, Kusuma I Putu Yana Arya , Aryana I Nyoman Rajin ,   Politeknik Negeri Bali, Sari I Gusti Agung Mas Krisna Komala ,   Politeknik Negeri Bali
Published: March 2021

This research was conducted at The Trans Resort Bali, a 5-stars hotel located in Seminyak, Badung, Bali. The purposes of this research was to found out the factors affected the customers’ decision to hold an event, found out the most dominant factor and found out the strategies should be applied to maintain the factors and improve the number of events at The Trans Resort Bali. The sample was 74 respondents using cluster sampling technique. The steps taken in data processing was looking for the results of the validity test and the reliability test of the data, after that factor analysis consist of 6 steps. Based on the results of the research, there were 4 factors affecting the customers’ decision to hold events at The Trans Resort Bali. These factors are facility and environmental factors with a percentage of the variance of 46.193%, service quality factors with a percentage of the variance of 5.928%, information factors with a percentage of the variance of 5.503% and promotion factors with a percentage of the variance of 5.294%. The value of the accuracy of the model is 60% with a residual of 40%. From the 4 factors were found the most dominant factor which is facilities and environment factors consist of 4 variables, namely (1) Ballroom & Boardroom that is luxurious and spacious, (2) attractive and luxurious venue design, (3) strategic hotel location and (4) complete meeting and event facilities.
Development of ecotourism potential in Sambori Tribe, Bima, West Nusa Tenggara, Indonesia
Authors:   Taman Siswa Teacher Training and Education College, Zulharman Zulharman , Noeryoko Mochamad ,   Taman Siswa Teacher Training and Education College, Khaldun Ibnu ,   Taman Siswa Teacher Training and Education College
Published: March 2021

The purpose of this research is to explore the potential of ecotourism that can be developed in Sambori Tribe, Bima. Besides, to identify the right strategy for developing ecotourism on family medicinal plants in Sambori Tribe based on community and stakeholder perceptions. The research method used was descriptive methods with survey and observation techniques. The study using purposive sampling to get the correct data. The data is in the form of local herbal products developed into tourism destinations and economic benefits that are to improve the economic welfare of marginalized communities. Aspects of the development include flora in the form of herbs, fauna, natural attractions with a view of the mountains with cool air. in addition, this herbal plant can improve the accessibility and socio-cultural life of the community. Furthermore, the improvement of quality of life in Sambori, Bima is carried out through herbal obar plants to improve the quality of healthy life as well as an area with the potential of herbal plant ecotourism. It has a diversity of flora and fauna potentials as well as a very suitable landscape potential as a tourist attraction. The result of the study found that Sambori Tribe has the potential of flora and fauna and the landscapes.Public health development strategies in the future, not only can be done in hospitals, it can also be done at home through live pharmacies based on medicinal family plants that can be used as an improvement of public health, economy and ecotourism in the Sambori Tribe. in addition, with the potential of live pharmacies, will have an impact on the appeal of high biological nature with a beautiful natural panorama.
The outbreak of COVID-19 and its impact in South Korea’s Tourism: A hope in Domestic Tourism
Authors:   Ajou University, Gurung Kapil
Published: March 2021

The recent COVID-19 pandemic has resulted an unprecedented impact on global economy. However, South Korea is effectively controlling the pandemic by implementing different level of social distancing measure. Most of the events are either postponed or cancelled and public places are operating by maintaining social distance and mandatory use of mask. Therefore, the aim of this study is to investigate the future impact on tourism and hospitality industry caused by social distancing due to pandemic. The conceptual methodology was used to discuss on the secondary data from various sources. The finding states that the flight operations were halted, hotel occupancy reduced, and employees forced to take unpaid leave. In addition, the result discussed on the negative impact on tourism and hospitality sector due to pandemic. This paper concludes with few positive signs in domestic tourism sector and suggestion for authority to execute best policy in future for whole tourism industry.
ANALISA MODIFIKASI ALGORITMA STEMMING UNTUK KASUS OVERSTEMMING
Authors: Rossi Hersianie Stephanie Betha
Published: March 2021

