bluuebunny/crossref_metadata_2025 huggingface dataset:
Scaling Up the Primary Health Integrated Care Project for Chronic Conditions in Kenya: Study Protocol for an Implementation Research Project
Authors: Nolte Ellen , Kamano Jemima , Naanyu Violet , Etyang Anthony , Gasparrini Antonio , Hanson Kara , Koros Hillary , Mugo Richard , Murphy Adrianna , Oyando Robinson , Pliakas Triantafyllos , Were Vincent , Barasa Edwine , Perel Pablo
Published: April 2021

BackgroundAmid the rising number of people with NCDs, Kenya has invested in strengthening primary care and in efforts to expand existing service delivery platforms to integrate care for managing chronic disease. One such approach is the AMPATH model, established in 2001 in western Kenya to provide HIV treatment and control services. The model was progressively adapted and developed further to provide care for people with other chronic conditions. Building on this experience, the Primary Health Integrated Care Project for Chronic Conditions (PIC4C) was launched in 2018 to further strengthen primary care services for the prevention and control of hypertension, diabetes, breast and cervical cancer. This study seeks to understand how well PIC4C delivers on its intended aims and to inform and support scale up of the PIC4C model for integrated care for people with selected chronic conditions in Kenya.MethodsThe study is guided by a conceptual framework on implementing, sustaining and spreading innovation in health service delivery. We use a multimethod design combining qualitative and quantitative approaches, involving: (1) in-depth interviews with health workers and decision-makers to explore experiences of delivering PIC4C; (2) a cross-sectional survey of patients newly diagnosed with diabetes or hypertension and in-depth interviews to understand how well PIC4C meets patients’ needs; (3) a cohort study with an interrupted time series analysis to evaluate the degree to which PIC4C leads to health benefits such as improved management of hypertension or diabetes; and (4) a cohort study of households to examine the extent to which the national hospital insurance chronic care package provides financial risk protection to people with hypertension or diabetes within PIC4C.Workshops with decision-makers and other key people at local, county, national and international levels will ensure early and wide dissemination of the findings of the work to allow for the wider scale up of this model of care.DiscussionOur study will generate new knowledge about the key mechanisms and factors that shape the successful implementation of novel ways of delivering more integrated services to better manage and support people with chronic conditions in low resource settings. It will expand understanding of intended and unintended consequences of integrating NCD management into existing care programmes. This knowledge can be leveraged to inform and improve the design and implementation of similar programmes elsewhere in Kenya and beyond.
A simple method for predicting emerging SARS-CoV-2 variants using outgroups infecting non-human hosts
Authors: Katoh Kazutaka , Standley Daron M.
Published: April 2021

The ability to predict emerging variants of SARS-CoV-2 would be of enormous value, as it would enable proactive design of vaccines in advance of such emergence. Based on molecular evolutionary analysis of S protein, we found a significant correspondence in the location of amino acid substitutions between SARS-CoV-2 variants recently emerging and their relatives that infected bat and pangolin before the pandemic. This observation suggests that a limited number of sites in this protein are repeatedly substituted in independent lineages of this group of viruses. It follows, therefore, that the sites of future emerging mutations in SARS-CoV-2 can be predicted by analyzing their relatives (outgroups) that have infected non-human hosts. We discuss a possible evolutionary mechanism behind these substitutions and provide a list of frequently substituted sites that potentially include future emerging variants in SARS-CoV-2.
The Impact of Improved Lid of Underground Tanks “Tanka” On Breeding of An. Stephensi In Western Rajasthan, India
Authors: Singh Himmat , Gupta Sanjeev Kumar , Vikram Kumar , Saxena Rekha , Sharma Amit
Published: April 2021

Background: Western Rajasthan of India has a typical desert climate. Until the introduction of canal water irrigation system, malaria was an unstable and seasonal occurrence. Due to scarcity of water, community practiced to have one large underground tank (locally known as Tanka) in their house to store water for long term use. Anopheles stephensi, one of the major malaria vectors, breeds in these "Tankas” if not properly covered and harbor a vector population throughout the year. Methods: Two villages Ajasar (intervention) and Tota (control) with similar ecological features were selected for the study. A pre-assessment was carried out in both villages to assess lids of Tankas, their breeding profile and the adult mosquito density. Awareness of community about malaria and mosquitoes was also assessed during pre-assessment period. In intervention village, lids were replaced with improved polyvinyl lids that were mosquito proof and last longer than conventional lids. Fitness of the lids, was assessed after one year. Entomological assessment was carried out in both intervention and non-intervention villages. The level of awareness of community was assessed both during pre and post intervention.Results : During the pre-assessment, Anopheles breeding was found in 22.1% (58/262) of Tankas of intervention village and 27.1% (19/70) of Tankas of control village. Tankas with iron lids were mainly positive in the intervention village (48.3%) and the control village (42.1%). In intervention village, 200 lids were replaced, and zero positivity was achieved. Before intervention, the species composition of An. stephensi was 46% in intervention and 55% in control village. Per Man Hour Density (PMHD) of An. stephensi was significantly reduced to 0.55 (94.95%) and 0.22 (97.8%) in post-intervention and follow-up, respectively in intervention village. Discussion: The adult density of An. stephensi was reduced significantly (97.8%) in intervention village. Breeding in underground tankas was completely checked in intervention village as compared to the control, where no such substantial reduction was observed. The awareness level of the community was also improved due to their involvement in the study.Conclusion: The study demonstrated that the small changes and interventions to reduce mosquitogenic conditions can be cost effective and long-lasting which may be helpful in control of malaria.
Incidence of emergency neurosurgical TBI procedures: A population-based study
Authors: Tverdal Cathrine , Aarhus Mads , Rønning Pål , Skaansar Ola , Skogen Karoline , Andelic Nada , Helseth Eirik
Published: April 2021

