Correct Course Research Articles

The use of physiotherapy methods in the complex treatment of patients with chronic laryngitis

Purpose of the study. Issues of voice quality and health as the main means of communication are becoming increasingly relevant. The increase in the incidence of chronic laryngitis among patients of different age groups is due to a significant list of etiological factors, including deteriorating environmental conditions, exposure to bad habits, a significant increase in stress levels and the presence of chronic concomitant diseases. In this aspect, it is important to take into account the increasing load on the vocal apparatus, as well as the increasing requirements for voice quality in modern society. Materials and methods. The purpose of this study was to increase the effectiveness of complex conservative treatment of patients with chronic laryngitis as a result of exposure to low-intensity laser radiation on the larynx area. 52 patients with voice disorders were examined and treated and were divided into two groups. The results. In group 1, 24 patients received complex treatment, which included a course of drug inhalations, phonopedagogical correction, and compliance with the voice regime. In group 2, consisting of 28 patients, a similar complex conservative treatment was supplemented with laser therapy for the larynx area. When conducting a comparative analysis of the results of therapy, based on an assessment of the dynamics of patient complaints, data from a videolaryngostroboscopic study and acoustic analysis of the voice, a more pronounced improvement in the clinical and functional state of the larynx was found in patients of the 2nd group. Conclusion. Consequently, the use of low-intensity laser therapy on the larynx area as part of complex conservative treatment of chronic laryngitis helps to achieve a significantly predominant clinical result and improve the quality of life of patients with chronic pathology of the vocal apparatus.

The Lessons from Sanctions on Iran and Their Impacts on the Development of Civil Aviation Understanding and Iranian Airlines

After the Islamic Revolution, Iran lived through many hard times not only because of its economic and financial resources such as oil and petroleum but also because of its historical, social, supremacy and leadership of some other Islamic countries and communities. Essentially, it has tried to defend its position for many years without sacrificing its Idiosyncratic Islamic governance structure within the world context or other Islamic countries, for these reasons, it has witnessed a lot of economic and financial sanctions or bans. Although Iran has a lot of highly qualified academicians and a workforce in the science of aviation, its civil aviation management structure and related activities, such as airline management, are very far from the average of the world depending on these financial and economic sanctions and bans by international orders. This situation is subjected to this research as a gap. This paper will analyse the civil aviation and air carrier industry of Iran under the impacts of these economic and financial bans and sanctions regarding four dimensions: Maintenance, Training and licensing, corporal development, and relationships with manufacturers. Essentially, at the beginning of the new age, in terms of international politics and conflicts in every continent of the world, new sanctions and bans are on the trouble agenda of world civil aviation agencies and institutions because of their highly political structure, and these bans and sanctions carry generally economic and financial identities, although they have international policy claims. There are a lot of possibilities on the desks of the civil aviation authorities for the burdens of these sanctions and bans and their sustainability impacts on civil aviation. Moving from the situation of Iran, the correct courses and necessary economic and financial policies will be suggested in this new world context and understanding.

Jednostranná nebo konkludentní? Problematické aspekty volby práva (nejen) v zajišťovacích instrumentech ve světle aktuální judikatury

This article deals with cases of <i>unilateral</i> and <i>tacit</i> choice of law, as less common examples of choice of law. These are entirely separate categories. Unilateral choice reflects the fact that it is the result of the will of only one person, and typically appears in unilateral legal acts (such as a financial guarantee in Czech law). Tacit choice, on the other hand, indicates that the intent to choose the law was expressed in a non-explicit way. Choice of law can be at the same time both unilateral and tacit, although this will not occur very often in practice. In the case of unilateral legal acts in the field of contract and tort law, there is a debate whether their conflict of laws regime falls under the EU’s unified conflict of laws rules (Rome I or Rome II Regulation) or under national law. There is no clear decision on the issue by the CJEU. The Czech Supreme Court has recently been given the opportunity to comment on this and some other issues of unilateral and implied choice of law. However, the Court rather missed this opportunity. It avoided the question of whether the national law or the Rome I Regulation applies to unilateral legal acts similar to a declaration of guarantee by (unfortunately incorrectly) applying the Rome Convention. The Court also applied the rules for a bilateral choice of law to an apparently unilateral choice of law in a rather complex manner. Moreover, its conclusion that the choice subjecting the declaration in question to “Danish statutes” is only an implied choice and not an express one is at least questionable. The article critically assesses this decision and shows in what respects a different (and more correct) course of action should be followed.

