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Does digitalization make competitive advantage more or less sustainable? One line of argument is that digitalization leads to hyper-competition and shorter spells of competitive advantage. An opposing claim is that digitalization leads to advantages of a size and sustainability unprecedented in the “old” economy. We argue that the likelihood of observing either of these outcomes depend on the extent to which the dominant business model(s) in a market combine the accumulation and use of Big Data with the generation and utilization of network effects. The more complementary Big Data and network effects are in a business model, the more likely that we will observe large and sustainable competitive advantages, and vice-versa. Furthermore, we argue that firms enjoying a data-driven network-advantage have strong incentives and ability to envelop to adjacent markets. In the longer run, such envelopment will cause an increasing number of markets to be characterized by more sustainable competitive advantages.

The polyarene complex of soils was investigated, and PAH sources were assessed quantitatively in soils in the area subjected to heterogeneous technogenic impact near the town of Zhirnovsk, Volgograd oblast. The objects of study were the soils on interfluve areas within the oil and gas field, including soils of agricultural lands, floodplains, urban area, as well as oil-contaminated soils. PAH concentrations vary from 16 to 330000 ng/g; light PAHs, naphthalene and phenanthrene homologues are predominant; heavy PAHs were detected in the amount of 78.5 ng/g mainly in the urban area. The Positive Matrix Factorization (PMF) model was used to indicate and quantify the PAH sources. The following sources of PAHs were identified: emanation, old oil injection, new oil injection, traffic, public gas-pyrogenic, public wood-pyrogenic, and biogeochemical. They determine, respectively, the following associations of PAHs in soils: diphenyl, anthracene-chrysene, chrysene-naphthalene, fluorene-benzo[ghi]perylene, tetraphene-benzo[ghi]perylene, pyrene-anthracene-benzo[a]pyrene, and phenanthrene associations.

Topicality. Recently, more and more works on the hepatotoxicity of NSAIDs have appeared in the literature. Presumably, all NSAIDs have hepatotoxicity, but the degree of adverse effects on the liver in different drugs is variable. Aim. To study the effect of different generations of NSAIDs on the functional state of the liver of the experimental animals. Materials and methods. Diclofenac sodium, piroxicam, indomethacin, meloxicam and celecocosib were selected for the comparative study. Changes in the functional state of the liver of intact rats during subchronic administration of the drugs selected, as well as their impact on the course of the model hepatitis were determined. The state of the liver was determined by the following indicators: the mass coefficient of the liver, the activity of alanine aminotransferase, alkaline phosphatase, the content of total protein, urea, cholesterol in the blood serum, the level of TBA-active products, diene conjugates, reduced glutathione, catalase and glycogen in the liver homogenate. Results and discussion. It was found that diclofenac, piroxicam, indomethacin in the doses of ED50 by the antiexudative activity when used for 14 days adversely affected the liver of intact animals, as well as worsened the course of the model hepatitis, i.e. had a pronounced hepatotoxic effect. Meloxicam and celecoxib did not show a pronounced adverse effect in the carbon tetrachloride hepatitis, but contributed to the deterioration of the functional state of the liver of intact rats, i.e. had a moderate hepatotoxic effect. Conclusions. By the level of hepatotoxicity the drugs studied can be arranged as follows: diclofenac > indomethacin > piroxicam > meloxicam > celecoxib.

We use topic modeling to study research articles in environmental and resource economics journals in the period 2000–2019. Topic modeling based on machine learning allows us to identify and track latent topics in the literature over time and across journals, and further to study the role of different journals in different topics and the changing emphasis on topics in different journals. The most prevalent topics in environmental and resource economics research in this period are growth and sustainable development and theory and methodology. Topics on climate change and energy economics have emerged with the strongest upward trends. When we look at our results across journals, we see that journals have different topical profiles and that many topics mainly appear in one or a few selected journals. Further investigation reveal latent semantic structures across research themes that only the insider would be aware.

O professor Belik na entrevista concedida à revista SER Social volta sua atenção para os temas do abastecimento alimentar e a Segurança Alimentar e Nutricional no Brasil. Em meio aos efeitos da pandemia do covid19, Belik comenta aspectos importantes das políticas publicas e da falta delas no campo da produção de alimentos, comercialização e acesso das pessoas à comida. Ao destacar os riscos do aprofundamento das condições de insegurança alimentar ante ao avanço da pobreza que se radicalizou bem antes dos efeitos da pandemia, Numa linguagem clara e desafetada a entrevista convida cada qual a enfrentar o desafio do quê fazer.

The article discusses the concept of an investment project and options for making an investment decision, goals and means, as well as factors and criteria necessary for this. On the example of a feasibility study, the economic state of the Astrakhan region and the Russian Federation is assessed, the main indicators are analyzed, the problem and the ways of its solution are identified.

Research data on the isotopic composition of carbon in soil lipids in the Zhirnovskoe and Bakhmet’evskoe oil and gas fields in the Medveditsa River basin, Volgograd oblast, Russia, are analyzed. Oil and atmospheric soil pollution is recorded. The variations in the isotopic composition are determined by both anthropogenic factors and the diversity of natural conditions. The isotopic composition of carbon in the lipids of the interfluvial soils (chernozems) is heavier (–26.9 to –29.2‰) than that in the alluvial soils (–29.4 to –31.3‰) because of the differences in the moistening and temperature conditions. Oil pollution appears as a lighter isotopic composition (–29.3 to –29.8‰) since oil isotopic composition is in general somewhat lighter (–28.4 to –30.6‰) as compared with unpolluted soils. Urban and transport infrastructure makes the isotopic composition of atmospheric CO2 lighter, thereby influencing the δ13С values of plants and soils.

INTRODUCTION. This study aims to investigate the social interest in SARS-CoV-2 and COVID-19 in the Internet media during the epidemic in Poland and serves as a complement to longitudinal surveys monitoring public perception in real time. METHODS. We quantitatively analyzed “coronavirus” digital footprints on the Internet, in particular, on Google, Twitter, YouTube, Wikipedia and electronic media represented by EventRegistry, from 15.01 to 07.04.2020 (before and after official introduction of COVID-19 to Poland on 04.03.2020). We present results on trend analysis supported by statistical techniques. RESULTS. We identified six major temporal clusters of the interest on the topic COVID-19: 1) Chinese, 2) Italian, 3) Waiting, 4) Mitigations, 5) Physical distancing and Lockdown, 6) Anti-crisis shield. There was an exponential increase of the interest when the Polish government “declared a war against disease” around 11/12.03.2020 with a massive response activity. Later on, there was a decay in the interest with additional phases related to physical distancing and an anti-crisis legislation act associated with pronounced local peaks. We have found that declarations of response strategies by the Polish prime minister or the minister of health gathered the highest attention of Internet users. So already enacted or in force events do not affect the interest to such an extent. We have observed very weak or even negative correlations between a colloquial search term “antiviral mask” in Google, encyclopaedic definition in Wikipedia “SARS-CoV-2” as well as official COVID-19 incidence series, implying different mechanisms governing the search for knowledge, panic related behaviour and actual burden of COVID-19. CONCLUSIONS. Traditional and social media do not only reflect reality, but also create it. Interest in COVID-19 (measured by topic intensity on the Internet) is unrelated to the officially notified viral pressure (measured by incidence) and probably physical risk of acquiring infection in Poland. As traditional media are ahead of social media in time, we advise to choose traditional news media for a quick dissemination of information, however for a greater impact, social media should be used. Otherwise public information campaigns might have less impact on society than expected.

