[The present-day epidemiology: challenges of public health and possibilities to settle them: the publications review].

Actually, the epidemiology is a dynamically developing medical science located at the intersection of social and biological branches of knowledge and bio-informatics. The new sources of data, the new methods create unique opportunities for epidemiologist. The number of epidemiological studies carrying out at the junction of several adjacent disciplines is increasing that requires harmonious interaction of specialists of different branches of medical knowledge. The change of the structure of global mortality towards chronic non-communicable diseases significantly affected the vector of epidemiological studies. Many interventional epidemiological projects are targeted to evaluation of effectiveness of new methods of prevention of cardiovascular, metabolic and oncological diseases. However, in recent years, the fight against unremembered infections affecting about 1 billion of people and taking away lives of 0.5 million people annually gained new importance. The current COVID-19 pandemic also affected epidemiology of communicable and chronic non-communicable diseases. Great attention is also currently attended to studying influence of social, economic and environmental factors on human health. The increase of average life expectancy of population contributes to development of epidemiology of the elderly. The new projects are initiated in the field of pharmacoepidemiology targeted to studying effectiveness of medications. The review of national and foreign publications considering current trends and achievements in the field of epidemiology. The reference retrieval engines such as PubMed, Google Scholar, CyberLeninka were used. The current directions of epidemiological research are analyzed. The challenges and development prospects of development of modern epidemiology are highlighted.

[Treatment of toxic hepatitis in COVID-19 patients].

BACKGROUND: The article reflects the clinical significance of the early diagnosis of toxic hepatitis in patients who have undergone a new coronavirus infection with the determination of clinical and laboratory predictors of the response to therapy. A dynamic analysis of the effectiveness of toxic hepatitis therapy in patients of three experimental groups and a control group is presented. AIM: The aim of the present study is to increase the effectiveness of the treatment of toxic hepatitis in patients who have undergone COVID-19. MATERIALS AND METHODS: On the basis of the newly created infection centers of the Central Clinical Hospital "RZhD-Medicine" and Vishnevsky 3-rd Central Military Clinical Hospital 996 patients with COVID-19, who had clinical and laboratory signs of toxic liver damage (cytolytic and/or cholestatic syndromes) against the background of COVID-19 therapy. RESULTS: On the 14th day from the start of therapy in group 3, there was a significant decrease in the clinical manifestations of jaundice in 163 (72.8%) patients, on the 21st day of treatment, this symptom was stopped in all patients. In groups 1 and 2, the decrease in clinical manifestations of jaundice was significantly lower - 122 (55.2%) and 134 (58.8%); p<0.05. At the end of therapy, no manifestations of jaundice were observed in all experimental groups, while in the control group, symptom reduction was achieved only in 47 (14.5%) patients. CONCLUSION: The use of drugs with hepatoprotective effect in the form of monotherapy in groups 1 (UDCA) and 2 (ademethionine) showed a low therapeutic effect with positive dynamics of clinical and laboratory indicators of toxic hepatitis activity. The use of combined treatment in group 3 (UDCA and ademethionine) demonstrated the maximum therapeutic effect, pronounced positive dynamics in the form of normalization of clinical and laboratory indicators of toxic hepatitis activity.

[Results of the implementation of measures aimed at improving medical care for patients with vascular diseases in the Tomsk region]. / Itogi realizatsii meropriyatii, napravlennykh na sovershenstvovanie meditsinskoi pomoshchi bol'nym s sosudistymi zabolevaniyami na territorii Tomskoi oblasti.

OBJECTIVE: To study the dynamics of population indicators: the total number of deaths from diseases of the circulatory system, coronary heart disease, cerebrovascular diseases and strokes, hospitalization profile for strokes, their structure and mortality in the Tomsk region for several years in comparison with these indicators for the Russian Federation and the Siberian Federal District. MATERIAL AND METHODS: A retrospective study was conducted using acute cerebrovascular accidents monitoring data and data of the Territorial body of state statistics of the Tomsk region in comparison with the literature data. The indicators of all causes of death, from circulatory diseases, coronary heart disease, cerebrovascular diseases and stroke in the territory of the Tomsk region, profile of hospitalization, structure of acute cerebrovascular accidents were analyzed for several years. Particular attention was paid to case fatality rate, one of the key indicators of the effectiveness of the system of care for patients with stroke. RESULTS: Typical for many regions of the Russian Federation predominance of chronic forms in the structure of mortality from circulatory diseases, the absence of significant differences in the structure of strokes, as well as the features of the Tomsk region in the form of high levels of hospitalization profile and hospital case fatality rate, were revealed. The dependence of hospital mortality on logistics is shown, on the basis of which assumptions are made about the possible causes of high fatality rates in the region: excessive centralization of the system of vascular centers and the absence of really working mechanisms for timely reevacuation from them. CONCLUSION: To bring chronic circulatory diseases structure in line with international standards, it is necessary to regulate the rules for formulating and coding diagnoses. In order to reduce hospital fatality rates in the Tomsk region, it is necessary to carry out organizational measures: opening a primary vascular department in the area of responsibility of the regional stroke center, as well as strengthening rehabilitation and palliative services for the timely reevacuation of patients from vascular centers.

