[Efficacy and safety of Aviandr in the treatment of anxiety in patients with adjustment disorders after COVID-19]. / Effektivnost' i bezopasnost' novogo preparata Aviandr v lechenii trevogi u patsientov s rasstroistvom adaptatsii posle perenesennoi ostroi koronovirusnoi infektsii.

OBJECTIVE: To investigate the efficacy and safety of Aviandr in the treatment of anxiety in patients with adjustment disorders after COVID-19. MATERIAL AND METHODS: A multicenter prospective open-label study included 109 patients of both sexes aged 18 to 65 years (70 women, 39 men, average age - 41.4±13.18 years) with a leading complaint of anxiety (Hamilton scale score, HAM-A ≥18 - ≤24), which arose after acute coronavirus infections. Clinical manifestations had to meet the diagnostic criteria F43.2 ICD-10. The drug Aviander was prescribed 20 mg 2 times a day for 4 weeks. At the end of taking the drug, patients were monitored for another 1 week (a delayed follow-up visit). Psychopathological, statistical and parametric research methods were used using standardized HAM-A, Montgomery-Asberg scales (MADRS), visual analog asthenia scale (VASH-A), Sheehan Disability Scale (SDS), digital character substitution test (DSST), general clinical impression scale (CGI). RESULTS: Data from 109\110 patients were analyzed to evaluate efficacy\safety. Aviandr was administered 20 mg 2 times daily for 4 weeks. Patients were followed for 1 week (delayed follow-up visit) at the end of treatment. Reducing the intensity of anxiety on the HAM-A scale was - 14.2±4.92 or 69.4±22.66% by the end of treatment. The response rate to therapy (responders are patients with a decrease in the total score on the HAM-A ≥50%) was 83.49%. Remission was achieved (sum of HAM-A scores ≤7) by the end of treatment 68.81% of patients, and 79.8% of patients at the follow-up visit. Significant changes were obtained on the MADRS, VAS-A, SDS and DSST scales. According CGI 45.9% of patients had «much improved¼ and 43.1% of patients had «very much improved¼ by the end of treatment; 58.7% of patients had «much improved¼ and of 33.9% patients had «very much improved¼ at the follow-up visit. 38 adverse events were reported in 27 (24.55%) patients during the study. A definite association with study drug was reported between 5 mild adverse events in 4 (3.64%) patients. No subjects withdrew from the study due to an adverse event. Positive dynamics (reduction of anxiety symptoms, decrease in asthenia) persisted after discontinuation of the study drug. No cases of withdrawal syndrome were observed. CONCLUSION: According to the results of the study, the anxiolytic, antidepressant, antiasthenic and pro-cognitive effects of Aviandr were observed. An increase in the social activity of patients was observed.

Dispositional mindfulness, alexithymia and sensory processing: Emerging insights from habituation of the acoustic startle reflex response.

There is growing evidence of beneficial effects of mindfulness developed through engaging in mindfulness training/practices on sensory and cognitive processing, emotion regulation and mental health. Mindfulness has also been conceptualised as a dispositional 'trait', i.e. the naturally-occurring ability of meditation-naïve individuals to display, in varying degree, a non-judgmental non-reactive present-moment awareness in everyday life. In this study we examined possible associations between dispositional mindfulness, alexithymia and sensory processing. Eye-blink startle responses to acoustic stimuli of varying intensity [90-dB or 100-dB over 70-dB (A) background] were assessed in 26 meditation-naïve adults (50 % men) using electromyographic recordings of the orbicularis muscle. All participants completed the Five Facet Mindfulness Questionnaire and the 20-item Toronto Alexithymia Scale. A negative association was found between dispositional mindfulness and alexithymia (r = -0.513). There was stronger startle habituation to 100-dB, compared to 90-dB probes. Stronger startle habituation (larger negative habitation slope values) to 100-dB probes was significantly associated with higher dispositional mindfulness (r = -0.528) and with lower alexithymia at trend level (r = 0.333). As indicated by commonality analysis, 10.6 % of explained variance in habituation (100-dB probes) was common to both alexithymia and mindfulness, 17.3 % was unique to mindfulness, but alexithymia made negligible unique contribution (0.5 %). These findings indicate similar startle habituation pattern in people with a high level of dispositional mindfulness to that reported previously by Antonova et al. (2015) in people with moderate mindfulness meditation practice intensity. Future studies should investigate the mechanisms, such as interoceptive awareness, that might underly these relationships.

