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Local allergic rhinitis is a new atopic disease recognized in modern allergy and rhinology. Its clinical symptoms are currently well described and compared with conventional allergic rhinitis, however, diagnostic and therapeutic protocols, including antigen-specific immunotherapy (ASIT), should be specified.Therefore, local allergic rhinitis often remains underdiagnosed and by mistake is referred to non-allergic rhinitis. Yet, the pathogenesis and mechanisms of allergen tolerance breakdown in this endotype of allergic rhinitis remain understudied. Researchers continue to study the network of tolerogenic cells and biomolecules, such as regulatory T cells, tolerogenic dendritic cells, interleukin (IL)-10, IL-35, transforming growth factor-β (TGF-b), vegetative innervation of the nose, and neurotransmitters. The review focuses on diagnostic markers of local allergic rhinitis.

This article provides a review of the phenomenon of entopy or local atopy from the viewpoint of allergic phenotypes and endotypes. A clinical form of the entopy endotype is local allergic rhinitis, which is still a fertile area for research. The exact mechanisms in the breakdown of allergen tolerance in entopy remain unclear. The review focuses on the pathogenesis, diagnostic algorithm, and the choice of treatment strategies in local allergic rhinitis.

Introduction. Metastatic spinal lesion remains one of the most difficult problems of modern medicine. The purpose of treatment of patients with metastatic spinal lesion is to reduce pain, improve the quality of life, restore stability in the affected segment, prevent or reduce neurological deficits. In order to build the right treatment tactics, it is necessary to evaluate the prognosis of the life of a patient with spinal metastases before treatment.The study objective is to evaluate the prognostic significance of the Tokuhashi scale in patients with metastatic spinal lesion.Materials and methods. The study included 124 patients with metastatic spinal lesion operated in the spinal department in the period from March 2013 to July 2019 (64 (52 %) men and 60 (48%) women). The average age was 59 years and ranged from 18 to 78 years. The catamnesis ranged from 1 month to 6 years. 6 (5 %) spinal tumors were radically removed, palliative removal was performed in 77 (62 %) cases. In the remaining cases, 41 (33 %) underwent vertebroplasty. The mandatory diagnostic protocol of the preoperative examination included oncological status, clinical and neurological examination. The functional status of the patient was assessed on the Karnofski scale, life expectancy – on the Tokuhashi scale. In terms of preoperative examination, patients underwent computed tomography examination with intravenous contrast of three zones: the thoracic, abdominal cavities and pelvic region to determine the degree of dissemination of the process and, in some cases, to identify the primary focus. Currently, positron emission tomography is the optimal method of investigation at the preoperative stage. However, this method is not yet available in all clinics, so performing computed tomography scans of three zones is currently the optimal “gold standard” for examining this category of patients..Results. The life expectancy estimate was calculated for each patient according to the Tokuhashi scale (2005). Survival analysis was performed using Kaplan-Meier curves within the Tokuhashi prognostic groups. The median survival within the Tokuhashi groups was more than 3 years for the group of 12–15 points (life expectancy over a year), 14 months for the group of 9–11 points (life expectancy 6 to 12 months) and 7 months for the group of 1–8 points (life expectancy less than 6 months). The Cox model was used to identify factors related to survival.Conclusion. Determining the tactics of surgical treatment of a patient with a metastatic lesion of the spine is a complex and multicomponent question to which there is no unambiguous answer. A multidisciplinary consultation is currently the most adequate and reliable way to determine the treatment strategy for this category of patients. The use of the Tokuhashi prognostic scale is an additional effective tool for determining the life expectancy of patients with spinal metastases, and thus, in some cases, serve as the tool with which it is possible to determine the tactics of surgical treatment of patients.

Objective: to identify independent risk factors affecting survival of patients with renal cell carcinoma (RCC) and tumor venous thrombosis who have undergone nephrectomy and thrombectomy.Materials and methods. This study included 768 patients with RCC complicated by tumor venous thrombosis who have undergone nephrectomy and thrombectomy. Median age was 58 years (range: 16-82 years); the male to female ratio was 2.3:1. The symptoms of tumor venous thrombosis were identified in 232 patients (30.2 %); laboratory abnormalities at baseline were observed in 456 patients (59.3 %). Grade I and II tumor thrombosis was diagnosed in 456 (59.3 %) and 201 (26.2 %) patients, respectively; grade III and IV thrombosis was found in 171 (22.3 %) and 177 (23.0 %) patients, respectively. One hundred and twenty-nine participants (16.8 %) had infrarenal inferior vena cava thrombosis. Regional metastases were detected in 188 individuals (24.4 %), distant metastases were registered in 274 patients (35.7 %). All patients have undergone surgery: either radical (n = 555; 72.3 %) or cytoreductive (n = 213; 27.7 %). All primary tumors were histologically classified as RCC (G3-4 in 337 cases; 43.9 %). A total of 719 patients (93.6 %) survived the perioperative period; 183 patients with metastasis (23.8 %) received systemic antitumor therapy.Results. The median follow-up was 24 months (range: 1-200 months). The 24-month overall and cancer-specific survival of all patients were 96.9 and 99.7 %, respectively; recurrence-free survival of patients after radical surgery reached 92.9 %. Progression-free survival among those patients who underwent cytoreductive surgery and received first-line therapy/follow-up was 41.7 %. Negative predictive factors of overall survival included hepatomegaly (p = 0.024), ascites (p = 0.033), level IV tumor thrombosis (p Conclusion. Stratification of patients operated on for RCC and venous tumor thrombosis with their allocation to prognostic groups will ensure the choice of an optimal management strategy.

Free carrier absorption of optical radiation in layers of an AlGaAs/GaAs heterostructure is studied by the method of probe radiation coupling in order to determine the absorption cross section parameter in the AlGaAs material with a high (22%) aluminium concentration. For this purpose, we have fabricated special samples based on AlGaAs/GaAs heterostructures simulating an n-type-doped laser waveguide with carrier concentrations in the range 5 × 1016− 3 × 1017cm−3. The doping profile and the composition and thickness of layers are measured and the temperature and spectral dependences of the absorption coefficient are studied. It is shown that an increase in temperature and in the probe wavelength leads to an increase in the absorption in the heterostructure layers.

