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The article develops to the analysis of the application of project management in the implementation of long-term interregional initiatives. The relevance of the study is due to modern experience in initiating and implementing major interregional initiatives. Practice shows that they need no alternative real project content, i. e. the availability of interconnected local investment projects, the implementation of each of which together provides high interregional (macro-regional) and region-wide importance. To date, there is a shortage of projects at the interregional level in Russia. This problem is recorded in the national Spatial Development Strategy.We formulate an author’s approach to defining of the interregional initiative as an activity to develop, present and launch a significant large complex interregional project (a set of interconnected investment and other related projects), potentially capable of having a significant impact on the social and economic development of the country, the federal district / macro-region.The study analysed detail the lessons learned from project management at the regional level, which can be useful for the implementation of integrated interregional initiatives. The main models of “spillovers” of experience of implementation of project management from federal to regional level for development of own initiatives of subjects of the Russian Federation (direct transfer, reset of state programs, project management of new spatial forms of organization of economic activity, initiation of joint projects with federal development institutions, etc.) are given.We have underlined possibilities project management in promoting interregional initiatives should focus on the following areas: taking into account innovative opportunities concentrated in systemically important economic complexes; Ranking projects in terms of effects for regional business communities. Projects involving and combining local resources should benefit.In regard with innovation development, we have proposed specific attention to interregional initiatives related to the acquisition of new knowledge, associations of the potential of regional scientific centers, synthesis of accumulated knowledge in the form of patents, advanced technologies, industrial models.

Introduction. Predicting the timing of inflammation control in acute obstructive pyelonephritis based on routine laboratory values is of great importance. This is essential for planning the next stage of management to eliminate the cause of obstruction.Objective. To evaluate the dynamics and prognostic value of systemic inflammatory response markers in the management of acute obstructive pyelonephritis (AOP).Materials & methods. We performed a prospective study of the dynamics of inflammatory markers in patients with AOP. The study included 113 patients with AOP. Nephrostomy tube was installed in 43 and ureteral stent in 70. Following parameters were assessed: leukocytosis, CRP, creatinine on the days 1-3-7 after drainage, duration of fever. The risk factors for long-term regression of leukocytosis were also investigated.Results. On post-op day 3, the average leukocytosis was 10.5 (± 2.46) *109, and 68.1% of patients are returned to normal leukocyte level, and on post-op day 7 — 7.9 (± 3.12) *109 and 75.2%, respectively. On post-op day 3, the average CRP level was 14.2 (± 63.95) mg/l, and 32.7% of patients had decrease to target values, on post-op day 7 — 13.1 (± 49.7) mg/l and 56.6%, respectively. On post-op day 6, fever resolved in 98% of patients. Diabetes mellitus was the only statistically significant factor that can influence the long persistence of leukocytosis (p < 0.05).Conclusion. Leukocytosis showed higher specificity as a marker of inflammatory regression than CRP for AOP treatment. On post-op day 7, 75% of patients demonstrated laboratory and clinical signs for the inflammatory process relief. The presence of diabetes mellitus significantly prolongs the regression of the inflammatory response.

The next institutional cycle of the EU begins in a period of unprecedented uncertainty in the global economy and the presence of a number of large-scale problems in the European economic space. The author considers possible economic and political directions in the activities of the new composition of the European Commission. A hypothesis is put forward that the main priority will be to ensure the competitiveness of the European space, the development of new regulatory documents of a geo-economic nature and their implementation in practice. At the initial stage, an assessment of the genesis of the new economic and political stage with an analysis of the main regulatory decisions is presented. The work presents economic initiatives for 2023-early 2024 to ensure economic security and anti-subsidy regulation. These decisions are very significant, in the opinion of the author, as they form a drift from the “geopolitical” to the “geoeconomic” role of the commission. Further, the priorities of the economic policy of the new European Commission are formed from three components: ensuring raw material security, maximizing the competitiveness of the EU, protecting the adopted climate goals with partnership with the widest possible range of countries to promote common interests. To analyze the external background of the “geoeconomic turn” of Brussels with its significant number of new initiatives, the analysis showed a significant weakening of the EU's position in the world economy, associated with a lag in productivity. The article concludes that the main risks of the “geoeconomic turn” are in the political sphere. Its subjects may not be able to overcome numerous obstacles to the implementation of the new industrial course, associated with the need to take into account the heterogeneous impact of various industries on the EU economy. In the future, the presented article has analytical potential for studying other countries and regions in which economic policy integrates the search for efficiency in responses to external challenges.

Abstract Observation‐based simulations of the ionosphere were performed with the NRLMSISE‐00 model for six locations around the globe during 1–9 February 2022, which includes the so‐called Starlink Storm. Unlike other studies, we focused on the magnetically quiet days around the storm. Unexpectedly, the observed values of the F2‐layer peak density were ∼50% larger than the simulated values. We show that this implies that the daytime O density in the thermosphere was systematically ∼30% larger than the NRLMSISE‐00 predicts. Further investigation shows that this discrepancy is not an exclusive feature of the period around the Starlink Storm and a similar problem happens for some periods for different years. It is unclear if the reason is an actual increase of the O density or its underestimation by the model. Resolving this problem is critical for providing accurate predictions of the atmosphere to avoid the degradation of normal operation or even loss of space assets.

