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Стаття присвячена деяким проблемним питанням притягнення до кримінальної відповідальності за насильницьке зникнення. Зазначено, що аналіз звітів про кримінальні правопорушення, розміщених на сайті Офісу Генерального прокурора, які містять інформацію про кількість зареєстрованих фактів злочинів за ст. 146-1 КК України, показав динаміку, що за перші півтора роки дії цієї статті не було зареєстровано жодного кримінального провадження. У подальші роки кількість зафіксованих випадків насильницьких зникнень почала зростати, а значний стрибок відбувся на початку повномасштабного вторгнення РФ в Україну. Однак сьогоднішні показники реєстрації таких злочинів значно менші порівняно з 2022 роком. Офіційна статистика щодо злочинів, передбачених ст. 146-1 КК України, ймовірно, не відображає реального стану, оскільки виявлення та фіксація таких випадків ускладнені через військовий час і окупацію відповідних територій України. Досліджено, що термін «насильницьке зникнення» був вперше застосований нерядовими організаціями Латинської Америки в 1960-ті роки та є дослівним перекладом іспанського словосполучення «disaparacion forzada», який розкриває концепцію насильницького зникнення як жорстокого порушення прав людини та злочину, скоєного прямо чи опосередковано за підтримки органів державної влади з метою усунення політичних опонентів. Проаналізовано, що склад насильницького зникнення, передбачений ч. 1 ст. 146-1 КК України, є формально-матеріальним, а ч. 2 ст. цієї статті – формальним за об’єктивною стороною. Автором зроблено висновок, що криміналізація в нашій державі насильницького зникнення була необхідною для протидії цьому особливо тяжкому порушенню прав людини, оскільки інші положення чинного кримінального законодавства не відображають комплексного характеру тієї шкоди, яку й спричиняє (або може в подальшому спричинити) насильницьке зникнення. Крім того, специфічна юридична природа досліджуваного кримінального правопорушення дозволяє розмежувати його від подібних злочинів. Зокрема, це включає наявність його спеціального суб’єкта та таку обов’язкову ознаку, як подальша відмова визнати факт арешту, затримання або позбавлення волі людини в будь-якій іншій формі або приховування інформації про долю чи місцезнаходження цієї людини.

Abstract Sequestration of infected red blood cells (iRBCs) in the microcirculation is a hallmark of cerebral malaria (CM) in post-mortem human brains. It remains controversial how this might be linked to the different disease manifestations, in particular brain swelling leading to brain herniation and death. The main hypotheses focus on iRBC-triggered inflammation and mechanical obstruction of blood flow. Here, we test these hypotheses using murine models of experimental CM (ECM), SPECT-imaging of radiolabeled iRBCs and cerebral perfusion, MR-angiography, q-PCR, and immunohistochemistry. We show that iRBC accumulation and reduced flow precede inflammation. Unexpectedly, we find that iRBCs accumulate not only in the microcirculation but also in large draining veins and sinuses, particularly at the rostral confluence. We identify two parallel venous streams from the superior sagittal sinus that open into the rostral rhinal veins and are partially connected to infected skull bone marrow. The flow in these vessels is reduced early, and the spatial patterns of pathology correspond to venous drainage territories. Our data suggest that venous efflux reductions downstream of the microcirculation are causally linked to ECM pathology, and that the different spatiotemporal patterns of edema development in mice and humans could be related to anatomical differences in venous anatomy.

This article is devoted to the study of the issues of innovative organizations personnel motivation. The author describes the features of innovative organizations: stimulating scientific research, innovation and the search for non–standard solutions, therefore their principles of motivation should be aimed specifically at the implementation of these tasks. The article is related to the issues of increasing the productivity and efficiency of companies. Often in traditional organizations, staff motivation systems are created without taking into account the opinions of employees and have little correlation with the company’s values. According to the author, for productive innovation, it is important to develop and implement a policy that encourages innovative approaches, as well as creativity and initiative of employees. A well thought out staff motivation system plays a key role in the application of this policy, which ultimately contributes to the successful implementation of ambitious projects, increasing profits and the image of the organization. The article presents the characteristics of motivational incentives, namely monetary and non–monetary. The author substantiates the thesis that in order to stimulate innovative activity to employees needs to choose an individual approach, and non–monetary motivation in this case turns out to be more important than the monetary component.

Currently, in conditions of high risk of the continuation of the pandemic and the introduction of new sanctions, the preservation of both professional health and the working capacity of the working population is of particular relevance. Therefore, it is of great importance to determine the real state of the management system of the process of reducing the disability of the working population of the country’s regions. For this purpose, a socio -logical study was carried out, consisting in a survey using a specially developed questionnaire of heads of government bodies of the regions of the country. The analysis of the results of the study made it possible to identify the existing situation on this problem in a number of regions of the country and systematize both the main factors currently constraining the development of the management system for reducing the level of disability of the working population in the regions, and to determine the type of necessary assistance required by the regions from the federal authorities for the successful development of this management system. The article was prepared as part of the research work of the state task of the RANEPA.

