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Background The COVID-19 vaccination campaign in several European countries involved collaboration between public health and Primary Health Care (PHC).Objective To highlight the role of PHC professionals in the COVID-19 vaccination rollout, specifically in terms of vaccine administration, communication and contributing to vaccination population coverage.Methods A descriptive retrospective study of the COVID-19 vaccination campaign across 28 European countries was conducted, covering data from December 2020 to November 2021. Data were collected by key informants recruited from each country, who were health professionals involved in their national vaccination campaigns. Utilising an ad-hoc semi-structured questionnaire, information was gathered on organisation, communication strategies, priority groups, vaccine types, and vaccination pathways in PHC.Results PHC participated in communication strategies in 10 out of 28 countries, and vaccination was voluntary in most of them. The priority groups for vaccination varied across Europe, and the availability of vaccines in PHC differed between countries within the European Union (EU) and non-EU countries. The BioNTech Pfizer vaccine was the most widely available vaccine in most countries, followed by Moderna and AstraZeneca. PHC administered COVID-19 vaccines to the population, being the nurses the most involved, followed by general practitioners. Vaccination appointments were available online in 18/28 or by phone in 15/28, direct appointments at health centres were available in 8/28. In several countries, healthcare professionals who administered vaccines were given extra compensation for their role.Conclusion PHC professionals played a crucial role in the successful distribution and administration of COVID-19 vaccines in European countries.

Various studies have shown that testosterone levels heavily impact many areas of a man’s health. Low serum testosterone (and, by analogy, late onset hypogonadism) may be responsible for such conditions as type 2 diabetes, obesity in abdominal area, and most of all, heightened cardiovascular risk (CV). Among other outcomes researchers have pointed out metabolic syndrome and dyslipidemia, as well as increased risk of anxiety disorders and major depressive disorder. There have also been reports of testosterone’s influence on fertility, bone mineral density and the development of polycythemia. All of these effects can be linked to the increased levels of inflammatory markers caused by low testosterone and lead to higher risk of premature death. Overly high testosterone, however, has been proven to have a notable influence on men’s personality, as well as other psychological and social traits, both in endogenously elevated testosterone level, and in patients with history of anabolic- androgenic steroid use. The last decade’s research of testosterone’s impact on the organism has brought contradictory results. Therefore, examination and understanding of the influence of its abnormal levels proves important to not only guarantee the best quality of hypogonadism treatment, but also to efficiently prevent any side effects or complications associated with testosterone use.

La Brucelosis es una enfermedad zoonótica extendida a nivel mundial en el ganado bovino, ocasionada principalmente por Brucella abortus, previamente reportada en ciertas regiones del Ecuador. La caracterización de las cepas circulantes de Brucella spp. en ganaderías lecheras resulta importante para comprender la epidemiología de esta enfermedad. La tipificación bacteriológica de la Brucella spp. es un proceso lento, riesgoso y requiere de laboratorios especializados. El objetivo de este estudio fue tipificar las cepas de Brucella spp. que afectan al ganado bovino en la provincia del Azuay, mediante ensayos moleculares, a partir de muestras de sangre y leche de vacas seropositivas a brucelosis. En fincas seropositivas a ELISA-Indirecto en leche, se seleccionaron 70 vacas Holstein mestizas, reactoras individualmente a las pruebas Rosa de Bengala y confirmadas con ELISA competitivo. Se extrajo el ADN de esas muestras de sangre y leche confirmando en un inicio la viabilidad del material genético de bovino con oligonucleótidos específicos para el género Bos. La amplificación de ADN para Brucella spp. se realizó por PCR-AMOS con cebadores de genero para la región IS711 y de especie para Brucella abortus, Brucella mellitensis, Brucella suis y Brucella ovis. Se pudo identificar ADN bovino en 65 (92,8 %) muestras de leche y en 62 (88,5 %) muestras de sangre. Un total de 62 muestras de ADN extraído de leche resultaron positivas (95,4 %) al género Brucella spp. y todas las muestras de sangre resultaron negativas. El PCR-AMOS mostró bandas con un peso molecular de 498 pb en muestras de cuatro animales correspondiente a B. abortus. Este es el primer estudio de identificación molecular en la provincia del Azuay con evidencia científica de la especie de Brucella spp. circulante en las ganaderías bovinas de la zona, contribuyendo de base para la identificación futura de los biovares de B. abortus aún no reportados en esta zona del país.

Purpose — To analyze the influence of the halal industry on the development of exports of halal products in Indonesia. Method — The type of data used in this research is quantitative and from secondary data sources. The research data was obtained from data from the Ministry of Industry and the Ministry of Trade of the Republic of Indonesia in the form of reports on the halal industry in Indonesia and exports of halal products in Indonesia for the 2015–2021 period. Result — The results of this study indicate that the halal quality of food and beverages, including export activities, has a major impact that can boost the economy. Muslim fashion has not had much of an impact on Indonesia's halal export growth due to intense competition from other countries and a lack of domestic fashion designers. Halal pharmaceutical and cosmetic products have a major impact on expanding exports of Indonesian halal products. As a result, this industry has a great opportunity to enter the world's halal cosmetic and pharmaceutical industries. Contribution — The halal industry's potential can be maximized even further in order to boost export value and reserve foreign exchange, making it one of the forces boosting Indonesia's economic growth.

