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The improvement seen in the diagnostic procedures and treatment of thoracic tumours means that patients have an increased chance of longer overall survival. Nevertheless, we can still find those who have had a recurrence or developed a secondary cancer in the previously treated area. These patients require retreatment including re-irradiation. We have reviewed the published data on thoracic re-irradiation, which shows that some specific healthy tissues can tolerate a significant dose of irradiation and these patients benefit from aggressive treatment; however, there is a risk of damage to normal tissue under these circumstances. We analysed the literature data on re-irradiation in the areas of vertebral bodies, spinal cord, breast, lung and oesophagus. We evaluated the doses of primary and secondary radiotherapy, the treatment techniques, as well as the local control and median or overall survival in patients treated with re-radiation. The longest OS is reported in the case of re-irradiation after second breast-conserving therapy where the 5-year OS range is 81 to 100% and is shorter in patients with loco-reginal re-irradiation where the 5-y OS range is 18 to 60%. 2-year OS in patients re-irradiated for lung cancer and oesophagus cancer range from 13 to 74% and 18 to 42%, respectively. Majority grade ≥3 toxicity after second breast-conserving therapy was fibrosis up to 35%. For loco-regional breast cancer recurrences, early toxicity occurred in up to 33% of patients resulting in mostly desquamation, while late toxicity was recorded in up to 23% of patients and were mostly ulcerations. Early grade ≥3 lung toxicity developed in up to 39% of patients and up to 20% of Grade 5 hemoptysis. The most frequently observed early toxicity grade ≥3 in oesophageal cancer was oesophagitis recorded in up to 57% of patients, followed by hematological complications which was recorded in up to 50% of patients. The most common late complications included dysphagia, recorded in up to 16.7% of patients. We have shown that thoracic re-irradiation is feasible and effective in achieving local control in some patients. Re-irradiation should be performed with maximum accuracy and care using the best available treatment methods with a highly conformal, image-guided approach. Due to tremendous technological progress in the field of radiotherapy, we can deliver radiation precisely, shorten the overall treatment time and potentially reduce treatment-related toxicities.

Short bursts of repeating patterns [intervals of recurrence (IoR)] manifest themselves in many applications, such as in the time-series data captured from an athlete's movements using a wearable sensor while performing exercises. We present an efficient, online, one-pass, and real-time algorithm for finding and tracking IoR in a time-series data stream. We provide a detailed theoretical analysis of the behavior of any IoR and derive fundamental properties that can be used on real-world data streams. We show that why our method, unlike current state-of-the-art techniques, is robust to variations in repeats of the same pattern adjacent to each other. To evaluate our algorithm, we build a wearable device that runs our algorithm to conduct a user study. Our results show that our algorithm can detect intervals of repeating activities on edge devices with high accuracy (over 70% F1 -Score) and in a real-time environment with only a 1.5-s lag. Our experimental results from real-world datasets demonstrate that our approach outperforms state-of-the-art algorithms in both accuracy and robustness to variations of the signal of recurrence.

On the Internet respectable economists are debating on the topic "False theses of Marxism: the tendency of the rate of profit to fall". Dozens of economists are involved in these debates. Some believe that K. Marx is right, others believe that he is wrong. At the same time, the disputants reveal negligence in relation to each other, a complete misunderstanding of the text of "CAPITAL", but they also admit accusations against K. Marx, such as: "his understanding of the meaning of the concept of" constant capital "was amateurish", or "the mechanism of "surplus time" was invented and the appropriation of workers' labor in this mythical "surplus time", and so on, etc. We cannot agree with such an attitude towards K. Marx, who left us (humanity!) An invaluable ideological legacy, manuscripts not fully published during his lifetime under the general title "CAPITAL".

The structure of the working day from the point of view "a necessary and additional product and its cost" is considered, two divisions of a social production, the productive capital and the income of a society, and also concepts " productive force" and "labour productivity" are determined. It was possible to specify "the law of the profit" and "the law of efficiency of a social production" and to formulate the unknown person till now "the law of proportional development of a social production by the example of change of structure of an end-product of a society".

America, having reduced its production at home, scattered it all over the world, where only it is beneficial to money capitalists, bankers and financial oligarchs, everyone who shares American interests.

Various aspects of surface enhanced Raman scattering amplification in gases and liquids have been investigated utilizing active Raman enhancing surfaces and waveguide resonators. We demonstrate that surface enhanced Raman scattering amplification in gases is not as selective as in liquids. Thus, we develop a portable express analyzer of gas based on a surface-enhanced waveguide resonator. Its Raman scattering gain coefficient is compared quantitatively with that of a bulk Kagome Raman resonator. We estimate the Raman scattering gain coefficient in a hollow metal-plated tube due to multiple wall reflections of the pumping and scattered light beams. We consider Raman scattering amplification in a mirror tube, given an enhancing Raman surface as opposed to a simple focusing of the beam in a gas medium. For in-field gas monitoring online, the surface-enhanced Raman scattering waveguide resonator was combined with a portable spectrometer. The express gas analyzer with an active surface enhanced Raman scattering waveguide resonator proves superior to similar conventional technology in measurement speed and stability. We discuss an example of the practical application of the proposed system.

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and a major cause of cancer-related morbidity and mortality around the world. Frequently, concurrent liver dysfunction and variations in tumor burden make it difficult to design effective and standardized treatment pathways. Contemporary treatment guidelines designed for an era of personalized medicine should consider these features in a more clinically meaningful way to improve outcomes for patients across the HCC spectrum. Given the heterogeneity of HCC, we propose a detailed clinical algorithm for selecting optimal treatment using an evidence-based and practical approach, incorporating liver function, tumor burden, the extent of disease, and ultimate treatment intent, with the goal of individualizing clinical decision making.

