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A man in his mid-50s presented with palpitations, chest pain and syncope. After initial workup for a non-ST elevation myocardial infarction, a CT scan revealed metastatic melanoma. The malignancy was infiltrating his right ventricle, resulting in recurrent ventricular tachycardia. Although initially hard to manage, his arrhythmias were eventually controlled with medication. Unfortunately, despite an initial response to immunotherapy, he died six months after diagnosis.Cardiac metastases are rare, but melanoma has a high predication for metastasising to the heart and a small number of cases of such metastases causing ventricular arrhythmias have previously been reported. This case shows the importance of concurrent investigations when patients report multiple, seemingly unrelated symptoms as a unifying diagnosis may be uncovered.

An analytical study was carried out aimed at reducing the level of disability of employees of industrial enterprises of the country. It has been revealed that the disability of employees can be a consequence of both various accidents and diseases, including professional ones. An action plan is proposed to reduce the values of disability indicators both in the field of labor protection and medical support of employees. Target corporate programs at industrial enterprises are described. The features of personnel support of work to reduce the level of disability of employees are disclosed. The role of telemedicine technologies in the framework of industrial medicine is reflected. The economic and social effectiveness of the application of the best technologies and practices used in the implementation of the main organizational, medical and socio-economic measures to reduce the disability of employees of an industrial enterprise is shown.

For a long time, associated petroleum gas was considered a by-product of oil production. Its properties were underestimated and most of the extracted raw materials were burned. However, the development of the gas and petrochemical industry has made it possible to take a fresh look at the possibilities of using associated petroleum gas: the extraction of valuable products from it using hydrocarbon processing technology. Currently, each oil producing company adheres to the approach to the rational use of associated gas, which is based on its use as a feedstock for obtaining valuable hydrocarbon products. In this regard, there is a growing need to carry out technical and economic feasibility for projects to extract target liquid hydrocarbons from associated petroleum gas.The article outlines the difficulties in applying the traditional approach to the implementation of technical and economic feasibility for projects to extract target liquid hydrocarbons from associated petroleum gas and natural gas in large fields with developed infrastructure. The need to develop a new, more efficient methodology for conducting technical and economic feasibility of such projects in terms of reducing the time and cost of work is indicated.The authors proposed a methodology for creating a software tool for conducting an express technical and economic feasibility on the extraction of target liquid hydrocarbons from associated petroleum gas and natural gas. This methodology will allow in a short time and at minimal cost to rank and select the most attractive projects for further full-fledged technical and economic feasibility and exclude work on conducting a technical and economic feasibility of obviously unprofitable projects.

Allogeneic hematopoietic stem cell transplantation is the only curative treatment for many life-threatening diseases. Due to the difficulty of finding an HLA-identical donor, transplantation from a haploidentical donor has become a frequent alternative. This option is associated with a higher risk of graft-versus-host disease (GVHD). In this article, we present the current view on the pathogenesis, treatment and prevention of GVHD and report a clinical case of acute GVHD after allogeneic hematopoietic stem cell transplantation from a haploidentical donor with post-transplant cyclophosphamide prophylaxis. The patient's parents gave consent to the use of their child's data, including photographs, for research purposes and in publications.

Our previous experience of using plerixafor and granulocyte colony stimulating factor (G-CSF) in addition to treosulfan-based conditioning in patients with Wiscott–Aldrich syndrome (WAS) demonstrated efficacy and a decreased risk of severe graft failure after hematopoietic stem cell transplantation (HSCT) with TCRab + /CD19 + graft depletion. Because of the remaining risk of graft failure in WAS patients following HSCT with unmanipulated grafts reported in a number of large-scale retrospective studies, we used plerixafor and G-CSF in conditioning regimens in 6 WAS patients who received native bone marrow as a graft source. None of the patients developed severe organ toxicity in the early post-transplantation period. All of them had long-term full donor chimerism in whole blood and the CD3 + line and a good graft function. At the last follow-up, 5 patients are alive at 3.7 to 74.7 months after HSCT (median follow-up time: 24.0 months). One patient died of chronic lung graft-versus-host-disease at 18 months after the transplantation. Despite limited experience, we believe that additional hematopoietic stem cell mobilization with plerixafor and G-CSF in treosulfan-based conditioning regimens may be effective in WAS patients undergoing HSCT with an unmanipulated graft. The study was approved by the Independent Ethics Committee and the Scientific Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology. Key words: plerixafor, conditioning regimen, hematopoietic stem cell transplantation, Wiscott–Aldrich syndrome, unmanipulated graft

Congenital nephrogenic diabetes insipidus (CNDI, arginine vasopressin resistance) is a rare inherited disorder characterized by insensitivity of the kidney to the antidiuretic effect of vasopressin. NDI is clinically characterized by polyuria with hyposthenuria and nocturia and polydipsia. In the majority of cases, about 90%, nephrogenic diabetes insipidus is an X-linked recessive disorder caused by mutations in the AVP V2 receptor gene (AVPR2). In the remaining cases, about 10%, the disease is autosomal recessive or dominant and, for these patients, mutations in the aquaporin 2 gene (AQP2) have been reported. To date, the nucleotide variants registered in AQP2 were sporadic, there is no data on the presence of «frequent» mutations and the prevalence of the disease both among the global population and among individual ethnic groups. In this paper, we describe 12 cases of arginine vasopressin resistance caused by a new homozygous mutation p.R113C in AQP2 presented among the indigenous population of the Republic of Buryatia.

