Search

Background: In recent years, pump-based insulin therapy, also known as continuous subcutaneous insulin infusion (CSII), has become a common treatment for children with type 1 diabetes mellitus (T1DM). Despite the fact that, in general, children with type 1 diabetes achieve the best glycemic control indices during pump therapy, while there is a significant heterogeneity of metabolic outcomes among individual patients, many children with CSII do not reach the target level of HbA1c.Objective: To assess the level of glycemic control and factors associated by withdrawal of use, the response to treatment with prolonged use of CSII in children with type 1 diabetes.Materials and methods: The study included 458 children aged 1 to 18 years, treated to pump therapy at least 3 years before the study, the presence of the analyzed data in the register.Results: The level of HbA1c decreased by -0.7% compared with the primary endpoint, which was accompanied by an increase in the number of patients who reached the target level of HbA1c (1c over 9% for pump insulin therapy, as well as in patients who regularly use additional bolus and basal functions and CGM. The main reason for stopping the use of the insulin pump is the inconvenience of using and wearing — 47.7%. Risk factors for pump abandonment: later age of start treatment on CSII and frequent episodes of severe hypoglycemia.Conclusion: According to the results of the study, it was shown that pump therapy is an effective method of insulin therapy, which allows to achieve a lower level of HbA1c compared to the initial values.

Metallized film capacitors (MFCs) are used in many applications requiring high volumetric energy characteristics. Along with an increase in the dielectric permittivity of the polymer film, operating in overload mode is a simple way to dramatically increase the energy density of capacitors for relatively short periods. The unique feature of MFC, a self-healing (SH) ability, makes this possible. However, the task is complicated by the lack of information on the energy characteristics of SH in real capacitors, especially when they are voltage overstressed. Part 1 of this article contains the results of experimental investigations of SH processes in overload modes under the soft-training test. At the level of voltage up to 8 of nominal values, three types of SH were discovered: single, repetitive, and multiple. The energy characteristics of SH processes obtained in real MFCs varied widely from those in the literature data. The cumulative SH energy characteristic was introduced and proposed for diagnostic purposes. The reasons for repetitive SH were investigated and analyzed. Equivalent parallel resistance as a sensitive diagnostic parameter of the overloaded MFC was chosen and applied.

Sergey N Avdeev,1 Alexander A Vizel,2 Vladimir N Abrosimov3 ,† Andrey A Zaicev,4 Galina L Ignatova,5 Rustem F Khamitov,2 Marina P Mikhaylusova,6 Julia S Shapovalova,7 Elena F Pavlysh,8 Basil I Trofimov,9 Alexander V Emelyanov,10 Tatiana I Martynenko,11 Vladimir A Martynenko,12 Natalia E Kostina,13 Danila A Chizhov,14 Olga Yu Chizhova,10 Natalia A Kuzubova,15 Elena V Makova,16 Ekaterina V Makarova17,18 1I.M. Sechenov First Moscow State Medical University, Moscow, Russia; 2Kazan State Medical University, Kazan, Russia; 3Ryazan State Medical University Named After Academician I.P. Pavlov, Ryazan, Russia; 4The Main Military Clinical Hospital Named After Academician N.N. Burdenko, Moscow, Russia; 5Regional Clinical Hospital No. 4, Chelyabinsk, Russia; 6Pirogov Russian National Research Medical University, Moscow, Russia; 7Chelyabinsk Road Clinical Hospital “Russian Railways”, Chelyabinsk, Russia; 8Nikiforov’s All-Russian Center for Emergency and Radiation Medicine of the Emergencies, St. Petersburg, Russia; 9I.P. Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia; 10North-Western State Medical University Named After I.I. Mechnikov, St. Petersburg, Russia; 11Regional State City Hospital No. 5, Barnaul, Russia; 12Regional State Clinical Hospital, Barnaul, Russia; 13Voronezh Regional Clinical Hospital No. 1, Voronezh, Russia; 14St. Petersburg State City Polyclinic No. 106, St. Petersburg, Russia; 15St. Petersburg State Vvedenskaya City Clinical Hospital, St. Petersburg, Russia; 16State Samara City Hospital No. 4, Samara, Russia; 17Privolzhsky Research Medical University, Nizhny Novgorod, Russia; 18State City Clinical Hospital No. 10, Nizhny Novgorod, Russia†Professor Vladimir Abrosimov passed away on January 22, 2019Correspondence: Sergey N AvdeevI.M. Sechenov First Moscow State Medical University, 8– 2, Trubetskaya St., Moscow, 119991, RussiaTel +7-495-465-74-15Fax +7-495-465-52-64Email serg_avdeev@list.ruBackground: Chronic cough declines quality of life and increases risk of complications in patients with chronic obstructive pulmonary disease (COPD). Reducing cough severity and associated negative effects is important therapeutic goal in COPD. Rengalin with anti- and protussive activity is based on technologically processed antibodies to bradykinin, histamine and morphine.Aim: To evaluate efficacy and safety of Rengalin in treatment of cough in patients with COPD.Methods: Patients (n=238, mean age 64.3± 8.2 years) with stable COPD and persistent cough despite maintenance therapy (anticholinergics, beta-2-adrenergic agonists, inhaled corticosteroids) were included and randomized in the study. The severity of cough assessment (according to the “Cough Severity Score”), COPD impact on patient’s life (COPD Assessment Test, CAT), and spirometry were performed at screening. Patients took Rengalin or Placebo 2 tablets 2 times daily for 4 weeks. The endpoints were proportion of patients who responded to treatment, dynamics of cough severity, and severity of COPD symptoms. Intention-to-treat (per protocol) analysis was performed.Results: Positive response to Rengalin was recorded in 83.6 [85.7]% (vs 72.6 [72.7]% in Placebo group, p=0.0422 [p=0.0163]). Double decrease of cough severity was reported in 42.2 [43.8]% in Rengalin group (versus 32.7 [32.7]% in Placebo; p=0.1373 [p=0.0907]). The total CAT score decreased by 3.3± 4.2 [3.6± 3.9] points (versus 2.5± 4.1 [2.5± 4.2] in Placebo group); the difference between groups was 0.79± 4.16 [1.04± 4.02] points (p=0.0870 [p=0.0416]). The number of patients with adverse events (AEs) in Rengalin (n=13) and Placebo (n=12) groups did not have significant differences (p=1.00). No AEs with certain relationship with study drug were registered.Conclusion: Rengalin is an effective and safe drug in patients with stable COPD and persistent cough, despite stable doses of maintenance therapy according to the GOLD guidelines. Four-week therapy decreases severity of cough by two times in more than 40% of patients.Trial Registration: ClinicalTrials.gov (id: NCT03159091).Keywords: cough, cough management, chronic obstructive pulmonary disease, treatment, Rengalin

