bluuebunny/crossref_metadata_2025 huggingface dataset:
Conflict determinants in Africa
Authors: Dunne J. Paul , Tian Nan
Published: October 2019

This article considers the determinants of conflict in Africa. It revisits the greed versus grievance debate to consider the specific regional context and changing nature of conflict in Africa. This is a literature that has grown rapidly in economics and political science, but some recent developments in modeling and conceptualization are providing important new contributions. The article uses the zero-inflated ordered probit technique that deals with the problem of excess zeros in datasets, revisits the definition of conflict, and improves upon some proxy measures. It also considers the substantive as well as statistical significance of the variables. Changes in the technique used provide more support for the influence of grievance terms than given credit for with the usual probit model approach. Both greed and grievance determine conflict in Africa.
Don’t just click 'download': The case of U.S. military expenditure data
Authors: Brauer Jurgen
Published: October 2019

With a view toward two purposes, the article examines measures of United States military expenditure. It first discusses what types of data would be most suitable for the analysis of the economic burden of such expenditure and it explains, second, why existing databases with U.S. (and global) military expenditure coverage have limited validity, and therefore utility, for the first purpose. The article advances the concepts of minimal and maximal augmented military expenditure measures to better capture the full economic resource burden imposed on an economy than do the presently available measures. The difference of current measures to the proposed augmented measures is not primarily one of an intercept change but mostly of a slope change. The article claims that, by fiscal year 2018, the economic burden imposed by military expenditure on the U.S. economy when using the augmented measures is about double the size of the burden as measured by all of the currently available measures. Since, to date, most empirical work on the effects of military expenditure on economies tends to rely on inappropriate measures, misleading findings may have resulted.
Minociclina como alternativa en el tratamiento de pulpotomía de dientes temporales
Authors: Orellana Centeno José Eduardo , González Osorio Mauricio
Published: October 2019

Objetivo. Determinar la eficacia de la minociclina en gel de liberación prolongada siendo un agente antimicrobiano en el tratamiento de la pulpotomía infantil y la eficacia de la minociclina aplicada como medicamento en el tratamiento de pulpotomía. Métodos. A 39 órganos dentales se les realizó el tratamiento de pulpotomía de acuerdo a la técnica descrita por Sweet y cols., previo y posterior a la colocación del medicamento minociclina, se tomó una muestra (colocación de punta de papel) y se realizó conteo de microorganismos por método de conteo de placa. Resultados. Se realizó una revisión clínica y radiográfica, haciéndolo a los 15, 30, 90 y 180 días, los resultados se registraron de acuerdo al instrumento clínico y radiográfico de la Asociación Americana de Odontología Pediátrica (AAPD). Se presentó tres casos de fracaso que representa apenas el 8%, teniendo un éxito de 92% este tratamiento. Conclusiones. Se concluyó que la medicación con minociclina resulta un auxiliar valioso en la desinfección local de la cámara pulpar y por tanto para el tratamiento de pulpotomías.
Estrategia competitiva y rentabilidad de las empresas peruanas exportadoras de polos de algodón
Authors: Lara Hidalgo Carol Rocío
Published: October 2019

Objetivo: Inferir los elementos de la estrategia competitiva que afectan la rentabilidad de las empresas peruanas exportadoras de polos de algodón. Método: El método de la investigación es correlacional al tratar de identificar y formular relaciones existentes entre las variables propuestas en base a datos históricos y datos obtenidos de 144 empresas exportadoras peruanas de polos de algodón. Para el análisis y procesamiento de datos se utilizaron técnicas de correlación lineal simple, Pearson, Spearman y Chi Cuadrado. Los programas usados fueron Microsoft Excel e IBM SPSS. Se usó información primaria (encuesta y estados financieros) y secundaria (estadística gubernamental, tesis y artículos científicos). Resultados: Se determinó que existe correlación directa entre costos y gastos con ventas de las empresas, este mismo caso se presenta entre exportaciones nacionales y ROE, asimismo, se evidencia relación directa entre los precios de los polos de algodón y exportaciones. El diseño es otro componente que tiene un impacto directo en la rentabilidad de la empresa. Conclusiones: Existe una estrecha relación entre los indicadores por el uso de la estrategia de liderazgo en costos y la estrategia de diferenciación que influyen en la rentabilidad de las empresas exportadoras.
La imposición selectiva al consumo en el Perú: Entre el fin recaudatorio y la extrafiscalidad
Authors: Ríos Culquicondor Raúl Enrique
Published: October 2019

Objetivo: El propósito de la investigación es determinar si los fundamentos de la imposición selectiva, su estructura, finalidad e importancia teórica se corroboran en la práctica. Para ello, se cuestiona si la modificación en mención fue con fines recaudatorios o si fue más bien, una medida desalentadora de consumo. Método: Es una investigación cualitativa ya que el fenómeno es explorado y descrito desde la perspectiva del investigador y se fundamenta en la revisión de literatura, en el contexto y en la intuición. Resultados: En mayo de 2018, el Ministerio de Economía y Finanzas dictó diversos decretos supremos incrementando las tasas del Impuesto Selectivo al Consumo en el Perú. Los productos afectados por el alza fueron los combustibles, las bebidas azucaradas, las bebidas alcohólicas, y los vehículos nuevos y usados. La disposición lejos de pasar desapercibida, se tornó controversial y mediática, poniendo en manifiesto la desinformación que existe sobre este tributo. Conclusiones: En la práctica la imposición selectiva se ve distorsionada en cuanto a los fundamentos teóricos que la sustentan, es decir, el impuesto no está cumpliendo su finalidad extrafiscal (desmotivar el consumo de los bienes afectos con el gravamen) sino en cambio, casi por inercia y apoyado en las características económicas de los bienes que son sujetos con el gravamen, el fin fiscal está superando a la extrafiscalidad tradicional que debe perseguir la imposición selectiva.
Estigma o realidad: ¿Eficiencia de las empresas públicas? Análisis de casos peruanos y mexicanos
Authors: Farías Ruelas Luz María , Verástegui Corrales Cleofé Maritza , Bobbio Rosas Emilio Gustavo
Published: October 2019

