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BACKGROUND: The most common malignant neoplasm of the endocrine system is thyroid cancer. In Russia, as in other countries of the world, the incidence rate is steadily increasing. Thus, it is extremely important to assess the problem of health disorders due to thyroid cancer within the framework of socially significant disability caused by malignant neoplasms in the Russian Federation. AIMS: To analyze the spectrum of types and degree of disability in people with disabilities due to thyroid cancer. MATERIAL AND METHODS: The article presents the results of the analysis of the spectrum of the main types of disability in the general contingent of disabled people due to thyroid cancer among the adult population of Moscow (20152019). RESULTS: The dynamics of disability both in the contingent of first recognized and in the contingent of re-recognized disabled people (VPI and PPI) was characterized by an increase in the number of disabled people and the transformation of the structure of general disability. There is a clear change in the ratio towards an increase in the share of PPI from 55.1% in 2015. up to 68.0% in 2019, while the share of VPI decreased from 44.9% in 2015 to 32.0% in 2019. The predominant gender cohort was women, and the age category was the elderly. The main types of life restrictions were the restriction of the ability to self-serve (98.6% of the VPI and 97.9% of the PPI), to work (94.7% of the VPI and 94.6% of the PPI) and to move (21.3% of the VPI, 21.8% of the PPI). A low proportion of restrictions on the ability to control ones behavior, learning, communication and orientation was revealed (0.31.2%). The first degree of disability prevailed in the contingents of VPI and PPI (p 0.0001). In the contingent of men, the proportion of disabled people with the third degree of disability was higher compared to the contingent of women. CONCLUSION: Dynamic assessment of the degree of severity of functional disorders and associated life restrictions should be carried out at all stages of medical and social rehabilitation in order to monitor the effectiveness of medical and rehabilitation measures, assess the quality of life and prevent progression (secondary prevention of disability).

Aim. To analyze the methods of teaching analytical toxicology in the National University of Pharmacy (NUPh). Materials and methods. Analytical, systematic, logical methods of teaching the discipline, as well as scientific publications of domestic and foreign scientists were used. Results. The topicality of teaching the discipline “Analytical toxicology” at the Department of Analytical Chemistry and Analytical Toxicology of the NUPh (Kharkiv) has been discussed in the article. The features of teaching the discipline in current conditions have been analyzed. The possibility of conducting the chemico-toxicological analysis, which results are necessary for solving many legal and other important issues, has been described. The main tasks facing analytical toxicology, its difference from analytical chemistry and other pharmaceutical disciplines, as well as the significance of the knowledge gained by applicants for higher education that they need in their further practical activities have been considered. The structure of the educational process when studying the discipline “Analytical toxicology”, including theoretical and practical sections, is presented. Modern chemical and physicochemical methods of analysis widely used in analytical toxicology have been described. Conclusions. To train applicants for higher education in the specialty 226 “Pharmacy, Industrial pharmacy”, the study of the discipline “Analytical toxicology”, which is closely related to chemical, biological and medical disciplines, is important. The knowledge gained by applicants for higher education makes it possible to correctly understand the fundamentals of analytical toxicology, apply the theoretical and practical skills obtained in their further practical activities and become fully qualified specialists in the field of chemico-toxicological analysis. Key words: analytical toxicology; analytical chemistry; chemico-toxicological analysis; intoxication; toxicant.

The results of an analysis of the incidence of thyroid cancer (thyroid cancer) in the Russian Federation (20082018) are presented. With increasing age, the incidence of thyroid cancer increases. Dominated by people aged 55 years and above (52.9%). Over the 10-year period (20082018), the increase in the rough indicator of the incidence of thyroid cancer was 49.03%, the standardized 43.5%. The prevalence of thyroid cancer among the population of the Russian Federation in 2018 amounted to 114.1 per 100,000 population, which is 52.5% higher than in 2008 (74.8). This is due to several reasons: the demographic aging of the population, an increase in the incidence rate, and an improvement in the detection of the disease among the population (from 17.4% in 2008 to 34.3% in 2018). There was an increase in the share of thyroid cancer patients registered in oncological institutions of the Russian Federation for 5 years or more from the moment of diagnosis (from 61.6% to 68.8%, respectively), and the index of accumulation of patients with thyroid cancer (from 12.4 to 13.9 respectively). In the cohort of thyroid cancer patients, identified actively, the proportion of patients with a tumor process of stage III was 77.7%, and with a running tumor process (stage IIIIV) 21%. There is a differentiation of the territories of the Russian Federation both in terms of early detection and morphological verification of thyroid cancer, and the volume of radical treatment and the use of various methods for its implementation.

Aim to evaluate the efficiency and usefulness of augmented reality (AR) technology using HoloLens glasses for laparoscopic partial nephrectomy (LPN). Materials and methods From July to December 2019, a total of 5 patients with localized kidney cancer (cT1aN0M0) underwent AR-assisted LRP. The mean RENAL score was 6 points (5-8). Preoperatively, all patients underwent contrast-enhanced multispiral computed tomography (MSCT). The three-dimensional reconstructions of the kidney, tumor, part of the abdominal aorta with the renal artery and its branches, part of the inferior vena cava with the renal vein were segmented with color coding and connected into a single virtual 3D model, which was loaded into the program in order to display image in AR glasses. The duration of surgery and thermal ischemia, type and frequency of intraoperative complications, as well as the time spent on preparing the 3D model and the Microsoft HoloLens device were evaluated. To assess the feasibility of using AR technology intraoperatively, a Likert scale was filled out by the surgeon. Results It took 10 (9-11) hours to prepare the model, including time to optimize the model and to set up its display and interactions. The setup of HoloLens required an average of 7.8 (5- 12) min. The total duration of the operation and the period of warm ischemia was 108 (90-120) and 20 (15-25) min, respectively, while intraoperative blood loss was 160 (110-250) ml. In all cases, a negative surgical margin was found. The surgeon who performed all the operations assessed the use of AR technology with the HoloLens device as highly beneficial in all clinical cases. Conclusion The use of AR technology with a HoloLens holographic device during LPN can lead to improved treatment outcomes.