Introduction. The study of myocardial damage in COVID-19 and hemorrhagic fever with renal syndrome (HFRS) is relevant, especially for HFRS-endemic regions. Aim. Comparative study of clinical and electrocardiographic signs of myocardial damage in HFRS and COVID-19. Materials and methods. A retrospective comparative analysis of clinical data, ECG and troponin test was performed in patients with HFRS (n = 62) and patients with COVID-19 (n = 30) of moderate and severe forms. Results. The heart rate (HR) in the group of patients with HFRS is less than in the COVID-19 group (p < 0.05). The average value of systolic blood pressure in both groups refers to normotension, in the group of patients with HFRS is significantly lower than the same indicator in the group of COVID-19 patients. According to the results of an ECG study of patients with COVID-19 (n = 30), sinus rhythm was observed in 30 (100%), sinus tachycardia – in 2 (6.6%), sinus bradycardia – in 6 (20%), while differences in the frequency of sinus bradycardia in comparison with patients with HFRS are statistically significant. AV blockade of the 1st degree is observed in both diseases, in the group of HFRS with a higher frequency, but the differences are unreliable. Prolongation of the QT interval was found in patients in both groups, with coronavirus infection (13.3%) more often than with hantavirus infection (3%), the differences are statistically insignificant. ECG in patients with HFRS with lung damage shows signs of overload of the right atrium, unlike in patients with COVID-19. Troponin was positive in two patients in each group: two patients with HFRS had myocarditis, one patient with COVID-19 had acute coronary syndrome. Conclusion. Myocardial damage in both hantavirus and new coronavirus infections has common features due to a systemic inflammatory reaction, electrolyte disorders, and significant differences.

In recent decades, there has been an increase in the prevalence and medical and social burden of osteoarthritis (OA) and nonspecific back pain in all countries of the world. The First Multidisciplinary Bilateral Russia-Uzbekistan Expert Council presented innovations in the prognosing, personalized prevention and adjuvant therapy of degenerative-dystrophic diseases of the joints and spine, the evidence base for the effectiveness and safety of the use of drugs that modify the course of OA (Disease-modifying osteoarthritis drugs, DMOADs): chondroitin sulfate, glucosamine sulfate, undenatured type II collagen for adjuvant pharmaconutraceutical support – prevention and adjuvant therapy (treatment) of OA and nonspecific lumbosacral pain. The expert counsil resolution presents an optimized algorithm for the management, prevention and adjuvant therapy of OA and non-specific back pain, maintaining the function of healthy joints after intense physical activity with the inclusion of the drug Chondroguard solution for intra-articular and intramuscular administration (INN – chondroitin sulfate) and a new pharmaconutraceutical from the DMOADs group – TRIO trademark Chondroguard® (Chondroguard®TRIO).

Introduction. The histone methylation regulates gene expression and plays a role in genomic stability participating in DNA repair. Dimethylation of histone 3 lysine 36 (H3K36me2) is an important histone modification which is responsible for gene expression activation. H3K36me2 is a product of methyltransferase activity of NSD1, NSD2, NSD3, and ASH1L proteins. NSD1 mutations are known to often occur in head and neck squamous carcinoma. The presence of NSD1 mutations highly correlates with increased survival, especially for patients with laryngeal cancer. The aim of this study was an in vitro investigation of the role of NSD1 in the cell proliferation of laryngeal squamous cell cancer and non-small lung cancer cells, as well as a study of the effect of disruption of the NSD1 gene expression on cisplatin treatment response.Material and Methods. Using TCGA, correlation analysis was performed to compare NSD1 wild type and mutant patient survival. NSD1 knockout cell lines models of laryngeal and non-small cell lung cancer were developed using the CRISPR/ Cas9 system. The effect of NSD1 knockout on H3K36me2 level was evaluated by western blot. Proliferation and IC50 of cisplatin in control and knockout cells were studied as well.Results. It was demonstrated that NSD1 knockout decreased the H3K36me2 level and cell proliferation in laryngeal squamous cell cancer cells and increased the sensitivity of head and neck cancer cells to cisplatin treatment, while there was no effect of NSD1 knockout in a non-small cell lung cancer cell line.Conclusion. Based on the data obtained, it can be concluded that the NSD1 protein is a potential target for inhibitor development following in vitro and in vivo testing in head-neck squamous cell carcinoma models. More studies are needed for better understanding of the regulation of tumor cell growth by NSD1.