En las últimas dos décadas, se ha implementado en América Latina la gestión basada en resultados para los entes públicos, buscando incrementar eficiencia. La investigación tiene como propósito identificar para Perú y México, los resultados del impacto directo en la eficiencia de la aplicación del recurso público, visto desde un incremento directo a los bienes y servicios que se ofrecen a los ciudadanos. Servicios como trámites directos en las dependencias gubernamentales, entre otros; bienes, derechos o subsidios, otorgados directamente a los ciudadanos: alumbrado, programas de apoyo a grupos con extrema pobreza, vialidades, entre otros. El estudio se va enfocar en mitos y realidades, intereses políticos, y la presentación de una serie de medidas que conducirían a la optimización de las empresas públicas; toda vez que, en otros continentes, sí existe un beneficio directo a la sociedad por contar con empresas públicas eficientes. Incluso en América Latina, han existido y existen empresas que desmienten el dicho popular por su rentabilidad, entendida como un beneficio directo a la sociedad; ya sea a través de ingresos públicos que son destinados a bienes y servicios públicos directos en las ciudades, o por su calidad y eficiencia en la atención y seguimiento a los trámites ingresados por los ciudadanos. Quizás la ineficiencia de los entes públicos no constituya una realidad, sino una falacia construida por entes interesados en que se vuelva una verdad incontrastable.
Gestión empresarial de la industria cementera peruana, la corrupción y el Niño costero, 2016-2017
Authors: Arrarte Mera Raul Alberto , García Villegas Emilio Gabriel
Published: October 2019

Objetivo: Analizar si la gestión empresarial de la industria cementera peruana superó los problemas de la corrupción y el Niño Costero en el periodo 2016-2017. Método: Es una investigación de tipo aplicada, documental y descriptiva, con diseño no experimental que pretende dar razones del porqué de los fenómenos en estudio. La muestra es de un censo del sector cemento que abastece a todo el Perú. Resultados: El análisis estructural de las inversiones nos muestra una empresa típicamente industrial que prioriza el largo plazo en vez del corto; 85% de los activos no corrientes en el 2017 y 88% en el año 2016. Conclusiones: La rentabilidad patrimonial en la industria cementera fue de más a menos en el periodo 2016 al 2017, excepto la empresa Cementos Yura, que tuvo rendimiento superior al 10% en ambos periodos de 2016 y 2017. En cuanto al valor económico agregado, todas las empresas tuvieron saldos negativos y no crearon valor para los accionistas en el periodo bajo estudio.
Las exportaciones mineras, los impuestos directos e indirectos y su incidencia en la recaudación tributaria del Gobierno Central: 2017 -2019
Authors: Villa Morocho Eduardo , Gomero Gonzales Nicko Alberto , Masuda Toyofuku Victor Ricardo
Published: October 2019

Objetivo: Determinar cómo las exportaciones de commodities inciden en los ingresos tributarios del Gobierno Central y el tipo de relación que existe entre de los impuestos directos e indirectos. Método: Se aplicó el método descriptivo correlacional, estructurándose una matriz de correlación y líneas de regresión, para ello se empleó datos oficiales de la SUNAT, INEI, BCRP. Resultados: En el estudio se evidencia el mayor aporte del IGV en la recaudación tributaria, seguido del impuesto a la renta, pero por el grado de correlación alcanzado este último impuesto tiene mayor incidencia en la recaudación fiscal. Sin embargo, al contrastar las exportaciones mineras con los impuestos directos se aprecia una débil, pero negativa relación de dependencia lo cual implica que la recaudación tributaria es débilmente afectada por las exportaciones de minerales. Conclusiones: Se concluye, por el grado y tipo de correlación obtenido, que el aumento de las exportaciones mineras no ejerce mayores cambios en la recaudación tributaria siendo además el impacto de tipo inverso.
Geographic distribution analysis of the genus Xenodacnis (Birds: Thraupidae) using ecological niche modeling
Authors: Aguilar Juan M.
Published: October 2019

Xenodacnis is a monotypic thraupid genus restricted to the tropical high Andes of Peru and Ecuador. Its only species, X. parina has a large discontinuous distribution from central Ecuador to southern Peru. To date, three subspecies are recognized, all separated by geographical barriers that clouded promote allopatric events. The taxonomic affinities of the Ecuadorian population have not been assessed since its discovery in the 1970s at the Cajas National Park in Azuay province. I studied the environmental affinities between the distribution of the described subspecies and the Ecuadorian population bias ecological niche modeling. I found a distinctive ecological niche in the distribution of each of the analyzed populations and also for the southern Arequipa population. These different environmental niche conditions come apart by deep Andean valleys playing a role as geographical barriers for the isolation of these populations that need further taxonomic analysis.
Sesenta y cuatro nuevos registros para la flora del Perú a través de inventarios biológicos rápidos en la Amazonía peruana
Authors: Torres Montenegro Luis A. , Ríos Paredes Marcos A. , Pitman Nigel C.A. , Vriesendorp Corine F. , Hensold Nancy , Mesones Acuy Ítalo , Dávila Cardozo Nállarett , Huamantupa Isaú , Beltrán Hamilton W. , García-Villacorta Roosevelt , Mori Vargas Tony J. , Neill David A. , Fine Paul V.A. , López-López Jill T. , Núñez Iturri Gabriela , Palacios Walter , Salinas Revilla Norma , Trujillo Calderón William
Published: October 2019

