[Emergency laparoscopy in the treatment of perforated gastroduodenal ulcers]. / Ekstrennaya laparoskopiya pri lechenii perforativnykh gastroduodenal'nykh yazv.

OBJECTIVE: To compare the results of endoscopic and open treatment of perforated gastroduodenal ulcers. MATERIAL AND METHODS: There were 445 patients with perforated gastroduodenal ulcers between 2013 and 2021. Endoscopic suturing of perforation was performed in 172 patients (38.7%), 273 ones underwent open surgery. RESULTS: Among 172 patients scheduled for endoscopy, 160 (93.6%) ones underwent laparoscopic suturing of perforation. Morbidity rate was 5.0% (n=8), postoperative mortality rate - 1.3% (n=2). Comparison of the outcomes after laparoscopic suturing of ulcers in 160 patients and open surgery in 134 patients showed that laparoscopy was followed by 2.5 times lower incidence of complications and 3 times lower postoperative mortality. CONCLUSION: Diagnostic laparoscopy is advisable in patients with perforated ulcers and no contraindications. In most cases, surgery can be successfully and effectively completed without conversion to laparotomy. Endoscopic closure of ulcerative defect is preferable since this procedure has certain advantages over traditional intervention, contributes to significant reduction in morbidity, mortality and hospital-stay.

Topological structures in chiral media: Effects of confined geometry.

We theoretically study orientational structures in chiral magnetics and cholesteric liquid crystal (CLC) nanosystems confined in the slab geometry. Our analysis is based on the model that, in addition to the exchange and the Dzyaloshinskii-Moriya interactions, takes into account the bulk and surface anisotropies. In CLC films, these anisotropies describe the energy of interaction with external magnetic/electric field and the anchoring energy assuming that magnetic/electric anisotropy is negative and the boundary conditions are homeotropic. We have computed the phase diagram and found that the ground state of the film is represented by various delocalized structures depending on the bulk and surface anisotropy parameters, κ^{b} and κ^{s}. These include the z helix and the z cone states, the oblique, and the x helicoids. The minimum energy paths connecting the ground state and metastable helicoids and the energy barriers separating these states are evaluated. We have shown that there is a variety of localized topological structures such as the skyrmion tube, the toron, and the bobber that can be embedded in different ground states including the z cone (conical phase) and tilted fingerprint states. We have also found the structure called the leech that can be viewed as an intermediate state between the toron and the skyrmion tube.

[Molecular monitoring of the rotavirus (Reoviridae: Sedoreovirinae: Rotavirus: Rotavirus A) strains circulating in Nizhny Novgorod (2012-2020): detection of the strains with the new genetic features].

INTRODUCTION: The pentavalent rotavirus vaccine has been registered in Russia, however, the vaccination coverage remains low, and an annual increase in the incidence of rotavirus infection is unavoidable. In this regard, molecular monitoring of rotaviruses in order to search for new variants possessing epidemic potential is an urgent task. MATERIAL AND METHODS: PCR genotyping and VP4 and VP7 genes sequencing were used to characterize rotaviruses circulating in Nizhny Novgorod in 2012-2020. The phylogenetic analysis of the strains was carried out using the BEAST software package. RESULTS: The spectrum included 17 genotypes with predominance of G9P[8] (37,4%). Detected in this study genotypes G1P[4], G1P[9], G2P[8], G4P[4], G4P[6], G8P[8], and G9P[4] were not previously identified in Nizhny Novgorod. The circulation of DS-1-like strains possessing genotypes G1P[8], G3P[8], G8P[8], or G9P[8] and a short RNA pattern had been shown. Rotaviruses of the common genotypes were genetically heterogeneous and belonged to different phylogenetic lineages and/or sublineages (P[4]-IV-a; P[4]-IV-b; P[8]-3.1; P[8]-3.3; P[8]-3.4 and P[8]-3.6; G1-I; G1-II; G2-IVa-1; G2-IVa-3; G3-1; G3-3; G4-I-c; G9-III; G9-VI). DISCUSSION: These results extend the available data on the genotypic structure of rotavirus populations in Russia and show the genetic diversity of viral strains. G3P[8] DS-1-like viruses were representatives of the G3-1 lineage, new for the territory of Russia, and had the largest number of amino acid substitutions in the VP7 antigenic epitopes. CONCLUSION: The emergence and spread of strains with new genetic features may allow rotavirus to overcome the immunological pressure formed by natural and vaccine-induced immunity, and maintain or increase the incidence of rotavirus infection.

