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The purpose of this study is to determine the relationship between the GPA of graduates of social majors at National Technical University «Kharkiv Polytechnic Institute» (Ukraine) with the results of the entrance assessment, learning motivation, achievement motivation, and perception of teacher leadership, based on the correlation and regression analysis of the study with a total of 502 respondents. Results of the presented study demonstrate a significant correlation between the level of academic success and the level of educational and cognitive motivation of graduates (r = 0.644, ? < 0.010). A less strong connection was found between graduates' GPA and the entrance examination results (r = 0.502, ? < 0.010). The weakest, albeit statistically significant, relationship is between GPA variables and students' perception of teacher leadership (r = 0.160, p < 0.010), as well as between GPA and motives for creative self-realization (r = 0.139, ? < 0.010). The article also carried out a correlation analysis for groups of students by level of education, form of study, majors, and gender of respondents. Obtained results are discussed with the purpose of improving the procedure for selecting applicants for admission to universities and improving the educational process.

We extend our recently developed sparse-stochastic fragmented exchange formalism for ground-state near-gap hybrid DFT to calculate absorption spectra within linear-response time-dependent generalized Kohn-Sham DFT (LR-GKS-TDDFT) for systems consisting of thousands of valence electrons within a grid-based/plane-wave representation. A mixed deterministic/fragmented-stochastic compression of the exchange kernel, here using long-range explicit exchange functionals, provides an efficient method for accurate optical spectra. Both real-time propagation as well as frequency-resolved Casida-equation-type approaches for spectra are presented, and the method is applied to large molecular dyes.

Relevance. A potential for zoonotic transmission of highly pathogenic coronavirus strains to humans was of little concern to health care providers, which came as a surprise and led to a coronavirus pandemic in 2020 spring. In 2023 fall, there was higher number of humans infected with coronavirus infection. In 2024, influenza outbreaks characterized by wave-like temperature changes are observed, which may indicate the emergence of a new virus strain. Currently, it is of interest to study the effects related to novel coronavirus infection on human immune system. To date, the immune responses for individual parameters from leukocyte blood formula have been studied, but insufficient attention has been paid to the cumulative impact, due to the fact that many parameters behave ambiguously and it has not been possible to determine the cumulative impact on the immunogram. The aim of the study is to investigate models describing the dynamics in immunogram changes during the pandemic in adolescents living in Perm Krai. The objectives were to analyze differential equations describing a change in immunogram parameters; to summarize study results on impaired immunity due to exposure to coronavirus infection. Results. Differential equations were analyzed and the extremum and age patient parameters with the greatest deviation from the reference interval were determined. Conclusion. Despite the fact that individual elements of flow cytophotometric analysis are oscillatory in nature with large impulses, the generalization of flow cytophotometric analysis indices showed an interesting pattern characterized by a smooth change towards increasing deviation in older adolescence for all studied parameters. Flow cytophotometric analysis indices being within the reference range had the same modality towards negative trend with increasing age only differed by the fact that in the disease state the deviation was twice as large. Without disease, the excess of flow cytophotometric analysis indicators had a positive trend with increasing age, and the decrease of flow cytophotometric analysis indicators from the reference interval had a negative trend. In the disease state with decreased immunoglobulins, when flow cytophotometric analysis exceeded the reference interval, there was a convex deviation in the negative direction with increasing age. When decreasing from the reference interval, a convex curve with a positive trend is observed. Upon elevated immunoglobulins exceeding the reference interval flow cytophotometric analysis has a convex positive trend, whereas for at lowering the reference interval flow cytophotometric analysis also has a convex positive trend exceeding 5 times.

Background. In recent years, the topic of artificial intelligence (AI) in medicine has been actively discussed not just as a promising solution but the one that can help to improve some results. A significant growth of interest in AI systems all over the world began in the early-mid 2010s, which allowed us to consider the practical application of such systems. The aim of the study is to analyze all the software products (SP) registered in our country as a medical device, including those with AI technology, and to evaluate their applicability in traumatology and orthopedics. Methods. The study included all the SP having a registration certificate of a medical device according to the OKPD2 code 58.29.XX.XXX (services for publishing other software). In the state register of medical devices and organizations (individual entrepreneurs), which is engaged in the production and manufacturing of medical devices, we found 111 registered SP according to the inclusion criterion, as at February 14, 2024. Results. We proposed to categorize all registered SP as follows: systems working with the DICOM standard images (47 pcs, 42%), laboratory data (20 pcs, 18%), microscopy images (7 pcs, 6%), photographic images (5 pcs, 5%), medical information systems (4 pcs, 4%), text data mining systems (3 pcs, 3%), clinical decision support systems (3 pcs, 3%), Holter ECG analysis (2 pcs, 2%), other systems (16 pcs, 14%). Systems applicable to traumatology and orthopedics accounted for 4 pcs (4%). Conclusions. Unfortunately, the real-world applicability of existing solutions in the field of traumatology and orthopedics can be regarded as minimal in comparison with pulmonology, oncology, and laboratory diagnostics, where AI programs have already achieved significant success.

Актуальність наукового дослідження полягає у тому, що наявна квестія запобігання корупції поміж співробітників поліції є не тільки пробле­мою МВС України, а й національним питанням, зокрема. Мета статті полягає в аналізові типо­логії корупційних виявів в органах Національної поліції України. У контексті наукової розвідки застосовано низку загальнонаукових та галу­зевих методів, зокрема, метод аналізу, синтезу, історичний й логічний, діалектичний, історич­ний та синергетичний, системний методи. За­значено, що корупція в органах поліції є фено­меном, котрий позиціонує собою ризик не тіль­ки усталеним учинам структурних підрозділів правоохоронних органів, а втім і таким, котрий за осібним змістом здійснює негативний уплив стосовно розвію соціальних стосунків, розвію держави, котра пред’являє осібні права власне на домінування доктрин верховенства права, паритету усіх перед законом, які є властивими саме демократичній правовій державі. У статті зазначено, що превенція корупції в учинах співробітників органів правоохорони є компонентом загальної антикорупційної політи­ки держави, котра корелює з державними на­мірами запобігання цьому негативному феноме­нові, охоплює у собі власне стратегію розвитку публічних та правових стосунків щодо нейтралі­зування чи локалізування дій посадових осіб НП України (чинників) корупції та консеквентному упливу за підтримки конгруенції правового ін­струментарію з метою досягнення вставленої мети, котра усталюється власне у сфері реаліза­ції Національною поліцією України поставлених перед нею завдань. Водночас, важливим чин­никомзапобігання корупційним деліктам поміж співробітників поліції, є зростання їх громадян­ської свідомості. Наголошено увагу на тому, що корупційні де­лікти поміж співробітників поліції є вкрай небез­печним явищем, котре, на жаль, є властивим і зарубіжним поліцейським. Зазначено, що корупцію можливо здолати за обставин, коли кожен поліцейський почуватиме безпосередню відповідальність стосовно звер­шення спільного прагнення - формування неза­лежної власне від корупції поліції. Зазначено, що значна кількість зарубіжних держав спромоглася сформувати сучасний діє­вий механізм запобігання корупційним право­порушенням поміж співробітників поліції. Ура­ховуючи європейський вибір нашої держави, є доконечна потреба у розробленні й реалізації інноваційної антикорупційної політики із ураху­ванням позитивних факторів існуючого міжна­родного досвіду.

