Main Groups Research Articles

Long‐term organic management: Mitigating land use intensity drawbacks and enhancing soil microbial redundancy

AbstractBackgroundSoils under organic farming systems exhibit better quality and higher biological activity than conventional systems. Manure addition, especially coupled with reduced or no tillage, significantly enhances microbial biomass and activity by improving soil physical properties and providing carbon (C) and nitrogen (N) sources. While several studies have examined the effects of transitioning from conventional to organic farming on soil chemistry and biochemistry, limited research has explored the influence of land use variations on soil fertility within long‐term organic farming systems.AimsTherefore, the aim of this study was to assess how three different land uses—pasture, vegetable crops, and orchard—affected soil fertility under a long‐term organic farming system.MethodsSoil samples were collected from the 0 to 15 cm layer of plots used for pasture, vegetable crops and orchard, being the latter cover cropped with legumes, and analyzed to determine chemical and biochemical soil parameters.ResultsContrary to expectations, high land use intensity (vegetable crops and orchard soils) resulted in increased soil organic C and total N, compared to low intensity (pasture). Such an increase was ascribed to farmyard manure addition that counteracted the negative impact of tillage. Consequently, microbial biomass C and activity also increased. The greatest availability of organic substrates favored bacteria, particularly gram‐positive strains, shaping the microbial community. However, despite changes of microbial biomass and of the main microbial groups, microbial activity was only slightly affected, suggesting high functional redundancy of microorganisms in long‐term organic farming soil.ConclusionsResults suggested that if land use intensification provides for organic supply, its negative impact on soil fertility may be mitigated.

Pharmacological correction of the activity of bone remodelling markers in the oral fluid of patients with generalised periodontitis depending on blood type

This article presents the data on the effectiveness of the treatment complex we developed on the activity of bone remodelling markers in the oral fluid during the treatment of generalized periodontitis, depending on the blood group. The use of our proposed drugs of general and local action in patients with generalized periodontitis of different blood groups allowed to reduce the average content of TRACP in the oral fluid by 18.25%, while increasing the level of BSALP by 27.64% in comparison with the corresponding data before treatment, p, р1<0.05, 0.01, which indicates the predominance of bone remodelling processes over osteoresorption processes in patients of the main group. The tactics of treatment of patients with generalized periodontitis of different blood groups, which we propose, is more effective than the conventional therapy and contributes to a faster achievement of remission of generalized periodontitis.

A Computational Multiscale Modeling Method for Nanosilver-Sintered Joints with Stochastically Distributed Voids

A high power density is required in wide band gap power semiconductor packaging, which has led to the popularity of sintered nanosilver as an interconnecting material. However, affected by stochastically distributed voids in its microstructure, this material in practice exhibits instability leading to reduced reliability. In this paper, a computational multiscale modeling method is proposed to simulate the influence of micro-voids on macro-properties, providing an efficient tool to analyze the aforementioned problem. At the micro-scale, the three-parameter Weibull distribution of the equivalent Young’s modulus and the normal distribution of the equivalent Poisson’s ratio are captured by Monte Carlo-based finite element simulation on the reconstructed stochastic representative elements, where the density and distribution morphology of micro-voids are taken into consideration. At the macro-scale, the effect of the microscopic voids is transferred through a random sampling process to construct the multiscale model. The effectiveness and validity of the proposed method are verified through experimental case studies involving the modeling of nanosilver-sintered joints sintered at temperatures of 275°C and 300°C. In addition, the effects of the sintering temperature on the dispersion of the micro-voids, the distribution fluctuation of the constitutive parameters, and the mechanical properties are also discussed based on numerical and experimental results.Graphical

Clinical and Laboratory Features and Maternal Outcomes in Pregnant Women with Critical Lung Damage in the COVID-19

