A Sharp Turn toward the Market: Economic Reform in Russia (1992–1998) and Its Consequences

By analyzing and systematizing the literature accumulated over the past twenty years on the history of reforms, we can put in order the existing views on the processes that took place during these transformations and de ne a new vector in understanding the socio-economic development of Russia in the last decade of the 20th century and the rst decades of the 21st century. The rst step in this direction is the analysis of publications that re ect the preparation, progress and results of the contemporary economic reforms in the 1990s. The historiographic review includes the monographs written both by the advocates of the shock therapy, and their opponents and critics, rst of all, Members of the Russian Academy of Sciences. The study of this literature allows to reveal the spectrum of opinions on whether the shock therapy was the preferred version of transformations, on assessing the results of reforms by the end of the 1990s and the opportunities for alternative ways to make the transition from a planned to a market economy. In particular, the advocates of the «shock therapy» refer to the threat of famine and civil war to justify decisions that led to decline in output, hyperin ation and other negative trends. Their critics point out that the lack of public support caused the market reforms to fail. By acknowledging the obvious, i. e. a signi cant deterioration of economic indicators, the advocates see their success in establishing the system of market institutions, and, on this basis, insist there was no alternative to implemented version of reforms. In turn, their opponents believe that the alternatives to the «shock therapy» existed, and their distinctive feature would have been the gradual cultivation and not the forced administrative introduction of market economy institutions.This article has been prepared with the support in the form of a Grant No. 16–02–00016a from the Russian Foundation for Humanities

Clinical features of sporadic multigland parathyroid disease

Background. Sporadic multigland parathyroid disease (MGD) account for 1/4 of all cases of primary hyperparathyroidism (PHPT). There are no specific signs of MGD in comparison with single-gland parathyroid disease in PHPT. The only radical treatment is surgical, therefore, determining the number of excessively functioning parathyroid glands at the preoperative stage is important for choosing the extent of the operation and the success of the treatment in general.The aim. To identify the specific signs of multigland parathyroid disease in patients who underwent surgery for primary hyperparathyroidism. Methods. We conducted a single-center prospective study including 126 cases of surgical treatment of PHPT from December 2019 to June 2021. The study included an analysis of demographic, clinical, laboratory parameters and visual methods of topical diagnosis of parathyroid glands (ultrasound, scintigraphy, multislice computed tomography). The main endpoint of the study was the identification of characteristic signs of MGD in patients with PHPT.Results. Lower values of creatinine (p ≤ 0.01; Mann – Whitney U-test), albuminadjusted calcium (p ≤ 0.05; Mann – Whitney U-test), parathyroid hormone (p ≤ 0.01; Mann – Whitney U-test), glomerular filtration rate (p ≤ 0.01; Mann – Whitney U-test) and inconsistency of two methods of preoperative imaging (p ≤ 0.01; χ2) were set as specific signs of multigland compared with single-gland parathyroid disease. Conclusion. The results of preoperative biochemical and imaging studies can become the basis for differentiating single-gland and multigland parathyroid disease in primary hyperparathyroidism

Quality of life of patients with singleand multigland parathyroid disease in sporadic primary hyperparathyroidism before and after surgical treatment

Background. In 15–25 % of cases, the cause of primary hyperparathyroidism (PHPT) is multigland parathyroid disease. The complexity of clinical and laboratory prognosis, low efficiency of imaging methods, inaccurate assessment of the radicality of the surgery are the components of the problem of this variant of the disease. Quality of life (QOL) is an important criterion for the effectiveness of surgical treatment. A study of the QOL in patients with multigland parathyroid disease in PHPT has not been previously conducted in our country. The aim of the study. To assess the quality of life of patients with single- and multigland parathyroid disease in sporadic primary hyperparathyroidism before and after parathyroidectomy (PTE). Methods. As part of a prospective observational study, the quality of life of 64 patients with PHPT before and after PTE was assessed using SF-36 (Short Form 36) questionnaire: main group (n  =  13) – patients with multigland parathyroid disease; comparison group (n = 51) – patients with single-gland parathyroid disease. The quality of life indicators of the patients were compared with those in a sample of the Irkutsk region population similar in gender and age. Results. Before performing PTE, the quality of life of patients with PHPT was lower than that of the Irkutsk region population. The greatest decrease in both health components was registered in the main group. In 90 % of patients, the quality of life improved after PTE, while in the main group changes were established 1 year after the surgery, in the comparison group – 6 months after the surgery. Transient complications (laryngeal paresis) and disease outcomes (hypocalcemia, hypoparathyroidism) did not interfere with the improvement of quality of life in both groups. When persistence was detected, no significant improvement in QOL was established. Conclusion. The quality of life of patients with PHPT is significantly reduced. PTE improves the QOL of these patients, and only persistence of the disease does not allow this to be achieved. Therefore, surgical tactics aimed at reducing the frequency of persistence will achieve a decent quality of life in the majority of patients with multigland parathyroid disease in PHPT