Durante el período 2000 – 2016, se llevaron a cabo 15 inventarios biológicos en áreas remotas en el pie de monte andino y el llano amazónico del Perú. En estos inventarios, 27 botánicos colectaron un total de 9397 especímenes de plantas vasculares fértiles. Hasta finales del 2017, más de la mitad de estos especímenes se han identificado a nivel de especie, de los cuales 64 especies y 2 géneros (Dicorynia y Monopteryx) representan nuevos registros para la flora del Perú. Si esta tasa de novedades se mantiene, el número de registros nuevos en el material de los inventarios podría aumentar, lo cual nos indica que aún queda mucho por descubrir en la flora andino-amazónica del Perú.
Primer registro del pulpo ‘Octopus’ selene Voss, 1971 (Cephalopoda: Octopoda) en aguas peruanas con comentarios de su distribución geográfica
Authors: Cardoso Franz , Hochberg F.G.
Published: October 2019

En el presente trabajo se registra de primera vez ‘Octopus’ selene en aguas peruanas y se amplía su rango de distribución sur hasta Cabo Blanco, Piura, Perú. Cuatro ejemplares machos de 34 – 50 mm LM fueron capturados entre los 03°34’S y 04°06’S a profundidades de 109 a 150 m. Se proporciona una breve descripción, con observaciones taxonómicas y comentarios sobre su distribución geográfica de esta especie.
Discourse Analysis of Grammatical Cohesion Devices in College Students’ Academic Writing Essay
Authors: Trisnaningrum Yuliani , Alek Alek , Hidayat Didin Nuruddin
Published: October 2019

ABSTRACTThe study was undertaken to investigate grammatical cohesion devices use in college students’ academic writing essay as a part of discourse analysis. The study also explored to find out the kinds of grammatical cohesion devices specifications in college students’ academic writing essay. The researchers conducted this study with attention to know the college students’ writing quality at tertiary education. Further, the researchers employed Halliday & Hasan (1976) conceptual framework related to grammatical cohesion devices. The study was conducted to 42 college students enrolling on an online writing course. The researchers applied descriptive and analytical study by giving an assignment to assess grammatical cohesion devices use in college students’ academic writing essay. Data were collected from college students’ academic writing essay. The findings revealed that 1048 grammatical cohesion devices were used in the essays. Other findings indicated that the highest use of grammatical cohesion devices were reference with 53.53% and conjunction. The data also pointed out that the college students were more familiar with reference and conjunction use rather than substitution and ellipsis. The result also indicated that the lack of grammatical cohesion devices use in terms of comprehension, knowledge and ability in writing leads the college students use inappropriate grammatical cohesion devices.ABSTRAKPenelitian ini bertujuan menginvestigasi penggunaan perangkat grammatical cohesive device/kohesi tata bahasa pada penulisan akademik esai mahasiswa. Penelitian ini juga bermaksud untuk menggali jenis-jenis spesifikasi kohesi tata bahasa pada esai mereka. Dalam penelitian ini, para peneliti ingin mengetahui kualitas penulisan esai mahasiswa di perguruan tinggi. Untuk mencapai tujuan tersebut, para peneliti menggunakan kerangka konseptual dari Halliday dan Hasan (1976) terkait dengan kohesi tata bahasa. Penelitian ini melibatkan 42 mahasiswa yang mengikuti kelas menulis via daring. Penelitian menggunakan studi deskriptif dan analitik dengan menugaskan para mahasiswa menulis esai. Temuan dari penelitian ini menunjukkan bahwa terdapat 1048 kohesi tata bahasa yang dipergunakan dalam esai-esai tersebut. Selanjutnya, temuan lain menunjukkan bahwa penggunaan kohesi tata bahasa tertinggi adalah referensi 53,53% dan kata penghubung 45,80%. Temuan lainnya adalah mahasiswa lebih familiar terhadap dua aspek tersebut daripada substitusi dan elipsis. Hasil penelitian juga menunjukkan bahwa kurangnya tata kohesi bahasa dalam hal pemahaman, pengetahuan, dan kemampuan dalam menulis menyebabkan para mahasiswa menggunakan tata bahasa kohesi yang kurang variatif. How to Cite: Trisnaningrum, Y., Alek, Hidayat, D. N. (2019). Discourse Analysis of Grammatical Cohesion Devices in College Students’ Academic Writing Essay  . IJEE (Indonesian Journal of English Education), 6(1), 79-90. doi:10.15408/ijee.v6i1.12502
Identifying Patients With Kawasaki Disease Safe for Early Discharge: Development of a Risk Prediction Model at a US Children’s Hospital
Authors: Hester Gabrielle Z. , Watson David , Nickel Amanda J. , Ryan Nicholas , Jepson Bryan , Gray James , Bergmann Kelly R.
Published: October 2019

OBJECTIVES:

To develop a model to predict risk of intravenous immunoglobulin (IVIg) nonresponse in patients with Kawasaki disease (KD) to assist in early discharge decision-making.

METHODS:

Retrospective cohort study of 430 patients 0 to 18 years old discharged from a US children’s hospital January 1, 2010, through July 31, 2017 with a diagnosis of KD. IVIg nonresponse was defined as at least 1 of the following: temperature ≥38.0°C between 36 hours and 7 days after initial IVIg dose, receipt of a second IVIg dose after a temperature ≥38.0°C at least 20 hours after initial IVIg dose, or readmission within 7 days with administration of a second IVIg dose. Backward stepwise logistic regression was used to select a predictive model.