In clinical practice, we use the term “fusiform aneurysm” for local expansion of artery. Under this generic term specialists understand heterogeneous arterial pathology, which is very important for diagnosis and choosing the treatment. We conducted an analysis of scientific literature published in 1987–2019, including 63 foreign and 4 Russian sources devoted to pathogenesis and types of non-saccular aneurysms. Among non-saccular aneurysms, dolichoectatic aneurysms are distinguished, rather of genetically or non-atherosclerotic origin and fusiform aneurysm acquired due to dissection processes. Features of mechanisms of their formation, variants of clinical course and methods of treatment are presented.

Currently, the problem of treating sepsis is acute. To study these morphological and functional changes, animal models are used, for example, a model of experimental peritonitis, cecal ligation and puncture (CLP). However, there is only insufficient research on the description of internal organ rearrangements, in particular, skin morphological picture. The aim of the study was to assess of changes in mice internal organs in case of sepsis modeling. Materials and Methods. The authors performed cecal ligation and puncture in mice (n=40) to form experimental peritonitis and severe sepsis. In the control group (n=10), a sham surgery was conducted: a midline laparotomy was followed by layer-by-layer deaf suturing of the surgical wound. Results. The authors observed CLP-induced disorders in all vital organs, especially in the liver (violation of the beam structure of the hepatic lobules with signs of balloon dystrophy and necrosis areas, leukocyte infiltration, plethora of sinusoids), kidneys (thinning of the visceral layer of the Bowman’s capsule, narrowing of the afferent arteriole lumen, balloon dystrophy of proximal and distal tubules, widespread disappearance of the brush border in nephrocytes) and the spleen (hyperplasia of the white pulp with a large number of apoptotic lymphocytes). Moreover, signs of mild inflammatory infiltration were observed in the skin. Conclusion. The morphological changes found during the study corresponded to the reaction of the test organs in sepsis. The proposed CLP method for experimental peritonitis can be used as a sepsis model. Keywords: sepsis, cecal ligation and puncture (CLP), skin, inflammation. В настоящий момент остро стоит проблема лечения сепсиса. Для изучения данных морфофункциональных изменений используют модели на животных, например модель экспериментального перитонита – лигирование и пункцию слепой кишки (cecal ligation and puncture, CLP). Однако исследований, касающихся описания перестроек внутренних органов, в частности морфологической картины кожного покрова, проведено явно недостаточно. Цель исследования. Морфологическая оценка изменений внутренних органов мышей в условиях моделирования сепсиса. Материалы и методы. У мышей (n=40) проводили лигирование и пункцию слепой кишки для формирования экспериментального перитонита (CLP) и тяжелого сепсиса. В контрольной группе (n=10) осуществляли «фиктивную» операцию – срединную лапаротомию с последующим послойным глухим ушиванием операционной раны. Результаты. Во всех жизненно важных органах наблюдали нарушения, индуцированные CLP, особенно в печени (нарушение балочного строения печеночных долек с признаками баллонной дистрофии и зонами некроза, лейкоцитарная инфильтрация, полнокровие синусоидов), почках (истончение висцерального листка капсулы Боумена–Шумлянского, сужение просвета приносящих артериол, баллонная дистрофия проксимальных и дистальных канальцев, повсеместное исчезновение щеточной каемки в нефроцитах) и селезенке (гиперплазия белой пульпы с наличием большого количества апоптотических лимфоцитов), а также отмечали признаки слабой воспалительной инфильтрации в коже. Заключение. Обнаруженные в ходе исследования морфологические изменения соответствуют реакции исследуемых органов при сепсисе. Предложенный метод CLP для создания экспериментального перитонита можно использовать в качестве модели сепсиса. Ключевые слова: сепсис, cecal ligation and puncture (CLP), кожа, воспаление.

Topicality. Increase in the use of antipsychotics and antidepressants in many countries led to augmentation of acute poisoning amount with lethal cases. Among them, the main part is combined poisoning, including combination with other medicines, which significantly complicates the conduction of chemical-toxicological analysis.Aim. To conduct the analytical review of side effects and lethal cases of acute poisoning by antipsychotics and antidepressants, including combination with other medicines.Materials and methods. Analysis of websites and online literature sources such as: ehealthme.com, patientsville.com, Academia.edu, PubMed, ResearchGate, Scopus etc.Results and discussion. According to the results of sources analysis, in the period from 2013 to 2018, there were registered 5094 cases of side effects and 56 lethal poisonings with the use of the most commonly used antipsychotics of phenothiazine derivatives. Also 6013 cases of side effects and 675 lethal poisonings were registered with the use of tricyclic antidepressants. The main side effects and causes of fatalities have been identified. The combined use of antipsychotics and antidepressants and its simultaneous application with medicines from other pharmacological groups, increases the risk of poisoning. It greatly complicates the chemical and toxicological searches to determine the cause of poisoning.Conclusions. The conducted research determined the factors of deterioration the toxicological situation recently which has developed with the use of antipsychotics and antidepressants and substantiated feasibility of the development of methods of chemical-toxicological analysis for drugs that caused fatal poisoning.

Objective. To analyze the presence of infectious pathogens in the intervertebral disc tissues as possible pathogenetic factor in the development of degenerative diseases of the spine. Material and Method. In 2017–2018, a prospective exploratory research was conducted, which included 64 patients with degenerative disease of the spine who met the following inclusion criteria: the presence of clinically and instrumentally proven hernias of the intervertebral discs in the lumbosacral spine, the absence of a history of surgical interventions on the spine, non-intake of antibacterial drugs for the year before surgery, and Modic I and /or II type changes on MRI. All patients underwent interventions with sampling of intervertebral disc material; a total of 80 discs were examined. The obtained materials were subjected to microbiological and histopathological studies.Results. Out of 64 patients, only 1 (1.6 %) revealed the presence of bacterial flora in the intervertebral disc tissue (Propionibacterium acnes strain). It can be assumed that the identified bacterial flora is the result of contamination. It is also possible that the infectious agent joined already during the development of degenerative disease of the spine. If the bacterial flora was a pathogenetic factor, then it can be assumed that the pathogenesis of the disease is polyetiological and includes the infectious process as a rare event.Conclusions. Given the high interest of specialists in the pathogenesis of degenerative diseases, it seems appropriate to conduct further studies in this direction using various laboratory diagnostic methods with high sensitivity and specificity.

