Search

BackgroundA composite metric for the quality of glycemia from continuous glucose monitor (CGM) tracings could be useful for assisting with basic clinical interpretation of CGM data.MethodsWe assembled a data set of 14-day CGM tracings from 225 insulin-treated adults with diabetes. Using a balanced incomplete block design, 330 clinicians who were highly experienced with CGM analysis and interpretation ranked the CGM tracings from best to worst quality of glycemia. We used principal component analysis and multiple regressions to develop a model to predict the clinician ranking based on seven standard metrics in an Ambulatory Glucose Profile: very low-glucose and low-glucose hypoglycemia; very high-glucose and high-glucose hyperglycemia; time in range; mean glucose; and coefficient of variation.ResultsThe analysis showed that clinician rankings depend on two components, one related to hypoglycemia that gives more weight to very low-glucose than to low-glucose and the other related to hyperglycemia that likewise gives greater weight to very high-glucose than to high-glucose. These two components should be calculated and displayed separately, but they can also be combined into a single Glycemia Risk Index (GRI) that corresponds closely to the clinician rankings of the overall quality of glycemia (r = 0.95). The GRI can be displayed graphically on a GRI Grid with the hypoglycemia component on the horizontal axis and the hyperglycemia component on the vertical axis. Diagonal lines divide the graph into five zones (quintiles) corresponding to the best (0th to 20th percentile) to worst (81st to 100th percentile) overall quality of glycemia. The GRI Grid enables users to track sequential changes within an individual over time and compare groups of individuals.ConclusionThe GRI is a single-number summary of the quality of glycemia. Its hypoglycemia and hyperglycemia components provide actionable scores and a graphical display (the GRI Grid) that can be used by clinicians and researchers to determine the glycemic effects of prescribed and investigational treatments.

Amyloidosis is characterized by damage to several organ systems, which leads to diagnostic delays and progression of the pathological process. The described clinical case demonstrates a long diagnostic search in a patient with AL-amyloidosis. According to the literature, the most often described manifestation of the disease is kidney damage that manifests as nephrotic syndrome. This case is interesting because the reason for hospitalization was liver damage. Laboratory tests revealed cholestatic and cytolytic syndromes and dyslipidemia. Differential diagnostic included diseases with liver damage. In the hospital nephrotic syndrome was identifi ed, renal biopsy was performed that proved the diagnosis of AL-amyloidosis with combined damage to the gastrointestinal tract, liver and kidneys.

Целью данного исследования является определение связи энтропии временных параметров сигналов в робастной системе управления с величиной дискретизации системного времени (в развитие работ trspy 1185, trspy 1274). В качестве примера объекта исследования рассмотрен процесс и его сигналы экстренного торможения высокоскоростного состава при наличии скольжения колёс по рельсам. Решена задача нахождения абсолютной погрешности ступенчатой и линейной интерполяции сигнала управления по равномерным выборкам из него с применением моделей составных гармонических полуволн. Предварительно, при обследовании объекта управления, определяются максимальные величины параметров сигнала и полуволн: скорость, ускорение и резкость. Параметры спектра отсутствуют по причине большой инерционности объектов управления, процессов и сигналов. Для определения величин интервалов равномерной дискретизации времени рассмотрены две группы моделей «гармонических полуволн». Первая группа моделей описывается гармоническими функциями времени, параметры которых согласованы. Вторая группа моделей описывается составными гармоническими функциями времени, тем самым согласуются временные параметры сигналов. Доказано, что при увеличении энтропии максимальных величин параметров сигналов увеличивается величина интервала дискретизации времени без увеличения погрешности интерполяции. Таким образом, величина энтропии параметров сигналов служит индикатором их рассогласованности. Приведены результаты моделирования и графики, полученные в среде математического пакета MathCAD. Результаты предназначены для оптимизации загрузки задачами ввода и первичной обработки информации процессоров в робастных системах автоматики реального времени, например, используемых для управления высокоскоростными поездами при штатном экстренном торможении и экстренном торможении в условиях скольжения или юза.

A model of the activity of hydrothermal-metasomatic systems confined to certain structural elements is proposed in the present article. The model is based on the analysis of a large volume of traditional studies: measurements of porosity coefficients, permeability, pyrolytic measurements - together with specific measurements: isotopic composition of carbonate rocks, temperature of homogenization of gas-liquid inclusions, studies of the composition of rocks with a scanning electron microscope, a description of petrographic thin sections. The model allows to generalize the results of the impact of hydrothermal-metasomatic systems on the reservoir properties of the rocks of the BazhenovAbalak complex: constructive – leaching processes and increasing reservoir properties, and destructive – massive mineral formation that fills the pore space, up to the formation of secondary seals.

