Individual Manifestations Research Articles

Therapy with direct antiviral drugs in patients with HCVassociated cryoglobulinemic vasculitis – is it always possible to achieve complete clinical and immunological responses after the virus eradication?

Background. The use of direct acting antiviral drugs (DAАs) leads to the achievement of a stable virological response (SVR) in 95–100 % of patients with HCV-associated cryoglobulinemic vasculitis (HCV-CV). However, in some patients, despite the eradication of the virus, clinical and immunological markers of vasculitis still remain.The aim: to evaluate clinical and immunological responses in patients with HCV-CV in comparison with patients with "asymptomatic" HCV- associated cryoglobulinemia (HCV- СG) after achieving SVR with the help of DAАs with long-term dynamic observation (12 months).Patients and Methods: The study included 45 patients: 23 with HCV-CV and 22 with "asymptomatic" HCV-CG, who underwent antiviral therapy with DAAs. Clinical-immunological, virological data were evaluated: before treatment, 12 weeks (3 months) and 48 weeks (12 months) after the end of treatment.Results: After a course of DAAs, SVR was diagnosed in all 45 (100 % of patients). In patients with HCV-CV, an immunological response (complete and partial) was observed by week 12 (SVR12) – in 56.5 % and by week 48 (SVR48) – in 73.9 % patients. In 6 patients (26.1 %), the immunological response was not achieved by SVR48. The rate of complete and partial clinical response 12 weeks after the end of treatment at the SVR12 period in patients with HCV-CV was 65.2 %, to the time of SVR48 amounted to 78.3 % patients. In 5 (21.7 %) individual manifestations of CV persisted and/or relapsed. In patients with HCV-CG, the frequency of complete and partial immunological responses after DAAs therapy was 77.3 % – by SVR12 and 86.3 % – by SVR48, respectively. No response was observed in 3 patients and it was characterized by trace-level of cryoglobulinemia.Conclusion: In most patients with HCV-CV eradication of HCV with help of DAAs leads to the achievement of clinical and immunological remission of the disease. However, in 20 % of patients manifestations of HCV-CV persist / recur immediately after the end of treatment or later relapses are observed. Based on these observations, patients with HCV-CV, especially those with severe underlying skin and kidney disease, are required long-term monitoring after SVR is achieved.

Performativity of the Memory of Religious Places through Sound and Image

In this essay, we explore and deepen the confluence between sound and image, linking and relating concepts, purposes and coherence of artistic practices mediating and reconfiguring the memory of religious places. We observed that the performativity of memory, as an autobiographical concept, can be enhanced through live audiovisual performances in religious places. We have established that the performativity of memory in religious places can promote a spatial ‘self’, creating dynamic, immersive and physical experiences in the religious places. And we argue that the construction of this spatial ‘self’ involves processes of social and artistic reconfiguration that contribute to transforming not only the social dynamics within the community but also the artistic representations of memory. These main findings were reached following a process of research through artistic practice, thus a systematization of the processes involved in approaching three religious places. It also assumes the (de)construction of the sense of place throughout a personal reading on the mediation through nonverbal means. In this research, we also observed that the aesthetic and performative configurations can have an impact on the most individual manifestations of religion, religiosity and religious belief, influencing the interpretation and creation of meaning, evoking emotional and spiritual responses.

Caregiver-reported dental manifestations in individuals with genetic neurodevelopmental disorders.

Children with neurodevelopmental disorders (NDDs) often have poor oral health and dental abnormalities. An increasing number of genes have been associated with neurodevelopmental conditions affecting the oral cavity, but the specific dental features associated with many genes remain unknown. To report the types and frequencies of dental manifestations in children with neurodevelopmental conditions of known genetic cause. A 30-question survey assesing ectodermal and dental features was administered through Simons Searchlight, with which formed a recontactable cohort of individuals with genetic NDDs often associated with autism spectrum disorder (ASD). Data were collected from a largely paediatric population with 620 affected individuals across 39 genetic conditions and 145 unaffected siblings without NDDs for comparison. Drooling, difficulty accessing dental care, late primary teeth eruption, abnormal primary and permanent teeth formation, misshapen nails, and hair loss were more frequent in individuals with NDDs. Additionally, we evidenced an association between three new pathogenic gene variant/oral manifestation pairs: CSNK2A1/unusual primary teeth, DYRK1A/late primary teeth eruption, and PPP2R5D/sialorrhea. Our results demonstrate that genetic NDDs caused by mutations in CSNK2A1, DYRK1A, and PP2R5D are associated with unique dental manifestations, and knowledge of these features can be helpful to personalize dental care.

