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Aim to compare the results of vacuum aspiration biopsy (VAB) and sectoral resection in the treatment of benign breast tumors. Material and methods.During the study we compared the results of treatment in two groups of patients. The main group included 50 patients (mean age 54.830.934 years) who underwent VAB, the control group comprised 55 patients (mean age 55.7041.998 years) who underwent sectoral resection. Before the surgery, a tumor biopsy was performed with the following cytological and histological examination. The diagnosis of fibroadenoma was predominant. After the operation, a histological analysis of the received preparations was done. We assessed the immediate postoperative results, such as: blood loss, operation time, intensity of pain syndrome, bed-day number, quality of life after the operation. Results.The duration of surgery was significantly lower in patients with VAB than in patients with sectoral resection (p=0.000). The blood loss after surgery did not differ significantly (p=0.921) and did not exceed 10 ml in both groups. The groups under study were comparable according to the results of the histological examination (Student's t-test was 0.501, p=0.651). In each group, the pain syndrome was assessed in the postoperative period according to a 10-point pain scale after 3 hours, 8 hours, 24 hours, 3 days, 5 days and 10 days after surgical intervention. In the VAB group, the scores were significantly lower, p=0.000. The average number of bed-days in patients of the control group was 10.322.814, in the main group 1 day, the difference was statistically significant (p=0.000). The frequency of possible complications (hematoma, seroma, infection, deformity of the mammary gland, residual masses after removal) was significantly lower (p=0.013) in patients of the main group. When assessing the life quality of patients after surgery with the MOS SF-36 questionnaire, we found that the indicators were significantly higher in patients of the VAB group (Psychological Health Scale p=0.008, Social Functioning Scale p=0.003, Physical Condition Scale p=0.041).

Diastrophic dysplasia (DTD) is an uncommon pathology which falls under the group of skeletal dysplasias with its first symptoms observed from birth. The pathology is often featured by short stature and abnormally short extremities (also known as short-limbed dwarfism); the osseous structures of the body (bones and joints) are characterized through defective development in many body regions. More than 300 genes were reported to be involved in DTD etiology with autosomal recessive, autosomal dominant and X-linked manner. We describe clinical case of a 42-year-old woman from the west of Ukraine with diastrophic dysplasia and two pathogenic variants c.1020_1022del (p.Val341del) and c.1957T>A (p.Cys653Ser) identified in SLC26A2 gene. SLC26A2-related diastrophic dysplasia was confirmed based on the presence of pathogenic variants in SLC26A2, which is associated with autosomal recessive forms of skeletal dysplasia, combined with phenotypic symptoms and radiographic findings.

The problem of zoonoses remains relevant in the context of reliable prevention of human disease and effective ways to achieve this result, in particular through the impact on susceptible animals by the efforts of veterinary medicine. Anthrax is an acute, particularly dangerous infectious disease of all species of farm, domestic and wild animals, as well as humans, which is caused by Bacillus anthracis microbes. The causative agent of anthrax belongs to the group of aerobic spore-forming bacteria and exists in two main forms: vegetative and spore. The vegetative form in the body of an infected animal can form a "capsule". In Ukraine, according to the provisions of the current "Instruction for the prevention and control of animal anthrax" (2000), the main method of preventing anthrax among animals is regular vaccination of animals susceptible to this disease. The authors conducted a retrospective analysis of the epizootic and epidemiological situation of anthrax in Ukraine for the period 1994–2021 and made a critical assessment of the performance of mandatory measures for specific prevention of susceptible animals. In order to find out the ecological and geographical features of the spread of anthrax, data on outbreaks of the disease in cattle, swine, small ruminants and humans on the territory of Ukraine were analyzed by regions for the time period under investigation. Over the past 28 years in Ukraine, animal anthrax was registered in in all areas except Zhytomyr region. In total, during the analyzed period, 177 affected points and 637 infected animals (cattle, small ruminants, pigs, horses, wild and fur-bearing animals, dogs) were registered (estimated at 3.59 animals per outbreak). Cattle were most often involved in the epizootic process, followed by pigs and small ruminants, while horses and other animal species were least infected. Ecological and geographical analysis showed that the largest number of affected points among animals during the analyzed period was found in Kyiv, Volyn, Kharkiv, Luhansk, Khmelnytskyi, Cherkasy, Odesa, and Vinnytsia regions. A small number of affected points during the analyzed period were found in Zakarpattia, Ternopil, Kherson, Autonomous Republic of Crimea, Poltava, Dnipropetrovsk and Ivano-Frankivsk regions. During the analyzed period, 68 people in 11 regions of Ukraine were infected with anthrax, 15 outbreaks were registered (4.46 people per outbreak). Most cases were reported in Donetsk, Kyiv and Odesa regions. The association between outbreaks of anthrax in animals and cases of anthrax among humans has been established, this dependency was 86.6% (the index of contiguity, which takes into account the number of years with simultaneous registration of animal and human cases, was 0.5). The authors thoroughly proved that it is vaccination among susceptible animals that will finally prevent the incidence of anthrax among people.

Dissecting aortic aneurysm is one of the most dangerous diseases of the aorta, often leading to severe complications or death. Currently, due to the increased level of diagnosis and the speed of care for patients with aortic diseases, there is now a need to improve approaches to the treatment of this condition. This paper presents the outcomes of a technique developed at our center, Shumakov National Medical Research Center of Transplantology and Artificial Organs, for selective antegrade cerebral perfusion (SACP) when performing prosthetic replacement of the aortic arch under circulatory arrest. Surgical treatment is performed on an emergency basis. During these surgeries, we focused on preventing neurological complications. Analysis of the efficacy and safety of our SACP technique shows that we obtained positive outcomes. In the analysis of 10 cases of aortic arch replacement, there was no evidence indicating the presence of any neurological complication. This technique allows for more adequate monitoring of perfusion during reconstructive interventions on the ascending aorta and aortic arch than the classical perfusion technique.

Effects of metal halides additives on radiation characteristics of microwave-driven high pressure sulphur lamp were experimentally studied. Electrodeless discharge was excited and maintained in the mixture of sulphur vapour (5–6) atmospheres and vapour of NaI (~ 0.07 Torr) and LiI (~ 0.12 Torr) at microwave frequency of 2.45 GHz and power of (280–560) W in the quartz spherical bulb of 35 mm in diameter inserted in the cylindrical resonator of 73 mm in diameter and 125 mm in height. To maintain bulb walls at homogeneous temperature, the bulb was rotated with the speed of the 12 r/c. It was found that the addition of low pressure sodium and lithium halides caused the increase of lamp efficacy by (11–13) %, colour temperature by 16 %, and colour rendering index by 4 %. To further improve lamp characteristics, the increase of additives partial pressures was recommended.