[Active surgical approach for retroperitoneal liposarcoma]. / Rol' aktivnoi khirurgicheskoi taktiki pri zabryushinnoi liposarkome.

OBJECTIVE: To assess the influence of active surgical approach on the long-term postoperative outcomes in patients with retroperitoneal liposarcoma. MATERIAL AND METHODS: A retrospective study included 190 patients with retroperitoneal liposarcoma. The effect of malignancy grade, adjuvant chemotherapy, number of separate tumor nodes in primary neoplasm and the first relapse, as well as the number of previous total resections on survival rate was analyzed. RESULTS: Overall and relapse-free survival is significantly worse in patients with high-grade retroperitoneal liposarcoma (G2-3) compared to low-grade (G1) tumor (plog-rank=0.000). Multifocal growth of primary tumor (p=0.869; plog-rank=0.607) and multiple (>1) separately located nodes in abdominal cavity and retroperitoneal space at the first relapse (plog-rank=0.158 to 0.985) did not significantly impair prognosis after total resection of all types of retroperitoneal liposarcoma regardless malignancy grade. Adjuvant chemotherapy does not significantly improve relapse-free survival. Overall survival was significantly higher in patients who underwent ≥4 previous total resections compared to 1 surgical treatment for all types of retroperitoneal liposarcoma regardless malignancy grade (p=0.000; plog-rank=0.001). CONCLUSION: The only potentially radical treatment for patients with retroperitoneal liposarcoma is surgery. We reported the advantages of active surgical approach for improvement of long-term outcomes in patients with retroperitoneal liposarcoma.

[Differentiated surgical approach for retroperitoneal non-organ liposarcoma]. / Differentsirovannyi podkhod v khirurgii zabryushinnykh neorgannykh liposarkom.

OBJECTIVE: To determine the indications for combined and organ-sparing surgery depending on malignancy grade of retroperitoneal liposarcoma. MATERIAL AND METHODS: A retrospective study included 190 patients with retroperitoneal liposarcoma. Influence of malignancy grade, lesion of adjacent organs and resection/excision of adjacent organs on the overall and recurrence-free survival was studied. Moreover, we analyzed the issue of kidney-sparing surgery and nephrectomy. RESULTS: Overall and recurrence-free survival were significantly worse in high grade (G2-3) compared to low-grade tumors (G1) (p=0.0001; log-rank test). Visceral invasion was revealed in 23% of patients with low-grade (G1) tumors and 53% of patients with high-grade (G2-3) neoplasms. Visceral invasion significantly impairs overall and recurrence-free survival in both low grade (G1) and high-grade (G2-3) tumors (p=0.0001; log-rank test). In case of low grade (G1) retroperitoneal liposarcoma, overall and recurrence-free survival was similar after combined surgery without histologically confirmed visceral invasion of liposarcoma and organ-sparing surgery (p=0.006; p=0.053; log-rank test). On the contrary, high grade (G2-3) tumor was followed by significantly better overall and recurrence-free survival after combined surgery without histologically confirmed visceral invasion compared to organ-sparing surgery (p=0.006; p=0.053; log-rank test). Recurrence-free survival was similar after kidney-sparing surgery and nephrectomy among patients with low-grade (G1) tumor (p=0.456; log-rank test). In case of high-grade retroperitoneal liposarcoma (G2-3), recurrence-free survival was significantly worse after kidney-sparing surgery compared to nephrectomy (p=0.039; log-rank test). CONCLUSION: Surgery is the only potentially radical treatment of patients with retroperitoneal liposarcoma. Organ-sparing including kidney-sparing surgery is advisable for low-grade liposarcoma (G1). On the contrary, organ-sparing surgery impairs long-term results and prognosis in patients with high-grade tumors (G2-3). Combined operations including nephrectomy are justified for high-grade retroperitoneal liposarcoma (G2-3).