Interpretation as a form of intercultural communication plays an important role in modern geopolitical conditions, hence the role of the interpreter as a mediator between languages and mentalities acquires even greater significance as high-quality interpretation ensures successful international communication. The authors focus on studying simultaneous interpreting as a cognitive process and set the goal of analyzing how the incoming message is perceived and processed in the mind of the interpreter and then transformed into a target language message. Applying the method of comparative cognitive transformation, the authors arrive at the conclusion that, since the interpreter operates on the cognitive level, the process of deverbalizing the source message is a transformation of the ordinary language into a language of thought, thus rendering the gist of the original can be achieved through identifying the underlying concepts in the source language message and finding correlations in the target language. Before attempting to formulate the target message, the interpreter should first deverbalize the original and get rid of its linguistic form, that is, cognitively imagine the sense of the message as a certain space of connections. Effective international communication with the target language recipients means that the interpreter needs to account for the pragmatics of the speech act and find a ready-made concise variant expressing a similar idea in the target language.

Aim: comparative analysis of the expression profile of plasma microRNAs and target genes in patients with complicated pregnancy.Materials and Methods. A prospective observational comparative study in parallel groups was carried out. The study included 73 women divided into three groups: the main group – 42 patients with preeclampsia (PE), the comparison group – 12 pregnant women with fetal growth retardation (FGR), the control group – 19 clinically healthy women with uncomplicated pregnancy. An examination was performed, which included the analysis of clinical characteristics and the study of microRNA expression in blood plasma using the real-time polymerase chain reaction.Results. MicroRNA hsa-miR-210-5p and hsa-miR-1972 were not identified in any plasma sample. Analyzing plasma microRNAs in group of women with PE showed significant changes in the expression levels of hsa-miR-517a-3p (p = 0.025), hsa-miR-517c-3p (p = 0.036), hsa-miR-574-5p (p = 0.015), hsa-miR-517a-3p (p < 0.001) and an increase in miR-20a-5p (p = 0.046) compared to control group. No significant differences were found in the miRNA expression profile in group of women with FGR compared to control group. Assessing an influence of the studied microRNAs on regulatory signaling pathways allowed to establish that hsa-miR-miR-146a-5p, -181a-5p, -210-3p, -517a-3p, -517c-3p, -574-3p, -574-5p, -1304-5p are potential regulators of the reaction cascades involved in the PE pathogenesis.Conclusion. The changes revealed in the circulating blood plasma miRNA level indicate the presence of specific transcriptomic alterations during complicated course of pregnancy.

THE PURPOSE. The features of the rheological behavior of composite fuel oil suspensions depending on the shear rate, temperature and composition of the composite fuel are considered.METHODS. Suspensions with a coal content of 30, 40 and 50% (by weight) were prepared. The mixing time varied from 1 to 10 minutes. The samples of fuel oil were examined using a Rheomat RM 100 rotary viscometer to determine the values of dynamic viscosity at different shear rates and temperature.RESULTS. The results of experimental studies of the dynamic viscosity of fuel oil as a function of the shear rate and temperature are obtained. The best values of coal dust content in fuel oil suspensions for fuel transportation have been determined.CONCLUSION. The obtained research results can be used by both energy companies and transport companies to determine the technological viscosity indicators of composite suspension fuels used as boiler fuel and fuel for marine engines.

Introduction. Giant cell tumor of bone is a relatively rare, locally aggressive osteolytic skeletal neoplasm with uncertain behavior: recurrence rates up to 70 % and distant metastases occur 2–6 % of cases. Nowadays denosumab is the choice of therapy for patients with unresectable or advanced disease. However, the efficiency, duration or administration and most of all safety of continuous denosumab are not established.Materials and methods. Fourty advanced or unresectable giant cell tumor cases were observed from 2005 till 2020 in N.N. Blokhin National Medical Research Center of Oncology. The average age of pts was 33,6 ± 13,1 years (18–64), and the women and men ratio was about 2,1 : 1. The most commonly affected sites were long bones of the lower extremities (22,5 %), sacrum (22,5 %), long bones of the upper extremities (17,5 %), spine (17,5 %), pelvis (10 %) and others. 70 % of cases were anatomically compounded due to tumor localization and 27,5 % of cases were primary disease. 37,5 % of cases were with pulmonary metastases. Patients underwent computed tomography / magnetic resonance imaging every 3 months during the first three years and then once every six months. Patient received subcutaneous denosumab 120 mg every 4 weeks with a loading dose of 120 mg subcutaneous on study days 8 and 15. After 2 years monthly therapy and confirmed stabilization effect patient then received maintenance therapy: once in three months injection. All patients received daily calcium and vitamin D supplement.Results. Median follow-up was 52,8 ± 41,3 months (3–219 months). The average denosumab injections were 25 ± 16 (4–85). Clinical and radiographically stabilization of the effect occurred on average at 12 ± 8 (4–32) injections. Hypocalcemia was registered in one case (2.5 %). There was significant improvement of Karnofsky scale, Visual analogue scale (VAS) and Watkins scale (p Conclusions. In this study we showed evidence of safety and effectiveness of continuous denosumab for unresectable or advanced giant cell tumor even with once in three months injection therapy. Denosumab for advanced giant cell tumor of bone became a choice of treatment, but we need further investigation for observation long term denosumab effectiveness and complications.