Aronia melanocarpa (Michx.) Elliott, ×Sorbaronia fallax (C. K. Schneid.) C. K. Schneid. nothosubsp. fallax, and ×Sorbaronia fallax nothosubsp. mitschurinii (A. Skvortsov & Maitul.) A.Stalažs, belonging to the Rosaceae family, are grown as fruit plants. They are known to horticulturists as garden chokeberry or black chokeberry. The fruit of these species is the richest source of biophenols in the plant kingdom and suitable raw material for the production of functional foods with high nutraceutical value. The work aimed to examine the basic and polyphenolic composition of fruit chokeberry and rowan-chokeberry hybrids of different taxonomic groups. Experimental plants were grown at the orchard of the National University of Life and Environmental Sciences of Ukraine in the Kyiv region. Fruit of 10 cultivars developed in Belorussia, the Czech Republic, Finland, Russia, Ukraine, and the USA were collected during 2020 and 2021. The fruit was analyzed for dry matter, soluble solids, sugars, pectin substances, organic titratable acidity, ascorbic acid, and biophenols. Chokeberry fruit contains on average 24.4–29.2% dry matter, 16.0–21.1% soluble solids, 6.5–8.9% sugars, 0.40–0.80% pectin, and 0.95–2.15% organic acids on raw material. Bioactive components of chokeberry fruit are ascorbic acid (24.7–45.9 mg/100 g), total polyphenols (998–4840 mg/100 g), including anthocyanidins (9–217 mg/100 g), flavonoids (23–1422 mg/100 g), and chalcones (9–59 mg/100 g). If the group ×S. fallax nothosubsp. mitschurinii cultivars is morphologically constant and like A. melanocarpa simple in leaf shape, then the group ×S. fallax nothosubsp. fallax cultivars was different in the morphology of leaves from lobate to pinnate and fruit color from purple to black in the study. Chokeberry fruit composition varied between each year and especially between taxonomic groups and cultivars. Fruit harvested in 2021 had the lowest dry matter, soluble solid, sugars, and ascorbic acid in comparison with 2020. In contrast, titrated acidity was consistent between years. The fruit of garden chokeberries is a good source of ascorbic acid. ×S. fallax cultivars with the exception ‘Titan’ are richer on ascorbic acid. The fruit of A. melanocarpa ‘Dwarf’ has the highest content of total polyphenols, flavonoids, and chalcones. There are significant differences between ×S. mitschurinii cultivars in biochemical content. Purple-fruited ‘Titan’ has the lowest content of all biologically active substances, than other cultivars belonging to the same ×S. fallax taxonomic group. The black-fruited ×S. fallax nothosubsp. fallax genotypes, including the first chokeberry cultivar ‘Vseslava’ of Ukrainian breeding, often have a high or the highest content of ascorbic acid, total polyphenols, anthocyanidins, flavonoids, and chalcones, which is valuable for garden chokeberry breeding.

An analytical study was carried out aimed at reducing the level of disability of employees of industrial enterprises of the country. It has been revealed that the disability of employees can be a consequence of both various accidents and diseases, including professional ones. An action plan is proposed to reduce the values of disability indicators both in the field of labor protection and medical support of employees. Target corporate programs at industrial enterprises are described. The features of personnel support of work to reduce the level of disability of employees are disclosed. The role of telemedicine technologies in the framework of industrial medicine is reflected. The economic and social effectiveness of the application of the best technologies and practices used in the implementation of the main organizational, medical and socio-economic measures to reduce the disability of employees of an industrial enterprise is shown.

Abstract Various vision-threatening eye diseases including age-related macular degeneration (AMD) and central serous chorioretinopathy (CSCR) are caused due to the dysfunctions manifested in the highly vascular choroid layer of the posterior segment of the eye. In the current clinical practice, screening choroidal structural changes is widely based on optical coherence tomography (OCT) images. Accordingly, to assist clinicians, several automated choroidal biomarker detection methods using OCT images are developed. However, the performance of these algorithms is largely constrained by the quality of the OCT scan. Consequently, determining the quality of choroidal features in OCT scans is significant in building standardized quantification tools and hence constitutes our main objective. This study includes a dataset of 1593 good and 2581 bad quality Spectralis OCT images graded by an expert. Noting the efficacy of deep-learning (DL) in medical image analysis, we propose to train three state-of-the-art DL models: ResNet18, EfficientNet-B0 and EfficientNet-B3 to detect the quality of OCT images. The choice of these models was inspired by their ability to preserve the salient features across all the layers without information loss. To evaluate the attention of DL models on the choroid, we introduced color transparency maps (CTMs) based on GradCAM explanations. Further, we proposed two subjective grading scores: overall choroid coverage (OCC) and choroid coverage in the visible region(CCVR) based on CTMs to objectively correlate visual explanations vis-à-vis DL model attentions. We observed that the average accuracy and F-scores for the three DL models are greater than 96%. Further, the OCC and CCVR scores achieved for the three DL models under consideration substantiate that they mostly focus on the choroid layer in making the decision. In particular, of the three DL models, EfficientNet-B3 is in close agreement with the clinician’s inference. The proposed DL-based framework demonstrated high detection accuracy as well as attention on the choroid layer, where EfficientNet-B3 reported superior performance. Our work assumes significance in bench-marking the automated choroid biomarker detection tools and facilitating high-throughput screening. Further, the methods proposed in this work can be adopted for evaluating the attention of DL-based approaches developed for other region-specific quality assessment tasks.