Introduction. The spread of the delta strain of the SARS-CoV-2 virus during the third and fourth waves of the pandemic led to the fact that a large cohort of pregnant women and maternity women needed respiratory support, standard treatment methods had no effect, and negative outcomes for the mother and fetus has increased.Purpose of the study. The aim is to determine clinical and laboratory features and maternal outcomes in pregnant women with the coronavirus disease 2019 (COVID-19) and critical lung damage.Materials and methods. A comparative study was conducted, followed by a retrospective analysis of clinical and laboratory features, maternal outcomes in 56 pregnant women with COVID-19 treated in this maternity hospital in the first-fourth wave of the pandemic. The research method is continuous, sequential. The first group (main) consisted of 28 women with severe or extremely severe form of the course of COVID-19 and critical lung damage (more 75 %); The second group (comparison) — 28 pregnant women with a moderate form of the disease and lung damage of 25–50 %. Screening assessment of the degree of endogenous intoxication was carried out. The severity of the disease was determined by the evaluation scale National Early Warning Score (NEWS).Results. Laboratory parameters of patients at admission and at the height of the disease have statistically significant differences in the general blood test, such as higher levels of leukocytes, eosinophils, rod-shaped neutrophils, hemoglobin, as well as lymphopenia and monocytopenia in women of the main group at the height of the disease. At the same time, the hematological indices of intoxication in the main group exceed the value of these indicators in the comparison group by two times. Patients of both groups had high levels of acute-phase markers of inflammation — C-reactive protein and ferritin, — an indicator of tissue destruction of lactate dehydrogenase, however, both at admission and at the height of the disease, these indicators were statistically significantly higher in the group of women with critical lung damage. In general, 20/28 patients (71.4 %) of group 1 had an extremely severe course of the disease, 8/28 (28.6 %) had a severe course. In second group, 28/28 patients (100 %) had moderate-severe NCI (p = 0.000), while recovery was noted in all of them. Outcomes of COVID-19 in women with critical lung damage: recovered — 25/28 (89 %); 3/28 (10.7 %) the patients died from complications of COVID-19 of an extremely severe degree.Discussion. The most frequent laboratory anomaly was leukocytosis and a rod-shaped shift in the midst of the disease in women with critical lung damage, as well as a statistically significant increase in the level of C-reactive protein, lactate dehydrogenase, D-dimer. Pulmonary complications (parapneumonic pleurisy, pneumothorax, pneumomediastinum, hydrothorax, lung abscess) and extrapulmonary complications (encephalopathy, panic attacks, acute liver injury, sepsis, thromboembolic complications) were observed only with critical lung damage.Conclusion. In the laboratory, at the height of the disease, in the group of pregnant women with critical lung damage, leukocytosis and stab shift are statistically significantly more common. Hematological indices of intoxication, leukocyte and hematological, confirm endogenous intoxication at the height of the disease. A statistically significantly higher level of aspartate aminotransferase, lactate dehydrogenase, C-reactive protein, D-dimer is determined upon admission to the hospital and at the height of the disease as markers of systemic inflammatory response and cytolysis, which demonstrates the defeat of several organ systems simultaneously.

Problematic smartphone use among russian and foreign medical students: prevalence, content consumed, associations with other forms online behavior

Aim of the study was to investigate the prevalence of problematic smartphone use, the characteristics of the content consumed and associations with other forms of online behavior among Russian and foreign medical students. Material and methods. 296 medical students were examined using the online survey method: 219 Russians (main group) and 77 foreigners (comparison group); 107 (36.2 %) boys and 189 (63.8 %) girls; age 20 [18; 21] years (median [lower quartile; upper quartile]). The structure of online behavior was assessed: adaptive, non-adaptive, and pathological (PIU) Internet use; specific forms of PIU: problematic use of computer games and social networks, mixed and undifferentiated form of PIU. The values of the total score of the scales of the applied psychometric questionnaires were determined. The indicators were compared in the general group of subjects, in groups of Russians and foreigners, including gender. Results. Problematic smartphone use is typical for 14.2 % of all surveyed. The share of smartphone addicts is higher among foreigners than among Russians (27.3 and 8.0 %, respectively), both boys and girls. PIU prevailed among foreigners (16.1 and 7.4 %), they are more often dependent on social networks (34.5 and 2.4 %). Foreign women were distinguished by a high incidence of problematic use of computer games (20.0 and 3.6 %) and social networks (25.0 and 3.1 %), as well as a mixed form of PIU (20.0 and 2.5 %). The content consumed by Russians (boys + girls) was dominated by being on social networks (77.6 Russians and 46.7 % foreigners) and listening to music (50.7 and 31.2 %, respectively). Gender differences in content included more frequent use of social networks by Russian students, both boys (81.1 and 48.1 %) and girls (76.5 and 43.5 %); more frequent listening to music by Russian males in comparison with foreign males (66.0 and 29.6 %) and Russian females (66.0 and 45.8 %). Foreign boys use smartphones for games more often than foreign girls, the preoccupation with smartphone games is higher among Russian women as well. Conclusions. The prevalence of problematic smartphone use, the characteristics of the content consumed and associations with other forms of PIU among Russian and foreign students were established. In our opinion, it is necessary to carry out further research aimed at solving an urgent medical and social problem of timely diagnosis of smartphonedependent behavior and prevention of somatic and neuropsychic health disorders associated with it in young people. The current range of indicators to be studied in people with problematic smartphone use should include an analysis of comorbid psychosomatic disorders (recurrent pain: headaches, abdominal pain, back pain) and features of psychosocial characteristics, taking into account age, sex and ethnic differences of electronic gadget users.

