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Background: The clivus, a key skull base structure for neurosurgeons due to its proximity to brainstem areas, is formed by the fusion of two bones. A rare variation, the canalis basilaris medianus (CBM) or clival canal, can exist within the occipital bone. The clivus has a rich venous network, and the CBM's presence might be linked to veins or embryonic structures. Understanding the CBM is valuable for interpreting clival fractures and during neurosurgery. This study aimed to determine the frequency and morphometric parameters of the CBM. Material and methods: Fifty-nine dry adult skulls were selected for the investigation. Morphometric measures included establishing the diameters of the internal and external foramina of the CBM, the length of the canal, and its distance from the foramen magnum (FM), jugular tubercles, and lateral margins of the basilar part of the occipital bone. Results: Out of the 59 skulls investigated, only a single specimen contained the CBM. Thus, the frequency of canal presence in our sample was 0.59 %. The internal foramen of the CBM was located on the internal surface of the clivus, 4.03 mm anteriorly to the FM with a diameter of 2.84 mm. Further, the canal passed through the clivus and had its external foramen on the external surface of the clivus at 0.11 mm above the pharyngeal tubercle and its distance from the FM was 9.19 mm. The length of the CBM was established at 8.16 mm. Conclusion: The CBM is a rare variation of the basilar part of the occipital bone. Therefore, the possibility of the existence of this variation should be considered when analyzing CT and MRI images to avoid misinterpretation of their results and during surgical interventions in this area.

This Letter to the Editor provides an update on the research from the Glushkov Institute of Cybernetics of the National Academy of Sciences of Ukraine. The Institute’s clinical research team is currently rehabilitating the military personnel of the Defense Forces of Ukraine with combat stress reaction and post-traumatic stress disorder using hybrid e-rehabilitation methods and techniques. Current research in the field of digital health and IoMT in Ukraine is creating innovative information technology for computerized electrocardiography. The conduct of rehabilitation and research in an active war zone with safety concerns, limited resources for research, and intermittent loss of power and water is very challenging.

During the care of patients with novel coronavirus infection at the Lomonosov MSU Medical Research and Education Center from April 21 to June 13, 2020, we observed cases of spontaneous mediastinal emphysema (spontaneous pneumomediastinum) as a manifestation or a probable complication of COVID-19.The aim of the paper. To provide clinical case descriptions and approaches to the management of patients with spontaneous pneumomediastinum in COVID-19 associated pneumonia, as they are not addressed in the current clinical guidelines, and therefore are worthy of special attention.Among 224 patients with laboratory-confirmed diagnosis of the novel coronavirus infection COVID-19, five cases of pneumomediastinum without pneumothorax were identified. Of these, in two cases the pneumomediastinum developed during noninvasive lung ventilation (NLV) (one case) and invasive lung ventilation (one case). In three cases, spontaneous mediastinal emphysema was not associated with lung ventilation. By the time of publication, one case of pneumomediastinum was completed, and four patients remained hospitalized. All five patients were males aged from 52 to 84 years.This paper presents in depth the description of two cases of mediastinal and subcutaneous emphysema in patients with COVID-19.

The study of the structure, shape and size of the skull and its individual structures is in great demand not only from the point of view of expansion of knowledge of craniology, but also modern practical medicine. This is due to the rapid development of new methods for diagnosing pathological processes and the development of less traumatic methods of surgical treatment. The purpose of this study is to establish the size of the transverse parameters of the middle cranial fossa of a mature person depending on the three extreme types of skull. The research was conducted using a study of 50 craniotomograms and 50 bone preparations of the skull of men and women of mature age. The studied material was divided into three groups from the standpoint of studying individual anatomical variability. In order to achieve the goal of the study, the transverse parameters of the middle cranial fossa of mature people at different levels and from both halves were measured. The established indicators of transverse dimensions show that all latitudinal parameters tend to increase from the anterior parts of the middle cranial fossa to the posterior parts. The results of the study also show that the total latitudes and transverse dimensions of the left and right parts of the middle cranial fossa predominate in brachicrans and gradually decrease to dolichocrans with average values in mesocrans. This coincides with the fact that the brachycrane has a short and wide skull shape, the dolichocrane has an elongated and narrow one, and the mesocrane has average skull length and width values. The results of this study significantly supplement the existing information on the individual anatomical variability of the middle cranial fossa of a mature person and also allow more detailed application of these data in practical medicine.