Background: Ovulatory dysfunction accounts for 20-25% of the cases of infertility. The main treatment modality for anovulatory infertility is ovarian stimulation. Clomiphene citrate (CC) and letrozole (LET) are the drugs of choice but which is the best choice for first line treatment is debatable. Objective: Compare the treatment outcome of anovulatory infertility by CC and LET. Method: A prospective randomized controlled trial including two groups of anovulatory subfertile patients was carried out at a tertiary care center and patients were randomized to either CC 50 mg (n=127) which was the standard first line treatment used at the center as the control and LET 2.5 mg (n=121) as the trial drug which is the off labelled, yet currently prescribed for the anovulatory sub-fertile patients daily from the 2nd to 6th day of the menstrual cycle. Follicle number on day 12, endometrial thickness, pregnancy rates and multiple pregnancies were assessed. The data were analyzed using MINITAB 14. Results: The mature follicles count (>18mm) on day 12 was not significantly different in two treatment groups (CC: 1.323± 0.935 and LET: 1.175±0.797). However, the mean endometrial thickness of the LET treated patients was significantly higher than the CC group (0.7691±0.0887 cm and 0.695± 0.134cm respectively). The clinical pregnancy rate of the LET group was significantly higher than the CC treated group (49% vs. 38%). There was no significant difference in the miscarriage rates (16% in both arms). Conclusions: LET treatment enhances the endometrial thickness compared to CC with higher clinical and ongoing pregnancy rates. The higher pregnancy rates with LET may be due to its favorable effects on endometrial thickness and the receptivity owing to its less anti-estrogenic properties.

The urgency of Epstein-Barr virus infection is explained by wide circulation of Epstein-Barr virus among children and adults, its tropism to immunocompetent cells with lifelong persistence after primary infection and polymorphism of clinical manifestations from subclinical forms, infectious mononucleosis to formation of oncological, autoimmune hematological diseases.Persistence of Epstein - Barr virus Leads to suppression of cellular immunity, decreased production of interferons and nonspecific protection factors, which contributes to reactivation of persistent infection, most often without mononucleosis-like syndrome, and the appearance of atypical mononuclears in blood with the formation of lymphoproliferative, intoxication, astheno-vegetative syndrome, long-term subfebrile condition, which dictates the need for immunocorrective therapy. This article presents a clinical case describing and analyzing the course of a chronic Epstein-Barr virus infection in a preschool child (5 years 8 months) with a pre-morbid background. Episodes of reactivation of chronic persistent infection occurred under the mask of acute respiratory infection with lymphoproliferative syndrome, purulent tonsillitis, purulent adenoiditis. Therapy, including antibiotics, short-course antiviral agents, bacterial lysates, and physiotherapy, had a temporary and short-lived effect. meglumine acridonacetate. The described clinical case demonstrates the effectiveness of the inclusion of meglumine acridonacetate, which has antiviral, immunomodulatory and anti-inflammatory effects, in the complex treatment of Epstein-Barr virus infection, This allowed to obtain fairly rapid positive clinical dynamics of relieving intoxication and febrile and lymphoproliferative syndromes in the acute period, and subsequently - astheno-vegetative syndrome and achieve the transition of active chronic Epstein - Barr virus infection into a latent form.

Стаття присвячена вирішенню проблеми представлення медичних знань у процесі вдосконалення контенту після- дипломного навчання для зменшення когнітивного навантаження. Розглянуто види когнітивного навантаження та шляхи його зменшення. Запропоновано використання таксономізації природномовних текстів в якості підходу до структуризації медичної інформації та онтології для інтегрованого подання агрегованих інформаційних ресурсів у процесі навчання. Наведено приклад використання онтології як ефективного засобу зменшення когнітивного на- вантаження.

The main vectors of the development of an interdisciplinary methodology for studying the problem of living systems in the context of the implementation of the concept of digitalization of the state are considered. As a result of the research, it is established that the main directions of this development are the development and implementation of fundamental, exploratory and applied research of various living systems aimed at improving the efficiency of their functioning against the background of preserving the health and prolonging the longevity of the country’s population.

This article presents the history of the formation of the State Central Institute for Advanced Medical Education, the present-day Russian Medical Academy of Continuing Professional Education at the Ministry of Health of the Russian Federation (Moscow). This study involved documents found in the Russian State Archive of Scientific and Technical Documentation. The problem statement is the first of is kind in Russian historiography. The paper contains a detailed description of the early years of the Central Institute for Advanced Medical Education (1930–1938). It also outlines the main directions of the Institute activity during the period in question, e.g. correspondence courses for doctors from remote regions. The authors investigated the personnel issue in the context of historical reconstruction. They demonstrated the key challenges that the institution had to face and address in its early days. The analysis proved that the Institute provided invaluable experience in training professional medical personnel in the shortest time possible under difficult historical conditions.

The analysis of the normative legal documentation regulating the procedure for holding competitions for the best project is performed. The modern methodology and technology of selection and expert evaluation of investment projects in the state and commercial sectors of the economy are considered. The types of risks of ineffective management decisions are determined based on the analysis of the results of expert evaluation of these investment projects, including in the field of medicine.

Russia is rapidly increasing the use of digital technologies in all spheres of public life. The speed, with which new technologies appear and are implemented, leads to the fact that people cannot quickly adapt to them. In this regard, in some cases, there may be social tensions, reluctance to use modern advances in digital technologies and other social problems. There is also a overestimation of the importance and impact of the introduced technologies on improving the socio-economic and political life of the country.In this regard, it is of interest to assess the attitude of citizens to the developing digital technologies, and, primarily, to digital services that are introduced in the system of providing state and municipal services and in the sphere of interaction between the state and society. This study is an attempt to make this kind of assessment. The background of the study was the adopting and approving in 2018 the national project “Digital economy of the Russian Federation” and the Federal programs implemented within the framework of this project, as well as the state programs and projects preceding the national project that accompany the formation of the infrastructure of the digital state.The authors conducted a survey of 541 respondents from 49 regions of the Russian Federation to determine and assess the attitude of citizens to the digitalization of public services. During the survey, respondents were asked questions about the use of Federal and regional portals of public services, about awareness of the availability and possibility of using public technologies and services, about the convenience of services and the ability to use them. As a result of the survey, conclusions are drawn about the advantages and disadvantages of using the electronic service of public services, as well as an assessment of the attitude of citizens to the digitalization of public services.