Adiponectin, the most common plasma adipocytokine, plays a crucial metabolic and anti-inflammatory role. With insulin resistance associated with obesity, an increase of adiponectin concentration, which leads to the activation of signaling pathways involved in the regulation of metabolism, occurs. Currently, adiponectin is being investigated as a potential therapeutic target for metabolic syndrome, although more research is required to understand the underlying mechanisms controlling its levels. In this review, we will examine the main mechanisms that control adiponectin levels in blood serum and its role in insulin-sensitizing effect, as well as evaluate the potential use of adiponectin and its receptors as a potential therapeutic target.

Relevance. Increased intra-abdominal pressure (IAP) in patients with severe acute pancreatitis (AP) is one of the triggers for the development of a functional organ failure, which leads to death. In this case, the favorable outcome of treatment of patients with severe AP is largely determined by early diagnosis and timely elimination of intra-abdominal hypertension (IAH). At the same time, there is no unified and agreed opinion on the principles and specific methods of eliminating the IAH syndrome in patients with severe AP today, which greatly complicates the choice of treatment strategy and tactics.Aim of study. To assess the role and clinical significance of IAP monitoring in patients with severe AP with various manifestations of organ dysfunction and, offer a set of therapeutic measures aimed at resolving intra-abdominal hypertension.Material and methods. The current study included 199 patients with severe AP, divided into two groups depending on the chosen treatment strategy. Group I included 107 patients where the diagnosis and treatment of the disease corresponded to generally accepted standards. Group II included 92 patients, where, in order to objectify the severity and prognosis of the course of AP, along with standard studies, IAP and APACHE II scale indicators were additionally monitored during treatment, and the severity of organ dysfunctions was assessed. In these patients the choice of medical tactics, including the use of conservative and surgical interventions, was made on a differentiated basis, based on the severity of the disease and the dynamics of the IAH.Results. The role and significance of IAP monitoring and APACHE II scale indicators in the treatment of patients with severe AP were determined. The use of a differentiated approach to the choice of treatment strategies for patients with AP considering the severity of the disease and severity of IAH syndrome results in reduced hospital mortality by 10.3% and reduced postoperative mortality by 11.4%.Conclusion. Monitoring of intra-abdominal pressure and APACHE II scale indices in conjunction with standard clinical and laboratory parameters allows patients to be clearly stratified according to the severity of acute pancreatitis, which helps optimize the choice of treatment tactics, including methods and timing of surgery, as well as the use of a set of effective therapeutic measures aimed at eliminating intra-abdominal hypertension.

Depression and the complications of its pharmacotherapy remain relevant issues in modern medicine. Since the advent of the first antidepressants, more than 60 years ago, to the present, their arsenal has expanded significantly. On the one hand, the emergence of new antidepressants is a great achievement in psychopharmacology, and on the other hand, due to their specificity, antidepressants cause many complications. In addition, in recent years, the list of diseases in which off label (outside the instructions) use these drugs has expanded significantly, and given the fact that for these diseases, anti-depressants are prescribed in combination with other drugs, so the risk of developing side effects increases significantly . This article analyzes the frequently encountered side effects of antidepressants, the mechanisms of their occurrence when using both first-generation antidepressants (three and tetracyclic antidepressants, monoamine oxidase inhibitors) and newer drugs from the group of selective serotonin reuptake inhibitors. The conditions for the rational use of antidepressants are also presented, which allows to optimize their use and the safety of pharmacotherapy for depression. Thus, today it is necessary to create new safer antidepressants that selectively inhibit the reuptake of one of monoamines (for example, serotonin) and third-generation drugs with a “double” effect, i. e. selectively and equipotentially inhibiting the reuptake of serotonin and norepinephrine.

Analysis of the relationship between the epicardial fat with adipokine and system ST2/IL-33 in-hospital period, and also with the extent of fibrosis of the atrial myocardium through the year after myocardial infarction in patients with visceral obesity. Examined 88 patients with myocardial infarction (MI). Visceral obesity (VO) is established by computed tomography. In fact the presence VO the patients divided into two groups. Determined the concentration of leptin, adiponectin, stimulating growth factor (ST-2) and interlekin-33 (IL-33) in serum on 1st, 12-day in-hospital period and 1 year after MI. Thickness epicardial adipose tissue (EAT) and the percentage of cardiovirus of the myocardium was measured by the method MRI, respectively, on the 12th day of hospitalization and a year after MI. The control group consisted of 30 people. Statistical analysis of data was performed using nonparametric tests. Patients with MI is associated with an increase in the thickness of EAT, imbalance of adipokines with increased leptin, decreased adiponectin in early in-hospital period and development of cardiovirus. Higher values of IL-33 and ЅT2 in the early in-hospital period MI patients with no accompanied by a lower prevalence of cardiovirus in the post-hospital period. The thickness of epicardial fat is directly dependent on the prevalence of myocardial fibrosis, the concentrations of IL-33 and in inverse proportion to the concentration of ЅT2. The degree of cardiovirus is in inverse proportion to the concentration of IL-33 and directly dependent on the concentration of ST2. The increase in EAT closely linked to the development of fibrosis of the atrial myocardium after year. The thickness of EAT more patients MI, which is most pronounced imbalance of adipokines. The metabolic activity of EAT correlated with increased IL-33 and ST2 decrease.

Aim. African Swine Fever (ASF) is a viral infection in domestic pigs and wild boars.It is estimated that ASF causes more than one billion EUR losses in Eastern Europe everyyear. In Poland, after initial outbreaks in 2014, almost 90% of pig farms stopped their production(in regions affected up to June 2017) due to restrictions (Jarynowski, Belk, 2019). InNovember 2019, the ASF virus has been confi rmed in a wild boar in the Wschowa poviat,just 30 km from the pig production hub in Wielkopolska (the so-called “swine district”).Recent rapid propagation of the ASF from East to West of Europe encouraged us to prepareanalysis of the Internet media awareness in Poland refl ecting the above mentioned socialdynamics.Methods. Using computational techniques we analyse agents and events in the Internetmedia. The intensive control measures against ASF in the European Union signifi cantlytransform biosecurity, trade, sanitary, environmental regulations and ethical standardscausing protests of various social groups of interest: 1) farmers (who are not ready to applye-methodology 2019 (6) 101biosecurity measures), 2) ecologists (who do not agree with governmental policy of wildboar depopulation) and 3) hunters with public administration (that have to take control onwild boar population).Results. In particular, we have reviewed possible ways of public opinion’s infl uenceusing Twitter, Facebook and mainstream websites’s data of selected groups of interest. Weidentify two main frames of events: 1) Culling of wild boar to minimize ASF spread and therisk of transmission to domestic pigs caused massive protest among ecological associationsin Poland, due to opposition of some experts in beginning of 2019; 2) jump of the virus toWestern Poland caused intensive discussion and lobbying of farmers postulates at the turnof 2019/2020.Conclusions. We claim that reliable analysis of the perception of the ASF is importantto understand possible confl icts and issues. We have provided analysis of usability of availableInternet resources as Secondary Data Digital Footprints.Key words: The Internet media, Social Media, Risk perception, African Swine Fever,ASF, Digital traces, Veterinary Public Health.