Atopic dermatitis is a common inflammatory skin disease, which is most frequently occurred in children. The disease is characterized as chronic, but only 20% of children have severe atopic dermatitis, while the other 80% achieve a long-term remission by the age of 8. The article summarizes the main details about atopic dermatitis, including statistical epidemiological data, signs of a severe course of atopic dermatitis, criteria for determining the severity of the disease and the main aspects of a stepwise approach to the therapy. The authors paid special attention to the factors worsening the course of atopic dermatitis: the role of allergens and provoking factors, secondary infection, drug hypersensitivity, concomitant diseases, breach of dermatologist’s prescriptions. Despite the large arsenal of modern therapeutic methods, the therapy of a long, persistent course of atopic dermatitis may not produce a proper effect, and this is the reason why the disease acquires a torpid course. Such clinical cases call for finding new therapeutic methods, in particular the use of Janus kinase inhibitors. In the article, the authors described a clinical case: a 17-year-old patient K. complained of widespread rashes on the skin of the trunk accompanied by intense itching; the patient had been suffering from atopic dermatitis since early childhood, the skin process had a recurrent character with alternating periods of remissions and exacerbations about 2 times a year. The case describes the successful use of Janus kinase inhibitor that was capable to reduce the signaling of many cytokines that contribute to the development of signs and symptoms of the disease, in a patient with severe relapsing atopic dermatitis, who showed insufficient efficacy of therapy with standard methods.

We show that robustly transitive endomorphisms of a closed manifolds must have a non-trivial dominated splitting or be a local diffeomorphism. This allows to get some topological obstructions for the existence of robustly transitive endomorphisms. To obtain the result we must understand the structure of the kernel of the differential and the recurrence to the critical set of the endomorphism after perturbation., We rewrote Lemmas 2.7 and 4.7 in order to be clearer and add some referee's sugentions. We would like to thanks the referee for their suggestion and comments

Introduction. The study of the manifestations of symptoms of COVID-19 and hemorrhagic fever with renal syndrome (HFRS) is an important aspect of the diagnosis, especially for regions endemic for HFRS.Aim. To conduct сomparative study of the clinical symptoms and parametres of a complete blood test at the onset of the disease with lung involvement in patients with HFRS and COVID-19 with moderate severity.Materials and methods. A retrospective comparative analysis and identification of laboratory data of patients with moderate form of HFRS with respiratory syndrome (n = 52) and patients with moderate severity form of COVID-19 (n = 52) upon admission to the hospital was carried out.Results. Fever is one of the main symptoms for both diseases, characterizing the degree of severity. At the same time, the temperature in patients with HFRS on admission was higher than in patients with COVID-19 (p < 0.05). Shortness of breath is much more often recorded in the group of patients with viral pneumonia COVID-19 (p = 0.0001). The oxygen saturation index (SpO2) in patients with HFRS was below 95%, but the average value of 96.4% was normal, while in patients with COVID-19 the average value was 92.8% (p < 0.05). When comparing the indicators of the general blood test, there was a statistically significant excess of the level of red blood cells and hematocrit in the group of patients with COVID-19, with a comparable level of hemoglobin in both groups. The average value of the absolute content of platelets was significantly lower, and the number of patients with thrombocytopenia is much higher in the group of patients with HFRS.Conclusion. Kidney damage in HFRS is the main clinical and laboratory syndrome, but it is important to remember that lung damage by the type of viral pneumonia in HFRS is also possible. In all suspicious cases, an examination for SARS-CoV-2 and serological diagnosis of hantavirus infection are indicated.

Fabienne Peter (2020) recently proposed a taxonomy of accounts of the meta-normative grounds of political legitimacy. In this article, I argue that there is an important distinction left out of that taxonomy that complicates the picture. This is the distinction between attitude-independent and attitude-dependent conceptions of normative truth. Through an examination of these conceptions of normative truth (and correlate interpretations of what counts as a normative reason) I argue that what Peter calls a fact-based conception of legitimacy may collapse into a will-based conception. Further, the distinction has important implications for what Peter calls the belief-based conception. Finally, I defend the will-based conception against Peter's arbitrariness objection through an examination of ideally coherent eccentrics.

