Multivariate Analysis of Refusal Strategies in Request Situations: The Case of Russian JFL Learners

Using decision tree analysis by SPSS Classification Trees (Version 18.0), the present study investigated the rank order of significance between the five factors (i.e., power factor, distance factor, situational factor, culture/language factor, and type of refusal strategy) when predicting the choice of refusal strategies in request situations. To examine the frequency of refusal strategies, we conducted a discourse completion test in the L1 and L2 of Russian JFL students and compared them with Russian and Japanese native speakers. The findings show that there is a hierarchical order among the factors involved in realization of request refusals. The effects of cultural and language differences are very complex and deeply intertwined with the content of refusal situations and nature of specific strategies. The results were able to demonstrate in which conditions the following occurred: the influence of L2 (Japanese) onto L1 (Russian), the maintenance of Russian national identity, and the accommodation to the target language culture

Practice-oriented technologies as a means of forming students' communicative competence

One of the most important features of professional activity is the ability to build a dialogue, organize business communication. The possession of communicative competencies provides the student with the opportunity to quickly achieve their goals through the implementation of speech turnovers and constructions that comply with the principles and standards of speech etiquette, affecting the establishment and maintenance of the psychological climate in the process of interaction. The purpose of the article is to review the experience of forming communicative competencies with the help of practice-oriented technologies. Requirements for the formation of communicative competencies are reflected in regulatory documents. The competencies under consideration represent the student's ability to build productive professional interaction using various communication methods. We reveal the motivational, cognitive, and active components of communicative competencies, reflecting the desire for interpersonal communication and support for established interaction, the student's understanding of the value of communicative competencies in future professional activities, and the ability to organize effective cooperation. Practice-oriented technologies, including case studies and design, contribute to solving professional problems through group discussions and situation analysis. The study revealed the impact of practice-oriented technologies implemented in higher education institutions on the formation of students' communicative competence

Prognostic value of left ventricular global longitudinal strain and mechanical dispersion by speckle tracking echocardiography in patients with ischemic and nonischemic cardiomyopathy: a systematic review and meta-analysis

Aim. To conduct a systematic review and meta-analysis in order to evaluate the prognostic value of left ventricular global longitudinal strain (LV GLS) and LV mechanical dispersion (LVMD) in ischemic and nonischemic cardiomyopathy.Material and methods. We searched PubMed, Google Scholar and Embase for studies on the prognostic value of LV GLS and LVMD in ischemic and nonischemic cardiomyopathy. Hazard ratios (HR) from included studies were pooled for metaanalysis.Results. Twelve studies were selected from 314 publications for this systematic review and meta-analysis. In total, 2624 patients (mean age, 57,3 years; mean follow-up, 40,8 months) were included in the analysis. Meta-analysis showed that decreased LV GLS was associated with an increased risk of ventricular arrhythmias (VAs) (adjusted HR: 1,10 per 1% of GLS; 95% CI: 1,01-1,19; p=0,03) and major adverse cardiovascular events (MACE): adjusted HR: 1,22 per 1% of GLS; 95% CI: 1,11-1,33; p<0,0001). Patients with VAs had greater LVMD than those without it (weighted mean difference, 33,69 ms; 95% CI: -41,32 to -26,05; p<0,0001). Each 10 ms increment of LVMD was significantly and independently associated with VA episodes (adjusted HR: 1,18; 95% CI: 1,08-1,29; p=0,0002).Conclusions. LV GLS and LVMD assessed using speckle tracking provides important predictive value and can be used as an effective tool for stratifying risk in patients with ischemic and nonischemic cardiomyopathy

Impact of assessment of fractional flow reserve and instantaneous wave-free ratio on clinical outcomes of percutaneous coronary intervention: a systematic review, meta-analysis and meta-regression analysis

Aim. To conduct a systematic review and meta-analysis to compare clinical outcomes in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) using conventional coronary angiography (CAG) or fractional flow reserve (FFR)-guided PCI. In addition, FFR-guided PCI and PCI guided with instantaneous wave-free ratio (iFR) were compared.Material and methods. PubMed, Google Scholar databases were searched for studies comparing clinical outcomes in patients with CAD undergoing CAG-guided or FFR/iFR-guided PCI. Dichotomous data analysis was presented as odds ratio (OR) with 95% confidence interval (CI). Adjusted hazard ratio (HR) values from studies with similar evaluation criteria were pooled for meta-analysis.Results. Six randomized controlled trials (RCTs) from 184 publications were selected for this systematic review and meta-analysis. A total of 2193 patients (mean age, 64,2 years, mean follow-up, 28,0 months) were included. Analysis of RCTs showed that CAG-guided and FFR-guided PCI did not have a significant difference in the incidence of major adverse cardiovascular events (MACE) (OR: 0,78; 95% CI: 0,61-1,00; p=0,05; I2=0%), all-cause death (OR: 0,86; 95% CI: 0,51-1,44; p=0,57; I2=0%) or emergency revascularization (OR: 0,69, 95% CI: 0,46-1,04, p=0,08, I2=0%). However, FFR-guided PCI was associated with a reduced risk of subsequent MI compared with CAG-guided PCI (OR: 0,70; 95% CI: 0,50-0,99; p=0,04; I2=0%). In addition to the results of previous RCTs, we conducted a metaanalysis of 3 observational studies. In total, the CAG-guided and FFR-guided PCI groups included 165012 and 11450 patients, respectively. A meta-analysis showed that FFR-guided PCI was associated with a reduced risk of all-cause mortality (HR: 0,74; 95% CI: 0,63-0,87; P=0,0003) and MI (HR: 0,75; 95% CI: 0,61-0,94; p=0,01). In addition, there was no significant difference between iFRand FFR-guided PCI in terms of MACE (OR: 0,97; 95% CI: 0,76-1,23; p=0,81), all-cause mortality (OR: 0,66; 95% CI: 0,40-1,10; p=0,11), MI (OR: 0,83; 95% CI: 0,56-1,24; p=0,37) or emergency repeated revascularization (OR: 1,16; 95% CI: 0,85-1,58; p=0,34).Conclusion. FFR-guided PCI is associated with a reduced risk of all-cause mortality and subsequent MI compared with CAG-guided PCI. At the same time, the iFR-guided PCI is not inferior to the FFR-guided method in terms of MACE rate