Insitu magnesium calcium phosphate cements formation: From one pot powders precursors synthesis to in vitro investigations.

Calcium phosphate cements are of great interest for researchers and their applications in medical practice expanded. Nevertheless, they have a number of drawbacks including the insufficient level of mechanical properties and low degradation rate. Struvite (MgNH4PO4) -based cements, which grew in popularity in recent years, despite their neutral pH and acceptable mechanical performance, release undesirable NH4 + ions during their resorption. This issue could be avoided by replacement of ammonia ions in the cement liquid with sodium, however, such cements have a pH values of 9-10, leading to cytotoxicity. Thus, the main goal of this investigation is to optimize the composition of cements to achieve the combination of desirable properties: neutral pH, sufficient mechanical properties, and the absence of cytotoxicity, applying Na2HPO4-based cement liquid. For this purpose, cement powders precursors in the CaO-MgO-P2O5 system were synthesized by one-pot process in a wide composition range, and their properties were investigated. The optimal performance was observed for the cements with (Ca + Mg)/P ratio of 1.67, which are characterized by newberyite phase formation during setting reaction, pH values close to 7, sufficient compressive strength up to 22 ± 3 MPa (for 20 mol.% of Mg), dense microstructure and adequate matrix properties of the surface. This set of features make those materials promising candidates for medical applications.

Screening of familial hypercholesterolemia among patients in age under 40 years old exposed by duplex scanning of carotid arteries, by the local registry data.

AIM: To identify patients with probable FH among Duplex-2013 registry patients under the age of 40 years, to analyze their lipid spectrum and duplex carotid artery data, to evaluate the changes of their lipid spectrum parameters. MATERIALS AND METHODS: The Duplex-2013 registry database was used for this study (n=2550). Patients under the age of 40 years were selected for follow-up analysis (n=192). RESULTS: 20 of them were selected on the basis of Simon Broome criteria as patients with possible FH. The FH group (n=20) and the control group (n=172) had significant differences in age (35.1 ± 4.01 vs. 32.62 ± 5.29, p=0.044), male gender (18 of 20 (90%) vs 92 of 172 (53%), p=0.003), TC (7.64 ± 0.63 vs 5.34 ± 0.91, p=0.0001) and LDL-C cholesterol (5.45 ± 0.62 vs 3.28 ± 0.78, p=0.00001). When comparing the groups by the combined criterion of atherosclerosis (IMT > 1.0 mm and / or atherosclerotic plaque in the carotid artery >20%), it was noted that signs of carotid atherosclerosis were more often recorded in the FH group compared with the control group (40% vs 26%). Repeated laboratory studies of TC and LDL-C in the FH group after 2.5 years showed their significant dynamics (7.64 ± 0.63 vs 6.03 ± 1.04, p=0.007, 5.45 ± 0.63 vs 3.84 ± 1.24, p=0.035). CONCLUSION: The frequency of detection of FH in the cohort study was 1:10 (11% of all patients). Thus, patients referred for duplex scanning of carotid arteries can be a potential target for screening for FH.

Equilibrium Skyrmion Lattice Ground State in a Polar Easy-plane Magnet.