BackgroundPerturbed mitochondrial energetics and vitamin A (VitA) metabolism are associated with the pathogenesis of diet-induced obesity (DIO) and type 2 diabetes (T2D).MethodsTo test the hypothesis that VitA regulates tissue-specific mitochondrial energetics and adverse organ remodeling in DIO, we utilized a murine model of impaired VitA availability and high fat diet (HFD) feeding. Mitochondrial respiratory capacity and organ remodeling were assessed in liver, skeletal muscle, and kidney tissue, which are organs affected by T2D-associated complications and are critical for the pathogenesis of T2D.ResultsIn liver, VitA had no impact on maximal ADP-stimulated mitochondrial respiratory capacity (VADP) following HFD feeding with palmitoyl-carnitine and pyruvate each combined with malate as substrates. Interestingly, histopathological and gene expression analyses revealed that VitA mediates steatosis and adverse remodeling in DIO. In skeletal muscle, VitA did not affect VADP following HFD feeding. No morphological differences were detected between groups. In kidney, VADP was not different between groups with both combinations of substrates and VitA transduced the pro-fibrotic transcriptional response following HFD feeding.ConclusionThe present study identifies an unexpected and tissue-specific role for VitA in DIO that regulates the pro-fibrotic transcriptional response and that results in organ damage independent of changes in mitochondrial energetics.

BackgroundDespite numerous empirical studies and systematic reviews conducted on the effectiveness of interventions improving psychological well-being, there is no holistic overview of published systematic reviews in this field. ObjectiveThis bibliometric study explored the scientific patterns of the effectiveness of different psychosocial interventions improving well-being among various categories of individuals with mental and physical diseases, to synthesize well-being intervention studies, and to suggest gaps and further studies in this emerging field. MethodsThe bibliometric analysis included identifying the most productive authors, institutions, and countries; most explored fields and subjects of study; most active journals and publishers; and performing citation analysis and analyzing publication trends between 2014 and 2022. We focused on data retrieved from known databases, and the study was conducted with a proven bibliometric approach. ResultsIn total, 156 studies were found concerning the research domains and retrieved using LENS software from high-ranking databases (Crossref, Microsoft Academic, PubMed, and Core). These papers were written in English by 100 authors from 24 countries, among which, the leading country was the United Kingdom. Descriptive characteristics of the publications involved an increased number of publications in 2017 (n=35) and 2019 (n=34) and a decreased number in 2021 (n=4). The top 2 leading authors by citation score are James Thomas (3 papers and 260 citations) and Chris Dickens (3 papers and 182 citations). However, the most cited study had 592 citations. BMJ Open (n=6 articles) is the leading journal in the field of medicine; Clinical Psychology Review (n=5), in psychology; and Frontiers in Psychology, in psychological intervention (n=5) and psychology (n=5). The top 2 publishers were Wiley (n=28) and Elsevier (n=25). ConclusionsThis study indicates an overall interest in the declared domains within the last decade. Our findings primarily indicate that psychosocial interventions (PIs) were evaluated as being effective in managing mental and physical problems and enhancing well-being. Cognitive behavioral therapy was assessed as being effective in treating anxiety, psychoeducation in relapse prevention, and gratitude interventions in improving overall health, and the mindfulness approach had a positive impact on decreasing distress and depression. Moreover, all these intervention types resulted in an overall increase in an individuals’ well-being and resilience. Integrating social and cultural factors while considering individual differences increases the efficiency of PIs. Furthermore, PIs were evaluated as being effective in managing symptoms of eating disorders, dementia, and cancer. Our findings could help provide researchers an overview of the publication trends on research domains of focus for further studies, since it shows current findings and potential research needs in these fields, and would also benefit practitioners working on increasing their own and their patients' well-being.