Background
The rates of emergency neurosurgery in traumatic brain injury (TBI) patients vary between populations and trauma centers. In planning acute TBI treatment, knowledge about rates and incidence of emergency neurosurgery at the population level is of importance. This study aimed to present incidence rates and patient characteristics for the most common TBI-related emergency neurosurgical procedures.
Methods
Oslo University Hospital is the only trauma center with neurosurgical services in Southeast Norway, which has a population of 3 million. We extracted prospectively collected registry data from the Oslo TBI Registry – Neurosurgery over a five-year period (2015–2019). For age-adjusted incidence according to the direct method, we used the 2013 European standard population (ESP) and 2000–2025 WHO World standard population distributions. We conducted multivariate logistic regression models to assess variables associated with emergency neurosurgical procedures.
Results
A total of 2151 patients with pathological head CT scans were included. One or more emergency neurosurgical procedure was performed in 27% of patients. The crude incidence was 3.9/100 000 person-years. The age-adjusted incidences in the standard population for Europe and the world were 4.0/100 00 and 3.3/100 000, respectively. The most frequent emergency neurosurgical procedure was the insertion of an intracranial pressure monitor, followed by evacuation of the mass lesion. Male sex, road traffic accidents, severe injury (low GCS) and CT characteristics such as midline shift and compressed/absent basal cisterns were significantly associated with an increased probability of emergency neurosurgery, while older age was associated with a decreased probability.
Conclusions
The incidence of emergency neurosurgery in the general population is low and reflects neurosurgery procedures performed in patients with severe injuries. Hence, emergency neurosurgery for TBIs should be centralized to major trauma centers.
Constructing a Gas Explosion Inversion Model in a Straight Roadway Using GA-BP Neural Network
Authors: Tan Bo , Zhang Heyu , Cheng Gang , Liu Yanling , Zhang Xuedong
Published: April 2021

When the location and intensity of the source of the explosion is determined, the severity and impact of the explosion can be analyzed and predicted, such as the overpressure, temperature, and toxic gas propagation. In order to provide the theory of emergency rescue work, improve rescue efficiency, to protect the safety of rescue personnel. In addition, to determine the gas explosion source location and intensity of the accident investigation also has an important role, on the one hand,it helps to determine the accident-related responsible person, on the other hand,it also can more accurately judge the nature of the accident and the cause of the explosion, summarize the accident experience, for the future prevention of such accidents provide guidance experience. Therefore, the location and intensity of the source of the explosion through the field data inversion is of great significance. Based on Genetic Algorithm (GA, and similarly hereinafter) to improve the back propagation(BP) neural network theory, the use of the method through the gas explosion experiments and simulation of overpressure data inversion of roadway gas explosion source location and intensity, the establishment of roadway gas explosion disaster inversion model for emergency rescue and accident investigation to provide data support.
Experimental Study on the Troperty Degradation and Failure Mech- Anism of Weakly Cemented Sandstone Under Dry-wet Cycles
Authors: Song Zhaoyang , Tan Jie , Liu Zhiqiang , Sun Lihui , Ning Fangbo
Published: April 2021

Taking the weakly cemented sandstone of Erdos, China, as the research object, the evolution law between the relative stress of weakly cemented sandstone and the multiparameters of the acoustic emission under different dry-wet cycles was explored, and the critical failure identification mode of weakly cemented sandstone under dry-wet cycles was established. The results show that as the number of dry-wet cycles increases, the wave velocity loss rate gradually increases. Overall, the longitudinal wave loss rate is larger than the shear wave loss rate, indicating that the longitudinal wave is more sensitive to the degradation of weakly cemented sandstone. With an increase in the number of dry-wet cycles, the fracture crack is mainly caused by the main crack penetration failure, and the secondary crack is significantly reduced. The fractal dimension decreases with an increase in the dry-wet cycles and reaches its maximum at 0 dry-wet cycles, which means that 0 dry-wet cycles witness the most complex morphology of fractures within the weakly cemented sandstone. This finding indicates that the dry-wet cycle inhibits the generation and expansion of fractures. The event rate appears to be close to 0 before the rupture, and then the platform oscillates, followed by a sudden increase. The acoustic emission b-value is relatively high during the initial stage and then decreases, which is the initial damage process. The elastoplastic phase rises again, the peak stage decreases rapidly, and the weakly cemented sandstone undergoes unstable damage. The change in the acoustic emission entropy value is exactly the opposite of the b-value change law. When the weakly cemented sandstone reaches the critical failure state under different dry-wet cycles, the relative stress value is 95%. The test results provide new methods and a basis for the damage evolution mechanism and fracture prediction of weakly cemented sandstone under dry-wet cycles.
The CCL7-CCL2-CCR2 Axis Regulates Age-Related Alterations in ADSCs 
Authors: Li Keya , Shi Guiying , Lei Xuepei , Huang Yiying , Li Xinyue , Bai Lin , Qin Chuan
Published: April 2021

