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Background: The COVID-19 pandemic has transformed health care delivery through the rise of telehealth solutions. Though telemedicine-based care has been identified as safe and feasible in postoperative care, data on initial surgical consultations in the preoperative setting are lacking. We sought to compare patient characteristics, anticipated downstream care utilization, and patient-reported experiences (PREs) for in-person versus telemedicine-based care conducted for initial consultation encounters at a hernia and abdominal wall center. Methods: Patients evaluated at an abdominal wall reconstruction center from August 2021 to August 2022 were prospectively surveyed. Patient characteristics, anticipated downstream care utilization, and PREs were compared. Results: Of the 176 respondents, 50.6% (n = 89) utilized telemedicine-based care and had similar demographic and disease characteristics to those receiving in-person care. Telemedicine-based care saved a median of 47 min [interquartile range 20–112.5 min] of round-trip travel time per patient, with 10.1% of encounters resulting in supplemental in-person evaluation. A large proportion of telemedicine-based and in-person encounters resulted in recommendations for operative intervention, 38.2% versus 55.2%, respectively. Indirect costs of care were significantly lower for patients utilizing telemedicine-based services. Patient satisfaction related to encounters was non-inferior to in-person care. Overall, the majority of patients responded that they preferred future care to be delivered via telemedicine-based services, if offered. Conclusions: Preoperative telemedicine-based care was associated with significant cost-savings over in-person care related with comparable patient satisfaction. Health systems should continue to dedicate resources to optimizing and expanding perioperative telemedicine capabilities. [ABSTRACT FROM AUTHOR]

We report a synthesis of a series of molecular compounds and coordination polymers of Zn2+, Mn2+ Cd2+, Eu3+, and Tb3+ with 4-allyl-2,3,5,6-tetrafluorobenzoic acid (4-Afb) anions and 1,10-phenanthroline with compositions [Zn(H2O)(phen)(4-Afb)2] (1), [Mn(H2O)(phen)(4-Afb)2]n·nH2O (2), [Cd(H2O)(phen)(4-Afb)2]n (3), [Cd(phen)(4-Afb)2]n (4), [Ln2(phen)2(4-Afb)6] (Ln = Eu 5Eu; Tb 5Tb). It is shown that the obtained cadmium coordination polymers have various compositions and structures, depending on crystallization conditions. The prepared compounds are characterized by single-crystal XRD, powder XRD, IR spectroscopy, and CHN analysis. Noncovalent interactions are analyzed using the Hirshfeld surface analysis. It is determined that the crystal packings is mainly stabilized by π⋯π, C–H⋯F, and C–F⋯π interactions. The photoluminescent properties of the 5Eu and 5Tb complexes are studied. It is shown that the structure-forming effects of non-covalent "arene–perfluoroarene" interactions can be possibly used for preorganizing reactive functional groups in the crystal. [ABSTRACT FROM AUTHOR]

Structure vibration under the influence of unsteady hydrodynamic forces caused by the flow around their surfaces can adversely affect durability and rupture life. Reducing the adverse effects of hydrodynamic forces is currently possible with the help of linked CFD and vibration calculations. However, for an adequate description of the associated processes one should use calculation models and approaches specific to the hydro-vibration problem. To justify and validate such approaches, an experimental model was developed and a series of structure excitation tests in water flow was carried out.The model comprises two cylinders installed sequentially in water crossflow. Vibration levels, pressure and velocity fluctuations were measured in the tests as a functions of the flow velocity. The application of different non-intrusive measurement techniques was possible due to relatively simple test model construction which may be used for cross-validation and experimental uncertainty quantification.Flow-structure interaction, caused by synchronization effect of the flow separation frequency (or it’s spectral components) and eigenfrequency of cylinder, was analyzed based on simultaneously measured data. The tests performed gave the information about dynamical characteristics of the flow and vibration parameters of cantilevered cylinders. The experimental results are used for identification of required accuracy of hydrodynamic forces calculation by CFD and validation of oneand two-way linked methods for flow excitation frequency calculation.

