Влияние взаимодействия в системе «Врач – Пациент» на состояние больных

The study focuses on the search for ways to solve the problem of improving the quality of medical care for heart disease patients; the effectiveness of patients’ treatment is determined by the science-oriented medicine achievements and the general psycho-emotional states arising in various situations of doctor-patient interaction. The aim of the study is to identify the types of doctors and their impacts on patients’ psycho-emotional states and attitudes toward the disease. The study was conducted in a number of clinical hospitals in Moscow (Russia). It involved 167 doctors and 1,248 patients with arterial hypertension, coronary heart disease, and arrhythmias, aged 43 to 82 years. The study was carried out using valid psychodiagnostic techniques. There were statistically significant differences in the characteristics of the response to the disease in heart disease patients, whose physicians established with them collaborative, caring, directive, authoritarian and alienated relationships.El estudio se centra en la búsqueda de formas de resolución el problema de mejorar la calidad de la asistencia médica a los pacientes con enfermedades cardiovasculares, cuya eficacia del tratamiento se determina por los logros de la medicina naturalmente orientada a la ciencia y la condición psique-emocional general que se produce en situaciones diversas de su interacción con el médico tratante. El observatorio del estudio es identificación de los tipos de médicos tratantes y sus efectos sobre la condición psique-emocional y la actitud hacia la enfermedad de los pacientes.  El estudio se llevó a cabo sobre la base de la serie de hospitales clínicos en Moscú (Rusia). En el estudio participaron 167 médicos y 1248 pacientes con hipertensión arterial, enfermedad isquémica coronaria y arritmias, de 43 a 82 años. El estudio se realizó con la ayuda de técnicas psiquediagnósticas validas. Se han obtenido las diferencias estadísticamente fidedignas en los indicadores de la respuesta a la enfermedad en pacientes con enfermedades cardiovasculares, cuyos médicos tratantes establecen relaciones cooperativas, de tutela, directivas, autoritarias y suspendidas con ellos.Исследование ориентировано на поиск способов решения проблемы повышения качества оказания медицинской помощи пациентам с сердечно-сосудистыми заболеваниями, эффективность лечения которых определяется как достижениями естественно-научно ориентированной медицины, так и общим психоэмоциональным состоянием, возникающим в различных ситуациях его взаимодействия с лечащим врачом. Цель исследования – выявление типов лечащих врачей и их влияния на психоэмоциональное состояние и отношение к болезни пациентов.  Исследование проводилось на базе ряда клинических больниц г. Москвы (Россия). В исследовании приняли участие 167 врачей и 1248 пациентов с артериальной гипертонией, ишемической болезнью сердца и аритмиями, в возрасте от 43 до 82 лет. Исследование осуществлялось с помощью валидных психодиагностических методик. Были получены статистически достоверны различия в показателях особенностей реагирования на болезнь у пациентов с сердечно-сосудистыми заболеваниями, лечащие врачи которых устанавливают с ними сотруднические, опекающие, директивные, авторитарные и отстраненные отношения

Studying the Effectiveness of Teacher Training in Organization of Open Education

The modern concept of open education modifies the traditional learning format through advanced information and communications technology. This fact imposes special requirements for all participants in the learning process and makes it necessary to reconsider the tasks and functions of students and teachers. This is relevant, therefore, to find a way of making a gradual transition to the model of open education. Based on an experiment with introductory training, the authors perform an empirical assessment of teachers’ preparedness to organize open education and use open educational resources (OER). The effectiveness of the introductory training of teachers was checked by means of interviewing and testing respondents. The research results showed that there were significant changes in the training criteria: according to the motivational and value-based criterion, virtually all teachers displayed a positive shift in their attitude to organization of open education; in terms of the cognitive criterion, the teachers acquired thorough knowledge of open education tools; according to the operational criterion, the teachers acquired the necessary skills in developing and introducing OER. In the process of observation, we recorded a rise in the number of teachers with a sufficient (by 60.5% compared with the verification stage) and high (by 16.6%) level of preparedness. The introductory training, therefore, is a principal component in the stable system of open education