The problem of territorial development is quite relevant for countries that cause a wide range of development issues: a low level of quality of life, underdeveloped infrastructure, migration of the working-age population to urban areas, etc. countryside. Certain difficulties in the development of rural areas are currently characteristic of Kazakhstan, 41 percent of whose population lives in rural areas. In recent years, there has been a stable trend of the outflow of the rural population, mainly young people, to the cities. The main reason for this phenomenon is dissatisfaction with the living conditions in the countryside. Rural areas of the country are characterized by low incomes of the population, underdeveloped transport infrastructure, lack of many utilities, insufficient provision of social services (health, education, culture).This situation cannot but worry the country’s leadership, since it has a multi-vector impact on the socio-economic development of Kazakhstan: food self-sufficiency of the country’s regions, the export potential of the agricultural sector, and the balanced structure of the economy. In this connection, there is a need for a detailed solution of problems and the search for their ways, methods and mechanisms for achieving goals. According to the authors of the article, the proposed author’s model can become a basis for optimal development of the country.The authors analyzed the existing definitions of “development”, “rural areas”, “development of rural areas”, gave their own formulation of the definition of the development of rural areas. Based on the study of foreign experience, important aspects of rural development policy have been identified, the authors have proposed mechanisms by which rural development can be implemented.The article focuses on the importance of interaction between all stakeholders interested in the development of rural areas.The purpose of this article is to develop the author’s conceptual model for the development of rural areas based on a theoretical review of existing definitions.The results of the research - the author’s definition and the proposed conceptual model are of interest both for scientific research in this area and for practical programs for rural development.

Although all advantages of a standard approach to teaching students new skills, we are increasingly faced with problems such as the inability to pay an equal amount of attention to many students, to work through and unambiguously highlight all possible problems and mistakes, to close knowledge gaps. Also, all these difficulties are becoming even more urgent given the current state of affairs in the world and the global transition to an online learning format. As a possible solution to the problem, one can consider the creation of independent intelligent systems capable of taking on a part of the load of teachers and automatically participating in the process of teaching students. The subject of research in this article is the process of analyzing the steps for solving algebraic equations using the Lobachevsky-Graeffe-Dandelen method. The goal is to model the process of solving algebraic equations and to identify all possible steps, difficulties and problems in solving such problems. Objective: development of a system capable of monitoring the execution of all necessary steps for a given solution, identifying and classifying possible student mistakes in the process of mastering the skill and work them out. In the process of the task, the following results were obtained: one possible solution for learning to solve an n-degree algebraic equation using the Lobachevsky-Greffe-Dandelen method has been described. On the basis of the signal-parametric approach to diagnostics of faults in dynamic systems the mathematical diagnostic models are created which allow detecting classes of errors by comparing the results of Student's calculations and the results of system calculations. The features and possible difficulties of application of the proposed diagnostic models are presented. An intelligent self-contained tutor system was developed and integrated into the work at practical classes on "Theory of Automatic Control" by 3rd year students of the National Aerospace University.

The Hoffa fracture is an extremely rare injury of one or two condyles of the femur in the frontal plane, more often associated with injury to other structures of the knee joint area. The main cause of the Hoffa fracture is considered to be a high-energy injury (road accident in 80.5% of cases). The isolated Hoffa fracture accounts for 0.65% of all femoral fractures. To date, there is no consensus on surgical approach or optimal technique of internal fixation for the frontal fracture of the femoral condyles. There is also a large percentage of mistakes in the X-ray diagnosis of this pathology. The existing classifications have not found wide application in clinical practice, being difficult and inapplicable for solving the issue of treatment tactics and preoperative planning. The aim of the study is to present modern views on the diagnosis, principles and techniques of surgical treatment of patients with the Hoffa fractures based on the analysis of the literature. Based on the analyzed literature, conclusions are drawn about the need for careful collection of injury anamnesis, increased surgeon caution in the presence of this injury clinical picture and the simultaneous absence of pathology on standard knee joint X-rays, the need to perform an additional examination in the form of lateral (non-standard) projections of the knee joint X-rays, CT or MRI. During preoperative planning, preference should be given to minimally invasive technologies, including arthroscopically-associated methods of treatment.

Migrants are a growing segment of the highly educated international workforce, and these skilled migrants (SMs) are critical to the growth of developed, mature economies. SMs frequently report negative workplace experiences antithetical to their integration, raising important questions about how organizations might help these host-country newcomers to transition to become organizational insiders. Our aim is to integrate a broad and multidisciplinary literature and identify opportunities where organizations and managers might intervene to enable a successful socialization process and improve SMs’ workplace experiences. We review the empirical research from 2000 to 2019 for SMs employed in developed, mature economies and focus on the SMs’ workplace experiences postorganizational entry. We employ a three-phase socialization model (anticipatory socialization, accommodation, and adaptation) as our organizing framework to identify SMs’ key challenges and outcomes, consider those challenges and outcomes through a socialization lens, and isolate the challenges and outcomes that characterize each transition point (from anticipatory socialization to accommodation and from accommodation to adaptation). We then use these distinguishing characteristics to recommend activities that organizations can implement at each transition to facilitate SMs’ socialization process. By leveraging the three-phase socialization model to align organizational activities with SMs’ workplace experiences, we extend the field’s understanding of SM socialization (inparticular) and of the organizational socialization process (more generally). Refereed/Peer-reviewed

