bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring the Efficiency of Health Systems: A Case of Mental Health in Middle East and North Africa Countries
Authors: Safaei Lari Majid , Emamgholipour Sefiddashti Sara
Published: May 2021

Background: Mental disorders and problems put a heavy burden on communities. Since resources allocated to the mental health systems are finite, it seems necessary to assess the efficiency of mental health systems. In this study, we assess the efficiency of mental health care systems across 12 Middle East and North Africa (MENA) countries in 2014.
Methods: We used data envelopment analysis (DEA). The number of psychiatrists and nurses working in the mental health sector, the number of beds in mental hospitals, and the healthcare expenditures were included as inputs. The disability-adjusted life years (DALYs) of mental and substance use disorders was considered as the output. This approach is an input-oriented and a variable returns to scale.
Results: Countries such as Egypt, Iraq, Lebanon, and Qatar with the efficiency scores of 1.00 are entirely efficient. However, Bahrain and Iran with the efficiency scores of 0.50 and 0.58 are the most inefficient countries, respectively. After measuring the efficiency model, the radial super-efficiency showed that Egypt and Lebanon with the efficiency scores of 4.73 and 4.09 were ranked as the first and second by far. Qatar and Iraq compared with the previous analysis, and with the efficiency scores of 1.72 and 1.58, were ranked as the third and fourth. Bahrain and Iran were as inefficient as the previous model.
Conclusion: This study depicted a general portrait of the performance of mental health systems across MENA countries. Countries performed efficiently, have taken advantage of comprehensive programs in mental health sector. Countries are strongly recommended to complement their datasets of mental health to make future studies able to evaluate mental health systems more accurately and perfectly.
In Silico Comparison of Separate or Combinatorial Effects of Potential Inhibitors of the SARS-CoV-2 Binding Site of ACE2
Authors: Shakhsi-Niaei Mostafa , Heidari Soureshjani Ehsan , Kazemi Babaheydari Ali
Published: May 2021

Background: The COVID-19 is a pandemic viral infection with a high morbidity rate, leading to many worldwide deaths since the end of 2019. The RBD (Receptor Binding Domain) of SARS-CoV-2 through its spike utilizes several host molecules to enter host cells. One of the most important ones is the angiotensin-converting enzyme 2 (ACE2), an enzyme normally engaged in renin angiotensin pathway and is responsible for hypertension regulation. As different articles have analyzed separate compounds which can bind ACE2 as the potential virus entry blockers, and each one with a different molecular docking algorithm, in this study we compared all candidate compounds individually as well as their combinations using a unique validated software to introduce most promising ones.
Methods: We collected and prepared a list of all available compounds which potentially can inhibit RBD binding site of the ACE2 from different studies and then reanalyzed and compared them using the Patchdock (ver. 1.3) as a suitable molecular docking algorithm for analysis of separate compounds or their combinations.
Results: Saikosaponin A (e.g. in Bupleurum chinense), Baicalin (e.g. in several species in the genus Scutellaria), Glycyrrhizin (Glycyrrhiza glabra), MLN-4760 and Umifenovir better occupied ACE2 to inhibit viral RBD binding and are suggested as the top five inhibitors of the SARS-CoV-2 binding site of ACE2. Their combinatory effects were also inspiring concurrent ACE2 blockade.
Conclusion: The results propose greatest compounds and their combinatory anti-SARS-CoV-2 effects in order to decrease the time and expenses required for further experimental designs.
The Synergistic Combination of Cisplatin and Piperine Induces Apoptosis in MCF-7 Cell Line
Authors: Fattah Abolfazl , Morovati Ali , Niknam Zahra , Mashouri Ladan , Asadi Amirhooman , Tvangar Rizi Shirin , Abbasi Mojtaba , Shakeri Fatemeh , Abazari Omid
Published: May 2021

Background: Piperine is a natural compound obtained from the Piper nigrum that exhibits anti-proliferative and anti-cancer activity in cancer cell lines. We analyzed the cytotoxic effect of piperine combined with cisplatin compound in the human MCF-7 breast cancer cell line and the underlying mechanism.
Methods: The present in vitro study was performed on MCF-7 cell line in Jahrom University of Medical Sciences between, Jahrom, Iran from 2016 to 2017. Cultured MCF-7 cells were seeded into four groups: a control group (untreated group), a group treated with cisplatin, a group treated with piperine and a group treated with cisplatin and piperine. Cell viability was analyzed using the MTT assay method. Flow c-ytometric analysis was investigated for apoptosis. The mRNA and protein expression of the apoptotic regulators p53, Bcl-2, Bax, caspase 3 and caspase 9 were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting analysis.
Results: Piperine (20 and 30 µM) in combination with cisplatin (5, 10 and 15 µM) for 24 h synergistically inhibited cell viability of MCF-7 breast cancer cells more than piperine and cisplatin used alone. Synergistic antibreast cancer activities cisplatin (5 µM) and piperine (20 µM) were via inducing apoptosis. Piperine (20 µM) and cisplatin (5 µM) for 24 h induce apoptosis strongly through reduction of Bcl-2 and increase of caspase 3, p53, caspase 9, and Bax.
Conclusion: Piperine in combination with cisplatin could trigger p53-mediated apoptosis more effective than cisplatin alone in MCF-7 breast cancer cells, reducing the toxic dose of cisplatin used in cancer chemotherapy.
Effects of Seasonal Changes on the Patients Flux to Basic Health Units in Pakistan
Authors: Shirazi Jafir Hussain , Ishtiaq Ali Muhammad , Jamal Asif , Saqib Zafeer , Rashid Abdul
Published: May 2021