Background and ObjectivesAdipose-tissue derived stem cells (ADSCs) autologous transplantation have been a promising strategy for aging-related disorder. But the relationship between ADSCs senescence and organismal aging were still no consistent conclusions. Toward this end, we analyzed the senescence properties of ADSCs from different age donors to furthermore understand the differences of cells between young and senile donors and verify the influence of organismal aging on the proliferation and function of ADSCs in vitro, providing the theoretical basis for the clinical application of autologous ADSCs transplantation.Methods and ResultsWe detected the characteristics, function, gene expression, apoptosis, cell cycle, SA-β-gal staining, and transcription features of ADSCs from 1-month mice and 20-month mice. ADSCs from old donors had some senescence-associated changes with less ability to proliferation than ADSCs from 1-month mice. Differentiation ability, cell surface markers, and SA-β-Gal staining did not differ across donor age, while cells exhibit a more remarkable age-related changes through continuous passages. According to the results of transcriptome analysis, the CCL7-CCL2-CCR2 axis and Hippo signaling pathway would be considered as its possible mechanisms. ConclusionsOur study reveals that ADSCs from old donors have some age-related alterations. The CCL7-CCL2-CCR2 which lies behind this change would be a potential target for gene therapy to reduce harmful effects of ADSCs from old donors. To make autologous transplantation work better, we would recommend that ADSCs should be cryopreserved in youth with minimum number of passages.
Automatic Tolerance Selection for Approximate Bayesian Computation
Authors: Karabatsos George
Published: April 2021

Approximate Bayesian Computation (ABC) can provide inferences from the (approximate) posterior distribution based on intractable likelihoods. The quality of ABC inferences relies on the choice of tolerance for the distance between the observed data summary statistics, and the pseudo-data summary statistics simulated from the likelihood, used within the context of an algorithm which samples from the approximate posterior. However, the ABC literature does not provide an automatic method to select the best tolerance level for the given dataset at hand, and in ABC practice finding the best tolerance level can be time consuming. This note introduces a fast automatic estimator of the tolerance, based on the parametric bootstrap. After the tolerance estimate is calculated, it can then be input into any suitable importance sampling or MCMC algorithm to approximate from the target approximate posterior distribution. This tolerance estimator is illustrated through ABC analyses of simulated and real datasets involving several intractable likelihood models. This includes the analysis of a real 23,000-node network dataset involving stochastic search model selection.
Cervicovaginal COVID-19 Positivity: A Pilot Study
Authors: Çiplak Barış , Şimşek Yavuz , Kara Mustafa , Akyol Rukiye , Hizmali Lokman , Akça Veysel , Sayhan Işıl , Sezgin Fikriye Milletli , Şahin Yahya , Eroğlu Sercan , Dağli Selda Songur , Çelik Fatma , Köylü Zeynep
Published: April 2021

Purpose: ACE 2 RNA expression has been detected in organs of the female reproductive tract, suggesting that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could potentially infect female reproductive organs. In this study, we investigated the presence of SARS-CoV-2 virus in the cervicovaginal fluid.Materials and Methods: Our study included 31 female patients aged 18–65 years. The presence of SARS-COV-2 RNA was investigated by RT-PCR in two separate cervicovaginal swab samples collected from patients 14 days apart. Viral RNA was extracted using viral nucleic acid buffer (vNAT) solution, and SARS-COV-2 RNA was analyzed using Bio-speedy SARS-CoV-2 RT-qPCR kits in Bio-Rad CFX96 TouchTM device.Results: The first and second cervical swab samples were collected from 22 of 31 patients 14 days apart. The first cervical swab sample was collected from 9 patients; however, the second swab sample could not be collected after 14 days. SARS-COV-2 RNA result was negative in 100% of a total of 53 cervicovaginal swab samples collected. Moreover, the SARS-COV-2 RNA result was negative in the nasopharyngeal swab of babies after delivery in three pregnant women.Conclusion: Negative SARS-COV-2 RNA results in cervicovaginal swab samples suggest that there is no sexual transmission of COVID-19 and no vertical transmission during pregnancy. However, the number of studies conducted on this subject and the sample size examined are still insufficient.
Gamma-valerolactone-assisted nanolignin as a powerful building block in nanomedicine
Authors: Chen Liheng , Luo Si-Man , Huo Cong-Min , Shi Yun-Feng , Feng Jun , Zhu Jingyi , Xue Wei
Published: April 2021

The authors have requested that this preprint be removed from Research Square.
Kinetics of killing and mode of action of Cinnamomum impressicostatum crude stem – bark extract on Methicillin Resistant Staphylococcus aureus
Authors: Buru Ayuba Sunday , Neela Vasanthakumari , Mohandas Kavitha , Pichika Mallikarjuna Rao
Published: April 2021

