Non-fused nonfullerene acceptors with asymmetric benzo[1,2-b:3,4-b', 6,5-b"]trithiophene (BTT) central donor core and different acceptor terminal units for organic solar cells.

Here in, we have designed two new unfused non-fullerene small molecules based on asymmetric benzo[1,2-b:3.4-b', 6,5-b"]trithiophene (BTT) central donor core and different terminal units, i.e. 2-(3-oxo-2,3-dihydro-1H-inden-1-ylidene)malononitrile (NFA-4) and 1,3-diethyl-2-thioxodi hydropyrimidine-4,6(1H,5H)-dione (NFA-5) and their optical and electrochemical properties were investigated. Employing a wide band-gap copolymer D18, the binary D18: NFA-4 and D18:NFA-5 bulk heterojunction-based organic solar cells realized an overall power conversion efficiency of about 17.07% and 11.27 %, respectively. The higher value of power conversion efficiency for the NFA-4-based organic solar cells, as compared to the NFA-5 counterpart, is attributed to the enhanced values of short circuit current, open circuit voltage, and fill factor. After the incorporation of NFA-5 into the binary bulk heterojunction D18:NFA-4, the ternary organic solar cells attained a power conversion efficiency of 18.05 %, which is higher than that for the binary counterparts and attributed to the increased values of short circuit current, fill factor, and open circuit voltage. The increased value of short circuit current is associated with the effective utilization of excitons through the energy transfer from the NFA-5 to NFA-4 as the NFA-4 exhibits a more significant dipole moment than the NFA-5 and is effectively dissociated into a free charge carrier.

[Experience of using Experience of using NefroBest-N for rehabilitation of patients undergoing radical laparoscopic cystectomy].

AIM: To evaluate the efficacy and safety of NefroBest-N in patients undergoing to the radical cystectomy with neobladder formation. MATERIALS AND METHODS: A total of 60 patients with invasive bladder cancer aged 56 to 75 years, treated at A.I. Burnazyan SRC FMBC and at the M.A. Podgorbunsky Kuzbass linical Hospital of Emergency Medical Care in 2022, were included in randomized multicenter parallel group study. All patients underwent radical cystectomy with a formation of Studer neobladder. The main group included those who received the drug NefroBest-N, 1 capsule 2 times a day for 90 days. In the control group, only symptomatic therapy according to current standards was administered. The study consisted of a screening period of up to 4 days (Visit 1) and a period of 90+2 days to evaluate the efficiency of therapy, including 3 visits: day 14 (Visit 2), 30+2 days (Visit 3) and 90+2 days (Visit 4). Laboratory examination and imaging studies included biochemistry panel (urea, creatinine, K, Na, CRP), urinalysis (presence of mucus, leukocytes), urine culture (bacteriuria), physical examination, renal and neobladder ultrasound with determination of postvoid residual volume. In addition, evaluation of the quality of life was also performed. RESULTS: Evaluation of efficacy and safety of NefroBest-N was carried out. Administration of NefroBest-N resulted in a more rapid improvement of urinalysis, including a significant decrease in severity of leukocyturia and amount of mucus. In addition, degree of bacteriuria was reduced according to the urine culture. The quality of life was also improved. CONCLUSION: NefroBest-N has a favorable efficacy and safety profile. According to our experience, NefroBest-N significantly reduces recovery time and improves the quality of life of patients who have undergone radical cystectomy with a neobladder formation.

Energetic Electron Precipitation Driven by Electromagnetic Ion Cyclotron Waves from ELFIN's Low Altitude Perspective.

We review comprehensive observations of electromagnetic ion cyclotron (EMIC) wave-driven energetic electron precipitation using data collected by the energetic electron detector on the Electron Losses and Fields InvestigatioN (ELFIN) mission, two polar-orbiting low-altitude spinning CubeSats, measuring 50-5000 keV electrons with good pitch-angle and energy resolution. EMIC wave-driven precipitation exhibits a distinct signature in energy-spectrograms of the precipitating-to-trapped flux ratio: peaks at >0.5 MeV which are abrupt (bursty) (lasting ∼17 s, or ΔL∼0.56) with significant substructure (occasionally down to sub-second timescale). We attribute the bursty nature of the precipitation to the spatial extent and structuredness of the wave field at the equator. Multiple ELFIN passes over the same MLT sector allow us to study the spatial and temporal evolution of the EMIC wave - electron interaction region. Case studies employing conjugate ground-based or equatorial observations of the EMIC waves reveal that the energy of moderate and strong precipitation at ELFIN approximately agrees with theoretical expectations for cyclotron resonant interactions in a cold plasma. Using multiple years of ELFIN data uniformly distributed in local time, we assemble a statistical database of ∼50 events of strong EMIC wave-driven precipitation. Most reside at L∼5-7 at dusk, while a smaller subset exists at L∼8-12 at post-midnight. The energies of the peak-precipitation ratio and of the half-peak precipitation ratio (our proxy for the minimum resonance energy) exhibit an L-shell dependence in good agreement with theoretical estimates based on prior statistical observations of EMIC wave power spectra. The precipitation ratio's spectral shape for the most intense events has an exponential falloff away from the peak (i.e., on either side of ∼1.45 MeV). It too agrees well with quasi-linear diffusion theory based on prior statistics of wave spectra. It should be noted though that this diffusive treatment likely includes effects from nonlinear resonant interactions (especially at high energies) and nonresonant effects from sharp wave packet edges (at low energies). Sub-MeV electron precipitation observed concurrently with strong EMIC wave-driven >1 MeV precipitation has a spectral shape that is consistent with efficient pitch-angle scattering down to ∼ 200-300 keV by much less intense higher frequency EMIC waves at dusk (where such waves are most frequent). At ∼100 keV, whistler-mode chorus may be implicated in concurrent precipitation. These results confirm the critical role of EMIC waves in driving relativistic electron losses. Nonlinear effects may abound and require further investigation.