The article's abstract is not available.
An Analysis of the Effectiveness of Leg-Dropping from the Bed before and after Sleep in Correcting Pelvic Displacement
Authors: Lee Han Yong , Kim Beom Ho , Ju Sung Bum
Published: May 2021

The article's abstract is not available.
The Importance of Screening in Prevention of Postpartum Depression
Authors: Asgarlou Zoleykha , Arzanlou Mohammad , Mohseni Mohammad
Published: May 2021

The article's abstract is not available.
Negative Rhesus Antigen D in Childhood Leukemia: A Risk Factor or a Defense Mechanism?
Authors: Shahriari Mahdi , Dehghankhalili Saeid , Heiran Alireza , Daneshfard Babak
Published: May 2021

The article's abstract is not available.
Infertility Related Quality of Life and Self-Efficacy among Infertile Couples: A Dyadic Approach
Authors: Maroufizadeh Saman , Omani-Samani Reza , Hosseini Mostafa
Published: May 2021

The article's abstract is not available.
Effect of Critical Period of Weed Competition and Its Management Option in Sweet Corn [Zea mays (L.) var. saccharata strut] Production: A Review
Authors: Hussen Arebu
Published: May 2021

Sweet corn [Zea mays (L.) var. saccharata strut] is the most important variety of maize with high sugar content. It contains a glossy sweetish endosperm and primarily grown for human food. It requires moderately high temperature from 22oC up to 33oC, high light intensity and adequate and well distributed rainfall of not less than 200mm during growing season. It can be grown on the wide range of soils. However, it performs best on neutral, well drained, well aerated and moderately heavy, deep fertile soils. Sweet corn is not so much competing with weeds like other crops. Avoid the influence of weed competition on the growth and development of sweet corn produce maximum yield and the economic importance of sweet corn used for conception and health benefits. By so far it is good in health and as medicinal uses it should be managed without affecting by weeds. The weed management option properly controls by the method of mechanical, biological, chemical and integrated weed management. In general, it is significant that properly controlling critical period weed competition in sweet corn reducing the competition of light, water, nutrient and space and maximizing the yield of sweet corn.
Rhythmic Changes in Serum Progesterone and Estradiol-17β in Surti Goats under Different Synchronization Protocols
Authors: Yede A.B. , Khasatiya C.T. , Singh Virendra Kumar , Kumar David
Published: May 2021

Background: Success of any estrous synchronization protocol to optimize production and reproduction in goats requires deeper insight of dynamic regulation of hormones progesterone and estradiol-17β. Surti goats reared mostly by marginal livestock owners are native to Gujarat. Present study was conducted to study rhythmic changes in serum progesterone and estradiol-17β in Surti goats under different synchronization protocols. Methods: 18 Surti goats were divided equally (n=6) in 3 groups viz. G1, G2 and G3 (control). G1 and G2 groups were injected with GnRH analogue (day 0 and 11) and PGF2α analogue (day 9). Progestogen sponge was kept intravaginal in G1 group (day 0) and removed (day 11) before GnRH analogue injection. G3 group (control) received placebo of 2 ml normal saline simultaneous to treatment groups. Result: Levels were higher at estrus and lower at day 30 for Estradiol-17β and vice versa for progesterone. Coefficient of variation for estradiol-17β at estrus and for progesterone at day 30 was lower for G1 and higher in control. It was concluded that GPG synchronization protocol with intravaginal progestogen was better to synchronize estrus and establish reproductive cyclicity in Surti goats as it effectively minimized variability of progesterone during pregnancy and estradiol-17β at estrus.
Linking Drought Intensity with Rice Yield in Nagaland
Authors: Nongbri Baiarbor , Feroze S.M. , Singh Ram , Ray L.I.P.
Published: May 2021

Background: Rainfall being one of the most important factors of production for rainfed kharif rice, occurrence of drought may have serious implication on rice yield. Hence, this study is an attempt to understand the linkage between drought and yield of rice in Phek and Dimapur district of Nagaland where rice is the primary crop. Methods: Reconnaissance Drought Index was calculated using gridded daily rainfall (0.25o X 0.25o) and temperature (1o X 1o) (o=degree) data for the year of 1975-2013. Result: The annual mean temperature has increased by 0.03oC in Phek and Dimapur district during the study period. The increasing linear trends for annual temperatures are significant whereas, the linear trend for annual rainfall shows decreasing but insignificant trend. About 38.46% and 41.02% of the 39 years under study were ‘Normal condition-dry’ in Phek in Dimapur district, respectively. Moderate and severe drought occurred more frequently in Dimapur than Phek. After 1994, majority of the years were drought years and the frequency of occurrence was higher in Dimapur. The drought occurrences negatively impacted the rice yields and the rice yield may reduce by 13.85% in normal condition dry to 18.45% in extreme drought condition.
Inheritance Pattern of Mungbean Yellow Mosaic Virus (MYMV) Disease Resistance in Blackgram [Vigna mungo (L.) Hepper]
Authors: Vadivel K. , Manivannan N. , Mahalingam A. , Satya V.K. , Ragul S.
Published: May 2021