Background This study evaluated the mode of action of Cinnamomum impressicostatum on Methicillin Resistant Staphylococcus aureus (MRSA). Cinnamon is one of the most popular spices used by mankind to enhance the flavour of his cuisine. In addition, cinnamon contains medicinally important essential oils in its leaves, stems, twigs, fruits and inner and outer bark. Many species of cinnamon are widely used in traditional medicinal systems around the world for the treatment of a wide variety of infectious diseases including tuberculosis and salmonellosis.Methods The crude stem – bark water extract of C.impressicostatum was generated using sequential soxhlet extraction. The antibacterial activity of the extract was investigated by performing broth microdilution assays and determination of the Minimum Inhibitory Concentration (MIC). A time kill study was performed to determine the killing efficiency of the extract. Potential bacteriolytic activity of the extract against MRSA was evaluated. Potential summative or synergistic killing effects of the extract when supplemented with 7.5% NaCl was also determined. Leakage of intracellular cytoplasmic components through the bacterial plasma membrane was analysed by determining absorbance at 260 nm. Scanning Electron Microscopy was used to study the damaging effects of the extract on the cell wall of MRSA.Results The Soxhlet crude water extract of C.impressicostatum stem - bark recorded the highest zone of inhibition (i.e. 21.0  1.4 mm) in disk diffusion assays. Its Minimum Inhibitory Concentration (MIC) against MRSA was 19.5 g mL-1 and its Minimum Bactericidal Concentration was 39.0 g mL-1 . The combinatorial effect of the extract supplemented with 7.5% NaCl resulted in a marked decrease in bacterial growth suggesting enhanced killing with the use of NaCl that may be summative or synergistic in nature. Evidence suggests that treatment with the crude extract causes cytoplasmic leakage, possibly by damage to the bacterial cell wall or cytoplasmic membrane. This was substantiated by post treatment scanning electron microscopic analysis which revealed alterations in cell wall topology, possible damage to the bacterial cell wall and plasma membrane and the presence of vast amounts of cellular debris.Conclusion The results of this study indicate that the killing efficacy of C.impressicostatum stem - bark extract against MRSA is enhanced by NaCl and that treatment with the plant extract induces gross and irreversible cellular damage eventually leading to bacteriolysis. The bioactive compound(s) contained in the plant extract thus show immense potential for development into efficacious antibacterial drugs.
Long-term Economic Effects of Aridification on the GDPs of Africa and Asia
Authors: Malpede Maurizio , Percoco Marco
Published: April 2021

We examine the effects of human-induced desertification on economic growth by exploiting a 56 km-by-56 km grid-cell global dataset on the annual frequency from 1990–2015. We find that areas that experienced large soil aridification are associated with a reduction in GDP per capita. Our results indicate that from 1990–2015, aridification reduced the GDPs of African and Asian countries by 12% and 2.7%, respectively. Our estimates are robust to adding higher-order terms of geo-climatic variables and controlling for country-specific linear trends, which allows us to project future costs of desertification. Our findings show that desertification will generate losses in GDP growth by 16% and 6.7% in Africa and Asia, respectively.
Effects of sporadic transthyretin amyloidosis frequently on the gallbladder and the correlation between amyloid deposition in the gallbladder and heart
Authors: Ichimata Shojiro , Hata Yukiko , Nishida Naoki
Published: April 2021

The aim of the study is to evaluate the clinicopathological features of cholecystic ATTR deposition in patients with cardiac involvement, investigate the correlation of amyloid deposition severity in the gallbladder and the heart, and compare its prevalence in the gallbladder and other organs. Fifty patients with sporadic ATTR amyloidosis were identified. Of these, we evaluated 15 patients who underwent gallbladder sampling accurately. Among 10 patients (67%) with cholecystic deposition, six exhibited detectable deposition in the hematoxylin and eosin-stained specimens, and all of them displayed obstructive vascular deposition (VD). The severity of gall bladder VD was statistically correlated with that of cardiac VD and atrial interstitial deposition (ID). Additionally, all patients exhibiting cholecystic ID displayed severe ventricular and atrial IDs. In visceral organs excluding the heart, amyloid deposition was commonly observed in the lungs (93%), followed by the gastrointestinal tract (47%‒80%), liver (60%), and periosteal tissues (53%). The involvement of gallbladder was prevalent and comparable to that of the gastrointestinal tract. Moreover, the severity of cholecystic deposition was correlated with that of cardiac deposition. Therefore, pathologists should be aware that sporadic ATTR amyloidosis is a common condition and should not be overlooked.
Multivariate Outlier Detection by Using Two-Dimensional Correlation
Authors: Dikbas Fatih
Published: April 2021

