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У статті наводиться аналіз якості життя згідно з опитувальником QOLIE‑31 у 48 пацієнтів з епілепсією, яким здійснювалася ритмічна транскраніальна магнітна стимуляція (рТМС). Аналіз результатів проведеного дослідження з використанням рТМС і мінімальних терапевтичних доз антиепілептичних препаратів показав, що подібна комбінація фармакологічних і фізичних чинників дозволяє контролювати перебіг епілепсії та забезпечує досить високу протисудомну дію. Отримані результати дозволили обгрунтовано доповнити медикаментозне лікування епілепсії проведенням курсу рТМС, домогтися оптимального терапевтичного результату в кожного пацієнта з мінімальним ризиком побічних ефектів, а також поліпшити якість його життя.

Метою нашого дослідження були визначення можливостей 18F-ФДГ-ПЕТ/КТ (позитронно-емісійна томографія, поєднана з комп’ютерною томографією, із застосуванням 18F-фтордезоксиглюкози) для латералізації та локалізації вогнища при скроневій і позаскроневій епілепсії і картування функціонально значущих зон мозку в даній категорії пацієнтів. Матеріали та методи. 18F-ФДГ-ПЕТ/КТ реалізовувалася на основі статистичного аналізу з використанням тривимірної стереотаксичної проекції поверхні (3D-SSP) на робочій станції ADW4.6 із застосуванням програмного пакета CortexID. Одночасно аналізувалися клінічні дані, результати магнітно-резонансної томографії та електроенцефалографії (ЕЕГ). Обстежено 42 пацієнти (25 чоловіків і 17 жінок, вік яких становив 33 ± 11 років), які страждають від епілепсії з фармакорезистентним перебігом, із застосуванням таких методів: магнітно-резонансної томографії головного мозку, 18F-ФДГ-ПЕТ/КТ, ЕЕГ і ЕЕГ-картування. Час проведення ПЕТ/КТ із моменту останнього нападу становив від 3 до 14 днів. Результати. У 21 пацієнта з 42 (у 50 % випадків) візуально виявлені вогнища гіпометаболізму в скроневій (переважно), а також тім’яній і лобовій частках півкуль головного мозку. Виявлені фокуси і зони гіпометаболізму, як правило, відповідали епілептогенному вогнищу, що встановлене за даними ЕЕГ-картування. При порівнянні гіпометаболічних фокусів і ділянок, візуально і статистично виявлених на 18F-ФДГ-ПЕТ/КТ, локалізація епілептичного вогнища за даними рутинної ЕЕГ була порівнянною в 16 з 42 пацієнтів, а за даними ЕЕГ-картування — у 20 з 42 пацієнтів. При оцінці 18F-ФДГ-ПЕТ/КТ за допомогою програмного пакета CortexID додатково констатувалися гіпометаболізм і зони асиметрії метаболічної активності у 8 з 42 пацієнтів (в 19 % випадків), що не були виявлені при стандартній візуальній оцінці. У 31 % випадків (у 13 з 42 пацієнтів) були відсутні вірогідні ознаки патологічної метаболічної активності головного мозку. Висновки. 18F-ФДГ-ПЕТ/КТ головного мозку є важливим компонентом діагностичних алгоритмів у пацієнтів з епілепсією. Важливо відзначити, що сукупна оцінка даних 18F-ФДГ-ПЕТ/КТ із результатами інших методів дослідження підвищує точність діагностики, оскільки особливістю патогенезу епілепсії є динамічні зміни, що відмічаються в різних структурах мозку. Виявлені вогнища гіпометаболізму 18F-ФДГ можуть розглядатися як функціональна недостатність і бути відносним показанням для підвищення інтеграційного контролю мозку за допомогою методів нейромодуляції або фармакологічної корекції.