According to global health statistics, respiratory diseases, together with infectious complications and hereditary lung diseases, rank as the third leading cause of death. Today, lung transplantation (LTx) is a well-recognized modality of treatment for end-stage chronic lung disease. However, the number of LTx surgeries performed is much lower than other solid organs. This is due to the high requirements for the potential donor and characteristics of the lung graft, reflecting the efficiency of gas exchange function. Non-compliance with the selection criteria leads to deselection of donors, which, according to various estimates, occurs in 80–85% of cases. One of the ways to increase the number of lung transplant surgeries is to restore them to the level of optimal gas exchange parameters, which can be achieved and objectively assessed during normothermic ex vivo lung perfusion (EVLP). EVLP is becoming increasingly common at leading transplantation centers in Europe and North America. This has significantly increased the number of transplant surgeries as a result of using lungs procured from suboptimal donors and rehabilitated via EVLP. In our pilot study, the developed Russian-made mechanical circulatory support system showed that performing normothermic EVLP for isolated lungs under experimental conditions is feasible. Basic and optimized perfusion protocols have fully shown that they are reliable and efficient.

The article provides a detailed analysis of the development in Russia of African studies throughout the entire period of its existence - from the first fragmentary knowledge about the African continent, brought to Russian soil by individual travelers and enthusiasts to modern comprehensive research in Africa by the largest Russian scientific centers, among which, of course, the leading positions are held by the Institute for African Studies of the Russian Academy of Sciences. The work exposes the evolution of the development of African studies as a science through the pre-revolutionary, Soviet and post-Soviet periods. A powerful impetus for the study of Africa was given in the late 1950s. This was due to the victory of national liberation movements in African countries and the formation of independent states on the continent. The author shows the increased interest in African studies at the present stage of development of our country, when the African vector of Russian foreign policy is becoming more and more in demand. Despite the limited human, organizational and financial resources, Russian African studies are currently on the rise. The international recognition of the achievements of Russian African studies imposes an additional obligations on Russian scientists. Taking into account the practical significance of their works, the conclusions and proposals they contain for the development of Russian-African relations, they feel even greater responsibility. The latest vivid example of this was the active participation of Russian African scientists in the preparation and successful holding of the first Russia-Africa Summit and Economic Forum in Sochi on October 23-24, 2019.

Background Phylogenetic analyses of closely related species of mosquitoes are important for better understanding the evolution of traits contributing to transmission of vector-borne diseases. Six out of 41 dominant malaria vectors of the genus Anopheles in the world belong to the Maculipennis Group, which is subdivided into two Nearctic subgroups (Freeborni and Quadrimaculatus) and one Palearctic (Maculipennis) subgroup. Although previous studies considered the Nearctic subgroups as ancestral, details about their relationship with the Palearctic subgroup, and their migration times and routes from North America to Eurasia remain controversial. The Palearctic species An. beklemishevi is currently included in the Nearctic Quadrimaculatus subgroup adding to the uncertainties in mosquito systematics. Results To reconstruct historic relationships in the Maculipennis Group, we conducted a phylogenomic analysis of 11 Palearctic and 2 Nearctic species based on sequences of 1271 orthologous genes. The analysis indicated that the Palearctic species An. beklemishevi clusters together with other Eurasian species and represents a basal lineage among them. Also, An. beklemishevi is related more closely to An. freeborni, which inhabits the Western United States, rather than to An. quadrimaculatus, a species from the Eastern United States. The time-calibrated tree suggests a migration of mosquitoes in the Maculipennis Group from North America to Eurasia about 20–25 million years ago through the Bering Land Bridge. A Hybridcheck analysis demonstrated highly significant signatures of introgression events between allopatric species An. labranchiae and An. beklemishevi. The analysis also identified ancestral introgression events between An. sacharovi and its Nearctic relative An. freeborni despite their current geographic isolation. The reconstructed phylogeny suggests that vector competence and the ability to enter complete diapause during winter evolved independently in different lineages of the Maculipennis Group. Conclusions Our phylogenomic analyses reveal migration routes and adaptive radiation timing of Holarctic malaria vectors and strongly support the inclusion of An. beklemishevi into the Maculipennis Subgroup. Detailed knowledge of the evolutionary history of the Maculipennis Subgroup provides a framework for examining the genomic changes related to ecological adaptation and susceptibility to human pathogens. These genomic variations may inform researchers about similar changes in the future providing insights into the patterns of disease transmission in Eurasia.