The article presents the modern views of clinicians and geneticists on one of the most severe genetic disorders of skeletal and connective tissues - osteogenesis imperfecta. The review provided the literature data that showed the incidence rates, genetic heterogeneity of osteogenesis imperfecta, as well as the role of some proteins involved in the construction of bone tissue, as well as a clinical classification of the main types of the disorder. The authors described a clinical case: a girl with typical clinical and radiological manifestations of the rarest of all types of osteogenesis imperfecta - type II (perinatal-lethal, congenital osteogenesis imperfecta, Vrolik’s syndrome). The child’s diagnosis was verified by a parallel DNA sequence analysis which showed a heterozygous mutation in exon 29 (c.1966G> A) of COL1A1 gene not previously described in the literature. It caused the substitution of glycine for serine at position 656. The role of antenatal diagnostics and the importance of medical genetic counselling of the family before planning the next pregnancy due to the existing risk of re-birth of a sick child is outlined. Due to the fact that majority of the patients with the most prognostically unfavourable type II osteogenesis imperfecta, as a rule, die in utero, the described case of observation of the girl with typical clinical and X-ray signs of the disorder for almost 3 months of postpartum period is extremely rare and highly indicative. The detection of the heterozygous mutation in exon 29 (c.1966G > A) of COL1A1 gene by a parallel DNA sequence analysis which was not previously described in the literature gives an additional significance to the described observation.

Caesarean section is one of the oldest operations in the history of mankind and is the most common surgical intervention in obstetric practice. Translated from Latin, «caesarean section» means «royal cut», and in the days of the Roman Empire, only people marked with a special gift could be born in this way. According to one of the existing legends, this is how Gaius Julius Caesar was born, and it was the incision in his mother's womb that gave him the name «Caesar». However, given the fact that his mother died when Caesar was 46 years old, the legend still has the right to remain a legend. It is also believed that by removing the baby from the womb of the deceased mother, the ancient Greek god Asclepius, the doctor, was born — he was also Aesculapius among the Romans. His mother was struck by Zeus the Thunderer for her infidelity to her husband Apollo, but the child was taken out alive after the woman's death. Be that as it may, the first mentions of a caesarean section do not at all date back to the 16th century, as was commonly believed, but have much deeper roots. It is believed that even some famous people were born by removing them from their mother's womb, and this gave them a chance at life. The beginning of the scientific version of the appearance of the caesarean section operation can be considered the publication of the monograph by F. Rousset in 1581, in which a sufficiently detailed description of the technique of the cesarean section operation was provided and a list of indications for it was given [2]. Today, this operation is a fairly common surgical intervention that can significantly alleviate the suffering of a woman in labor, avoid a number of complications, and sometimes save the life of a mother and child.

Mini-EUSO is part of the JEM-EUSO program and operates on board the International Space Station (ISS). It is a UV-telescope with single-photon counting capability looking at nighttime downwards to the Earth through a nadir-facing UV-transparent window. As part of the pre-flight tests, the Mini-EUSO engineering model, a telescope with 1/9 of the original focal surface and a lens of 2.5 cm diameter, has been built and tested. Tests of the Mini-EUSO engineering model have been made in laboratory and in open-sky conditions. Laboratory tests have been performed at the TurLab facility, located at the Physics Department of the University of Turin, equipped with a rotating tank containing different types of materials and light sources. In this way, the configuration for the observation of the Earth from space was emulated, including the Mini-EUSO trigger schemes. In addition to the qualification and calibration tests, the Mini-EUSO engineering model has also been used to evaluate the possibility of using a JEM-EUSO-type detector for applications such as observation of space debris. Furthermore, observations in open-sky conditions allowed the studies of natural light sources such as stars, meteors, planets, and artificial light sources such as airplanes, satellites reflecting the sunlight, and city lights. Most of these targets could be detected also with Mini-EUSO. In this paper, the tests in laboratory and in open-sky conditions are reported, as well as the obtained results. In addition, the contribution that such tests provided to foresee and improve the performance of Mini-EUSO on board the ISS is discussed.

Objectives. To develop a new system for predicting the outcome of secondary peritonitis and analyze its accuracy in comparison with the most common analogous systems. Methods. The study is based on the analysis of treatment results in patients (n=352) with secondary peritonitis. At admission sepsis was diagnosed in 15 (4.3%) patients, septic shock - in 4 (1.1%) persons. There were the following main causes of death in the mortality structure: purulent intoxication and/or sepsis - 51 cases (87.9%), cancer intoxication - 4 (6.9%) cases, acute cardiovascular failure - 3 cases (5.2%). The efficacy of the Mantheim Peritoneal Index (MPI), WSES prognostic score, APACHE-II scale, gSOFA score and Peritonitis Prediction System (PPS) developed by the authors were analyzed. The likelihood of the effect of 85 clinical and laboratory parameters on the outcome of patients with secondary peritonitis using nonparametric methods of statistical research (Fisher’s test, Mann-Whitney test, Chi-square with Yates correction) have been analyzed. Criteria predictively associated with lethal outcome (p

Background. The West Siberian basin which is one of the main oil and gas regions of Russia is characterized not only by classical structural traps but also by extremely complex geological objects of Achimov sequence. Thereby, it is quite difficult to evaluate perspectives of license areas within which we can discover those Achimov type of deposits, especially at regional stage exploration in terms of a complete absence of 3D seismic data and uneven coverage of area by 2D seismic surveys. Aim. This article is devoted to the methodology description for probabilistic assessment of the resource base of non-structural traps in the Achimov strata in areas with different 2D-seismic exploration degree. Materials and methods. The methodology based on the “density” method which in relation to the evaluated area uses statistics of estimated parameters and number of bodies in the field analogs. The general line of this paper is how to use this methodology for resource base evaluation in the zones of Achimov deposits intersection as the most promising from the point of further development. Results. As part of the project evaluation according to the proposed approach, the resource base was divided into components — resources of objects in areas of possible intersection and resources of single, non-intersecting objects. Conclusions. It provides an opportunity to spot and conduct a technical and economic assessment of previously uneconomic reservoirs.

