bluuebunny/crossref_metadata_2025 huggingface dataset:
Antibody and T Cell Response to SARS-CoV-2 Messenger RNA BNT162b2 Vaccine in Kidney Transplant Recipients and Hemodialysis Patients
Authors: Bertrand Dominique , Hamzaoui Mouad , Lemée Veronique , Lamulle Julie , Hanoy Mélanie , Laurent Charlotte , Lebourg Ludivine , Etienne Isabelle , Lemoine Mathilde , Le Roy Frank , Nezam Dorian , Plantier Jean-Christophe , Boyer Olivier , Guerrot Dominique , Candon Sophie
Published: June 2021

Significance Statement

Antibody and T cell responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccines are poorly reported in kidney transplant recipients (KTRs) and patients on hemodialysis (HDPs). The authors investigated the response to BNT162b2 vaccine in 45 KTRs and ten HDPs. After the second dose, 88.9% of HDPs and only 17.8% of KTRs developed anti–SARS-CoV-2 antibodies. A specific T cell response was induced in 100% of HDPs and 57.8% of KTRs. The immune response seemed influenced by the immunosuppressive regimen in KTRs, particularly tacrolimus and belatacept. These results could help to better define the strategy of vaccination in this immunocompromised population.

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a high rate of mortality in patients with ESKD, and vaccination is hoped to prevent infection.

Methods

Between January 18 and February 24, 2021, 225 kidney transplant recipients (KTRs) and 45 patients on hemodialysis (HDPs) received two injections of mRNA BNT162b2 vaccine. The postvaccinal humoral and cellular response was explored in the first 45 KTRs and ten HDPs.

Results

After the second dose, eight HDPs (88.9%) and eight KTRs (17.8%) developed antispike SARS-CoV-2 antibodies (P<0.001). Median titers of antibodies in responders were 1052 AU/ml (IQR, 515–2689) in HDPs and 671 AU/ml (IQR, 172–1523) in KTRs (P=0.40). Nine HDPs (100%) and 26 KTRs (57.8%) showed a specific T cell response (P=0.06) after the second injection. In responders, median numbers of spike-reactive T cells were 305 SFCs per 106 CD3+ T cells (IQR, 95–947) in HDPs and 212 SFCs per 106 CD3+ T cells (IQR, 61–330) in KTRs (P=0.40). In KTRs, the immune response to BNT162b2 seemed influenced by the immunosuppressive regimen, particularly tacrolimus or belatacept.

Conclusion

Immunization with BNT162b2 seems more efficient in HDPs, indicating that vaccination should be highly recommended in these patients awaiting a transplant. However, the current vaccinal strategy for KTRs may not provide effective protection against COVID-19 and will likely need to be improved.
Effect of flow and volume-oriented incentive spirometer exercise on the hemodynamic parameters in cardiac surgery patients. Pilot interventional study
Authors:   Student BPT, Deccan Education Society's Brijlal Jindal college of Physiotherapy, Pune, India., Keny Pranjal , Pagare Rajani ,   Professor and HOD (Cardiovascular and Respiratory Physiotherapy), Deccan Education Society's Brijlal Jindal college of Physiotherapy, Pune, India.
Published: June 2021

Background: The 2 types of incentive spirometers (flow and volume-oriented) prescribed after cardiac surgery demonstrate a difference in the pattern of breathing, diaphragm mobility, pulmonary function test. Limited research is available on effect of incentive spirometer on hemodynamic parameters. Purpose: To provide hemodynamic perspective for preference of a specific type of incentive spirometer after cardiac surgery. Method: Ideal method of performing breathing on their prescribed incentive spirometer was explained. On 2nd day post surgery, heart rate, respiratory rate, oxygen saturation and blood pressure were noted immediately before and after performing 8 breaths on incentive spirometer. Results: The intergroup comparison i.e., difference between changes caused by flow and volume-oriented incentive spirometers are statistically insignificant. The intra group comparison, the changes in hemodynamic parameters by flow and volume-oriented incentive spirometers are statistically insignificant, except for heart rate with flow-oriented incentive spirometers showed statistically significant increase. Conclusions: There is no difference in the impact of flow oriented and volume-oriented Incentive spirometers on hemodynamic parameters in post cardiac surgery patients. KEY WORDS: Incentive spirometer, Cardiac surgery, Heart rate, Blood pressure, Respiratory Rate, Oxygen saturation.
Yusuf Ziya Paşa’nın Hayatı Ve Keban’da Yaptırdığı Konak Hamamı
Authors: YILDIRIM Selda , AYTAÇ İsmail
Published: June 2021