Background: SB3 (trastuzumab-dttb) is a biosimilar approved globally based on its similarity with reference trastuzumab (TRZ) demonstrated by thorough comparability exercises in analytical, biological, and clinical studies. In a randomized, double-blind, multicenter Phase 3 study of 875 patients with HER2-positive early or locally advanced breast cancer in the neoadjuvant setting, equivalent efficacy, similar safety, pharmacokinetics, and immunogenicity between SB3 and TRZ were shown. However, when quality attributes of TRZ were examined, downward drifts in antibody-dependent cell-mediated cytotoxicity activities (ADCC) were observed in the TRZ lots with expiry dates ranging from Aug 2018 to Dec 2019. Some of these lots of the reference product were found to be used in the Phase 3 study. After completing the Phase 3 study, patients from select countries were included in a follow-up observational study to monitor cardiac safety and survival. Here, we report the final survival results, including post-hoc subgroup analysis based on ADCC status, at a median follow-up of 68 months. Methods: During the follow-up observational study, the protocol was amended to include additional patients who originally were enrolled in the Phase 3 study but had not been followed in the observational study, in order to collect a larger sample of survival data. For these additional patients, medical records from the last assessment in the Phase 3 study through the date of enrollment in the follow-up study were collected retrospectively. As post-hoc analysis, patients in the TRZ arm were stratified into two subgroups: patients who received during neoadjuvant treatment at least one vial of TRZ with downward drift in ADCC as “Drifted TRZ”, and the others as “Non-drifted TRZ”. Event-free survival (EFS) and overall survival (OS) were assessed. Results: Of 875 patients randomized in the Phase 3 study, 538 patients (SB3, N=267; TRZ, N=271) were enrolled in the follow-up observational study: 367 patients were initially enrolled in the follow-up study, and 171 patients were additionally enrolled following the protocol amendment. The median follow-up duration was 68 months from randomization in the Phase 3 study. 54 events (20.2%) in the SB3 arm, and 67 events (24.7%) in the TRZ arm were reported (HR 0.84 [0.58, 1.20], p=0.335). 22 deaths (8.2%) and 38 deaths (14%) were reported in SB3 and TRZ arms, respectively (HR 0.61 [0.36, 1.05], p=0.073). In post-hoc analysis, of 271 patients in TRZ arm, 107 patients were grouped as “Non-drifted TRZ”, and 164 patients as “Drifted TRZ”. 19 events (17.8%) in the Non-drifted TRZ group and 48 (29.3%) events in the Drifted TRZ group occurred (HR 2.57 [1.28, 5.14], p=0.008). 9 deaths (8.4%) in the Non-drifted TRZ group and 29 deaths (17.7%) in the Drifted TRZ group were reported (HR 3.87 [1.37, 10.93], p=0.011). No difference was observed between SB3 arm and Non-drifted TRZ group in terms of EFS (HR 1.28 [0.73, 2.22], p=0.391) and OS (HR 0.99 [0.42, 2.31], p=0.975). Conclusions: Comparable long-term efficacy results in EFS and OS were shown at 68 months of follow-up, further supporting biosimilarity of SB3 to the reference product. Currently, these follow-up results represent the longest monitoring data of patients treated with a trastuzumab biosimilar for HER2-positive early or locally advanced breast cancer. Citation Format: Xavier Pivot, Mark D Pegram, Javier Cortes, Diana Lüftner, Gary H Lyman, Giuseppe Curigliano, Igor M Bondarenko, Mikhail Dvorkin, Jin Hee Ahn, Seock-Ah Im, Maria Litwiniuk, Yaroslav V Shparyk, Gwo Fuang Ho, Nikolay V Kislov, Marek Wojtukiewicz, Tomasz Sarosiek, Yee Soo Chae, Jin Seok Ahn, Hyerin Jang, Sujung Kim, Jiwon Lee, Soo Young Lee, Ye Chan Yoon. Final survival analysis of a phase 3 study comparing SB3 (trastuzumab biosimilar) and reference trastuzumab in HER2-positive early or locally advanced breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-13-04.

Successful implantation involves a high degree of development of spiral arteries, combined with high proliferative activity, which ensures the formation of a healthy placenta, full uterine-placental circulation, and the birth of a healthy child. The placenta is the unique organ of the biological monitoring, the mirror of pregnancy. Identification of placental markers of miscarriage is a promising direction for preventing reproductive losses. The aim of the work is to identify the markers of miscarriage and premature labor in the structures of the chorion and placenta. Materials and methods. The main group included tissue samples of the 22 chorions and 64 placentas after termination of current pregnancy from women with a history of reproductive losses. The control group included tissue samples of the 20 chorions after artificial abortion and 20 placentas after physiological pregnancy and birth. The placenta was examined according to the protocol (form No. 013-1/0). The expressions of VEGF, CD31/PECAM1, CD105/Endoglin/TGFβ 1/3 Receptor, Bcl-2α Ab-1, TNF-α, CD45/T200/LCA, CD56/NCAM1 were studied in the structures of chorion and placenta by immunohistochemistry. Results. Based on histological and immuno-histochemical study of chorion and placenta samples in women with reproductive history and termination of the current pregnancy, it was established that embryo-endometrial dysfunction is the cause of miscarriage in the first trimester, and inflammation is the precondition of preterm birth; markers of miscarriage and premature labor in the structures of the chorion and placenta have been identified. Conclusions. The markers of miscarriage are pathomorphological changes in endometrium and chorion combined with high expression of TNF-α and NK-CD56, low expression of CD31/PECAM1, negative expression of VEGF to indicate a violation of cytotrophoblast invasions. The markers of inflammation and premature labor are structural and functional changes of placenta in combination with moderate expression of TNF-α in syncytium, high expression of NK-CD56 in villous stroma, high expression of CD45/T200/LCA in the decidual membrane.

This article is a continuation of a large-scale research devoted to the identification of patterns of human community development, which has been conducted by the author for many decades.Purpose: is to study the possible transformation of the world after the COVID-19 pandemic from the perspective of the need to switch to a new, crisis-free development paradigm, which is a logical continuation of the previous author's works.Methods: the study is based on the application of a complex of general scientific methods, including analysis, generalization, comparison, etc., and is based on an interdisciplinary approach. The results and conclusions of the work are based on the use of the author's methodological tools, which were formed within the framework of the general research direction.Results: the article analyzes the current state of the global world in the absence of effective ways out of the deepest crisis that has long gripped almost the entire world and has been multiplied by the COVID-19 pandemic. The study of the fundamental works of foreign scientists has shown that their main thesis is that the future of the world lies in the transition to a new development paradigm (NDP), but to fully understand it, it is necessary to develop a new scientific paradigm (NSP). Based on the use of the author's development of the NSP, it is demonstrated that the future of the world depends on the choice of a development model. The author has proved the necessity and possibility of transition to a new development paradigm based on the synchronous development and implementation of a single development strategy for the global world and each country separately.Conclusions and Relevance: after the COVID-19 pandemic, the world will change only if there is a transition to a new crisis-free paradigm for the development of the human system. The NSP developed by the author can become the tool that allows you to give a complete understanding of the NDP, and see what the world can and should be like after the coronavirus pandemic.

Respiratory diseases, together with infectious complications and hereditary lung diseases, rank third in international mortality statistics. Today, lung transplantation is a recognized method of treating end-stage lung diseases. However, the number of transplant surgeries performed is not much. This is down to the high requirements on the condition of a potential lung donor and directly on the quality of the donor lung. This has significantly limited the number of optimal donors. Rehabilitation of donor lungs to optimal gas exchange indicators can be achieved and objectively assessed in the course of ex vivo lung perfusion (EVLP). The EVLP procedure is widespread in leading transplantation centers in Europe and North America. It allows to significantly expand the pool of donor lungs, thereby serving a greater number of patients in need of lung transplantation. The possibility of EVLP procedure using publicly available perfusion equipment was demonstrated. The optimized protocol fully demonstrated its reliability and efficiency. The developed perfusion solution had no statistically significant differences in comparison with the Steen SolutionTM, which in the future will serve as an alternative for EVLP procedure.

