Early and late outcomes of combined and staged surgeries in patients with concomitant atherosclerotic lesions of the coronary and brachiocephalic arteries

Objective. To study the early and late outcomes of surgical treatment of patients with concomitant atherosclerotic lesions of coronary and brachiocephalic arteries while choosing a treatment strategy based on the developed diff erentiated approach algorithm.Material and Methods. The study comprised 243 patients with combined atherosclerotic lesions of the coronary and carotid arteries examined during the period from 01.07.2014 to 01.01.2021. Patients underwent revascularization surgeries based on the algorithm for choosing the volume and stages of surgical intervention, which was previously developed in the Federal Center for Cardiovascular Surgery named after S.G. Sukhanov. A single-stage combined surgery of coronary artery bypass grafting (CABG) and carotid endarterectomy (CEE) was performed in 104 patients (42.8%); 139 patients (57.2%) received staged revascularization including 102 patients (73.4%) who received CABG as the fi rst step and 37 patients (26.6%) who received CEE as the fi rst step of surgery. The endpoints for both early and late results were death from all causes, stroke, transient ischemic attack (TIA), acute myocardial infarction (AMI), and combined endpoint that included all of the above. Average follow-up time was 41.1 ± 21.8 months.Results. No fatal outcomes were in any group during the early postoperative period. At the hospital stage, there were 5 cases (2.1%) of stroke, 1 case (0.4%) of TIA, and 3 cases (1.2%) of acute MI. Long-term results were evaluated in 225 patients (92.3%). The overall survival rate was 93.8%. There were 5 cases (2.4%) of MI, 11 cases (4.9%) of stroke, and 1 case (1.0%) of TIA. No signifi cant diff erences were observed in immediate and long-term endpoints between the groups of staged and combined interventions as compared to immediate (AMI: p = 0.680; TIA: p = 0.500; acute cerebrovascular events: p = 0.567; combined: p = 0.940) and long-term results (deaths: 0.860; AMI: p = 0.906; TIA: p = 0.528; acute cerebrovascular events: p = 0.378; combined: p = 0.669).Conclusion. Based on successful experience with treating the concomitant atherosclerotic lesions of the coronary and brachiocephalic arteries, the proposed algorithm allowed to perform safe procedures in both arterial basins and to achieve satisfactory results in in-hospital and long-term periods in the Federal Center for Cardiovascular Surgery named after S.G. Sukhanov (Perm).

THE POLITICAL SITUATION IN TATARSTAN AND THE REPUBLIC’S RELATIONS WITH THE FEDERAL CENTER IN 2010 – 2020

The article examines the political situation in Tatarstan, including the results of the elections to the republican and all-Russian authorities, and also shows some aspects of the relationship between the Republic of Tatarstan and the federal center in 2010-2020.

Technological university in Brazil: examining the development and (de)construction of the model

Based primarily on an analysis of laws and legal frameworks, this qualitative exploratory study aims to examine the development, context, construction, as well as deconstruction, of the technological university model in Brazil. The Federal University of Technology – Paraná (UTFPR) is the only technological university in the country. The analysis presented herein demonstrates that its development is the outcome of movements and efforts within its predecessor, the Federal Center of Technological Education of Paraná (CEFET-PR), to respond to the deconstruction of the technical education model, on which the Institution was based, during the Fernando Henrique Cardoso government. The concept of a technological university has not been replicated in any government since the transformation of CEFET-PR to UTFPR, not even during the Workers’ Party (PT) government, which introduced the model. We conclude that, despite efforts from within, the legal apparatus and the pursuit of certain characteristics and goals, such as obtaining world class status, are aligning UTFPR increasingly toward the profile of traditional universities.

REPEATED VOTING AT THE ELECTIONS OF THE RUSSIAN GOVERNORS

The elections of the governors traditionally arouse significant interest among voters. As with other personalized votes, the winning candidate is required to provide absolute, not relative, support from the electorate. However, the practice that has developed over the past decade demonstrates the extremely rare use of repeated voting to determine the results of gubernatorial elections, and the few examples are rather an exception to the general rule. The above circumstances indicate the relevance of studying this aspect of the regional electoral process. Materials and methods. When preparing the article, federal and regional legislation, materials of election campaigns were analyzed. The main methods used are technical-legal, formal-legal, comparative-legal. Results. Repeated voting in elections of heads of governors is one of the mechanisms that ensure the full implementation of the will of voters, guaranteeing the election of the candidate with the greatest electoral support. However, some aspects of the legislation on gubernatorial elections, in particular, the limited number of subjects for nominating candidates and the procedure for supporting the nomination of candidates by elected officials of local self-government, entails a reduction in competition and, as a consequence, the determination of the results of voting in one round. A few episodes of re-voting, as a rule, were observed in regions that have either complicated relations with the federal center or an internal political conflict. Conclusions. Based on the results of the study, the expediency of liberalizing the requirements for the nomination and registration of candidates for the position of governor is substantiated.

