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В обзоре литературы изложены современные данные о модулирующем действии монооксида азота в зависимости от уровня его концентрации на воспалительную реакцию и процесс апоптоза. Показано дуальное действие монооксида азота в респираторном тракте — предупреждение развития инфекционного процесса и усиление поражения легочной ткани.

В огляді літератури викладено сучасні дані щодо особливостей редокс-процесів, що відбуваються в просвіті респіраторного тракту при муковісцидозі.

Aims TAK-071 is a muscarinic M1 receptor positive allosteric modulator designed to have low cooperativity with acetylcholine. This was a first-in-human study to evaluate the safety, pharmacokinetics, and pharmacodynamics of TAK-071. Methods TAK-071 was administered as single and multiple doses in a randomized, double-blind, placebo-controlled, parallel-group design in healthy volunteers alone and in combination with donepezil. Laboratory, electrocardiogram (ECG) and electroencephalogram (EEG) evaluations were performed. Cerebrospinal fluid and blood samples were taken to evaluate the pharmacokinetics (PK), relative bioavailability and food effect. Results TAK-071 was safe and well tolerated, and no deaths or serious adverse events occurred. TAK-071 demonstrated a long mean (% coefficient of variation) half-life of 46.3 (25.2%) to 60.5 (51.5%) hours and excellent brain penetration following oral dosing. Coadministration with donepezil had no impact on the PK of either drug. There was no food effect on systemic exposure. Quantitative EEG analysis revealed that TAK-071 40-80 mg increased power in the 7-9 Hz range in the posterior electrode group with eyes open and 120-160 mg doses increased power in the 16-18 Hz range and reduced power in the 2-4 Hz range in central-posterior areas with eyes open and eyes closed. Functional connectivity was significantly reduced after TAK-071 at high doses and was enhanced with coadministration of donepezil under the eyes-closed condition. Conclusions PK and safety profiles of TAK-071 were favorable, including those exceeding expected pharmacologically active doses based on preclinical data. When administered without donepezil TAK-071 was largely free of cholinergic adverse effects. Further clinical evaluation of TAK-071 is warranted.

Aim. To investigate the technical difficulties of performing the stages of vitreoretinal surgery, the peculiarities of the surgical technique in young patients with the proliferative stage of diabetic retinopathy (DR). Methods. Twelve patients (12 eyes) with type 1 diabetes mellitus (DM) were selected. Their average age was 26±2 years (from 19 to 30 years). There were 4 men and 8 women. All patients had DM since childhood. Selection criteria: presence of indications for vitreoretinal surgery for proliferative DR, age of patients with type 1 DM not more than 30 years, onset of DM in childhood. Results. Initially, the clinical manifestations of proliferative DR in young people with type 1 DM were distinguished by the severity of neovascular and fibrous growths, a tendency to hemorrhages, and the complexity of preoperative preparation in the form of panretinal laser coagulation, at least partial. Surgical removal of vitreoretinal adhesions and elimination of neovascularization zones differed in technical difficulties associated with their higher density and the area of retinal tissue lesion. Conclusion. Surgical treatment of proliferative DR in young patients has a number of technical difficulties associated with the density and length of fibrovascular vitreoretinal growths, the difficulty of separating them due to the high tendency of newly formed vessels to hemorrhages. Key words: proliferative diabetic retinopathy; endovitreal surgery; type 1 diabetes mellitus; young age.

Aims Dysregulation of histone methylation epigenetic marks may result in intellectual and developmental disability, as seen in Kabuki syndrome. Animal data suggest that increasing histone methylation by inhibiting lysine-specific demethylase 1A (LSD1) may improve cognitive outcomes in a model of Kabuki syndrome. TAK-418 is a novel LSD1 inhibitor, developed as a potential therapeutic agent for central nervous system disorders such as Kabuki syndrome. Here, we report safety, tolerability, pharmacokinetic and pharmacodynamic profiles of single and multiple doses of TAK-418 (ClinicalTrials.gov: NCT03228433, NCT03501069). Methods Two randomized, double-blind, placebo-controlled, phase 1 studies of oral TAK-418 were performed, a first-in-human single-rising-dose (SRD) study (5-60 mg) in healthy adult male and female volunteers (placebo, n = 10; TAK-418, n = 30), and an SRD (120-160 mg) and multiple-rising-dose (MRD) study (20-160 mg once daily for 10 days) in healthy female volunteers (placebo, n = 2 [SRD] and n = 6 [MRD]; TAK-418, n = 6 [SRD] and n = 18 [MRD]). Results TAK-418 was well tolerated. No clinically significant changes in laboratory test results or vital signs were observed and no serious adverse events were reported. TAK-418 had a nearly linear pharmacokinetic profile, with rapid absorption and short terminal half-life across the evaluated dose range. No obvious accumulation was observed after daily administration for 10 days. Administration with food delayed peak plasma concentrations but overall exposure was unaffected. TAK-418 rapidly crossed the blood-brain barrier and generally showed a dose-dependent response in the peripheral pharmacodynamic biomarker formyl-flavin adenine dinucleotide. Conclusion The brain-penetrant LSD1 inhibitor TAK-418 was well tolerated, with pharmacokinetic and pharmacodynamic effects that support further investigation.

Purpose. To investigate the technical features and difficulties of performing vitreoretinal surgery in proliferative diabetic retinopathy (DR) in young patients. Material and methods. 12 patients (12 eyes) aged 19 to 30 years, averaging 26±2 years. There were 4 men and 8 women. All patients had diabetes mellitus (DM) in childhood. The duration of type 1 diabetes ranged from 12 to 18 years. Results. Initially, 8 eyes showed combined retinal and peripapillary neovascularization with gliza on the vascular arcades. In 4 eyes, there was both diffuse hemophthalmos and preretinal clots of varying length and volume. In 8 eyes, dense adhesion of the altered posterior hyaloid membrane and the inner border membrane was revealed. In 4 eyes, vasoproliferative membranes were determined, which contributed to the development of traction effects on the retina. The most dangerous was the traction component on the macular retina. Conclusion. Surgical treatment of proliferative DR in young patients has a number of technical difficulties associated with the anatomical features of the macular interface and the features of the proliferative response to surgery. Noteworthy is the minimum time for the transition of DR to the proliferative stage. Key words: proliferative diabetic retinopathy, endovitreal surgery, type 1 diabetes mellitus.

Introduction: Excessive salt intake (ESI) is a well-established risk factor of chronic non-communicable diseases (NCDs). Russia is among the countries with the high salt consumption. Population-based strategies to reduce salt intake have a potential for significant contribution to reduce the burden of NCDs. Modeling studies to justify the need and quantify the potential of these measures have been performed in several countries, but the evidence from Russia is still scarce. Aim: To forecast the efficiency of selected population-based prevention strategies to reduce salt intake in Russia. Methods: Potential efficiency of two population-based strategies was assessed. Introduction of the national excise tax on sodium used for industrial food production was the first strategy. The second strategy was a long term health literacy mass-media campaign aimed to reduce salt intake combined with a voluntary reduction in salt content in processed foods by manufacturers. Russia-specific impact of ESI on NCDs and population attributive risk (PAR) were calculated using previously assessed economic burden (EB) of ESI. The prediction period was 15 years. The changes in PAR after the introduction of population-based prevention strategies and changes in the EB of selected NCDs were calculated. Results: The first and the second programmed had a potential to reduce ESI prevalence by 2.99 % and 7.49 %, respectively. The corresponding numbers of prevented cases of NCDs were 23 352 and 57 874. Avoided direct medical costs exceeded 390 million rubles for the first strategy and over 969 million rubles for the second. The cumulative economic effect over 15 years was 4.10 billion rubles for the introduction of the new tax while the predicted cumulative economic effect of the second programme was 9.9 billion rubles. Conclusions: Although the population-based prevention strategies selected for this study have not yet been implemented in Russia, both have a significant potential to reduce the burden of NCDs and have substantial economic efficiency.

