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This article presents a comparative analysis of the technical and economic efficiency of a derivation-type inverter micro hydro power plant with an energy storage system and an auto-ballasted micro hydro power plant. The authors justify the possibility of saving financial resources by reducing the length of the derivationtype micro hydro power plant's pressure pipeline with an energy storage system. To optimally control the generating and transforming equipment of an autonomous power supply system, a control algorithm is proposed based on criteria for limiting the range of hydrogenerator rotational frequencies and ensuring the rational operating mode of the electric energy storage batteries according to the load's power consumption schedule. The possibility of using the charging current of the electric energy storage battery in combination with traditional resistive ballast to create a braking control moment for the hydrogenerator is justified. The article considers issues related to regulating the rational generated power of the hydrogenerator by aligning the power consumption schedule using electric energy storage systems, which allows reducing the length of the pressure pipeline and, consequently, capital costs. Thus, the article represents a comprehensive analysis of the technical and economic efficiency and optimal control of a derivation-type inverter micro hydro power plant with an energy storage system, which can be used in the design and operation of similar power supply systems.

The work is devoted to the study of the novel process of catalytic decomposition of light hydrocarbons on a catalyst at temperatures of 550 °С and 600 °C at various pressures. The CVD process is a new COx-free approach for hydrogen production. A glass fiber fabric was used as a catalyst, which was preliminarily modified by the application of additional outer layers of NiO and porous silica. A technical mixture of propane and butane was used as feedstock. The main purpose is to investigate the effects of pressure and temperature on the production of hydrogen and carbon nanofibers over a glass-based catalyst. As a result of the decomposition of the mixture, the yield of hydrogen was 266–848 L/gcat, and that of carbon nanofibers was 3–10 g/gcat. Increasing the pressure of propane-butane mixture decomposition led to an increase of the catalyst lifetime. The highest yield of hydrogen and carbon nanofibers was achieved at 1 bar and 600 °C.

In the article the problem of compliance to treatment is discussed considering pharmacodynamics of different classes of psychotropic drugs. Use of antipsychotics is associated with a high risk of non-compliance. Antipsychotics can inhibit the endogenous reward system and decreasing its tone reduce adherence to treatment. Both antidepressants and anxiolytics increase the tone of the reward system. But if for antidepressants an increase in adherence is associated with the activation of the reward system limited by related clinical effects, for anxiolytics high adherence to treatment is associated to the rapid development of specific effect and an indirect increase in the tone of the reward system with an increase general subjective satisfaction with treatment. The tolerance associated with the chronic use of benzodiazepine anxiolytics secondarily worsens the situation leading to the development of pathological addiction.

Rationale. The refinement of liver transplantation technique, the development and implementation of new surgical technologies into clinical practice, including those for inferior vena cava reconstruction, are important for the improvement of surgery outcomes.The study purposes were to present our own modification of cavocavostomy and options for its technical implementation in deceased donor liver transplantation, as well as to study the clinical effects and the impact of new surgical technique on the outcomes.Material and methods. A retrospective, single-centre study included the data from 109 consecutive deceased donor liver transplantations performed between 2012 and 2021. In 106 procedures, inferior vena cava reconstruction was performed either according to the classic technique (group 1, n=23, 22%), or using our own modification of cavocavostomy (group 2, n=83, 78%). To assess the clinical efficacy and safety of the new surgical technique, we compared the characteristics of donors and recipients, intraoperative parameters, features of early postoperative course, incidence of surgical complications, initial function, immediate and long-term graft survival. Three piggyback procedures were not included in the comparative analysis.Results. Two groups were generally comparable in terms of the characteristics of donors and recipients, however, the classic inferior vena cava was significantly more often used during transplants for unresectable parasitic liver lesions (17% vs. 1%, p=0.008) and retransplantations (30% vs. 5%, p=0.002). There were no statistically significant differences in the main intraoperative parameters between groups 1 and 2. The duration of transplantations was 8.0 h (interquartile range: 6.5–8.5 h) and 7.0 h (interquartile range: 6.0–8.0 h), p=0.112; anhepatic phase lasted 70 min (interquartile range: 60–75 min) and 70 min (interquartile range: 59–90 min), p=0.386; warm ischemia time was 45 min (interquartile range: 38–52 min) and 45 min (interquartile range: 38–50 min), p=0.690; inferior vena cava was clamped for 47 min (interquartile range: 40–55 min) and 50 min (interquartile range: 40–55 min), p=0.532. The volumes of intraoperatively transfused blood components were, respectively: packed red cells 630 ml (interquartile range: 0–1280 ml) and 600 ml (interquartile range: 0–910 ml), p=0.262; blood reinfusion 770 ml (interquartile range: 360–1200 ml) and 700 ml (interquartile range: 0–1200 ml), p=0.370; fresh frozen plasma 2670 ml (interquartile range: 2200 and 3200 ml) and 2240 ml (interquartile range: 1880–2900 ml), p=0.087.When using classic caval reconstruction technique, the proportion of grafts with early dysfunction was higher: 44% vs. 17% (p=0.011), due to the higher rate of retransplantations in this group. The incidence of acute kidney injury (by RIFLE > I) was 35% and 19% (p=0.158), the need for renal replacement therapy was 22% and 15% (p=0.520) in group 1 and group 2, respectively. The total incidence of surgical complications in the early postoperative period was 30% and 16%, p=0.110.Conclusions. The proposed technique of cavocavostomy can be considered as a priority method for caval reconstruction during deceased donor liver transplantation, with the exception of specific indications for the use of the classic technique (retransplantation, involvement of the inferior vena cava wall in a parasitic process or presentation of a tumor node to it, as well as in cases of widespread adhesive process in the abdominal cavity, hypertrophy of the 1 segment of the native liver, the presence and location of TIPS, thinning of the wall of the retrohepatic inferior vena cava, the risk of graft compression with its large size).The choice of the cavocavostomy variant should be carried out taking into account the size ratio of the graft to the recipient's right subdiaphragmatic space, and the topography features of the recipient's hepatic veins.