Мета. Визначення ключових аспектів підвищення ефективності надання реабілітаційної допомоги за рахунок впровадження інноваційних технологій. Матеріали і методи. Бібліографічний метод з можливістю "згортання інформації". Методологія дослідження базувалася на системному підході. Для вирішення поставлених завдань застосовано метод системного аналізу (системно-історичний і системно-структурний). Результати. Система реабілітації в Україні є важливим елементом національної системи охорони здоров'я, що спрямована на відновлення фізичного та психічного здоров'я пацієнтів. Вона включає в себе різноманітні методики та підходи, орієнтовані на індивідуальні потреби кожного пацієнта. В Україні система реабілітації пройшла довгий шлях розвитку, адаптації та вдосконалення, особливо з урахуванням сучасних викликів, таких як військові конфлікти та зростання кількості пацієнтів із травматичними ураженнями. Для подальшого розвитку системи необхідно вирішувати існуючі проблеми: оптимізація ресурсів (ефективне використання медичних ресурсів та обладнання завдяки точному обліку і аналізу даних, зниження адміністративних витрат та часу на обробку паперової документації); покращення комунікації та співпраці (забезпечення інтеграції та обміну даними між різними медичними установами, підвищення рівня координації дій медичних працівників); введення аналізу і прогнозування за рахунок існування системи постійного моніторингу шляхом створення баз даних. Підвищення ефективності реабілітаційних заходів в Україні вимагає комплексного підходу, що включає впровадження сучасних технологій, підготовку кваліфікованих кадрів, використання мультидисциплінарного підходу, впровадження програм телереабілітації, підвищення обізнаності населення та покращення матеріально-технічної бази. Висновки. Навмисне та поетапне впровадження інновацій у систему реабілітаційної допомоги є ключовим для забезпечення ефективності та якості надання реабілітаційної допомоги. Використання наявного позитивного досвіду, залучення фахівців, ретельне планування та закріплення на законодавчому рівні дозволять створити ефективну систему реабілітації, яка відповідатиме сучасним вимогам і потребам пацієнтів.

Background Hospitalizations are a resource-intensive form of healthcare use, particularly for persons with chronic conditions such as those with HIV. Interhospital transfers typically appear as separate records in Canadian databases; misclassifying transfers as independent hospitalizations can bias key metrics such as readmission rates. We examined approaches of combining sequential, related records into hospitalization episodes of care (HEoCs) among persons with and without HIV (PWH; PWoH) in British Columbia (BC), Canada. Methods BC hospitalization records (1992 to 2020) were sourced from the Comparative Outcomes and Service Utilization Trends (COAST) study, a data linkage that includes samples of PWH and PWoH. We constructed 8 HEoC definitions that varied by the: a) time gap between records, and b) transfer indication. Comparisons were informed by the proportion of multi-record HEoCs (mHEoCs; episodes with multiple hospitalization records) generated, and feasibility given data quality. Results We analyzed 98,553 hospitalization records from 13,498 PWH, and 1,874,507 hospitalization records from 385,011 PWoH. Across the definitions, the proportion of mHEoCs varied from 2.46% to 5.27% for PWH and 2.73% to 4.18% for PWoH. Definitions requiring no transfer indication yielded the highest proportion of mHEoCs, whereas those requiring two-way agreement of hospital identifiers yielded the lowest proportion of mHEoCs. Patterns were comparable among PWH and PWoH. A pragmatic approach to defining HEoCs can be a reasonable option for general purposes – requiring at least one populated hospital identifier field, and ≤ 1 day gap between hospitalizations. Conclusions Various approaches can be employed to combine sequential, related hospitalization records into HEoCs to help provide less biased estimates of hospitalization-related metrics.

The aim of the study was to summarize the available data on the relationship between adipose tissue mediators and cancer in patients with metabolic syndrome. Material and methods. A literature search was conducted using the PubMed and eliBRARY databases. Of the 400 articles published over the past 20 years, 58 studies were included in the review. Results. There is evidence of an unfavorable course of cancer in patients with metabolic syndrome that is explained by the presence of common pathogenetic pathways. In this review, special attention is paid to adipose tissue mediators that regulate the course of inflammation. The involvement of adipose tissue mediators in the pathogenesis of cancer is discussed. The relationship between adipokines of adipose tissue and the effects of specialized pro-resolving mediators (SpRM), which are metabolites of polyunsaturated fatty acids (resolvins, protectins and maresins), are considered. the associations of mediators that regulate the intensity of inflammation with the metabolic syndrome and cancer are discussed. Conclusion. Further studies will contribute to a better understanding of the relationship between metabolic syndrome and cancer and the search for adequate predictive markers to select the most effective drug strategy for correcting metabolic syndrome.

Bronchial asthma (BA) continues to be a difficult disease to diagnose. Various factors have been described in the development of BA, but to date, there is no clear evidence for the etiology of this chronic disease. The emergence of COVID-19 has contributed to the pandemic course of asthma and immunologic features. However, there are no unambiguous data on asthma on the background and after COVID-19. There is correlation between various trigger factors that provoke the development of bronchial asthma. It is now obvious that the SARS-CoV-2 virus is one of the provoking factors. COVID-19 has affected the course of asthma. Currently, there is no clear understanding of whether asthma progresses during or after COVID-19 infection. According to the results of some studies, a significant difference was identified between the development of asthma in people after COVID-19. Mild asthma and moderate asthma do not increase the severity of COVID-19 infection. Nevertheless, oral steroid treatment and hospitalization for severe BA were associated with higher COVID-19 severity. The influence of SARS-CoV-2 infection is one of the protective factors. It causes the development of severe bronchial asthma. The accumulated experience with omalizumab in patients with severe asthma during COVID-19, who received omalizumab during the pandemic, has strongly suggested that continued treatment with omalizumab is safe and may help prevent the severe course of COVID-19. Targeted therapy for asthma with the use of omalizumab may also help to reduce severe asthma associated with COVID-19. However, further studies are needed to prove the effect of omalizumab. Data analysis should persist, based on the results of the course of asthma after COVID-19 with varying degrees of severity.