The dynamic socioecological model of economic inequality and psychological tendencies: A cycle of mutual constitution

AbstractEconomic inequality is one of the defining challenges of our era. Social science research links higher levels of economic inequality to a range of undesirable outcomes, including more crime, social anomie, and ill health. Social psychological research is at the forefront of investigating how economic inequality shapes the human mind and behavior, but it has mostly focused on explaining how economic inequality at the societal level causes individual level manifestations. In this review, we reconceptualize economic inequality as a dynamic system, and we adopt a socioecological perspective to explain how economic inequality and psychological tendencies mutually constitute each other. First, we show how the psychological experience of economic inequality is afforded by social and physical environments that people interact with. Next, we show that through mechanisms such as norm formation, individuals and institutions can maintain or change economic inequality. Our socioecological perspective highlights the self‐reinforcing cycle of economic inequality and individual behavior, and it discusses to what extent lived experiences and psychological manifestations of economic inequality may differ across economic strata. We end by discussing the implications of our model for the research agenda in the social psychology of economic inequality.

Maxims in the artistic discourse of Olga Kobylyanska

The purpose of the article is to analyze the maxims regulating family and domestic relations in the artistic discourse of the prominent Bukovinian writer in terms of syntactic organization, verbal content and semantic diversity. The relevance of the scientific article is determined by the need to study individual verbal manifestations in the artistic discourse of the Bukovіnian writer for the formation of a coherent cognitive-pragmatic concept of her artistic discourse. Research methods. In the article as the main general scientific methods of analysis and synthesis are used, as well as linguistic – descriptive, structural methods and method of component analysis. The novelty of scientific research lies in deepening the study of the artistic discourse of O. Kobylyanska. In addition, the analysis of the maxims in O. Kobylyanska's texts has not yet been the subject of linguistic analysis. Conclusions. Maxims are autosemantic, relatively independent statements based on popular common sense, the writer's intellectual level and precedent phenomena. The class of maxims consists of paremias, which include author's modifications of paremias, sayings based on folk mythologems and author's maxims. Maxims function in the text as a separate statement or as part of the context. Folk paremias function as precedent phenomena in the form of a simple sentence. Author's maxims can take the form of identification sentences. Often, maxims are included in the constructions of vocations, taking the form of direct speech. We fix the author's maxims in the form of a rhetorical question and an exclamatory sentence. In the artistic discourse of O. Kobylyanska, a considerable group of maxims regulates family and household relations. Among them, certain thematic groupings can be distinguished: maxims of an instructive nature, maxims about love, gender characteristics, about women, about married life etc.

Changes in therapeutic response, ocular manifestations of Graves' orbitopathy and quality of life during the first year after orbital radiotherapy.

The aim of our study was to assess the changes in the therapeutic response, ocular manifestations of GO and quality of life during the first year after OR. The study involved 26 consecutive patients with active moderate-to-severe GO indicated for OR, 18 females, mean age 57 ± 12.5. At baseline, all patients underwent comprehensive ocular examination and thyroid hormone and antibody testing. Then, OR was performed with a total dose of 20Gy, divided into 10 sessions of 2Gy each with concomitant oral intake of low-dose glucocorticoids. Therapeutic response and individual ocular manifestations were evaluated 1, 3, 6 and 12months after OR, and QoL-at 3, 6 and 12months by a disease-specific questionnaire. One month after OR, 61.6% of patients had a therapeutic response (full or partial). During the follow-up, the proportion of full-responders gradually increased up to 57.5% at 12months, while that of non-responders gradually decreased, reaching 11.5% at 12months. All individual ocular manifestations improved significantly 1-3months after OR. QoL related to visual functioning increased significantly at 6months, whereas QoL related to appearance improved significantly at 12months. The vast majority of our patients with active moderate-to-severe GO exhibited full or partial therapeutic response after OR. The initial effect on the therapeutic response and individual ocular parameters was evident as soon as 1-3months after the procedure. OR also has a beneficial effect on patients' QoL. NCT05775185/07.03.2023, retrospectively registered.