A radiator is used to remove a portion of the heat generated by a vehicle engine. It is challenging to efficiently maintain the heat transfer in an automotive cooling system even though both internal and external systems need enough time to keep pace with catching up with evolving engine technology advancements. The effectiveness of a unique hybrid’s heat transfer nanofluid was investigated in this study. The hybrid nanofluid was mainly composed of graphene nanoplatelets (GnP), and cellulose nanocrystals (CNC) nanoparticles suspended in a 40:60 ratio of distilled water and ethylene glycol. A counterflow radiator equipped with a test rig setup was used to evaluate the hybrid nano fluid’s thermal performance. According to the findings, the proposed GNP/CNC hybrid nanofluid performs better in relation to improving the efficiency of heat transfer of a vehicle radiator. The suggested hybrid nanofluid enhanced convective heat transfer coefficient by 51.91%, overall heat transfer coefficient by 46.72%, and pressure drop by 34.06% with respect to distilled water base fluid. Additionally, the radiator could reach a better CHTC with 0.01% hybrid nanofluid in the optimized radiator tube by the size reduction assessment using computational fluid analysis. In addition to downsizing the radiator tube and increasing cooling capacity over typical coolants, the radiator takes up less space and helps to lower the weight of a vehicle engine. As a result, the suggested unique hybrid graphene nanoplatelets/cellulose nanocrystal-based nanofluids perform better in heat transfer enhancement in automobiles.

Визначається, задля створення надійного сучасного наукового фундаменту розуміння сутності соматичних прав людини у процесі біомедичних досліджень доцільним вбачається історичний екскурс у специфіку дослідження того чи іншого правового питання конституційно-правових засад закріплення окремих соматичних права, виділення певних пріоритетів дослідження, формулювання доктринальних положень, на підставі яких і формувалося раніше діюче та чинне законодавство. Це дозволить виділити певні тенденції розвитку як правової доктрини, так і нормотворчої діяльності, результатом якої є докорінне вдосконалення чинного законодавства України, у тому числі й кодифікованого змісту, окреслити певні проблемні питання із одночасним з’ясуванням шляхів їх вирішення у різні історичні періоди із тим, щоб уникнути в майбутньому негативного та запозичити позитивний досвід. Саме врахування історичного досвіду доктринальних досліджень певних правових феноменів, стверджують вчені, дозволяє формувати досконалу сучасну наукову базу для вдосконалення конституційно-правового статусу того чи іншого правового інституту. Вказується, історія становлення та розвитку механізму реалізації та захисту соматичних прав людини є невід’ємною складовою частиною історико-правового процесу. Вивчення позитивного досвіду в цій галузі, яка має глибоке історичне коріння та тісно пов’язана із соціально-економічними й політичними процесами, є важливим як для теорії, так і для практики. Невід’ємним елементом наукової розвідки будь-якого рівня та спрямування є ґрунтовна саме джерельна база, критичний аналіз і систематизація якої – першочергове завдання справжнього вченого. Саме це уможливлює здійснення об’єктивного й неупередженого дослідження в галузі юриспруденції, на чому наголошують сучасні науковці.

Drug-induced atrial fibrillation / flutter (DIAF) is a serious and potentially life-threatening complication of pharmacotherapy. Purpose of the work: systematization and analysis of scientific literature data on drugs, the use of which can cause the development of DIAF, as well as on epidemiology, pathophysiological mechanisms, risk factors, clinical picture, diagnosis and differential diagnosis, treatment and prevention of DIAF. Analysis of the literature has shown that many groups of drugs can cause the development of DIAF, with a greater frequency while taking anticancer drugs, drugs for the treatment of the cardiovascular, bronchopulmonary and central nervous systems. The mechanisms and main risk factors for the development of DIAF have not been finally established and are known only for certain drugs, therefore, this section requires further study. The main symptoms of DIAF are due to the severity of tachycardia and their influence on the parameters of central hemodynamics. For diagnosis, it is necessary to conduct an electrocardiogram (ECG) and Holter monitoring of an ECG and echocardiography. Differential diagnosis should be made with AF, which may be caused by other causes, as well as other rhythm and conduction disturbances. Successful treatment of DIAF is based on the principle of rapid recognition and immediate discontinuation of drugs (if possible), the use of which potentially caused the development of adverse drug reactions (ADR). The choice of management strategy: heart rate control or rhythm control, as well as the method of achievement (medication or non-medication), depends on the specific clinical situation. For the prevention of DIAF, it is necessary to instruct patients about possible symptoms and recommend self-monitoring of the pulse. It is important for practitioners to be wary of the risk of DIAF due to the variety of drugs that can potentially cause this ADR.

In recent years, enterovirus infection (EVI) retains its cyclical nature with an increase in the incidence rate in the Russian Federation in 2000, 2006, 2009, 2013 and 2017. Observation of 41 patients with laboratory-confirmed enteroviral meningitis (EVM) in 2000, 54 children in 2013, and 56 patients in 2018 revealed the clinical and laboratory features of this clinical form of the disease, mainly concerning changes in hemo- and liquorogram parameters, which allowed to trace the evolutionary changes during this infection in children.