Nodular fasciitis (NF) is a benign reactive or inflammatory condition of mesenchymal fibroblasts. Rapid growth and histological features make nodular fasciitis a mimicker of malignancies such as sarcomas, however, nodular fasciitis is a benign lesion and does not metastasize. Although the etiology of nodular fasciitis is uncertain, histopathologically, it bears a close resemblance to organizing granulation tissue, and myofibroblastic proliferation may be initiated by a local injury or local inflammatory process, which supports a reactive proliferation theory triggered by trauma. Surgical excision is recommended for diagnosis and treatment to exclude malignancy. We are hereby reporting a case of nodular fasciitis on the front surface of the neck, 86 years old patient. Tumor grew rapidly and reached 9-10 cm., and which was clinically suspected as a malignancy located. An ultrasound examination was performed. Based on the clinical and ultrasound data, it was decided to perform an extended biopsy to establish the final diagnosis it. Tumor has been removed as a solid mass. The material was sent for histopathological examination. Based on the history, clinical picture, and histopathological examination, the lesion was diagnosed as nodular fasciitis. After surgery patient expressed satisfaction with the result of treatment. In cases of nodular fasciitis, proactive efforts are needed to perform histopathologic evaluation and treatment because nodular fasciitis tends to grow rapidly.

Aim. To study the opinion of the population about satisfaction with the accessibility and quality of primary health care for diseases of the arteries of the lower extremities in institutions of the Sverdlovsk region, as well as to identify problems in the organization of its provision. Methods. From January to June 2019, an anonymous survey of 384 patients with diseases of the arteries of the lower extremities who applied for a consultative appointment with a cardiovascular surgeon at the clinic of the Sverdlovsk Regional Clinical Hospital No. 1 was carried out. A representative sample was determined by formulae, in which, out of the general population the number of registered cases of arterial disease of the lower limbs in the Sverdlovsk region, was acceptable. The survey involved 301 (78.4%) men and 83 (21.6%) women. Results. More than 90% of respondents were over 50 years old. More than 35% of respondents expected a referral for a consultation with a specialist later than 1 month away. The accessibility and timeliness of obtaining specialized medical care were influenced by the geographical remoteness from the regional center. The presence of queues in outpatient clinics at the place of residence, the difficulty in obtaining a coupon for an appointment with a doctor, the inaccessibility of free research, as well as the inconvenient work schedule of specialist doctors were the main reasons for not obtaining medical care. When examined in the clinic at the place of residence, more than half of the respondents used their own money. Just over a third of patients (35.2%) thought that the level of medical care has improved over the past decade, 19.5% thought that it had become worse, 16.4% that it had not changed, and 28.9% found it difficult to answer. About half of the respondents (48.8%) were satisfied with the result of the medical care provided, 11.2% were not satisfied, and 40% of the patients found it difficult to answer. Conclusion. The shortcomings identified in the organization of outpatient care in medical institutions of the Sverdlovsk region indicate the need to improve primary health care for patients with lower limb arterial disease. Such improvements will achieve the goals and objectives of the National Healthcare project through the development of telemedicine technologies and the development of organizational and functional patient routing models, standard operating procedures for examining more patients with cardiovascular pathology by primary care physicians, and their active introduction into public health practice.

Among socially significant diseases that are characterized by high prevalence rates, malignant neoplasms occupy the leading positions. Thyroid cancer is the most common malignant neoplasm of the endocrine system. Purpose of the study. Analysis of recurrent disability due to thyroid cancer in the adult population in Moscow (2015–2019). Materials and research methods. The structure of repeated disability due to thyroid cancer by sex, age and disability group was studied. The dynamics of the number of the PPI contingent was traced and the level of repeated disability due to this pathology was determined. The number of observations was 4660 PPI. Research results. It was found that in the structure of repeated disability due to thyroid cancer, women predominated by gender. The trend towards an increase in the number of PPI took place in all major age groups of the adult population. The prevalence of PPI with group III disability, the proportion of which was 66.0% (PPI with group II – 32.5%, PPI with group I – 1.5%). The visibility indicator in 2019 in relation to 2015 (taken as 100%) was equal in the general contingent of PPI among disabled people of group I – 142.9%, group II – 374.1%, group III – 249.3% ...

It is noted in the article that the problem of nursing staff shortage is relevant to all healthcare organizations. According to the study performed in the basic institutions (the municipal hospital and polyclinic) the staffing level is about 70 % without large changes in dynamics. In addition, a significant portion of nurses (especially in the polyclinic) are the persons of pre-retirement and retirement age. Only 28.9 % of nurses did not think about the possibility of changing the location and nature of their work. The factors that can affect the ability to attract and retain personnel were analyzed using the nurses’ survey. It was found that 82.2 % of respondents believe that their workload is high; 58.3 % of them told that their work does not fully correspond to the functional responsibilities. There are the problems in the relationship in the team (including doctors and managers). Respondents consider that it is necessary to improve the organization of the labor process in the institution, the system of wage and motivation as a whole, to work for increasing the prestige of the profession. A number of measures aimed to improve the personnel management in health care organization are proposed.

Phosphorus (P) is central to storing and exchange of energy and information in cells including those of microalgae. The overwhelming majority of microalgae are naturally acclimated to low-P environments; hence, they are capable of taking up and storing P in large amounts whenever it becomes available. The ability to take up more P than necessary for immediate growth is termed “luxury uptake.” Understanding this phenomenon constitutes a crucial insight into nutrient-driven processes in natural algal communities such as harmful algal blooms, as well as into the operation of algae-based technologies for sustainable usage of P such as recycling of the nutrient from wastewater to biofertilizers. The bulk of P acquired during luxury uptake is stored in the form of inorganic polyphosphate, the compound with nearly ubiquitous presence and multifaceted function in the cell. Although seminal works on luxury P uptake and polyphosphate metabolism were carried out fifty years ago, application of modern “omics” approaches and advanced imaging microscopy techniques enabled obtaining a deeper mechanistic insight into these processes. Nevertheless, our knowledge about luxury P uptake remains much more limited in comparison with that about P shortage and mechanism tolerance to this stress in microalgae. In this review the knowledge of luxury P uptake originating from classical phycological and biochemical methods is confronted with the recently obtained understanding of molecular mechanisms of P transport to the cell, polyphosphate biosynthesis, regulation, and genetic control of these processes. Biotechnological implications of the knowledge about luxury P uptake accumulated to date are discussed in the context of algae-based approaches to sustained usage of nutrients and industrial cultivation of microalgae.