Aim. To use the cluster analysis of clinical and laboratory data, characteristic to children aged 6 to 24 months with acute diarrhea, in demonstrating the signs of infectious or functional intestinal disorders. Materials and methods. 56 children admitted to the children’s infectious unit with diarrhea and 31 healthy toddlers of the control group were observed. Anamnesis, laboratory blood and urine tests, microscopy and bacteriological cultures of feces on selective media and tests to identify adeno- and rotaviruses were performed. The presence of Clostridium difficile A/B toxins in the stool, hemoglobin, fecal calprotectin (FC) and the content of undigested fecal carbohydrates also were studied. Results. Children who in their majority have received antibiotics only in 58.9 % of cases were corresponding to the bacterial or viral nature of the disease or the infection was clinically highly probable. Another 41.1 % of patients has experienced non-infectious diarrhea. In 7.1 % of all cases the diarrhea was triggered by an increase of the carbohydrate content in the stool. Diarrhea had the same mechanism in 3.4 % of patients with Giardia lamblia. In 17.9 % of patients the frequent bowel movements were the manifestation of symptomatic (parenteral) diarrhea caused by extraintestinal diseases, and in another 7.1 % the intestinal hypermotility was not explained but resembled irritable bowel syndrome in adults. Additionally, cluster analysis identified 5.4 % of patients with non-infectious diarrhea who had only significantly increased FC corresponding to allergic or immune inflammation in the gut. Conclusions. The classification of patients for the causes of diarrhea became possible due to the microbiological tests and highly informative markers of intestinal health – fecal calprotectin and reducing substances (carbohydrates) in the stool.

Currently, the key issues in domestic economy are issues of competitiveness and quality of goods produced in Ukraine. Ukrainian market of meat products conquers consumers with a wide assortment but one should not rejoice at sucha rich list of names. Many enterprises focused on the production of meat products use technical requirements as regulatory documentation. Technical requirements make it possible to significantly reduce the quality of manufactured goods and prevent healthy competition. Food products manufactured according to technical requirements have a reduced cost that is beneficial to many enterprises in Ukraine. Responsibility for the quality of finished product lies not on manufacturer but with the buyers and forensic merchandising experts themselves. Topic relevance is due to the need to inform consumers about quality and consumer properties of cooked sausages of various manufacturers sold in the retail chain. Therefore, planning as a function of assortment management for the merchant is to determine the way of future actions, content and sequence of steps leading to the intended goal. Assortment planning methods should allow evaluating the product in three areas: profitability, competitiveness, compliance with quality and safety requirements. Theoretical research basis were research papers in the field of merchandising, in particular: I. I. Shtyk, L. V. Peshuk and N. V. Budnik, who patented the histological method for studying multicomponent meat systems. Investigating the Ukrainian market of cooked sausages, the methods of commodity assessment of the safety, quality of meat products and their identification were applied. Article Purpose is to investigate methods for identifying the quality of sausages to identify counterfeit products, analyze the procedure for conducting merchandising assessment.

The objective. Prevention of diagnostic errors associated with the rare detection of syphilis in patients in neurological hospitals. Results. A clinical case from the practice of dermatovenereologists is given. Conclusions. For timely detection of neurosyphilis it is necessary to conduct a cerebrospinal fluid examination of all patients in the neurological hospital who have a positive result of non-treponemal and treponemal tests in the serum.

Here we summarize uptodate data on the influence of the most significant micro, macroelements, and vitamins, such as magnesium, vitamin D, iron, and folic acid, on the course of pregnancy and childbirth in obese women. The paper considers both domestic and foreign recommendations for correcting nutritional deficiencies to prevent the development of complications from the pregravid stage to the end of lactation. Nowadays, the deficiency of micro-, macroelements and vitamins is an extremely urgent problem, especially in a group of special risk, i.e. overweight and obese women, whose number is steadily growing simultaneously with an increase of the number of pregnant women of 35+ years of age. It is important to consider a woman's body mass index to prescribe the minimum effective dose of the necessary drugs. Timely preventive personalized correction of the micronutrient state can reduce the risks of such major obstetric syndromes as preeclampsia, premature birth, fetal growth retardation, miscarriage, and placental dysfunction.

А new Vovchansk Uranium Ore district is allocated within the Orikhiv-Pavlohrad structural-metallogenic zone (SMZ) of the Azov metallogenic region. It is represented by Dibrova REE-U-Th deposit and a number of less studied ore occurrences. This deposit, according to ore mineralogy and age, geological and structural features, can be related to potassium-uranium metasomatite type. Dibrova deposit is considered to be possible analogue of mineralization of the Central Ukrainian Uranium Ore district. Among the main diagnostic characteristics of Dibrova deposit are: 1) location within the Mesoarchean trough-like structure superimposed on the Paleoarchean basement. 2) Spacial and genetic association with Paleoproterozoic two-feldspar granitoids of Dibrova type, which are considered to be related to Saltychia intrusive complex. 3) Regional and local faults, favorable for emplacement of numerous bodies of aplite-pegmatitic granitoids and associated intensive metasomatic alterations of rocks. The flexural fold was formed at the intersection of multidirectional faults, which is also favorable for ore mineralization. 4) Mineralization is confined to metasomatically altered aplite-pegmatites, less often to microcline quartzites of Dibrova suite. 5) K2O/Na2O ratio of ore-bearing granitoids reaches 3.5 and thorium-uranium ratio varies from 1.0 to 4.0. 6) Ores are composed by quartz (70–90 %) as predominant mineral and microcline. Minor minerals (up to 10–15 %) are represented by sillimanite, muscovite, biotite. 7) Accessory minerals include monazite, zircon, rutile, nasturan, brannerite, uraninite, molybdenite. 8) Among trace elements are niobium, lead, molybdenum, bismuth, copper, zinc and tin. Economic REE-U-Th mineralization was da­ted at 1.9–2.2 billion years. It is formed through circulation of hydrothermal-metasomatic fluids associated with the emplacement of Paleoproterozoic aplite-pegmatitic granites of the Dibrova type. Study of monazite and uraninite inclusions by the CHIME techniques confirms the Paleoproterozoic age of mineralization, 2085–2115 Ma. At the same time, the influence of Mesoarchean Yanvarske granitoids for the formation of REE mineralization during early pre-ore stage is not excluded.