Severe combined immunodeficiency (SCID) is a group of inborn errors of immunity (IEI) characterized by severe T- and/or B-lymphopenia. At birth, there are usually no clinical signs of the disease, but in the first year of life, often in the first months the disease manifests with severe infections. Timely diagnosis and treatment play a crucial role in patient survival. In Ukraine, the expansion of hemostatic stem cell transplantation and the development of a registry of bone marrow donors in the last few years have created opportunities for early correction of IEI and improving the quality and life expectancy of children with SCID. For the first time in Ukraine, we initiated a pilot study on newborn screening for severe combined immunodeficiency and T-cell lymphopenia by determining T cell receptor excision circles (TRECs) and kappa-deleting recombination excision circles (KRECs). The analysis of TREC and KREC was performed by real-time polymerase chain reaction (RT-PCR) followed by analysis of melting curves in neonatal dry blood spots (DBS). The DBS samples were collected between May 2020 and January 2022. In total, 10,350 newborns were screened. Sixty-five blood DNA samples were used for control: 25 from patients with ataxia-telangiectasia, 37 - from patients with Nijmegen breakage syndrome, 1 – with X-linked agammaglobulinemia, 2 – with SCID (JAK3 deficiency and DCLRE1C deficiency). Retest from the first DBS was provided in 5.8% of patients. New sample test was needed in 73 (0.7%) of newborns. Referral to confirm or rule out the diagnosis was used in 3 cases, including one urgent abnormal value. CID (TlowB+NK+) was confirmed in a patient with the urgent abnormal value. The results of a pilot study in Ukraine are compared to other studies (the referral rate 1: 3,450). Approbation of the method on DNA samples of children with ataxia-telangiectasia and Nijmegen syndrome showed a high sensitivity of TRECs (a total of 95.2% with cut-off 2000 copies per 106 cells) for the detection of these diseases. Thus, the tested method has shown its effectiveness for the detection of T- and B-lymphopenia and can be used for implementation of newborn screening for SCID in Ukraine.

Los procesos productivos de las empresas requieren dar cuenta de la importancia de aplicar producción más limpia dentro de su quehacer diario; evitando prácticas cada vez más contaminantes que afectan la vida de las personas, merman la calidad del producto y deterioran el medio ambiente. Por tanto, el presente estudio describe las estrategias de producción más limpia, aplicadas al proceso productivo de la curtiembre en el Ecuador. La metodología presenta una investigación descriptiva con un enfoque cualitativo, la técnica seleccionada es la observación y el instrumento aplicado es una entrevista semiestructurada a un experto empresarial del sector de la curtiembre; posteriormente se aplicó una triangulación para el análisis de datos. Finalmente, a través de un análisis del proceso de producción y materia prima utilizada, se establecen las estrategias de producción más limpia que benefician al producto final y al ambiente.

La transformación digital es un proceso complejo, que ha permitido a las organizaciones unirse a la llamada revolución digital, y al mismo tiempo, ir de la mano de los requerimientos de las actuales y nuevas generaciones, que se caracterizan por pasar la mayor parte de su tiempo en redes sociales y concretar sus compras a través de distintas plataformas. Este estudio de caso, propone un modelo piloto para la Asociación de Ebanistas del Cantón Mejía, aplicado a negocios tradicionales, con productos artesanales; que prácticamente no tienen presencia digital y tienen alto pronóstico de desaparecer frente a los cambios constantes y acelerados de la tecnología. El tipo de investigación utilizado es cuantitativa, a través de la aplicación de encuestas para levantamiento de información desde los consumidores y asociados; así como los pasos a seguir que propone el modelo son: iniciar con un diagnóstico integral, seguido de un diagnóstico digital, para luego aplicar un conocimiento profundo del cliente, a través del buyer persona y finalmente analizar herramientas de negocios digitales que se pueden aplicar al negocio. Como resultado se ha obtenido que la puesta en marcha de un modelo piloto basado en presencial - digital, generará rápido posicionamiento en la mente de los consumidores, lo que conlleva a que el negocio se transforme y genere utilidades a través del posicionamiento de marca.

The article formulates the theoretical foundations of the study of dramatic text, distinguishes between the concepts of “dramatic text” (affects the reader) and “dramatic work” (verbalizes the theatrical action for the viewer), because these linguistic realities are in the relationship of inclusion. A dramatic text is a unity organized according to certain laws, which has a clear structure: a certain number of lines, designed with the help of the author's remark, forms a dialogical unity; the combination of dialogic units forms a scene; the set of scenes constitute an act; several acts create a complete work. Obligatory factors of expressiveness of the dramatic text that influence the development of dialogic parts of the characters are pragmatic components of speech which are considered as certain rules of successful communication. In the communicative-pragmatic paradigm dramatic text is defined as a specific type of artistic text that has its own structural and speech features due to a combination of informational, pragmatic, stylistic and cognitive aspects, where the pragmatic aspect is found in speech acts, syntactic organization of cues. The scientific novelty of the research is DT of Bukovinian’s writers of the late nineteenth – early twentieth century that have not yet been the subject of analysis. The relevance of scientific research requires a holistic analysis of the dramatic text and difference between the concepts of “dramatic text” and “dramatic composition”, the study of mandatory factors of expressiveness of dramatic text, influencing the development of dialogic parts. The following methods and techniques of linguistic analysis are used in the article: system-functional analysis, method of discussion analysis, contextual-interpretive method. Conclusions. Dramatic text is a complex phenomenon with its own peculiarities of functioning. It is possible to penetrate into the structure of a dramatic text, to reveal the meaning of the author's intentions due to the volume-pragmatic division of the text. The communicative-pragmatic organization of DT influences the processes of active aesthetic influence of a work of art on the consciousness of the addressee. We see the prospect of the represented research in the further deepening of knowledge about the categorical features of the text in the communicative-pragmatic aspect.