Background: Mungbean yellow mosaic virus (MYMV) disease is the most destructive disease in blackgram. Development of MYMV resistant varieties is one of the best possible solutions to avoid the yield reduction in blackgram. There are conflicting reports on the genetics of resistance to MYMV disease claiming that it is controlled by both dominant and recessive genes. Hence the present study was aimed to understand the inheritance pattern of the MYMV disease resistance in eight crosses of blackgram. Methods: Parents, F1 and F2 generation of eight cross combinations were raised during July - Sep, 2018 at National Pulses Research Centre, Tamil Nadu Agricultural University, Vamban, Tamil Nadu. An infector row of CO 5 was raised to intensify the MYMV disease pressure after every eight rows. Based on disease incidence on 60th day after sowing, two phenotypic classes were formed among F2 plants with the scales of (1 to 3) as resistant phenotype and (4 to 9) as susceptible phenotype. The goodness of fit to Mendelian segregation ratio for MYMV disease resistance in the segregating population was tested by Chi square test (Stansfield, 1991). Result: The MYMV disease incidence was tri-genically controlled with inhibitory gene action in four crosses viz., MDU 1 x Mash 114, CO5 x Mash 114, MDU 1 x VBN 6 and CO 5 x VBN 6. Complementary gene action with two genes was observed in four crosses viz., MDU 1 x Mash 1008, CO 5 x Mash 1008, MDU 1 x VBN 8 and CO 5 x VBN 8. Differences in number of genes were observed due to the presence of recessive inhibitory gene in both male and female parents of the crosses which had complementary gene action for MYMV disease. The putative gene symbols assigned for the six genotypes viz., S1S1S2S2ii (MDU 1 and CO 5), s1s1s2s2II (Mash 114 and VBN 6) and s1s1s2s2ii (Mash 1008 and VBN 8), respectively.
Micro-nutrients Seed Priming and rhizobium Coating on Seed Vigour, Crop Growth and Seed Yield in Blackgram (Vigna mungo L.)
Authors: Kavitha S. , Srimathi P.
Published: May 2021

Background: Black gram is the important pulses crop, grown throughout the country; gives low seed yield mainly due to poor management and low soil fertility. Development of suitable technology is essential to enhance productivity. Seed priming is one such effective technology which enhance rapid and uniform emergence to achieve high vigour, leading to better stand establishment and yield. The current research aimed to study micronutrient seed priming and rhizobium coating on seed germination, seedling vigour, crop growth and seed yield in black gram. Methods: Blackgram seeds were primed with 10 different micronutrient solutions with different concentrations and evaluated for its quality parameters to find out suitable seed priming technique. Seeds from two best priming treatments were coated with rhizobium @ 30g/kg of seed and evaluated for its production potential and resultant seed quality under field condition. Result: Seed priming with 0.5% ZnSO4 at 1/3rd seed to solution ratio for 3 hours recorded higher germination (96%) and vigour index (3811) than control which recorded 84% seed germination and 2528 of vigour index under laboratory experiment. Field experiments revealed that, seeds primed with 0.5% ZnSO4 and coated with rhizobium @ 30g per kg of seeds improved seed yield by 13.2% over control.
Purification, Characterization and Bioefficacy of Legume Lectins against Mustard Aphid
Authors: . Deeksha , Sangha Manjeet Kaur , Bala Manju , Sharma Sucheta
Published: May 2021

Background: Lectins are carbohydrate binding proteins which perform diverse roles in plants. One important role is in plant defense. These proteins hold great potential as entomotoxic proteins as a part of integrated pest management. Methods: Lectins were purified and characterized from seeds of two legumes, Glycine max-Soybean and Lens culinaris-Lentil, employing ammonium sulfate fractionation and ion exchange chromatography. Bioefficacy of the purified lectins was evaluated against mustard aphid. Result: Lectins isolated from seeds of soybean (Glycine max agglutinin GMA-I, II) and lentil (Lens culinaris agglutinin LCA-I) were purified upto 9.30 (GMA-I), 4.60 (GMA-II) and 8.70 (LCA-I) fold, respectively. Lectin characterization revealed that soybean agglutinin and lentil agglutinin were specific towards D-Galactose and D-mannose, respectively. Insect bioassay was carried out with five different concentrations (10, 20, 30, 40, 50 µg/ml) of purified lectins of soybean and lentil against mustard aphid. The lethal concentration LC50 value for GMA-I was obtained as 32.1 µg/ml with a 95% confidential interval of 18.2 to 40.5 µg/ml and that of LCA-I was 19.1 µg/ml with a 95% confidential interval of 9.3 to 26.8 µg/ml. Lentil lectin (LCA-I) with lower LC50 value, was found to be the potential candidate for integrated pest management.
SINIF ÖĞRETMENİ ADAYLARININ MESLEKİ KİMLİK ALGILARININ İNCELENMESİ
Authors: ALPTEKİN Müjgan , KINGIR Sevgi
Published: May 2021

Bu araştırmada, sınıf öğretmeni adaylarının mesleki kimlik algılarının incelenmesi amaçlanmıştır. Araştırmada, sınıf öğretmeni adaylarının mesleki kimlik algılarının cinsiyet, üniversite, sınıf seviyesi, akademik not ortalaması, anne ve baba öğrenim düzeyi, öğretmenlik mesleğini seçmede en etkili olan kişi ve durum ve öğretime yönelik öz yeterlik algısı ile ilişkisi de incelenmiştir. Araştırmaya Ankara’da üç devlet üniversitesinde öğrenim gören 752 sınıf öğretmeni adayı katılmıştır. Demografik Bilgi Formu, Meslek Öncesi Öğretmen Kimlik Ölçeği ve Öğretmen Öz Yeterlik Ölçeği ile veriler toplanmıştır. Bulgular sınıf öğretmeni adaylarının mesleki kimlik algılarının genel olarak yüksek olduğunu göstermiştir. Sınıf öğretmeni adaylarının mesleki kimlik algılarında öğrenim gördükleri üniversitelere ve sınıf düzeylerine göre anlamlı bir farklılık görülmezken, cinsiyete göre kadın öğretmen adayları lehine anlamlı farklılık bulunmuştur. Sınıf öğretmeni adaylarının mesleki kimlik algıları ile akademik not ortalamaları arasında olumlu ve anlamlı bir ilişki tespit edilmiştir. Sınıf öğretmeni adaylarının öğretime yönelik öz yeterlik algıları arttıkça mesleki kimlik algılarında da artış saptanmıştır. Çalışma sonucunda, uygulamaya ve araştırmaya yönelik bazı önerilerde bulunulmuştur.
Application of the lyophilization system for preparation of reference materials for composition of nutrition products
Authors: Medvedevskikh M. Y. , Vostrikova N. L. , Sergeeva A. S. , Studenok V. V.
Published: May 2021

The article presents the application of the lyophilization system for preparation of reference materials (RM) for composition of nutritive products samples. The purpose of the research was the development of lyophilization procedure of RM for composition of poultry meat samples preparation with certified values of mass fraction of moisture, nitrogen (protein) and fat.