Актуальность. Данная работа представляет собой исследование и анализ влияния острого гнойного синусита на состояние пациента по данным визуально-аналоговой шкалы. При этом изучалось как общее влияние заболевания, так и вклад отдельных симптомов в общую картину. Актуальность проблемы обусловлена тем, что в периодической литературе преимущественно встречаются работы, посвященные хроническому риносинуситу. При этом острому гнойному риносинуситу посвящено относительно мало работ. Цель исследования: при помощи визуально-аналоговой шкалы оценить клиническую картину острого гнойного риносинусита с учетом отдельных симптомов (боль, заложенность носа, выделения из носа, снижение обоняния), влияния пола, возраста, количества пазух с воспалением, нозологии. Материалы и методы. 172 взрослых пациента с подтвержденным (в том числе пункциями околоносовых пазух) гнойным риносинуситом. Результаты. Острый гнойный риносинусит протекает со значимым снижением качества жизни, при этом доминирующее значение среди симптомов имеют заложенность носа и ринорея. Общее состояние оценивается пациентами тяжелее, чем каждый отдельный симптом, что может говорить о недостаточной оценке интоксикационного компонента заболевания или о взаимном усилении отдельных симптомов острого синусита. Выводы. Не обнаружены достоверные корреляции между отдельными симптомами риносинусита и количеством воспаленных околоносовых пазух, возрастом и полом практически для всех форм риносинусита. Лишь для фронтита выявлена корреляция между количеством воспаленных пазух и болью. Не обнаружено различий в оценке состояния между мужчинами и женщинами. Четыре пятых от количества пациентов (85,9 %) оценили свое состояние как тяжелое или средней тяжести, при этом более половины (59,3 %) имели непосредственное отрицательное влияние заболевания на качество жизни. Корреляционные взаимосвязи между оценкой общего состояния и отдельными симптомами были сопоставимы.

The article describes the peculiarities of drug provision for patients with psoriatic arthritis (PsA) in the Republic of Karelia. We present a clinical case of effective treatment with interleukin 17 inhibitor ixekizumab (IXE) in a randomized clinical trial and real clinical practice in a patient with PsA. The distinctive feature of this case is the severity of PsA course that was not controlled by standard methods of therapy. IXE treatment was characterized by a rapid clinical improvement of both articular and skin symptoms and subsequent achievement of remission, which lasted for 3 years (on the therapy). The forced interruption of the treatment led to the relapse of the disease in a short amount of time. In 2 years IXE therapy was resumed; after 6 months of continuing treatment a stable remission of PsA was achieved. The patient is still in clinical remission (on therapy).

Introduction One of the most common injuries in children is clavicle fractures. They account for up to 14 % of all pediatric bone injuries. Aim Comparative evaluation of the effectiveness of surgical and conservative methods of treating closed clavicle fractures in children. Materials and methods Between 2011 and 2018, 1,800 children with clavicle fractures referred to the traumatology and orthopedic department at the Children's Clinical Hospital No. 9 in Yekaterinburg.Most of them were treated conservatively, and 94 (5.2 %) children were hospitalized for surgical treatment. Depending on age and type of displacement, children received different conservative treatments, such as Deso dressing in children under two years old, figure-eight-bandage in children over two years of age. Surgical treatment was open reduction of fragments and fixation with either a Kirschner wire or a titanium elastic nail (TEN); titanium plates were used in several cases. For a comparative assessment of the results of the treatment methods for clavicle fractures, two groups of patients were formed. Results Shortening of consolidated clavicle was not observed in children of the main group treated surgically. In several cases, the elongation of the clavicle was revealed by no more than 1 cm. Patients in the comparison group showed shortening of the broken clavicle in three cases, no more than 1.3 cm. Conclusion After surgical treatment, the length of the shoulder girdle was fully restored; insignificant shortening after conservative treatment did not cause functional disorders.

Scleroma is a chronic specific infectious disease of the respiratory tract, which has various forms with different activity of the process. In this work, we studied the concentration of fibronectin as a marker of scleroma activity in 39 patients, including 18 patients with an infiltrative form and 21 patients with a cicatricial form. The fibronectin content in the blood serum of patients with the infiltrative form was 708.1 ±29.4 ug ml. In the group of patients with cicatricial scleroma, the fibronectin concentration was 412.5 ± 20.1 ug ml (the differences between the groups are statistically significant, p < 0.001). In none of the groups of patients with scleroma a relationship was found between the level of fibronectin and the duration of the disease, sex and age, and the prevalence of the pathological process in the respiratory tract. The data obtained make it possible to use the study of fibronectin concentration as a marker of the activity of the scleroma process.

The leading place among cardiovascular diseases in the world – 50% – belongs to the ischaemic heart disease. Coronary bypass grafting is the golden standard for treatment of patients with multivessel ischaemic heart disease. The modern level of coronary surgery makes it possible to perform safe and efficacious direct revascularisation with hospital lethality not exceeding 1-3%. This article presents a review of literature devoted to the history of coronary surgery development including analysis of relevant sources dated 2010-2020 published in PubMed and Google Scholar databases: from first experimental procedures in the beginning of the 20th century and indirect myocardial revascularisation methods to direct bypass grafting of the impaired heart vessels actively developed since early 1960s. The article describes types of grafts applied with description of advantages and disadvantages of each one as well as contemporary methods and conditions for coronary bypass grafting and further prospects in development of ischaemic heart disease surgery.