PurposeVoluntary collective turnover can be costly for workplaces. The authors investigate the effectiveness of high-performance work system (HPWS) intensity as a tool to manage voluntary collective turnover. Further, the authors investigate a cynical workplace climate (CWC) as a boundary condition on the HPWS intensity–voluntary collective turnover relationship.Design/methodology/approachThe unit of analysis is the workplace, with human resource (HR) managers providing data on HPWS practices in Time 1 (T1) and voluntary collective turnover two years later. Aggregated employee data were used to assess the cynical workplace climate. Hierarchical regression analysis was used to test the hypotheses.FindingsThis study’s results demonstrate a negative relationship between HPWS intensity and voluntary collective turnover when there is a low cynical workplace climate. The authors find that in a high cynical workplace climate, HPWS intensity is ineffective at managing voluntary collective turnover.Research limitations/implicationsThis study’s results show that HPWS intensity needs to be well received by the workforce to be effective in reducing voluntary collective turnover.Practical implicationsTo increase the chances of HPWS intensity reducing voluntary collective turnover, workplaces need to assess the level of employee cynicism in their workplace climates. When the climate is assessed as low in cynicism, the workplace can then consider implementing an HPWS.Originality/valueThe authors explain why the HPWS intensity–voluntary collective turnover relationship varies across workplaces. As HR practices are subject to interpretation, workplaces need to look beyond the practices in their HPWS and focus on employee receptivity to HR practices.

Background: Running clinical facilities implies facing many challenges, as neat time management and fluid care processes. A method that warrants small changes and an interconnected and collaborative proceeding is convenient for adjusting clinical processes and avoiding unwanted side effects. From an organizational perspective, a smooth clinical process translates also into a levelled occupation of team members as reflected by over-time and absenteeism. Methods: The policlinic nurse team introduced weekly mini-huddles of maximum 15 minutes to discuss work organizational issues, with structured access to collaborating professionals and their hierarchies. The team selected the topic of patients presenting without a planned appointment. Nurse’s over-time stock and absenteeism were assessed before and after the intervention. Results: The clinical process had six steps, of which the patient’s waiting room period was transformed into a nurse’s evaluation and triage period followed by a transmission note to the physician. The new process decreased the average stock of nurse’s team over-time from 65.5 to 46.8 hours (-29%), and the nurse’s absenteeism from 4.6 % to 1.97 % (-57%). Conclusion: By cautious and collaborative proceeding, and the choice of an earnest issue by front nurses, we levelled the nurse’s workload and pleased patients and professional teams.

BACKGROUND: The placement of a pulmonary-to-systemic arterial shunt in children with severe pulmonary hypertension (PH) has been demonstrated, in relatively small studies, to be an effective palliation for their disease.OBJECTIVES: The aim of this study was to expand upon these earlier findings using an international registry for children with PH who have undergone a shunt procedure.METHODS: Retrospective data were obtained from 110 children with PH who underwent a shunt procedure collected from 13 institutions in Europe and the United States.RESULTS: Seventeen children died in-hospital postprocedure (15%). Of the 93 children successfully discharged home, 18 subsequently died or underwent lung transplantation (20%); the mean follow-up was 3.1 years (range: 25 days to 17 years). The overall 1- and 5-year freedom from death or transplant rates were 77% and 58%, respectively, and 92% and 68% for those discharged home, respectively. Children discharged home had significantly improved World Health Organization functional class (P < 0.001), 6-minute walk distances (P = 0.047) and lower brain natriuretic peptide levels (P < 0.001). Postprocedure, 59% of children were weaned completely from their prostacyclin infusion (P < 0.001). Preprocedural risk factors for dying in-hospital postprocedure included intensive care unit admission (hazard ratio [HR]: 3.2; P = 0.02), mechanical ventilation (HR: 8.3; P < 0.001) and extracorporeal membrane oxygenation (HR: 10.7; P < 0.001).CONCLUSIONS: A pulmonary-to-systemic arterial shunt can provide a child with severe PH significant clinical improvement that is both durable and potentially free from continuous prostacyclin infusion. Five-year survival is comparable to children undergoing lung transplantation for PH. Children with severely decompensated disease requiring aggressive intensive care are not good candidates for the shunt procedure.

Today's vehicles are advancing from stand-alone transportation means to vehicle-to-vehicle, and vehicle-to-infrastructure communications enabled devices which are able to exchange data through the transportation communication infrastructure. As the IoT and data remain intrinsically linked together, the fast-changing mobility landscape of intent-based networking for the Internet of connected vehicles comes with a great risk of data security and privacy violations. This paper considers the privacy issues in the distributed edge computing, in which the data is communicated between a number of vehicles in the IoT layer and potentially untrusted edge controllers at the edge of the network. The sensory data communicated by the vehicles contain sensitive information, such as location and speed, which could violate the users' privacy if they are leaked with no perturbation. Recent studies suggest mechanisms for randomizing the stream of data to ensure individuals' privacy. Although the past works on differential privacy provide a strong privacy guarantee, they are limited to applications where communication parties are trusted and/or there is no correlation between the users or the featured of sensory data. In this paper, we address this gap by proposing a differentially private data streaming system that adds a correlated noise in the vehicle's side (IoT layer) rather than the transportation infrastructure. Also, our system is able to ensure a strong privacy level over time. The proposed mechanism is data-adaptive and scales the noise with respect to the data correlation. Our extensive experiments demonstrate that the utility of the output generated by our method outperforms the recent approaches.