Objective: vascular complications (VCs) following liver transplantation (LT) can pose a significant threat to the recipient’s life – as the risk of graft loss increases significantly when blood flow in the graft is impaired. Diagnosis and early treatment of VCs seems to be a pressing issue in transplantology. The aim of this study is to evaluate the incidence, treatment and outcome of VCs in patients after orthotopic LT at the Center for Surgery and Donor Coordination, Rostov Regional Clinical Hospital.Materials and methods. Between July 2015 and April 2023, 100 orthotopic LTs were performed. VCs were retrospectively identified and analyzed.Results. The overall incidence of VCs was 24% (n = 24): hepatic artery stenosis, 5% (n = 5); intra-abdominal bleeding, 6% (n = 6); hepatic artery dissection, 2% (n = 2); intrahepatic venous thrombosis Budd–Chiari syndrome), 2% (n = 2); portal vein thrombosis, 1% (n = 1); inferior vena cava thrombosis/iliofemoral deep vein thrombosis, 2% (n = 2); inferior vena cava stenosis, 1% (n = 1); hepatic vein stenosis, 1% (n = 1); recurrent hepatic artery stenosis/thrombosis, 2% (n = 2); mesenteric vein thrombosis, 2% (n = 2).Conclusion. Most VCs following orthotopic LT occur in the early postoperative period and can lead to a high risk of graft dysfunction and patient death. Early recognition, diagnosis, and treatment of post-LT complications are critical to successful short- and long-term graft function and patient survival, even in patients with asymptomatic complications. Treatment options typically include surgical revascularization, percutaneous thrombolysis, percutaneous angioplasty, retransplantation, or, less commonly, a conservative approach.

Objective: to evaluate the outcomes of heart transplants performed at Rostov Regional Clinical Hospital within five years.Materials and methods. Between 2017 and 2022, 29 orthotopic heart transplants (HT) were performed in our clinic. Heart failure was caused by postinfarction cardiosclerosis (21 cases, 72.4%) and dilated cardiomyopathy (8 cases, 27.6%). Among the recipients, 27 (93.1%) were men and 2 (6.9%) were women. Mean age was 53.14 ± 8.7 years (34 to 67 years). All patients received quadruple-drug immunosuppressive therapy, including induction with monoclonal antibodies; calcineurin inhibitor, mycophenolic acid, and corticosteroid were used after HT.Results. In-hospital mortality was 10.34% (n = 3). The causes of death were multiple organ failure and infectious and septic complications. After discharge, 4 (13.8%) recipients died over 5 years. Rejection reaction with the development of graft dysfunction (3 recipients, 75%), infectious and septic complications (1 recipient, 25%) were the causes of death in the long-term period. The survival rate was analyzed according to the Kaplan–Meier estimate. One-year survival was 80.9%. Three-year survival rate corresponded to the 5-year survival rate – 70.56%. Five-year survival of patients surviving the first year after HT was 86.1%. Maximum follow-up period was 64 months.Conclusion. HT continues to be the gold standard for patients with end-stage heart failure. Five-year HT experience in our center has shown a survival rate that is comparable to that of the International Society for Heart and Lung Transplantation (ISHLT).

This is a comprehensive overview on our research work to link interdisciplinary modeling and simulation techniques to improve the predictability and reliability simulations (PARs) of compressible turbulence with shock waves for general audiences who are not familiar with our nonlinear approach. This focused nonlinear approach is to integrate our “nonlinear dynamical approach” with our “newly developed high order entropy-conserving, momentum-conserving and kinetic energy-preserving methods” in the quantification of numerical uncertainty in highly nonlinear flow simulations. The central issue is that the solution space of discrete genuinely nonlinear systems is much larger than that of the corresponding genuinely nonlinear continuous systems, thus obtaining numerical solutions that might not be solutions of the continuous systems. Traditional uncertainty quantification (UQ) approaches in numerical simulations commonly employ linearized analysis that might not provide the true behavior of genuinely nonlinear physical fluid flows. Due to the rapid development of high-performance computing, the last two decades have been an era when computation is ahead of analysis and when very large-scale practical computations are increasingly used in poorly understood multiscale data-limited complex nonlinear physical problems and non-traditional fields. This is compounded by the fact that the numerical schemes used in production computational fluid dynamics (CFD) computer codes often do not take into consideration the genuinely nonlinear behavior of numerical methods for more realistic modeling and simulations. Often, the numerical methods used might have been developed for weakly nonlinear flow or different flow types other than the flow being investigated. In addition, some of these methods are not discretely physics-preserving (structure-preserving); this includes but is not limited to entropy-conserving, momentum-conserving and kinetic energy-preserving methods. Employing theories of nonlinear dynamics to guide the construction of more appropriate, stable and accurate numerical methods could help, e.g., (a) delineate solutions of the discretized counterparts but not solutions of the governing equations; (b) prevent numerical chaos or numerical “turbulence” leading to FALSE predication of transition to turbulence; (c) provide more reliable numerical simulations of nonlinear fluid dynamical systems, especially by direct numerical simulations (DNS), large eddy simulations (LES) and implicit large eddy simulations (ILES) simulations; and (d) prevent incorrect computed shock speeds for problems containing stiff nonlinear source terms, if present. For computation intensive turbulent flows, the desirable methods should also be efficient and exhibit scalable parallelism for current high-performance computing. Selected numerical examples to illustrate the genuinely nonlinear behavior of numerical methods and our integrated approach to improve PARs are included.

The paper describes actual problem of socio-economic inequality between the East and West of Germany. We examine the analysis of sociological differences between parts of the country in terms of the results of German unity policies, the introduction of coronavirus restrictions, technological equipment and economic potential. All those issues are considered with key works of German literature of recent years on understanding the contradiction «East-West». It is determined that the ongoing intellectual attempts have not overcome the split in the country. Additionally, we examine the federal government’s concept of a «new look to the East» was explored. The results show that as an independent region, for which the western part of the country does not serve as an indisputable reference point. Most likely, in fact, this approach has shifted the focus from the traditionally important internal chronic shortages of new lands in economic power, labor, infrastructure and technology. This problem is particularly relevant in connection with the lack of representation of people from East Germany in key positions in many areas of society and politics. This explains why its that these issues will be considered in a special concept of the federal government, adopted at the beginning of 2023. The second part of the state's efforts is related to changes in approaches to the implementation of regional policy in the country and financing of measures to improve the economic structures of the regions. The author concludes that they are synchronized with the tasks of ensuring energy security and accelerating the transformation at oil refineries and ports in eastern Germany after the cessation of oil and gas supplies from Russia. In this regard, we consider that the continuation of the polycrisis in the country makes a decisive contribution to the growing disillusionment of East Germans in politics. On the example of this analyses, we obtained that they do not reject democracy as such, but are much more critical of political actions than the population of the western part of Germany.