The nonlinear optical responses of perovskite films CsPbI2Br, MAPbI3 + 1% PVC, MA0.15FA0.75Cs0.1PbI2.85Br0.15, and MA0.15FA0.75Cs0.1PbI3, irradiated by femtosecond laser pulses with wavelengths of 1064 and 532 nm, are investigated using z-scan measurements. Nonlinear absorption is found to occur in perovskite films irradiated at a wavelength of 1064 nm; the nonlinear absorption coefficient in thin films (45 – 65 nm) greatly exceeds that in thick ones (120 – 350 nm): 524 – 928 and 38 – 50 cm GW−1, respectively. It is shown that the nonlinear absorption saturation intensity for perovskite films depends on the pump pulse duration and increases with pulse shortening. It is also established that the nonlinear absorption coefficient of organometallic perovskite films exceeds that of a film of inorganic perovskite CsPbI2Br. Bleaching of film samples during z-scanning at a wavelength of 532 nm is related to the irreversible photochemical degradation of films exposed to intense light. The kinetics of photochemical bleaching of the films is detected at a wavelength of 532 nm.

To raise the stimulated Brillouin scattering (SBS) threshold, we have fabricated an optical fibre having a core heavily doped with germanium oxide and displaced from the fibre axis. A method has been proposed for broadening the SBS gain spectrum of the fibre by winding it onto a small-diameter spool, and a broadening of the spectrum by 5.4 dB has been demonstrated, which indicates an increase in SBS threshold by 4.1 dB.

A novel method of stimulated Brillouin scattering (SBS) gain suppression in passive single-mode optical fibers is proposed and experimentally verified. The effect is achieved due to special propagation conditions created for a number of the core-bounded acoustic modes effectively involved in the SBS, such that its gain becomes approximately evenly distributed over a wide spectral range, thereby proportionally reducing its maximum. To verify and investigate this method in depth, single-mode large-mode-area (LMA) fibers with correspondingly optimized acoustic index profiles are fabricated, experimentally tested, and analyzed. Uneven complex doping of the core with two additives, P2O5 and F, forms a high-contrast gradient acoustic index profile while maintaining a quasi-uniform optical refractive index profile. With a contrast of P2O5 of more than 6 mol.%, we achieved 8 dB of SBS suppression over conventional uniformly doped LMA fibers. Moreover, it is shown that more than 10 dB of SBS gain suppression can be achieved if the optimal dopant distribution is realized.

The paper considers a method for determining the motion parameters of moving objects based on the results of space zonal survey. A system of equations is proposed for determining the motion parameters under various conditions of motion of a moving object (on a plane, in three-dimensional space, and with a single and multiple observation). The speeds and accelerations of moving objects (vehicles, etc.) are determined by measuring the relative position of zonal images on complex materials of panchromatic and multispectral survey (pansharpening) taking into account the location of optoelectronic converters of spectral channels relative to each other in the target survey equipment. A feature for determining the direction of movement of moving objects using the colors of zonal images is formed. Algorithms for calculating the speed and acceleration for the case of rectilinear motion of objects are developed. The results of processing real images are presented.

Endometriosis is a prevalent disease in females of the childbearing age. It may be accompanied by bowel involvement. In such cases, the most frequently observed lesion locations are the rectum and the rectosigmoid with the occurrence rate of 3-37 %. Treatment of severe forms of deep infiltrating endometriosis with bowel wall involvement is one of the most challenging problems of modern gynaecology. Apart from general intra- and postoperative risks (haemorrhage, infection, direct damage to the organs) or bowel and bladder dysfunction, one of the most severe complications is the development of anastomotic leaks. This article presents a review of literatures dated 2010-2020 searched for in PubMed and Google Scholar databases and devoted to operative treatment of patients with deep infi ltrating endometriosis. We made an emphasis on the effi cacy of the multidisciplinary approach to operative treatment of patients with deep infiltrating endometriosis and bowel involvement. Multidisciplinary laparoscopic treatment has become a standard of medical aid in deep infiltrating endometriosis. Depending on the size of endometrial lesion and the location of bowel involvement, complete removal of the infiltrate or bowel resection is performed in cooperation with an experienced colorectal surgeon. The operative tactics in laparoscopic endometriosis resection, including bowel resection, may provide advantages for both the patients and the healthcare system. The optimal model is to be chosen drawing on the basis of the maximum benefit for the patient.

Deep infiltrating endometriosis with bowel involvement remains the most difficultly treated form of the endometriosis. It is defined as endometriosis penetrating greater than 5mm beneath the peritoneum. Treatment of severe forms of deep infiltrating endometriosis with bowel wall involvement is one of the most complex issues in modern surgical gynaecology. Efficacy of the multidisciplinary approach to operative treatment of patients with deep infiltrating endometriosis and bowel involvement is demonstrated via an example of our own clinical case.

Any professional activity centres around a person with his/her individual psychological characteristics and possible deviant behaviour. Armed security officers working at hazardous industrial facilities (HIF) may pose a potential threat. The study aimed to improve the system of job-related psychological selection to identify psychological causes behind offences committed by HIF security officers. The criteria underpinning new systems of job-related psychological selection have to be valid. Questions of validity may also arise as regards individual psychodiagnostic tests included in the new system. Professionally important qualities (PIQ) of HIF security officers were identified through a psychographic study and expert interviews with military guards working at critical state facilities. The personality traits identified in those HIF security officers who committed offences were presented as “profiles”. We developed a psychological selection module as the main processing module of the job-related psychological selection system. The module implements basic selection algorithms. The validity of test methods used in the module was assessed in view of their prevalence in traditional approaches to job-related psychological selection of military personnel. The empirical testing of the psychological selection module was carried out during the recruitment of HIF security officers. The next phase of the study is to complete reliability

The purpose of the study is to investigate the effect of a new type of compliant substrate based on an AlGaAs superstructure layer (SL) and a protoporous Si (proto-Si) layer formed on a crystal Si (c-Si) layer on the practical implementation and specific features of the epitaxial growth of GaAs layers by metal–organic chemical vapor deposition. It is for the first time shown that the low-temperature growth of high-crystal-quality epitaxial GaAs films can be implemented due to the use of compliant SL/proto-Si substrates. The introduction of a SL into the composition of a compliant substrate in addition to proto-Si makes it possible to neutralize a number of negative effects of low-temperature growth, to reduce the level of stresses in the epitaxial layer, to protect it from self-doping with Si atoms, to reduce the number of technological operations of the growth of transition buffer layers, and to improve the structural and morphological characteristics of the epitaxial layer.

