Elite opinion and foreign policy in post-communist Russia

Russian elite opinion on matters of foreign policy may be classified as ‘Liberal Westerniser’, ‘Pragmatic Nationalist’ and ‘Fundamentalist Nationalist’, terms that reflect longstanding debates about the country’s relationship with the outside world. An analysis of press statements and election manifestoes together with a programme of elite interviews between 2004 and 2006 suggests a clustering of opinion on a series of strategic issues. Liberal Westernisers seek the closest possible relationship with Europe, and favour eventual membership of the EU and NATO. Pragmatic Nationalists are more inclined to favour practical co-operation, and do not assume an identity of values or interests with the Western countries. Fundamentalist Nationalists place more emphasis on the other former Soviet republics, and on Asia as much as Europe, and see the West as a threat to Russian values as well as to its state interests. Each of these positions, in turn, draws on an identifiable set of domestic constituencies: Liberal Westernisers on the promarket political parties, Pragmatic Nationalists on the presidential administration and defence and security ministries, and Fundamentalist Nationalists on the Orthodox Church and Communists

Эффективность работы мобильной бригады в комплексной паллиативной помощи пациентам с Вич-инфекцией

The article presents the experience of the mobile team as an integral component of palliative care for patients with HIV infection.Objective: To analyze the effectiveness of the mobile team as a key component of palliative care for patients with advanced stages of  HIV infection and comorbid conditions.Materials and methods: In 2018, a joint project of the St. Petersburg AIDS Center and the BF (charity foundation) «Humanitarian Action» created a mobile team to provide  onsite medical and social assistance to patients with HIV  infection. The article presents the results of the project for 2018–2019. We studied the composition of patients, their needs for various types of support, as well as assessing the problems in providing this type of service to patients with HIV infection.  The analysis of the work of the mobile team for 2018–2019. The composition of patients in need of medical and social assistance was studied. Results. In the supervision of the mobile team were 79 patients with HIV. The main tasks of the mobile team were to identify patients with HIV infection who suffered from severe opportunistic diseases, for various reasons they could not come to the doctor’s center for antiretroviral therapy, and also monitor the effectiveness of treatment and psychological support for sedentary and hard-to-reach groups of patients.Conclusion: Given the increase in the number of patients with advanced HIV infection and comorbid conditions, the creation of mobile teams that are part of palliative care is an essential part of comprehensive medical and social care.  В статье представлен опыт работы мобильной бригады в комплексной паллиативной помощи пациентам с ВИЧ-инфекцией.Цель: проанализировать эффективность работы мобильной бригады как ключевого  компонента паллиативной помощи больным с продвинутыми стадиями ВИЧ-инфекции и коморбидными состояниями.Материалы и методы: в 2018 г. совместным проектом Центра по профилактике и борьбе со СПИД и инфекционными заболеваниями (Центр СПИД) и благотворительного фонда «Гуманитарное действие» создана мобильная бригада для оказания выездной медицинской, социальной и психологической помощи больным с ВИЧинфекцией. Основными задачами мобильной бригады были мониторинг течения заболевания, оценка эффективности проводимого лечения, а также выявление показаний для госпитализации в стационар. Кроме того, осуществлялась социальная помощь и психологическая поддержка пациентов и их родственников. Результаты: на курации у специалистов мобильной бригады находились 79 пациентов с ВИЧ-инфекцией, которые по состоянию здоровья не могли самостоятельно прибыть на  обследование в Центр СПИД и получить антиретровирусную терапию. В статье представлены результаты работы проекта за 2018–2019 гг., изучен состав пациентов, их потребности в различных видах помощи, а также оценены проблемы в оказании данного вида услуг пациентам с ВИЧ-инфекцией.Заключение: с учетом роста количества пациентов с поздними стадиями ВИЧ-инфекции и коморбидными состояниями работа мобильных бригад является высокоэффективным звеном  комплексной медицинской, социальной и психологической помощи. Кроме того,создание мобильных бригад может быть результатом успешного взаимодействия Центра СПИД и профильных НКО

In Vivo Electroporation Enhances the Immunogenicity of an HIV-1 DNA Vaccine Candidate in Healthy Volunteers

DNA-based vaccines have been safe but weakly immunogenic in humans to date.We sought to determine the safety, tolerability, and immunogenicity of ADVAX, a multigenic HIV-1 DNA vaccine candidate, injected intramuscularly by in vivo electroporation (EP) in a Phase-1, double-blind, randomized placebo-controlled trial in healthy volunteers. Eight volunteers each received 0.2 mg, 1 mg, or 4 mg ADVAX or saline placebo via EP, or 4 mg ADVAX via standard intramuscular injection at weeks 0 and 8. A third vaccination was administered to eleven volunteers at week 36. EP was safe, well-tolerated and considered acceptable for a prophylactic vaccine. EP delivery of ADVAX increased the magnitude of HIV-1-specific cell mediated immunity by up to 70-fold over IM injection, as measured by gamma interferon ELISpot. The number of antigens to which the response was detected improved with EP and increasing dosage. Intracellular cytokine staining analysis of ELISpot responders revealed both CD4+ and CD8+ T cell responses, with co-secretion of multiple cytokines.This is the first demonstration in healthy volunteers that EP is safe, tolerable, and effective in improving the magnitude, breadth and durability of cellular immune responses to a DNA vaccine candidate.ClinicalTrials.gov NCT00545987

