bluuebunny/crossref_metadata_2025 huggingface dataset:
Значение экстрацеллюлярных везикул в патогенезе и диагностике неалкогольной жировой болезни печени (обзор литературы)
Authors: Stepanov Yu.M. , Lukianenko O.Yu.
Published: December 2019

Экстрацеллюлярные везикулы (ЭВ) — это небольшие мембранные везикулы, выделяемые клетками во внеклеточную среду. ЭВ представлюют собой коммуникационные молекулы и могут влиять на целый ряд целевых клеток в окружающей их клеточной среде, а также могут оказывать дистанционное действие. ЭВ рассматриваются в качестве высокочувствительных биомаркеров хронических заболеваний печени. В статье приведен обзор современных литературных данных о роли ЭВ в патогенезе неалкогольной жировой болезни печени (НАЖБП), а также диагностическом значении ЭВ в разрезе НАЖБП. Рассмотрены вопросы классификации ЭВ, строение ЭВ, описаны молекулы, входящие в состав ЭВ. Уделено внимание особенностям идентификации ЭВ в сыворотке крови. Подробно рассмотрены вопросы роли ЭВ в формировании и развитии НАЖБП. В cтатье показано, что в прогрессировании НАЖБП имеют значение как ЭВ, происходящие из гепатоцитов, так и внепеченочные и бактериальные ЭВ. Показано, что значение ЭВ при НАЖБП не ограничивается формированием дисметаболических изменений, а включает развитие воспаления и фиброза печени. С другой стороны, ЭВ могут использоваться в качестве транспортеров экзогенных молекул РНК в клетки печени. ЭВ-ассоциированные ncRNA уверенно признаются в качестве важных регуляторов биологических процессов как в физиологических, так и в патологических условиях.
Особенности микрофлоры ран пациентов с травматическими повреждениями вспомогательного аппарата глаза и способность выделенных штаммов к образованию биопленок
Authors: Petrenko О.V. , Dranko М.M. , Golubnicha V.M. , Hritsay L.V.
Published: December 2019

Актуальность. Проблема гнойно-воспалительных осложнений при травмах вспомогательного аппарата глаза остается актуальной для клинической офтальмохирургии, поскольку данные состояния нередко обусловливают тяжелое протекание пред- и послеоперационного периода, которое проявляется нарушением общих и местных механизмов регулирования, генерализацией процесса и задержкой заживления ран. Цель исследования заключалась в изучении видового состава микрофлоры ран вспомогательного аппарата глаза, определении чувствительности выделенных микроорганизмов к наиболее часто используемым антибиотикам и их способность образовывать биопленки. Материалы и методы. В работе исследовали видовой состав микрофлоры ран 53 пациентов с травматическими повреждениями вспомогательного аппарата глаза за 2018–2019 годы. Осуществлено исследование мазков с ран с последующим определением видового состава и идентификацией микроорганизмов, которые проводили с использованием классических бактериологических методик. Результаты. Идентифицировали 67 штаммов микроорганизмов. Доминирующим оказался Staphylococcus aureus, второе место занял Acinetobacter spp., третье — Micrococcus spp. Частота выявления микроорганизмов в монокультуре с ран составила 33 (66 %), в 17 (34 %) случаях — в ассоциациях. Исследовали чувствительность выделенных штаммов к наиболее часто используемым антибиотикам, среди которых наиболее активным оказался гатифлоксацин. Провели оценку формирования биопленок штаммами S. aureus, поскольку он является комменсалом и превалирует в этиологии раневой инфекции (31 %). Выводы. Установлено, что у штаммов S. aureus (n = 21), которые выделили из ран пациентов, в 15 случаях (71 %) наблюдалась высокая способность к формированию биопленок, в 6 случаях (29 %) отмечалось умеренное биопленкообразование.
Гострий тонзилофарингіт у дітей. Сучасний стан проблеми
Authors: Kramarov S.O. , Yevtushenko V.V. , Ivanova L.A. , Gorbatiuk I.B.
Published: December 2019

Гострий тонзилофарингіт — одне з найпоширеніших інфекційних захворювань у дітей. Найбільш поширена вірусна етіологія. Серед бактеріальних причин основним збудником є Streptococcus pyogenes, або β-гемолітичний стрептокок групи A, що спричиняє близько 30 % епізодів. Дифтерія і некробацильоз нечасті, але пов’язані з тяжким перебігом захворювання. У процесі діагностики шкали клінічної оцінки можуть допомогти клініцистам краще прогнозувати підозрювану бактеріальну етіологію шляхом вибору пацієнтів. Використання алгоритмів діагностики може бути корисним для виявлення й скринінгу випадків, що не потребують антибіотикотерапії. Для лікування стрептококового тонзилофарингіту рекомендуються бета-лактамні антибіотики або макроліди. Правильна діагностика бактеріального тонзилофарингіту й правильне використання антибіотиків на основі наявних наукових даних мають вирішальне значення.
Парвовірусна інфекція В19V: огляд літератури. Частина 1
Authors: Kiriienko V.T. , Zaytsev I.A. , Potii V.V. , Nesteruk Ye.S.
Published: December 2019

У статті наведені сучасні дані про різні аспекти проблеми парвовірусної інфекції. На підставі аналізу даних літератури описані етіологія, епідеміологія, шляхи передачі інфекції, особливості патогенезу у дорослої людини й фетальної парвовірусної інфекції. Наведені клінічні прояви основних форм захворювання.
Аналіз клінічних випадків мембранозного фарингіту, асоційованого з Corynebacterium ulcerans
Authors: Shostakovych-Koretska L.R. , Mavrutenkov V.V. , Budayeva I.V. , Revenko G.O.
Published: December 2019