Overstemming merupakan pemenggalan kata ke bentuk asal (root word) yang berlebihan. Hal ini menyebabkan kata tersebut bermakna sangat berbeda dengan kata asal. Namun, stem yang dihasilkan sama bentuknya. Untuk mengatasi permasalahan tersebut, penelitian sebelumnya telah menerapkan algoritma stemming dengan tabel aturan kata. Namun kekurangan dari tabel aturan kata ini adalah kesulitan dalam menambahkan jenis kata yang mengalami overstemming. Oleh karena itu, penelitian ini bertujuan untuk memodifikasi algoritma overstemming tersebut. Penelitian ini akan menggabungkan algoritma stemming (hybrid stemming) yaitu algoritma look-up table, tabel aturan kata dan algoritma stemming Porter yang biasa digunakan. Dataset yang digunakan dalam pengujian adalah atribut judul pada dokumen publikasi ilmiah. Hasil pengujian menunjukkan bahwa modifikasi algoritma stemming menghasilkan recall sebesar 89, 9%.Saran untuk penelitian selanjutnya adalah pengujian dapat dilakukan menggunakan atribut lainnnya pada dokumen publikasi.
Antibiotic resistance of intestinal strains of Kl. pneumoniae in newborns in a maternity hospital
Authors:   Kazan (Volga) State Medical University, NIKOLAEVA I. V. , SHAIKHIEVA G. S. ,   Republican Clinical Infectious Hospital named after Prof. A.F. Agafonov, GRIGORYEVA T. V. ,   Kazan Federal University, VASILYEV I. U. ,   Kazan Federal University, GERASIMOVA E. S. ,   CITILAB Association of Clinical Diagnostic Laboratories, VASILYEV I. U. ,   Kazan Federal University, GERASIMOVA E. S. ,   CITILAB Association of Clinical Diagnostic Laboratories, LEONTIEVA N. S. ,   CITILAB Association of Clinical Diagnostic Laboratories
Published: March 2021

Antibiotic resistance and resistome of intestinal strains of Kl. pneumoniae colonizing healthy babies in maternity hospitals were studied. According to the results of phenotype studies, Kl. pneumoniae in 92,3% of cases were ESBL producers and showed resistance to ampicillin, amoxiclav, co-trimoxazole, less to ciprofloxacin and nitrofurantoin. 90% of intestinal Kl. pneumoniae had multiple resistance to antimicrobial drugs. According to a genome-wide study, beta-lactamase genes were found in all strains. blaOXA-1 was found in 60%, blaTEM-30 in 70%, blaCTX-M-15 in 70%, blaSHV in 100% of the strains. Genes for resistance to aminoglycosides were found in 90%, fluoroquinolones — in 40%, sulfonamides — in 80%, chloramphenicol — in 70%, tetracycline — in 50%, and trimethoprim – in 70% of Kl. pneumoniae strains.
Features of the placental microbiota in premature rupture of membrane at full-term pregnancy
Authors:   Samara State Medical University, KAGANOVA M. A. , SPIRIDONOVA N. V. ,   Samara State Medical University, KATYUSHINA V. O. ,   Samara State Medical University
Published: March 2021