[Assessment of the levels of neuron-specific enolase and BDNF at the stages of rehabilitation in the acute and early recovery periods of ischemic stroke]. / Otsenka urovnei neironspetsificheskoi enolazy i mozgovogo neirotroficheskogo faktora na etapakh reabilitatsii v ostrom i rannem vosstanovitel'nom periodakh ishemicheskogo insul'ta.

BACKGROUND: The issue of the diagnostic significance and clinical value of neuron-specific enolase (NSE) and brain-derived neurotropic factor (BDNF) in the acute period of stroke remains controversial. Therefore, it is advisable to study the correlation of biomarkers with the clinical characteristics of stroke in the time period of early recovery. OBJECTIVE: To monitor NSE and BDNF levels in peripheral blood, to analyze the clinical and laboratory correlations in patients with ischemic stroke at the stages of medical rehabilitation in the early recovery period. MATERIAL AND METHODS: Forty-nine patients with ischemic stroke in the middle cerebral artery were examined. The observation period is 90 days. Observation Points are Day 1; Day 14; Day 45; Day 90. The National Institute of Health Stroke Scale (NIHSS), the Fugle-Meyer Scale (FMA), the Modified Rankin Scale (mRS) were administered. NSE was determined in blood serum by enzyme-linked immunosorbent assay, BDNF was analyzed on a multiplex analyzer. RESULTS AND CONCLUSION: NSEDay1 in patients was significantly higher than in the comparison group (pDay1-comparison group<0.001) with a trend to a maximum decrease on the 90th day of stroke (pDay1-90<0.001). BDNFDay1 turned out to be lower than in the comparison group (pDay1-comparison group=0.006) and significantly increased by the 14th day of the stroke (pDay1-14<0.001; pDay14-comparison group=0.637). A negative correlation was found between a decrease in NSEDay14 and an increase in BDNFDay14 (r= -0.349; p=0.05). A positive correlation was found between an increase in BDNFDay14 and a decrease in mRS scores Day90 (r=0.499, p=0.035). Outcomes in patients in group 1 (after stages I and II of rehabilitation) on the assessment scales were significantly better than in patients discharged after stage I for outpatient monitoring - group 2 (p<0.05). In group 1, BDNFDay90 did not differ from BDNFDay14 (pDay14-90-Group1=0.17), and in group 2 it was significantly lower by the end of the early recovery period (pDay14-90-Group2=0.002).

Zinc Switch in Pig Heart Lipoamide Dehydrogenase: Steady-State and Transient Kinetic Studies of the Diaphorase Reaction.

Elevation of intracellular Zn2+ following ischemia contributes to cell death by affecting mitochondrial function. Zn2+ is a differential regulator of the mitochondrial enzyme lipoamide dehydrogenase (LADH) at physiological concentrations (Ka = 0.1 µM free zinc), inhibiting lipoamide and accelerating NADH dehydrogenase activities. These differential effects have been attributed to coordination of Zn2+ by LADH active-site cysteines. A detailed kinetic mechanism has now been developed for the diaphorase (NADH-dehydrogenase) reaction catalyzed by pig heart LADH using 2,6-dichlorophenol-indophenol (DCPIP) as a model quinone electron acceptor. Anaerobic stopped-flow experiments show that two-electron reduced LADH is 15-25-fold less active towards DCPIP reduction than four-electron reduced enzyme, or Zn2+-modified reduced LADH (the corresponding values of the rate constants are (6.5 ± 1.5) × 103 M-1·s-1, (9 ± 2) × 104 M-1·s-1, and (1.6 ± 0.5) × 105 M-1·s-1, respectively). Steady-state kinetic studies with different diaphorase substrates show that Zn2+ accelerates reaction rates exclusively for two-electron acceptors (duroquinone, DCPIP), but not for one-electron acceptors (benzoquinone, ubiquinone, ferricyanide). This implies that the two-electron reduced form of LADH, prevalent at low NADH levels, is a poor two-electron donor compared to the four-electron reduced or Zn2+-modified reduced LADH forms. These data suggest that zinc binding to the active-site thiols switches the enzyme from one- to two-electron donor mode. This zinc-activated switch has the potential to alter the ratio of superoxide and H2O2 generated by the LADH oxidase activity.