[The combination of moral and law norms in regulation of medical activity].

The article considers proposals developed according results of the study and targeted on improving social regulation of medical activities on basis of complex institutional approach. The complexity of approach lies in the fact that in regulation of public relations in health care opposition between norms of law and norms of morality is not allowed because in medicine they inter-condition and inter-complement each other. The institutional aspect of approach is reflected in tight interaction of moral and legal foundations, as well as in mechanisms of implementation of social standardization of specific sphere of medical activity. The formalized model of integrated institutional approach is presented. The importance of bioethics, in which principle of inter-complementarity of morality and law is realized to its maximum extent is emphasized. The significance of structural principles of bioethics that characterize totality of stable relationships of subjects of medical intervention is highlighted. The emphasis is made on interrelation between principles of bioethics and medical ethics, on norms of medical ethics, that largely determine content of professional duty of physician. The norms of medical ethics are grouped into three systems: "doctor-patient", "doctor-colleague" and "doctor-society" that are contained in international ethical documents and "The Code of Professional Ethics for Physicians" of the Russian Federation. The importance of internal and external mechanisms of implementation of complex social regulation of medical activity is marked.

[Results of laparoscopic pelvic exenterations]. / Rezul'taty laparoskopicheskikh tazovykh ekzenteratsii.

OBJECTIVE: To analyze clinical outcomes after pelvic exenteration for advanced primary or recurrent pelvic cancer. MATERIAL AND METHODS: We analyzed the outcomes in 35 patients after pelvic exenteration for advanced primary or recurrent pelvic cancer (gynecological cancer, urologic cancers, colon cancer). There were 3 (8.57%) men and 32 (91.43%) women. Mean BMI was 26 kg/m2. RESULTS: Total exenteration was performed in 10 (28.57%) patients, anterior exenteration - 18 (51.43%) patients, posterior exenteration - 7 (20.0%) patients. Intraoperative complications (damage to the common iliac vessels) occurred in 1 (2.86%) patient. Mean surgery time was 280 minutes (range 180-600), mean intraoperative blood loss - 400 ml (range 100-2000). Mean postoperative ICU-stay was 24 hours. Major postoperative complications Clavien-Dindo grade 3-4 were detected in 3 (8.57%) patients. One (2.86%) patient died in 84 days after surgery from multiple organ failure due to progression of disease (Clavien-Dindo grade 5). There were 4 (11.43%) patients with complications Clavien-Dindo grade ≥3. Negative resection margin (R0) was achieved in 32 (91.43%) cases. The follow-up period ranged from 2 to 70 months (median 16.5 months). Overall survival was assessed in 25 patients. Other 10 patients or their relatives did not get in touch and therefore did not participate in assessment of survival. Overall 2-year survival assessed in 6 patients with cervical cancer was 24%. Overall 2-year survival estimated in 8 patients with bladder cancer was 100%. A patient with colon cancer lived for 23 months. Among 2 patients with vulvar cancer, 1 patient died in 25 months after surgery, the second one was followed-up for 11 months. Patients with primary multiple tumors were followed-up for 10-21 months. Overall 1-year survival was 100%. One patient died after 21 months. CONCLUSION: Analyzing own findings and world literature data, we can conclude that laparoscopic technique ensures better intra- and postoperative results compared to standard laparotomy. However, there are insufficient data to confirm superiority of laparoscopic approach regarding oncological results.

[Nutraceutical correction in the complex non-drug treatment of metabolic syndrome]. / Nutritsevticheskaya korrektsiya v kompleksnom nemedikamentoznom lechenii metabolicheskogo sindroma.