The accuracy of descriptive statistics might be influenced by the existence of outliers in data sets. An observation which might not be considered as an outlier in the univariate case might be a multivariate outlier. Therefore, determination of outliers might make multivariate analysis more robust by providing an opportunity for making required corrections before modelling studies. This paper presents the implementation of the two-dimensional correlation method in the determination of multivariate outliers among the observations of six precipitation stations in Turkey. The two-dimensional correlation method considers the averages of the parts of the whole series instead of the average of the whole series and enables determination of the location of the outlier in the compared series. The obtained results point out that an outlier analysis for hydrologic variables should consider the two-directional behavior and the presented two-dimensional correlation method proves to be a strong alternative to be used in outlier and irregularity detection studies even with a limited number of available data. The 2DCorr software used in the study is freely provided as a supplementary material.
Quality Assessment of Selected Ground Water Sources Around a University Teaching Hospital Liquid Waste Treatment Plant
Authors: Adegbe Elijah Abakpa , Maina Lois Riyo , Adeniji Shola Elijah , Fasanya Opeoluwa Olusola , Okoduwa Stanley Irobekhian Reuben
Published: April 2021

Background:The study conducted a comprehensive assessment of the quality of selected groundwater sources around the liquid waste treatment plant of Ahmadu University Teaching Hospital Shika, Nigeria. Water samples were collected from four (4) hand-dug wells following standard procedures, ten (10) physicochemical parameters and seven (7) heavy metals were analyzed.Results: All the physicochemical parameters studied were within the WHO specified limits except for DO which was less and turbidity which was higher. Heavy metals were found in the all the groundwater sources that were studied. However, the concentration of some heavy metals exceeded the specified limits recommended by the World Health Organization (WHO). The heavy metal presence in the groundwater sources may be connected to human activities such as waste disposal containing these metals around the groundwater sources and liquid waste from the hospital which can may have seeped into the wells.Conclusion: By implication, this study shows that the hand-dug wells were not safe for drinking. It is recommended that wells be sited away from dumpsites and waste treatment plants and effluents from waste treatment plants should also be properly treated before their subsequent discharge into the environment. This study has generated a baseline data that will be useful in monitoring heavy metal pollution.
Healthcare Providers’ Implementation of Patient-Centred Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) in Practice A Protocol for a Mixed Method Systematic Review
Authors: Wolff Angela C , Dresselhuis Andrea , Hejazi Samar , Dixon Duncan , Gibson Deborah , Howard A Fuchsia , Liva Sarah , Astle Barbara , Reimer-Kirkham Sheryl , Noonan Vanessa K , Edwards Lisa
Published: April 2021

Background: Substantial literature has highlighted the importance of patient-reported outcome and experience measures (PROMs and PREMs, respectively) to collect clinically relevant information to better understand and address what matters to patients. The purpose of this systematic review is to synthesize the evidence about strategies for implementing individual-level PROMs and PREMs data by healthcare providers in their everyday practice.Methods: This mixed method systematic review protocol describes the design of our synthesis of the peer-reviewed research evidence (i.e., qualitative, quantitative, and mixed methods), systematic reviews, organizational implementation projects, expert opinion, and grey literature. Keyword synonyms for “PROMs,” PREMs,” and “implementation” will be used to search eight databases with limiters of English from 2009 to 2019. Study selection criteria includes implementation at the point-of-care by healthcare providers in any practice setting. Eligible studies will be critically appraised using validated tools (e.g., Joanna Briggs Institute). Guided by the review questions, data extraction and synthesis will occur simultaneously to identify biographical information and methodological characteristics as well as classify study findings related to implementation processes and strategies. As part of the narrative synthesis approach, two frameworks will be utilized: (a) Consolidated Framework for Implementation Research (CFIR) to identify influential factors of PROMs and PREMs implementation and (b) Expert Recommendations for Implementing Change (ERIC) to illicit strategies. Data management will be undertaken using NVivo 12TM. Discussion: Data from PROMs and PREMs are critical to adopt a person-centred approach to healthcare. Findings from this review will guide subsequent phases of a larger project that includes interviews and a consensus-building forum with end users to create guidelines for implementing PROMs and PREMs at the point of care. Systematic Review Registration: PROSPERO CRD42020182904
The application of logarithmic charts when evaluating the equilibrium concentrations of all particles in acid-base systems
Authors: Tanganov B. B.
Published: April 2021

Until recently, due to the absence of other suitable approaches, equilibrium concentrations in acid-base systems have been studied exclusively by measuring the pH of a solution. However, this method can not be used for organic (non-aqueous) solvent solutions. It is known that the ionic strength of a solution, which is a fundamental component in assessing the activity coefficient and the thermodynamic dissociation constant of an electrolyte, is influenced by the ions present in the system. The concentration of these ions is variable during interactions in aqueous and more complex non-aqueous solutions, which differ significantly in their physicochemical properties (boiling temperature, structure, permittivity, autoprotolysis constant, solvating ability, dipole moment, viscosity, etc.). Meanwhile, in order to obtain more objective and valid estimates of acid-base interactions, in addition to the activity of hydrogen ions, appropriate account should be taken of the equilibrium concentrations of all particles in the solution, which affect its ionic strength. In this article, on the basis of the law of mass action and equations describing equilibrium processes, the ionic product of a solvent, electrical neutrality and material balance in a solution, the corresponding equations were derived and a method was proposed for considering the effect of the concentrations of all particles in the system (not only hydrogen ions – pH), significantly affecting the properties of acid-base equilibrium systems. The proposed method can also be used to obtain the dependence of the equilibrium concentrations of all process substances on the state of the medium (test solution), determined by various chemical and instrumental methods in logarithmic coordinates, which makes it pos-sible to directly assess the equilibrium concentra- tions of all particles present in the system.
The effect of the nature of the сhalcogen atom on the extraction and adsorption characteristics of chalcogen-containing oligomers based on chlorex
Authors: Altynnikova E. E. , Grabel'nykh V. A. , Russavskaya N. V. , Sinegovskaya L. M. , Abdikalykov Ye. N. , Nalibayeva A. M. , Bishimbayeva G. K , Rozentsveig I. B.
Published: April 2021

