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Article: [CORRELATION OF INDIVIDUAL AND JOINT INTEREST WITHIN MEDICAL LEGAL RELATIONS (REVIEW)].

Knysh, S / Oderiy, O / Sarana, S / Hayrapetyan, A / Bova, Y

2019 , Issue 292-293, Page(s) 134–139

Abstract: The objective of the article is to determine the content and correlation of individual and joint interest within medical legal relations in Ukraine. To achieve this objective the authors have applied general scientific and special methods of cognition. ... ...

Abstract	The objective of the article is to determine the content and correlation of individual and joint interest within medical legal relations in Ukraine. To achieve this objective the authors have applied general scientific and special methods of cognition. The materials of research were statistical data on infectious diseases about the state of vaccinations in Ukraine, judicial practice, and national legislation. It has been concluded that individual and joint interest within medical legal relations are aimed at various objects: individual and public health. These objects are interconnected as general and special, since public health is a combination of individual health. It has been established that public and individual health does not have an economic content, cannot participate in the economic turnover, but have a social value. The prevalence of joint interest over the individual has been grounded. Individual interest within medical legal relations has been defined as the orientation of an individual to protect own health. It has been proved that joint (public) interest within medical legal relations is a set of individual (private) interests of individuals in the health care area. This interest is manifested in the formation of collective immunity, control over the spread of infectious diseases, the creation of conditions for affordable medical care, etc.
MeSH term(s)	Delivery of Health Care/legislation & jurisprudence ; Humans ; Legislation, Medical ; Public Health/legislation & jurisprudence ; Ukraine
Language	Russian
Publishing date	2019-10-04
Publishing country	Georgia (Republic)
Document type	Journal Article ; Review
ZDB-ID	2443648-3
ISSN	1512-0112
ISSN	1512-0112
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Book ; Thesis: Angular momentum representation of laser-driven matter waves

Hayrapetyan, Armen

twisted electrons and atoms

2014

Author's details	[put forward by Armen, Hayrapetyan]
Language	English
Size	IV, 90 S.
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Univ., Diss.--Heidelberg, 2014
Note	Zsfassung in dt. Sprache
Database	Library catalogue of the German National Library of Science and Technology (TIB), Hannover

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Article: Medical Education in Armenia: An Overview.

Markosian, Christopher / Sargsyan, Gayane / Shariff, Sanobar / Abovyan, Yelena / Hekimian, Kim / Margaryan, Khachatur / Hayrapetyan, Aram / Shekherdimian, Shant / Tamamyan, Gevorg

Journal of medical education and curricular development

2023 Volume 10, Page(s) 23821205231203831

Abstract: This article serves to describe the medical education system of Armenia, a country located in the cross-section of Europe and Asia. Similar to other countries in the region, its medical education system is structured into undergraduate (6 years), ... ...

Abstract	This article serves to describe the medical education system of Armenia, a country located in the cross-section of Europe and Asia. Similar to other countries in the region, its medical education system is structured into undergraduate (6 years), postgraduate (1-4 years), and continuing education components. Its largest medical university, Yerevan State Medical University (YSMU), is the predominant institute for medical education and has enrollment of not only Armenian citizens, but also international students from India, Iran, Russia, and other countries. According to publication metrics, research activity at YSMU is increasing. Finally, the unique relationship between the country and its global diaspora has facilitated collaborative efforts in not only medical education, but also the delivery of care and capacity building. Significant challenges remain for each stage of medical education, such as the lack of standardized licensing or board examinations and oversight of the number of resident physicians per specialty.
Language	English
Publishing date	2023-10-19
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2798123-X
ISSN	2382-1205
ISSN	2382-1205
DOI	10.1177/23821205231203831
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Integrating hepatitis C treatment into multidrug-resistant TB care.

Kirakosyan, O / Melikyan, N / Falcao, J / Khachatryan, N / Atshemyan, H / Oganezova, I / Aznauryan, A / Yeghiazaryan, L / Sargsyants, N / Hayrapetyan, A / Balkan, S / Hewison, C / Huerga, H

Public health action

2022 Volume 12, Issue 2, Page(s) 96–101

Abstract: Background: Direct-acting antivirals (DAAs) are not widely used for patients with chronic hepatitis C virus (HCV) infection and multidrug- or rifampicin-resistant TB (MDR/RR-TB). We describe the implementation aspects of a new integrated model of care ... ...

