Aspectos metodológicos de la evaluación de la eficiencia de la política social regional en la superación de la orfandad social

Among the methodological issues of studying the problem of social orphanhood, an important place is occupied by the search for effective markers for assessing dynamics on the one hand, and the effectiveness of social policy in overcoming social orphanhood on the other. That attempt to systematically evaluate the scale and severity of the phenomenon, as well as the key factors that determine its dynamics. However, these approaches do not allow us to identify the connection between social work and the dynamics of improving the situation with social orphanhood in the region. The presented study proposes a new model for assessing the dynamics of social orphanhood. Its difference from other methodological approaches is that the main emphasis is on assessing the orientation of the complex of shifts in the processes of identifying, placement of orphans and canceling decisions on their transfer to families. This model allows us to assess the role of social policy in overcoming social orphanhood. In this model, we developed authoring methods for ranking the regions of Russia by the dynamics of indicators integrated into the "auspiciousness" index of changes in the social orphanhood. Also, the author presents a model that assesses the situation in the region from the point of view of the "social support efficiency index" to overcome the social orphanhood. The models used to assess the dynamics of social orphanhood have been tested as a tool for identifying key markers of the efficiency of social policy.Entre las cuestiones metodológicas de estudiar el problema de la orfandad social, un lugar importante está ocupado por la búsqueda de marcadores efectivos para evaluar la dinámica, por un lado, y la efectividad de la política social para superar la orfandad social, por el otro. Ese intento de evaluar sistemáticamente la escala y la gravedad del fenómeno, así como los factores clave que determinan su dinámica. Sin embargo, estos enfoques no nos permiten identificar la conexión entre el trabajo social y la dinámica de mejorar la situación con la orfandad social en la región. El estudio presentado propone un nuevo modelo para evaluar la dinámica de la orfandad social. Su diferencia con otros enfoques metodológicos es que el énfasis principal está en evaluar la orientación del complejo de cambios en los procesos de identificación, colocación de huérfanos y cancelación de decisiones sobre su transferencia a las familias. Este modelo nos permite evaluar el papel de la política social en la superación de la orfandad social. En este modelo, desarrollamos métodos de autor para clasificar las regiones de Rusia por la dinámica de los indicadores integrados en el índice de "auspiciosidad" de los cambios en la orfandad social. Además, el autor presenta un modelo que evalúa la situación en la región desde el punto de vista del "índice de eficiencia del apoyo social" para superar la orfandad social. Los modelos utilizados para evaluar la dinámica de la orfandad social se han probado como una herramienta para identificar marcadores clave de la eficiencia de la política social

Development of Human Pancreatic Innervation

Human pancreatic innervation is of particular interest due to its possible role in the pathogenesis of such diseases as diabetes mellitus, pancreatitis and pancreatic cancer. Despite the clinical importance, data concerning pancreatic innervation during human ontogeny and in various disorders are very limited. In this chapter, we present a review on human pancreatic autonomic innervation on the basis of the literature data and our previous results. Special attention is paid to the innervation of the endocrine pancreas. Gradual branching of neural network was seen during human pancreatic development. Innervation of the foetal pancreas is more abundant than in adults. In agreement with previous observations, we have revealed a close integration and similarity between endocrine cells and nervous elements in the developing human pancreas. Moreover, simultaneous interactions between the nervous system components, epithelial cells and endocrine cells were detected in the pancreas during prenatal human development. It has been suggested that pancreatic innervation plays an important role not only in regulation of endocrine and exocrine activity but also in normal islet morphogenesis

Na,K-ATPase Acts as a Beta-Amyloid Receptor Triggering Src Kinase Activation

Beta-amyloid (Aβ) has a dual role, both as an important factor in the pathology of Alzheimer’s disease and as a regulator in brain physiology. The inhibitory effect of Aβ42 oligomers on Na,K-ATPase contributes to neuronal dysfunction in Alzheimer’s disease. Still, the physiological role of the monomeric form of Aβ42 interaction with Na,K-ATPase remains unclear. We report that Na,K-ATPase serves as a receptor for Aβ42 monomer, triggering Src kinase activation. The co-localization of Aβ42 with α1- and β1-subunits of Na,K-ATPase, and Na,K-ATPase with Src kinase in SH-SY5Y neuroblastoma cells, was observed. Treatment of cells with 100 nM Aβ42 causes Src kinase activation, but does not alter Na,K-ATPase transport activity. The interaction of Aβ42 with α1β1 Na,K-ATPase isozyme leads to activation of Src kinase associated with the enzyme. Notably, prevention of Na,K-ATPase:Src kinase interaction by a specific inhibitor pNaKtide disrupts the Aβ-induced Src kinase activation. Stimulatory effect of Aβ42 on Src kinase was lost under hypoxic conditions, which was similar to the effect of specific Na,K-ATPase ligands, the cardiotonic steroids. Our findings identify Na,K-ATPase as a Aβ42 receptor, thus opening a prospect on exploring the physiological and pathological Src kinase activation caused by Aβ42 in the nervous system

Качество диагностики идиопатического легочного фиброза врачами первичного звена Краснодарского края

