Эскалация этнополитических конфликтов: рациональный расчет элит и эмоциональная реакция масс

The authors of the article have tasked themselves with demonstrating that ethnopolitical conflicts always have a significant emotional component, which lies in cultural stereotypes, unmet (imaginary and real) expectations, historical grievances, parties’ mythologized ideas about each other, etc. In turn, the rejection of any dissent by the conflict parties determines a dualistic view of the world, which demonstrates the division into absolute good and absolute evil, and leads to a tough confrontation between the carriers of the “highest truth” with those who prevent its implementation. The authors emphasize that it is due to this excessive emotional component actualized by the demands of ethnic identity that ethnopolitical conflicts are characterized by a high degree of irrationality, expressed in a huge potential for aggressiveness and hostility, far beyond the rational awareness of the interests of the conflict parties, and the choice of a strategy for interaction and search for a compromise. A particularly rapid escalation of conflict occurs when an ethnic group tends to perceive itself as a “victim” of value claims on the part of “alien” groups. However, the authors believe that it is impossible to reduce the ethnopolitical conflict solely to the affective behavior of its participants. Longterm use of violence is a social process; therefore, it cannot be based only on strong emotions, but, on the contrary, has to presuppose the development of certain norms, sanctions, roles, etc. That is, violence must be rationalized, explained and channeled. Therefore, the authors emphasize the crucial role of “ethnic entrepreneurs” in the escalation of ethnopolitical conflicts. Their activity can be viewed as a “production of ideological conflicts”, i.e., as a deliberate indoctrination of ordinary conflict participants in order to strengthen ethnic solidarity and/or armed struggle as a means of “national liberation” and achievement of other goals that are significant to ethnic entrepreneurs. Consequently, since emotions cannot be completely separated from rational thinking, the nature of most ethnopolitical conflicts depends both on subjective factors and on objective structural elements. Thus, all of them, combining rational and emotional activities, in one proportion or another, produce three types of conflicts: the struggle for resources, the clash of interests, the emotional upholding of ethnocultural identity

Biochemical monitoring in sports: focal points for improvement

Literature data analysis along with decades of experience in sports medicine (biochemistry of sports included) enabled us to classify and explain key points that would be appropriate to consider when conducting biochemical research in sports, but in doing so we believe that the relevant research studies make just a part of a comprehensive medical and pedagogical monitoring

Overcoming stability problems in microwave-assisted heterogeneous catalytic processes affected by catalyst coking

Microwave-assisted heterogeneous catalysis (MHC) is gaining attention due to its exciting prospects related to selective catalyst heating, enhanced energy-efficiency, and partial inhibition of detrimental side gas-phase reactions. The induced temperature difference between the catalyst and the comparatively colder surrounding reactive atmosphere is pointed as the main factor of the process selectivity enhancement towards the products of interest in a number of hydrocarbon conversion processes. However, MHC is traditionally restricted to catalytic reactions in the absence of catalyst coking. As excellent MW-susceptors, carbon deposits represent an enormous drawback of the MHC technology, being main responsible of long-term process malfunctions. This work addresses the potentials and limitations of MHC for such processes affected by coking (MHCC). It also intends to evaluate the use of different catalyst and reactor configurations to overcome heating stability problems derived from the undesired coke deposits. The concept of long-term MHCC operation has been experimentally tested/applied to for the methane non-oxidative coupling reaction at 700¿C on Mo/ZSM-5@SiC structured catalysts. Preliminary process scalability tests suggest that a 6-fold power input increases the processing of methane flow by 150 times under the same controlled temperature and spatial velocity conditions. This finding paves the way for the implementation of high-capacity MHCC processes at up-scaled facilities

Methods of physical rehabilitation of elderly people for the prevention and treatment of sarcopenia