Актуальність. Наведені дані аналітичного огляду токсикологічних наслідків застосування прохлороперазину. Прохлороперазин є досить часто вживаним лікарським препаратом з нейролептичною та антиеметичною активністю, який виробляється як генеричний засіб у багатьох країнах світу у вигляді таблеток, супозиторіїв та ін’єкційних форм.Мета роботи. Проведення аналітичного огляду побічних дій та гострих отруєнь прохлороперазином при контрольованому та неконтрольованому застосуванні.Результати та їх обговорення. Відповідно до даних інформаційних джерел у період з 2010 по 2016 рр. у світі зареєстровано 258 випадків гострого отруєння прохлороперазином. Серед головних причин отруєнь визначені побічні дії препарату під час лікування у терапевтичних дозах. Прохлороперазин несумісний з препаратами,що пригнічують ЦНС, підвищує ризик неонатальних ускладнень при вживанні вагітними. До 10 % від загальної кількості гострих отруєнь прохлороперазином – це летальні випадки через передозування з суїцидальною метою. Визначені лікарські препарати, що застосовувались одночасно з прохлороперазином при суїцидах: клоназепам, лоразепам, апразолам, ібупрофен, напроксен, діазепам, сероквель, депакот тощо.Висновки. Показано, що за умов наявності в установах проведення судово-медичної експертизи методів хімікотоксикологічного аналізу на прохлороперазин кількість зареєстрованих випадків отруєнь препаратом, зокрема в Україні, може бути значно більшою., Topicality. The article presents the analytical review data of the toxicological effects of prochlorperazine usage. Prochlorperazine is a sufficiently used drug with neuroleptic and antiemetic activity. It’s produced as a generic drug in many countries in the world in the form of tablets, suppositories and injection.Aim. To conduct an analytical review of prochlorperazine side effects and acute poisonings of controlled and uncontrolled usage.Results and discussion. According to information sources, in the period from 2010 till 2016 year were registered 258 cases of prochlorperazine acute poisoning in the world. The main causes of acute prochlorperazine poisoning noted with side effects of the treatment of it in therapeutic doses. Prochlorperazine is incompatible with drugs that suppress the central nervous system and increases the risk of neonatal complications if pregnant women use. Approximately 10 % of prochlorperazine numbers of acute poisonings are lethal cases of overdose. They are often due to suicide drug overdose. The drugs that were used simultaneously with prochlorperazine for suicide were defined: clonazepam, lorazepam, aprazolam, ibuprofen, naproxen, diazepam, seroquel, depacote, etc.Conclusions. It is shown that if the methods of chemical-toxicological analysis of prochlorperazine will be presented in corresponding institutions of forensic medical expertise the number of registered cases of poisoning significantly increase, particularly in Ukraine., Актуальность. Приведены данные аналитического обзора токсикологических последствий применения прохлорперазина. Прохлорперазин достаточно часто применяемый лекарственный препарат с нейролептической и антиэметической активностью, который производится как генерическое средство во многих странах мира в виде таблеток, суппозиториев и инъекционных форм.Цель работы. Проведение аналитического обзора побочных эффектов и острых отравлений прохлорперазином при контролируемом и неконтролируемом применении.Результаты и их обсуждение. Согласно данным информационных источников в период с 2010 по 2016 гг. в мире зарегистрировано 258 случаев острого отравления прохлорперазином. Среди главных причин отравлений определены побочные действия препарата при лечении в терапевтических дозах. Прохлорперазин несовместим с препаратами, угнетающими ЦНС, повышает риск неонатальных осложнений при применении беременными. До 10 % от общего количества острых отравлений прохлорперазином – это летальные случаи вследствие передозировки с суицидальной целью. Определены лекарственные препараты, которые применялись одновременно с прохлорперазином при суицидах: клоназепам, лоразепам, апразолам, ибупрофен, напроксен, диазепам, сероквель, депакот и др.Выводы. Показано, что при наличии в учреждениях проведения судебно-медицинской экспертизы методов химико-токсикологического анализа на прохлорперазин количество зарегистрированных случаев отравлений препаратом, в том числе в Украине, может быть значительно выше.

The growing dynamics of cooperation between Russia and China in various spheres of economic activity generate the need for training bilingual specialists. Russia has a significant educational potential, which includes a wide range of specialties and professions, it is an attractive country of study for students from China. The article based on in-depth interviews and analysis of statistical data, is aimed at identifying some of problematic issues regarding education of Chinese students in Russia. The research interest is focused on determining the educational and everyday needs of Chinese students, the motivational grounds for choosing a country of study, the prospects for internalization in the labor market and self-realization after qualification. The main factors that motivate the Chinese youth to receive education in Russia are: the attractiveness of the Russian language and culture, and the financial accessibility of Russian education. The results of the research allow also to conclude that the educational potential of Russia in relation to Chinese students in comparison with the countries of North America and Western Europe is realized insufficiently. The authors identified main reasons for such situation: the vague prospects for Chinese graduates of Russian universities in the labor market and the active policy of the Chinese government to return home students who received education abroad.