The Use of Empirical Mode Decomposition on Heart Rate Variability Signals to Assess Autonomic Neuropathy Progression in Type 2 Diabetes

In this study, we investigated the use of empirical mode decomposition (EMD)-based features extracted from electrocardiogram (ECG) RR interval signals to differentiate between different levels of cardiovascular autonomic neuropathy (CAN) in patients with type 2 diabetes mellitus (T2DM). This study involved 60 participants divided into three groups: no CAN, subclinical CAN, and established CAN. Six EMD features (area of analytic signal representation—ASRarea; area of the ellipse evaluated from the second-order difference plot—SODParea; central tendency measure of SODP—SODPCTM; power spectral density (PSD) peak amplitude—PSDpkamp; PSD band power—PSDbpow; and PSD mean frequency—PSDmfreq) were extracted from the RR interval signals and compared between groups. The results revealed significant differences between the noCAN and estCAN individuals for all EMD features and their components, except for the PSDmfreq. However, only some EMD components of each feature showed significant differences between individuals with noCAN or estCAN and those with subCAN. This study found a pattern of decreasing ASRarea and SODParea values, an increasing SODPCTM value, and a reduction in PSDbpow and PSDpkamp values as the CAN progressed. These findings suggest that the EMD outcome measures could contribute to characterizing changes associated with CAN manifestation in individuals with T2DM.

Altruism as an anthropological-biological determinant of the contractual regulation of relations

The application of the anthropological and sociological research approach, according to which the patterns of emergence, existence and development of law are determined exclusively by the social dimension of human existence, actually leaves out of consideration the biological nature of the creator of legal norms. And this nature, as confirmed by the results of numerous studies of the behaviour of various social animals, significantly affects the social existence of the latter. Therefore, for the sake of comprehensive knowledge of these regularities, an anthropological and biological approach (based on the recognition of the evolutionary nature of humans and the conditioning of the state and law by certain biological properties of the human individual) should also be applied. This will contribute to interdisciplinary research and the development of legal science based on them.The article is devoted to individual manifestations of human biological nature, namely altruism as an anthropological-biological determinant of contractual regulation of social relations. The concepts and types of this determinant are clarified, and the signs of kin and reciprocal altruism are characterized. It is substantiated that the latter contributes to the spread of social ties and the establishment of norms of physical behaviour. The dependence between the manifestation of altruistic behaviour, the emergence of contractual relations and their regulation in both animals and humans has been demonstrated. A parallel is made with the psychological theory of law of L. Petrażyсki regarding the justification of the emergence of legal relations, in particular, in the field of private contracts. It was concluded that imperative-attributive emotions in the concept of this theorist are a manifestation of mutual altruism. It is noted that altruistic behaviour is aimed at the creating and recognising of protonorms, in particular, the emergence of duties and corresponding rights of a contractual nature. Therefore, the study of individual manifestations of altruism in the environments of animals and people can be useful for deepening the knowledge of the origins of legal regulation.

Formation and development of prerequisites for international legal protection of vulnerable population groups: historical and legal discourse