Main parameters of secondary refinement and continuous casting for 400 mm wheel steel billets of grade 2 (GOST 10791–2011) manufactured by AO TAGMET are determined that provide the minimum nonmetallic inclusion content and absence of steelmaking defects detected with railway wheel ultrasonic monitoring. Additional monitoring procedures for continuously cast billet quality control are described in order to provide steel chemical composition homogeneity over a billet cross section and to minimize central porosity.

The research purpose is to realize a multi-stage model developed by the authors to show fatigue failures accumulation and failures of anti-friction materials and layers in slider bearings. The model describes: a scattered accumulation of micro-cracks, formation and development of a micro-crack system up to a limiting state of an object. There are solved some problems. The problem of model parameter identification on the basis of the analysis of babbit sample tests is solved with the use of the simplest optimization method – a method of a deformable polyhedron. At that there are used principles of the least-squares method. A new result is four model parameters obtained finally. A computation problem of anti-friction babbit layer life required the development of a new software product. Software testing is carried out as a comparison of bearing-sample tested for fatigue and calculated life of these samples. The calculated and experimental lives are consistent. It confirms model working capacity.

Achieving the control of bronchial asthma (BA) in real clinical practice remains an unresolved problem, despite the expansion of therapeutic options in this area. Guidelines about when and for whom should a particular treatment be used continue to develop. Increasing of inhaled corticosteroid dose (ICS) in combination with a long-acting β2-agonist (LABA) does not always lead to the desired result, although a combined LABA-ICS inhaler could improve the course of asthma and increase adherence. The addition of tiotropium bromide to LABA-ICS requires the use of two inhalers. The targeted biological therapy is associated with the complexity of phenotyping and is possible only in specialized medical centers. Mometasone furoate, indacaterol acetate, and glycopyrronium bromide in fixed doses were combined in Breezhaler® inhaler for asthma maintenance therapy once per day. This way of treatment helps to realize full potential of maintenance inhalation therapy of bronchial asthma and to simplify the achievement of control over the disease in routine clinical practice.

Polymer film capacitors are widely used in modern power equipment, because of excellent volumetric characteristics in combination with high-voltage application ability. Using segmented electrodes of nanometer thickness increased the capacitor’s performance and reliability because of the self-healing feature. In this paper, we present the results of the experimental investigation and numerical simulation of electrothermal destruction of the metallized film capacitors segmented electrodes during the self-healing process. The destruction processes were investigated for both a single gate and single segment, comprising four parallel gates connected to the segment. The numerical simulation was conducted by means of COMSOL Multiphysics software. The model takes into account the heat flow from metal layer to polymer film since it has significant influence on the destruction process. Based on a good agreement of experimental and numerical results, the simulation model was proposed for the real metallized film capacitor segmented electrodes design. The model allows evaluating the single segment isolating time during self-healing, the energy required for the isolating, effective value of segmented electrodes surface resistance.

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of disability and mortality. The paper discusses the role of single inhaler triple therapy in COPD maintenance treatment. Trelegy Ellipta - the first fixed triple combination registered in Russia - is taken as an example. Below we deliberate on classes of components and their mechanism of action, clinical effectiveness, influence on exacerbations' risk, functional and patient-reported outcomes, safety, and mortality reduction. We also discuss the approaches for triple therapy administration to COPD patients recommended by a row of national and global guidelines.