Bu makalede nitel çalışma yöntemi kullanılmıştır. Yusuf Ziya Paşa’nın hayatı ve vakfetmiş olduğu eserlerden Elazığ İli Keban İlçesi’nde yer alan Konak Hamamı tanıtılarak, Osmanlı Siyasi ve Türk-İslam Sanatı Tarihi bakımından önemi değerlendirilmiştir. Yusuf Ziya Paşa, çeşitli alanlarda aldığı eğitimler ve kabiliyetinin bir sonucu olarak III. Selim ve II. Mahmut devirlerinde iki kez sadrazamlık olmak üzere birçok önemli görevde bulunmuştur. Bu özelliklerinin yanı sıra hayırsever bir kişiliğe sahip olan Paşa, kurmuş olduğu vakıflar yolu ile Malatya, Keban, Çemişgezek, Erzurum, Trabzon ve İstanbul gibi şehirlerde bani olarak, kendisinin yapmış olduğu hat levha örnekleriyle de Türk Sanatına katkılar sağlamış önemli bir devlet büyüğüdür. Yusuf Ziya Paşa’nın yaptırmış olduğu eserlerden makalemize konu olan Keban’daki konak hamamı büyük oranda tahrip olmuştur. Beden duvarları ayakta olan hamamın kubbe örtüsü tamamen çökmüştür. Hamam, 18. Yüzyıl sonu Osmanlı Mimarisini yansıtmaktadır. Bu yapı planı, malzemesi ve işlevi açıklandıktan sonra dönemi içerisinde değerlendirilmiştir.
YEMEN’DE ÇATIŞMALI SÜREÇ VE DİNAMİKLERİ
Authors: KOCA Nazlı
Published: June 2021

Bu makalede, farklı tarihsel gelenekten gelen farklı siyasi yapıların 1990’da birleştiği Yemen Cumhuriyeti’nde devam eden çatışmaların yapısal sebepleri analiz edilmiştir. Çatışmalar Arap isyanlarından çok daha önce başlamış fakat Arap isyanları sonrası şiddetlenerek devam etmiş ve 2015’te ABD desteği ve Suudi Arabistan ile 10 Arap ülkesinin askeri müdahaleleriyle uluslararası hale gelmiştir. Çalışmada, Yemen'in son elli yılına damgasını vurmuş devrik Devlet Başkanı Ali Abdullah Salih’in 2017 yılında Husiler tarafından öldürülmesine kadar geçen süre ele alınmıştır. Bu bağlamda, çalışmada ileri sürülen düşünce Yemen’de yaşanılan Husiler- Yemen Hükümeti arasındaki çatışmaların bir mezhep savaşı olmadığı, Arap isyanları ile başlamadığı, anlaşmazlıkların ve kırılmaların tarihsel olarak çok önceki süreçlere dayandığıdır. Bu görüşü desteklemek amacıyla sürekli farklılaşan çıkarlara göre değişen farklı grupların birbirleriyle kurdukları iş birlikleri incelenmiştir.
La Suisse innove avec fide
Authors: MERCIER Dao
Published: June 2021

Le système fide « Français, Italiano, Deutsch en Suisse », opérationnel depuis 2012, représente la volonté de la Suisse à promouvoir l’intégration linguistique des migrants adultes. En français, il s’intitule « fide français en Suisse – apprendre, enseigner, évaluer ». L’innovation de fide réside dans la cohérence de son système et dans ses principes didactiques s’inspirant du Cadre européen commun de référence pour les langues CECRL tout en respectant ceux déterminés dans l’andragogie ou la formation d’adultes. Ma contribution aura pour but de présenter le système fide en mettant l’accent sur cette application du CECRL dans ce contexte andragogique et ce, dans chaque étape du processus de l’apprentissage, de l’enseignement et de l’évaluation.
Les enjeux des cultures régionales chinoises dans la didactique du chinois langue étrangère et les perspectives pédagogiques innovantes
Authors: WANG Lei
Published: June 2021

Lorsqu’un apprenant effectue son séjour en mobilité dans un pays comme la Chine, où les langues et les cultures régionales sont très variées et toujours vivantes, quelles conséquences peuvent avoir l’écart entre le capital linguistique et culturel standardisé que l’apprenant a acquis à l’école et ses expériences dans la région où il séjourne ? Comment l’apprenant mobilise-t-il ses compétences pour s’adapter à ces différences afin de réussir ? En travaillant sur le retour d’expériences des étudiants de chinois de l’Inalco, nous avons analysé les enjeux des cultures régionales dans la représentation, la compétence interculturelle et la motivation des étudiants. La fin de l’article est consacrée à des propositions pédagogiques qui visent à valoriser le séjour en mobilité des apprenants et à enrichir l’enseignement/l’apprentissage du chinois langue étrangère.
Accéder à et comprendre des contenus en portugais par des étrangers
Authors: MENEZES Cláudio
Published: June 2021

Avec l’émergence des bibliothèques numériques, l’accessibilité à distance est devenue une pratique courante dans le cyberespace. Dans le domaine universitaire, un certain nombre d’initiatives sont connues, telles que le NDLTD – un réseau international de mémoires et de dépôts de thèses – ou la BDTD – Bibliothèque numérique de thèses et de mémoires au Brésil. Ce sont des interfaces qui permettent d’accéder au texte intégral des documents dans la langue originale du texte. De plus, dans le contexte actuel de mondialisation, l’offre d’inscription d’étudiants étrangers dans les universités est devenue plus importante, ce qui implique la nécessité d’un service de bibliothèque pour ce type d’utilisateur. Étant donné le volume important de contenu scientifique, la traduction complète de ces documents semblerait être une tâche herculéenne irréalisable. Dans ce contexte, cette recherche vise à identifier les obstacles rencontrés par les étrangers pour accéder à et comprendre le contenu scientifique. Elle a comme objectif de développer une méthodologie supportée par une application informatique qui pourrait améliorer la compréhension des étudiants en leur facilitant ces contenus. La méthodologie proposée peut être adaptée à n’importe quelles langues. On peut également envisager son adaptation aux langues des signes et à la communication orale. La communication proposée couvre divers aspects : – la place de la compétence culturelle et du multilinguisme dans les dispositifs d’apprentissage des langues ; – l’interaction entre l’apprentissage des langues et la socialisation des élèves / apprenants allophones ; – la question de l’autonomie dans les dispositifs d’apprentissage ; – la question de la formation des professeurs de langue seconde et de la langue de scolarisation ; – l’intégration sociale, culturelle et professionnelle des apprenants allophones – les langues accessibles sur le Web.
Gobernar la casa, la familia y a sí misma: imperativos de la educación infantil femenina en Colombia (primera mitad del siglo XX)
Authors: León-Palencia Ana Cristina
Published: June 2021