The article describes a new class of organizational and technical systems - intelligent aviation systems, whose operational principles provide the increased safety of an aircraft flight. The development of systems of this class is primarily explained by the need to record statistical data on the main causes of aviation accidents (human factor - up to 87%, failure of aviation equipment - up to 15%, external factors - 2% of all cases). A scientific problem is formulated related to the importance of creating methods for assessing and predicting the threat of an accident based on direct control of changes in the values of characteristics that affect flight safety. For this, it is proposed to use the methods and means of the scientific and technical direction of artificial intelligence, which will reveal the immediate causes of an aviation accident and prevent them using the flight safety management system. The technical characteristics are considered, the properties of the system under study are presented, which determine the principles of its functioning: intelligence, information content, speed, controllability, interdependence of subsystems, flight safety, including identification of the threat of an accident, its prediction and parry. The above principles of the functioning of the system under study, which are part of the methodology for managing the safety of an aircraft in flight, are implemented in a set of methods and algorithms. Among them should be noted the intelligent method for assessing the threat of an aviation accident, the method for predicting the threat of an accident, the method for supporting decision-making by the crew in the event of the threat of an accident, as well as the method for synthesizing the control law for countering the threat

Background The vaccine is a preparation of biological origin containing antigens that stimulate the body’s immune system to produce acquired immunity. Vaccines can contain killed or “live” (attenuated) microorganisms as well as fragments of these (antigens). Although many vaccines are used routinely in pregnancy to provide a seroprotective immune response for mother, fetus and neonate there is much controversy over their use during this unique time. The aim of the study was to find out about the knowledge of adult Poles on the use of preventive vaccinations during pregnancy. Methods The study involved 700 people (100%) aged 18 to 80 years ($$ \overline{x} $$ x ¯ = 32.16 ± 16.46). Most of the respondents were women (511; 73%). The study consisted of 9 questions about preventive vaccinations of pregnant women and 5 questions about members of the studied group. The aforementioned questions formed the basis of the preparation of the presented article. Results A significant part of respondents (322; 46%) did not have knowledge on the topic of safeness of using preventive vaccinations during pregnancy, 196 (28%) respondents believed that such procedure is not safe. Most of the respondents (371; 53%) did not know about the possibility of using “live” vaccines during pregnancy. 14 (2%) of respondents believed that pregnancy should be terminated in case of administration of a “live” vaccine to a pregnant woman. According to 294 (42%) respondents, vaccinations with “live” vaccines should be completed at least 3 months before the planned pregnancy. The subjects were not aware of the issue of post-exposure vaccination against tetanus and rabies among pregnant women. The respondents’ responses were divided on the issue of the safest trimester of pregnancy for vaccine administration. Almost 1/3 of the respondents (203; 29%) indicated the third trimester as the safest for their performance. Conclusion The knowledge of the surveyed group, the majority of whom were women, about the use of vaccinations before and during pregnancy was unsatisfactory. There is a need to educate the public about the benefits and risks of performing or avoiding preventive vaccinations during pregnancy.

Relevance. The paper demonstrates the need to implement modern diagnostic techniques for diagnosis of precancerous and cancerous lesions at early or preclinical stages. Additional diagnostic methods are necessary, e.g. tissue autofluorescence, which allows revealing insidious pathological risk zones, particularly precancerous and cancerous lesions, to evaluate the condition of the oral tissues in patients with chronic oral mucosa disorders, especially caused by trauma. Purpose – to assess trauma-specific effectiveness of autofluorescence spectroscopy (AFS) in risk group patients with chronic trauma of the oral mucosa to reveal early malignization signs.Materials and methods. 25 subjects were selected for the study and divided into 2 groups: main group – 20 patients with different manifestations of chronic oral mucosa trauma; control group – 5 subjects without visible clinical manifestations and without oral trauma factors. Autofluorescence spectroscopy was performed in both groups using AFS-400 stomatoscope.Results. The received data demonstrated that the change in autofluorescence doesn’t allow drawing final conclusions on the presence or absence of chronic oral trauma malignization signs.Conclusion. AFS-400 stomatoscope may be effective in differentiating between healthy and damaged tissues, but there is no solid evidence that the change in fluorescence shade can help differentiate between various types of damaged tissues. Autofluorescence spectroscopy should be considered as an additional method for examination of patients with chronic oral mucosa trauma to reveal early malignization signs.

OBJECTIVE Our objective was to determine the incidence and risk factors for intravenous acetazolamide-associated acute kidney injury (AKI).METHODS We utilized a retrospective cohort study including patients RESULTS A total of 868 patients met study criteria (male 55.8%, median age 0.66 years [IQR 0.19, 3.0 years]). Intravenous acetazolamide was administered at 5.1 ± 2.8 mg/kg/dose for a median of 4 doses (IQR 2, 6). Median baseline SCr was 0.28 mg/dL (IQR 0.22, 0.37), corresponding to a creatinine clearance of 115 ± 55 mL/min/1.73 m2. Acute kidney injury occurred in 26.8% (n = 233) of patients (stage I = 20.1%, stage II = 3.7%, stage III 3.1%), and no patients received renal replacement therapy. An ordinal logistic regression model identified an increased odds of AKI with cyclosporine, ethacrynic acid, and piperacillin-tazobactam administration.CONCLUSIONS Acute kidney injury occurs frequently in critically ill pediatric patients receiving intravenous acetazolamide.

Complement is known to play a role in ischemia and reperfusion injury (IRI). A general paradigm is that complement is activated by self-reactive natural IgM antibodies (nAbs), after they engage postischemic neoepitopes. However, a role for nAbs in lung transplantation (LTx) has not been explored. Using mouse models of LTx, we investigated the role of two postischemic neoepitopes, modified annexin IV (B4) and a subset of phospholipids (C2), in LTx. Antibody deficient Rag1−/−recipient mice were protected from LTx IRI. Reconstitution with either B4 or C2nAb restored IRI, with C2 significantly more effective than B4 nAb. Based on these information, we developed/ characterized a novel complement inhibitor composed of single-chain antibody (scFv) derived from the C2 nAb linked to Crry (C2scFv-Crry), a murine inhibitor of C3 activation. Using an allogeneic LTx, in which recipients contain a full nAb repertoire, C2scFv-Crry targeted to the LTx, inhibited IRI, and delayed acute rejection. Finally, we demonstrate the expression of the C2 neoepitope in human donor lungs, highlighting the translational potential of this approach.