Malignancies during pregnancy are usually treated similarly to the malignancies in non-pregnant patients. Results of controlled therapeutic trials are typically not available. However, registered studies associated with some of the most common malignancies exist. In case of ovarian cancer, due to its rarity – especially with the primary metastatic cases – only individual case reports are available. The article presents a case with par aortal abdominal, thoracic and cervical lymph node metastasis in a 33-years-old pregnant female. She was treated with primary systemic chemotherapy since early pregnancy. At 32 weeks of gestation, the patient gave birth to a girl (1460g) by caesarean section. Subsequently, the patient received 3 more cycles of chemotherapy with carboplatin/paclitaxel and bevacizumab for 30 months as well as letrozole maintenance therapy. Three years after the initial diagnosis, complete instrumental assessment showed unremarkable results without tumour recurrence.

The development of acute kidney injury (AKI) in preterm infants with hemodynamically significant patent ductus arteriosus (HSPDA) is an additional burden on homeostatic mechanisms, leading to loss of fluid, electrolyte balance, and acid-base disturbance and increasing the risk of mortality by 50%. Therefore, early detection of AKI in preterm infants with HSPDA is extremely important in terms of improving treatment outcomes.Purpose — to create, evaluate and further analyze the binary logistic regression model of AKI on the background of HSPDA in premature infants.Materials and methods. The group of study participants consisted of 40 premature babies with HSPDA, who were admitted for treatment on the first day of life to the Department of Anesthesiology and Neonatal Intensive Care at MI «Dnepropetrovsk Regional Children's Clinical Hospital» Dnepropetrovsk Regional Council». On the third to fifth day of life, 23 (57.5%) patients were diagnosed with AKI. Clinical and laboratory examination included obstetric history, gestational age, weight, physical examination, clinical analysis of blood and urine, arterial blood oxygen saturation, biochemical methods — examination of urea, serum and urine creatinine, serum and urine sodium, serum potassium. The concentration index of creatinine, fractional excretion of sodium, glomerular filtration rate (GFR) according to the Schwartz formula were calculated. Instrumental methods of examination included echocardiography with Doppler, ultrasound Doppler of renal vessels, renal spectroscopy in the near infrared region. In order to preliminarily determine the diagnostic potential of some clinical'anamnestic and laboratory data, the parameters of the sample with AKI and the sample without this pathology were compared: in the case of interval scale the Mann–Whitney U-test was used, in the case of categorical scale — χ2-test or Fisher's exact test. Spearman's rank correlation was used to form the optimal set of input variables for regression modeling. The method of binary logistic regression was used to develop a diagnostic model of AKI development on the background of HSPDA in premature infants.Results. At the stage of exploratory data analysis (several dozen parameters of clinical and biochemical analysis of blood and urine, renal hemodynamics, renal oxygenation and therapeutic measures on the first day), as well as clinical and anamnestic data, it was found that AKI has a significant relationship with 14 interval ( maximum blood flow velocity in the interlobar renal artery, minimum blood flow velocity in the interlobar renal artery, resistance index in the interlobar renal artery, maximum blood flow velocity in the main renal artery, diameter of the open arterial duct, renal oxygenation, fractional renal tissue extraction of oxygen, serum creatinine, GFR, creatinine concentration index, urinary sodium, fractional sodium excretion, urine protein, diastolic blood pressure) and 9 nominal values (the size of the patent ductus arteriosus on the first day of more than 2 mm, ibuprofen therapy at a dose of 20 mg/kg on the first day, ibuprofen therapy on the first day of life, furosemide treatment, history of renal disease in the mother, chronic foci of infection in the mother, hypertension of pregnancy, threat of abortion, necrotizing enterocolitis in the patient on the first day of life).Conclusions. The most significant predictors of AKI development in premature infants with HSPDA are the parameter of maximum blood flow velocity in the interlobar renal artery, HSPDA diameter greater than 2 mm and serum creatinine level on the first day of life. The sensitivity of the AKI logistic regression model, in which HSPDA diameter and serum creatinine level are used as explanatory variables, is 91%, specificity — 88%, overall accuracy — 90%. Replacement of serum creatinine in the logit function for the maximum blood flow velocity in the interlobar renal artery allows to increase the sensitivity of the model up to 96%, and the overall accuracy up to 93%.The study was conducted in accordance with the principles of the Helsinki Declaration. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of parents of children was obtained for the research., Развитие острого повреждения почек (ОПП) у недоношенных детей с гемодинамически значимым открытым артериальным протоком (ГЗОАП) является дополнительной нагрузкой на гомеостатические механизмы, вызывая потерю баланса жидкости, электролитов, а также нарушение кислотно-щелочного состояния, что увеличивает риск смертности на 50%. Раннее выявление ОПП у недоношенных с ГЗОАП крайне важно с точки зрения улучшения результатов лечения.Цель — создать, оценить и провести последующий анализ бинарной логистической регрессионной модели ОПП на фоне ГЗВАП у недоношенных детей.Материалы и методы. Группу участников исследования составили 40 недоношенных детей с ГЗОАП, поступивших для лечения на 1-е сутки жизни в отделение анестезиологии и интенсивной терапии новорожденных КП «Днепропетровская областная детская клиническая больница» ДОС». На 3–5-е сутки жизни у 23 (57,5%) пациентов диагностировано ОПП. Клинико-лабораторное обследование включало акушерский анамнез, гестационный возраст, вес, физикальный осмотр, клинический анализ крови и мочи, насыщение артериальной крови кислородом, биохимические методы — исследование мочевины, креатинина в сыворотке крови и моче, натрий крови и мочи, калий крови. Проведен расчет концентрационного индекса креатинина, фракционной экскреции натрия, скорости клубочковой фильтрации по формуле Шварца. Инструментальные методы обследования — эхокардиография с допплерометрией, ультразвуковая допплерография сосудов почек, спектроскопия почек в ближней инфракрасной области. С целью предварительного определения диагностического потенциала отдельных клинико-анамнестических и лабораторных данных сопоставлены показатели выборки с ОПП и выборки без этой патологии: при интервальной шкале использовали U-критерий Манна–Уитни, в случае категориальной шкалы — χ2-критерий или точный критерий Фишера. Ранговая корреляция Спирмена применена при формировании оптимального набора входящих переменных для моделирования регрессии. Для разработки диагностической модели возникновения ОПП на фоне ГЗОАП у недоношенных детей использован метод бинарной логистической регрессии.Результаты. На этапе анализа данных (несколько десятков параметров клинического и биохимического анализа крови и мочи, почечной гемодинамики, почечной оксигенации и терапевтических мероприятий на первые сутки), а также клинико-анамнестических данных выявлено, что ОПП имеет значимую взаимосвязь с 14 интервальными (максимальная скорость кровотока в интерлобарной почечной артерии, минимальная скорость кровотока в интерлобарной почечной артерии, индекс резистентности в интерлобарной почечной артерии, максимальная скорость кровотока в магистральной почечной артерии, диаметр открытого артериального протока, почечная оксигенация, фракционная тканевая экстракция кислорода в почках, креатинин крови, скорость клубочковой фильтрации, концентрационный индекс креатинина, натрий мочи, фракционная экскреция натрия, белок мочи, диастолическое артериальное давление) и 9 номинальными показателями (размер открытого артериального протока в первые сутки более 2 мм, ибупрофенотерапия в дозе 20 мг/кг в первые сутки, ибупрофенотерапия в первые сутки жизни, применение фуросемида, заболевания почек в анамнезе матери, хронические очаги инфекции у матери, артериальная гипертензия беременных, угроза прерывания беременности, некротизирующий энтероколит у пациента в первые сутки жизни).Выводы. Наиболее значимыми предикторами развития ОПП у недоношенных детей с ГЗОАП являются показатель максимальной скорости кровотока в интерлобарной почечной артерии, диаметр ГЗОАП более 2 мм и уровень сывороточного креатинина на 1-е сутки жизни. Чувствительность модели логистической регрессии ОПП, в которой в качестве объясняющих переменных применяют диаметр ГЗОАП и уровень креатинина крови, составляет 91%, специфичность — 88%, общая точность — 90%. Замена в логит-функции креатинина крови на максимальную скорость кровотока в интерлобарной почечной артерии позволяет повысить чувствительность модели до 96%, а общую точность — до 93%.Исследование выполнено в соответствии с принципами Хельсинской Декларации. Протокол исследования утвержден Локальным этическим комитетом указанного в работе учреждения. На проведение исследований получено информированное согласие родителей детей., Розвиток гострого пошкодження нирок (ГПН) у недоношених дітей із гемодинамічно значущою відкритою артеріальною протокою (ГЗВАП) є додатковим навантаженням на гомеостатичні механізми, що спричиняє втрату балансу рідини, електролітів, а також порушення кислотно-лужного стану та збільшує ризик смертності на 50%. Отже, раннє виявлення ГПН у недоношених із ГЗВАП є вкрай важливим з точки зору поліпшення результатів лікування.Мета — створити, оцінити та провести подальший аналіз бінарної логістичної регресійної моделі ГПН на тлі ГЗВАП у недоношених дітей.Матеріали та методи. Групу учасників дослідження становили 40 недоношених дітей з ГЗВАП, які надійшли для лікування на 1-шу добу життя до відділення анестезіології та інтенсивної терапії новонароджених КП «Дніпропетровська обласна дитяча клінічна лікарня» ДОР». На 3–5-ту добу життя у 23 (57,5%) пацієнтів діагностовано ГПН. Клініко-лабораторне обстеження включало акушерський анамнез, гестаційний вік, вагу, фізикальний огляд, клінічний аналіз крові та сечі, насичення артеріальної крові киснем, біохімічні методи — дослідження сечовини, креатиніну в сироватці крові та сечі, натрій крові та сечі, калій крові. Проведено розрахунок концентраційного індексу креатиніну, фракційної екскреції натрію, швидкості клубочкової фільтрації за формулою Шварца. Інструментальні методи обстеження — ехокардіографія з допплерометрією, ультразвукова допплерографія судин нирок, спектроскопія нирок у ближній інфрачервоній зоні. З метою попереднього визначення діагностичного потенціалу окремих клініко-анамнестичних та лабораторних даних зіставлено показники вибірки з ГПН та вибірки без цієї патології: у разі інтервальної шкали використано U-критерій Манна–Вітні, у разі категоріальної шкали — χ2-критерій або точний критерій Фішера. Рангову кореляцію Спірмена застосовано у формуванні оптимального набору вхідних змінних для моделювання регресії. Для розробки діагностичної моделі виникнення ГПН на тді ГЗВАП у недоношених дітей використано метод бінарної логістичної регресії.Результати. На етапі розвідкового аналізу даних (декілька десятків параметрів клінічного і біохімічного аналізу крові та сечі, ренальної гемодинаміки, ренальної оксигенації та терапевтичних заходів на 1-шу добу), а також клініко-анамнестичних даних виявлено, що ГПН має значущий взаємозв'язок із 14 інтервальними (максимальна швидкість кровотоку в інтерлобарній нирковій артерії, мінімальна швидкість кровотоку в інтерлобарній нирковій артерії, індекс резистентності в інтерлобарній нирковій артерії, максимальна швидкість кровотоку в магістральній ренальній артерії, діаметр відкритої артеріальної протоки, ренальна оксигенація, фракційна тканинна екстракція кисню в нирках, креатинін крові, швидкість клубочкової фільтрації, концентраційний індекс креатиніну, натрій сечі, фракційна екскреція натрію, білок сечі, діастолічний артеріальний тиск) і 9 номінальними показниками (розмір відкритої артеріальної протоки понад 2 мм на 1-шу добу, ібупрофенотерапія у дозі 20 мг/кг на 1-шу добу, ібупрофенотерапія на 1-шу добу життя, застосування фуросеміду, захворювання нирок в анамнезі матері, хронічні вогнища інфекції в матері, артеріальна гіпертензія вагітних, загроза переривання вагітності, некротичний ентероколіт у пацієнта на 1-шу добу життя).Висновки. Найбільш значущими предикторами розвитку ГПН у недоношених дітей з ГЗВАП є показник максимальної швидкості кровотоку в інтерлобарній нирковій артерії, діаметр ГЗВАП понад 2 мм і рівень сироваткового креатиніну на 1-шу добу життя. Чутливість моделі логістичної регресії ГПН, в якій в якості пояснюючих змінних застосовують діаметр ГЗВАП і рівень креатиніну крові, становить 91%, специфічність — 88%, загальна точність — 90%. Заміна в логіт-функції креатиніну крові на максимальну швидкість кровотоку в інтерлобарній нирковій артерії дає змогу підвищити чутливість моделі до 96%, а загальну точність — до 93%.Дослідження виконано відповідно до принципів Гельсінської Декларації. Протокол дослідження ухвалено Локальним етичним комітетом зазначеної в роботі установи. На проведення досліджень отримано інформовану згоду батьків дітей.