Introduction. Modern algorithms for the diagnosis and treatment of allergic rhinitis (AR) recommend a stepwise approach for managing symptoms of the disease. A part of patients with AR have symptoms that indicate to the past COVID-19 followed by significant impairment of the olfactory function. The article places special emphasis on the intranasal glucocorticosteroid option of treatment to manage nasal and general symptoms in persistent AR.The aim of the study is to evaluate the efficacy of mometasone furoate in patients with a confirmed diagnosis of persistent AR, olfactory disorders, and past COVID-19 infection.Materials and methods. A total of 72 patients with persistent AR were included in the randomized controlled prospective study. All patients had a history of olfactory dysfunction with varied severity, which persisted after COVID-19 infection.Results. Measuring the severity of nasal and general symptoms on Day 15 of treatment showed a positive outcome in both groups: the patients of the main group experienced changes, to a greater extent, in nasal congestion, rhinorrhea, olfactory disorders, the patients of the control group generally demonstrated a reduction in nasal congestion, rhinorrhea, itching and sneezing, and improvement of sleep. The final measuring of the severity of complaints on Day 30 of treatment showed that patients of the main group managed to cure the olfactory disorders (0.9 points on the VAS), nasal congestion (0.4 points on the VAS), rhinorrhea and itching (0.2 points on the VAS). Sleep disorders continued to disturb patients in both groups, its improvements in the main group were statistically insignificant.Conclusions. The complaints of nasal congestion, impaired olfactory function and sleep disorders were noted to prevail in patients with persistent form of AR after COVID-19. The followed measuring of the olfactory function using the SST-12 screening test showed that all patients had anosmia. It has been confirmed that the use of mometasone furoate in the treatment of persistent AR in patients with severe olfactory dysfunction after COVID-19 would be appropriate.

Background. The novel coronavirus infection (COVID-19) pandemic has had a significant impact on all areas of health care system, including organ donation and transplantation. Despite this, there were no large Russian studies of COVID-19 course and outcomes in liver transplant recipients.The study purpose was to determine prevalence, clinical course, severity, outcomes of COVID-19, as well as to assess the safety and efficiency of vaccination for disease prevention in liver transplant recipients.Material and methods. 260 recipients (71% of all patients at risk of COVID-19 disease) who underwent liver transplantation at State Research Center – Burnasyan Federal Medical Biophysical Center from May 2010 to September 2021 were included in a single-center cross-sectional study. Data collection was performed during a telephone or face-to-face interview from September 6, 2021 to September 20, 2021. If patients were hospitalized with COVID-19, we also analyzed the results of laboratory and instrumental tests, other medical documentation.Results. By mid-September 2021, the incidence of COVID-19 after liver transplantation was 31% (75 cases in 260 recipients). Asymptomatic course was observed in 11 (15%) patients. Hospitalization was required in 18 (28%) cases. In one case, COVID-19 infection was the cause of death. Mortality and death rate in the study cohort were 1% (1/75) and 0.4% (1/260), respectively. Risk factors that statistically significantly increased the likelihood of infection with SARS-CoV-2 were contact with the patient (OR: 12.9; 95% CI: 6.6 - 25.0) and non-compliance with non-specific prophylaxis measures (OR: 2.0; 95 % CI: 1.1 - 3.7). The recipient's age of 60 years or more significantly increased the risk of severe infection (OR 5.0; 95% CI: 1.3 - 18.7). None of the immunosuppressive therapy regimens significantly increased the risk of severe disease. Tacrolimus monotherapy or in combination with other drugs reduced the risk of severe COVID-19 (OR: 0.2; 95% CI: 0.1 - 0.95). Vaccination against SARS-CoV-2, which was performed in 42 (17%) recipients, did not cause serious adverse events and significantly reduced the risk of COVID-19 disease (OR: 7.2; 95% CI: 1.7 - 31.3). The detection rate of specific IgG antibodies to SARS-CoV-2 was 94% in recipients who had undergone the disease and 45% among those vaccinated (p

Aim: to determine the nature of the cytokine response in patients with measles infection of varying severity, both with and without complications. Materials and methods. 65 patients who were treated in the Kharkiv regional infectious hospital from 2017 to 2019 were included in the study. All patients were divided into 4 groups depending on the severity of the disease and the presence of complications. All patients included in the study on the day of admission to the hospital and on the 10th day of hospital stay were examined for serum concentrations of pro- and anti-inflammatory cytokines as well as interferons alpha and gamma, which was carried out by solid-phase enzyme immunoassay using kits manufactured by “Vector-best” company (RF) according to the manufacturer’s instructions. Statistical processing of the obtained data was carried out using the IBM SPSS Statistics 22.0 software package. Results. The study of the levels of pro- and anti-inflammatory cytokines in dynamics showed a decrease in their levels on the 10th day of hospital stay in patients who did not have complications, and their increase in patients whose illness was accompanied by the development of pneumonia. Levels of INFα and INFγ in dynamics increased in all groups of patients. Significant changes in relation to the control group in the ratio of pro- and anti-inflammatory cytokines in the dynamics were observed only in patients with a dissociative type of cytokine response. In patients of this group on the 1st and 10th days of hospital stay the ratio index of IL-6/IL-10 was shifted towards a significant predominance of proinflammatory cytokines. Conclusions. The study demonstrates the presence of three possible types of cytokine response in patients with measles infection of varying severity: normoreactive, dissociative and hyporeactive. Each type was typical to a specific group of patients and influenced the clinical course of the disease and the development of complications, which is associated with the dynamics of increasing levels of pro- and anti-inflammatory cytokines and increasing levels of INFα and INFγ. The dynamics of increase in levels of these factors in severe disease is lower than in moderate disease. Taking into account the obtained data it can be assumed that in process of anti-infectious immunity formation in response to measles infection the prevalence of the Th-1 immune response over the Th-2 response becomes important.