У роботі наведені 4 клінічні випадки мембранозного фарингіту, спричиненого Corynebacterium ulcerans, в осіб 27, 32, 44 та 46 років із детальним аналізом. Показана роль зоонозного збудника Corynebacterium ulcerans у виникненні захворювання, подібного до класичної дифтерії. Наголошено на важливості вакцинопрофілактики дифтерії з метою запобігання захворюваності на зоонозну інфекцію, що викликана Corynebacterium ulcerans.
Актуальні питання хвороби Лайма. Огляд сучасних міжнародних рекомендацій
Authors: Kramarov S.O. , Hrechukha Ye.O.
Published: December 2019

Хвороба Лайма є найпоширенішою трансмісивною інфекційною хворобою, вектором для якої виступають кліщі. Діагностичний підхід залежить від форми захворювання, але як і раніше серед стратегій перевага надається клінічній діагностиці. Методом вибору серед лабораторних тестів є визначення сироваткових антитіл. Збудник хвороби чутливий до антибіотиків одразу декількох класів, при цьому їх вибір та доза базуються на синдромі хвороби. Після хвороби у пацієнтів можуть залишатися неспецифічні симптоми, за наявності яких не рекомендується додаткова антибіотикотерапія. Автори нижченаведених рекомендацій виступають проти перевірки кліщів на наявність Borrelia burgdorferi після укусу. Профілактична антибіотикотерапія рекомендується дітям і дорослим протягом перших 72 годин лише у випадку з високим ризиком розвитку інфекції. Дотримання простих правил індивідуального захисту, застосування репелентів і своєчасний огляд дозволять уникнути розвитку інфекції.
The Effects of Financial Derivatives on Earnings Management and Market Mispricing
Authors: Oktavia Oktavia , Siregar Sylvia Veronica , Wardhani Ratna , Rahayu Ning
Published: December 2019

This study aims to examine the effects of financial derivatives on earnings management and market mispricing. A cross-country analysis was applied within the scope of four ASEAN (Association of Southeast Asian Nations) countries that comply with IAS 39, consisting of the Philippines, Indonesia, Malaysia, and Singapore. A sample of 1,395 firm-years of companies using financial derivatives were engaged for study and the evidence shows that the use of financial derivatives for hedging purposes decreases the magnitude of the earnings management. In addition, this study also supports the idea that earnings expectations embedded in the stock returns of companies using financial derivatives, that meet the hedge accounting criteria, reflect the difference in the persistence of cash flow components more accurately than those using financial derivatives for speculative purposes.
Linking supervisor incivility with job embeddedness and cynicism: The mediating role of employee self-efficacy
Authors: ALOLA UJU VIOLET , Asongu Simplice A , Alola Andrew Adewale
Published: December 2019

Applying the conservation of resource resources theory and the self-efficacy theory, this study investigates the relationship between supervisor incivility, self-efficacy, cynicism and the job embeddedness of employees in the hotel industry. The role of self-efficacy, as an important variable that mediates the relationship between the predictor and the criterion variable, is significantly evaluated. A non-probability sampling technique was used to collect 245 questionnaires from frontline employees of five and four-star hotels in Nigeria. The findings reveal that supervisor incivility has a negative effect on self-efficacy and a positive effect on cynicism, and that self-efficacy negatively affects cynicism. There was no significant relationship with job embeddedness in the study.  Importantly, the investigation establishes that self-efficacy is a mediating variable between supervisor incivility and cynicism. The study noted the importance of adopting a policy that introduces periodic seminars and professional training for both employees and supervisors, as a means for curbing incivility and cynicism. The study concludes with theoretical and practical implications, leaving room for further investigation
MEMORY AS A METHOD FOR FILMMAKING
Authors: Emilio Angel Reyes Bassail
Published: December 2019

This research develops a method for filmmaking that uses autobiographical memory as a guiding principle for the production of images. The proposed method comes as the result of a double gesture in which I wanted to a) acquire a subjective understanding of memory that came from artistic practice; and b) materialize the process of memory through film.

I used the filmmaking apparatus as a technique to give visibility to the process of remembering and forgetting: I worked with strategies such as the elaboration of a “memory diary”; the drawing of spoken portraits and locations based on memories; casting techniques which involved a dialectical approach towards memory; scouting trips to find places from my memory; hypnosis sessions as a technique to recover lost memories; reenactments of memories; a method to direct actors that relied on memory as a guiding mechanism; and the editing of the footage through a process of memory associations.