Purpose: to determine causal relationships between factors influencing soil erosion in agricultural lands in the south of Russia, review methods and strategies for its reduction. Discussion. Under the prevailing influence of water and wind erosion in the region under consideration, this problem becomes complex, affecting physical, socio-economic and environmental aspects. Over 37 % of the surveyed lands are affected by this negative factor, and the reduction in yield in heavily washed-out areas can exceed 50 %. In this regard, we examined agricultural lands in the south of Russia that are exposed to water and wind erosion. The research is based on extensive information resources such as agricultural reports, industry statistics and previous research studies. Conclusions. Based on the unobvious, indirect consequences of soil erosion of agricultural land, interconnected by positive feedback, a self-reinforcing cycle is formed, leading to a constant increase in erosion processes. The factors reducing soil erosion on agricultural land and their interaction are examined. These methods make it possible to reduce the use of production resources and erosion by 20 % and up to 50 %, respectively, and improve the condition of the soil in the long term by 30 %. The use of biotechnology has made it possible to increase the yield of some crops by 21 %, the amount of macroelements from 5.3 to 6.13 %, and protein by 20 %. It is concluded that it is necessary to influence not only the factors of occurrence or conditions of the erosion and removal of the fertile soil layer, but also the possible consequences. All this will reduce the degradation of agricultural land, and these aspects can be used to develop sustainable land use strategies and introduce modern technologies in agriculture to preserve soil resources and improve the living standards.

The article examines the peculiarities of cultural practices among Ukrainian youth in the conditions of a full-scale war. The research identified the most popular cultural practices among Ukrainian youth. It revealed the obstacles that prevent young people from attending cultural events more frequently. Special attention was given to identifying the most desired cultural services. Based on the respondents' answers, a matrix of cultural needs satisfaction was formed, which established a zone of cultural needs deficit. This zone represents those needs that have the highest demand among young people but remain unsatisfied. It includes festivals, cultural-historical excursions, comedy concerts, evenings, art exhibitions, and public lectures. The study also revealed the specifics of consuming cultural online products among young people and the level of demand for cultural events of this format. It was also found that almost every fifth young Ukrainian is currently involved in volunteer projects in the cultural sphere. However, nearly half of the surveyed youth do not participate in such events but express a desire to get involved. This indicates that young people have a demand for participation in volunteer cultural projects, and therefore, it is important to involve youth in various initiatives for the reconstruction and development of Ukrainian culture as a significant agent of social change.

Aim. To assess awareness of blood pressure (BP) level, adherence to therapy and achievement of target BP in residents of Russian regions as part of the 2023 hypertension (HTN) screening campaign.Material and methods. During May 2023, 4613 participants from 23 cities of Russia took part in the screening. Participation was voluntary without restrictions on sex. All patients aged over 18 years. During screening, BP and pulse were measured three times using automatic or mechanical BP monitors, and a questionnaire about behavioral risk factors, concomitant diseases and therapy was filled out. HTN was diagnosed with systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or taking antihypertensive therapy (AHT).Results. The analysis included data from 4585 respondents aged 18 to 95 years with an average age of 45 [28;59] years, of which 1729 were men (37,7%). The proportion of hypertensive patients was 49,6%. Among them, 62,8% took AHT and achieved target BP in 76,6% and 45,7% with the target BP criterion

The article proposes to study the influence of new protein-containing raw materials, namely cricket flour (CF) Acheta domesticus on the quality of whipped flour semi-finished product (WFP) research methods. The study used generally accepted methods for determining the rheological properties of the dough: the dependence of viscosity on shear stress, temperature, and rate of deformation of the dough, as well as the elasticity of finished products and physicochemical properties of the finished semi-finished product. The mass fraction of moisture was determined by drying to constant weight. The mass fraction of ash not dissolved in 10% hydrochloric acid in absolute dry matter was determined using the dry method in a muffle furnace. The mass fraction of protein was determined by the Kjeldahl method. Alkalinity was determined by the titrometric method. The mass fraction of total sugar was determined by the iodometric method. During the manufacture of WFP, cricket flour was added to 5.0-15.0%. The results of rheological parameters showed that adding CF to the dough in an amount of 15.0% significantly affected the viscosity and plasticity of the dough, which led to a decrease in volume and porosity in the finished semi-finished product. According to physicochemical parameters, it was found that with increased BC concentration, the mass fraction of protein increases (from 4.4% in conventional WFP to 62.06% with the addition of CF in the amount of 10.0%). At the same time, the mass fraction of total sugar decreases. The mass fraction of moisture in the finished semi-finished product also changes. The resiliency and elasticity of the finished products were determined by the laboratory method using the "Labor" penetrometer. According to the results of studies of resiliency and elasticity of the finished product, it was determined that the semi-finished product with the addition of 15.0% cricket flour had the lowest indicators compared to the products with the addition of 5.0% and 10.0% cricket.

Abstract Haplo-insufficiency of the gene encoding the myelin protein PMP22 leads to focal myelin overgrowth in the peripheral nervous system and hereditary neuropathy with liability to pressure palsies (HNPP). Conversely, duplication of PMP22 causes Charcot-Marie-Tooth disease type 1A (CMT1A), characterized by hypomyelination of medium to large caliber axons. The molecular mechanisms of abnormal myelin growth regulation by PMP22 have remained obscure. Here, we show in rodent models of HNPP and CMT1A that the PI3K/Akt/mTOR-pathway inhibiting phosphatase PTEN is correlated in abundance with PMP22 in peripheral nerves, without evidence for direct protein interactions. Indeed, treating DRG neuron/Schwann cell co-cultures from HNPP mice with PI3K/Akt/mTOR pathway inhibitors reduced focal hypermyelination. When we treated HNPP mice in vivo with the mTOR inhibitor Rapamycin, motor functions were improved, compound muscle amplitudes were increased and pathological tomacula in sciatic nerves were reduced. In contrast, we found Schwann cell dedifferentiation in CMT1A uncoupled from PI3K/Akt/mTOR, leaving partial PTEN ablation insufficient for disease amelioration. For HNPP, the development of PI3K/Akt/mTOR pathway inhibitors may be considered as the first treatment option for pressure palsies.