[The effect of medical social and social economic factors on development of disability in children].

The trends in economic situation requires periodic repetition of studies concerning qualitative evaluation of impact of medical, social and economic factors on population health at the regional level. The purpose of the study is to establish the relationship between the disability of children and the main medical, social and socioeconomic indices in the Russian Federation. The materials and methods. The official data on prevalence of disability in children of 0-17 years and the level of basic medical, social and socioeconomic indices were analyzed in the context of 83 subjects of the Russian Federation in 2017-2019. The demographic and epidemiological data and data on medical care support of children population were used as medical and social indices. The socioeconomic indices (unemployment rate, cash income, housing conditions and consumption of basic food products were used as the socioeconomic indices. The Spearman rank correlation method was used to determine the particular relationships. The results. It was established that the significant inter-regional variability of disability of children both in the Federal Okrugs and the subjects of The Russian Federation persists. The relationship of various degrees of intensity between the prevalence of disability of children in the subjects of the Russian Federation and many medical, social and socioeconomic factors such as demographic indices (fertility, mortality); level of primary and total morbidity of children of all age groups; medical care support (medical personnel, pediatric beds); unemployment level; average per capita cash income; percentage of population with cash incomes below cost of living; total area of residential premises that is on average per inhabitant; share of young families registered as needing housing from total number of families with children aged under 18 years; consumption of cheaper food. The conclusion. The obtained results are to be taken into account in the development of programs of preventing disability of children avoiding to place full responsibility on the health care system only.

[The results of phase III multicenter open randomized controlled study REM-Chol-III-16 in patients with intrahepatic cholestasis syndrome caused by chronic diffuse liver diseases].

AIM: To assess the safety and efficacy of Remaxol, solution for infusion, compared with parenteral form of S-adenosyl-L-methionine, in the treatment of patients with intrahepatic cholestasis syndrome accompanying chronic diffuse liver diseases of various etiology. MATERIALS AND METHODS: In a multicenter open-label comparative study of the safety and efficacy of Remaxol (inosine + meglumine + methionine + nicotinamide + succinic acid) 317 patients aged 18 to 65 years were randomized into 2 groups: patients of the experimental group (n=168) received intravenous Remaxol, solution for infusion, 400 ml, and patients of the control group (n=149) Heptral (S-adenosyl-L-methionine) 800 mg. The duration of treatment was 10 days. The primary efficacy endpoint was the proportion of patients who responded to therapy, as demonstrated by dynamics of laboratory parameters of liver functional status: decrease in gamma glutamyl transpeptidase level by 40%, and/or alkaline phosphatase level by 30%, and/or decrease total bilirubin level by 30% from baseline by the end of the treatment course. RESULTS: The proportion of responders was 51% in the Remaxol group vs. 44.9% in the Heptral group (p=0.303); the lower limit of the one-sided 95% confidence interval for the difference in the proportions of responders was -4.01%, which exceeds the non-inferiority margin pre-defined by the study protocol, thus, the non-inferiority hypothesis was proven, i.e. Remaxol at a dose of 400 ml/day demonstrates similar efficacy to Heptral at a dose of 800 mg/day in patients with intrahepatic cholestasis syndrome associated with chronic diffuse liver diseases. Similar positive trends in the levels of transaminases, total bilirubin and the severity of pruritus were revealed in both treatment groups. We did not reveal statistically significant between-group differences in the frequency of adverse events definitely related to the study treatment. CONCLUSION: Administration of Remaxol as a part of the pathogenetic therapy of patients with intrahepatic cholestasis syndrome who need hepatoprotection is justified.

