The main reasons for the exit of entrepreneurs from business

The purpose of the article is to study the reasons for the termination of entrepreneurial activity, as well as the accumulated experience of entrepreneurs leaving their business. Research on the principles and concepts of business termination became widespread in the late twentieth and early twenty-first century. At first, only Western European and American scientists were interested in this problem. Since 2005, the geography of researchers has expanded significantly. Our analysis is based on the consideration of monographs, articles in peer-reviewed scientific journals, published working papers and research reports. The article presents the characteristics of the main reasons and ways of entrepreneurs out of business. Author proposes their classification and systematization. The results of the study can be used in scientific research of entrepreneurship. They can be used in the educational activities of higher educational institutions. The results are of interest to existing entrepreneurs, helping them to properly build business exit programs

EAEU Expands International Cooperation: Latin American Trend

Integration associations are trying to expand their composition or sphere of interaction / influence. In modern international relations, the importance of transregionalism is increasing due to strengthening interdependence of countries at the global level and the formation for a new architecture of the world economy. The Eurasian Economic Union (EAEU) is trying to integrate itself into the world economy as an independent regional economic center and increase its competitiveness. Therefore, the Eurasian Economic Union seeks to develop transregional interaction with various regions, including Latin American and the Caribbean countries that caused the increasing role of Latin America in the context of the formation for a polycentric world system. The aim of the study is to identify transregional interaction specifics between the Eurasian Economic Union and Chile, Peru, Ecuador, Cuba, and Argentina. On the basis of a comparative analysis of political and legal documents on cooperation, according to legal forms, institutional mechanisms and areas of cooperation the authors have concluded that the Eurasian Economic Union (EAEU), in contrast to the European Union, implements classical transregionalism model with Latin American countries. Wherein, the Memo- randum of understanding is the mechanism that does not create rights and obligations, within the framework of international law. The signing of such documents on cooperation between the Eurasian Economic Union and Latin American countries is the initial stage for strengthening mutual trade and economic cooperation, exchange of experience and information on regional economic integration, research and development so can be considered as element of soft power

Predictive value of apoptotic microparticles to mononuclear progenitor cells ratio in advanced chronic heart failure patients

AbstractBackgroundAcutely decompensated chronic heart failure (ADHF) is considered a life-threatening event. Despite contemporary treatment strategies of ADHF, frequent recurrent hospitalizations due to other cardiovascular reasons after discharge of patients from hospital occur. The objective of the study was to examine the prognostic value of circulating endothelial-derived apoptotic microparticles (EMPs) to mononuclear progenitor cells (MPCs) ratio for post-discharge patients with clinical stabilization after ischemic ADHF.MethodsWe consecutively enrolled 136 patients (62 male) with coronary artery disease (CAD) admitted with a primary diagnosis of ADHF. All patients gave written informed consent for participation in the study. At baseline, all enrolled patients were hemodynamically stable and they had New York Heart Association (NYHA) III/IV classes of ischemic chronic heart failure (CHF). Observation period started at discharge from the hospital and was up to 3 years. Flow cytometry analysis for quantifying the number of EMPs and angiogenic MPCs was used.ResultsCalculated EMP to MPC ratios in survivor and dead patient cohort were 8.4 (95% CI=7.6–9.2) and 78.9 (95% CI=53.0–116.6), respectively (p=0.001). MPCs, EMPs, NYHA class, N-terminal pro-brain natriuretic peptide (NT-proBNP) and increased NT-proBNP>30% within 24–84h of admission period remained statistically significant for all-cause mortality, CHF-related death, and CHF-related rehospitalization, whereas left ventricular ejection fraction and high-sensitivity C-reactive protein for all variables did not. We found that the addition of EPMs to MPCs ratio to the ABC model (NT-pro-BNP, increased NT-pro-BNP>30%) improved the relative integrated discrimination indices by 19.6% for all-cause mortality, by 21.7% for CHF-related death, and by 19.5% for CHF-related rehospitalization.ConclusionWe demonstrated that EMP to MPC ratio is considered an important indicator of an imbalance between angiogenic and apoptotic responses with possible relation to cardiovascular outcomes in post-discharge patients with clinical stabilization after ischemic ADHF

