Covalent Binding Antibodies Suppress Advanced Glycation: On the Innate Tier of Adaptive Immunity

Non-enzymatic protein glycation is a source of metabolic stress that contributes to cytotoxicity and tissue damage. Hyperglycemia has been linked to elevation of advanced glycation endproducts, which mediate much of the vascular pathology leading to diabetic complications. Enhanced glycation of immunoglobulins and their accelerated vascular clearance is proposed as a natural mechanism to intercept alternative advanced glycation endproducts, thereby mitigating microvascular disease. We reported that antibodies against the glycoprotein KLH have elevated reactivity for glycopeptides from diabetic serum. These reactions are mediated by covalent binding between antibody light chains and carbonyl groups of glycated peptides. Diabetic animals that were immunized to induce reactive antibodies had attenuated diabetic nephropathy, which correlated with reduced levels of circulating and kidney-bound glycation products. Molecular analysis of antibody glycation revealed the preferential modification of light chains bearing germline-encoded lambda V regions. We previously noted that antibody fragments carrying V regions in the germline configuration are selected from a human Fv library by covalent binding to a reactive organophosphorus ester. These Fv fragments were specifically modified at light chain V region residues, which map to the combining site at the interface between light and heavy chains. These findings suggest that covalent binding is an innate property of antibodies, which may be encoded in the genome for specific physiological purposes. This hypothesis is discussed in context with current knowledge of the natural antibodies that recognize altered self molecules and the catalytic autoantibodies found in autoimmune disease

Functions of Ironical Mode in the Russian Travelogue

The research is performed within the linguistic stylistic approach which allows to determine the pragmatic foundation as existence of the ironic mode. The article is devoted to consideration of travelogue as a special type of text and to the evidence that irony is one of the universal features of travelogue as a text, which helps to define the borders between "own" and "other" and is aimed at perception of these borders. The material for analysis includes the texts of the 19 th and 20 th centuries, which vividly express the author's ironic attitude towards the reality. The functions of ironic mode in the Russian travelogue are revealed. The dominating role of the educating function is demonstrated. It is determined that ironic mode is characterized by polyfunctionality – simultaneous actualization of several functions, including: motivational (the motivation of readers to follow the author's travel as well as accept his ideas), expressive and contact-setting (as combination of contact initiation and harmonization of communication), aesthetic (making an object of description artistic and sensitive) functions. The research might continue with studying the ironic mode in travelogue of different times in a comparative aspect as well as analyzing the ironic mode within the peculiarities of the author's individual style

Outpatient management of patients with peripheral artery disease by cardiologists or surgeons: influence on the prognosis and prevalence of surgical interventions