Severe asthma is a heterogeneous disease consisting of several endotypes and phenotypes diagnosed due to different biomarkers. Frequency of different endotypes and phenotypes in real clinical practice needs further investigation.The aim of this study was to assess biomarkers of T2-inflammation in patients with severe asthma in a single secondary care center.Methods. We examined 96 adult outpatients (34% male) with severe asthma. Data collected included demographics, smoking history, asthma exacerbations during previous 12 months, medication use, comorbidities. Lung function tests were assessed by using the Spirograph 2120 (Vitalograph, Great Britain). Blood eosinophils (Eos) were measured by automatic haemoanalyser. Atopic status was determined by positive skin prick-test (> 3 mm) and/or serum specific IgE to common inhalant allergens. Serum total IgE levels were assessed by immunofluorescence assay. FeNO was measured by a chemiluminescence analyzer (Model LR4000; Logan Research, Rochester, UK). Presence of allergy, need for regular oral steroid use, blood Eos ≥ 150 cell/μl and FeNO ≥ 20 ppb were considered as markers of T2-driven inflammation. Asthma control and quality of life were assessed by using Russian versions of ACQ-5 and St. George's Respiratory Questionnaire (SGRQ). Statistical analyses were performed with Statistica Ver. 10.0 (StatSoft, Inc., USA).Results. The majority of patients with severe asthma (93%) have at least one or more elevated markers (presence of allergy, need for regular oral steroid use, Eos ≥ 150 cell/μl or FeNO ≥ 20 ppb) of T2-inflammation. Biomarkers levels did not differ in non-steroid-dependent and steroid-dependent patients. The most frequent markers were allergy and blood Eos ≥ 150 cell/μl. Two or more elevated biomarkers were revealed in 72% of patients.Conclusion. The majority of patients with severe asthma in real clinical practice have signs of T2-inflammation. It seems that many severe asthmatics have indications for prescription of biological and can be treated by more than one of monoclonal antibodies against major cytokines of T2-inflammation.

BACKGROUND: According to research, only 38% of patients reach glycated hemoglobin targets. It is possible to improve the effectiveness of medical care for children with T1D using modern technologies, including continuous glucose monitoring (CGM). AIMS: To evaluate the effectiveness of outpatient monitoring of children and adolescents with T1D with regular use of professional continuous glucose monitoring. METHODS: The inclusion criteria: age 812 years; T1D at least 1 year; insulin therapy by multiple injections of insulin; inadequate glycemic control of T1D: НbА1с level of 7.5% and higher and / or children and adolescents with frequent episodes of hypoglycemia (usually 4 times a week) or with a history of severe hypoglycemia; signed informed consent. All patients initially and 12 weeks after inclusion in the study conducted a study of the level of НbА1с, and also performed CGM for 6 days. Based on the results of CGM, glycemia indicators and daily doses of insulin were recorded, treatment was evaluated and corrected, and recommendations for self-monitoring were made. Glucose monitoring was carried 120144 hours using the blind method iPro2 (Medtronic, USA). RESULTS: In all, 99 children aged 818 years were included in the study in all centers. The decrease in the level of НbА1с by the end of the study was 0.72%, while the proportion of patients who reached the target level of НbА1с (defined as 7.5%) was statistically significantly higher at the end of the study (15.5% and 2%, respectively; p0.05). During the study, patients showed a trend towards a decrease in the average level and variability of glycemia by the end of the study, however, statistical significance was achieved only in relation to the average level of glycemia (p=0.04). Conducted insulin therapy, determined by the average daily doses of long-acting and short-acting insulin, did not statistically significantly change at the end of the study. The frequency of DKA episodes and severe hypoglycemia did not statistically significantly differ from the initial level. CONCLUSIONS: For children with poor glycemic control of T1D, the use of professional CGM is effective in terms of glycemic control and a safe method.

According to international guidelines in recent years, it has been proposed that bronchial asthma (BA) with fixed airflow obstructions (FAO) be identified as a separate phenotype.The aimof the study was the clinical and functional characterization and identification of risk factors for the formation of the phenotype BA with FAO.Materials.We examined adult outpatients with BA (n = 432) and a combination of BA and chronic obstructive pulmonary disease (COPD) without exacerbation (n = 58). Anamnesis collection, objective examination, spirometry with the assessment of obstruction reversibility (spirograph 2120 Vitalograph, UK), atopic status assessment (skin samples or specific IgE in serum) were performed. The level of eosinophils and neutrophils in peripheral blood was determined (by the impedance method on the automatic haemoanalyzer). Nitric oxide of exhaled air was measured by a chemiluminescent gas analyzer (Logan 4100, UK). BA control and quality of life of patients were evaluated using the Russian language versions of the Asthma Control Questionnaire (ACQ-5) and the St. George's Hospital Respiratory Questionnaire (St. George's Respiratory Questionnaire – SGRQ) respectively. Statistical analysis was carried out using parametric and non-parametric methods using the application program package Statistica 10. The value of bilateral p < 0.05 was considered statistically significant.Results.Among patients with BA without COPD, the incidence of FAO was 31%, with the most frequent (60%) FAO was found in severe BA and less often – in the mild (7%) and medium (36%) course of the disease. Among patients with a combination of BA and COPD, a severe course of the disease prevailed – 77%. Patients with FAO were older and had a longer duration of disease. The presence of FAO was accompanied by lower rates of pulmonary function, a higher frequency of positive markers of eosinophilic inflammation, worse indicators of control over BA and quality of life, a higher need for “emergency” drugs and drugs to support the treatment of BA, including biological therapy, increased use of healthcare resources. The risk factors for FAO in patients with BA include the debut of BA under 25 years of age (odds ratio (OR) – 1.6), sensitization to ticks of house dust (OR – 1.8), passive smoking (OR – 6.5), suffered during the life of pneumonia (OR - 3.0).Conclusion. The combination of BA + FAO can be considered as a separate phenotype of the disease with a more severe course and less favorable prognosis.