The most important direction in the development of fundamental and applied physics is the study of the properties of optical systems at nanoscales for creating optical and quantum computers, biosensors, single-photon sources for quantum informatics, DNA sequencing devices, detectors of various fields, etc. In all these cases, nanosize light sources such as dye molecules, quantum dots (epitaxial or colloidal), color centers in crystals, and nanocontacts in metals are of utmost importance. In the nanoenvironment, the characteristics of these elementary quantum systems—pumping rates, radiative and nonradiative decay rates, the local density of states, lifetimes, level shifts—experience changes, which can be used to create nanosize light sources with the desired properties. Modern theoretical and experimental works on controlling the emission of elementary quantum systems with the help of plasmonic and dielectric nanostructures, metamaterials, and metamaterial nanoparticles are analyzed.

Mini-EUSO is a new space-based experiment designed primarily to observe showers that develop in atmosphere due to the interaction between molecular nitrogen and Ultra High Energy Cosmic particles (above 1021 eV) crossing by. It belongs to the JEM-EUSO program, which includes several past experiments all devoted to develop new larger size satellite detectors like K-EUSO and POEMMA for future UHEC Rays study from space. Mini-EUSO is a multiwavelenght telescope launched on August 2019 with the unmanned Soyuz MS-14 rocket to the International Space Station and currently operating on board the Russian Zvezda module, facing a UV-transparent window watching Earth in Nadir direction. The telescope optics comprise a main detection system employing two double-sided Fresnel lenses focusing UV (300–400 nm) light onto an array of 36 Hamamatsu Multi-Anode PhotoMultiplier Tubes, each of 64 channels for a total of 2304 pixels working in single photon counting mode, providing a wide field of view (44°) correpsonding to a ground area of 263 x 263 km2 with a highly fast time resolution up to few microseconds. Mini-EUSO includes also multiple ancillary sensors such as visible (400–780 nm) and NIR (1500–1600 nm) cameras covering a wide range of radiation wavelenght as well as a 64 channels Multi-Pixel Photon Counter Silicon PhotoMultiplier array which will increase the Technology Readiness Level of this ultrafast imaging sensor. Beside the primary objective, the mission aims to study different event such as meteoroids, Transient Luminous Event, search for Strange Quark matter and thanks to its space-time resolution is capable to provide UV Earth maps over the surface covered during ISS orbits. In this work we will present the detector integration, the qualification measurements on ground and some preliminary data.

Mini-EUSO is a telescope launched on board the International Space Station in 2019 and currently located in the Russian section of the station. Main scientific objectives of the mission are the search for nuclearites and Strange Quark Matter, the study of atmospheric phenomena such as Transient Luminous Events, meteors and meteoroids, the observation of sea bioluminescence and of artificial satellites and man-made space debris. It is also capable of observing Extensive Air Showers generated by Ultra-High Energy Cosmic Rays with an energy above 10$^{21}$ eV and detect artificial showers generated with lasers from the ground. Mini-EUSO can map the night-time Earth in the UV range (290 - 430 nm), with a spatial resolution of about 6.3 km and a temporal resolution of 2.5 μs, observing our planet through a nadir-facing UV-transparent window in the Russian Zvezda module. The instrument, launched on 2019/08/22 from the Baikonur cosmodrome is based on an optical system employing two Fresnel lenses and a focal surface composed of 36 Multi-Anode Photomultiplier tubes, 64 channels each, for a total of 2304 channels with single photon counting sensitivity and an overall field of view of 44°. Mini-EUSO also contains two ancillary cameras to complement measurements in the near infrared and visible ranges. In this paper we describe the detector and present the various phenomena observed in the first year of operation.

The article covers the principles of holding the infusion therapy at the prehospital stage with the ongoing uncontrolled bleeding. The scientific work shows the effectiveness of isoosmolar crystalloid solutions in conditions of low capillary pressure, which is typical for blood loss. The article shows that the concept of an acceptable hypotension is the most optimal approach to the infusion therapy if the ongoing bleeding is suspected in peacetime as well as in combat conditions. Recommendations are given for ensuring and maintaining venous access during short, long and delayed evacuation of victims with the suspected ongoing bleeding.

We present an overview, based on satellite observations at low Earth orbits, on electromagnetic radiation from ground power transmission lines at an industrial frequency 50–60 Hz. Particular attention has been given to Chibis-M and DEMETER satellite observations. The electric 40-cm antenna of the micro-satellite often recorded 50–60 Hz radiation (known as Power Line Emission (PLE)) when it flew over industrialized areas of the planet. The PLE spectral amplitude varied from 1.2 to 18 (μV/m)/Hz0.5, which corresponds to the electric field amplitude E~1 μV/m. We report results of numerical calculations of the electromagnetic response of the atmosphere and ionosphere to a large-scale surface emitter at a frequency of 50 Hz. According to simulation results, PLE with an intensity of ~1 μV/m observed on satellites in the nightside ionosphere at midlatitudes can be excited by an unbalanced current 8–10 A in a power transmission line above the earth's crust with conductivity of 10–3 S/m. At middle and low latitudes with an inclined geomagnetic field, the maximum response in the upper ionosphere to the transmission line radiation should be seen shifted equatorward, although this shift is less than that upon guidance by the geomagnetic field. The maximum amplitude of the electromagnetic response of the ionosphere to the power transmission line emission decreases for an inclined geomagnetic field, but insignificantly. To date, the PLE intensity in near-Earth space has turned out to be higher than the intensity of natural radiation in this range (Schumann resonances and ion whistlers), and continues to grow with the technological development of mankind.

Miller Fisher syndrome is one of the forms of Guillain–Barrе́ syndrome, characterized by a clinical triad that includes ophthalmoplegia, ataxia and areflexia, with the possible addition of moderate peripheral tetraparesis. During the year that has passed since the start of the pandemic of the new coronavirus infection COVID‑19, international publications have presented a few cases of Miller Fisher syndrome, which developed in patients at different times after the COVID‑19 infection – from 3–5 days to 3 weeks. The article presents a description of a clinical case of Miller Fisher syndrome, which occurred with 34‑year‑old man 21 days after the COVID‑19 infection. The clinical manifestations of Miller Fisher syndrome were typical and included diplopia, areflexia, and ataxia. At the beginning of the disease, there was a transient episode of speech impairment in the form of mild dysarthria. Oculomotor disorders predominated in the clinical picture over other components of the classical triad. On the background of treatment with human immunoglobulin G, there was a complete regression of symptoms.This description of Miller Fisher syndrome, which developed after the postponed infection with COVID‑19, is the first in Russia. The presented case demonstrates the ability of the SARS‑CoV‑2 virus to induce the development of an autoimmune disease. Practitioners should take into account the possibility of Miller Fisher syndrome developing in the event of an acute onset of diplopia, ataxia and areflexia in patients after a previous COVID‑19 infection.