The extraction and adsorption characteristics of chalcogen-containing oligomers derived from chlorex and elemental chalcogens in the hydrazine hydrate–base systems were studied. Sulphur- and selenium-containing oligomers synthesised in hydrazine hydrate–monoethanolamine systems are soluble in organic solvents. The as-obtained solutions are capable of extracting the following ions from water solutions: Hg2+, Cd2+, Zn2+, Pb2+, Cu2+ and Ni2+. Oligomers synthesised in the hydrazine hydrate–water–KOH system (sulphur- and selenium-containing oligomers) and a tellurium-containing oligomer obtained in the hydrazine hydrate–KOH system were used as adsorbents. It was assumed that the extraction and adsorption of metal ions by chalcogen-containing oligomers is carried out through the formation of complexes in which the chalcogen atoms act as ligands. The effect of the nature of chalcogen atoms on the possibility of forming complexes, i.e. on the extraction and adsorption properties of the oligomers used, was considered using the theory of hard and soft acids and bases (HSAB). According to this theory, the cations Hg2+ and Cd2+ belong to soft acids, while the cations Zn2+, Pb2+, Cu2+ and Ni2+ belong to acids of intermediate hardness. Chalcogen atoms are classified as soft bases. The conducted experiment showed that Hg2+ and Cd2+ ions are easily extracted and adsorbed by all the oligomers used, while the intermediate-hardness cations most easily interact with the sulphur-containing oligomers. The formation of oligomer–metal complexes was confirmed by analysing IR and 77Se NMR spectra recorded for sulphur- and selenium-containing oligomers before and after the extraction. The recorded IR spectra contained obvious changes in the nature of the absorption bands due to the stretching vibrations of the C–S and C–Se bonds. An additional signal of de-screened selenium nuclei was observed in the 77Se NMR spectrum. An insignificant change in the nature of the IR spectra in the region of stretching C–O vibrations indicated a weak participation of oxygen in the formation of complexes. It can be assumed that the role of oxygen in maintaining the high rates of extraction and adsorption is associated with an increase in the flexibility of macromolecules, which ensures a more favourable geometry for complex formation.
Gemological and mineralogical-petrographic study of the Eastern Sayan serpentinites
Authors: Anisimova A. A.
Published: April 2021

The purpose of the research is to study the mineralogical and petrographic characteristics of the Eastern Sayan serpentinites in order to identify their most decorative varieties. The objects of the study are the samples of serpentinites from the Ulan-Khodinskoye and Khokhurtovskoye deposits of the Eastern Sayan. Six samples were studied macroscopically then polished plates were made from them for gemological examination and thin sections for microscopic examination. All studies were carried out using standard gemological methods at the Gemmology Research Laboratory of the Irkutsk National Research Technical University. The petrographic study of thin sections was carried out using an Axio Lab A1 microscope. Macroscopically, two main ornamental varieties of serpentinite were identified: spotted bluish-green serpentinite and massive serpentinite of the color from dark green to black. The spotted structure of serpentinite is determined by numerous inclusions of ore minerals including magnetite and iron oxides. Its hardness is 4.5 on the Moh’s scale, its gloss is matte. The data on the main gemological characteristics of the samples corresponding to the results of already published studies of gem-quality serpentinites from other deposits were also obtained. Having analyzed the microstructure and mineral composition of the Eastern Sayan serpentinites, their correspondence to the spotty and massive decorative varieties of serpentinites from other Russian deposits was revealed. At the moment, this material is not duly appreciated, although it may well be used as a sculptural and jewelry-ornamental decorative stone.
Improving design and application method of screening bucket excavators
Authors: Cheban A. Yu.
Published: April 2021