The article analyzes the practical results of the study of the effect of the method of physiotherapeutic influence on the effectiveness and timing of treatment and recovery of patients with metabolic disorders who need restorative dental treatment and prosthetics in order to compensate for secondary adentia in the form of incomplete dentition. The study involved three groups of patients (two experimental and one control) with a diagnosis of insulin-resistant type II diabetes mellitus and moderate severity. The main type of specialized dental treatment was the tactic of edentulous compensation by means of prosthetic constructions placed in the oral cavity in support of previously installed dental implants. Throughout the study, special attention was paid to monitoring and analyzing various aspects of the psychoemotional state of prosthetic patients, disturbed mainly due to dental stress, the development of which was aggravated by metabolic disorders already existing in patients of this category. Studies of the psychoemotional state of the prosthetic patients were carried out at all stages of preclinical assessment and diagnosis, as well as during the intraclinical period: initial examination, preparation for the installation of implants and prosthetic structures, as well as their subsequent general and functional rehabilitation, as well as in parallel in all groups in which study. The primary empirical generalization of significant clinical information of a psycho-somatic and purely psychological nature was carried out in the direction of determining the depth and duration of the action of correlates of prevention and leveling of the emerging dental stress with the main neurohumoral factors that provide such important characteristics of osseointegration in the postoperative period as the engraftment of installed dental implants and their subsequent stability as a support for the placement and installation of prosthetic dental structures. There was an increased complexity of prosthetics due to the presence of manifestations of osteopenic syndrome as a consequence of metabolic disorders developed in patients. The study assesses the possible improvement in the prognosis of this type of dental treatment precisely as a consequence of the use of the mesodiencephalic modulation method, which makes it possible to facilitate the solution of a number of problems facing the clinician, mainly of a psychological nature.

Background High-frequency thalamic stimulation is an effective therapy for essential tremor, which mainly affects voluntary movements and/or sustained postures. However, continuous stimulation may deliver unnecessary current to the brain due to the intermittent nature of the tremor. Objective We proposed to close the loop of thalamic stimulation by detecting tremor-provoking movement states using local field potentials recorded from the same electrodes implanted for stimulation, so that the stimulation is only delivered when necessary. Methods Eight patients with essential tremor participated in this study. Patient-specific support vector machine classifiers were first trained using data recorded while the patient performed tremor-provoking movements. Then, the trained models were applied in real-time to detect these movements and triggered the delivery of stimulation. Results Using the proposed method, stimulation was switched on for 80.37 ± 7.06% of the time when tremor-evoking movements were present. In comparison, the stimulation was switched on for 12.71 ± 7.06% of the time when the patients were at rest and tremor-free. Compared with continuous stimulation, a similar amount of tremor suppression was achieved while only delivering 36.62 ± 13.49% of the energy used in continuous stimulation. Conclusions The results suggest that responsive thalamic stimulation for essential tremor based on tremor-provoking movement detection can be achieved without any requirement for external sensors or additional electrocorticography strips. Further research is required to investigate whether the decoding model is stable across time and generalizable to the variety of activities patients may engage with in everyday life. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Summary To properly assess environmental safety, it is crucial to identify environmental pollution risks resulting from a certain type of business activity. A special place among such activities is occupied by the organization of hydrocarbon production in the Arctic region, due to the extreme vulnerability of this area to anthropogenic impacts, which can lead to irreversible consequences for the environment. To solve this problem, the authors are developing a universal methodology that allows to assess environmental risks in the design of oil fields in the region, as well as to respond in a timely manner to dangerous anthropogenic impacts. In the present work, the first results related to the development of risk assessment criteria, their weight, as well as the structure and sequence of assessment are presented.

The study was designed to evaluate the clinical performance characteristics of the First Sign® SARS-CoV-2 Antigen Test, a visual read lateral flow immunoassay (W.H.P.M., Inc.). Individuals presenting at the study sites were evaluated by health care providers for COVID-19 symptoms and sequentially enrolled. The standard of care nasopharyngeal swab sample was first collected for RT-PCR testing. Participant self-collection nasal swab sample was then obtained for the Antigen Test. The clinical performance characteristics of the study device were calculated by comparing participant study device test result recorded at the point of care with the participant matched RT-PCR results provided by qualified CLIA high complexity laboratories. A total of 128 symptomatic adult participants were included in the study, of which 46.8% (60/128) were determined to be RT-PCR positive for SARS-CoV-2. The mean comparator cycle threshold value (Ct) for RT-PCR positive participants included in the study was Ct 25 (range Ct 18-Ct 39). The First Sign® SARS-CoV-2 Antigen Test demonstrated an overall clinical sensitivity of 96.7% (58/60) and a clinical specificity of 98.5% (67/68) when compared with EUA RT-PCR comparator results for the detection of SARS-CoV-2 in symptomatic individuals within 5 days of symptom onset. The clinical sensitivity for samples with RT-PCR Ct

Epidemiology, prevention, early management of cervical spine trauma and it's reduction are the objectives of this review paper. A PubMed and MEDLINE search between 2009 and 2019 were conducted using keywords. Case reports, experimental studies, papers other than English language and and unrelated studies were excluded. Up-to-date information on epidemiology of spine trauma, prevention, early emergency management, transportation, and closed reduction were reviewed and statements were produced to reach a consensus in 2 separate consensus meeting of World Federation of Neurosurgical Societies (WFNS) Spine Committee. The statements were voted and reached a positive or negative consensus using Delphi method. Global incidence of traumatic spinal injury is higher in low- and middle-income countries. The most frequent reasons are road traffic accidents and falls. The incidence from low falls in the elderly are increasing in high-income countries due to ageing populations. Prevention needs legislative, engineering, educational, and social efforts that need common efforts of all society. Emergency care of the trauma patient, transportation, and in-hospital acute management should be planned by implementing detailed protocols to prevent further damage to the spinal cord. This review summarizes the WFNS Spine Committee recommendations on epidemiology, prevention, and early management of cervical spine injuries.

Essential tremor is a common neurological disorder, characterised by involuntary shaking of a limb. Patients are usually treated using medications which have limited effects on tremor and may cause side-effects. Surgical therapies are effective in reducing essential tremor, however, the invasive nature of these therapies together with the high cost, greatly limit the number of patients benefiting from them. Non-invasive therapies have gained increasing traction to meet this clinical need. Here, we test a non-invasive and closed-loop electrical stimulation paradigm which tracks peripheral tremor and targets thalamic afferents to modulate the central oscillators underlying tremor. To this end, 9 patients had electrical stimulation delivered to the median nerve locked to different phases of tremor. Peripheral stimulation induced a subtle but significant modulation in five out of nine patients—this modulation consisted mainly of amplification rather than suppression of tremor amplitude. Modulatory effects of stimulation were more pronounced when patient’s tremor was spontaneously weaker at stimulation onset, when significant modulation became more frequent amongst subjects. This data suggests that for selected individuals, a more sophisticated control policy entailing an online estimate of both tremor phase and amplitude, should be considered in further explorations of the treatment potential of tremor phase-locked peripheral stimulation.