Abstract	Background: Direct-acting antivirals (DAAs) are not widely used for patients with chronic hepatitis C virus (HCV) infection and multidrug- or rifampicin-resistant TB (MDR/RR-TB). We describe the implementation aspects of a new integrated model of care in Armenia and the perceptions of the healthcare staff and patients. Methods: We used qualitative methods, including a desktop review and semi-structured individual interviews with healthcare staff and with patients receiving HCV and MDR/RR-TB treatment. Results: The new integrated model resulted in simplified management of HCV and MDR/RR-TB at public TB facilities. Training on HCV was provided for TB clinic staff. All MDR/RR-TB patients were systematically offered HCV testing and those diagnosed with HCV, offered treatment with DAAs. Treatment monitoring was performed by TB staff in coordination with a hepatologist. The staff interviewed had a positive opinion of the new model. They suggested that additional training should be provided. Most patients were fully satisfied with the care received. Some were concerned about the increased pill burden. Conclusion: Integrating HCV treatment into MDR/ RR-TB care was feasible and appreciated by patients and staff. This new model facilitated HCV diagnosis and treatment among people with MDR/RR-TB. Our results encourage piloting this model in other settings.
Language	English
Publishing date	2022-06-06
Publishing country	France
Document type	Journal Article
ISSN	2220-8372
ISSN	2220-8372
DOI	10.5588/pha.22.0002
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Ethambutol-resistance testing by mutation detection using MTBDRsl.

Margaryan, H / Rüsch-Gerdes, S / Hayrapetyan, A / Mirzoyan, A

International journal of mycobacteriology

2016 Volume 5 Suppl 1, Page(s) S50

Abstract: Aims and objectives: Despite the successes in managing drug-susceptible TB, drug-resistant (DR) tuberculosis is a major challenge to the effectiveness of National Tuberculosis Program in Armenia, placing the country in the list of 18 high-burden ... ...

Abstract	Aims and objectives: Despite the successes in managing drug-susceptible TB, drug-resistant (DR) tuberculosis is a major challenge to the effectiveness of National Tuberculosis Program in Armenia, placing the country in the list of 18 high-burden countries for MDR-TB in the WHO European Region. Estimated burden of MDR-TB in 2012 was 9.4 (7-12) and 43 (38-49) among retreatment TB cases. A total of 92 laboratory confirmed cases had been reported to the WHO (57 new and 35 previously treated) out of 511 cases tested for MDR-TB. GenoType MTBDRsl is a new molecular kit designed for rapid identification of the resistance to the second-line antituberculosis drugs with a single strip. The aim of this study was to identify the mutation that confers resistance to ethambutol (EMB) in Mycobacterium tuberculosis in comparison with the phenotypic drug susceptibility test (DST). Ethambutol is used in M/XDR-TB regimens only if it is susceptible by DST results. Methods: A set of 173 drug resistances TB isolates during 2011 and 2012 period, being either acid fast bacterium positive or negative but culture positive resistant to isoniazid, rifampin, or both according to the GenoType MTBDR plus assay were consecutively tested, using the GenoType MTBDRsl (MTBDR plus version 1.0 and MTBDRsl version 2.0 Hain Lifescience, Nehren). embB gene analysis and the results were compared to phenotypic EMB testing (DST). The DNA preparation method used as described recommended by the manufacturer. Results: Genotypic analysis identified mutations at codon 306 of the embB gene in 20.8% (36/173) and miss band of wild type in 12.71% (22/173) of the resistant isolates in comparison to only 14.45% (25/173) of those that were phenotypically resistant to EMB by DST MGIT liquid media. Mutation locus were identified in embB MUT1B and embB MUT1A 8.67% (15/173) and 12.13% (21/173), simultaneously. Phenotypic retesting in MGIT demonstrated that 45 (306 of the embB gene and miss band of wild type together) genotypically resistant isolates were phenotypically resistant to EMB. This implies that 58.62% (33/58) of EMB resistance had been phenotypically missed by routine laboratory procedures. EMB resistance was closely linked to multidrug resistance (MDR); 70.69% (41/58) of the EMB-resistant isolates were resistant to both isoniazid and rifampicin. Conclusion: Implementation of more accurate diagnosis of EMB resistance may enhance patient management in Armenia, as standardized treatment of MDR-TB with second-line drugs is currently dependent on the outcome of the EMB resistance test.
Language	English
Publishing date	2016-12
Publishing country	Netherlands
Document type	Journal Article
ISSN	2212-554X
ISSN (online)	2212-554X
DOI	10.1016/j.ijmyco.2016.06.007
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Quality of care provided to tuberculosis patients in Armenia: How satisfied are the patients?