The article is focused on the mythologized photos of the global migration phenomena circulating in the ordinary consciousness and in the media. Authors consider deconstruction of this mythology important for two reasons. Firstly, the reproduction of negative stereotypes about migration allows the right-wing populist parties and movements to accumulate political capital, provoking new waves of anti-migration sentiments and creating a vicious circle. Secondly, these sentiments directly or indirectly influence the decision-makers. As a result, decision-making process in the field of migration regulation become influenced by irrational factors. Turning to common misconceptions about international migration, authors show that: a) the mechanical extrapolation of modern demographic trends into the distant future and causal relationship between demographic indicators and migration processes are not scientifically justified; b) there is no direct correlation between the size of the population in less developed regions and the intensity of migration flows from these regions to industrialized countries; c) international migration is by no means a one-way South - North process; d) perception of North countries migration policies, as charity, is fundamentally wrong because it doesnt take into account the complex interdependence of modern world. In addition, authors demonstrate inadequacy of the image of a migratory tsunami threatening to flood Europe.

One of the most effective solutions in medical rehabilitation assistance is remote patient / person-centered rehabilitation. Rehabilitation also needs effective methods for the “Physical therapist – Patient – Multidisciplinary team” system, including the statistical processing of large volumes of data. Therefore, along with the traditional means of rehabilitation, as part of the “Transdisciplinary intelligent information and analytical system for the rehabilitation processes support in a pandemic (TISP)” in this paper, we introduce and define: the basic concepts of the new hybrid e-rehabilitation notion and its fundamental foundations; the formalization concept of the new Smart-system for remote support of rehabilitation activities and services; and the methodological foundations for the use of services (UkrVectores and vHealth) of the remote Patient / Person-centered Smart-system. The software implementation of the services of the Smart-system has been developed.

Objective. Establish morphometric features of the position, shape and size of tentorium cerebelli nerves in middle-aged people. Methods - macro and microscopic examination of tentorium cerebelli and its nerve structures, morphometry of all departments of tentorium cerebelli, microscopic study of the structure and innervation of tentorium cerebelli leaves stained with hematoxylin-eosin, and also by the Schubich-Hodos method using Schiff's reagent, individual preparations impregnated by the method of Rasskazova-Kupriyanov. The obtained data were systematized from the position of the doctrine V.M. Shevkunenko about individual anatomical variability and were substantiated by means of a variational-statistical analysis. Results. The study found that the main source of innervation of tentorium cerebelli is tentorial nerve. There are two main forms of the branching of tentorial nerve in the tissue tentorium cerebelli: one-sided and double-sided. The diameter of the nerve trunks of tentorial nerve reaches values from 2.70 to 3.16 mm in men and 2.46 to 2.98 mm in women; the diameter of the lateral and medial branches does not exceed 1.55-2.30 mm (men) and 1.47-2.12 mm (women); the diameter of the intermediate twigs is 500-900 microns in the first and 350-920 microns in the others; the diameter of the fins is 40-170 and 10-160 microns. The highest rates of brachicephals are slightly reduced in mesocephals, and reach the smallest values in the dolichocephals. The length of the trunks tentorial nerve is in the range from 1.50 to 2.28 cm; the length of the main branches does not exceed 2,05-3,10 cm; the length of the zone of innervation of the terminal branches of the tentorial nerve is from 1.40 to 1.95 cm. This parameter has the highest rates in people with a dolichocephalic form of the head, the smallest - in people with brachycephalic form.