The aim of the study is to assess the quality of diagnosis made by the primary care physicians of Krasnodarski krai in patients with idiopathic pulmonary fibrosis (IPF) admitted to the Pulmonology Department of our hospital for the period of 2013 – 2015. Methods. A retrospective analysis of 83 medical records (form 003-U) of patients with IPF diagnosed in our Department has been performed. Men (63.86%) over the age of 50 years (90.37%) prevailed in the study. The most frequent concomitant conditions in patients with IPF were ischemic heart disease (20.48%), hypertension (16.87%), and gastroesophageal reflux disease (15.66%). In the presence of typical clinical picture, the diagnosis of IPF was suspected by primary care physicians in 22.89% of patients. Results. It was revealed that underdiagnosis of diffuse reticular changes, honeycombing, traction bronchiectasis and overdiagnosis of bilateral infiltration of the lung tissue, bilateral small focal formations, and ground- glass opacities took place in interpreting of CT images by primary care radiologists. Conclusion. In most patients the diagnosis of IPF is established for the first time at the stage of «honeycombing», which indicates late diagnosis of the disease.Целью исследования явилась оценка качества диагностики идиопатического легочного фиброза (ИЛФ) врачами первичного звена Краснодарского края. Материал и методы. Проведен ретроспективный анализ 83 медицинских карт пациентов (форма 003-У), госпитализированных в пульмонологическое отделение Государственного бюджетного учреждения здравоохранения «Научно-исследовательский институт – краевая клиническая больница № 1 имени С.В.Очаповского» в 2013–2015 гг., с установленным в стационаре диагнозом ИЛФ. Среди больных ИЛФ преобладали лица мужского пола (63,86 %)в возрасте старше 50 лет (90,37 %). Среди сопутствующих заболеваний у больных ИЛФ наиболее часто отмечались ишемическая болезнь сердца (20,48 %), гипертоническая болезнь (16,87 %), гастроэзофагеальный рефлюкс (15,66 %). При наличии типичной клинической картины диагноз ИЛФ был заподозрен врачами первичного звена у 22,89 % пациентов. Результаты. Установлено, что при интерпретации данных компьютерной томографии врачами лучевой диагностики первичного звена имеет место гиподиагностика диффузных ретикулярных изменений, «сотового легкого», тракционных бронхоэктазов и гипердиагностика двусторонней инфильтрации легочной ткани, двусторонних мелкоочаговых образований, изменений по типу «матового стекла». Заключение. У большинства пациентов диагноз ИЛФ устанавливается впервые на стадии «сотового легкого», что свидетельствует о поздней диагностике заболевания

Barnase as a New Therapeutic Agent Triggering Apoptosis in Human Cancer Cells

RNases are currently studied as non-mutagenic alternatives to the harmful DNA-damaging anticancer drugs commonly used in clinical practice. Many mammalian RNases are not potent toxins due to the strong inhibition by ribonuclease inhibitor (RI) presented in the cytoplasm of mammalian cells.In search of new effective anticancer RNases we studied the effects of barnase, a ribonuclease from Bacillus amyloliquefaciens, on human cancer cells. We found that barnase is resistant to RI. In MTT cell viability assay, barnase was cytotoxic to human carcinoma cell lines with half-inhibitory concentrations (IC(50)) ranging from 0.2 to 13 microM and to leukemia cell lines with IC(50) values ranging from 2.4 to 82 microM. Also, we characterized the cytotoxic effects of barnase-based immunoRNase scFv 4D5-dibarnase, which consists of two barnase molecules serially fused to the single-chain variable fragment (scFv) of humanized antibody 4D5 that recognizes the extracellular domain of cancer marker HER2. The scFv 4D5-dibarnase specifically bound to HER2-positive cells and was internalized via receptor-mediated endocytosis. The intracellular localization of internalized scFv 4D5-dibarnase was determined by electronic microscopy. The cytotoxic effect of scFv 4D5-dibarnase on HER2-positive human ovarian carcinoma SKOV-3 cells (IC(50) = 1.8 nM) was three orders of magnitude greater than that of barnase alone. Both barnase and scFv 4D5-dibarnase induced apoptosis in SKOV-3 cells accompanied by internucleosomal chromatin fragmentation, membrane blebbing, the appearance of phosphatidylserine on the outer leaflet of the plasma membrane, and the activation of caspase-3.These results demonstrate that barnase is a potent toxic agent for targeting to cancer cells

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

International Approaches to the Analysis of the Phenomena of BRICS Transregionalism

The article analyzes the essence, location, status, and role of the informal BRICS grouping. The authors examine and compare the different points of view on this phenomenon and believe that the comparative and economical approaches that dominate in the contemporary studies of the BRICS are unproductive. While member countries of the Association are experiencing economic slowdown or recession, BRICS is gradually becoming a political phenomenon of the global world.BRICS is considered the center of an impact of the regional leaders on three continents. A specifi c model of communication of the member countries of the BRICS and their partners is polylogue as one of the methods to solve the problem of equitable participation of all countries of the global world in the process of global governance. In the geopolitical framework of the BRICS and their partners, it is the formation of an extra-American zone of interaction, which will gradually evolve into a Global nonWestern project.