The skyrmion lattice state (SkL), a crystal built of mesoscopic spin vortices, gains its stability via thermal fluctuations in all bulk skyrmion host materials known to date. Therefore, its existence is limited to a narrow temperature region below the paramagnetic state. This stability range can drastically increase in systems with restricted geometries, such as thin films, interfaces and nanowires. Thermal quenching can also promote the SkL as a metastable state over extended temperature ranges. Here, we demonstrate more generally that a proper choice of material parameters alone guarantees the thermodynamic stability of the SkL over the full temperature range below the paramagnetic state down to zero kelvin. We found that GaV4Se8, a polar magnet with easy-plane anisotropy, hosts a robust Néel-type SkL even in its ground state. Our supporting theory confirms that polar magnets with weak uniaxial anisotropy are ideal candidates to realize SkLs with wide stability ranges.

Edge states and skyrmion dynamics in nanostripes of frustrated magnets.

Magnetic skyrmions are particle-like topological excitations recently discovered in chiral magnets. Their small size, topological protection and the ease with which they can be manipulated by electric currents generated much interest in using skyrmions for information storage and processing. Recently, it was suggested that skyrmions with additional degrees of freedom can exist in magnetically frustrated materials. Here, we show that dynamics of skyrmions and antiskyrmions in nanostripes of frustrated magnets is strongly affected by complex spin states formed at the stripe edges. These states create multiple edge channels which guide the skyrmion motion. Non-trivial topology of edge states gives rise to complex current-induced dynamics, such as emission of skyrmion-antiskyrmion pairs. The edge-state topology can be controlled with an electric current through the exchange of skyrmions and antiskyrmions between the edges of a magnetic nanostructure.

Chiral Surface Twists and Skyrmion Stability in Nanolayers of Cubic Helimagnets.

Theoretical analysis and Lorentz transmission electron microscopy (LTEM) investigations in an FeGe wedge demonstrate that chiral twists arising near the surfaces of noncentrosymmetric ferromagnets [Meynell et al., Phys. Rev. B 90, 014406 (2014)] provide a stabilization mechanism for magnetic Skyrmion lattices and helicoids in cubic helimagnet nanolayers. The magnetic phase diagram obtained for freestanding cubic helimagnet nanolayers shows that magnetization processes differ fundamentally from those in bulk cubic helimagnets and are characterized by the first-order transitions between modulated phases. LTEM investigations exhibit a series of hysteretic transformation processes among the modulated phases, which results in the formation of the multidomain patterns.

Time Dependence of the Electron and Positron Components of the Cosmic Radiation Measured by the PAMELA Experiment between July 2006 and December 2015.

Cosmic-ray electrons and positrons are a unique probe of the propagation of cosmic rays as well as of the nature and distribution of particle sources in our Galaxy. Recent measurements of these particles are challenging our basic understanding of the mechanisms of production, acceleration, and propagation of cosmic rays. Particularly striking are the differences between the low energy results collected by the space-borne PAMELA and AMS-02 experiments and older measurements pointing to sign-charge dependence of the solar modulation of cosmic-ray spectra. The PAMELA experiment has been measuring the time variation of the positron and electron intensity at Earth from July 2006 to December 2015 covering the period for the minimum of solar cycle 23 (2006-2009) until the middle of the maximum of solar cycle 24, through the polarity reversal of the heliospheric magnetic field which took place between 2013 and 2014. The positron to electron ratio measured in this time period clearly shows a sign-charge dependence of the solar modulation introduced by particle drifts. These results provide the first clear and continuous observation of how drift effects on solar modulation have unfolded with time from solar minimum to solar maximum and their dependence on the particle rigidity and the cyclic polarity of the solar magnetic field.

Three-dimensional chiral skyrmions with attractive interparticle interactions.

We introduce a new class of isolated three-dimensional skyrmion that can occur within the cone phase of chiral magnetic materials. These novel solitonic states consist of an axisymmetric core separated from the host phase by an asymmetric shell. These skyrmions attract one another. We derive regular solutions for isolated skyrmions arising in the cone phase of cubic helimagnets and investigate their bound states.

[CHANGES IN THE AREA OF THE WOUND SURFACE ON EXPOSURE LOW­DOSE VACUUM].