Previous studies have explored neurofeedback training for Parkinsonian patients to suppress beta oscillations in the subthalamic nucleus (STN). However, its impacts on movements and Parkinsonian tremor are unclear. We developed a neurofeedback paradigm targeting STN beta bursts and investigated whether neurofeedback training could improve motor initiation in Parkinson’s disease compared to passive observation. Our task additionally allowed us to test which endogenous changes in oscillatory STN activities are associated with trial-to-trial motor performance. Neurofeedback training reduced beta synchrony and increased gamma activity within the STN, and reduced beta band coupling between the STN and motor cortex. These changes were accompanied by reduced reaction times in subsequently cued movements. However, in Parkinsonian patients with pre-existing symptoms of tremor, successful volitional beta suppression was associated with an amplification of tremor which correlated with theta band activity in STN local field potentials, suggesting an additional cross-frequency interaction between STN beta and theta activities.

This Innovative Practice Full Paper presents development of individual learning paths system in engineering education using the example of the Moscow Aviation Institute (MAI). A set of technological approaches, called Industry 4.0, appeared about 10 years ago. The modern technological era is inextricably linked with project management, integrated programs and research, IT solutions, including the use of artificial intelligence in all areas of activity, as well as with interdisciplinary approaches. Therefore, a new interactive environment of education and science is emerging among universities, research centers, industry and enterprises.The new environment puts forward new personnel training requirements. Taking into account the explosive pace of development and introduction of technologies, today advanced engineering universities together with the industry form a realtime forecast of personnel needs and the map of competencies of the future. The system of engineering education is based on the principles of individualization of educational and professional paths, practical orientation, development of soft skills, mobility. Personal education path - it’s not just a student’s choice, but it’s very labor-intensive, properly designed work of educational institution, where not only the whole university is engaged, but also its partner employers.The Moscow Aviation Institute is implementing the integrated concept of "personalization". The peculiarity of individual learning path at the university is that at the first stage of its formation the potential direction and place of professional activity are determined, the necessary competencies to be acquired are accounted, and an individual development plan is formed. The holders of the typical student paths at Moscow Aviation Institute are the internal employer-divisions - Competency Centers, which have become the integrators of forward-looking technologies and are conducting a large number of projects commissioned by the industry. Also, the MAI Competence Centers help students to form the path to the professions in demand in the future, providing an opportunity for practice and mastering additional engineering, technological and managerial competences.Students comprehend their personal learning pathways at three levels. First at the level of the educational program through the identification of elective courses and places of practice after consultation with the tutor. Second, at the academic level, they master the chapters and topics that are the most relevant to student’s current or future professional activity. Finally, a committed student can use internships, hackathons, Academic exchange and many other ways to form a unique path, outside the formal learning process.At the same time, an important task is the formation of healthy competition between students in obtaining access to certain modules of individual path.

High frequency Deep Brain Stimulation (DBS) targeting the motor thalamus is an effective therapy for essential tremor (ET). However, since tremor mainly affects periods of voluntary movements and sustained postures in ET, conventional continuous stimulation may deliver unnecessary current to the brain. Here we tried to decode movement states based on local field potentials (LFPs) recorded from motor thalamus and zona incerta in real-time to trigger the switching on and off of DBS in three patients with ET. Patient-specific models were first identified using thalamic LFPs recorded while the patient performed movements that tended to trigger tremor in everyday life. During the real-time test, LFPs were continuously recorded to decode movements and tremor, and the detection triggered stimulation. Results show that voluntary movements can be detected with a mean sensitivity ranging from 76.8% to 88.6% and a false positive rate ranging from 16.0% to 23.1% Postural tremor was detected with similar accuracy. The closed-loop DBS triggered by tremor detection suppressed intention tremor by 90.5% with a false positive rate of 20.3%.Clinical Relevance - This is the first study on closed-loop DBS triggered by real-time movement and tremor decoding based solely on thalamic LFPs. The results suggest that responsive DBS based on movement and tremor detection can be achieved without any requirement for external sensors or additional electrocorticography strips.

Objectives: Unilateral subthalamic nucleus (STN) deep brain stimulation (DBS) for Parkinson's disease (PD) improves ipsilateral symptoms, but how this occurs is not well understood. We investigated whether unilateral STN DBS suppresses contralateral STN beta activity in the local field potential (LFP), since previous research has shown that activity in the beta band can correlate with the severity of contralateral clinical symptoms and is modulated by DBS. Materials and Methods: We recorded STN LFPs from 14 patients who underwent bilateral STN DBS for PD. Following a baseline recording, unilateral STN stimulation was delivered at therapeutic parameters while LFPs were recorded from the contralateral (unstimulated) STN. Results: Unilateral STN DBS suppressed contralateral beta power (p = 0.039, relative suppression = −5.7% ± [SD] 16% when averaging across the highest beta peak channels; p = 0.033, relative suppression = −5.2% ± 13% when averaging across all channels). Unilateral STN DBS produced a 17% ipsilateral (p = 0.016) and 29% contralateral (p = 0.002) improvement in upper limb hemi‐body bradykinesia‐rigidity (UPDRS‐III, items 3.3‐3.6). The ipsilateral clinical improvement and the change in contralateral beta power were not significantly correlated. Conclusions: Unilateral STN DBS suppresses contralateral STN beta LFP. This indicates that unilateral STN DBS modulates bilateral basal ganglia networks. It remains unclear whether this mechanism accounts for the ipsilateral motor improvements.