In this study we assessed the interaction of different strains of Bacillus cereus with murine peritoneal macrophages and cultured phagocytic cells (Raw 264.7 cells). Association, internalization, intracellular survival, routing of bacteria to different compartments and expression of MHCII were assessed in cells infected with different strains of B. cereus in vegetative form. Association values (adhering + internalized bacteria) and phagocytosis were higher for strain B10502 than those for strains 2 and M2. However, after 90 min interaction, intracellular survival was higher for strain 2 than for strains M2 and B10502. Acquisition of lysosomal markers by B. cereus containing vacuoles (BcCV), assessed by LAMP1 and Lysotracker labelling occurred shortly after internalization. The highest ratio of LAMP1(+)-BcCV was found for strain M2. This strain was able to survive longer than strain B10502 which routes to LAMP1 containing vacuoles to a lesser extent. In addition, strain M2 stimulated expression of MHCII by infected cells. Confocal analyses 60 or 90 min post-infection showed different percentages of co-localization of bacteria with Lysotracker. Results suggest strain-dependent interaction and intracellular killing of B. cereus by phagocytic cells. These findings could be relevant for the pathogenic potential of Bacillus cereus strains. [ABSTRACT FROM AUTHOR]

Abstract Background The purpose of this study is to forward the implementation of an operational evidence-based state screening program of common diseases in Ukraine, where currently no state-based and evidence-based screening (EBS) exists. EBS should be performed by Family Doctors in a primary care setting and concern prevalent diseases in adults, such as: obesity (BMI), hypertension (BP measurement), diabetes (glycaemia), dyslipidemia (cholesterol/lipids), colon cancer (FOBT/colonoscopy), breast cancer (mammography), STIs (chlamydia, syphilis), HIV, HBV, HCV (i.e. serology or other rapid tests), HPV (swabs), cervical cancer (test Pap). depression (i.e., PHQ-9), and smoking (i.e., Fagerstrom). Methods Four needs-based research actions were led among citizens and healthcare professionals, based on multidimensional empowerment. Internal Strengths and Weaknesses of the ongoing implementation process were identified through these studies, whereas external Opportunities and Threats were determined by the present socio-cultural and political context. This SWOT analysis is likely to guide future state-based initiatives to accomplish EBS implementation in Ukraine. Results Internal Strengths are the bottom-up multidimensional empowerment approach, teaching of EBS and the development of an internet-based platform “Screening adviser” to assist shared decision making for person-centred EBS programs. Internal Weaknesses identified for the Family Doctors are a heterogeneous screening and the risk of decreasing motivation to screen. External Opportunities include the ongoing PHC reform, the existent WONCA and WHO support, and the existence of EBS programs in Europe. External Threats are the lack of national guidelines, not fully introduced gate keeping system, the vulnerable socio-economic situation, the war situation in the East of Ukraine and the Covid-19 pandemic. Conclusions We started EBS implementation through research actions, based on a multidimensional empowerment of citizens, HCP and in EBS pathways involved stakeholder teams, to foster a sustainable operational human resource to get involved in that new EBS pathway to implement. The presented SWOT-analysis of this ongoing implementation process allows to plan and optimize future steps towards a state based and supports EBS program in Ukraine.

The aim of the study is to evaluate the clinical characteristics of patients with hypertriglyceride associated acute pancreatitis. A single-center observational study of a series of cases was performed on the basis of the Kyiv Department of Surgery for Liver, Pancreas and Bile Tracts named after V.S. Zemskov in the period from 2018 to 2019. Investigation includes patients with acute pancreatitis and hypertriglyceridemia (the triglycerides level is more than 1.7 mmol/l). Exclusion criteria: patients with acute pancreatitis with normal triglyceride levels, patients with acute pancreatitis with elevated triglycerides, that have not been treated enough. All patients were evaluated by Charlson index of comorbidity, body mass index, alcohol history, relapses and severity of disease. All patients were monitored throughout inpatient treatment, from hospitalization to discharge to home or death. The end point of the study was the discharge of the patient to home after the elimination of the manifestations and complications of acute pancreatitis or death of the patient. The 234 patients who were hospitalized and treated with a diagnosis of acute pancreatitis, 27 patients had hypertriglyceridemia and 3 of them were excluded from the study. The study involved 24 patients. Therefore, the frequency of acute pancreatitis associated with high triglycerides was 11.5% (27/234), with the average level of triglyceridemia was 10.1 ± 2.4 mmol / l (range 5.8 - 13.6 mmol / l) , 75% of patients (18/24) had moderate hypertriglyceridemia (2.3 - 11.2 mmol / l), 25% (6/24) - severe (11.2 - 22.4 mmol / l) . The median age was 32 years (quarterly interval 31.5 - 35 years). There were 18 men (75%) and 6 women (25%). Alcohol-induced pancreatitis was observed in 17 (70.8%) patients with hypertrtiglyceridemia. The median body mass index is 28.9 kg / m 2. Normal weight was 33% (8/24) patients, excessive - 25% (6/24), obesity I stage - 29% (7/24) obesity II stage - 8% (2/24) obesity III stage - 4% (1/24). The Charlson comorbidity index ranged from 0 to 5 points, in 1 patient it was 5 points, in 3 patients - 2 points, in 3 patients - 1 point. Diabetes mellitus were in 25% of patients (6 /24), two of them was diagnosed at first. Recurrent cases of disease were in 58.3% of patients (14 /24), 10 of 14 had a history of two cases of acute pancreatitis. In 71% (17 /24) observed a light stage of the disease, 25% (6 /24) - pancreatitis medium degree of severity and in 4% (1 /24) of the patient severe pancreatitis. Mortality was 4%. Conclusions. The frequency of hypertriglyceride-associated acute pancreatitis is 11.5%. In light, moderate and severe pancreatitis, the average degree of hypertriglyceridemia (blood triglycerides 2.3 -11.2mmol/l) was prevailed. Hypertriglyceride-associated acute pancreatitis has no specific complications, but has a tendency to recurrence. Patients with hypertriglyceridemia need constant laboratory monitoring (determination of triglycerides), pharmacological therapy and follow-up to prevent the development of acute pancreatitis.

