The Problem of Institutional Corruption in the System of Higher Education

The article analyzes modern problems and trends of development of the system of higher education. The persistent expansion of regulation and uncontrolled growth of bureaucracy increase dependence of regulated areas on private interests of those who have access to the regulatory machine. This tendency has not bypassed the academic sphere, and, in many instances, there is a clear discrepancy between the proclaimed objectives and observed results. The vivid example is the Russian system of higher education, which is the main focus of the present study. We explain this phenomenon through the lens of the institutional corruption theory and argue that the observing evolution of modern academia forms a wrong system of incentives, bringing to the hands of bureaucrats excessive power, which, eventually, distorts the performance of the higher education sphere and undermines the effectiveness of this important institution

Sources of nitrous oxide and fate of mineral nitrogen in sub-Arctic permafrost peat soils

Nitrous oxide (N2O) emissions from permafrost-affected terrestrial ecosystems have received little attention, largely because they have been thought to be negligible. Recent studies, however, have shown that there are habitats in the subarctic tundra emitting N2O at high rates, such as bare peat (BP) surfaces on permafrost peatlands. Nevertheless, the processes behind N2O production in these high-emission habitats are poorly understood. In this study, we established an in situ 15N-labeling experiment with two main objectives: (1) to partition the microbial sources of N2O emitted from BP surfaces on permafrost peatlands and (2) to study the fate of ammonium and nitrate in these soils and in adjacent vegetated peat (VP) surfaces showing low N2O emissions. Our results confirm the hypothesis that denitrification is mostly responsible for the high N2O emissions from BP. During the study period, denitrification contributed ∼ 79 % of the total N2O emissions from BP, whereas the contribution from ammonia oxidation was less (about 19 %). Both gross N mineralization and gross nitrification rates were higher in BP than in VP, with high C/N ratios and a low water content likely limiting N transformation processes and, consequently, N2O production in the latter soil type. Our results show that multiple factors contribute to high N2O production in BP surfaces on permafrost peatlands, with the most important factors being the absence of plants, an intermediate to high water content and a low C/N ratio, which all affect the mineral-N availability for soil microbes, including those producing N2O. The process understanding produced here is important for the development of process models that can be used to evaluate future permafrost–N feedbacks to the climate system.peerReviewe

Immunomodulating and Revascularizing Activity of Kalanchoe pinnata Synergize with Fungicide Activity of Biogenic Peptide Cecropin P1

© 2017 N. S. Zakharchenko et al. Previously transgenic Kalanchoe pinnata plants producing an antimicrobial peptide cecropin P1 (CecP1) have been reported. Now we report biological testing K. pinnata extracts containing CecP1 as a candidate drug for treatment of wounds infected with Candida albicans. The drug constitutes the whole juice from K. pinnata leaves (not ethanol extract) sterilized with nanofiltration. A microbicide activity of CecP1 against an animal fungal pathogen in vivo was demonstrated for the first time. However, a favorable therapeutic effect of the transgenic K. pinnata extract was attributed to a synergism between the fungicide activity of CecP1 and wound healing (antiscar), revascularizing, and immunomodulating effect of natural biologically active components of K. pinnata. A commercial fungicide preparation clotrimazole eliminated C. albicans cells within infected wounds in rats with efficiency comparable to CecP1-enriched K. pinnata extract. But in contrast to K. pinnata extract, clotrimazole did not exhibit neither wound healing activity nor remodeling of the scar matrix. Taken together, our results allow assumption that CecP1-enriched K. pinnata extracts should be considered as a candidate drug for treatment of dermatomycoses, wounds infected with fungi, and bedsores

Bactericide, Immunomodulating, and Wound Healing Properties of Transgenic Kalanchoe pinnata Synergize with Antimicrobial Peptide Cecropin P1 In Vivo