Este artículo de investigación presenta algunos resultados de un estudio sobre las prácticas de educación de la niña en Colombia a finales del siglo xix e inicios del siglo xx. Tales prácticas emergieron en el marco de tres desplazamientos: en primer lugar, una modificación en la comprensión de lo femenino, sintetizada en el paso del bello sexo a la mujer moderna; en segundo lugar, los ajustes en la educación de las niñas que pasaron del espacio familiar a la escuela; en tercer y último lugar, se instaló una figura de la mujer en el ámbito social más ligada a su papel de madre que al de esposa. Estos desplazamientos sirvieron como condición de posibilidad para un tipo de prácticas educativas cuyo objetivo se centró en una tarea que se volvió imperativa: gobernar a otros y a sí misma. Esto implicó que, aunque las prácticas de educación femenina mantuvieron su confinamiento en el hogar, la mujer se tornara en pieza fundamental de las estrategias de gobierno de la población en la primera mitad del siglo xx. A partir de la lectura temática de manuales de pedagogía, urbanidad, puericultura, higiénicos, de revistas médicas y pedagógicas de amplia circulación, de normatividad educativa, entre otras fuentes documentales analizadas a través de las herramientas de carácter arqueológico de cuño foucaultiano, en el texto se desarrollan tres asuntos: uno de orden conceptual, otro de carácter político y uno más de tipo práctico.
Social participation and depressive symptoms of carer-employees of older adults in Canada: a cross-sectional analysis of the Canadian Longitudinal Study on Aging
Authors: Wang Li , Ji Chris , Kitchen Peter , Williams Allison
Published: June 2021

Objectives

This study used two waves of data from the Canadian Longitudinal Study on Aging (CLSA) to investigate the association between social participation and depressive symptoms in carer-employees (CEs) and non-carer-employees (NCEs).

Methods

Adopting Pearlin et al.’s stress model, multivariate linear regression was used to examine the relationships among carer role, social participation, and depressive symptoms in Canadian employees using the first two waves of CLSA data, while controlling for possible confounders.

Results

Higher levels of social participation were found to be associated with lower depressive symptoms in both waves. Social participation was found to moderate depressive symptoms for CEs when compared with NCEs in Wave 2 but not in Wave 1.

Conclusion

The present study highlights the importance of social participation in reducing CEs’ depressive symptoms. The findings provide support for innovative policy and intervention efforts to encourage and enhance social participation at work via carer-friendly workplace policies for CEs across Canada.
Relative Effectiveness of Conceptual Change Texts with Concept Cartoons and 5E Learning Model with Simulation Activities on Pre-Service Teachers’ Conceptual Understanding of Waves
Authors: TAŞLIDERE Erdal
Published: June 2021

The purpose of this study was to investigate both the individual and relative effectiveness of two conceptual change interventions, gender and their interactions on preservice science teachers’ conceptual understanding and their misconceptions in mechanical waves. The interventions are conceptual change texts enriched with concept cartoons (CCTCC) and 5E learning model enriched with simulation activities (5ESA) respectively. Participants are 66 sophomores from two intact classes. A quasi-experimental design was used as a research methodology. One group studied the concept of mechanical waves with the CCTCC and the other studied it with the 5ESA. Students’ conceptual understanding levels and misconceptions were measured by a Four-Tier Mechanical Waves Misconception Test as pre and post-test. Preliminary analysis indicated that there was no significant difference among the intervention groups’ pre-conceptual understanding levels. Individual effects of the treatments from pre to post-tests were investigated by paired-sample t-tests and the main effects of the treatments, gender and their interactions on post-conceptual understanding levels were examined via two-way ANOVA. The results of t-tests showed that both treatments significantly affected learners’ conceptual understanding levels individually. ANOVA results yielded a significant treatment effect on behalf of the CCTCC, but the effects of the gender and gender*treatment interaction on students’ post-conceptual understanding levels were insignificant. Findings showed that the conceptual change approach accompanied by conceptual change text enriched with concept cartoons is likely to be more effective for increasing students’ conceptual understanding level and decreasing their misconceptions in mechanical waves.
Psephellus pyrrhoblepharus Ekstrelerinin Sitotoksik Aktivitesi
Authors: TAŞTAN Pelin , ARMAĞAN Güliz , DAĞCI Taner , KIVÇAK Bijen
Published: June 2021