The poultry meat of two types was used as the primary material for RM for poultry meat composition preparation -1) white meat (chicken breast); 2) red meat (chicken thigh). The procedure included pounding, boiling, freezing and lyophilisation (syn. freeze drying). The researches for homogeneity were implemented with hot air dryer standard system from the State primary standard GET 173-2017. Measurement of nitrogen (protein) mass fraction was performed on State secondary standard GVET176-1-2010. Measurements of fat mass fraction were performed with accordance to State Primary Reference Measurement Procedure.

The total time of lyophilization process for samples № 1 and № 2 was 19 and 28 hours, respectively. The total mass loss for sample № 1 was about 63 %, for sample № 2 was about 65 %. The difference in material moisture mass fraction values of materials dried on different trays of freeze dryer was statistically significant, i. e., material was non-homogeneous. To obtain a homogeneous material, an additional homogenization procedure was performed: grinding in a laboratory mill, sieving through a sieve, thorough mixing and conditioning. The certified values of moisture, nitrogen, protein, fat mass fraction for the sample № 1 were accordingly 4,5 %, 14,74 %, 92,1 %, 7,9 %. The same values in the same sequence were 6,3 %, 12,21 %, 76,3 %, 23,8 %.

The procedure of lyophilisation was developed for production of reference materials for composition of boiled and freeze-dried poultry meat. The usage of this lyophilisation system allowed to ensure a RM expiration date of six months at ambient temperature of (7±3) °C and relative humidity no more than 60 %. The Reference Materials for composition of boiled and freeze-dried poultry meat was added into Register of certified RMs under № GSO 11276-2019 by the results.
Feed reference materials in the system of metrological support of agro-industrial complex laboratories
Authors: Stupakova G. A. , Dengina S. A. , Ignatyeva E. E. , Shchipletsova T. I. , Mitrofanov D. K.
Published: May 2021

The authors provided information about the developed matrix feed reference materials, certified for quality, nutritional value and toxicological contamination indicators for metrological support of analytical work in the article to confirm the compliance of products with requirements of national standards. Information on the stages of development of feed reference materials (selection and preparation of reference material, studies of heterogeneity and stability of feed reference material) is presented. There are demonstrated the results of reference materials certification according to certified indicators, their correctness confirmed by the results of thirty accredited laboratories.

The developed reference material of sunflower meal is registered in the State Register of approved types of reference materials under the number GSO 11612-2020. Reference materials of the composition of toasted soybean feed meal and complete feed for poultry (broilers) are approved as Industry-Specific by the Ministry of Agriculture of the Russian Federation (Department of Plant Production, Mechanization, Chemicalization and Plant Protection).

Feed reference materials are intended for metrological support of agro-industrial complex laboratories.
PENGARUH DINAMIKA OSEANOGRAFI TERHADAP EKOSISTEM MANGROVE DI DESA PAGATAN BESAR
Authors: Dewi Ira Puspita , Nursalam Nursalam , Widyanata Dimas
Published: May 2021

Ekosistem mangrove di pesisir Desa Pagatan Besar telah berkembang menjadi kawasan ekowisata mangrove yang membentang sepanjang 1 km di Pesisir Barat Desa Pagatan Besar. Desa Pagatan Besar dengan berbagai dinamika biofisiknya mempunyai potensi terjadinya perubahan bentang alam, yang umumnya dipengaruhi oleh gelombang dari Laut Jawa. Penelitian ini secara umum bertujuan (1) menganalisis riwayat gelombang maksimum 21 tahun, (2) menganalisis arus rata-rata selama 4 tahun terakhir, (3) mengamati pengaruh dinamika oseanografi terhadap perubahan garis pantai dan tutupan mangrove. Metode penelitian meliputi penelusuran literatur, pengumpulan data, pengolahan dan analisis data. Data gelombang diperoleh dari peramalan gelombang menggunakan data angin dari situs ECMWF dianalisis dengan plot series dan wave rose. Data arus diolah dengan metode least square pada software WTWC MATLAB untuk mengetahui pola distribusi arus total, pasang surut, dan residu setiap komponen arus. Analisis terhadap perubahan garis pantai dan tutupan mangrove menggunakan tumpang susun citra satelit Landsat tahun 1999, 2009 dan 2019. Hasil penelitian ini adalah (1) gelombang maksimum selama 21 tahun dominan terjadi pada Musim Barat (Desember – Februari) dengan ketinggian rata-rata 1,515 meter. Gelombang maksimum tertinggi terjadi pada tahun 2001 yaitu 2,03 meter, (2) Rata-rata kecepatan arus total pada Musim Barat mencapai 14,91 cm/s, arus pasut sebesar 13,88 cm/s dan arus residu sebesar 6,17 cm/s, dengan pola dominan ke arah timur laut dan tenggara, (3) Terjadi perubahan garis pantai (sedimentasi dan abrasi) serta penurunan luasan mangrove sebesar 4,68 Ha selama periode 1999 – 2009.
ESTIMASI SUMBERDAYA BATUBARA SEAM 1 MENGGUNAKAN METODE CIRCULAR 891 USGS DAERAH TANAH MERAH, KOTA SAMARINDA PROVINSI KALIMANTAN TIMUR
Authors: Balfas Muhammad Dahlan , Anjarwati Retno , Sasmito Koeshadi
Published: May 2021