The article discusses the heterogeneous mechanisms of the pharmacodynamics of antidepressants that underlie the therapeutic response. Sharing the similar clinical activity, antidepressants determine the development of drug-induced homeostasis by means of different molecular mechanisms (selective or nonselective blockade of monoamine reuptake, inhibition of monoamine oxidase, blockade of certain monoamine receptors). However, an increase of serotonin and other monoamines concentrations in the synapses of the central nervous system is only the initiating factor in the development of specific clinical effects. The latter are probably determined by other neurochemical effects, including changes in the density of postsynaptic receptors and an increase in the synthesis of neurotrophic factors. However, the primary mechanisms that increase monoamine concentrations in the synapses might not always “work properly”, leading to the lack of efficacy of the initial antidepressant, while the probability of the therapeutic response to the subsequent antidepressant remains rather high. Thus, the efficacy of an antidepressant may depend on the baseline differences in the neurochemical state contributing to the pathological “depressive” homeostasis. The heterogeneous neurochemical effects of antidepressants can determine the dissociation of existing neuronal interactions, leading to the development of the new — druginduced — homeostasis. At the same time, it is possible that stimulation of general neurotrophic processes by antidepressants may contribute to the progression and chronicity of pathology due to the ambiguous influence on certain stages of the pathological process. This determines the significance of neurophysiological studies of central disturbances in depression and search of fundamentally new neurochemical targets for the treatment of depressive states associated with various mental disorders.

Rationale. Secondary, or functional, mitral regurgitation is the most common complication of heart failure. Dysfunction of one or more mitral valve structures occurs in 39–74% of patients thus complicating the course of the disease and significantly worsening the prognosis in patients with left ventricle dilatation. An unfavorable prognosis in patients with the development of mitral regurgitation is conditioned by the progressive changes that form a vicious circle: the continuing volume overload and dilatation of the left ventricle cause its remodeling, leading to further dilatation of the mitral valve annulus. Dysfunctions of the papillary muscles lead to the increased tension of the left ventricle wall and increased mitral regurgitation. Clinically, this process is manifested by the congestive heart failure progression and worsened prognosis of the further course, which in the future may lead to considering the inclusion of this patient group on the waiting list for heart transplantation.Purpose. The purpose of this article is to review the role of surgical management in patients with heart failure complicated by mitral regurgitation.Conclusions. The main principles of the treatment for functional mitral regurgitation include the reverse left ventricular remodeling and mitral valve repair or replacement surgery which lead to an improved quality of life, the transition of patients to a lower functional class, reduced hospital admission rates, and also to a regression or slower progression of the heart failure and to an improved survival.

Scintillation of pulsar radio signals caused by the interstellar medium can in principle be used for interstellar interferometry. Changes in the dynamic spectra as a function of pulsar longitude were in the past interpreted as having spatially resolved the pulsar magnetosphere. Guided by this prospect we used very long baseline interferometry observations of PSR B1237+25 with the Arecibo and Green Bank radio telescopes at 324 MHz and analyzed such scintillation at separate longitudes of the pulse profile. We found that the fringe phase characteristics of the visibility function changed quasi-sinusoidally as a function of longitude. Also, the dynamic spectra from each of the telescopes shifted in frequency as a function of longitude. Similar effects were found for PSR B1133+16. However, we show that these effects are not signatures of having resolved the pulsar magnetosphere. Instead, the changes can be related to the effect of low-level digitizing of the pulsar signal. After correcting for these effects the frequency shifts largely disappeared. Residual effects may be partly due to feed polarization impurities. Upper limits for the pulse emission altitudes of PSR B1237+25 would likely be well below the pulsar light cylinder radius. In view of our analysis, we think that observations with the intent of spatially resolving the pulsar magnetosphere need to be critically evaluated in terms of these constraints on interstellar interferometry.

We present an uncommon case of liver graft dysfunction caused by seronegative hepatitis C-related fibrosing cholestatic hepatitis after cadaver liver transplantation for unresectable liver metastases of neuroendocrine small intestine cancer followed by living relation donor liver fragment retransplantation for primary graft nonfunction. Early postoperative period was complicated by hepatic artery thrombosis, cerebral hemorrhage, acute cellular rejection, bilateral polysegmental pneumonia, bleeding into neck soft tissues, severe surgical site infection, and sepsis. Anticoagulant therapy, as well as the absence of Hepatitis C Virus antibodies made difficult early diagnostics of fibrosing cholestatic hepatitis. A present-day antiviral therapy produced a complete clinical and virological response. At control examination performed at 240 days after surgery, there were neither signs of cancer progression no graft dysfunction. Liver transplantation in that case was an example of radical and effective treatment method for unresectable liver metastases of neuroendocrine small intestine cancer. Timely diagnosis and proper treatment of fibrosing cholestatic hepatitis made it possible to save the liver graft and patient's life.

Background: Research into the pathogenesis and morphogenesis of new coronavirus infection (COVID-19) is currently a hot topic that requires the accumulation, management and analysis of the data. Understanding the mechanisms of the disease and their characteristics would help to improve diagnostic quality, treatment efficacy and reduce mortality. Aim: To identify morphological and immunohistochemical characteristics of the bronchopulmonary lymph node tissues in autopsied patients with COVID-19. Materials and methods: The study was carried out on 44 autopsy samples from patients who were hospitalized and died from the new coronavirus infection COVID-19 in the Moscow Regional Research and Clinical Institute. Macroscopic, histological, and immunohistochemical assessment methods were used.Results: We found stereotypical abnormalities in the morphology and cellular composition of the lymphoid tissue depending on the duration of the disease. These included signs of B-cell-mediated immunity suppression manifested by a decrease in the number and size of lymphoid follicles and occurs at latest after 7 days from the onset of the disease. In the patients with the disease duration of up to 14 days, the T-cell pool of the lymph nodes is represented mainly by CD4+ T-lymphocytes. With longer duration of the disease, there is a gradual increase in the number of lymphoid follicles and their sizes, with changes of the CD4+ to CD8+ T-cell ratio towards higher CD8+ counts. After 21 days of the disease, the CD4+ to CD8+ ratio levels off.Conclusion: The results obtained indicate a direct damaging effect of SARS-CoV-2 on the lymph node tissues of the bronchopulmonary group. The possibility of secondary transient immune deficiency and infectious complications in patients with a new coronavirus infection is discussed.