The purpose — to study the microbial placental landscape at premature rupture of membrane (PROMt) in comparison with intact membranes at full-term pregnancy. Material and methods. At the City Clinical Hospital No. 1 named after N.I. Pirogov, 43 pregnant women at 37–41 weeks of gestation (24 persons with PROMt in the main group and 19 patients in the control group with intact membranes) placental tissue were taken during elective cesarean section for RT-PCR of the following microorganisms: Lactobacillus spp, Enterobacteriaceae, Streptococcus spp., Staphylococcus spp., Gardnerellavaginalis / Prevotella bivia / Porphyromonas spp., Eubacterium spp., Sneathia spp. / Leptotrihia spp. / Fusobacteriumspp, Megasphaera spp. / Veillonella spp. / Dialister spp., Lachnobacterium spp. / Clostridium spp., Mobiluncus spp. / Corynebacterium spp., Peptostreptococcus spp., Atopobiumvaginae, Mycoplasma hominis, Ureaplasma (urealyticum + parvum), Candida spp., Mycoplasma genitalium. Results. The presence of a total bacterial mass of 103.1–104.5 Ge/sample was revealed at the placenta of full-term pregnancy. Sterile placentas were found both in the control (21,1%) and in the main groups (41,6%). In the placenta samples, we observed the predominance of the laboratory total bacterial mass (TBM) over the calculated one, i.e. they contained DNA of microorganisms that was not identified by the standard panel — the «unidentifiable» microorganisms (in the main group — 25,0% and in the control group — 52,6%). Enterobacteriaceae spp. (102,6 Ge/sample) were detected on the placental tissues of the patients with intact membrane. The placental microflora is gradually replaced by the vaginal one, obligate and facultative microflora of the vaginal biotope appeared. The presence of Lactobacillus spp. in placental tissues is characteristic only for patients with PROMt. Conclusion. A small amount of bacterial mass can be detected by RT-PCR at the physiologically full-term pregnancy, represented by Enterobacteriaceae spp. Lactobacillus spp. and anaerobic vaginal flora are also detected on placental samples at full-term pregnancy with PROMt.
Optimization of treatment of lymphopharyngeal ring organ hypertrophy in children infected with herpes viruses
Authors:   Kazan (Volga) State University, Pokrovskaya E. M. , Khaliullina S. V. ,   Kazan State Medical University, Anokhin V. A. ,   Kazan State Medical University, Khaliullina K. R. ,   Kazan State Medical University, Khaertinov Kh. S. ,   Kazan State Medical University, Krasnozhen V. N. ,   Kazan State Medical Academy — Branch Campus of the FSBEI FPE RMACPE MOH Russia
Published: March 2021

The aim of the work is to evaluate the prevalence of herpes virus infection of nasopharynx mucosa in children with hypertrophy of adenoid and palatine tonsils to improve the complex treatment methods. An open continuous prospective analytical study was carried out, which included examination and treatment of 186 patients with chronic adenoiditis. The patients were divided into three groups. The first group included 146 children with a diagnosis of adenoids grade 3 – 90 people; adenoids grade 3, hypertrophy of the tonsils grade 2-3 – 56 people. Endoscopic adeno- or adenotonsillotomy was performed in patients of the first group. Patients of the second group had adenoids grade 1–2 and received conservative treatment. Patients of the third group were children with compensatory hypertrophy of the palatine tonsils and recurrences of adenoids, who had a history of endoscopic anesthetic adenotomy. All patients were examined for the presence of Epstein-Barr and cytomegaloviruses DNA in swabs from the nasopharynx and oropharynx by PCR. The result was positive in 63.3% of patients with pharyngeal tonsil hypertrophy and in 76.8% of patients with pharyngeal and tonsil hypertrophy. The calculation of the odds ratio indicated that the probability of hypertrophy of these tonsils in children infected with herpes viruses is 3.3 times higher (OR 3.3; 95% CI 1.2-9.1) than in uninfected ones. Patients from the first group with a positive test result for herpes viruses, in addition to surgical and basic therapy, received a drug with antiviral and immunomodulatory activity. The results of endoscopic adenotomy and adenotonzillotomy in combination with the administration of etiotropic therapy indicated a high treatment efficiency.
Alport syndrome and the polypharmacy problem in the practice of ENT specialists
Authors:   Kazan State Medical University, MAMLEEV R. N. , SINCHUGOV A. V. ,   Children’s Republican Clinical Hospital, Ministry of Health of Republic of Tatarstan, ASADULLINA R. M. ,   Kazan State Medical University
Published: March 2021

Genetically determined diseases, Alport syndrome in particular, are traditionally the object of polypharmacy. The addition of intercurrent infection aggravates this situation, since it requires comedication directed at the focus of infection. Multiple drug interactions, which lead to a weakening of the therapeutic effect of some drugs and increase the toxic potential of others, require attention from all participants of the therapeutic process.
Critical heart disease (atresia of the pulmonary artery with an intact interventricular septum) in pediatric practice
Authors:   Kazan State Medical University Ministry of Health of the Russian Federation, SADYKOVA D. I. , SABIROVA D. R. ,   Kazan State Medical University Ministry of Health of the Russian Federation, SOLOVYEVA N. A. ,   Kazan State Medical University Ministry of Health of the Russian Federation, KULAKOVA G. A. ,   Kazan State Medical University Ministry of Health of the Russian Federation, KURMAEVA E. A. ,   Kazan State Medical University Ministry of Health of the Russian Federation, MALOV A. A. ,   Kazan State Medical University Ministry of Health of the Russian Federation, KOCHETKOVA T. I. ,   Children’s Republican Clinical Hospital of the Ministry of Health of Republic of Tatarstan
Published: March 2021