The aim of the review is to analyze the prevalence of sarcopenia in the elderly age group, the causes of its occurrence, and to present modern methods of prevention and physical rehabilitation. The study focuses on the relationship between exercise, training effects and physiological mechanisms, as well as the safety of various types of strength, anaerobic and multimodal training, which have a positive impact during the prevention and rehabilitation treatment of sarcopenia. Literature reviews, meta-analyses, and original studies are included that focus on older people in all settings, using validated assessment tools and methods. A literature search was conducted in four electronic databases – PubMed, Cochrane Library, Scopus, Springer, for the period from 2012 to June 30, 2022. There were no restrictions on the language bias of the publication. Search strategy. The keywords used to define the terms of participation in the review are “older/advanced age”, “sarcopenia” and “sarcopenic obesity”. Articles were included if they met the following criteria – cohorts with mean or median age ≥ 60 years and any of the following definitions of sarcopenia: European Working Group on Sarcopenia in the Elderly (EWGSOP), Asian Working Group on Sarcopenia (AWGS), International Working Group on Sarcopenia (IWGS). To ensure comparability of interventions, the review included studies that were conducted for at least 8 weeks, and the distribution of patients by study design was randomized. Also, articles involving hospitalized patients are excluded

Enchanced preoperative rehabilitation as part of the complex perioperative rehabilitation of patients with super-obesity and obstructive sleep apnea syndrome (clinical outlook)

Obesity is a global social and economic problem. The bariatric surgery is a most effective treatment for obesity. The presented clinical case demonstrates the usage of principles of enchanced perioperative rehabilitation for the preoperative preparation of a patient with super obesity and with severe obstructive sleep apnea and alveolar hypoventilation syndrome.A 54-year-old patient was hospitalized with complaints of obesity, impossibility of persistent weight loss conservatively, severe daytime sleepiness, frequent nocturnal awakenings (up to 8 times per night). The patient’s weight was 230 kg with a height of 157 cm (BMI 93.5 kg / m2). The examination revealed a syndrome of sleep apnea of mixed genesis of extremely severe degree, chronic night hypoxemia of an extremely severe degree. Preoperative preparation was performed in accordance with the program of enchanced perioperative rehabilitation. The duration of preoperative preparation was 19 days; weight loss — 40 kg (%WL -17,4), compensation of comorbidities was achieved as well. After that the patient underwent a laparoscopic sleeve gastrectomy. There were no complications in the postoperative period. Length of postoperative hospital stay was 6 days. At follow-up examination one year after surgery, body weight dropped from 230 to 153 kg (% WL-33.5), a significant improvement of the quality of life was achieved.The enchanced perioperative rehabilitation program can be successfully used as an effective method for preoperartive preparation of the patients with morbid obesity in combination with severe obstructive sleep apnea syndrome.and obesity hypoventilation. It can be a reasonable alternative to the standard program with preoperative intragastric balloon treatment. The use of this technique allows to increase the effectiveness of treatment of these high-risk patients, as well as to reduce the risk of perioperative complications

Влияние полноты реализации программы ускоренного выздоровления пациентов, перенесших резекцию ободочной кишки по поводу рака, на эффективность лечения