Amaç: Birçok Psephellus ve Centaurea türü antipiretik, antiinflamatuar, diüretik ve sitotoksik gibi önemli farmakolojik aktivitelere sahiptir. Endemik bir bitki olan Psephellus pyrrhoblepharus (Boiss.) Wagenitz, Elazığ, Türkiye’den toplanmıştır. Son günlerde kanserde terapötik amaçlar için bitki kaynaklı bileşiklerin kullanımına olan ilgi artmaktadır. Bir kanser türü olan karaciğer kanseri de tüm dünyada milyonlarca insanı etkilemekteyken, karaciğer kanserini tedavi etmek için herhangi bir yaklaşım son derece değerlidir. Bu çalışmada, insan karaciğer kanseri hücresi (HepG2) kullanılarak P. pyrrhoblepharus bitkisinin topraküstü kısımlarından hazırlanmış olan metanol:su (1:1), kloroform ve n-hekzan ekstrelerinin sitotoksik potansiyelini değerlendirilmesi amaçlanmıştır. Gereç ve yöntemler: 3-(4,5-dimetiltiyazol-2-il)-2,5-difenltetrazolyumbromit (MTT) metodu kullanılarak, insan karaciğer kanser hücre hatlarında (HepG2) farklı konsantrasyonlarda (50, 100, 200 ug/ml) MTT, farklı zaman noktalarında (6, 12, 24 s) çalışmalar gerçekleştirildi. Bulgular: Sitotoksisite ile ilgili olarak, farklı zaman noktalarında ekstrelerin maruziyetlerinin ardından hücre canlılığının azaldığı gözlenmiştir. Bununla birlikte, en yüksek sitotoksik aktivite, 24 saatte 100 ug/ml konsantrasyondaki kloroform ekstresinde gözlenmiştir. Bitkinin kloroform ekstresi, metanol:su ve n-hekzan ekstreleri ile karşılaştırıldığında 12 saatte 200 ug/ml konsantrasyonda en yüksek sitotoksik etkinliği göstermiştir. Sonuç: P. pyrrhoblepharus ekstrelerinin HepG2 karsinoma hücrelerinde doza ve zamana bağlı bir şekilde sitotoksik etki gösterdiği ileri sürülebilir. Genel olarak elde edilen sonuçlar, toksisite tehlikesi olmadan farklı uygulamalarda kullanılabilecek P. pyrhoblepharus ekstrelerinin eşik konsantrasyonları hakkında bilgi sağlamıştır.
Cerebrovascular aneurysm clipping training models with pulsatile blood flow
Authors: Encarnacion Ramirez M.J.
Published: June 2021

Introduction. Neurosurgery trainees are finding it increasingly difficult to obtain operative experience as the main surgeon in aneurysm procedure. Good quality cadaver dissection opportunities are also not widely available for neurosurgery residents. Simulation is emerging as a useful training aid for neurosurgery. Surgical treatment of cerebral aneurysms requires specialized skills development and proficient use of microsurgical instruments. Furthermore, any advance in neurosurgical training methods is of potential value to both neurosurgeons and patients.

The study objective is to introduce a 3D aneurysm clipping training model to enhance skill acquisition and development.

Materials and methods. The brain model is made using a 3D printed resin mold. The mold is filled with silicone Ecoflex 00–10 and mix with Silc Pig pigment additives to replicate the color and consistency of brain tissue. Dura is made from quick drying silicone paste with grey dye. The blood vessels are made from a silicone 3D printed mold of a magnetic resonance angiography. Liquid with paprika oleoresin (E160c) dye is used to simulate blood and is pumped through the vessels to simulate pulsatile motion.

Results and conclusion. These models offer an alternative method to train residents and preoperative planning. They are affordable and easy to recreate and hence can standardize training in multiple centers. With advancing technology, 3D technology is becoming an import part of medical education.
Long-term clinical and radiological outcomes after total lumbar disc replacement at the lumbosacral junction
Authors: Stepanov I. A. , Beloborodov V. A. , Saakyan Z. S. , Tomashov I. I. , Trepeznikov V. G.
Published: June 2021

The study objective is to analyze long-term clinical and radiological outcomes in patients after performing total lumbar disc replacement at the level of the lumbosacral junction.

Materials and methods. A multicenter retrospective observational cohort study was performed. The study included medical records of patients who underwent total lumbar disc replacement at the level of the lumbosacral junction. Both clinical and instrumental parameters were assessed. According to the eligibility criteria, 93 patients were included in the study (38 men, 55 women, mean age 39.9 ± 7.5 years). The average postoperative observation period for the respondents was 33.4 ± 9.5 months.

Results. The severity of pain in the lumbar spine on a visual analogue scale significantly decreased (from 7.3 ± 2.5 to 1.9 ± 2.2 cm, p <0.001). The indicators of the quality of life according to the Oswestry Disability Index and according to the Short Form-36 scale (including the mental and physical components) of the studied group of respondents significantly improved (from 43.4 ± 17.6 to 18.9 ± 16.0 %, р <0.001 and from 30.8 ± 8.5 to 52.3 ± 12.4 %, p <0.001, respectively). From the 12th month of observation of the respondents, a significant decrease in the values of the range of motions of the operated segment was noted from 5.3 ± 3.2° to 4.1 ± 3.6° (p <0.009). Also, from the 12th month of postoperative observation, a slight decrease in the values of the range of motions of the adjacent segment from 8.6 ± 4.1° to 7.8 ± 3.8° (p >0.05) was verified. The value of global lumbar lordosis after the installation of a lumbar intervertebral disc prosthesis at the level of the lumbosacral junction significantly increased from 49.1 ± 4.8° to 55.6 ± 5.5° (p <0.001). Intervertebral disc prostheses with a lordotic angle of 10° reliably positively correlate with an increase in the values of segmental lordosis, in contrast to implants with an angle of 6° (rS = 0.86, p = 0.04). The severity of pain in the lumbar spine according to visual analogue scale and the range of motion of the operated segment has a significant negative correlation in the late periods of postoperative follow-up (24 and 36 months, rS = -0.74, p = 0.015).