Introduction. Organotin compounds are promising candidates for antitumor drugs. Identification of pathogenetic features of the general toxic effect of hybrid organotin compounds during the period of the greatest severity of the intoxication clinical picture will allow to estimate the risk of hepatotoxic and nephrotoxic complications with the administration of bis (3,5–di– tert–butyl–4–hydroxyphenylthiolate) dimethyltin (Me-3) and ((3,5–di–tert–butyl–4–hydroxyphenylthiolate) triphenyltin (M-e5) as chemotherapeutic agents.Аim: To conduct a comparative analysis of morphological and biochemical changes with a single intragastric administration of hybrid organotin compounds Me-3 and Me-5 in the maximum tolerated dose (MTD) on the 7th day of the toxic process development.Material and Methods. Hybrid organotin compounds Me-3 and Me-5 were administered once intragastrically to Wistar rats (females) at a MTD of 2000 mg/kg and 750 mg/kg, respectively. Biochemical and morphological studies were carried out on the 7th day of the development of intoxication symptoms according to standard methods.Results. With the introduction of Me-3 and Me-5 in the liver, signs of fatty dystrophy of varying severity were revealed, with a predominant lesion of centrolobular hepatocytes, an increase in the size of portal tracts due to edema and fibrosis, and scant lymphocytic infiltration. With the introduction of Me-5, morphological changes were more severe, with the involvement of the vascular bed of the organ in the process. When the tested compounds were administered in the kidneys, the same type of damage to the glomerular apparatus and renal tubules was recorded, characteristic of toxic nephropathy. Unidirectional changes in the blood of experimental animals were revealed in the group of nonspecific biochemical markers of cytolysis: a moderate decrease in transaminase activity and an increase in the activity of creatine kinase (CC), lactate dehydrogenase (LDH) and creatinine levels. The process of formation of urea and protein synthesis was functionally preserved.Conclusion. On the 7th day of the development of intoxication with a single intragastric administration of hybrid organotin compounds Me-3 and Me-5 in the maximum tolerated doses, biochemical and morphological changes in the body of animals could be attributed to a moderate degree of severity.

Aim. IThe presented study aims to identify current trends and key directions for the introduction of quantum technologies into the management practices of Russian credit institutions to improve their performance in the medium term.Tasks. The authors comparatively analyze current trends in the application of quantum technologies in the banking business; forecast key trends in their development in the medium term in the context of the Russian banking sector.Methods. The authors use the methods of comparative and system analysis, scientific abstraction, and hypothesis.Results. Practical examples of the introduction of modern quantum technologies in the foreign and Russian banking business are provided. As a result, priority directions and areas of their application are identified with an emphasis on the domestic banking sector: credit scoring, assessment of the value and risk of investment, diversification of investment portfolios, financial forecasting, crisis prediction, fraud detection, protection of banking and customer databases from the quantum threat, and increasing the level of banking cybersecurity in general.Conclusions. Despite the novelty of quantum technologies in the banking business, the role they will play in banking in the near future is difficult to overestimate. Quantum computers can significantly improve the performance of banking IT systems by solving computational tasks that even super-powerful conventional computers are not able to tackle on their own. They significantly increase the efficiency of modeling complex systems and processes; accelerate the soultion of problems associated with resource optimization, logistics, finance, and trading; simplify work with big data using artificial intelligence (AI) and machine learning models in neural networks; help to combat cyber attacks and fraud in financial markets.

Background. Redox reactions are an important part of metabolism and are necessary both for replenishing energy needs and for delivering and utilizing oxygen. In the progression of bronchopulmonary pathology, an important role belongs to the excess amount of various compounds accumulated as a result of activation of lipid peroxidation, which leads to disruption of the membrane structure, lipid metabolism and toxic effects on cells and tissues of various organs and systems. The article summarizes current knowledge about the role of antioxidant enzymes in the pathogenesis of community-acquired pneumonia and non-obstructive bronchitis in children. They are of key importance in the stabilization of oxidative stress in the respiratory system pathology. A regulatory role in the antioxidant defense system of the enzyme superoxide dismutase (SOD) has been shown.Design and methods. The study involved 68 children (10–16 years old): 37 children with bronchitis, 31 with community-acquired pneumonia and 25 healthy children. Blood samples were taken for the subsequent SOD level determination.Results. A significant decrease in the SOD level and a low rate of normalization of its parameters in children with pneumonia were revealed. In children with bronchitis, the initial change in the SOD level was less significant, with a higher rate of its recovery.Conclusion. A significant SOD decrease in pneumonia indicates decompensation of oxidative stress processes in this group.

Syncope is a short-term transient loss of consciousness associated with a decrease or cessation of blood supply to the brain. Syncope is one of the causes of falls in older patients, leading to increased hospitalizations and deaths. There is an increased susceptibility to syncope with advancing age and sometimes it occurs with no identifiable cause. Orthostatic hypotension, carotid sinus syndrome, neuromediated syncope, structural heart disease, and cardiac arrhythmias are the common contributors to syncope in older adults. Given the high risk in this group of patients, a structured and integrated approach to the management of older patient with syncope is required. Implementing the algorithm for the management of such patients allows us to evaluate the syncope cause, assess the risk and choose the optimal treatment for older patients.

Cardiopulmonary exercise testing is a study that provides both prognostic and diagnostic information about the state of the cardiovascular, respiratory systems and metabolic processes allowing us to determine how these systems contribute to a decrease in exercise tolerance. A large number of clinical studies using this method have shown its safety and diagnostic value. However, due to insufficient education among doctors and little experience, CPNT is currently not widely used in diagnostics, especially in the geriatrics. This review of available literature over the last 10 years is devoted to the relevance of the use of cardiopulmonary exercise testing in older and oldest older patients, the essence and methodology of the study, possible changes in indicators in patients with frailty, chronic heart failure, and diseases of the bronchopulmonary system.

