[Remote monitoring of population health and performance reserves]. / Distantsionnyi monitoring rezervov zdorov'ya i rabotosposobnosti naseleniya.

The deterioration of the demographic situation and the public health problem in Russia in the late twentieth and early twenty-first centuries has assumed menacing proportions. In this regard, the need to improve the health care system, the formation of a culture of health, and the responsibility of citizens for the preservation of health and high performance has become apparent. OBJECTIVE: Design and development of a system for remote monitoring and improvement of health reserves and performance of an individual and the whole population based on the prenosological examination, the numerical assessment of body systems reserves, and implementation of adequate individual health improvement programs. MATERIAL AND METHODS: Targeted population survey 2000-2020 with measurement of 18 morphofunctional indices allowed to form a database (760 thousand subjects) and develop the Health Navigator technology with the numerical assessment of health and performance reserves of individuals of different ages. This technology formed the basis for the design of the system of remote monitoring and improvement of population health reserves with results processing, storage, and analysis on local and remote servers. RESULTS AND DISCUSSION: Monitoring of health and performance reserves of the population was developed as a browser-based telemedicine technology consisting of a number of sequential actions (operations) performed by healthcare providers and patients: 1) targeted examination of the patient; 2) computer processing of the results using a software and information complex; 3) presentation to the patient and discussion of a formalized «Health Reserve Profile¼ and a draft personal wellness program; 4) implementation of 100-150 days health improvement program based on the means of natural therapy. CONCLUSION: Appraisal of the remote monitoring system in several country regions confirmed its efficiency and the considerable interest of specialists and the population in its use. The developed system allows to accelerate and standardize the work of health care providers, establish continuous cooperation with patients, increasing their health culture and protection from early diseases.

[Renal abscess in children].

INTRODUCTION: Renal abscesses are relatively rare in children, but they can lead to prolonged hospital stay and life-threatening complications. Scrutiny of the literature over the past two decades indicates the absence of a unified tactic for the treatment of purulent-destructive forms of pyelonephritis in children, while more and more articles are appearing in terms of a low -key approach to the treatment of renal abscess in children. MATERIALS AND METHODS: From 2005 to 2019, we treated 59 children with the renal abscess. Among the patients were 22 (37.3%) boys and 37 (62.3%) girls. The location of the abscess on the right was determined in 30 (50.8%) children, on the left, in 29 (49.2%). The average age of the patients was 109 months. The median size of kidney abscess among all patients was 29 [21; 42] mm (range from 12 to 69 mm). RESULTS: The results of treatment were evaluated in the period from 3 months to 5 years. In 27 (45.8%) patients, conservative treatment gave a positive effect, while in 32 (54.2%) abscess puncture was performed under ultrasound guidance. The median hospitalization in patients after an abscess puncture was 15 [14; 18] days, against 13 [9; 17] days for children receiving only antibiotic therapy. The duration of hospital stay was significantly longer in the group of patients who underwent puncture (p=0.019). The effectiveness of conservative therapy was a lot lower in patients with a kidney abscess of more than 3 cm, 60% versus 31% (p=0.026). All 59 patients recovered completely, and none of them required an open surgery to drain a suppurative focus of a kidney or nephrectomy. CONCLUSION: Conclusion. Our experience confirms the literature data, indicating the need to use a conservative approach to the treatment of patients with the renal abscess as a first-line therapy. Identification of an abscess with a diameter of more than 3 cm in patients considerably increases the likelihood of using an abscess puncture with the absence of the efficacy of a conservative approach.

[Comparison of functional magnetic resonance urography and dynamic renal scintigraphy in the functional assessment of ureteropelvic junction obstruction in children].