Atresia of the pulmonary artery with an intact interventricular septum is a rare critical heart disease (CHD) in which there is no communication between the right ventricle and the pulmonary artery and the life of a newborn depends on the functioning of the open arterial duct. The article presents a clinical observation of a child diagnosed in the first hours of life with Atresia of the pulmonary artery valve. Open arterial duct. Open oval window. Ductus-dependent pulmonary circulation. In the Cardiac Surgery Department, an operation was performed: open valvuloplasty of the pulmonary artery valve and creation of a systemic pulmonary anastomosis in modification. After discharge on the 18th day of life, the patient was under the supervision of a district pediatrician with regular monitoring of clinical and laboratory data and instrumental research methods (ECG, echocardiography, measurement of oxygen saturation) and consultation with a cardiologist and cardiac surgeon. At the age of 2 years 5 months radical surgery was performed: Plastic valve pulmonary artery, tricuspid valve plasty, plasty of the right branch of the pulmonary artery, the elimination of systemic-pulmonary anastomosis, plastic ASD in conditions of artificial circulation. The patient was discharged with recovery. Careful monitoring of the child’s health by a pediatrician, cardiologist and cardiac surgeon allowed preventing the occurrence of complications in the postoperative period and determining the optimal timing of anatomical radical correction of the defect, which led to full recovery and ensured the harmonious development of the girl.
Clinical case of infective endocarditis
Authors:   Family Medicine Center LLC, ISAKOVA E. Yu. , ATAMANOVA T. Yu. ,   Family Medicine Center LLC
Published: March 2021

The article presents the results of clinical observation of a patient with a favorable course and outcome of infective endocarditis in the presence of pronounced echocardiographic changes that arose during long-term follow-up of the patient for the underlying disease (hypertension). The clinical characteristics of the disease, the dynamics of instrumental, and the laboratory data during therapy are presented. The diagnosis of infective endocarditis was established by a team of doctors according to the modified Duke criteria (according to Li): one large criterion — echocardiographic signs (vegetation on the valve), one small criterion — chronic rheumatic heart disease, chronic tonsillitis. Information on the infective endocarditis development against the background of chronic rheumatic heart disease in identical twins is presented.
Predicting the effectiveness of rehabilitation treatment for obese children in a polyclinic
Authors:   Yaroslavl State Medical University, MASKOVA G. S.
Published: March 2021

The purpose — to create a model for predicting the effectiveness of rehabilitation of obese children based on the consideration of risk factors. Material and methods. The study involved 250 children of 7–14 years old with obesity of 1–3 degrees, who received rehabilitation during 2 months in a children’s polyclinic. Before interventions, the children were assessed for anamnestic data, clinical status, dietary and physical activity stereotypes. The assessment of the rehabilitation effectiveness was carried out based on the clinical, functional and emotional status of the child and the calculation of the effectiveness of rehabilitation coefficient (ERC). A comparative analysis of the prevalence of risk factors in 2 groups of children was carried out, depending on the ERC: positive or negative. Statistical analysis was performed using the Kruskalm — Wallis and Kendall Tau methods, the risk and odds ratios were estimated, the ROC analysis procedure was performed. Statistical significance was p < 0,05. Results. The factors influencing the rehabilitation effectiveness were as follows: obesity in first-line relatives; the body fat and body mass indices, abdominal obesity, thyroid enlargement, muscle strength endurance, systolic blood pressure, self-esteem of health, excess food intake, frequency of a weekly milk consumption, frequency of drinking water during the day, frequency of shopping, sleep regularity, and daily exercise. The model for predicting the rehabilitation effectiveness was created based on one-step accounting of risk factors, the predictive power of was 91%. Conclusion. The оne-time consideration of risk factors allows identifying children with a positive and negative prognosis of rehabilitation.Children with a positive prognosis were directed to a polyclinic for rehabilitation, and among children with a negative prognosis, the reasons for the alleged failure were determined (secondary nature of obesity, insufficient physical activity of the offered programs, etc.).
Cerebral microangiopathy (disease of small blood vessels) and age-related hypogonadism in men
Authors:   Каzan State Medical University, GAIFUTDINOV R. T.
Published: March 2021