A clinical case of successful repair of a combination of total anomalous pulmonary venous connection (TAPVC) with collector stenosis in one-day-old newborn. Only one case of successful correction of such a pathology is reported previously. The operation was performed with cardiopulmonary bypass and temporary antegrade brain perfusion. The narrowed aortic area was resected, the integrity of the aortic arch was restored using an extended anastomosis, and TAPVC correction was performed using a “sutureless technique”. The postoperative period was uneventful. The newborn was discharged from hospital on the 12th day.

Underwater vehicles used for surveys and inspections are equipped with computer vision systems based on video cameras. The efficiency of such underwater vehicles depends on the onboard software used, the development of which must take into account the peculiarities of operating conditions. The separate system’s test of the underwater vehicle can be used as a simulation of the conditions for its operation. The model used for verification of the video system should take into account the environment, lighting, characteristics of on-board video cameras and the dynamics of the underwater vehicle. In the proposed model, the virtual seabed environment is created from a schematic image based on visualization. The calculation of the lighting of the simulated scene has a ray-tracing method. The camcorder model takes into account geometric parameters such as focus, pixel sizes, etc. That model uses perspective projection rules to describe the operation of the video camera. Practical implementation of the mathematical model can simulate two on-board video cameras at the same time. The developed model takes into account the spatial movement of the underwater vehicle. The developed model takes into account the spatial movement of the underwater vehicle. This feature of the model allows you to control linear and angular velocities. Considering these characteristics makes it possible to form video frames from the position of the underwater vehicle. This article presents the mathematical model of forming video frames of the seabed by an underwater vehicle.

Clinical case report of uncommon inappropriate shock of subcutaneous defibrillator in early postoperative period due to air in close proximity of shock electrode is presented.

The article discusses approaches to ensuring the required level of reliability of radio electronic means when designing the design of products, taking into account the metrological and diagnostic support during their operation. It is known that up to 80% of the current repair time is occupied by the search for defects, therefore, special attention is paid to the influence of the product design on minimizing the average diagnosis time. The quantity of elements of modern radio electronic means is constantly increasing due to the expansion of their functions and automation of technological operations, but the requirements for their reliability remain constant. This contradiction can be solved by increasing the reliability of the element base, which leads to an increase in the cost of the product, which is not always acceptable. Therefore, there is a problem of providing the necessary values of reliability in other ways, including taking into account the requirements of maintainability of products in the design, as well as improving metrological and diagnostic maintenance during operation in real conditions using modern advances in metrology and technical diagnostics. Thus, there is a problem of quantitative assessment of the impact of the design of radio electronic means on their reliability, as well as a reasonable choice of recovery options for maintenance in the minimum time. This will provide the required values of reliability without additional costs during the operation of radio electronic means. Possible options for restoring the operability of multi-output objects, which include power supply subsystems, are considered. It is shown that a reasonable choice of design, metrological and diagnostic support reduces the time of current repair by up to 30%.The use of the results obtained in the design of promising and existing radioelectronic devices for various purposes makes it possible to increase the efficiency of current repairs in real conditions., У статті розглядаються підходи до забезпечення необхідного рівня надійності радіоелектронних засобів під час проектування конструкції виробів з урахуванням метрологічного і діагностичного забезпечення під час їх експлуатації. Відомо, що до 80 % часу поточного ремонту припадає на пошук дефектів, тому особлива увага приділяється впливу конструкції виробу на мінімізацію середнього часу діагностування. Розглянуто можливі варіанти відновлення працездатності багатовихідних обʼєктів, до яких віднесено підсистеми електроживлення. Показано, що обґрунтований вибір конструкції, метрологічного і діагностичного забезпечення зменшує до 30 % час поточного ремонту.Використання отриманих результатів у проєктуванні перспективних та існуючих радіоелектронних засобів різноманітного призначення дозволить підвищити ефективність поточного ремонту в реальних умовах.

Objective This study determines the differences in the distal gut and vaginal microbiome in African American (AA) women by prepregnancy body mass index and gestational weight gain (GWG) comparing women with and without obesity and by obesity class. Study Design We prospectively sampled the vaginal and distal gut microbiome in pregnant AA women at two time points during pregnancy. Samples were analyzed using high-throughput sequencing of the V4 region of the 16S ribosomal ribonucleic acid gene. Results Distinct differences in vaginal and distal gut α-diversity were observed at time point 1 between women with and without obesity by total GWG. Significant differences in distal gut β-diversity were also found at time point 1 in obese women by GWG. Within the Bacteroides genus, a significant association was observed by total GWG among obese women which was absent in nonobese women. Women with class III obesity who experienced low GWG had the lowest abundance of distal gut Bacteroides and appreciably higher relative abundance of a consortia of vaginal taxa including Atopobium, Gardnerella, Prevotella, and Sneathia. Conclusion These results contribute new evidence showing that GWG in combination with obesity and obesity class is associated with an altered distal gut and vaginal composition early in pregnancy among AA women.