PURPOSE: In order to determine the role and significance of functional magnetic resonance urography (fMRU) in the diagnosis of ureteropelvic junction obstruction (UPJO), a comparative analysis of the results of fMRU and dynamic renal scintigraphy (DRS) was carried out. MATERIALS AND METHODS: From January 2017 to December 2019, fMRU and diuretic DRS were performed in 36 patients (mean age 89+/-63 months). Boys - 26 (72.2%), girls - 10 (27.8%). Left-sided hydronephrosis was detected in 23 (63.9%) children, right-sided in 12 (33.3%) patients, and bilateral lesions in 1 (2.8%) patient (2 renal units (RU)). Antenatal hydronephrosis was detected in 9 (25%) patients, and postnatally in 27 (75%) patients. According to ultrasound data, grade II hydronephrosis occurred in 11 (29.8%) RU, grade III - in 21 RU (56.7%), and grade IV - in 5 RU (13.5%) according to the SFU classification. A diuretic test was performed in 26 patients. RESULTS: Median and quartiles of differential renal function (DRF) according to fMRU data on the affected side were 37% [29; 43], and according to DRS - 46% [40;49]. When performing fMRU, a positive diuretic test was detected in 20 patients, 5 patients - negative and 1 patient - doubtful, and according to the DRS data, 12 patients had a positive test, 10 patients - negative and 4 patients - doubtful. Differences in DRF between fMRU and DRS varied between 0.7-33%. The average value of differences in DRF on the affected side was 11.3+/-8.5%. When comparing the results of DRF on the affected side, a moderate correlation was found on the Cheddock scale (r=0.59, p<0.05) between fMRU and DRS data. In comparison of the DRF using the Wilcoxon test, statistically significant differences were revealed (p<0,05). SUMMARY: Our experience demonstrates the high potential of fMRU in terms of replacing the classical methods of diagnosis of UPJO in children, taking into account the high correlation coefficients between the results of fMRU and DRS. Standardization of the fMRU protocol will increase the diagnostic relevance of information and in the future will make fMRU the only necessary study to determine management tactics for patients with UPJO.

[Social, demographic and clinical characteristics of female patients with schizophrenia and HIV]. / Sotsial'no-demograficheskie i klinicheskie osobennosti VICh-infitsirovannykh zhenshchin, bol'nykh shizofreniei.

OBJECTIVE: To evaluate social, demographic and clinical characteristics of women with schizophrenia and HIV. MATERIAL AND METHODS: Medical histories of patients who were in inpatient treatment during 2017 were retrospectively studied. A total of 174 medical histories were analyzed, but the final analysis included 40 HIV-infected patients (main groups) and 48 patients without HIV infection (comparison group). These groups included patients with a diagnosis of schizophrenia or acute polymorphic psychotic disorder. All patients with HIV infection were examined by a specialist and an immunological analysis was performed. Correlation analysis was performed between quantitative clinical indicators (duration of illness, number of hospitalizations, the number and duration of remissions, etc.) and immunological parameters. RESULTS AND CONCLUSION: Patients with schizophrenia and HIV infection are more often hospitalized and stay in the hospital longer than patients with schizophrenia without HIV infection, which may in part be determined by the social problems of this cohort of patients. There is a relationship between individual indicators of the immune status of the patients, the duration and some features of the course of mental illness. Regular treatment of HIV infection correlates with a lower frequency of hospitalizations in a psychiatric hospital due to an exacerbation of the mental state.

First Data on the Contact Zone and Hybridization between the Cryptic Species of Shrews Sorex araneus and S. satunini (Eulipotyphla, Mammalia).

For the first time, based on sequence variation of microsatellite loci and the mtDNA cytb gene fragment, population genetic structure of the common shrew and Caucasian shrew in their contact zone was investigated. It was demonstrated that, although there was no complete reproductive isolation between the species under consideration, the gene flow was considerably limited. These data testify to the established reliable reproductive barriers between the common shrew and Caucasian shrew.

Towards Semantic Brain Mapping Methodology Based on a Multidimensional Markup of Continuous Russian-Language Texts: an Attempt at Validation and Development.

In the present study, we combine linguistic annotation of oral texts in Russian with the registration of BOLD signal in functional MRI experiments to determine how and where semantic categories are represented in the human brain. Using the same stimuli material, we also analyze the differences in cortical activation in three thematic domains: description of nature, description of working principles of technical devices and more self-referential texts, addressing the question of human identity in conflict situations. We discuss methodological problems within the two approaches (microanalysis and macroanalysis) to study brain activation in natural conditions, i.e. under a continuous speech flow. Within the thematic domain studies, only minimally significant differences in brain activation were registered during the listening to texts from the three thematic groups. This outcome leads to the conclusion that the approach of thematic group contrasts (cognitive subtraction methodology) is not sufficient to study the mechanisms of text comprehension, and should be replaced by the modeling of multidimensional representations of semantic categories in time. Within the semantic category approach, we describe the neurolinguistic process of text understanding as the activation of 15 clusters responsible for semantic categories (e.g. "Conflict", "Mental", "Social"). Our data demonstrate that the clusters are widely distributed across the human brain. In contrast to the previous studies, we suggest that deep subcortical structures are involved in the processing of certain categories as well. The observed lateralization of category processing underlines the involvement of the right hemisphere in the processing of meaning.