Davtyan, Karapet / Aghabekyan, Seda / Davtyan, Hayk / Hayrapetyan, Armen / Aslanyan, Garry

Journal of infection in developing countries

2019 Volume 13, Issue 5.1, Page(s) 28S–34S

Abstract: Introduction: Adherence to tuberculosis (TB) treatment as an important determinant for the successful cure of patients can be increased by focusing on patient satisfaction. The objective of this study was to evaluate patient satisfaction with TB ... ...

Abstract	Introduction: Adherence to tuberculosis (TB) treatment as an important determinant for the successful cure of patients can be increased by focusing on patient satisfaction. The objective of this study was to evaluate patient satisfaction with TB services, different aspects of patient satisfaction, and demographic, health and treatment characteristics associated with satisfaction. Methodology: Overall 505 randomly selected TB patients that received treatment during 2014-2015 in Armenia underwent a cross-sectional telephone survey. Patient satisfaction items were selected from the Patient Satisfaction Questionnaire (PSQ-18). The Consultation and Relational Empathy (CARE) and Patient Enablement Instrument (PEI) were also used. Treatment adherence was assessed using the Morisky Adherence Scale. Results: The respondents comprised 386 (76.4%) men and 119 (23.6%) women with a mean age of 45.5 ± 0.7 years. Nearly 99% (n = 500) of them were treatment-adherent. However, 45 (8.9%) mentioned the side effects as a reason for not following the treatment, revealing the non-adherence level of approximately 9%. About 93% of the patients were generally satisfied with the TB services, about 46% were satisfied with consultation and relational empathy and about 95% were satisfied with patient enablement. Being unsatisfied with TB services was associated with treatment non-adherence, inpatient treatment, drug-resistant TB, higher education, being unmarried, having a family income of below 50,000AMD (~120 USD) on average, being unsatisfied with consultation and empathy and place of residence. Conclusions: This study reports that TB patients are highly satisfied with TB care in Armenia. However, addressing specific characteristics associated with satisfaction may improve the TB program.
MeSH term(s)	Adult ; Armenia ; Cross-Sectional Studies ; Disease Management ; Female ; Humans ; Interviews as Topic ; Male ; Medication Adherence/statistics & numerical data ; Middle Aged ; Patient Satisfaction/statistics & numerical data ; Quality of Health Care ; Tuberculosis/diagnosis ; Tuberculosis/drug therapy
Language	English
Publishing date	2019-05-16
Publishing country	Italy
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2394024-4
ISSN	1972-2680 ; 2036-6590
ISSN (online)	1972-2680
ISSN	2036-6590
DOI	10.3855/jidc.10873
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Book ; Online: The PANDA Barrel DIRC

Dzhygadlo, R. / Belias, A. / Gerhardt, A. / Lehmann, D. / Peters, K. / Schepers, G. / Schwarz, C. / Schwiening, J. / Traxler, M. / Wolf, Y. / Schmitt, L. / Böhm, M. / Gumbert, K. / Krauss, S. / Lehmann, A. / Miehling, D. / Düren, M. / Hayrapetyan, A. / Köseoglu, I. /

Schmidt, M. / Wasem, T. / Sfienti, C. / Ali, A.

2024

Abstract: The PANDA experiment at the international accelerator Facility for Antiproton and Ion Research in Europe (FAIR), Darmstadt, Germany, will address fundamental questions of hadron physics using $\bar{p}p$ annihilations. Excellent Particle Identification ( ... ...

