bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telaah Konstruktivis Partisipasi Cina dalam the Campaign to Stop Killer Robots
Authors: Waluyo Bambang dwi , Fahd Ryan Muhammad 
Published: July 2021

Studi ini mencoba menjelaskan motivasi Cina atas keterlebitannya dalam the Campaign to Stop Killer Robots meskpiun dalam waktu yang bersamaan terus mengembangkan senjata otonom mematikan. Studi ini mempergunakan konsep Transformasi Militer dari Martin van Creveld untuk mempertegas signifikansi LAWS dan jga teori Interstitial Conception of Politics dari Christian Reus-Smit untuk menganalisis motivasi Cina. Teori ini menjelaskan bahwa setiap tindakan politik pasti ditentukan oleh empat elemen yakni: (1) ideografis (2) etis (3) purposif, dan (4) instrumental.Artikel ini menemukan bahwa motivasi utama keterlibatan Cina adalah (1) untuk mempertahankan diskursus “the peaceful rise of China”, dan (2) untuk mengerem Amerika Serikat, kompetitor utama Cina dalam teknologi LAWS.
In use stability of chemical anticancer drugs and biologics
Authors: Astier A. 
Published: July 2021

Background. For hospital pharmacists and nurses it is critical to have real data about the stability of injectable drugs in practical situations: opened drug formulation, after the reconstitution of lyophilized production or after the dilution in various vehicles. Unfortunately, these data are seldom available. The manufacturer’s stability data are usually quoted as “stable for 24 hours at 4 °C” not for the true reasons, but considering the possible bacterial contamination or due to the fact that stability tests were only conducted during a very short period. This problem is of paramount importance for therapeutic proteins, mainly monoclonal antibodies, because the latter are very expensive.
Objective. To define the in use stability of anticancer drugs.
Materials and methods. Analysis of literature data on this topic; own study on diluted rituximab stability.
Results and discussion. Biologic drugs have revolutionized the treatment and prevention of many debilitating and life-threatening diseases. Biologics are much bigger and have a much more complicated structure than classical drugs. Principal causes of biologics’ instability include temperature changes, dilution, absorption, oxidation, shaking and shearing etc. Protein instability can be divided into physical and chemical instability. The former includes aggregation, denaturation and absorption on surfaces, and the latter – desamidation, disulfide bonds breakage and formation, oxidation, hydrolysis, isomerization, non-disulfide cross-linking, and deglycosylation. Instability of anticancer drugs and biologicals can lead to their toxicity, immunogenicity and efficacy loss. Instability can be overcome by the centralization of pharmacy handling, but firstly it needs to be thoroughly studied with the help of modern methods. The own study has revealed that the diluted rituximab is stable up to 6 months in polyolefin bags stored at 4 or 22 °C. The preparations can be realized without any problems. There also no fear of instability in case of thermal excursions. Such findings if introduced in practice can save about 150,000 euros a year.
Conclusions. 1. In-use analysis of proteins requires several methods. 2. Instabilities are divided into physical and chemical. 3. Aggregation is an initial response to any stress and must be completely eliminated.
Monitoring of blood clotting during bleeding
Authors: Ahmed A. 
Published: July 2021