Attitude towards the risk-based approach implementation into the russian healthcare system among employees of medical organizations

Aim of the study was to develop recommendations for improving procedures and unifying the content of risk management of the healthcare system to preserve public health based on an analysis of the opinions of doctors, organizers and experts of the healthcare system. Material and methods. As part of a quantitative online survey conducted from September to December, 2022, 104 respondents working in the healthcare system of the Russian Federation were interviewed. Additionally, 6 in-depth interviews were conducted with the organizers and experts of the healthcare sector as part of a qualitative sociological study. Desk research included analysis of scientific literature, and the regulatory framework related to the introduction of a risk-based approach to healthcare. Results and discussion. The article presents an analysis the perception of risks in healthcare by doctors, organizers and experts at the level of a medical organization, of the healthcare system and of public health (macro level), with the identification and classification of the main risk groups, on the basis of which risk-management’ measures can be built. The results of the study testify to the insufficiently deep introduction of risk management into the management system of medical organizations. The half of the respondents noted the low and extremely low level of risk management principles’ usage in their own organizations (50 % of respondents) and in Russian medical organizations in general (58.6 % of respondents). At the same time, from a third to a half of the participants found that it was difficult to answer about risk management implementation in their organizations, due to the lack of a unified methodology, imperfection of standards and quality control system of this set of measures, lack of specialists who could manage risks, lack of educational activities. To introduce a systematic approach to the unification of risk management processes, it is necessary to develop and approve the methodology of best practices, as well as take care of the training of specialists. Conclusions. In order to implement a systematic approach to the unification of risk management processes, it is necessary to develop and approve a methodology of best practices, as well as to take care of the training of specialists. It is imperative that hospital managers and staff focus on improving the organizational culture of patient safety management as the basis for their mission to preserve public health. It is necessary to continue further research in this direction in order to develop a strategy for countering risks at the level of public health as a medical and social resource of society.

Indicators of Mineral Metabolism in the Oral Fluid in Patients with Gastroesophageal Reflux Disease

Disruption of the digestive system in the gastrointestinal tract, namely in gastroesophageal reflux disease, leads to the development of pathological processes in the oral cavity, changing the homeostasis of the viscoelastic gel layer of the esophageal mucosa. Thus, it has been proven that there are reflex connections between the receptor apparatus of the esophageal mucosa and the efferent nerve fibers of the salivary glands, which can be disrupted in GERD. Therefore, saliva is involved in providing effective protection of the esophagus. As a result, the content of mineral components changes significantly: in particular, the level of calcium and enzyme composition.
 Aim to study the indicators of mineral metabolism: the content of calcium, alkaline, and acid phosphatases in mixed saliva in patients with gastroesophageal reflux disease.
 Methods 60 patients of various ages who underwent inpatient treatment at the IFNMU University Clinic were examined, where pH-metry was performed to determine acidity. The main group consisted of patients diagnosed with GERD, with decreased and increased acidity. The content of indicators of mineral metabolism in saliva was determined as follows: calcium (Ca) - photometric method with arsenase -111; acid phosphatase (AC) was determined by the Hillman method, alkaline phosphatase (AL) by hydrolysis of p-nitrophenyl phosphate at pH -10.4, release of p-nitrophenol and phosphate. The norm of indicators of mineral metabolism was established on 30 practically healthy volunteers. Statistical processing of data was carried out using the Microsoft Excel program by calculating the arithmetic mean.
 Conclusions thus, the results obtained indicate that in GERD there is a violation of mineral metabolism in the oral fluid. The oral fluid is the first to come into contact with the reflux agent. This leads to a violation of saliva neutralization, so the study of saliva mineral composition can be considered as an early diagnostic marker for gastroesophageal reflux disease.