RESULTS:

IVIg nonresponse occurred in 19% (81 of 430) of patients. We identified a multivariate model (which included white blood cell count, hemoglobin level, platelet count, aspartate aminotransferase level, sodium level, albumin level, temperature within 6 hours of first IVIg dose, and incomplete KD) with good predictive ability (optimism-adjusted concordance index: 0.700) for IVIg nonresponse. Stratifying into 2 groups by a predictive probability cutoff of 0.10, we identified 26% of patients at low risk for IVIg nonresponse, with a sensitivity and specificity of 90% and 30%, respectively, and a negative predictive value of 93%.

CONCLUSIONS:

We developed a model with good predictive value for identifying risk of IVIg nonresponse in patients with KD at a US children’s hospital. Patients at lower risk may be considered for early discharge by using shared decision-making. Our model may be used to inform implementation of electronic health record tools and future risk prediction research.
Historical Perspectives: Low Birthweight and Preterm Infants in Indonesia
Authors: Haksari Ekawaty Lutfia
Published: October 2019

The incidence of infants with low birthweight (LBW), prematurity, and small for gestational age (SGA) in Indonesia remains high, and the morbidity and mortality in these infants are significant. To study these groups of infants in Indonesia, the author searched PubMed/Medline, the Cochrane Library, Google, Indonesian reports, local publications, and doctoral and master theses in English and Indonesian from 1987 to February 2019. In this review, the development of local reference growth charts of infants born in Indonesia is described, as well as the importance of these curves in defining the prevalence of SGA infants. Some of the risk factors associated with LBW, preterm, and SGA Indonesian infants are described. The author also discusses the effectiveness of specific interventions, such as kangaroo mother care, early initiation of enteral feedings, increased breastfeeding rates, and identifying the optimal timing of hospital discharge. Some of the morbidities associated with LBW infants born in Indonesia are described. Advances in hospital care and postdischarge follow-up of LBW, preterm, and SGA infants born in Indonesia are critical to decrease the morbidity and mortality rates associated with these populations.
Necrotizing Enterocolitis: Enhancing Awareness for the General Practitioner
Authors: Wertheimer Fiona , Arcinue Roxanne , Niklas Victoria
Published: October 2019

Necrotizing enterocolitis (NEC) has been recognized for well over 5 decades yet remains the most common life-threatening surgical emergency in the newborn. The incidence of NEC has decreased steadily in preterm and very-low-birthweight infants over several decades and is typically uncommon in term newborns and infants with a birthweight greater than 2,500 g. Evidence accumulating during the past decade, however, suggests that practitioners should consider NEC in this broader subset of term infants with chromosomal and congenital anomalies complicated by heart or gastrointestinal defects when signs and symptoms of feeding intolerance, abdominal illness, or sepsis are present. The short- and long-term consequences of NEC are devastating in all infants, and although early disease recognition and treatment are essential, promoting human milk feeding as a primary modality in prevention is critical. This article highlights our current understanding of the pathophysiology, the clinical presentation, the risk factors for NEC in term infants compared with premature infants, and the treatment of NEC and discusses strategies in the prevention of NEC. Finally, we review the long-term consequences of NEC and the importance of primary care practitioners in the long-term care of infants after hospitalization for NEC.
Updating the probability of failure of rock wedges
Authors: Hernandez-Carrillo Rodrigo , Beltran Gloria
Published: October 2019

In hard rock masses, discontinuities control the slope stability, rather than block matrix breakage. The relative position of joints and slope face defines the most likely mechanisms of failure. Among these mechanisms, the wedge failure is one of the most common ways of failure in which joint sets dip and dip direction, slope geometry and direction, external forces (including water pressure and earthquake) and rock and joints mechanical properties control the stability. The determination of these input parameters is not straightforward, mainly due to their variability and the limited amount of information available. Besides, in most projects, input parameters come from different sources (e.g., expert opinion, back-calculation, laboratory tests, field test or different project stages). Therefore, this limited information from different sources should be appropriately incorporated into the stability analysis to assist the design and decision-making process. In this context, random sets arise as a powerful tool to combine different sources of information and to perform a reliability assessment under limited information. This feature makes it possible to update the probability of failure as new evidence is available. With this framework, this paper presents a reliability assessment of wedge stability in a rock slope of a sandstone quarry, located in Une Cundinamarca, where information on mechanical and geometrical parameters has been collected for 20 years.
First confirmed record of Jaguarundi, Herpailurus yagouaroundi (É. Geoffroy, 1803) (Mammalia, Carnivora, Felidae), on the western slope of the Peruvian Andes
Authors: García-Olaechea Alvaro , Appleton Robyn D. , Piana Renzo P.
Published: October 2019

The presence of the Jaguarundi, Herpailurus yagouaroundi, west of the Peruvian Andes have not been considered in recent studies due to lack of evidence. We document its presence in the Laquipampa Wildlife Refuge, on the western slope of the Peruvian Andes, using camera traps. The closest previous record was approximately 129 km north, in a montane forest of Amazonas region on the eastern slope of the Andes. It is imperative that further research is conducted on carnivore species west of the Peruvian Andes to better understand the distribution of lesser known species such as the Jaguarundi.
Opistognathus nigromarginatus Rüppell, 1830 (Perciformes, Opistognathidae), Bridled Jawfish: a first record from Malaysia
Authors: Mat Jaafar Tun Nurul Aimi , Lee Jen Nie , Abd Ghaffar Mazlan , Sheikh Abdul Kadir Siti Tafzilmeriam , Seah Ying Giat
Published: October 2019