Conclusion. The total lumbar disc replacement technique is an effective method of surgical treatment of patients with degenerative diseases of the intervertebral discs of the lumbosacral spine, including at the level of the lumbosacral junction.
Vascular decompression with videoendoscopy as a treatment for glossopharyngeal nerve neuralgia: clinical case and literature review
Authors: Vinokurov A. G. , Kalinkin A. A. , Bocharov A. A. , Kalinkina O. N. , Chupalenkov S. M.
Published: June 2021

The objective is to demonstrate the effectiveness of the vascular decompression with videoendoscopy in the treatment of classical glossopharyngeal nerve neuralgia by a clinical case and to summarize the literature data on this subject. Clinical case. In February 2020, a 56-year-old patient with a clinical picture of glossopharyngeal nerve neuralgia was admitted to the Research Clinical Center of Specialized Medical Care and Medical Technologies. The pain syndrome bothered about 3 years, constantly took carbamazepine at a dose of 1200 mg per day, amitriptyline 75 mg per day, clonazepam 2 mg per day without effect. After further examination and differential diagnosis of causal neuralgia of the glossopharyngeal nerve, a neurovascular conflict appeared between the glossopharyngeal nerve, the posterior inferior cerebellar and vertebral arteries. A good postoperative clinical result was obtained. An analysis of the available scientific literature on this problem is carried out.

Results. After performing vascular decompression of the root of the glossopharyngeal and vagus nerves, pain completely regressed (BNI - I, VAS - 0). 6 months after surgery, there is no pain, the patient does not receive drug therapy. In the course of the analysis of available literature, the effectiveness of vascular decompression in the treatment of patients with classical neuralgia reaches 98 %.

Conclusion. Given the low incidence of glossopharyngeal neuralgia, the correct diagnosis and the choice of an appropriate treatment method determine the outcome of the disease. The performed operation in the volume of vascular decompression of the glossopharyngeal nerve root with the use of videoendoscopy allowed to completely stop the pain syndrome.
Endovascular treatment of complex bifurcation aneurysms using the pConus device: clinical cases
Authors: Kiselev V. S. , Sosnov A. O. , Gafurov R. R. , Perfiliev A. M.
Published: June 2021

The objective is to present the clinical experience of using the pConus stent-like device in the treatment of complex bifurcation aneurysms.

Clinical cases. A 64-year-old patient was admitted with complaints of periodic headache without loss of consciousness and an increase in focal symptoms. Saccular aneurysms of the anterior communicating artery and the left superior cerebellar artery were found without signs of subarachnoid hemorrhage. For occlusion of the aneurysm of the left superior cerebellar artery (dimensions 7.4 х 5.3 mm, neck width 5.0 mm, facing left and up, body/neck ratio 1.48, the branch of the artery branched off from the neck), a pConus device (crown diameter 8 mm) was used with micro-coils.

A 61-year-old patient was admitted with complaints of headache in the occipital region, accompanied by repeated vomiting and an increase in blood pressure to 200/110 mm Hg. Subarachnoid hemorrhage and a saccular aneurysm of the basilar artery bifurcation (facing up, anteriorly and somewhat to the left, measuring 4.9 x 3.4 mm, neck width 3.1 mm, dome/neck ratio 1.1) were revealed. A pConus device was used for micro-coils occlusion (4-25-6 mm).

In the postoperative period, both patients did not experience an increase in focal neurological symptoms. Control angiography after 6 months confirmed stable occlusion, all major vessels were passable.

Conclusion. In the described cases, there were no technical problems during the installation and implantation of the device. The use of the pConus device in the treatment of complex bifurcation aneurysms technically simplifies surgical intervention, since it does not require catheterization of the efferent vessels of the aneurysm.
Multi-stage treatment of non-specific spondylodiscitis of the cervical spine
Authors: Sytnik A. V. , Obolenskiy V. N. , Lvov I. S. , Kordonskiy A. Yu. , Rozhanskiy S. A.
Published: June 2021

The objective is to present a clinical case of successful treatment of a patient with recurrent spondylitis at the cervical level.

Clinical case. A 65-year-old patient was diagnosed with purulent spondylodiscitis at the level of C6-C7 vertebrae with the epidural and paravertebral abscesses and spinal cord compression. Emergency left colotomy, paravertebral abscess dissection, corporectomy of the C6 vertebra, abscess removal, anterior spondylodesis with bone autograft and titanium plate were performed. Massive antibacterial therapy was prescribed. After the operation, the volume of movement in the left limbs was restored, and on the 15th day after the operation, the patient was discharged. On the 36th day after discharge, she was hospitalized again with hematuria. A recurrence of suppuration in the area of the operation and phlegmon of both feet was revealed. Revision of the surgical wound and rehabilitation of the purulent focus on the neck, surgical intervention for phlegmon were performed. In purulent foci, Staphylococcus aureus was verified, which is sensitive to the main antibacterial drugs. Antibacterial therapy was continued, then, after changing the microflora in the wound, other antibiotics were prescribed. There was a pain in the area of the left spinal root C5. The connection of the fistula course with the titanium plate, the increase of pathological kyphosis at the level of the overlying vertebrae was found. The wound was examined, the titanium plate was removed, and the halo device was applied to correct the pathological kyphosis. After the operation, the radicular pain syndrome regressed, and the axis of the cervical spine was restored. After 1 month, the posterior combined fixation of the cervical spine at the C3-Th7 level was performed, and the halo device was dismantled. After 6 months, the patient was stopped wearing the Philadelphia neck collar, no recurrence of suppuration was observed, and a complete regression of neurological disorders was noted. After 1 year, a complete bone block is preserved between the C4-C7 vertebrae.

