Interactivity in teaching students moderators

The new paradigm for creating a European space for higher education is a prerequisite forintroducing an interactive educational environment in accordance with the system of methods, forms andmeans of education that is in use. The application of interactive teaching methods in higher medical school fortraining health professionals improves pedagogical interaction, forms competence for communication and workin a team, and increases the chances of free personal development. In this context, we aimed to determine thesatisfaction of teachers and students with the implementation of interactive learning environment in thediscipline Health promotion. Scientific methods were used for the collecting and statistical processing of thereceived unique information: interviewing, inquiry, observation, documentary, interviewing, desk research, andanalysis of variance (ANOVA). The results demonstrated the applicability of interactivity in teaching studentsmoderators and formulated conclusions: the establishment and maintenance of an interactive educationalenvironment in higher medical school is a favorite of teachers, there is a direct correlation between innovationof professional training of future health professionals and the quality of their preventive activities in theirmedical practice as moderator

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

Ongoing COVID-19 syndrome and post-COVID-19 syndrome: Long-term symptoms and residual changes after SARS-CoV-2 infection

Recently, in the time SARS-CoV-2 pandemic, there is increasing interest among the medical community in post-COVID-19 residual symptoms including structural and functional changes in different organs and systems. The symptom characteristic and parameters of these changes in the period after illness are in the process of registration and complete clarification, and the first results were published. It becomes clear that symptoms of COVID-19 (over 30 in number) even among those with a “mild form” of the disease remain for a long time after the acute phase in a large number of patients. More data are needed on the somatic, mental and emotional characteristics of patients who have undergone COVID-19, the so-called „prolonged COVID-19 syndrome“, despite the lack of a generally accepted definition.. Knowledge of its clinical characteristic will help physicians to recognize its manifestations, and the healthcare system to prepare for its prevention and treatment

Phenotypes of COPD patients with a smoking history in Central and Eastern Europe: The POPE Study

Chronic obstructive pulmonary disease (COPD) represents a major health problem in Central and Eastern European (CEE) countries; however, there are no data regarding clinical phenotypes of these patients in this region. Participation in the Phenotypes of COPD in Central and Eastern Europe (POPE) study was offered to stable patients with COPD in a real-life setting. The primary aim of this study was to assess the prevalence of phenotypes according to predefined criteria. Secondary aims included analysis of differences in symptom load, comorbidities and pharmacological treatment. 3362 patients with COPD were recruited in 10 CEE countries. 63% of the population were nonexacerbators, 20.4% frequent exacerbators with chronic bronchitis, 9.5% frequent exacerbators without chronic bronchitis and 6.9% were classified as asthma - COPD overlap. Differences in the distribution of phenotypes between countries were observed, with the highest heterogeneity observed in the nonexacerbator cohort and the lowest heterogeneity observed in the asthma - COPD cohort. There were statistically significant differences in symptom load, lung function, comorbidities and treatment between these phenotypes. The majority of patients with stable COPD in CEE are nonexacerbators; however, there are distinct differences in surrogates of disease severity and therapy between predefined COPD phenotypes. Copyright ©ERS 2017

Inhaled therapies in patients with moderate COPD in clinical practice: current thinking

COPD is a complex, heterogeneous condition. Even in the early clinical stages, COPD carries a significant burden, with breathlessness frequently leading to a reduction in exercise capacity and changes that correlate with long-term patient outcomes and mortality. Implementation of an effective management strategy is required to reduce symptoms, preserve lung function, quality of life, and exercise capacity, and prevent exacerbations. However, current clinical practice frequently differs from published guidelines on the management of COPD. This review focuses on the current scientific evidence and expert opinion on the management of moderate COPD: the symptoms arising from moderate airflow obstruction and the burden these symptoms impose, how physical activity can improve disease outcomes, the benefits of dual bronchodilation in COPD, and the limited evidence for the benefits of inhaled corticosteroids in this disease. We emphasize the importance of maximizing bronchodilation in COPD with inhaled dual-bronchodilator treatment, enhancing patient-related outcomes, and enabling the withdrawal of inhaled corticosteroids in COPD in well-defined patient groups

New improved algorithm for sky calibration of L-Band radiometers JÜLBARA and ELBARA II

We propose a new algorithm for sky calibration of the L-band radiometers JULBARA and ELBARA II, introducing the effective transmissivities of the instruments. The suggested approach was tested using experimental data obtained at the Selhausen test site, Germany. It was shown that for JULBARA the effective transmissivities depend strongly on the air temperature and decrease with increasing air temperature, while for ELBARA II such strong dependence was not observed. It was also shown that the effective transmissivities account for the antenna and feed cable loss effects, and for the variations of the radiometer gain due to air temperature changes. The new calibration algorithm reduces significantly the bias of brightness temperature estimates for both radiometers, especially for JULBARA