Background. The risk of bleeding and thrombotic events should be weighed before, during and after surgery. To facilitate this process, it is advisable to ask yourself the following questions: if we start the operation now, will the bleeding develop? If we delay the intervention, will a thrombotic event occur? Are the patient’s antithrombotic drugs effective?
Objective. To describe the blood coagulation monitoring system.
Materials and methods. Analysis of literature sources on this topic.
Results and discussion. Coagulopathy can be congenital and acquired, the latter including iatrogenic. The causes of congenital coagulopathies include hemophilia, von Willebrand factor deficiency, thrombocytopenia, and antiphospholipid syndrome. Antiplatelet drugs and direct oral anticoagulants are the main causes of iatrogenic coagulopathies. Other causes of acquired coagulopathies include hemostasis failure, disseminated intravascular coagulation syndrome, and post-surgical coagulopathies of various types. In order to treat bleeding in coagulopathies, desmopressin, tranexamic acid, coagulation factors, and protamine are administered. Laboratory tests needed to detect coagulopathies include prothrombin time, activated partial thromboplastin time, thrombin time, international normalized ratio, fibrinogen levels, and coagulation factors. The limitations of these tests include their non-dynamic nature, lack of ability to predict the risk of bleeding, time and financial costs, inability to understand the pathophysiological mechanism of bleeding. There may also be an error in the analysis due to the addition of citrate and calcium to the samples. Rapid tests to assess the hemostasis system include determination of activated coagulation time, Hepcon heparin monitoring system, thromboelastography and platelet mapping, platelet aggregometry using multiple electrodes, rotational thromboelastometry, and sonoreometry.
Conclusions. 1. For best results, coagulopathy should be anticipated, detected, and treated in a timely manner. 2. The strength of blood clots depends on platelets and fibrinogen. 3. It is advisable to use rapid tests to assess hemostasis and repeat them regularly, as bleeding and blood clotting are dynamic processes. 4. The effects of hemodilution, acid-base balance and temperature should be kept in mind.
Risks of work with cytotoxic drugs
Authors: Bosnak A.S. 
Published: July 2021

Background. Cytotoxic drugs (CTD) are widely used in medicine for the treatment of tumors and other diseases. According to the definition, CTD are the drugs, which are toxic for cells, that is, interrupt their replication or growth. Effects of CTD are not targeted, that’s why when they get into the organism, they can harm not only target cells, but any other cells, and not only the patient, but also the other people who contact with them, especially, the healthcare workers (HCW).
Objective. To define the risks of work with CTD.
Materials and methods. Analysis of the literature data on this topic.
Results and discussion. In case of breaking the safety rules, HCW may contact CTD. They can be exposed via skin contact, inhalation of aerosols or swallowing of the particles of CTD, via needle injuries. Actions and procedures, which can be accompanied by the contact of HCW with CTD, include drug preparation and administration, handling of drug containers and waste materials, handling the biological liquids of CTD-treated patient, cleaning of the spills or items, polluted by biological liquids. Exposure to CTD can result in the abdominal pain, hair loss, vomiting, liver injury, nasal sores, contact dermatitis and allergic reactions, miscarriages and fetal malformations (in pregnant women), changes in total blood analysis, mutations appearance. It is not proven that long occupational exposure to CTD leads to cancer, despite it is known that the majority of CTD have genotoxic, cancerogenic and mutagenic effects. Tactics of risk minimization in work with CTD includes definition of risk groups (pregnant women, newbies), assessment of the potential harms of used drugs, written fixation and often reassessment of risk estimation, HCW education. The latter must include methods of CTD preparation, peculiarities of CTD usage and waste handling, correct usage of individual protective equipment (IPE) etc. CTD must be prepared exclusively by the HCW, who underwent the adequate training, and in the specialized settings (HEPA-filtered exhaust systems, negative pressure rooms, absorbing surface covers). IPE must include vinyl or nitrile gloves, waterproof long-sleeved robe or overall with elastic cuffs, goggles or face shield, respirator, shoe covers. Potentially polluted by CTD waste must be collected into the polypropylene or polyethylene bags with the appropriate labeling.
Conclusions. 1. CTD may harm not only target cells, but also the other cells, and not only patients, but all the other exposed people. 2. CTD exposure may lead to the abdominal pain, hair loss, vomiting, contact dermatitis, miscarriages and fetal malformations, etc. 3. There is a spectrum of protective measures to protect HCW from CTD exposure (IPE, equipment of specialized working places for CTD solutions’ preparation, correct waste handling).
Abnormal uterine bleeding: the role of office hysteroscopy
Authors: Medvedev M.V. 
Published: July 2021