Absztrakt: Bevezetés: A biszfoszfonátok által okozott állcsontnekrózis (BRONJ) az életminőséget jelentősen befolyásoló megbetegedés, mely mind általános, mind sebészeti vonatkozásaiban indokolja a korai diagnózis felállítását, illetve a kialakulás kockázatának felmérését. Célkitűzés: A BRONJ prognózisának becslése nem megoldott, számos radiológiai lehetőség közül a legkedvezőbbnek a fogászatban használatos képalkotó eljárások tűnnek, melyek közül a legígéretesebb lehet a ’cone-beam computed tomography’ (CBCT). Az oralisan alkalmazott biszfoszfonátterápia következtében kialakuló BRONJ kockázatbecslését nem hangsúlyozzák a vizsgálatok, a nagyobb kockázatot jelentő intravénás alkalmazásra fókuszálnak. Módszer: Méréseinket – az eddig publikált vizsgálatokkal ellentétben – preoperatív CBCT-felvételeken végeztük, ezáltal a kockázatbecslés lehetőségét közvetlenül vizsgáltuk. Vizsgálatainkat CBCT-felvételek értékelésével végeztük; reprezentatív területként a foramen mentale középvonalában elhelyezkedő frontális metszeteket választottuk ki, és több ponton mértünk denzitást, a corticalis csontállomány vastagságát, valamint a foramen mentale átmérőjét is megmértük. Az első vizsgálati csoportban olyan osteoporosisos betegeket vizsgáltunk, akiknél oralis biszfoszfonátterápiát követően alakult ki BRONJ. A második csoportban olyan betegeket néztünk, akik osteoporosis miatt oralis biszfoszfonátterápiában részesültek, és a szájsebészeti beavatkozást követően nem alakult ki BRONJ. A kontrollcsoportban olyan betegek voltak, akik nem kaptak a BRONJ etiológiájában szereplő gyógyszert. Eredmények: Eredményeink alapján elmondható, hogy a preoperatív CBCT-felvételeket értékelve nem tapasztalható jelentős különbség a BRONJ-elváltozástól szenvedők és az egészségesek csontdenzitási értékei között. Következtetés: Ezek alapján kijelenthető, hogy a sugárterheléssel járó CBCT-felvétel az osteoporosis miatt oralis biszfoszfonátot szedők esetében a BRONJ prognosztikai becslésére nem alkalmazható. Mindez fontos ahhoz, hogy a prognózisbecsléshez a pácienst érő sugárdózist ne emeljük szükségtelenül az ALARA (as low as reasonably achievable)-elv értelmében. Orv Hetil. 2020; 161(21): 867–872.

The article presents a biotechnical system for researching the cerebral cortex stimulation through receptor systems by exposure to sound and light of changing color. The system allows simultaneous exposure of both eyes, the difference in the frequencies of stimulation of the left and right eyes being close to brain wave frequencies. It also allows local stimulation of neural fields of the cerebral cortex and hippocampus with modulated magnetic fields. Tests showed that the developed system could be used for rehabilitation and restoration of both long-term and short-term memory in post-stroke patients.

To determine the dependence of adiponectin gene expression by subcutaneous, epicardial and perivascular adipocytes on the degree of coronary lesion in coronary heart disease.84 patients with coronary artery disease were examined. Of these, 39 people showed a moderate degree of atherosclerotic lesion of the coronary bed (less than or equal to 22 points) on the SYNTAX Score scale, 20 severe (2231 points), and 25 extremely severe (more than 32 points). Upon admission to the hospital, all patients underwent an echocardiographic study (Echocardiography, Acuson, Germany) with the calculation of the ejection fraction (EF) of the left ventricle (LV) to assess its systolic function. During a planned surgical intervention (coronary bypass surgery, CABG), adipocytes of subcutaneous, epicardial (EAT) and perivascular adipose tissue (PVAT) were taken. Adiponectin gene expression was evaluated by polymerase chain reaction (real-time PCR) using TaqMan probes. Statistical analysis was performed using Statistica 9.0.The maximum level of adiponectin expression was detected in adipocytes of PVAT, and the minimum EAT. With an increase in the degree of atherosclerotic lesion of the coronary bed, the expression of the adiponectin gene in adipocytes of local depots significantly decreases r=-0.82; p=0.023. Moreover, the low level of gene expression in EAT correlated with a decrease in LV EF by r=0.73; p=0.03. In adipocytes of subcutaneous and especially PVAT, gene expression was the highest in patients with a moderate degree of coronary lesion.Low adiponectin gene expression in EAT is associated with an increase in the degree of atherosclerotic lesion of the coronary bed and a decrease in LV EF.Цель. Выявить зависимость экспрессии гена адипонектина подкожными, эпикардиальными и периваскулярными адипоцитами от степени поражения коронарного русла при ишемической болезни сердца. Материалы и методы. Обследованы 84 пациента с ишемической болезнью сердца. Из них у 39 человек по шкале SYNTAX Score выявлена умеренная степень атеросклеротического поражения коронарного русла (меньше или равно 22 баллов), у 20 тяжелая (2231 балл) и у 25 крайне тяжелая (более 32 баллов). При поступлении в стационар всем больным проведено эхокардиографическое исследование (Acuson, Германия) с расчетом значения фракции выброса (ФВ) левого желудочка (ЛЖ) для оценки его систолической функции. Во время планового оперативного вмешательства (коронарного шунтирования) проводился забор адипоцитов подкожной, эпикардиальной (ЭЖТ) и периваскулярной жировой ткани (ПВЖТ). Экспрессию гена адипонектина оценивали с методом полимеразной цепной реакции в реальном времени с использованием зондов TaqMan. Статистический анализ выполнен с помощью программы Statistica 9.0. Результаты. Максимальный уровень экспрессии адипонектина выявлен в адипоцитах ПВЖТ, а минимальный ЭЖТ. С увеличением степени атеросклеротического поражения коронарного русла значительно снижается экспрессия гена адипонектина в адипоцитах локальных депо (r=-0,82; p=0,023). При этом низкий уровень экспрессии гена в ЭЖТ коррелировал с уменьшением ФВ ЛЖ (r=0,73; p=0,03). В адипоцитах подкожной жировой ткани и особенно ПВЖТ экспрессия гена была самой высокой у пациентов с умеренной степенью поражения коронарного русла. Заключение. Низкая экспрессия гена адипонектина в ЭЖТ ассоциирована с увеличением степени атеросклеротического поражения коронарного русла и уменьшением ФВ ЛЖ.

Aim. To assess the changes of biochemical markers in hospitalization, the relationship with the severity of myocardial fibrosis and the epicardial adipose tissue (EAT) thickness one year after myocardial infarction (MI).Material and methods. A total of 88 patients (65 men and 23 women) with MI were examined. The percentage of cicatricial changes in the myocardium and the EAT thickness were measured using the magnetic resonance imaging (MRI) one year after MI. In the hospitalization (days 1 and 12) and 1 year after MI, the concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP), stimulating growth factor (ST2), interleukin-33 (IL-33) and type I collagen (COL-1). The data were analyzed using descriptive statistics, correlation and ROC analysis, and logistic regression (Statistica 9.0).Results. One year after MI, cicatricial changes were detected in 68 (77%) patients: 27 people had myocardial fibrosis 15%. We established that myocardial fibrosis after MI is associated with unfavorable medical history, a complicated course during in-hospital period and higher concentrations of ST2, NT-proBNP, COL-1 compared with patients without myocardial fibrosis. High levels of ST2, NT-proBNP increase the risk of myocardial fibrosis by 1,2 and 1,8 times after hospitalization, respectively. In patients with myocardial fibrosis >15%, IL-33 level was significantly lower in the 1st day of MI. It was found that the EAT thickness increases with fibrosis of 5-15%. An increase in the left (LV) and right ventricular (RV) EAT thickness by 1,33 times and 1,34 times, respectively, increases the risk of myocardial fibrosis (LV EAT thickness, mm (OR 1,33; 95% CI (1,08-1,4), AUC 0,75; RV EAT thickness, mm (OR 1,34; 95% CI (1,15-1,43), AUC 0,79). In patients with myocardial fibrosis >15%, EAT thickness decreases and correlates with NT-proBNP increase in the acute period and a one year after MI.Conclusion. The development of myocardial fibrosis one year after MI is associated with an increase in ST2, NT-proBNP, COL-1, both in the hospitalization and 1 year after MI. The decrease in IL-33 concentration during hospitalization with MI is accompanied by the development of fibrosis >15% of the myocardium.