A fall is defined as an event, which results in a person coming to rest inadvertently on the ground or floor or other lower level, except in cases, which are the result of a blow, loss of consciousness, sudden paralysis or an epilepsy [1]. Falls and fear of falling cause serious health problems, which, in turn are associated with high injury rate, high medical costs and a negative impact on quality of life. Older and senile patients with cardiovascular disease (CVD) are at high risk of falling. However, in clinical practice, the prevalence of falls and the risks of falls are not well understood and underestimated by physicians and patients themselves. An increased risk of falling is associated with various factors, such as drugs, structural heart disease, orthostatic hypotension and arrhythmias, as well as gait and balance disorders, physical weakness, sensory disturbances. These risks are especially important with the growing number of older people with cardiovascular disease. All physicians involved in the care of patients with CVD should pay attention to the assessment, prevention and treatment of falls in adults with heart disease, and the treatment of cardiovascular disease in patients at risk of falls.

Research justification. Corneal ulcer is a common corneal pathology dangerous because of its complications, which occur in 2.5–37.9 % of cases despite modern treatment. Thus, the development of novel methods improving the results of corneal ulcer treatment is very important.Research objective was to evaluate the efficacy of lactoferrin-based therapy for experimental suppurative corneal ulcer.Material and methods. The study was performed in male chinchilla rabbits. Three intact rabbits (6 eyes) were used as control animals. Staphylococcus suppurative corneal ulcer was modeled in both eyes of 63 experimental animals. These rabbits were randomized into three groups. The first group was administered placebo therapy, the second group received antibacterial therapy, and the third group — instillations of lactoferrin. The area of ulcerative lesion was used as the measure of the therapeutic efficacy of the treatment. Then, a histological study was performed, and microsamples were photographed with LOMO TC-500 digital camera (Russia).Results. Lactoferrin instillations resulted in reliable increase in the number of transfers from infiltration stage to epithelization stage, decrease in the percentage of ulcerations, and in the proportion of critical thinning of the cornea, as well as decrease in the proportion of perforations. However, it was noticed that lactoferrin treatment when continued after the end of epithelization process resulted in excessive formation of opaque scar tissue.Conclusion. Local administration of lactoferrin stimulates the epithelium regeneration and the formation of the connective tissue and thus prevents the development of complications of suppurative corneal ulcer. However, the identified excessive formation of opaque scar tissue in lactoferrin treatment lasting too long has to be taken into consideration when developing the optimal scheme for lactoferrin treatment.

In the modern world, such a situation has developed that the development of nuclear energy and the use of sources of ionizing radiation in various fields of activity have created a potential threat of radiation hazard to humans. In this connection, the actual direction is the study of ways to increase the radioresistance of human cells and tissues to the action of ionizing radiation. In addition, radioprotective compounds are also important in radiotherapy, since normal tissues of patients must be protected from radiation damage when using high doses of radiation in the treatment of malignant neoplasms. However, the radioprotectors currently used have some disadvantages. The aim of this work is to study the radioprotective properties of fumaric acid and 3-hydroxypyridine fumarate under the action of gamma radiation and radiation of 12C ions on tumor (SK-N-BE neuroblastoma) and normal (hTERT fibroblasts) human cells. The effect of radiation was evaluated according to the criteria of cell survival in culture, doubling time and clonogenic activity. It has been shown that the use of fumaric acid and 3-hydroxypyridine fumarate has a radioprotective effect on normal and tumor cells when they are irradiated with gamma radiation at doses of 1, 4, 6 and 10 Gy. The use of fumaric acid and 3-hydroxypyridine fumarate does not have a radioprotective effect on tumor cells when they are irradiated with 12C ions. A comparative analysis of the results of the action of the preparations with gamma rays and 12C ions showed a significant dependence of the manifestation of modifying properties on the quality of radiation. The study of cell doubling time showed that the presence of drugs in the control did not increase this indicator. On the contrary, under the action of gamma radiation at a dose of 10 Gy, the preparations reduced the doubling time of fibroblasts by more than two times and the doubling time of neuroblastoma cells by almost 1.5 times. The data obtained indicate that the antioxidant properties of the studied preparations open up new possibilities for modifying the action of ionizing radiation in the treatment of oncological diseases. The use of fumaric acid and 3-hydroxypyridine fumarate will reduce the radiation load on healthy cells, including reducing the effect of secondary products on healthy cells beyond the Bragg peak under the action of carbon ion therapy.