The article uses the methods of comparative analysis of the data of resource satellite systems to evaluate the informative capacity of Sentinel-2B satellite images. Remote sensing data processing and analysis methods are used to determine the suitability of Sentinel-2B data for assessing the state of open soils, including those contaminated with petroleum products.

High-efficiency harmonic generation is observed in a semiconducting polymer RR-P3HT [regioregular poly(3-hexylthiophene)], which exhibits a high nonlinear susceptibility [χ (2) > 10−6 m V−1] under pumping by a pulsed fibre laser. The harmonic generation efficiency in RR-P3HT is comparable or higher than that observed for liquid crystals, which are used in reference experiments to estimate the susceptibility [the quadratic susceptibility of a nematic liquid crystal NLC 1289 is χ (2) ≈ 2 × 10−6 m V−1]. No generation is observed in polythiophene with a random structure, RRa-P3HT [regiorandom poly(3-hexylthiophene)], at the same pump power. It is experimentally demonstrated that a necessary condition for generating the second and third harmonics in a polymer, along with a high pump power density, is the presence of a large power density gradient (exceeding 1013 W m−3). Based on a preliminary theoretical analysis, we can suggest that the quadrupole mechanism, which is a consequence of the regularity of RR-P3HT structure in the thin near-wall layer, may contribute significantly to the nonlinear radiation conversion in semiconducting polymers.

Lucilia sericata bottle fly worms can be used to heal infected, chronic, or necrotic wounds, including those associated with ulceration and diabetic foot. The study aimed to evaluate changes in the microflora in patients treated with L sericata larvae due to leg ulcers and diabetic foot. One hundred twenty‐nine patients diagnosed with lower limb ulceration and diabetic foot were enrolled in the study, of which 80 of them met the eligibility criteria for maggot debridement therapy (MDT). On the contrary, 49 unqualified patients were offered ozone therapy (22 with leg ulcers; 27 with diabetic foot). In each of these patients, a microbiological swab was performed before and after the start of therapy. The group of 80 patients was further divided into four equal groups in terms of the treated area (lower leg vs foot) and the number of larvae/cm2 (5 vs 10). Twenty‐three particular species of bacteria in the infected wound were studied microbiologically in terms of presence/absence within the wound environment before and after treatment of patients with diabetic foot and lower limb ulceration. It was noted that there was a more intensive bacterial accumulation in the feet of patients compared to legs; furthermore, this applies to almost all analysed species. Diabetes status is also a clinical factor that generates a lower chance of bacterial appearance in the wound environment. Densification of MDT larvae per wound area unit also reduced the chance of the presence of Corynebacterium species, Enterobacteriaceae, Pseudomonas aeruginosa, Staphylococcus aureus MSSA, and Streptococcus coagulase negativa; however, it increased the likelihood of occurrence for Proteus mirabilis and the Proteus species. A microbiological analysis in this non‐reference study shows the efficacy of larval therapy for leg and foot ulcers. Rearrangement of the microflora within the wound has been reported as a result of the therapy.

The article analyzes the current trends in the development of public institutions in Ukraine. The role of non-governmental public organizations in providing social services is considered. The main trends in the development of the private sector have been studied. The role of grant projects is highlighted. The role and place of the private sector in the provision of social services has been considered. Examples of implementation of local initiatives and receiving grant support have been analyzed. The importance and urgency of the problems of non-governmental organizations in the field of social services have been highlighted. Youth organizations that join socially-oriented initiatives are developing. Directing relevant initiatives and work of youth organizations activates young people in local communities, involves in the advisory bodies formation, localization of relevant projects implemented at the level of united territorial communities of villages and small towns, where in previous years youth activity was low. In a decentralized environment, no matter how capable the community is, there are always issues that are difficult to solve at the expense of the local budget. As practice shows, several issues of local importance, which cannot be solved by the budget of the united territorial community, can be successfully solved at the expense of other resources, including grants. Most of the international projects were implemented territorially in Uman and adjacent territorial communities. Their success depended on fruitful intersectoral cooperation with the Faculty of Social and Psychological Pedagogy, which provided organizationally, volunteer and psychological support, and the Department of Labor and Social Protection of Uman City Council, which provided effective communication between all branches of government, information and financial support.

One of the priority direction of the personnel work in the Ministry of the Internal Affairs of Russia today is to ensure the intended use of personnel and except the cases of assigning the excessive official duties to the officers of the internal affairs bodies that are not related to their posts. At the same time, much attention is paid to the implementation of the officers’ rights, aimed not only at the successful realization of law enforcement functions, but also have a compensating, stimulating nature. In this regard, the target of the article is to point out the dependence between the effectiveness of the internal affairs officers work, the satisfaction with their service conditions and the balance of their rights and official duties. The state of this balance and the possibility of its change are reflected in the main legislative and other regulatory legal acts establishing the legal status of internal affairs bodies’ officers. In addition to the analysis of the listed documents, the article separately considers the procedure of compiling and using job regulations (job instructions) as documents directly regulating official activities. The result of the research is the recommendations for amending the regulatory legal acts and improving the organizational foundations, which allow providing the balance of the officers’ rights and service duties.

The beneficial use of chemicals in modern human society inevitably leads to their emission into the environment. Pharmaceuticals are crucial for improving and safeguarding public health, whether treating acute infections with historically poor prognoses or increasing the length and quality of our lives by treating chronic conditions such as cardiovascular diseases, cancer, endocrine disorders and improving psychiatric well-being. The use of pharmaceuticals is unlikely to diminish and as such we expect their continuous or even increasing discharge into aquatic and terrestrial environments, predominantly through excretion by patients. This article is protected by copyright. All rights reserved.