In connection with the ongoing pandemic of the novel coronavirus infection, the study of its morphopathology and the analysis of autopsy data are relevant. At the same time, attention should be paid to thromboses that play a significant role in the development of fatal outcomes in COVID-19, even taking into account the prescription of anticoagulant therapy to most patients.To make an assessment of morphological changes and a statistical analysis of the structure of mortality in COVID-19 on the basis of autopsy results in the Volgograd Region in 2020.The study was based on data from «The system for information on the work of the Volgograd Regional Autopsy Bureau» with a search for cases according to U07.1 code (the COVID-19 virus was identified) in January 1, 2020, to December 31, 2020, as well as on the autopsy materials of the Volgograd Regional Autopsy Bureau, and microscopic examination with photo fixation. Statistical processing was performed using the R programming language.During the above period, 1119 deaths were identified with a confirmed diagnosis of COVID-19. Anatomopathological examination of the autopsy material showed that 77.54% of cases had blood clots mainly in the vessels of the pulmonary microvasculature, often only in the single veins during the applied anticoagulant therapy.Analysis of variance indicated that the obtained result statistically significantly differed from the random distribution, and the probability of the presence of blood clots of specified localization was 3.17 times higher (CI 2.3-4.4;Thus, this investigation has revealed that the high frequency of thrombosis detected in the presence of perivascular and intra-alveolar diapedesis hemorrhages in COVID-19 confirms the tendency of patients with a severe course of the disease to manifest hemostatic disorders, significant blood vascular endothelial injury, and obvious vascular impermeability.В связи с продолжающейся пандемией новой коронавирусной инфекции являются актуальными изучение ее патоморфологии и анализ данных аутопсий. При этом следует обратить внимание на тромбозы, играющие значительную роль в развитии летальных исходов при COVID-19 даже с учетом назначения антикоагулянтной терапии большинству пациентов.Провести оценку морфологических изменений и статистический анализ структуры смертности при COVID-19 на основе исследования материалов патолого-анатомических вскрытий в Волгоградской области за 2020 г.Исследование основано на данных «Информационной системы работы Волгоградского областного патолого-анатомического бюро» с поиском случаев по коду U07.1 (COVID-19, вирус идентифицирован) за период с 01.01.20 по 31.12.20, а также материалах патолого-анатомических вскрытий ГБУЗ «Волгоградское областное патолого-анатомическое бюро» и микроскопического исследования с фотофиксацией. Статистическую обработку выполняли с помощью языка программирования R.За указанный период выявлено 1119 умерших с подтвержденным диагнозом COVID-19. При проведении патолого-анатомического исследования аутопсийного материала в 77,54% случаев обнаружены тромбы преимущественно в сосудах микроциркуляторного русла легких, часто лишь в единичных венах на фоне применяемой антикоагулянтной терапии. Полученный результат, согласно дисперсионному анализу, статистически значимо отличается от случайного распределения, а вероятность наличия тромбов указанной локализации в 3,17 раза (ДИ 2,3—4,4;Таким образом, обнаруженная в исследовании высокая частота тромбозов на фоне периваскулярных и внутриальвеолярных диапедезных кровоизлияний при COVID-19 подтверждает склонность пациентов с тяжелым течением заболевания к манифестации нарушений в системе гемостаза, значительному повреждению эндотелия кровеносных сосудов и выраженному нарушению сосудистой проницаемости.

An association between high serum calcium/phosphate and cardiovascular events or death is well-established. However, a mechanistic explanation of this correlation is lacking. Here, we examined the role of calciprotein particles (CPPs), nanoscale bodies forming in the human blood upon its supersaturation with calcium and phosphate, in cardiovascular disease. The serum of patients with coronary artery disease or cerebrovascular disease displayed an increased propensity to form CPPs in combination with elevated ionised calcium as well as reduced albumin levels, altogether indicative of reduced Ca2+-binding capacity. Intravenous administration of CPPs to normolipidemic and normotensive Wistar rats provoked intimal hyperplasia and adventitial/perivascular inflammation in both balloon-injured and intact aortas in the absence of other cardiovascular risk factors. Upon the addition to primary human arterial endothelial cells, CPPs induced lysosome-dependent cell death, promoted the release of pro-inflammatory cytokines, stimulated leukocyte adhesion, and triggered endothelial-to-mesenchymal transition. We concluded that CPPs, which are formed in the blood as a result of altered mineral homeostasis, cause endothelial dysfunction and vascular inflammation, thereby contributing to the development of cardiovascular disease.

Background There is a limited amount of data on the safety profile of the COVID-19 vector vaccine Gam-COVID-Vac (Sputnik V). Previous infodemiology studies showed that social media discourse could be analyzed to assess the most concerning adverse events (AE) caused by drugs. Objective We aimed to investigate mild AEs of Sputnik V based on a participatory trial conducted on Telegram in the Russian language. We compared AEs extracted from Telegram with other limited databases on Sputnik V and other COVID-19 vaccines. We explored symptom co-occurrence patterns and determined how counts of administered doses, age, gender, and sequence of shots could confound the reporting of AEs. Methods We collected a unique dataset consisting of 11,515 self-reported Sputnik V vaccine AEs posted on the Telegram group, and we utilized natural language processing methods to extract AEs. Specifically, we performed multilabel classifications using the deep neural language model Bidirectional Encoder Representations from Transformers (BERT) “DeepPavlov,” which was pretrained on a Russian language corpus and applied to the Telegram messages. The resulting area under the curve score was 0.991. We chose symptom classes that represented the following AEs: fever, pain, chills, fatigue, nausea/vomiting, headache, insomnia, lymph node enlargement, erythema, pruritus, swelling, and diarrhea. Results Telegram users complained mostly about pain (5461/11,515, 47.43%), fever (5363/11,515, 46.57%), fatigue (3862/11,515, 33.54%), and headache (2855/11,515, 24.79%). Women reported more AEs than men (1.2-fold, P Conclusions After the Sputnik V vaccination, Russian Telegram users reported mostly pain, fever, and fatigue. The Sputnik V AE profile was comparable with other vector COVID-19 vaccines. Discussion on social media could provide meaningful information about the AE profile of novel vaccines.

In this study we studied the relationships between adipokines (leptin, soluble leptin receptor) in adipose tissue (AT) and cardiovascular disease (CVD) risk factors. Methods Fat tissue biopsies were obtained from 134 patients median aged 64.0 (48.0; 68.0) with stable CAD undergoing coronary artery bypass grafting. Traditional cardiovascular risk factors and patient treatment have been recorded. AH was defined as systolic blood pressure >140 mm Hg Art., diastolic blood pressure >90 mm Hg. Dyslipidemia was defined as a previously detected increase in total serum cholesterol (>200 mg/dl), triglycerides (>200 mg/dl), or low-density lipoprotein (LDL) cholesterol (>150 mg/dl) for at least 1 year, or use of lipid-lowering drugs. Smoking was classified as current or former smokers; current smoking status was defined as at least one cigarette daily over the last year. Adipocytes were isolated from subcutaneous (SAT), epicardial (EAT), and perivascular AT (PVAT) samples. Isolated adipocytes were cultured for 24-h after which, Then adipocytes were immediately processed to RNA extraction and determination of adipokines gene expression. Results In this study, we showed that men with CAD LEP and LEPR expression were lower in PVAT, whereas only the latter was decreased in SAT. Thus, LEPR expression in local fat depots appeared to differ in men and women, which is consistent with previous reports. Men with CAD showed lower LEP expression than women in EAT, whereas no significant differences were observed in SAT. Patients 51–59 years old were characterized by the lowest LEP expression in SAT and the highest LEP and LEPR expression in EAT and PVAT. Those >60 years presented the highest levels of LEPR in SAT. The presence of dyslipidemia in patients with CAD correlated with decreased LEPR expression in EAT, which is an unfavorable sign and may potentially lead to the development of leptin resistance. In patients with AH, LEP expression in EAT and LEPR expression in SAT and PVAT is increased. AH >20 years was associated with increased LEP in ATs. Smokers with CAD exhibited higher levels of LEP expression in SAT and EAT, and LEPR expression in SAT. Conclusions The results of the study indicate a close association of traditional CVD risk factors with adipocytokine imbalance in patients with CAD. The results indicate the potential of the fat depot and leptin and its receptor data as a drug application point. The study of the molecular basis of PVAT and EAT function can provide a more complete understanding of the etiopathogenetic mechanisms of CVD and develop an effective strategy for their prevention and control. Funding Acknowledgement Type of funding sources: None.