Increasing the reliability requirements for electromagnetic compatibility of electronic equipment requires the creation of protective coatings that absorb electromagnetic radiation or the development of new radio-absorbing materials. In the frequency range up to 1 GHz, radio-absorbing materials based on Ni–Zn ferrites are of the greatest interest. The absorption of electromagnetic radiation by ferrites occurs owing to resonant phenomena at the level of domains and atoms. Improving the performance of ferrites is possible by modifying their surface properties. In this paper, gradient structures for products of electromagnetic radiation protection are obtained by treating the surface of Ni–Zn ferrite samples with a low-energy electron beam. To generate the electron beam, a unique installation was used—a fore-vacuum plasma electronic source that allows forming and transporting a beam with a power density of up to 105 W/cm2 under conditions of high pressure and high gas outflow. As a result of processing, gradient structures were found on the surface of ferrites. A theoretical analysis and experimental study was carried out for the obtained “nonmagnetic conductor–ferrite” structures characterized by an increased attenuation coefficient and a reduced reflection coefficient of electromagnetic radiation in the frequency range from 0.5 to 2.5 GHz. The possibility of obtaining near-surface layers depleted in zinc with increased electrical conductivity and reduced magnetic permeability is shown.

Urinary tract infections are a common global problem among physicians of various specialties, including therapists, pediatricians, nephrologists and urologists. Today UTI is one of the leading bacterial infections in both adult and child populations. The main type of therapy and prevention of recurrent UTI is the use of drugs with an antibacterial effect (antibiotics, uroseptics). An urgent problem in modern medical practice is the increasing antibiotic resistance, which requires the development of new approaches to therapy and prevention, including UTI. In recent years, special attention has been paid to the study of vitamin D receptor (VDR) gene polymorphisms as a possible risk factor determining the predisposition to a number of infectious and noninfectious diseases. More than 200 polymorphisms of the VDR gene have been identified, four of which – FokI, BsmI, ApaI, and TaqI – are particularly common. Different VDR alleles can cause small changes in receptor function, which can affect resistance or susceptibility to a particular infection. The review presents data from modern studies demonstrating the relationship between vitamin D supply and development, the frequency of recurrence and the nature of the course of UTI. In one study, vitamin D has been shown to enhance the cathelicidin-mediated antibacterial action of bladder epithelial cells. It also demonstrated the currently known defense mechanisms of vitamin D against urinary tract infections, including its effect on components of the innate immune system.

Pseudomembranous colitis is a pathological condition in which there is damage to the mucous membrane of the large intestine with focal or diffuse fibrin depositions resulting from exposure to factors of the pathogenicity of Clostridium difficile. This disease has become quite widespread in recent years. The widespread and not always properly controlled prescription of antibiotics can lead to the development of a serious complication caused by this pathogen. The pathological condition develops against the background or after the end of the ongoing antibiotic therapy; its initial manifestation is antibiotic-associated diarrhea (AAD). Most often, this condition is diagnosed in postoperative patients against the background of a general decrease in immunity, as well as as a result of prolonged and uncontrolled intake of antibiotics. It has been proven that the frequency of Clostridium difficile colonization increases sharply during hospitalization, thus, this infection was referred to hospital ones. The main clinical manifestation of pseudomembranous colitis is diarrhea; stool can become more frequent, up to 5-7 times a day, while feces are scanty and not abundant. In addition to diarrhea, abdominal pain and flatulence may occur. The diagnosis is established on the basis of the fact of increased stool within two or more days for 8 weeks after taking antibiotics confirmed by the patient.

Epilepsy is a chronic neurological disease that manifests itself in the body's predisposition to the sudden onset of seizures. The incidence of a combination of epilepsy and pregnancy in the general population does not exceed 1%. The features of the course of this disease against the background of pregnancy, the requirements for the choice of antiepileptic drugs during gestation and their possible effect on the fetus are presented in the article.

It is quite rare, but in the practice of a family doctor, a condition may occur when, after an upper respiratory tract infection, flu or tonsillitis, the patient develops petechial rashes, hemorrhages in the mucous membranes, articular syndrome develops and abdominal pain appears. The first elements of the rash appear symmetrically first on the lower extremities, and then spread throughout the body. Joint lesions are characterized by severe pain syndrome and swelling; changes usually affect large joints – knee and ankle, but sometimes smaller articular surfaces are affected. Hemorrhages in the intestinal wall and mesentery are the cause of abdominal pain, flatulence, bowel disorders; nausea and vomiting are possible, sometimes mixed with blood. All these signs are characteristic of hemorrhagic vasculitis, which is also called Henoch–Schonlein purpura, capillary toxicosis or allergic purpura. For the first time, a description of several cases of purpura associated with arthritis was given by a German doctor Johann Schonlein in 1937, and a few decades later this nosology was described in detail by Eduard Henoch in his scientific work. In this pathological condition, autoimmune damage to small arteries is observed, as a result of which they become fragile, their permeability increases, resulting in the development of microthrombosis and multiple small hemorrhages in the skin, mucous membranes and internal organs. The disease most often occurs in children and adolescents, however, cases of diagnosis of hemorrhagic vasculitis have been described in adults as well [7].

Goal. To evaluate the structure of somatic and ophthalmological polymorbidity, etiology, and course of the disease in patients with uveitis on the basis of clinical, laboratory, and instrumental research methods based on the data of a 24-hour ophthalmological hospital. Materials and methods. We examined 655 patients diagnosed with uveitis who were treated in the adult ophthalmology department of the GBUZ TO OKB No. 2 for the period from 2017 to 2019. All patients underwent standard laboratory, clinical, and instrumental examinations. In addition, the leukocyte index, a marker of viral infections (MVI), was determined. Results. The average age of patients with uveitis was 51 years, with a significant (p < 0.05) prevalence of cases of anterior uveitis over posterior and panuveitis. Pathology of the cardiovascular system occupies a leading position in the structure of somatic polymorbidity, mainly in women. Gender dependence in patients with rheumatic diseases, pathology of the gastrointestinal tract and endocrine system, bronchopulmonary pathology, cancer, and HIV infection was not detected. A method of early diagnosis of the nature of the course of the inflammatory process of the vascular membrane (acute or chronic) by determining the age of the patient and the indicator of MVI is proposed. Conclusions. Modern monitoring of the diagnosis of this disease and adequate empirical treatment with antiviral drugs with an extended spectrum of activity until the results of ELISA are obtained, followed by treatment correction, will prevent early disability of the population and improve the quality of life.