Tujuan dari penelitian ini adalah untuk mengetahui tonase batubara berdasarkan tingkat kepercayaan geologi ke dalam kategori sumberdaya tereka, tertunjuk, dan terukur menggunakan metode Circular 891 USGS. Penelitian ini juga dilakukan melalui pemetaan geologi detail daerah penelitian yaitu di Desa Tanah Merah, Kota Samarinda, kemudian dilakukan korelasi antar singkapan batubara guna mengetahui sebaran batubara tersebut. Setelah mengetahui sebaran batubara dapat dilakukan perhitungan sumberdaya tereka, tertunjuk dan terukur. Data yang diperoleh dari penelitian ini yaitu data singkapan batubara yang ditemukan di daerah penelitian. Data hasil pengamatan lapangan yang telah didapatkan kemudian diolah menggunakan rumus perhitungan volume dan tonase batubara, untuk sumberdaya tereka diperoleh hasil 945.468,74 m3, tertunjuk diperoleh hasil 700.020,23 m3, sedangkan untuk sumberdaya terukur diperoleh hasil 349.335,77 m3, kemudian dikalikan dengan densitas batubara yaitu 1,3 ton/m3. Estimasi sumberdaya tereka dengan radius 750 m diperoleh tonase sebesar 1.229.109,36 ton, sumberdaya tertunjuk dengan radius 500 m diperoleh tonase sebesar 910.026,30 ton. Sedangkan sumberdaya terukur dengan radius 250 m diperoleh tonase sebesar 454.136,50 ton.
Features of Risk Stratification, Diagnosis and Secondary Prevention in Patients with Multifocal Arterial Disease. Part 2: Treatment Options
Authors: Grachev V. G. , Vedenskaya S. S. , Smolenskaya O. G.
Published: May 2021

The similarity of the pathogenesis of atherosclerosis and atherothrombotic complications, regardless of their location, makes the approaches to secondary prevention similar, which include lifestyle modification, pharmacotherapy of hemodynamic disorders, metabolic changes and hemostasis. Secondary prophylaxis in patients with multifocal arterial lesions using antihypertensive, antithrombotic and lipid-lowering therapy provides a more pronounced decrease in the incidence of cardiovascular complications than in lesions of single vascular lesions due to a higher initial risk. However, these treatments do not reduce the risk to the level that is achieved by treating patients with less atherosclerotic lesion. In this regard, it is of interest to use the currently available new methods and regimens of drug therapy in patients with multifocal arterial lesions, which make it possible to more intensively influence the mechanisms of atherosclerosis progression and more effectively prevent the development of its complications.
Adherence to Medical Treatment in Elderly Patients with Coronary Artery Disease in the Settings of Primary Outpatient Care
Authors: Zyryanov S. K. , Fitilev S. B. , Vozzhaev A. V. , Shkrebneva I. I. , Shindryaeva N. N. , Klyuev D. A. , Stepanyan L. N. , Lutsenko A. M. , Tsai A. T. , Danilova A. A.
Published: May 2021

Aim. To study medication adherence in elderly patients with coronary artery disease (CAD) in primary care practice.

Material and methods. The study conducted in out-patient clinic of Moscow city. 293 elderly (≥65 years) patients with established CAD included. The following patient data obtained via electronic medical record system: demography, medical history, modifiable risk factors and prescribed pharmacotherapy. Level of medication adherence measured by Morisky scale (MMAS-8) via telephone survey.

Results. According to Morisky scale high adherence was identified in 146 (49.8%) elderly patients, moderate adherence – in 99 (33.8%) patients, low adherence – in 48 (16.4%) patients. Analysis of specific questions of the scale done in non-adherent patients revealed signs of unintentional non-adherence due to forgetfulness (45.9%) and signs of intentional non-adherence due to patients feeling worse (35.8%) or better (28.4%). By means of dichotomic interpretation of Morisky scale results the population under research was divided into two groups: 147 (50.2%) non-adherent patients and 146 (49.8%) – totally adherent patients. These groups were comparable in terms of sex (female 71.2 vs 68.0%; p>0.05) and age (median 73.5 vs 73.0 years; p>0.05) distribution, and medical history: myocardial infarction (39.0% vs 38.8%), atrial fibrillation (37.0 and 41.5%), chronic heart failure (90.4% vs 91.2%), diabetes (26.7% vs 24.5%). There were fewer smokers in adherent group (0.7% vs 6.5%; p<0.05). As primary antianginal pharmacotherapy adherent and non-adherent patients were equally prescribed beta-blockers (75.3% vs 75.5%; p>0.05). Drugs that improve prognosis were also prescribed comparably: antiplatelets (66.4% vs 61.9%; p>0.05), anticoagulants (36.3% vs 44.9%; p>0.05), statins (82.2% vs 79.6%; p>0.05), renin-angiotensin system inhibitors (89.0 and 87.8%; p>0.05). Adherent patients had lower mean values of lipids: total cholesterol (4.7±1.2 vs 5.2±1.4 mmol/l; p<0.05) and low density cholesterol (2.4±0.9 vs 2.8±1.2 mmol/l; p<0.05). Non-adherent elderly patients made more visits to general practitioner (median 5 vs 3 visits; p<0.05). Share of patients receiving drugs within supplementary pharmaceutical provision program was comparable in both groups (53.7% vs 50.7%; p>0.05).