While doing this research, I inadvertently found that the techniques I used led to a process in which memories were rewritten through experimentation. Thus, the method produced a conceptualization of "memory" that frames it as a creative process. In the process of working on this project, I developed a very subjective approach to the craft of filmmaking that was informed by my particular relationship with memory. Thus, the proposed method of using personal memory as a core mechanism for the production of audio-visual products can be utilized as a tool for film education, promoting the creation of personal film languages based on an individual's memory, and as device to reflect on the subjective process behind an individual's artistic practice.
Swarming Event
Authors: Christina Stadlbauer
Published: December 2019

Witnessing a swarm of honeybees flying out of their hive is rare – especially in the urban environments. Because beekeepers manage their bees and take measures to prevent swarming from happening, the emergence of a swarm is regarded as bad beekeeping management. However, this event is a honeybee colony's birth and is an impressive show of nature's excellency.
Kin Tsugi Transformations
Authors: Christina Stadlbauer
Published: December 2019

Christina'S practice “Kin Tsugi Transformations”, pivots around Kin Tsugi – the ancient Japanese craft and art of repairing broken ceramics by using silver or gold. Christina is intrigued by both the hands on work and the thinking behind this form of repair. She applies the principle to many materials and also more conceptually.
In Kin Tsugi Transformations, utmost attention is given to the process rather than the outcome. The ritual character of this work takes shape as participatory interventions and in group practice. A more daring strand takes the concept into the microbiology lab where healing with the help of bacteria is introduced.
A Novel Model of Diabetic Complications: Adipocyte Mitochondrial Dysfunction Triggers Massive β-Cell Hyperplasia
Authors: Kusminski Christine M. , Ghaben Alexandra L. , Morley Thomas S. , Samms Ricardo J. , Adams Andrew C. , An Yu , Johnson Joshua A. , Joffin Nolwenn , Onodera Toshiharu , Crewe Clair , Holland William L. , Gordillo Ruth , Scherer Philipp E.
Published: December 2019

Obesity-associated type 2 diabetes mellitus (T2DM) entails insulin resistance and loss of β-cell mass. Adipose tissue mitochondrial dysfunction is emerging as a key component in the etiology of T2DM. Identifying approaches to preserve mitochondrial function, adipose tissue integrity, and β-cell mass during obesity is a major challenge. Mitochondrial ferritin (FtMT) is a mitochondrial matrix protein that chelates iron. We sought to determine whether perturbation of adipocyte mitochondria influences energy metabolism during obesity. We used an adipocyte-specific doxycycline-inducible mouse model of FtMT overexpression (FtMT-Adip mice). During a dietary challenge, FtMT-Adip mice are leaner but exhibit glucose intolerance, low adiponectin levels, increased reactive oxygen species damage, and elevated GDF15 and FGF21 levels, indicating metabolically dysfunctional fat. Paradoxically, despite harboring highly dysfunctional fat, transgenic mice display massive β-cell hyperplasia, reflecting a beneficial mitochondria-induced fat-to-pancreas interorgan signaling axis. This identifies the unique and critical impact that adipocyte mitochondrial dysfunction has on increasing β-cell mass during obesity-related insulin resistance.
Targeting the NADPH Oxidase-4 and Liver X Receptor Pathway Preserves Schwann Cell Integrity in Diabetic Mice
Authors: Eid Stéphanie A. , El Massry Mohamed , Hichor Mehdi , Haddad Mary , Grenier Julien , Dia Batoul , Barakat Rasha , Boutary Suzan , Chanal Johan , Aractingi Selim , Wiesel Philippe , Szyndralewiez Cédric , Azar Sami T. , Boitard Christian , Zaatari Ghazi , Eid Assaad A. , Massaad Charbel
Published: December 2019

Diabetes triggers peripheral nerve alterations at a structural and functional level, collectively referred to as diabetic peripheral neuropathy (DPN). This work highlights the role of the liver X receptor (LXR) signaling pathway and the cross talk with the reactive oxygen species (ROS)–producing enzyme NADPH oxidase-4 (Nox4) in the pathogenesis of DPN. Using type 1 diabetic (T1DM) mouse models together with cultured Schwann cells (SCs) and skin biopsies from patients with type 2 diabetes (T2DM), we revealed the implication of LXR and Nox4 in the pathophysiology of DPN. T1DM animals exhibit neurophysiological defects and sensorimotor abnormalities paralleled by defective peripheral myelin gene expression. These alterations were concomitant with a significant reduction in LXR expression and increase in Nox4 expression and activity in SCs and peripheral nerves, which were further verified in skin biopsies of patients with T2DM. Moreover, targeted activation of LXR or specific inhibition of Nox4 in vivo and in vitro to attenuate diabetes-induced ROS production in SCs and peripheral nerves reverses functional alteration of the peripheral nerves and restores the homeostatic profiles of MPZ and PMP22. Taken together, our findings are the first to identify novel, key mediators in the pathogenesis of DPN and suggest that targeting LXR/Nox4 axis is a promising therapeutic approach.
HB-EGF Signaling Is Required for Glucose-Induced Pancreatic β-Cell Proliferation in Rats
Authors: Maachi Hasna , Fergusson Grace , Ethier Melanie , Brill Gabriel N. , Katz Liora S. , Honig Lee B. , Metukuri Mallikarjuna R. , Scott Donald K. , Ghislain Julien , Poitout Vincent
Published: December 2019