[Clinical efficacy of neurometabolic therapy of dissomical disorders in asthenic syndrome]. / Klinicheskaia éffektivnost' neirometabolicheskoi terapii dissomnicheskikh rasstroistv pri astenicheskom sindrome.

AIM: To analyze the efficacy of cytoflavin in the complex treatment of sleep disorders in asthenic syndrome. MATERIAL AND METHODS: One hundred patients with sleep disorders and asthenic syndrome of various etiology and severity were studied. The patients were divided into three groups depending on the type of therapy: the first group received intravenous infusions of cytoflavin for 10 days; the second group, in addition to cytoflavin, received per os melatonin (3 mg or 5 mg) at bedtime; the third group in addition to cytoflavin received per os zopiclone (7.5 mg) at bedtime. RESULTS: On the 14th day of the study, a decrease in severity or complete relief of asthenia manifestations (according to the SHAS scale) and, accordingly, improvement or normalization of sleep in 97% of patients was found. At the same time, during polysomnographic study, the data obtained are characteristic for improving the quality of sleep phases mainly in the first and second groups of patients and, to a lesser extent, in the third group. CONCLUSION: Cytoflavin effectively suppresses the main manifestations of asthenic syndrome, including sleep disorders.

[The choice of antibiotic according the results of standard bacteriological analysis and express-method without isolation of pure cultures.]

The efficiency of choosing antibiotics using two methods was analyzed. The first method is based on standard laboratory analysis including isolation of pure cultures of prospective agent and detection of their individual sensitivity to antibiotics. The second method is based on a new express-technique permitting to simultaneously evaluate effect of pharmaceuticals on cultivated and not cultivated yet bacteria without isolation of pure cultures. At that, the second method permits to determine efficiency of antibiotics namely in those concentrations that can be made in the given nidus of infection. The study demonstrated existence of discrepancy between results obtained by using the given methods. The cause of discrepancy can be presence of not cultivated yet bacteria in pathologic sample. In favor of this assumption testify the received data concerning samples from patients where were presented a significant number of spore-former bacteria having additional mechanisms of resistance to antibiotics. Furthermore, the implemented study established antibiotics characterized by the greatest discrepancy of results obtained by applied methods that indicates the necessity of revision of schemes of implementation of start or empiric therapy.

[Evaluating the effectiveness of the new mouthguard design in athletes involved in power sports]. / Otsenka effektivnosti primeneniya novoi konstruktsii zubnoi shiny u sportsmenov, zanimayushchikhsya silovymi vidami sporta.

The aim of the study was to assess the effectiveness of the new mouthguard design for functional rehabilitation of dental system in athletes involved in contact power sports. The functional state of dental system was evaluated by interferential electromyography of masticatory muscles and Doppler ultrasound examination of periodontal tissues. Before mouthguard use the asynchrony of masticatory muscles was seen which was released after the mouthguard application: electromyographic activity of the left and right masticatory muscles was balanced and the decrease in biopotentials amplitude was found out. The mouthguard also caused no functional disorders in periodontal tissues.

Inhomogeneity of charge-density-wave order and quenched disorder in a high-Tc superconductor.

It has recently been established that the high-transition-temperature (high-Tc) superconducting state coexists with short-range charge-density-wave order and quenched disorder arising from dopants and strain. This complex, multiscale phase separation invites the development of theories of high-temperature superconductivity that include complexity. The nature of the spatial interplay between charge and dopant order that provides a basis for nanoscale phase separation remains a key open question, because experiments have yet to probe the unknown spatial distribution at both the nanoscale and mesoscale (between atomic and macroscopic scale). Here we report micro X-ray diffraction imaging of the spatial distribution of both short-range charge-density-wave 'puddles' (domains with only a few wavelengths) and quenched disorder in HgBa2CuO4 + y, the single-layer cuprate with the highest Tc, 95 kelvin (refs 26-28). We found that the charge-density-wave puddles, like the steam bubbles in boiling water, have a fat-tailed size distribution that is typical of self-organization near a critical point. However, the quenched disorder, which arises from oxygen interstitials, has a distribution that is contrary to the usually assumed random, uncorrelated distribution. The interstitial-oxygen-rich domains are spatially anticorrelated with the charge-density-wave domains, because higher doping does not favour the stripy charge-density-wave puddles, leading to a complex emergent geometry of the spatial landscape for superconductivity.