Angular and torsional malalignments of the paediatric knee joint

Abnormal angular and torsional alignment of the lower extremities during growth are acommon reason for consultation of apaediatrician or orthopaedist. There is often uncertainty about the pathological value of these abnormalities and the need for treatment, even among specialists. In the course of physiological growth and development processes, the axial and torsional alignment of the legs sometimes change considerably and in characteristic patterns. The ability to assess whether abnormal angular or torsional alignments of the lower limb in the course of growth should still be regarded as normal or already as pathological, depending on age and gender, is essential for the treating physician and requires precise knowledge of the physiological development processes and the tolerable limits in all three spatial dimensions. After careful explanation to the frequently concerned parents, arestrictive approach with observation of the spontaneous course of correction on the basis of regular clinical check-ups makes sense in the majority of cases. Pathological deviations from the physiological conditions are rare overall, can be idiopathic or of secondary origin and should be further clarified diagnostically using imaging procedures. As conservative measures are ineffective, pronounced angular and/or torsional deformities of the legs requiring treatment can only be corrected by surgical intervention, even in children and adolescents. The surgical treatment modalities available are varied and differ in terms of their invasiveness and complication profile, depending on the localization, type and severity of the deformity, as well as the age and possible concomitant diseases of the affected child or adolescent.

What do you do with a normal appearing appendix? A national study of Pediatric Surgeons.

Surgeons may encounter a grossly normal appearing appendix in a patient with clinically suspected appendicitis. The purpose of this study is to determine the practice of pediatric surgeons in Saudi Arabia when this is encountered, and determine the reasons behind their decision making. An electronic survey was sent to all pediatric surgeons in Saudi Arabia. Data points collected included demographics, peri-operative imaging preference, and personal practice when managing an intra-operative grossly normal appendix in symptomatic children. A total of 105 responses were obtained yielding a response rate of 33.8% The majority of respondents, 88 (87.1%) would remove the appendix while 13 (12.9%) would leave it in situ. The most common reason for removing the appendix was the possibility of microscopic/Endo appendicitis 71 (34.8%) while the most common reason for leaving the appendix in situ was the possible usage of the appendix for reconstructive benefits in the future 11 (50%). The overwhelming majority 87 (86.1%) felt that there were no sufficient guidelines on removal of the normal appearing appendix at the time of surgery for suspected acute appendicitis. The majority of pediatric surgeons in Saudi Arabia would proceed with an appendectomy when an intra-operative grossly normal appendix is seen in patients suspected to have acute appendicitis. There is a clear lack of published pediatric guidelines and large studies to guide the correct course of action.

Characteristics of microsporogenesis in the triploid apple tree and it’s parental form in connection with usage in breeding at the polyploid level