The main objectives of chronic obstructive pulmonary disease (COPD) therapy are to reduce the severity of symptoms and the risk of exacerbations. The article discusses the role of local and systemic inflammation in the pathogenesis of COPD as well as various mechanisms of pharmacological influence on it. Approaches to prescribing basic therapy for patients with COPD, recommended by various national and global guidelines (clinical recommendations of the Russian respiratory society, criteria of the Global Initiative for Chronic Obstructive Lung Disease (GOLD), guidelines of the National Institute for Health and Clinical Excellence (NICE)), as well as recommendations on the therapy frequency review are considered. Currently, so-called triple combinations – fixed combinations of double bronchodilators with inhaled glucocorticosteroids – are being developed and registered in the world, and their place and significance in the treatment of COPD raise many discussions. The paper discusses the role of fixed triple combinations in reducing the incidence of COPD exacerbations, the impact on functional and patient-reported outcomes, and provides recommendations for the use of triple combinations in patients with COPD, taking into account the benefit/risk ratio.

Public organization “Russian Association of Endocrinologists”. Clinical guidlines.

The article explores the possibility of using inulin and lamb in meat loaf technology. Physicochemical and organoleptic characteristics of meat loaf were studied, and the positive effect of inulin on the finished product was proved. Inulin is a plant-derived carbohydrate that has unique nutritional and technological benefits. Inulin reduces the risk of colon cancer, atherosclerosis, osteoporosis, diabetes and obesity, maintains low levels of triglycerides and cholesterol in the blood serum, stimulates the immune system, improves the water-holding ability and stability of the emulsion, and also changes the texture and viscosity of food products. As a functional food ingredient, it can be used in various foods as a substitute for fat. The inclusion of inulin in meat products seems to be useful in the production of low-fat products with the desired texture and sensory properties. Currently, the use of inulin in the technology of preparing meat loaf based on lamb is practically not studied. When developing and optimizing the formulations of meat products, an important point is the qualitative composition of food ingredients, which provides physiological needs of the human body for energy and necessary nutrients, taking into account age and existing medical and biological recommendations. Basing on the studies, a formulation and a technological scheme for the production of a meat product were developed. Thus, there was obtained a functional product of good quality, with increased nutritional and biological value, that meets all the requirements of the consumer.

A method of control for an ordered group of particles that levitate in an ultrasonic field and structures of rectilinear segments is proposed. An ultrasonic field in air at a frequency of 40 kHz and particles whose dimensions are less than a quarter of a wavelength or thin cylindrical objects with diameters of less than a quarter of a wavelength are considered. The ultrasonic field is formed using four phased arrays of radiators that are placed oppositely on lateral faces of a rectangular parallelepiped. The radiators form a distribution of the standing wave field in the plane, which provides levitation of particles in a rectangular grid in a plane layer. With the use of numerical simulation and experimentally, it has been shown that the obtained distribution is stabilized and the particles remain immobile at local minimums of the Gor’kov potential. Moreover, regulation of the phase difference of opposite radiators provides controlled motion of a group of particles in a horizontal plane and a change in the focusing plane of side radiators provides controlled motion of a group of particles along the vertical plane. It has been shown experimentally that not only small particles but also structures assembled of rectilinear segments whose length is much greater than the wavelength can levitate in this field distribution.

The current state of the patients’ management with nasal polyposis and allergic rhinitis has become the basis for a deep analysis of the currently available data on the prevalence of diseases (with a focus on severe forms), as well, available possibilities and disadvantages of conservative therapy are considered. The approaches to assessing the severity and control of diseases and the influence of an uncontrolled course on the quality of the patients’ life are presented. Particular attention is paid to a new class of drugs – monoclonal antibodies, which might change the patients’ treatment paradigm of severe uncontrolled course of allergic rhinitis and nasal polyposis. The efficacy and safety issues of immunobiological therapy are discussed on the example of the IgE-targeted medicine omalizumab. The potential place of the drug in the treatment of the mentioned above forms of nasal polyposis and allergic rhinitis is indicated.

Mild bronchial asthma (BA) occurs in 50–75% of patients with this disease. It is characterized by clinical symptoms that are controlled by low doses of inhaled glucocorticoids (IGCS) or anti-leukotriene drugs. Mild BA reduces the quality of life of patients, is accompanied by the development of severe, in some cases fatal exacerbations, and is characterized by a significant cost of treatment. One of the main problems in the management of patients with this disease is their low adherence to IGCS treatment and the excessive use of short-acting 2-adrenomimetic agents. Several clinical studies have shown that the use of a combination of budesonide/formoterol (Symbicort® Turbuhaler®) in an «as needed» mode reduces the incidence of severe exacerbations of mild BA as well as low doses of budesonide, and is characterized by a lower cumulative dose of this glucocorticoid. The results obtained were the basis for the creation of a new treatment concept, which gives preference to the combination of IGCS / formoterol «as needed» in mild BA as a supporting therapy, and for the management of symptoms of the disease.