Aim. To analyze hospital admission and ambulatory care of the patients with arterial hypertension (AH) in federal districts and regions from the perspective of the WHO concept of diseases, which can be treated in ambulatory settings (ambulatory care sensitive conditions, ACSC).Material and methods. For analysis we used data from annual forms of federal statistical monitoring (12 and 14), which includes data on hospital admissions with hypertension in federal districts and separate regions in 2017. Hypertension included diseases characterized by raised blood pressure, ICD10: I10-I13.Results. We performed the analysis of 12 and 14 forms per districts and regions of the Russian Federation. Regions with increased hospitalization rates and an increased ratio of the hospitalizations to number to outpatients visits were identified. High variability of these indicators was observed both among both between regions and federal districts. The values of the ratio indicator vary from 0.0131 in the Nizhny Novgorod Region to 0.0234 in the Chechen Republic. The average value of the ratio in the federal district varies from 0.032 in the Volga Federal District to 0.119 in the North Caucasus Federal District. In the North Caucasus and Far East Federal District the value of the indicator is significantly higher than in other districts.Conclusion. Assessing diseases which can be treated in ambulatory setting scan be one of the tools for evaluating the quality of medical care in primary care facilities. However, before including ACSC as an indicator of the quality of health care delivery, a deeper understanding of the reasons that can impact its rates is required.