Highlights. The study shows for the first time that during the three-year follow-up of patients with diseases of the arteries of the lower extremities in the observation groups of a general surgeon and a cardiologist, adverse events (myocardial infarction, stroke, amputation, disability) and deaths occurred more often in a surgeon than a cardiologist. The study proves the correctness and real benefit of such an approach with the involvement of a cardiologist to the outpatient stage of management of a complex cohort of patients with atherosclerosis of the vessels of the lower extremities.Aim. To study the effect the outpatient observation of patients with peripheral arteries disease (PAD) by cardiologists and surgeons has on timing and prevalence of reconstructive surgery and the prognosis of patients. Methods We analyzed the data on 585 PAD patients who underwent outpatient observation from 2010 to 2017, dividing them into 2 groups. The first group (131 patients) managed by an surgeon; the second (454 patients) managed by a cardiologist. Since the groups were not comparable in terms of the initial parameters, the comparability of patients in the groups (observation by a surgeon or by a cardiologist) was achieved using pseudorandomization. The follow-up period was three years; we assessed the incidence of deaths, adverse events, and the prevalence of reconstructive operations.Results. During a three-year follow-up the 1st group, compared with the 2nd, had more deaths in general (p<0.001), death from cardiac causes (p = 0.045), from stroke (p><0.001), as well as the total number of adverse events (p><0.001) and disability (p = 0.065). Indications for reconstructive surgery on the lower extremities arteries (LEA), and operations frequency were comparatible in groups. Amputation history, taking diuretics, presence of rhythm disturbances, and management by a surgeon increased the risk of adverse outcomes. Management by a cardiologist, reconstructive LEA surgeries, female sex improved the prognosis of patients. Conclusion Observation of PAD patients by a cardiologist contributes to a higher frequency of optimal drug therapy by patients and can reduce the number of adverse events in patients and improve their survival without affecting the timing and frequency of reconstructive LEA surgeries. Keywords Peripheral atherosclerosis • Outpatient follow-up • Optimal drug therapy • Reconstructive surgery>˂ 0.001), death from cardiac causes (p = 0.045), from stroke (p˂ 0.001), as well as the total number of adverse events (p˂ 0.001) and disability (p = 0.065). Indications for reconstructive surgery on the lower extremities arteries (LEA), and operations frequency were comparatible in groups. Amputation history, taking diuretics, presence of rhythm disturbances, and management by a surgeon increased the risk of adverse outcomes. Management by a cardiologist, reconstructive LEA surgeries, female sex improved the prognosis of patients.Conclusion. Observation of PAD patients by a cardiologist contributes to a higher frequency of optimal drug therapy by patients and can reduce the number of adverse events in patients and improve their survival without affecting the timing and frequency of reconstructive LEA surgeries.Highlights. The study shows for the first time that during the three-year follow-up of patients with diseases of the arteries of the lower extremities in the observation groups of a general surgeon and a cardiologist, adverse events (myocardial infarction, stroke, amputation, disability) and deaths occurred more often in a surgeon than a cardiologist. The study proves the correctness and real benefit of such an approach with the involvement of a cardiologist to the outpatient stage of management of a complex cohort of patients with atherosclerosis of the vessels of the lower extremities.Aim. To study the effect the outpatient observation of patients with peripheral arteries disease (PAD) by cardiologists and surgeons has on timing and prevalence of reconstructive surgery and the prognosis of patients. Methods We analyzed the data on 585 PAD patients who underwent outpatient observation from 2010 to 2017, dividing them into 2 groups. The first group (131 patients) managed by an surgeon; the second (454 patients) managed by a cardiologist. Since the groups were not comparable in terms of the initial parameters, the comparability of patients in the groups (observation by a surgeon or by a cardiologist) was achieved using pseudorandomization. The follow-up period was three years; we assessed the incidence of deaths, adverse events, and the prevalence of reconstructive operations.Results. During a three-year follow-up the 1st group, compared with the 2nd, had more deaths in general (p<0.001), death from cardiac causes (p = 0.045), from stroke (p><0.001), as well as the total number of adverse events (p><0.001) and disability (p = 0.065). Indications for reconstructive surgery on the lower extremities arteries (LEA), and operations frequency were comparatible in groups. Amputation history, taking diuretics, presence of rhythm disturbances, and management by a surgeon increased the risk of adverse outcomes. Management by a cardiologist, reconstructive LEA surgeries, female sex improved the prognosis of patients. Conclusion Observation of PAD patients by a cardiologist contributes to a higher frequency of optimal drug therapy by patients and can reduce the number of adverse events in patients and improve their survival without affecting the timing and frequency of reconstructive LEA surgeries. Keywords Peripheral atherosclerosis • Outpatient follow-up • Optimal drug therapy • Reconstructive surgery>˂ 0.001), death from cardiac causes (p = 0.045), from stroke (p˂ 0.001), as well as the total number of adverse events (p˂ 0.001) and disability (p = 0.065). Indications for reconstructive surgery on the lower extremities arteries (LEA), and operations frequency were comparatible in groups. Amputation history, taking diuretics, presence of rhythm disturbances, and management by a surgeon increased the risk of adverse outcomes. Management by a cardiologist, reconstructive LEA surgeries, female sex improved the prognosis of patients.Conclusion. Observation of PAD patients by a cardiologist contributes to a higher frequency of optimal drug therapy by patients and can reduce the number of adverse events in patients and improve their survival without affecting the timing and frequency of reconstructive LEA surgeries

Assessment of Pre-test and Clinical Probability in the Diagnosis of Chronic Coronary Syndrome — What's New?

In the 2019 European Society of Cardiology (ESC) guidelines, the diagnostic algorithm for chronic coronary syndrome (CCS) was significantly changed, a significant revision of the pretest probability assessment scale (PTP) was made, an assessment of the clinical probability of obstructive coronary artery disease was proposed, the recommendations on the use of diagnostic tests in various groups of patients were updated. Such a radical change in approaches to the diagnosis of CCS raised many questions that had to be answered by further studies conducted in the past two years. The review provides data on the validation of the new PTP scale and the proposed assessment of the clinical probability of obstructive coronary artery disease, taking into account risk factors and with the additional inclusion of information on the calcium index of coronary arteries. The proposals of experts on new algorithms for the choice of non-invasive / invasive examination of this category of patients were also considered. Overall, the new PTV rating scale (ECS 2019) has been validated and validated in retrospective analyzes of cohort studies. The scale for assessing the clinical likelihood of obstructive coronary artery disease makes it possible to classify 3.8-5 times more patients as a low probability of coronary artery disease compared to the assessment of PTP alone. Assessment of the post-test probability of coronary artery disease does not allow to confirm the presence of obstructive lesion and was not used. The experts proposed new modifications of the diagnostic algorithm (with a detailed assessment of the clinical probability, as well as without taking it into account), which require verification in further studies. Therefore, it is advisable to conduct prospective studies to confirm the possibility of reducing the total number of non-invasive and invasive studies in patients with suspected coronary heart disease, as well as the safety of such a decrease in diagnostic procedures