Urinary tract infections (UTIs) are one of the most common reasons for antibiotic prescriptions among women worldwide. UTIs are also associated with intra- and postoperative catheterization, which is an essential component of many gynecological surgical procedures, including midurethral sling (MUS) placement. The aim of this study was to compare the incidence of UTI subsequent to a MUS procedure. The study involved 562 female patients who underwent MUS procedures due to stress urinary incontinence (SUI). Patients were assigned in a 1:1 ratio to two study groups: patients receiving 500 mg of ciprofloxacin three times a day for 3 consecutive days after surgery or patients receiving 5 mL of Canephron taken orally three times a day for 3 weeks. After analyzing the collected data, it was found that in the group of patients receiving ciprofloxacin, 29 women (10.98 %) had a UTI, whereas in the group of patients receiving Canephron, 36 women (13.64 %) had a UTI within 6 months after the patient’s MUS procedure. No statistically significant difference between the two groups was noted. Postoperative prophylaxis with a phytodrug can be perceived as an attractive option in the reduction of antibiotic consumption among female patients after a MUS procedure.

The influence of various rhythmic extreme cold effects on the state of autonomic regulation of heart rate in young and aged rats was studied. According to the spectral analysis of heart rate variability, it has been found that in young rats, using rhythmic extreme cold exposures (RECE) temperature regimens of (-120 °С; -120 °С; -120 °С) and (-60 °С; -120 °С; -120 °С) significantly increased adaptive capabilities of the body due to the activation of its own homeostatic regulatory systems. At the same time, the combined regimen of RECE (-60 °С; 120 °С; -120 °С) occurred to be the most optimal for aged animals, since its use was not accompanied with an excessive activation of sympathoadrenal system at the early stages of experimental studies, in contrast to the regimen (120 °С; -120 °С; -120 °С). In addition, the use of this cooling mode contributed to a statistically significant increase in the total power of spectrum of neurohumoral regulation not so much due to a rise in activity of humoral-metabolic regulation link, the prevalence of which is characteristic of an old age, but due to an increase in the tone of vegetative centers, herewith the parasympathetic effects on the myocardium prevailed sympathetic ons.

This study investigates the antecedents and consequences of organization-level inclusion climate. A national sample of human resource decision-makers from 100 organizations described their firms' formal diversity management programs; 3,229 employees reported their perceptions of, and reactions to, their employers' diversity management. Multilevel analyses demonstrate that identity-conscious programs (programs that target specific identity groups) generate an inclusion climate. Moreover, the analyses provide evidence of multilevel mediation: In organizations with an inclusion climate, individual employees perceive the organization as fulfilling its diversity management obligations and respond with higher levels of affective commitment. This study represents an important step toward understanding how a shared perception of organizational inclusiveness develops and how inclusion climate facilitates the achievement of diversity management objectives. The findings also shed light on the important role of identity-conscious programs in promoting organizational commitment within a diverse workforce. Refereed/Peer-reviewed

Some opportunities to apply the paradigm of symbolic formalisms for solving planning and coordination problems in netcentric civil (commercial) systems is shown. An approach to solving these problems with the help of numerical assessments of the degree of situation awareness of persons making decisions on managing componentsof a netcentric system is proposed.

Background: Cognitive decline remains difficult to predict as structural brain damage cannot fully explain the extensive heterogeneity found between MS patients. Objective: To investigate whether functional brain network organization measured with magnetoencephalography (MEG) predicts cognitive decline in MS patients after 5 years and to explore its value beyond structural pathology. Methods: Resting-state MEG recordings, structural MRI, and neuropsychological assessments were analyzed of 146 MS patients, and 100 patients had a 5-year follow-up neuropsychological assessment. Network properties of the minimum spanning tree (i.e. backbone of the functional brain network) indicating network integration and overload were related to baseline and longitudinal cognition, correcting for structural damage. Results: A more integrated beta band network (i.e. smaller diameter) and a less integrated delta band network (i.e. lower leaf fraction) predicted cognitive decline after 5 years ([Formula: see text]), independent of structural damage. Cross-sectional analyses showed that a less integrated network (e.g. lower tree hierarchy) related to worse cognition, independent of frequency band. Conclusions: The level of functional brain network integration was an independent predictive marker of cognitive decline, in addition to the severity of structural damage. This work thereby indicates the promise of MEG-derived network measures in predicting disease progression in MS.

Laura Kulik,1 Leonardo G da Fonseca,2 Aiwu Ruth He,3 Jordi Rimola,4 Andrea Wilson Woods,5 York F Zöllner,6 Peter R Galle7 1Northwestern University, Chicago, IL, USA; 2Clinical Oncology, Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; 3Georgetown University, Washington, DC, USA; 4Radiology Department, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain; 5Blue Faery: The Adrienne Wilson Liver Cancer Association, Birmingham, AL, USA; 6Hamburg University of Applied Sciences, Competence Center Health, Hamburg, Germany; 7University Medical Centre Mainz, Mainz, GermanyCorrespondence: Peter R GalleUniversity Medical Centre Mainz, Mainz, GermanyTel +49 6131 177275Email Peter.Galle@unimedizin-mainz.deAbstract: A virtual expert roundtable was convened on April 16, 2020, to discuss the evolving landscape of care for treating patients with advanced hepatocellular carcinoma (HCC) and discuss questions related to patient care and treatment selection. This commentary presents highlights from this discussion and provides an expert opinion about approaches to treatment for HCC in the Americas and the European Union. We anticipate that atezolizumab plus bevacizumab will become the standard of care for advanced HCC patients. However, this approach will make decisions regarding the sequencing of treatments for second-line therapies and beyond more challenging. Therapy will require individualization based on patient characteristics and preferences, while insurance coverage decisions and requirements may also impact the options that patients can access. Additional research regarding prognostic and predictive biomarkers is needed to help better identify optimal treatment approaches for specific patient populations. Multidisciplinary tumor boards will continue to play a critical role in guiding treatment selection for individual patients. Atezolizumab plus bevacizumab offers a promising new first-line therapeutic option for patients with advanced HCC, but more research is needed to optimize and individualize patient therapy.Keywords: hepatocellular carcinoma, immuno-oncologics, biomarkers, patient-reported outcomes

