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In this article, we briefly summarize the experiments performed during the first run of the Advanced Wakefield Experiment, AWAKE, at CERN (European Organization for Nuclear Research). The final goal of AWAKE Run 1 (2013-2018) was to demonstrate that 10-20 MeV electrons can be accelerated to GeV energies in a plasma wakefield driven by a highly relativistic self-modulated proton bunch. We describe the experiment, outline the measurement concept and present first results. Last, we outline our plans for the future. This article is part of the Theo Murphy meeting issue 'Directions in particle beam-driven plasma wakefield acceleration'.

High-energy particle accelerators have been crucial in providing a deeper understanding of fundamental particles and the forces that govern their interactions. To increase the energy of the particles or to reduce the size of the accelerator, new acceleration schemes need to be developed. Plasma wakefield acceleration1-5, in which the electrons in a plasma are excited, leading to strong electric fields (so called 'wakefields'), is one such promising acceleration technique. Experiments have shown that an intense laser pulse6-9 or electron bunch10,11 traversing a plasma can drive electric fields of tens of gigavolts per metre and above-well beyond those achieved in conventional radio-frequency accelerators (about 0.1 gigavolt per metre). However, the low stored energy of laser pulses and electron bunches means that multiple acceleration stages are needed to reach very high particle energies5,12. The use of proton bunches is compelling because they have the potential to drive wakefields and to accelerate electrons to high energy in a single acceleration stage13. Long, thin proton bunches can be used because they undergo a process called self-modulation14-16, a particle-plasma interaction that splits the bunch longitudinally into a series of high-density microbunches, which then act resonantly to create large wakefields. The Advanced Wakefield (AWAKE) experiment at CERN17-19 uses high-intensity proton bunches-in which each proton has an energy of 400 gigaelectronvolts, resulting in a total bunch energy of 19 kilojoules-to drive a wakefield in a ten-metre-long plasma. Electron bunches are then injected into this wakefield. Here we present measurements of electrons accelerated up to two gigaelectronvolts at the AWAKE experiment, in a demonstration of proton-driven plasma wakefield acceleration. Measurements were conducted under various plasma conditions and the acceleration was found to be consistent and reliable. The potential for this scheme to produce very high-energy electron bunches in a single accelerating stage20 means that our results are an important step towards the development of future high-energy particle accelerators21,22.

Plasma wakefield acceleration is a promising technology to reduce the size of particle accelerators. The use of high energy protons to drive wakefields in plasma has been demonstrated during Run 1 of the AWAKE programme at CERN. Protons of energy 400 GeV drove wakefields that accelerated electrons to 2 GeV in under 10 m of plasma. The AWAKE collaboration is now embarking on Run 2 with the main aims to demonstrate stable accelerating gradients of 0.5–1 GV/m, preserve emittance of the electron bunches during acceleration and develop plasma sources scalable to 100s of metres and beyond. By the end of Run 2, the AWAKE scheme should be able to provide electron beams for particle physics experiments and several possible experiments have already been evaluated. This article summarises the programme of AWAKE Run 2 and how it will be achieved as well as the possible application of the AWAKE scheme to novel particle physics experiments.

Aim. To determine independent predictors of recurrent myocardial infarction (MI) and to create a model for predicting recurrent coronary events in working-age patients.Material and methods. The study included 424 patients (median age 50 (43,5; 55,0) years). In 2017, all patients underwent treatment at the Perm Regional Vascular Center due to the first MI. We retrospectively analyzed the patient data with regard to medical history, comorbidities, diagnostic results, and treatment. After 2 years, information on recurrent MI was collected by analyzing data from electronic medical records of patients. Depending on the outcome, all patients were divided into two groups: with (n=78) and without (n=346) recurrent MI. Using the SPSS Statistics v.20, v.23 software package, we compared the central demographic, clinical, diagnostic parameters in the groups. Univariate and multivariate regression analyzes were performed to determine independent predictors of recurrent MI.Results. Multivariate regression established the following independent predictors of recurrent MI: left ventricular ejection fraction

The paper presents a concise literature review on the concomitant course of the most common nosological entities in the population, such as arterial hypertension (AH) and acid-dependent diseases (ADD). Data on the prevalence, commonness of etiological and pathogenetic factors, the specific features of a clinical course, and diagnostic difficulties are analyzed in persons with AH associated with ulcerative and gastrointestinal reflux diseases. The causes and consequences of these nosological entities are shown; their clinical, morphological, and hemodynamic features are covered. The results of investigations characterizing the specific features of autonomic regulation, diurnal blood pressure variations, and the central hemodynamics in the comorbidity of the diseases in question are given. The rational antihypertensive therapy of AH concurrent with ADD is presented in terms of their impact on gastrointestinal tract disease.