An effective method of creating triploid apple cultivars, which are superior in their characteristics to diploid cultivars, is the crossing of heterochromosomal forms of the type: 2x×4x, 4x×2x. In order to provide a wide range of genetic diversity of riploid hybrids, it is necessary to have a large set of tetraploid donor forms of diploid gametes. A limited set of such forms is a limiting factor for this direction of breeding. And the effectiveness of work on obtaining new valuable apple varieties based on the use of the polyploidy method largely depends on their diversity Therefore, the identification of new apple tetraploids, as well as the study of cytoembryological features of their generative structures, the determination of the quality of the formed gametes necessary for successful breeding and for predicting the results of these works are relevant. Meiosis during microsporogenesis was studied in two tetraploid apple forms. To study meiosis during microsporogenesis, temporary pressed specimen were prepared by the acetohematoxylin method; the propionic-lacmoid method was used to determine the ploidy of hybrid offspring. Microscopic studies were carried out on a Nikon-50i microscope at a magnification of 10 x 105 x 40, 10 x 1.5 x 100. The analysis of the course of meiosis during microsporogenesis in apple tetraploid 34-21-39 [30-47-88(4x)×Krasa Sverdlovska(2x)] and its parent form 30-47-88 [Liberty×13-6-106 (Suvorovetz seedling)] showed that the hybrid 34-21-39 was characterized by the most correct course of meiosis. The largest percentage of deviations and the diversity of morphological types of disorders were detected in the form 30-47-88. Common types of violations were noted. Despite the presence of disorders during meiosis in tetraploid forms, microsporogenesis ended with the formation of visually normal one–dimensional pollen: 89% in the form 34-21-39 and 50% in the form 30-47-88. In combinations of crosses involving the studied forms, a high yield of triploid plants was noted. Consequently, the tetraploid apple forms 34-21-39 and 30-47-88 can be recommended for hybridization for the purpose of mass production of triploid seedlings. The results allow us to conclude that the tetraploid apple forms 34-21-39 and 30-47-88 can be used in breeding as pollinators in heteroploid crosses (2x×4x) to obtain triploid genotypes.

Constitutional and legal responsibility of subjects of the election process: general principles

The scientific article examines and analyzes the general principles of the constitutional and legal responsibility of the subjects of the election process. It has been established that legal responsibility in constitutional law means social and public legal responsibility for violation of the current constitutional legislation of Ukraine. This responsibility can be both direct, the types and extent of which are established by the constitutional legislation of Ukraine (constitutional-legal responsibility), and indirect, the types and extent of which are determined by other branches of Ukrainian law. It was determined that the normative basis of constitutional and legal responsibility is the establishment of actual illegal actions in constitutional and legislative acts that cause constitutional and legal responsibility. The actual basis for the emergence of constitutional-legal responsibility is a constitutional offense committed by the subject of constitutional-legal relations. The procedural basis for the emergence of constitutional liability is a decision made by the relevant body (official) regarding a constitutional offense. It is emphasized that the constitutional and legal responsibility of the subjects of the election process ensures the correct course of elections and compliance with democratic principles, and also guarantees that the elections are held openly, honestly and taking into account the rights and interests of all citizens. Its legislative regulation and optimal practical application is critical for ensuring democracy, legitimacy and stability of government, as it includes compliance with constitutional norms, protection of voters’ rights, ensuring the honesty and transparency of the electoral process and protection of the constitutional order in the country. In summary, when analyzing the essence of the constitutional and legal responsibility of the subjects of the election process, it should be taken into account that the basis for this responsibility is their constitutional and legal nature and status. Constitutional and legal responsibility for violation of election legislation has a significant political color, as it is determined by the subject’s participation in election processes that relate to the organization of elections and their conduct; determination of who should exercise state power; covers the interaction between the state and citizens and reflects the desire of subjects to achieve power and influence on the formation of general decisions of the state, including their leading role in this process.