Conclusion. Half of elderly patients with CAD are non-adherent to treatment in primary care setting. Medical history and structure of pharmacotherapy do not influence level of adherence in this population. Among adherent patients fewer individuals smoke and mean values of lipids are lower. Non-adherent elderly patients cause higher load on general practitioner, supplementary pharmaceutical provision program provided no better adherence in the population under research.
Anticoagulant Therapy in Patients with Non-valvular Atrial Fibrillation in Real Clinical Practice: in Appropriate Dose Reductions
Authors: Ionin V. A. , Bliznuk O. I. , Baranova E. I. , Shlyakhto E. V.
Published: May 2021

Aim. To study the frequency of administration of direct oral anticoagulant (DOACs) in doses recommended and not recommended by the instructions of the drugs in non-valve atrial fibrillation (AF) patients.

Material and methods. 10663 case histories of patients hospitalized for 5 years (2014-2018) were studied, 1307/10663 (12,3%) case histories of patients with AF were selected. In patients with AF, the risk of stroke and systemic embolism, the risk of bleeding, the anticoagulant therapy (ACT) recommended at the prehospital stage and its adequacy was evaluated.

Results. 1 261/1 307 (96,5%) patients had a non-valve AF. The risk of stroke and systemic embolism was 4,7±1,5 (CHA2DS2-VASс), 97,5% of patients with non-valve AF (1229/1261) needed ACT. Only 665/1229 (54.1%) patients with AF received ACT at the time of hospitalization and 578/1229 (47,0%) of patients did not receive ACT. Before hospitalization 281/665 (42,3%) patients received vitamin K antagonist (warfarin). The international normalized ratio in the target range (2,0-3,0) was in 111/281 (39,5%) patients. 57,7% (384/665) outpatients with AF received NOAC: rivaroxaban - 180/384 (46,9%) patients, dabigatran etexilate - 110/384 (28,6%) patients, apixaban - 94/384 (24,5%) patients. Inappropriate reduced doses of DOAC were revealed in 68/384 (17,7%) patients: apixaban - 23,4%, dabigatran - 16,4% and rivaroxaban - 15,6% (p>0,05).

Conclusion. In real clinical practice 42,3% AF patients used warfarin, only 39,5% of them had INR in target values. DOAC in inappropriate reduced doses used 17,7% patients.
Analysis of Anticoagulant Therapy in the Elderly Patients, in Clinical Practice of Family Medicine Centers in the Kyrgyz Republic
Authors: Mamatov S. M. , Kanat kyzy B. , Musakeev A. O. , Kinderbaeva N. K. , Tagaev T. J.
Published: May 2021

Aim. To study the current state of the anticoagulant's prescription in elderly and senile patients with atrial fibrillation in the clinical practice of family medicine center, in the southern regions of the Kyrgyz Republic.

Material and methods. Of the 1974 ambulatory medical observation cards, 470 patients with atrial fibrillation were selected who had indications for prescribing antithrombotic therapy (87 [18.5%] men and 383 [81.5%] women; 212 [45.1%] urban residents and 258 [54.9%] rural residents). The average age was 66.9±10.2 years. The analysis included data from 387 patients who received anticoagulant therapy. The frequency of prescribing antithrombotic therapy has been studied.

Results. There were indications for anticoagulant therapy in 387 patients. Anticoagulants were taken by 167 (43.2%) patients, antiplatelet agents - 196 (50.6%), no therapy - 24 (6.2%). Anticoagulant therapy in 153 patients included warfarin, while only 11.8% had adequate INR control after one year of follow-up. Rivaroxaban was prescribed in 14 (8.4%) patients. 50% of patients had antiplatelet agents instead of anticoagulants, which were mainly prescribed by therapists of rural family medicine centers.

Conclusion. In the southern regions of the republic, an unfavorable situation is observed with the prescription and management of elderly and senile patients on anticoagulant therapy. It is necessary to continue the research across the country in order to obtain a complete and real picture of the problem, and to develop a unified and relevant recommendation.
Prescribing Drugs not in Accordance with the Official Instructions for Medical Use (Off-label), Clinical Guidelines, Standards of Medical Care and Legal Regulation in the Russian Federation. Part 2
Authors: Navasardyan A. R. , Martsevich S. Yu. , Gabay P. G.
Published: May 2021

Prescribing drugs not in accordance with the official instructions for medical use (off-label) has medical and legal aspects. From a medical point of view, such an appointment can be dictated by clinical urgency, when there is no alternative therapy, and on the other hand, doctors often prescribe off-label drugs unknowingly, and also when there is another drug with registered indications. The article analyzes the regulations governing such appointments. The article describes possible inconsistencies between clinical guidelines and standards of medical care in this matter, the role of the medical commission, the impact on the quality and safety of medical care, as well as the types of legal liability of a medical worker that may arise when a drug is prescribed not according to instructions.
Treatment Strategy Options in Inoperable Chronic Thromboembolic Pulmonary Hypertension Patients
Authors: Marukyan N. V. , Simakova M. A. , Zubarev D. D. , Moiseeva O. M.
Published: May 2021