The regularities of colemanite dehydration under non-isothermal conditions are investigated. It is established that colemanite, supplied to the Russian Federation from Turkey, has calcite in its composition. The chemical composition of colemanite is determined using the X-ray fluorescence analysis method. It is shown that the processes of dehydration of colemanite under non-isothermal conditions at a heating rate of 10 °С / min are accompanied by two endothermic effects at 660,7 K and 675,7 K with a total mass loss of 17,3 %. The rate of mass loss of colemanite from the temperature at heating up to 773 K, at which colemanite dehydrates and passes into the amorphous phase, is also studied. The regularities of changes in the rate of dehydration of colemanite are established. It is shown that the maximum values of the dehydration rate of colemanite are observed in the temperature range of 653–678 K. The activation energy of colemanite dehydration is determined to be 86,000 J/mol. Based on the experimentally obtained data, the rate constant of the colemanite dehydration process is calculated. The process of dehydration of colemanite is adequately described by the formal equation of kinetics. Most of the kinetic curve is adequately described by the resulting kinetic equation. It is proposed to describe the mechanism of dehydration of colemanite by a two-stage process, accompanied at the first stage by the removal of crystallization water, and at the second stage-by the removal of hydroxyl groups

А new Vovchansk Uranium Ore district is allocated within the Orikhiv-Pavlohrad structural-metallogenic zone (SMZ) of the Azov metallogenic region. It is represented by Dibrova REE-U-Th deposit and a number of less studied ore occurrences. This deposit, according to ore mineralogy and age, geological and structural features, can be related to potassium-uranium metasomatite type. Dibrova deposit is considered to be possible analogue of mineralization of the Central Ukrainian Uranium Ore district. Among the main diagnostic characteristics of Dibrova deposit are: 1) location within the Mesoarchean trough-like structure superimposed on the Paleoarchean basement. 2) Spacial and genetic association with Paleoproterozoic two-feldspar granitoids of Dibrova type, which are considered to be related to Saltychia intrusive complex. 3) Regional and local faults, favorable for emplacement of numerous bodies of aplite-pegmatitic granitoids and associated intensive metasomatic alterations of rocks. The flexural fold was formed at the intersection of multidirectional faults, which is also favorable for ore mineralization. 4) Mineralization is confined to metasomatically altered aplite-pegmatites, less often to microcline quartzites of Dibrova suite. 5) K2O/Na2O ratio of ore-bearing granitoids reaches 3.5 and thorium-uranium ratio varies from 1.0 to 4.0. 6) Ores are composed by quartz (70–90 %) as predominant mineral and microcline. Minor minerals (up to 10–15 %) are represented by sillimanite, muscovite, biotite. 7) Accessory minerals include monazite, zircon, rutile, nasturan, brannerite, uraninite, molybdenite. 8) Among trace elements are niobium, lead, molybdenum, bismuth, copper, zinc and tin. Economic REE-U-Th mineralization was da­ted at 1.9–2.2 billion years. It is formed through circulation of hydrothermal-metasomatic fluids associated with the emplacement of Paleoproterozoic aplite-pegmatitic granites of the Dibrova type. Study of monazite and uraninite inclusions by the CHIME techniques confirms the Paleoproterozoic age of mineralization, 2085–2115 Ma. At the same time, the influence of Mesoarchean Yanvarske granitoids for the formation of REE mineralization during early pre-ore stage is not excluded.

Mosquitoes are vectors of dangerous human diseases such as malaria, dengue, Zika, West Nile fever, and lymphatic filariasis. Visualization of the linear and spatial organization of mosquito chromosomes is important for understanding genome structure and function. Utilization of chromosomal inversions as markers for population genetics studies yields insights into mosquito adaptation and evolution. Cytogenetic approaches assist with the development of chromosome-scale genome assemblies that are useful tools for studying mosquito biology and for designing novel vector control strategies. Fluorescence in situ hybridization is a powerful technique for localizing specific DNA sequences within the linear chromosome structure and within the spatial organization of the cell nucleus. Here, we introduce protocols used in our laboratories for chromosome visualization and their application in mosquitoes.

BackgroundUnderstanding the evolutionary relationships between closely related taxa is important for mosquitoes that transmit human diseases. Six out of 41 dominant malaria vectors in the world belong to the Maculipennis group, which is subdivided into two North American subgroups (Freeborni and Quadrimaculatus), and one Eurasian (Maculipennis) subgroup. Although previous studies considered the Nearctic subgroups as ancestral, details about their relationship with the Palearctic subgroup, and their migration times and routes from North America to Eurasia remain controversial. The Eurasian species An. beklemishevi is currently included in the North American Quadrimaculatus subgroup adding to the uncertainties in mosquito systematics.ResultsTo reconstruct historic relationships between the North American and Eurasian mosquitoes, we conducted a phylogenomic analysis of 11 Palearctic and 2 Nearctic species based on 1271 orthologous genes using their transcriptomic or genomic sequences. The analysis indicated that the Palearctic species An. beklemishevi clusters together with other Eurasian species and represents a basal lineage among them. Also, An. beklemishevi is related more closely to An. freeborni, which inhabits the Western United States, rather than to An. quadrimaculatus, a species from the Eastern United States. The time-calibrated tree suggests a migration of mosquitoes in the Maculipennis group from North America to Eurasia about 20-25 million years ago through the Bering Land Bridge. A Hybridcheck analysis demonstrated highly significant signatures of introgression events between allopatric species An. labranchiae and An. beklemishevi. The analysis also identified ancestral introgression events between An. sacharovi and its Nearctic relative An. freeborni despite their current geographic isolation.ConclusionsOur phylogenomic analyses reveal migration routes and adaptive radiation timing of Holarctic malaria vectors and strongly support inclusion of An. beklemishevi into the Maculipennis subgroup. The vectorial capacity and the ability to diapause during winter evolved multiple times in Maculipennis evolution. Detailed knowledge of the evolutionary history in the Maculipennis subgroup will help us better understand the current and future patterns of malaria transmission in Eurasia.