This work is aiming at estimating the radiation doses to members of the public in case of an emergency exposure situation related to a hypothetical uranium mining tailings dam rupture at the UDC - Decommissioning Unit of Caldas, MG, Brazil. The calculations will help to managing the exposures of emergency workers and residents in the region downstream the dam. The computer code chosen to perform the simulations was FLO-2D@ software. Due to the uncertainties involved, mainly regarding the waste rheology and activity concentrations and in parameters values to be used in the dose assessment, considerations were made for the study to present results derived from conservative assumptions. Through the creation of flood maps, it was possible to estimate the extent of the areas affected by the released materials. The results showed that in a scenario of the tailings dam breach, deposition of mud shall extend over 20 km downstream affecting an area of nearly 3 km2. Total dose for a member of the public living in most affected areas would be around 43 mSv/y in the early phase after the accident. Although only shielding would be recommended under current radiation protection regulation, evacuation/relocation is suggested due to the presence of long-lived radionuclides. This protective measure would probably already be indicated by the accident itself, regardless of radiological reasons. More realistic assessment should be performed before returning people, considering long-term environmental transport and uses of the area. It must also be considered that long-term exposures have more restricted recommended acceptable levels than those for the emergency phase.

Irrigated agriculture is the highest water user in Sri Lanka. Therefore, when there is an increasing demand of other sectors such as drinking, industries, environment etc., it is required to reallocate water from the irrigated agriculture sector to meet this increased demand. However, this needs to be done while ensuring the food security of the nation using the virtual water concept, which is defined as the embedded water in a product. Therefore, this study is conducted with the objective of assessing the, i) virtual water of agricultural production, ii)virtual water of food imports and exports, iii) virtualwater trade and iv) water footprint of the nation. The dataon crop water requirements, extent cultivated, imported,and exported agricultural products were collected fromsecondary sources and the analysis was made accordingto the globally accepted methodology. The annual virtualwater value of domestic production is found to be 8.13Gm3 of which paddy contributes 54.7%. The averagevirtual water value of paddy in Maha season is less thanthat in the Yala season whilst the virtual water value ofpaddy in minor schemes are higher than that in the majorschemes in both seasons implying that more water isrequired to produce 1kg of paddy in minor schemes. Thenet import of Virtual water is 3.8 Gm3 per year. The waterfootprint of Sri Lanka is 12.0 Gm3 per year with a percapita water footprint of 535.22 m3 per year. The waterrequired for domestic production is about 15.8% of thesurface runoff of the country indicating the possibility ofmeeting the food demand with the available waterresources.

Aim To determine the effect of minimally invasive interventions on the quality of life (QoL), pain syndrome, and cosmetic effect in patients with a pathology of chest aorta as compared with a group of traditional access.Material and methods From 2016 through 2020, 77 of 226 (34%) patients with an aneurysm in the proximal chest aorta and mini-sternotomy were prospectively selected starting from 2017. To evaluate differences between the effects of mini-sternotomy and the traditional access on QoL and pain syndrome a control group of patients with full sternotomy (n=77) was formed using pseudorandomization. Intergroup comparison of QoL, pain syndrome, and cosmetic parameters was performed at various time points.Results Mini-sternotomy provided a decrease in pain syndrome both during the early period (day 3), and during movements upon discharge. Also, mini-sternotomy decreased the duration of stay in the hospital compared to full sternotomy (8.1±2.1 vs. 8.9±2.5 days, respectively; р>0.0331). A more frequent use of analgesics by patients with full sternotomy was noted. Mini-sternotomy was associated with a faster recovery of most QoL parameters according to the SF-36 questionnaire at one year after surgery. The questionnaire included summarizing parameters of physical and mental health components (Physical Health Component, Physical Health (PH): 54.3±11.9 vs. 58.2±8.2, respectively; p=0.046; Mental Health Component, Mental Health (MH): 53.8±6.8 vs. 57.8±9.5, respectively; p=0.013). In addition, patients with minimal access showed higher values of the cosmetic effect by a 5-score scale (4.08±0.8 vs. 4.39±0.8, respectively; p=0.049) and a greater interest to having a minimal access surgery.Conclusion Mini-sternotomy beneficially influences the pain syndrome, cosmetic outcome, and QoL and provides a shorter duration of rehabilitation and a sooner return to work and everyday life compared to full sternotomy.

The present study aims to understand the role of the economic crises of capitalism, hate speech and populism in the rise of the extreme right in Brazil especially in the 2018 presidential election. For that, a theoretical-descriptive analysis of the causes of these factors was made according to the thesis of historical institutionalism, making use of the hypothetical-deductive method to better understand the crisis of democracy in Brazil and in the world. Finally, an understanding of these peculiar situations is proposed as a pathway to dissolve these tensions so that the population can free itself from these anti-democratic ties and seek the reconstruction of a more participatory, ethical and more democratic Brazil.

The article describes the current issues in occupational medicine and the ways to resolve them in the context of the spread of a new coronavirus infection COVID-19. The risks of COVID-19 infection in medical and non-medical workers are considered. Modern approaches to establishment of COVID-19 causal relationship with occupation and medical examinations in patients with COVID-19 are presented. The main provisions of the National concept of healthcare-associated infections relevant in the context of COVID-19 pandemic are presented. Problems in public health care related to restructuring of work of medical organizations in conditions of COVID-19 spread are shown. Attention is paid to mental health disorders in medical workers providing medical care to patients with COVID-19. The prospects of development and implementation of measures for prevention of COVID-19, its complications and adverse outcomes taking into account complex assessment of working environment and professional health of workers are considered from the position of occupational medicine.