Introduction. There is controversy in the literature as to whether deep neuromuscular blockade (NMB) improves the surgical conditions during laparoscopic surgery. We hypothesized that moderate NMB can be used with Pressure support ventilation Pro (PSVpro) during laparoscopic and robotic abdominal surgery without compromising the surgical conditions. Objectives. The aim of the study is to assess the effect of moderate NMB with PSVpro ventilation on surgical conditions during laparoscopic and robotic surgery. Materials and methods. The study included 36 patients scheduled for elective laparoscopic or robotic abdominal surgery under general anesthesia. All patients were randomized into two groups. Group 1 — moderate NMB and pressure support ventilation — PSVpro (N = 17 people), group 2 — intensive NMB and pressure control ventilation–volume guaranteed — PCV-VG (N = 19 people). Surgical conditions were evaluated using a the 5-point Leiden-Surgical Rating Scale (L-SRS) every 15 minutes. Additionally, the duration of anesthesia and surgery, the consumption of muscle relaxants and the level of intra-abdominal pressure were recorded. Results. The median of 515 intermediate assessments in both groups was 5 [5; 5] points (minimum 3; maximum 5), no statistically significant differences (p = 0.28). The medians of the final assessments were also 5 [5; 5] points in group 1 (minimum 4; maximum 5) and 5 [5; 5] points in group 2 (minimum 4; maximum 5), no statistically significant differences between groups (p = 0.32). Final scores corresponding to acceptable, poor and extremely poor surgical conditions were not recorded. Conclusions. The use of moderate NMB with PSVpro mode did not worsen surgical conditions during laparoscopy, but may reduce the consumption of muscle relaxants.

Anterior cervical discectomy and fusion is a common procedure for degenerative cervical radiculopathy. In 1996, Dr. H.D. Jho reported an operative technique allowing nerve root decompression via anterior uncoforaminotomy whereas avoiding fusion.To assess long-term clinical and radiological outcomes of anterior uncoforaminotomy in patients with degenerative cervical spine pathology.A single clinic, retrospective cohort study.Adult patients who underwent anterior uncoforaminotomy from 2013 to 2018.Clinical outcomes were assessed using VAS, NDI, SF-36 criteria. Radiological parameters included sagittal balance, disc height and White anPanjabi criterion.All patients underwent unilateral single-level anterior uncoforaminotomy, and long-term clinical and radiologic follow up was carried out. Clinical outcomes were assessed using VAS, NDI, SF-36 criteria. Radiological parameters evaluated included sagittal balance, disc height and White and Panjabi criteria (3.5 mm of translation, 11 degrees of kyphosis). The mean follow-up period was 33.3 ± 10.6 months (range 12-57 months).All measures of clinical outcome improved. VAS (neck) and VAS (arm) decreased 3 [2; 4] and 5 [3; 5.2] points (median [interquartile range]), respectively (p0.001); NDI improved from 0.38 [0.36; 0.4], to 0.29 [0.22; 0.34] (p0.001). Two patients (6%) required additional surgery one year after operation. There were no complications in the perioperative period. Disc height decreased 0.8 mm [0.1; 2.1] (p0.001). All patients retained stability of the cervical spine based on White and Panjabi criteria. Sagittal balance parameters did not change significantly.Uncoforaminotomy is an effective and safe method to decompress a unilateral single-level nerve root in degenerative cervical radiculopathy whereas preserving anatomy and motion of the cervical spine.

A method for reducing the side lobe level (SLL) of the combination factor (CF) of a linear equidistant phased array antenna (LEPAA) in a given direction within the framework of the model problem with given partial diagrams is presented. We obtained analytical dependences of the amplitude distribution (AD) and phase distribution (PD) of the signal at the inputs of the LEPAA emitters on the angles in the direction to which the minima of the LEPAA CF are formed. An example of SLL suppression is considered. We investigated the dependence of the SLL CF LEPAA on the bit capacity of the power amplifiers and phase shifters in the LEPAA channels. It is shown that an LEPAA CF SLLs of –100 dB is achieved with account for the bit capacity of the power amplifiers and phase shifters in a given direction with 16-bit sampling, and an LEPAA CF SLLs of –200 dB is achieved with 32-bit sampling.

Acute blood loss is the most common cause of death in armed conflicts. During the great Patriotic war, 37.2% of the wounded died on the battlefield from acute blood loss and its consequences. According to statistics of military surgeons in local wars, the percentage of deaths from bleeding on the battlefield has remained quite high in recent decades: in Afghanistan, 43% due to untimely first aid for gunshot and mine-explosive wounds, of which 27% died from acute blood loss. During counter-terrorism operations in the North Caucasus, acute blood loss was the cause of death in 26.6% of cases. Analysis of recent armed conflicts shows that the main causes of death on the battlefield are the consequences of penetrating wounds, in particular blood loss with combined traumatic brain injuries of various origins. The issue of analgesia for a lack of circulating blood volume, as well as for continuing bleeding, is complex due to the need to prevent the development of shock conditions against the background of possible side effects of anesthesia. The paper presents pharmacometric and toxicometric characteristics of a model agonist of opioid receptors in acute blood loss of moderate hypovolemia in an experiment. It was shown that the sensitivity of white rats and rabbits to intravenous anesthesia according to the criteria of deep anesthesia increased by 7.3 and 7.5 times, respectively; there were no changes in the mortality criterion for acute blood loss of moderate hypovolemia. A decrease in the speed of action and an increase in the duration of the effect of deep anesthesia in hypovolemia after intravenous administration of a model opioid receptor agonist at doses of 1 ED50 was revealed. An assessment of the breadth of therapeutic action of the model agonist of opioid receptors was made, according to the results of which an increase in this indicator was revealed. It is shown that it is necessary to clarify the anaesthetic manual for more severe variations of polytrauma with blood loss.