The OBJECTIVE was to determine the effect of anemia on the volume of blood loss during total hip arthroplasty in patients with end-stage renal disease. MATERIAL AND METHODS. The study was based on the data of 41 patients with pathology of hip joint who underwent primary hip replacement. In the group 1 – the group of comparison (n=20), there was no correction of anemia. In the group 2 – the main group (n=21), erythropoietin was applied 2 months before the operation, until the blood hemoglobin level exceeded 100 g/l, hematocrit – more than 30 %. RESULTS. In the first group of patients, there was the severe anemia: hemoglobin – (88.6±4.6) g/l, the number of red blood cells – (2.7±0.3·1012)/l, hematocrit – (27±2) %. In the second group, 2 months after using erythropoietin, hemoglobin level was (114.9±7.1) g/l, red blood cell count was (3.6±0.4·1012)/l, hematocrit was (33±2) %. Blood coagulation time before operation was (15.1±2.4) min in the first group, (8.7±1.8) min in the second group. Statistically significant difference was noted in blood loss: 59.2 %. In the first group, red blood cell mass transfusion was required in the volume of (554±205) ml for 18 patients (26 doses), plasma – in the volume of (641±67) ml for 20 patients (40 doses). In the second group, blood transfusion was performed for 3 patients in the volume of (321±116) ml. An inverse correlation between blood hematocrit, blood clotting time and blood loss was noted. The correlation coefficient was 0.9. CONCLUSION. The inverse correlation was indicated between the level of hematocrit, blood clotting time and blood loss. The use of erythropoietin in advance of reaching a blood hematocrit of >30 % could significantly reduce the risk of bleeding, reduce the amount of operating blood loss and reduce complications in the postoperative period.

Sergey Avdeev,1,2 Zaurbek Aisanov,3 Vladimir Arkhipov,4 Andrey Belevskiy,3 Igor Leshchenko,5 Svetlana Ovcharenko,6 Evgeny Shmelev,7 Marc Miravitlles81Department of Pulmonology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation; 2Clinical Department, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia, Moscow, Russian Federation; 3Department of Pulmonology, N.I. Pirogov Russian State National Research Medical University, Moscow, Russian Federation; 4Department of Clinical Pharmacology and Therapy, Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation; 5Department of Phthisiology, Pulmonology and Thoracic Surgery, Ural State Medical University, Ekaterinburg, Russian Federation; 6Department of Internal Diseases No.1, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation; 7Department of Differential Diagnostics, Federal Central Research Institute of Tuberculosis, Moscow, Russian Federation; 8Pneumology Department, University Hospital Vall d’Hebron/Vall d’Hebron Research Institute (VHIR), Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, SpainAbstract: Observational studies indicate that overutilization of inhaled corticosteroids (ICS) is common in patients with chronic obstructive pulmonary disease (COPD). Overprescription and the high risk of serious ICS-related adverse events make withdrawal of this treatment necessary in patients for whom the treatment-related risks outweigh the expected benefits. Elaboration of an optimal, universal, user-friendly algorithm for withdrawal of ICS therapy has been identified as an important clinical need. This article reviews the available evidence on the efficacy, risks, and indications of ICS in COPD, as well as the benefits of ICS treatment withdrawal in patients for whom its use is not recommended by current guidelines. After discussing proposed approaches to ICS withdrawal published by professional associations and individual authors, we present a new algorithm developed by consensus of an international group of experts in the field of COPD. This relatively simple algorithm is based on consideration and integrated assessment of the most relevant factors (markers) influencing decision-making, such a history of exacerbations, peripheral blood eosinophil count, presence of infection, and risk of community-acquired pneumonia.Keywords: COPD, exacerbation, inhaled corticosteroid, patient follow-up, guideline adherence, treatment algorithm