The review discusses the contribution of age-related male hypogonadism to the formation of cerebral microangiopathy (disease of small brain vessels) (CMA/SVD). The current explanation of the nature of CMA by an ischemic-hypoxic process, which is based on hypo- or hyperperfusion of the white matter of brain due to a complex of various causes, does not explain the etiopathogenesis of CMA. The article considers a violation of the neuroglyovascular connection, represented by a vessel, astrocytic glia, and a neuron, as the cause of SVD development. The main role in the CMA formation is assigned to endothelial dysfunction, all variants of which (vasomotor, thrombophilic, adhesive, angiogenic) can be traced in SVD. The role of disorders of the main functions of arterial vessels — conducting and damping, as well as liquorodynamics disorders in the CMA pathogenesis is discussed. The data indicating the involvement of testosterone and its derivatives in the formation of cerebral vascular pathology are presented. It is emphasized that this participation can be of one kind in men with early physiological uncomplicated hypogonadism, when the hypothalamic-pituitary system is involved in the process, and of another kind in complicated or late climax. At that, an increase in the production of gonadotropin — releasing hormone (GnRH), the content of FSH and LH in peripheral blood is considered as a reaction to an age-related decrease in androgen function, and the vegetative dysfunction, metabolic and other disorders inherent in this period of life – as a result of changes in the functioning of the entire hypothalamus-pituitary-testicular axis. In complicated age-related hypogonadism, the resulting endocrine or somatic pathology is included in the process of small vessel disease formation. In late hypogonadism, the androgen function fades, and the hypothalamic-pituitary system begins to function in a different mode. Often, the clinic and mechanism of CMA formation are determined by diseases inherent in old age. The differences in the pathogenetic mechanisms of CMA development at various periods of IgG determine the need for a differentiated approach to the preventive means and methods of CMA therapy in men of the involutional period. The presented information may be useful for better understanding of CMA development in individuals with age-related hypogonadism.
Association of RS2498796 gene АКТ1 polymorphism with the risk of endometrial hyperplasia
Authors:   Kazan State Medical University, GABIDULLINA R. I. , NUHBALA F. R. ,   Kazan State Medical University, SMIRNOVA G. A. ,   Kazan State Medical University, VALEEVA E. V. ,   Kazan State Medical University, GARIPOVA G. Kh. ,   City Clinical Hospital № 7
Published: March 2021

The purpose — to estimate the prevalence of rs2498796 polymorphism of the АКТ1 gene and reveal its association with the risk of endometrial hyperplasia. Material and methods. The study included 180 residents of the Republic of Tatarstan: 79 patients with endometrial hyperplasia, 101 women without endometrial pathology. Determination of rs2498796 polymorphism of the АКТ1 gene was carried out by the method of real time polymerase chain reaction. The study performed a χ2 test and evaluated the odds ratio. Results. The ratio of homozygous for the allele C (C/C), heterozygous (C/T) and homozygous for the allele T (T/T) rs2498796 of the AKT1 gene was in the main group 35 (44,3%), 30 (38%), and 14 (17,7%), in the control group – 46 (45,5%), 45 (44,6%), and 10 (9,9%) respectively. The frequency of the T allele and the C allele rs2498796 in women with endometrial polyps was comparable to that in the control group (χ2=0,81, р=0,37). Conclusion. Among 180 females of the Republic of Tatarstan included into the study, the associations of rs2498796 polymorphism of the АКТ1 gene with the risk of endometrial hyperplasia were not identified.
Primary hyperoxaluria: diagnostics, treatment, outcomes
Authors:   Belarusian State Medical University, BAIKO S. V.
Published: March 2021