Types of hemodynamic response to orthostasis according to continuous blood pressure monitoring: a case series of heart failure with reduced ejection fraction

Heart failure (HF) is associated with unfavorable outcomes and high health care costs. Determination of the hemodynamic response to orthostasis can be an additional tool in assessing the stability and compensation of HF patients. Active orthostatic test (AOT) with blood pressure monitoring serves as a simple and available screening method. However, a complete characteristic of the hemodynamic response, especially during the first minute of orthostasis, can be obtained only with continuous blood pressure monitoring. The presented case series demonstrate the types of hemodynamic response in patients with heart failure with reduced ejection fraction in AOT with continuous blood pressure monitoring, available data on the mechanisms of its development, clinical and prognostic role, and also presents the advantages and limitations of AOT

Responsibility as a universal component of soft competencies of vocational education teachers

The article considers the need to develop specialists’ soft skills that ensure pre-adaptation to the changing requirements of the labor market. Based on the analysis of empirical research and the requirements of educational standards, a list of soft competencies of a vocational education teacher is proposed. An assumption is made about the role of responsibility in the structure of soft skills of a modern specialist. The article presents the data of a pilot study of responsibility among teachers of secondary vocational education in Ekaterinburg.Рассмотрена необходимость развития у специалистов «гибких» навыков, обеспечивающих преадаптацию к запросам изменяющегося рынка труда. На основе анализа эмпирических исследований и требований образовательных стандартов предложен перечень soft-компетенций для педагога профессионального образования. Высказано предположение о важной роли ответственности в структуре soft skills современного специалиста. Приведены результаты пилотажного исследования ответственности у педагогов среднего профессионального образования г. Екатеринбурга

Frequency of hemodynamic response to orthostatic stress in heart failure with reduced ejection fraction, associations with clinical blood pressure

Aim. To assess hemodynamic response to active standing test (AST) with beat-to-beat blood pressure (BP) monitoring, their association with office BP and symptoms of orthostatic intolerance in patients with heart failure (HF).Material and methods. Outpatient HF patients with documented  left ventricular ejection  fraction <40%, followed   up in a HF center  and receiving optimal medical therapy, underwent AST with beat-to-beat  non-invasive BP monitoring.Hemodynamic response was assessed according to the European Federation of Autonomic Societies criteria.Results. The study included 87 patients (mean age, 57±10 years; men, 76%). Normal hemodynamic response to orthostatic stress was observed  in 36 (41,4%) patients. Pathological response prevailed during the first minute of orthostatic stress — initial orthostatic hypotension (OH) (n=29, 33,3%) and delayed BP recovery (n=18, 20,7%).  Classical OH was detected  in 4 (4,6%)  patients. There was no orthostatic hypertension, defined as an increase in systolic BP (SBP) ≥20 mm Hg. According to office BP, hypotension was observed in 19 (21,8%) patients (SBP <90 mm Hg in 4 patients and 90-100 mm Hg in 15), hypertension (SBP >140 mm Hg) in 11 (12,6%) patients. Pathological response to orthostatic stress were more often observed  in office  SBP >140 mm Hg compared  to SBP ≤140 mmHg (90,9% and 53,9%, p=0,020).Orthostatic intolerance was noted in 43 (49,4%) patients and were not associated with the level of office SBP (p=0,398) or pathological responses to orthostatic stress (p=0,758 for initial OH and p=0,248  for delayed  BP recovery).Conclusion. The pathological hemodynamic response in AST with beat-to-beat BP monitoring in ambulatory patients with HF is most often represented  by initial OH and delayed BP recovery associated  with office SBP >140 mmHg. The frequency of symptoms of orthostatic intolerance did not differ between groups depending on the presence of an inadequate response to orthostatic stress

Benzene and toluene in the surface air of northern Eurasia from TROICA-12 campaign along the Trans-Siberian Railway