Background: Observational studies have documented lower risks of coronary heart disease and diabetes among moderate alcohol consumers relative to abstainers, but only a randomized clinical trial can provide conclusive evidence for or against these associations. Aim: The purpose of this study was to describe the rationale and design of the Moderate Alcohol and Cardiovascular Health Trial, aimed to assess the cardiometabolic effects of one alcoholic drink daily over an average of six years among adults 50 years or older. Methods: This multicenter, parallel-arm randomized trial was designed to compare the effects of one standard serving (∼11–15 g) daily of a preferred alcoholic beverage to abstention. The trial aimed to enroll 7800 people at high risk of cardiovascular disease. The primary composite endpoint comprised time to the first occurrence of non-fatal myocardial infarction, non-fatal ischemic stroke, hospitalized angina, coronary/carotid revascularization, or total mortality. The trial was designed to provide >80% power to detect a 15% reduction in the risk of the primary outcome. Secondary outcomes included diabetes. Adverse effects of special interest included injuries, congestive heart failure, alcohol use disorders, and cancer. Results: We describe the design, governance, masking issues, and data handling. In three months of field center activity until termination by the funder, the trial randomized 32 participants, successfully screened another 70, and identified ∼400 additional interested individuals. Conclusions: We describe a feasible design for a long-term randomized trial of moderate alcohol consumption. Such a study will provide the highest level of evidence for the effects of moderate alcohol consumption on cardiovascular disease and diabetes, and will directly inform clinical and public health guidelines. Fil: Spiegelman, Donna. Harvard University. Harvard School of Public Health; Estados Unidos Fil: Lovato, Laura C.. Universidad de Barcelona; España Fil: Khudyakov, Polyna. Harvard University. Harvard School of Public Health; Estados Unidos. Universidad de Barcelona; España Fil: Wilkens, Trine L.. Universidad de Copenhagen; Dinamarca Fil: Adebamowo, Clement A.. University of Maryland; Estados Unidos Fil: Adebamowo, Sally N.. University of Maryland; Estados Unidos Fil: Appel, Lawrence J.. No especifíca; Fil: Beulens, Joline W.J.. No especifíca; Fil: Coughlin, Janelle W.. No especifíca; Fil: Dragsted, Lars Ove. Universidad de Copenhagen; Dinamarca Fil: Edenberg, Howard J. No especifíca; Fil: Eriksen, Jane N.. Universidad de Copenhagen; Dinamarca Fil: Estruch, Ramon. Universidad de Barcelona; España Fil: Grobbee, Diederick E.. No especifíca; Fil: Gulayin, Pablo Elías. No especifíca; Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Krystal, John H.. University of Yale. School of Medicine; Estados Unidos Fil: Lazo, Mariana. No especifíca; Fil: Murray, Margaret M.. University of Yale. School of Medicine; Estados Unidos Fil: Rimm, Eric B.. Harvard University. Harvard School of Public Health; Estados Unidos Fil: Schrieks, Ilse C.. Universidad de Barcelona; España Fil: Williamson, Jeff D.. No especifíca; Fil: Mukamal, Kenneth J.. Harvard Medical School; Estados Unidos

A tapered Er-doped fiber amplifier for high peak power pulses amplification has been developed and tested. The core diameter changed from 15.8 µm (mode field diameter (MFD) 14.5 µm) to 93 µm (MFD 40 µm) along 3.7 m maintaining single-mode performance at 1555 nm (according to the S2-method, the part of the power of high-order modes does not exceed 1.5%). The amplification of 0.9 ns pulses with spectral width below 0.04 nm up to a peak power above 200 kW (limited by self-phase modulation) with a slope pump-to-signal conversion efficiency of 15.6% was demonstrated.

Purpose. Demonstration of our own case of treatment of serous retinal detachment with a fossa of the optic nerve disc (OND). Material and methods. We observed patient B. at the age of 24 years with a diagnosis of optic nerve disc anomaly, central serous retinal detachment. Visual acuity on admission: 0.1, does not correct. A 25G endovitreal intervention was performed. With the help of tweezers, a flap of the internal limiting membrane (ILM) with a wide base was formed from the temporal part of the macula, within the vascular arcades. Then, liquid-air replacement was carried out, followed by placing the inverted flap of the ILM in the area of the OND fossa. Result. On the 5th day after the operation, visual acuity improved to 0.2, metamorphopsias decreased. According to the data of optical coherence tomography (OCT), a significant decrease in the height of neuroepithelial detachment was noted. After 4 months visual acuity reached 0.4. Complaints about metamorphopsia were stopped. The OCT picture showed a complete absence of retinal detachment. In this case, the inverted flap of the ILM in the area of the OND fossa was clearly visualized. Conclusion. 1. The displaced inverted flap of the ILM can be used to close the defect in the OND fossa. 2. This method made it possible to stop serous retinal detachment and significantly improve visual functions. 3. Given the rather rare occurrence of this pathology, further replication of this method is necessary to test its effectiveness. Key words: serous retinal detachment, fossa of the optic nerve disc, inverted flap of the internal limiting membrane.

The article presents the positive and negative externalities of the formation of the digital economy of Russia. The reasons for these problems

The diagnosis and treatment of acute pancreatitis is the task of surgeons. However, quite often this disease is taking its course in the guise of other surgical or therapeutic pathology. To select the right diagnostic and treatment policy of patient management, it is necessary to keep in mind that there is a possibility of the atypical course of acute pancreatitis.

Unhealthy diet is associated with high morbidity and mortality from chronic non-communicable diseases (NCDs) which in turn are associated with high economic costs. A significant proportion of these costs is attributed to insufficient fresh fruits and vegetables in the diet worldwide with large country-to-country variation warranting research in various settings including Russia. The aim: to assess the economic burden of insufficient consumption of fruits and vegetables in Russia in 2016 due to their contribution to the development of major NCDs. Methods: The calculation was made using population attributive risk for the development of cardiovascular diseases, type 2 diabetes and cancer from meta-analyses and the data on the prevalence of fruits and vegetables consumption and the abovementioned diseases in the Russian population. The economic costs from the main NCDs were calculated using the human capital method. The share of health care system costs and economic losses due to morbidity and mortality from NCDs associated with fruits and vegetables underconsumption was assessed. Results: The contribution of insufficient consumption of fruits and vegetables to the morbidity and mortality from cardiovascular diseases, coronary heart disease and stroke were 5 % each (95 % CI: 3.0-6.2), 5% (95 % CI: 3.7-6.2) and 10 % (95 % CI: 4.9-15.9), respectively. Corresponding proportions for lung cancer was 8.9 % (95 % CI: 3.7-14.4). The economic burden associated with this risk factor, amounted more than 134 billion rubles (95 % CI: 78.8-173.3 billion rubles), 0.16 % of GDP of the Russian Federation in 2016. Indirect losses due to premature mortality (86 %) prevailed in the structure of the economic burden. Conclusions: The high prevalence of fruits and vegetables underconsumption in Russia and its significant contribution to the morbidity and mortality from NCDs are associated with significant economic costs from this risk factor.

BACKGROUND: Vitamin D metabolites support innate immune responses to Mycobacterium tuberculosis. Data from phase 3, randomized, controlled trials of vitamin D supplementation to prevent tuberculosis infection are lacking. METHODS: We randomly assigned children who had negative results for M. tuberculosis infection according to the QuantiFERON-TB Gold In-Tube assay (QFT) to receive a weekly oral dose of either 14,000 IU of vitamin D(3) or placebo for 3 years. The primary outcome was a positive QFT result at the 3-year follow-up, expressed as a proportion of children. Secondary outcomes included the serum 25-hydroxyvitamin D (25[OH]D) level at the end of the trial and the incidence of tuberculosis disease, acute respiratory infection, and adverse events. RESULTS: A total of 8851 children underwent randomization: 4418 were assigned to the vitamin D group, and 4433 to the placebo group; 95.6% of children had a baseline serum 25(OH)D level of less than 20 ng per milliliter. Among children with a valid QFT result at the end of the trial, the percentage with a positive result was 3.6% (147 of 4074 children) in the vitamin D group and 3.3% (134 of 4043) in the placebo group (adjusted risk ratio, 1.10; 95% confidence interval [CI], 0.87 to 1.38; P = 0.42). The mean 25(OH)D level at the end of the trial was 31.0 ng per milliliter in the vitamin D group and 10.7 ng per milliliter in the placebo group (mean between-group difference, 20.3 ng per milliliter; 95% CI, 19.9 to 20.6). Tuberculosis disease was diagnosed in 21 children in the vitamin D group and in 25 children in the placebo group (adjusted risk ratio, 0.87; 95% CI, 0.49 to 1.55). A total of 29 children in the vitamin D group and 34 in the placebo group were hospitalized for treatment of acute respiratory infection (adjusted risk ratio, 0.86; 95% CI, 0.52 to 1.40). The incidence of adverse events did not differ significantly between the two groups. CONCLUSIONS: Vitamin D supplementation did not result in a lower risk of tuberculosis infection, tuberculosis disease, or acute respiratory infection than placebo among vitamin D–deficient schoolchildren in Mongolia. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT02276755.)