Procedure of manufacturing K. pinnata water extracts containing cecropin P1 (CecP1) from the formerly described transgenic plants is established. It included incubation of leaves at +4°C for 7 days, mechanical homogenization of leaves using water as extraction solvent, and heating at +70°C for inactivating plant enzymes. Yield of CecP1 (after heating and sterilizing filtration) was 0.3% of total protein in the extract. The water extract of K. pinnata + CecP1 exhibits favorable effect on healing of wounds infected with S. aureus (equal to Cefazolin) and with a combination of S. aureus with P. aeruginosa (better than Cefazolin). Wild-type K. pinnata extract exhibited evident microbicide activity against S. aureus with P. aeruginosa but it was substantially strengthened in K. pinnata + CecP1 extract. K. pinnata extracts (both wild-type and transgenic) did not exhibit general toxicity and accelerated wound recovery. Due to immunomodulating activity, wild-type K. pinnata extract accelerated granulation of the wound bed and marginal epithelialization even better than K. pinnata + CecP1 extract. Immunomodulating and microbicide activity of K. pinnata synergizes with microbicide activity of CecP1 accelerating elimination of bacteria

Impact of preoperative mild cognitive impairment on cerebrovascular events and cognitive status in patients undergoing coronary artery bypass grafting: data from 5-year follow-up

Aim. To assess the incidence of cerebrovascular events and cognitive status in the long-term period after coronary artery bypass grafting (CABG) in patients with and without preoperative mild cognitive impairment (MCI).Material and methods. This prospective study involved 115 patients aged 45 to 69 years, who were admitted to the hospital for elective on-pump CABG. All patients underwent clinical, laboratory, ultrasound, neuroimaging and neuropsychological examination 3-5 days before and 5-7 years after CABG. Cognitive functioning was assessed using screening neuropsychological scales and neuropsychological testing with an assessment of neurodynamics, attention and short-term memory. Pre-CABG MCI was diagnosed based on the criteria by R. Petersen et al. Therefore, the patients were divided into two groups: with (n=51) and without MCI (n=64).Results. It was found that strokes and dementia during the long-term postoperative period of CABG were observed only in the group of patients with preoperative MCI (7,84%). Five-seven years after CABG, a decrease in cognitive status according to neuropsychological scales was found in all patients (p≤0,05). A decrease in neurodynamics, attention and short-term memory compared to the preoperative level was found in 47,92% of patients with preoperative MCI, without MCI — in 40,63%. Neurodynamic disorders occurred equally frequently in both groups (63,8% and 57,8% of patients, respectively). Memory impairments were more often observed in patients with MCI (55,3%) compared to those without MCI (34,4%) (OR=2,36, 95% CI, 1,09-5,12, p=0,03). According to brain multislice computed tomography in the group with preoperative MCI, the number of patients with cysts and leukoaraiosis 5-7 years after CABG was higher than in those without MCI (p≤0,05).Conclusion. In the long-term (5-7 years) postoperative period of CABG, more than 40% of patients demonstrate a decrease in cognitive status, regardless of preoperative data. At the same time, preoperative MCI is associated with adverse cerebrovascular events and dementia, accompanied by morphological brain abnormalities. Due to the revealed facts, it is necessary to optimize approaches to drug treatment and secondary prevention of cognitive decline after cardiac surgery

Связь результатов нейропсихологического тестирования и показателей регионарного мозгового кровотока по данным ОФЭКТ у пациентов кардиохирургического профиля