Asymmetrically coordinated main group atomic In-S1N3 interface sites for promoting electrochemical CO2 reduction

Asymmetrically coordinated main group atomic In-S1N3 interface sites for promoting electrochemical CO2 reduction

The effect of vaccination against the COVID-19 on the course and outcomes of a new coronavirus infection: a retrospective analysis of laboratory and clinical indicators of hospitalized patients

BACKGROUND: The Gam-COVID-Vac vaccine was proven effective in preventing the severe course and adverse outcomes of COVID-19 during different periods of the pandemic. However, the effect of vaccination on laboratory marker levels in hospitalized patients during the spread of the omicron variant of SARS-CoV-2 has not been sufficiently studied.
 AIM: To assess the effect of vaccination on the severity and outcomes of COVID-19 in hospitalized patients during the dominance of the SARS-CoV-2 omicron variant in Russia.
 MATERIALS AND METHODS: This case–control study included adult patients diagnosed with COVID-19 (U07.1) and hospitalized in infectious hospitals in Moscow between February 1, 2022, and July 31, 2022 (n=119). The main group included individuals vaccinated with two doses of Sputnik V vaccine (n=59). The control group included individuals who were not vaccinated (n=60). The median patient age was 66 [interquartile range, 41–66] years, and 58.8% were female. The chi-square test for categorical variables and the Mann–Whitney test for continuous variables were used for the analysis. P-values 0.05 were considered statistically significant.
 RESULTS: Viral pneumonia was less likely to develop in the vaccinated group than in the unvaccinated group (46.7% and 18.6%, respectively, p = 0.007). The proportion of patients without lung damage (0 CT-severity scores) in the vaccinated group (72.0%) was significantly higher than that in the unvaccinated group (42.9%) (p=0.003). In the vaccinated group, the levels of C-reactive protein on admission were lower (29.1 [7.4–68.6] mg/L and 75.1 [32.4–104.0] mg/L, p 0.001), and the highest level was recorded during hospitalization (38.2 [12.0–84.0] mg/L and 92.2 [45.3–137.4] mg/L, p 0.001). The D-dimer levels before discharge were lower in the group of patients vaccinated 6 months ago than in the unvaccinated group (157.0 [107.0–297.0] ng/mL and 316.0 [125.0–556.0] ng/mL, respectively, p = 0.014). The frequency of deaths in the control group (11.7%) was 6.9 times higher than that in the main group (1.7%) (p = 0.030).
 CONCLUSIONS: Completion of the primary vaccination course of Sputnik V vaccine resulted in lower levels of prognostic markers of severe COVID-19 (C-reactive protein and D-dimer) and a decrease in the frequency of pulmonary and fatal outcomes than in the unvaccinated group during the dominance of the omicron variant of SARS-CoV-2.

Efficient Spiking Neural Networks with Biologically Similar Lithium-Ion Memristor Neurons.

Benefiting from the brain-inspired event-driven feature and asynchronous sparse coding approach, spiking neural networks (SNNs) are becoming a potentially energy-efficient replacement for conventional artificial neural networks. However, neuromorphic devices used to construct SNNs persistently result in considerable energy consumption owing to the absence of sufficient biological parallels. Drawing inspiration from the transport nature of Na+ and K+ in synapses, here, a Li-based memristor (LixAlOy) was proposed to emulate the biological synapse, leveraging the similarity of Li as a homologous main group element to Na and K. The Li-based memristor exhibits ∼8 ns ultrafast operating speed, 1.91 and 0.72 linearity conductance modulation, and reproducible switching behavior, enabled by lithium vacancies forming a conductive filament mechanism. Moreover, these memristors are capable of simulating fundamental behaviors of a biological synapse, including long-term potentiation and long-term depression behaviors. Most importantly, a threshold-tunable leaky integrate-and-fire (TT-LIF) neuron is built using LixAlOy memristors, successfully integrating synaptic signals from both temporal and spatial levels and achieving an optimal threshold of SNNs. A computationally efficient TT-LIF-based SNN algorithm is also implemented for image recognition schemes, featuring a high recognition rate of 90.1% and an ultralow firing rate of 0.335%, which is 4 times lower than those of other memristor-based SNNs. Our studies reveal the ion dynamics mechanism of the LixAlOy memristor and confirm its potential in rapid switching and the construction of SNNs.