This review presents an analysis of recent publications on the principles of diagnosis and management of patients with chronic thromboembolic pulmonary hypertension (CTEPH). The authors emphasize the importance of patient's operability assessment regarding the possibility of performing pulmonary thrombendarterectomy - a radical treatment option due to complete post-thrombotic material removal from the branches of the pulmonary artery. In the case of an inoperable type of CTEPH, such a method of transcatheter treatment as step-by-step balloon angioplasty of the pulmonary artery (BPA) is proposed. The article clearly outlines the principles of selection, patient training and techniques for BPA. The authors demonstrated their own patented method of the peripheral vascular bed visualization in the case of recanalization of chronic occlusions, which increases the safety of this intervention. Particular attention is paid to hybrid approaches using a soluble guanylate cyclase stimulator, riociguate in combination with BPA for high risk CTEPH patients. The review presents the data of the post hoc analysis of the CHEST-1 study and the data of real clinical practice of the use of riociguat in combination with the endovascular method of treatment on the example of the leading expert groups in Europe, who demonstrated in their studies the positive effect of riociguat on the hemodynamic parameters and the frequency of perioperative complications.
Comorbidities and Percutaneous Coronary Intervention in Elderly Patients with Acute Coronary Syndrome
Authors: Gilyarov M. Yu. , Konstantinova E. V. , Atabegashvili M. R. , Solntseva T. D. , Anichkov D. A. , Kostina А. N. , Polybin R. V. , Udovichenko A. E. , Svet A. V.
Published: May 2021

Aim. To assess comorbidities in elderly patients with acute coronary syndrome (ACS) and to analyze patient subgroups with different treatment strategies in the Regional Vascular Center (RVC).

Material and methods. The prospective study included 205 patients with confirmed ACS 75 years and older, the mean age was 81±4.9 years, and 68% were women. ST segment elevation myocardial infarction (STEMI) was diagnosed in 46 (22.4 %) patients, non-ST segment elevation myocardial infarction (NSTEMI) was diagnosed in 159 (77,6 %) patients. The Charlson Comorbidity Index (CCI) was calculated in every patient. Early outcomes were defined as those assessed during hospital stay. Late outcomes were assessed at 6 months after the discharge using phone calls and/or clinic visits. All patients provided written informed consent.

Results. Percutaneous coronary intervention (PCI) was performed in 42% of patients. In patients with STEMI and NSTEMI PCI was performed in 73% and 32%, respectively. Mean CCI score was 7.9 points: 7.6 points in men and 8.04 in women. Patients with STEMI had higher CCI score than NSTEMI patients (p<0.01): 8.1 points and 7.1 points, respectively. Patients who underwent PCI had lower CCI score (7.2 points) than patients in non-PCI group (8.2 points; p<0.05). Patients with STEMI in PCI and non-PCI groups had significant difference in CCI score (p<0.05): 7.4 and 8.4 points, respectively. Mean CCI score in patients who died in hospital was 8.5 while discharged patients had 7.6 points (p<0.01). In 6 months 13 patients (6.3%) died, their mean age was 84.9 years, mean CCI was 9 points, PCI was performed in 3 (23%) patients.

Conclusions. Elderly patients with ACS had high comorbidity level assessed by CCI score. Higher CCI score was associated with PCI non-performance in elderly patients. Elderly patients with STEMI had higher CCI score than patients with NSTEMI which was significantly associated with PCI non-performance. Patients who died in hospital or in 6 months after the ACS onset had higher CCI score than other elderly patients with ACS.
The Efficacy of Thrombolytic Therapy in Inferior Myocardial Infarction with Damage to the Right Ventricular
Authors: Mazur E. S. , Mazur V. V. , Kuznetsova N. S. , Rabinovich R. M. , Myasnikov K. S.
Published: May 2021

Aim. To study the results of thrombolytic therapy and accuracy of electrocardiographic assessment of thrombolysis efficiency in inferior myocardial infarction with and without right ventricular lesion.

Material and methods. The118 patients with inferior myocardial infarction were included in this study. They received TLT in the first 12 hours of the disease. The dynamics of ST-segment in 90 minutes from the TLT start and coronary angiography data were analyzed.

Results. Right ventricular myocardial infarction (RVMI) was diagnosed in 49 (41.5%) of 118 patients by echocardiography. Patients with and without RVMI did not differ in age, gender and comorbidities, but patients with RVMI were more likely to have arterial hypotension, atrioventricular block, and atrial fibrillation. All patients with RVMI had occlusion of the right coronary artery (RCA) in the proximal (34.7%) or medial segment (65.3%). Occlusion of the circumflex coronary artery was found in 20 (29.0%) patients without RVMI, and RCA occlusion - in other patients. The infarction-associated artery blood flow equal TIMI 2-3 was found in 17 (34.7%) patients with RVMI and in 46 (66.7%) patients without RVMI (p<0.005). ST-segment decrease by 50% or more in 90 minutes from the TLT was found in 35 (71.4%) patients with RVMI and in 49 (71.0%) patients without RVMI (p>0.05). The false-positive assessment of thrombolysis efficiency was noted in patients with and without RVMI in 21 (42.9%) and 11 (15.9%) cases (p <0.005), respectively. There were no false-positive assessments in patients with RVMI when using ST-segment decrease to the isoline.

Conclusion. TLT should be considered effective in patients with inferior myocardial infarction with the right ventricle lesion, if ST-segment decreases to isoline in 90 minutes from the TLT start.
The Role of Rivaroxaban in a Comprehensive Protection Strategy for Patients with Atrial Fibrillation
Authors: Zolotovskaya I. A. , Sabanova V. D. , Davydkin I. L.
Published: May 2021