Background. Cancer occurring in recipients of living donor liver transplantation may be characterized by a progressive course requiring an immediate specialized treatment initiation and adjustment of immunosuppression regimen. Aim. To specify the malignancy development mechanisms and risk factors in the recipients of living donor liver transplantation. Material and methods: 275 living donor liver transplantations were made in Burnasyan Federal Medical Biophysical Center of FMBA from 2010 to 2020. Forty two (15.27 %) patients underwent surgery for hepatocellular carcinoma. The median time to the onset of malignancy development was estimated. The incidence of malignancy in general population and in recipients of living donor liver transplantation was compared. Results. The development of neoplastic lesion was registered in 9 cases (3.27%). Malignances were detected in 8 cases (2.90%). Median time to the onset of malignancy development was 48 months. 1, 3, and 5 year overall survival rates were 97%, 96%, 94%;respectively; 1, 3, and 5 year survival rates after transplantation for hepatocellular cancer were 97%, 91%, 91% respectively. Survival rate of patients with De-novo malignancy was 90%. Conclusion. Recipients of living donor liver transplantation have an increased risk of malignancy development that requires a close long-term follow-up.

The author conducts a comparative analysis of authoritarian liberalism’s concepts in contemporary political theory. The article deals with the main directions of interpretation of authoritarian liberalism in the framework of methodological approaches and conceptual models of neoliberalism, ordoliberalism, John Rawls' theory of political liberalism, Jan-Werner Mueller's “restrained democracy”, Jürgen Habermas' “legitimation crisis”, Colin Crouch's “post-democracy”, Michael Wilkinson's “de-democratization”, Crawford Macpherson's “participatory democracy”, Wolfgang Streeck's “democratic capitalism crisis”, Giandomenico Majone's «crypto-federalism». The basic analytical concept is the idea of authoritarian economic liberalism, fi rst proposed by H. Heller and K. Polanyi. For the purpose of methodological refl ection, an analytical review of methods and concepts based on modern political and constitutional theory and used in the study of the institutional specifi cs of authoritarian liberalism has been carried out. Authoritarian liberalism is conceptualized as the neoliberal ideology and practice of de-democratization and restriction of democracy, which results in regionalization of protest against the supranational regime of liberal democracy and political integration in Europe. If authoritarian liberalism focuses on economic liberalism, then authoritarian ways of implementing policies are subject to the interests of private property: authoritarianism strengthens economic liberalism, which, in turn, reinforces the EU's “authoritarian transformation”. In the context of the Euro-crisis, authoritarian liberalism restricts traditional forms of representative democracy, political struggle, and the legitimation of power, contributing to the reanimation of ethnic nationalism. In contemporary Europe, right-wing euroskeptics are gaining popularity. The authoritarian-liberal restriction of social democracy can lead not only to the strengthening of capitalism, but also to the revival of the reactionary forms of «new nationalism» and authoritarian illiberalism. The EU is developing today in the “neo-colonial paradigm” in accordance with the relations between the core and the periphery between creditor countries and debtor countries. Transnational solidarity suppressed by authoritarian liberalism can become a democratically legitimate tool for resolving a fundamental confl ict between market capitalism and representative democracy

Objective. To analyze the spectrum and frequency of inner ear anomalies in patients with congenital hearing impairment in Yakutia.Material and methods. A total of 165 patients with congenital hearing impairment were surveyed. All the patients were examined by an audiologist, an educational audiologist, and a neuropsychiatrist. All the patients underwent X-ray computed tomography (X-ray CT) of temporal bone structures (which was supplemented by magnetic resonance imaging (MRI) in some cases).Results. Based on modern ideas about inner ear anomalies and their classification, the authors first analyzed the spectrum and frequency of inner ear anomalies in patients with congenital hearing impairment in Yakutia. Inner ear malformations were identified in 16 (9.7%) of the 165 patients with hearing impairment, which corresponds to that in the previously studied samples of deaf people in different countries (from 3% to 35%). Of the inner ear structures, the cochlea and vestibule were more commonly affected. Abnormalities of the internal auditory meatus, semicircular canals, and vestibular aqueduct were less common. In general, the spectrum of anomalies was represented by 7 different malformations. Incomplete partition type II (IP-II) (34.3%) came first in incidence among all the abnormalities. Incomplete partition type III (IP-III) (18.7%) ranked second in incidence. The expansion of the internal auditory meatus (12.5%) and vestibular aqueduct (12.5%) occupied the third place. Inner ear anomalies occurred as concurrences that are difficult to interpret and classify in half (50%) of all the cases.Conclusion. Analysis of the spectrum and frequency of temporal bone abnormalities in Yakutia suggests that every 10 patients with congenital hearing impairment have one or another inner ear structural malformation (9.7%) and require accurate and timely diagnosis using up-to-date X-ray CT and MRI techniques.

Despite the widespread use of mechanical circulatory support systems, modern optimal drug therapy and various interventional methods of heart transplantation remain the "gold standard" for the treatment of end-stage heart failure patients.At the same time the required number of heart transplants is significantly increasing due to the progressively increasing number of patients needing transplants and the actual donor pool. In recent years there has been a trend towards the increase in the number of recipients and the decrease in the number of donor organs. However, the use of donor hearts with pathological changes, including left ventricular myocardial hypertrophy, remains a controversial topic. It is believed that the use of expanded criteria significantly increases the risk of graft failure in the post-transplant period and leads to deterioration of immediate and long-term results. This work aimed to analyze the data on using donor hearts with left ventricular myocardial hypertrophy for allotransplantation.Authors declare no conflict of interest.

The authors make a distinction between such concepts as ‘lower social class’ (‘lumpen-proletariat’), ‘criminal community’ and ‘cultural underground’, and identify significant differences between the lower social strata in traditional and modern societies. The single ‘lower social world’ of traditional societies had its own cults, culture and organization and was an opposite of the ‘upper social world’. The religious definition of its ritual impurity was the basis for discrimination and segregation of its members and social groups. In modern societies, the lower class disintegrates and cannot be considered a single social anti-system: its ‘fragments’ - the prison part of the criminal community, counter-cultural underground and forbidden sects - are not connected with each other; the upper privileged part of criminal communities (a system of patronages with horizontal and vertical social ties) became a part of the modern society elite. At the same time, the system of patron-client relations that invisibly permeates modern societies necessarily implies corruption, at least the ‘soft corruption’. The authors consider such a phenomenon as an ‘underground’ in modern societies defining it as countercultural groups consisting mainly of well-educated representatives of the middle-class. The article also describes the underground of the Soviet society before and after perestroika which cannot be defined as a lower class of the contemporary Russian society. In conclusion, the authors suggest that in the Russian culture there is a kind of refined image of the ‘social bottom’ that influenced scientific ideas about it and is based on the social representations of the lower social class in the traditional society.