[Retroperitoneal dedifferentiated liposarcomas: semi-quantitative assessment of the dedifferentiated component and prognosis]. / Zabryushinnye dedifferentsirovannye liposarkomy: polukolichestvennaya otsenka dedifferentsirovannogo komponenta i prognoz.

OBJECTIVE: To evaluate the impact of malignancy grade and the proportion of the dedifferentiated component (DC) in retroperitoneal dedifferentiated liposarcomas (DDLS) on the course and prognosis of the disease. MATERIAL AND METHODS: The retrospective study enrolled 74 patients with primary retroperitoneal DDLS who underwent radical surgical treatment in the N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia. Histological surgery specimens from all cases of DDLS were reexamined and reclassified. According to malignancy grades and the proportion of the dedifferentiated component in the tumor, the patients were divided into the comparison groups included in the intergroup analysis of overall and relapse-free survival (OS and RFS) rates. The authors also analyzed the relationship between the proportion of the dedifferentiated component in DDLS and the frequency of adjacent organ invasion. RESULTS: Patients with a more than 15% dedifferentiated component had significantly lower OS rates than those with a less than 15% one (p=0.0001; log-rank test). The median OS in the DDLS group with a less than 15% dedifferentiated component was 91 months (95% CI, 82-100); that in the DDLS group with a more than 15% dedifferentiated component was 29 months (95% CI 17-41). The 5-year overall survival rates in the groups with less than 15% and more than 15% dedifferentiated components were 69% and 2%, respectively. The group with a more than 15% dedifferentiated component had significantly lower RFS rates than that with a less than 15% one (p=0.0001; log-rank test). In the DDLS groups with less than 15% and more than 15% dedifferentiated components, the median RFS rates were 25 months (95% CI 23-27) and 13 months (95% CI 8-18), respectively. In these groups, the 2-year RFS rates were equal to 50% and 9%, respectively. In the DDLS groups with less than 15% and more than 15% dedifferentiated components, pathologically confirmed invasion into the adjacent organs was observed in 32% and 63% of cases, respectively. There were no statistically significant differences in the OS and RFS of patients with DDLS according to tumor grade (p=0.069; p=0.102). CONCLUSION: This investigation suggests that DDLS have a more aggressive course with an increasing proportion of the dedifferentiated component in the tumor. Considering the histological variability in the dedifferentiated component, which is demonstrated in the research and scientific literature, as well as lack of a prognostic impact of histological grade, the authors believe that semi-quantitative assessment of the proportion of the dedifferentiated component in DDLS is able to serve as a simple and efficient morphological marker for the course of the disease and prognosis in retroperitoneal DDLS.

Heterogeneity of soil contamination by 90Sr and its absorption by herbaceous plants in the East Ural Radioactive Trace area.

A nuclear accident occurred at the production association Mayak in the Urals in 1957. Approximately 74 PBq of radioactive substances were released into the environment, which resulted in the contamination of a vast area, named the East Ural Radioactive Trace (EURT). We have studied the current levels of contamination of soils and plants by 90Sr in the head part of the EURT. The heterogeneity of soil contamination (concentrations and contamination densities) in the EURT zone was considered at three scales. 1) At the macro-level, the soil contamination by 90Sr decreased by three orders of magnitude in the cross section of the zone. 2) At the meso-level, the variability of the soil contamination was estimated within several sectors, selected by the results of macro-scale mapping. 3) At the micro-level, differences in soil contamination between individual samples (0.01 m2) selected at the site (1000 m2) exceeded the one order of magnitude. The similarity of geometric mean (GM) values of the soil contamination was shown, based on the measurements of 3, 25 and 30 soil samples at the micro-level. In 57% of cases, the value of the GM obtained by 3 measurements differed by no >20% from the GM value by 25 measurements. In the most of cases, the differences in GM obtained by these two methods did not exceed 40%. Thus, in small sites it is possible to take only three soil samples to assess the level of soil contamination. We evaluated the absorption variability of 90Sr for six species of herbaceous plants (Rumex confertus, Leonurus quinquelobatus, Arctium tomentosum, Urtica dioica, Lathyrus pratensis, Bromopsis inermis). The range of concentration ratios (CRwo-soil) for 90Sr was 0.003-0.49, and the diapason of aggregated transfer factors (Tag) was 0.56-7.3. The 'plant species' factor determined about 55% of the total variability of CRwo-soil and Tag.

