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Introduction. The purpose of the work is to study the causes of corrosion destruction of bus bodies of the enterprise. In the course of work, it was revealed that the main causes of intensive corrosion destruction of bus bodies are insufficiently high corrosion resistance of metals used in the manufacture of the body frame. The main places of occurrence of foci of corrosion of the body are: wheel arches; rear and lower parts of the bus, which are more susceptible to adverse road conditions; the upper and lower parts of the window openings in case of violation of the tightness of the seal. In the course of the study, initial data were obtained to determine the conditions and factors determining condensation on the cooled surfaces of bus bodies entering the indoor parking area; a set of organizational and technical measures aimed at reducing the intensity of corrosion wear of the company’s vehicle bodies was developed.Materials and methods. The results of observations of changes in the technical condition of bus bodies, parameters of their maintenance conditions were used, methods of a priori ranking of factors and classification were used. The results and recommendations on the technical operation of bus bodies are described.Results. As intermediate results of the conducted research, the data on the influence of the technical condition of bus bodies on the indicators of technical operation were obtained, which make it possible to justify the modes of maintenance and storage of motor vehicles. The data obtained make it possible to simulate the processes affecting the technical condition of bus bodies, which is the basis for the development of optimization measures.Discussion. It is noted that the approach implemented during the study enables to establish a set of factors affecting the technical condition of bus bodies, and to determine the consequences of premature achievement of the limit state by the elements of the load-bearing structure.Conclusion. As a generalizing conclusion, it is noted that the practical implementation of the developed methodology ensures the development and implementation of sound measures to increase their durability in the practical activities of road transport enterprises.

АКТУАЛЬНОСТЬ: Количество уголовных дел, возбуждаемых против врачей — анестезиологов-реаниматологов в Российской Федерации, не уменьшается. Однако подробный анализ за последние годы не проводился, и в первую очередь это было обусловлено пандемией новой коронавирусной инфекции COVID-19 и теми ограничениями, которые были с ней связаны. ЦЕЛЬ ИССЛЕДОВАНИЯ: Провести анализ уголовных дел в отношении врачей — анестезиологов-реаниматологов, возбужденных по различным статьям Уголовного кодекса Российской Федерации (УК РФ) за последние четыре года — с 2019 по 2022 г. МАТЕРИАЛЫ И МЕТОДЫ: Поиск уголовных дел был выполнен в следующих электронных базах данных: «Судебные решения РФ» и «Государственная автоматизированная система Российской Федерации ”Правосудие”». По результатам поиска было рассмотрено 66 уголовных дел против врачей — анестезиологов-реаниматологов. РЕЗУЛЬТАТЫ: Выявлены основные статьи УК РФ, по которым наиболее часто привлекают к ответственности врачей — анестезиологов-реаниматологов. Представлены гендерные и территориальные распределения уголовных дел по регионам Российской Федерации. Определены наиболее значимые и часто совершаемые дефекты оказания медицинской помощи. Приведены примеры наиболее громких и сложных уголовных дел. ВЫВОДЫ: Создается впечатление, что количество уголовных дел против врачей — анестезиологов-реаниматологов несколько уменьшилось после 2019 г., однако мы считаем, что это связано с пандемией новой коронавирусной инфекции, по этой причине множество судебных дел еще находится на стадии расследования и не были завершены в срок.

ЦЕЛЬ ИССЛЕДОВАНИЯ: Описать имеющиеся данные о показаниях, осложнениях, реализации и альтернативных стратегиях использования физического сдерживания у взрослых пациентов в отделениях реанимации и интенсивной терапии. МАТЕРИАЛЫ И МЕТОДЫ: Комплексный обзор, проведенный в базе данных Cochrane, PubMed, Scopus, LILACS, Nursing Database, научной электронной библиотеки eLibrary. Поиск производился по запросам: «физическое ограничение», «фиксирующие устройства в реанимации», «безопасность пациента», «фиксация пациента». РЕЗУЛЬТАТЫ: Окончательный выбор состоял из 93 статей, из которых были извлечены показания, осложнения, алгоритмы и альтернативные стратегии. ВЫВОДЫ: Описаны наиболее распространенные практики в отношении физических ограничений в России и за рубежом, отмечена необходимость разработки и внедрения протоколов использования физических ограничений в отделениях интенсивной терапии.