The article is devoted to highlighting the process of formation and development of the prerequisites for the creation of a modern set of norms of international law, aimed at protecting vulnerable groups of the population - parts of society with different numbers, with an increased risk compared to other groups or the rest of society of being affected by the effects of a discriminatory nature, becoming victims of violence (especially during armed conflicts), natural, man-made disasters or economic shocks. Usually, the term “vulnerable groups” is used for the elderly, children, certain categories of women, refugees, people with disabilities, migrant workers, indigenous peoples and national minorities, religious minorities. The chronological boundaries of the study cover the period from ancient times to 1919.Today, despite the apparent legal protection, these population groups in their everyday life still continue to face manifestations of discrimination and social stigmatization, despite the fact that international law emphasizes the principle of respect for human rights and declares the equality of people in their rights (political, economic, environmental, etc.), regardless of certain specific factors, including the nature or degree of their vulnerability.This problem became particularly acute with the beginning of the Russian-Ukrainian war. Such exceptional actualization is due to the fact that in wartime, unfavorable external and internal factors (primarily humanitarian, economic, ecological) that affect the risks of various most vulnerable categories of people falling into difficult life circumstances, compared to peacetime, are extremely intensified.The article emphasizes that in relation to the era of pre-classical international law, there is no reason to speak of any systematic protection of vulnerable categories of the population. At that time, we see only individual manifestations of a compassionate attitude towards women, children, the disabled, and the elderly. There were no special international legal acts in this area.It was noted that the actual formation of the foundations of international legal protection of vulnerable population groups took place only in the era of classical international law, especially in the second half of the 19th - at the beginning of the 20th century. An important place in the protection of vulnerable categories of the population at the end of the 19th century. signed agreements that specifically laid the international legal foundations for the protection of women, primarily the fight against trafficking in women. During this period, a number of international treaties aimed at protecting the poorest sections of the population were concluded. Among them are agreements on mutual support of poor sailors, sick people, abandoned children, etc. At the same time, important steps were taken to ensure the protection of the rights of religious minorities. An important milestone on the way to the creation of an international legal basis for the protection of vulnerable sections of the population during wartime was the adoption of the Geneva Convention on the Amelioration of the Fate of Wounded and Sick Soldiers in Land War on August 22, 1864, the Brussels Declaration on the Laws and Customs of War of 1874, the Hague the Convention on the Laws and Customs of the Land War of 1907, which, although not directly aimed at protecting the rights of vulnerable groups of the population, were nevertheless tentatively aimed at the implementation of this task.

Treatment of hypophosphatasia

ypophosphatasia is a systemic metabolic disorder due to genetically determined deficient activity of the tissue non-specific alkaline phosphatase (TNAP). The phenotypic presentation is characterized by a wide spectrum of clinical manifestations regarding both, affected body systems and organs as well as the severity of associated deficits. Appropriate treatment strategies thus have to be multimodal in order to cover individual disease manifestation. For patients with disease onset before adulthood, enzyme replacement therapy with asfotase alfa is approved in Europe to treat the bone manifestations of the disease. Available data from clinical trials as well as real-word evidence confirm encouraging results of this treatment in severely affected children with substantial improvement regarding radiographic and functional outcome parameters as well as overall survival. In adult patients with disease manifestation pursuant to the label, published results also report substantial amelioration of disease-specific deficits along with functional improvements. Meanwhile, there is are also data supporting the safety and efficacy of long-term treatment with asfotase alfa over several years. While inflammatory muskuloskeletal pain - seemingly the most prevalent clinical manifestation along with exhaustion - can transiently be mitigated with on-demand NSARs, essential treatment options to causatively overcome that issue are still lacking. Accordingly, maintenance of musculoskeletal health and functionality requires sustained supportive treatment including physiotherapy and individually adjusted technical orthopedic support. The use and potential clinical impact of phosphate and vitamin B6 on the course of the disease requires further investigation. Current data regarding the use of bone-targeted compounds established for osteoporosis is critical in terms of antiresorptive, while osteoanabolic treatment strategies appear feasible. Considering further organ manifestation including orodental, gastrointestinal and neurological symptoms etc., the entirety of therapeutic measures should be coordinated among a multidisciplinary team and overlooked at an experienced center, while individual tasks can preferably be accomplished at local facilities near the patient’s home.

Celiac disease in children - diagnosis in light of the current 2020 ESPGHAN guidelines

Celiac disease is a chronic immune disorder of the small intestine that is triggered by the consumption of gluten in genetically predisposed individuals. The disease is difficult to diagnose and treat, and its incidence is increasing. It can have different symptoms and clinical manifestations in individuals. Diagnosis is usually based on the presence of specific antibodies and histopathological examination of biopsy specimens from the small intestine. The only effective treatment is a gluten-free diet for life. Diagnosis of celiac disease in children is mainly based on the presence of specific an- tibodies in the blood, such as antibodies to tissue transglutaminase (tTG), antibodies to endomysium (EMA) or deamidated gliadin peptides (DGP). In addition, genetic testing is also used in diagnosis to detect the presence of HLA DQ2 or DQ8 genes, which are often present in people with celiac disease. The final diagnosis of celiac disease is based on a combination of the results of these tests and the presence of characteristic lesions in the small intestine, which are detected during endoscopy and small bowel biopsy.