The aim of the study was to assess the level of resistin in local fat depots and the possibility of correcting the level of resistin using rosuvastatin and metformin. Methods This study was performed at the Federal State Budgetary Institution's Research Institute for Complex Issues of Cardiovascular Diseases. The study included 84 patients with ischemic heart disease (IHD), who were planned to undergo coronary artery bypass grafting (CABG). The average age of the patients was 63.8 (50.1; 68.6) years. Patients were included in the study after they provided written informed consent. In order to study the combined effect of atorvastatin and metformin on the functional activity of adipocytes in the SAT, EAT, and PVAT, isolated adipocytes were cultured for 24 hours with the addition of drugs at different concentrations: 1 μmol/L atorvastatin (SigmaAldrich, China) + 1 mmol/L metformin (USP, Norway); 5 μmol/L atorvastatin + 10 mmol/L metformin. Then, the expression of mRNA resistin genes (RSTN) was assessed. Statistical analysis was performed using GraphPad Prism 6 (GraphPad Software), nonparametric tests, and multivariate statistics methods. Results The level of RSTN expression in the EAT was the highest compared to the SAT (2.6 times, p=0.0014) and the PVAT (1.9 times, p=0.0017). The level of secretion of the resistin in the culture medium of adipocytes corresponded to the expression of the resistin gene. Cultivation of adipocytes with rosuvastatin showed that low concentrations (1 μmol/L) did not have a significant effect on the functional activity of adipocytes. At the same time, 5 μmol/L rosuvastatin reduced the level of RSTN expression and protein secretion, but only in subcutaneous adipocytes in compared with control. Culturing adipocytes with metformin at a concentration of 10 mmol/L reduced the level of RSTN expression and protein secretion in the culture medium in all three adipose tissues. At the same time, 1 mmol/L metformin did not have a significant effect. The use of a combination of the drugs rosuvastatin and metformin at various concentrations led to a decrease in the RSTN expression in the SAT, EAT, and PVAT, but only when 5 μmol/L rosuvastatin + 10 mmol/L metformin were used. Conclusion Thus, the level of resistin in adipocytes of adipose tissue of patients with IHD is influenced only by rosuvastatin at a concentration of 5 μmol/L and only on adipocytes of adipose tissue, reducing the level of RSTN expression and protein secretion in the culture medium. Metformin was more effective than rosuvastatin and at high concentrations (10 mmol/L) reduced RSTN expression and protein secretion in the culture medium regardless of the localization of adipocytes. The combined use of high concentrations of rosuvastatin (5 μmol/L) and metformin (10 mmol/L) of patients with IHD had a comparable effect with metformin at a concentration of 10 mmol/L. Funding Acknowledgement Type of funding sources: None.

We have designed a silicon detector based on an avalanche photodiode for detecting vacuum ultraviolet radiation. It was demonstrated that the detector has a photon detection efficiency superior to 0.65 electrons / photon, in the wavelength range from 114 to 170 nm, with an external quantum yield from 49 to 7000 electrons / photon at a reverse-bias voltage from 190 to 315 V, respectively. The detector’s active area diameter is 1.5 mm.

BackgroundThere is a limited amount of data on the COVID-19 vector vaccine Gam-COVID-Vac (Sputnik V) safety profile. Previous infodemiology studies showed that social media discourse could be analyzed to assess the most concerning adverse events (AE) caused by drugs.ObjectiveWe aimed to investigate mild AEs of Sputnik V based on a participatory trial conducted on Telegram in the Russian language. We compared AEs extracted from Telegram with other limited databases on Sputnik V and other COVID-19 vaccines. We explored symptom co-occurrence patterns and determined how counts of administered doses, age, gender, and sequence of shots could confound the reporting of AEs.Materials and MethodsWe collected a unique dataset consisting of 11,515 self-reported Sputnik V vaccine AEs posted on the Telegram group, and we utilized natural language processing methods to extract AEs. Specifically, we performed multi-label classifications using the deep neural language model BERT “DeepPavlov”, which we pre-trained on a Russian language corpus and applied to the Telegram messages. The resulting AUC score was 0.991. We chose symptom classes that represented the following AEs: fever, pain, chills, fatigue, nausea/vomiting, headache, insomnia, lymph node enlargement, erythema, pruritus, swelling, and diarrhea.ResultsThe results of the retrospective analysis showed that females reported more AEs than males (1.2-fold, Pβ = .05 per year, PThe Lancet. However, the AEs reported in Telegram posts were consistent (Pearson correlation r=.94, P=.02) with those reported in the Argentinian post-marketing AE registry.ConclusionAfter receiving the Sputnik V vaccination, Telegram users complained about pain (47%), fever (47%), fatigue (34%), and headache (25%). The results showed that the AE profile of Sputnik V was comparable with other COVID-19 vaccines. Examining the sentinel properties of participatory trials (which is subject to self-reporting biases) could still provide meaningful information about pharmaceutics, especially if only a limited amount of information on AEs is provided by producers.

Funding Acknowledgements Type of funding sources: None. Aim to determine the features of adiponectin expression, secretion of adiponectin and its receptors in local fat depots in CVD. Materials and methods The study included 90 patients with СAD (Group 1) and 60 patients with heart defects (Group 2). Adipocytes were isolated from samples of subcutaneous (SAT), epicardial (EAT) and perivascular (PVAT) adipose tissue obtained during CABG or heart valve replacement. The expression of adiponectin was determined by qPCR using TaqManTM Gene Expression Assays (Applied Biosystems, USA) in the ViiA 7 Real-Time PCR System (Applied Biosystems, USA), the levels of expression products was determined using enzyme immunoassay (Bender MedSystems GmbH, Vienna, Austria). The data were analyzed using the statistical software Statistica 9.0. Results EAT adipocytes were characterized by the lowest adiponectin expression relative to adipocytes of other localization both in Group 1 and Group 2. In patients Group 1 adiponectin expression in EAT was reduced relative in SAT and PVAT (by 1.2 and 1.5 times). In Group 2, the adiponectin mRNA in the EAT was lower than in the SAT and PVAT (1.4 and 1.5 times). The expression of adiponectin in EAT in Group 2 exceeded the same indicator in Group 1 by 1.2 times. The maximum expression of adiponectin was observed in the PVAT culture in patients of both groups. For Group 2, this indicator exceeded the values of Group 1 by 1.2 times. The content of adiponectin in the culture EAT was lower than in the SAT, both in Group 1 and Group 2 (by 1.3 and 1.13 times). The level of this indicator in Group 2 was 1.4 times higher than in Group 1. PVAT adipocytes of patients with CAD were characterized by the lowest level of adiponectin secretion in comparison with adipocytes of other localization. The adiponectin level in the PVAT of Group 2 exceeded that of fat stores of other localization and in Group 1 patients by 1.8 times. There were no statistically significant differences in the expression and concentration of adiponectin in the culture of adipocytes of the SAT between the groups of patients. In Group 1, the lowest level of AdipoR1 was found in the adipocyte culture of the PVAT. Noteworthy is the decrease in the level of AdipoR1 in Group 1 compared to the level of Group 2, observed in the SAT and PVAT: 1.3 and 1.5 times. There were no significant differences in the concentration of the AdipoR1 in the EAT, as well as AdipoR2 in all types of AT between the groups of patients. Conclusion: in CVD the EAT is characterized by minimal expression and secretion of adiponectin, regardless of nosology. In CAD despite the high level of expression of adiponectin, the adipocytes of the PVAT were found to have the lowest content in comparison with adipocytes of other localization. Dysregulation of the adiponectin/AdipoR axis is observed in PVAT, which may be due to low expression of adiponectin receptors and long-term processes of its post-translational modification and oligomerization in CAD.