The research is devoted to the interaction of verbal and non-verbal means of communication in the dramatic text. In the scientific research the expansion of the semantic space of terms is taken into account. It helped to understand the theory and enabled to use the idea of communication. Taking into account the specificity of dramatic text (DT) – it’s clearly distinguished author's speech and speech of characters. DT is defined as a two-level entity, which is the unity of verbal (character speech) and non-verbal commu- nication (author’s communication); a complex semiotic unit, the po- lyphony of which forms author's speech. The novelty of scientific research is that the notion of implication for the first time were intro- duced to the terminology apparatus of the DT, which is understood by the minimal structural and semantic unity of verbal and non-verbal components (remarks and replicas) that are viewed as single visual, cognitive and communicative, provide a comprehensive pragmatic influence on the addressee. The relevance of scientific research is determined by the need to analyze extralinguistic implicatures with remarks on the desig- nation of silence and their linguistic means in the dramatic texts of Bukovinian writers (Yu. Fedkovich, S. Vorobkevich, S. Yarychevsky, I. Sinyuk). Communicatively meaningful silence has a certain emotion- al color and is a means of communication that gives a variety of com- municative meanings of a semantically-pragmatic nature. The following methods and techniques of linguistic analy- sis are used to achieve the goal and task: the system-functional analy- sis, the method of discursive analysis, the contextual-interpretive meth- od, the method of stylistic analysis, the conversion analysis. Conclusions. Silence is a full-fledged extralinguistic compo- nent of the implicature in dramatic text. Communicatively meaningful silence has a certain emotional color and is a means of communication that conditions a variety of communicative meanings of a semantically- pragmatic nature. The prospect of the study involves a systematic anal- ysis of the implicatures, taking into account the universal, ethnospecific and individual markers of the dramatic text of the Bukovinian writers.

Indonesia yang terletak di daerah tropis yang menyebabkan kulit masyarakatnya mudah mengalami penuaan dini dan kecokelatan. produk kosmetik tersebut sebagian besar mengandung bahan kimia sintetik yang berbahaya. Untuk itu, produk kosmetik berbahan aktif alami atau fitokosmetik yang efektif serta aman digunakan perlu dikembangkan. Salah satu tanaman bahan alam yang khas dari Kalimantan Selatan yang berpotensi dikembangkan sebagai sediaan kosmetik adalah Sungkai (Peronema canescens Jack). Tujuan penelitian untuk menentukan aktivitas antioksidan dan aktivitas tabir surya daun Sungkai. Metode yang digunakan untuk penetapan aktivitas antioksidan adalah metode DPPH menggunakan spektrofotometer uv-vis dan untuk penentuan aktivitas tabir surya menggunakan spektrofotometer uv-vis. Hasil penelitian menunjukan bahwa ekstrak tanaman P.canescens mengandung antrakuinon, flavonoid, saponin, tanin, dan fenol. Tanaman P.canescens memiliki Inhibitory Concentration 50 (IC50 ) sebesar 42,219±19,440 ppm dan memiliki aktivitas tabir surya dengan nilai spf (Sun Protecting Factor) dengan konsentrasi 600 ppm, 400 ppm, 200 masing-masing sebagai berikut: 24±0.31 ; 16±0.34; dan 8±0.3. Kesimpulan dari penelitian ini Sungkai (Peronema canescens Jack) memiliki aktivitas sebagai antioksidan dan memiliki aktivitas tabir surya sehingga berpotensi dikembangkan menjadi natural skin care.