Individual Risk Assessment for Population Living on the Territories Long-Term Polluted by Organochlorine Pesticides

The long-term storage of unutilized pesticides raised new problems of long-term environmental contamination. The study presents the results of surveying 151 individuals in 7 villages living close to pesticide-contaminated localities. All individuals have been surveyed concerning their consumption habits and lifestyle characteristics. An assessment of the general exposure risks of the local population was carried out using the analysis of pollutants in food products and the average levels of their consumption in the region. The cohort risk evaluation revealed that the greatest risk was associated with the regular consumption of cucumbers, pears, bell peppers, meat, and milk. The new model to estimate individual risks of long-term pesticide pollution was proposed as a calculation of the combined action of 9 risk factors, including individual genotypes, age, lifestyle, and personal pesticide consumption rates. The analysis of the predictive ability of this model showed that the final score for individual health risks corresponded to the development of chronic diseases. A high level of chromosomal aberrations was evidenced for individual genetic risk manifestations. The combined influence of all risk factors revealed contributions of 24.7% for health status and 14.2% for genetic status, while other impacts go to all unaccounted factors.

Prevalence and diagnostic significance of de-novo 12-lead electrocardiogram patterns following covid-19 infection in elite soccer players

Abstract Funding Acknowledgements Type of funding sources: None. Background Considering that myocarditis is implicated in 5-15% of all exercise related sudden cardiac deaths in athletes, following a novel viral pandemic, the identification and risk-stratification of affected athletes remains an important priority. Given its widespread availability, the inclusion of a 12-lead electrocardiogram (ECG) is common to all consensus-based protocols from North America and Europe. However, a single cross-sectional ECG is problematic because several physiological repolarisation changes are also common manifestations in individuals with myopericarditis. Purpose The aim of our study was to report on the prevalence and diagnostic significance of de-novo ECG patterns following COVID-19 infection in a well-defined cohort of elite soccer players in the English, Dutch and Brazilian leagues. Methods In this multicentre observational study, between March 2020–May 2022, we evaluated consecutive athletes with COVID-19 infection. ECGs were reported in accordance with the International recommendations for ECG interpretation in athletes. The following patterns were also considered abnormal if they were not detected on the pre-COVID-19 infection ECG: PR-segment depression, new J-point and ST segment elevation, low QRS voltages, QRS fragmentation, new ST-segment depression, new T-wave inversion, biphasic T-waves and a reduction in the T-wave amplitude by 50% or T-wave flattening. Athletes exhibiting de-novo ECG changes underwent cardiovascular magnetic resonance (CMR) scans. One club mandated CMR scans for all players (n=30) following COVID-19 infection, despite the absence of cardiac symptoms or de-novo ECG changes. Results 511 soccer players (median age 21-years, IQR:18-26-years) were included, of which 88% were male and 58% white. 17 (3%) athletes demonstrated de-novo ECG changes, which included, a reduction in T-wave amplitude in the inferior and lateral leads (n=5), inferior leads (n=4) and lateral leads (n=4); inferior T-wave inversion (n=7), and ST-segment depression (n=2). 15 (88%) athletes with de-novo ECG changes revealed CMR evidence of inflammatory cardiac sequalae. All athletes who underwent a mandatory CMR irrespective of illness severity or ECG findings, had normal findings. Athletes revealing de-novo ECG changes, had a higher prevalence of cardiac symptoms (71% v 12%; p<0.0001) and longer median symptom duration (5-days, IQR:3-10) compared with athletes without de-novo ECG changes (2-days, IQR:1-3; p<0.001). Among athletes without cardiac symptoms, the additional yield of de-novo ECG changes to detect cardiac inflammation was 17%. Conclusions 3% of athletes demonstrated de-novo ECG changes post COVID-19 infection, of which 88% were diagnosed with inflammatory cardiac sequalae. Most affected athletes exhibited cardiac symptoms; however de-novo ECG changes contributed to a diagnosis of cardiac inflammation in 17% of athletes without cardiac symptoms.