Relevance of classical management concepts in the contemporary era – a case study of Fayol’s principles

Purpose This hypothetical case study aims to revisit the classical model given by Henri Fayol whereby he put forward a set of 14 principles to guide managers in decision-making across organizations. The case study showcases the dilemma in which the top manager of an automobile company finds himself when some of the very basic principles – on which the whole discipline of management is founded – are ignored. It will also serve as an aid for faculty members in B-Schools to teach students the significance of basic management principles postulated many years back which stand relevant even in contemporary times.Design/methodology/approach This case study is based on a hypothetical scenario in the corporate world. Different incidents in a fictitious automobile manufacturing firm are presented and the corresponding principles given by Henri Fayol are inferred.FindingsThis case study highlights that decision-making gets complicated if fundamental principles of management are not complied with. The decision taken during each and every situation which has been discussed in this case study is contrary to the correct course of action as propounded by Fayol. Modern-day managers must acknowledge the relevance and importance of these principles for achieving success in business.Originality/value This case study underscores that even in this volatile business environment where most of the management practices are technology-driven, we cannot disregard the most elementary rules of management. The managers working at different levels in the organizational hierarchy may be guided to make the right decisions in situations similar to the ones described.

Equivocal diagnostics: Making a 'good' point-of-care test for elimination in global health.

What is a diagnostic test for? We might assume the answer to this question is straightforward. A good test would help identify what disease someone suffers from, assist health providers to determine the correct course of treatment and/or enable public health authorities to know and intervene in health at the level of the population. In this article, we show that what a specific diagnostic test is for, the value it holds for different actors, and what makes it good, or not, is often far from settled. We tell the story of the development and design of a rapid antibody test for onchocerciasis, or river blindness, tracking multiple iterations of the device through three configurational moments in the framing of onchocerciasis disease and reshaping of the global health innovation ecosystem. Efforts to build that ecosystem for diagnostics are often premised on the notion that public health needs for diagnostics are pre-given and stable; the challenge is seen to be how to incentivize investment and find a customer base for diagnostics in under-resourced settings. By contrast, we show that for any disease, diagnostic needs are both multiple and constantly in flux, and are unlikely to be met by a single, stand-alone product. In the case of the onchocerciasis Ov-16 rapid test, the failure to recognize and address the multiplicity and instability of diagnostic needs in the innovation process resulted in the development of a rapid point of care test that might be manufactured, procured and used, but is unloved by public health experts and commercial manufacturers alike. The equivocal value of the onchocerciasis rapid test, we suggest, reveals the inadequacy of the current global health innovation ecosystem for developing diagnostic 'goods'.

Next-generation sequencing survey of acute febrile illness in Senegal (2020-2022).

Acute febrile illnesses (AFI) in developing tropical and sub-tropical nations are challenging to diagnose due to the numerous causes and non-specific symptoms. The proliferation of rapid diagnostic testing and successful control campaigns against malaria have revealed that non-Plasmodium pathogens still contribute significantly to AFI burden. Thus, a more complete understanding of local trends and potential causes is important for selecting the correct treatment course, which in turn will reduce morbidity and mortality. Next-generation sequencing (NGS) in a laboratory setting can be used to identify known and novel pathogens in individuals with AFI. In this study, plasma was collected from 228 febrile patients tested negative for malaria at clinics across Senegal from 2020-2022. Total nucleic acids were extracted and converted to metagenomic NGS libraries. To identify viral pathogens, especially those present at low concentration, an aliquot of each library was processed with a viral enrichment panel and sequenced. Corresponding metagenomic libraries were also sequenced to identify non-viral pathogens. Sequencing reads for pathogens with a possible link to febrile illness were identified in 51/228 specimens, including (but not limited to): Borrelia crocidurae (N = 7), West Nile virus (N = 3), Rickettsia felis (N = 2), Bartonella quintana (N = 1), human herpesvirus 8 (N = 1), and Saffold virus (N = 1). Reads corresponding to Plasmodium falciparum were detected in 19 specimens, though their presence in the cohort was likely due to user error of rapid diagnostic testing or incorrect specimen segregation at the clinics. Mosquito-borne pathogens were typically detected just after the conclusion of the rainy season, while tick-borne pathogens were mostly detected before the rainy season. The three West Nile virus strains were phylogenetically characterized and shown to be related to both European and North American clades. Surveys such as this will increase the understanding of the potential causes of non-malarial AFI, which may help inform diagnostic and treatment options for clinicians who provide care to patients in Senegal.