The history of Xanthium genus research in a protected area in European Russia (Mordovia State Nature Reserve) has been reviewed based on available data (herbarium collections, publications, archive of Chronicles of Nature). We found that X. strumarium was the only species, which has been mentioned in the Mordovia State Nature Reserve since 1939. However, the overview of available data allowed us to conclude that all Xanthium plants found in this protected area to date belong to Xanthium orientale, an invasive alien species.

Dear Colleagues!We are glad to present the 11th Edition of the Standards of Specialized Diabetes Care. These evidence-based guidelines were designed to standardize and facilitate diabetes care in all regions of the Russian Federation.The Standards are updated on the regular basis to incorporate new data and relevant recommendations from national and international clinical societies, including World Health Organization Guidelines (WHO), International Diabetes Federation (IDF), European Association for the Study of Diabetes (EASD), American Diabetes Association (ADA), American Association of Clinical Endocrinologists (AACE), International Society for Pediatric and Adolescent Diabetes (ISPAD) and Russian Association of Endocrinologists (RAE). Current edition of the “Standards” also integrates results of completed randomized clinical trials, as well as findings from the national studies of diabetes mellitus (DM), conducted in close partnership with a number of Russian hospitals.Latest data indicates that prevalence of DM in the world increased during the last decade more than two-fold, reaching some 537 million patients by the end of 2021. According to the current estimation by the International Diabetes Federation, 643 million patients will be suffering from DM by 2030 and 783 million by 2045.Like many other countries, Russian Federation experiences a sharp rise in the prevalence of DM. According to Russian Federal Diabetes Register, there are at least 4 962 762 patients with DM in this country on 01.01.2023 (3,42% of population) with 92,3% (4 581 990) – Type 2 DM, 5,6% (277 092) – Type 1 DM and 2,1% (103 680) – other types of DM, including 8 758 women with gestational DM. However, these results underestimate real quantity of patients, because they consider only registered cases. Results of Russian epidemiological study (NATION) confirmed that 54% of patients with Type 2 DM are undiagnosed. So real number of patients with DM in Russia is 11-12 million patients (about 7% of population). This is a great long-term problem, because a lot of patients are not diagnosed, so they don’t receive any treatment and have high risk of vascular complications.Severe consequences of the global pandemic of DM include its vascular complications: nephropathy, retinopathy, coronary, cerebral and peripheral vascular disease. These conditions are responsible for the majority of cases of diabetes-related disability and death.In accordance with the Federal Law № 489-FZ of 25.12.2018 medical care should be provided on the basis of the clinical recommendations. Therefore, clinical recommendations posted in the rubricator of the Ministry of Health of the Russian Federation (https://cr.minzdrav.gov.ru) being the priority.This edition of the Algorithms for Specialized Care for Patients with Diabetes Mellitus contains the main information from the clinical guidelines for the management of diabetes mellitus in adults and children (“Type 1 Diabetes in Children (2022)”, “Type 1 Diabetes in Adults (2022)”, “Type 2 diabetes mellitus in children (2021)”, “Type 2 diabetes mellitus in adults (2022)”), as well as the updated data.New information has been added about indications for using of antihyperglycemic drugs and their instructional restrictions; algorithm of treatment of type 2 diabetes mellitus has been updated; clarifications have been made on the range of glycemic control in pregnant women; information on the treatment of diabetic complications and the management of pediatric patients has been added. In 2023, Russian diabetology suffered an unbearable loss - Alexander Yuryevich Mayorov, who was the executive editor of the previous issues and an active participant of the work on all the previous editions of “Algorithms” from the moment they were founded, passed away. This publication is dedicated to the memory of Alexander Yuryevich, who was an example of the service to patients and medicine, a friend, teacher, mentor, generously sharing his knowledge and the sample of the execution of the medical duty to all of us. On behalf of the Working Group