Background. Abnormal uterine bleeding (AUB) is any menstrual cycle disorder that does not meet normal parameters of regularity, frequency, duration, and intensity. AUB are divided into acute and chronic. According to modern paradygm, when describing menstrual disorders, terms “AUB”, “heavy menstrual bleeding”, “intermenstrual bleeding”, “postmenopausal bleeding” should be used.
Objective. To highlight the role of office hysteroscopy in the treatment of AUB.
Materials and methods. Analysis of literature sources on this topic.
Results and discussion. According to the etiology, AUB are classified with the help of PALM-COEIN system: P – polyp, A – adenomyosis, L – leiomyoma, M – malignancy and hyperplasia (causes of structural disorders), C – coagulopathy, O – ovulatory dysfunction, E – endometrial dysfunction, I – iatrogenic causes, N – causes not established (causes not related to structural disorders). At different ages, the main causes of AUB are different (in childhood – injuries, infections, ovarian tumors, in childbearing age – anovulation, pregnancy, endocrine disorders, in old age – endometrial cancer). When examining patients with AUB, one should carefully collect a history, carry out physical and gynecological examination, determine the condition of the thyroid gland, exclude coagulopathy and pelvic diseases. Office and even portable hysteroscopy is a modern method of visual diagnosis of AUB. Techniques for hysteroscopic removal of intrauterine pathological formations include curettage under the control of a hysteroscope, removal with forceps or laser, hysteroresectoscopy, intrauterine morcelation. Office hysteroscopy can successfully detect and treat polyps, leiomyomas, isthmocele, chronic endometritis, hyperplasia. AUB is often accompanied by iron deficiency anemia (IDA). In severe cases or in the case of planned surgical interventions, IDA require treatment with intravenous iron preparations. Clinical data show that patients with preoperative anemia treated with iron preparations before surgery do not require blood transfusions in the postoperative period. Sufer (“Yuria-Pharm”) is a trivalent iron for intravenous administration. The dose is calculated individually for each patient based on the level of hemoglobin and the severity of iron deficiency. In case of severe blood loss during the operation, it is advisable to use tranexamic acid (Sangera, “Yuria-Pharm”), which is 10 times more effective than ethamsylate and 26 times – than aminocaproic acid. In a multicenter, randomized, double-blind, placebo-controlled WOMAN study of 20,000 women with postpartum haemorrhage, tranexamic acid reduced fatalities by more than 30 % and the need for urgent surgery for hemostasis by more than 35 %.
Conclusions. 1. AUB can have different etiology, which largely depends on the age of the patient. 2. Office hysteroscopy is a promising method of visualization diagnosis and treatment of AUB. 3. Intravenous iron preparations can be used to correct anemia after AUB, and tranexamic acid – to stop an excessive bleeding.
L-arginine as a medication
Authors: Medved V.I. 
Published: July 2021

Background. L-arginine takes part in the ornithine cycle, in which ammonia is neutralized with urea formation. Accordingly, in the absence of L-arginine, toxic ammonia accumulates in the organism.
Objective. To describe the use of L-arginine as a medication.
Materials and methods. Analysis of literature sources on this topic.
Results and discussion. Nitric oxide (NO) is a universal mediator in the regulation of cellular functions and intercellular communication. Deficiency of this substance is a key element of endothelial dysfunction. In the human body, NO is produced from L-arginine and performs an extremely important function of vasodilation due to the relaxation of vascular smooth muscle cells. Other physiological functions of NO include the transmission of neural signals in the central and peripheral nervous system, nervous activity, histamine secretion by mast cells, intestinal peristalsis, erection, killer action against bacteria and cancer cells. Arginine deficiency occurs in hypertension, coronary heart disease, obliterating disease of peripherl arteries, primary pulmonary hypertension, obstetric and perinatal pathological conditions. Potential ways to eliminate NO deficiency include the administration of its precursor – L-arginine (Tivortin, “Yuria-Pharm”) or its donors (molsidomine, nitrates). Tivortin has antioxidant and detoxifying effects, reduces endothelial dysfunction, activates urea synthesis, promotes glucose utilization, increases blood insulin.
Conclusions. 1. NO deficiency is a key element of endothelial dysfunction. 2. Physiological functions of NO are vasodilation, transmission of neural signals, intestinal motility, etc. 3. In the human body NO is formed from L-arginine. 4. Arginine deficiency occurs in hypertension, coronary heart disease, obliterating disease of the peripheral arteries, primary pulmonary hypertension, obstetric and perinatal pathological conditions. 5. L-arginine (Tivortin) prescription is one of the ways to eliminate NO deficiency. 6. Tivortin has antioxidant and detoxifying effects, reduces endothelial dysfunction, and promotes glucose utilization.
Endothelial protection of the microcirculatory tract in obstetrics
Authors: Nosenko O.M. 
Published: July 2021