to investigate the morphological and immunohistochemical features of placental damage due to theincorporation of 137Cs depending on the scenario of pregnancy completion.The study material consisted of placentas from 60 women with reproductive losses inanamnesis and signs of termination of the current pregnancy (first group) and placental samples from 30 women with an uncomplicated gestation and an unencumbered anamnesis (control group). The detailed study required the distribution of placental samples from the first group into subgroups. Subgroup 1a included 38 placentas from women who gave birth at 37-40 weeks, despite signs of termination of the current pregnancy. Subgroup 1b - placentas of 13 women who gave birth at a gestation period of 28-36 weeks + 6 days. Subgroup 1c - 9 placental samples from women who gave birth at a gestation period of 22-27 weeks + 6 days. The volumetric activity of the 137Cs in the placentas was measured using β-spectrometer. The histology of the placenta was studied using a standard technique. The following expressions were studied in placenta: CD31 / PECAM-1, CD45 / T200 / LCA, CD56 / NCAM-1, CEA / CD66e Ab-2, Vimentin, using indirect streptavidin peroxidase detection method.Placentas accumulate 137Cs. The different volumetric activity of the isotope correlates with scenarios of pregnancy. Due to the action of incorporated 137Cs with a specific mass of more than 1.1 Bq/kg, placental dysfunction develops. The consequences of placental dysfunction depend on the volumetric activity of the 137Cs and the preservation of adaptive and compensatory reactions in the placenta. Morphological and immunohistochemical features of placental damage to incorporated 137Cs were established, depending on the scenario of completion of pregnancy. A marker of unfavorable completion of pregnancy is the expression of a carcinoembryonic antigen (CEA) in the placenta.Premature termination of pregnancy (PTP) is a multifactorial pathology associated with pathological changes in immune and neuroendocrine regulation and hereditary, infectious, and environmental factors that disrupt the adaptation mechanisms in the mother-placenta-fetus system. Intraplacental irradiation of 137Cs is one of the factors in the multifactorial nature of reproductive losses. As a result of intraplacental irradiation of 137Cs, the architecture of the placenta is disturbed, the activity of pro-inflammatory cytokines CD45 and CD56 increases, and the coagulation cascade is activated. Extreme effects depend on the volumetric activity of the isotope incorporated in the placenta and the organ's compensatory capacity. Accumulation of up to 1.0 Bq/kg 137Cs does not affect the course of gestation. Internal irradiation with an activity of 4.5-10.4 Bq/kg 137Cs triggers late preterm labor. The nature of the damages corresponds to the category of «lesion of the maternal stroma» of the placenta. The volumetric activity of 137Cs over 10.4 Bq/kg is a probable cause of early preterm labor and antenatal fetal death. At the same time, the maternal and fetal structures of the placenta suffer damage. Expression of vimentin is a marker of placental destruction due to internal irradiation of 137Cs with a specific gravity of more than 4.5 Bq/kg. Expression of CEA in the structures of the placenta of women with PTP is a unique find and marker of premature birth and antenatal fetal death with intraplacental irradiation of 137Cs with an activity of more than 4.5 Bq/kg.Meta: doslidyty morfologichni ta imuno-gistokhimichni osoblyvosti urazhennia platsenty vnaslidok inkorporuvannia 137Cs zalezhno vid stsenariiu zavershennia vagitnosti. Materialy ta metody. Material doslidzhennia – platsenty 60 zhinok z reproduktyvnymy vtratamy v anamnezi taoznakamy pereryvannia potochnoï vagitnosti (osnovna grupa) i platsenty 30 zhinok z neuskladnenym perebigomvagitnosti ta neobtiazhenym anamnezom (kontrol'na grupa). Dlia detal'nogo analizu zrazky platsenty osnovnoïgrupy podilyly na pidgrupy. Do pidgrupy 1a uviĭshly 38 platsent vid zhinok, iaki narodyly v termini 37–40 tyzhniv,nezvazhaiuchy na oznaky pereryvannia potochnoï vagitnosti. Pidgrupa 1b – platsenty 13 zhinok, iaki narodyly v termini vagitnosti 28–36 tyzhniv + 6 dniv. Pidgrupa 1c – 9 zrazkiv platsenty vid zhinok, iaki narodyly v termini vagitnosti 22–27 tyzhniv + 6 dniv. Ob’iemnu aktyvnist' inkorporovanogo 137Cs u platsenti vyznachaly za dopomogoiu β-spektrometriï. Gistologichne doslidzhennia platsenty provodyly za standartom. U platsenti doslidzhuvaly taki ekspresiï: CD31/PECAM-1, CD45/T200/LCA, CD56/NCAM-1, CEA/CD66e Ab-2, Vimentin, vykorystovuiuchy nepriamyĭmetod vyiavlennia streptavidynperoksydazy.Rezul'taty. Vstanovleno, shcho platsenty nakopychuiut' 137Cs. Rizna ob’iemna aktyvnist' izotopu koreliuie zi stsenariiamy vagitnosti. Vnaslidok diï inkorporovanogo 137Cs z pytomoiu masoiu ponad 1,1 Bk/kg rozvyvaiet'sia platsentarna dysfunktsiia. Naslidky platsentarnoï dysfunktsiï zalezhat' vid ob’iemnoï aktyvnosti 137Cs i zberezhennia adaptatsiĭno-kompensatornykh reaktsiĭ u platsenti. Zalezhno vid stsenariiu perebigu vagitnosti vstanovleno morfologichni ta imunogistokhimichni osoblyvosti urazhennia platsenty inkorporovanym 137Cs. Markerom nespryiatlyvogozavershennia vagitnosti ie ekspresiia rakovo-embrional'nogo antygenu (REA, CEA) v platsenti.Vysnovky. Nevynoshuvannia vagitnosti (NV) tse mul'tyfaktorna patologiia, pov’iazana z patologichnymy zminamyimunnoï ta neĭroendokrynnoï reguliatsiï, spadkovymy, infektsiĭnymy ta ekologichnymy faktoramy, iaki porushuiut'adaptatsiĭni mekhanizmy v systemi «maty–platsenta–plid». Intraplatsentarne oprominennia 137Cs – odyn iz chynnykiv u bagatofaktorniĭ pryrodi reproduktyvnykh vtrat. Vnaslidok vnutrishn'oplatsentarnogo oprominennia 137Cs porushuiet'sia arkhitektura platsenty, pidvyshchuiet'sia aktyvnist' prozapal'nykh tsytokiniv CD45 ĭ CD56, aktyvuiet'sia kaskad koaguliatsiï. Ekstremal'ni efekty zalezhat' vid ob’iemnoï aktyvnosti inkorporovanogo v platsenti izotopu ta kompensatornoï spromozhnosti organu. Nakopychennia do 1,0 Bk/kg 137Cs ne vplyvaie na perebig gestatsiï. Vnutrishnie oprominennia z aktyvnistiu 4,5–10,4 Bk/kg 137Cs vystupaie trygerom piznikh peredchasnykh pologiv. Kharakter poshkodzhen' nalezhyt' do kategoriï «Urazhennia materyns'koï stromy». Ob’iemna aktyvnist' 137Cs ponad 10,4 Bk/kg -ĭmovirna prychyna rannikh peredchasnykh pologiv ta antenatal'noï zagybeli ploda. V ts'omu vypadku, poshkodzhennia zaznaiut' materyns'ki ta plodovi struktury platsenty. Ekspresiia vimentynu – marker platsentarnoï destruktsiïvnaslidok vnutrishn'ogo oprominennia 137Cs pytomoiu masoiu ponad 4,5 Bk/kg. Ekspresiia REA v platsentakh zhinok zNV – unikal'na znakhidka i marker peredchasnykh pologiv ta antenatal'noï zagybeli ploda pry vnutrishn'oplatsentarnomu oprominenni 137Cs pytomoiu masoiu ponad 4,5 Bk/kg.