[The volume of the contralateral testis in unilateral non-palpable cryptorchidism a diagnostic criterion to optimize surgical strategy].

AIM: Given the need to reduce the number of unnecessary laparoscopies, this study aimed to calculate the threshold values of contralateral testicular volume in unilateral non-palpable cryptorchidism to optimize diagnosis and surgical strategy. MATERIALS AND METHODS: From 2010 to 2016, contralateral testicular volume was prospectively evaluated in 78 patients aged under nine years with unilateral non-palpable cryptorchidism. The volume of healthy testes was calculated by multiplying length * width * height * 0.71. The patients were divided into two groups. Group 1 comprised 41 (52.6%) children with inguinal or intra-abdominal testes, who underwent orchiopexy for undescended testis. The second group consisted of 37 (47.4%) patients with severely hypoplastic testes that needed to be removed, or with testicular aplasia. In both groups, we matched the age (in months) at the time of surgery and the volume of the contralateral testis. Logistic regression was used to develop the diagnostic model. For the model, the ROC-curve (Receiver Operating Characteristic) was constructed, and the threshold of the contralateral testicular volume was selected. RESULTS: All patients with contralateral testicular volume greater than 2.25 ml had testicular aplasia, or hypoplasia (sensitivity 100.0%, specificity 73.0%). All patients with a contralateral testicular volume less than or equal to 1.04 ml had inguinal or intra-abdominal testes (specificity of 100%, the sensitivity of 34%). The area under the ROC curve calculated to assess the quality of the model was 92.6%, suggesting the high predictive power of the model. CONCLUSION: Revision scrototomy is indicated in patients with testicular volume exceeding 2.26 ml, while diagnostic laparoscopy is the optimal primary intervention in patients with the contralateral testicular volume of less than or equal to 1.04 ml.

[Spinal dural arteriovenous fistulas. A series of clinical cases and an analysis of the literature data]. / Dural'nye spinal'nye arteriovenoznye fistuly. Seriia sobstvennykh klinicheskikh nabliudenii i analiz dannykh literatury.

Spinal dural arteriovenous fistulas (SDAVFs) are the most common vascular malformation of the spinal cord, causing segmental lesions of the spinal cord due to venous ischemia. Functional outcomes of treatment in SDAVF patients are favorable, but the rate of improvement varies from 25 to 100%, which complicates prediction of the treatment outcome. AIM: the study aim was to identify a relationship between fistula localization and clinical manifestations and evaluate the effect of disease duration and severity of neurological impairments on immediate and long-term treatment outcomes, based on analysis of the literature and own data. MATERIAL AND METHODS: In September 2016, we performed a PubMed search for publications using keywords 'spinal arteriovenous fistula', 'treatment', and 'outcome'. We selected publications containing information on the patient's age, fistula location, disease duration, and evaluation of symptom severity (Aminoff-Logue scale) preoperatively, postoperatively, and at least 3 months after surgery. The analysis also included data on patients operated on at the clinic. A total of 187 patients were included in the analysis. RESULTS: The fistula was most often located at the T6, T7, and T9 level, with motor disorders being more severe for fistulas located at or below the T9 vertebra. Surgical isolation of the fistula improved the functional state of patients, with patients under the age of 60 years having a better prognosis for recovery of impaired functions. Motor disorders significantly regressed in the early postoperative period in all patients, but in the long-term period, there was worsening of motor disorders in patients with a better baseline functional state.

[Comparative evaluation of drainage methods used for penetrating gunshot cerebral injuries].

The paper presents a comparative evaluation of the methods of gunshot craniocerebral wounds draining, applied when the primary surgical treatment at the stages of medical evacuation of the limited contingent of Soviet troops in Afghanistan. An analysis of occurring infectious complications and outcomes of surgical treatment of the wounded is given. Based on clinical observations revealed most effective method of the active drainage gunshot traumatic brain injuries. The advantages of tidal drainage, appropriate for mechanical cleaning of wounds, allows controlling hemostasis, using antibacterial solutions are given.