Surgical treatment of patients with combined oncological and vascular pathology of the brain

The aim of the study were describing the results of surgical treatment of patients with combined oncological and vas‑ cular pathology of the brain and analyzing the scientific literature on the treatment of such combined diseases.Materials and methods. Four patients who underwent surgery for combined oncological and vascular brain pathology in 2020 year in Federal Center for Brain and Neurotechnology and in Sklifosovsky Research Institute of Emergency Care. A review of the literature on the features of the treatment of this category of patients was carried out.Results. Surgery of such combinations is not routine for neurosurgeons; each case deserves special attention. We operated on two patients simultaneously, оne – aneurysm clipping and radiosurgical treatment of the tumor were performed.

Small and medium businesses in Switzerland and multinational companies

The article gives a comparative study of the main elements of Swiss system of business — transnational corporations and small and medium companies (SMEs). Using the methods of statistical analysis, systematic and comparative approaches the author analyzes their role in country economy, modification of activities and changes of their positions in innovative spheres. The author examines the factors of attractiveness and preferences which have influenced the location of TNC headquarters in Switzerland and its new trends. Multinationals are a driving force for Switzerland`s economy development. Swiss multinationals are also leaders in foreign direct investments. The study shows special significance of small and medium enterprises for Swiss economy and exports, their contribution to innovations and R&D. Foreign trade provides the greatest impetus for SMEs growth. The author analyzes the process of internationalization of small and medium companies in specific conditions of small country and their support by different instruments in the framework of three-tier system of interaction (federal center — cantons — municipalities) including financial support and preferential taxation. The federal government supports SMEs in obtaining bank loans by funding loan guarantee cooperatives. As a result it was envisaged that transnational companies and SMEs cooperated in creating a competitive and innovative economy and cluster model in Switzerland. The author notes the negative influence of pandemia on Swiss economy and MNC and SME, but at the same time there are some signs of its recovery.

DEVELOPMENT OF ENVIRONMENTAL VOLUNTEERING IN EDUCATIONAL ORGANIZATIONS

Рассмотрены проблемы развития экологических добровольческих практик в общеобразовательных организациях. Обосновывается предположение, что вовлечение обучающихся в создание и реализацию социально-значимых экологических проектов способствует формированию гражданской позиции школьников и становится эффективным инструментом их социализации. Эмпирическую базу статьи составляет исследование, проведенное Федеральным центром дополнительного образования и организации отдыха и оздоровления детей. Материалы данного исследования вводятся в научный оборот впервые. This article is devoted to the problems of the development of environmental volunteer practices in educational organizations. The assumption is substantiated that the involvement of students in the creation and implementation of socially significant environmental projects contributes to the formation of the civic position of schoolchildren and becomes an effective tool for socialization. The empirical basis of the article is a study conducted by the Federal Center for Continuing Education and Organization of Recreation and Recreation of Children. The materials of this research are being introduced into scientific circulation for the first time.

A look into the future: System-dynamic modeling of the political transformation of regional elites (Russia, 2021–2035)

The purpose of this study is to examine the ways in which the Russian regional administrative and political elites can change in 2021–2035. The authors attempted not only to find the most positive variants, but also to assess their probability and to describe the conditions for their implementation. There are seven predictive scenarios for the development of regional elites, which were constructed as a result of computer experiments with a system-dynamic model. The developed model is implemented in Powersim Studio 10. The model encompasses the main mechanisms and channels for recruiting elites as well as actors that have influenced the elite substitution system. The study is a follow-up to the work that was published in the Journal of Political Research and devoted to realistic and counterfeit scenarios of elite transformation in 1985–2019. The geographic framework within which the model can be applied spans — with some caveats — the European part of Russia. Modeling showed that some predictive scenarios are negative and even catastrophic for the progress of regional elites and for relations «federal center — regions». Moreover, such scenarios can be initiated not only by some unlikely events like the «Russian Maidan» (Ukrainization scenario), but also by erroneous actions of the federal government (Regency scenario). It has been revealed that the introduction of unified principles of monitoring and analysis, as well as centralized personnel management (Technocracy scenario) in the regions can solve all three key problems of elite evolution — namely, maintaining elite loyalty, achieving their acceptable quality, and gaining legitimacy.

POST-SOVIET HISTORY OF TATARSTAN: CHANGING THE RELATIONSHIP SYSTEM WITH THE FEDERAL CENTER IN 2000-2010.

The article considers the process of settlement of legal aspects of relations between the Republic of Tatarstan and the federal center in the period from 2000 to 2010.