The molecular mechanisms of β-cell compensation to metabolic stress are poorly understood. We previously observed that nutrient-induced β-cell proliferation in rats is dependent on epidermal growth factor receptor (EGFR) signaling. The aim of this study was to determine the role of the EGFR ligand heparin-binding EGF-like growth factor (HB-EGF) in the β-cell proliferative response to glucose, a β-cell mitogen and key regulator of β-cell mass in response to increased insulin demand. We show that exposure of isolated rat and human islets to HB-EGF stimulates β-cell proliferation. In rat islets, inhibition of EGFR or HB-EGF blocks the proliferative response not only to HB-EGF but also to glucose. Furthermore, knockdown of HB-EGF in rat islets blocks β-cell proliferation in response to glucose ex vivo and in vivo in transplanted glucose-infused rats. Mechanistically, we demonstrate that HB-EGF mRNA levels are increased in β-cells in response to glucose in a carbohydrate-response element–binding protein (ChREBP)–dependent manner. In addition, chromatin immunoprecipitation studies identified ChREBP binding sites in proximity to the HB-EGF gene. Finally, inhibition of Src family kinases, known to be involved in HB-EGF processing, abrogated glucose-induced β-cell proliferation. Our findings identify a novel glucose/HB-EGF/EGFR axis implicated in β-cell compensation to increased metabolic demand.
The Novel Adipokine Gremlin 1 Antagonizes Insulin Action and Is Increased in Type 2 Diabetes and NAFLD/NASH
Authors: Hedjazifar Shahram , Khatib Shahidi Roxana , Hammarstedt Ann , Bonnet Laurianne , Church Christopher , Boucher Jeremie , Blüher Matthias , Smith Ulf
Published: December 2019

The BMP2/4 antagonist and novel adipokine Gremlin 1 is highly expressed in human adipose cells and increased in hypertrophic obesity. As a secreted antagonist, it inhibits the effect of BMP2/4 on adipose precursor cell commitment/differentiation. We examined mRNA levels of Gremlin 1 in key target tissues for insulin and also measured tissue and serum levels in several carefully phenotyped human cohorts. Gremlin 1 expression was high in adipose tissue, higher in visceral than in subcutaneous tissue, increased in obesity, and further increased in type 2 diabetes (T2D). A similar high expression was seen in liver biopsies, but expression was considerably lower in skeletal muscles. Serum levels were increased in obesity but most prominently in T2D. Transcriptional activation in both adipose tissue and liver as well as serum levels were strongly associated with markers of insulin resistance in vivo (euglycemic clamps and HOMA of insulin resistance), and the presence of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). We also found Gremlin 1 to antagonize insulin signaling and action in human primary adipocytes, skeletal muscle, and liver cells. Thus, Gremlin 1 is a novel secreted insulin antagonist and biomarker as well as a potential therapeutic target in obesity and its complications T2D and NAFLD/NASH.
Interplay of Placental DNA Methylation and Maternal Insulin Sensitivity in Pregnancy
Authors: Hivert Marie-France , Cardenas Andres , Allard Catherine , Doyon Myriam , Powe Camille E. , Catalano Patrick M. , Perron Patrice , Bouchard Luigi
Published: December 2019

The placenta participates in maternal insulin sensitivity changes during pregnancy; however, mechanisms remain unclear. We investigated associations between maternal insulin sensitivity and placental DNA methylation markers across the genome. We analyzed data from 430 mother-offspring dyads in the Gen3G cohort. All women underwent 75-g oral glucose tolerance tests at ∼26 weeks of gestation; we used glucose and insulin measures to estimate insulin sensitivity (Matsuda index). At delivery, we collected samples from placenta (fetal side) and measured DNA methylation using Illumina EPIC arrays. Using linear regression models to quantify associations at 720,077 cytosine-guanine dinucleotides (CpGs), with adjustment for maternal age, gravidity, smoking, BMI, child sex, and gestational age at delivery, we identified 188 CpG sites where placental DNA methylation was associated with Matsuda index (P < 6.94 × 10−8). Among genes annotated to these 188 CpGs, we found enrichment in targets for miRNAs, in histone modifications, and in parent-of-origin DNA methylation including the H19/MIR675 locus (paternally imprinted). We identified 12 known placenta imprinted genes, including KCNQ1. Mendelian randomization analyses revealed five loci where placenta DNA methylation may causally influence maternal insulin sensitivity, including the maternally imprinted gene DLGAP2. Our results suggest that placental DNA methylation is fundamentally linked to the regulation of maternal insulin sensitivity in pregnancy.
The Local Paracrine Actions of the Pancreatic α-Cell
Authors: Rodriguez-Diaz Rayner , Tamayo Alejandro , Hara Manami , Caicedo Alejandro
Published: December 2019

Secretion of glucagon from the pancreatic α-cells is conventionally seen as the first and most important defense against hypoglycemia. Recent findings, however, show that α-cell signals stimulate insulin secretion from the neighboring β-cell. This article focuses on these seemingly counterintuitive local actions of α-cells and describes how they impact islet biology and glucose metabolism. It is mostly based on studies published in the last decade on the physiology of α-cells in human islets and incorporates results from rodents where appropriate. As this and the accompanying articles show, the emerging picture of α-cell function is one of increased complexity that needs to be considered when developing new therapies aimed at promoting islet function in the context of diabetes.
Confirming the Bidirectional Nature of the Association Between Severe Hypoglycemic and Cardiovascular Events in Type 2 Diabetes: Insights From EXSCEL
Authors: Standl Eberhard , Stevens Susanna R. , Lokhnygina Yuliya , Bethel M. Angelyn , Buse John B. , Gustavson Stephanie M. , Maggioni Aldo P. , Mentz Robert J. , Hernandez Adrian F. , Holman Rury R.
Published: December 2019

OBJECTIVE

We sought to confirm a bidirectional association between severe hypoglycemic events (SHEs) and cardiovascular (CV) event risk and to characterize individuals at dual risk.

RESEARCH DESIGN AND METHODS

In a post hoc analysis of 14,752 Exenatide Study of Cardiovascular Event Lowering (EXSCEL) participants, we examined time-dependent associations between SHEs and subsequent major adverse cardiac events (CV death, nonfatal myocardial infarction [MI] or stroke), fatal/nonfatal MI, fatal/nonfatal stroke, hospitalization for acute coronary syndrome (hACS), hospitalization for heart failure (hHF), and all-cause mortality (ACM), as well as time-dependent associations between nonfatal CV events and subsequent SHEs.