A specimen (125.5 mm in standard length) of bridled jawfish, Opistognathus nigromarginatus Rüppell, 1830 was collected from the Pulau Bidong, Terengganu, Malaysia using research trawler. Opistognathus nigromarginatus previously has been recorded from Southern Africa to the Persian Gulf, India, Thailand, and Vietnam. We document the first record of this species in Malaysia and the southernmost occurrence in the South China Sea and Western Pacific Ocean. Detailed morphometric and meristic data are presented along with brief diagnostic characters.
ANÁLISE DA QUALIDADE DOS SERVIÇOS DE HOSTELS EM OURO PRETO- MINAS GERAIS
Authors: Macedo Yamauchi Denis Akio , Mendanha Reis Bárbara Cristina , Rodrigues Maurinice Daniela
Published: October 2019

Tal estudo teve por objetivo analisar as principais características da qualidade de serviços em hostels em Ouro Preto a partir da perspectiva do cliente. Como teorias de base, utilizou-se a qualidade em serviços e a escala ServQual. Trata-se de uma pesquisa do tipo survey, utilizando entrevista in-depth, análise de websites, amostragem e aplicação de questionários à 98 hóspedes. Como principais resultados, detectou-se que segurança, localização e preço foram os aspectos mais citados para qualidade esperada, enquanto que na qualidade experimentada qualidade dos funcionários, limpeza e localização foram os aspectos mais destacados. Em relação aos itens que mais geram satisfação, tanto questionários quanto websites apontaram a qualidade dos funcionários, as instalações e a localização. A partir dessa análise, verificou-se imprescindível a capacitação dos funcionários a fim de garantir os resultados já obtidos, assim como melhorias em instalações e segurança, por exemplo, a fim de aproximar qualidade esperada e experimentada.
NOVAS METODOLOGIAS DE ENSINO E APRENDIZAGEM – LEGO SERIOUS PLAY® ADAPTADO
Authors: Dias Elton Pereira , De Lima Ana Carolina Praeiro , Santos Marcelo Dos
Published: October 2019

O artigo analisa o projeto voltado para a educação corporativa utilizando de um método denominado Lego Serious Play®, que consiste na aprendizagem e desenvolvimento a partir do uso de peças Lego®. O método pode ser aplicado em ambiente acadêmico a fim de melhorar o desempenho de alunos. Para tal realização, a metodologia usada foi a pesquisa exploratória com características de uma pesquisa qualitativa, uma vez que utiliza-se também de análise e comparação de dados para obtenção de resultados. A partir desta análise, concluiu-se que o projeto é viável tanto em ambientes corporativos, como em ambientes acadêmicos, uma vez que houve de fato uma evolução no desempenho e na nota dos alunos que fizeram uso do método em sala de aula. O projeto é de suma importância, pois busca desenvolver o aprendizado de um grupo de pessoas e de adquirirem novos conhecimentos, aplicados a evolução e planejamento das organizações.
Concatenated Coding for Multilevel Flash Memory with Low Error Correction Capabilities in Outer Stage
Authors: Taubin Feliks , Trofimov Andrey
Published: October 2019

One of the approaches to organization of error correcting coding for multilevel flash memory is based on concatenated construction, in particular, on multidimensional lattices for inner coding. A characteristic feature of such structures is the dominance of the complexity of the outer decoder in the total decoder complexity. Therefore the concatenated construction with low-complexity outer decoder may be attractive since in practical applications the decoder complexity is the crucial limitation for the usage of the error correction coding.

We consider a concatenated coding scheme for multilevel flash memory with the Barnes-Wall lattice based codes as an inner code and the Reed-Solomon code with correction up to 4…5 errors as an outer one.

Performance analysis is fulfilled for a model characterizing the basic physical features of a flash memory cell with non-uniform target voltage levels and noise variance dependent on the recorded value (input-dependent additive Gaussian noise, ID-AGN). For this model we develop a modification of our approach for evaluation the error probability for the inner code. This modification uses the parallel structure of the inner code trellis which significantly reduces the computational complexity of the performance estimation. We present numerical examples of achievable recording density for the Reed-Solomon codes with correction up to four errors as the outer code for wide range of the retention time and number of write/read cycles.
Psychosocial approach: quality of life in young people with elevated blood pressure
Authors: Sadykova D. I. , Lutfullin I. Ya.
Published: October 2019

Aim. To study quality of life (QoL), as an instrument for standardized assessment and monitoring of patients’ psychosocial status. Psychosocial approach is particularly important in diseases with psychosomatic component, such as essential arterial hypertension (EAH). Material and methods. QoL was assessed in 101 adolescents (62 boys, 39 girls; age 14-17 years) with various EAH forms, as well as in 38 healthy adolescents (comparison group, CG). Based on the results of 24-hour blood pressure monitoring (BPM), all patients were divided into 3 groups: with white-coat hypertension (n=32); with labile AH (n=33); and with stable AH (n=36). QoL was assessed with the MOS SF-36 scale, measuring not only absolute QoL values, but also the “proxy-problem” phenomenon (the discrepancy between QoL reported by the patients themselves and their proxies – parents). Results. Compared to the CG, adolescents with various BP levels demonstrated reduced QoL. QoL reduction was minimal in adolescents with white-coat hypertension, and maximal in patients with labile AH. In the latter group, both physical and psychological functioning parameters were reduced. The parents of EAH adolescents typically overestimated the severity of physical dysfunction of their children, while underestimating the magnitude of psychological dysfunction. Conclusion. The results obtained confirm the important role of psychosomatic mechanisms in AH pathogenesis, and emphasize the need for psychiatrist or clinical psychologist’ participation in the treatment of hypertensive adolescents. In adolescents with stable AH, physical dysfunction was predominant.
Clinico-demographic characteristics of the patients with decompensated chronic heart failure Clinico-demographic characteristics of the patients with decompensated chronic heart failure
Authors: Tereshchenko S. N. , Kositsyna I. V. , Dzhaiani N. A. , Gnidkina N. A. , Golubev A. V.
Published: October 2019