Road transport plays an important role in the life of modern society, satisfying the transport needs of almost all sectors of the economy and the population. Mass motorization has led to a number of problems, the severity of which is increasing every day. The most urgent problems are caused by the negative impact of motor transport on the environment and the problems associated with the release of greenhouse gasses that lead to climate change on a planetary scale. According to many experts, one of the most difficult and one of the most promising methods to reduce the severity of these problems is the use of liquefied natural gas as an automobile fuel. Scientific and applied developments in this direction are largely innovative in nature. Assessment of technical and economic indicators of their practical implementation will determine the area of effective application and identify key consumers of this fuel and energy scheme. The purpose of the study is to improve the efficiency of the operation of motor vehicles based on the results of the analysis of technical and economic indicators of using liquefied gas as an automobile fuel. The achievement of the designated goal is ensured by solving such tasks as analysis of technological and technical and economic parameters of the use of liquefied methane; development of an algorithm for conducting technical and economic analysis, formalization of input data and parameters; testing of the developed algorithm in practice, obtaining the results of technical and economic analysis; generalization of the results obtained, formulation of conclusions and practical recommendations. Due to the lack of accumulated experience in the practical operation of vehicles using liquefied methane, the methods of mathematical modeling of the object of study and multi-criteria analysis conducted with respect to the data obtained from the results of modeling are applied in the work. The main result of the study is an established multidimensional domain determined by a combination of key parameters such as fuel cost, vehicle cost, its annual mileage and other parameters. These multidimensional areas constitute the scientific novelty of the results of the performed research. The overlay of the identified multidimensional area on the area formed on the basis of the analysis of the structural parameters of the regional fleet of vehicles allows you to identify key consumers and generate the data necessary to determine the infrastructure parameters that ensure the implementation of the technology in question. One of the promising areas of further research within the framework of the designated topic is the development of a methodology for the formation of infrastructure parameters that ensure the effective use of liquefied methane as an automobile fuel.

The article contains relevant information on the influence of the technical condition of the driving axles on the reliability and durability of the car. The analysis of scientific and technical literature and infor-mation on the operating conditions of trucks is based on a systematic approach to assessing the operational condition of a vehicle. Studying the recommendation of scientific works and technical documentation allowed us to establish insufficient attention to the problem of thermal preparation of the drive axle during operation in winter conditions. For an objective assessment of the technical condition of the drive bridge, the main factors that determine the influence of the driver and the environment on the working process of transmission and power distribution in the transmission were considered. Based on the experience of operating KаmAZ trucks, it is concluded that the impact of negative factors on the probability of component failure during operation in winter conditions is complex. The purpose of this study is to study the thermal loading of the truck’s driving axles in winter conditions. Based on information about the rational ranges of operating temperatures of transmission oil and axle parts, the task of theoretical and experimental study of the thermal state of the transmission is posed. The main provisions of the developed methodology for calculating the heat balance of the drive axle are presented, which takes into account significant environmental factors and represents scientific novelty. Critical zones of the drive axle have been identified, the thermal state of which during winter operation affects the reliability and durability of parts. The article presents the results of experimental studies of the leading bridges of the KаmAZ automobile. Ro-ad tests were carried out under various operating conditions in order to establish temperature gradients in the critical zones of the nodes. Thermograms of critical zones were taken sequentially at different stages of the run. The results obtained confirm the theoretical positions of the authors full of scientific and practical interest. It is recommended that thermal preparation of the drive axles be carried out before winter operation. The continuation of scientific research is associated by the authors of the article with the implementation of the method of on-board control and maintaining rational temperatures of gear oil and axle parts during winter operation of cars.

Lumbar drainage is one of the methods used to prevent the occurrence of intracranial hypertension and treatment of nasal liquorrhea in patients after by endonasal transsphenoidal endoscopic removal of tumors of the chiasmosellar region. The application of this method intraoperatively is a standard procedure to facilitate manipulation of the brain surgeon, but prolonged post-operative drainage is used extremely selectively and depending on the approaches taken in the specific medical organization. The present paper describes different frequency and risks of lumbar drainage after the surgery. Our aim was to assess the efficacy and safety of postoperative drainage of liquor from the surveyed patients. We observed 80 patients in the postoperative period who were conducted passive lumbar drainage. The assessment was performed of the cell count and discharge of the liquor, depending on the size of the tumor. During the study, it was found that the optimal timing of drainage is: 3 days for patients with small and medium-sized pituitary adenomas and 5 days for patients with large and giant adenomas. In all cases, the maximum values of cell count were observed on the first day and they gradually reduced by the 3-5th days due to reorganization of the liquor and reduced inflammatory response. Postoperative meningitis developed in 6 (5.8 %) cases and in 3 cases this complication led to death. It has been found, that prolonged liquor drainage meets the standards of safety and effectiveness for the correction of intracranial hypertension and accelerates the rehabilitation of the CSF.