The purpose of the study is to increase the productivity and economic efficiency of mining operations using screening bucket excavators on the basis of the introduction of a new technical and technological solution that expands equipment functionality. The study involves the analysis of known designs of screening buckets installed on excavators that ensure material separation to be carried out simultaneously with excavation and loading works. It is noted that a promising development direction of screening buckets is a design with working drums. The article presents an excavator with a modernized screening bucket and its operation technology, which allows to start rock mass sorting in the bucket while the excavator is turning to the place of unloading. The improved screening bucket is equipped with a hinged movable bottom controlled by hydraulic cylinders to accumulate fine fractions screened through the working drums. Fine fractions accumulated in the moving bottom are unloaded into a dump truck, after which screening continues directly into the body of the dump truck. Screening finished, the movable bottom closes and the excavator unloads the coarse fractions remaining in the bucket into another vehicle. Unloading is carried out by bucket turning. The combination of screening and excavator turning reduces the operation cycle time, which increases the performance of both the excavator and dump trucks. The use of a modernized screening bucket with a moving bottom eliminates the loss of valuable fine material as a result of spilling when the excavator turns for unloading. The movable bottom can be installed on the screening buckets of known designs and does not require their significant alteration. Application of the proposed technical and technological solution will reduce unit costs and increase the efficiency of work.
Сritical care echocardiography and transpulmonary thermodilution in patients with sepsis. Pilot study
Authors: Tyurin I. N. , Rautbart S. A. , Ganieva I. I. , Aleksandrovsky A. A. , Kozlov Igor A.
Published: April 2021

Introduction.The cardiac dysfunction in sepsis (septic cardiopathy) diagnosis is an actual problem.
Objectives. To study the correspondence between the indicators obtained with сritical care echocardiography and transpulmonary thermodilution, and to assess their predictive significance in relation to the risk of mortality.
Materials and methods. The study involved 25 patients aged 45 (31–68) years with abdominal sepsis or septic shock. The severity of the condition upon admission to the intensive care unit was 13 (11–16) points on the APACHE II scale, and 8 (6.5–9.5) points on the SOFA scale. Septic shock was diagnosed in 52 % of patients.
Results. Cardiac index, stroke volume index, left ventricular ejection fraction and global cardiac ejection fraction, as well as heart filling volumes established by echocardiography and transpulmonary thermodilution were moderately correlated with each other (rho 0.408–0.538; p < 0.05). Dilation of the left ventricle (end-diastolic volume index 80–115 ml/m2) was detected in 16 % of patients. A decrease of the left ventricle ejection fraction (48–23 %) was registered in 24 % of cases. Transpulmonary thermodilution indices were not associated with a left ventricular ejection fraction value below 50 %. Neither left ventricular ejection fraction nor left ventricular filling volumes were predictors of adverse sepsis outcomes. The predictor of mortality was the cardiac function index determined with transpulmonary thermodilution (OR 0.3361; 95 % CI 0.1351–0.8363; p = 0.019), the value of which < 5.8 min–1 predicted mortality with sensitivity of 85.7 % and specificity of 72.2 % (AUC 0.817; p = 0.0057).
Conclusions. Ultrasound assessment of cardiac activity with the calculation of left ventricular filling volumes and left ventricular ejection fraction should not be considered as a non-invasive alternative to transpulmonary thermodilution in patients with sepsis. The heart function index can diagnose abnormal heart function that increases the risk of mortality in abdominal sepsis.
Analysis of criminal cases against doctors of surgical specialties on the article “Causing death by negligence due to improper performance of the person’s professional duties”
Authors: Gorbachev Vladimir I. , Netesin E. S. , Gorbacheva S. M. , Sumin S. A. , Khamidulin M. V. , Utkin N. N.
Published: April 2021

Introduction. Currently, there is a serious increase in complaints from citizens to the Investigative Committee of the Russian Federation. Accordingly, there has been an increase in criminal cases initiated against medical workers. The group of specialists of maximum risk includes, first of all, doctors of surgical specialties: surgeons; anesthesiologists-resuscitators; obstetricians-gynecologists.
Objectives. Analyze the criminal cases against surgeons initiated under the second part of Article 109 of the Criminal Code of the Russian Federation.
Materials and methods. The search for criminal cases was carried out in the following electronic databases: Court decisions of the Russian Federation (https://court decisions.rf) and the state automated system of the Russian Federation “Justice” (https://bsr.sudrf.ru/bigs/portal.html), the search depth was — the last five years.
Results. Found 235 court decisions in cases open under Part 2. Art. 109 of the Criminal Code of the Russian Federation. An assessment of territorial and gender characteristics was carried out. Defects in the provision of medical care identified by the courts and incriminated to doctors are presented. The attitude of doctors of surgical specialties to the charges brought and the applied terms of the main types of punishment are presented: restriction of freedom and deprivation of the right to engage in medical activities. Attention is drawn to the aggravating and mitigating circumstances used by the courts.
Conclusions. The most problematic moments in the treatment of patients in the presented surgical specialties are invasive manipulations and surgical interventions.
New coronavirus infection COVID-19: clinical and prognostic significance of plasma fibrinogen level
Authors: Bulanov Andrey Yu. , Simarova I. B. , Bulanova E. L. , Siniavkin D. O. , Feklistov A. Yu. , Rabotinsky S. E. , Katrish S. A.
Published: April 2021