Classical Interventions: Hegel, Klenze and the Aesthetics of Purity

ABSTRACT In August of 1834, in a ceremony atop the Athenian Acropolis, the German architect Leo von Klenze ordered the dismantling and removal of all non-classical buildings from the hilltop. The results of the ensuing purification transformed the site from a multicultural complex of buildings that had accrued over centuries into what is essentially a minimalist museum, as we know it today. I argue that we can best understand Klenze’s classical intervention if we view it in the context of the discourse of a Romantic-era aesthetics of purity through which it appears self-evidently as the correct course of action. The most comprehensive articulation of this discourse appears in the lectures on aesthetics that Hegel gave in Berlin in the 1820s. Hegel argues that the perfection of Greek classical art emerges only as an overcoming of the misshapen and failed attempts at art that preceded it, which he calls “symbolic” or “oriental” (Egyptian, Persian, Indian). The human spirit, Geist, can materialize itself as a work of art only by Europeanizing itself, by shedding all oriental otherness. We can read Klenze’s intervention, which strips away all remnants of Ottoman Turkish architecture from the acropolis, as this aesthetics of purity written in stone.

GENERAL PRINCIPLES OF ENFORCEMENT PROCEEDINGS IN ADMINISTRATION

Numerous general principles are used in administrative enforcement proceedings, which mainly take a directival form. In the study, research has been focused on the description and analysis relating to general rules of law, principles of administrative law and principles of administrative procedure used in enforcement proceedings. However, special attention was paid to the general principles having their source in the Law of June 17, 1966, on Administrative Enforcement Proceedings.The aim of this research is an attempt to synthesize these principles and show their role in involuntary proceeding. When starting the research, a research hypothesis was put forward, which assumes that the application of general principles in enforcement proceedings in administration guarantees their correct course, and the principles themselves are a set of norms shaped mainly by legal provisions. The analyses carried out allowed to confirm the thesis and to identify a number of de lege ferenda conclusions, indicating the need to revise some rules. First of all, attention was drawn to the lack of terminological consistency regarding the general principles of enforcement proceedings. Further attention was paid to the need for legislative changes regarding the formation of the principle of conducting enforcement in a manner least burdensome for the obliged, which in the author’s opinion is too general. Another conclusion is the demand for a revision of the provisions of Articles 8 to 10 of the Law on Administrative Enforcement Proceedings. These provisions, which are a manifestation of the principle of respect for the minimum subsistence, are outdated and do not reflect the current situation, especially of farmers.

Generalities concerning the Capitalization on some Elements of Military Art in the Russian-Ukrainian War

The article addresses some points of view regarding the particularities of military art, as a result of studying the military actions carried out in the Russian-Ukrainian war, expressing a general character and serving to achieve the proposed objectives. The author focused his attention on the examination of the sources, the elucidation of various phenomena and significant moments about military art, in correlation with the mutations of the battlefield. The mentioned results were obtained following the study of the factual material and the formulation of some ideas from the learned lessons, which will later be useful in the national military art. The author approaches the visions of the operations based on the analysis of the phenomena, laws and established principles regarding the conduct of the armed struggle, the existing conceptions of the universal military thought. In conclusion, choosing of the correct course of action will depend on the ratio of forces and means of the conflicting parties, the action plans of one’s own forces and of the adversary, as well as the visionary capabilities of the commanders.

Generalități asupra valorificării unor elemente ale artei militare în războiul ruso-ucrainean

The article addresses some points of view regarding the particularities of military art, as a result of studying the military actions carried out in the Russian-Ukrainian war, expressing a general character and serving to achieve the proposed objectives. The author focused his attention on the examination of the sources, the elucidation of various phenomena and significant moments about military art, in correlation with the mutations of the battlefield. The mentioned results were obtained following the study of the factual material and the formulation of some ideas from the learned lessons, which will later be useful in the national military art. The author approaches the visions of the operations based on the analysis of the phenomena, laws and established principles regarding the conduct of the armed struggle, the existing conceptions of the universal military thought. In conclusion, choosing of the correct course of action will depend on the ratio of forces and means of the conflicting parties, the action plans of one’s own forces and of the adversary, as well as the visionary capabilities of the commanders.