The cervical cancer is one of the most common diseases in world. This malignancy is the seventh highest prevalence oncological disease worldwide and the second highest prevalence oncological disease of women in the world. Meanwhile women need to be infected by human papilloma virus (HPV) is absolutely necessary for it further evolution, HPV DNA was found in 99.97% cases of disease. Except cervical cancer, HPV cause 85% of rectal cancer, 50% of the vulva, vagina and penis cancers, 20% of oropharyngeal cancer and 10% of larynx and esophagus cancers. In 2009, 14 000 women were diagnosed with cervical cancer in Russia. The growth in morbidity was 19% (in comparison with 1999). The most effective recognised measure for almost each infection prophylaxis is a vaccination. Two human papilloma virus vaccines are available in Russia nowadays — Gardasil and Cervarix, produced in Belgium and the Netherlands respectively. Cervarix is a bivalent vaccine based on virus-like particles (VLP) of two types. Recombinant major capsid proteins L1 HPV 16 and HPV 18 express in baculovirus expression system and self-assembled into virus-like particles (about 70 percent of cervical cancers are caused by HPV 16 and HPV 18). VLP of each strain produced in different baculovirus vectors and then combined in single drug. Gardasil is like Cervarix with few exceptions. Producing organisms are fungi S. cerevisiae in this case, and this vaccine contains low-risk HPV 6 and HPV 11 VLP. Thus, Gardasil is quadrivalent HPV-6/11/16/18 vaccine. These vaccines are very effective in averting infection of disease and don’t have significant side-effects, however they have some disadvantages. Firstly, they have a high price because of necessity of their expression in eukaryotic cells. Secondly, they are strain-specific, so vaccines are completely effective only for virus’s strains which are represented in the vaccine. Thirdly, it`s the absence of therapeutic (treatment of established infection) value of stated vaccines. According to information from literature, N-terminus of the L2 protein can induce non strain-specific neutralizing antibody that protects organism from papillomavirus challenge. E7 protein is a virus oncogene, its function is unlimited proliferation of infected cells that cause malignization in chronic course of disease. This protein is a very attractive target for therapeutic vaccines because of its necessity both for virus life cycle and sustenance of malignant phenotype in cancer cells. So, in this research the design of immunogen on the base of proteins HPV L2 and E7 is selected, vaccine on the base of which will avoid the disadvantages of Gardasil and Cervarix listed above. The stain-producer of protein on the base of cells E. coli was created. The protein was purified in denaturing reducing conditions by metal-affine chromatography and refold by sequential remove of urea and 2-mercaptoethanol.

Background. The development of modern neuromorphology, neurosurgery and neurology requires a detailed study of neurovascular structures of the dura mater encephali and its processes. Objective. To determine the features of histological topography of blood supply and innervation of the dura mater encephali and its processes in people with individual anatomical variability of the head and skull. Methods. The survey was conducted on 30 specimens of dura mater encephali and its processes. Morphometry of neurovascular structures of dura mater and its processes was performed using new methods and devices developed by us. Results. New methods and devices that are necessary for a more detailed study of neurovascular structures of dura mater and its processes were developed, tested and implemented. Conclusion. First proposed and implemented in practice "Method for making total anatomical preparations of the tentorium cerebelli and its derivative venous structures", that allows to make comprehensive preparations of the native tent of the cerebellum and its derivative venous structures. Developed and tested new device designs: "Wet storage tank drugs membranes of the brain"; "The device for long-term storage of wet preparations of membranes of the brain "; "Device for the study of drugs konveksital wet surface dura mater of the brain"; "Device for the study of macroscopic basal neurovascular structures dura mater of the brain"; "Combination tool for the study of relationships neurovascular structures dura mater of the brain".

Abstract  Pre-and postflight examinations of cosmonauts participating in missions ISS-3 to ISS-9 on the International Space Station were performed using a computer-aided method of integrated assessment of the oculomotor system. The role and significance of the vestibular system in the eye tracking were determined; the individual and general characteristics of spontaneous oculomotor reactions and oculomotor reactions induced by visual and vestibular stimuli after a long-term stay at zero gravity (126–195 days) were determined; and the changes in the indices of oculomotor reactions were monitored. Studies of the vestibular function, intersensory interactions, and the tracking function of the eyes in the crew members were performed on the second, fifth (sixth), and ninth (tenth) days of the readaptation period. The results of the postflight examinations showed a significant change in the accuracy, velocity, and temporal characteristics of eye tracking and an increase in the vestibular reactivity. It was shown that the structure of visual tracking (the accuracy of fixational eye rotations and smooth tracking) was disturbed (the appearance of correcting saccades, the transition of smooth tracking to saccadic tracking) only in those cosmonauts who, in parallel to an increased reactivity of the vestibular input, also had central changes in the oculomotor system (spontaneous nystagmus, gaze nystagmus). With one exception, recovery of the indices of the accuracy of tracking eye movements in cosmonauts to the background level in the selected period of examination was not observed, although a positive trend was recorded. [ABSTRACT FROM AUTHOR]