[Circadian rhythms of antioxidant enzyme's activity in young and adult rats under light deprivation conditions.]

We studied the age-related features of circadian rhythms of superoxide dismutase (SOD) and catalase activity in the liver of rats under light deprivation. In standard light conditions (LD), significant daily fluctuations in SOD activity with a maximum at 07:00 am was detected only in young animals (1,5 months) but catalase activity was observed in young (1,5 months) and in adults (7,5 months) with peak at 04:00 am. The daily dynamics of total and specific activity of SOD and catalase in the liver in young and adult rats differed depending on the period of ontogeny in which the impact of light deprivation began. When the females and offspring were moved to darkness after birth (group LD/DD), the circadian rhythms of SOD and catalase activitys were observed in young and were absent in adult rats. However, circadian rhythms of the antioxidant enzymes (AOE) activities were inherent only adult rats when light deprivation impacted on pregnant females (group DD/DD). Changes in circadian rhythms under light deprivation were characterized either by a phase shift of the enzymes activity (in the LD/DD group) or by a violation of their develpoment in ontogeny (in the DD/DD group). During aging significant decreasing of catalase activity was compensated by an increase in the amplitude of circadian rhythms of activity of this enzyme in animals of all groups. A distinctive feature of daily fluctuations in AOЕ activity in young rats in LD and LD/DD groups can be considered the presence of an ultradian rhythm in the general circadian cycle, which had a second peak with a smaller amplitude and shorter period.

Omalizumab substantially improves dermatology-related quality of life in patients with chronic spontaneous urticaria.

BACKGROUND: Chronic spontaneous/idiopathic urticaria (CSU/CIU) has substantial detrimental effects on health-related quality of life (HRQoL) with an effect comparable to or worse than many other skin diseases. OBJECTIVE: To assess the effect of omalizumab on CSU patients' HRQoL, measured by the Dermatology Life Quality Index (DLQI) in three phase III studies ASTERIA I, ASTERIA II and GLACIAL. METHODS: A post hoc analysis examined changes in DLQI scores, distribution of patients across DLQI bands and the proportion reaching minimal clinically important difference (MCID) following omalizumab vs. placebo. RESULTS: Omalizumab 300 mg significantly improved total DLQI scores vs. placebo, with a mean decrease from baseline to week 12 of -10.3 vs. -6.1 (P < 0.0001) in ASTERIA I, -10.2 vs. -6.1 (P = 0.0004) in ASTERIA II and -9.7 vs. -5.1 (P < 0.0001) in GLACIAL. A significant shift from high disease impact on life at baseline towards less impact at week 12 was seen with omalizumab 300 mg vs. placebo (P < 0.001; all studies). The proportion of patients where change in mean total DLQI score from baseline to week 12 reached an MCID of ≥4 was 74.1%, 76.0% and 77.2% in ASTERIA I, II and GLACIAL, respectively (P < 0.01; all studies). LIMITATIONS: Maximum duration of omalizumab treatment was 24 weeks. CONCLUSION: This additional analysis assessed the impact of CSU and benefit of treatment with omalizumab by exploring different facets of DLQI data by treatment arm at multiple assessment points. The original aspects of analysis included applying the concept of the recently validated score for the MCID of the DLQI, changes in DLQI domain scores and in the distribution of subjects based on validated total DLQI score bands. It showed consistently that omalizumab provides significant and clinically relevant improvements in many aspects of HRQoL that are important to patients with CSU. These results contribute to a better understanding of the impact of CSU and its treatment on patients and can support clinical decision-making in routine medical practice.