The free-piston generator has more merits than the traditional reciprocating engines, and has been under extensive investigation. This study focuses on the development two novel perspective ideas unlike already advanced the linear free piston generator. These are: (1) to make both piston and cylinder free that provides ideally balancing of the system; (2) to turn from the linear scheme of a generator to rotary design because of simplicity and compactness. The mathematical simulation of operation of the linear two-stroke cycle alternator with both free piston and cylinder was conducted with using the model of zero-dimensional dynamics. Combustion of methane-air mixture with excess air ratio of 1.2 was considered. Both heat and friction losses were taken into account. Operation particularities of such system were analyzed. It was found that oscillation amplitude of moving parts did not exceed of 70 mm at frequency of ∼50 Hz for alternator with following basic parameters: cylinder bore of 80 mm, length of 400 mm, piston length of 120 mm. Mass of both piston and cylinder was chosen identical and equal of 3 kg. It was shown that the efficiency of the chemical energy conversion reached of 46%, and specific power was high as 40 kW/l at compression ratio of 40. The lab scale pneumatic alternator in rotor variant with both free rotor and cylindrical body was assembled for experimental demonstration of rotary design capability. The alternator was fed with compressed air of low pressure below of 6 atm. The electrical power in the load reached of 10 W at input power with intake compressed air about 100 W. The results indicate that alternators with both free piston and cylinder in linear and rotary designs have the potential to achieve high efficiency and provide the vibration – free operation. Keywords: ICE, Alternator, Free piston, Hybrid engines

Objective. To optimize diagnosis of various variants of morphologically verified extrinsic allergic alveolitis (EAA), by determining the most significant clinical and radiological indicators of its development.Material and methods. Examinations were made in 82 patients with morphologically confirmed EAA, including 10 people with acute EAA, 38 with subacute EAA, 26 with chronic EAA, and 8 with recurrent EAA. Their medical history data were studied; physical examination, clinical blood, pulmonary function (PF), and lung diffusing capacity tests, and high-resolution computed tomography (HRCT) of the chest were performed. Transbronchial and/or video-assisted thoracoscopic lung biopsies were used for morphological studies.Results. Four disease course variants were identified. Disease duration, adherence to a specific antigenic effect, and the clinical, radiological, and morphological patterns of the disease were determined for its each variant.Conclusions. 1. Acute EAA is characterized by an abrupt onset and rapid (no more than 3 months) development with a preponderance of intoxication syndrome (Cumulative Index (CI), 2.1 ± 0.2 scores); subacute EAA is characterized by a slower (8.5–10 months) development with a predominance of respiratory symptoms (CI, 2.5 ± 0.1 scores), the steady progression of which is observed in chronic EAA (CI, 2.9 ± 0.2 scores). Recurrent EAA in previously cured patients is accompanied by both syndromes simultaneously (CI, 2.7 ± 0.3). 2. The characteristic feature of acute EAA on HRCT of the chest is the extent of ground-glass opacity in both lungs (more than 3 segments) and perivascular infiltrates; that of subacute EAA is microfocal dissemination; that of chronic EAA is macrofocal changes in the presence of interlobular septal thickening, as well all the development of cystic changes in the subpleural zones. In recurrent EAA, all the listed symptoms may appear. 3. Enlarged intrathoracic lymph nodes are most common in subacute EAA in 45.9% of cases and less common in acute and chronic EAA in 20 and 23.8% of cases, respectively. In all disease variants, lymph node hypertrophy affects the bifurcation and paratracheal groups and less often the bronchopulmonary and tracheobronchial groups; the sizes vary from 11 to 20 mm with means of 13.0 ± 1.2 mm.

The development trends and the state of income tax systems in the world and the countries of the Eurasian Economic Union have been analyzed. Their similarities and differences have been revealed. The problem of harmonization of the legislation of income taxation of individuals has been considered. The assessment of justice and efficiency of the existing systems of income taxation in the countries of the Eurasian Economic Union has been carried out. The concept of harmonization has been proposed, which allows not only to unify the laws of the Eurasian Economic Union countries, but also to ensure an increase of the efficiency and fairness of the system of income taxation of individuals.

The comparative analysis of strategy and practice of social and economic reforms in Russia and China for the last 30 years is carried out. Basic distinction as in setting of the goals of reforms, and strategy and practice of their realization is detected. It is established that both on concrete economic achievements, and from the point of view of viability of the chosen model of economic development of society China much more surpasses Russia. Experience of modernization of China can be useful to more effective and socially oriented reforming of Russia.