In recent years, the mechanical support of blood circulation has proved to be a vital therapy for a terminal heart failure, and is considered as a "bridge" to transplantation or is used on a permanent basis in a patient who can not be included in the waiting list for a donor organ. Recent studies of the critical heart failure treatment during an assist device in situ have shown the myocardial recovery at the molecular and cellular levels. However, the transition of these changes to a functionally stable recovery of the heart function, which would allow the long-term results to be achieved without a heart transplant or switching off the mechanical support, is now rather an exception to the rule. At this time, the cause of the discrepancy between the high rate of recovery at the cellular and molecular levels and the low rate of cardiac function recovery remains poorly understood. Patients with chronic progressive heart failure can demonstrate the normalization of many structural myocardial abnormalities after a mechanical support that is actually a reverse remodeling. However, the reverse remodeling is not always considered equivalent to clinical recovery. The aim of this research is to study a significant improvement in the structure and function of the myocardium during the mechanical support of blood circulation.

Reducing radiation exposure in computed tomography is a relevant medical task due to the growing number of studies and the lack of generally accepted approaches to their conduct in the radiological community. One way to reduce the effective dose in contrast-enhanced computed tomography of the abdomen is to optimize the protocol of examination, which can include four scans: in the native, arterial, venous and delayed phases. However while providing repeated studies in patients with oncological diseases, it is possible to confine one or two phases, which will allow the radiologist to visualize observed pathological changes and to evaluate the response to the treatment, as well as detect the recurrence in case of the monitoring of the patients. In the present study, two groups were formed on the basis of a sample of 514 patients. In group 1 (control), CTB was performed according to a three- or four-phase protocol. In group 2, the same patients with an interval from 1 to 5.5 months were performed with computed tomography -OBP according to a single or two-phase protocol depending on the degree of vascularization of the tumor tissue and the clinical situation. At the same time, a decrease in the average effective dose in patients in group 2 compared with group 1 was demonstrated by 63% (p

Currently, the analysis of the fibrosis severity during the restructuring of the surrounding extracellular matrix (ECM) is studied in most of the research works devoted to “cardiac remodeling”. At the same time, the role of the basal membrane of cardiomyocytes in heart diseases was not studied. The basal membrane of cardiomyocytes is a highly organized layer of the ECM which is located on the outer side of the sarcolemma. Degradation of ECM components is carried out by different types of matrix metalloproteinases (MMP), which have proteolytic activity and are actively involved in the process of ECM remodeling, destroying its components such as collagen, elastin, fibronectin, glycosaminoglycans and other structural components.Aim. To evaluate the ECM status in patients with coronary artery disease and its effect on left ventricular myocardial remodeling.Material and methods. Morphological and immunohistochemical (IHC) examination of left ventricular myocardial biopsies was performed in 16 patients undergoing left ventricular reconstruction in combination with coronary artery bypass grafting.Results. The IHC study revealed the accumulation of matrix metalloproteinase-9 in the cytoplasm of cardiomyocytes. This accumulation was combined with partial or complete destruction of the basal membranes (BM) of cardiomyocytes formed by type IV collagen.Conclusion. Type IV collagen destruction in basal membranes of left ventricular cardiomyocyteswasrevealed. It iscausedbytheactionofmatrixmetalloproteinase-9, which accumulates in the cell cytoplasm.

Abstract The paper presents the results of the study on proliferation and biofilm formation by Staphylococcus aureus and Staphylococcus epidermidis under the influence of cell-free extracts obtained by the author’s method and containing derivatives of probiotic strains Вifidobacterium bifidum and Lactobacillus reuteri. The aim of this work was to study the ability of cell-free extracts containing derivatives of probiotics Bifidobacterium bifidum and Lactobacillus reuteri to influence proliferation and biofilm formation by staphylococci in vitro, to evaluate the prospects of their use for the correction of microecological disorders and adjuvant therapy of staphylococcal infection. Materials and methods. Cell-free extracts were obtained from commercial strains B. bifidum and L. reuteri by the authors’ method. Reference strain of S. aureus AТСС 25923 and clinical isolate of S. epidermidis were used as a test cultures. The investigation of the proliferation and biofilm formation by staphylococci was carried out by spectrophotometric method using a microtiter-plate reader “Lisa Scan EM” (Erba Lachema s.r.o., Czech Republic). Results. It has been established that the effect of cell-free extract on proliferation and biofilm formation depends on the type of extract and on the species of staphylococcus. Among the five studied extracts, only one significantly inhibits the proliferation and biofilm formation of both staphylococci species. It is the cell-free extract, obtained from L. reuteri culture, grown in its own disintegrate supplemented with glycerol and glucose. The proliferative activity of S. aureus is sensitive to the L. reuteri derivatives while the proliferative activity of S. epidermidis is sensitive to the B. bifidum derivatives. The filtrates of disintegrates have stimulatory effect, while the filtrates of cultures have inhibitory effect on the staphylococcal proliferation. The biofilm formation by S. aureus is significantly inhibited by B. bifidum derivatives and is stimulated by L. reuteri derivatives. The biofilm formation by S. epidermidis is stimulated by derivatives of bifidobacteria and does not change in the presence of derivatives of lactobacteria in the growth medium. Conclusions. Obtained results indicate a high bioregulatory potential of cell-free extracts of probiotic origin and the possibility of drugs development for microecological disorders correction on their basis. They also confirm that the method of obtaining probiotic derivatives with bacteriotropic activity through precursor-directed biosynthesis is promising. Cell-free extract, obtained from L. reuteri culture, grown in its own disintegrate supplemented with glycerol and glucose, exhibits pronounced anti-staphylococcal activity in vitro. After confirming efficacy in vivo, it can be recommended for the adjuvant therapy of staphylococcal infections.