The thyroid cancer is the most prevalent oncologic disease of endocrine organs, characterized by multi factorial risk of development. The purpose of the study was to analyze dynamics of indices of thyroid cancer morbidity of population of the Russian Federation, considering gender and age differences in 2008-2018. The increase of "rough" indicator of thyroid cancer morbidity of male population made up to 56.6%, and of female population - 48.3%. The dynamics of standardized indicator in gender contingents was characterized by increasing up to 48.7% in males and up to 43.9% in females. There is an increasing of thyroid cancer morbidity with age and prevalence of the morbidity in females as compared with males in all age categories. The highest morbidity was established in male population aged 65-69 years (8.3 per 100,000 population) and in females aged 55-64 years (27.3 per 100,000 population). In the territories of the Russian Federation, in the gender aspect, variations in thyroid cancer morbidity were established. both in male and female populations, maximal thyroid cancer morbidity was established in the North Western and Siberian Federal Okrugs, and morbidity below national level was registered in the Privolzhskiy and North Caucasian Federal Okrugs. It is necessary to take into account differentiation of the territories of the Russian Federation in terms of the thyroid cancer morbidity in different gender and age groups for development of rational measures of early identification of risk factors, diagnosis and treatment of patients.

Bursts of beta frequency band activity in the basal ganglia of patients with Parkinson's disease (PD) are associated with impaired motor performance. Here we test in human adults whether small variations in the timing of movement relative to beta bursts have a critical effect on movement velocity and whether the cumulative effects of multiple beta bursts, both locally and across networks, matter., Bursts of beta frequency band activity in the basal ganglia of patients with Parkinson's disease (PD) are associated with impaired motor performance. Here we test in human adults whether small variations in the timing of movement relative to beta bursts have a critical effect on movement velocity and whether the cumulative effects of multiple beta bursts, both locally and across networks, matter. We recorded local field potentials from the subthalamic nucleus (STN) in 15 PD patients of both genders OFF-medication, during temporary lead externalization after deep brain stimulation surgery. Beta bursts were defined as periods exceeding the 75th percentile amplitude threshold. Subjects performed a visual cued joystick reaching task, with the visual cue being triggered in real time with different temporal relationships to bursts of STN beta activity. The velocity of actions made in response to cues prospectively triggered by STN beta bursts was slower than when responses were not time-locked to recent beta bursts. Importantly, slow movements were those that followed multiple bursts close to each other within a trial. In contrast, small differences in the delay between the last burst and movement onset had no significant impact on velocity. Moreover, when the overlap of bursts between the two STN was high, slowing was more pronounced. Our findings suggest that the cumulative, but recent, history of beta bursting, both locally and across basal ganglia networks, may impact on motor performance. SIGNIFICANCE STATEMENT Bursts of beta frequency band activity in the basal ganglia are associated with slowing of voluntary movement in patients with Parkinson's disease. We show that slow movements are those that follow multiple bursts close to each other and bursts that are coupled across regions. These results suggest that the cumulative, but recent, history of beta bursting, both locally and across basal ganglia networks, impacts on motor performance in this condition. The manipulation of burst dynamics may be a means of selectively improving motor impairment.

The article presents the results of the analysis of the long-term dynamics of indicators of primary disability due to malignant neoplasms of the adult population in the Russian Federation. The study volume was 1919677 people aged 18 years and older. An increase in the share of newly recognized disabled people (VPI) in the structure of the total number of VPI as a result of all diseases from 17.6% in 2008 to 32.4% in 2017 (an average of 24.2% per year) was found. In the structure of the primary disability due to ZNO, elderly and middle age IDDs prevail. The level of primary disability among the middle-aged population is decreasing, while among the young and elderly age segments, is increasing. The structure of primary disability due to ZNO by severity is characterized by the predominance of VPI II and I groups of disability with a lower proportion of VPI III group. It has been established that in the Russian Federation there is a regional differentiation of subjects according to the level of disability due to EIT, which allows us to identify regions with an unfavorable situation and the need to optimize measures for primary and secondary medical and social prevention and rehabilitation.

Subject. Facial aesthetics is an important motivating factor for many patients seeking orthodontic treatment. An aesthetically pleasing and balanced face is one of the objectives of orthodontic treatment. An understanding of the soft tissues and their normal ranges enables a treatment plan to be formulated to normalize the facial traits for a given individual. Aim. The aim of the present study is to further investigate the use of soft tissue analysis in the quantification of facial profile, and to investigate differences between different ethnic and gender groups. Methodology. A number of studies considered on various aspects of facial measurements in orthodontics. Results. Skeletal, dental and facial profile differences exist, when subjects from distinct ethnic groups are compared. Thus, each group should be evaluated differently, considering their racial characteristics, in order to produce better diagnosis and treatment planning. The necessity and acceptability of teeth extraction during orthodontic treatment and its effects on facial profile, has greatly concerned orthodontists for many years and has not lost its urgency till now. However, the definition of an attractive and pleasing face is subjective, with many factors involved (culture, personality, ethnic background, age). On the other hand, several medical specialties (orthognathic and plastic surgery, orthodontics, dental prosthetics) have the ability to change facial features. Hence, there is a need for clinicians working in the maxillofacial area to know the aesthetic standards of a face that guide the aesthetic soft tissue treatment goals in their patients. Conclusion: It will be useful to conduct investigations for further definitions and observations of correlated relationship between hard and soft tissues of maxillofacial system by taking into consideration: the patient's age at time of treatment, type of anomaly, differences in maxillofacial anatomical structures of various ethnic groups.