The experiment was conducted to ascertain the level of genetic diversity in sweet potato accessions using microsatellites. Thirty sweet potato accessions obtained from the International Potato Center (CIP), Kumasi, Ghana, Mozambique, and local germplasm of the National Root Crops Research Institute (NRCRI), Umudike, Abia State, Nigeria, as well as sweet potato vines from local farmers' fields in Jos, Plateau State, and Bauchi State, Nigeria, were analyzed for genetic diversity using five microsatellite markers. The results showed that the polymorphic SSR loci revealed diverse relationship among the sweet potato cultivars, which was grouped into four major clusters by unweighted pair group method analysis (UPGMA) method. Cluster analysis showed a Jaccard co-efficient ranging from 0.0 to 3.0 indicating high genetic diversity. The primers detected a total of 18 alleles and the number of alleles per locus was 4 for IBR-19, IBR-286, IBR-297 and 3 for IBR-16 and IBR-242 with an average of 3.67 alleles per locus. The polymorphic information content (PIC) of the markers varied from 0.35 to 0.72 with an average of 0.497. Marker IBR-19 revealed the highest PIC of 0.72, while marker IBR-297 had the lowest PIC of 0.35. Observed heterozygosity ranged from 0.32 to 0.89 with a mean of 0.675 across the five SSR loci. The results from the Analysis of molecular variance (AMOVA) which was used to quantify the diversity level and genetic relationship among the thirty sweet potato accessions indicated that a high diversity was mostly distributed within the populations for sweet potato accessions (75.12%) and (15.67%) among the populations.

Huntington’s disease is a serious inherited neurodegenerative disorder characterized by of motor, cognitive and psychiatric features. The disease is caused by an abnormally expanded CAG repeat expansion in the HTT gene and the production of mutant huntingtin protein.The disease usually manifests in adulthood, but the manifestation in childhood and youth is also described, which is noted in 5–10 % of cases. The disease predominantly affects the neostriatum, resulting in a characteristic clinical picture.The most promising approaches to etiotropic therapy of Huntington’s disease are a number of DNA- (CRISPR/Cas9 system) and RNA-directed methods (antisense oligonucleotides, RNA interference), methods that directly reduce the level of mutant gentingtin (chimera molecules), as well as approaches based on inactivating the DNA mismatch repair system using the FAN1 enzyme.

A case report of the application of endoscopic photodynamic therapy in a patient with inoperable squamous-cell cancer of the middle-thoracic part of the esophagus is presented. Two sessions of photodynamic therapy with a 1.5 month interval have been performed. Photosensitizer Photodithazin and a diode laser were used for the treatment. No complications were observed. The treatment resulted in a complete tumor resorption.

Aims: Backpropagation is an algorithm for adjusting the weight of neural networks in the training stage. The performance of backpropagation has proven superior in optimizing the weight of neural networks; however, this method needs improvement in the initiation stage, where the random process creates local optimal solution. Applying an algorithm based on the global search is an alternative to solve the drawback of backpropagation. One global search method with superior performance is particle swarm optimization. In this research, we apply the hybridization of backpropagation and particle swarm optimization (BP-PSO) to overcome the problem of backpropagation. Study Design: Research Papers and Short Notes. Place and Duration of Study: Department of Informatics, Faculty of Mathematics and Natural Sciences, Udayana University, between June 2022 and November 2022. Methodology: The dataset used in this study is a handwriting image dataset of the mathematical symbol. There are 240 symbols consisting of 180 images for training and 60 for testing. The robustness of the PSO method in obtaining the optimum global solution is expected to help backpropagation out of local optimal solutions. The application of PSO is carried out at the initial weight initialization stage of the artificial neural network. The tuning parameters of the artificial neural network are the number of neurons in the hidden layer and the value of the learning rate. There are three combinations in the number of neurons in the hidden layer, namely 10, 20, and 30. Meanwhile, the learning rate values are five different combinations, namely 0.1 to 0.9, the minimum error value is 0.01, and the maximum number of epochs is 1000. We carry out five repetitions in each test scenario. Results: The performance results showed that PSO has succeeded in optimizing backpropagation, where the accuracy of the BP-PSO is higher than BP without optimization. The accuracy of BP-PSO is 97.2%, while the BP is 94.4%. The optimal learning rate value and the optimal number of hidden layers are 0.1 and 30 neurons, respectively. Conclusion: The performance results showed that PSO has succeeded in optimizing backpropagation, where the accuracy of the BP-PSO is higher than BP without optimization. The optimization process of weighting the artificial neural network as the initial weight for later retraining shows a higher average accuracy, while decreasing the average number of epochs does not optimize initial weight.