The prevalence of hypertension in the Russian Federation (RF) has been growing in recent years, which causes significant socio-economic burden. Aim . To evaluate economic burden of hypertension in the RF in 2016 including direct costs and economic losses caused by decreased labor efficiency. Material and methods . The calculation included the prevalence of hypertension in the RF and the relative risk of hypertension for cardiovascular diseases (CVD) (including stroke and coronary heart disease), chronic obstructive pulmonary disease (COPD), type 2 diabetes mellitus (DM2), cancer of the trachea, bronchi and lungs, breast and prostate. The calculation included Russian statistics on noncommunicable diseases (NCD) for 2016. Statistical analysis – calculations were performed by Microsoft Excel 10.0 Results . Population attributable risk (PAR) of hypertension in mortality from all CVDs was 34%, in morbidity – 30%, including PAR in mortality from coronary heart disease and stroke 38% and 60%, respectively; the same in morbidity – 28% and 14%, respectively. For DM2 PAR in mortality was 1%, in morbidity – 18%. For COPD PAR in morbidity was ≈24%. PARs in morbidity and mortality for lung, bronchi and trachea cancer were ≈12%, for prostate cancer ≈3%, and for breast cancer 6%. Direct medical costs associated with the analyzed NCDs exceeded 84 billion rubles, direct non-medical costs – over 1.5 billion rubles. In the structure of economic burden, the main part was associated with gross domestic product (GDP) losses due to premature mortality due to hypertension. Conclusion . The total economic burden associated with hypertension in 2016 amounted to 869936 million rubles that corresponded to 1% of Russian GDP.

A set of structural and spectroscopic methods of diagnostics is used to study the influence of a nanoporous silicon (por-Si) transition layer on the practical implementation and specific features of growth of GaN layers on SiC/por-Si/c-Si templates by molecular-beam epitaxy with the plasma activation of nitrogen. It is shown that a por-Si transition layer introduced into a template, in which a 3C-SiC layer is created by the method of atom substitution, offers unquestionable advantages over standard silicon substrates. Specifically, such an approach makes it possible to lower the level of stresses in the crystal lattice of the epitaxial GaN layer by about 90% and to reduce the fraction of vertical dislocations in the GaN layer. The GaN layer is grown on the surface of the SiC layer, which in turn is on the surface of the SiC/por-Si/c-Si template. It is found for the first time that the use of the SiC/por-Si/c-Si template brings about the formation of a qualitatively more uniform GaN layer free of visible extended defects.

Roller presses are most common pelletizing and compacting machines for fine-grained materials in metallurgy and related industries. Rollers with replaceable tires, whose effective surfaces are equipped with molding elements, are major components that directly exert a force on the material being compacted. The press surface configuration significantly influences the compaction conditions and the quality of pellets. Analysis of information sources shows that there is currently no single systematic approach to choosing the rational surface configuration for roller press tires. A large number of process and service parameters indicates that the choice of rational surface configuration for press tires should be based on multivariate analysis methods. Therefore, a systematic approach to the choice of rational geometrical parameters for roller press tires and a method that implements this approach have been developed. The method represents the problem in question as a three-level hierarchy: options for the design of tires, criteria to evaluate the rationality, and the most rational tire design. A specific example demonstrates how the proposed approach is applied to choose the configuration of pressing surfaces to promote the required parameters of charge compaction, the tires having the longest possible service life, and ensure that the press is operated within its technical characteristics. The proposed systematic approach and the method developed to implement it allow the geometrical parameters of press roller surfaces to be compared and evaluated for rationality at the design stage. The results can be used as a constituent part in the development of specialized software for the calculation and design of roller presses.

Aim. To assess five-year changes of somatic risk factors and comorbidities in patients with angina of effort.Material and methods. The study included 320 patients (143 men and 177 women aged 40-69 years) with coronary artery disease (CAD), class I-III angina of effort. Patients underwent examinations in 2012 in three medical centers of the Republic of Ingushetia (Russia), and in 2017 they were invited for a second complex examination with questionnaires, biochemical analysis, and instrumentation.Results. Over the five-year follow-up, there was an increase of men with class III effort angina up to 45%; a similar trend was observed in women. Both men and women experienced a three-fold increase in the incidence of type 2 diabetes. Initially and during the follow-up, chronic obstructive pulmonary disease was diagnosed 2 times more often in men than in women, which may be associated with smoking. A small increase in the total cholesterol level was recorded in the cohort; among women, these changes were significant. Target levels reach no more than 20% of patients. A significant increase of blood glucose levels over the 5-year period was observed in a cohort of men and women with effort angina.Conclusion. Over the 5-year follow-up, there was a clinical deterioration of the effort angina, which is associated with an increase in the incidence of some somatic diseases and the severity of the main behavioral and biological risk factors.

Background Understanding hepatitis C virus (HCV) transmission among people who inject drugs (PWID) is essential for HCV elimination. We aimed to differentiate reinfections from treatment failures and to identify transmission linkages and associated factors in a cohort of PWID receiving opioid agonist therapy (OAT). Methods We analyzed baseline and follow-up specimens from 150 PWID from 3 OAT clinics in the Bronx, New York. Next-generation sequencing data from the hypervariable region 1 of HCV were analyzed using Global Hepatitis Outbreak and Surveillance Technology. Results There were 3 transmission linkages between study participants. Sustained virologic response (SVR) was not achieved in 9 participants: 7 had follow-up specimens with similar sequences to baseline, and 2 died. In 4 additional participants, SVR was achieved but the participants were viremic at later follow-up: 2 were reinfected with different strains, 1 had a late treatment failure, and 1 was transiently viremic 17 months after treatment. All transmission linkages were from the same OAT clinic and involved spousal or common-law partnerships. Conclusion This study highlights the use of next-generation sequencing as an important tool for identifying viral transmission and to help distinguish relapse and reinfection among PWID. Results reinforce the need for harm reduction interventions among couples and those who report ongoing risk factors after SVR.

