A Fractional Epidemiological Model for Bone Remodeling Process

This article focuses on modeling bone formation process using a fractional differential approach, named bones remodeling process. The first goal of the work is to investigate existence and uniqueness of the proposed fractional differential model. The next goal is to investigate how similar is the proposed approach to the method based on system classical differential equations. The dynamical system of equations used is built upon three main parameters. These are chemical substances, namely, calcitonin secretion, osteoclastic and osteoblastic, which are involved in the bone’s formation process. We implement some numerical simulations to graphically show the impact of an arbitrary fractional order of derivative. We finally obtained that modeling bone formation process using fractional differential equations yielded comparable results with those obtained through a system of classical differential equations. Flexibility in the choice of the fractional order of derivative is an advantage as it helps in selecting the best fractional order of derivative.

Results of a six-year prospective study of surgical treatment of patients with combined atherosclerosisof coronary and brachiocephalic arteries based on differentiated approach

Objective. To present the results of surgical treatment of patients with multifocal atherosclerosis based on a differential approach of surgical strategy. Materials and methods. During the period of 20142021 in the S.G. Sukhanov Federal Center for Cardiovascular Surgery, Perm, we operated 243 patients with combined atherosclerosis of coronary and carotid arteries; 104 (42.8 %) patients underwent a one-stage coronary and carotid artery surgeries, and 139 (57.2 %) patients underwent a staged correction of pathology. Critical lesion of the coronary arteries was revealed in 16 (6.6 %) patients, single-vessel critical lesion in 24 (9.9 %), two-vessel and three-vessel critical lesion was detected in 87 (35.8 %) and 79 (32.5 %) patients, respectively. 145 (59.7 %) patients had a critical lesion of the carotid arteries, and 16 (6.58 %) had a bilateral critical lesion. We have developed an algorithm for choosing treatment tactics in patients with concomitant atherosclerotic lesions of the coronary and carotid arteries. Depending on our differential approach, we selected 104 (42.8 %) patients who underwent a one-stage surgery, and 139 (42.8 %) patients who were subjected to a staged treatment. Results. A total hospital mortality was 0 %. In the staged group, 1 case of transitory ischemic attack (TIA) (0.7 %) was recorded, in the group of combined interventions there was no TIA. In the group of combined interventions, there were 3 (2.9 %) cases of the perioperative stroke and 1 (0.9 %) case of myocardial infarction. In the group that underwent staged interventions, there were 2 (1.4 %) cases of perioperative stroke and 2 (1.4 %) cases of myocardial infarction. Both groups had similar combined results (death, acute MI, stroke) 5 (3.6 %) for the staged group and 4 (3.8 %) for the combined one. There was no significant difference in any of the endpoints. Conclusions. The proposed approach to the choice of techniques for treatment of combined lesions of the carotid and coronary arteries based on the differential approach is safe and permits to adequately eliminate the lesions.

Early infantile epileptic encephalopathy type 54: clinical and neurophysiological aspects

A clinical case of a boy aged 20 months old with early infantile epileptic encephalopathy (EIEE) type 54 due to mutated HNRNPU gene presumably suffering from genetic generalized epilepsy and impaired psychomotor development is described. Exome-wide sequencing was carried out by using NextSeq 500 (Illumina, USA). Video electroencephalographic (VEEG) monitoring was conducted by using NeuroScope NS425 (Biola, Russia). The patient was noted to suffer from neonatal delayed motor development and muscular hypotonia with atypical petit mal epilepsy with regional onset at the occipital-parietal-posterior temporal areas based on VEEG data developed at age of eight months as well as progressive psychoemotional disorders. Ethosuximide and valproic acid administered together were efficient in alleviating EIEE seizures that requires to be further followed up. The data obtained allow to identify a precise etiology of epilepsy and apply a differential approach to administer anti-epileptic agents.

Determination of Duration of the Intensive Phase of Chemotherapy for Respiratory Tuberculosis in Children without Bacterial Excretion and at No Risk of Multiple and Extensive Drug Resistance

The objective of the study: to develop criteria to evaluate the duration of the intensive phase of chemotherapy for respiratory tuberculosis in children without bacterial excretion and at no risk of multiple and extensive drug resistance of tuberculous mycobacteria.Subjects and methods. Totally, 93 patients with newly diagnosed respiratory tuberculosis without bacterial excretion and at no risk of multiple and extensive drug resistance of tuberculous mycobacteria. Their age varied from 2 to 12 years old. Regimen III was used: the intensive phase – 4 drugs (isoniazid, rifampicin, pyrazinamide, ethambutol – HRZE).Results. The intensive phase lasted for 2 months in 39.8% of cases – the main criteria were achieved (relief of intoxication symptoms, normal blood rates, positive or stable CT changes) after 2 months and there was no indication to extend the duration of it. The intensive phase lasted for 3 months in 37.6% of cases – the main criteria were achieved after 2 months and there was at least one additional indication to extend it (17.2%); and the main criteria were achieved after 3 months and there was no indication to extend the duration of it (20.4%). The intensive phase lasted for more than 3 months (4 to 6 months) in 22.6% of cases – the main criteria were achieved after 3 months and there was at least one additional indication to extend it (12.9%), as well as in the case of failure to achieve the main criteria after 3 months regardless of the presence/absence of additional indications to extend its duration (9.7%).Conclusion. Various combinations of the main criteria and additional indications made the basis for differential approach to determining the duration of the intensive phase of chemotherapy in children with respiratory tuberculosis

Differential approach to the treatment of macular hemorrhages in valsalva retinopathy

Purpose. Analysis of the diagnosis results and treatment of patients with macular hemorrhages in Valsalva retinopathy. Material and methods. The analysis was included 4 patients (4 eyes) with a diagnosis of Valsalva retinopathy. All patients were underwent a standard ophthalmological examination, as well as optical coherence tomography with angiography function (OCT-A). Results. To evaluate the results obtained in the course of a different approach to the treatment of macular hemorrhages. Conclusion. It is necessary to determine the approach to the choice of treatment tactics for patients with Valsalva retinopathy in a timely and differentiated manner, taking into account the prescription of the pathological process, the localization and volume of hemorrhage. Key words: macular hemorrhage, preretinal hemorrhage, internal limiting membrane (ILM), Valsalva retinopathy.

The perception of palm oil by Millennials: A semantic differential approach

The study aims at exploring the consumer perception of products containing palm oil, considering the impact on choices by the recent media campaign on the sub-ject. The exploratory analysis is focused on Millennials and uses the semantic dif-ferential methodology. The data are processed using a Multiple Factor Analysis. Moreover, homogeneous clusters of consumers are obtained by using hierarchical clustering on principal components. The results show that the sample is divided in three clusters: the first pays a lot of attention towards the absence of palm oil in food products, considering this aspect as a sign of a healthier product, more natu-ral and with a higher quality; the second shows a higher environmental sensibility; the third does not pay any attention to the absence of palm oil in food products, and considers the issue of its absence as a trend, a sort of status symbol and some-thing that negatively impacts the taste of certain foods.

Engaging in a New Field: Business Owning Families’ Differential Approach to Impact Investing

We develop a theoretical framework explaining why and how business owning families (BOF) engage in impact investing. Despite its exponential growth, the burgeoning field impact investing is still subject to competing interpretations and varying practices. Building on the framework proposed by Nason et al. (2019b), we argue that a BOF’s frame of reference (backward vs. forward looking and internally vs. externally oriented) constitutes a relevant heterogeneity that triggers a unique driver for engaging in impact investing and a distinct set of practices to do so.