Negative Consequences of Corruption in Public Procurement

The subject matter of the study deals with the norms of national legislation on combating corruption and public procurement, as well as research works on the negative consequences of corruption in public procurement. The purpose of the study is to examine and systematize knowledge about the negative consequences of corruption in public procurement. The objectives of the study are: to examine provisions of national legislation on combating corruption in public procurement; interdisciplinary research of approaches to considering the consequences of corruption and its individual manifestations in public procurement; systematization of the negative consequences of corruption in public procurement using methods of grouping and typologization. In the course of the study, the author identified the normative prerequisites for the relevance of studying the issue posed. The analysis of the results of the research on the consequences of corruption and its individual manifestations in the field of public procurement allowed us to identify two groups of such consequences: internal and external. Economic, legal, social, political, moral and psychological negative consequences are identified using the method of typologization. When applying an interdisciplinary approach to the study of the negative consequences of the phenomenon under consideration, the author identified the industry-wide nature of such consequences, consisting in their harmful effects not only on the public procurement system itself, but also on other spheres of public life and, subsequently, on all major state and public mechanisms.

Urticaria after breakthrough Omicron BA.5.1 severe acute respiratory syndrome coronavirus 2 infection in a triple-vaccinated (Pfizer) patient: a case report

BackgroundSevere acute respiratory syndrome coronavirus 2 continues to threaten public health. The virus is causing breakthrough infections in vaccinated individuals. Also, scarce information is available about cutaneous manifestations after severe acute respiratory syndrome coronavirus 2 infection.Case presentation and findingsA case of a triple-vaccinated (Pfizer) 37-year-old Hispanic American (Colombian) male who developed urticaria after Omicron BA.5.1 severe acute respiratory syndrome coronavirus 2 breakthrough infection is described. Virus isolation and whole genome sequencing along with immune and molecular assays were performed. Dermatological manifestations (skin rash and urticaria) after Omicron BA.5.1 infection were observed. Sequence analysis of the Omicron BA.5.1 isolate also revealed several important mutations. Hemogram analysis revealed leukocytosis and neutrophilia. Serology testing revealed anti-spike immunoglobulin G serum titers but negative detection of immunoglobulin M at 10 days after symptom onset. Anti-nucleocapsid, anti-spike 1 immunoglobulin G, anti-spike trimer, and anti-receptor-binding-domain immunoglobulin G and immunoglobulin E sera were detected at different titers 10 days after symptom onset. Several serum levels of chemokines/cytokines (Interferon-α, interferon-γ, interleukin-12/interleukin-23p40, interleukin-18, interferon gamma-induced protein-10, monocyte chemoattractant protein-1, monokine induced by gamma, macrophage inflammatory protein-1α, chemokine (C-C motif) ligand-5 , tumor necrosis factor-β1, Tumor necrosis factor-α) were detected, but interleukin-2, interleukin-4, interleukin-6, interleukin-8, and interleukin-17A were below the limit of detection.Interpretation and conclusionsTo our knowledge, this is the first study describing skin effects of a severe acute respiratory syndrome coronavirus 2 Omicron BA.5 variant breakthrough infection in a triple-vaccinated patient in Colombia. Several important mutations were found in the spike glycoprotein of the virus isolated; these mutations are associated with immune evasion and changes in antigenic properties of the virus. Physicians overseeing coronavirus disease 2019 cases should be aware of the potential skin effects of the infection. Pathogenesis of severe acute respiratory syndrome coronavirus 2 infection and its association with proinflammatory cytokines and chemokines may enhance the development of urticaria and other skin manifestations in immunized individuals. However, further studies are needed to better understand the complexity of coronavirus disease in such situations.

СИНДРОМ SAPHO: СЛОЖНОСТИ ПОСТАНОВКИ ДИАГНОЗА НА ПРИМЕРЕ КЛИНИЧЕСКОГО СЛУЧАЯ. РЕНТГЕНОРАДИОЛОГИЧЕСКАЯ ВИЗУАЛИЗАЦИЯ

Purpose: Demonstrate the possible manifestations of SAPHO syndrome. Material and methods: 38-year-old woman with suspected SAPHO syndrome were performed scintigraphy and SPECT/CT for evaluate the localization and abundance of the process. Results: Osteosclerosis and hyperostosis of the left clavicle, osteosclerosis of the L1 vertebra and other, less pronounced changes, accompanied by active accumulation of the 99mTc-MDP, were revealed. Conclusion: It is important to remember the specific complex of symptoms of this nosological entity and the possible isolated onset of individual manifestations, which was also observed in our case.