The results of remote detection of objects containing explosives with a lidar detector of traces of explosives in combination with a portable express gas chromatograph are presented. It is shown that the lidar detector of traces of explosives confidently detects the simulators of TNT, hexogen, and PETN from a distance of 5 m when sounding the surface of a sample. Laser action on the sample surface causes desorption of vapors, which are reliably detected by the gas chromatograph. It is shown that the joint use of the laser sounding and gas chromatography techniques makes it possible to increase the reliability of detection of explosives. The prospects of using the gas chromatography in the development of laser sounding techniques are determined.

Funding Acknowledgements Type of funding sources: None. Introduction In 30%, the cause of strokes is AF. 90% of cases, thromboembolism occurs in the cerebral arteries, condemning the patient not only to disability, but also to death. Considering that the formation of blood clots occurs in hemodynamically inactive areas of the LA, which is the apendege of the LA, it is advisable to combine surgical treatment of AF with its exclusion from systemic blood flow. Purpose Analyze the frequency of strokes in the follow up period in patients who have undergone surgical treatment of AF in combination with LAA resection. Materials and Methods 364 patients were divided into 3 groups depending on the volume of operative treatment and the rhythm of the controlling strategy, 105 dropped out of the study due to the lack of data collection capability. • Group I included 80 patients who underwent surgical AF treatment with LAA resection combined with valvular pathology correction or myocardial revascularization. Lethal outcome in this group was recorded in 6 (7.5%) patients caused by non-cardiac pathology. Surgical treatment of AF was performed by MAZE IV and left side MAZE. • Group II - 140 people who performed valve pathology correction, without surgical treatment of AF and without LAA resection. • Group III included 39 patients with a persistent form of AF who performed only LAA resection in combination with correction with another cardiac pathology. Group II and III mortality were 23 patients. All patients in group I and III underwent LAA resection to exclude a possible source of blood clots. The stump was sutured with a continuous two-row suture on the base up to 2 mm from the LA wall. After 36 months, patients from group I underwent echocardiography, electrocardiography, Holter monitoring, and a cardiologist examination. Group II and III analyses were performed by patient telemetry. Results • Long-term three-year results showed complete 100% freedom from acute cerebral circulation disorder in group I, where surgical treatment of AF was performed in combination with LAA resection; • In group I with a persistent form of AF without LAA resection - acute cerebral circulation disorder occurred in 36 patients, which was 28.8%; • In group III with permanent fibrillation with LAA resection, of the 31 patients, thromboembolic complication occurred in 4 patients (12.9%). It is worth noting that after surgery in the distant period, patients of group I increased the average value of the ejection fraction by 4%, decreased volumes of the LA, and the functional class on NYHA changed from III to II, I. Conclusion The study performed the highest degree of absence of stroke in group I in early and follow up period. First of all, this is due to a comprehensive approach to the treatment of cardiac pathology, the preservation of sinus rhythm and LAA resection. Which, in addition to absence of stroke, leads to an improvement in the quality of life and a decrease in the functional class of heart failure.