Aim. In patients with different types of sinus node dysfunction (SND), to study inflammation marker levels and assess their value as predictors of SND development. Material and methods. The study included 83 individuals: 63 patients with SND (the main group) and 20 controls. The main group was divided into three subgroups: Subgroup 1, with vegetative SND (VSND); Subgroup 2, with Type I and II sick sinus syndrome (SSS); and Subgroup 3, with tachy-brady syndrome, or Type III SSS. In all participants, the measurement of serum levels of inflammation markers, cardiac electrophysiological testing, and long-term electrocardiography monitoring were performed. The inflammation markers of interest included tumour necrosis factor alpha (THF-α), interleukin (IL) 6, IL-4, C-reactive protein (CRP), and fibrinogen. Results. Compared to controls, SND patients were characterised by increased levels of TNF-α and IL-6. TNF-α concentration was linked to SND type, with the highest levels observed in patients with tachy-brady syndrome. Elevated levels of inflammation markers independently predicted SND development. In particular, VSND risk was 2,5 times higher in patients with IL-6 concentration >3 pg/ml. SSS risk doubled when the levels of IL-6 increased from 2,5 pg/ml to 4 pg/ml. TNF-α levels >16 pg/ml were associated with a 1,5-fold increase in the risk of Type I-II SSS transformation into tachy-brady syndrome. Conclusion. Increased expression of inflammation cytokines in SND patients could be directly linked to pathogenetic mechanisms of this arrhythmic syndrome.

In patients with various clinical forms of coronary heart disease (CHD), essential arterial hypertension (EAH), or chronic heart failure (CHFD), roentgen-structural and roentgen-spectral analysis of serum facies was performed. In total, 159 patients were examined (mean age 57,2±6,08 years). All participants were divided into six groups: Group I – with Functional Class (FC) III effort angina (n=19); Group II – with healing myocardial infarction, MI (n=10); Group III – with paroxysmal recurrent atrial fibrillation, PRAF (n=19); Group IV – with Stage II EAH (n=34); Group V – with FC III–IV ischemic CHF (n=17); and Group VI – relatively healthy people (n=30). Microphotography of the serum facies was performed using electronic microscopy (S-3400N); energy-dispersive spectral analysis of the facies was also performed. Increased peripheral zone with spherical crystals, together with globular formations and decalcination in the centre was linked to the diagnosis of stable angina. Peripheral zone decrystallization, increased central zone with rosette-like crystals, and weight percentage of phosphorus >0,5% was observed in MI patients. No obvious zone separation, increased number of radial fissures, migration of crystal mass from central to peripheral area, and weight percentages of carbon, magnesium, and calcium in the central area of >10%,

Aim. To investigate the associations between brachiocephalic atherosclerosis (BCAS) and arterial hypertension (AH); to study the potential for AH control after surgery. Material and methods. The study included 70 patients (17 women, 53 men; mean age 62,5±7,5 years), who underwent planned surgery due to BCAS and carotid stenosis, CS (n=50) or brachiocephalic artery (BCA) malformation (n=20). AH duration varied from 4 months to 32 years. Levels of systolic blood pressure (SBP) were 115-192 mm Hg (mean SBP 151,5±27,26 mm Hg). Blood flow in aortal arch arteries was assessed by duplex BCA scanning. BP levels were registered within the 24 hours before the surgery, and then 3-5 days and 1-3 months after the intervention. Results. In patients with CS, risk of BP elevation increased with age (р=0,04). Before the surgery, higher BP levels were registered in Group I patients: mean BP was 103,6±11,3 mm Hg vs. 91,7±6,6 mm Hg (р=0,00007). After the intervention, these differences were no longer observed. In patients with CS, post-intervention BP levels decreased due to reduction in both systolic BP (from 145,1±14,7 to 135,6±12,3 mm Hg; р=0,02) and diastolic BP (from 83,3±10,2 to 78,1±9,7 mm Hg; р=0,02). In patients with BCA malformation, no significant BP reduction was registered.Conclusion. In BCAS patients, BP elevation was mostly explained by CS and progressed with age, while surgery facilitated BP reduction.