Objective: to evaluate the outcomes of thrombectomy performed using different surgical techniques in renal cell carcinoma (RCC) patients with extensive tumor venous thrombosis.Materials and methods. This study included 345 RCC patients with extensive tumor venous thrombosis who underwent surgical treatment.The median age was 57 years (range: 16—79 years); the male-to-female ratio was 1:1.9. Two hundred and sixty patients (75.4 %) had their tumor thrombus originating from the right renal vein, 85 patients (24.6 %) — from the left renal vein. In 169 patients (49.0 %), the thrombus spread to the retrohepatic inferior vena cava (IVC), while in 176 patients (51.0 %), it spread above the diaphragm (to the intrapericardial IVC in 59 patients (17.1 %) and to the right heart cameras in 117 patients (33.9 %)). Regional metastases were found in 90 individuals (26.1 %), while distant metastases were observed in 124 patients (35.9 %). All patients underwent surgical treatment (radical in 251 patients (72.8 %) and cytoreductive — in 94patients (27.2 %)); the technique of vascular control and circulatory support was chosen individually. In 97 patients (28.1 %), the control over the cranial thrombus boarder did not require opening of the chest cavity; eleven patients (3.2 %) were operated on with cardiopulmonary bypass.Results. The median surgery time was 215 minutes; the median blood loss was 4500 mL. Intraoperative complications were registered in 209 patients (60.6 %) and postoperative complications were observed in 118 patients (35.1 %) (including those of grade I—II in 43 individuals (12.8 %) and grade III—V in 75 individual (22.3 %)). The in-hospital mortality rate was 10.7 % (37/345). At a median follow-up of 32.3 months, overall and diseasespecific survival rates among all patients were 51.9 % and 68.3 %, respectively; relapse-free survival rate in 226patients who have undergone radical surgeries and discharged from the hospital was 61.5 %; progression-free survival rate in 82 patients who have undergone cytoreductive surgery was 33.0 %. The method ofIVC control and circulatory support had no effect on both short-term and long-term treatment outcomes (p >0.05 for both).Conclusion. The use of minimally invasive techniques of vascular control and avoidance of cardiopulmonary bypass in carefully selected RCC patients with extensive tumor venous thrombosis do not worsen the outcomes of nephrectomy and thrombectomy.

A technique is proposed for carrying out flight calibration of a photomultiplier tubes (PMTs) of the photodetector in the orbital TUS detector of ultra-high-energy cosmic rays in the absence of a calibration signal. The new technique consists in calculating two statistical characteristics of digitized signals from detected events (their mean value A and variance $$\sigma _{A}^{2}$$ ) and constructing the linear approximation $$\sigma _{A}^{2}$$ (A) for stationary signals. This technique has been tested in a laboratory experiment with a photodetector module, which is identical to the modules used in the detector. As a result, the gains of most photodetector channels of the TUS detector have been estimated again and the changes that occurred (in particular, the “aging effect”) have been analyzed.

In the paper the research has been performed to obtain the stress distribution through the thickness of the rolled products along the deformation zone in the conditions of roughing rolling and in the conditions of quasi-stationary temperature distribution during finishing rolling at the Steckel mill. The research has been performed by the simulation based on the Abaqus CAE 6.14-2 software and analytical modeling of the hot rolling process of coils at the Steckel mill with dimensions of 15 mm × 1500 mm, made of steel grade S355JR+AR, according to the requirements of EN 10025-2. The obtained deviations of the rolling force between simulation, analytical modeling and actual data have comparable results and a similar trend of changes through the passes, the average value of which does not exceed 1.54 % and - 1.77 %. The beginning of the continuous layer formation of equivalent stress during roughing rolling has been determined, and, accordingly, the beginning of the deformation penetration through the entire thickness of the semi-rolled product has been also determined that occurs in the pass 6 when reduction equals 14 %.

Introduction Detachment or sharp gross prolonged displacement of the skin, subcutaneous fatty tissue from the underlying fascia over more than 1 % of the body surface with disorders of blood supply to these and sometimes underlying tissues results from high-energy mechanical action of various moving objects and force applied at an angle. Purpose to develop a classification of integumentary tissue detachments based on the variety of clinical types, severity, extent, combination of injuries with a possible quantitative assessment of their severity and extent. Methods Analysis of the literature and our own experience of treating 40 patients with detachments of integumentary tissues enabled to identify criteria for classifying patients into groups. Results A classification and rating scales were developed that reflect the area, depth of tissue damage, localization, general condition of the patient and the stage of the pathological process. Discussion The analysis of the literature on this topic showed that, to date, none of the proposed classifications is optimal. There is no clear definition of the area of compromised integumentary tissues relative to the entire surface of the human body. The issue of pathological process staging has not been reflected; damage and crushing of bones, muscle tissue, neurovascular formations have not been reflected; there is no clearly formulated algorithm for treating a patient depending on the stage and severity of tissue damage. Conclusion Application of the classification of integumentary tissue detachments which has been proposed enables to more objectively assess the nature of local tissue damage, taking into account t he general condition of the patient.

A method for triggering a laser synchro-signal diode in a single-pass quantum cryptographic system is proposed. The method allows reducing the level of stray influence in an optical fiber from scattered laser radiation by $${\sim}$$ 2 orders of magnitude and increasing the length of a single-fiber communication line when generating a secret key to 95 km.