Purpose The purpose of this paper is to explore how circular start-ups design and implement innovation into their business models to increase their positive impact. Design/methodology/approach This qualitative study is based on an exploratory multiple-case study involving six circular start-ups with positive impact in Poland. Data gathering took place via in-depth interviews with start-up founders. Findings The analysis demonstrates that three factors, which are strongly interconnected, can significantly influence the development of a circular start-up. The first is the purpose-led motivation for circularity as a solution, mostly concentrated on the environmental education of different market actors. The second factor is built on the aim to increase the positive impact by addressing the most pressing social and environmental problems. It determines the impact on society as well as on the environment and the extent to which its model can be scaled up. The third factor is driven by the understanding of the purpose of the innovation, concentrated on the business model innovation regarding circularity. Practical implications This paper demonstrates the benefits for diverse stakeholders and the importance of using circular business models in start-up development. Circularity can be perceived as a main part of the new approach to improve sustainability. Originality/value Circular start-ups represent a new phenomenon in the entrepreneurial market. While the structure and logic of the circular business model in start-ups are significantly unexplored in the management literature, this model is viewed as a crucial step in the direction of increasing the positive impact of start-ups. From a theoretical and practical perspective, it is important to understand the differences and similarities in this area within different markets.

BACKGROUND AND AIMS Radioembolization (yttrium-90 [Y90]) is used in hepatocellular carcinoma (HCC) as a bridging as well as downstaging liver-directed therapy to curative liver transplantation (LT). In this study, we report long-term outcomes of LT for patients with HCC who were bridged/downstaged by Y90. APPROACH AND RESULTS Patients undergoing LT following Y90 between 2004 and 2018 were included, with staging by United Network for Organ Sharing (UNOS) tumor-node-metastasis criteria at baseline pre-Y90 and pre-LT. Post-Y90 toxicities were recorded. Histopathological data of HCC at explant were recorded. Long-term outcomes, including overall survival (OS), recurrence-free survival (RFS), disease-specific mortality (DSM), and time-to-recurrence, were reported. Time-to-endpoint analyses were estimated using Kaplan-Meier. Univariate and multivariate analyses were performed using a log-rank test and Cox proportional-hazards model, respectively. During the 15-year period, 207 patients underwent LT after Y90. OS from LT was 12.5 years, with a median time to LT of 7.5 months [interquartile range, 4.4-10.3]. A total of 169 patients were bridged, whereas 38 were downstaged to LT. Respectively, 94 (45%), 60 (29%), and 53 (26%) patients showed complete, extensive, and partial tumor necrosis on histopathology. Three-year, 5-year, and 10-year OS rates were 84%, 77%, and 60%, respectively. Twenty-four patients developed recurrence, with a median RFS of 120 (95% confidence interval, 69-150) months. DSM at 3, 5, and 10 years was 6%, 11%, and 16%, respectively. There were no differences in OS/RFS for patients who were bridged or downstaged. RFS was higher in patients with complete/extensive versus partial tumor necrosis (P

The optimal flight safety management of an aircraft is considered, on the basis of which the signal for parrying the threat of an aviation accident is calculated. In the process of analyzing the factors affecting the flight safety of the aircraft, the psychophysical state of the crew, the serviceability of the aircraft’s onboard equipment and the flight weather conditions are separated into separate groups. Based on the performed analysis, a target function of aircraft flight safety management is proposed in the form of a maximum, which is provided by the output signal of the aircraft flight safety management system. The calculation of the control signal is based on a count state of the flight conditions of the aircraft, which allows us to estimate the causal relationship of the factors of threat of the accident, and to determine the control signal with the safety of the vessel. In the course of this work, an algorithm for calculating the aircraft safety control signal has been developed. The results obtained during the work can be used for software and hardware implementation of aircraft flight safety management systems, as well as for the design of systems and complexes of its onboard equipment.

The evolution of locoregional therapies in the last decade has been refined with improved patient selection and a development of a more personalized approach. In doing so, there has been associated improved outcomes and less toxicity. With the rapidly changing landscape of systemic therapy, the role of locoregional therapies alone or in combination for downstaging and curative intent will continue to evolve.

Barium hexaferrite (i.e., BaFe12O19) finds application in magnetic memory and radio frequency devices. Here, we report highly textured BaFe12O19 magnetoplumbite thin film growth by pulsed laser deposition directly on amorphous thermal oxide wafers (i.e., SiO2/Si) opening an avenue for the monolithic integration of ferrites onto silicon-based platforms compatible with semiconductor systems and processing. The films and, in particular, their interfaces have been characterized by vibration sample magnetometery, scanning and transmission electron microscopy, and energy dispersive x-ray spectroscopy. In the past, comparable hexaferrite films have been grown only on crystalline substrates with well-matched lattice parameters, e.g., sapphire or magnesium oxide.