Background: Systemic thrombolytic therapy (STLT) with alteplase is the method of choice in all patients with acute ischemic stroke (IS) within the first 4.5 hours after the symptom onset. There is a noticeable difference between men and women in the clinical characteristics and results of stroke treatment; however, results of studies have been contradictory. Aim: To evaluate the efficacy of STLT with alteplase in women compared to men, depending on the presence of some risk factors for stroke. Materials and methods: This open-label prospective observational non-interventional cohort study of STLT in IS included 209 patients (102 women, the main group, and 107 men, or the comparison group) aged 32 to 86 years. All patients received STLT with alteplase within 4.5 hours from the onset of IS symptoms. The primary endpoint of the study was 28-day survival, and the secondary endpoint was the achievement of mobility independence (0 to 2 points by the modified Rankin Scale (mRS)). Results: The demographic and clinical patient characteristics of both groups were comparable, but women were on average 5 years older than men (p = 0.003). The index IS was not the first one in 31.4% of women and 23.4% of men (p 0.05). There were no significant differences in the severity of stroke and the timing of STLT. Men had a high mortality rate in the acute period of IS, but the difference was non-significant. PST-STLT hemorrhagic transformation was more common in men, with the difference being non-significant (2 0.743, p = 0.389). Women were more likely to have type 2 diabetes mellitus (DM2) (37.3% and 20.6%, respectively, 2 7.111, p = 0.008). In women, there was a trend towards better symptom regression by about 1 point (p = 0.129). The women with DM2 had a 13% higher survival than men (p = 0.038). The numbers of patients achieving independence (02 points on the mRS scale) by Day 28 was not different (56 women and 52 men). No between-groups differences were found in the numbers of patients with arterial hypertension and atrial fibrillation. Only 13 women (12.75%) and 21 men (20%) had a normal body mass index, while 56.3% of women and 46.7% of men had obesity 2 or 3 grades, with the gender differences being non-significant. Conclusion: In women, who have received STLT in the acute period of IS, the death rates and the functional outcomes were non-inferior to those in men, despite their older age, hyperglycemia in the acute period and past history of DM2. The risk factors for stroke in women, compared to men, could be the potential cause of more frequent IS recurrence (every third case in women and every fourth in men was recurrent). Despite a number of negative factors (age, obesity, metabolic syndrome, hyperglycemia, DM2, atrial fibrillation), there was a trend towards better outcomes of STLT in women.

A new coalition government in Germany came into power at the end of 2021. The paper describes Germany’s 2022 G7 Presidency as a first major foreign policy priority and test. The article considers that this period gave the German government the opportunity to test diverse political initiatives. These include proposals in the economic and climate sphere, in the regulation of the labor market, the prospects for the global agro-industrial complex, and overcoming the consequences of the pandemic. The creation of the Climate Club has become the most ambitious project. In this regard the G7 will unify their environmental standards within the club. It will stimulate the entry into the club of countries that are also taking action to combat climate change. Additionally, we examine the of sectoral communiqués. Analysis showed that Olaf Scholz’s government did not propose any truly breakthrough initiatives. Many key ideas were duplicated from the Elmau summit in 2015. In each sectoral area, financial and military support for the Ukrainian regime was noted in the documents. In the author’s opinion, the strategic move of the German Presidency was to invite the leaders of India and South Africa to a key meeting, as well as to coordinate with the Indonesian G20 Presidency. The author comes to the conclusion that the results of the German presidency are twofold. On the one hand, despite the Ukrainian conflict, attempts have been made to develop the climate agenda. It is emphasized that main issue was the modernization of the WTO. Was put on the other hand, these topics constantly disappeared due to the topics of support for Ukraine. Most likely, the G7 once again demonstrated the soft nature of the organizational structure. The author concludes that main decisions to put pressure on Russia remained in the shadow of the sanctions packages of the European Union.

Introduction. In this article, we consider global approaches to the research and assessment of human capital formation and its role in the global educational system. We have explored the terms and definitions of digital education – the inseparable part of higher education. We have identified and analysed the essential connection between digital education and human capital. Goal. Our research objective is to analyse and introduce certain software and determine its efficiency in educational system. The article presents a list of principal criteria for formation of human capital, the latter required for complex assessment of a student's human capital formation. Materials and methods. We describe an original instruction for using the software application «Defining Individual's Human Capital Score» and the database «Dynamic Patterns of Human Capital Score» (intellectual products) in order to estimate a student's human capital formation. The research was tested at the Southern Federal University and based at the Academy of Psychology and Pedagogics among students in their first to fourth year of studies. Results and discussion. Using the data obtained from the software tests we studied the efficiency of applying individual learning path in human capital formation of students. All the results were saved in the database. Conclusion. As one of the methods for assessment of human capital formation, this software demonstrated its efficiency and considerable impact in pedagogical, psychological, economic, and cultural aspects. In the future it will encourage overall positive evolution of digital education and human capital in Russia and facilitate innovation, growing workforce productivity, and learning the necessary professional and managerial skills.