Objective. To estimate the informative value of computed tomography (CT) in the planning of inferior vena cava (IVC) resection in patients with alveococcosis of the liver on the basis of the extent of contact of parasitic masses with its wall around the circumference.Material and methods. CT studies and surgery protocols were retrospectively analyzed in patients with liver alveococcosis in the period between 2014 and 2017.Results. The CT-measured extent of contact of parasitic masses along the circumference of IVC was compared with the intraoperative pattern for its involvement and with resection volume data. CT findings show that circular resection was not required in contact of parasitic mass with the IVC wall over a 90° stretch; the resection could be performed in 29, 86, and 100% of patients in contact over 180, 270, 360° stretches, respectively.Conclusion. CT can assess whether there may be IVC invasion when planning a surgical intervention. The threshold value of the extent of contact of parasitic masses with IVC, as evidenced by CT, is 180°, at which the possibility of circular resection and vein prosthesis should be considered.

The development of psychotic symptoms is traditionally linked to the increase of the functional activity of endogenous dopaminergic system. Antipsychotic effect of existing medications is associated with direct blockade of postsynaptic dopamine receptors. However, direct antagonistic activity is «alien» to physiological mechanisms of neurotransmission modulation, and presynaptic autoreceptor blockade mау produce a reverse (agonistic) effect, enhancing neurotransmitter release. On the other hand, anti-dopamine effect can be achieved by indirect antagonistic activity—by presynaptic dopamine depletion, which is consistent with the natural, physiological mechanisms of reducing neurotransmission. It can be assumed that modulation of presynaptic regulation is one of the promising directions for the development of antipsychotic drugs of future generations.

Nowadays, Moroccan oasis agro-ecosystems are under intense effect of natural and anthropogenic factors. Therefore, this essay proposes to use Leaf Area Index (LAI) to assess the consequences of the oases long-term biodegradation. The index was used as a widely-applied parameter of vegetation structure and an important indicator of plant growth and health. Therefore, a new optical multispectral Sentinel-2 data were used to build a long term LAI time series for the area of the Erfoud and Rissani oases, Errachidia province in Drâa-Tafilalet region in Morocco. Nine images of LAI spatial distribution over the study area were obtained by means of SNAP Biophysical Processor over the period since July 2015 till May 2018. Time series analysis of the resultedmaps has revealed a stable trend towards the average LAI decreasing and vegetation structure simplification as a consequence.

Synthetic Aperture Radar (SAR) is an active remote sensing technique capable of providing high-resolution imagery independent from daytime and to great extent unimpaired by weather conditions. Unlike the passive remote sensing active radars receive its' own reflected signal. Features of received signal make able to obtain additional information about surface objects and covers. Because of signal, double reflecting upon vertical surfaces like walls, it become common to study urbanized areas using SAR data. Because of mostly similar spectral characteristic of the typical buildings' roofs and sandy soils, that are distinguishing for Morocco, classification using visible and NIR multispectral remote sensing data is complicated. Thus, SAR data processing technique is rather useful while application to deserted area studying and urbanized areas identification.

The spat of the bivalve mollusc Crassostrea gigas (Thunberg, 1793) was found and photographed on artificial and natural substrates in Donuzlav Lake and Artillery Bay. However, up to this point the planktonic larval stages of C. gigas were not registered in this water areas.

Principles of adequate pharmacotherapy in psychiatry imply that shifting from one antipsychotic to another requires recalculation of the effective dose using the «chlorpromazine equivalent». The latter is deemed a reference measure for finding equally effective doses among antipsychotics. Given the molecular masses of the active substances and recommended drug doses, the association between the potential antipsychotic efficacy and the «complexity» of the molecules is analyzed in the present study. It is shown that the treatment efficacy is connected with the number of the substance molecules consumed with the certain drug dose. The lack of difference between «selective» and «non-selective» antipsychotics regarding association of their molecular masses and respective clinical activity challenges the suitability of the «chlorpromazine equivalent» for calculating antipsychotic doses. We assume that the approach based on the proportional ratio utilizing the highest drug dose recommended by the manufacturer is more adequate method of the antipsychotic dose estimation.

Given the differences in the pharmacological and clinical effects of antidepressants, criteria for their differential choice in the treatment of depression associated with comorbid medical illnesses are suggested. Based on these criteria and general rules of clinical pharmacology, principles of antidepressant treatment in patients with comorbid medical illnesses aimed to optimize the therapeutic process and to prevent treatment resistance are developed.

Management of treatment-resistant depression is one of the most important problems in modern psychiatry. Comorbidity of depression with medical diseases is one of the predisposing factors for the development of treatment resistance due to various mechanisms, including genetic, endocrine, neuroimmune, pharmacogenic, psychosocial, etc. Along with the efforts to reduce the negative effects of the above-mentioned mechanisms (limited by currently available therapeutic options), optimization of antidepressant treatment with regards to existing comorbid medical problems is important for prevention of treatment resistance development.

The role of nonspecific immunity factors in the pathogenesis of bronchial asthma in children with different clinical forms and degrees of severity of its course has been investigated in the work. A total of 228 children with BA who were aged from 5 to 14 years were examined. We determined the complement titer (C0) in the serum, components of complement C2 and C3a, the protein component of blood serum of properdin, and the level of total serum IgE. The data were statistically processed using Student's t-test. In patients with non-allergic form of BA, the greatest increase in deviation from the norm was noted in relation to the circulating immune complexes (CIC)(t = 16.74). The second ranking place occupies an increased content of C3a (t = 8.21), then in descending order from IgE (t = 4.55) to C0 (t = 1.89). Rating of the degree of deviation from the norm of indices of nonspecific immunity in patients with atopic BA has shown that, in contrast to patients with non-allergic form of BA, the main pathogenetic role belongs to reactive hypersensitivity (IgE; t = 17,39). The value of immunocomplex hypersensitivity in atopic form of BA is in the second ranked place. In children with mixed BA, an intermediate pathogenetic variant was identified, which consisted in approximately equal activity of both immunocomplex and reactive reactions with a certain dominant of the first: from CIC (t = 13.66) to IgE (t = 11.19). Thus, the obtained data confirm that in the pathogenesis of bronchial asthma in children is involved immunocomplex immunological mechanism (type III according to Gell-Coombs), which enhances immunospecific reactions, aggravating the severity of the course of the disease. In the blood serum of children with bronchial asthma, there is a decrease in the protein component properdin, which is consumed to activate the alternative (properdin) complement pathway through C3a, nonspecific immunological mechanisms are able to stimulate and maintain chronic allergic inflammation in the bronchopulmonary system in children with bronchial asthma.