The Ruling on Alerting the Verses of the Qur’an in Prayer

Praise be to Allah, and may prayers and peace be upon the faithful Prophet. Prayer holds a high position in Islam, and the Sharia clarifies its rulings, as well as what validates or invalidates them. Due to human nature being prone to forgetfulness and distraction, worshippers often find themselves in situations where they need to correct their actions during prayer and alert others to possible mistakes. Many times, an Imam may be uncertain about the correct course of action, or congregants may inadvertently disrupt his prayer with conversations. In such cases, it becomes necessary to address the issue and continue with the prayer. This research aims to benefit worshippers, including Imams and congregants, by providing guidance on correcting prayers and avoiding accidental omissions, as well as offering strategies for alerting others when necessary. The research discusses various examples of Quranic verses that can be remembered and utilized during prayer to alert the Imam, the congregation, or others. The title of this research is: "The Ruling on Alerting with Quranic Verses During Prayer". Its primary objectives include mentioning examples of Quranic verses suitable for alerting. The research is structured into an introduction, four main sections, and a conclusion. The first section covers the warning of praise and similar actions, the second focuses on alerting with Quranic verses, the third explores the positions of early scholars regarding Quranic verse alerting, and the fourth provides examples of Quranic verses suitable for alerting during prayer.

Osteopathic correction in the complex therapy of children with astigmatism

Introduction. One of the current tasks of healthcare is the preservation of vision in children, prevention of blindness and visual impairment. In Russia, more than 1 million children suffer from visual impairments: myopia, hypermetropia, astigmatism, amblyopia. It is especially important to identify refractive errors and their complex correction in primary school children, since actual school loads are comparable in intensity to the visual loads of adults engaged in visually strenuous work. Osteopathic correction has proven itself well in the complex therapy of accommodative asthenopia of adult patients with visually strenuous work. However, the effectiveness of osteopathic correction in the complex treatment of accommodative asthenopia in children has not been sufficiently studied.The aim of the study was to evaluate the effectiveness of osteopathic correction in the complex therapy of children with astigmatism.Materials and methods. The study involved 40 children aged 7 to 11 years with the presence of simple, complex hypermetropic astigmatism, complex myopic astigmatism, mixed astigmatism. Two groups were formed: the control group — 20 children who received standard treatment (constant wearing of corrective glasses, pleopto-orthoptic treatment); the main group — 20 children who additionally received a course of osteopathic correction (3 sessions with an interval of 1 month). In each group, two subgroups were additionally identified: children with hypermetropic astigmatism, HA (16 in the main group and 15 in the control group), and children with myopic astigmatism, MA (4 in the main and 5 in the control group). The number of these subgroups was insufficient to test any statistical data on them hypotheses. In each subgroup, the osteopathic and ophthalmological (visual acuity, astigmatism, fatigue of the visual analyzer) status before and after therapy was evaluated in each group. Descriptive statistics were calculated for all subgroups based on the results of the study. Statistical hypotheses were tested in relation to subgroups of children with HA.Results. At the beginning of the study, 100 % of children with astigmatism had regional somatic dysfunctions of the head. Regional somatic dysfunction of the dura mater was detected in the main group in 69 % of children with HA and in 100 % of children with MA, and in the control group, respectively, in 73 and 100 %. After complex therapy, which included osteopathic correction, children with HA revealed statistically significantly (p<0,05) fewer cases of biomechanical disorders of the head regions and dura mater than children of the corresponding subgroup of the control group. Also, children with HA in the main group had statistically significantly (p<0,05) more pronounced positive dynamics in a number of indicators of ophthalmological status: an increase in visual acuity, a decrease in the magnitude of astigmatism. After complex therapy, children with HA were characterized by significantly (p<0,05) less pronounced fatigue of the visual analyzer.Conclusion. The results of the study indicate the effectiveness of the inclusion of osteopathic correction in the complex therapy in children with HA. At the same time, it is advisable to continue research in this direction with the study of more ophthalmological parameters and on a more representative sample.