Abstract	The PANDA experiment at the international accelerator Facility for Antiproton and Ion Research in Europe (FAIR), Darmstadt, Germany, will address fundamental questions of hadron physics using $\bar{p}p$ annihilations. Excellent Particle Identification (PID) over a large range of solid angles and particle momenta will be essential to meet the objectives of the rich physics program. Charged PID in the target region will be provided by a Barrel DIRC (Detection of Internally Reflected Cherenkov light) counter. The Barrel DIRC, covering the polar angle range of 22-140 degrees, will provide a $\pi/K$ separation power of at least 3 standard deviations for charged particle momenta up to 3.5 GeV/c. The design of the Barrel DIRC features narrow radiator bars made from synthetic fused silica, an innovative multi-layer spherical lens focusing system, a prism-shaped synthetic fused silica expansion volume, and an array of lifetime-enhanced Microchannel Plate PMTs (MCP-PMTs) to detect the hit location and arrival time of the Cherenkov photons. Detailed Monte-Carlo simulations were performed, and reconstruction methods were developed to study the performance of the system. All critical aspects of the design and the performance were validated with system prototypes in a mixed hadron beam at the CERN PS. In 2020 the PANDA Barrel DIRC project advanced from the design stage to component fabrication. The series production of the fused silica bars was successfully completed in 2021 and delivery of the MCP-PMTs started in May 2022. Comment: XI International Workshop on Ring Imaging Cherenkov Detectors
Keywords	High Energy Physics - Experiment ; Physics - Instrumentation and Detectors
Subject code	621
Publishing date	2024-01-12
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Book ; Online: Design and performance of the Fermilab Constant Fraction Discriminator ASIC

Xie, Si / Apresyan, Artur / Heller, Ryan / Madrid, Christopher / Dutta, Irene / Hayrapetyan, Aram / Los, Sergey / Pena, Cristian / Zimmerman, Tom

2023

Abstract: We present the design and performance characterization results of the novel Fermilab Constant Fraction Discriminator ASIC (FCFD) developed to readout low gain avalanche detector (LGAD) signals by directly using a constant fraction discriminator (CFD) to ... ...

Abstract	We present the design and performance characterization results of the novel Fermilab Constant Fraction Discriminator ASIC (FCFD) developed to readout low gain avalanche detector (LGAD) signals by directly using a constant fraction discriminator (CFD) to measure signal arrival time. Silicon detectors with time resolutions less than 30 ps will play a critical role in future collider experiments, and LGADs have been demonstrated to provide the required time resolution and radiation tolerance for many such applications. The FCFD has a specially designed discriminator that is robust against amplitude variations of the signal from the LGAD that normally requires an additional correction step when using a traditional leading edge discriminator based measurement. The application of the CFD directly in the ASIC promises to be more reliable and reduces the complication of timing detectors during their operation. We will present a summary of the measured performance of the FCFD for input signals generated by internal charge injection, LGAD signals from an infrared laser, and LGAD signals from minimum-ionizing particles. The mean time response for a wide range of LGAD signal amplitudes has been measured to vary no more than 15 ps, orders of magnitude more stable than an uncorrected leading edge discriminator based measurement, and effectively removes the need for any additional time-walk correction. The measured contribution to the time resolution from the FCFD ASIC is also found to be 10 ps for signals with charge above 20 fC.
Keywords	Physics - Instrumentation and Detectors ; High Energy Physics - Experiment
Subject code	621
Publishing date	2023-06-12
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Molecular genetics of Mycobacterium tuberculosis resistant to aminoglycosides and cyclic peptide testing by MTBDRsl in Armenia.

Margaryan, Hasmik / Farnia, Parissa / Hayrapetyan, Armen / Mirzoyan, Alvard

International journal of mycobacteriology

2016 Volume 5 Suppl 1, Page(s) S159–S160

Abstract: Objective/background: The GenoType MTBDRsl test rapidly detects resistance to ethambutol, fluoroquinolones, second-line aminoglycosides (amikacin [AMK] and kanamycin [KAN]), and cyclic peptides (capreomycin [CAP]) in Mycobacterium tuberculosis. ... ...