Disputable Issues of Etiology and Pathogenesis of Tertiary Hyperparathyroidism

Hyperparathyroidism is a clinical and laboratory syndrome characterized by high production of the chief cells of the parathyroid hormone, a calcium-phosphorus metabolism disorder and the organ failure (kidneys, bone tissue).There are primary, secondary and tertiary hyperparathyroidism.This literature review is focused on tertiary hyperparathyroidism and includes the following sections: definition of different forms of hyperparathyroidism, the role of vitamin D in the tertiary hyperparathyroidism development, the development of tertiary hyperparathyroidism in chronic kidney disease patients, the development of tertiary hyperparathyroidism in patients after kidney transplantation, differential diagnosis various forms of hyperparathyroidism, indications for surgical tertiary hyperparathyroidism treatment in patients with kidney disease, in patients with normal kidney function.Objective. The objective of this literature review is to study the current information about this definition, pathogenesis, diagnosis and treatment of tertiary hyperparathyroidism.Methodology. The literature review was taken in English data bases MEDLINE (Pubmed), Scopus, Cochlear library, using following keywords: “secondary hyperparathyroidism pathogenesis diagnosis treatment”, “tertiary hyperparathyroidism pathogenesis diagnosis treatment”, “development of tertiary hyperparathyroidism from secondary hyperparathyroidism”, “chronic vitamin D deficiency, hyperparathyroidism”, “early stages of chronic renal failure, hyperparathyroidism”. Also, search for the same keywords was completed in Russian data base Elibrary.Discussion. Both the lack of a common understanding of this problem, and the presence of diverse and contradictory data of the etiology and pathogenesis indicate the need for further study of tertiary hyperparathyroidism

Expansion of human mesenchymal stem/stromal cells (hMSCs) in bioreactors using microcarriers: lessons learnt and what the future holds

Human mesenchymal stem/stromal cells (hMSCs) present a key therapeutic cellular intervention for use in cell and gene therapy (CGT) applications due to their immunomodulatory properties and multi-differentiation capability. Some of the indications where hMSCs have demonstrated pre-clinical or clinical efficacy to improve outcomes are cartilage repair, acute myocardial infarction, graft versus host disease, Crohn’s disease and arthritis. The current engineering challenge is to produce hMSCs at an affordable price and at a commercially-relevant scale whilst minimising process variability and manual, human operations. By employing bioreactors and microcarriers (due to the adherent nature of hMSCs), it is expected that production costs would decrease due to improved process monitoring and control leading to better consistency and process efficiency, and enabling economies of scale. This approach will result in off the shelf (allogeneic) hMSC-based products becoming more accessible and affordable. Importantly, cell quality, including potency, must be maintained during the bioreactor manufacturing process. This review aims to examine the various factors to be considered when developing a hMSC manufacturing process using microcarriers and bioreactors and their potential impact on the final product. As concluding remarks, gaps in the current literature and potential future areas of research are also discussed

An approach for integrating kerberized non web-based services with web-based identity federations

Many identity federations are designed to be used with web browsers. This paper proposes an approach for integrating non web-based applications with web-based identity federations using Kerberos protocol. We evaluate this approach by making NFS server available for users of SAML-based identity federation of Baden-Württemberg state of Germany. We make use of LDAP-Facade software for federating non web-based services. We have modified the web-interface component of LDAP-Facade to enable the registration with kerberized services. Our approach can be used without modifications on the client side. Copyright © 2015 SCITEPRESS - Science and Technology Publications. All rights reserved

Forming of tee parts by a process that combines diffusion welding and pneumothermal forming in the superplastic regime

An alternative method is described for making tees. The article discusses the main stages in the advanced method, which combines diffusion welding and pneumothermal forming in the superplastic regime. The process of superplastic pneumothermal forming is modeled and calculated results are reported. In the method, pneumothermal forming is preceded by diffusion welding. © 2013 Springer Science+Business Media New York