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases” Purpose To study the preoperative status and assess the rate of in-hospital complications in patients with newly diagnosed type 2 diabetes mellitus (DM) undergoing coronary artery bypass grafting compared to patients with previously diagnosed DM and normoglycemia. Materials and Methods. 708 consecutive patients who underwent coronary artery bypass grafting (CABG) between 2011 to 2012 at the Research Institute for Complex Issues of Cardiovascular Diseases were included in the study. All patients without positive history of diabetes underwent an oral glucose tolerance test (ОGTT). The lab findings were interpreted in accordance with the recommended diagnostic criteria for diabetes and other glycemic disorders. Results. DM screening before coronary artery bypass grafting allowed to diagnose type 2 diabetes in 8.9% (n = 63) and prediabetes in 10.4% (n = 74) of the study population. The preoperative screening increased the number of patients with DM from 15.2% (n = 108) to 24.1% (n = 171), and with prediabetes from 3.0% (n = 21) to 13.4% (n = 95). The total number of patients with carbohydrate metabolism disorders increased from 18.2% (n = 129) to 37.5% (n = 266). The study groups did not differ in the rate of in-hospital complications due to a relatively low number of occurred events. However, a trend towards higher rate of in-hospital complications after CABG was defined among patients with newly diagnosed and previously diagnosed DM. The regression analysis demonstrated the presence of the relationships between the previously diagnosed DM2 and the total number of significant complications (odds ratio (OR) - 1.350, 95% confidence interval (CI): 1.057-1.723, p = 0.020) and prolonged in-hospital stay (OR 1.609, 95% CI: 1.202-2.1555, p = 0.001). The significance of the mentioned above relationships increased with the addition of newly diagnosed diabetes to the regression model as a probable predictor (for in-hospital complications: OR = 1.731, 95% CI: 1.131-2.626, p = 0.012; for prolonged in-hospital stay: OR 2.229, 95% CI: 1.412-3.519, p Conclusion The newly diagnosed diabetes mellitus affects the prognosis of CABG as well as the previously diagnosed DM. The obtained results suggest the importance of active preoperative DM screening.

Funding Acknowledgements Type of funding sources: None. Purpose To evaluate morphological and functional cardiac parameters and to assess changes in markers of perioperative myocardial injury in patients undergoing different prehabilitation program before elective coronary artery bypass grafting (CABG). Methods 60 male patients with stable coronary artery disease (CAD) underwent screening in the preoperative period and were randomized into two groups. Group 1 (n = 30, mean age 61.5 [56; 63]) underwent supervised treadmill exercises at intensity corresponding to 80% of VO2 peak during the preoperative management. Group 2 (n = 30, mean age 62.0 [56; 64]) patients did not undergo any additional trainings. Patients underwent a standard echocardiographic (ECHO-CG) study in the preoperative period and at days 5-7 after CABG. Serum markers of myocardial injury (troponin I, NT-proBNP) were measured in both groups of patients in the preoperative period before training (point 1), at the end of exercise training session (point 2) and at days 5-7 (point 3) after CABG. Results Left ventricular end-systolic dimension (p = 0.039) and left ventricular end-systolic volume (p = 0.039) increased by 8.5% and 18% in patients who underwent supervised exercise trainings as compared to the baseline values. An increase in these parameters was more pronounced in the control group (17% (p = 0.00029) and 41% (p = 0.00028), respectively). Both groups were comparable in troponin I levels at three study points. Troponin I values were within the reference range. NT-proBNP levels showed a downward trend in patients with prehabilitation at the end of the training sessions, while in the control group NT-proBNP levels increased. An increase in NT-proBNP levels was reliable in patients without exercise trainings (p = 0.003) after CABG compared to the preoperative values. However, changes in NT-proBNP levels were insignificant in patients who underwent prehabilitation (p > 0.05). Conclusion The safety of high-intensity exercise trainings in the prehabilitation program for CABG had been confirmed by laboratory markers indicative for myocardial injury. The obtained data proved the efficiency of active prehabilitation for optimizing morphological and functional cardiac parameters as well as inducing cardioprotection.

A method for diminishing electrosurgery-induced thermal damage to biological tissues by correcting the power output is considered. The output power is corrected according to the type of biological tissue and the impedance increment caused by coagulation. The results of a study of biological tissue impedance substantiating the feasibility of this method are presented.

Objective: To study the characteristics of the expression of inducible NO synthase (iNOS) in hippocampal fields CA1 and CA3 in adult male humans and adult rats exposed to combined stress. Materials and methods. The hippocampi of 10 men in the second period of adulthood (35–60 years) with pathology of the cardiovascular system and pain stress due to acute myocardial infarct and 10 subjects who died for reasons other than cardiovascular disease were studied. The experimental material included the brains of 20 white adult male rats divided into a control group and an experimental group subjected to combined stress. The levels of expression and relative areas of iNOS-immunoreactive material (IRM) were determined. Results. Hippocampal fields CA1 and CA3 in humans with >50% stenosis of the middle cerebral artery (MCA) showed increases in the relative area and increases in the level of expression of iNOS-IRM. Stressed animals showed increases over controls in the relative area of iNOS-IRM in field CA3 and in the level of expression of iNOS-IRM in fields CA1 and CA3. Conclusions. Marked changes in the form of damage to neurons in the pyramidal layer of the hippocampus and increases in the level of expression of iNOS were seen in field CA3 both in humans with MCA stenosis and in experimental animals subjected to combined stress.

Perivascular adipose tissue surrounds most large blood vessels and plays an important role in vascular homeostasis. Recent studies have shown that perivascular adipose tissue effects vasodilation and vasoconstriction, which indicates that the perivascular adipose tissue regulates tone and diameter of the vessels. Adipocytokines and chemokines, secreted from the perivascular adipose tissue, apparently have direct access to the adjacent arterial wall by diffusion, or through vasa vasorum . The present data indicate that perivascular adipose tissue plays an important role in atherosclerosis, hypertension. Recently, some studies were performed that examined the role of perivascular adipose tissue in non-atherosclerotic vascular diseases, such as neointimal formation, aortic aneurysm, arterial stiffness and vasculitis. The present review will discuss a role of perivascular adipose tissue in pathogenesis of atherosclerosis, hypertension and non-atherosclerotic vascular diseases.