The article describes the change in the level of antimicrobial resistance of infectious agents of acute infected necrotizing pancreatitis in patients in the dynamics of the disease and the treatment, classified the data according to the sensitivity of microorganisms. The main purpose of the prospective cohort study is to determine the taxonomic structure of pathogens of pancreatic infection in patients with acute necrotizing pancreatitis in the dynamics The relevance of the study of this pathology is the importance of the phenomenon of increasing the level of antibiotic resistance during long-term antibiotic therapy, which is shown to patients with pancreatic infection. The methodology of the study consisted of three-stage bacteriological monitoring and subsequent qualitative and quantitative evaluation of microbial agents and antibiotic resistance characteristics according to the stratified classification of the European Center for Disease Control ( Magiorakos et al., 2012): the taxonomic structure of pancreatic pathogens in 123 microbial isolates identified during the study was evaluated using antibioticogram results. The duration of the study was the entire duration of the diagnosed infectious process and averaged 33.4 days. The object of the study was selected microbial isolates, which were isolated in the above terms from the biological material of patients: aspirate parapancreatic fluid clusters in the initial stage, removed pancreatic sequesters in the second stage, and isolation from the drainage of the bursa omentalis and retroperitoneum in the third stage. The study empirically confirms and theoretically proves that the qualitative component of microbial pathogens of acute infected necrotic pancreatitis is characterized by time dependence: the level of classified resistance is higher in the third stage of the study compared with the obtained characteristics of the microorganisms in the first stage and, accordingly, in the second stage of the study; a consistent bacteriological characteristic indicates a transition from mono- to mixed infection (р< 0,001) with the inclusion of all members of the 'ESKAPE'-group in the second stage and the predominance of the gram-negative flora at each stage. The fungal component of the microorganisms is represented by the sole pathogen since the second stage of the study in the group with bacteria only. The results of the study may be useful in predicting the success of antibiotic therapy at different stages of the disease and the expected bacteriological characteristics in successive bacteriological crops of biological material of patients during the acute infected necrotizing pancreatitis.

An important place in mass music culture belongs to the song hit – a phenomenon which attributes have not still been explored well finally. Among them – a video clip as a specific form of hit’s incarnation and an artiste’s image as a communicative feature of the phenomenon’s existence. The ascertainment of these aspects is the main objective of the study. The logic of achieving this objective led to the choice such a methodology: the method of analyzing scientific literature on the problem (to determine the degree of its elaboration and the prospect of further exploration), the method of intonation analysis (in the study of the musical language’s features and the principles of composition’s organization), the functional method (aimed at studying the degree of subject’s dependence on audience’s socio-cultural inquiries), the communicative method (that allows take into consideration the factor of the compositions’ existence in the public consciousness, the audience’s reaction to them and artiste’s personality), the comparative method (to study the genre and intonation and also the individual image components of the song hit). The song hit aims to reach the widest possible audience so this fact dues to the presence of such components as a media virus and a meme in its structure. They are directed at appealing to psychological “sensitive points”, the rooting in the mind and the causing of their further distribution, they can be found at all the song hit’s levels and they aim at the comprehensive coverage of the listener/viewer. Results. The song hit’s communicative nature determines the significance of its visual component represented by the video clip. In addition to the representative function, this embodiment is the most effective media virus tool. Moreover, the hit’s promoting, the marketing nature extends to its performer’s competitiveness. This aspect involves the obligatory presence the viral properties in the image, which can cause the audience’s emotional response. The artiste’s representative function necessitates constant and purposeful work on his image.

Introduction/Context: The term core value (CV) can be defined as fundamental beliefs or principles, guiding one's behavior in a social context. Though core competencies of family medicine (FM) have been clearly defined by WONCA, there has been an ongoing debate on what the CVs are for family doctors (FDs). Ukraine is a developing country in the middle of Europe with a population of 43 million inhabitants, gained independence from the Soviet Union in 1991. Ukraine is a low-income country, developing a modern European healthcare system, especially regarding FM. To implement WONCA standards, it is mandatory to assess the ongoing understanding of CVs in clinical daily practice among active FDs, working in different countries of Europe including Ukraine.Research questions: How do Ukrainian FDs (Delphi group experts) define the CVs of FM in Ukraine and how important are these CVs to a wider population of Ukrainian FDs in their everyday practice?Methods: A mixed method study was conducted in two steps during August and September 2020 in Ukraine. The first part was a qualitative Delphi round (three rounds) design among 20 Ukrainian FDs who were familiar with teaching and terms like CV. A consensus list of six CVs has emerged from the Delphi round study. The second part was a quantitative survey among Ukrainian FDs, who were not specially used to discussing CVs. The consensus list of those six CVs was then submitted to 2000 FDs (randomly selected) who were not involved in the Delphi team, to rank those values from one to nine, according to the importance from their personal point of view. Demographic characteristics have been assessed for all the participants of the Delphi round and quantitative survey.Results: Twenty FDs were involved as experts in the first Delphi round, whereas only five experts continued their participation in the second and the third rounds of the survey. The following six CVs emerged from the Delphi round: comprehensive approach, care coordination, first recourse, continuity of care, integrated approach, and patient and family centered care. The final sample consisted of 375 FDs (19% response rate). There were 323 (88.7%) female and 34 (9.3%) male FDs in the sample. The mean age of the participants was 44.6±13.5 years.Discussion/Conclusion: Defining CVs for FM by Ukrainian FDs in a given socio-economical and historical-cultural setting is crucial to optimize primary medical care and to guarantee an appropriate and successful implementation of WONCA standards as well as CVs in different countries including those where reformation of the health system is ongoing.