Welded joints of structure steels have lower corrosion resistance in comparison to base metal. To increase corrosion resistance of welded joints and heat-affected zone they use longtime and energy-consuming methods of thermal and mechanic processing. The article covers the possibility of using the superplasticity deformation (SD) effect for processing of welded joints. The effect of SD is that metals and alloys with a small grain size (of the order of 10 μm) under conditions of isothermal deformation at a certain temperature acquire the ability for unusually large plastic deformations while reducing the deformation resistance. Grain-boundary sliding during superplasticity provides a high degree of structural homogeneity. If the metal does not have the small grain size, then during isothermal deformation at appropriate temperature the SD effect will not be fully manifested but will cause relaxation of residual micro and macro strains, recrystallization, which can be used during processing of welded joints to ensure their full strength. There have been carried out the investigation of processing methods impact - SD, thermal cycling and influence of post-welding treatment on corrosion rate and microstructure of steels 20 and 30KhGSA. It is shown that after deformation in superplasticity mode there is low corrosion rate and more favorable microstructure in the studied samples of steel. Post-welding processing of welded joints in SD mode provides low tool loads and low energy costs.

In the article the authors consider possibility of worked out program complex “Dif Pro Generator” application for eutectic characteristics modeling as independent method of three-component mutual systems research and as express-method for more reliable information selection, if data of different investigators about non-variant points compositions and temperature are contradict.

In December, 2021 at the IXth All-Russian Congress «Pulmonary Hypertension 2021» the first Eurasian guidelines for the diagnosis and treatment of pulmonary hypertension associated with congenital heart disease in adults were approved. The expert group discussed many contentious issues, including the need for diagnostic tests for vasoreactivity. Invasive registration of the reaction of the pulmonary vessels to vasodilators – a vasoreactivity testing – in idiopathic, hereditary and drug- and toxin-induced pulmonary arterial hypertension (PAH) is used to determine indications for calcium antagonist therapy, in PAH associated with uncorrected congenital heart disease (CHD) in children – to determine the indications for surgical treatment. The use of a vasoreactivity testing to assess the operability of adult patients with congenital heart disease is inappropriate. An overview of the performance technique, specific pulmonary vasodilators and criteria for evaluating the test for vasoreactivity in various subgroups of PH associated with CHD is given.

Association of Cardiovascular Surgeons of Russia Russian Society of Cardiology (RSC)Association of Pediatric Cardiologists of RussiaRussian Scientific Society of Specialists in X-Ray Endovascular Diagnostics and TreatmentAll-Russian Public Organization for the Promotion of Radiation Diagnostics and Therapy "Russian Society of Radiologists and Radiologists".Task Force members declared no financial support/conflicts of interest. If conflicts of interest were reported, the member(s) of the working group was (were) excluded from the discussion of the sections related to the area of conflict of interest.

Disclaimer The EAC Guidelines represent the views of the EAC, and were produced after careful consideration of the scientific and medical knowledge, and the evidence available at the time of their publication. The EAC is not responsible in the event of any contradiction, discrepancy, and/or ambiguity between the EAC Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the EAC Guidelines fully into account when exercising their clinical judgment, as well as in the determination and the implementation of preventive, diagnostic, or therapeutic medical strategies; however, the EAC Guidelines do not override, in any way whatsoever, the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient’s health condition and in consultation with that patient and, where appropriate and/or necessary, the patient’s caregiver. Nor do the EAC Guidelines exempt health professionals from taking into full and careful consideration the relevant official updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient’s case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional’s responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription.