Nijmegen breakage syndrome (NBS) is a DNA repair disorder characterized by combined immunodeficiency and a high predisposition to lymphoid malignancies. The majority of NBS patients are identified with a homozygous five base pair deletion in the Nibrin (NBN) gene (c.657_661del5, p.K219fsX19) with a founder effect observed in Caucasian European populations, especially of Slavic origin. We present here an analysis of a cohort of 136 NBS patients of Eastern Slav origin across Belarus, Ukraine, Russia, and Latvia with a focus on understanding the geographic distribution, incidence of malignancy, and treatment outcomes of this cohort. Our analysis shows that Belarus had the highest prevalence of NBS (2.3 per 1,000,000), followed by Ukraine (1.3 per 1,000,000), and Russia (0.7 per 1,000,000). Of note, the highest concentration of NBS cases was observed in the western regions of Belarus and Ukraine, where NBS prevalence exceeds 20 cases per 1,000,000 people, suggesting the presence of an “Eastern Slavic NBS hot spot.” The median age at diagnosis of this cohort ranged from 4 to 5 years, and delay in diagnosis was more pervasive in smaller cities and rural regions. A total of 62 (45%) patients developed malignancies, more commonly in males than females (55.2 vs. 34.2%; p=0.017). In 27 patients, NBS was diagnosed following the onset of malignancies (mean age: 8 years). Malignancies were mostly of lymphoid origin and predominantly non-Hodgkin lymphoma (NHL) (n=42, 68%); 38% of patients had diffuse large B-cell lymphoma. The 20-year overall survival rate of patients with malignancy was 24%. However, females with cancer experienced poorer event-free survival rates than males (16.6% vs. 46.8%, p=0.036). Of 136 NBS patients, 13 underwent hematopoietic stem cell transplantation (HSCT) with an overall survival of 3.5 years following treatment (range: 1 to 14 years). Indications for HSCT included malignancy (n=7) and immunodeficiency (n=6). Overall, 9% of patients in this cohort reached adulthood. Adult survivors reported diminished quality of life with significant physical and cognitive impairments. Our study highlights the need to improve timely diagnosis and clinical management of NBS among Eastern Slavs. Genetic counseling and screening should be offered to individuals with a family history of NBS, especially in hot spot regions. © Copyright © 2021 Sharapova, Pashchenko, Bondarenko, Vakhlyarskaya, Prokofjeva, Fedorova, Savchak, Mareika, Valiev, Popa, Tuzankina, Vlasova, Sakovich, Polyakova, Rumiantseva, Naumchik, Kulyova, Aleshkevich, Golovataya, Minakovskaya, Belevtsev, Latysheva, Latysheva, Beznoshchenko, Akopyan, Makukh, Kozlova, Varabyou, Ballow, Ong, Walter, Kondratenko, Kostyuchenko and Aleinikova. We thank all doctors for clinical help for patients. We also appreciate the support of patient and their parents for agreeing to take part in this study. TP thanks Sergey?Nikulshin, Marika Grutupa, and Zanna Kovalova. We thank Joseph Dasso for editing this manuscript, primarily for proper English.

We present a scheme for an integrated four-wave mixing source of narrow-band path-entangled photon pairs with efficient spatial pump self-rejection. The scheme is based on correlated loss in a system of waveguides in Kerr nonlinear media. We demonstrate that this setup allows for upwards of 100dB pump rejection, without additional filtering. The effect is reached by driving the symmetric collective mode that is strongly attenuated by an engineered dissipation, while photon pairs are born in the antisymmetric mode. A similar set-up can additionally be realized for generation of two-photon NOON states, also with pump self-rejection. We discuss implementation of the scheme by means of the coherent diffusive photonics, and demostrate its feasibility both in glass (such as fused silica-glass and IG2), and planar semiconductor waveguide structures in indium phosphide (InP) and in silicon., 12 pages, 6 figures

Premature ventricular contractions (PVC) is a very common type of arrhythmia. Some patients require surgical treatment. The search for the safest methods of surgical treatment is an important research task.Aim. To evaluate the efficacy and safety of catheter ablation in patients with idiopathic ventricular arrhythmias depending on the implementation of X-ray control.Material and methods. The study included 183 patients admitted to the Federal Center for Cardiovascular Surgery for elective surgery, with frequent idiopathic PVC and indications for surgical treatment of arrhythmia. In the majority of patients with idiopathic PVC, the central origin of ectopia is the right ventricular outflow tract (RVOT). The patients were divided into two groups: group 1 (n=90) — patients with idiopathic PVC after fluoroscopy-guided radiofrequency ablation (RFA); group 2 (n=93) — patients after RFA without fluoroscopy. All patients underwent electrocardiography, echocardiography, and electrophysiological testing. All patients before and after RFA underwent 24-hour Holter monitoring.Results. Among patients of group 1, the initial success of RFA was 62,2%, and in group 2 — 71% (p=0,21). Surgery complications were registered in 3,3% and 4,3% of patients of groups 1 and 2. No deaths have been reported. The duration of surgery did not depend on the use of fluoroscopy. Among patients with failed initial RFA, the effectiveness of subsequent interventions was 88,6%. The greatest efficiency of initial RFA was observed when the ectopic ventricular focus was located in RVOT The lowest efficiency of RFA was observed when the focus was located in the left ventricular papillary muscles.Conclusion. RFA in patients with idiopathic PVC without fluoroscopy does not increase the complication rate and the duration of surgery and have a comparable efficacy compared to fluoroscopy-guided RFA.

A technology has been developed for the synthesis of bacterial nanocellulose from oat hulls and Miscanthus. The Мedusomyces gisevii Sa-12 microbial producer was found to synthesize bacterial nanocellulose of high quality, regardless of the feedstock type and pretreatment method thereof.