A cost-consequence analysis of the Xpert Xpress CoV-2/Flu/RSV plus test strategy for the diagnosis of influenza-like illnesses

Aims Influenza-like illnesses (ILI) affect millions each year in the United States (US). Determining definitively the cause of symptoms is important for patient management. Xpert Xpress CoV-2/Flu/RSV plus (Xpert Xpress) is a rapid, point-of-care (POC), multiplex real-time polymerase chain reaction (RT-PCR) test intended for the simultaneous qualitative detection and differentiation of SARS-CoV-2, influenza A/B, and respiratory syncytial virus (RSV). The objective of our analysis was to develop a cost-consequence model (CCM) demonstrating the clinico-economic impacts of implementing PCR testing with Xpert Xpress compared to current testing strategies. Methods A decision tree model, with a 1-year time horizon, was used to compare testing with Xpert Xpress alone to antigen POC testing and send-out PCR strategies in the US outpatient setting from a payer perspective. A hypothetical cohort of 1,000,000 members was modeled, a portion of whom develop symptomatic ILIs and present to an outpatient care facility. Our main outcome measure is cost per correct treatment course. Results The total cost per correct treatment course was $1,131 for the Xpert Xpress strategy compared with a range of $3,560 to $5,449 in comparators. POC antigen testing strategies cost more, on average, than PCR strategies. Limitations Simplifying model assumptions were used to allow for modeling ease. In clinical practice, treatment options, costs, and diagnostic test sensitivity and specificity may differ from what is included in the model. Additionally, the most recent incidence and prevalence data was used within the model, which is not reflective of historical averages due to the SARS-CoV-2 pandemic. Conclusion The Xpert Xpress CoV-2/Flu/RSV plus test allows for rapid and accurate diagnostic results, leading to reductions in testing costs and downstream healthcare resource utilization compared to other testing strategies. Compared to POC antigen testing strategies, PCR strategies were more efficient due to improved diagnostic accuracy and reduced use of confirmatory testing.

Recent Progresses on Pathophysiology, Diagnosis, Therapeutic Modalities, and Management of Non-alcoholic Fatty Liver Disorder

Abstract: Non-alcoholic fatty liver disease (NAFLD) is currently the utmost common chronic liver disorder that happens through all age groups and is identified to occur in 14%-30% of the general population, demonstrating a critical and grossing clinical issue because of the growing incidence of obesity and overweight. From the histological aspect, it looks like alcoholic liver damage, but it happens in patients who avoid remarkable alcohol usage. NAFLD comprises a broad spectrum, ranging from benign hepatocellular steatosis to inflammatory nonalcoholic steatohepatitis (NASH), different levels of fibrosis, and cirrhosis. Patients with NASH are more susceptible to more rapid progression to cirrhosis and hepatocellular carcinoma. There is no single factor that drives proceeding from simple steatosis to NASH. However, a combination of multi parameters such as genetic background, gut microflora, intake of high fat/ fructose dietary contents or methionine/choline-deficient diet, and consequently accumulated hepatocellular lipids mainly including triglycerides and also other bio-analytes, such as free fatty acids, cholesterol, and phospholipids display a crucial role in disease promotion. NAFLD is related to overweight and insulin resistance (IR) and is regarded as the hepatic presentation of the metabolic syndrome, an amalgamation of medical statuses such as hyperlipidemia, hypertension, type 2 diabetes, and visceral obesity. Despite the increasing prevalence of this disease, which imposes a remarkable clinical burden, most affected patients remain undiagnosed in a timely manner, largely related to the asymptomatic entity of NAFLD patients and the unavailability of accurate and efficient noninvasive diagnostic tests. However, liver biopsy is considered a gold standard for NAFLD diagnosis, but due to being expensive and invasiveness is inappropriate for periodic disease screening. Some noninvasive monitoring approaches have been established recently for NAFLD assessment. In addition to the problem of correct disease course prediction, no effective therapeutic modalities are approved for disease treatment. Imaging techniques can commonly validate the screening and discrimination of NAFLD; nevertheless, staging the disease needs a liver biopsy. The present therapeutic approaches depend on weight loss, sports activities, and dietary modifications, although different insulin-sensitizing drugs, antioxidants, and therapeutic agents seem hopeful. This review aims to focus on the current knowledge concerning epidemiology, pathogenesis, and different biochemical experiments and imaging modalities applied to diagnose the different grades of NAFLD and its management, as well as new data about pharmacological therapies for this disorder.