To date, pathology of the cardiovascular system is the most common, tends to increase, most often leads to disability and mortality of the population at a young working age and is an important medical and social problem. The purpose of the study was to establish the features of micro organization of the mitral valve in white rat in norm and after opioid action. The study material is presented by histological samples of a mitral valve of the white rat. The study was performed on 30 adult white reproductive age rats weighing 160-220 g. The experimental animals were injected intramuscularly 1 time per day for the same period of 42 days (6 weeks) with the opioid drug analgesic “Nalbuphine”. Using histological methods, 30 mitral valves of white rat were examined. Microscopy of histological preparations of the valves of the heart was performed sequentially, assessing the morphological changes in the norm and under the action of the opioid after 6 weeks of the experiment. Emphasis was placed on the presence or absence of endothelial layer, as well as the condition of endothelial cells in normal and at the action of the damaging factor, determining the signs of their dystrophy, desquamation and proliferation. It is established that the normal mitral valve is represented by endocardial folds. The rat endocardium consists of three layers: endothelial (endothelial cells rich layer, attached to the basement membrane), subendothelial (connective tissue rich in fibroblasts) and a muscular-elastic layer (represented by smooth myocytes, plaited collagen fibers). After 6 weeks of administration of Nalbuphine, the mitral valve is in a stage of decompensation, when the outer and inner endothelial layers are destroyed, the endothelial cells are deformed, the subendothelial layer is represented by single bundles of different directions. In the musculo-elastic layer, contact between smooth myocytes and fragmented and thinned, collagen and elastic fibers is lost. This study allows us to conclude on the destructive effect of opioid agents on the valvular apparatus of the heart.

Purpose of the study. A comprehensive quantification of ectopic fat depots using modern methods of radiation diagnosis in patients with ischemic heart disease. Patients and methods. The study included 76 patients with a verified diagnosis of ischemic heart disease (IHD). The control group consisted of 32 people without clinical manifestations of IHD. All patients to assess the area and volume of visceral adipose tissue, as well as measuring the volume of paraaortic adipose tissue at the level of the abdominal aorta were performed multispiral computed tomography (MSCT) at the level of L3–L5 vertebrae. In order to visualize and morphometry pericoronary and paraaortic adipose tissue at the level of the thoracic aorta, patients in both groups were performed MSCT angiography of the coronary arteries with ECG synchronization. To visualize the epicardial fat depot with an assessment of the thickness of the adipose tissue layer, magnetic resonance imaging (MRI) of the heart was performed. Results. During the comparative analysis, significantly higher values of quantitative indicators of the main ectopic fat depots were noted in patients with coronary artery disease. Estimation of the prevalence of obesity according to BMI data in the compared groups showed no significant differences. Considering the standard values of the area and volume of visceral adipose tissue, the prevalence of obesity was significantly higher in the group of patients with IHD. Conducted correlation analysis showed the relationship of quantitative indicators of ectopic visceral, para-aortic and epicardial fat depots. Moreover, in the group of patients with IHD, stronger correlations were found between the fat depots of different localization (r = 0,71, p = 0,013 in group with IHD and r = 0,59, p = 0,039 in group without IND). Conclusion. Modern tomographic methods allow for a comprehensive quantification of ectopic fat depots. Significantly higher morphometry indices of the studied fat depots in patients with coronary artery disease demonstrate the need to develop a unified diagnostic algorithm for reliable stratification of cardiometabolic risk.

This article discusses the efficiency of passive solar systems auxiliary integrated into buildings and focuses on trombe wall. The first paragraph deals with measurement methods applicable for passive systems. Following chapter describes the elimination and correction of result uncertainities. The main part focuses on measurement and evaluation of trombe wall. The real passive solar system is integrated into model family house. The optimisation process and improvements are explained as the main result of this research.

Adipose tissue dysfunction characterized by a loss of homeostatic functions It is observed in patients with obesity, insulin resistance and diabetes. In case of violation of the physiological properties in adipose tissue, an increased production of cytokines and chemokines occurs with the infiltration of tissue by immune cells. In turn, immune cells also produce cytokines, metalloproteinases, reactive oxygen species and chemokines, which are involved in tissue remodeling, cellular signal transduction and immunity regulation. The presence of inflammatory cells in adipose tissue affects organs and tissues. So in the blood vessels, inflammation of perivascular adipose tissue leads to vascular remodeling, superoxide production, endothelial dysfunction with loss of the bioavailability of nitric oxide, contributing to the development of various vascular diseases. In adipose tissue dysfunction, adipokines are also produced, such as leptin, resistin, and visfatin. These substances contribute to metabolic dysfunction, alter systemic homeostasis, sympathetic outflow, glucose regulation, and insulin sensitivity. Thus, the study of the mechanisms of interaction between immune cells and adipose tissue is promising and may be an important therapeutic target.

Ghrelin is a multifunctional peptide hormone, mainly synthesized by P / D1 cells of the stomach fundus mucosa. Its basic effect, which is realized via GHS-R1 α receptor in the arcuate and the ventromedial nucleuses of hypothalamus, is stimulation of the synthesis of pituitary hormones. Ghrelin is involved in control of appetite and energy balance, regulation of carbohydrate and lipid metabolism, cell proliferation and apoptosis, as well as modulation of functioning of gastrointestinal, cardiovascular, pulmonary and immune systems. It was found that cardiomyocytes are able to synthesize ghrelin. High concentrations of GHS-R1α in the heart and major blood vessels evidence for its possible participation in functioning of cardiovascular system. Ghrelin inhibits apoptosis of cardiomyocytes and endothelial cells, and improves the functioning of the left ventricle (LV) after injury of ischemia-reperfusion mechanism. In rats with heart failure (HF) ghrelin improves LV function and attenuates development of cardiac cachexia. In addition, ghrelin exerts vasodilatory effects in humans, improves cardiac function and reduces peripheral vascular resistance in patients with chronic HF. The review contains of the predictive value of ghrelin in the development and prevention of cardiovascular disease.

O objetivo do trabalho é investigar o papel das certificações na coordenação das cadeias globais de frutas frescas, ressaltando mais especificamente o caso das frutas tropicais produzidas nos Polos irrigados de Petrolina-Juazeiro e Açú-Mossoró localizados na região Nordeste do Brasil. Observa-se nas últimas décadas uma crescente relevância da atuação dos selos de certificações nas cadeias de produtos frescos. Este movimento é encabeçado por cadeias de supermercados que estabeleceram procedimentos a serem adotados dentro dos integrantes das cadeias globais de produtos frescos. Portanto, este trabalho parte das seguintes questões de pesquisa: qual tem sido o papel desempenhado pelas certificações nas cadeias globais de frutas frescas produzidas no Nordeste? Para responder tais questões este trabalho faz uma revisão da literatura sobre as certificações e seus impactos na coordenação das cadeias globais de frutas frescas. Além disso, foram coletados dados secundários de bases estatísticas, bem como, foi realizada uma pesquisa de campo. Observou-se que as certificações desempenham um papel central na cadeia de produção de frutas frescas do nordeste, uma vez que define os padrões técnicas e normas éticas de produção, bem como, consegue se apropriar das quase-rendas geradas dentro da cadeia