Background. Today, when most processes and phenomena have a periodic structure that is not always homogeneous and depends on a number of irregular events, the classical spectral analysis based on the Fourier transform does not always allow an objective and reliable investigation. A promising alternative to the classical spectral analysis can be a wavelet transform, based on a well-localized function in both time and frequency domains, which allows us to analyze irregular processes. The purpose of the research was to analyze the potentials of the wavelet transform for the analysis of the spectral characteristics of cardiological time series with some heterogeneity; to develop a software application that allows performing wavelet analysis of data and building wavelet spectra, which are illustrative and easy in interpreting the obtained results. Material and methods. 37 cardiological time series were studied. We developed an application for the application package Mathematika 5.0 that allows building and analyzing the wavelet spectra of the studied data. Results. An alternative method for analyzing the spectral characteristics of the studied cardiological time series has been developed and clearly demonstrated. It allows observing the dynamics of the change in periods over the entire observation interval without performing the interval splitting, as would be required by the classical Fourier analysis. Conclusion. For the studied groups of patients the identified periods, found with the help of the wavelet transform have been presented. The advantages of using wavelets over the classical spectral analysis, which in cases of unstable time series does not allow tracking the dynamics of the changing in the data spectrum, have been demonstrated.

There are 3-10 % cases of chronic osteomyelitis among abscessed surgical disorders. Osteomyelitis develops in 3-25 % of cases after open bone fractures and in 1-8 % of cases after closed fracture surgical treatment, along with this chronic osteomyelitis relapses happen in 20-35 % of cases, which, in turn, needs definitive treatment to the extent of abscission. Staphylococcus aureus dominates in cases of chronic osteitis. The role of proteuses, enterococcuses, bacteroids, peptococcuses and other microorganisms grows. Osteomyelitis is a type of purulent surgical infection in which a macroorganism interacts with a pathogenic microflora. The osteomyelitis clinic differs from the phase, form and pathogenetic process. There are primary and secondary (osteomyelitis, acute and chronic phase, toxic, septicopyemic and local forms. The methods of treatment of osteomyelitis are conservative and surgical, and also their combination.

On the contrary to the previous expectations, the most common Chornobyl catastrophe victim’s pathology was the vascular pathology of an eye. The work is devoted to the assessment of changes in capillary tubes, arterioles and venules, which were irradiated as a result of Chornobyl catastrophe and those who have been exposed to radiation while working in the Chornobyl exclusion zone. The results of eye vascular system examination is presented by 615 persons: 358 Chornobyl clean-up workers, inspected in 1993–1994, 2007–2008 and 257 participants of works at the «Shelter» object, that were inspected in 2007–2008 and in 2017. Microcirculatory damages in conjunctiva are the most early ionizing radiation induced eye damage. Dose dependence from microcirculatory damages in conjunctiva has been proved. The conjunctiva index, which characterizes the evaluation degree of microcirculatory abnormalities value for individuals irradiated at a dose of up to 10 mSv was 5.33±0.34, at a dose of 10 to 30 mSv – 9.71±0.93. Thus, a significant (t=4.42, p

A new control method for a rectifier based on a transformer with a rotating magnetic field (TRMF) containing an even number of sections of circular winding (CW), which makes it possible to double the number of ripples of rectified voltage in the supply-voltage period, is considered. It leads to a reduction in the ripple amplitude and improves the quality of rectified voltage. The geometrical similarity of the CW of a TRMF making it possible to implement the new control method is analyzed. Switching algorithms of power switches for the classical and new control methods for any quantity of an even number of CW sections are presented. As an example, a switching queue of power switches for a CW with ten sections is considered. The output-voltage shapes for different depths of control are shown. The calculating procedure of the control characteristic for the classical and new control methods, as well as corresponding diagrams, are presented. For the presented example with ten sections of CW, the efficiency of the new control method was evaluated and the dependences of the voltage-ripple ratio on the RMS of rectified voltage are presented. A comparative analysis of the number of ripples for different quantity of CW sections was conducted, and the harmonic composition of output voltage spectrum for the example under consideration is determined. It has been concluded that, in the case of using the new control method for achieving the desired quality of rectified voltage, the number of CW sections may be halved compared with the classical control method, which will simplify the manufacture of a transformer magnetic conductor, halve the number of pairs of power switches switching the CW taps, and decrease the mass, dimension, and cost factors of a semiconductor switch and the TRFM itself as a whole. Using the new control method makes it possible to make a controlled rectifier with an even number of sections of a CW transformer almost as efficient as using a transformer with an uneven number of CW sections and the classical control method. The new control method ensures the fulfillment of the requirements for the available value of the ripple ratio of the output voltage of a controlled rectifier based on a transformer with a rotating magnetic field set out by State Standard YuST 13109-97 at a lower RMS of rectified voltage.