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias in clinical practice and important additional risk factor for the development of cognitive impairment (CI) and dementia as it has been shown in recent studies. According to the Diagnostic and statistical manual of mental disorders latest revision CI refers to a decrease of one or more higher cortical functions that provide the processes of perception, storage, transformation and transmission of information compared to the premorbid level. The main hypothesis that explains the relationship between AF and dementia is the assumption that in the presence of this arrhythmia a brain substance is damaged due to microembolism and cerebral microbleeding. The high clinical significance of AF as well as CI served as a background for the development by European experts several consensus documents concerning the problem of the relationships between these conditions. In addition, they emphasize the role of anticoagulant therapy as a preventing tool for the development of stroke, which can be a factor in the CI progression in patients with AF, with particular priority to direct oral anticoagulants (DOACs). In randomized clinical trials, meta-analyses and systematic reviews have been shown that the use of DOACs, as compared to vitamin K antagonists, is a more rational strategy for preventing stroke associated with AF. Among the DOAC class, rivaroxaban is worth noticing as a drug that has a favorable efficacy profile for primary and secondary stroke prevention. Rivaroxaban distinguishing characteristics are a once daily administration as well as a calendar package which is practically important for patients with CI.

The article analyzes the automated information system “Nalog”, which is used by the tax authorities to tackle various problems related to the functions of the Federal tax service. Automation of the processes, carried out by the tax authorities allows to improve the efficiency of the tax system by improving the efficiency and quality of decisions; to improve the efficiency and productivity of tax inspectors; to provide tax inspections at all levels with complete and timely information on changes in tax legislation; to provide reliable data on the counting of taxpayers and on the effectiveness of control over compliance with tax legislation; to improve the quality and efficiency of accounting; to obtain data on the receipt of taxes and other payments to the budget; to analyze the dynamics of the receipt of tax amounts and the possibility of forecasting this dynamics; to reduce the volume of document circulation in paper form. However, the existing architecture of the automated information system “Nalog” was formed more than 10 years ago and during its existence underwent only minor changes. The development of information technologies, including in the field of public administration, as well as significant changes in the system of tax administration determines the relevance of the development of approaches to the modernization of the existing information system of tax authorities. The article proposes the directions and principles of modernization of the automated information system “Nalog”, reveals the main directions of construction of a new automated system and the parameters to control the level of achievement of goals as a result of modernization of the existing system in the following areas: centralization of processing and storage of information of tax authorities; the development of electronic interaction of public administration with taxpayers, the development of information means of interaction with external users; creation of operational and support systems and subsystems of tax administration; results of formation and development of information and analytical system in the activities of tax authorities; automation of administrative and economic activities of tax authorities; social performance criteria.

Renewable energy use is spreading worldwide presenting the future of the power engineering - its renewable resources and low ecological impact characterize one of the best technologies to support permanently growing energy consumption and contribute to sustainable development. But its development is sometimes hampered by lack of suitable technologies and strong positions of the competing conventional energy production. Moreover, critics emphasize such problems of renewable energy use as unstable energy production, complicated connection to power lines, some ecological problems. To prove its efficiency renewable energy development needs support by relevant resource and ecological assessments. This paper presents our research concerning wind farm location issue regarding both production efficiency and minimal ecological impact. Our field research in Crimea was directed at on-site assessment of wind farm location efficiency as well as studies of public opinion concerning local wind farms and wind energy use in general. It was found out that Crimean wind farms have controversial location efficiency related to its power production. But their ecological impact was minimal proved by both on-site measurements and sociological survey results. It was also found that wind turbine noise impact had a very complicated character, but had no significant ecological impact.

Розглянуто тренди розвитку технологій післядипломного навчання та безперервного професійного розвитку лікарів. Підкреслюється, що університети, як і раніше, є ідеальним місцем для передавання та продукування знань. Однак, конкурувати з онлайн навчанням університетам, що пропонують типову контактну освіту, абсолютно марно. Постулюється, що безліч технологій передавання знань практично унеможливлює рішення завдання стандартизації траєкторій навчання та забезпечення ефективного індивідуалізованого трансферу знань. Висловлюється думка про необхідність розроблення алгоритмів своєчасного виявлення індивідуальних особливостей у засвоєнні навчального матеріалу та на їх основі створення адаптивних навчальних систем.

The surface block of cervical plexus in combination with general anesthesia provides nociceptive protection at all stages of the surgery. However, its use is associated with the risk of puncture of large vessels of the neck and resulting complications: unintentional intravascular administration of a local anesthetic and formation of a hematoma.The objective: to demonstrate the advantages and effectiveness of superficial cervical plexus block with the use of ultrasound guidance in carotid surgery.Subjects and methods. The method of inplane ultrasound-guided single-insertion was used. The superficial cervical plexus block was performed under ultrasound guidance (Fujifilm Sonosite Edge Inc. – US) with a linear sensor (Sonosite HFL38 13-6MHz).Results. The superficial cervical plexus block with ultrasound guidance allowed choosing the most appropriate area for the administration of local anesthetic, visualizing the movement of the puncture needle in the neck structures and minimizing the risks of damage to large vessels and nerves, excluding the possibility of intravascular injection of a local anesthetic.

In the conditions of the Chuvash Republic new hybrids of potato selected by the All-Russian Research Institute of potato farming named after A.G. Lorkh were studied. The studies were carried out on heavy-loamy gray forest soils. As a result of selection work from 2010 to 2017 more than 11.000 breeding samples were studied. For 2015-2017 years of study on the complex of economically valuable traits two breeding numbers were identified: 1683-12-2 and 1691- 12-5. According to the results of crop accumulation in the dynamics the duration of vegetation of these hybrids was determined. The accumulation of most of the harvest of the hybrid 1683-12-2 was observed in the period between the second registration (55 days from germination) to a total harvest, during the aging of the vegetative mass of the potato. Hybrid 1691-12-5 accumulated the bulk of the crop on the 55th day after full shoots-89.0 %. The vegetation period of breeding number 1683-12-2 was 85 days, which allowed to refer it to the group of middle - ripening varieties, and in 1691-12-5 the growth period was 72 days, which is typical for the middle-early maturity group.

