Left Ventricular Thrombosis: Current Perspective and Use of Direct Oral Anticoagulants br

Left ventricular thrombus (LVT) is a serious risk factor for systemic embolism development. Despite the evident danger of this condition, currentguidelines describe management of patients with this potentially fatal complication very briefly. LVT can complicate myocardial infarction where its in-cidence is around 10%, as well as various forms of cardiomyopathies and novel coronavirus infection. According to clinical guidelines vitamin K antag-onists (VKAs) should be used as treatment of choice for thrombus resolution. However, experts point out that this therapy lacks necessary evidentialbase and bears certain difficulties because of pharmacokinetic and pharmacodynamical properties of VKAs. These drawbacks are absent in direct oralanticoagulants (DOACs), the possibility of using which in LVT is being actively studied. As for now, published results of 3 randomised clinical trialshave demonstrated similar safety and efficacy profiles of DOACs and VKAs. Similarly, the majority of retrospective cohort studies did not observesignificant differences between two groups, where some of them have shown superiority of DOACs especially in terms of earlier thrombus resolution.Nevertheless, some studies have found DOACs ineffective and even potentially unsafe regarding systemic embolism. Existing data does not allow toform an unambiguous conclusion about the equivalence of DOACs and VKAs for LVT resolution. Large randomised clinical trials are needed todetermine efficacy and safety of such treatment in these patients.

Synthesis of N-heterocyclic amides based on (+)-camphoric acid and study of their antiviral activity and pharmacokinetics.

Efficient conditions for the synthesis of nitrogen-containing heterocyclic derivatives of (1R,3S)(+)-camphoric acid were selected. A series of heterocyclic compounds based on (+)-camphoric acid bearing pharmacophoric fragments was synthesized using the developed methodology. The compounds were tested for their antiviral activity against SARS-CoV-2 and H1N1 influenza viruses, and efficient inhibitors were identified that are of significant interest for further studies. The stability of the compounds and pharmaco-kinetics of the leader compound were studied when administered intragastrically and intramuscularly to mice at a dose of 200 mg kg-1 using the HPLC-MS/MS method.

Distance Learning in Language Courses Under the Constraints of the Covid-19 Pandemic: The Impact of Face-To-Face Learning on Student Motivation

The goal of the study is to establish and analyze the opportunities offered by online learning of language courses based on practical experience, what advantages and drawbacks of such learning can be found, and what are its prospects in terms of efficiency and effectiveness. The study provides substantiation for the relevance of studying distance learning of language disciplines in the COVID-19 pandemic and presents various approaches to researching the specific features of online language learning. The article presents the results of a case study of online learning of language courses in different age and professional groups of students of the M.K. Ammosov North-Eastern Federal University, Russia. The teaching of theoretical courses of the language cycle virtually does not suffer in terms of efficiency and effectiveness from the transition to fully online learning, while the teaching of practical courses should at best be combined, or blended because direct, personalized contact with the teacher is important for the development of students' learning motivation. That said, being deprived of such contact does not bring any harm to language students, especially when it is preceded by an extended period of instruction with personalized teacher-student contact. Online teaching of language courses offers the students the same opportunities as traditional classroom learning, with the exception of direct contact that results in the development and maintenance of students' learning motivation.

Prospects for the development of domestic gastronomic tourism in conditions of restrictions caused by the covid-19 pandemic

The development of the domestic tourism market in the conditions of existing restrictions in the world due to the COVID-19 pandemic is shaping the tourism industry in a new way as an integral attribute of modern society. Domestic tourism is gaining an increasing influence on the economy of many countries, as the domestic tourism industry provides an increase in gross domestic product, helps to overcome unemployment at the regional level, and contributes to the development of infrastructure facilities. The purpose of the article is to analyze the prospects for the development of domestic gastronomic tourism in conditions of restrictions caused by the COVID-19 pandemic. The article focuses on the main aspects of gastronomic tourism. The concept and essence of gastronomic tourism have been clarified, the classification of varieties of gastronomic tourism has been presented, SWOT analysis of gastronomic tourism in Russia has been carried out, the positive consequences of the development of gastronomic tourism in Russia and the world during the lifting of restrictions caused by COVID-19 have been determined. It has been concluded that gastronomic tourism is one of the key factors of the tourist attractiveness of the territory, is an important component of the sustainable development of the tourism sector, capable of generating significant economic and social benefits for the participants of the domestic tourism market. In this connection, today the infrastructure of gastronomic tourism in Russia requires expansion, which will be possible due to the support from the state, the creation of a favorable investment climate. © 2021 by ASERS® Publishing. All rights reserved.