Concepts and сriteria for the classification of small and medium-sized business in Russia

Purpose: The purpose of the article is to study the concepts and criteria for classifying businesses to the category of Small and Medium-sized business according to the legislation of the Russian Federation. In the course of the study, the authors analyzed the criteria by which the subjects are identified as Small and Medium-sized enterprises and, accordingly, are entitled to receive state support. Design/Methodology/Approach: The authors' analysis is based on the literature review and statistical data analysis regarding the concept of entrepreurship and its legal background. Findings: The authors presented analytical data on business entities, citizens engaged in entrepreneurial activity, state support of entrepreneurial activity and introduced a conceptual classification benchmark. Practical implications: Authors' findings could be applied in improving the legal and economic entrepreneurial frameworks of Russia. Originality/Value: The contribution of the article is the authors' approach in classifying SMEs (Small and Medium-sized entities) and their state support as well as recommendations regarding the entrepreneurial activity and its development.peer-reviewe

Immunological aspects of vaccination in HIV-infected patients

Until recently, HIV infection does not lose its relevance. In 2022, 630 000 people died and 1.3 million people became infected with the human immunodeficiency virus (HIV). HIV-positive persons develop more infectious diseases than healthy people do; the causative agents are mainly opportunistic microorganisms. Streptococcus pneumoniae is the main causative agent of infection in the lungs in HIV-infected persons. In order to prevent the development of severe pneumococcal infections and to overcome antibiotic resistance, vaccines have been developed. There are polysaccharide (PPV) and conjugate (PCV) vaccines. According to clinical recommendations, vaccination of previously unvaccinated HIV-infected patients is carried out regardless of T-helper cell level. However, no data were found on the effect of PCV13 on immunological memory cells. The purpose of this study is to assess an effect of PCV13 vaccination on the immune system in HIV-infected subjects. Materials and methods. The study included 200 patients with HIV infection, which were divided into two groups: I — received a dose of PCV13 (n = 100) and control group (n = 100). During the first visit, immunological and microbiological studies were carried out. On the second visit, a PCV13 was injected into the deltoid muscle. The third visit was made a year later, where immunological and microbiological studies were repeated. Participants were divided into 4 subgroups depending on CD4+ T cell level. The microbial study was done using a swab collected from the back of the throat. Results. During the immunological examination at visit 1, abnormalities were detected in all examined populations and immune cell subsets. At 12 months post-vaccination, the median levels of CD3+CD4+ and CD45RO+ T lymphocytes in the immunized group were higher than pre-vaccination levels compared to control group, in which the values changed insignificantly. Our data confirm the immunological effectiveness of PCV13 administration in HIV-infected patients. In patients with peripheral blood CD19+ lymphocyte deficiency, had increased microbial detection rate (p = 0.003). Conclusion. As a result, due to the high risk of pneumococcal pneumonia, HIV-infected patients should be immunized with a 13-valent pneumococcal conjugate vaccine

LINE-1 retrotransposon methylation in chorionic villi of first trimester miscarriages with aneuploidy

Purpose High frequency of aneuploidy in meiosis and cleavage stage coincides with waves of epigenetic genome reprogramming that may indicate a possible association between epigenetic mechanisms and aneuploidy occurrence. This study aimed to assess the methylation level of the long interspersed repeat element 1 (LINE-1) retrotransposon in chorionic villi of first trimester miscarriages with a normal karyotype and aneuploidy. Methods The methylation level was assessed at 19 LINE-1 promoter CpG sites in chorionic villi of 141 miscarriages with trisomy of chromosomes 2, 6, 8-10, 13-15, 16, 18, 20-22, and monosomy X using massive parallel sequencing. Results The LINE-1 methylation level was elevated statistically significant in chorionic villi of miscarriages with both trisomy (45.2 +/- 4.3%) and monosomy X (46.9 +/- 4.2%) compared with that in induced abortions (40.0 +/- 2.4%) (p < 0.00001). The LINE-1 methylation levels were specific for miscarriages with different aneuploidies and significantly increased in miscarriages with trisomies 8, 14, and 18 and monosomy X (p < 0.05). The LINE-1 methylation level increased with gestational age both for group of miscarriages regardless of karyotype (R = 0.21, p = 0.012) and specifically for miscarriages with trisomy 16 (R = 0.48, p = 0.007). LINE-1 methylation decreased with maternal age in miscarriages with a normal karyotype (R = - 0.31, p = 0.029) and with trisomy 21 (R = - 0.64, p = 0.024) and increased with paternal age for miscarriages with trisomy 16 (R = 0.38, p = 0.048) and monosomy X (R = 0.73, p = 0.003). Conclusion Our results indicate that the pathogenic effects of aneuploidy in human embryogenesis can be supplemented with significant epigenetic changes in the repetitive sequences