Studying the relationship between oral lichen planus and periodontal disease: Value on periodontal pathogens and oral hygiene

BACKGROUND: Oral lichen planus is a chronic inflammatory condition of the oral mucosa characterized by white, lacy lesions. The etiology of oral lichen planus is complex and remains unclear, but it is thought to be a T-cell mediated autoimmune disease. Several factors have been implicated in the pathogenesis of oral lichen planus, including genetic predisposition, dental materials, iatrogenic factors, infections, autoimmunity, and bowel disease. The microflora of the oral cavity plays an important role in maintaining oral health and preventing disease. However, its role in the development and progression of oral lichen planus is not yet totally understood. Some studies have shown that there are differences in the microflora of oral lichen planus patients compared to healthy controls. These differences may be related to the inflammatory process in oral lichen planus, or they may be a contributing factor to the disease.
 AIM: Identify the prevalence of the detection of periodontopathogenic microorganisms in oral lichen planus patients and compare their prevalence in healthy non-oral lichen planus patients.
 MATERIALS AND METHODS: A cross-sectional, single-center study was conducted. A total of 75 patients were recruited, 45 with oral lichen planus and 30 healthy controls. The groups were formed by simple random sampling. The diagnosis of oral lichen planus was confirmed histologically in the main group. The forms and localization of oral lichen planus were determined in the main group based on clinical examination. In the control group, patients were divided into two subgroups depending on the presence of chronic periodontitis or gingivitis. The prevalence of periodontal pathogens was assessed based on the analysis of culture results. Among the 48 bacteria isolated from the oral mucosa of the affected site in the main and control groups, we focused on the microbiota of only periodontal bacteria to study their role and assess their impact on disease progression.
 RESULTS: Among the 45 patients with a clinical diagnosis of oral lichen planus, there were 10 (22.22%) men and 35 (77.78%) women, with a mean age of 55.3±13.4 years. The control group included 30 healthy volunteers, 8 (26.67%) men and 22 (73.33%) women, with a mean age of 54.8±12.7 years. In patients with oral lichen planus regardless of their periodontal status the percentage of seropositivity for A. actinomycetemcomitans, V. parvula, P. gingivalis, T. denticola is higher compared to their healthy counterparts with gingivitis and periodontitis.
 CONCLUSION: The study found an increased frequency of detection of pathogenic microorganisms, such as A. actinomycetemcomitans, V. parvula, P. gingivalis, and T. denticola, in patients with oral lichen planus, regardless of the presence of periodontitis. These periodontopathogens may be associated with oral lichen planus. However, further studies are needed to clarify their role in the pathogenesis of the disease.

Efficacy of combined phytotherapy (NefroBest® and UroBest®) in female patients with urolithiasis and preoperative drainage of upper urinary tract before ureteroscopy

Introduction. In most cases, double-J stent placement is the initial method of drainage in patients with urolithiasis. Until ureteroscopic intervention, most patients report «stent-related symptoms» that reduce the quality of life.Objective. To improve the results of treatment in female patients with urinary stone disease (USD) and preoperative drainage of the upper urinary tract using double-J stent by assessing the effect of the NefroBest® and UroBest® complexes on the prevention of the development of «stent-related symptoms» and inflammatory processes.Materials & methods. The study group included 90 female patients with USD, who were performed ureteroscopic interventions with preoperative stent placement from March to September 2023 in the Yudin City Clinical Hospital. Patients were divided into two groups: the main group 1 (n = 30) — patients who received phytotherapy with NefroBest® (30 days) and UroBest® (7 days) complexes after placement of an internal ureteral stent; the control group 2 (n = 60) — patients who did not receive specific therapy postoperatively.Results. According to the USSQ, in group 1 the median score due to urinary symptoms was 22 points, and in group 2 — 28 points (p = 0.001), when assessing symptoms associated with pain — 12 and 18 points (p < 0.001), general health — 17 points both and work performance — 9 and 11 points, respectively. Among patients in group 1, stonefree rate was observed in 90.0%, and among patients in group 2 — in 93.3%. In group 1, antibacterial therapy in the postoperative period was in 37.0% of patients, and in group 2 – among 53.0%.Conclusion. The co-use of the NefroBest® and UroBest® complexes in female patients with USD and preoperative drainage of the upper urinary tract using double-J stent can reduce the severity of symptoms associated with urination and pain, and postoperatively resulted in a lower incidence of infectious-inflammatory complications.