Primary hyperoxaluria (PH) is a rare autosomal recessive disease caused by defects in liver glyoxylate metabolism and leading to overproduction of oxalates. Of the three types of PH, type I is the most common and severe form of the disease, which is caused by deficiency or loss of the liver-specific, vitamin B6-dependent, peroxisomal enzyme alanine-glyoxylateaminotransferase (AGT). In all types of PH, urinary excretion of oxalate is strongly elevated (> 1 mmol /1,73 m2/24 h), which results in recurrent urolithiasis and/or progressive nephrocalcinosis and subsequently, with a decrease in glomerular filtration rate (GFR), to the deposition of oxalates in the tissues of the body and the development of systemic oxalosis. PH type I is diagnosed late, in > 30% of patients already at the terminal stage of renal disease (ESRD). Every fourth patient with PH type II achieves ESRD, but cases of ESRD in type III are extremely rare. The diagnosis of PH is based on clinical and imaging (ultrasound, X-ray, CT scan) findings, urine oxalate assessment, genetic analysis. Early initiation of conservative treatment (high fluid intake, sodium citrate, etc.) is aimed at preserving renal function. Pyridoxine treatment can be effective in about 30% of patients with PH type I. Time on dialysis in anticipation of transplantation should be short to avoid overt systemic oxalosis. Transplantation methods depend on the type of PH and on the degree of GFR reduction, but combined liver and kidney transplantation is the method of choice in patients with primary hyperoxaluria type I. High index of clinical suspicion of PH must be in patients with nephrocalcinosis and/or recurrent urolithiasis, especially if urinary stones are predominantly whewellite (calcium oxalate monohydrate) in order to start early conservative treatment and preserve kidney function.
Quasiallergy to β-lactam antibiotics as a predictor of therapeutic failures in the treatment of acute otitis media in children
Authors:   Kazan State Medical University, MAMLEEV R. N. , LUCHKINA E. V. ,   Children’s Republican Clinical Hospital, Ministry of Health of Republic of Tatarstan, ANDREEVA I. G. ,   Children’s Republican Clinical Hospital, Ministry of Health of Republic of Tatarstan
Published: March 2021

The wrong choice of starting antibiotic is one of the reasons for therapeutic failure in the treatment of acute otitis media in children. Currently, in Russia and around the world, macrolides are frequently used — drugs with low activity against Streptococcus pneumoniae. Prescription of macrolides in otiatrics is associated with the fear of allergies to β-lactam antibiotics (penicillins, cephalosporins), but this fear is highly hypertrophied and true anaphylaxis is extremely rare. Most often, there is a phenomenon of quasiallergy — a skin rash that is not associated with an allergy to an antibiotic. A detailed allergological history and the use of a proven algorithm of antibiotic therapy allow avoiding unnecessary frequent prescribing of macrolides and provide effective control over the focus of infection.
Lymphadenopathies in pediatric practice
Authors:   Kazan State Medical University, PIKUSA O. I. , SAMORODNOVA E. A. ,   Kazan State Medical University
Published: March 2021

The purpose — to present the information on the main causes of lymphadenopathies in children and the stages of differential-diagnostic search which complicate diagnosing and determining the treatment tactics. Material and methods. Analysis of literature data on lymphadenopathies in children, features of clinical manifestations under tumorous and non-tumorous etiology of the disease, and approaches to differential diagnostics. Results. The article presents the general information on etiology and classification of the characteristic clinical symptoms of lymphadenopathies in children, which are necessary for a pediatrician to determining the treatment tactics of a patient with this pathology. Conclusion. For duly diagnosing a child with lymphadenopathy, a pediatrician should be aware of a wide range of nosologies and be attentive to any detail of the case history, clinical picture and laboratory examination data, as it may influence not only the treatment efficiency but even life forecast for the patient.
Endocrine orbitopathy and methods of its diagnostics
Authors:   Saratov State Medical University named after V.I. Razumovsky, BOLOTOVA N. V. , FILINA N. Yu. ,   Saratov State Medical University named after V.I. Razumovsky, POLYAKOV V. K. ,   Saratov State Medical University named after V.I. Razumovsky, ALDASHKIN S. Yu. ,   Saratov State Medical University named after V.I. Razumovsky
Published: March 2021