Creating peritonitis in experimental conditions

The article deals to new method of modeling peritonitis in experiment. The designed model of the experiment is scalable and it allows studying reparational processes in abdominal cavity in conditions of prolonged experiment. It is easy-implementable, easy to monitor and as close as possible to typical course of peritonitis.В статье рассмотрен разработанный модернизированный метод моделирования перитонита в экспериментальных условиях. Модель эксперимента легко выпопнима и позволяет изучать процесс репарации в абдоминальной полости в условиях длительного эксперимента. Предложенная модель эксперимента позволяет упростить мониторирование лабораторных животных, при этом, максимально приближена к типичному течению перитонита

A Randomized Open Clinical Study of the Atherosclerosis Treatment Information Video Effect on Adherence to Long-Term Therapy in Patients with Cardiovascular Diseases

Aim. Study the effect of a study video, which was created by researchers and devoted to the atherosclerosis development and the effect of statin therapy on atherosclerotic plaque, on adherence to long-term therapy in patients with high or very high risk of cardiovascular complications.Material and methods. 120 patients admitted to hospital with cardiovascular diseases were included in the study. Patients were randomized into 2 groups: in the main group (n=60), the information video edited by the researchers was shown to patients on the eve of discharge, in addition to a printed brochure on lifestyle and diet modification, and in the control group (n=60), patients were given only a standard brochure. The motivating video shows the damage to the cardiovascular system by the atherosclerotic process and the beneficial effect on the body of constant intake of statins. After 1 and 3 months after discharge from the hospital, telephone calls were made, after which the patients had to visit the center for an objective examination by a researcher and control of laboratory parameters. After 1 month, 110 patients visited the center, after 3 months, 98 respondents visited the center.Results. The group with the information video demonstration noted more frequent adherence to medical recommendations compared to the control: after 1 month, 52 (96%) patients continued treatment versus 48 (86%) patients, 3 months after discharge 48 (96%) patients continued treatment versus 38 (79%) patients (p<0.05). After 1 month, 38 (70%) patients in the intervention group continued taking statins versus 29 (43%) respondents in the control group (p<0.05), 3 months after discharge, 40 (80%) patients in the intervention group continued to take statins versus 33 (69%) control patients (p<0.09).Conclusion. Demonstration of a motivating video about the effect of statins on the atherosclerosis course increases patient adherence to medicinal therapy, including adherence to statins

Differentiated treatment of patients with diffusion peritonitis requiring sanation relaparotomies

The article considers various options for the management of diffusion peritonitis, requiring sanation relaparotomies, raises problems of choosing a method of peritonitis sanation, optimization of tactics of this group of patients.В статье рассмотрены различные варианты ведения разлитого перитонита, требующие санационных релапаротомий; поднимаются проблемы выбора метода санации перитонита, оптимизации тактики ведения данной группы больных

Potential of machine learning methods in operational risk stratification in patients with coronary artery disease scheduled for coronary bypass surgery

Aim. To develop and evaluate the effectiveness of models for predicting mortality after coronary bypass surgery, obtained using machine learning analysis of preoperative data.Material and methods. As part of a cohort study, a retrospective prediction of in-hospital mortality after coronary artery bypass grafting (CABG) was performed in 2182 patients with stable coronary artery disease. Patients were divided into 2 following samples: learning (80%, n=1745) and training (20%, n=437). The initial ratio of surviving (n=2153) and deceased (n=29) patients in the total sample indicated a pronounced class imbalance, and therefore the resampling method was used in the training sample. Five machine learning (ML) algorithms were used to build predictive risk models: Logistic regression, Random Forrest, CatBoost, LightGBM, XGBoost. For each of these algorithms, cross-validation and hyperparameter search were performed on the training sample. As a result, five predictive models with the best parameters were obtained. The resulting predictive models were applied to the learning sample, after which their performance was compared in order to determine the most effective model.Results. Predictive models implemented on ensemble classifiers (CatBoost, LightGBM, XGBoost) showed better results compared to models based on logistic regression and random forest. The best quality metrics were obtained for CatBoost and LightGBM based models (Precision — 0,667, Recall — 0,333, F1-score — 0,444, ROC AUC — 0,666 for both models). There were following common high-ranking parameters for deciding on the outcome for both models: creatinine and blood glucose levels, left ventricular ejection fraction, age, critical stenosis (>70%) of carotid arteries and main lower limb arteries.Conclusion. Ensemble machine learning methods demonstrate higher predictive power compared to traditional methods such as logistic regression. The prognostic models obtained in the study for preoperative prediction of in-hospital mortality in patients referred for CABG can serve as a basis for developing systems to support medical decision-making in patients with coronary artery disease