RESULTS

SHEs were uncommon and not associated with once-weekly exenatide therapy (hazard ratio 1.13 [95% CI 0.94–1.36], P = 0.179). In fully adjusted models, SHEs were associated with an increased risk of subsequent ACM (1.83 [1.38–2.42], P < 0.001), CV death (1.60 [1.11–2.30], P = 0.012), and hHF (2.09 [1.37–3.17], P = 0.001), while nonfatal MI (2.02 [1.35–3.01], P = 0.001), nonfatal stroke (2.30 [1.25–4.23], P = 0.007), hACS (2.00 [1.39–2.90], P < 0.001), and hHF (3.24 [1.98–5.30], P < 0.001) were all associated with a subsequent increased risk of SHEs. The elevated bidirectional time-dependent hazards linking SHEs and a composite of all CV events were approximately constant over time, with those individuals at dual risk showing higher comorbidity scores compared with those without.

CONCLUSIONS

These findings, showing greater risk of SHEs after CV events as well as greater risk of CV events after SHEs, validate a bidirectional relationship between CV events and SHEs in patients with high comorbidity scores.
Redesigning Primary Care to Improve Diabetes Outcomes (the UNITED Study)
Authors: Peterson Kevin A. , Carlin Caroline , Solberg Leif I. , Jacobsen Rachel , Kriel Toni , Eder Milton
Published: December 2019

OBJECTIVE

The effective redesign of primary care delivery systems to improve diabetes care requires an understanding of which particular components of delivery consistently lead to better clinical outcomes. We identified associations between common systems of care management (SysCMs) and the frequency of meeting standardized performance targets for Optimal Diabetes Care (NQF#0729) in primary care practices.

RESEARCH DESIGN AND METHODS

A validated survey of 585 eligible family or general internal medicine practices seeing ≥30 adult patients with diabetes in or near Minnesota during 2017 evaluated the presence of 62 SysCMs. From 419 (72%) practices completing the survey, NQF#0729 was determined in 396 (95%) from electronic health records, including 215,842 patients with type 1 or type 2 diabetes.

RESULTS

Three SysCMs were associated with higher rates of meeting performance targets across all practices: 1) a systematic process for shared decision making with patients (P = 0.001), 2) checklists of tests or interventions needed for prevention or monitoring of diabetes (P = 0.002), and 3) physician reminders of guideline-based age-appropriate risk assessments due at the patient visit (P = 0.002). When all three were in place, an additional 10.8% of the population achieved recommended performance measures. In subgroup analysis, 15 additional SysCMs were associated with better care in particular types of practices.

CONCLUSIONS

Diabetes care outcomes are better in primary care settings that use a patient-centered approach to systematically engage patients in decision making, remind physicians of age-appropriate risk assessments, and provide checklists for recommended diabetes interventions. Practice size and location are important considerations when redesigning delivery systems to improve performance.
Epileptic seizures as the first manifestation of the frontoparietal arteriovenous malformation of the brain
Authors: Skrijelj Fadil , Mulic Mersudin
Published: December 2019

Abstract: Introduction: Arteriovenous malformations of the brain include a group of congenital disorders in the early development of arterial-venous blood vessels of the brain. Their clinical presentation is most common in the form of a brain hemorrhage, epileptic seizures, and headaches. Case report: We showed a man who at the age of 28 early in the morning after breakfast had the first generalized tonic-clonic seizure. After the second unprovoked epileptic seizure, antiepileptic therapy was introduced. The brain scanner showed the existence of arteriovenous malformations in the right frontoparietal region. As the size of the malformation was less than 30mm, it was decided that the patient should be treated with Gamma knife radiosurgery. After the successful radiosurgery together with the antiepileptic drugs treatment, the patient is in a stable 1.5 yearlong remission of epileptic seizures without neurological failures. Conclusion: Epileptic seizures can be the initial clinical manifestations of arteriovenous malformations of the brain. With an early diagnosis, adequate antiepileptic drugs therapy and neurosurgery, radiosurgery (Gamma Knife), which is often necessary, many symptomatic epilepsies enter a stable remission of epileptic seizures.
Combination of transcutaneous electrical nerve stimulation (tens) and occipital nerve block in refractory cluster headache
Authors: Silek Hakan
Published: December 2019

Cluster headache (CH) can be extremely resistant to medical treatment. There are no prognostic signs that can previously determent persistence and resistance to medical treatment. We report on medical treatment-resistant cluster headache that relieved with transcutaneous electric nerve stimulation treatment followed with occipital nerve block (ONB) method. A 39-year-old male patient that was diagnosed with a cluster headache that was resistant to a combination of the highest tolerated drug dose of verapamil, valproic acid, and oral methylprednisolone. Due to its resistance to medical treatment for one month, in addition, treatment with transcutaneous electric nerve stimulation and following (ONB) showed sudden and permanent control of headache.
Results of surgical techniques applied in blepharoptosis
Authors: Yucel Ozturk , Taha Ayyildiz , Rodop Ozlen , Yesim Oral , Seyhan Kocabas
Published: December 2019