Conclusion. The presented clinical case clearly illustrates the complexity of managing patients with inflammatory diseases of the cervical spine. Currently, there is no single treatment strategy for patients with spondylitis.
Financial and Legal Relations and Key Legal Categories in the Field of Megasience
Authors: Tkachenko R. V.
Published: June 2021

The paper is devoted to the examination of some legal aspects of the legislative regulation of public relations in the field of large-scale international research infrastructures. The author identifies the features of public relations in the field of Megasience, examines various approaches to the definition of this category. In particular, it is determined that it is the rules of financial law that regulate the complex of public relations within which public financial activities are carried out in the field under consideration, namely: relations concerning financing at the expense of centralized funds (budgets) as well as using extrabudgetary sources for creating large-scale research infrastructures — unique scientific Mega-science installations; relations associated with the application of various tax incentives and preferences, investment tax credits by scientific and other organizations involved in the implementation of Megascience projects; financial control and supervision relations in the process of creation and operation of global research infrastructure facilities. The author makes proposals concerning the need to develop and adopt a special federal law of the Russian Federation regulating public relations in the field under consideration, as well as public relations in the field of international collaboration related to the implementation of international research activities based on Megascience facilities by the States Parties to such activities. The author gives possible definitions of key concepts applied in the field of Megasience.
Legal Classification of Defects in Medical Care
Authors: Danilov E. O.
Published: June 2021

The paper studies the legal nature of defects in medical care and defines criteria for their legal classification. A retrospective analysis of the development of the institution of legal responsibility for improper medical treatment is carried out. The concept of a defect in medical care and related categories, their natural ontological characteristics and classifying legal features are investigated, doctrinal approaches to the legal assessment of defects in medical care are considered. It is noted that, despite the noticeable evolution that the question of the responsibility of doctors has undergone in the history of law, there is still no single approach to understanding the legal nature of defects in medical care in jurisprudence. In modern Russian legislation, as in the criminal laws of most foreign countries, there are no special standards for such defects classification. At the same time, in the interests of optimal legal regulation of relations in the field of medicine, today it is the legal definition and systematization of basic concepts and criteria for the legal classification of various medical incidents that matters and not the introduction into the law of special articles establishing criminal liability for improper provision of medical care. Thus, by combining all adverse events in medical practice under the general term "medical incidents", one can use the concept of "medical care defect" to distinguish incidents caused by inappropriate provision of medical services. The author proposes his own classification of defects in medical care dividing them into medical torts (offenses) and medical incidents (accidents and medical errors) based on the nature of the attitude of the subject of medical activity to their professional duties. A conceptual approach to the legal classification of medical care defects has been formulated.
Some Aspects of the Preventive Function of the Notaries
Authors: Korsik K. A.
Published: June 2021

The paper examines the notaries as an institution that ensures the legal security of a transaction in the course of its daily work. The author identifies the issues that prevent notaries from preventing fraudulent actions of parties to civil transactions when performing a notarial act. The State Duma of the Federal Assembly of the Russian Federation is considering a draft Federal Law No. 925889-7 "On Amending Certain Legislative Acts of the Russian Federation", specifically about a registrar of persons found incapable by court, the register of notifications of cancellation of powers of attorney made in electronic form. Thus, the author analyzes the issue of creating a register of persons recognized as having no legal capacity or partially incapable. The paper considers the positive experience of the Federal Notary Chamber in maintaining public registers. The author concludes that strengthening of the preventive function of the notaries in the legal system of society depends on the powers granted to this institution.
The Role of Customary International Law in Regulating the Activities of Armed Groups in the Field of Human Rights
Authors: Sharipov R. I.
Published: June 2021

Over the past decades, there has been a significant increase in the number of armed groups involved in armed conflicts around the world, as well as in their impact on the rights and freedoms of the population under their control. Facing various situations of systematic violations of human rights by non-state actors, experts in the field of international human rights law began to consider the theoretical justification for the mandatory nature of the provisions on the observance and protection of human rights for armed groups. In this regard, a number of scholars have turned to the theory of customary international law, the acceptability of which is being investigated by the author of this paper. The author examines the provisions underlying this theory and the persuasiveness of the argumentation used by its supporters. Based on an analysis of the nature of customary international law, its structural elements, their interpretation by the UN International Court of Justice in its decisions and the relationship of customary international law with peremptory norms of jus cogens, the author concludes that the theory under consideration is currently unable to explain the existence of obligations of armed groups in the field of human rights.
Methods for diagnosing the sex of adult human by anatomical and morphological features of arytenoid cartilages
Authors: Kalimullin Rafkat R. , Zvyagin Viktor N.
Published: June 2021