The article considers the impact of the COVID-19 pandemic on the process of implementing technologies for the organization of remote work both in management and in the technical sphere. The COVID-crisis is seen as a factor that has facilitated, accelerated and intensified the introduction of remote forms of work, because precisely due to the problem of new jobs during the COVID-19 pandemic both remote work and information-technological improvement of enterprises become relevant. The article is aimed at researching the development of remote forms of work under the influence of the COVID-19 pandemic. The object of the research is the process of introducing remote forms of work at Ukrainian enterprises. The subject of the the research is the organization of remote forms of work at enterprises during the COVID-19 pandemic. The article presents the results of the study (based on a survey) of the demand for a remote form of work and training among Ukrainians during the COVID-19 pandemic. 150 Ukrainians took part in the survey. Among them are women and men aged 18 to 65 who work and study both traditionally and remotely. The analysis of the data was carried out using a Google survey. The survey participants were asked topical questions about their possibility and desire for a complete transition to a remote form of work; level of development of the remote form of work at their enterprise or place of study. As result, the most positive and negative, according to the respondents, traits of a remote form of work are identified; also the most frequently used programs to provide remote work. The conclusions emphasize that Ukrainians are not only ready to accept new forms of work organization, but also actively adapt to them and, despite the shortcomings, the remote form of work is in demand and promising, especially in the context of quarantine measures caused by the COVID-19 pandemic.

This scientific article considers the constantly growing role of digital marketing in the overall range of business marketing activities in the modern world. The historical aspect of development and implementation of digital marketing is outlined in the first part of the article. The article considers the chronology of digital marketing development from the middle of the twentieth century and specific transition from classic to digital marketing. The key moments that changed the specifics of marketing are highlighted; the information of different approaches to the evolution of marketing is structured. The authors of the article analyze the diversification of the approaches defining the concept of digital marketing by domestic and foreign scientists. It is determined that the concept of «digital marketing» should be considered as a process of promoting goods and services of the enterprise with the involvement of digital technologies, mobile devices and the Internet in the general marketing activities of the business. Besides that, the difference between digital marketing and Internet marketing is also described by mentioning the main instruments involved in these processes. The work supplies examples of the efficient digital instruments which are important for brand promotion. The significant emphasis is placed on changes in marketing activities that contribute to the further development of brands. In the end of the article, the authors conclude that the current stage of the market economy development in a pandemic situation, fierce competition and global transition to online life creates new conditions in which the implementation of an effective promotion mechanism is an integral condition for each successful business seeking to increase its profits and pace of development.

Розглянуто моделі електронного уряду та обґрунтовано шляхи реалізації їх в Україні. Аналізуються відомі п’ять моделей успішної реалізації програм електронного урядування з відповідними етапами їх формування (моделі К. Лейна і Дж. Лі, К. Баума і А. ДіМайо, ООН, Дж. Хіллера та Ф. Белангера, К. Вескота) та модель сформованого е-уряду К. Андерсена і Х. Хенріксена. Кожна модель аналізується з огляду на стадії: трансакція, взаємодія, інтеграція, доступ до електронного уряду, надання урядом постійної інформації, забезпечення надання послуг, електронна демократія, електронна участь, трансформація уряду, або різні варіанти поєднання вищезазначеного. Обґрунтовано виклики, що стоять перед упровадженням програм електронного урядування, зокрема в Україні.

The major idea of this article is that for a scientifically based understanding of possible future for humanity we need a new knowledge of regularities for its development. The currently existing scattered knowledge is not sufficient for understanding fully and precisely as to where humanity is heading towards and whether it is possible to build a community with a shared future. Therefore, as shown herein, the concept for building such community can only be developed by means of the new scientific paradigm being shaped as substantiated by the author. The new knowledge implies the need to consider all processes and phenomena through the single objectively set goal for the human-system development, and to do this integrally, comprehensively, systemically, and on the basis of cross-disciplinary unification of all sciences and spiritual knowledge into the single trans-disciplinary knowledge with a single index and single criterion for efficiency. The possibility for the actual appearance on our planet of the community with a shared destiny for mankind, outlined first conceptually by the PRC Chairman Xi Jinping during his visit to Moscow in March 2013, as well as the mechanism for its realization, can only be understood when the paths to its construction are considered not only for the entire global world, but also for each individual country and each specific human individual.

Мета роботи – на підставі зіставлення особливостей попередніх епідемій коронавірусних інфекцій та аналізу патогістології, патогенезу COVID-19 і досвіду емпірично апробованого лікування таких хворих виділити перспективні напрямки подальших засобів терапії та профілактики. Наведено інформацію про зворотну залежність у ряді SARS→MERS→COVID-19 географічної поширеності з інкубаційним періодом і летальністю. У патогенезі COVID-19 виділено два основні патогенетичні механізми: пряме вірусне пошкодження епітелію легень, ендотеліоцитів капілярів і тканинних легеневих фібробластів, а також прогресуюча запальна реакція, що супроводжується «цитокіновою бурею», яка спочатку може призводити до «гострого респіраторного дистрес-синдрому» (ГРДС), а потім – й до так званого синдрому гострої запальної відповіді. Таким чином, патогенез COVID-19 схожий з грипозними «геморагічними пневмоніями» або грипозним геморагічним набряком легень. Це дає змогу припускати першорядне значення не етіотропної, а патогенетичної протинабрякової, протизапальної та ангіопротекторної терапії хворих на COVID-19. Перспективними профілактичними стосовно COVID-19 засобами видаються готові інтерферони або індуктори інтерфероногенезу.