This paper presents literature data indicating the relevance of endocrine orbitopathy studies. In Russia, there are practically no specialized centers where patients with endocrine orbitopathy can receive a comprehensive interdisciplinary examination and treatment. There is no algorithm for examining patients with early signs of endocrine orbitopathy. At the same time, late diagnosis of this pathology, lack of stable compensation for functional disorders of the thyroid gland, and errors in determining the phase of the endocrine orbitopathy lead to irreversible loss of vision. Literature data show the need to develop new available methods for early diagnosis and monitoring of patients with endocrine orbitopathy.
Prospects of measuring stress proteins levels as markers of impaired adaptation in newborns
Authors:   Kazan State Medical University, LOSKUTOVA E. V. , VAKHITOV Kh. M. ,   Kazan State Medical University
Published: March 2021

The present literature review summarizes current information on the role of heat shock proteins in the genesis of physiological and pathological states in humans and animals. Their important role in controlling the process of proper protein folding into a spatial structure is noted, which is of key importance for the course of adaptive reactions. According to a number of sources, heat shock proteins also play a protective role in relation to the mitochondrial and nuclear structures of cells of various organs and systems. There is evidence of the heat shock proteins participation in the cytokine regulation system, the processes of peroxide homeostasis, energy exchange, etc. The authors suggest that studying their level in a premature newborn will create a more complete picture of the nature of stress reactions course and characteristics in the early neonatal period.
Role of the maternal microbiome in the pathogenesis of preeclampsia
Authors:   Institute of Fundamental Medicine and Biology of Kazan Federal University, ZHELEZOVA M. E. , BEKTUR B. K. ,   Department of the medico-sanitary unit of the Kazan Federal University, SHARIPOVA R. I. ,   Department of the medico-sanitary unit of the Kazan Federal University
Published: March 2021

The purpose — to conduct a systematic analysis of the modern Russian and foreign publications on the role of microbiome in preeclampsia pathogenesis. Material and methods. Analysis of the modern Russian and foreign publications over the past eight years on the PubMed platform, systematic reviews of Cochrane, MEDLINE, and Google Scholar was conducted. Results. Preeclampsia is a severe manifestation of placental dysfunction resulting from angiogenic imbalance and inflammation. For a long time, the «sterile uterus» paradigm rejected the possible role of bacteria in the pathogenesis of preeclampsia and other complications of pregnancy. The introduction of new molecular genetics diagnostic methods made it possible to confirm the presence of bacterial communities in the uterus, placenta and amniotic fluid. The physiological microbiome maintains gravidar homeostasis, but dysbiosis in various niches is a potential cause of inflammation and can lead to pathological pregnancy outcomes such as preterm labor and preeclampsia. Conclusion. The microbiome of the oral cavity, intestines, vagina, uterus and placenta may play a certain role in the preeclampsia pathogenesis.
Borderline states in the adaptation period of late-term premature infants
Authors:   Municipal Children’s Clinical Hospital № 1, VOLIANYUK E. V. , ZAKIROVA A. M. ,   Kazan State Medical University
Published: March 2021

The purpose — to promote neonatologists’ knowledge of borderline conditions in late-term premature infants during the adaptation period for timely implementation of disease prevention measures. Material and methods. 130 children in neonatal period were observed in Children’s Hospital № 1 in Kazan. The main group consisted of 87 late-term premature infants, the comparison group included 43 full-term newborns. Results. In late-term premature infants, borderline states included neonatal jaundice at almost twice higher rate than in full-term children; other states included neonatal tremor, impaired thermoregulation, hypoglycemia, and intestinal colic. Conclusion. Knowledge of borderline states and their clinical manifestations in late-term premature infants, a thorough differentiated integrated approach, and adherence to their observation algorithm allow for their adequate correction and timely exclusion of the emerging pathological changes that require special examination and treatment.
Plasma Amyloid-β in Relation to Antibodies Against Herpes Simplex Virus, Cytomegalovirus, and Chlamydophila pneumoniae
Authors: Lopatko Lindman Karin , Weidung Bodil , Olsson Jan , Josefsson Maria , Johansson Anders , Eriksson Sture , Hallmans Göran , Elgh Fredrik , Lövheim Hugo
Published: March 2021

Background:

Amyloid-β (Aβ), the key constituent of Alzheimer’s disease (AD) plaques, has antimicrobial properties.

Objective:

To investigate the association between plasma Aβ and antibodies against the AD-related pathogens herpes simplex virus (HSV), cytomegalovirus (CMV), and C. pneumoniae.