Increasing the efficiency of non-destructive control of lamellar materials with single and double-layer structure is an urgent scientific and technical task. The aim of the work was to investigate the peculiarities of excitation and reception of plate waves (PW) in single-layer and two-layer materials by pulsed laser radiation in relation to detection of cracks in them and estimation of layer thickness at one-sided sounding. A methodology has been developed and experimental studies of the influence of moving the area of laser generation of PW over the surface of dural samples relative to the crack simulator of different depth with the subsequent reception of the signal at a characteristic angle of inclination have been carried out. A significant change in the structure of the wave front at localization of the moving wave source zone in the vicinity of the crack simulator was found, accompanied by a change in the ratio of extreme values of amplitudes of the received asymmetric mode Aextr up to 14–15 dB. At receiving the symmetric s0 mode the value of Aextr does not exceed 3–4 dB. The interpretation of this effect is given. A method and scheme of thickness measurement of twolayer materials with metallized coating and non-metallic base (glass-textolite) is proposed and developed, where samples with copper coating and glass-textolite base of different thickness are used as an example. In this case, the velocity or propagation time of PW, between two small aperture (non-directional) transducers with an acoustic base of 43 mm, is used as an informative parameter. In this case, the estimated sensitivity of the measured circuit to changes in the thickness of the metal coating is of 0.5 μm, and the base – twice as much.

The lack of positive evidence for Weakly Interacting Massive Particles (WIMPs) as well as the lack of discovery of supersymmetric (SUSY) particles at the LHC may appeal to a non-supersymmetric solution for the Standard Model problem of the Higgs boson mass divergence, the origin of the electroweak energy scale and the physical nature of the cosmological dark matter in the approach of composite Higgs boson. If the Higgs boson consists of charged constituents, their binding can lead to stable particles with electroweak charges. Such particles can take part in sphaleron transitions in the early Universe, which balance their excess with baryon asymmetry. Constraints on exotic charged species leave only stable particles with charge −2n possible, which can bind with n nuclei of primordial helium in neutral dark atoms. The predicted ratio of densities of dark atoms and baryonic matter determines the condition for dark atoms to dominate in the cosmological dark matter. To satisfy this condition of the dark-atom nature of the observed dark matter, the mass of new stable −2n charged particles should be within reach of the LHC for their searches. We discuss the possibilities of dark-atom binding in multi-atom systems and present state-of-the-art quantum mechanical descriptions of dark-atom interactions with nuclei. Annual modulations in such interactions with nuclei of underground detectors can explain the positive results of DAMA/NaI and DAMA/LIBRA experiments and the negative results of the underground WIMP searches.

Background. At present, there are no special studies that generally consider the details of the work of the Main Army Supply Committee (Zemgor) with the national minor-ities who worked in its engineering and construction squads. The purpose of this study is to identify a number of specific features of the interaction of Zemgor, as a public organization, with a non-Russian and belonging to a different cultural and religious tradition, the contin-gent of the lower level of these construction teams in the process of their recruitment and functioning to solve national tasks, which, against the background of the coming general crisis, seems very relevant. Materials and methods. This study is based on archival materi-als, organization reports, memoirs and the results of a number of contemporary works. This made it possible to consider aspects of this issue that had not previously attracted the atten-tion of researchers. The article is based on the principles of historicism, objectivity, and complexity. As a methodological basis, general scientific methods of collecting, analyzing and synthesizing historical data, comparative historical and historical genetic methods were used. Results. The features of Zemgor’s work with national minorities are described and considered. Conclusions. The work of the Main Army Supply Committee of the All-Russian Zemstvo and city unions (Zemgor) took place as part of solving an acute nation-wide problem to overcome the shortage of workers. The preparation of the procedure and the subsequent involvement by Zemgor of national minorities in the work was carried out taking into account a wide range of issues necessary for their effective application.

Процессы экстренного торможения в Европейской системе управления поездами (European Train Control System (ETCS)) связаны со ступенчатым регулированием ускорения (замедления) в зависимости от способности торможения поезда, данных рельефа и меняющейся погоды на маршруте движения. Эти процессы являются определяющими в ETCS. Процедура ступенчатого регулирования замедления осуществляется машинистом многократно в процессе торможения до полной остановки поезда. Начало экстренного торможения и его окончание, а так же сам процесс торможения сопровождается многократным импульсным срабатыванием тормозов, что приводит к скачкам замедления и, соответственно, к повышенному износу тормозной системы, снижению комфорта для пассажиров, из чего следует ограничение максимально допустимой скорости движения. В статье предложена новая концепция и методика построения математических моделей кривых экстренного торможения отличных от кривых ETCS и основанных на гармонических полуволнах. Показано, что кривые торможения ETCS описываются известными степенными полуволнами второго порядка. Совместное их исследование даёт основание утверждать, что применение этих кривых приводит к обязательному импульсному режиму срабатывания тормозов. Предложены два новых варианта моделей кривых экстренного торможения, описываемых гармоническими полуволнами. Первый вариант имеет одно импульсное срабатывание тормозов в конце интервала торможения. Второй вариант свободен от тормозных импульсов и позволяет использовать непрерывное регулирование. Эти модели объясняют особенности ETCS, содержат предложения по их устранению, применимы для разработки новых кривых экстренного торможения, которые позволяют плавно осуществлять экстренное торможение поездов. Работоспособность, отличия и преимущества перед кривыми торможения ETCS показаны на результатах математического моделирования процессов экстренного торможения.