The article is devoted to molybdenum mineralization of the Eastern flank of Au-Mo Serhiivka deposit, located in the Middle Dnipro megablock of the Ukrainian Shield (USh). The generalized description of mineralization is performed on such important questions: discovery and exploration history, structure and composition of the host rocks, metamorphic and metasomatic alteration of rocks, structural position and localization conditions of molybdenum mineralization, ore composition, description of major ore minerals, morphology of mineralization and the most widespread views about its genesis. Molybdenum ores were discovered and named East-Serhiivka occurrence for the first time in 1974, before the discovery of gold mineralization, which occurred in 1985. Serhiivka deposit consists of two Mesoarchaean volcanic-plutonic associations (VPA) of different composition: the early mafic and the late felsic. The Eastern flank of the deposit, where the molybdenum mineralization is concentrated, is a structural knot similar to the lying letter “T”. It is formed by complex joint of the sub-latitudinal Serhiivka and sub-meridional Solone subvolcanic bodies and the East-Serhiivka massif of plagiogranitoids of the late VPA, which intrude basic rocks of early VPA. Molybdenum mineralization is localized in linearly elongated zones with a chaotic network of thin quartz, carbonate-quartz veinlets and poor (2–5 %) sulfide impregnation, including molybdenite. About 20 vein-impregnated ore zones have been recovered with up to 100–150 m thickness and 0,01 to 0,3 %, sometimes more than 1 % average molybdenum grade. The ores are subdivided into two major mineral types: 1) quartz-molybdenite; 2) quartz-sulfide-gold-molybdenite. The main components of ores molybdenite and native gold are associated with pyrite, chalcopyrite, magnetite, occasionally – pyrrhotite, arsenopyrite, scheelite, bismuth telluride, silver and others. Typical non-metallic minerals are quartz, carbonate, feldspar, chlorite, amphibole, biotite, sericite. It is supposed hydrothermal-metamorphogenic genesis of molybdenum (and gold) ores. Molybdenite and gold are rarely detected in the same intersections, which indicates separate genesis of these minerals. According to the accepted classification molybdenum mineralization is systemized as linear stockwork. Molybdenum ores of Serhiivka deposit are mostly considered as independent, separate from gold mineralization, potentially workable mine. It is the most prospective one in the Middle Dnipro region, USh and Ukraine in general. We suggest a comprehensive approach to studying, resource and reserves evaluation of Serhiivka deposit, taking into account the potential of both molybdenum and gold mineralization, as well as concentrations of rhenium and osmium in molybdenite. Geological exploration on the base of this approach will increase investment prospects of Serhiivka gold-molybdenum deposit.

Методичні рекомендації складені з урахуванням сучасних відомостей про клінічні прояви харчового, ранового, ятрогенного, інгаляційного ботулізму та хвороби у немовлят. Клінічна картина харчового, ранового, ятрогенного, інгаляційного та «дитячого» ботулізму подібна й зводиться до білатерального паралічу черепних нервів; диспепсичних проявів; респіраторної дисфункції; відсутності гарячки, сплутаності свідо­мості, загальмованості, порушення чутливості. Наведено об’єктивні прояви при фізикальному обстеженні, методи лабораторної діагностики. Виділено фактори ризику захворювання. Стандартна лабораторна діагностика ботулізму ґрунтується на виявленні токсину у сироватці, шлунковому секреті, калі та зразках продуктів харчування шляхом постановки біологічної проби на мишах, зрідка – бактеріологічного та електрофізіологічного дослідження, імуноферментного аналізу, полімеразно-ланцюгової реакції. Детально проаналізовано лікування хворих на різні клінічні форми ботулізму. Враховуючи відсутність вітчизняних імунобіологічних препаратів, зібрано відомості про протиботулінічні препарати різних виробників, що дозволяє використати доступні у конкретних умовах зарубіжні препарати. Розглянуто різні способи уникнення тяжких ускладнень після антитоксичної терапії. Обговорено перспективу використання ефективних і безпечних вакцин від ботулізму.

ImportanceTrastuzumab has been the standard of care for the treatment of patients with ERBB2-positive breast cancer; however, cardiac events have been reported. This long-term follow-up study provides clinical evidence supporting the similarity of a trastuzumab biosimilar (SB3) to reference trastuzumab (TRZ).ObjectiveTo compare cardiac safety and efficacy between SB3 and TRZ for patients with ERBB2-positive early or locally advanced breast cancer after up to 6 years of follow-up.Design, Setting, and ParticipantsThis prespecified secondary analysis of a randomized clinical trial, conducted from April 2016 to January 2021, included patients with ERBB2-positive early or locally advanced breast cancer from a multicenter double-blind, parallel-group, equivalence phase 3 randomized clinical trial of SB3 vs TRZ with concomitant neoadjuvant chemotherapy who completed neoadjuvant and adjuvant treatment.InterventionsIn the original trial, patients were randomized to either SB3 or TRZ with concomitant neoadjuvant chemotherapy for 8 cycles (4 cycles of docetaxel followed by 4 cycles of fluorouracil, epirubicin, and cyclophosphamide). After surgery, patients continued SB3 or TRZ monotherapy for 10 cycles of adjuvant treatment per previous treatment allocation. Following neoadjuvant and adjuvant treatment, patients were monitored for up to 5 years.Main Outcomes and MeasuresThe primary outcomes were the incidence of symptomatic congestive heart failure and asymptomatic, significant decrease in left ventricular ejection fraction (LVEF). The secondary outcomes were event-free survival (EFS) and overall survival (OS).ResultsA total of 538 female patients were included (median age, 51 years [range, 22-65 years]). Baseline characteristics were comparable between the SB3 and TRZ groups. Cardiac safety was monitored for 367 patients (SB3, n = 186; TRZ, n = 181). Median follow-up was 68 months (range, 8.5-78.1 months). Asymptomatic, clinically significant LVEF decreases were rarely reported (SB3, 1 patient [0.4%]; TRZ, 2 [0.7%]). No patient experienced symptomatic cardiac failure or death due to a cardiovascular event. Survival was evaluated for the 367 patients in the cardiac safety cohort and an additional 171 patients enrolled after a protocol amendment (538 patients [SB3, n = 267; TRZ, n = 271]). No difference was observed in EFS or OS between treatment groups (EFS: hazard ratio [HR], 0.84; 95% CI, 0.58-1.20; P = .34; OS: HR, 0.61; 95% CI, 0.36-1.05; P = .07). Five-year EFS rates were 79.8% (95% CI, 74.8%-84.9%) in the SB3 group and 75.0% (95% CI, 69.7%-80.3%) in the TRZ group, and OS rates were 92.5% (95% CI, 89.2%-95.7%) in the SB3 group and 85.4% (95% CI, 81.0%-89.7%) in the TRZ group.Conclusions and RelevanceIn this secondary analysis of a randomized clinical trial, SB3 demonstrated cardiac safety and survival comparable to those of TRZ after up to 6 years of follow-up in patients with ERBB2-positive early or locally advanced breast cancer.Trial RegistrationClinicalTrials.gov Identifier: NCT02771795