Results of treatment of were analysed 30 patients over a long non­healing wounds and trophic ulcers, in which as a topical treatment, the method of vacuum therapy was applied. To study the activity of reparative regeneration in the wound using a dynamic method of determining the area of wounds using lqSquare computer program and immunohistochemical method for determining the Ki 67 positive cells in tissues of near wound area. It was found that low­dose exposure to vacuum at the wound contributed to increase the proliferative activity of tissues of near wound area and reduce the area of wound defect. Assessment of changes in the area of the wound surface is an important predictor of treatment efficacy, prevention of complications.

[[Morpho-functional peculiarities of course of purulent-septic wound process while impact of a low-dosed vacuum].]

Morpho-functional peculiarities of course of the purulent-septic wound process, while vacuum-therapy method application for local treatment of the wounds, were studied. High reparative effect of vacuum-therapy, caused by activation of the wound proliferative processes, was noted, It had permitted to improve the patients treatment results for purulent surgical diseases of soft tissues, to lower the rate of complications and reoperations and to improve their quality of life.

New upper limit on strange quark matter abundance in cosmic rays with the PAMELA space experiment.

In this work we present results of a direct search for strange quark matter (SQM) in cosmic rays with the PAMELA space spectrometer. If this state of matter exists it may be present in cosmic rays as particles, called strangelets, having a high density and an anomalously high mass-to-charge (A/Z) ratio. A direct search in space is complementary to those from ground-based spectrometers. Furthermore, it has the advantage of being potentially capable of directly identifying these particles, without any assumption on their interaction model with Earth's atmosphere and the long-term stability in terrestrial and lunar rocks. In the rigidity range from 1.0 to ∼1.0×10^{3} GV, no such particles were found in the data collected by PAMELA between 2006 and 2009. An upper limit on the strangelet flux in cosmic rays was therefore set for particles with charge 1≤Z≤8 and mass 4≤A≤1.2×10^{5}. This limit as a function of mass and as a function of magnetic rigidity allows us to constrain models of SQM production and propagation in the Galaxy.

Multiply periodic states and isolated skyrmions in an anisotropic frustrated magnet.

Multiply periodic states appear in a wide variety of physical contexts, such as the Rayleigh-Bénard convection, Faraday waves, liquid crystals and skyrmion crystals recently observed in chiral magnets. Here we study the phase diagram of an anisotropic frustrated magnet which contains five different multiply periodic states including the skyrmion crystal. We clarify the mechanism for stabilization of these states and discuss how they can be observed in magnetic resonance and electric polarization measurements. We also find stable isolated skyrmions with topological charge 1 and 2. Their spin structure, interactions and dynamics are more complex than those in chiral magnets. In particular, magnetic resonance in the skyrmion crystal should be accompanied by oscillations of the electric polarization with a frequency depending on the amplitude of the a.c. magnetic field. These results show that skyrmion materials with rich physical properties can be found among frustrated magnets. We formulate rules to help the search.

Time dependence of X-ray polarizability of a crystal induced by an intense femtosecond X-ray pulse.

The time evolution of the electron density and the resulting time dependence of Fourier components of the X-ray polarizability of a crystal irradiated by highly intense femtosecond pulses of an X-ray free-electron laser (XFEL) is investigated theoretically on the basis of rate equations for bound electrons and the Boltzmann equation for the kinetics of the unbound electron gas. The photoionization, Auger process, electron-impact ionization, electron-electron scattering and three-body recombination have been implemented in the system of rate equations. An algorithm for the numerical solution of the rate equations was simplified by incorporating analytical expressions for the cross sections of all the electron configurations in ions within the framework of the effective charge model. Using this approach, the time dependence of the inner shell populations during the time of XFEL pulse propagation through the crystal was evaluated for photon energies between 4 and 12 keV and a pulse width of 40 fs considering a flux of 10(12) photons pulse(-1) (focusing on a spot size of ∼1 µm). This flux corresponds to a fluence ranging between 0.8 and 2.4 mJ µm(-2). The time evolution of the X-ray polarizability caused by the change of the atomic scattering factor during the pulse propagation is numerically analyzed for the case of a silicon crystal. The time-integrated polarizability drops dramatically if the fluence of the X-ray pulse exceeds 1.6 mJ µm(-2).