Methods:

Plasma from 339 AD cases, obtained on average 9.4 years (±4.00) before diagnosis, and their matched controls were analyzed for Aβ40 and Aβ42 concentrations with Luminex xMAP technology and INNOBIA plasma Aβ-form assays. Enzyme-linked immunosorbent assays were utilized for analyses of anti-HSV immunoglobulin (Ig) G, anti-HSV1 IgG, anti-HSV2 IgG, anti-CMV IgG, and anti- C. pneumoniae IgG. Follow-up samples were available for 150 of the cases.

Results:

Presence and levels of anti-HSV1 IgG, anti-HSV2 IgG, anti-CMV IgG, and anti- C. pneumoniae IgG did not correlate with concentrations of Aβ42 or Aβ40 in cases or controls.

Conclusion:

Levels of plasma Aβ were not associated with antibodies against different AD-related pathogens.
Exploring the Analytical, Normative and Transformative Dimensions of Earth System Law
Authors: Kotzé Louis J. , Kim Rakhyun E.
Published: March 2021

In this article we argue that international environmental law cannot continue to exist in its present form for the purpose of the Anthropocene. We show that analytically, international environmental law and its lawyers are unable to fully understand and respond to the complex governance challenges arising from a complex Earth system. Normatively, international environmental law has failed to provide appropriate norms to prevent humans from encroaching on Earth system limits. In a transformative sense, international environmental law has not been sufficiently ambitious to achieve the type of radical transformations necessary to ensure planetary integrity and socio-ecological justice. We need a new legal paradigm that is better suited for the purpose of the Anthropocene that must address international environmental law’s analytical, normative and transformative concerns. We call this new paradigm earth system law. Building on our recent work, we offer here some preliminary thoughts about what we think the analytical, normative, and transformative dimensions of earth system law could and should entail, and why they would be more appropriate for the purpose of governing a complex Earth system in the Anthropocene.
The Future of the Planetary Trust in a Kaleidoscopic World
Authors: Weiss Edith Brown
Published: March 2021

Today, it is evident that we are part of a planetary trust. Conserving our planet represents a public good, global as well as local. The threats to future generations resulting from human activities make applying the normative framework of a planetary trust even more urgent than in the past decades. Initially, the planetary trust focused primarily on threats to the natural system of our human environment such as pollution and natural resource degradation, and on threats to cultural heritage. Now, we face a higher threat of nuclear war, cyber wars, and threats from gene drivers that can cause inheritable changes to genes, potential threats from other new technologies such as artificial intelligence, and possible pandemics. In this context, it is proposed that in the kaleidoscopic world, we must engage all the actors to cooperate with the shared goal of caring for and maintaining planet Earth in trust for present and future generations.
The Framework of Ecological Law
Authors: Bosselmann Klaus
Published: March 2021

Environmental law has always been hampered by its reductionist approach to the natural environment or more precisely, to the human-nature relationship. In contrast, ecological law would encourage us to think about the law from an Earth-centered perspective. But even more than thinking about the legal issues, ecological law reflects and advocates a changed mindset. We need to develop a mindset that is conscious of what has worked in the past and what promises to work in the future. This could be addressed through development of eco-centric law, inclusion of eco-centric grundnorm, transforming law and governance, and institutionalizing trusteeship governance. At the end, it is proposed that ecological law would frame our thinking in a way that reflects not only the traditional values of connectedness with nature, but equally leading cutting-edge sciences of today such as ecology, earth system science and health sciences.
Automated Comparative Study of Some Generalized Rough Approximations
Authors: Grabowski Adam
Published: March 2021

The paper contains some remarks on building automated counterpart of a comparison of some generalized rough approximations of sets, where the classical indiscernibility relation is generalized to arbitrary binary relation. Our focus was on translating rationality postulates for such operators by means of the Mizar system – the software and the database which allows for expressing and checking mathematical knowledge for the logical correctness. The main objective was the formal (and machine-checked) proof of Theorem 4.1 from A. Gomolińska’s paper “A Comparative Study of Some Generalized Rough Approximations”, hence the present title. We provide also the discussion on how to make the presentation more efficient to reuse the reasoning techniques of the Mizar verifier.