[The evaluation of quality of implementation of preventive medical examinations of underage persons in the Russian Federation].

The analysis was implemented concerning informational statistic data characterizing health of children population of different age groups in the Russian Federation on the basis of results of dispensarization in its federal okrugs and subjects in 2014. The purpose of the study was to discover ways and modes of developing and increasing efficiency of preventive examinations of underage population. The following indices were analyzed: coverage of children population by preventive medical examinations, distribution according health groups and medical groups for physical culture involvement, level and stricture of established total and primary morbidity, rate of dispensary registration, requirements in additional consultations, examinations and treatment in out-patient condition, day hospital, day-and-night hospital and also coverage with all these medical services. In the most of the subjects of the Russian Federation a high level of coverage of underage population with preventive medical examinations is registered. The percentage of healthy children population in the Russian Federation comprises more than one third of all covered by dispensarization. The significant variations in indices of rate of healthy children and children with functional disorders and chronic diseases in subjects of the Russian Federation is determined by quality and accessibility of medical care at the regional level. The established total and primary morbidity of children population in significant percentage (more than one third) of the subjects has a level higher than a national one. The leading causes of morbidity in children are diseases of respiratory system, musculoskeletal system, nervous system. In adolescents, these causes are diseases of musculoskeletal system, eye diseases and diseases of respiratory system. Despite high prevalence of chronic pathology in children population of the Russian Federation, the guidelines concerning treatment and rehabilitation on the basis of results of preventive medical examinations were developed in inadequate scope. The regional characteristics of the results of dispensarization are established. These results made it possible to sort out the most unfavorable territories and to determine defects in its organization and absence of continuity between medeical institutions providing the given type of medical services.

[Technologies for Complex Intelligent Clinical Data Analysis].

UNLABELLED: The paper presents the system for intelligent analysis of clinical information. Authors describe methods implemented in the system for clinical information retrieval, intelligent diagnostics of chronic diseases, patient's features importance and for detection of hidden dependencies between features. Results of the experimental evaluation of these methods are also presented. BACKGROUND: Healthcare facilities generate a large flow of both structured and unstructured data which contain important information about patients. Test results are usually retained as structured data but some data is retained in the form of natural language texts (medical history, the results of physical examination, and the results of other examinations, such as ultrasound, ECG or X-ray studies). Many tasks arising in clinical practice can be automated applying methods for intelligent analysis of accumulated structured array and unstructured data that leads to improvement of the healthcare quality. AIMS: the creation of the complex system for intelligent data analysis in the multi-disciplinary pediatric center. MATERIALS AND METHODS: Authors propose methods for information extraction from clinical texts in Russian. The methods are carried out on the basis of deep linguistic analysis. They retrieve terms of diseases, symptoms, areas of the body and drugs. The methods can recognize additional attributes such as "negation" (indicates that the disease is absent), "no patient" (indicates that the disease refers to the patient's family member, but not to the patient), "severity of illness", disease course", "body region to which the disease refers". Authors use a set of hand-drawn templates and various techniques based on machine learning to retrieve information using a medical thesaurus. The extracted information is used to solve the problem of automatic diagnosis of chronic diseases. A machine learning method for classification of patients with similar nosology and the methodfor determining the most informative patients'features are also proposed. RESULTS: Authors have processed anonymized health records from the pediatric center to estimate the proposed methods. The results show the applicability of the information extracted from the texts for solving practical problems. The records ofpatients with allergic, glomerular and rheumatic diseases were used for experimental assessment of the method of automatic diagnostic. Authors have also determined the most appropriate machine learning methods for classification of patients for each group of diseases, as well as the most informative disease signs. It has been found that using additional information extracted from clinical texts, together with structured data helps to improve the quality of diagnosis of chronic diseases. Authors have also obtained pattern combinations of signs of diseases. CONCLUSIONS: The proposed methods have been implemented in the intelligent data processing system for a multidisciplinary pediatric center. The experimental results show the availability of the system to improve the quality of pediatric healthcare.