This article summarizes the results of a study on the daily life of students at the Kazan Imperial Theological Academy in 1914–1917 when the life of civilians was severely affected by the First World War. Through the analysis of archival materials and literary sources, a close look is taken at such major constituents of everyday activities as space and time, material means, as well as clothing and dietary habits. During that period, most students resided in boarding houses, which also determined their living conditions: state-paid students received food, sleeping and working space, clothes, treatment, etc. The life of all students of the Academy revolved around the main building on the Arsk Field of Kazan. They spent most of their time there but were occasionally allowed to make short-term trips into the city. When the First World War broke out, the students started visiting more places. They went to the infirmaries and hospitals to take part in religious sermons and entertainment events. Many of them fell into a poor financial situation because the annual basic scholarship was only enough to pay for staying at the boarding house. The canteen no longer served sufficient meals, especially during the fast, so the students were malnourished and forced to seek out other sources of food. They were offered nutritious food only on holidays. The statutory clothes (raincoats, uniforms, jackets, trousers, and shoes) supplied by the Academy were of little use to keep warm in the cold seasons. In 1917, the biggest changes occurred. The premises of the Academy were gradually militarized. By the end of the year, due to the social upheavals and the economic crisis, only 142 out of 300 students continued their education. They were mainly accommodated in government apartments, and the classes were held either in the assembly hall or in the rector’s apartment.

Artisanal and small-scale coal mining (ASM) in Africa presents a complex challenge where environmental conservation and socioeconomic development must be carefully balanced. This article explores the intricate dynamics surrounding ASM in the African context, highlighting the multifaceted impacts on the environment and the socioeconomic well-being of local communities. Artisanal and small-scale coal mining is often characterized by low capital investment, limited mechanization, and dependence on manual labor. Despite this, miners face numerous problems due to the unstable socioeconomic situation and weak labor legislation. The article describes the practice of ASM in Africa: provides an overview of the growing significance of ASM in Africa, and sets the stage for understanding the intricate trade-offs faced in managing this sector. The development of ASM in Africa is examined, considering its historical context, drivers, and patterns of growth, emphasizing the need for context-specific approaches to address its complexities. The article delves into the environmental challenges posed by ASM, focusing on deforestation, land degradation, water and air pollution, and the loss of biodiversity. It examines the specific manifestations of these challenges in selected African countries, shedding light on the varied ecological consequences and their ramifications for sustainable development. Additionally, the socioeconomic dimensions of ASM are explored, acknowledging its potential as a livelihood source for many communities while also recognizing the social and economic vulnerabilities associated with it. The article discusses the interplay between ASM and local economies, including job creation, income generation, and the broader implications for poverty alleviation and sustainable development.

Background. Interest in the biological effects of electromagnetic radiation on biological objects is associated with the possibility of their use in solving a number of fundamental and applied problems: from the consideration of biological feedbacks in real time, which allows the development of electronic medical complexes, to the creation of neuro-computer interfaces, including components of living cells. Aim. The paper shows the development of a device for influencing biological objects with a permanent magnetic field, which allows modeling the basic parameters of the physical factor, for conducting a magnetobiological experiment with normalization of the effects of non-ionizing radiation of the specified parameters. Methods. The device for influencing biological objects of constant magnetic field allows to obtain, in a large volume, the most homogeneous magnetic field. Results. Mathematical modeling of changes in the morphofunctional state of the adrenal cortex according to eleven biological parameters at different periods of exposure to normalized constant magnetic field when exposed to the maximum permissible level was evaluated by the deviation of the interval indicator and its normalized value. The effect of this factor led to a deviation of the integral index in the glomerular zone of the adrenal glands on the 30th day was – 6,53 ± 1,30*10-2, later on the 60th day the deviation increased by 8,28 ± 1,55*10-2, on the 90th 4,84 ± 1,50*10-2, then on the 120th day, it did not differ from normalized. Conclusion. After the termination of the constant magnetic field in a series of 15–30 mT experiments, the morphofunctional state of the thymus returned to normal. Thus, the device is recommended for use in experimental activities.