The article describes the topicality of simulation-based technologies as a part of the practical training of anesthesiologists and emergency physicians. It validates the theoretical and practical background for inclusion of simulation-based technologies into the training in order to decrease the number of medical errors in one of the most highly technical fields of modern medicine. The authors share the experience of staged simulation-based training of anesthesiologists and emergency physicians in the Simulation Center of Altai State Medical University by the Russian Ministry of Health.

The paper deals with the Russian words referring to ‘freedom’ ( svoboda , volia , and their derivatives svobodnyj , vol’nyi , vol’nost’ , etc.) in both synchronic and diachronic aspects. I seek to elaborate and to refine the analysis given in some earlier publications (by Anna Wierzbicka and by myself). The paper analyzes the spatial dimension of the semantics of the words under consideration, the contrast between svoboda and volia before the Revolution, their semantic development during Soviet times and their current semantic status. It also considers metalinguistic comments on their semantics by Russian speakers. I make special reference to the role of these words in The First Circle by Alexander Solzhenitsyn and the problem of their translation into other languages. In addition, I briefly consider the use of the words in question in the translations of various texts into Russian (with reference to the parallel corpora of the Russian National Corpus). The starting point for such an analysis is the assumption that one may regard translation equivalents and paraphrases of a linguistic unit extracted from real translated texts as a source of information about its semantics. This approach is particularly efficient in case of language-specific words that defy translation. Translations into Russian may be even more revealing in this respect: when Russian is the source language, the choice of a paraphrase depends on the translator’s meta-linguistic reflection while an occurrence of a Russian language-specific expression in the target text, more often than not reflects a “naïve” choice of words as a part of “natural” linguistic activity.

The mathematical model presented in (Kulikov et al. 2018) can be used for the quantitative evaluation of the plutonium proliferation resistance. This requires the warm-up process of an implosion nuclear explosive device (NED) with a different structure to be analyzed with respect to various heat removal conditions and the option to be identified in which the NED remains operational for the longest time possible. The fraction of the 238Pu isotope with which, even in this case, the NED will prove to be operational only for quite a short time can be regarded as sufficient for the plutonium with such composition to be considered a proliferation resistant material. The purpose of the paper is to evaluate in quantitative terms the content of 238Pu in plutonium for ensuring its proliferation resistance and to identify the factors which influence significantly this evaluation. The data, procedures and findings from earlier works on the topic, as well as the authors’ own estimates and calculations were used for the study. It has been shown that the important factors involved in the plutonium proliferation resistance evaluation are the NED technology level and the required NED lifetime. Depending on the required lifetime, tougher requirements can be introduced with respect to the 238Pu content both from the standpoint of low-technology and high-technology NEDs. With a lifetime of five hours taken as the guide-mark (a NED is unlikely to be finally assembled, transported and used for such a short time), it is only plutonium containing 55% of 238Pu that can be considered a proliferation resistant fissile material.

The article describes the observation of successful total hip arthroplasty of protrusion coxarthrosis in the patient with end-stage renal disease.

Since the closed nuclear fuel cycle suggests that plutonium is extracted from irradiated fuel and is recycled in nuclear reactors as part of the loaded fuel, proliferation resistance of fissile materials (plutonium) is becoming a problem of a practical significance. It is important to understand to what extent the physical and technical properties of fissile materials are capable to prevent these from being diverted to nonenergy uses. This paper considers the term ”proliferation resistance” from a physical and technical point of view with no measures taken for the physical protection, accounting and control of nuclear materials. Thus, proliferation resistance of plutonium means that it is technically impossible to fabricate a nuclear explosive device (NED) of the implosion type due to the overheating of the device’s components and the resultant NED failure. The following conclusions have been made. The assessment of the plutonium proliferation resistance is not justified where it relies on the analysis of an implosion-type NED excluding the use of modern heat-resistant and heat-conducting chemical explosives (CE) which are inaccessible. Consideration of the asymptotic temperature profile in the NED components is not justified enough for the development of plutonium proliferation resistance recommendations. No options enabling the slowdown of the NED warm-up process have been exhausted for analyzing the physical and technical factors that determine the proliferation resistance of plutonium. General conclusion. The underlying rationale in a fundamental monograph by Dr. G. Kessler proved to be insufficiently valid, which has led to an unfounded inference as to the status of the plutonium proliferation resistance. The development of the procedures used and other factors taken into account are expected to increase the requirements to the content of the 238Pu isotope in plutonium for ensuring its proliferation resistance.