Evaluation of the safety and the rational use of schemes of combination therapy of "dry eye" syndrome

The study focused on the pathogenetic orientation of the therapy of transient « dry eye» syndrome (corneal-conjunctival xerosis (ССХ)) in patients after surgery for laser vision correction. Patients suffering from postoperative ССХ received, in the form of instillation of eye drops, preparations with an immunomodulatory effect, a para-aminobenzoic acid derivative interferon inducer in addition to the standard combination therapy regimen, including tobramycin, dexamethasone, and a preparation containing dextran-70 and hypromelase. To exclude chemical interaction, the time intervals for drug instillation were observed. When analyzing the dynamics of the course of CCX, the data of clinical and laboratory indicators of lacrimation, the results of instrumental examination, indicators of the course of the inflammatory process IL4 in the anterior chamber of the eye were taken into account. Based on a comparative analysis, a conclusion was made about the clinical and pharmacological advantage of complex therapy with the use of immunomodulatory agent.В исследовании был сделан акцент на патогенетическую направленность терапии транзиторного синдрома «сухого глаза» (ССГ) у пациентов после операции по лазерной коррекции зрения. Пациенты, страдающие послеоперационным ССГ получали в виде инстилляций глазных капель препараты с иммуномодулирующим эффектом, производное парааминобензойной кислоты, индуктор интерферона, дополнительно к схеме стандартной комбинированной терапии, включающей тобрамицин, дексаметазон и препарат, содержащий декстран-70 и гипромелазу. для исключения химического взаимодействия соблюдались временные интервалы инстилляции препаратов. При анализе динамики течения ССГ учитывались данные клинических и лабораторных показателей слезопродукция, результаты инструментального обследования, показатели течения воспалительного процесса в передней камере глаза, IL 4. На основании сравнительного анализа было сделано заключение о клинико-фармакологическом преимуществе комплексной терапии с применением иммуномодулирующего средства

Phase 1 Safety and Immunogenicity Evaluation of ADVAX, a Multigenic, DNA-Based Clade C/B' HIV-1 Candidate Vaccine

BACKGROUND: We conducted a Phase I dose escalation trial of ADVAX, a DNA-based candidate HIV-1 vaccine expressing Clade C/B' env, gag, pol, nef, and tat genes. Sequences were derived from a prevalent circulating recombinant form in Yunnan, China, an area of high HIV-1 incidence. The objective was to evaluate the safety and immunogenicity of ADVAX in human volunteers. METHODOLOGY/PRINCIPAL FINDINGS: ADVAX or placebo was administered intramuscularly at months 0, 1 and 3 to 45 healthy volunteers not at high risk for HIV-1. Three dosage levels [0.2 mg (low), 1.0 mg (mid), and 4.0 mg (high)] were tested. Twelve volunteers in each dosage group were assigned to receive ADVAX and three to receive placebo in a double-blind design. Subjects were followed for local and systemic reactogenicity, adverse events, and clinical laboratory parameters. Study follow up was 18 months. Humoral immunogenicity was evaluated by anti-gp120 binding ELISA. Cellular immunogenicity was assessed by a validated IFNgamma ELISpot assay and intracellular cytokine staining. ADVAX was safe and well-tolerated, with no vaccine-related serious adverse events. Local and systemic reactogenicity events were reported by 64% and 42% of vaccine recipients, respectively. The majority of events were mild. The IFNgamma ELISpot response rates to any HIV antigen were 0/9 (0%) in the placebo group, 3/12 (25%) in the low-dosage group, 4/12 (33%) in the mid-dosage group, and 2/12 (17%) in the high-dosage group. Overall, responses were generally transient and occurred to each gene product, although volunteers responded to single antigens only. Binding antibodies to gp120 were not detected in any volunteers, and HIV seroconversion did not occur. CONCLUSIONS/SIGNIFICANCE: ADVAX delivered intramuscularly is safe, well-tolerated, and elicits modest but transient cellular immune responses. TRIAL REGISTRATION: Clinicaltrials.gov NCT00249106.published_or_final_versio

Russia’s idea of the multipolar world order: origins and main dimensions

Contemporary international relations are rife with the ideological struggle over the potential nature of the rapidly changing world order. Two distinct paradigmatic positions have surfaced. One champions economic, cultural, and political globalization conducted under the leadership of the Western world. The other advocates a more particularistic approach that fends for a balance of interests, multiplicity of politico-cultural forms and multiple centers of international influence. The latter doctrine, often referred to as the multipolar world theory, is the subject of this paper. The discussion argues that the idea of a multipolar world order has emerged as Russia’s main ethical and ideological position advanced in the international arena. Its philosophical tenets buttress Russian society intellectually at home, providing the expedients to pursue the country’s foreign policy goals abroad. The paper examines a substantial value package with roots in both Russian and Western philosophy that sustains the multipolar world order theory