Обоснование. Эндотелиальные клетки различных сосудистых зон имеют разные форму и набор рецепторов, что позволяет им быть функционально гетерогенными. Функциями эндотелия являются транспортная, гемостатическая, вазомоторная, рецепторная, секреторная, сосудообразующая и барьерная. Для обеспечения каждой из этих функций эндотелий вырабатывает вещества, отвечающие за диаметрально противоположные функции. Состояние дисбаланса между медиаторами, в норме обеспечивающими оптимальное течение всех эндотелийзависимых процессов, получило название эндотелиальной дисфункции (ЭД).
Цель. Охарактеризовать защиту эндотелия и возможности коррекции ЭД в акушерстве.
Материалы и методы. Анализ данных литературы по этому вопросу.
Результаты и их обсуждение. Оксид азота (NO) играет важнейшую роль в физиологическом функционировании эндотелия во время беременности. Субстратом для синтеза NO выступает L-аргинин. При недостатке NO возникает ЭД, которая в сочетании с дефективной глубокой плацентацией является главной причиной развития основных акушерских осложнений (преэклампсии (ПЭ), синдрома задержки внутриутробного роста плода, преждевременных родов, преждевременной отслойки плаценты, привычного невынашивания). При ПЭ можно отметить изменение эндотелия различных сосудов, в том числе печеночных и мозговых. Выявление ЭД до беременности требует прегравидарной подготовки с помощью донаторов NO (L-аргинина). Накопление в крови беременных метилированных аналогов последнего ведет к снижению биодоступности NO и развитию ЭД. В результате запускается своеобразный порочный круг: ЭД усиливает ишемию и способствует образованию свободных радикалов, которые, в свою очередь, вызывают ЭД. Включение L-аргинина в комплексную фармакологическую профилактику и лечение перечисленных акушерских синдромов с целью преодоления патогенетических эффектов метилированных аналогов L-аргинина, прежде всего асимметричного диметиларгинина (ADMA), является патогенетически оправданным. Успешность данного подхода подтверждена в ряде исследований. Введение большого количества экзогенного L-аргинина вытесняет ADMA и восстанавливает эндогенный синтез NO до физиологического уровня. Тремя основными средствами для устранения ЭД в акушерстве выступают ацетилсалициловая кислота, препараты кальция и L-аргинин (Тивортин, «Юрия-Фарм»). Применение последнего позволяет предотвратить развитие ПЭ у женщин высокого риска, улучшить маточно-плацентарный кровоток, нормализовать объем околоплодных вод.
Выводы. 1. ЭД – основное звено патогенеза акушерских осложнений. 2. Основной молекулой, необходимой для нормального функционирования эндотелия, является NO. 3. Тивортин как субстрат для образования NO способствует устранению ЭД и улучшению маточно-плацентарного кровотока.
Safety and efficacy of the port-catheter systems during intensive intravenous chemotherapy in patients with multidrug-resistant tuberculosis and tuberculosis with extended resistance
Authors: Senko Yu.O. 
Published: July 2021