Made available in DSpace on 2020-12-12T01:42:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-11-01 Introduction: Chronic kidney disease (CKD) patients have a high incidence of cardiovascular diseases (CVD) which increases their morbidity and mortality. A sedentary lifestyle in CKD is directly linked to the onset of CVD. Physical activity can bring beneficial effects to CKD patients. Aims: The aim of this study was assess the impact of aerobic training on nontraditional cardiovascular risk factors in CKD patients on hemodialysis. Materials and Methods: This is a prospective, controlled, and randomized clinical trial with analysis of intention to treat. Thirty patients underwent an exercise treadmill test, an arterial stiffness evaluation, echocardiography and analysis of endothelial reactivity, and carotid ultrasound and laboratorial tests, including analysis of serum aldosterone. The intervention group (IG) (n =15) underwent aerobic exercise during hemodialysis 3 times a week for 4 months. The control group (CG) (n =15) had no intervention. All of the patients were reassessed after 4 months. Results: In the IG, there was a statistically significant improvement in flow-mediated vasodilation (FMV; p = 0.002) and a reduction in left ventricular hypertrophy (p = 0.006) and serum aldosterone (p = 0.016). There was an increase in C-reactive protein in the CG (p = 0.002). Conclusion: This aerobic training protocol was able to improve endothelial function with enhanced FMV and reduce left ventricular hypertrophy and serum aldosterone, which could have a positive impact on the reduction of nontraditional cardiovascular risk factors in CKD patients on hemodialysis. Division of Nephrology Department of Internal Medicine Botucatu Medical School São Paulo State University (UNESP) Division of Cardiology Department of Internal Medicine Botucatu Medical School São Paulo State University (UNESP) Division of Nephrology Department of Internal Medicine Botucatu Medical School São Paulo State University (UNESP) Division of Cardiology Department of Internal Medicine Botucatu Medical School São Paulo State University (UNESP)

Topicality. Psoriasis is a chronic autoimmune disease characterized by changes in the growth and differentiation of the epidermis. 2-5 % of the population of the planet have psoriasis, and it is 30 % in the structure of skin diseases. The multifactorial concept of the pathological process in psoriasis determines a wide range of pharmacotherapy of this disease. Modern antipsoriatic agents are not effective enough and have a variety of side effects. Aim . To summarize the existing scientific literature data conserning the possibility of treating psoriasis with carboxytherapy. Results and discussion. Carboxytherapy is an important part of the treatment and rehabilitation of patients with psoriasis. The antipsoriatic effect of carboxytherapy is realized through the local and resorptive effect of CO 2 : antiproliferative, antiinflammatory, antioxidant, antimicrobial, antihypertrophic, reparative and analgesic. Carboxytherapy in psoriasis promotes tissue detoxification, improves immunity, improves tissue trophism, and eliminates venous-interstitial lymphatic stagnation due to hemodynamic, tissue, and biochemical mechanisms of action of CO 2 . Conclusions. Carboxytherapy as an additional alternative to pharmacotherapy has a synergistic effect together with formulary therapy, but at the same time reduces the dosage of approved drugs and their side effects.

Background: The management of coronary artery disease in patients with type 2 diabetes (T2DM) who need myocardial revascularization is a great challenge. Aims: To study the role of newly diagnosed T2DM in the development of in-hospital adverse outcomes after coronary artery surgery (CABG). Methods: 708 consecutive patients underwent CABG were included. All patients without history of T2DM and with border fasting hyperglycemia underwent an oral glucose tolerance test. Results: The screening allowed to diagnose T2DM in 8.9% and prediabetes in 10.4% of the study population. The the number of patients with T2DM increased from 15.2% to 24.1%, and with prediabetes from 3.0% to 13.4%. The total number of patients with carbohydrate metabolism disorders increased from 18.2% to 37.5%. The trend towards higher rate of in-hospital complications after CABG was defined among patients with newly diagnosed and previously diagnosed T2DM. The regression analysis demonstrated the presence of the relationships between the previously diagnosed T2DM and the total number of significant complications (odds ratio (OR) 1.350, 95% confidence interval (CI): 1.057–1.723, p=0.020) and prolonged in-hospital stay (OR 1.609, 95%CI 1.202–2.155, p=0.001). The significance of these relationships increased with the addition of newly diagnosed T2DM to the regression model (for in-hospital complications: OR 1.731, 95% CI 1.131–2.626, p=0.012; for prolonged in-hospital stay: OR 2.229, 95%CI 1.412–3.519, p

BACKGROUND Oral intake is dependent on the gastric ability to accommodate the food bolus. Comparatively, neonates have a smaller gastric capacity than adults and this may limit the volume of their milk intake. Yet, we previously reported that the newborn rat gastric milk volume is greatest after birth and, when normalized to body weight, decreases with postnatal age. Such age-dependent changes are not the result of intake differences, but greater gastric accommodation and reduced emptying rate. AIM Hypothesizing that breastmilk-derived adiponectin is the factor regulating gastric accommodation in neonates, we comparatively evaluated its effects on the rat fundic muscle tone at different postnatal ages. METHODS In freshly dispersed smooth muscle cells (SMC), we measured the adiponectin effect on the carbachol-induced length changes. RESULTS Adiponectin significantly reduced the carbachol-stimulated SMC shortening independently of age. In the presence of the inhibitor iberiotoxin, the adiponectin effect on SMC shortening was suppressed, suggesting that it is mediated via large-conductance Ca2+ sensitive K+ channel activation. Lastly, we comparatively measured the newborn rat gastric milk curd adiponectin content in one- and two-week-old rats and found a 50% lower value in the latter. CONCLUSION Adiponectin, a major component of breastmilk, downregulates fundic smooth muscle contraction potential, thus facilitating gastric volume accommodation. This rodent's adaptive response maximizes breastmilk intake volume after birth.

This project focuses on optimisation of energy accumulation for various types of distributed renewable energy sources. The main goal is lo prepare charging - discharging strategy depending on actual power consumption and prediction of consumption and production of utilised renewable energy sources for future period. The simulation is based on real long term data measured on photovoltaic system, wind power station and meteo station between 2004 - 2021. The data from meleo station serve as the input for the simulation and prediction of the future production while ihc data from PV system and wind Turbine are used cither as actual production or as a verification of the predicted values. Various parameters are used for trimming of the optimisation process. Influence of the charging strategy, discharging strategy, values and shape of the demand tiom the grid and prices is described on typical examples of the simulations. The main goal is lo prepare and verify the system in real conditions with real load chart and real consumption defined by the model building with integrated renewable energy sources. Ihc system can be later used in general installations on commercial or residential buildings. © 2021, European Association for the Development of Renewable Energy, Environment and Power Quality (EA4EPQ).

The article summarizes the arguments and counter-arguments within the scientific discussion on improving the HR management system in medical centers through HR policy tools. The study’s main purpose is to form proposals and focus on the prospects for the development of HR management in medical institutions. Systematization of learned treatises and approaches on the development of HR management systems showed problems in HR management’s current methods and systems. The urgency of solving this scientific problem is that the improvement of HR policy could effectively form and modernize medical organizations’ personnel management systems. The study of improving the HR management system in medical centers was carried out in the following logical sequence: considering the basics of personnel management in the private organizations; studying the methods and current trends in personnel management; analyzing the current system of HR management and personnel management on the example of medical institutions of Ukraine; developing recommendations for improving the HR policy of medical centers have been formed considering the obtained results. The methodological tools of the study were the methods of comparison, the BSC system of Kaplan and Norton, the fundamental provisions of personnel management, the calculation method and the method of data analysis, and the Gantt chart. The object of the study is the HR policy of medical institutions in Ukraine. The article presents the empirical analysis results based on the identified problems of organizing a personnel management system. The essence and features of the HR policy of medical centers were determined. In the study, the authors considered the state of medical centers’ staffing and HR management methods in health care. To investigate the organizational structure and personnel in the current situation of HR management of medical centers, the analysis of personnel and financial indicators was conducted. The findings showed the deficiencies in the personnel document management and HR management system of medical centers and the reasons for staff turnover. The comparison method, Kaplan and Norton’s BSC system, Gantt chart, calculation, and data analysis allowed identifying the ways to improve the existing HR management system in organizations.