Aim. To study the impact of various methods of perioperative pain management on the frequency of postoperative complications in patients with lung cancer after thoracotomy. Materials and methods. The study involved 157 patients who were divided into 4 groups. Multimodal analgesia (MA) group: according to the concept of preemptive analgesia, patients received 1000 mg paracetamol IV 1 hour before surgery and 50 mg dexketoprofen IV; in the postoperative period, dexketoprofen and paracetamol were administered every 8 hours as well as epidural analgesia: 40 mg of 2 % lidocaine solution after a catheter was placed and continuous ropivacaine infusion at a dose of 2 mg/ml (6–14 ml/h) in the postoperative period. Thoracic epidural analgesia (TEA) group: epidural analgesia: administration of 40 mg of 2 % lidocaine solution after catheter placement, continuous ropivacaine infusion in the postoperative period at a dose of 2 mg/ml (6–14 ml/h). Preemptive analgesia (PA) group: according to the concept of preemptive analgesia – 1000 mg IV paracetamol 1 hour before surgery as well as 50 mg IV dexketoprofen; in the postoperative period, dexketoprofen and paracetamol were administered every 8 hours. Control group (C): patients received 50 mg IV dexketoprofen for postoperative analgesia. If the severity of the pain syndrome was more than 50 mm according to the visual analogue scale (VAS), patients of all groups were given 10 mg IV morphine. The study involved the registration of side effects in the postoperative period. Results. Among 157 patients, complications in the postoperative period were observed in 61 patients (38.85 %). The frequency of complications in MA group was 10.8 % of the total number of patients, in TEA group – 12.7 %, PA – 6.4 %, and in C group – 8.9 %. The most common complaint among TEA group patients was injection-site itching (13.5 %). PA group patients had a significantly lower number of complications compared to TEA group (p = 0.035). There was no statistically significant difference in the frequency of nausea or urinary retention in patients of all groups (p > 0.05). No difference was noted in the number of pulmonary complications depending on the method of perioperative analgesia (p > 0.05). 31 patients (75.6 %) of PA group did not have any complications, that was significantly different from TEA (p = 0.021) and MA (p = 0.039) patient groups. Conclusions. The use of paracetamol and dexketoprofen combination in the perioperative period allows to reduce (p = 0.035) the total number of postoperative anesthetic complications compared to the use of only thoracic epidural analgesia. The use of a multimodal approach combining epidural analgesia and administration of paracetamol and dexketoprofen does not reduce (p > 0.05) the overall frequency of complications compared to patients without epidural analgesia.

The relevance of the study of the legal regulation of dismissal of employees for improper performance of labour duties is due to the fundamental changes and reforms in labour legislation which require a more detailed study of the social and legal aspects of labour relations. The purpose of this study is to get acquainted with the procedure for dismissing employees, especially in the form of disciplinary proceedings for improper performance of duties. The study used a theoretical methodological approach, the method of legal hermeneutics, a formal legal, methodological approach, the method of deduction, the method of induction. In the course of the study, the characteristic aspects of labour relations in general, the specific features of the employment contract, and the procedures for dismissal for violation of relevant labour obligations in the framework of disciplinary proceedings were analysed. Modern judicial practice was considered, which provides an opportunity to analyse theoretical provisions in their reflection in the real practice of law enforcement in Ukraine to describe this particular procedure for dismissing an employee more thoroughly. The results of the study also identified certain problems in this area that may interfere with its effective functioning. These problems are related to the contradictory interpretation of legal norms regulating the procedure for dismissing an employee for improper performance of official duties. Therefore, to resolve this conflict of laws issue, the practice of the Supreme Court was considered, and the current legislation was analysed, which helps to provide explanations on all the features of the procedure for dismissing an employee legally. The study provides practical guidance for Ukrainian employers on how to properly dismiss employees for non-performance, ensuring compliance with the law, clear criteria for decision-making and the necessary documentation

Background. Developed in 1994 by H. Kitaoka et al. the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale (AOFAS-AHS) allows to assess pain, function, deformity and alignment of the foot and ankle. There is no Russian-language AOFAS-AHS questionnaire adapted according to current standards in the scientific literature. The aim of this paper is to perform the cross-cultural adaptation and to assess the validity of the Russian-language version of the AOFAS-AHS scale, including the evaluation of its psychometric properties. Methods. The original English version of the AOFAS-AHS scale was translated from English into Russian by a native Russian speaker. Then the questionnaire was back-translated into English by another translator whose native language is English. The next stage was the comparison of the original and back-translated versions, followed by the presentation of a pre-final cross-culturally adapted version, which was tested on 10 patients to ensure that the questions were comprehensible. The next step was the approval of the final version and its completion by patients to be operated on the hindfoot or ankle. The printed copy of the final version of the questionnaire was completed by the patients with an interval of 3 days. Total of 44 consecutive patients were enrolled, including 18 women (41%) and 26 men (59%), with a mean age of 61.7 (32-78) years. The psychometric properties of the Russian-language version of the AOFAS-AHS questionnaire (internal consistency, retest reliability, measurement error, responsiveness, and construct validity) were assessed based on the COSMIN (COnsensus-based Standards for the selection of health status Measurement INstruments) principles. Results. The mean score according to the AOFAS-AHS scale was 49.6 (min 2; max 82) out of a possible 100. The average time to complete the questionnaire was 4.2 minutes. All hypotheses formulated showed correlations of varying moderate to strong degrees. The Cronbach’s alpha coefficient was 0.76, which indicates a high level of internal consistency of the elements of the validated questionnaire. A good intra-class consistency of 0.83 was obtained, which shows a high degree of reliability of the questionnaire’s reproducibility. The ceiling and floor effects for the primary results of the questionnaires did not exceed 15%. The mean value of the Russian-language version of the AOFAS-AHS increased to 86.6 after surgical treatment. The values of standardized effect size (ES) and standardized response mean (SRM) were 5.56 and 4.83, respectively. Conclusion. The adapted Russian-language version of the AOFAS-AHS scale showed good psychometric properties and can be recommended for assessment of the physical activity in patients with ankle and hindfoot-related pathology and can also be used for monitoring the changes during the treatment.