Background. Yu-Port (“Yuria-Pharm”) is an implanted system for long-term infusions. This system allows multiple access to vessels for parenteral administration of drugs, fluids and nutrient solutions.
Objective. To describe the safety and efficacy of the port-catheter systems during intensive intravenous chemotherapy in patients with multidrug-resistant tuberculosis (TB) and TB with extended resistance.
Materials and methods. Analysis of the literature on this issue.
Results and discussion. Prolonged venous access is required in case of long-term infusion therapy or chemotherapy, as well as with the use of drugs that irritate the veins. Routine methods of vascular access have a number of disadvantages: the needle of the system damages the vessel with each injection; infusion cannula should be replaced every 3-5 days; the central venous catheter cannot be installed permanently (on average, for 1 week). Therefore, port systems consisting of a titanium port and a vascular catheter have long been used for long-term venous access. When installing the port system, the catheter is in the vein, the port is under the skin, and the needle is brought out. The advantages of the Yu-Port system include a large silicone membrane, fluid flow rate of 5 ml/s, compatibility with magnetic resonance imaging, and the absence of latex and polyvinyl chloride. The Yu-Port package contains installation instructions and all the necessary tools. The silicone membrane allows repeated piercing only with a special Yu-Port needle or the included needle. After the puncture, the membrane is tightened, because due to a special sharpening needle does not tear the membrane material, but pushes it apart. Jugular or subclavian access is most often used to install ports. The advantages of using port systems in chemotherapy include low traumaticity, painless injections, no discomfort, ease of drug administration and blood sampling for analysis, lower risk of developing phlebitis, long use duration (several years). Our own experience with port systems (56 patients in 2019-2020) showed significantly fewer premature treatment terminations due to side effects than in the group of standard infusion therapy (12.50 % vs. 22.6 %).
Conclusions. 1. Port systems consisting of a titanium port and a vascular catheter have long been used for long-term venous access. 2. The advantages of using port systems in chemotherapy include painless injections, no discomfort, ease of drug administration and blood sampling for analysis, lower risk of phlebitis, long use duration. 3. In patients who need long-term or multicomponent chemotherapy, for example, in multidrug-resistant TB, it is advisable to use port systems.
Chemotherapy and radiation therapy in locally advanced oropharyngeal cancer
Authors: Seriogina N.M. 
Published: July 2021

Background. About 650,000 new cases of head and neck cancer are diagnosed worldwide each year. About 66 % of these patients already have a common stage of the disease. Mortality up to one year is 38.8-44.4 %. The male/female ratio is 3.4:1. Smoking, alcohol consumption, human papillomavirus (HPV) infection, and herpes viruses are the main risk factors for the developing oropharyngeal cancer (OPC).
Objective. To identify the features and to describe the treatment of OPC.
Materials and methods. Analysis of literature data on this issue.
Results and discussion. HPV-associated OPC is characterized by the favorable survival rates. 60-80 % of patients with such OPC are non-smokers and do not abuse alcohol, the average age is 45-55 years. The main principles of diagnosis and treatment of locally advanced forms of OPC include the use of modern imaging methods, staging depending on HPV status, definitive chemoradiation therapy, dose escalation (66-72 Gray), the use of integrated boosts on the tumor and affected lymph nodes, radiation therapy (RT) without a break, the use of the adaptive RT method. It has been shown that RT split courses reduce local tumor control by 13 %, while increasing the risk of late radiation complications by 18-40 %. RT with modulated dose intensity is accompanied by the reduction in the risk of all-cause mortality by 21 %, as well as the risk of cancer-specific mortality, and by the reduction of the number of aspiration pneumonia cases. Adaptive RT is a modern RT technology that involves adjusting the radiation plan during the course of treatment due to the changes in the anatomy of the tumor and surrounding tissues. The main stages of adaptive RT are obtaining the current data from the megavolt computed tomography, recalculation of the dose distribution, comparison with the plan before treatment, and adaptation of the plan. The results of chemotherapy should be evaluated no earlier than 12 weeks after its completion. Rehabilitation after chemoradiation therapy (prevention of trismus) involves massage and training of the jaw muscles, maintaining proper posture, oral hygiene.
Conclusions. 1. HPV status is an important parameter in predicting the course of OPC. 2. HPV-associated OPC is characterized by the favorable survival rates. 3. The planned RT must be held without an interruption. 4. RT with modulated dose intensity is accompanied by the reduction in all-cause mortality by 21 %, as well as the risk of cancer-specific mortality. 5. The main area of research in HPV-associated OPC is the de-escalation of treatment regimens.