Anti-COVID-19 vaccine late hypersensitivity reaction

Background: First approved anti-COVID vaccines brought a new experience of hypersensitivity reactions into clinical practice. This experience and knowledge of mechanisms are important for further safer and wider use of these immunizations. Methods: Clinical and laboratory data collected in immunoallergology outpatient evaluation and consultation of informatic process. Written consent was obtained. Results: We report a case of a 33-year-old woman, a laboratory worker, who received the first dose of mRNA-based anti-COVID-19 vaccine. After 48-72h she presented with extensive generalized urticaria lesions and pruritus. She was admitted to the emergency department, treated with endovenous corticosteroid and antihistaminic, attenuating skin lesions. However, 12-24h later, urticaria exacerbated, with labial and bilateral ear swelling. She was medicated with oral prednisolone, gradually resolving symptoms. She had no concomitant alcohol/ drug consumption nor practiced physical exercise. She had antecedents of persistent allergic rhinitis and allergic bronchial asthma in the first step of treatment. She had no prior history of drug allergy nor adverse reactions to vaccines. Skin prick tests performed with commercial extracts of aeroallergens were positive for D. pteronyssinus, D. farinae, lepidoglyphus, olive tree pollen, grass pollen, and cat and dog dander. Skin prick test with latex was negative. Basal tryptase was 6.4 and total IgE 154.0 UI/mL. Spirometry was normal at basal condition. Prick test with anti-COVID-19 vaccine was negative. Intradermal test with 1/100 and 1/10 dilutions of anti-COVID-19 vaccine was also negative at 20-30 minutes. However, after 4h she showed hyperemia and swelling of about 7-8cm, localized at the place of both dilutions of intradermal test vaccine administration. PATCH tests performed with anti-COVID-19 vaccine were negative at 48h and 72h readings. She was diagnosed with anti-COVID-19 vaccine late hypersensitivity and, therefore, was not able to take the second dose. Discussion: We report a clinical case of late hypersensitivity to mRNA-based anti-COVID-19 vaccine in a patient without prior history of drug allergy. The reaction was documented with positive intradermal tests performed with 1/100 and 1/10 vaccine dilutions. According to EAACI indications, she did not receive the second dose of the vaccine. Extracts of vaccine components will help to understand adverse reactions and choosing an alternative vaccine, when available.

Features of Rehabilitation Therapeutic Treatment of Patients who have come through Coronavirus Disease

The purpose of the article is to consider the features of restorative therapeutic treatment of patients who have suffered a coronavirus infection. This disease can cause respiratory, physical and psychological dysfunction in patients. Therefore, restorative therapeutic treatment and rehabilitation are critical for both hospitalized and discharged patients with COVID-19. The author believes that many patients who have a history of a previous coronavirus infection note that they experience various unpleasant symptoms even six months after receiving negative tests. So, such patients may experience weakness, shortness of breath, tachycardia, instability of mental states, and so on. At the same time, against the background of an active fight against the spread of COVID-19, measures related to the rehabilitation of convalescents are receding into the background, which is fundamentally wrong. The paper analyzes the literature devoted to the problem of rehabilitation treatment after a coronavirus infection, and also applies comparative and comparative research methods. The author concludes that complications after COVID-19 can significantly worsen the quality of life of patients. For this reason, specialists need to identify the degree and level of complications and patients who have suffered a coronavirus infection as early as possible in order to prescribe appropriate medication or physiotherapy.