Topicality: vulvovaginal candidiasis (VVC) is a common disease caused by the infectious damage of the vulva and vagina by yeast-like fungi from Candida genus. According to the literature, a VVC episode occurs in 75% of women, and 5-8% of them get a recurring course of the disease. Frequent recurrences of the disease may result in the psychosexual disorder and reduce the women’s quality of life and recurrent vulvovaginal candidiasis (VVC) therapy is still a very difficult task.Purpose of the study: evaluate the efficacy of fluconazole (150 mg) in acute and recurrent vulvovaginal candidiasis.Materials and methods:A total of 89 women of reproductive age with acute and recurrent HCV were enrolled in the study, which were subdivided into 2 groups: the first group included women with acute vulvovaginal candidiasis (AVVC) (n = 51), and the second group - women with recurrent vulvovaginal candidiasis (RVVC) (n = 38). The Group I (AVVC) received fluconazole 150 mg once. Depending on the prescribed therapy, the second group (RVVC) was subdivided into two subgroups: patients in the IIa subgroup received fluconazole 150 mg intravenously, three times, at intervals of 2 days, and women in the IIb subgroup received fluconazole 150 mg for a period of 6 months in addition to the three-fold intake of fluconazole weekly. The follow-up period was 6 months after the end of therapy, during which the frequency of VVC recurrence and the effectiveness of the therapy was evaluated.Results of the study: our data showed that all patients with acute VVC had a discontinuation of symptoms of the disease and a normalization of laboratory parameters after treatment with fluconazole, and after the anti-relapse therapy course the incidence of VVC recurrences was significantly lower compared to the period before anti-relapse therapy (p = 0.038). It was shown that all the investigated strains of C. albicans (100%) were sensitive to fluconazole, and resistance was detected only in 1 strain of C. glabrata and 1 strain of C. krusei.

Gait disturbances in Parkinson's disease are commonly refractory to current treatment options and majorly impair patient's quality of life. Auditory cues facilitate gait and prevent motor blocks. We investigated how neural dynamics in the human subthalamic nucleus of Parkinsons's disease patients (14 male, 2 female) vary during stepping and whether rhythmic auditory cues enhance the observed modulation. Oscillations in the beta band were suppressed after ipsilateral heel strikes, when the contralateral foot had to be raised, and reappeared after contralateral heel strikes, when the contralateral foot rested on the floor. The timing of this 20–30 Hz beta modulation was clearly distinct between the left and right subthalamic nucleus, and was alternating within each stepping cycle. This modulation was similar, whether stepping movements were made while sitting, standing, or during gait, confirming the utility of the stepping in place paradigm. During stepping in place, beta modulation increased with auditory cues that assisted patients in timing their steps more regularly. Our results suggest a link between the degree of power modulation within high beta frequency bands and stepping performance. These findings raise the possibility that alternating deep brain stimulation patterns may be superior to constant stimulation for improving parkinsonian gait.SIGNIFICANCE STATEMENTGait disturbances in Parkinson's disease majorly reduce patients' quality of life and are often refractory to current treatment options. We investigated how neural activity in the subthalamic nucleus of patients who received deep brain stimulation surgery covaries with the stepping cycle. 20–30 Hz beta activity was modulated relative to each step, alternating between the left and right STN. The stepping performance of patients improved when auditory cues were provided, which went along with enhanced beta modulation. This raises the possibility that alternating stimulation patterns may also enhance beta modulation and may be more beneficial for gait control than continuous stimulation, which needs to be tested in future studies.

The feasibility of the production of ethylene and heavier olefins by introducing methane into the products of a rich methane flame is experimentally demonstrated. Such a process is promising for the direct production of ethylene, propylene, and heavier olefins directly from methane, the main component of natural gas.

Exaggerated basal ganglia beta activity (13-35 Hz) is commonly found in patients with Parkinson's disease and can be suppressed by dopaminergic medication, with the degree of suppression being correlated with the improvement in motor symptoms. Importantly, beta activity is not continuously elevated, but fluctuates to give beta bursts. The percentage number of longer beta bursts in a given interval is positively correlated with clinical impairment in Parkinson's disease patients. Here we determine whether the characteristics of beta bursts are dependent on dopaminergic state. Local field potentials were recorded from the subthalamic nucleus of eight Parkinson's disease patients during temporary lead externalization during surgery for deep brain stimulation. The recordings took place with the patient quietly seated following overnight withdrawal of levodopa and after administration of levodopa. Beta bursts were defined by applying a common amplitude threshold and burst characteristics were compared between the two drug conditions. The amplitude of beta bursts, indicative of the degree of local neural synchronization, progressively increased with burst duration. Treatment with levodopa limited this evolution leading to a relative increase of shorter, lower amplitude bursts. Synchronization, however, was not limited to local neural populations during bursts, but also, when such bursts were cotemporaneous across the hemispheres, was evidenced by bilateral phase synchronization. The probability of beta bursts and the proportion of cotemporaneous bursts were reduced by levodopa. The percentage number of longer beta bursts in a given interval was positively related to motor impairment, while the opposite was true for the percentage number of short duration beta bursts. Importantly, the decrease in burst duration was also correlated with the motor improvement. In conclusion, we demonstrate that long duration beta bursts are associated with an increase in local and interhemispheric synchronization. This may compromise information coding capacity and thereby motor processing. Dopaminergic activity limits this uncontrolled beta synchronization by terminating long duration beta bursts, with positive consequences on network state and motor symptoms.

Relevance: According to the literature, Vulvovaginal candidiasis (VVC) is diagnosed in 75% of women during life, and in 5-8% of women its recurrent course is developed (four or more episodes of exacerbation during 12 months). Recurrent vulvovaginal candidiasis (RVVC) is often observed in the presence of development risk factors, but often the recurrent course of the disease is developing among women without obvious risk factors. The literature shows that the development of a recurrent fungal infection is often caused by a violation of the local immune response, which is associated with the polymorphism of the immune system genes. Objective of the study : To develop criteria for forecasting the recurrent current volvovaginal candidiasis to improve the effectiveness of therapy. Study results : As a result of our study, it has been found that C. albicans remains the leading fungal species in the acute and recurrent VVC, but women with the recurrent course of VVC the prevalance of non-C. Albicans fungi is reliably higher than the patients with acute VVC (P = 0.037). Also, the sensitivity data obtained shows that most of the studied yeast fungi (97.5%) are sensitive to fluconazole. However, only in 10.5% of the non-C.Albicans strains resistance was detected. The determination of genetic predisposition to develop the recurrent current VVC, using the prediction model derived from our study, revealed that 77.8% of women with a genetic predisposition are developing a relapse of VVC. In view of these results and based on international recommendations (CDC, WHO, 2011) that it is appropriate to indicate the anti-recurring antifungal treatment to RVVC, it can be concluded that for patients with genetic predisposition to the development of recurrent VVC it is advisable to indicate the anti-recurrent antifungal therapy.

The use of CALS technology in the development and preproduction of the SSJ100 airplane is outlined.