Anticoagulant therapy of patients with atrial fibrillation is an integral part of their treatment strategy. The high risk of developing a cardioembolic stroke and the high comorbidity of this group of patients necessitates a comprehensive approach to treatment, taking into account all available risk factors. Atrial fibrillation is often asymptomatic and timely detection of these patients can be one of the most important tasks in the complex of measures aimed at protecting patients from stroke. The European Society of Cardiology's 2020 guidelines suggest the use of a CC to ABC patient management strategy. This strategy involves a number of measures aimed at managing atrial fibrillation, including confirming the diagnosis, determining the characteristics of atrial fibrillation and treatment tactics. One of the points of this strategy is the control of comorbidities and risk factors for cardiovascular diseases. To date, rivaroxaban has a number of convincing and reliable data on a high profile of efficacy and safety in the treatment of comorbid patients who not only have a high risk of stroke, but also need protection from coronary events and decreased renal filtration function. These data are confirmed by both the results of randomized clinical trials and data from real clinical practice. The review discusses the literature data describing the condition of patients with atrial fibrillation while taking direct oral anticoagulants, according to the search query “Atrial fibrillation, effectiveness and safety of rivaroxaban, warfarin, comorbidity, atrial fibrillation, efficacy and safety of rivaroxaban, warfarin, comorbid status” for the period from 2010 to 2020 in open sources PubMed and e-library, and a strategy for the comprehensive protection of patients with atrial fibrillation when using rivaroxaban is proposed for consideration.
The Effect of Family Financial Socialization Levels on Money Attitudes of University Students
Authors: KÜBİLAY Bilgehan , TUNÇEL Özgür
Published: May 2021

The purpose of the study is to manifest university students' relationships with money not only in terms of their family financial socialization levels, but also in terms of their demographic and socio-economic characteristics. Moreover, in order to measure family financial socialization levels of university students, a new two-dimensional scale, which is composed of “financial experience and learning” and “money management skills”, is developed. The study is crucial in that it is most likely to create positive financial behaviours between parents and students by means of developing informal education in family. Besides, the research is highly likely to become beneficial for creating new financial education programs in educational institutions particularly on the issues of money attitudes and financial socialization. As far as the cause and effect relationships are concerned, it is detected that students’ worries about savings and financial literacy decreased inasmuch as their financial experiences and learning increased. In addition to this result, it is observed that students’ mindful and responsible attitude increased in that their money management skills increased. Finally, it is ascertained significant differences between family financial socialization and demographic and socio-economic characteristics and also between money attitudes and demographic and socio-economic characteristics.
Water resource R&D efficiency in Korea – toward sustainable integrated water resources management
Authors: Cho Inkyung , Heo Eunnyeong , Park Jungkyu
Published: May 2021

In 2018, the Korean government established a legal foundation for integrated water management. Accordingly, various measures for integrated water management were taken, and water research and development (R&D) is being integrated with the Ministry of Environment. Strategic planning is needed for the efficient implementation of integrated large-scale water R&D. This study aims to analyze the efficiency of large-scale R&D programs in the field of water resources conducted by the Korean government and identify matters of priority for planning future water resources R&D programs. An empirical analysis was conducted using data envelopment analysis (DEA), in particular, a non-radial slack-based measure (SBM) model was applied to consider slacks in the input and output variables. The results showed that the efficiency of collaborative R&D projects was relatively lower than that of single projects. Further, corporate research institutes, which are typically considered as the leaders of technological innovation, were found to have conducted projects less efficiently than universities or public research institutes. Based on these results, this study recommends that: (1) a system to maximize the advantages of collaborative research should be established; (2) institutional support to enhance the enterprise's innovative activities should be prepared; and (3) comprehensive, long-term planning for integrated water management should be implemented.
Crop water productivity and yield response of two greenhouse basil (Ocimum basilicum L.) cultivars to deficit irrigation
Authors: Goldani Morteza , Bannayan Mohammad , Yaghoubi Fatemeh
Published: May 2021

This two-year study aimed to determine the most appropriate irrigation scheduling and crop water productivity (CWP) of basil plant under controlled conditions in Ferdowsi University of Mashhad, Iran. The experimental layout was a split-plot design with three replications. Three deficit irrigation (DI) levels (DI0: 100%, DI30: 70% and DI60: 40% of the field capacity) and two basil cultivars (Green and Purple) were applied to main and subplots, respectively. The results showed that there was a decrease in yield and an increase in CWP for fresh leaves and fresh and dry herb by decreasing the irrigation water. However, a significant difference between fresh leaves and fresh and dry herb yield of DI0 and DI30 treatment was not observed. The Green basil had higher leaves and herb yield and CWP than the other cultivar. A polynomial relationship was established between fresh leaves yield and crop evapotranspiration; however, the yield response factor (Ky) indicated a linear relationship between the relative reduction in crop evapotranspiration vs. the relative reduction in yield. The Ky values were obtained as 0.70 and 0.76 for Green and Purple basil, respectively. The results revealed that the irrigation regime of 30% water saving could ensure acceptable yield of basil plant and increase in CWP, especially for the Green basil cultivar.
The anaerobic biodegradation of emerging organic contaminants by horizontal subsurface flow constructed wetlands
Authors: Ilyas H. , Masih I. , van Hullebusch E. D.
Published: May 2021

The horizontal subsurface flow constructed wetland (HFCW) is widely studied for the treatment of wastewater containing emerging organic contaminants (EOCs): pharmaceuticals, personal care products, and steroidal hormones. This study evaluates the performance of HFCW for the removal of these types of EOCs based on the data collected from peer-reviewed journal publications. In HFCW, anaerobic biodegradation is an important removal mechanism of EOCs besides their removal by the filter media (through sedimentation, adsorption, and precipitation) and plant uptake. The average removal efficiency of 18 selected EOCs ranged from 39% to 98%. The moderate to higher removal efficiency of 12 out of 18 selected EOCs in HFCW indicates the suitability of this type of constructed wetland (CW) for the treatment of wastewater containing these EOCs. The reasonably good removal (>50% in most of the cases) of these EOCs in HFCW might be due to the occurrence of anaerobic biodegradation as one of their major removal mechanisms in CWs. Although the effluent concentration of EOCs was substantially decreased after the treatment, the environmental risk posed by them was not fully reduced in most of the cases. For instance, estimated risk quotient of 11 out of 18 examined EOCs was extremely high for the effluent of HFCW.