Temporal properties of Zernike modes for non-Kolmogorov turbulence.

Temporal properties of Zernike modes are investigated for the case of light wave propagation through the non-Kolmogorov turbulence. The calculations are performed for the weak-turbulence conditions with constant turbulence parameters along the propagation path and taking into account the effects of the outer and inner scale of the turbulence. It is shown that the difference between effects produced by the Kolmogorov and non-Kolmogorov turbulence is getting smaller when the aberration order is growing up and when the outer scale magnitude is decreasing. Also it is shown that the correlation time of an aberration is decreasing with increasing of its order and with decreasing of spectral index.

Hepatitis C virus: The role of N-glycosylation sites of viral genotype 1b proteins for formation of viral particles in insect and mammalian cells.

Hepatitis C virus (HCV) is characterized by considerable genetic variability and, as a consequence, it has 6 genotypes and multitude of subtypes. HCV envelope glycoproteins are involved in the virion formation; the correct folding of these proteins plays the key role in virus infectivity. Glycosylation at certain sites of different genotypes HCV glycoproteins shows substantial differences in functions of the individual glycans (Goffard et al., 2005; Helle et al., 2010) [1], [2]. In this study, differential glycosylation sites of HCV genotype 1b envelope proteins in insect and mammalian cells was demonstrated. We showed that part of glycosylation sites was important for folding of the proteins involved in the formation of viral particles. Point mutations were introduced in the protein N-glycosylation sites of HCV (genotype 1b) and the mutant proteins were analyzed using baculovirus expression system in mammalian and insect cells. Our data showed that, in contrast to HCV 1a and 2a, the folding of HCV 1b envelope proteins E2 (sites N1, N2, N10) and E1 (sites N1, N5) was disrupted, however that did not prevent the formation of virus-like particles (VLP) with misfolded glycoproteins having densities typical for HCV particles containing RNA fragments. Experimental data are supported by mathematical modeling of the structure of E1 mutant variants.

[Genetic Structure of the Common Shrew Sorex araneus L. 1758 (Mammalia, Lipotyphla) in Continuous and Fragmented Areas].

In this work the genetic variability of the common shrew populations Sorex araneus L. in Eastern Europe was studied via sequencing of the mitochondrial gene cyt b. A total of 82 sequences of the mitochondrial gene cyt b with a length of 953 basepairs were analyzed, including five chromosome races in a continuous area of the species in forest zone and two races in fragmented area in the steppe zone. Phylogeographic subdivision of the common shrew was not expressed, and there was no significant correlation between genetic and geographic distances in continuous areas. We did not acquire convincing evidence of the influence of narrow hybrid zones between chromosome races on the flow of neutral alleles. A significant p-distance (0.69 ± 0.27%) of geographically close populations of the chromosome race Neroosa indicates the formation of the karyotype of this race in the Pliocene or Pleistocene. In our work, the phylogeographic structure was determined more by species area fragmentation than by its karyotypic features.

[Provision of medical care to the wounded with craniocerebral injuries at stages of medical evacuation in mountains and desert areas].

The author shows that surgery with craniocerebral injuries should be fully performed at the stage of specialized medical care. Wounded have to be evacuated not earlier than 5-7 days after surgery with the mandatory use of a special air transport ("Scalpel" or "Spasatel"), accompanied by Anaesthetist. In the absence of the possibility of surgery in 5-7 days at this stage the wounded have to be evacuated by air to the center hospitals. On the stage there are only patients requiring specialized care because of health reasons. Wounded with gunshot wounds of the soft tissues of the head, and those with mild forms of brain damage during the explosive and combat injury (concussion, mild brain contusion) can be evacuated by air transport accompanied by a doctor or paramedic at any period of time after the injury (trauma).

Effect of chaperonin encoded by gene 146 on thermal aggregation of lytic proteins of bacteriophage EL Pseudomonas aeruginosa.