A 58-year-old patient with type 30 dystonia (OMIM619291) detected by genome-wide sequencing was described. A variant of rs778751388, not previously described in the literature, has been identified in the heterozygous state in exon 2 of 24 of the VPS16 gene, leading to the amino acid substitution of P.Cys36A4rg. DNA change (HG38)(protein change) 20:g.2859771TC ENST00000380445.8:c.106TC ENSP00000369810.3:p.Cys36Arg. The patient's disease began quite late, in the 4th decade of life, with spastic torticollis. Subsequently, the spread of the pathological process involving the muscles of the neck, the right upper limb, then the right lower limb, myoclonia of the right hand and tremor of the right lower limb was noted. Secondary mitochondrial disorders were revealed in the form of an increase in the level of lactate in the blood before and after loading with carbohydrates. A decrease in the activity of mitochondrial enzymes in peripheral blood lymphocytes was also revealed: succinate dehydrogenase, an enzyme of the mitochondrial respiratory chain complex II; -glycerophosphate dehydrogenase involved in mitochondrial fat metabolism; glutamate dehydrogenase (amino acid metabolism in mitochondria). The level of lactate dehydrogenase in peripheral blood lymphocytes in the patient was elevated. The identified secondary mitochondrial disorders may be an indication for the appointment of energotropic medicines along with levodopa drugs and dopaminergic receptor agonists. In the presented observation, it can be argued about autosomal dominant inheritance, since the patient has a characteristic clinical picture of the disease and a mutation in the heterozygous state in the VPS16 gene was detected.

The article considers the current problem to build terminals for the import of liquefied natural gas (LNG). The paper demonstrates that projects considered in recent years have been hampered due to lack of investment and lack of demand. Due to the aggravation of the conflict in Ukraine and the desire to reduce energy dependence on natural gas supplies from Russia, these projects is necessary for Germany’s economy. We examine the criticism of the projects by environmental public organizations. The article analyzes the unprecedented speed of investment decisions in the energy infrastructure, the newly created framework conditions by the Law on accelerating the construction of LNG terminals. The article discusses that the German federal government assigns them a key role in ensuring the security of gas supplies. On the example of key locations: Brunsbüttel, Wilhelmshaven and Stade, we examine various options potential investors. We hypothesise that in the future, these projects open up Germany the possibility of global natural gas supplies without the use of pipelines and, thus, interaction with new market players. Simultaneously, although LNG volumes from terminals in neighboring European countries are also available to the German natural gas market. This paper proved that in detail the importance for ensuring the reliability of gas supply of planned domestic investments that do not depend solely on commercial benefits. Significant positive impact of gas infrastructure is only found in the context of hydrogen energy in the country.

Introduction. The majority of patients who undergo radical prostatectomy, apart from loss of sexual function, note a decrease in penis size which negatively affects their self-esteem. Penile rehabilitation is a set of measures aimed at recovery of sexual function to improve the quality of life.Objective. To analyze various options for penile rehabilitation in order to choose a method for preventing penis size reduction in patients undergoing nerve-sparing radical prostatectomy.Materials and methods. Patients who undergo radical prostatectomy (n = 83) at status flaccid and status erect were measured: length, circumference of the base, body and glans penis (mm) at different periods of penile rehabilitation. As a control, the tumescence coefficient was determined using pharmacodopplerography. All results were evaluated before, at the 6th and 12th months after radical prostatectomy.Results. Depending on the type of restoration of erectile function, the patients were divided into several groups: group 1 – men without penile rehabilitation; group 2 – patients treated with phosphodiesterase inhibitors of type 5; group 3 – using vacuum erection device (VED) and group 4 – taking combined penile rehabilitation. Medians of tumescence coefficient in group 1 on the 6th and 12th months was 2.7 (2.4; 3.1) and 2.6 (1.9; 2.9), in group 2 – 2.8 (2.2; 3.5) and 2.9 (2.2; 3.5), in group 3 – 2.7 (2.3; 3.3) and 2.8 (2.3; 3.3), in group 4 – 3.0 (2.2; 3.2) and 3.1 (2.1; 3.2), respectively (p

April 16, 2022 marks the 100th anniversary of the Treaty of Rapallo, concluded between Russia and Germany during the Genoa Conference. His fate and role is still controversial. Particular attention is paid to the «spirit of Rapallo» – a realistic and pragmatic idea of peaceful development in the context of today’s increased politicization and curtailment of Russian-German economic relations. We consider that following a direct decrease in mutual trade the very significance of Russian-German economic cooperation is further underestimated emotionally and subjectively. Based on a cross-country cross-sectoral analysis, the paper analyzes the interdependence of the key economies of Russia and Germany are presented. We identified the key import positions of both countries. It is emphasized that a purely quantitative calculation of the reduction of ties may be insufficient, since it does not take into account the cascading economic effects generated from supply chains. Using results of surveys of the German business community, we assessed the strength of the sanctions measures introduced with the active support of Germany against Russia regarding the disconnection from the SWIFT system, the freezing of financial accounts, the measures introduced against the Central Bank of Russia – up to the freezing in principle of economic relations between countries are presented. The author concludes that the anniversary of the Rapallo Treaty, for objective reasons of the military-political situation, remained in the shadows and cannot again put forward considerations for constructive cooperation. Most likely, in the expert community, a reference to it may have an impact on western companies in order to prevent a complete break in business relations with Russian companies.

Three case studies of adults with Leber hereditary optic neuropathy with and without neurological symptoms are presented. An elevated blood lactate level and changes in the activity of the mitochondrial enzymes in peripheral blood lymphocytes were noted. Mutations in the mitochondrial DNA (G3460A in one patient and G11778A in two patients) were found. The patient with a G3460A mutation, in addition to reduced visual acuity, was diagnosed with a cerebellar disorder due to cerebellar vermis hypoplasia. These changes are indications for prescribing energotropic drugs (idebenone, carnitine); carnosine can also be prescribed. These case studies show that patients with optic nerve atrophy should be assessed for Leber hereditary optic neuropathy. Differential diagnosis with multiple sclerosis should be performed, since this condition often presents as optic neuropathy.