Objective: to assess ERP implementation results in patients with colon cancer and to reveal correlation between compliance of ERP protocol and efficacy of perioperative care.Materials and methods. 124 patients were included in the study. Main group consisted of 62 patients with ERP, others were controls. ERP compliance was assessed using original formula which considers number of accomplished elements of the Protocol and quality of performance of each element.Results. No significant difference between the groups in morbidity was obtained (1.6 % in main group vs 9.8 % controls; р = 0.06). Minor dependence in self-care was obtained in 90.5 % at third post-op day in main group vs 58.0 % in controls (p < 0.0001). Postoperative hospital stay was lower in main group (4.7 ± 0.1 vs 9.0 ± 0.6 days; p < 0.0001). Total hospital stay was lower in main group as well (7.2 ± 0.1 vs 14.1 ± 0.7 days; р < 0.0001). No mortality and readmissions occurred. ERP compliance rate was 80.0 % (56.9–93.3 %). Рostoperative hospital stay in patients with high protocol compliance (≥ 80 %) was significantly shorter then in patients with low protocol compliance (< 80 %): 4.3 ± 0.2 vs 5.1 ± 0.2; р = 0,005).Conclusion. ERP is effective and safe method of postoperative care in patients after colon resection and the effectiveness of the treatment correlates with protocol compliance rate resulted in shorter hospital stay.Целью работы стала оценка непосредственных результатов применения программы ускоренного выздоровления (ПУВ) пациентов, подвергшихся операциям на ободочной кишке, и изучение влияния полноты ее реализации на эффективность лечения.Материалы и методы. В исследование включены 124 пациента. Первую (основную) группу составили 63 больных, в отношении которых которых была применена ПУВ. Пациенты 2-й (контрольной) группы (n = 61) получали стандартное лечение. Для подсчета процента реализации ПУВ нами разработана формула, учитывающая не только количественную реализацию элементов программы, но и качество выполнения каждого из заявленных элементов.Результаты. Частота послеоперационных осложнений в группах и подгруппах достоверно не отличалась (1,6 % (n = 1) – в основной и 9,8 % (n = 6) – в контрольной; р = 0,056). Количество послеоперационных койко-дней ниже в основной группе и составила 4,7 ± 0,1 по сравнению с 9,0 ± 0,6 в контрольной (р < 0,0001). Достоверно ниже было и число общих койко-дней в основной группе (7,2 ± 0,1 против 14,1 ± 0,7 в контрольной (р < 0,0001)). Случаев повторной госпитализации и летальности не отмечено. Доля реализации ПУВ в нашей клинике составила от 56,9 до 93,3 %, медиана – 80 %. Число послеоперационных дней у пациентов с реализацией программы на 80 % и более был достоверно ниже, чем у пациентов с реализацией ПУВ < 80 %: 4,3 ± 0,2 против 5,1 ± 0,2, (р < 0,0001).Заключение. Предложенная ПУВ является эффективным и безопасным методом ведения пациентов, подлежащих хирургическому лечению по поводу рака ободочной кишки. Эффективность лечения, ассоциированная с укорочением сроков пребывания в стационаре, коррелирует с процентом реализации ПУВ

СУБТОТАЛЬНАЯ РЕЗЕКЦИЯ МОЧЕВОГО ПУЗЫРЯ КАК АЛЬТЕРНАТИВА ЦИСТЭКТОМИИ ПРИ ОБШИРНОМ ЕГО ВОВЛЕЧЕНИИ В ОПУХОЛЕВЫЙ ПРОЦЕСС У БОЛЬНЫХ С МЕСТНО-РАСПРОСТРАНЕННЫМ КОЛОРЕКТАЛЬНЫМ РАКОМ

The volume of an operation on the urinary bladder (UB) in case of its extensive involvement due to locally advanced colorectal can-cer varies from partial cystectomy to cystectomy. The results of a morphological examination of 18 patients after pelvic exenterationdemonstrated true invasion into the urinary bladder wall only in 7 (38.9%) cases. This created preconditions for organ-preservingtreatment. Combined operations with partial cystectomy were performed in 37 patients. Pathology showed true tumor invasion intothe urinary bladder wall in 13 (35.1%) cases. The bladder volume was 55.2±17.1 ml after surgery and 175 to 360 (230±31.2) mlfollowing autohydrotraining with pharmacological support made 3 months after surgery. No patient had recurrent urinary bladderdisease. The surgical results suggest that organ-preserving treatment does not violate the oncological radicalism principles and is aserious alternative to cystectomy: Firstly, there is no need for the technically complex stage of an operation - to create a urinaryreservoir. Secondly, urination is preserved by its natural way; there are no signs of urinary incontinence, which ensures the betterquality of life.  Субтотальная резекция мочевого пузыря как альтернатива цистэктомии при обширном его вовлечении в опухолевый процесс у больных с местно-распространенным колоректальным рако