This Special Issue of the International Journal of Telerehabilitation, dedicated to the evolving field of telerehabilitation, particularly in the context of cancer care. As we navigate through a period of significant global challenges, the importance of remote healthcare delivery has never been more evident. This issue seeks to highlight the advancements in telerehabilitation technologies, methodologies, and their practical applications in various healthcare settings.

This article explores the theoretical aspects of transdisciplinary research, with a specific focus on its application to telerehabilitation. The integration of multiple disciplines – ranging from medicine, digital health, and informatics to engineering and the social sciences – is increasingly necessary to address the complex challenges of delivering effective remote rehabilitation services. The article begins by outlining the conceptual framework, distinguishing between disciplinary, interdisciplinary, multidisciplinary, and transdisciplinary approaches, and highlighting the importance of transcending traditional disciplinary boundaries. The theoretical foundations discussed provide a basis for understanding how the convergence of diverse fields can lead to innovative solutions in telerehabilitation. The integration of disciplines is examined in detail, illustrating how collaborative efforts across medicine, technology, and behavioral sciences can enhance patient outcomes, improve accessibility, and foster the development of personalized rehabilitation plans. The article also covers the practical implications for clinical practice, emphasizing the need for a more collaborative model of care delivery and the potential for cost-effective, scalable solutions. Looking toward the future, the article identifies key areas for research, including the development of advanced technologies, exploration of new therapeutic modalities, and consideration of ethical and social impacts. The need for standardization and interoperability in telerehabilitation systems is also underscored, as these will be critical to ensuring the seamless integration of various technologies and platforms.

Purpose: The primary objective of this study was to develop and implement a Hybrid Cloud Environment for Telerehabilitation (HCET) to enhance patient care and research in the Physical Medicine and Rehabilitation (PM&R) domain. This environment aims to integrate advanced information and communication technologies to support both traditional in-person therapy and digital health solutions. Background: Telerehabilitation is emerging as a core component of modern healthcare, especially within the PM&R field. By applying digital health technologies, telerehabilitation provides continuous, comprehensive support for patient rehabilitation, bridging the gap between traditional therapy, and remote healthcare delivery. This study focuses on the design, and implementation of a hybrid HCET system tailored for the PM&R domain. Methods: The study involved the development of a comprehensive architectural and structural organization for the HCET, including a three-layer model (infrastructure, platform, service layers). Core components of the HCET were designed and implemented, such as the Hospital Information System (HIS) for PM&R, the MedRehabBot system, and the MedLocalGPT project. These components were integrated using advanced technologies like large language models (LLMs), word embeddings, and ontology-related approaches, along with APIs for enhanced functionality and interaction. Findings: The HCET system was successfully implemented and is operational, providing a robust platform for telerehabilitation. Key features include the MVP of the HIS for PM&R, supporting patient profile management, and rehabilitation goal tracking; the MedRehabBot and WhiteBookBot systems; and the MedLocalGPT project, which offers sophisticated querying capabilities, and access to extensive domain-specific knowledge. The system supports both Ukrainian and English languages, ensuring broad accessibility and usability. Interpretation: The practical implementation, and operation of the HCET system demonstrate its potential to transform telerehabilitation within the PM&R domain. By integrating advanced technologies, and providing comprehensive digital health solutions, the HCET enhances patient care, supports ongoing rehabilitation, and facilitates advanced research. Future work will focus on optimizing services and expanding language support to further improve the system's functionality and impact.