Aim. To study clinico-demographical characteristics of the patients with decompensated chronic heart failure (CHF). Material and methods. The analysis included the data of 112 patients hospitalised at Moscow City Clinical Hospital No. 68 due to decompensated CHF. The follow-up period lasted 30 days. Results. The mean age of the patients (33 % men, 67 % women) was 70,3±9,9 years. Older age (>70 years) was significantly more prevalent in women than in men (р=0,005). The main reason for CHF decompensation was inadequate pre-hospital therapy. The mean duration of the in-hospital treatment was 17,5±6,4 days. The level of 30-day fatality was 12,5 % (n=14). According to correlation analysis results, systolic blood pressure (SBP) level <100 mm Hg positively correlated with 30-day fatality (r=0,4; р=0,0001). Hemoglobin level <100 g/l also positively correlated with 30-day fatality (r=0,3; р=0,05). Conclusion. The prevalence of decompensated CHF is higher in women. Compared to men, women develop CHF in more advanced age. The main fatality-associated factors were low hemoglobin level, SBP <100 mm Hg, and age >70 years. The leading causes of death were pulmonary thromboembolism and diuretic therapy resistance.
Atorvastatin: evidence base 15 years later
Authors: Susekov A. V. , Khokhlova N. V.
Published: October 2019

HMG-CoA inhibitors have been widely used in primary and secondary prevention of atherosclerosis for more than 30 years. The evidence base for statins includes dozens of randomized clinical trials (RCT), involving hundreds of thousands patients. According to the results of the latest meta-analyses, reducing low-density lipoprotein cholesterol (LDL-CH) level by 1 mmol/l in statin-treated patients could decrease cardiovascular risk by 0,8 %. Atorvastatin (Liprimar®) is a modern synthetic statin, which has been thoroughly studied in several RCTs over the last 15 years. These trials demonstrated its effectiveness and tolerability in patients with chronic coronary heart disease, acute coronary syndrome (ACS), Type 2 diabetes mellitus, and arterial hypertension. In the studies comparing atorvastatin (10-80 mg/d) to other statins, baseline LDL-CH levels were reduced by 53 % in atorvastatintreated patients. Atorvastatin therapy was also well tolerated. Compared to placebo, atorvastatin therapy in the dose of 10 and 80 mg/d was associated with the incidence of hepatic transaminase elevation of 0,1 % and 0,6 %, respectively. This evidence base (in particular, the results of the trials on 80 mg/d atorvastatin therapy in ACS patients) has been a cornerstone of modern clinical guidelines, recommending target LDL-CH levels of 2 mmol/l. Currently, atorvastatin is the most widely prescribed statin in the majority of both developed and developing countries. Increasing initial dose and prescribing high-dose atorvastatin therapy (40-80 mg/d) could facilitate an improvement in treatment quality and a reduction in high levels of cardiovascular mortality inRussia.
Cardiovascular prevention in peri- and postmenopausal women
Authors: Voychenko N. A. , Kuznetsova I. V. , Mychka V. B. , Kirillova M. Yu. , Tolstov S. N.
Published: October 2019

The adverse consequences of estrogen deficiency in postmenopause include cardiovascular disease (CVD), which affects not only women’s quality of life, but also their life expectancy. Before premenopause, women have significantly lower risk of arterial hypertension than men of the same age. However, in people aged over 50, AH is more prevalent among women. Currently, most experts regard hormone replacement therapy (HRT) in peri- and postmenopausal women as pathogenetic, since it facilitates the adaptation of the female organism to the new metabolic state, with reduced ovarian function. Drospirenone, as a part of HRT, reduces CVD risk in postmenopausal women with climacteric disturbances.
Metabolic (cytoprotective) therapy of menopausal disturbances
Authors: Tolstov S. N. , Mychka V. B.
Published: October 2019

The paper presents modern views on cardiovascular aspects of menopause and metabolic therapy of menopausal disturbances with meldonium (Mildronate®). The role of estrogen deficiency in climacteric disturbance development, key pathogenetic mechanisms of menopausal metabolic syndrome (MS), and relevant features of arterial hypertension and endothelial dysfunction development are discussed. The data on Mildronate® clinical use for cardiovascular prevention are summarized. The wide prevalence and multiple clinical manifestations of menopausal disturbances point to the need for their complex therapy. Mildronate® therapy is a new approach for systemic correction of metabolic disturbances in women with climacteric symptoms and menopausal MS.
Treatment of proteinuria with lercanidipine associated with reninangiotensin axis-blocking drugs
Authors: Robles N. R. , Romero B. , Garcia de Vinuesa E. , Sánchez-Casado E. , Cubero J. J.
Published: October 2019