An unusual high-spin ground state of Co3+ in octahedral coordination in brownmillerite-type cobalt oxide.

The crystal and magnetic structures of brownmillerite-like Sr(2)Co(1.2)Ga(0.8)O(5) with a stable Co(3+) oxidation state at both octahedral and tetrahedral sites are refined using neutron powder diffraction data collected at 2 K (S.G. Icmm, a = 5.6148(6) Å, b = 15.702(2) Å, c = 5.4543(6) Å; R(wp) = 0.0339, R(p) = 0.0443, χ(2) = 0.775). The very large tetragonal distortion of CoO(6) octahedra (1.9591(4) Å for Co-O(eq) and 2.257(6) Å for Co-O(ax)) could be beneficial for the stabilization of the long-sought intermediate-spin state of Co(3+) in perovskite-type oxides. However, the large magnetic moment of octahedral Co(3+) (3.82(7)µ(B)) indicates the conventional high-spin state of Co(3+) ions, which is further supported by the results of a combined theoretical and experimental soft X-ray absorption spectroscopy study at the Co-L(2,3) edges on Sr(2)Co(1.2)Ga(0.8)O(5). A high-spin ground state of Co(3+) in Sr(2)Co(1.2)Ga(0.8)O(5) resulted in much lower in comparison with a LaCoO(3) linear thermal expansion coefficient of 13.1 ppm K(-1) (298-1073 K) determined from high-temperature X-ray powder diffraction data collected in air.

[Prospects for the use of nanomaterials and high technology in dentistry. Part 1].

The paper presents the possibility of using biologically inert nanomaterials and high technology in prosthetic dentistry. Protective coating of nanostructured titanium VT1-00 magnetic elements of the locking system of removable dentures provides durability and biological inertness and high quality aesthetic design. In assessing the microstructure of titanium protective coating of ferromagnetic elements and samarium-cobalt magnets found that the nanocrystalline coating is formed, resistant to external influences, can significantly improve strength, technical and biological characteristics of samarium-cobalt magnets and ferromagnetic alloys. Fifteen patients were manufactured dentures with magnetic locks. The analysis of performance evaluation prosthetic treatment of patients with the use of the proposed prosthetic shows that the majority of patients (86.6%) obtained a good result. Patients registered restoration of aesthetic standards and the basic functions of dentition.

[Complex treatment approach in patients with lower jaw defects].

The aim of the study was to evaluate the clinical efficiency of modern materials in complex treatment of patients with lower jaw defects. The study demonstrates the advantages of biologically inert materials (carbon composite material "Uglekon-M" and titanium alloys) for lower jaw defect restoration.

Comparative analysis of cells with combined apoptosis and proliferation markers in thyroid tissue specimens from patients with cancer, adenoma, and autoimmune diseases.

Combined phenotypes of cells with membrane and intracellular expression of apoptosis and proliferation regulation markers (p53, bcl-2, CD95, CD95L, Ki-67) were studied by flow cytometry of cell suspension from thyroid tissue specimens from patients with autoimmune diseases, adenoma, and thyroid cancer. The incidence of cell groups with phenotypes p53/Ki-67, p53/CD95, bcl-2/Ki-67, bcl-2/CD95, CD95/Ki-67, p53/CD95L, CD95/CD95L, and bcl-2/CD95L was evaluated and the density of receptor distribution on/in each cell group are presented. Patients with autoimmune diseases had high incidence of cells with phenotypes p53/Ki-67, p53/CD95, bcl-2/Ki-67, bcl-2/CD95, CD95/Ki-67, p53/CD95L, CD95/CD95L, and bcl-2/CD95L; cells with the bcl-2/CD95 phenotype were the most incident. Patients with thyroid adenoma had high levels of cells with p53/CD95L phenotype, while patients with thyroid cancer had significantly lower levels of p53 expression in the p53/CD95L cell group. The density of CD95L receptors on CD95/CD95L-positive cells was 4-7-fold higher in patients with thyroid tumors; the density of CD95L receptors on CD95/CD95L cells was maximum in thyroid adenoma and minimum in thyroid cancer. These data indicate differences in the expression of apoptosis and proliferation markers in thyroid adenoma, cancer, and autoimmune diseases. Analysis of the expression of these markers in the above diseases can be useful for differential diagnosis.