Consideration of illegal actions when imposing punishment for environmental crime

Both environmental risks and domestic violence exist in all countries of the world. This phenomenon is influenced by various factors: standard of living, ecological situation, environment, traditions, race, nationality and cultural values. This must be taken into account when imposing an appropriate punishment for commission of any illegal act. At the same time, family and domestic violence is not just a negative attribute of life of individual families, but also indicates serious issues of society, in the narrow sense, and the environment, in the broad sense. In connection with restrictions related to Covid-19 introduced in many countries, the level of domestic violence has increased, which proves a direct dependence on external negative factors in the field of health care, ecology, psychology, etc. Analysis of various factors influencing domestic violence has shown that this phenomenon has a high level of latency, and, as a rule, people learn about it only in cases where the consequences of such violence are difficult to hide due to their severity (for example, causing death or serious harm to health against the background of mental deviation). Having reviewed the news feeds over the past five years we can see that the relevance of the topic under consideration is beyond doubt, since the influence of environmental factors on the human psyche is not fully understood, and this aspect, one way or another, leads to the commission of illegal actions, which indicates the importance of balance between the environment, ecology and legality, society. The authors note that there is a synergistic relationship in which humanity interacts with the surrounding world, in all its diversity (water, land, natural resources, flora, fauna, etc.). n addition, some judgments of the European Court of Human Rights on environmental problems and the environment, protection from domestic violence, including with the participation of Russian Federation as a defendant, were considered. Based on the analysis of the decisions expressed, as well as the norms of national legislation, a theoretical justification for changing the national criminal and environmental legislation, in terms of imposition of punishment, is formulated. © The Authors, published by EDP Sciences, 2021.

Bendopnea as a predictor of CHF decompensation in patients with CKD and COVID-19

Objective. evaluation of the effect of the presence of chf and/or ckd or their symptoms in patients on the incidence and/or mortality from sars-cov-2. Materials and methods. a retrospective case-control study was conducted, and 165 patients were included in the final analysis. For statistical processing of the data obtained, the R language and the RStudio software environment was used. results. only 18 of all the patients included had covid-19. by the method of cluster analysis, all patients were divided into three clusters: the first one included 53.9% of patients, the second one - 21.2% and the third one - 24.8%. patients with covid were included in the first cluster (12 patients), in the second cluster there was only 1 patient with covid, in the third - 5 (X-squared = 3.1, df = 2, p value = o.22). cluster з was characterized by changes echo-cg indices, demonstrating higher values of esv, edd, lvpw, ivs and lower ef than in other clusters (patients with severe chf). cluster 2 was characterized by a lower gfr throughout the entire follow-up period, as well as negative dynamics of gfr (45 [38, 35;57, 65] ml/ min) during the year (patients with severe ckd). cluster 1 was represented by remaining patients. assessment of the symptoms (dyspnea, edema, bendopnea, ascites) in the studied cohort of patients revealed significant differences only in the presence of the symptom of bendopnea (P value = o.015), and the odds ratio of covid-19 was higher in the group of patients with symptom of bendopnea (OR = 5,8 (1.2;26.7). Conclusion. Thus, despite the high potential risk of illness and/or death from covid-19 in clusters 3 and 2 (i.e., the group of patients with severe chf and ckd, respectively), no increase in morbidity and/or mortality from covid-19 was revealed. on the contrary, the covid incidence in cluster 1, which included patients with more favorable clinical indicators of chf and ckd, was higher, but did not reach the statistical significance (P = o.222). apparently, it was attributable to the greater mobility of patients in this category as compared to patients in clusters 2 and 3. Цель исследования: изучить влияние наличия у пациентов с хсн и/или хбп или их симптомов на частоту заболеваемости и/или смертности от sars-cov-2. Материалы и методы. Проведено ретроспективное исследование случай-контроль. в окончательный анализ были включены 165 пациентов. Для статистической обработки полученных данных использовали язык R, программную среду RStudio. Результаты. Из всех включенных пациентов, только 18 переболели COV1D-19. Методом кластерного анализа все пациенты были разделены на три кластера: 1-й составил 53,9% пациентов, 2-й - 21,2% и 3-й - 24,8%. пациенты, перенесшие covid, попали в первый кластер (12 пациентов), во втором кластере оказался всего 1 пациент, в третьем - 5 (x-squared=3,1, df=2, p-value=0,22). Для кластера 3 характерны изменения показателей Эхо-КГ сердца, продемонстрировавшие более высокие значения ксо, кдр, зс, мжп и более низкую фв, чем в других кластерах (пациенты с тяжелой хсн). для кластера 2 характерна более низкая скф на протяжении всего периода наблюдения, а также отрицательная динамика показателей скф (45 [38, 35;57, 65] мин/мин) в течение года (пациенты с тяжелой хбп). первый кластер представлен остальными пациентами. Изучая симптомы (одышка, отеки, бендопноэ, асцит) у изучаемой когорты пациентов, были найдены значимые различия только в наличии симптома бендопноэ (p-value=0,015), и шанс заболевания covid-19 был выше в группе пациентов с симптомом бендопноэ (0Ш=5,8 (1,2;26,7). Заключение. Таким образом, несмотря на высокий потенциальный риск заболевания и/или смерти от covid-19 в кластерах 3 и 2 (т.е. группы тяжелых пациентов с выраженной сердечной недостаточность и хбп соответственно) увеличения заболеваемости и/или смертности от covid-19 выявлено не было. напротив, частота заболеваемости в кластере 1, который по основным показателям включил пациентов с более благоприятными клиническими показателями, была выше, однако это не достигло статистической значимости, p=0,222. По-видимому, это связано с большей мобильностью пациентов данной категории пациентов по сравнению с пациентами кластеров 2 и 3.