Introduction surgical treatment of urinary stone disease plays an important role in urological practice. Stone fragmentation can be performed using various lithotripters, from which Holmium fiber laser (Ho: YAG) has currently taken the main place. According to the current literature, a superpulsed thulium fiber laser with a wavelength of 1.94 m and a maximum power output of 40 W showed in vitro higher efficiency compared to Ho: YAG, while having the same safety profile. The use of a thulium fiber laser with a pulse energy of 0.025-6 J and a high repetition rate (up to 1600 Hz) allows to most effectively perform stone dusting during retrograde intrarenal surgery (RIRS). Aim to improve the performance of RIRS using the 1.94m superpulsed thulium fiber laser. Materials and methods a total of 152 patients with renal stones who were treated during the period from February 2018 to July 2019 were included in the study. The analysis of the laser settings, their effect on retropulsion and visibility when performing RIRS using a superpulsed thulium fiber laser with a wavelength of 1.94 m and a maximum power output of 40 W, a peak power of 500 W, as well as an assessment of the stone-free rate the first postoperative day and 3 months after the procedure was done. Results The most frequently used settings were as following: 0.5 J, 30 Hz, 15 W (No. 1), 0.15 J, 200 Hz, 30 W (No. 2), 0.8 J, 31.25 Hz, 25 W (No. 3), 0.8 J, 37.5 Hz, 30 W (No. 4). The statistical analysis of the influence of the settings on the quality of endoscopic imaging and retropulsion was carried out. In addition, the features of each settings were analyzed. The stone-free rate on the first postoperative day was evaluated using low-dose CT. Conclusion A superpulsed thulium fiber laser with a wavelength of 1.94 m and a maximum power of 500 W has shown high efficiency in clinical practice when performing RIRS, since it allows to have good endoscopic imaging, minimal retropulsion, and to perform stone dusting, which had a positive effect on the stone-free rate. Optimization of the settings of thulium fiber lithotripsy may improve the results of surgical treatment of urinary stone disease.

The SINP MSU is implementing a program to create compact detectors for studying the atmosphere and near-Earth space from small spacecrafts of the Cubesat type. Within the framework of this program, the AURA detector of ultraviolet radiation of the Earth’s atmosphere described in this article has been developed and tested. The device is a four-channel photometer based on silicon photomultiplier from the SensL Co. Its compactness, low supply voltage, and durability are the factors that determine the advantages for its use in nanosatellites.

To date, the most discussed issue is the rational dosage and duration of cholecalciferol preparations course for the correction and prevention of hypovitaminosis D. Objective of the research: to compare the structure of provision and the median 25 (OH) D before (2013–2016) and during the introduction into clinical practice (2018–2019) of the National Program Vitamin D Deficiency in Children and Adolescents in the Russian Federation: Modern approaches to correction» in young children. Materials and methods: the study had two stages. The first stage took place as a part of the RODNICHOK2 study from 2013 to 2016 before the implementation of the National Program «Vitamin D Deficiency in Children and Adolescents in the Russian Federation: Modern Approaches to Correction». The second stage of the study took place in 2018–2019 during the implementation of the National Program in clinical practice. The study participants were 246 children aged from 1 month to 3 years who took cholecalciferol preparations. The assessment of calcidiol concentration in the blood serum was assessed by the method of chemiluminescence immunoassay (CLIA) using reagents Liaison® 25OH Vitamin D Total Assay on the Liaison Dia Sorin Pleutschland GmbH device in the centralized laboratory of Scientific Center EFIS Ltd, Moscow. Results: during the introduction into clinical practice of the National Program, the frequency of prescribing a dosage of 500 IU/day significantly decreased to 4,9% (χ2=80,4, p

Semiconductor nanocrystals represent a promising class of solution-processable optical-gain media that can be manipulated via inexpensive, easily scalable colloidal techniques. Due to their extremely small sizes (typically

The analysis of literature data on the most common general clinical and specific systems for predicting the outcome of peritonitis was carried out. The informativeness of the methods for predicting the outcome of peritonitis was performed according to the parameters of sensitivity and specificity (Se and Sp). The sum of the proportions of correct forecast results characterizes the accuracy of the method (Ac). We also calculated the predictive value of a positive result (PPV; hereinafter referred to as predictive value), which is the proportion (probability) of unfavorable outcomes among all patients with a high risk of death. The article also demonstrates the assessment of predictive ability using the example of four common scales for predicting the outcome of secondary peritonitis. The results of the study showed that none of the studied systems for predicting the outcome of peritonitis is universal and absolutely reliable. Despite the fact that all the studied systems (scales) are used in clinical practice, none of them can completely satisfy surgeons, primarily in the choice of access, the volume of surgery and the option for its completion.

Rubella, along with toxoplasmosis, cytomegalovirus and herpes, belongs to TORCH infections, diseases that can have a detrimental effect on the fetus if infected during pregnancy. The disease is caused by a virus, the only known source and carrier of which is human. Mostly children and young people are susceptible to the disease; they tolerate the disease quite easily. Of the clinical symptoms, it should be noted the appearance of a rash, a slight increase in temperature, regional lymphadenitis, and sometimes conjunctivitis. In adults, joint inflammation can also occur, which usually lasts 3–7 days. The rubella virus is most dangerous when a woman first becomes infected during pregnancy, especially in the first trimester. The probability of intrauterine infection of the fetus in this situation is 90 %, as a result of which it may die or develop congenital rubella syndrome (CRS). As a result, children with congenital rubella syndrome can suffer from developmental defects, hearing and visual impairments, diabetes mellitus and thyroid disorders. To prevent intrauterine infection of the fetus, vaccination against rubella is carried out, which leads to the development of stable immunity. Today rubella vaccination is carried out in 168 countries of the world, which allows immunization coverage of about 70 % of women. The countries of the African continent and Southeast Asia are the least affected by rubella vaccination, as a result of which there are about 4 cases of births of children in utero infected with the virus per 1000 births.

The protocol-independent architecture for three axis force sensor data processing is considered. The force sensor is based on a MLX90393 triaxial magnetic sensor, capable of transmitting data via SPI protocol or I2C protocol, depending on the force sensor modification. The data generated by the MLX90393 requires additional processing before usage. To address this issue a software library is developed. Such a library shall provide means for protocol selection based on the force sensor modification. Three alternative architectural library implementations are consid­ered: the two independent program modules for both SPI and I2C protocol data transmission and processing, the two dependent program modules for SPI and I2C data transmission and one template-based module for the data processing, the two dependent program modules for SPI and I2C data transmission based on a single abstract class and the data processing module working with a pointer to the abstract class implementation. Three experimental library implementations are developed, nine experiments are performed with varying library usage setups, supplemented with one experiment with no data processing for the reference. Various criteria are considered, both quantitative and qualitative, including, but not limited to the compiled program size and the ease of library integration. The experimental results are analysed with the help of stated criteria, conclusions and practical recommendations are made.