Asymmetric bimodal accelerator cavity for raising rf breakdown thresholds.

We consider an axisymmetric microwave cavity for an accelerator structure whose eigenfrequency for its second lowest TM-like axisymmetric mode is twice that of the lowest such mode, and for which the fields are asymmetric along its axis. In this cavity, the peak amplitude of the rf electric field that points into either longitudinal face can be smaller than the peak field which points out. Computations show that a structure using such cavities might support an accelerating gradient about 47% greater than that for a structure using similar single-mode cavities, without an increase in breakdown probability.

Universal indirect enzyme-linked immunosorbent assay for monitoring of human and animal brucellosis in Kazakhstan.

Combinations of conventional serological methods and new ELISA procedures were evaluated to develop the most efficient and effective diagnostics for the detection of brucellosis in humans and animals. Sera from humans (n=249) and animals (n=99) were collected from brucellosis endemic areas (Zhambyl district and Enbekshi-Kazakh district of Almaty region in Kazakhstan) for serologic analysis. Sera from the humans reacted positively in the RBT (38.5%), SAT (43.3%), iELISA (42.5%) while sera from the animals reacted positively in RBT (79.8%), SAT (89.9%), CF (87.8%), iELISA (100%). Greater seropositivity was detected in animals as compared to human samples. All positive sera were also evaluated on an indirect ELISA (iELISA). Bacterial isolation was attempted on seropositive human sera. Our data indicate that the combination of conventional serological tests (SAT and CF), combined with the iELISA is optimal for the processing of large numbers of samples and the most efficient detection of human and animal brucellosis.

Anomalies in the Fermi surface and band dispersion of quasi-one-dimensional CuO chains in the high-temperature superconductor YBa2Cu4O8.

We have investigated the electronic states in quasi-one-dimensional CuO chains by microprobe angle resolved photoemission spectroscopy. We find that the quasiparticle Fermi surface consists of six disconnected segments, consistent with recent theoretical calculations that predict the formation of narrow, elongated Fermi surface pockets for coupled CuO chains. In addition, we find a strong renormalization effect with a significant kink structure in the band dispersion. The properties of this latter effect [energy scale (∼40 meV), temperature dependence, and behavior with Zn-doping] are identical to those of the bosonic mode observed in CuO2 planes of high-temperature superconductors, indicating they have a common origin.

[The assessment of the radiation quality of marine sediments].

The processes of ecosystems secondary pollution owing to interaction with bottom sediment are analyzed. Long-run consequences of contamination are investigated using the model describing the radionuclide migration dynamic in bottom sediment on account of transport processes due to diffusion and convection. Intricate bottom sediment forming procedure in water bodies of this kind is allowed. Model structure, numerical technique solution generation and analysis of results are represented.

Scanning tunneling spectroscopy in the superconducting state and vortex cores of the beta-pyrochlore KOs2O6.

We performed the first scanning tunneling spectroscopy measurements on the pyrochlore superconductor KOs2O6 (T(c)=9.6 K) in both zero magnetic field and the vortex state at several temperatures above 1.95 K. This material presents atomically flat surfaces, yielding spatially homogeneous spectra which reveal fully gapped superconductivity with a gap anisotropy of 30%. Measurements performed at fields of 2 and 6 T display a hexagonal Abrikosov flux line lattice. From the shape of the vortex cores, we extract a coherence length of 31-40 A, in agreement with the value derived from the upper critical field H(c2). We observe a reduction in size of the vortex cores (and hence the coherence length) with increasing field which is consistent with the unexpectedly high and unsaturated upper critical field reported.

[Relation between radiation safety criteria of human and the environment].

System approach is used for developing of procedures of complex radiation safety of human and the environment. Relation between radiation safety criteria of human and the environment is considered by the example of different strategies of water bodies using. It is demonstrated that as to water bodies (though the methodology and conclusions are correct to terrestrial ecosystems too) observance of human radiation safety standards on condition that environment resources are used unrestrictedly (considering radiation factor) is necessary and sufficient to protection of objects of the environment. It allows reaching compromise between anthropocentric and ecological approaches to radiation protection of the environment from general biospheric principles.

Environmental radioactivity studies and regulatory issues.

During the last decades, Russia has developed regulations applying to the territories affected by radioactive contamination. Some regulatory approaches appear to be quite ineffective and contradictory. This paper shows by means of examples the problems and issues associated with some existing situations. A better way for the future is indicated.