Pulmonary arterial hypertension (PAH) is severe and often times rapidly progressive disease with fatal outcome. The concept of initial combination of PAH-specific therapies in high risk patients at baseline was first described in the European guidelines on pulmonary hypertension (PH) in 2009, and in low or intermediate risk patients at baseline in 2015. Interestingly, that in Cologne Experts Consensus, and then in the 6th World Symposium on PH medical community started considering initial combination therapy as one of the most important pillars in PAH treatment algorithms in 2018. As of August 2020, as many as 8 formulations of 7 reference PAH-specific drugs are licensed for medical use in the Russian Federation. On top of that, 6 abbreviated drugs (generics) have also become available few years ago. Unfortunately, intravenous and subcutaneous prostacyclin analogs (PCA) and tadalafil are not approved for PH patients treatment in the Russian Federation. In this narrative review paper we attempted to describe studies on initial dual combination therapy with PAH-specific drugs registered in Russia, i.e. ambrisentan and riociguat, macitentan and riociguat, macitentan and sildenafil in low or intermediate risk patients at baseline, as well as iloprost inhaled and sildenafil, iloprost inhaled and bosentan in high risk patients. Some beneficial pharmacological effects due to the synergy between ambrisentan plus riociguat, and inhaled iloprost plus sildenafil appear to be interesting and require further clinical confirmation. Other initial combinations of PAH-specific agents require large-scale clinical trials as well.

Russian Society of Cardiology (RSC)With the participation: Association of Cardiovascular Surgeons of Russia, Russian Respiratory Society, Federation of Anesthesiologists and Resuscitators, Association of Rheumatologists of Russia, National Congress of Radiation Diagnosticians.

Pulmonary hypertension (PH) in pediatrics is a polygenic multifactorial condition with extremely adverse prognosis. Selection of optimal management is a severe task. In absence of treatment the mean life duration in children is not higher one year. Last two decades, revolution in approaches to treatment improved the survival of this patients group. Recently, pediatricians and pediatric cardiologists have three drugs groups that act on the main pathogenetic chains of PH: endothelin pathway, nitric oxide pathway and prostacyclin pathway. At the moment, approaches to pediatric PH are based on the data obtained in the trials on adult patients. However, not long ago there were first randomized trials on children performed. The group of authors of current article presents a modern view on the problem of PH in children, and expert recommendations on children management. Class of recommendations and evidence level were set by the data obtained in pediatric population or on adult population with at least 10% of children included. To the strategy, developed by the Russian clinicians, laid the analysis of experience of the pathology treatment in Russian Federation, as the current practics and clinical guidelines on pediatric PH in Europe, and the recent trials published.

High grade pulmonary hypertension (HGPH) determines invalidization, low quality of life and causes fatal outcomes. Aim of the study: to use echocardiography to evaluate the morphological and functional condition of ventricular myocardium and criteria determining prognosis. Materials and methods: 40 patients with HGPH aged 3 to 56 underwent echocardiography for the period of 1999-2000 in the Center and were divided into the following groups: 1) patients with congenital heart disease and Eisenmenger complex (22); 2) patients with progressing pulmonary hypertension after a vicium cordis is corrected; 3) patients with primary pulmonary hypertension (PLH) (11). Echocardiography was used to evaluate: systolic function – ejection fraction for each ventricle, fractional change in right ventricle, cardiac index of the greater circle; diastolic function of the ventricles, LV excentricity index, reflecting septum geometry, the degree of RV hypertrophy, end diastolic square of the right ventricle, hemodynamics of the lesser circle. Results: in patients with progressing pulmonary hypertension after a vicium is corrected and in patients with pulmonary hypertension we have revealed RV dysfunction and decreased cardiac index of the greater circle which defines a severe clinical course of the disease. In a group with NYHA IV we observed a marked decrease in RV systolic function, impaired RV diastolic function in a restrictive way and decreased cardiac index of the greater circle. In patients with a septum defect and Eisenmenger complex RV diastolic function was not impaired in a restrictive way (end diastolic pressure in RA and RV not increased), despite significantly dilated right heart chambers, decreased RV systolic function and cardiac index of the greater circle. Therefore we draw a conclusion that a defect levels RV failure defining a favorable prognosis. Preserved ventricular systolic function, their hypertrophy and normal cardiac index of the greater circle is typical in most cases of septum defects, persisting ductus arteriosus and Eisenmenger complex. The severe clinical course is defined by a significant hypoxemia, playing an important role in the impairment of either ventricle.