Abstract Arc welding operations are considered to be risky procedures by generating hazardous welding fume for human health. This study focuses on the key characteristics, as well as dispersion models, of welding fumes within a work zone. Commercial and widely used types of electrodes with various types of covering (rutile, basic, acidic and rutile-cellulose) were used in a series of experiments on arc welding operations, under 100 and 150 amps of electric current. According to the results of this study, maximum levels of pollution with particles of PM10 fraction occur in the workspace during arc welding operations. Disregarding the types of electrodes used, the 3D models of dispersion of the РМ10 particles at the floor plane exhibit corrugated morphologies while also demonstrate high concentrations of the РМ10 particles at distances 0–3 m and 4–5 m from the emission source. The morphology of these particles is represented by solid and hollow spheres, ‘nucleus-shell’ structures, perforated spheres, sharp-edged plates, agglomerates of the tree-like (coral) shape. At last the bifractional mechanism of fume particle formation for this type of electrodes is also shown and described. In this article results are reported, which demonstrate the hazards of the arc welding process for human health. The results of the characterization of WFs reported improve our understanding of risks that these operations pose to human health and may strengthen the need for their control and mitigation.

Activating mutations of EGFR are associated with sensitivity of non-small cell lung cancer (NSCLC ) to tyrosine kinase inhibitors (TKI). Liquid biopsy using circulating cell-free tumor DNA (cfDNA) is proposed in cases when formalin fixed paraffin embedded (FFPE) tumor tissue is not available and for monitoring of EGFR status. In the study we evaluated new qPC R assay for EGFR mutations in plasma cfDNA. Sensitivity of the assay was 1 % of the mutant allele for L858R, L861Q, S768I mutations and deletions in exon 19, and 5 % of the mutant allele for G719X or T790M mutations Before surgery, mutation was detected in plasma of 4 out of 7 patients (57 %) with mutant EGFR in FFPE tumor tissue. Mutations found in cfDNA completely matched those found in tumor tissue in 2 cases. In one case with G719X and S768I mutations in FFPE tissue, only S768I was found in cfDNA. In another case, T790M was detected in plasma in addition to L858R that was present in tumor tissue. No EGFR mutations were detected in plasma DNA from 12 healthy volunteers and 13 cases of NSCLC with wt EGFR suggesting 100 % specificity of the assay. Liquid biopsy detected EGFR mutations in cfDNA in 8 of 16 cases of NSCLC with mutant EGFR being under therapy with TKI. Among them, 7 cases had mutations in liquid biopsy that matched those in tumor tissue and another case had T790M in addition to L858R. In 3 cases increased mutant allele frequency was detected 212 months before clinical progression.

PCR clamping/wild-type blocking PCR with non-extendable locked nucleic acid (LNA) oligonucleotides is used for sensitive detection of somatic mutations in tumors. Various versions of the technique use different DNA polymerases and LNA oligonucleotides with and without additional phosphorothioate modifications. Here we studied requirements for successful PCR clamping with LNA oligonucleotides and Taq DNA polymerase for analysis of mutations in KRAS and BRAF genes by means of real-time PCR and Sanger sequencing. We found that addition of phosphorothioate linkages at the 5’-end of LNA oligonucleotide to protect from 5’- exonuclease activity of Taq DNA polymerase did not improve clamping. For most target sequences, efficient clamping was observed at melting temperature of LNA oligonucleotide 20‑25°C above annealing/extension temperature of the PCR with a 2-step protocol. Under such conditions, simple and sensitive detection of mutations in KRAS and BRAF genes was feasible using real-time PCR with TaqMan probes or Sanger sequencing.

Aim of the study. Aim of the study was to estimate the occurrence of pathogenic mutations in the BRCA1 gene in Russian breast cancer patients.Material and methods. Complete coding sequence of the BRCA1 gene of 445 early onset breast cancer patients (under 40 years) from Novosibirsk region (Russia) were analyzed by targeted Next Generation Sequencing (NGS) using Ion Torrent platform. Results. Forty (9%) carriers of various pathogenic mutations were revealed. Thirty five (7,9%) patients carried 5382insC mutation, described earlier as a founder mutation for Slavic population. Five (1.1%) patients carried various pathogenic mutations, namely C61G, 462delCC, E143X, 4153delA, and IVS18+1G>T. Besides, 29 genetic variants with no clinical significance or with unknown clinical significance were detected in BRCA1 gene among 445 early onset breast cancer patients. Conclusions. Data on the frequency of genetic variations in the BRCA1 gene among early onset breast cancer patients in the Novosibirsk Region (Russia) were obtained. Proportion of the 5382insC mutation is 87.5% of all pathogenic mutations in the BRCA1 gene found in patients.