Abstract	Objective/background: The GenoType MTBDRsl test rapidly detects resistance to ethambutol, fluoroquinolones, second-line aminoglycosides (amikacin [AMK] and kanamycin [KAN]), and cyclic peptides (capreomycin [CAP]) in Mycobacterium tuberculosis. According to data from Global Drug Resistance Surveillance Report (2007), Armenia is counted as a high-burden country for multidrug-resistant tuberculosis (MDR-TB). The estimated burden of MDR-TB in 2012 was 9.4 (7-12) and 43 (38-49) among retreatment TB cases. A total of 92 laboratory confirmed cases were reported to the World Health Organization (57 new and 35 previously treated) out of 511 cases tested for MDR-TB. Methods: A set of 77 drug-resistant TB isolates during 2011 and 2012 period, being either acid-fast bacterium positive or negative but culture-positive resistant to isoniazid, rifampin, or both according to the GenoType MTBDR plus assay, were consecutively tested using GenoType MTBDRsl. rrs gene analysis and the results from GenoType MTBDRsl were compared with phenotypic drug resistance testing. The DNA preparation method was performed as recommended by the manufacturer (Genotype MTBDR plus version 1.0 and Genotype MTBDRsl version 2.0 Hain Lifescience Nehren, Germany). Results: Aminoglycosides are key drugs for the treatment of MDR-TB. A total of 77 drug-resistant TB and four extensively drug-resistant M. tuberculosis isolates from Armenian TB patients were analyzed to characterize mutations within rrs and to compare with phenotypic drug resistance testing. Simultaneously, the following were identified: 65 (84.41%) rrs wild type (WT), 1 (1.3%) rrs WT MUT1 and MUT2 (WT; A1401G and G1484T), 1 (1.3%) rrs WT1, MUT1 (A1401G), 9 (11.7%) rrs WT1, MUT1 (A1401G), and 1 (1.3%) rrs WT1, MUT1. Mutation at position 1401 in rrs leads to resistance to KAN (7/77=9%), AMK (9/77=11.68%), and CAP (5/77=6.49%). Eleven (14.28%) streptomycin-resistant strains had a rrs mutation. Conclusion: Isolates with rrs structural gene mutations were cross-resistant to streptomycin, KAN, CAP, and AMK. Detection of the A1401G mutation appeared to be 100% specific for the detection of resistance to KAN and AMK. Being the first assessment, these data establish the presence of phenotypic drug-resistant and extensively drug-resistant strains using molecular profiling and are helpful in understanding aminoglycoside resistance on a molecular level.
Language	English
Publishing date	2016-12
Publishing country	Netherlands
Document type	Journal Article
ISSN	2212-554X
ISSN (online)	2212-554X
DOI	10.1016/j.ijmyco.2016.07.010
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Tuberculosis treatment and Smoking, Armenia, 2014-2016.

Balian, Dikran Raffi / Davtyan, Karapet / Balian, Andre / Grigoryan, Anna / Hayrapetyan, Armen / Davtyan, Hayk

Journal of clinical tuberculosis and other mycobacterial diseases

2019 Volume 8, Page(s) 1–5

Abstract: Introduction: Tuberculosis and tobacco prove to be increasingly apparent world problems. Armenia is a developing country which is facing issues related to the high rates of tobacco consumption. Moreover, it is among the list of high multi-drug resistant ...

Abstract	Introduction: Tuberculosis and tobacco prove to be increasingly apparent world problems. Armenia is a developing country which is facing issues related to the high rates of tobacco consumption. Moreover, it is among the list of high multi-drug resistant (MDR) Tuberculosis TB burden countries. Treatment success rate in Armenia for sputum smear-positive cases never reached World Health Organization's (WHO) target of 85% in last 15 years. Data from different studies completed across the world suggests that there is an association between smoking and negative treatment outcomes. Methods: This retrospective study was designed to investigate aforementioned associations between TB treatment outcomes and smoking status of TB patients. Data for the study were derived from the national data available in the electronic database of the Armenian National TB Center. Results: Based on inclusion and exclusion criteria 992 TB patients registered in 2014 were enrolled in this study. All of them are were TB patients in which 387 were smokers and 605 were non-smokers. Notably, adjusted analysis showed that individuals who smoked during TB treatment had 1.61 higher odds of having unsuccessful TB treatment outcome. Additionally, consistent with the literature, statistically significant association was identified between TB treatment outcome and other well factors such as sputum smear status (OR = 2.24, Conclusions: The smoking, HIV positive status, positive sputum smear microscopy test were identified as an important factors associated with the unsuccessful TB treatment outcome in Armenia. It highlights the necessity of having specific restrictions and campaign programs to reduce smoking rates among TB patients in order to improve current TB treatment and care services throughout Armenia.
Language	English
Publishing date	2019-03-16
Publishing country	England
Document type	Journal Article
ISSN	2405-5794
ISSN	2405-5794
DOI	10.1016/j.jctube.2017.04.001
Database	MEDical Literature Analysis and Retrieval System OnLINE

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