Background. Recovery from COVID-19 does not always proceed without complications, especially in patients who have suffered severe forms of the disease. Most researchers confirm a significant increase in the incidence of osteonecrosis of the femoral head (ONFH) after COVID-19. However, there is no clear opinion on the individual aspects of the development and course of the disease. This is an extremely important issue that allows us to identify the main risk groups for the development of post-COVID-19 osteonecrosis and, consequently, to perform the earliest possible screening of this complication. Aims of the study: 1) To evaluate the impact of the past COVID-19 on epidemiologic parameters and clinical course of osteonecrosis of the femoral head in patients; 2) to study the causes of its development. Methods. We have analyzed the data of medical histories of 674 patients diagnosed with osteonecrosis of the femoral head who sought medical care in 2018 and in 2022. Patients were divided into 4 groups according to the presumed causes of development of the disease. The first group enrolled 183 patients who underwent COVID-19 and received steroid therapy (ST). The second group included 78 patients who underwent COVID-19 without ST therapy. The third group consisted of 103 patients with ONFH that manifested in 2022 without COVID-19 in the previous medical history. The comparison group was made up of 310 patients who developed ONFH in 2018 before the appearance of the SARS-CoV-2 virus. Results. The sample of patients with COVID-19-associated osteonecrosis differed significantly from patients without COVID-19, in terms of gender, age, time of disease onset, extent of the femoral head damage, and disease progression rate (p0.001). The level of early ONFH diagnosis was extremely low, not differing from that in the pre-pandemic period. Conclusion. The COVID-19 pandemic has increased the incidence of ONFH, significantly modifying both its epidemiology and clinical picture. Nevertheless, the vigilance of practitioners remains extremely low, which affects the timely diagnosis of the disease.

Background: Herpetic stromal keratitis (HSK) is an immunomodulatory disease that develops as a result of herpes simplex virus (HSV)1 or HSV2 reactivation. HSK is the most common form (20-50%) of recurrent herpetic keratitis (HK) that most commonly results in significantly reduced vision. It is well known that changes in biological compound levels in tear fluid can be indicative of the state of the ocular surface and determine whether ocular surface pathology is present, and, therefore, can be used as diagnostic markers of pathological changes in the ocular surface. Lactoferrin (LF) is one of these compounds and has been proven to have innate antibacterial, antifungal, antiviral, antiparasite, anti-inflammatory, immunomodulatory, antioxidative and other properties. Purpose: To determine tear Lf concentration in patients with recurrent acute HSK, its effect on functional characteristics of the ocular surface, and the therapeutic effect of Lacto eyedrops in the comprehensive treatment for this disorder. Material and Methods: The study was conducted at the site of Corneal Pathology Department and Immunology Laboratory of the Institute in January to December 2021. Seventeen patients (17 affected eyes and 17 fellow eyes) with recurrent acute HSK were included in the study. Mean patient age plus or minus standard deviation (SD) was 48.7 ± 16.0 years. The ophthalmological examination included biomicroscopy of the bulbar conjunctiva and cornea, fluorescein test, determination of corneal sensation and basal tear production (Schirmer’s II test), and microbiological examination of the conjunctiva. Tear Lf concentration was determined by a human Lf enzyme-linked immunosorbent assay (ELISA) kit (Elabscience Biotechnology, Inc., Wuhan, China). The results were photometrically measured at 450 nm with an ELISA reader (Stat Fax 2100, Awareness Technology Inc, Palm City, FL). Lacto eyedrops were administered two times a day for 30 days. Tear Lf concentrations were determined at baseline and at day 30. Results: Mean tear LF concentration plus or minus SD in eyes of patients with recurrent HSK was 1.21 ± 0.52 g/l, with no significant difference between the affected eye and fellow eye. However, a subnormal tear LF concentration was more common in the affected eye than in the fellow eye (χ2 = 4.24, р = 0.04). After a 30-day anti-inflammatory treatment with Lacto eyedrops, mean tear LF concentration plus or minus SD increased by 47% to 1.78 ± 0.7 g/l in the affected eyes. A corneal sensation score of 1 to 9 was 12.4 times more common in HSK eyes than in fellow eyes (OR = 12.4; 95% CI, 2.0–76.8), which reflects neurosensory abnormalities in the affected eye. Corneal sensation loss, was, however, more common in HSK eyes with a low tear Lf concentration than in fellow eyes with a low tear Lf concentration. Median basal tear production (as assessed by Schirmer’s II test) was as low as 7-8 mm in eyes with a low tear Lf concentration and as high as 13-16 mm in eyes with a high tear Lf concentration (p < 0.05). There was a direct correlation between the basal tear production and the tear Lf concentration (r=0.45; p < 0.05). Among study patients with recurrent HSK, 24.9% showed baseline microbiological evidence of potentially pathogenic or fungal organisms in the conjunctiva. A course of multicomponent anti-inflammatory treatment with Lacto eyedrops contributed to complete removal of these organisms. Conclusion: We determined mean tear Lf concentrations in affected and fellow eyes of patients with recurrent HSK, and established certain relationships between functional characteristics of the ocular surface and tear Lf concentrations in these eyes. A disinfecting effect of Lacto eyedrops against any microorganisms present in the conjunctival sac of patients with recurrent HSK was confirmed by the absence of culture growth on completion of the multicomponent anti-inflammatory treatment.

The subject of this study is the algorithms for measuring the angular positions of radio emission sources. The goal of this study is to develop an improved algorithm for signal processing in amplitude direction finders that will provide several unambiguous measurement angles at high steepness of the discrimination characteristic by combining measurements of systems with different widths of antenna patterns. The task: to develop an optimal signal processing algorithm for a four-antenna amplitude direction finding system, two antennas of which have a wide radiation pattern and the other two have a narrow one; to test the overall performance of the resulting algorithm by simulating the direction finder; to develop and conduct a study of an experimental model of a four-antenna direction finder, which includes two antennas with wide radiation patterns, two antennas with narrow radiation patterns, radio frequency paths, and a signal processing unit that implements the developed algorithm; to analyze the effectiveness and features of the application of the developed algorithm, and to compare the results of simulation modeling and experimental research. The methods used are statistical methods and optimal solutions for solving problems of statistical synthesis of signal processing algorithms in passive radio systems, computer simulation modeling methods, and experimental research methods. The following results were obtained. The algorithm for signal processing in a four-antenna direction finding system was synthesized using the maximum likelihood method. By simulation modeling, the overall effectiveness of measurement integration in multi-antenna amplitude direction finders was confirmed, and the peculiarities of the synthesized algorithm application were revealed, namely, the need to introduce additional proportionality coefficients into the measurement channels. During the experimental studies of the developed model of the direction finder, the results of the simulation modeling were confirmed. Conclusions. To determine the direction of radiation sources by amplitude direction finders, it is advisable to simultaneously use systems with wide and narrow antenna patterns, the measurements of which are combined by the proposed algorithm. This makes it possible to simultaneously expand the range of unambiguous measurement angles and increase the accuracy of measurements within the equal-signal zone. The disadvantage of using the algorithm is the nonlinear form of the obtained discrimination characteristics and the need to determine additional proportionality coefficients heuristically.