A Bayesian functional approach to test models of life course epidemiology over continuous time.

Life course epidemiology examines associations between repeated measures of risk and health outcomes across different phases of life. Empirical research, however, is often based on discrete-time models that assume that sporadic measurement occasions fully capture underlying long-term continuous processes of risk. We propose (i) the functional relevant life course model (fRLM), which treats repeated, discrete measures of risk as unobserved continuous processes, and (ii) a testing procedure to assign probabilities that the data correspond to conceptual models of life course epidemiology (critical period, sensitive period and accumulation models). The performance of the fRLM is evaluated with simulations, and the approach is illustrated with empirical applications relating body mass index (BMI) to mRNA-seq signatures of chronic kidney disease, inflammation and breast cancer. Simulations reveal that fRLM identifies the correct life course model with three to five repeated assessments of risk and 400 subjects. The empirical examples reveal that chronic kidney disease reflects a critical period process and inflammation and breast cancer likely reflect sensitive period mechanisms. The proposed fRLM treats repeated measures of risk as continuous processes and, under realistic data scenarios, the method provides accurate probabilities that the data correspond to commonly studied models of life course epidemiology. fRLM is implemented with publicly-available software.

Целесообразность оказания психотерапевтического воздействия в коррекционной работе с заикающимися взрослыми

This article substantiates the relevance of the approach to viewing stuttering as a variant of personality disorder accompanied by negative psychosocial states and the necessity of supplementing therapy for this disorder with psychotherapeutic intervention methods aimed at neutralizing the corresponding states of the patient. A review of the main ideas of contemporary researchers on the problematic phenomenon of stuttering in its psychological and emotional aspects is presented, alongside an analysis of data from conducted experimental research aimed at evaluating the effectiveness of psychotherapeutic intervention in the comprehensive system of stuttering correction. Within the framework of the study, a program aimed at neutralizing dysfunctional psychological states in individuals with stuttering was developed and implemented, involving 12 participants aged between 18 and 27 years. Comparative analysis of data from the experimental group of participants revealed significant differences ‘before' and ‘after' the correction course with psychotherapeutic intervention, as well as in comparison with the control group after speech therapy correction without the use of psychotherapeutic intervention. These findings confirm the effectiveness of the presented methodology. Based on the totality of the data obtained, it can be asserted that the introduction of psychotherapeutic technologies into the system of comprehensive stuttering correction is expedient. This creates a premise for a significant improvement in the psychosocial state of patients, which is important not only for the prevention of relapses but also for enhancing the quality of life of people with stuttering. The implementation of interdisciplinary approaches, akin to the combination of methods and techniques of speech therapy alongside psychotherapeutic technologies, aids individuals with stuttering in mastering psychological methods of regulating dysfunctional states, creating conditions for establishing confident, stable speech.