The malignant skin tumors are neoplasms of visual localization and their diagnostic is extremely complicated because of diversity of their clinical forms. Among all skin malignant tumors, a melanoma holds a particular place being socially important problem because of high level of lethality related to significant metastatic potential of tumor and lower efficiency of therapy of later forms of disease. The article describes development and implementation of algorithm of rendering medical preventive care to patients of risk group of development of malignant skin tumor on the basis of investigation of actual epidemiological situation with morbidity of basalioma, melanoma, squamous cell carcinoma of skin in population of the Sverdlovsk region during 2000-2015 and detection of factors conditioning late diagnostic of malignant skin tumors. According to actual epidemiological data, an increasing of morbidity of both melanoma and other malignant skin tumors is observed in the Russian Federation on the whole and in the Sverdlovsk region. The article pays attention to that physicians of various specialties are to timely send patients of risk groups or with «suspicious» neoplasms to dermatovenerologist to specify character of neoplasm and to resolve issue concerning necessity of dispensary observation. The necessity is noted of tighter interaction of dermatoverologists and oncologists. Thereby, implementation of algorithm of rendering medical care to patients of risk groups of malignant skin tumors in the Sverdlovsk region promotes increasing of quality and accessibility of medical care to population, earlier detection of patients, decreasing of load of oncologic service by non-profile patients.

Objective. To assess the immediate and long-term results of stenting of the unprotected left coronary artery (LCA) trunk in patients, by using different types of drug-eluting stents.Material and methods. The follow-up covered 282 patients who had undergone stenting of the unprotected LCA trunk. The mean follow-up was 34.6 [33.9; 35.3] months. The patients were divided into groups according to the type of a first-, second-, and third-generation implanted stent.Results. The incidence of adverse cardiovascular events in the patients of Group 1 was significantly higher than in those in Groups 2 and 3 (29 and 7.6%, pp=0.02). The incidence of adverse cardiovascular events was comparable between Groups 2 and 3, despite a shorter duration of dual antiplatelet therapy in the third-generation stent group. The absence of stent postdilatation in the LCA trunk is an independent risk factor for adverse prognosis.Conclusion. The use of second- and third-generation stents along with changes in the technical aspects of stenting of the unprotected LCA trunk leads to a substantial reduction in the risk of adverse cardiovascular events and allows the indications for intervention to be expanded in this patient category.

A low temperature vacuum cell 220 cm in length with windows of quartz, ZnSe, and KBr has been designed for working with the high resolution Bruker IFS 125-M Fourier spectrometer. It provides a threshold sensitivity to absorption on the order of 10–7 cm–1, and allows recording absorption spectra of gases in the temperature range from 200 to 296 K in the region 1000–20 000 cm–1 with an accuracy of 0.9 K.

A circuit was constructed based on a heterodyne receiver to measure the spectral characteristics of Ka-band high-power nanosecond microwave pulses. The circuit included a receiving antenna, three input waveguide directional couplers with different coupling coefficients, a variable waveguide attenuator, two coaxial-to-waveguide adapters, a microwave cable, an additional directional waveguide coupler, as well as a heterodyne receiver consisting of an electrically controlled electronic attenuator, a mixer and a local oscillator combined in one unit. The developed circuit was intended to measure the spectral characteristics of high-power nanosecond microwave pulses in the range of 35.7–37 GHz.

A typical approach to minimizing the early failures (“infant mortality”) of the modern metallized film capacitors (MFCs) is to conduct a burn-in test at applied voltage slightly more (at 30 – 50%) than nominal value. During the test, an external capacitor bank is used as a capacitive storage device with an energy significantly exceeding the energy level of the capacitor under the test. Thus, the amount of energy in the self-healing (SH) process is practically unlimited, which may lead to catastrophic failure of the capacitor. Recently, the soft training test for application of such capacitors in overload modes has been proposed. This can significantly improve the MFCs technical characteristics. We present the results of experimental and theoretical study on SH processes of MFCs in soft training test, allowing the capacitors to operate at voltages 3 – 5 times higher than nominal value. The MFC’s degradation is associated with the equivalent parallel resistance (EPR) decreasing due to numerous SH events. On the base of the developed physical model, the relationship between critical value of testing voltage and EPR as a diagnostic parameter is offered.

Numerical simulation of metal-film capacitors segmented electrodes was conducted. Conventional segmentation with intersegment bridges and novel hybrid segmentation were simulated and compared with all-over metallized electrodes. The calculated characteristics are: surface resistance of the electrodes active area of the electrodes resulting in overall capacitance, current density distribution. It was established that surface resistance of hybrid-segmented metallization is much lower than one of bridge-patterned, and close enough for all-over metallization. The hybrid-segmented electrodes were found to be less overloaded by current.

Background. Insulin pump therapy in increasingly frequently used in the Russian Federation in recent years, which requires an evaluation of the treatment in order to improve its efficacy and safety. Objective — the study was aimed at complex monitoring (long-term efficacy and safety, state of medical care, factors associated with metabolic control, and factors hindering its use) of the continuous subcutaneous insulin infusion (CSII) in children, adolescents, and young adults with type 1 diabetes mellitus (DM1) from various regions of the Russian Federation. Material and methods. Data of 395 DM1 children and adolescents from 60 regions of the Russian Federation were collected from the pediatric CSII register of the Endocrinology Research Center. The following data were analyzed in different age groups (0 to 7 years, 8 to 11 years, 12 to 17 years, and 18 to 25 years): glycemic control, the incidence of acute complications, discontinuation of CSII, characteristic features of blood glucose monitoring, and supplies coverage. Results. Initiation of CSII is accompanied by decrease in HbA1c level with the lowest values within the period from 6 to 24 months (–0.7±1.5% compared to the baseline level). However, 6 years after CSII initiation, HbA1c values do not differ significantly from the baseline values. The target HbA1c level (less than 7.5%) is observed in 43.6% of children aged 0 to 7 years, 32.7% of children aged 8 to 11 years, 24.2% of adolescents aged 12 to 17 years, and 28% of young adults aged 18 to 25 years. Regular self-monitoring of glycemia, 4 and more times per day, was performed by 83% of patients, while the frequency of continuous glucose monitoring (CGM) was low, 12.7% in the whole population. The incidence of acute complications in children and adolescents under 18 years did not differ significantly and the lowest incidence was observed in the age group 18 to 25 years. The effectiveness of CSII depended on the frequency of self-monitoring, CGM use, and supplies coverage. CSII discontinuation rate was 4.6 cases per 100 patient-years. The main reasons for discontinuation of CSII included the inconvenience of its use and the cost of supplies. Conclusions. Many children and the majority of adolescents with DM1, who use CSII, did not reach target HbA1c level despite the adequate self-monitoring. Many patients do not use CGM and refuse CSII. This necessitates the efforts to improve the efficacy and overcome barriers to the use of CGM and CSII.