Morphological criteria for sporadic multiple parathyroid gland disease

Background. There are no specific morphological signs for sporadic multiglandular disease (MGD) in primary hyperparathyroidism (PHPT). The aim of the study. To study the structure of the morphological substrate of primary, secondary and tertiary hyperparathyroidism and to assess the effectiveness of morphological criteria in the diagnosis of sporadic multiglandular disease in primary hyperparathyroidism. Methods. The study included 69  patients; 18  patients with PHPT and sporadic multiglandular disease (npreparation  =  31) formed the main group, 51  patients (npreparations  =  104) – the comparison group. The comparison group was divided into 3 subgroups: 1) patients with PHPT and solitary parathyroid gland (PTG) lesions – 26 patients (npreparations = 26); 2) patients with secondary hyperparathyroidism (SHPT) – 15 patients (npreparations = 48); 3) patients with tertiary hyperparathyroidism (TGPT) – 10 patients (npreparations = 30). Results. The morphological structure of the comparison groups is homogeneous: group  1 is represented by parathyroid adenoma (26  (100  %)), groups  2 and  3 – by hyperplasia (48 (100 %) and 30 (100 %), respectively). Most of the PTG specimens of the main group are represented by hyperplasia (25 (80 %)), and in 1/5 cases – by adenomas (6 (19.4 %)). Sporadic multiglandular disease in PHPT was characterized by a predominant frequency of detecting the absence of a capsule and a rim of unchanged tissue, as well as the presence of adipocytes (pχ2 < 0.01). Components of the  PTG morphological structure make it possible to identify changes specific to  the  sporadic multiglandular disease in PHPT, with a diagnostic efficiency of 76.5–90.3 %. Conclusion. Sporadic multiglandular disease in any clinical variant of hyperparathyroidism is characterized by a high prevalence of hyperplasia – 80 % in PHPT and 100  % in SHPT and  TGPT. The following morphological criteria for sporadic multiglandular disease in PHPT have been established: the presence of adipocytes in the PTG parenchyma (diagnostic efficiency (DE) – 90 %)); absence of a capsule (DE = 78 %) and a rim of unchanged gland tissue (DE = 76 %)

Multiglandular Parathyroid Disease: the Results of Surgical Treatment

Background. Sporadic multiple gland disease in primary hyperparathyroidism occurs in 7 to 33 % of cases. The absence of specific risk factors, low sensitivity of imaging methods, and low efficiency of bilateral neck exploration and intraoperative monitoring of parathyroid hormone indicate the complexity of the diagnosis and treatment of this disease’s form. Aim of the research. To analyze the results of surgical treatment of multiple lesions of the parathyroid gland in primary and secondary hyperparathyroidism. Methods. There was retrospective study, which included 100 observations of surgical treatment for primary and secondary hyperparathyroidism in the thoracic department of Irkutsk Regional Clinical Hospital from May 2018 to September 2019. The main point was to identify the frequency of surgical treatment outcomes in patients with multiple parathyroid lesions. As part of the study, potential predictors of multiple gland disease in primary hyperparathyroidism were analyzed. Results. Multiple gland disease in primary hyperparathyroidism occurs in 29 % of cases and causes persistence of the disease (p ≤ 0.01). Signs of multiple gland disease in primary hyperparathyroidism include the level of ionized calcium, parathyroid hormone (p ≤ 0.05), creatinine level and glomerular filtration rate (p ≤ 0.01). A negative result of intraoperative monitoring correlates with persistence of primary hyperparathyroidism in multiple lesions (χ2, p ≤ 0.05). Selective parathyroidectomy is associated with persistence of hyperparathyroidism in multiple lesions (χ2, p ≤ 0.05), while total parathyroidectomy is associated with remission of the disease (χ2, p ≤ 0.05). We did not find a statistically significant relationship between the results of surgical treatment for morphology of the parathyroid glands (χ2, p > 0.1). Conclusion. Multiple gland disease is the main cause of persistence of primary hyperparathyroidism. This form of the disease corresponds to lower levels of calcium, parathyroid hormone, and kidney function. Persistence factors have been established: removal of less than four parathyroid glands and a negative result of intraoperative monitoring of parathyroid hormone. Bilateral neck exploration does not reduce the incidence of disease persistence

Integration of international students into medical university educational environment: students and medical teachers surveys

This study analyzed the perception of the current process of integration of foreigners in the educational process of the Russian university (UGMU), also analyzed the perception of integration in the following 3 groups: foreign students, teachers, Russian-speaking students. The problems encountered by all groups of respondents in the integration process were identified, and the relationship between these problems was determined