In this paper, authors discover the advantages of the attention-based neural network application to the natural language dependency-parsing task. The authors explain the architecture and show the results of comparison between attention-based neural network and long-short memory neural networks in relation to the dependency-parsing task.

Formulation of the problem. Over the past few years, there has been little progress in object detection techniques. The most efficient are complex computational ensemble methods, which usually combine several low-level image properties with high-level properties. However, every day interest in artificial intelligence is growing, and the idea of using neural networks on board a spacecraft, with the possibility of making decisions and issuing one-time commands, is very promising, since it makes it possible to analyze a large data stream in real time without resorting to ground station, thereby not losing information when transmitting a packet. The purpose of the work is to conduct research on the possibility of effective use of modern models of neural networks, to develop a methodology for their use in the problem of object detection and analysis of the element base for hardware implementation with the possibility of using convolutional neural networks for thermovideotelemetry on board a spacecraft. Results of work. An approach has been formulated that combines two key ideas: 1) application of high-throughput convolutional neural networks for downward processing of image regions in order to localize and segment objects; 2) preliminary training for the auxiliary task, followed by fine tuning of the domain, which gives a significant increase in performance in the case when the training data is insufficient. The analysis of the element base for the possibility of hardware implementation of neural networks on board a spacecraft using electrical radio products of domestic and foreign production is carried out. Practical significance. The efficiency of preliminary network training for an auxiliary task is shown, followed by fine tuning of the subject area. A technique is described that makes it possible to increase the average accuracy of detecting objects in an image by more than 30%. The analysis of the existing element base, the possibility of hardware implementation of neural networks on board the spacecraft using electrical radio products of domestic and foreign production, as well as the criteria for selecting key elements.

The article analyses the issue of the NATO missile defense development and the evolution of views in the Russian political, military and expert circles. In 2009, the U. S. President Baraсk Obama declared a start of the NATO missile defense system construction with a goal to be able to intercept a limited nuclear strike from Iran. Russia is in doubt about the stated purpose of the European missile defense and considers it to be a threat to its own strategic nuclear forces. The European missile defense construction has been experiencing technical obstacles and political difficulties: the cancellation of deployment of interceptor SM‑3 IIB and delays in establishing operational capability of the Aegis Ashore land-based missile defense system in Poland. The current architecture of the NATO missile defense, which allows only to intercept a limited number of incoming warheads, has no significant impact on Russian retaliatory strike capability. Nevertheless, the missile defense in Europe remains an irritating factor in relations between Russia and the USA. Apparently, Biden’s arrival in the White House creates an opportunity for parties to address the issue during negotiations on the New START follow-on Treaty. The research addresses the history of Russia–USA–NATO cooperation on theatre missile defense and the reasons for the failure of the joint missile defense in Europe. The author justifies the reanimation of the Joint Data Exchange Center project and outlines the idea of its transformation to the Multilateral Data Exchange Center. Acknowledgments. The article was prepared within the project “Post-crisis world order: challenges and technologies, competition and cooperation” supported by the grant from Ministry of Science and Higher Education of the Russian Federation program for research projects in priority areas of scientific and technological development (Agreement № 075-15-2020-783).

Transcranial magnetic stimulation is currently used in psychiatry, neurology, pediatrics, traumatology, and other fields of medicine for the non-invasive diagnosis and treatment of many diseases. Currently, the TMS technique is used only in the conditions of stationary clinics with the use of expensive hardware systems and complex software. The first disadvantage of such installations is the mandatory need for medical personnel to perform the procedure. And the second is the weight and size of the device, which makes it absolutely not mobile. An urgent problem is the creation of a portable device that can be used also in ambulatory conditions. There are several problems that need to be solves in order to create the portable TMS-devise. One of them is the choice of functional material for the structural element. The Department of Engineering Science and Technology of MEPhI presents the basic principles of application of a new methodology for the experimental study of the electrophysical properties of composites with a nanometric level of component dispersion.

The purpose of the study: analysis of medical and social problems and factors affecting the availability and compliance of a gluten-free diet, based on a survey of parents of children with celiac disease living in southern Russia. Purpose of the Study: Analysis of the medical and social problems and factors affecting the availability and adherence to the gluten-free diet based on the results of the questioning survey of the parents of children with celiac disease that are residents of the south of Russia. Children Characteristics and Study Methods. The study include 200 families that bring up the children with the celiac disease at the ages from 10 months to 18 years. The patients included 116 (58%) girls and 84 (42%) boys. The medical and social issues were studied using the developed questionnaire consisting of the open questions and intended as self-administered by the patient parents. Results. 87% of the families noted the significant difficulties in adhering to the diet, 75% were forced to refuse to travel with children, 56% of the surveyed were unable to visit the public spaces, restaurants, and 90% indicated the impossibility and difficulties in purchase of the gluten-free products. The strict adherence to the diet at school age is much worse. The main reasons for the deliberate non- adherence to the gluten-free diet are the high cost of food, lack of funds to purchase it. The patient families spend RUB 8,000– 9,000 per month in average to purchase the gluten-free products. There is a great demand of patients for the imported products with the relevant quality marks. The psychological symptoms were noted in the patients with celiac disease in response to the introduction of the gluten-free diet, manifested by the depression, aggression, irritability, high level of the anxiety. Conclusion. The main difficulties faced by the families that bring up the children and adolescents with the celiac disease include the social and psychological maladjustment of the patients, reduced finances, search and purchase of the high-quality gluten-free products and the necessity to adapt the child and family members to the dietary habits.

The design of a liquid calorimeter with a closed absorbing load for measuring the energy of high-power microwave pulses in the range of 8–38 GHz is described. The calorimeter was designed to measure the energy of microwave pulses ranging from 1 to 500 J at a nominal power level of about 500 MW. The calorimeter includes a waveguide absorbing load and an automated control system. The waveguide absorbing load includes a segment of a circular overmoded cylindrical waveguide; the cylindrical wall is made of a dielectric pipe. The volume between the waveguide and the outer casing made of duralumin is filled with ethyl alcohol. Inside the waveguide, there is a cone made of duralumin, providing the best matching of the load. The automated control system includes a control and registration unit, an algorithm for determining the meniscus position, a power supply, a program that runs directly on the calorimeter control unit, and a control program for personal computer.