The paper describes the experience of treatment during the preparation of stone objects from the collection of Bolgar State Historical and Architectural Museum-Reserve, which consist of 200 storage units, for museum display. The collection includes gravestones of the 13th-14th centuries decorated with ornamental carvings, inscriptions, monochrome painting, and fragments of architectural decor made of limestone, tuff and plaster. The objects date back to the period of the Bolgar ulus being part of the Golden Horde. Most of them are in poor condition and require restoration and conservation. Besides, the museum cannot provide a complete display of the collection in the existing exposition conditions. In order to provide the conditions for collection display, a lapidarium is being constructed in the territory of the Bolgar Museum-Reserve. Preservation of cultural heri­tage sites requires joint efforts by various specialists - conservators, curators, and archaeologists. Along with the development of an exposition concept and its spatial and architectural solutions, a cycle of conservation treatment of the objects is performed, which is described in this paper.

Abstract This paper presents the results of a coordinated measurement campaign with ground based and satellite observations over European and Japanese regions during September 5–6, 2017. Two incoherent scatter radars, two satellite missions, International Reference Ionosphere (IRI-2016) empirical model, and Field Line Interhemispheric Plasma (FLIP) physical model were employed to examine the regular behavior of the F2-layer peak height and density and the topside ionosphere electron density, electron, and ion temperatures as well as traveling ionospheric disturbances (TIDs). The daily ionospheric variations over Kharkiv and Shigaraki exhibited similar behavior qualitatively and quantitatively. The results show that none of the empirical IRI-2016 models of F2-layer peak height, topside electron density, and temperature can be preferred for predicting the key qualitative features of variations in ionospheric plasma parameters over Kharkiv and Shigaraki. The likely reason is rapid day to day changes in solar activity and series of moderate enhancements of magnetic activity occurring in the observation period and preceding days. Compared with IRI-2016 model, the FLIP physical model was shown to provide the best agreement with the observations when constrained to follow the observed diurnal variations of F2-layer peak height both over Europe and Japan. This paper presents the first direct comparison of the mid-latitude electron density measured by the Swarm satellite with incoherent scatter radar data and it confirms the high quality of the space-borne data. For the first time, evidence of the possible need to increase the neutral hydrogen density in NRLMSISE-00 model by at least a factor of 2 was obtained for the Asian longitudinal sector. The TIDs, which have predominant periods of about 50 min over Europe and 80 min over Japan, were detected, likely caused by passage of the solar terminator. Such a difference in the periods could indicate regional features and is the topic for further research.

The article analyzes the results of the clinical application of the plant phytocomplex which contains extracts of medicinal plants (centaury herbs, lovage roots, rosemary herb and lingonberry leaves), which promotes the normalization of urinary tract function and reduces dysuric disorders, as well as pain syndrome in cystitis and pyelonephritis. At the University Clinic of Urology, Russian National Research Medical University named after N. I. Pirogov in the period from November 2019 to March 2020, a prospective, single-center, randomized study was conducted, which included 60 patients with a diagnosis of acute pyelonephritis. Patients were divided equally into 2 groups: treatment group (n = 30) receiving complex therapy, including empirical antibiotic therapy and a herbal complex for 1 month, and a control group (n = 30) not receiving specific phytotherapy. After 1 month of continuous administration of the drug, the frequency of re-hospitalizations and episodes of hyperthermia was less in the study group. A decrease in the titer of the pathogen and the growth rate of pathogenic microflora, according to urine culture, was observed in treatment group. The specific phytotherapy in the composition of complex therapy allows you to effectively cope with the inflammatory process, as well as reduce the frequency of recurrence of urinary tract infections.

Introduction. Systemic thrombolytic therapy (STT) is an effective and accessible method of reperfusion treatment for ischaemic stroke. However, it is not yet evident how the risk factors preceding ischaemic stroke affect disease progression and outcome, as well as the efficacy of STT. The study aimed to examine the results of STT in stroke patients, depending on their risk factors, severity of those risk factors, and the success in managing them at the prehospital stage. Materials and methods. We examined 229 patients who underwent SST, of whom 201 survived and 28 died. The presence of hypertension, type 2 diabetes mellitus, atrial fibrillation, or metabolic syndrome, as well as blood sugar level, lipid panel results, and body mass index were assessed. Results. Ischaemic stroke subtype, the length of time from symptom onset to start of STT, or the presence of hypertension did not have a statistically significant effect on 28-day mortality. Patient age, NIHSS score, presence/absence of type 2 diabetes mellitus and atrial fibrillation, modified Rankin Scale score, blood sugar level, body mass index, and the presence of metabolic syndrome had a statistically significant influence on 28-day mortality. Data from the survived 201 patients were used to analyze the correlation between risk factors and functional recovery after ischaemic stroke. For patients with moderate and mild ischaemic stroke, statistically significant inverse correlations were found for age, blood sugar level, and body mass index. Conclusion. An inverse correlation was found between 28-day mortality and age, severity of neurological impairment, blood sugar level at onset, body mass index, and the presence of the metabolic syndrome. The obesity paradox was not identified in regard to survival, but patients with hypercholesterolemia had more significant regression of neurological symptoms and better functional recovery. Receiving statins and having a target cholesterol level were not found to have a positive effect on patient recovery in the first 28 days after disease onset, likely because of greater severity of the overall vascular disease.