ASSESSMENT OF THE LIFE QUALITY OF PERSONS WITH KNEE JOINT INJURIES AFTER SURGERY INTERVENTION

ASSESSMENT OF THE LIFE QUALITY OF PERSONS WITH KNEE JOINT INJURIES AFTER SURGERY INTERVENTION

Evaluation of the multiple-deficit hypothesis among dyslexic Arabic-speaking children.

This study examined the multiple-deficit hypothesis among Arabic-speaking elementary school students. A total of 90 students, divided into three main groups based on their performance on an Arabic word-reading task: dyslexic (n = 30), regular age-matched (n = 30), and 3rd-grade regular students, who were matched to the dyslexic group in regard to their reading proficiency level (n = 30). Participants underwent a nine-domain Arabic reading experiment that measured accuracy and fluency to evaluate general reading proficiency. The performance of Arabic dyslexic students was significantly worse than age-matched controls, but similar to young matched controls based on the reading level of each cognitive task. Moreover, dyslexic students showed deficits in three or more cognitive functions, depending on severity. This study adds to the limited empirical research on the double-deficit hypothesis and its extension to the multiple-domain model among young Arabic students.

Survival of Patients With Primary Cutaneous Melanoma (Stages 0-IIА and IIB-IIC), Depending on the Presence of the <i>BRAF</i> Mutation in the Tumor and Surgical Treatment Option

Background: Cutaneous melanoma is an extremely aggressive disease with an unpredictable prognosis. Even among patients with similar tumor parameters and extent of surgical treatment, survival may vary. The extent of surgical resection of primary cutaneous melanoma is well-established, and a BRAF mutation in the tumor is an unfavorable prognostic factor for patient survival. The mutation presence is mainly used as a marker for prescribing targeted therapy. The impact of the extent of surgery and the method for restoring a tissue defect on survival of patients with similar stages remains unexplored. The impact of the BRAF mutation in the tumor on survival of patients with cutaneous melanoma depending on the surgery method has also not been studied. We analyzed the surgical treatment outcomes of 221 patients with primary cutaneous melanoma (stages 0-IIA and IIB-IIC) who were found to have the BRAF mutation and underwent different extents of tumor excision with closure of the surgical tissue defect.Objective: To analyze the impact of the BRAF mutation in the tumor on 5-year survival of patients with primary cutaneous melanoma (stages 0-IIA and IIB-IIC), depending on the extent of surgery and the method of replacing the tissue defect.Materials and methods: We used data from 221 patients with primary cutaneous melanoma (stages 0-IIA and IIB-IIC) and assessed their BRAF mutation status, extent of tumor excision, and method of closing the tissue defect. The patients were divided into 2 groups: the main group (wide excision of the tumor and plastic replacement of the tissue defect) and the comparison group (standard margin and linear closure of the tissue defect). After surgery, all the patients underwent tumor analysis for the BRAF p.V600E/K mutation using real-time PCR. DNA was isolated using the cobas® DNA Sample Preparation Kit on a cobas® z 480 analyzer. We used the following statistical methods: frequency analysis, z test to check the equality, and Kaplan-Meier survival analysis and such software as MedCalc 12.5 (1993-2013, MedCalc Software) and SPSS 26 (IBM Corp, 2019, IBM SPSS Statistics for Windows, Armonk, NY, USA). Results: Wide excision of primary cutaneous melanoma (stages 0-IIA and IIB-IIC) was found to increase 5-year progression-free survival in patients with subsequent plastic replacement of the tissue defect compared with patients with standard margin and linear closure of the tissue defect and 5-year overall survival in patients with stage 0-IIA melanoma. In patients with 0-IIA stage melanoma and positive BRAF mutation test results, wide excision with reconstructive and plastic defect closure improved the 5-year progression-free survival. Conclusions: The 5-year progression-free survival and 5-year overall survival increased by 20.9% (P = .005) and 13.0% (P = .031), respectively, in patients who underwent wide excision of primary cutaneous melanoma followed by plastic replacement of the tissue defect compared with patients with standard excision of primary tumors and linear closure of the tissue defect. The 5-year progression-free survival increased by 23.7% (P = .017) in patients with stage IIB-IIC melanoma, regardless of the BRAF mutation. In patients with 0-IIa stage melanoma and positive BRAF mutation test results who underwent wide excision, the 5-year progression-free survival increased by 20.7% (P = .047) compared with patients who underwent tumor excision with a standard margin.

Macrophage activation contributes to diabetic retinopathy.