Serum Hemoglobin and Potassium Levels in Sudden Cardiac Death at Hemodialysis Center of Aziz Bhatti Hospital Gujrat

Background: Sudden cardiac arrest has become a serious pandemic and a substantial public health burden. Significant morbidity and death are linked to it. Hemodialysis is considerably a heavy burden on cardiac patients. A sudden cardiac arrest is sometimes a disastrous event that happens without warning and is regrettably a significant cardiac disease manifestation in individuals surviving on kidney dialysis. Aim: To determine Serum Hemoglobin and potassium levels in sudden cardiac death patients admitted in hemodialysis center of Aziz Bhatti Shaheed Teaching Hospital Gujrat. Study Design: Cross-Sectional Study Methodology: This research study was conducted at the hemodialysis center of Aziz Bhatti Shaheed Teaching Hospital Gujrat. The Ethics Committee approved to conduct of this descriptive cross-sectional study on 40 (20 males and 20 females) sudden cardiac patients. All information and the goal of the research project were explained to patients or their relatives before the collection of blood serum. Prescription drug lists, smoking histories, and medication or dialysis report data were randomly evaluated. Laboratory results from recent month were collected, together with dialysis run sheets and cardiac arrest data forms. Results: Results of this result study showed that the mean value of age was 50 years with a mean standard deviation of 15.1 (p= <0.001). The mean BMI (kg/m2) was estimated as 26.8 with a mean standard deviation value of 2.6 (p= 0.01). Almost 21.6% of male patients were smokers and overall 36.1% were associated with cardiac arrest due to coronary artery disease. Systolic blood pressure (mmHg) was 165 (95% CI of 117-140) (p= <0.001), diastolic blood pressure (mm Hg) was 89 ( 95% CI of 64-72) (p= <0.001), hemoglobin level was 0.73 (95% CI of 0.70-0.76) (p= <0.001), Hemoglobin A1 c was 6.4% (95% CI of 5.8-7.6) (p= <0.001), Urea was 56 (95% CI of 41-79) (p= <0.001), and estimated glomerulus filtration rate (mL/min per 1.73mm2 ) was 1.16 (1.10-1.22) in sudden cardiac patients with low K (serum <4.0mmole/L). For the sudden cardiac patients with higher K level (serum >4.0mmole/L) showed that there was a significant change in the estimated values i.e. estimated glomerular filtration rate (mL/min per 1.73 mm2) was 0.67 (95% CI of 0.54-0.58) (p=<0.01). The practical implication of this research study suggests that the higher proportion of cardiac patients were reported higher concentration of K level serum. For diagnosis purposes K-level was directly associated with the cardiac disease progression. Conclusion: Hemodialysis patients with sudden cardiac arrest had reported very low concentrations of potassium levels. Dialysate prescriptions should be continuously reviewed and changed, especially after hospitalization in high-risk patients, to lower the risk of adverse cardiac events during hemodialysis. It was suggested that in the high-normal range of serum potassium seems to be safe and is linked to better outcomes. Keywords: Sudden cardiac arrest, Hemodialysis, serum potassium level, Hemoglobin

Образ китайской поэзии в переводах В. Перелешина

The research aims to determine how the image of Chinese poetry is created in V. Pereleshin’s translations and to identify the key features of his cultural dialogue with China. The paper is devoted to the analysis of the image of Chinese poetry in translations by V. Pereleshin, mainly involving the materials of his anthology of translations of Chinese classical poetry “Poems on the Fan” and autographs of translations of Chinese poems. The peculiarities of Pereleshin’s translations are revealed in terms of the poetic form, translation adequacy, the manifestation of the creative individuality of the translator and in terms of the range of themes of Chinese poetry. The paper substantiates that the compliance with the miniature genre of Chinese poetry and the strict rhyming of Russian poetry is a distinctive feature of Pereleshin’s poetic translations. The scientific novelty lies in the fact that the paper is the first to conduct a detailed comparative study of the image of Chinese poetry in translations by V. Pereleshin as a representative of the Far Eastern branch of Russian literature in the synthesis of two scientific approaches: Russian literary criticism and studies of the Chinese literary tradition. As a result, it has been proved that the vivid image of Chinese classical poetry created by Pereleshin gives a general view of the form, content and range of themes of shi and ci poems and leads to the understanding of the cultural dialogue of Russian émigré poets with China.