One of the promising ways of expanding energy resource base is production of combustible gas from coalbeds. The yield of gaseous components from samples of Visean coals of Tatarstan upon thermal impact was studied in this work by combined thermogravimetric and IR spectrometric method. It is demonstrated that methane begins to appear actively at 384-405°C, depending on the test coal sample. In this process, the yield of methane could be as much as 30 wt. % and higher, which confirms the prospect of getting gaseous fuel from Visean coal deposits by thermal impact.

We propose a procedure for the evaluation of functional parameters of the three-dimensional structure of surface roughness by using the Mathcad software. The results of computation of these functional parameters for the working surface of the end gauge-block are presented.

In this article, the expected resources of copper scrap in the Russian Federation have been analyzed, and their amounts and use through 2035 have been estimated. The conclusion on reducing the supply of copper scrap resources in the country in the mid-term prospects as a result of the change in based on the scrap generation and notable decline in the copper consumption in the country since the 1990s has been explained. In addition, the possible presence of uncollected scrap reserves, which may ultimately affect the operations of producers of copper and copper-containing products and lead to increased competition over the raw materials on the market, has been assessed and analyzed.

Relevance.In recent years, the world has seen a high prevalence and mortality from respiratory diseases. This entails high economic costs for most developed countries. Objective: to conduct a content analysis of sources that provide information on the incidence and the population and soldiers of respiratory diseases and indicators characterizing it.Materials and methods.A content analysis of 50 sources of scientific literature devoted to the problem of respiratory diseases and published in 2009–2017 was conducted using domestic and foreign databases (PubMed, eLibrary, KiberLeninka). The paper also considered information from the Federal State Statistics Service of the Russian Federation (Rosstat). The incidence rates of this type of pathology among the population over a long period (2000–2016) and among military personnel for 2003–2016 were analyzed.Conclusion.Based on the analysis of the data, risk factors for the development of respiratory diseases were identified, as well as socio-economic damage caused to the militarians with community-acquired pneumonia.

An analytical model of the dependence of the capacitance of ceramic capacitors on applied voltage has been substantiated, both theoretically and experimentally. A method of determining the parameters of the analytical model was developed on the basis of an exact solution of the nonlinear differential equation of capacitor discharge. Experimental data for ferro-ceramic multilayered capacitors is provided. Correspondence of the results of the proposed method with data from direct measurements by an RLC measuring instrument and information specified by the capacitor manufacturer, throughout the working voltage range, is noted.

The problem of emulation of the Hopfield networks in active wireless networks is considered. A network with six elements communicating via radio channels is studied experimentally.

The concepts and methods of the visual representation of fluid dynamics computations of vortical flows are studied. Approaches to the visualization of vortical flows based on the use of various definitions of a vortex and various tests for its identification are discussed. Examples of the visual representation of solutions to some fluid dynamics problems related to the computation of vortical flows in jets, channels, and cavities and of the computation of separated flows occurring in flows around bodies of various shapes are discussed.

Aim. To determine the frequency of polymorphism of calcium channels gene CACNA1C (rs1006737) in healthy individuals and patients with hypertension. Methods. 94 patients with arterial hypertension and 102 healthy residents were examined. The age ranged from 18 to 35 years. Detection of SNP calcium channel genes CACNA1C (rs1006737) was performed by real time PCR. Checking of sampling genotypes’ for being in Hardy-Weinberg equilibrium and χ2-test were performed, and hazards ratio (OR) was evaluated as well. Results. It was established that allele G of CACNA1C gene (rs1006737) was 1,3 times less frequent in patients with hypertension compared to control group, and its frequency was 0.58 vs. 0.76, respectively (χ2=14.42, р=0.0001). In patients with hypertension allele A was detected 1.75 times more often with the frequency 0.42, and in healthy individuals the frequency was 0.24 (χ2=14.42, р=0.0001). Use of general inheritance model demonstrated that G/G genotype was 1.5 times less frequent and A/A genotype was 3.2 times more frequent in patients with hypertension than in healthy individuals (χ2=12.75, р=0.002). The risk of hypertension development was higher in carriers of allele A (HR=2.3, 95% CI 1.49-3.53, p=0.0001) and genotype A/A (HR=3.9, 95% CI 1.49-9.68, p=0.002) of SNP gene of CACNA1C molecule (rs1006737). Conclusion. Allele A and genotype A/A SNP CACNA1C (rs1006737) are predisposing factors to the development of arterial hypertension, carriership of G allele and genotype G/G CACNA1C (rs1006737) reduces the risk of hypertension development.