A model of a hypothetical process resulting in damage to DNA by ionizing radiation, as a result of which a nonlinear dose dependence of carcinogensis can form at dose 10–100 mGy, is examined on the basis of a microdosimetric approach. The model assumes that the primary damage to DNA interacts with short-lived products of irradiation before the DNA is repaired or transformed into a precancerous defect that is transferred to a daughter cell. It is shown that there are grounds for using the ICRP effective dose and dose rate lowering coefficient equal to 2 in the evaluation of the lifetime risk of irradiation with a significant dose and in the validation of criteria for radiation safety on the basis of data on morbidity and mortality in a cohort of Japanese atomic bomb survivors.

The financial crisis of 2008-2009 demonstrated the need for a comprehensive approach to risk management of financial institutions and financial area as a whole. Since then, a large number of macroprudential policy studies are published each year. In this paper we provide an overview of the main findings of 19 research papers in 2019. This allows us to draw conclusions about the main directions of current studies and to outline directions for future research.

A technical device developed by authors for prevention of unauthorized dropping (drop) of labour bodies and drays of building machinery is presented.

Some theoretical and methodological aspects of a role and value of innovative security in system of national security of the state are considered. The basic concepts of innovative security, essence of innovative security in formation of innovative economy, economy of knowledge are analyzed. Questions of innovative security get the special importance because now innovative technologies and processes of their introduction have crucial value for improvement of quality of life, expansion of possibilities of development and maintenance of national security of all without an exception of the states. In the majority of economically developed states already long time researches devoted to problems of national and economic security are conducted. And, the innovative component in these researches is considered as a component economic or scientific and technical (technological) security. The methodology of studying national and economic is in this time developed, security, there was a conceptual device and structure of categories «national security». Recognising importance of the spent workings out on a security problematics, it is necessary to notice that the system research devoted to studying of problems of maintenance of national security in the conditions of innovative development till now it was not spent. Especially it concerns processes of maintenance of interrelation of national security and innovative activity, formation of the concept of innovative security, its realisation in practice. Till now there is no unequivocal interpretation of essence of innovations, their influences on national and economic security. The analysis shows that at transition to an innovative way of development there are changes not only in economy and its making parts, but, and in world outlook, psychological, political, social and economic, scientifically-technological, educational and cultural spheres, institutional structures of the state and a society, in development of the person. That is, the spheres which problems of safe development cannot be solved within the limits of economic security are mentioned. There is an objective requirement, for the decision of these many-sided and multidimensional problems arising in the course of formation of innovative economy, its safe development to generate within the limits of system of national security a new direction innovative security.

Here we describe a 10-year-old girl with combined immunodeficiency presenting as recurring chest infections, lung disease and herpetic skin infections. The patient experienced two hematopoietic stem cell transplantations and despite full chimerism, she developed bone marrow aplasia due to adenovirus infection and died at post-transplant day 86. Immunologic investigation revealed low numbers of TRECs/KRECs, a severe reduction of memory B cells, absence of isohemagglutinins, and low IgG levels. Whole exome sequencing (WES) identified a novel heterozygous mutation in RAC2(c.275A > C, p.N92 T). Flow cytometric investigation of neutrophil migration demonstrated an absence of chemotaxis to fMLP. Cell lines transfected with RAC2 [N92 T] displayed characteristics of active GTP-bound RAC2 including enhanced NADPH oxidase-derived superoxide production both at rest and in response to PMA. Our findings broaden the clinical picture of RAC2 dysfunction, showing that some individuals can present with a combined immunodeficiency later in childhood rather than a congenital neutrophil disease.

The aim of this work was to determine the validity of the direct transfer of the recommendations of the ICRP on the nominal risk coefficients and tissue weighting factors in a future revision of the national Radiation Safety Standards (NRB). The article compares the background age and sex distribution, and morbidity and mortality rates of the nominal population, the ICRP used to develop the latest fundamental recommendations, with appropriate indicators for the populations of Russia and Japan as the main source of data for assessment of radiogenic risk in the second half of the last decade. It is revealed that the functions of survival and age-related morbidity and mortality of the Russian population, especially for males, is significantly different from the composite population, while for the Japanese population, the differences are relatively small. The estimates of radiogenic risk coefficients for cancers of various localization using calculation schemes and risk models of the ICRP Publication 103, but based on background data on incidence and mortality of the Russian population were obtained. Baseline incidence and mortality for the Russian population are worse compared to the composite population. Hence, risk coefficients for the Russian population can be taken lower than the recommended ICRP by approximately 20% for the total population and 30% for the persons of working ages. The results clearly demonstrate the inconsistency of the modern criteria of radiation protection, based almost exclusively on the account of carcinogenic effects of ionizing radiation, since it implies that radiation is more harmful for a healthier population. The results also show timeliness of issue of the choice of the calendar period for which the age-dependence of the intensity of cancer incidence and mortality from all causes are taken into account. The article justified the continuation of the discussion of the raised issues, as well as the issues of development the mathematical models used in the estimation of radiogenic risks.