[Morphoecological Aspects of Preimaginal Stages of Development of the Parasitic Wasp Minotetrastichus frontalis (Nees, 1834) (Insecta, Hymenoptera, Eulophidae)].

This work is devoted to studying the morphology and biology of preimaginal stages of development of the parasitic wasp Minotetrastichus frontalis. The morphological characteristics of eggs and larvae, the features of interaction of the parasitic wasp with the host (Phyllonorycter issikii), and other biological characteristics were determined. For the species identification of the studied specimens of insects, we performed molecular genetic analysis using a nuclear 28S RNA gene fragment as a molecular marker. The result showed a strong genetic polymorphism of the populations of the studied species for the selected marker.

Investigating virtual reality navigation in amnestic mild cognitive impairment using fMRI.

Spatial navigation requires a well-established network of brain regions, including the hippocampus, caudate nucleus, and retrosplenial cortex. Amnestic Mild Cognitive Impairment (aMCI) is a condition with predominantly memory impairment, conferring a high predictive risk factor for dementia. aMCI is associated with hippocampal atrophy and subtle deficits in spatial navigation. We present the first use of a functional Magnetic Resonance Imaging (fMRI) navigation task in aMCI, using a virtual reality analog of the Radial Arm Maze. Compared with controls, aMCI patients showed reduced activity in the hippocampus bilaterally, retrosplenial cortex, and left dorsolateral prefrontal cortex. Reduced activation in key areas for successful navigation, as well as additional regions, was found alongside relatively normal task performance. Results also revealed increased activity in the right dorsolateral prefrontal cortex in aMCI patients, which may reflect compensation for reduced activations elsewhere. These data support suggestions that fMRI spatial navigation tasks may be useful for staging of progression in MCI.

[Risk management of a patient on the basis of remote health monitoring: current situation and prospects].

Review is dedicated to the problem of remote monitoring of health status. Existing approaches to the organization of an outdoor monitoring of a patient using telemedicine technologies are reviewed and analyzed. A new approach to risk management of a patient which meets the requirements of pediatric hospital is provided.

Problems with mapping the auroral oval and magnetospheric substorms.

Accurate mapping of the auroral oval into the equatorial plane is critical for the analysis of aurora and substorm dynamics. Comparison of ion pressure values measured at low altitudes by Defense Meteorological Satellite Program (DMSP) satellites during their crossings of the auroral oval, with plasma pressure values obtained at the equatorial plane from Time History of Events and Macroscale Interactions during Substorms (THEMIS) satellite measurements, indicates that the main part of the auroral oval maps into the equatorial plane at distances between 6 and 12 Earth radii. On the nightside, this region is generally considered to be a part of the plasma sheet. However, our studies suggest that this region could form part of the plasma ring surrounding the Earth. We discuss the possibility of using the results found here to explain the ring-like shape of the auroral oval, the location of the injection boundary inside the magnetosphere near the geostationary orbit, presence of quiet auroral arcs in the auroral oval despite the constantly high level of turbulence observed in the plasma sheet, and some features of the onset of substorm expansion.

Current assessment of integrated content of long-lived radionuclides in soils of the head part of the East Ural Radioactive Trace.

Based on the datasets obtained during investigations from 2003 to 2012, the spatial distributions of (90)Sr, (137)Cs, and (239,240)Pu content in the soils of the head part of the East Ural Radioactive Trace (EURT) were mapped using the geographic information system ArcGIS. Taking into account the presence of spatial autocorrelation and anisotropy in the source data, an ordinary kriging method was applied to interpolate values of radionuclide contamination density at unsampled places. Further geostatistical data analysis was performed to determine the basic parameters of spatial dependencies and to integrally assess the contamination by long-lived radionuclides in soils of the central, east peripheral, and west peripheral parts of the trace. This analysis was based on simplified geometric models (sector- and rectangle-shaped areas). The Monte Carlo method was used to quantitatively assess the uncertainty of the values for the integrated quantities resulting from the statistical errors of the source data approximation.