The article provides new data on the association between changes in regional cerebral blood flow during SPECT and cognitive impairment in patients who underwent coronary artery bypass grafting and combined carotid endarterectomy and coronary artery bypass grafting with cardiopulmonary bypass. The possibilities of using SPECT as a diagnostic tool in localization of areas with a similar association, in assessing the dynamics in brain perfusion and cognitive functions in the pre- and postoperative period are shown.Aim. To determine the presence of an association between the indicators of regional cerebral blood flow according to single-photon emission computed tomography (SPECT) data and the data of neuropsychological testing in cardiac surgery patients.Methods. We studied the parameters of regional cerebral blood flow (rCBF) and the data of neuropsychological testing in 34 cardiac surgical patients who underwent coronary artery bypass grafting (CABG, n = 13) and combined carotid endarterectomy and CABG (n = 21). The state of the brain was assessed by SPECT using a radiopharmaceutical 99mTc-HMPAO (Ceretek). Assessment of cognitive functions before surgery, 2–3 days before, and in the early postoperative period, on days 5–7, was carried out using a hardware-software complex Status-PF.Results. A statistically significant relationship was found between the indices of rCBF according to neuropsychological testing data in the pre- and postoperative period. We noted a moderate correlation with the Beck Depression Scale indicators in the 1st (p = 0.010943) and 2nd (p = 0.000604) groups before surgery. There was a high correlation with visual-motor response time (VMR) before (p = 0.003878) and after the procedure (p = 0.001251), a moderate correlation with the number of errors (VMR) before the procedure (p = 0.042911) and a high correlation after the procedure (p = 0.003521) in the 1st group; in the 2nd group, there was a moderate correlation before (p = 0.004625) and after the procedure (p = 0 .005689). A moderate correlation with the indicators of attention after the procedure (p = 0.049611) was noted in the 1st group, in the 2nd group, we noted a moderate correlation before (p = 0.021969) and after the procedure (p = 0.008905). In the 2nd group there was a moderate correlation with the number of processed symbols (the Bourdon test) during the 1st minute before the procedure (p = 0.016491), a high correlation after the procedure (p = 0.007920), and a high correlation with the number of processed symbols during the 4th minute before the procedure (p = 0.001473). There was a moderate correlation with a total with number of processed symbols in the 2nd group before (p = 0.029073) and after the procedure (p = 0.024164), and a high correlation with the number of errors made after the procedure in the 1st (p = 0.006367) and 2nd (p = 0.013780) groups. A high correlation with indicators of attention after surgery (p = 0.000153) was noted as well. Conclusion. The indicators of regional cerebral blood flow obtained by SPECT in patients undergoing isolated CABG and combined CAE and CABG were associated with the data of neuropsychological testing and reflect changes in the cognitive status of patients.В работе получены новые сведения о связи изменений регионального мозгового кровотока при ОФЭКТ и когнитивных нарушений у пациентов кардиохирургического профиля, подвергшихся коронарному шунтированию и сочетанному вмешательству на коронарных и каротидных артериях в условиях искусственного кровообращения. Показаны возможности ОФЭКТ как диагностического инструмента в определении локализации областей с подобной связью, в оценке динамики изменений перфузии головного мозга и когнитивных функций в до- и послеоперационном периоде.Цель. Определить наличие связи между показателями регионарного мозгового кровотока (рМК) по данным однофотонной эмиссионной компьютерной томографии (ОФЭКТ) и данными нейропсихологического тестирования у кардиохирургических пациентов. Материалы и методы. Изучены показатели рМК и данные нейропсихологического тестирования 34 пациентов кардиохирургического профиля, подвергшихся коронарному шунтированию (n = 13) и сочетанному вмешательству на коронарных и каротидных артериях (n = 21). Состояние головного мозга оценено методом ОФЭКТ с радиофармпрепаратом 99mTc-HMPAO (Ceretec, GE Healthcare, Великобритания). Оценка когнитивных функций до хирургического вмешательства, за 2–3 дня, и в раннем послеоперационном периоде, на 5–7-й день, проведена на программно-аппаратном комплексе Status-PF.Результаты. Выявлена статистическая связь между показателями рМК и данными нейропсихологического тестирования в до- и послеоперационном периоде. Зарегистрирована заметная связь с показателями шкалы депрессии Бека в 1-й (p = 0,010943) и 2-й (p = 0,000604) группах до операции. В 1-й группе определена высокая связь со временем сложной зрительно-моторной реакции (СЗМР) до (p = 0,003878) и после (p = 0,001251) операции, заметная связь с количеством ошибок (СЗМР) до (p = 0,042911) и высокая связь после (p = 0,003521) операции; во 2-й группе заметная связь до (p = 0,004625) и после (p = 0,005689) вмешательства. В 1-й группе отмечена заметная связь с объемом внимания после операции (p = 0,049611), во 2-й группе заметная связь до (p = 0,021969) и после (p = 0,008905) вмешательства. Выявлена связь с количеством переработанных знаков пробы Бурдона: на 1-й минуте во 2-й группе заметная связь до (p = 0,016491) и высокая после (p = 0,007920) операции, на 4-й минуте во 2-й группе высокая связь до операции (p = 0,001473); с общим количеством переработанных знаков: во 2-й группе заметная связь до (p = 0,029073) и после (p = 0,024164) операции; с количеством совершенных ошибок высокая связь после операции в 1-й (p = 0,006367) и 2-й (p = 0,013780) группах; отмечена высокая связь с коэффициентом внимания после операции (p = 0,000153).Заключение. Показатели регионарного мозгового кровотока, полученные методом ОФЭКТ, у пациентов, перенесших изолированное коронарное шунтирование и симультанные вмешательства на каротидных и коронарных артериях, коррелируют с данными нейропсихологического тестирования и отражают изменения когнитивного статуса больных