Investigation of the chaperonin encoded by gene 146 of bacteriophage EL Pseudomonas aeruginosa that we characterized earlier has been continued. To reveal the mechanism of its functioning, new recombinant substrate proteins, fragments of gene product (gp) 183 containing the lysozyme domain were prepared. Their interaction with gp146 was studied. The influence of the phage chaperonin on the thermal aggregation of one of these gp183 fragments and endolysin (gp188) was investigated in both the presence and the absence of ATP by dynamic light scattering. In the absence of ATP, the phage chaperonin forms stable complexes with substrate proteins, thereby protecting them against thermal aggregation. Experimental data obtained for different substrate proteins are analyzed.

Complexes between anionic liposomes and spherical polycationic brushes. An assembly of assemblies.

This paper has at its objective the assembling of liposomal assemblies onto nanoparticles. In this manner, one generates nanoparticles with a high loading capacity. Thus, spherical spherical polycationic "brushes" (SPBs) were synthesized by graft polymerizing a cationic monomer, (trimethylammonium)ethylmethacrylate chloride, onto the surface of monodisperse polystyrene particles, ca. 100 nm in diameter. These particles were complexed with small unilamellar anionic liposomes, 40-60 nm in diameter, composed of egg lecithin (EL) and anionic phosphatidylserine (PS(1-)) in PS(1-)/EL ratios from 0.10 to 0.54, a key parameter designated as ν. These complexes were then characterized according to electrophoretic mobility, dynamic light scattering, conductivity, fluorescence, and cryogenic transmission electron microscopy, with the following main conclusions: (a) All added liposomes are totally associated with SPBs up to a certain saturation concentration (specific for each ν value). (b) The number of liposomes per SPB particle varies from 40 (ν = 0.1) to 14 (ν = 0.5). (c) At sufficiently high liposome concentrations, the SPBs experience an overall change from positive to negative charge. (d) SPB complexes tend to aggregate when their initial positive charge has been precisely neutralized by the anionic liposomes. Aggregation is impeded by either positive charge at lower lipid concentrations, or negative charge at higher lipid concentrations. (e) The liposomes remain intact (i.e., do not leak) when associated with SPBs, at ν ≤ 0.5. (f) Complete SPB/liposome dissociation occurs at external [NaCl] = 0.3 M for ν = 0.1 and at 0.6 M for ν = 0.5. Liposomes with ν = 0.54 do not dissociate from the SPBs even in NaCl solutions up to 1.0 M. (g) Complexation of the PS(1-)/EL liposomes to the SPBs induces flip-flop of PS(1-) from the inner leaflet to the outer leaflet. (h) The differences in the ability of PS(1-) (a cylindrical lipid) and CL(2-) (a conical lipid) to create membranes defects are attributed to geometric factors.

[Analysis of functionalized arene degradation pathways in model water-organic media].

The degradation of functionalized arenes exposed to a mixed culture of chemoorganoaeroheterotrophic microorganisms has been shown to predominantly occur through oxidative intradiol decyclization of the aromatic ring. The spatial structure of the catalytic center of intradiol dioxygenase and its complexes with catechol and protocatechuic acid has been characterized using quantum chemical modeling procedures. The dependence of the total energy of the enzyme-substrate complex on the length of the bond between the iron atom and the hydroxyl group of the substrate (Fe-4-OH and Fe-1-OH) before and after the separation of water and a tyrosine residue (Tyr) from the catalytic center has been demonstrated for the first time.

[Craniometric differences between karyotypic races of the common shrew Sorex araneus (Mammalia) as a result of limited hybridization].

The contact points of four karyotypic races (St. Petersburg, Moscow, Seliger and West Dvina) of the common shrew Sorex araneus L. were studied at the Valdai Hills (European Russia) in an area unimpeded by geographic barriers. The populations of the races are separated by narrow hybrid zones that represent the most complex heterozygous hybrid karyotypes. At these points of contact, the morphometric differentiation of karyotype races was examined in 12 cranial measurements in 190 shrews of a known karyotype. A. comparison of the mean values in studied samples of immature shrews revealed statistically significant differences and the correlation of some measurements in order to describe the level of musculus temporalis. It has been proposed that morphometric differences in the karyotypic races were preserved and accumulated because of a 50% reduction of the frequencies of hybrids. The deviation from the Hardy-Weinberg ration in the frequencies of the genotype and haploid sets of chromosomes in the hybrid zones can be attributed to a number of fatalities of hybrid embryos or the nonrandom mating of karyotypic races. The ethological isolation might arise in the evolution of some karyotypic races from the reduced fitness of the hybrids.