[Clinical and hygienic substantiation of individual biocorrection for ecologically dependent conditions in the critical groups of the population of Ukrainian industrial areas].

In the article there is considered the problem of pollution of the environment and human body with heavy metals, the effectiveness of individual biocorrection in critical groups of the population--pregnant women and children residing in technologically contaminated areas. In spite of the correspondence of the content of abiotic heavy metals to their MACs in the environment, the concentration of lead and cadmium in the internal environment of the organism in 1,6-15,4 times was found to exceed physiological norms that accompanied by a significant deficiency of essential trace elements. Similar situation has been proved to lead to a reduction in mental health and ability to learn in children, as well as to the various complications in pregnancy. The obtained results served as the scientific substantiation of the feasibility of biocorrection of the trace element imbalance ecological dependent states in the population of the industrial region. The proved high clinical effectiveness of this hygienic biocorrection is a scientific justification for widespread introduction of pectin preparations for health promotion, prevention of ecologically dependent states and increasing the adaptive capacity of the organism.

[Clinical hygienic substantiation for the individual biocorrection of ecologically dependent conditions in the critical population groups industrial areas of Ukraine].

In the article there is considered the problem of environmental and human body pollution with heavy metals, the effectiveness of individual biocorrection in critical population groups--pregnant females and children residing in technologically contaminated areas. It was established that, in spite of the correspondence of the content of abiotic heavy metals to their MACs in the environment, the concentration of lead and cadmium in the internal environment of the organism is 1,6-15,4 times larger than physiological norms and accompanied by substantial deficiency of essential trace elements. The similar situation in children was proved to cause the fall in mental capacity and learning ability, in pregnant females--to various complications. The obtained results were the scientific substantiation for the feasibility of performing of biocorrection for trace elements imbalance and ecologically dependent conditions in the population of the industrial region, proved its high clinical and hygienic efficiency, which is the basis for the wide introduction of pectin containing preparations with the aim to enforce the health, prevent ecologically dependent conditions and increasing the adaptive capacity of the organism.

The healthcare and societal burden associated with influenza in vaccinated and unvaccinated European and Israeli children.

Few data exist regarding the healthcare and societal burden of culture-confirmed influenza illness in European and Israeli children. The current analysis describes this burden in vaccinated and unvaccinated children 2-17 years of age. Healthcare and societal burden outcomes were prospectively collected for culture-confirmed influenza illness in three previous randomized studies: a study of live attenuated influenza vaccine (LAIV) versus placebo in children aged <48 months attending day care (N = 846-973), and studies of LAIV versus inactivated influenza vaccine (IIV) in children aged <72 months with recurrent respiratory infections (N = 1,609) and in children aged 6-17 years with asthma (N = 2,211). The incidence of each endpoint among enrolled subjects and subjects with influenza was determined by treatment group and by country. Among subjects with influenza, 57-91% missed school or day care, 45-90% used non-antibiotic medications, 29-55% of parents missed work, 17-55% used antibiotics, 11-62% had additional provider visits, and 9-20% had acute otitis media. Where evaluated, rates of outcomes were generally similar between countries. Among all children enrolled, LAIV recipients missed 324-902 and 150 fewer days of day care per 1,000 children than those of placebo and IIV recipients, respectively; parents of LAIV recipients missed 197-340 and 76 fewer days of work per 1,000 children than those of placebo and IIV recipients, respectively. Influenza illness in European and Israeli children 2-17 years of age resulted in a considerable absenteeism and healthcare utilization that was similar across the countries studied. These data underscore the potential benefits of annual vaccination of children against influenza.