Комбинированное лечение неклапанной фибрилляции предсердий: изоляция легочных вен и окклюзия ушка левого предсердия

Atrial fibrillation might occur up to 2% of the general population, with a lifetime risk of 24% in persons > 40 years of age. Catheter ablation is increasingly being used to treat drug-refractory atrial fibrillation. The long-term efficacy of catheter ablation is disappointing, with success rates about 50%. Stroke is one of the major complications of atrial fibrillation because of atrial thrombus formation. The overall annual stroke risk is 5% in patients with atrial fibrillation, increasing up to 15% in high-risk patients. The left atrial appendage was the source of thrombi in >90% of the patients with non-valvular atrial fibrillation. Anticoagulation should be given to prevent thromboembolic events. However, anticoagulant therapy has several disadvantages, such as (major) bleedings, interactions with some dietary components and other medications, and a narrow therapeutic range. In addition, patients with atrial fibrillation, especially the elderly, have low compliance. Exclusion of the left atrial appendage from the systemic circulation could be an alternative. Thus, the combination of the left atrial appendage closure with the isolation of the pulmonary veins appears to be a rational method for the treatment of atrial fibrillation. This approach eliminates the need for anticoagulants and reduces the risk of stroke.Распространенность фибрилляции предсердий составляет до 2% в общей популяции с увеличением риска до 24% у лиц старше 40 лет. Основным методом хирургического лечения фибрилляции предсердий является катетерная радиочастотная изоляция легочных вен. Однако долгосрочная эффективность аблации составляет около 50%. Инсульт является одним из основных осложнений фибрилляции предсердий из-за образования тромбов в левом предсердии. Вероятность инсульта у больных фибрилляцией предсердий составляет 5%, увеличиваясь до 15% у пациентов с высоким риском тромбоэмболических событий. Ушко левого предсердия является источником тромбов более чем у 90% пациентов с неклапанной фибрилляцией предсердий. Для профилактики тромбоэмболических событий назначаются оральные антикоагулянты. Однако антикоагулянтная терапия имеет ряд недостатков, таких как кровотечения, взаимодействие с некоторыми продуктами питания и лекарственными средствами, узкий терапевтический диапазон. Кроме того, больные фибрилляцией предсердий, особенно пожилые, имеют низкую комплаентность. Исключение ушка левого предсердия из кровообращения является альтернативой оральным антикоагулянтам. Таким образом, сочетание окклюзии ушка левого предсердия с изоляцией легочных вен представляется рациональным методом лечения фибрилляции предсердий. Данный подход нивелирует потребность в антикоагулянтах и снижает риск инсульта

Перспективы физической преабилитации в профилактике послеоперационной когнитивной дисфункции у пациентов при коронарном шунтировании

The review encompasses the latest literature on the prevention of postoperative cognitive dysfunction after coronary artery bypass grafting. We performed an attempt to provide all existing data on the prospects of using physical prehabilitation, particularly aerobic exercise, for prevention of cerebrovascular complications during coronary artery bypass grafting. The article summarizes recent studies on the effects of exercise trainings on wellbeing and cognitive functions. Particular attention has been paid to the review of the studies stating the presence of cerebroprotective effects and mechanisms of aerobic exercise on cognitive function. The prospects of aerobic prehabilitation before coronary artery bypass grafting for prevention of postoperative cognitive dysfunction are discussed.В статье представлен обзор литературных данных по проблеме профилактики послеоперационной когнитивной дисфункции после коронарного шунтирования. Авторы представили анализ литературных данных о возможности использования физической преабилитации и прежде всего аэробных физических тренировок в профилактике данного вида цереброваскулярных осложнений при выполнении коронарного шунтирования. В статье представлен обзор исследований, посвященных механизмам влияния физических тренировок в целом и на когнитивные функции. Особое внимание уделено обзору исследований по изучению церебропротективных механизмов аэробных физических тренировок на когнитивные функции. Обсуждаются перспективы использования аэробных физических тренировок перед коронарным шунтированием с позиций профилактики послеоперационной когнитивной дисфункции.