Background: One of the main issues of general personality identification is the ascertainment of the sex of impersonated or fragmented bodies. Sporadic studies in the forensic medical literature have reported larynx cartilage sexual dimorphism, among which arytenoid cartilages are absent. The publications have morphometric focus and do not consider the practical aspects of sex diagnostics, which have been determined in this study. Aim: To develop a method for determining sex using the features of sexually dimorphic anatomical and morphological arytenoid cartilage of an adult. Materials and methods: The anatomical and morphological features of arytenoid cartilage from 80 males and 80 females aged 2078 years were studied. The visual examination revealed differences related to sex based on nine characteristics. The reliability of the sexual dimorphism of traits was verified using the Chi-square test and proportionality coefficients. Results: The informational significance of the features was clarified, and the individual observations were digitized using the formula. The possibility of sex determination by arytenoid cartilage was established in 93.75% of cases. In the remaining 6.25% cases, it was deemed impossible to solve this problem using the given set of features. Conclusion: The method developed for determining sex is highly accurate and can be used in sex diagnostics during a forensic medical larynx examination of a decayed or a fragmented corpse.
The role of transanal drainage tube in low anterior resection for rectal cancer
Authors: Akhmetzyanov F Sh , Egorov V I , Ruvinskiy D M , Lûtikovа O V
Published: June 2021

Total mesorectal excision with low anterior resection has significantly improved the long-term outcomes of surgical treatment for rectal cancer, decreasing the local recurrence rate and increasing survival. However, total mesorectal excision is becoming one of the main factors for the development of colorectal anastomosis leakage, the rate of which reaches 20% in these operations. To minimize the complications associated with the inconsistency of the colorectal anastomotic suture, preventive intestinal stoma is formed when performing low anterior resections. That significantly worsen the quality of life of patients, their elimination requires re-hospitalization, and surgical interventions are accompanied by a high incidence of postoperative complications, reaching a rate of 20%, which has a significant impact on the cost of treatment for this category of patients. Transanal drainage is an alternative to the formation of preventive intestinal stoma and is devoid of its shortcomings. This literature review is devoted to an analysis of the effectiveness of transanal drainage in low anterior rectal resection. Until recently, transanal drainage has not yet gained popularity among surgeons due to the lack of evidence of its safety and effectiveness, and many studies are retrospective, including small samples. The review considered single-center, multicenter, randomized trials and a meta-analysis of the use of transanal drainage. Transanal drainage is an effective method for preventing the inconsistency of colorectal anastomotic suture, it is safe, and it surpasses the preventive intestinal stoma in a number of indicators.
The relationship between breastfeeding and maternal education and family income
Authors: Bezrukova A A , Yarmolinskaya M I , Sazonova O V , Spiridonova N V , Komarova M N
Published: June 2021

Aim. To assess the relationship between breastfeeding and maternal education and family income in Samara.

Methods. A survey was conducted among 174 mothers in the children's outpatient clinic, in which their children were assigned at the place of residence. Information on breastfeeding and its duration, mother's education, and family income were obtained by questionnaire and copying data from outpatient records. Pearson's chi-square, MannWhitney U test and logistic regression were used in the statistical processing of the data.

Results. There was a positive association of maternal education (2=11.25; p=0.024) and income (2=11.5; p=0.022) with breastfeeding practices. Higher education, compared with specialized secondary or secondary education, increased the likelihood of breastfeeding for more than 6 months with an odds ratio of 2.6 (95% confidence interval 1.185.73; p=0.018). The median (and its Q1Q3 quartiles) breastfeeding duration was 4.0 months (Q1Q3 2.014.0 months) for mothers with secondary or specialized secondary education and 12.0 months (Q1Q3 4.018.0 months; p=0.012) for mothers with higher education. It was found that 67.7% of women with incomes above the subsistence level per family member ($150) breastfed for more than 7 months and only 43.9% of women with incomes below the subsistence level (p=0.011). The likelihood of breastfeeding for more than 6 months in household income above one minimum wage per family member compared with household income below increases with an odds ratio of 2.18 (95% confidence interval 1.034.60; p=0.041). There was no relationship between lactation cessation and maternal education or family income.

Conclusion. There is a positive relationship between mother's education and family income and the practice of breastfeeding.
Medical and economic efficiency of dental caries prevention through the use of fluoride sealant in schoolchildren
Authors: Shaymieva N I , Khasanov R Sh , Olesova V N
Published: June 2021

Aim. To study the medical and economic efficiency of the program for the prevention of dental caries using UltraSeal XT among schoolchildren of Kazan.

Methods. In 2013, 200 schoolchildren from Kazan seen in the Republican Dental Clinic of the Ministry of Health of the Republic of Tatarstan (100 boys and girls aged 78) were selected. All patients were divided into two groups with similar distributions of sex and age: the test (main) group and control group. In the test group Sealants, the fissures of the first permanent molars were sealed with a composite fluorine-containing sealant according to the manufacturer's instructions. The control group was formed from children without dental sealants. The oral health assessment of children is reflected in the Examination Cards. Average indices of the severity of dental caries were determined (the number of decayed, filled and missing primary/permanent teeth dmft/DMFT). Re-examination of children was carried out in 2016 with the determination of the same indicators. The economic analysis was carried out using the method of mathematical modeling. Statistical processing was performed in Microsoft Office Excel 2017.