The paper presents data on the detection of an autoimmune process in the bronchopulmonary system in children with BA aged from 5 to 14 years in the period of exacerbation. The comparison group consisted of 25 healthy children aged from 7 to 14 years. It has been shown that lipopolysaccharide antigens from the interstitial connective tissue of bronchopulmonary structures obtained from accidentally killed children have a higher specificity than protein antigens and allow identifying morphological changes in the bronchopulmonary system, the severity of the course and monitoring the effectiveness of the therapy. Antigens obtained from the sectional material of the bronchopulmonary system of protein nature cannot be obtained industrially, since they are not standardized for protein, do not possess sterility, which greatly limits their use and reduces the diagnostic value. The multicomponent antigenic composition of protein homogenates obtained from the cell-tissue structures of the bronchopulmonary system does not clearly identify the nature of the morphological changes in bronchial asthma in children. Lipopolysaccharide antigens from bronchopulmonary structures do not contain protein in their composition; they can be obtained industrially under sterile conditions and stored in a lyophilized state for more than two years, which allows them to be widely used in immunodiagnostics of clinical forms and severity of asthma in children.

Aim - to characterize different methods for diagnosis of mycotic lesions of the pharynx used in medical practice. Materials and methods. This article describes various methods of laboratory diagnostics of tonsillopharyngeal mycosis and their indications; and presents the analysis of 117 adult cases of tonsillopharyngeal mycosis confirmed by the analysis of thick blood film after the incubation in thermoregulator combined with blood agar inoculation. In addition, this method includes a microflora test which in most chronical cases accompanies pharyngeal mycosis. Results. The study revealed relevant advantages of the presented methods of pharynx mycosis diagnostics, which not only detect the presence of mycelium and its morphology, but also evaluate its role in the inflammatory process. In addition, this method includes bacterial culture test that in most chronical cases accompanies pharynx mycosis. Out of 100% only 17.9% of observations (21 patients) showed Candida fungus in parasitic phase as mono-infection, the other 82.1% of cases proved bacterial presence. The most frequent combination was Candida and Streptococcus spp (including pneumococcus) that made up 41.9% of total observations. In 10.3% of cases Staphylococcus spp was detected. Other patients had more than two kinds of microorganisms. The following combinations were revealed: fungi, streptococci and staphylococci in 17.9% cases; fungi and streptococci with Klebsiella and\or Moraxella catarrhalis or other opportunistic pathogenic microflora in 12% cases. Conclusions. The most effective method of research of upper airway mycosis is the one that enables to reveal Candida fungi presence and concentration as well as to identify their status (saprophitic or parasitic) in the patient's body using thick blood microscopy. The value of this method increases with simultaneous evaluation of associated microflora and its relation to macroorganism. Being simple, cost-effective and highly informative, complex method of diagnostics of upper airway mycosis can be widely used in medical practice.

The aim of the work was to evaluate the effect of immunomodulation therapy on factors of nonspecific immunity in children with bronchial asthma (BA) by including interferon (cycloferon) in a standard therapy. 120 children with BA aged from 5 to 14 were examined. The main group (n = 60) included children who, in addition to basic therapy, received an interferon inducer (cycloferon) according to the generally accepted scheme. In comparison group were children who received only basic therapy (n = 60), depending on the severity of the disease. In control group were 25 healthy children. The level of serum interferon, virus-induced interferon production (VII), mitogen-stimulated production of interferon (MSI), phagocytic activity of neutrophils, as well as spontaneous and induced activity were determined. The arithmetic mean (M) and the absolute value error (m) were statistically calculated. The reliability of the differences was determined by the t-test of the Student (p < 0,05). The analysis of the indices of interferon status and phagocytic activity, depending on the type of therapeutic tactics, showed that as a result of the inclusion of cycloferon in the baseline, there was a significant increase in the levels of VII (p < 0,05) and MSI (p < 0,05 ), spontaneous and induced neutrophil activity. It was noted that this positive effect was more noticeable in moderate and severe BA (p < 0,05). Activation of factors of nonspecific protection contributed to a decrease in the frequency of exacerbations of BA in children, as well as a longer-term clinical remission in this contingent of children.

The paper deals with the non-contact method of monitoring the integrity of the main rotor blades of a helicopter. The available methods of monitoring the integrity of the main rotor blades of the helicopter are labor-intensive to implement, their reliability is low and they do not allow drawing a general picture of the state of rotor blades in flight. To solve this problem a method based on illumination of the blades by a probing microwave signal is proposed. Particular attention is given to the calculation of the power of the signal reflected from the helicopter main rotor blades. In deriving analytic equations it is assumed that a rotor blade is an undeformed flat metal surface. As a result, a spatial-temporal model of a probing SHF signal reflected from a helicopters main rotor blade has been obtained and the parameters of the model make it possible to assess the operational status of the main rotor of the helicopter.

В статье рассматривается особенности правовой социализации молодежи в современном российском обществе, специфические функции основных институтов правовой социализации, и среди них, в первую очередь, семья, образование (среднее и высшее) и средства массовой информации. Авторы определяют правовую социализацию как аспект общего процесса социализации; поэтому он находится под сильным влиянием социальных (трансформации) процессов, в частности кризиса отрицательным характером. Молодежь является наиболее чувствительной к социальным изменениям демографической группы, поэтому его основные черты сегодня являются социальная дезориентация и психологическая путаница при нестабильной и противоречивой социальной ситуации. В статье рассмотрены различные аспекты правовой социализации - его типы (социально контролируемых / регулируемых и спонтанное), определяющие факторы (например, состояние общества - стабильной или, наоборот, кризис), возможных исходов (положительных, таких как компетентный юридический сознание, а отрицательные - устойчивые провинившиеся практики) и т.д. авторы считают, что эффективная правовая социализация в условиях кризиса современного российского общества может быть достигнута путем координации усилий всех основных институтов правовой социализации в системе образования, так как молодое поколение позитивно воспринимают закон и другие элементы правовой системы.