Theory of skyrmion states in liquid crystals.

Within the Oseen-Frank theory we derive numerically exact solutions for axisymmetric localized states in chiral liquid crystal layers with homeotropic anchoring. These solutions describe recently observed two-dimensional skyrmions in confinement-frustrated chiral nematics [P. J. Ackerman et al., Phys. Rev. E 90, 012505 (2014)]. We stress that these solitonic states arise due to a fundamental stabilization mechanism responsible for the formation of skyrmions in cubic helimagnets and other noncentrosymmetric condensed-matter systems.

Cosmic-ray positron energy spectrum measured by PAMELA.

Precision measurements of the positron component in the cosmic radiation provide important information about the propagation of cosmic rays and the nature of particle sources in our Galaxy. The satellite-borne experiment PAMELA has been used to make a new measurement of the cosmic-ray positron flux and fraction that extends previously published measurements up to 300 GeV in kinetic energy. The combined measurements of the cosmic-ray positron energy spectrum and fraction provide a unique tool to constrain interpretation models. During the recent solar minimum activity period from July 2006 to December 2009, approximately 24,500 positrons were observed. The results cannot be easily reconciled with purely secondary production, and additional sources of either astrophysical or exotic origin may be required.

Confinement of chiral magnetic modulations in the precursor region of FeGe.

We report on magnetic susceptibility and specific heat measurements of the cubic helimagnet FeGe in external magnetic fields and temperatures near the onset of long-range magnetic order at TC = 278.2(3) K. Pronounced anomalies in the field-dependent χac(H) data as well as in the corresponding imaginary part χ''ac(H) reveal a precursor region around TC in the magnetic phase diagram. The occurrence of a maximum at T0 = 279.6 K in the zero-field specific heat data indicates a second-order transition into a magnetically ordered state. A shoulder evolves above this maximum as a magnetic field is applied. The field dependence of both features coincides with crossover lines from the field-polarized to the paramagnetic state deduced from χac(T) at constant magnetic fields. The experimental findings are analyzed within the standard Dzyaloshinskii theory for cubic helimagnets. The remarkable multiplicity of modulated precursor states and the complexity of the magnetic phase diagram near the magnetic ordering are explained by the change of the character of solitonic inter-core interactions and the onset of specific confined chiral modulations in this area.

Precursor phenomena at the magnetic ordering of the cubic helimagnet FeGe.

We report on detailed magnetic measurements on the cubic helimagnet FeGe in external magnetic fields and temperatures near the onset of long-range magnetic order at T(C)=278.2(3) K. Precursor phenomena display a complex succession of temperature-driven crossovers and phase transitions in the vicinity of T(C). The A-phase region, present below T(C) and fields H<0.5 kOe, is split in several pockets. The complexity of the magnetic phase diagram is theoretically explained by the confinement of solitonic kinklike or Skyrmionic units that develop an attractive and oscillatory intersoliton coupling owing to the longitudinal inhomogeneity of the magnetization.

Cosmic-ray electron flux measured by the PAMELA experiment between 1 and 625 GeV.

Precision measurements of the electron component in the cosmic radiation provide important information about the origin and propagation of cosmic rays in the Galaxy. Here we present new results regarding negatively charged electrons between 1 and 625 GeV performed by the satellite-borne experiment PAMELA. This is the first time that cosmic-ray e⁻ have been identified above 50 GeV. The electron spectrum can be described with a single power-law energy dependence with spectral index -3.18 ± 0.05 above the energy region influenced by the solar wind (> 30 GeV). No significant spectral features are observed and the data can be interpreted in terms of conventional diffusive propagation models. However, the data are also consistent with models including new cosmic-ray sources that could explain the rise in the positron fraction.