Objective: Our aim was to analyze the success rates of patients who underwent levator aponeurosis or frontal suspension with silicone tube surgery due to blepharoptosis according to the elevator function (LF) and to compare our results with the literature. Material and Methods: We included twenty-five eyes of 47 patients who had levator aponeurosis or frontal suspension with silicone tube surgery in this study. The patients were grouped as good, moderate, and poor according to their LF. Good and moderate patients had levator aponeurosis while poor patients had frontal suspension with silicon tube surgery. The follow-up period after surgery was 2 to 36 months. The results were evaluated with margin reflex distance (MRD) which greater than 2 mm was considered as successful, between 1 and 2 mm was satisfactory, and less than 1 mm was unsuccessful. Also, patients required revision surgery was considered as unsuccessful. Results: Twenty-nine (61.7%) men and 18 (38.3%) women with a mean age of 35.16 years (range = 0-84 years) were included in this retrospective study. Thirteen cases (27.7%) had bilateral, and 34 cases had unilateral ptosis(72.4%). Eight of the 13 patients with bilateral ptosis had bilateral and 5 of them had unilateral surgery. Blepharoptosis was due to congenital (60.0%), aponeurotic (19%), traumatic (1.8%), Horner's syndrome (1.8%) and myotonic dystrophy (1.8%). The preoperative mean MRD value was 0.56 ± 0.85 mm (0-3 mm). The levator function (LF) was poor in 18 eyes (32.7%), moderate in 9 eyes (16.4%) and good in 28 eyes (50.9%). Thirty-seven patients (67.3%) underwent levator aponeurosis, and 18 patients had frontal suspension with silicon tube surgery. In our postoperative controls, 33 patients were considered as successful. Three patients were considered as satisfactory, and one patient was considered unsuccessful. Discussion: Levator aponeurosis and frontal suspension with silicone tube surgeries are both effective surgical methods to treat ptosis. Postoperative success is positively affected by determining the surgery method, according to LF. Our results showed that elevator aponeurosis surgery is more satisfying in good and moderate cases, and frontal suspension with silicone tube is best in poor cases.
Clinical and laboratory characteristics of Neonatal Candida sepsis
Authors: Hadžić Devleta , Skokić Fahrija , Brkić Selmira , Saračević Amina
Published: December 2019

Introduction: Steady progress in intensive treatment worldwide has increased the survival of immature neonates, but with multiple invasive procedures, which has increased the risk of infection and, consequently, fungal sepsis. Candida is the dominant cause, with the rise of resistant non-albicans species. The mortality rate is high and requires timely suspicion and adequate treatment to counteract fatal outcomes. Objectives:To analyze the clinical and laboratory characteristics of Candida sepsis, compared to bacterial sepsis, in neonates treated in the neonatal intensive care unit. Methods: A retrospective cohort study conducted at the Intensive care unit of Pediatric Clinic Tuzla over a three-year period (2016-2018) analyzed the clinical and laboratory characteristics of neonates with Candida sepsis, evidenced by positive blood culture. The control group was neonates treated at the same time for proven bacterial sepsis. Statistical analysis applied standard methods, and the research was approved by the Ethics Committee of the institution. Results: Out of the total 921 neonates treated over a three-year period, culture-confirmed Candida sepsis was found in 48 (5.2%). Prematurity and low birth weight were the most significant risk factors and affected neonates had a more difficult clinical presentation, more receiving parenteral nutrition, mechanical ventilation, intravenous gamma globulin, and longer intensive treatment. Candida sepsis manifested mainly as late-onset. Laboratory abnormalities mainly included CRP elevation, anemia, leukocyte count deviations, and thrombocytopenia. There was no difference in mortality, 44 neonates recovered (91.7%), while 4 (8.3%) died. Antifungal therapy lasted 20.6 ± 6 days, and intensive treatment 38.2 ± 23.2 days, and was significantly longer compared to the control. All isolates were Candida species without in vitro resistance. In 8 neonates (16.7%) treatment complications were recorded. Conclusions: Neonatal Candida sepsis endangers life, complicates treatment, increases costs and mortality rate. Recovery depends on timely suspicion, adequate treatment, and supervision. Antifungal susceptibility is also important and requires monitoring of local epidemiological dynamics.
Secondary antiphospholipid syndrome revealed by the sudden onset of pneumonia: Case report
Authors: Lazović Biljana , Zlatković-Svenda Mirjana , Blažić Ivana , Kovač Jelena , Detanac Džemail , Milić Rade , Šarac Sanja , Detanac Dženana , Zugić Vladimir
Published: December 2019

Introduction: Secondary antiphospholipid syndrome (SAPS) is APS that occurs in the context of another medical condition. Although antiphospholipid antibodies (aPL) can occur in patients with viral, bacterial, or protozoal infections, they are rarely associated with thrombosis. Aim: To present an uncommon case of pneumonia and pleural effusion complicated with pulmonary thromboembolism in a patient with systemic lupus erythematosus (SLE), due to non-diagnosed secondary antiphospholipid syndrome. Case report: A 28 years old woman, never pregnant, with a family history of systemic lupus erythematosus, has been suffering from SLE from the age of 18. She had only articular and skin manifestations, without internal organ involvement. She has been taking Methotrexate (10 mg weekly) and Prednisone (5 mg daily) in the previous 10 years. She was presented at the Emergency department with the radiological finding of pleuropneumonia followed by temperature up to 39C, shortness of breath, cough, fatigue, and weakness. Results: She was treated initially with three antibiotics and thoracocentesis. She developed pulmonary thrombosis without deep venous thrombosis. Laboratory findings were: ESR = 37 mm/h, CRP = 2+, ANA = 1/80 peripheral, RF negative, anti-dsDNA = 147 (positive > 40), anti-Sm negative, anticardiolipin IgG antibody 158 GPL (up to 12), anticardiolipin IgM antibody 5.5 MPL (up to 10), anti-beta2-glycoprotein IgG and IgM were negative and lupus anti-coagulant was 88" (18"-55"). The patient underwent Heparin and Warfarin treatment, by checking INR to be in a 2.6 to 3.5 range. Prednisolone and Hydroxychloroquine were also started. Conclusion: All patients suspected with SLE should be evaluated for antiphospholipid antibodies (APL). However, APS diagnosis requires both clinical and laboratory features.
An evaluation of endoprosthesis and pertrochanteric external fixator results in elderly intertrochanteric femoral fractures
Authors: Ekrem Aydin , Ali Ates
Published: December 2019