Heavy metals may be one of the factors causing a change in sexual structure in the settlements of mussel Mytilus galloprovincialis Lam. cultivated on the Sevastopol seaside. The aim of the work was to study the influence of Zn+2, Cd+2, Pb+2, Hg+2, Cu+2 ions on the sex inversion of cultivated mussels during spring post spawning of gonads. Chronic intoxication of female mussel at ion concentration of 2 MPC was carried out for a month in laboratory conditions. After 3 months of a natural experiment, the sex of each mollusc was individually examined by the method of visual study of gonad smears. The sex inversion of the females occurred under the influence of all heavy metals. The maximum shares of males were observed after the influence of Cu+2 and Pb+2 – 65 and 52 %, respectively. Both laboratory and natural experiments showed high toxic effect of Cu+2 and Hg+2 ions, with female mortality reaching 33 and 13 %, respectively.

Introduction: In Romania, an increasing number of women are opting for abortion on demand, despite the large variety of contraceptive methods and their ease of use. Some of the factors that influence the decision of undergoing abortion are family, education and income. The aim of our study was to observe to what extent psychosocial factors had an influence on the decision of abortion on demand (DoAoD). Material and methods: Data were measured during a sociological survey-based study, including 603 patients who presented for abortion on request during the period 2015-2018 at the "Bega" University Clinic of Obstetrics-Gynecology, Timisoara. The study investigated the degree of information and use of contraceptive methods at the moment of pregnancy’s termination request. Based on measured data, the considered latent constructs were women’s general perception of abortion, emotional involvement regarding the pregnancy, relationship and family context, knowledge about the abortion’s consequences, and social status. A structural model was derived, describing the direct (and indirect) effects among latent variables. Results: The DoAoD model showed significantly adequate fit (χ2/df=1.53, GFI=0.91, CFI=0.98, RMSEA=0.05, and p

Research of currents is one of the primary tasks in the organization of an oyster-mussel farm. The main influence of the currents is on the distribution of shellfish feeding, the transfer and settling of larvae, and the supply of oxygen to the inhabitants of the farm. For the first time, studies of currents in the area of mariculture were conducted in 1999–2002. The aim of this work is to assess the effect of currents on the functioning of the oyster-mussel farm, as well as to clarify the information about the currents in the mariculture area. To measure the speed and direction of the currents, freely drifting landmarks with different depths of the damper were used. The coordinates of the tracers were recorded using the GPS receiver “Garmin 72 H”. All in all for the period 2014–2016 17 launches were conducted. In addition, the speed and direction of the wind in the vicinity of the farm were studied. It was found that the average currents velocity in the region of the truss at the surface was 11 cm·s-1, at depths of 6 and 10 m – 3 cm·s-1. The absolute values of the current velocity varied from 0.3 to 23.0 cm·s-1 at all horizons. Directions of currents on the surface coincided with the direction of the wind, in rare cases, minor deviations of the currents were observed due to the influence of the shoreline and the bottom. Compensatory counterflows are noted in the near-bottom horizons of the Karantinnaya Bay. Dominant directions of currents were determined, using the rose of the frequency of local wind directions. The most frequent directions of the currents on the farm were from the open sea (southern, south-eastern and eastern points) and the Karantinnaya Bay (northern and northeastern points). Currents of the western and south-western direction, carrying water from the Sevastopol Bay, were more rare. Almost no current of north-western direction was observed. In general, the speed and direction of the currents in the oyster-mussel farm were found favorable and optimal for the development of suspended conchioculture.

A pressure-induced phase transition of multiwall carbon nanotubes (MWNT) to a new structure at room temperature is studied using a shear diamond anvil cell, X-ray photoelectron spectra (XPS), transmission electron microscope (TEM) and Raman procedures. We observe a cardinal pressure-induced change in the nanoparticles shape from multi-shell tubes to multi-shell spheres. MWNT transforms to onions with layers cross-linked by sp3 bonds under the 45-65 GPa compressive stress combined with shear deformation at room temperature. TEM and XPS results show that about 40% of the carbon atoms in the new phase are sp3-bounded.

A clinical and epidemiological study for 14 years was conducted. Among TB patients, the percentage of persons with mixed infection (TB+HIV infection) increased during the observation period from 10 up to 64%. About one third of them had a pleura reaction with an accumulation of fluid between pleura’s petals. Pleuritis in patients with mixed infection were characterized by special features: pleurisy complicated another form of tuberculosis more often, in one-third of patients (29,8%) pleural liquid had hemorrhagic type, Mycobacterium tuberculosis in the pleural fluid was detected six times more often. The level of activity of adenosine deaminase and neopterin in the exudate of patients with tuberculosis and HIV infection remained significantly higher than in the control group of persons. These data can be useful in the diagnostics of specific diseases in HIV-infected patients.

In this paper we have studied the effectiveness of Polioksidony in the treatment of patients with chronic staphylococcus’s pharyngitis on background. It was found that the inclusion in the complex treatment of patients Polioksidony normalizes biotsinoz oropharyngeal secretions, increases the phagocytic activity of neutrophils and biocide , opsonizing properties serum normalizes the major classes of immunoglobulins in oropharyngeal secretions . Polioksidony has a positive effect on the clinical course of chronic pharyngitis and warns its recurrence, reduces the number of acute respiratory diseases and their complications.

The immune status and nature of immune frustration of children of different ages with the cerebral asthenic syndrome (CAS), who were prematurely born with perinatal defeat of the central nervous system (CNS) was studied. The obtained data argue that these children have the expressed imbalance among Тh-cages (Th1, Th2, Treg) and cytokines that shows the potential risk of inadequate reaction of these children on infectious and noninfectious immunogenes.

Impaired glucose tolerance (IGT) is the most wide-spread complication of long-term therapy of severe dermatoses with glucocorticoid hormones among possible steroid-induced disturbances of carbohydrate metabolism being also a component part of the conception « state prior to the development of diabetes». The mentioned complication leads to the development of cardiovascular pathology which in its turn worsens both the general state of the patient and aggravates the dermatosis course. In this connection the work on prophylaxis and therapy of steroid-induced IGT with metformin preparation having a number of therapeutic effects on human organism besides main hypoglycemic activity in patients with skin diseases was carried out.