Thermal analysis methods, primarily thermogravimetric analysis (TGA), play an important role in the study of phase transitions and degradation of active food components and auxiliary substances during heating or cooling. The most important areas of application of TGA in the food industry include the analysis of patterns of changes in the mass of the studied system during its heating or cooling due to the presence of phase transitions of the first kind and chemical reactions. In this work, a study of the change in mass of biscuit products during heating was carried out. The effect of replacing wheat flour with cricket flour in the amount of 5.0% on the structure of the resulting biscuit product compared to the control was determined. This study showed a change in the distribution of forms of connection of system water with dry substances of the system and, as a result, an expansion of the range of temperatures at which water evaporation from this sample took place. However, with a further increase in the amount of cricket flour in the recipe, which has an increased protein content, an increase in the part of the system water associated with the proteins of this raw material was observed. As a result, the range of temperatures at which water evaporation occurred from biscuit products with cricket flour in the amount of 10.0% and 15.0% decreased. It was noted in the work that the most acceptable functional and technological property of biscuit products is a wider range of forms of connection of system water with dry substances of such food products, since the presence of different forms of connection of water significantly determines the organoleptic indicators of finished products, terms and conditions its storage. The results obtained by the method of thermogravimetric analysis showed that, from the point of view of expanding the spectrum of forms of connection of system water with dry substances of the studied samples, the sample with the replacement of wheat flour with flour from crickets in the3 amount of 5.0% should be considered more acceptable.

BackgroundThe updated Veterans Aging Cohort Study (VACS) Index 2.0 combines general and human immunodeficiency virus (HIV)-specific biomarkers to generate a continuous score that accurately discriminates risk of mortality in diverse cohorts of persons with HIV (PWH), but a score alone is difficult to interpret. Using data from the North American AIDS Cohort Collaboration (NA-ACCORD), we translate VACS Index 2.0 scores into validated probability estimates of mortality.MethodsBecause complete mortality ascertainment is essential for accurate calibration, we restricted analyses to cohorts with mortality from the National Death Index or equivalent sources. VACS Index 2.0 components were ascertained from October 1999 to April 2018. Mortality was observed up to March 2019. Calibration curves compared predicted (estimated by fitting a gamma model to the score) to observed mortality overall and within subgroups: cohort (VACS/NA-ACCORD subset), sex, age 500 copies/mL, CD4 count

Стаття присвячена актуальним питанням правового регулювання участі професійних спілок у процедурі масового вивільнення працівників. Наголошується, що правове регулювання колективних звільнень потребує додаткового регулювання з огляду на соціальні та економічні виклики, які виникають внаслідок цього перед найманими працівниками. Визначається, що велике значення при масових вивільненнях має відігравати захисна діяльність профспілок, сутність і мета якої полягає у мінімізації негативного впливу ринкових чинників на зниження якості життя і праці найманих працівників. Досліджено акти Міжнародної Організації Праці та Директиву Ради Європейського Союзу щодо колективних звільнень, які покладають на роботодавців обов’язок консультуватися з представниками працівників і реагувати на їхні пропозиції. На підставі аналізу законодавства низки європейських країн акцентується увага на посиленні захисту працівників шляхом залучення їхніх представників, проведення консультацій та встановлення вимог до механізму проведення таких звільнень. Звертається увага, що в межах реалізації Угоди про асоціацію Україна зобов’язалася наблизити національне законодавство до семи директив ЄС з питань забезпечення гідної праці, соціальної політики та соціального діалогу і, як наслідок, зміни до КЗпП України та Закону України «Про зайнятість населення» частково враховують передбачені актами ЄС вимоги обов’язкового проведення консультацій із професійними спілками (представниками працівників) при масових вивільненнях працівників. Разом з тим, авторками наголошується, що консультації з профспілками про заходи щодо запобігання звільненням чи зведенню їх кількості до мінімуму мають носити не тільки формальний характер, а й бути направленими на пом’якшення несприятливих наслідків звільнень. Доводиться, що унормування процедури вивільнення працівників із залученням до цієї процедури професійних спілок дає змогу забезпечити додатковий захист уразливих верств населення, а для роботодавця ж участь профспілок у процедурах звільнення працівників виступає попереджувальним засобом, що мінімізує його фінансові витрати у разі порушення ним процедури вивільнення.

Стаття присвячена актуальним питанням захисту прав працівників при масових вивіль­неннях, що відбуваються в умовах економічної кризи. Акцентується увага, що сучасний етап трансформації та розвитку економіки України потребує якісно нових орієнтирів одним з яких є розробка та впровадження дієвих механізмів, спрямованих на побудову соціально відпові­дального бізнесу. У сучасних нестабільних рин­кових умовах працівники є одним із найцінніших ресурсів будь-якого підприємства, тому проце­дура вивільнення має здійснюватися з ураху­ванням їх прав та особистих інтересів. Дове­дено, що сучасна політика підприємств у сфері вивільнення працівників обмежується виконан­ням норм трудового законодавства. Скорочення працівників можуть призвести до пєсимістичних і негативних настроїв в колективі, побоювання працівників наступними потрапити під чергове скорочення, що негативно впливає на продук­тивність праці і може призвести до відтоку ка­дрів. Визначається, що турбота про звільнених працівників попередить виникнення негативних настроїв, нормалізує атмосферу в трудовому ко­лективі. Обґрунтовується позиція, що соціально відповідальний роботодавець повинен макси­мально впроваджувати механізми, які б сприя­ли подальшому працевлаштуванню звільнених працівників. Враховуючи цей фактор, зверта­ється увага на доцільність застосування вітчиз­няними роботодавцями методів гнучкої політики зайнятості, одним з яких є аутплейсмент, сут­ність якого полягає в тому, щоб допомогти пра- ціникам, що потрапили під скорочення, адапту­ватися в нових для них обставинах, виробити власну стратегію пошуку відповідного робочого місця і знайти роботу. Зазначено, що у західних країнах, аутплейсмент як соціально-орієнтована технологія вивільнення персоналу є найпоши­ренішим видом послуг, а її застосування впли­ває на загальний імідж роботодавця. Наголошу­ється, що практика застосування аутплейсмен­ту в Україні перебуває на стадії становлення, у перспективі ця процедура набуде широкого за­стосування, адже налагоджені взаємовідносини роботодавця з працівниками, як наявними, так і колишніми - запорука ефективного управління та успішного функціонування соціально відпові­дального бізнесу.