Volatile organic compounds (VOCs) were measured by proton transfer reaction mass spectrometry (PTR-MS) on a mobile laboratory in a transcontinental TROICA-12 (21 July–4 August 2008) campaign along the Trans-Siberian Railway from Moscow to Vladivostok. Surface concentrations of benzene (C6H6) and toluene (C7H8) along with non-methane hydrocarbons (NMHCs), CO, O3, SO2, NO, NO2 and meteorology are analyzed in this study to identify the main sources of benzene and toluene along the Trans-Siberian Railway. The most measurements in the TROICA-12 campaign were conducted under low-wind/stagnant conditions in moderately ( ∼  78 % of measurements) to weakly polluted ( ∼  20 % of measurements) air directly affected by regional anthropogenic sources adjacent to the railway. Only 2 % of measurements were identified as characteristic of highly polluted urban atmosphere. Maximum values of benzene and toluene during the campaign reached 36.5 and 45.6 ppb, respectively, which is significantly less than their short-term exposure limits (94 and 159 ppb for benzene and toluene, respectively). About 90 % of benzene and 65 % of toluene content is attributed to motor vehicle transport and 10 and 20 %, respectively, provided by the other local- and regional-scale sources. The highest average concentrations of benzene and toluene are measured in the industrial regions of the European Russia (up to 0.3 and 0.4 ppb for benzene and toluene, respectively) and south Siberia (up to 0.2 and 0.4 ppb for benzene and toluene, respectively). Total contribution of benzene and toluene to photochemical ozone production along the Trans-Siberian Railway is about 16 % compared to the most abundant organic VOC – isoprene. This contribution, however, is found to be substantially higher (up to 60–70 %) in urbanized areas along the railway, suggesting an important role of anthropogenic pollutant sources in regional ozone photochemistry and air quality

Primary Terminal Haemochromatosis in a 50 Year-Old Patient

Aim. A clinical description of end-stage hereditary haemochromatosis manifested with chronic alcohol abuse.Key points. A 50-yo patient referred with marked general weakness as a major complaint. The patient had a history of long-term alcohol consumption at toxic doses, putative cirrhosis, paroxysmal atrial fibrillation, type 2 diabetes mellitus. The patient's severity on admission was conditioned by marked hypotension. Further examination aimed at excluding occult gastrointestinal bleeding, adrenal insufficiency, decompensated heart failure. Bronze skin and icteric sclerae were positive. Blood tests revealed severe macrocytic hyperchromic anaemia, thrombocytopae-nia, hyperbilirubinaemia, hypoalbuminaemia, hypocoagulation, elevated transaminases, hyponatraemia, elevated creatinine (CKD DPI 63 mL/min), severe hyperferritinaemia. Faecal occult blood test and EGDS for bleeding were negative. Abdominal ultrasound exposed signs of liver cirrhosis and portal hypertension (ascites, splenomegaly). Echocardiographic evidence of dilated cardiomyopathy of all chambers, a reduced 24% ejection fraction at absent acute myocardial infarction. Primary haemochromatosis was suspected upon high ferritin, transferrin iron saturation and multiple organ dysfunction. Genotyping revealed the HFE 845G > A variant diagnostic of haemochromatosis type 1. Clinical diagnosis: Primary disease: haemochromatosis (homozygous variant HFE 845G > A (A/A)): liver cirrhosis, Child-Pugh class C. Portal hypertension: splenomegaly, ascites. Dilated cardiomyopathy. Diabetes mellitus. Complications: multiple organ dysfunction (SOFA 16). Liver failure: jaundice, hypoalbuminaemia, hypocoagulation. Cardiac rhythm and conduction disorder: paroxysmal atrial fibrillation. Acute cardiac failure with underlying CHF IIb, NYHA class 3. Acute renal failure (anuria) with underlying CKD stage 3 (CKD DPI 63 mL/min). Moderate macrocytic hyperchromic anaemia. Acute and chronic adrenal failure. Despite a cardiovascular and renal failure compensation therapy and albumin transfusion, the patient died. Autopsy revealed a marked organ infiltration with haemosiderin (heart, stomach, liver, pancreas, lungs, kidneys, adrenal glands).Conclusion. The case describes a classical clinical manifestation of haemochromatosis: bronze skin hyperpigmentation, liver cirrhosis, diabetes mellitus, cardiomyopathy, adrenal insufficiency. Terminal haemochromatosis, severe cardiac and renal failure decompensation precluded phlebotomy and chelation therapy. A lethal outcome was conditioned by multiple organ dysfunction with underlying massive haemosiderin deposition in most organs