Objective: to reflect on a 5-year experience in liver transplant surgery at the Rostov Regional Clinical Hospital. Materials and methods. Liver transplant was performed in Rostov Oblast in July 2015 for the first time. There were 52 liver transplant surgeries performed in the region by the end of February 2020. Cirrhosis due to viral hepatitis is the leading indication for liver transplantation in 33.3% of patients. The average age of recipients was 43.5 ± 15.8 years. Male recipients accounted for 59.6% of cases. Nine recipients got liver transplants from blood relatives, while 43 recipients received an organ from post-mortem donors. For two patients, liver graft was obtained by splitting the liver into two lobes using the in situ split technique. Results. The average duration of surgery was 5.14 ± 1.92 hours. Blood loss during surgery did not exceed 1400 ml. Up to 93% of lost blood was recovered using the reinfusion system. The need for red blood cell transfusion was observed in 48.1% of cases. Fresh frozen plasma was transfused in all cases. Early postoperative complications were observed in 15 patients (29.4%), and some of them had several complications simultaneously. Biliary and vascular complications, which were eliminated by minimally invasive methods and open surgeries, had a significant influence on liver transplant outcome. In-hospital mortality was 5.6%. The causes of death were intra-abdominal bleeding (1), portal vein thrombosis (1) and biliary sepsis (1). Four more people died in the long term after being discharged from hospital: lung cancer (1), graft rejection (1) and fungal sepsis (2). Conclusion. Liver transplant outcome depends on the skills and experience of the specialists implementing this program. Post-transplant in-hospital and long-term mortality depends on the presence and nature of complications, and on the possibility of early treatment.

Introduction. The development of upper and lower urinary endoscopic surgery has brought about an increase in the number of urethral strictures after transurethral procedures.Material and methods. A retrospective analysis was performed involving the treatment results of 72 patients with urethral strictures after transurethral surgery in 2011-2016. All the patients underwent standard examination, including US, residual urine analysis, uroflowmetry, retrograde and micturating urethrography, IPSS and QoL questioning and general clinical tests.Results and discussion. The median of observation comprised 28 months. Bulbous urethra appeared to be the most frequent localisation of urethral strictures (87.5 %). The median stricture length was 2 cm with the mean maximum urine flow rate equal to 5.9 ± 2.7 mL/s. The median IPSS score counted 25 points. The type and number of surgical procedures were as follows: internal optic urethrotonomy (29), anastomotic urethroplasty (18), single-stage skin flap urethroplasty (3), single-stage urethroplasty using buccal mucosa graft (17), multiple-stage urethroplasty using buccal mucosa graft (1), meatotomy (1), single-stage navicular fossa urethroplasty using buccal mucosa graft (1). Internal optic urethrotonomy was to be effective in 52 % cases, while other surgical procedures showed 89 % effectiveness. The pathomorpho-logic studies revealed severe inflammation without signs of stroma fibrosis within urethral strictures.Conclusion. Transurethral endoscopic procedures appear to be the main causative factor (in 54 % cases) for iatrogenic urethral strictures.

Background: Robotic mechanotherapy is considered as a promising area of physical rehabilitation of multiple sclerosis patients, while it ensures high training efficacy. Aim: To study the effect of physical training using with the ExoAtlet exoskeleton for lower extremities the functioning of patients with multiple sclerosis. Materials and methods: This was a prospective, open, uncontrolled, single center study. The rehabilitation course with the ExoAtlet exoskeleton included 43 patients (14 male and 29 female, aged from 28 to 59 years, mean age 43,5 ± 9,12 years) with remitting multiple sclerosis in remission (RMS-R) (n = 20) and secondary progressive course (VPRS) (n = 23), with the EDSS scores from 3 to 8. One of the inclusion criteria was the presence of motor paresis of the lower extremities. Training with the ExoAtlet exoskeleton was performed 5 days a week for two weeks. The neurological deficits and functioning were assessed with the Kurtzke expanded disability status scale (EDSS), the multiple sclerosis functional composite (MSFC) test, including the assessment of walking (Timed 25 Footwalk), of upper limb functions (9-Hole PegTest, 9-HPT), and of mental functioning (Symbol Digit Modalities Test, SDMT) before and after the rehabilitation course. Cognitive functions were assessed by the Montreal Cognitive Assessment (MoCA) scale. Results: The rehabilitation course resulted in a significant decrease of neurological deficiency by EDSS (by 0.26 score, 5%, p < 0.001). The MSFC test showed an improvement in all subtests: SDMT by 2 points, or 4.9% (p = 0.018), Timed 25-Footwalk by 3.2 seconds, or 19.6% (p < 0.001), 9-HPT for the dominant hand by 1.6 seconds, or 5% (p = 0.004), and for the non-dominant hand by 2.1 seconds, or 6.2% (p = 0.006). The improvement in the MoCA test after the rehabilitation course was 1.6 points, or 6% (p < 0.001). Conclusion: The study confirmed the positive effect of the exoskeleton in the lower extremities, such as restoration of the walking function in multiple sclerosis patients. There was a positive trend towards restoring of hand motor skills and cognitive functions.

We present ionospheric observational results obtained over Ukrainian Antarctic Akademik Vernadsky station. Ionospheric parameters (peak electron density and height, electron density and electron and ion temperatures in the topside) during the period near the local winter solstice in the Southern Hemisphere (June 28—29, 2019) are considered. The main objective is to show distinctive features of variations in ionospheric parameters during a prolonged period with very low solar and magnetic activities, and minimal daily insolation. Methods. F2 layer peak electron density and height were calculated from ionograms obtained with ionosonde installed at the station with subsequent profile inversion. Defense Meteorological Satellite Program (DMSP) and Swarm data acquired over the station are used as well. Diurnal variations of electron density, and electron and ion temperatures at the altitude of the satellites’ orbits were calculated using a set of sub-models of the International Reference Ionosphere-2016 (IRI-2016) model. Results. We found a very good agreement between the observed and model variations of F2 layer peak electron density. Significant (by ~2 times) nighttime enhancement of electron density was observed on June 29. Electron density models show the similar increase of the density at the same time interval but this enhancement is much more smoothed comparing with the observations. Peak height values obtained using ionosonde are very close to ones calculated with the IRI-2016 sub-models. Satellite data are in a good consistency with the IRI model predictions, especially for electron density obtained by Swarm satellite. Conclusions. Multi-instrumental observations revealed a number of unique features of the ionosphere over Antarctic Peninsula under minima of solar and magnetic activities, and daily insolation.