Until the present moment, the combination of arterial hypertension (AH) and acid-peptic disease (APD) has been understudied. The aim of this study was to assess the circadian profile of blood pressure (BP) in patients with AH and APD. In total, the study included 42 men, aged 20-57 years, with a combination of AH and APD. The comparison group included 24 patients with isolated AH. All participants underwent BP monitoring (Kardiotekhnika-04-AD device). The diagnoses of duodenal ulcer (DU) and gastro-oesophageal reflux disease (GERD) were verified with fibrogastroduodenoscopy. The patients with isolated AH had significantly greater hypertensive load (higher mean BP levels and BP load indices), compared to the individuals with AH and APD. These results point to more severe clinical course of AH and higher complication risk in the former group, compared to the patients with a combination of AH and APD.

Addressing sustainable development challenges, Russia is seeking new opportunities for the use of thin-walled cold-cast structures to meet the requirements of cost-effectiveness, eco-friendliness, and rapid construction. The study aims to explore the possibilities of design and calculation of low-rise buildings erected from lightweight thin-walled steel structures using frame construction technology. The design solutions for the roof, walls, floors, and foundation are exemplified using concrete examples. The load capacity off framing studs, roof beams, and floor slabs was calculated. Three methods were used for calculation - Eurocode 3, direct strength test, and ultimate load test in compliance with AISI standards.

Aim. To investigate principal interrelations between heart, arterial and venous parameters, characterizing the common process of cardiovascular system (CVS) remodeling during arterial hypertension (AH) development and progression.Material and methods. The study included 184 patients with primary AH. CVS structure and function were assessed at baseline and after treatment with antihypertensive medications (AHM).Results. The module approach to AH structural and hemodynamic type description is proposed. Modern AHM are studied in regard to their venotropic action, effects on orthostatic tolerance and interrelations between structural and functional parameters of CVS components in AH patients. Mathematical algorithms assessing modern AHM potential for individual patients, taking into account baseline clinical, functional, structural and hemodynamic parameters, are presented.Conclusion. Antihypertensive therapy could be optimized by taking into consideration modern AHM effects on individual CVS components and their interrelations in AH patients.

Aim. To compare carvedilol and metoprolol tartrate effects on hemostasis in patients with post-infarction chronic heart failure (CHF), receiving complex therapy. To study deep venous thrombosis (DBT) incidence in CHF patients without additional risk factors (RFs) for venous thrombosis.Material and methods. The study included 60 patients, aged 60,58±8,16 years, with Functional Class (FC) II and III CHF (CHF duration 5,17±4,83 years). The main group (n=30) received carvedilol (44,17±7,86 mg/d at the end of follow-up), and the comparison group (n=30) - metoprolol (110,0±39,17 mg/d). Hemostasis parameters and DVT signs were assessed at baseline and after 4 months of the treatment.Results. In the hospital, laboratory thrombophilia was verified in all CHF patients. After 4 months of the therapy, positive hemostasis dynamics was observed in both main and comparison groups. One case of calf DVT, without pulmonary artery thromboembolia, was registered in a female with FC III CHF, who received metoprolol.Conclusion. Additional blockade of alpha-1-receptors and antioxidant activity of carvedilol could explain better hemostasis control in patients from carvedilol group.