RESEARCH STUDY ON COMMUNICATIVE COMPETENCE FEATURES OF SOCIAL SPHERE SPECIALISTS

Purpose of the study: To study the ways to increase the communicative competence of social sphere specialists, aimed at the formation of professional and personal qualities, communicative skills, and development of professional interest and success. Methodology: Some theoretical and empirical research methods are used: analysis of publications in social work, normative documentation on the research issue; diagnostic methods: questioning, testing, interviews; experimental methods: ascertaining, forming, and control stages of the experiment; stating, forming and control stages of the experiment; methods of statistical processing of research results. Main Findings: The main results of the study showed that the modern practice of successful organization of social service activities requires a thoughtful approach. The head, together with the full-time psychologist, should monitor the communicative competence of the specialists working at this service and timely organize the work to overcome the manifestations of professional burnout of specialists and prevent their professional deformation. The significance of the influence of active teaching methods on interpersonal communication has allowed us to develop and test several practically effective teaching methods that increase the effectiveness of interaction with others in professional communication. Applications of this study: This study reveals the possibilities of improving the communicative competence of the specialists working at social service departments in modern conditions of systematic emotional overload when performing their professional duties. This theme is quite relevant for the activities of any service within “person to person” interaction, especially a social one, having its specifics and directed at helping a person facing a social problem. Novelty/Originality of this study: The novelty of this study is in justifying the need for organizing activities to improve the communicative competence of social service specialists using modern socio-psychological developments. In the modern practice of holding social work, this component is often overlooked, which subsequently leads to frequent conflicts among social service employees and recipients of social services, a gradual loss of interest in the work performed, and, as a result, its indifferent fulfilment

Clinical symptoms and ECG data in women with acute coronary syndrome

Background. There are many differences in chest pain symptoms between men and women in terms of location, nature, and additional symptoms. The issue of describing the differences in chest pain in men and women with acute coronary syndrome (ACS), as well as their correlation with changes in the electrocardiogram (ECG) and coronary angiography (CAG) remains relevant.Methods. The study included 588 patients of the cardiology department of the Novokuznetsk City Clinical Hospital No. 1 from 2013 to 2017 with a diagnosis of ACS. Depending on the gender, the subjects were divided into two groups: Group I – 330 men; Group II – 258 women.Results. ACS with ST elevation was more common in men (45.8 %) than in women (33.3 %; p = 0.002). There were no pathological ECG changes in women in 58.1 % of cases, in men – in 45.5 % (p < 0.001). ECG type Q/ST elevation was detected more often in men (45.8 %) than in women (33.3 %; p = 0.002). The absence of coronary artery lesions was observed in 27.9 % of men and 44.2 % of women (p < 0.001). Hemodynamically significant coronary artery stenosis was more common in men (57.6 %) than in women (38.7 %; p < 0.001). In a typical angina clinic, hemodynamically significant coronary artery disease in patients with Q/without ST elevation ACS was detected in 40.2 % of men and in 58.5 % of women (p = 0.002). In the atypical angina clinic, hemodynamically significant lesions of coronary artery were more common in men (40.6 %) than in women (34.1 %; p = 0.02).Conclusion. In women atypical chest pains and intact coronary arteries were detected more often than in men, and hemodynamically significant coronary artery stenosis were found less often than in men. In men, a more pronounced pathology of the coronary arteries in ACS was revealed, in women – great difficulties in diagnosing ACS

Master Education and Academic Career Track in Russia

The master’s degree is an obligatory stage for those who are planning to enter PhD. That is why it should have a clear academic track. Embedding the master’s degree in the academic track allows universities to sum up their efforts to support young scientists. There is an urgent need to support scientific centers in Russian universities. When the universities are competing for academic leadership, academic tracks become the ground for the development strategies.Previous researches showed that most students were ready to choose an academic track when they were master’s students. Thus, the academic track starts long before entering the doctoral programs. The study results reveal that master’s students do not have an opportunity to build an individual academic track within “hybrid” master’s programs. The Russian master’s degree programs shortly involve young researchers in projects, and this applies to all types of universities, including the research ones. The structure and ways of involving students in science do not differ in undergraduate and postgraduate programs. Master’s students who choose academic track do it without changing the major program. However, this trend doesn’t cover all the students. Master’s students use academic tracks to upgrade their professional skills for the further career but not at university or scientific institution

How to Attract Women in STEM and Help Them Become Successful: The Review of Practices of Overcoming Gender Stereotypes

Gender imbalance among students in STEM (Science, Technology, Engineering and Mathematics) is a worldwide problem leading to negative social and economic consequences. Despite the widespread “myth of gender equality” in Russia, this problem is also relevant for our country. The share of male students in most STEM fields in Russian universities significantly exceeds the share of female students, especially in engineering and technical fields. The article is aimed at analyzing the existing experience of combating gender stereotypes in STEM educational programs. It provides an overview of seven types of practices: 1) informing girls about gender stereotypes and their negative consequences; 2) practices aimed at developing “growth mindset”; 3) influence through “role models” and the formation of friendship networks based on interest in STEM; 4) class composition management; 5) organization of active learning; 6) emphasis on the public benefit of career in STEM; 7) creating a positive climate through working with stereotypes of male teachers and students. The article also discusses the applicability of these practices in the Russian educational context