One of the main reasons of metal film capacitors failure in pulse modes is a degradation of contacts between film metallization and solid electrodes—contact edges. This paper presents the results of experimental investigations of modeled contact edges behavior under current pulses of varying amplitude, duration, and quantity. It was found that the contact edge degradation is caused only by metallization destruction and independent on metal of the solid electrodes (“shoopage”). Depending on pulse parameters and dissipated energy in the contact edge, the contact erosion rate is in the range of (0.4– $2.7) \times 10^{-3}$ g/J. Current pulse polarity effect on contact edge degradation was found: mean time to failure (MTTF) of the contact edge depends on its polarity, i.e., on the direction of the current flow through the contact during charge or discharge of capacitor. For different contacts polarities the difference between MTTFs reaches 20%–60% depending on pulse parameters. Based on these facts, one makes a supposition that the timely changing of the capacitor’s terminals polarity can lead to the increasing of capacitor lifetime.

The problem of choosing an effective approach to determining the fatigue strength of welded butt joints at the stage of crack nucleation is solved. The results of the calculations performed according to the existing building code from the specified strength characteristics and the calculations that take into account local elastoplastic deformation in stress concentration zones are compared. Full-scale specimens of the welded joints of pair angles are tested in the low-cycle fatigue region at a constant load. The kinetics of the state of stress in the zones of terminating flange welded joints is studied by a tensometric method. It is shown that the stage of fatigue crack nucleation is best described using the deformation criterion of fracture: a comparison of the results of calculating the number of cycles to the nucleation of a fatigue crack with experimental data demonstrates good agreement.

The method of determining safe operating conditions for a supporting beam-rod structure under an abnormal load has been proposed. The locomotive cab frame loading in the case of obstacle collision has been considered. The proposed deterministic engineering evaluation of complex structural stress makes it possible to determine the limiting surface in the three-dimensional space of the representative parameters of the obstacles and locomotive speed. This surface limits the safe operating area of the vehicle in predetermined variation ranges of obstacle parameters. Based on the example of the locomotive cab calculation, it has been shown how its requirements of strength retention should be justified in order to preserve the safety of the drivers and expensive cab equipment.

We report the case of a 12-year-old boy with a glucokinase (GCK) mutation, and diabetes with hyperinsulinemia and insulin resistance. For 4 years, the patient intermittently received insulin medications Actrapid HM and Protaphane HM (total dose 5 U/day), with glycated hemoglobin (HbA1c) levels of 6.6%-7.0%. After extensive screening the patient was found to carry a heterozygous mutation (p.E256K) in GCK (MIM #138079, reference sequence NM_000162.3). Insulin therapy was replaced by metformin at 1,700 mg/day. One year later, his HbA1c level was 6.9%, postprandial glycemia at 120 min of oral glucose tolerance test was 15.4 mmol/L, hyperinsulinemia had increased to 508.9 mU/L, homeostasis model assessment index was 114.2 and the Matsuda index was 0.15. Insulin resistance was confirmed by a hyperinsulinemic euglycemic clamp test - M-index was 2.85 mg/kg/min. This observation is a rare case of one of the clinical variants of diabetes, which should be taken into account by a vigilant endocrinologist due to the need for nonstandard diagnostic and therapeutic approaches.

Planar silicon nanostructures that are formed as a very narrow silicon quantum well confined by delta-barriers heavily doped with boron are used to study the dielectric properties of DNA oligonucleotides deposited onto the surface of the nanostructures. The capacitance characteristics of the silicon nanostructures with oligonucleotides deposited onto their surface are determined by recording the local tunneling current- voltage characteristics by means of scanning tunneling microscopy. The results show the possibility of identifying the local dielectric properties of DNA oligonucleotide segments consisting of repeating G–C pairs. These properties apparently give grounds to correlate the segments with polymer molecules exhibiting the properties of multiferroics.

RATIONALE: Continuous subcutaneous insulin infusion (CSII) is an effective method for optimizing glycemic control in children with type 1 diabetes mellitus (DM1). However, the use of CSII does not always result in adequate glycemic control. Telehealth can be applied as one of the methods to improve the effectiveness of treatment.AIMS: To evaluate the use of remote medical support of children and adolescents with DM1 and its influence on glycemic control, quality of life, and incidence of acute complications of DM1.MATERIALS AND METHODS: We conducted a 24-week multi-institutional prospective open-label controlled clinical trial. 180 children and adolescents were included in this study and divided into the following categories: 1) age 8–18 years; 2) DM1 at least 1 year; 3) pump insulin therapy Medtronic Paradigm (Medtronic MiniMed, USA) at least 6 months; 4) self-monitoring of glycemia at least 4 times a day and replacement of the insulin pump infusion system at least once every 3 days; 5) inadequate glycemic control of DM1: the level of glycated hemoglobin (HbA1c) 7.5% or higher. Patients were assigned to a remote consultation group (RC; n=100) or a traditional control group (TC; n=80). All patients were trained on the basic principles of DM1 and CSII, and we measured initial HbA1c, then after 12 and 24 weeks, also registered and analyzed glycemic indicators and daily doses of insulin, evaluated and corrected the treatment. Patients or their parents in the RC group sent pump data via the Internet to the pump insulin therapy center at least once every 2 weeks at home and received treatment recommendations in response.RESULTS: The total number of patients included in the study in all institutions was 180 children at 8–18 years. Patients in both groups did not differ in age, gender, duration of DM1 and CSII, and HbA1c level. The total amount of remote consultations for all institutions was 949. The decrease in the level of HbA1c by the end of the study against the initial one was statistically significantly greater in the RC group: 1.17% compared to 0.59% in the TC group (p1c (CONCLUSIONS: Remote monitoring in children with DM1 resulted in significant improvements in glycemic control (HbA1c, glycemic variability, and hypoglycemic frequency). The accumulation of evidence on the effectiveness and safety of telehealth in DM should contribute to implementing this approach in practical health care.