СРАВНИТЕЛЬНЫЙ АНАЛИЗ ДАННЫХ ДВУХЭНЕРГЕТИЧЕСКОГО КОМПЬЮТЕРНОГО ТОМОГРАФА И РЕЗУЛЬТАТОВ МИНЕРАЛОГИЧЕСКОГО ИССЛЕДОВАНИЯ МОЧЕВЫХ КАМНЕЙ ПРИ УРОЛИТИАЗЕ

Introduction. The idea of using dual-energy computed tomography (DECT) originated in the early development of computed tomography (CT). However, only recently, advances in radiation diagnosis have made it possible to use dual-energy CT for routine clinical use. We describes the characteristic features of dual-energy CT scanners, as well as the results of a study of 245 patients with urolithiasis, the identification of urinary stones in vivo and the subsequent comparative characteristics with mineralogical studies of uroliths. Purpose. Evaluate the possibility of using DECT in the diagnosis of urolithiasis with the determination of the chemical composition of urinary stones in vivo. Materials and methods. A group of patients (n=245) aged 18 to 84 years was examined. All patients with the established diagnosis-urolithiasis-were treated with DECT (Somatom Definition, Siemens, Forchheim, Germany) with data processing, then in-vitro infrared spectrometry (IR-Alpha-P spectrometer) to determine the true composition of the calcu lus. Results. After conducting the DECT and then ROC analysis and comparing the results with the IR-spectrometry data, it was established that stones with an average density of less than 500 HU according to DECT can be attributed to urate, with a uric acid content of more than 50% with a sensitivity of 91,1% (34 stones of 35) and specificity of 100% — the content of uric acid is also determined in polymineral calculi with a content of less than 50%. The knowledge gained on the composition and structure of the stone in vivo can subsequently be used in pathogenetic treatment and prevention of complications in patients with urolithiasis, and influence the choice of the tactics of removing the uroliths. Conclusions. The obtained results give the right to apply DECT in the diagnosis of urolithiasis, and with high sensitivity to identify urate stones in vivo, thereby influencing the choice of the tactics of removal of uroliths and pathogenetic treatment, as well as the prevention of complications in patients with urolithiasis.Идея применения двухэнергетической компьютерной томографии (ДЭКТ) возникла в раннем развитии компьютерной томографии (КТ). Однако только в последнее время достижения в лучевой диагностике сделали возможным использование ДЭКТ для повседневного клинического применения. В статье описываются характерные особенности двухэнергетических КТ-сканеров, а также результаты обследования 245 пациентов с мочекаменной болезнью, идентификация мочевых камней in vivo и последующая сравнительная характеристика с минералогическим исследованием уролитов. Цель работы: оценить возможность применения ДЭКТ в диагностике мочекаменной болезни с  определением химического состава мочевых камней in vivo. Обследована группа пациентов (n=245) в  возрасте от  18 до  84 лет. Всем пациентам с  установленным диагнозом мочекаменной болезни выполнялась ДЭКТ (Somatom Definition, Siemens, Forchheim, Germany) с обработкой данных, затем производилась in vitro ИК-спектрометрия (спектрометр ИК-Фурье Alpha-P) для установления истинного состава конкремента. После проведения ДЭКТ, а затем ROC-анализа и сопоставлении результатов с данными ИК-спектрометрии установлено, что конкременты средней плотностью менее 500 HU по данным ДЭКТ могут быть отнесены к уратам, при содержании мочевой кислоты более 50% с чувствительностью 91,1% (34 конкремента из 35) и специфичностью 100% — содержание мочевой кислоты определено также и в полиминеральных конкрементах при содержании ее менее 50%. Полученные знания о составе и структуре камня in vivo в последующем могут быть использованы в  патогенетическом лечении и  профилактики осложнений у  пациентов с МКБ, а также влиять на выбор тактики удаления уролитов. Полученные результаты дают право применять ДЭКТ в диагностике мочекаменной болезни, а также с высокой чувствительностью идентифицировать уратные камни in vivo, тем самым влиять на выбор тактики удаления уролитов и патогенетического лечения, а также профилактики осложнений у больных уролитиазом