Prognostic models to predict individual early postoperative morbidity after liver resection for colorectal liver metastases (CLM) are not available but could enable optimized preoperative patient selection and postoperative surveillance for patients at greater risk of complications. The aim of this study was to establish a prognostic model for the prediction of morbidity after liver resection graded according to Dindo.N = 679 cases of primary liver resection for CLM were retrospectively analyzed using univariable and multivariable ordinal regression analyses. Receiver operating characteristics curve (ROC) analysis was utilised to assess the sensitivity and specificity of predictions and their potential usefulness as prognostic models. Internal validation of the score was performed using data derived from 129 patients.The final multivariable regression model revealed lower preoperative levels, a greater number of units of intraoperatively transfused packed red blood cells (pRBCs), longer duration of surgery, and larger metastases to independently influence postoperatively graded morbidity. ROC curve analysis demonstrated that the multivariable regression model is able to predict each individual grade of postoperative morbidity with high sensitivity and specificity. The areas under the receiver operating curves (AUROC) for all of these predictions of individual grades of morbidity were 0.700, indicating potential usefulness as a predictive model. Moreover, a consistent concordance in Grades I, II, IV, and V according to the classification proposed by Dindo et al. was observed in the internal validation.This study proposes a prognostic model for the prediction of each grade of postoperative morbidity after liver resection for CLM with high sensitivity and specificity using pre- and intraoperatively available variables.Prognostische Modelle zur Vorhersage der individuellen früh-postoperativen Morbidität nach Leberresektion von kolorektalen Lebermetastasen sind nicht verfügbar, könnten aber eine optimierte präoperative Patientenselektion und postoperative Überwachung von Patienten mit erhöhtem Risiko ermöglichen. Ziel dieser Studie war daher ein prognostisches Modell für die Vorhersage der Morbidität nach Leberresektion klassifiziert nach Dindo zu etablieren.N = 679 Fälle von primären Leberresektionen kolorektaler Lebermetastasen wurden retrospektiv unter Nutzung von multivariabel und ordinalen Regressionsanalysen ausgewertet. Analysen der Receiver operating characteristics curve (ROC) wurden zur Überprüfung der Sensitivität und Spezifität der Vorhersagen und der potenziellen Bedeutung als prognostisches Modell eingesetzt. Das Modell wurde anhand weiterer 129 Fälle intern validiert.Das finale multivariable Regressionsmodel zeigte für niedrige präoperative Hb-Werte, hohen intraoperativen Transfusionsbedarf, lange OP-Zeiten sowie größere Metastasen einen deutlichen Einfluss auf die postoperative Morbidität. Die Analyse der ROC-curve beweist die Fähigkeit des multivariable Regressionsmodels die einzelnen Grade postoperativer Morbidität mit hoher Spezifität und Sensitivität vorherzusagen. Die “Area under the receiver operating curve” (AUROC) für die Vorhersage aller einzelnen Morbiditätsgrade von 0,700 unterstreicht den potenziellen Nutzen als prognostisches Model. Die interne Validierung zeigt eine klare Konkordanz hinsichtlich der Grade I, II, IV und V nach Dindo.Diese Studie schlägt ein prognostisches Modell für die Vorhersage der postoperativen Morbidität nach Leberresektion von kolorektalen Lebermetastasen mit hoher Sensitivität und Spezifität unter Nutzung von prä- und intraoperativen Variablen vor.

Annotation. Among gynecological diseases, external genital endometriosis leads to disorders of reproductive function and promotes the development of infertility. Currently, the search for less traumatic and more effective treatments for endometriosis continues. The aim of our study was to analyze the diameter of endometrioid cysts in women with infertility on the background of endometriosis before and after sclerotherapy using pre-pregnancy preparation of a complex vitamin preparation with inositol and vitamin D3. The study included 105 women aged 22 to 40 years with endometriosis-associated infertility. The presence of cysts was confirmed by ultrasound and bimanual examination. The drug FT 500 plus was prescribed in a dosage of 1 sachet – once a day from the 2nd or 3rd day of the cycle for 2 menstrual cycles (the cycle in which sclerotherapy was performed and the next cycle). Vitamin D3 “EuTilia D3” was prescribed in prophylactic doses of 2000 IU to women, or therapeutic (depending on the diagnosed or refuted diagnosis of vitamin D hypovitaminosis). The sclerotherapy procedure was performed by transvaginal puncture of the cyst and aspiration of its contents under the control of transvaginal ultrasound, introduction into the capsule of the cyst (without violating its integrity) 76% ethanol solution. It was found that women with endometriosis-associated infertility, who underwent pre-pregnancy preparation with a complex vitamin preparation with inositol and vitamin D3 after sclerotherapy, probably decreased the diameter of cysts in the right (5.85 times) and left (5.57 times) ovaries relative to data before sclerotherapy. When comparing the diameter of cysts in women who underwent pre-pregnancy preparation with a complex vitamin preparation with inositol and vitamin D3, depending on the type of surgery (sclerotherapy or cystectomy) found a probable decrease in the diameter of cysts after sclerotherapy in the right (82.89%) and left (82.05%) ovaries for such data after cystectomy. Therefore, sclerotherapy with pregravidar preparation with a complex vitamin preparation with inositol and vitamin D3 in women with endometriosis-associated infertility probably reduces the diameter of cysts relative to the experimental group without pregravidar preparation, as well as to the group with a history of cystectomy.

The low accessibility of natural gas fields and transporting pipelines requires portable online analyzers of the composition of natural gas, ensuring nearly chromatographic precision and capable of in situ analysis of a wide range of gases, including infrared-inactive ones (hydrogen, oxygen, nitrogen, chlorine). We have developed an express method of gas analysis meeting all the requirements for analysis of natural gas and its derivative mixtures using a portable 532 nm Raman spectrometer rigidly connected to a hollow-core crystal photonic fiber.