Managing floodplains using nature-based solutions to support multiple ecosystem functions and services

Floodplains include unique environments shaped over a long time horizon along rivers and smaller streams and formed by alluvial sediments. As floodplains are flat, often with highly fertile and well-accessible land, they have become the intrinsic focus of human society—while providing a variety of goods and ecosystem services. Intensive land use of floodplains is degrading their natural values and significantly reducing their ecosystem functions and services. A significant part of these key services is related with the ability of floodplains to retain water and nutrients, which can be understood as a flood control and a water-retention function. Although these ecosystems serve a number of other basic functions, the importance of floodplains as a place for water retention during extreme discharges caused by intense rainfall or snowmelt and the supply of water in times of drought are essential under conditions of global change. In order to increase the ability of floodplains to perform these functions, it is increasingly required to preserve the connectivity of rivers with surrounding floodplains and adapt human activities to maintain and restore river ecosystems. This article reviews the recent understanding of floodplain delineation, the most common causes of disturbance, the ecosystem functions being performed, discussing in turn the measures being considered to mitigate the frequency and magnitude of hydrologic extremes resulting from ongoing environmental changes. This article is categorized under: Water and Life > Conservation, Management, and Awareness Engineering Water > Planning Water

Management of heart failure patients in Russia: perspectives and realities of the second decade of the XXI century

The article highlights the central components of Russian heart failure (HF) management programs in actual clinical practice. The experience of the Competence Center of Almazov National Medical Research Center, as well as opportunities and prospects for improving the monitoring of decompensated HF

Assessment of Autonomic Cardiac Control in Women with Cardiac Syndrome X using Time Related Autonomic Balance Indicator

Abstract The various CVD (AH, CHF, IHD) have a different circadian profile of autonomic cardiac control (ACC), compared to the profile in healthy subjects (HS). In this study we analyze the specific abnormalities in ACC circadian changes in women with cardiac syndrome X (CSX). The Introduction CSX is usually diagnosed in the presence of typical exertional chest pain, a positive response to exercise testing, and normal coronary angiograms. According to J. C. Kaski "Patients with CSX represent a diagnostic and therapeutic riddle" G. Rosano, P. Ponikowski, St. Adamopoulos, et al Methods The study comprised of 25 women (55.4±9.4) with CSX and 22 healthy women (47.3±10.9). All patients are with fulfilled criteria for CSX at the period of pre-or postmenopause and with "clear" coronary arteries verified from angiography or multi-slice CT. Stratification by risk factors, comorbidity and pharmacological management have been done using a standardized protocol. The ACC changes were assessed by HRV indices from ECG recordings in resting state (RS) and by parasympathetic (Valsalva manoeuvre; VM), or sympathetic (handgrip test; HT) stimulation. I

Clinical and paraclinical manifestation COVID-19 in different age children

COVID-19 is an infectious disease caused by a new coronavirus first discovered in 2019. The infection has spread rapidly throughout the world and affects people of all ages. Thus, 12.7% of all SARS-CoV-2 patients are children. Purpose — to establish the clinical and paraclinical manifestations of the course of COVID-19 in children, depending on age to predict the severity of the disease’s manifestation. Materials and methods. The 60 children aged from 3 months to 17 years old with laboratory-confirmed SARS-CoV-2 were examined. All patients underwent general clinical, laboratory, and instrumental examinations and received therapy according to Ukrainian National protocol. SARS-CoV-2 infection was confirmed by real-time PCR. Results. Thus, in young children COVID-19 begins acutely (90.0%) with intoxication (75.0%), fever (65.0%), nasal congestion (25.0%), rhinorrhea (20.0%), dry cough (60.0%), increased ESR and C-reactive protein (55.0%). The course of COVID-19 in children 4–6 years is accompanied by acute onset (85.71%), fever (85.71%), pharyngitis (85.71%), lymphopenia (28.56%), and no CT signs of lesions (71.43%). In children 7–12 years old, COVID-19 causes intoxication (88.89%), fever (83.33%), pharyngitis (55.56%), dry cough (77.78%), lymphocytosis (16.67%) with accelerated ESR (38.89%) and pneumonia (38.89%). The course of COVID-19 in children was older than 13 years old characterized by fever (73.33%), pharyngitis (66.67%), dry cough (73.33%), olfactory loss (20.0%), leukopenia (20.0%), ESR acceleration (20.0%), and a decrease in prothrombin (13.33%) without pulmonary lesions (73.33%). Conclusions. These data suggest that the severity and duration of clinical and laboratory manifestations of COVID-19 depend on the child’s age. The course of COVID-19 in children of all age groups is mostly of moderate severity with a favorable prognosis ((56.67%) hospitalized children did not have any complications). Only children from 7 to 12 years old need additional attention due to the severe manifestations of intoxication (88.89%) and the risk of complications with pneumonia (38.89%). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors

Conception of the evidence-based medicine teaching from a position of the doctors’ continuous professional development

Представлені досвід викладання принципів доказової медицини, особливості практично-орієнтованого навчання студентів та лікарів, форми безперервного професійного навчання лікарів. Визначені актуальні напрями та методи педагогічних інновацій.The article presents the experience of the evidence-based medicine teaching, peculiarities of the practically-oriented education of the students and doctors, forms of the continuous doctors’ professional education. The important tendencies andmethods of the educational innovations are determined

Implementation of innovative tools in clinical discipline teaching in emergency conditions

Незважаючи на поширення імплементації дистанційної освіти на медичних факультетах, застосування інтерактивного навчання та інноваційних технологій залишається недостатньо дослідженим та спостерігається обмеження у їх упровадженні. Інтерактивне навчання включає застосування технічних ресурсів під час викладання (онлайн-тести, відеоконференції, чати, онлайн-дискусії, віртуальні класи, віртуальне навчальне середовище, синхронне та асинхронне використання аудіо та/або відео, онлайн-ігри, онлайн-кейси, репозиторій, ePBL, ePortfolio та ін.). Упровадження інтерактивних засобів дає змогу розширити можливості викладання для більш якісного засвоєння навчального матеріалу та може сприяти підвищенню у студентів самостійності у прийнятті клінічних рішень не лише в умовах надзвичайного стану.Despite the spread of the implementation of distance education in medical faculties, the use of interactive learning and innovative technologies remain insufficiently researched and there are limitations in their implementation. Interactive learning includes using technical resources in teaching (online tests, video conferences, chats, online discussions, virtual classes, virtual learning environments, synchronous and asynchronous use of audio and video, online games, online cases, repository, ePBL, ePortfolio, etc.). The advantages of interactive learning include flexibility in time and place of use, quick access to a huge amount of information, economic attractiveness, and in the case of an asynchronous learning model – the individuality of the student's perception The innovative tool's implementation allows you to expand teaching opportunities for better assimilation of educational material. It can contribute to increasing students' independence in making clinical decisions not only in emergency conditions