Diabetic retinopathy (DR) is recognized as a neurovascular complication of diabetes, and emerging evidence underscores the pivotal role of inflammation in its pathophysiology. Macrophage activation is increasingly acknowledged as a key contributor to the onset and progression of DR. Different populations of macrophages originating from distinct sources contribute to DR-associated inflammation. Retinal macrophages can be broadly categorized into two main groups based on their origin: intrinsic macrophages situated within the retina and vitreoretinal interface and macrophages derived from infiltrating monocytes. The former comprises microglia (MG), perivascular macrophages, and macrophage-like hyalocytes. Retinal MG, as the principal population of tissue-resident population of mononuclear phagocytes, exhibits high heterogeneity and plasticity while serving as a crucial connector between retinal capillaries and synapses. This makes MG actively involved in the pathological processes across various stages of DR. Activated hyalocytes also contribute to the pathological progression of advanced DR. Additionally, recruited monocytes, displaying rapid turnover in circulation, augment the population of retinal macrophages during DR pathogenesis, exerting pathogenic or protective effect based on different subtypes. In this review, we examine novel perspectives on macrophage biology based on recent studies elucidating the diversity of macrophage identity and function, as well as the mechanisms influencing macrophage behavior. These insights may pave the way for innovative therapeutic strategies in the management of DR.

РАСПРЕДЕЛЕНИЕ ГЕНОТИПОВ ГЕНА SLC2A9, УРОВЕНЬ МОЧЕВОЙ КИСЛОТЫ И МЕТАБОЛИТЫ ПУРИНОВОГО ОБМЕНА У ПАЦИЕНТОВ С АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ И ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙ

The aim is to investigate the frequency of genotypes and alleles of the SLC2A9 gene rs734553 polymorphism, the level of serum uric acid (sUA) and metabolites of purine metabolism in patients with arterial hypertension (AH) and atrial fibrillation (AF), as well as in healthy individuals. Material and methods. The study included 154 patients: 50 were healthy individuals (group 0), of which 22 (44%) were men and 28 (56%) were women aged 50 [45;53] years and 104 were patients with AH and AF (main group), of which 94 (90.4%) were men and 10 (9.6%) were women aged 55 [45; 61] years. The main group was divided into subgroups: subgroup I – patients with AF without a history of AH and other rhythm disorders (n=13); subgroup II – patients with AH in combination with AF (n=68); subgroup III – patients with AH without a history of AF or other rhythm disturbances (n=23). Hyperuricemia was detected in 34 (22.1%) patients, normal uric acid levels were revealed in 120 (77.9%) patients. All patients were studied using clinical, laboratory, instrumental and molecular genetic research methods. The level of sUA was determined by the enzymatic colorimetric method. Serum xanthine oxidase was measured using a method based on a solid phase sandwich-type enzyme-linked immunosorbent assay. Metabolites of purine metabolism in blood plasma were measured using the method of high-performance liquid chromatography. The SLC2A9 gene rs734553 polymorphism was determined using the polymerase chain reaction with real-time detection of results. Results. The patients with AH and AF, as compared to healthy individuals, had more severe disturbances of purine metabolism, characterized by higher concentration of sUA (330 [283; 412] µmol/l and 197 [161; 229] µmol/l (p<0.001), respectively). Also, in contrast to the group of healthy individuals, the group of patients with AH and AF demonstrated an increase in the level of adenosine (p=0.001), and a decrease in the levels of hypoxanthine and xanthine (p<0.001). There were no statistically significant differences in xanthine oxidase activity level (p>0.05), however, in 54% of patients in the main group it was higher than normal values. The dominant allele A and the dominant genotype A/A of the SLC2A9 gene rs734553 polymorphism (75%, p=0.005; 64%, p=0.001, respectively) occurred significantly more often in healthy individuals, while the recessive allele C and the heterozygous genotype A/C were found significantly more often in the group of patients with AH and AF (41.3%, p=0.005; 48.1%, p=0.003, respectively). The C/C genotype (41.7%, p=0.001) was significantly more common in patients with AH in combination with AF and hyperuricemia, compared to patients with AH combined with AF without hyperuricemia as well as healthy individuals (6.8%; 14%, p=0.001, respectively). Patients with AH in combination with AF and the C/C genotype were characterized by a significantly higher level of sUA (p=0.003) compared to patients with the A/A genotype. Conclusions. A statistically significant predominance of the recessive allele C of the SLC2A9 gene rs734553 polymorphism was established in patients with AH and AF compared with healthy individuals (p=0.005). In patients with AH in combination with AF and hyperuricemia, the C/C genotype was significantly more common (41.7%, p=0.001). Patients with AH in combination with AF and the C/C genotype were characterized by a significantly higher level of sUA (p=0.003) compared to patients with the A/A genotype.