Aim. To study the effects of carvedilol and metoprolol tartrate on endothelium mono-layer and remodeling of myocardium, large vessels and kidneys in patients with post-infarction chronic heart failure (CHF).Material and methods. The study included 50 patients (33 males, 66 %) with stable post-infarction chronic heart failure (CHF), Functional Class (FC) II-III. Mean CHF duration was 5,22+0,67 years. In 41,7 % patients, FC II CHF was diagnosed, in 58,3 % - FC III CHF. Clinical examination was performed at baseline and after 4 months of beta-adrenoblocker therapy. Main group (n=25) was administered carvedilol, control group - metoprolol tar-trate(n=25). Daily dose was titrated gradually; in carvedilol group, itwas43,ll±l,84 mg/d, in metoprolol group - 128,75+8,63 mg/d. Myocardial structure and function were assessed by echocardiography (EchoCG), vessel wall structure - by measuring intima-media thickness in common carotid arteries (CCA IMT). Endothelium monolayer and kidney function were assessed by measuring microalbuminuria (MAU) level.Results. Four-month carvedilol therapy was associated with a substantial decrease in MAU (-47,4 %) and CCA IMT (-10,6 %); in metoprolol group, these changes were not significant. EchoCG results demonstrated a significant left cardiac chamber reduction.Conclusion. Carvedilol improved endothelial function, facilitated reverse remodeling of myocardium, vessel wall and kidneys. Therefore, carvedilol therapy might be recommended for target organ protection in CHF

Aim. To study heart remodeling in patients with rheumatoid arthritis (RA) and/or arterial hypertension (AH); to identify clinical features of each remodeling type in individuals with RA and AH. Material and methods. In total, 257 patients were examined: 112 with RA and AH, 105 – with RA only, and 40 – with AH only. Heart structure and function was assessed by ultrasound method (“Acuson Aspen”, USA). Results. Pathological left ventricular (LV) remodeling types were observed in 97,5 %, 87 %, and 96,4 % of patients with AH only, RA only, and RA combined with AH, respectively. Concentric LV hypertrophy was typical for AH subjects (85 %). In RA subjects, all three LV remodeling types were observed: eccentric hypertrophy (22,3 %), concentric hypertrophy (27,2 %), concentric remodeling (36,9 %), together with normal heart geometry (13 %). In participants with AH and RA, LV remodeling types were similar to those in participants with isolated AH. Conclusion. In patients with AH and RA, eccentric LV remodeling was typically associated with early manifested RA, while concentric LV hypertrophy development was mostly determined by AH clinical course.

Hemic hypoxia influence on lipid profile and vasodilating endothelial function in iron-deficiency anemias was studied in 35 patients. Blood lipid profile, lipid peroxidation, blood antioxidant potential, and vasodilating endothelial function were assessed. Anemia, regardless of its etiology, was characterized by antiatherogenic lipid profile dynamics, antioxidant stress, and endothelial dysfunction development, that could be regarded as severe vascular dysfunction predictor. Anemic syndrome severity plays an important role in the development of metabolic dysbalance and endothelial dysfunction.

Pathologic left ventricular (LV) remodeling was registered in 96. 4 % of patients with arterial hypertension (AH) and rheumatoid arthritis (RA). For AH patients, concentric LV hypertrophy (LVH) was quite typical (85 %); RA patients demonstrated similar prevalence of all LVH types: eccentric LVH (22.3 % > ), concentric LVH (27.2 % > ), concentric remodeling (36.9 %). Ln individuals with RA and AH, LV remodeling structure was similar to that in RA-free hypertensive patients. For early RA debut, eccentric LVH was more typical; development of concentric LVH depended mostly on AH characteristics. Ln combination ofRA and AH, LV systolic dysfunction was relatively rare; at the same time, silent diastolic dysfunction (DD) was registered in 70 % > of cases. Silent DD, detected during stress echocardiography, was observed in 24 % > of patients with AH and RA; Type 1 DD - in 46 % >.

Blood lipid profile, lipid peroxidation, and plasma/red blood cell antioxidant activity were studied in 127 individuals with acute and chronic leukemia. All patients, regardless of leukemia morphology, demonstrated antiatherogenic changes in lipid profile, as well as activated lipid peroxidation and decreased antioxidant reserve. These disturbances can be explained by anemia severity and diminished absolute numbers of functionally active, lipid-producing white blood cells. At autopsy, macroscopic examination of aorta and coronary artery tissue (47 cases of leukemia and 23 cases of other cancers), demonstrated significantly less manifested aortic and coronary atherosclerosis in leukemia, comparing to lung or gastro-intestinal cancers.