Objective: In this study, 14-month clinical outcomes of the endoprosthesis and pertrochanteric external fixator application are retrospectively evaluated in elderly patients with pertrochanteric fractures. Patients and Method: A total of 45 patients of 65 years old and older (25 females and 20 males) with a mean age of 78.1, who were treated due to intertrochanteric femur fracture between November 2013 and December 2014 and whose controls could be made were included in this study. The deaths that occurred within the postoperative 1 year were not included in the study. 28 patients with endoprosthesis as Group I, and 17 patients with pertrochanteric external fixator as Group II were evaluated. Results: Table 2 shows the clinical evaluation results of the patients according to different criteria by the groups. The mean operation time was 45 min in Group I and 20 min in Group II. The external fixator application time is significantly shorter. The mean hospital stay was 14 days for Group I and 10 days for Group II. The hospital stay period of the external fixator group is 4 days shorter. While 7 patients were taken into the intensive care unit in Group I postoperatively, only 1 patient was taken into the same unit in Group II. This difference was significantly in favor of the external fixator group. While 14 patients in Group I needed a preoperative and postoperative blood transfusion, no patient needed blood transfusions in Group II. External fixator application is significantly more advantageous in terms of patient hemodynamics. The mean time to postoperatively move the extremity independently in the bed was 24 hours in Group I and 36 hours in Group II. All patients were exposed to the Harris hip scoring in the postoperative 12. month (the fixator was removed for the external fixator group). Conclusion: In addition to internal fixation options and endoprosthesis applications in elderly intertrochanteric femoral fractures, an external fixator may also be a good treatment alternative with appropriate patient selection and proper application in accordance with the technique thanks to its short surgical time, less blood loss and easy applicability.
SWOT-Analysis of Public-Private Partnership in the Agro-Industrial Complex on the Example of the Republic of Moldova
Authors:   Peoples’ Friendship University of Russia, Zalevskaya Tatyana Dmitrievna
Published: December 2019

The paper raises the question of the functioning of public-private partnership (PPP) in the agro-industrial complex of the Republic of Moldova as one of the typical agrarian countries. In this case, PPP is considered as an institutional formation of a systemic nature, which has a synergistic effect. It was determined that in RM the issue of reviving the agrarian business and the speedy transfer of the agrarian sector to advanced technological rails is an acute issue. But this problem requires a differentiat-ed approach: large and medium-sized businesses are potentially the most effective partners of the state in implementing strategic PPP projects, and small businesses are the most effective executor of strategic programs in the implementation of small projects, which are now widely subsidized. As a result of the study, the main problems in the field of PPP in the agricultural sector of the Republic of Moldova are structured through a SWOT analysis: the almost complete absence of PPP projects, the low level of support for large and medium-sized businesses, as well as the lack of programs for the development of small and medium-sized businesses in the countryside, except for subsidizing priority projects. But simple subsidizing is not enough to solve the large-scale task of overcoming the agricul-tural sector of the Republic of Moldova from the crisis, and training programs and soft loan programs are needed. The SWOT analysis of public-private 2 partnerships in the agricultural sector of the Repub-lic of Moldova makes it possible to proactively as-sess both the strategic advantages and the strategic risks of implementing PPP and form the most effec-tive policy of interaction between the state and pri-vate institutions for the maximum development of the country’s agricultural sector.
Dynamics of Value-Need Orientations and Emotional Comfort of Students During Their Study at The University
Authors:   Smolensk State University, Avchinnikova Svetlana Olegovna
Published: December 2019

The problem of emotional and psychological chang-es in the students’ personality in the process of higher professional education obtaining is dis-cussed in the paper. The subject of the study is the value-need restructuring of the personality and the psychological conditions caused by it, indi-cating the student adaptation. The data of an empir-ical study of 144 students are carried out twice using the methodology “Value-need orientations rating”. The values are grouped by significance level and needs by degree of satisfaction. It is noted that in the system of students’ value preferences from the 1st to 3rd study year, individual positive changes oc-cur, indicating the preference of active adapta-tion strategies. The characteristics of students’ emo-tional comfort, due to the ability to meet personally significant needs, are compared. The state of emo-tional discomfort was diagnosed in 15 % of 1st year students. The positive dynamics of the students’ psychological state in the learning process is statis-tically confirmed, however, 15 % of respondents recorded a decrease in the level of emotional com-fort by 3rd year. It is concluded that when developing programs of psychological and pedagogical support for students, one should take into account the indi-vidual value-need profile and the level of emotional comfort.
Spiritual and Moral Qualities of Personality of Educators Engaged in Inclusive Education
Authors:   South Ural State University (National Research University), Rylskaya Elena Aleksandrovna , Koneva Oksana Borisovna ,   South Ural State University (National Research University), Morozova Svetlana Vitalyevna ,   South Ural State University (National Research University)
Published: December 2019