Globalisation and information technology are having an active impact on various spheres of society, from the economic sphere to labour relations. The direct impact on the labour sphere can be seen in the change in trends in the definition of working hours, as today there are more opportunities for compromise between employees and employers on setting working hours and agreeing on the possibility of non-fixed working hours. This has resulted in flexible working arrangements. This is what makes this study relevant. The purpose of this study is to identify the benefits of non-fixed working hours and to analyse the challenges faced by participants in labour relations when establishing flexible working hours in the context of globalisation. It is important to study global patterns and trends in the introduction of flexible working hours at the international level, taking into account international regulations. It is also advisable to assess the impact of international recommendations on the formation of national labour legislation in the framework of non-fixed working hours. In order to achieve this purpose, a number of methods of scientific knowledge were used, such as systematic analysis, synthesis, formal legal method, dialectical method and method of analysis of regulatory documents. The findings will serve as a basis for further research in this area and will contribute to the development of recommendations for adapting the current legislation to the realities of today, the rapid development of information technology and globalisation.

Background. According to the analysis of large arthroplasty registers we have noted the increase in the use of non-cemented implants, because the latter shows the same results of implant survival as well as cemented implants. On the other hand, they can affect the quality of the bone around the implant in different ways. These components differ in shape, length, and surface properties. According to the analysis of the arthroplasty register of the Vreden National Medical Research Center of Traumatology and Orthopedics, a significant decrease of the Alloclassic femoral stem using can be noted. In parallel the use of its SL-PLUS MIA modification has increased significantly. Aims of the study: 1) to determine the influence of changes in the design of the Zweymüller-type femoral stem on midterm and long-term outcomes and its survival; 2) to identify the characteristics of adaptive remodeling of periprosthetic bone tissue around these femoral stems; 3) to determine risk factors for aseptic loosening of these femoral stems. Methods. 492 cases of hip arthroplasty using the Alloclassic and SL-PLUS MIA femoral stems were observed, with an average follow-up 78.6 months. The patients were divided into 2 groups according to the type of femoral stem. The assessment the hip articulation condition was carried out using the HHS and OHS. The intensity of the pain syndrome was assessed by VAS, and the level of patient’s satisfaction. The dynamic analysis of X-rays was also performed visually. Results. A significant improvement in clinical and functional results was observed according to the HHS and OHS in both groups of patients, regardless of the type of femoral stem. Analysis of X-rays over time showed differences in the behavior of these two femoral component models. The radiolucent lines around the femoral stem are absent in SL-PLUS MIA group, in Alloclassic stem group radiolucent lines are present even at a minimal period (12 months). We also found that a tight fit of Zweymüller femoral stems in the distal shaft is a risk factor for severe stress-shielding syndrome, especially in the funnel channels. But ceteris paribus, a distal tight fit of SL-PLUS MIA stems despite similar geometry of the distal part does not lead to such frequent manifestation of severe stress shielding. Conclusion. The change in Zweymüller stem design from Alloclassic to SL-PLUS MIA improved the nature of adaptive remodeling in the periprosthetic area of the femur. It may improve the long-term results of primary hip arthroplasty, but these differences require closer observation.

Background.Nowadays the knee arthroplasty register of the Vreden National Medical Research Center of Traumatology and Orthopedics (hereinafter referred to as the Vreden Center) contains clinical and statistical data on more than 39,000 primary and revision knee replacements, that mimics current state of this kind of surgery in Russia. Aimofthestudy to analyze the last decade trends in primary knee arthroplasty in largest Russian arthroplasty center. Methods.Data were obtained from the register of the Vreden Center for the period from 2011 to 2022. Information on knee arthroplasty included epidemiologic and numerous peri-operative data including type of surgery and implant, degree of constrain, primary patella resurfacing etc. Resultsanddiscussion.From 2011 to 2022, 36,350 (92.3%) primary arthroplasties performed at the Vreden Center. The number of interventions increased more than twice: from 1,678 in 2011 to 3,924 in 2022. Similar trends observed in Australia and Sweden, where the number of knee arthroplasties increased by 8.2% and 8% in 2021 compared to 2020, respectively. The frequency of primary patellar resurfacing at the Vreden Center was 2.2% over the entire period of observation. On the contrary, the rate of patella replacement increased from 41% in 2005 to 76.1% in 2021 in Australia and from 24.4% in 2015 to 31.9% in 2020 in Switzerland. The partial knee arthroplasty showed enormous growth more than 14 times: from 0.3% in 2011 to 4.3% in 2022 at the Vreden Center. Worldwide unicompartmental knee replacement is still less popular than total and its number widely varies: 4.2% in the USA, 6.9% in Australia, 9.2% in Canada, 11.9% in Norway, 12.8% in Sweden, and 18.4% in Switzerland. Posterior cruciate ligament (PCL) retaining total knee arthroplasties (TKA) prevailed at the Vreden Center: 68.3%, while in other countries it utilize even more widely: 70.5% in Norway, 75% in New Zealand and 93.5% in Sweden. The total length of hospital stay (LOS) decreased dramatically from 19.6 in 2011 to 8.6 in 2022 at the Vreden Center. Nevertheless, there are still opportunities to improve it: by the way in Canada the average LOS for TKA is 2.3 and the USA 0.8 and 1.7 for partial and total arthroplasty, respectively. Conclusion.The main current trends of knee arthroplasty in Russia are the following: increase the number of surgeries, reduced LOS, TKA without patella resurfacing and with PCL retention, finally the growth of partial knee arthroplasties.

The aim of the article is to analyze the existing approaches to determining the essence of the intellectual capital of an organization and its structure. According to the results of the carried out analysis of interpretations of the category of «capital of enterprise», it is determined that such a capital is considered as resources (financial, material, intangible) that, in turn, form the enterprise’s assets; the accumulated values in the form of fixed assets, intangible assets, marketable securities, inventory assets; the accumulated values both in the form of money and the tangible, intangible and financial components. The results of the further study of the interpretation of the category of «intellectual capital» by domestic and foreign researchers showed the existence of the following basic approaches to the consideration of intellectual capital: as the sum of knowledge of employees that can be assessed and can bring additional profit to the enterprise; as a result of employees’ intellectual work – intellectual products together with resources of the enterprise; as intangible assets of the enterprise; as economic relations that arise in the process of both formation and use of the intellectual resources of the enterprise. The authors draw the conclusion that the category of «intellectual capital» acquires a fairly broad meaning. It includes the human capital of the organization, which is its most dynamic and complex component and provides the basis for the formation of structural capital. In other words, intellectual capital means all the intellectual resources and capabilities of the enterprise, which constitute the source of the future income and represent a factor in terms of the growth of market value. Prospects for further research in this direction are consideration of intellectual capital in the context of its impact on the formation of enterprise potential.