COVID-associated coagulopathy is currently widely discussed in the medical press. There are no unambiguous ideas about its mechanisms and significance at the present time. One of the manifestations is hyperfibrinogenemia. The study of specific changes in this laboratory indicator is of interest from the point of view of evaluating the prognosis of the course of coronavirus infection and selecting therapy.
Objectives. Analysis of plasma fibrinogen dynamics in patients with COVID-19, assessment of clinical and prognostic significance of the indicator.
Materials and methods. The retrospective study included 350 patients undergoing inpatient treatment for SARS-CoV-2 infection. At the time of analysis, 49 patients (14 %) died, and the rest were discharged from the hospital. The dynamics of fibrinogen content was evaluated, compared with the outcomes of the disease, clinical complications of a thrombotic or hemorrhagic nature, and other laboratory indicators.
Results and conclusion. A characteristic feature of COVID-associated coagulopathy is hyperfibrinogenemia (the maximum value of fibrinogen is 6.2 ± 1.7 g/l) as a manifestation of systemic inflammation with a transition in 14 % of patients to hypofibrinogenemia (the minimum value is 1.57 ± 0.29) due to hepatic dysfunction and consumption coagulopathy. In the context of pharmacological antithrombotic prevention, hyperfibrinogenemia did not show clinical significance as a risk factor for thrombosis, while a decrease in fibrinogen less than 2.0 g/l was associated with a 9-fold increase in the risk of hemorrhagic complications in patients with coronavirus infection (OR 9.913 СI 95 % [1.613–60.931]). A decrease in fibrinogen below normal values and an excess of 9.0 g/l are equally predictors of an adverse outcome in patients with COVID-19. The relative risk of death was 3.263 СI 95 % (1.970–5.407) and 2.574 СI 95 % (1.265–5.237), respectively.
Methodological aspects of desflurane application in modern anesthesiology. Review
Authors: Ovezov Alexey M. , Pivovarova A. A. , Halimov M. R.
Published: April 2021

Introduction. Desflurane is the last inhalational anesthetic approved for use in the Russian Federation. The experience of its use in the country in comparison with sevoflurane is still not great for a number of reasons, including the insufficient volume of methodological literature in Russian.
Objectives. To highlight the methodological aspects of the use of desflurane in modern anesthesiology.
Materials and methods. The search for sources was carried out using the resources of the Russian scientific electronic library (eLIBRARY.ru), the bibliographic database of articles from the US National Library of Medicine (NCBI), the ClinicalKey electronic library, and the Scopus abstract and citation database. The search depth is 7 years.
Results. A review of publications in 2014–2020, devoted to the methodology of using modern vapor-generating anesthetics, has been performed. The methodological techniques of anesthesia with desflurane are described in detail: inhalation induction, maintenance of anesthesia using a low and minimal flow of fresh gas, the peculiarities of the period of awakening and post-anesthetic rehabilitation are given.
Conclusion. Desflurane is not the drug of choice for inhalation induction of anesthesia, but has a number of distinctive feature: advantages for using with low or minimal fresh gas flow; superiority in speed and predictability of the period of early post-anesthetic rehabilitation; safety of use, both in elderly patients and in children; relevance for Outpatient anesthesiology, Bariatric surgery, and programs for Enhanced Recovery After Surgery.
Hodgkin’s Lymphoma in HIV-Infected Patients
Authors: Pivnik Aleksandr Vasilevich , Vukovich A.M. , Kremneva N.V. , Dubnitskaya M.G. , Tsakhilova A.V.
Published: April 2021

Aim. To assess clinical and laboratory characteristics of the unique category of HIV-positive patients with hepatitis C or B co-infection combined with Hodgkin’s lymphoma (HL). Materials & Methods. The paper provides data on 85 HIV-positive patients with HL followed-up at the Department of Hematology and Secondary Immunodeficiencies of the AS Loginov Moscow Clinical Scientific Center from 2002 to 2019 (data on 2008-2010 are not available). The distribution of patients by sex was approximately equal, median age was 35 years (range 20-74 years). Results. Histological HL variant is predominantly mixedcell with many positive tests for Epstein-Barr virus. More than 80 % of patients with concomitant HIV infection were admitted to the AS Loginov Center with HL stage III/IV. Most of them received highly active anti-retroviral therapy (HAART) before HL diagnosis. The distinguishing feature of HIV-positive patients with HL appeared to be high (as compared to HIV patients with other lymphoma variants) CD4+ lymphocyte count. This phenomenon is considered within the framework of immune reconstitution inflammatory syndrome (IRIS). A clue to this phenomenon may lay the foundation in addressing the issue of lymphoma genesis and development. Viral load was moderate and undetectable. Hepatitis C and/or B co-infection was identified in 95 % of patients. Antiviral therapy for concomitant hepatitis C was administered concurrent with HAART. All patients received АBVD, BEACOPP-14, BEACOPP-escalat-ed, DHAP, ESHAP antitumor regimens. Radiotherapy was used if necessary. In hepatitis C HAART and direct-acting drugs were administered concurrent with chemotherapy. No severe adverse reactions were observed. Even before starting antitumor treatment of HL patients with concomitant HIV and/or hepatitis viral infections, mortality was 8 %. But in the group of patients with the same co-infections who received HL chemotherapy, mortality was 10 %. The cause of death was HL stage IVB with viral liver cirrhosis, agranulocytosis, and sepsis. Conclusion. Diseases considered incurable in the past, such as HL and hepatitis C, can be healed today. Compromised immunity of HIV-positive patients can be successfully stabilized with HAART.