Insulin therapy is a pharmaceutical treatment used for patients with diabetes to normalize blood glucose level. In patients receiving insulin therapy, optimization of blood glucose levels can be achieved using various types of insulin and various methods, such as MDI (multiple daily injections) and CSII (continuous subcutaneous insulin infusion). This review describes actual key features of CSII for diabetes patients.Инсулинотерапия — фармацевтическое лечение, используемое у больных диабетом для снижения уровня глюкозы крови. У пациентов, получающих инсулинотерапию, оптимизация уровня глюкозы крови может быть достигнута с помощью различных типов инсулина и разными методами, такими, как MDI (multiple daily injections) — режим множественных ежедневных инъекций, CSII (continuous subcutaneous insulin infusion) — длительная подкожная инфузия инсулина и традиционная терапия.

Currently, cold atmospheric plasma (CAP) generators are applied for biological and medical investigations. There are several methods of cold plasma formation. In this paper optimization of electrode system is performed for portable CAP generator producing pulsed corona discharge. The cylindrical ground electrode shape and needle tip-dielectric surface distance optimization were performed. The pulsed and voltage-current characteristics of discharge for optimal electrode systems are presented.

The article deals with issues related to the study of the connection forms of moisture removed during the drying process of thermolabile heterogeneous products. The difficulties, emerging while developing drying process controlling methods, optimizing energy, material costs, and temperature regimes, necessitate further research. It is shown that the existing methods of studying the forms of moisture connection with the material have significant drawbacks and generally give a qualitative assessment of the state of moisture in the material or are very time-consuming and require long-term laboratory studies. An approach to determining the forms of moisture bond in the material based on graph-analytical analysis of the drying kinetics is proposed, which allows qualitative and quantitative assessment of the state of moisture in the product. With the help of a graphical editor, typical drying kinetics curves were processed and the dependences of the value that characterizes the speed of change in the drying rate on the moisture content of the product were obtained. It is proposed to introduce a new value in the drying theory - drying acceleration. The analysis of the obtained curves testifies to the presence of extremes and inflection points corresponding to the critical moisture content, as well as the presence of areas with slowing or accelerating changes in the drying rate, allowing setting intervals for removing moisture with different binding energy. The approach considered in the article to determining the forms of moisture communication in the material will not only give a qualitative and quantitative assessment of the state of moisture in products, but also reduce the time for analysis and improve the accuracy of the results.

Asthma is a widespread, phenotypically heterogeneous, chronic disease characterized by inflammation and airflow obstruction, bronchial hyperresponsiveness and recurrent symptoms of respiratory discomfort. On the one hand, the treatment of asthma is based on the determination of the severity and on the control of symptoms. On the other hand, it is based on the risk management of exacerbations. The control of asthma in most patients is achieved as a result of conventional treatment with inhaled corticosteroids or a combination of them with long-acting beta-2-agonists. However, a substantial proportion of patients with difficult asthma phenotypes (severe atopic asthma, asthma and obesity, smoker’s asthma, asthma in the elderly, asthma with fixed airflow obstruction) can be refractory to the conventional therapy. Additional therapy with the long-acting anticholinergic drug such as tiotropium can optimize the control in these patients. This article describes the complex phenotypes of asthma and the clinical cases of tiotropium efficacy in therapy of such patients.

Planar silicon nanostructures that are formed as a very narrow silicon quantum well confined by δ barriers heavily doped with boron are used to study the dielectric properties of DNA oligonucleotides deposited onto the surface of the nanostructures. The capacitance characteristics of the silicon nanostructures with oligonucleotides deposited onto their surface are determined by recording the local tunneling current–voltage characteristics by means of scanning tunneling microscopy. The results show the possibility of identifying the local dielectric properties of DNA oligonucleotide segments consisting of repeating G–C pairs. These properties apparently give grounds to correlate the segments with polymer molecules exhibiting the properties of multiferroics.

Methods of laser modification allow us to observe macroscopic quantum phenomena in nanostructured (cluster) materials. The laser synthesis of nanoparticles/nanoclusters with different topologies in semiconductor PbTe samples is performed via direct laser modification of thin films under the action of continuous laser radiation with a wavelength of 1.06 μm and a power density of ~105 W/cm2. Nanoparticles with bimodal distribution in lateral dimensions are obtained on the surfaces of the samples. The electrophysical properties of such structures can be controlled as desired by modifying their topology. Variations in electric properties depending on the particle location density are demonstrated. The results are interpreted based on the existence of quantum coherent processes with tunneling transitions and hopping conductivity. This approach is promising for the fabrication of elements and devices in optoelectronics and photonics based on new physical principles, and of different hybrid optoelectrical schemes.