Comorbid conditions in patients with hypertension on the background of occupational hazards create additional problems in the treatment of hypertension. An analysis of working conditions in 76 workers of the Ivano-Frankivsk armature factory who underwent regular medical check-ups regarding first-/second-degree hypertension (the main group) showed that they were exposed to occupational hazards of chemical (acrolein carbon, iron oxide, chromium, fluorine compounds, sulfuric acid) and physical (high temperature, noise, vibration, electromagnetic radiation, dust) nature for a long period of time (from 4 to 11 years). Comorbid conditions were most often observed among the patients of the main group as compared to the patients of the control group (n = 17), who were not exposed to occupational hazards - 82.06% and 73.34% of cases, respectively. In the patients of the main group, chronic bronchitis was detected in 26.56% of cases and coronary artery disease was diagnosed in 25.09% of cases as compared to 8.33% and 18.34% of cases in the control group. At the same time, 38.89% of hypertensive patients of the main group were diagnosed with chronic bronchitis and concomitant coronary artery disease, which were not observed in the patients of the control group. The patients of the main group were more likely to have dyslipidemia, left ventricular hypertrophy, aortic fibrosis, hypertensive retinopathy as compared to the patients of the control group. In the control group, patients with overweight and type 2 diabetes mellitus prevailed. Quality of life assessment using the 36-Item Short Form Health Survey among the patients of the main group revealed a significant decrease in the indicators of physical and vital activity, fulfillment of daily professional duties. In the control group, a worsening emotional state prevailed.

Rats thrive in human-dominated landscapes and have expanded to a near global distribution. Norway rats (Rattus norvegicus) contaminate food, damage infrastructure, and are reservoirs for zoonotic pathogens that cause human diseases. To limit these negative impacts, entities around the world implement intervention and control strategies designed to quickly and drastically reduce the number of rats in a population. While the primary goal of these interventions is to reduce rat numbers and their detrimental activities, there are important, yet unexplored, population genetic implications for these rapid population declines. Here, we compare the population genetics of R. norvegicus before, immediately after, and several months following a rodenticide-based eradication campaign targeting rats in an urban slum of Salvador, Brazil. This slum has been the focus of long-term research designed to understand and reduce the risk of leptospirosis for people in this area. We also look for a clear source of rats contributing to population recovery, by either rebounding through breeding of local survivors, or by immigration/reinvasion of the site. We found evidence of severe genetic bottlenecks, with the effective population size dropping 85–91% after eradication, consistent with declines in population sizes. These rapid declines also led to a strong shift in the genetic structure of rats before and after the eradication campaign. Relatedness increased in two of the three study areas after eradication, suggesting reduced population sizes and an uneven impact of the campaign across colonies within the population. Lastly, dozens of low-frequency alleles (mean frequency of 0.037) observed before the campaign were undetected after the campaign, potentially lost from the population via drift or selection. We discuss the public health and ecological implications of these rapid genetic impacts of urban control efforts. Our data suggests that targeting the genetic viability of rat populations may be another important component for integrated pest management (IPM) strategies, designed to reduce urban rats.

Background: The COVID-19 pandemic has necessitated changes in European healthcare systems, with a significant proportion of COVID-19 cases being managed on an outpatient basis in primary healthcare (PHC). To alleviate the burden on healthcare facilities, many European countries developed contact-tracing apps and symptom checkers to identify potential cases. As the pandemic evolved, the European Union introduced the Digital COVID-19 Certificate for travel, which relies on vaccination, recent recovery, or negative test results. However, the integration between these apps and PHC has not been thoroughly explored in Europe., Objective: To describe if governmental COVID-19 apps allowed COVID-19 patients to connect with PHC through their apps in Europe and to examine how the Digital COVID-19 Certificate was obtained., Methodology: Design and setting: Retrospective descriptive study in PHC in 30 European countries. An ad hoc, semi-structured questionnaire was developed to collect country-specific data on primary healthcare activity during the COVID-19 pandemic and the use of information technology tools to support medical care from 15 March 2020 to 31 August 2021. Key informants belong to the WONCA Europe network (World Organization of Family Doctors). The data were collected from relevant and reliable official sources, such as governmental websites and guidelines., Main Outcome Measures: Patient's first contact with health system, governmental COVID-19 app (name and function), Digital COVID-19 Certification, COVID-19 app connection with PHC., Results: Primary care was the first point of care for suspected COVID-19 patients in 28 countries, and 24 countries developed apps to complement classical medical care. The most frequently developed app was for tracing COVID-19 cases (24 countries), followed by the Digital COVID-19 Certificate app (17 countries). Bulgaria, Italy, Serbia, North Macedonia, and Romania had interoperability between PHC and COVID-19 apps, and Poland and Romania's apps considered social needs., Conclusions: COVID-19 apps were widely created during the first pandemic year. Contact tracing was the most frequent function found in the registered apps. Connection with PHC was scarcely developed. In future pandemics, connections between health system levels should be guaranteed to develop and implement effective strategies for managing diseases.