The special features of inclusive educational envi-ronment require that teachers have specific personal qualities. The least studied ones among them are spiritual and moral ones (spirituality, warm-heartedness, empathy, acceptance of others, trans-communication potential, personal egocentrism). The results of the study show that teachers who consider inclusive education necessary have higher rates of spirituality and warm-heartedness. That ones who deny the idea of inclusion are character-ized by the predominance of physicality in the struc-ture of their personal profiles. The interrelations between the spiritual and moral qualities of teachers working in the sphere of inclusive education are based on the principles of coherence and diver-gence with the system-forming role of spirituality. All the spiritual and moral characteristics studied are ambiguously associated with the syndrome of pro-fessional burnout. Thus we can see their protective and compensatory or provocative significance for the development of this syndrome.
Communicative skills and emotional burnout of the teacher in subject-subject interaction with students
Authors:   Russian Academy of Education, Sunnatova Rano Izzatovna
Published: December 2019

Interaction between teachers and students can be both a resource for the formation of mutual under-standing and trust, and a block not only for relation-ships, but also for the formation of activity and ori-entation of the student for self-development. The problem has a considerable history of scientific study, nevertheless, the practice of the modern school even more reveals the unresolvedness of certain difficulties. The study involved 72 teachers and 402 students of comprehensive Moscow school. The main focus was directed to the following com-ponents of relations between teachers and children: a) the degree of satisfaction of students with how teachers treat them; b) characteristics of communi-cative professionally significant skills of teachers; c) features of emotional burnout of teachers as a professionally determined condition; d) the relation-ship between emotional burnout and the formation of communicative skills. The analysis of the results of the empirical study showed that the emotional component of communication skills is the basis of the characteristics of the attitude of teachers toward children. Emotional burnout of teachers can be con-sidered as a consequence of the destructiveness of emotional aspects in relationships with others.
Stress Factors in Professional Activity of Personnel of Preschool Educational Institution
Authors:   Nevinnomyssk State Institute for Humanities and Technical Sciences, Balyk Anna Sergeevna , Makarenko Inna Petrovna ,   Nevinnomyssk State Institute for Humanities and Technical Sciences
Published: December 2019

The paper discusses the problem of stress in the activity of personnel of the preschool educational institution. It analyses the concept of stress and its causes, examines the aspects of stress in profes-sional activity for further selection of methods of its prevention and correction. A specific feature of the development of the state of occupational stress is the combination of such adverse factors as work-load and psychological and organizational fac-tors. In the process of studying the topic, the au-thors came to a conclusion that in the first place psychological factors are directly related to the spe-cifics of the organization of work: the degree of freedom of decision making, the level of independ-ent influence on their working situation, the possi-bility to choose the ways and timing of performing a task and control over it. Organizational factors and the specifics of the emerging interpersonal relations during the performance of official duties are among the most significant factors that can cause stress in the professional environment. The problem of occu-pational stress, including occupational stress in personnel of preschool educational institutions, is gaining increasing scientific and practical relevance as the contents and conditions of work are inten-sively changing and the requirements to the compe-tence level, dynamism, and stress resistance of teachers and educators are rising.
Self-Identification and Representations of Information Environment in University Students
Authors:   Ulyanovsk State University, Sedunova Anastasiya Sergeevna
Published: December 2019

The paper presents the results of a study of the in-dividual and personality characteristics of infor-mation interaction based on a subjective assess-ment of the model of interpersonal relationships and perception of the Internet. The relevance of the study is associated with the current trend towards an expanded understanding of the communicative and, more broadly, the information space in connec-tion with the creation of a specific flexible subject-oriented educational environment. The empirical study involved three groups of indicators: self-esteem and personality identification characteris-tics; subjective assessment of interaction on the Internet; characteristics of an individual model of communicative space. The analysis reviled structural associations between the characteristics of self-identification, representations of Internet interac-tion, and the characteristics of interpersonal rela-tionships, as well as the features of the characteris-tics under consideration for the subgroups with different levels and types of self-esteem. The main hypothesis is verified by means of correlation analy-sis for nonparametric data.
Problems of Functioning of Social Institutions of Education, Family, and Marriage in Modern Russian Society
Authors:   North Ossetian State University, Kusova Diana Olegovna , Naskidaeva Elena Khazbievna ,   North Ossetian State University
Published: December 2019

In the XXI century, a transformation of the Russian society has occurred. The introduction of capitalist market mechanisms into the Russian economy has led to changes in all spheres of the state and socie-ty. Social changes have led to changes in insti-tutions such as the family, marriage, education, and science. The causes and the process of change of the most important social institutions are the sub-ject of many scientific studies. Scientists are still debating whether these processes of deformation of the modern Russian institutions have been caused by exogenous or endogenous factors. The most important exogenous factors are the impact of the Western capitalist value system, the modern global problems, changes common to all mankind, etc. Endogenous factors that have led to the transfor-mation of the Russian social institutions are the crisis in the Russian economy, the cultural changes of the Russian society itself, etc. While examining this issue, the authors study the crisis of social in-stitutions of the contemporary Russian society and its influence on the demographic situation in the country. The relevance of the study is manifested in the need to study the dramatic transformations of social institutions in Russia and to develop ways to overcome the negative consequences of these transformations.