Пищевой статус и структура потребления макронутриентов у больных туберкулезом с различной лекарственной устойчивостью возбудителя

The objective: to assess the nutritional status and actual nutrition of respiratory tuberculosis patients with various drug resistance patterns.Subjects and methods. The actual nutrition of tuberculosis patients was assessed using a standard questionnaire containing questions about the amount of food and meals consumed at home in the last 30 days preceding the survey. Assessment of anthropometric indicators and the survey were carried out by medical workers when the patients were admitted to hospital. Patients were enrolled from April to August 2018 out of 300 respiratory tuberculosis patients who had a positive result of a sputum test for M. tuberculosis. The multidrug resistant tuberculosis group consisted of 222 patients, while the group of those drug susceptible or having mono- or polyresistance included 78 patients.Results. It was found out that the home diet of patients with active respiratory tuberculosis was imbalanced in respect of basic nutrients and energy. The following was detected: lack of protein in the diet (including the one of animal origin) in 80.6 ± 2.3% with a depth of more than 55.7%; excess unbalanced fat consumption in 66.6 ± 2.7%; insufficient consumption of dietary fiber in 45.0 ± 2.8%. Multidrug resistant tuberculosis patients consumed more energy and macronutrients (proteins, fats, dietary fiber, animal protein, cholesterol, and fatty acids) both in absolute terms and relative to individual needs, but at the same time they had worse nutritional status indicators; 37,2% of them had malnutrition of the 1st to 3rd degree. At the same time, patients with multidrug resistant tuberculosis were significantly more often HIV-positive, they had disseminated and chronic tuberculosis, the treatment of which itself lead to a decrease in appetite, malnutrition, metabolic and digestion disorders.Цель исследования: оценка пищевого статуса и фактического питания больных туберкулезом органов дыхания с различной лекарственной устойчивостью возбудителя.Материалы и методы. Оценка фактического питания больных туберкулезом проводилась с использованием стандартного опросника, содержащего вопросы, характеризующие количество потребляемых пищевых продуктов и блюд в домашних условиях в течение последних 30 дней, предшествовавших опросу. Определение антропометрических показателей и опрос проводили медицинские работники в момент поступления пациентов в стационар. Выборка пациентов сформирована в период с апреля по август 2018 г. из 300 больных туберкулезом органов дыхания, выделявших M. tuberculosis. Группу туберкулеза с множественной лекарственной устойчивостью составили 222 больных, группу с сохраненной чувствительностью M. tuberculosis к противотуберкулезным препаратам, а также с моно/полирезистентностью ‒ 78 пациентов.Результаты. Установлено, что домашнее питание больных активным туберкулезом органов дыхания характеризовалось несбалансированностью основных пищевых веществ и энергии. Выявлены: недостаток белка в рационе (в том числе животного происхождения) ‒ у 80,6 ± 2,3% с глубиной более 55,7%; избыточное несбалансированное потребление жиров ‒ у 66,6 ± 2,7%; недостаточное потребление пищевых волокон ‒ у 45,0 ± 2,8%. Больные туберкулезом с множественной лекарственной устойчивостью потребляли больше энергии и макронутриентов (белков, жиров, пищевых волокон, животного белка, холестерина, жирных кислот) как в абсолютном выражении, так и относительно индивидуальной потребности, но вместе с тем имели худшие показатели пищевого статуса, 37,2% лиц имели недостаточность питания 1-3-й степени. При этом больные туберкулезом с множественной лекарственной устойчивостью значимо чаще имели ВИЧ-положительный статус, распространенный и хронический туберкулез, лечение которого само приводит к снижению аппетита, недоеданию, нарушению обмена и усвоения пищевых веществ.Авторы заявляют об отсутствии у них конфликта интересов

Peasant settlers and the ‘civilizing mission’ in Russian Turkestan, 1865-1917

This article provides an introduction to one of the lesser-known examples of European settler colonialism, the settlement of European (mainly Russian and Ukrainian) peasants in Southern Central Asia (Turkestan) in the late nineteenth and early twentieth centuries. It establishes the legal background and demographic impact of peasant settlement, and the role played by the state in organising and encouraging it. It explores official attitudes towards the settlers (which were often very negative), and their relations with the local Kazakh and Kyrgyz population. The article adopts a comparative framework, looking at Turkestan alongside Algeria and Southern Africa, and seeking to establish whether paradigms developed in the study of other settler societies (such as the ‘poor white’) are of any relevance in understanding Slavic peasant settlement in Turkestan. It concludes that there are many close parallels with European settlement in other regions with large indigenous populations, but that racial ideology played a much less important role in the Russian case compared to religious divisions and fears of cultural backsliding. This did not prevent relations between settlers and the ‘native’ population deteriorating markedly in the years before the First World War, resulting in large-scale rebellion in 1916

LONG-TIME NUMERICAL INTEGRATION OF THE THREE-DIMENSIONAL WAVE EQUATION IN THE VICINITY OFAMOVING SOURCE

We propose a family of algorithms for solving numerically a Cauchy problem for the three-dimensional wave equation. The sources that drive the equation (i.e., the right-hand side) are compactly supported in space for any given time; they, however, may actually move inspace with a subsonic speed. The solution is calculated inside a finite domain (e.g., sphere) that also moves with a subsonic speed and always contains the support of the right-hand side. The algorithms employ a standard consistent and stable explicit finite-difference scheme for the wave equation. They allow one to calculate the solution for arbitrarily long time intervals without error accumulation and with the fixed non-growing amount of the CPU time and memory required for advancing one time step. The algorithms are inherently three-dimensional; they rely on the presence of lacunae in the solutions of the wave equation in oddly dimensional spaces. The methodology presented in the paper is, in fact, a building block for constructing the nonlocal highly accurate unsteady artificial boundary conditions to be used for the numerical simulation of waves propagating with finite speed over unbounded domains

Global Discrete Artificial Boundary Conditions for Time-dependent Wave Propagation

We construct global artificial boundary conditions (ABCs) for the numerical simulation of wave processes on unbounded domains using a special non-deteriorating algorithm that has been developed previously for the long-term computation of wave-radiation solutions. The ABCs are obtained directly for the discrete formulation of the problem; in so doing, neither a rational approximation of "non-reflecting kernels," nor discretization of the continuous boundary conditions is required. The extent of temporal nonlocality of the new ABCs appears fixed and limited; in addition, the ABCs can handle artificial boundaries of irregular shape on regular grids with no fitting or adaptation needed and no accuracy loss induced