Background: Primary Health Care (PHC) plays a crucial role in managing the COVID-19 pandemic, with only 8% of cases requiring hospitalization. However, PHC COVID-19 data often goes unnoticed on European government dashboards and in media discussions. This project aims to examine official information on PHC patient care during the COVID-19 pandemic in Europe, with specific objectives: (1) Describe PHC's clinical pathways for acute COVID-19 cases, including long-term care facilities, (2) Describe PHC COVID-19 pandemic indicators, (3) Develop COVID-19 PHC activity indicators, (4) Explain PHC's role in vaccination strategies, and (5) Create a PHC contingency plan for future pandemics., Methods: A mixed-method study will employ two online questionnaires to gather retrospective PHC data on COVID-19 management and PHC involvement in vaccination strategies. Validation will occur through focus group discussions with medical and public health (PH) experts. A two-wave Delphi survey will establish a European PHC indicators dashboard for future pandemics. Additionally, a coordinated health system action plan involving PHC, secondary care, and PH will be devised to address future pandemic scenarios., Analysis: Quantitative data will be analysed using STATA v16.0 for descriptive and multivariate analyses. Qualitative data will be collected through peer-reviewed questionnaires and content analysis of focus group discussions. A Delphi survey and multiple focus groups will be employed to achieve consensus on PHC indicators and a common European health system response plan for future pandemics. The Eurodata research group involving researchers from 28 European countries support the development., Discussion: While PHC manages most COVID-19 acute cases, data remains limited in many European countries. This study collects data from numerous countries, offering a comprehensive perspective on PHC's role during the pandemic in Europe. It pioneers the development of a PHC dashboard and health system plan for pandemics in Europe. These results may prove invaluable in future pandemics. However, data may have biases due to key informants' involvement and may not fully represent all European GP practices. PHC has a significant role in the management of the COVID-19 pandemic, as most of the cases are mild or moderate and only 8% needed hospitalization. However, PHC COVID-19 activity data is invisible on governments' daily dashboards in Europe, often overlooked in media and public debates., (© 2024. The Author(s).)

Background: During the COVID-19 pandemic, the majority of patients received ambulatory treatment, highlighting the importance of primary health care (PHC). However, there is limited knowledge regarding PHC workload in Europe during this period. The utilization of COVID-19 PHC indicators could facilitate the efficient monitoring and coordination of the pandemic response. The objective of this study is to describe PHC indicators for disease surveillance and monitoring of COVID-19's impact in Europe., Methods: Descriptive, cross-sectional study employing data obtained through a semi-structured ad hoc questionnaire, which was collectively agreed upon by all participants. The study encompasses PHC settings in 31 European countries from March 2020 to August 2021. Key-informants from each country answered the questionnaire. Main outcome: the identification of any indicator used to describe PHC COVID-19 activity., Results: Out of the 31 countries surveyed, data on PHC information were obtained from 14. The principal indicators were: total number of cases within PHC (Belarus, Cyprus, Italy, Romania and Spain), number of follow-up cases (Croatia, Cyprus, Finland, Spain and Turkey), GP's COVID-19 tests referrals (Poland), proportion of COVID-19 cases among respiratory illnesses consultations (Norway and France), sick leaves issued by GPs (Romania and Spain) and examination and complementary tests (Cyprus). All COVID-19 cases were attended in PHC in Belarus and Italy., Conclusions: The COVID-19 pandemic exposes a crucial deficiency in preparedness for infectious diseases in European health systems highlighting the inconsistent recording of indicators within PHC organizations. PHC standardized indicators and public data accessibility are urgently needed, conforming the foundation for an effective European-level health services response framework against future pandemics., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Public Health Association.)

Background and Aim: Primary health care (PHC) supported long-term care facilities (LTCFs) in attending COVID-19 patients. The aim of this study is to describe the role of PHC in LTCFs in Europe during the early phase of the pandemic., Methods: Retrospective descriptive study from 30 European countries using data from September 2020 collected with an ad hoc semi-structured questionnaire. Related variables are SARS-CoV-2 testing, contact tracing, follow-up, additional testing, and patient care., Results: Twenty-six out of the 30 European countries had PHC involvement in LTCFs during the COVID-19 pandemic. PHC participated in initial medical care in 22 countries, while, in 15, PHC was responsible for SARS-CoV-2 test along with other institutions. Supervision of individuals in isolation was carried out mostly by LTCF staff, but physical examination or symptom's follow-up was performed mainly by PHC., Conclusion: PHC has participated in COVID-19 pandemic assistance in LTCFs in coordination with LTCF staff, public health officers, and hospitals.