Purpose. This article aims to provide an in-depth examination of the digital health system of Ukraine, focusing on the emerging trends, precise definitions, established standards, and recent legislative revisions that shape the practice and implementation of eHealth solutions within the country. Background. The digital health landscape in Ukraine has witnessed significant transformations, especially in the wake of the COVID-19 pandemic and subsequent military conflicts. These events have catalyzed the expansion of telemedicine services, leading to innovative approaches in healthcare delivery. The national strategy underscores the necessity for human-centric and accessible telemedicine, reinforced by technological neutrality, and harmonization with global standards. Methods. A review of the current literature, national strategies, and legal documents was conducted, alongside an analysis of data usage and service provision patterns in various Ukrainian regions. Participation in the "Science for Safety and Sustainable Development of Ukraine" competition facilitated project initiatives like the development of a cloud-based platform for patient-centered telerehabilitation for oncology patients. Findings. The utilization of telemedicine has significantly increased in conflict-affected regions, demonstrating the need for, and the effective deployment of, digital health strategies under crisis conditions. Private health facilities and entrepreneurs have been pivotal in the provision of telemedicine services. Legislative efforts have been geared toward framing telemedicine as an integral component of the national eHealth system, ensuring interoperability, and aligning with international standards and the Internet of Medical Things (IoMT). Interpretation. The findings underscore the resilience and adaptability of the Ukrainian healthcare system in the face of adversity. There is a clear trend towards a more integrated, patient-focused, and technologically advanced healthcare model, aligning with international trends and prioritizing public health goals over private profits. This progress, however, is contingent upon continuous development, investment in technological infrastructure, and legislative support to sustain and advance digital health initiatives.

This Letter to the Editor provides an update on the research from the Glushkov Institute of Cybernetics of the National Academy of Sciences of Ukraine. The Institute’s research team in collaboration with Ternopil National Medical University began a new project called “Development of the cloud-based platform for patient-centered telerehabilitation of oncology patients with mathematical-related modeling.” The project is dedicated to the development of a hybrid cloud-based platform, and the creation on its basis of information technology for the telemedicine rehabilitation of cancer patients, and adapted for patients with combat stress disorder. The distinctive features of the proposed technology are a combination of artificial intelligence methods with accurate mathematical methods for optimization: developing mathematical models of problems of discrete, and non-smooth optimization, subgradient space transformation algorithms (to minimize non-smooth functions with tens of thousands of variables), and a method of global equilibrium search, etc.

The physical motivations, present status, main results in study of cosmic rays and in the field of gamma-ray astronomy as well future plans of the TAIGA-1 (Tunka Advanced Instrument for cosmic ray physics and Gamma Astronomy) project are presented. The TAIGA observatory addresses ground-based gamma-ray astronomy and astroparticle physics at energies from a few TeV to several PeV, as well as cosmic ray physics from 100 TeV to several EeV. The pilot TAIGA-1 complex is located in the Tunka valley, 50 km west from the southern tip of the lake Baikal.

The corrected dependence of the mean depth of the EAS maximum $X_{max}$ on the energy was obtained from the data of the Tunka-133 array for 7 years and the TAIGA-HiSCORE array for 2 years. The parameter $\langle\ln A\rangle$, characterizing the mean mass compositon was derived from these results. The differential energy spectrum of primary cosmic rays in the energy range of $2\cdot 10^{14}$ – $2\cdot 10^{16}$ eV was reconstructed using the new parameter $Q_{100}$ the Cherenkov light flux at the core distance 100 m. Change of the parameter for the energy reconstuction for the TAIGA-HiSCORE from $Q_{200}$ to $Q_{100}$ provides a decreasing energy threshold for the spectrum to about 200 TeV.

The Tunka-Grande experiment is a scintillation array with about 0.5 km$^2$ sensitive area at Tunka Valley, Siberia, for measuring charged particles and muons in extensive air showers (EASs). Tunka-Grande is optimized for cosmic ray studies in the energy range 10 PeV to about 1 EeV, where exploring the composition is of fundamental importance for understanding the transition from galactic to extragalactic origin of cosmic rays. This paper attempts to provide a synopsis of the current results of the experiment. In particular, the reconstruction of the all-particle energy spectrum in the range of 10 PeV to 1 EeV based on experimental data from four observation seasons is presented.