Storylines for Future Projections of Precipitation Over New Zealand in CMIP6 Models

AbstractLarge uncertainty exists in the sign of long‐term changes in regional scale mean precipitation across the current generation of global climate models. To explore the physical drivers of this uncertainty for New Zealand, here we adopt a storyline approach applying cluster analysis to spatial patterns of future projected seasonal mean precipitation change across CMIP6 models (n = 43). For the winter precipitation change signal, the models split roughly into two main groups: both groups have a very robust wet signal across the west coast of the South Island but differ notably in terms of the sign of precipitation change across the north of the North Island. These far north winter precipitation differences appear related to how far the Hadley cell edge and regional eddy‐driven jet shift across the models relative to their historical positions. In contrast, for summer, most models have a markedly weaker and spatially non‐uniform response, where internal variability often plays a large role. However, a small group of models predict a robust wet signal across most of the country in summer. This “wet model” group is characterized by a regional La Niña‐like increase in high pressure shifted further to the south‐east of New Zealand, associated with more frequent north‐easterly flow over the country and accompanied by significant warming of local sea surface temperatures. This regional circulation response appears related to changes in stationary Rossby wave paths as opposed to changes in La Niña occurrence frequency itself.

Association of Overweight and Obesity with Monosymptomatic Nocturnal Enuresis in 5-15 Years Old Children

Background: Monosymptomatic nocturnal enuresis (MNE) has increasingly been reported as a challenging issue for families and children due to its impact on the psychological aspects of children and on reducing their concentration at school the next day. Obesity might serve as a risk factor for voiding dysfunction in children. Our study aimed to evaluate the relationship between excess body mass index (BMI) in children and MNE. Methods and Results: This case-control study included 60 children diagnosed with MNE (the main group [MG]) and 60 children without MNE (the control group [CG]) aged 5-15 years. Proper matching between the two groups concerning age and sex was adopted. Age, weight, family history, and complete medical history were recorded for each participant. In the MG, 18(30%) children had excess BMI, and 42(70%) had normal BMI. In contrast, 9(15%) children in the CG had excess BMI, and 51(85%) children had normal BMI, indicating a statistically significant association between increased BMI and MNE (P=0.049). The frequency of positive family history was significantly higher among the MG than the CG (P=0.0001). The findings of this study showed no significant relationship between gender and a family history of enuresis with excess BMI in children with MNE (P=0.679 and P=0.234, respectively). Conclusion: Obesity and overweight in children have an influence on the development of MNE.

Who receives most? Gendered consequences of divorce on public pension income in West Germany and Sweden

Abstract Sweden and West Germany have had persistently high divorce rates in recent decades, but these two welfare states were differently equipped to mitigate the economic consequences of divorce for individual security in old age: Sweden followed a gender-equal policy approach to enable women and men to achieve economic autonomy, while West Germany, following the male-breadwinner model, introduced the system of ‘divorce-splitting’ to account for differences in women's and men's income. Against this background, this study uses large-scale register data from the German Public Pension Fund and the Swedish population registers to examine how divorce is related to the monthly public old-age pension income of women and men. The main comparison groups are divorced and (re)married individuals who entered retirement between 2013 and 2018. We descriptively show annual income histories from ages 20 to 65, and calculate monthly public old-age pension income with respect to lifetime income and pension regulations, such as the supplements/deductions for ‘divorce-splitting’. Multiple ordinary least square regression models further examine how family status relates to monthly public old-age pension income by gender. The results reveal that women and men in Sweden experience similar working histories, although women's incomes are lower. This is also reflected in women still having lower pension incomes than men. However, divorced and married women show comparable pension incomes, while divorced men receive approximately 26 per cent less pension income than married men. In West Germany, divorced women have significantly higher pension incomes than married women. The system of ‘divorce-splitting’ increases women's and decreases men's pension incomes, which seems to equalise their pension incomes. However, both stay below a married man's pension income. The findings indicate economic inequality in public old-age pension income by family status in Sweden and West Germany.