A humanitarian approach to the digitization of education

Digitization is a global, all-encompassing process, affecting all spheres of human life and society. In this context education is not an exception, and the changes taking place in it are a natural result of the rapid development, wide dissemination and accessibility of information technology and networks. Understanding the methodological and philosophical foundations and principles of the process is a necessary phase of the transition to the digital education, the digital society and the digital economy. In the narrow sense digital education can be understood as a conversion of learning materials and the learning process itself from analog to digital format (i.e. electronic textbooks, electronic libraries, open online courses and webinars, video lectures, etc.), but this phenomenon can be considered in broader terms as the complex changes of infrastructural, managerial, behavioral, cultural nature. Recent events (quarantine almost all over the world because of the Covid-19 pandemic) have made it clear that the broad approach to digitization is necessary for the translation of all education systems across the world to an online format, since it refers not only to the form of presenting educational and control materials but first and foremost to the aspects of general behavior, psychological, cognitive and axiological issues. Studies have shown that in the process of transferring education from the classroom to a distance form, all participants of the educational process (students, teachers, education managers, parents) underwent a reassessment of views on education and its role in the life of a person and society. Furthermore, the contradictions, implicitly or weakly expressed prior to the forced and urgent transition to the distant form, were sharpened, and the problems related, for the most part, not to the technical aspects (although these problems also exist), but to the components of education such as communication, personal development, socialization and even physiology, became most urgent. All this requires more in-depth study, a comprehensive and systematic understanding of all the elements not only from the standpoint of functionality, but also axiological, epistemological, ontological and anthropological meanings. It has become obvious that the focus should be placed not on the technical tools with which digital education is implemented, but on a humanitarian approach with its humanistic values, in the center of which is a person: teacher-pupil /student-director-parent. As participants of the educational process, they determine the goals, objectives and methods of activity, select the appropriate technical means and evaluate their training, educational and development potential;they are the centrum omnium that underlies education. This article is devoted to the digital transformation of education in view of the humanitarian approach based on the study of culture, values and history of mankind as a whole and of the people in particular, supported by the pedagogical, psychological, sociological and communication theories that focus on the person, the individual. © 2020, Kazan Federal University. All rights reserved.