Documented case of the clinical observations of the complicatedcourse of beef tapeworm infection (Taenia saginata) have a child 17 years of age. Three years ago, the patient first noticed the active isolation of the cuttings from the anus. Other clinical symptoms were absent and the disease was latent. At the end of may 2017, symptoms of an acute abdomen developed and an appendectomy was performed on 03.06.2017. Diagnosis after surgery: acute gangrenous perforative appendicitis, periappendicular abscess, diffuse purulent peritonitis. 07.06.2017 was a single vomiting. In the vomit seen the segments of the flat worm. 09.06.2017, segments of worms found in the feces. They were identified as arthropods of Taenia saginata. From 14.06.2017 the patient’s condition worsened, the temperature increased, there were pains in the left half of the chest. In the following days the condition remained grave. According to CT (from 19.06.2017) helminth was determined in the lumen of the left lower salt bronchus. Bronchoscopy was performed (21.06.2017), which reduced the presence of signs of inflammation of the left lower salt bronchus. Worms are not detected. Sputum sowing was performed, but sputum microscopy was not carried out. Ultrasound (23.06.2017) showed the presence of fluid in the left pleural cavity. Puncture was performed and 70 ml of serous fluid was obtained. In the future, double-prosodical puncture which was obtained 600 and 500 ml of a yellow viscous exudate. On 29.06.2017, teniid eggs were found in sputum. Praziquantelum is prescribed 25 mg / kg once. On 04.07.2017, the fourth puncture of the pleural cavity was performed, 200 ml of light yellow effusion was obtained. In the days following the symptoms of pleurisy had disappeared and 10.07.2018, came recovery. Lung damage, which developed as a result of aspiration of the arthroplasty Taenia saginata was accompanied by a rare dry cough and moderate severe intoxication syndrome. The severity of the patient’s condition was determined by severe respiratory failure and pain. Auscultation of the wheezing was not. Over the lesion was sharply pronounced weakened breathing. In the peripheral blood was determined by high ESR, moderate leukocytosis and no eosinophilia.

Approaching to health care digital economy gives dramatic new opportunities for regulation. At the same time information transparency leads to civil society growth of trust. The Russian “Digital Economy” program provides considerable means until 2024. The Ministry of Health also develops the Uniform state information system of health care. Compliance of these efforts to modern scientific paradigms of digital economy and to the nowadays world trends in digital health care with the purpose to estimate correctness of the directions and approaches chosen are analysed. On the basis of the modern theory of management in the sphere of difficult social and economic systems the analysis of the best world practices compliance to features of the of digital health care applications in Russia the conclusion that outdated hierarchical principles of control and regulation need to be refused is drawn. The new conceptual model on the basis of community of autonomous network agents is offered.

The trail was conducted with the purpose to compare two heating devices in the groups of patients who had surgery due to varicose veins of the lower extremities with spinal anesthesia with intravenous sedation in the intra- and post-operative periods. It was found out that warming with the help of blankets with active self-heating technology is more efficient for prevention and treatment of intra-operative hypothermia compared to resistive mattresses. The article includes discussion of mechanisms of intra-operative hypothermia development, its negative effects and measures for its prevention and treatment. Recommendations on the use of this equipment are given.

The BRCA1 5382insC and CHEK2 1100 delC mutations were analyzed in 3850 of non-selected breast cancer patients residing in Novosibirsk region, Russia. One hundred seventy probands, BRCA1 5382insC or CHEK2 1100delC mutation carriers, were found. The study demonstrated that more than 80 % of probands informed relatives about their hereditary or familial cancer risk. Fifty-nine BRCA1 5382insC and CHEK2 1100 delC mutation carriers were found among 144 proband’s relatives. Mutation carriers or their relatives were interviewed two years after starting the project. At least 18 % of the mutation carriers reported primary tumor or recurrence of the tumor 2 years after starting the project.

У статті в стислій формі висвітлено актуальні питання факторів ризику, механізмів розвитку, диференційної діагностики болю в спині. Простежено місце та роль медикаментозних блокад як діагностичного та лікувального методу при болях у спині, їх раціонального застосування. Медикаментозні блокади дозволяють проводити пролонгований менеджмент болю. Застосування ультразвуку робить цей метод більш точним, а дозування кортикостероїдів – оптимальним. Використання пролонгованого комбінованого препарату Депос у цій ситуації має додаткові переваги. Своєчасне втручання при болю у спині, належна діагностика та динамічне спостереження разом з подальшими превентивними заходами є запорукою оптимальної якості життя, скорочення строків непрацездатності, попередження хронізації та рецидивів.

A comparison of two methods for measurement of the free carrier recombination lifetime in the unpassivated samples of high resistivity n-type silicon single crystalls (reference samples of "GIREDMET") was made. The methods were based on the photoconductivity decay measurements (High frequence and /-PCD). Effective recombination lifetime value in the range 1-1500 /is were achieved by changes of the sample thickness from 0,4 to 10 mm. Bulk recombination lifetime was calculated using the relation between the effective recombination lifetime and the sample thickness. It was shown that random and systematic errors for two methods are of the same order.