Widespread Aneurysms Secondary to Myosin Light-Chain Kinase Gene Mutation Leading to Multifocal Right Hemispheric Stroke (P3-5.001)

<h3>Objective:</h3> Familiarize providers with the presence of the Myosin Light-Chain Kinase (MYLK) and the possible vascular manifestations in individuals carrying this autosomal dominant gene mutation. <h3>Background:</h3> Myosin Light-Chain Kinase is a ubiquitously expressed kinase involved in the physiological contraction of smooth muscle cells within hollow organs. Variations in the Myosin Light-Chain Kinase (MYLK) gene lead to decrease in phosphorylation of 20kDa regulatory light-chain leading to a reduction in smooth muscle contractile function. MYLK gene mutations have been associated with autosomal dominant thoracic aortic aneurysms and dissections, however there are limited studies mentioning the involvement of other vascular structures containing these dysfunctional smooth muscle cells. In this report, we present a case of a 43-year-old individual who presented to the hospital for quadrantanopia, hearing loss and headache who was subsequently found to have an acute stroke of multiple foci involving the right ACA and MCA territories. Past medical history was significant for hemochromatosis, early onset coronary artery disease in self and close family members. Etiology workup revealed a right internal carotid artery aneurysm measuring 10cm. Complains of abdominal pain led to imaging revealing focal dissection of the abdominal aorta, a right common iliac artery 2.3cm aneurysm as well as a proximal celiac artery 1.7cm aneurysm. On outpatient genetic testing, the patient was found to be a carrier of the MYLK (p.Val509Met) gene mutation; variance was of unclear significance, however familial thoracic aneurysms/dissections have been reported in the Clinical Variance Database. The patient has since been managed with dual anti-platelet therapy and was instructed to follow closely with neurological and vascular surgery for close monitoring. <h3>Design/Methods:</h3> NA <h3>Results:</h3> NA <h3>Conclusions:</h3> This case highlights the MYLK gene mutation and its possible relationship with widespread malformations in the carotid, celiac, and mesenteric vasculature to familiarize practitioners with manifestations and clinical sequelae of individuals affected with this gene. <b>Disclosure:</b> Dr. Hamzoian has nothing to disclose. Dr. Abdelmasih has nothing to disclose. Dr. Ditamo has nothing to disclose. Dr. Kahila has nothing to disclose.

Integral testing indicators individual features of various playing roles volleyball players at the specialized basic training stage

Rationale and purpose: Volleyball has a unique feature of combining both tall attackers and small, fast liberos in one team. The purpose of the study was to develop individual programs of the educational and training process of volleyball players at the stage of specialized basic training based on factor models of their readiness.&#x0D; Material and Methods: The women's volleyball team of the Children's League of Ukraine of sports boarding school No. 1 in the city of Kharkiv took part in the study, in the number of 12 players aged 15-16 years. The testing was carried out on 10 tests of physical fitness. From the methods of statistical analysis, the method of descriptive statistics, factor analysis by the method of principal components with the determination of the individual manifestation of each factor in female athletes, and cluster analysis were used.&#x0D; Results: On the basis of the factor analysis, the structure of the preparedness of volleyball players at the stage of specialized basic training was determined, in which four pronounced factors were revealed. The model of the existing or possible belonging of the players to the role according to the determined factor structure is determined: in the forwards of the first tempo, the factors "speed-power readiness" and "power endurance" come to the fore, in the attackers of the second pace - "speed-power readiness" and "speed endurance", in "communication" - "speed endurance" and "special (aerobic-anaerobic) endurance", in libero - "power endurance" and "special (aerobic-anaerobic) endurance". Using this scheme, you can determine the individual potential opportunities of different players to play in different roles.&#x0D; Conclusions: As a result of the cluster analysis, the functions of volleyball players were clarified and the players most similar to each other in terms of their preparation structure were identified, which sometimes causes some difficulties for coaches when working with athletes with implicitly expressed game functions. Individual profiles of players were compiled and individual recommendations for training volleyball players were developed based on the individual values of readiness factors and the results of cluster analysis.