Aim. To reveal cognitive deficit after coronary artery bypass, the influence of citicoline, piribedil on the state of higher cerebral functions in the early and late periods after surgery.Material and methods. The study included 94 patients with ischemic heart disease. All patients were divided into 3 groups. Patients of the first group (n=30) were prescribed citicoline as a cerebral neuroprotective drug. Patients of the second group (n=32) had piribedil in addition to standard therapy. Patients of the control group (n=32) had only a standard treatment without any neuroprotective drugs. All patients underwent coronary artery bypass surgery. The cognitive function was assessed before, 10 days after and six months after coronary artery bypass.Results. Patients of group 1 and 2 had achieved pre-surgical levels of cognitive tests results 6 months after coronary artery bypass. The control group had achieved initial levels only in three tests: visual memory (immediate simulation; p=0.008), categorical association (p=0.002), clock drawing test (Wilcoxon test; p=0,005), while other indices were reduced in comparison with the initial ones.Conclusion. The obtained results allow considering the studied drugs as a protectors of cognitive function after surgery. Randomized controlled double-blind studies on large samples are needed to confirm these results.

In article questions of safety of transport processes on roads of the Russian Federation of the vehicles caused by reliability are considered. Authors considered activities on safety of the movement at design stages of the created car. For a solution authors used mathematical models on the basis of probability theory.

The brake device in which high quality brake achieved through a set of moving and stationary discs interacting braking. The efficiency of the proposed braking device is exposed experimental results.

In this clinical case is presented simultaneous operation on two vitally important body systems (respiratory and cardiovascular) using cardiopulmonary bypass. Patient with aortic stenosis and severe heart failure in combination with maligna ncy apex of the right lung was made an operation in one stage – lung lobe resection and aortic valve replacement with satisfactory results. Were defined the indications for this operation, stages approach and analyzed the immediate results of the operation. Key words: simultaneous surgery, aortic stenosis, lung cancer. Понятие «симультантная операция» введено A. Rei-fferscheid в 1971 году. Термин происходит от английского слова «simultaneously» одновременность. Конкурирующая патология сердца, наряду с хроническими обструктивными заболеваниями легких, является наиболее частым сопут-ствующим заболеванием у пациентов со злокачественными новообразованиями и встречается в 13,5 - 28% случаев [8]. В настоящее время под симультантными операциями пони-мают хирургическое вмешательство, одновременно произ-водимое на двух и более органах, по поводу этиологически не связанных между собой заболеваний [9]. Основной этап операции направлен на устранение основного наиболее опасного для жизни больного патологического процесса, а сопутствующего – на ликвидацию заболевания, выяв-ленного в период до- или в период интраоперационного обследования. При раке лёгкого симультантные операции, как правило, ограничены резекцией доли или лобэктоми-ей и реваскуляризацией миокарда или вмешательство на клапанах сердца [2, 4, 6]. В настоящее время нет единого алгоритма оперативного лечения больных с высоким риском осложнений со стороны сердечно-сосудистой системы. Традиционно хирургическое вмешательство проводится по-этапно: первый этап – оперативное лечение по поводу зло-качественного новообразования, вторым этапом выполняют аорто-коронарное шунтирование (АКШ). Симультантные операции исключают возможность развития осложнений со стороны опухоли (прогрессирование опухолевого про-цесса, кровотечение из распадающейся опухоли и др.) в межэтапный период, позволяют в ранние сроки осуществить радикальное вмешательство по поводу новообразований

Негативные демографические тенденции России, на-чиная с 90-х годов прошлого столетия, актуализировали проблемы борьбы с ранней смертностью, особенно в трудоспособном возрасте [2]. Учитывая вклад сердечно-сосудистых заболеваний в общую смертность, которая достигает в разные годы и в разных регионах до 55 % от общей смертности, логично было направление особо при-стального внимания именно на эту проблему.Во всех индустриально развитых странах расходы на медицинскую помощь растут независимо от типа систе-мы здравоохранения. Ключевым принципом экономики является положение, согласно которому все ресурсы имеют альтернативные пути использования. Выделение же ре-сурсов для определенных целей делает недоступным иное, возможно лучшее, их применение. Этот же принцип при-меним для расходов в секторе здравоохранения. Например, ресурсы, выделяемые на имплантируемые кардиовертер-де-фибрилляторы, могли бы удовлетворить такие потребности здравоохранения, как лечение сердечной недостаточности, программы пренатальной помощи, обеспечение вакцина-ции. Главной целью экономики здравоохранения является определение наиболее эффективного использования доступ-ных ресурсов для оказания медицинской помощи больным.