The article draws attention to the cyclical nature of the fragmentation of the territories of the post-Soviet space. It is indicated that for the first time these processes occurred in the western part of the once united state and that these processes are unfinished and can be continued in new forms with new conditions for implementation. The stages of regeneration of a separated economic system aimed at creating a separate economic and social system capable of independent reproduction are described. Opportunities and conditions for the development of the innovative economy of a state with a special status, as well as the constraints that hinder the efficiency and effectiveness of innovative processes, are examined using a specific example. The types of manufacturing of products and services that are promising in the context of innovative development are highlighted and mechanisms for their implementation are proposed. The possibilities and directions of economic cooperation and specialization to ensure the innovative development of the state with a special category status are determined. Based on the methods of analysis and synthesis, a systematic approach, the conditions and consequences for the economy of the decision to create a new territorial entity are shown. Using the grouping method, the reasons that impede the formation of an innovative economy and the opportunities for innovative development that a state with a special status receives in the event of economic integration with a stronger economy are systematized. Particular attention is paid to the problems of retaining qualified personnel and creating an effective public administration system, including state regulation of the innovation economy. The stages of the formation of a new economic management system are examined; its shortcomings and high dependence on established processes and relationships are shown. The organizational processes that determine the innovative potential of the state in the new conditions of functioning are disclosed. В статье обращается внимание на цикличность в дроблении территорий постсоветского пространства. Указывается, что впервые данные процессы произошли в западной части некогда единого государства и что эти процессы незакончены и могут быть продолжены в новых формах с новыми условиями реализации. Раскрыты этапы регенерации отделившейся экономической системы, направленные на создание отдельной экономико-социальной системы, способной к самостоятельному воспроизводству. На конкретном примере рассмотрены возможности и условия развития инновационной экономики государства с особым статусом, а также ограничения, сдерживающие эффективность и результативность инновационных процессов. Выделены перспективные в контексте инновационного развития виды производства продукции и услуг, а также предложены механизмы по их реализации. Определены возможности и направления экономической кооперации и специализации для обеспечения инновационного развития государства с особым статусом. На основе методов анализа и синтеза, системного подхода показаны условия и последствия для экономики решения о создании нового территориального образования. С помощью метода группировок систематизированы причины, препятствующие формированию инновационной экономики, и возможности для инновационного развития, которые получает государство с особым статусом в случае экономической интеграции с более сильной экономикой. Особое внимание уделено проблемам сохранения квалифицированных кадров и создания эффективной системы государственного управления, в том числе государственного регулирования инновационной экономики. Рассмотрены стадии формирования новой системы управления экономикой, показаны ее недостатки и высокая зависимость от устоявшихся процессов и отношений. Раскрыты организационные процессы, определяющие инновационный потенциал государства в новых условиях функционирования.

Training physicians at the courses not only should increase their general level of education in the specialty, but also provide opportunities for self-improvement through in-depth analysis of their practical activities and introduction of modern techniques and technologies into their own surgical practice. To implement this approach, we have improved the well-known methodology for conducting seminar sessions - the "round table". The main actors in individual seminars were the most experienced doctors. Each of them, if desired, chose the topic of the lesson, which best suited his specialization and work experience. The material was presented in the form of a presentation and consisted of the following main parts: introduction, theoretical and practical parts and conclusions. The most valuable was the practical part, in which the speaker presented his own results of diagnosis and treatment of the pathology that was being considered. Obligatory in this part of the presentation was the section "complications and mortality." The speaker analyzes the new methods of treatment he introduced personally, gives examples from his own practice and demonstrates data of laboratory, radiation, endoscopic diagnostics, photos and video materials. All doctors take part in the discussion. The teacher places the main accents and outlines the ways of further development of science in one or another direction. All 144 listeners who took part in this positively evaluated the innovation. At the same time, 106 (75%) of listeners defined positively the role of the teacher as a moderator of the educational process, and 119 (82,6%) indicated an increase in the motivational component. The fact of obtaining new knowledge and its practical importance was noted by 84 (58,3%) of the listeners. Comparative analysis of the traditional and proposed methods showed the advantage of the latter: 87,4% of positive responses to test assignments based on the proposed method of teaching, versus 71,3% for traditional ones. Thus, the improved “round table” method used has allowed to significantly improve the level of professional training of doctors and to increase the motivational component of lifelong learning.

The aim of study: to estimate the frequency of postoperative complications and the ways of their reduction in patients after performing «large volume» surgical interventions on the example of radical cystectomy (RCE).Materials and methods. The study included 73 patients who underwent RCE. All patients were divided into 2 groups: the main group consisted of 29 patients who remained under the active supervision of the therapist throughout the entire hospitalization and underwent preoperative preparation (cardiac examination, correction and prescription of medication). The comparison group comprised 44 patients whose medical history was retrospectively analyzed. Patients of this group did not undergo advanced therapeutic monitoring, both in the preoperative and postoperative period.Results. In patients of the main group, despite the presence of concomitant pathology in most cases, including cardial pathology, the frequency of postoperative complications was statistically significantly lower than in the comparison group. There were no lethal cases from cardioembolic complications in patients undergoing active therapeutic monitoring. The observation of the therapist throughout the entire hospitalization, as well as the use of the surgical protocol of early activation of the patient, significantly reduced the length of hospitalization, as well as the length of stay in the intensive care unit.Conclusion. The introduction of the program of preoperative preparation and therapeutic postoperative monitoring led to a reduction in the incidence of cardiac death and duration of hospitalization in patients undergoing extensive surgical intervention.