Results. The use of sealants at the age of 78 years provided a lower level of caries severity in deciduous teeth (4.093.0; p 0.01). There was no statistically significant difference between the DMFT score of permanent teeth in children aged 78 years in the test group and the dmft score of deciduous teeth of children in the control group (p 0.05). The DMFT score in the permanent teeth of children in the test group of this age cohort (78 years old) was 0.660.95. The mean severity of dental caries DMFT index of 12-year-olds children with permanent dentition in the test group was 0.771.07, which is 1.52 more healthy teeth than in the control group DMFT score 2.291.59 (t=4.01; p 0.01). The medical and economic efficiency of the fluoride prevention of dental caries in 12-year-olds schoolchildren through the use of a composite fluorine-containing sealant is expressed in the eradication of caries (less than 1 affected tooth according to the World Health Organization classification) and amounts to 437.38 rubles of notional saved costs per child for sealing versus dental treatment.

Conclusion. The use of a fluoride composite material reduces the severity of dental caries in children and the notional saved costs for sealing teeth.
Mitral regurgitation followed by acute coronary syndrome
Authors: Dzeytova Aminat Kh-M. , Bolgucheva Madina B. , Gagieva Dolatkhan A. , Bezieva Khadishat A. , Gazdieva Leila O.
Published: June 2021

Mitral regurgitation followed by acute coronary syndrome is a dangerous pathological condition which can to threat patient. Precise evaluating severity of mitral regurgitation followed by acute coronary syndrome could be difficult. Management of patients depends on severity of mitral regurgitation. Current review describes role of echocardiographic parameters in assessment of severity of mitral regurgitation.
The role of cytomegalovirus and interleukin-8 in destabilization of atherosclerotic lesions in humans
Authors: Maltseva Svetlana V. , Pigarevsky Peter V. , Davydova Natalya G. , Snegova Vlada A.
Published: June 2021

Relevance. Currently, the role of persistent infections in the atherogenesis development mechanism is not fully understood. Therefore, its important to analyze the role of viral infection against the background of the pro-inflammatory cytokines expression in atherosclerotic plaque destabilization.
The aim of the work was a comparative immunohistochemical study of cytomegalovirus (CMV) and IL-8 in different types of human atherosclerotic lesions during their destabilization.
Materials and methods. The study was carried out on 130 autopsy samples of human aorta. CMV was detected by direct immunofluorescent antibody staining. IL-8 was detected by two-stage streptavidin-biotin antibody staining.
Results. It has been shown that active detection of both CMV and IL-8 is characteristic of atherogenesis foci of the arterial intima with the most intense immune-inflammatory changes. The obtained results indicate the synergism of the cellular response to CMV and IL-8 in the vascular wall during the destabilization atherosclerotic lesions process.
Conclusion. According to the results of the work, it can be concluded that both the presence of CMV in atherosclerotic lesions and the high production of IL-8 play a significant role in the formation of unstable atherosclerotic plaques in the vascular wall.
Scientific platform, development and implementation of effective immunodiagnosis of tuberculosis infection in the Russian Federation
Authors: Kudlay Dmitry A.
Published: June 2021

The review presents scientific information about modern approaches to immunodiagnosis of tuberculosis infection in the Russian Federation, which allows to control the spread of infection and prevent the development of the disease in individuals infected with Mycobacterium tuberculosis (MTB). The results of Russian and foreign studies have shown a low total sensitivity of the Mantoux tuberculin skin test, which indicates a low predictive value of the test for the diagnosis of tuberculosis infection. The article presents the results of preclinical and clinical studies of a new diagnostic test for the detection of tuberculosis infection using Diaskintest. The results substantiate the purpose of Diaskintest for the diagnosis of tuberculosis infection, assessment of the process activity; differential diagnosis of tuberculosis; differential diagnosis of post-vaccination and infectious immune response (delayed-type hypersensitivity); monitoring the effectiveness of treatment. The article presents the results information on the screening of tuberculosis infection in the Russian Federation using Diaskintest, its significance, efficacy, and safety. The results of scientific studies carried out in recent years to assess the effectiveness of immunodiagnostics in the Russian Federation give reason to believe that the introduction of a modern screening method for diagnosing tuberculosis infection using Diaskintest can significantly improve the quality of doctors work on the early detection of various manifestations of tuberculosis infection and significantly reduce the states material costs for combating with tuberculosis.
Mechanisms of the influence of adiponectin on apolipoproteins A-1 and B production by human hepatocytes
Authors: Tanyanskiy Dmitriy A. , Dizhe Ella B. , Oleinikova Galina N. , Shavva Vladimir S. , Denisenko Aleksandr D.
Published: June 2021

The aim of the study was to find out the mechanisms of the adiponectin effect on apolipoproteins (apo) A-1 and B production by human hepatocytes.
Materials and methods. The study was performed on the human hepatoma cell line HepG2. The expression of the apoA-1 gene was evaluated at the mRNA level by quantitative PCR with reverse transcription, and the production of apo B by ELISA method. The activity of lipogenesis was assessed by the inclusion of labeled 14C-acetate in triglycerides, as well as by mRNA expression of lipogenesis genes, and by the estimation of total triglycerides content in cells. To determine the involvement of signaling pathways, the RNA interference method was used.
Results. Knockdown of genes, coding the specific receptors, AMP-activated protein kinase, and its regulated transcription factors inhibited adiponectin-dependent stimulation of apoA-1 gene expression in hepatocytes. Adiponectin had no effect on lipogenesis and apo B production under basal conditions, but suppressed these processes induced by the addition of oleate.
Conclusion. Adiponectin stimulates the production of apo A-1 in hepatocytes by inducing the transcription of the apoA-1 gene and suppresses the secretion of apo B by affecting lipogenesis. These effects may underlie the effect of adiponectin on lipoproteins metabolism.