Aim. To evaluate the structure of multimorbidity, outcomes and the potential effect of dapagliflozin in patients with a combination of cardiovascular disease (CVD) and type 2 diabetes in Russian clinical practice.Material and methods. The data of 10 registries with the inclusion of 22957 people, including 4370 with type 2 diabetes in 6 regions of the Russian Federation, were analyzed. Scenarios for reducing mortality from all and cardiovascular causes and hospitalizations for CVD were simulated among groups of patients with diabetes combined with myocardial infarction (MI) and diabetes combined with heart failure with reduced ejection fraction (HFrEF) based on data from the Federal Registry of diabetes, the RECVASA and REGION registries, relative risks associated with analyzed adverse events from the DECLARE study.Results. When analyzing the data of all 22957 patients with CVD included in the registries, it was found that the proportion of patients with comorbid diabetes was on average 19.0%. Of the various diagnoses of CVD, the combination with diabetes was most often recorded in patients that had MI – 2.0%, stroke – 22.5% and heart failure – 24.0%. In the RECVASA registry (Ryazan) for 4 years of follow-up of 699 patients with a combination of CVD and diabetes mortality from all causes was 20.9%, and from cardiovascular causes – 15.6%. The simulated number of potentially prevented cardiovascular deaths with dapagliflozin taking in patients with diabetes combined with MI for 4 years in Russia will be 39124, and 37440 cardiovascular hospitalizations. The number of potentially preventable deaths from all causes among patients with diabetes combined with HFrEF will be 4543, cardiovascular deaths in 1995, and the number of prevented cardiovascular hospitalizations will be 7072.Conclusion. According to data from the registries of CVD patients in 6 regions of the Russian Federation, it was revealed that in real clinical practice the proportion of people with comorbid diabetes averaged 19% both at the outpatient and hospital stages. These subgroups of multimorbid patients have both the highest risk of developing fatal and non-fatal cardiovascular complications, and the largest number of indications for prescribing drugs that affect the prognosis due to effects on both CVD and diabetes.

As per data provided by the WHO, about one third of death cases due to cancer are caused by risk factors that can be modified. Also, according to data provided by several authors, 4 modifiable risk factors cause 70% of malignant neoplasm cases that could have been prevented. Malignant neoplasms occupy the 2nd rank place in mortality structure in the Russian Federation. A significant share of analyzed malignant neoplasms can potentially be prevented provided that risk factors are corrected; therefore, investments into prevention should be a core in any activity aimed at public health improvement. Our goal was to evaluate economic losses that occurred due to most common oncologic diseases related to behavioral risk factors among population in Russia in 2016 (including costs borne by the public healthcare and losses in the economy). Our analysis comprised direct expenses borne by the public healthcare or, in other words, money spent on oncologic diseases treatment, direct funds allocated to pay disability allowances and temporary disability payments as well as indirect losses in the economy associated with untimely deaths and disability among employable population. Aggregated economic losses that occurred due to 10 most common malignant neoplasms included into our analysis amounted to 241.3 billion rubles or 0.3% of the country GDP in 2016. Direct expenses accounted for 71.7% of the total losses while GDP losses caused by untimely deaths and disability amounted to 28.3%. The highest direct expenses borne by the public healthcare were due to colorectal cancer (52 billion rubles) and cancer in the trachea, bronchial tubes, and lungs (50 billion rubles). Our data indicate it is necessary to invest into oncologic diseases prevention and treatment. These investments can produce a significant economic effect in long-term period thus making for economic growth.

Globalization process triggered the search for new approaches needed to ensure competitiveness and efficiency of business-entities. Due to intensifying international competition on market connected with access both to resources and information and to business partners, efficiency and competitiveness of enterprises dropped. When organizational ties between enterprises develop, partners’ mutually beneficial relations are established. By analyzing current approaches of overseas and home scientists the author points out that in conditions of network economy development the effectiveness of business entities’ interaction can rise, in case partners’ relations are formed and developed within the frames of associations, as the most advanced form of management of complicated economic systems. The article studies inter-organizational ties between industrial enterprises in the form of three-level object of the management system. Each level is structured in the form of elementary projections. It is shown that to change the position of effective business entities it is necessary to upgrade the organizational structure of management and to develop inter-organizational ties with business entities. The author designed theoretical tools, which gives an opportunity for industrial enterprises to reach synergy effect of network interaction, to provide coordination of all participants’ work that could intensify cooperation, raise competitiveness and, improve efficiency of joint activity of entities and economy in general.

We studied the intensity of respiratory burst of neutrophils in the venous blood of women at different stages of reproduction using the chemiluminescent method (BHL-07). The analysis of the of luminol-dependent latex-induced luminescence parameters demonstrated that the neutrophils of pregnant women are in the primed state and equally respond to latex-mediated induction during both normal pregnancy and in case of threatened miscarriage or premature birth. However, childbirth leads to the deactivation of neutrophils, while the intensity of active radical generation does not significantly differ from that in non-pregnant women.

Tobacco smoking is a significant behavioral modifiable risk factor (RF) for the development of chronic non-communicable diseases (CNCD). As numerous studies show, in all countries, smoking is associated with significant economic damage (ED). Aim . To evaluate ED of tobacco smoking in 2016, in the Russian Federation and costs associated with tobacco use in economy, connected with morbidity and mortality from main four groups of CNCD: cardiovascular diseases (CVD), chronic obstructive pulmonary disease (COPD), type 2 diabetes (DM2) and the main ten cancer types (CT). Material and methods . According to data on the prevalence of tobacco smoking and relative risks of large studies and meta-analyzes, the population attributive risk was calculated for four groups of CNCD: CVD, COPD, DM2 and the main ten CT. To assess ED, the proportion of each RF in morbidity and mortality was determined. The ED associated with tobacco smoking was calculated based on its prevalence in the Russian population according to an ESSE-RF population study. Results . The calculated population attributive risk associated with smoking in the Russian Federation (2016), in mortality for all CVDs, was 12,8%, in morbidity — 8,8%. The risk of coronary artery disease was 11,5%, stroke — 9,6%, and its mortality — 10,6% and 5,6%, respectively. The ED associated with tobacco smoking in 2016 exceeded 421,4 billion rubles (0,49% of gross domestic product). In the ED structure of the analyzed nosologies, tobacco smoking accounts for 12,41% (for CVD in general), 18,74% (for COPD), 11,32% (for DM2) and 23,13% (for bronchopulmonary CT). Conclusion . The ED of tobacco smoking amounted to 421,41 billion rubles or 0,49% of gross domestic product in 2016. Assessing of the smoking-related ED is an important argument in improving public health measures’, in favor, analysis of population measures to reduce the prevalence of smoking, determination of measures with a high practice potential in the Russian Federation, and developing proposals for their implementation.

Dexmedetomidine is a preferred agent for light sedation with minimal adverse effects. We report a case of acute colonic pseudo-obstruction following dexmedetomidine use in a patient with alcohol withdrawal. He was treated with benzodiazepines first to control the withdrawal symptoms, then escalated to dexmedetomidine once delirium tremens ensued. Later on, the patient developed abdominal distension and vomiting. Imaging showed dilated bowel loops and absence of peristalsis on ultrasound. Decompression with the nasogastric (NG) tube was done, with high output from the NG tube. Dexmedetomidine infusion was used twice, and once it was stopped, the NG tube output was reduced, with the resumption of gastrointestinal motility and improvement of the abdominal distension. Recent similar reports of functional intestinal obstruction following alpha-2 (α2) agonist use necessitate further studies of intestinal motility following dexmedetomidine use and awareness of the possible side effect of dexmedetomidine on intestinal motility.

A module for tool development (including design) is analyzed within the framework of the proposed design procedure for nonstationary production systems. Specifically, the tool considered is used for slipway machining of channels to be welded into submarine hulls.