Aim. Most calcium antagonists do not seem to reduce microalbuminuria or proteinuria. We have tried to assess the antiproteinuric effect of a calcium channel blocker, lercanidipine, in patients previously treated with ACE inhibitors or angiotensin receptor blockers.Design and methods. The study included 68 proteinuric (>500 mg/day) patients (age 63,1±12,9 years, 69,1 % males and 30,9 % females). All patients were receiving ACE inhibitors (51,4 %) or angiotensin II receptor blockers (48,6 %) therapy but had higher blood pressure (BP) than recommended for proteinuric patients (<130/80 mm Hg). Patients were clinically evaluated one, three, and six months after starting treatment with lercanidipine (20 mg/day). Samples for urine and blood examination were taken during the examination. When needed, a third drug was added to treatment. Creatinine clearance was measured using 24 h urine collection.Results. BP significantly decreased from 152±15/86±11 mm Hg to 135±12/77±10 mm Hg at six months of follow-up (p<0,001). After six months of treatment, the percentage of normalized patients (BP <130/80 mm Hg) was 42,5 %, and the proportion of patients whose BP was below 140/90 mm Hg was 58,8 %. Plasmatic creatinine did not change nor did creatinine clearance. Plasmatic cholesterol also decreased from 210±48 to 192±34 mg/dL (p<0,001), as did plasma triglycerides (from 151±77 to 134±72 mg/dL,p=0,022). Basal proteinuria was 1,63±1,34 g/day; it was significantly (p<0,001) reduced by 23 % at the first month, 37 % at three months, and 33 % at the last visit.

Conclusion. Lercanidipine at 20 mg dose, associated with renin-angiotensin axis-blocking drugs, showed a high antihypertensive and antiproteinuric effect. This antiproteinuric effect seems to be dose-dependent as compared with previous reports and proportionally higher than blood pressure reduction.
Arterial hypertension and metabolic syndrome: specifics of antihypertensive therapy
Authors: Abasova L. I. , Dashdamirov R. L. , Bakhshaliev A. B.
Published: October 2019

This review summarizes the literature evidence on humoral disturbances in arterial hypertension (AH), as well as on AH interrelationship with individual components of metabolic syndrome (MS). Based on the results of multi-centre randomised trials, the rationale for the use of antihypertensive agents with favourable metabolic profile is demonstrated, in particular, for antagonists of slow calcium channels, angiotensin-converting enzyme inhibitors, and selective imidazoline receptor agonists.
Dynamics of clinical, functional, and immune parameters in patients with myocardial infarction and early fluvastatin administration
Authors: Belov V. V. , Bezdol’nova S. Yu. , Dolgushin I. I.
Published: October 2019

Aim. To assess the interrelations in the dynamics of immune, clinical, and functional parameters among patients with myocardial infarction (MI) and early fluvastatin administration. Material and methods. The study included 129 men, aged from 42 to 67 years (mean age 57 years): 99 MI patients and 30 healthy controls. In all participants, clinical, biochemical, functional, and immune parameters were assessed, with comparisons between healthy individuals vs. MI patients, as well as between MI patients taking fluvastatin (80 mg/d) vs. MI patients not receiving this medication. Results. In men with MI, chronic systemic inflammation was manifested in elevated levels of C-reactive protein, interleukin (IL) 1β, IL8, tumor necrosis factor α, immunoglobulin A and G, and complement components, as well as in decreased levels of IL1 receptor antagonist, CD 3, CD 4, CD 16, and CD 4/CD 8, compared to healthy controls. Early fluvastatin administration (first post-MI hours) was associated with reduced severity of immune disturbances and systemic inflammation. Conclusion. In MI patients, early fluvastatin administration is associated with a significant reduction in systolic and diastolic blood pressure levels, compared to controls, as well as with a substantial increase in exercise capacity at 2 months.
Masked inefficacy of arterial hypertension treatment: prevalence and predictors
Authors: Smirnova M. I. , Oganov R. G. , Gorbunov M. V. , Deev A. D. , Andreeva G. F.
Published: October 2019

Aim.To assess the prevalence of masked inefficacy of arterial hypertension treatment (AH MTI) and its predictors in various clinical groups and for various blood pressure (BP) control strategies, in order to evaluate the true effectiveness of antihypertensive therapy (AHT).Material and methods.AHT effectiveness was assessed in two groups of the patients with Stage I-II AH (n=219 and n=39), by comparing the ratios of clinical (cl) to ambulatory (a) BP parameters. AH MTI was defined as elevated aBP and target clBP levels during AHT. The potential predictors of AH MTI included gender, age, body mass index (BMI), anamnestic data, frequency of the clinical visits to measure BP, quality of life (QoL) parameters (GWBQ questionnaire), circadian BP profile, orthostatic BP, and ECG signs of left ventricular hypertrophy (LVH).Results.AH MTI prevalence in Groups I and II was 11,0-15,7 % and 22,6-58,1 %, respectively, depending on the definition used. The groups were significantly different in terms of age, BMI, and QoL questionnaire III and VI domains. According to the regression analysis results, in Group I AH MTI was associated with QoL questionnaire II, V, and VI domains, baseline parameters of 24-hour BP monitoring, 24-hour systolic BP (SBP) variability, minimal daytime levels of mean BP, and metoprolol and atenolol therapy. In Group II, AH MTI was predicted by age, BMI, previously administered AHT, alcohol consumption, orthostatic SBP levels, Sokolow-Lyon index, Cornell voltage and Cornell product, Gubner index, and QoL questionnaire I, IV, and VI domains.Conclusion.AH MTI prevalence is associated with some baseline characteristics of the patients and the character of AHT. Due to regression to the mean, AH MTI prevalence could increase substantially when clBP parameters are measured more often.
Enoxaparin in cardiovascular disease: how to improve effectiveness and safety?
Authors: Yavelov I. S.
Published: October 2019