Медицинская и экономическая эффективность различных способов ликвидации петлевой илеостомы

in the context of optimizing the financial mechanisms of the national healthcare system, introducing the single-channel financial principle and further developing the insurance-based medicine in Russia, a competent financial accounting becomes an important element of the entire healthcare system.Aim – compare the economic effectiveness of various methods of closing a loop ileostomy.Materials and methods. The study included 327 patients randomized into 3 groups. in group 1, the closure of an ileostomy was performed manually with the formation of an end-to-end ileo-ileoastomosis; in group 2, the anastomosis was formed in the ”side by side” manner; and in group 3, a semi-automated surgical technique was used for the anastomosis formation.Results. The average cost of the treatments (per patient) in groups 1 and 2 was 131,704.90 rubles. and 145,473.70 rubles, respectively, while in group 3, the cost was higher – 167,443,60 rubles (p <0,001). This cost increase in Group 3 was mainly due to the cost of a disposable stapler and cassettes.Conclusion. The formation of a manual ileoileoanastomosis of the end-to-end type was less budget-consuming in comparison with the other methods. The semi-automated procedure based on disposable parts was the most expensive method of closing a loop ileostomy.В условиях оптимизации финансирования медицинской отрасли, внедрения одноканального финансирования и системы страховой медицины в России возникает необходимость вести грамотный финансовый учет материальных затрат.Цель – сравнить экономическую эффективность различных способов ликвидации петлевой илеостомы.Материалы и методы. В исследование включено 327 пациентов, которые были рандомизированы в три группы. В группе 1 закрытие илеостомы выполнено ручным способом с формированием илео-илеоанастомоза по типу «конец-в-конец», во группе 2 наложение анастомоза осуществлялось по типу «бок-в-бок», в группе 3 использовалась аппаратная методика формирования анастомоза.Результаты. Усредненные затраты лечения на одного пациента в группах 1 и 2 составили 131704,90 руб. и 145473,70 руб. соответственно, в то время как в группе 3 стоимость была выше – 167443,60 руб. (р<0,001). Увеличение стоимости в группе 3 в основном было обусловлено стоимостью одноразового сшивающего аппарата и кассет.Выводы. Формирование ручного илео-илеоанастомоза по типу «конец-в-конец» было экономически более выгодным в сравнении с другими способами. Использование аппаратной методики оказалось самым дорогим методом ликвидации петлевой илеостомы за счет стоимости расходных материалов.

Long-Term Results of Medical and Surgical Methods for Elimination of the Internal Anal Sphincter Spasm in Chronic Anal Fissure (NCT03855046)

Aim: evaluation of long-term results of injection of botulinum toxin type A into the internal anal sphincter and performing lateral internal sphincterotomy in combination with excision of chronic anal fissure.Materials and methods. The study included 176 patients (73 (41.5 %) men and 103 (58.5 %) women) older than 18 years; randomization into the compared groups was carried out by random number generation in a computer program. Patients, researchers and surgeons were not blinded. Patients of the main group underwent fissure excision in combination with relaxation of the internal anal sphincter by botulinum toxin type A (BTA) at a dosage of 40 units, patients of the control group underwent lateral internal sphincterotomy (LIS) with excision of chronic anal fissure. Long-term results of complex treatment were studied in 126 patients (54 (43 %) men and 72 (57 %) women), the median follow-up was 12.3 (12.2; 15.7) months. Statistical analysis was carried out in the program Statistica 13.3 (TIBCO Software Inc., USA).Results. In the long-term postoperative period, the indicators of mean resting anal pressure were lower in the LIS group (p = 0.04). The compared groups were comparable in terms of the level mean squeeze anal pressure (p = 0.69); however, in patients of the BTA group, the level of this indicator increased over time (p = 0.001). None of the patients of the compared groups had anal incontinence and relapse of the disease.Discussion. In the framework of the performed study, in some patients from the compared groups, spasm of the internal anal sphincter persisted throughout the observation period, and in some patients it occurred again, while no signs of relapse fissure were detected. The functional and clinical results of treatment obtained by us cast doubt on the exclusivity of the increased tone of the internal anal sphincter as the main link in the pathogenesis of chronic anal fissure in some patients and indicates the presence of other factors in combination with which the course of the disease is determined. The above facts do not exclude the possibility of recurrence of anal fissure in a more distant period of observation.Conclusion. Medical relaxation with botulinum toxin type A at a dosage of 40 units can serve as an alternative to lateral internal sphincterotomy as a method of eliminating spasm of the internal anal sphincte