Dynamics of neurological recovery was assessed in 121 patientswith atherosclerotic stenosis of the internal carotid arteries sufferedfrom stroke. Patients underwent carotid endarterectomythat was carried out from 1 month to 5 years after stroke.Somatic, neurologic and neuropsychological state, as well asfunctional characteristics and quality of life were assessed, andutrasound testing of the brachiocephalic arteries and neuroimagingstudies were carried out. After carotid endarterectomy,significant decrease in the severity of focal neurologicalsymptoms and cognitive impairment, increase in quality of lifeand functional improvement was registered. Post-operatively,ischemic events occurred in 2.5% of patients.

Rasmussens encephalitis (RE) is a rare inflammatory brain disease characterized by severe intractable epilepsy and unilateral progressive motor defect associated with contralateral hemispheric atrophy. The authors present clinical features, EEG and MRI data and results of effective treatment of patient withadult onset RE. Despite the predominance of RE in children, stressed is the necessity of taking into consideration this condition in adults as well in differential diagnostics of intractable epilepsies.

MRI morphometry of the substantia nigra (SN) and the rednucleus was performed in patients with Parkinsons disease (PD)(1 and 3 stage by Hoehn and Yahr) and healthy individuals usingmodes T2 and T2*-WI on magnetic resonance system InitialAchieva 3.0T. Nonsignificant volume decrease of SN wasrevealed in patients with early manifestations of PD, and viceversa, its increase in symptomatic PD, which can be regarded asan analogue of the well-known phenomenon of ultrasonographyin PD. Significantly greater than in the control SN volumeasymmetry was marked in PD patients, and asymmetryincreased in the progression of the disease. The findings suggestthe possibility of using MRI morphometry of the brainstemstructures to assess the course of the neurodegenerative processin PD.

In 40 patients with ischemic stroke in the vertebrobasilar basin,complex assessment of disturbances of patients equilibrium andsteadiness was carried out in the early restorative period, includingrespective clinical scales and stabilometry. Compared withcommonly used in clinical practice non-instrumental assessment,the introduction of stabilometric criteria helps to improvethe diagnostics of equilibrium/stability changes and allows controllingobjectively the patients condition on treatment and furtherfollow-up, thus increasing the efficiency of rehabilitationprocedures.

One method of surgical treatment of Peyronie’s disease are lengthening surgery. The operation is the incision plaque stunica albuginea and the subsequent replacement of the defect. For replacement of defect using different materials. The authors used as graft autologous tissue – the buccal mucosa. The buccal graft mucosa at the moment shows how personal experience is the most suitable for the formulation of an “ideal graft”. The authors have experience in treating 28 patients of this procedure. Analysis of long-term observation results showed satisfactory results patients and their female partners; all patients achieved penis straightening, without shortening its lengt.

The aim of this study was to determine the correlations between markers of oxidant-antioxidant stress in the blood of experimental animals, as well as the content of bilirubin and activity of enzymes in experimental obstructive jaundice. Studies were conducted on 84 adult male Wistar rats (180-230 g). Animals were divided into 4 groups: intact (n = 12), control (n = 24), L-lysine escinate (0,5 mg/kg, n = 24) and glutargin (40 mg/kg, n = 24). The isolation and ligation of the common bile duct below confluence was carried out under general anesthesia. The test preparations were administered 1 time per day, intraperitoneally. Evaluation of the treatment efficacy was carried out on 4th and 10th day of the study. The content of malonic dialdehyde (MDA), aldehyde- (APH) and ketone-phenylhydrazones (CPH), bilirubin and the activity of superoxide dismutase (SOD), catalase, aspartate aminotransferase (ALT) and alanine aminotransferase (AST) in the blood were determined using conventional techniques. The correlation links between common markers (bilirubin, AST, ALT) and indicators characterizing oxidant-antioxidant stress (MDA, APH, CPH, SOD, catalase) were determined in the study. High rate of correlation between them was established. The results allow to evaluate indirectly the intensity of oxidative metabolism processes in the liver, which can be used in clinical practice to assess the severity degree of the patients with progressive obstructive jaundice.

Purpose: presenting temperature variations of electrons and ions obtained at the Institute of Ionosphere (Kharkiv) with an incoherent scatter radar in the growth phase of the 24th cycle of solar activity, and compare them with the corresponding data of IRI-2012 model. Desing/methodology/approach: Data are obtained by incoherent scattering. Method of solving the inverse radiophysics problem was used for analysis. Two-dimensional ambiguity function was used for specification. Findings: A significant difference has been found between experimental data and model data. So, for all days of observation, the model overestimated the night temperature values and underestimated them by day. The maximum difference is about 500 K at night and 800 K in the daytime. Also, the effects of appearance of midday collapse of electron temperature during the equinoxes are considered. Conclusions: It is confirmed that to adequately describe the ionospheric processes it is necessary to use a systematic approachwhich takes into account, in particular, the interaction between ionospheric regions located in magneto-conjugate areas. Such regularities should be taken into account for correction of ionospheric model for the Central European region.

Performed a series of the X-parameters measurements of high-power S-band power amplifier. This method is the foundation to provide similar measurements and as result to obtain the behavioral model of power amplifier to further simulations in ADS. This method describes all the calibration and measurement steps to obtain X-parameters.