Koshova S. P. Особливості психічних змін у хворих тяжкими соматичними захворюваннями = Features of mental changes in patients with severe medical diseases. Journal of Education, Health and Sport. 2016;6(7):75-90. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.57123 http://ojs.ukw.edu.pl/index.php/johs/article/view/3663 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 25.05.2016. Revised 25.06.2016. Accepted: 28.06.2016. УДК159. 923 Особливості психічних змін у хворих тяжкими соматичними захворюваннями С. П. Кошова Національна медична академія післядипломної освіти імені П. Л. Шупика Реферат У статті розглядається проблема психосоматичних захворювань, вплив значущих переживань на формування та перебіг психосоматичних розладів, особливості розвитку особистості в онтогенезі, взаємозалежність емоційної сфери психіки людини та стану її здоров’я, висвітлюються особливості психічних змін хворих при соматичних захворюваннях. Ідея про можливість впливу психічного стану на фізичне здоров'я не нова, про це говорив ще давньогрецький філософ Платон, який стверджував, що душа і тіло є єдиним цілим. Пізніше його ідеї підтримали багато вчених, і сьогодні все частіше стає зрозуміло, що наші емоції часто керують нашим фізичним станом. Ключові слова: захисні механізми, онтогенез, психіка, емоції, суб’єктивні переживання, стрес, адаптаційні процеси, психосоматичні розлади, здоров’я людини, ієрархизованість мотивів. Features of mental changes in patients with severe medical diseases S. P. Koshova Shupyk National Medical Academy of Postgaduate Education Abstract The problem of psychosomatic diseases, the impact of significant experiences the formation and progress of psychosomatic disorders, especially the development of personality in ontogenesis, interdependence emotional sphere of the human psyche and the state of her health, mental changes, specific features of patients with somatic diseases. The idea of the possible impact on the mental state of physical health is not new, this was still the ancient Greek philosopher Platon, who argued that the soul and the body are inseparable. Later, it supported the idea many scientists today is increasingly becoming clear that our emotions often govern our physical condition. Keywords: protective mechanisms, ontogenesis, mind, emotions and subjective experiences, stress, adaptive processes, psychosomatic disorders, health, hierarchy of motives. Реферат ОСОБЕННОСТИ ПСИХИЧЕСКИХ ИЗМЕНЕНИЙ У БОЛЬНЫХ ТЯЖЕЛЫМИ СОСАТИЧЕСКИМИ ЗАБОЛЕВАНИЯМИ. В статье рассматривается проблема психосоматических заболеваний, влияние значимых переживаний на формирование и течение психосоматических расстройств, особенности развития личности в онтогенезе, взаимозависимость эмоциональной сферы психики человека и состояния его здоровья, освещаются особенности психических изменений больных при соматических заболеваниях. Идея о возможности влияния психического состояния на физическое здоровье не нова, об этом говорил еще древнегреческий философ Платон, который утверждал, что душа и тело являются единым целым. Позже его идеи поддержали многие ученые, и сегодня все чаще становится понятно, что наши эмоции часто управляют нашим физическим состоянием. Ключевые слова:защитные механизмы, онтогенез, психика, эмоции, субъективные переживания, стресс, адаптационные процессы, психосоматические расстройства, здоровье человека, иерархизованисть мотивам.

Mutations in KRAS and BRAF genes in 80 colorectal cancer (CRC) samples from Russian patients were tested using two methods: 1) allele-specific real-time PCR (as-rt PCR) and 2) wild-type blocking PCR with Sanger sequencing (WTBS). Material and methods. Sections of fresh frozen or formalin-fixed paraffin embedded tumor tissue from 80 patients were used in the study. Tumor tissue content was determined on H&E stained sections. Samples were first tested by as-rtPCR for common mutations of the KRAS gene (G12C, G12S, G12R, G12V, G12D, G12A, G13D) and mutations BRAFV600E. After that samples were evaluated in PCR with oligonucleotide blocking amplification of wild-type DNA for enrichment with mutant allele followed by Sanger sequencing of the PCR DNA (WTBS method). Results. In 5 (6.3 %) cases samples had low tumor tissue content (

Increasing the number of patients with complicated forms of chronic pancreatitis and pancreatic cysts observed in recent decades. Mostly people of working age are susceptible to disease. This makes the issue a social importance.The article presents a modern view of the choice of method of surgical treatment of chronic pancreatitis and cystic optimal terms of therapy, depending on the degree of “maturity” of pancreatic cysts. A detailed analysis of both traditional surgery and advanced minimally invasive treatment for pancreatic cysts is performed in this review of the literature.Emphasis is placed on radical methods of treatment, particularly in the duodenum-preserving operations. Pathogenic study is carried out. The problem of choosing the most radical and at the same time the organ-preserving technique, helping to improve the immediate and long-term results, the quality of life and social and labor rehabilitation, has not lost its relevance. Studies carried out in this area are currently important.

The paper reviews the data available in the literature on the identification of tumor cells in bone marrow and peripheral blood in different tumors and breast cancer. Analysis of the majority of investigations suggest that the presence of tumor cells in the bone marrow correlates with early disease recurrences and lower survival; to detect bone marrow tumor cells is one of the most important approaches to early identifying metastases and improving the results of treatment for breast cancer. The paper gives the results of an investigation conducted at the N.N. Aleksandrov Republican Research and Practical Center for Oncology and Medical Radiology in 2008 to 2014, which established that the presence of cancer cells in the bone marrow is a poor prognostic sign: the 3-year relapse-free survival of patients with the unaffected and affected bone marrow was 88.7 and 69.3 %, respectively (p < 0.01).

Проаналізовано методики кількісного та інтегрального оцінювання впливу стресу в лікарів у процесі тестування їхніх знань під час атестації. Обґрунтовано проблеми, що виникають при дослідженні стресів у навчальній діяльності. Проведений аналіз теоретичних та емпіричних досліджень стресових станів лікарів при навчанні під час безперервного професійного розвитку дозволяє стверджувати, що ознаки стресового стану в лікарів під час складання іспитів досить добре вивчені, але ідентифікація їх та рівень відповідності стресу не мають математичного підтвердження. Тому висловлена думка, що управління стресом можливе лише шляхом використання індивідуальних прогностичних характеристик на основі статистичного моделювання. Представлено загальні критерії оцінювання стресового стану за об'єктивними показниками. Показано, що досягнення об'єктивних оцінок компетентності, знань та вмінь лікарів під час комп'ютерного тестування повністю залежить від забезпечення ефективної адаптації до зовнішніх і внутрішніх обставин іспиту. Також постулюється, що неодмінною складовою процесу комп'ютерного іспиту є його комплементарна до особистості організація процесу, в результаті чого емоційне сприйняття процесу навчання буде позитивним, іспити формуватимуть позитивну самооцінку, процес засвоєння знань стане систематичним і цілісним.