Heterometallic {Eu2Cd2} complexes [Eu2(NO3)2Cd2(Phen)2(2,4-Nbz)8]n·2nMeCN (I) and [Eu2(MeCN)2Cd2(Phen)2(3,5-Nbz)10] (II) with the 2,4-dinitrobenzoate (2,4-Nbz) and 3,5-dinitrobenzoate (3,5-Nbz) anions and 1,10-phenanthroline were synthesized. The compounds obtained were characterized by X-ray single-crystal analysis, powder X-ray diffraction analysis, IR spectroscopy, and elemental analysis. Moreover, the thermal stability of the complexes was also studied. Analysis of the crystal packing showed that where 1,10-phenanthroline is combined with various isomers of dinitrobenzoate anions, different arrangements of non-covalent interactions are observed in the complex structures. In the case of the compound with the 2,4-dinitrobenzoate anion, these interactions lead to a significant distortion of the metal core geometry and formation of a polymeric structure, while the complex with the 3,5-dinitrobenzoate anion has a structure that is typical of similar systems. The absence of europium metal-centered luminescence at 270 nm wavelength was shown. For all the reported compounds, a thermal stability study was carried out that showed that the compounds decomposed with a significant thermal effect.

Cell and tissue nanomechanics, being inspired by progress in high-resolution physical mapping, has recently burst into biomedical research, discovering not only new characteristics of normal and diseased tissues, but also unveiling previously unknown mechanisms of pathological processes. Some parallels can be drawn between early development and carcinogenesis. Early embryogenesis, up to the blastocyst stage, requires a soft microenvironment and internal mechanical signals induced by the contractility of the cortical actomyosin cytoskeleton, stimulating quick cell divisions. During further development from the blastocyst implantation to placenta formation, decidua stiffness is increased ten-fold when compared to non-pregnant endometrium. Organogenesis is mediated by mechanosignaling inspired by intercellular junction formation with the involvement of mechanotransduction from the extracellular matrix (ECM). Carcinogenesis dramatically changes the mechanical properties of cells and their microenvironment, generally reproducing the structural properties and molecular organization of embryonic tissues, but with a higher stiffness of the ECM and higher cellular softness and fluidity. These changes are associated with the complete rearrangement of the entire tissue skeleton involving the ECM, cytoskeleton, and the nuclear scaffold, all integrated with each other in a joint network. The important changes occur in the cancer stem-cell niche responsible for tumor promotion and metastatic growth. We expect that the promising concept based on the natural selection of cancer cells fixing the most invasive phenotypes and genotypes by reciprocal regulation through ECM-mediated nanomechanical feedback loop can be exploited to create new therapeutic strategies for cancer treatment.

Unlike standard nanodiamonds (NDs), boron-doped nanodiamonds (BNDs) have shown great potential in heating a local environment, such as tumor cells, when excited with NIR lasers (808 nm). This advantage makes BNDs of special interest for hyperthermia and thermoablation therapy. In this study, we demonstrate that the negatively charged color center (NV) in lightly boron-doped nanodiamonds (BNDs) can optically sense small temperature changes when heated with an 800 nm laser even though the correct charge state of the NV is not expected to be as stable in a boron-doped diamond. The reported BNDs can sense temperature changes over the biological temperature range with a sensitivity reaching 250 mK/√Hz. These results suggest that BNDs are promising dual-function bio-probes in hyperthermia or thermoablation therapy as well as other quantum sensing applications, including magnetic sensing.