The review analyses the specifics of enoxaparin therapy in the most prevalent cardiovascular diseases, such as acute coronary syndrome, venous thromboembolism, and atrial fibrillation. The decision strategy is presented for difficult and non-standard clinical situations (renal dysfunction, elderly age, heparin medication change, or abnormal body weight), when the optimal balance between effectiveness and safety requires modifying the standard treatment protocols.
Effectiveness of the fixed-dose combination therapy with perindopril and amlodipine in coronary heart disease patients after coronary artery bypass graft surgery
Authors: Iskenderov B. G. , Sisina O. N. , Kameneva O. A.
Published: October 2019

Aim.To study the effectiveness of the fixed-dose combination therapy with perindopril and amlodipine (Prestance 5/5 mg/d) in coronary heart disease (CHD) patients after coronary artery bypass graft (CABG) surgery.Material and methods.The clinical trial included 65 patients (37 men, 28 women aged 45-68 years; mean age 56,3±3,5 years) after CABG. All patients were randomised into two groups: the control group (CG; n=35) and the main group (MG; n=30). Both groups received antiplatelet agents and statins, while the MG patients additionally received Prestance (5/5 mg/d). Prestance therapy started three-four weeks after CABG and lasted for four months. All participants underwent 24-hour monitoring of ECG and blood pressure (BP), Doppler echocardiography, and Doppler ultrasound of brachial and common carotid arteries.Results.Compared to the CG, the MG demonstrated decreased incidence of pain and painless ischemia episodes, reduced maximal ST segment depression and its total duration, and increased rate threshold of myocardial ischemia. In addition, Prestance therapy was associated with improved systolic and diastolic heart function and significantly improved endothelium-dependent vasodilatation. In patients with normal BP, Prestance (5/5 mg/d) did not cause hypotension, but reduced excessive BP variability. In the MG, acute coronary syndrome (ACS) was registered in 1 individual (3,3 %), while in the CG, it was registered in 4 patients (11.4 %), and in 3 cases, coronary artery stenting was performed.Conclusion.In patients with normal BP, Prestance (5/5 mg/d) therapy in the early post-CABG period had a pronounced anti-ischemic, cardio- and vasoprotective effects, and also prevented excessive BP variability.
Diuretic therapy effects on the signal-averaged ECG parameters of atrial complex and supraventricular arrhythmias in patients with coronary heart disease and chronic heart failure
Authors: Shugushev Kh. Kh. , Gaeva A. A.
Published: October 2019

Aim. To study the signal-averaged ECG (SA-ECG) parameters of atrial complex and supraventricular arrhythmias (SVA) in patients with coronary heart disease (CHD) and chronic heart failure (CHF), treated with diuretics (D) torasemide and furosemide. Material and methods. The study included 107 patients with CHD and CHF. All participants underwent 24-hour ECG monitoring and the registration of SA-ECG atrial complex parameters. In total, 52 patients received furosemide, and 55 were administered torasemide. Results. In both groups, D therapy was associated with some increase in the duration of filtered P and LAS5, as well as a decrease in RMS20. These changes were more pronounced in the furosemide-treated patients. Torasemide demonstrated better effects on the SVA dynamics, which manifested in the decreased numbers of single, paired, and grouped SV extrasystoles. Conclusion. In CHD and CHF patients, the disturbed atrial depolarisation was manifested in negative dynamics of SA-ECG atrial complex parameters. Torasemide therapy did not affect the atrial complex parameters and also reduced SVA incidence, which made torasemide a medication of choice for patients with CHD and CHF.
The role of vasodilating β-blockers in patients with complicated hypertension: focus on nebivolol
Authors: Giles T. D.
Published: October 2019

Despite their proven mortality and morbidity outcomes benefits, β-blockers remain substantially underused in patients with cardiac conditions. Reluctance to prescribe β-blockers may be owing to concerns about tolerability with the traditional drugs in this class. β-blockers with vasodilatory properties, such as carvedilol and nebivolol, may overcome the tolerability and metabolic issues associated with traditional β-blockers. Because endothelial dysfunction, the pathophysiologic hallmark of hypertension, may be heightened in populations with difficult-totreat hypertension (e.g., elderly patients, African American patients), a vasodilating β-blocker may be a particularly appropriate choice for these patient groups.
Arterial hypertension: morbidity and mortality in the non-organized Bryansk Region population
Authors: Konstantinov V. V. , Erchenkova V. E. , Timofeeva T. N. , Balanova Yu. A. , Kapustina A. V. , Deev A. D. , Lelchuk I. N.
Published: October 2019

Aim. To study the incidence of arterial hypertension (AH) and to evaluate AH effects on morbidity and mortality levels, in the presence of associated clinical conditions (ACC), target organ damage (TOD), risk factors (RFs), and various social characteristics, among the nonorganized Bryansk Region population. Material and methods. The study included a representative population sample (n=2435), examined in 2004. Response rate was 83,6%; the age of the participants ranged from 19 to 64 years. Results. AH incidence in men and women reached, respectively, 36,63 and 36,8 per 1000 person-years. In total, 101 deaths were registered, with 45,6% represented by cardiovascular disease (CVD), and 29,7% by coronary heart disease (CHD). Among CVD deaths, 65,2% were coronary deaths. AH incidence was associated with age, hypercholesterolemia, alcohol consumption, heart rate (HR), various RF combinations, high normal blood pressure (BP), and place of residence. Mortality levels were significantly higher in AH patients with ACC, TOD, and RFs. The SCORE-assessed total CVD risk increased to high and very high levels in men aged over 50 years, while in women, moderate risk levels were reached only at the age of 60. Conclusion. Development and implementation of preventive AH programmes should incorporate the assessment of ACC, TAD, and RFs. Place of residence should also be taken into account, since the current epidemiological situation is worse among rural residents.