The subject matter of this study is algorithms for measuring the components of an aircraft speed vector and altitude. The goal of this study is to improve algorithms for processing wideband stochastic pulse signals in helicopter low-altitude and flight-speed radio systems by introducing secondary signal processing based on artificial intelligence elements. The tasks to be solved are as follows: to develop an optimal algorithm for determining the speed and altitude of flight for a helicopter radio complex; to supplement the signal processing algorithm with an artificial intelligence-based processor to determine the "safety" of the current trajectory; provide the pilot with relevant information about possible options for further actions based on an analysis of the current position of the helicopter and flight parameters; and to analyse the efficiency of the proposed complex when using various artificial intelligence-based algorithms. The methods used are as follows: methods of mathematical statistics and optimal solutions for solving problems of statistical synthesis of active radio complex structure; methods of machine learning; and methods of computer simulation. The following results were obtained. The algorithms for signal processing in a helicopter radio complex are obtained by the method of maximum likelihood, and the use of three radio channels to calculate the full vector of speed and altitude is argued. The structure of a secondary information processing system, using algorithms based on artificial intelligence is proposed. The effectiveness of determining the safety of the current landing trajectory using various algorithms based on artificial intelligence (LinearSVC, GaussianNB, DecisionTreeClassifier, RandomForestClassifier, KNeighborsClassifier, MLPClassifier and RidgeClassifier) was analysed. Conclusions. The simulation results show that in the presence of accurate (noise-free) information on the current location of the helicopter, its axial velocities, and a map of the terrain with defined areas dangerous for landing, the DecisionTreeClassifier and RandomForestClassifier algorithms can provide a high probability of correctly determining the safety of the current landing trajectory. At the same time, in the presence of instability in the measurements of helicopter movement parameters, only the RandomForestClassifier algorithm maintains high accuracy.

ObjectiveThe contribution of beta-cell dysfunction to type 2 diabetes (T2D) is not restricted to insulinopenia in the late stages of the disease. Elevated fasting insulinemia in normoglycemic humans is a major factor predicting the onset of insulin resistance and T2D, demonstrating an early alteration of beta-cell function in T2D. Moreover, an early and chronic increase in fasting insulinemia contributes to insulin resistance in high-fat diet (HFD)-fed mice. However, whether there are genetic factors that promote beta-cell-initiated insulin resistance remains undefined. Human variants of the mitochondrial transporter ABCB10, which regulates redox by increasing bilirubin synthesis, have been associated with an elevated risk of T2D. The effects of T2D ABCB10 variants on ABCB10 expression and the actions of ABCB10 in beta-cells are unknown.MethodsThe expression of beta-cell ABCB10 was analyzed in published transcriptome datasets from human beta-cells carrying the T2D-risk ABCB10 variant. Insulin sensitivity, beta-cell proliferation, and secretory function were measured in beta-cell-specific ABCB10 KO mice (Ins1Cre-Abcb10flox/flox). The short-term role of beta-cell ABCB10 activity on glucose-stimulated insulin secretion (GSIS) was determined in isolated islets.ResultsCarrying the T2Drisk allele G of ABCB10 rs348330 variant was associated with increased ABCB10 expression in human beta-cells. Constitutive deletion of Abcb10 in beta-cells protected mice from hyperinsulinemia and insulin resistance by limiting HFD-induced beta-cell expansion. An early limitation in GSIS and H2O2-mediated signaling caused by elevated ABCB10 activity can initiate an over-compensatory expansion of beta-cell mass in response to HFD. Accordingly, increasing ABCB10 expression was sufficient to limit GSIS capacity. In health, ABCB10 protein was decreased during islet maturation, with maturation restricting beta-cell proliferation and elevating GSIS. Finally, ex-vivo and short-term deletion of ABCB10 in islets isolated from HFD-fed mice increased H2O2 and GSIS, which was reversed by bilirubin treatments.ConclusionsBeta-cell ABCB10 is required for HFD to induce insulin resistance in mice by amplifying beta-cell mass expansion to maladaptive levels that cause fasting hyperinsulinemia.

The problem of increasing heat resistance and corrosion and erosion resistance of gas turbine units in compressor stations was solved through the development of new layered materials containing nanostructured grains. The authors carried out a destruction analysis of gas turbine units in compressor stations. It was shown that after 10–30,000 h of operation, the greatest damage occurred when the gas turbine operated in dusty environments at high temperatures (or in air environments with a high salt content). The developed layered composites include the thermal barrier and functional reinforced nanostructured layers consisting of refractory carbides and oxides. This paper describes the destruction mechanism of gas turbine units under the influence of high-temperature aggressive environments. As a result, a new formation technology for reinforced nanostructured layered composites has been developed. The developed composition makes it possible to increase the heat resistance of materials by approximately 10 times. This significantly increases the reliability and durability of gas turbine units in compressor stations. The structural and mechanical parameters of the layered nanostructured heat-resistant composites have been studied.

(1) Background: Tinnitus involves the conscious awareness of a tonal or composite noise for which there is no identifiable corresponding external acoustic source. For many people, tinnitus is a disorder associated with symptoms of emotional distress, cognitive dysfunction, autonomic arousal, behavioural changes, and functional disability. Many symptoms can be addressed effectively using education or cognitive behavioural therapy. However, there is no treatment that effectively reduces or alters tinnitus-related neurophysiological activity and thus the tinnitus percept. In this systematic review, we evaluated the effectiveness of neuromodulation therapies for tinnitus that explicitly target pathological synchronous neural activity. (2) Methods: Multiple databases were searched for randomised controlled trials of neuromodulation interventions for tinnitus in adults, with 24 trials included. The risk of bias was assessed, and where appropriate, meta-analyses were performed. (3) Results: Few trials used acoustic, vagal nerve, or transcranial alternating current stimulation, or bimodal stimulation techniques, with limited evidence of neuromodulation or clinical effectiveness. Multiple trials of transcranial direct current stimulation (tDCS) were identified, and a synthesis demonstrated a significant improvement in tinnitus symptom severity in favour of tDCS versus control, although heterogeneity was high. (4) Discussion: Neuromodulation for tinnitus is an emerging but promising field. Electrical stimulation techniques are particularly interesting, given recent advances in current flow modelling that can be applied to future studies.