Mutations in the LMNA gene cause developing of several phenotypes, both with isolated involvement of cardiac, muscle, adipose and bone tissues, and with their combination. The dominance of cardiovascular signs in the clinical performance and false clarity in nosology definition can cause underestimation of subclinical markers of other systems partaking. It leads to an incorrect interpretation of the true disease etiology, failure in genetic diagnostics, and untimely determination of the correct management and prognosis. The article presents clinical cases that demonstrate both the most typical manifestations of laminopathy and rare combinations of symptoms, which represent a certain diagnostic difficulty.

Rationale & Objective: Hepatitis B virus (HBV) transmission in hemodialysis units has become a rare event since implementation of hemodialysis-specific infection control guidelines: performing hemodialysis for hepatitis B surface antigen (HBsAg)-positive patients in an HBV isolation room, vaccinating HBV-susceptible (HBV surface antibody and HBsAg negative) patients, and monthly HBsAg testing in HBV-susceptible patients. Mutations in HBsAg can result in false-negative HBsAg results, leading to failure to identify HBsAg seroconversion from negative to positive. We describe 4 unique cases of HBsAg seroconversion caused by mutant HBV infection or reactivation in hemodialysis patients. Study Design: Following identification of a possible HBsAg seroconversion and mutant HBV infection, public health investigations were launched to conduct further HBV testing of case patients and potentially exposed patients. A case patient was defined as a hemodialysis patient with suspected mutant HBV infection because of false-negative HBsAg testing results. Confirmed case patients had HBV DNA sequences demonstrating S-gene mutations. Setting & Participants: Case patients and patients potentially exposed to the case patient in the respective hemodialysis units in multiple US states. Results: 4 cases of mutant HBV infection in hemodialysis patients were identified; 3 cases were confirmed using molecular sequencing. Failure of some HBsAg testing platforms to detect HBV mutations led to delays in applying HBV isolation procedures. Testing of potentially exposed patients did not identify secondary transmissions. Limitations: Lack of access to information on past HBsAg testing platforms and results led to challenges in ascertaining when HBsAg seroconversion occurred and identifying and testing all potentially exposed patients. Conclusions: Mutant HBV infections should be suspected in patients who test HBsAg negative and concurrently test positive for HBV DNA at high levels. Dialysis providers should consider using HBsAg assays that can also detect mutant HBV strains for routine HBV testing. Index Words: hemodialysis, hepatitis B virus infection, hepatitis B virus mutation, hepatitis B surface antigen mutation, hepatitis B surface antigen seroconversion

Russia tries to find its own niche in processes of international labour distribution relevant to its intellectual, industrial and scientific potential in order to become a full-fledged participant of global economy, to use advantages of the international exchange, which could provide economic growth and effective reforming of the national economy structure. It implies the necessity to develop the advanced system of international collaboration institutions and shape a set of efficient tools to control processes of Russian economy integration into the global economic system in condition of globalization, as well as to work out a well-grounded state strategy in the field of regional policy. The article investigates planning of concentration processes, managing these processes on scientific basis and choosing the optimum size of enterprises. The mentioned-above issues are very important in the system of industrial production planning. Planning of industrial concentration requires thorough parameter estimation. Some factors are effective in all industries, others - within the frames of certain industries or groups of related ones. The economic effect of concentration is connected with raising technical and economic indicators in product manufacturing as a result of increasing the size of production and enterprises. The author proves that concentration of big production capacities, material and labour resources at one enterprise could provide more effective and economical use of key production components (equipment, raw materials and lab our). At the same time opportunities to raise labour productivity and cut costs were identified.

Previous world studies proved the associations between excess salt intake and the risk of chronic non-communicable diseases (CNCD). Excess salt intake is a significant behavioral risk factor (RF), having a high prevalence in the Russian Federation (49,9%). The assessment of the economic damage (ED) of the RF is a significant cause for investment in its correction. Aim . To assess the ED of excess salt intake in the Russian Federation in 2016, including the direct costs of the health care system and economic waste due to morbidity and mortality from CNCD associated with salt intake. Material and methods . Based on information on the prevalence of excess salt intake and relative risks (RR), according to meta-analyzes and large studies, we calculated population attributable risk (PAR) for cardiovascular diseases (CVD), stroke, type 2 diabetes (T2D), stomach cancer. To assess the ED, we determined share of RF in the morbidity and mortality from CNCD, and then PAR was calculated. We used data from the Federal State Statistics Service, parameters of Annual Forms of Federal Statistical Monitoring, the results of Program of state guarantees for free medical care and the corresponding diagnosis-related groups for 2016. The ED associated with excess salt intake was calculated on the basis of its prevalence in the Russian population based on the ESSE-RF population study — 49,9%. The calculations were performed in Microsoft Excel 10.0. Results . The calculated PAR, associated with excess salt intake, for CVD mortality and morbidity was 5% and 7% respectively; for stroke: in mortality — 17%, in morbidity — 10%. For T2D PAR in the morbidity was ~18%, for stomach cancer — 7%. In the top of direct medical costs associated with excess salt intake were CVD expenses (>15 billion rubles), of which >3 billion accounted for by stroke. All direct medical costs in 2016 exceeded 19 billion. The ED associated with the excess salt intake exceeded 160,9 billion rubles in 2016, i.e. 0,19% of the gross domestic product of Russian Federation for the analyzed year. The largest contribution of excess salt intake is in the damage associated with CVD (122,8 billion rubles), where half (68,1 billion rubles) is attributable to the ED associated with stroke. In the structure of the ED of each nosology, excess salt intake cause from 4,5% (CVD in general) to 17% (for T2D) and 16,1% (stroke) of the entire damage. Conclusion . The calculations of ED from CNCD are extremely demanded today; they serve to justify the introduction of population prevention measures in the country, assess and model the effectiveness of such measures in the complex or their components.

Nowadays, dedicated computer programs developed on the basis of finite element analysis and using modern mathematical models of physicochemical processes are widely applied in designing new or optimizing existing devices and installations firing organic fuels. Such multiparametric tasks, which encompass a wide range of physical problems, are predominantly solved by means of CFD modeling based on the finite volume method. This numerical method for integrating systems of differential equations with partial derivatives features versatility and numerical stability. Particular problems that are dealt with by applying computer programs that use CFD modeling are solved in a few sequential stages: preparing the problem for solving, verifying the mathematical model, visualizing the calculated results and preprocessing them, and analyzing the obtained results. The article discusses the experience gained with modeling and suggests the main recommendations on using this software product in engineering practice for solving particular problems concerned with ignition and burnout of gaseous and liquid fuel and emission of harmful combustion products in power installations for developing new or optimizing existing designs of various furnace and burner devices.

The use of a heavily doped germanosilicate fibre with a W-profile refractive index and small core diameter in stretchers of ultrashort laser pulses with their subsequent amplification and compression in all-fibre laser systems is considered. The application of fibres of this type makes it possible to stretch, amplify, and then compress a laser pulse with minimum distortions of its initial shape and width. Due to the dispersion properties of these fibres, which allow the pulse duration to be increased significantly at a small fibre length and the third-order positive dispersion of the diffraction-grating-based output compressor to be compensated for, amplified pulses with an energy of 2 μJ and width of 250 fs, free of a picosecond pedestal, are obtained. Several types of fibres intended for the use in stretchers of ultrashort laser pulses are comparatively analysed from the point of view of their dispersion compatibility with a diffraction-grating-based output compressor.