Novel Photosensitizers Trigger Rapid Death of Malignant Human Cells and Rodent Tumor Transplants via Lipid Photodamage and Membrane Permeabilization

BACKGROUND: Apoptotic cascades may frequently be impaired in tumor cells; therefore, the approaches to circumvent these obstacles emerge as important therapeutic modalities. METHODOLOGY/PRINCIPAL FINDINGS: Our novel derivatives of chlorin e(6), that is, its amide (compound 2) and boronated amide (compound 5) evoked no dark toxicity and demonstrated a significantly higher photosensitizing efficacy than chlorin e(6) against transplanted aggressive tumors such as B16 melanoma and M-1 sarcoma. Compound 5 showed superior therapeutic potency. Illumination with red light of mammalian tumor cells loaded with 0.1 µM of 5 caused rapid (within the initial minutes) necrosis as determined by propidium iodide staining. The laser confocal microscopy-assisted analysis of cell death revealed the following order of events: prior to illumination, 5 accumulated in Golgi cysternae, endoplasmic reticulum and in some (but not all) lysosomes. In response to light, the reactive oxygen species burst was concomitant with the drop of mitochondrial transmembrane electric potential, the dramatic changes of mitochondrial shape and the loss of integrity of mitochondria and lysosomes. Within 3-4 min post illumination, the plasma membrane became permeable for propidium iodide. Compounds 2 and 5 were one order of magnitude more potent than chlorin e(6) in photodamage of artificial liposomes monitored in a dye release assay. The latter effect depended on the content of non-saturated lipids; in liposomes consisting of saturated lipids no photodamage was detectable. The increased therapeutic efficacy of 5 compared with 2 was attributed to a striking difference in the ability of these photosensitizers to permeate through hydrophobic membrane interior as evidenced by measurements of voltage jump-induced relaxation of transmembrane current on planar lipid bilayers. CONCLUSIONS/SIGNIFICANCE: The multimembrane photodestruction and cell necrosis induced by photoactivation of 2 and 5 are directly associated with membrane permeabilization caused by lipid photodamage

Genomic Dissection of Bipolar Disorder and Schizophrenia, Including 28 Subphenotypes

publisher: Elsevier articletitle: Genomic Dissection of Bipolar Disorder and Schizophrenia, Including 28 Subphenotypes journaltitle: Cell articlelink: https://doi.org/10.1016/j.cell.2018.05.046 content_type: article copyright: © 2018 Elsevier Inc

http://archaeologie.pro/en/archive/8/141/

The article summarizes primary results of technological analysis of textile fragments (45 items) from the Mari 9th-10th-century burials located at the Rusenikha and Nizhnyaja Strelka burial ground sites in the Vetluga-Vyatka interfluve area. Six textile groups have been singled out: 1) woolen fabric of plain weave; 2) woolen fabrics of twill weave; 3) plain weave cloths from plant fibers; 4) silk fabrics; 5) cords and cord tassels from woolen yarn; 6) fragments of felt. They are remains of garments, mats and fabrics used for wrapping funerary gifts. An attempt to reconstruct the cut of individual parts of the garments has been made by the authors