The use of complex non-drug technologies at the stage of rehabilitation of metabolic syndrome (MS) includes multifactorial correction of its main manifestations: abdominal obesity, insulin resistance, arterial hypertension and dyslipidemia. A prospective randomized study on the use of low-calorie diet (LCD) and nutraceutical correction of the nutritional status of patients with MS was carried out. OBJECTIVE: To study the effect of a non-drug complex including LCD, physical exercises, as well as correction of the gut microbiome and hepatic protection in relation to reduction of visceral fat volume in abdominal obesity and the dynamics of lipid and carbohydrate metabolism hormones in metabolic syndrome. MATERIAL AND METHODS: 120 patients with MS were randomized into 2 groups: Group 1 received LCD, physical exercises in the gym, and physical activity like daily walking up to 3-5 km/day. Group 2 received LCD, physical exercises in the gym, physical activity like daily walking up to 3-5 km/day, as well as nutraceutical correction of increased appetite, gut probiotic composition, hepatic protection. The treatment duration was 4 weeks. Anthropometric methods in order to control the body weight, waist and hip circumferences and bioimpedansometry were used. RESULTS: As a treatment result, patients in group 1 represented a reduction in body weight, lean and active cell mass, a decrease in musculoskeletal mass and a decrease in total fluid due to extracellular fluid. A decrease in total cholesterol and blood triglyceride fraction was noted. Leptin decreased by 13.96%. Patients of the 2nd group represented a decrease in body weight, fat mass, lean mass, total fluid and extracellular fluid. There was a statistically significant increase in active cell mass, skeletal muscle mass. There was a decrease in total cholesterol, triglycerides and transaminases. Due to weight loss and fat mass reduction a decrease in leptin expression by 29.85% and decrease in blood insulin levels by 11.2% were noted. CONCLUSION: Thus, LCD accompanied by nutraceutical correction of the gut microbiota and hepatic protection can be effectively used in combination with physical training in order to reduce the fat mass without pre-sarcopenia development that was confirmed by positive dynamics of volume indices, bioimpedance measurements and reduction in leptin and insulin expression.

[Unilateral combined lap partial nephrectomy and pyelolithotomy for ipsilateral tumor & kidney staghorn stone]

OBJECTIVE: To discuss the feasibility, safety, and effectiveness of conventional laparoscopic partial nephrectomy combined with pyelolithotomy for patients with ipsilateral renal tumor and staghorn kidney stone. MATERIALS AND METHODS: Retrospective multicentral comparative study. Group "Combo" was presented by patients with the mentioned combined pathology (n=15). Group "Standart" (n=69) formed from common patients who underwent standard lap partial nephrectomy for renal tumor in the absence of kidney stones. Perioperative factors and results were studied and compared. Video presentation of combined surgical technique is available at: https://youtu.be/fAfYJDvGzsU. RESULTS: Of all patients, no positive margins, no conversions to open surgery or nephrectomy & any complications Clavien >III were detected. There were no any significant differences between the two groups except for OR time (150 [120; 210] vs 130 [100; 180] min; p=0,001). Differences between indexes of WIT (16,27+/-3,8 vs 15,9+/-4,5 min; p=0,107), EBL (200 [150; 300] vs 200 [150; 300] cc; p=0,981), length of stay (7 [6;9] vs 8[6;9] days; p=0,611), intraop complications (0,00 vs 4,3%; p=0,411) and values of postop Clavien III rate (0,00 vs 4,3%; p=0,411) for "Combo" & "Standart" respectively were comparable as well as oncological outcomes. Stone-free rate for combined procedures reached 93,3%. CONCLUSION: conventional laparoscopic partial nephrectomy combined with pyelolithotomy for patients with ipsilateral renal tumor and staghorn kidney stone is safe and efficient alternative to 2-step treatment of this rare disease.

[The mechanisms of regulation of disputes concerning inappropriate medical services support].

The article presents the results of comparative study of dispute resolution mechanisms related to the improper provision of medical services. On the basis of consumer model of physician-patient relationship basic options of pretrial and alternative mechanisms of settlements of disputes related to inadequate rendering of paid medical services are considered. On the basis of legal design for consumers and medical personnel the simple and evident statement of possible alternatives of mechanisms of settlement of disputes is presented. Te preferable design is consecutive application of all pretrial and alternative mechanisms of settlement of disputes. In case when there is no desirable result is the final decision is taken by court. It is concluded that the settlement of most disputes (90%) using pretrial and alternative dispute resolution mechanisms will significantly reduce time to resolve conflicts, as well as minimize unfavorable moral and economic consequences for consumers and providers of medical services.

The ELFIN Mission.

The Electron Loss and Fields Investigation with a Spatio-Temporal Ambiguity-Resolving option (ELFIN-STAR, or heretoforth simply: ELFIN) mission comprises two identical 3-Unit (3U) CubeSats on a polar (∼93∘ inclination), nearly circular, low-Earth (∼450 km altitude) orbit. Launched on September 15, 2018, ELFIN is expected to have a >2.5 year lifetime. Its primary science objective is to resolve the mechanism of storm-time relativistic electron precipitation, for which electromagnetic ion cyclotron (EMIC) waves are a prime candidate. From its ionospheric vantage point, ELFIN uses its unique pitch-angle-resolving capability to determine whether measured relativistic electron pitch-angle and energy spectra within the loss cone bear the characteristic signatures of scattering by EMIC waves or whether such scattering may be due to other processes. Pairing identical ELFIN satellites with slowly-variable along-track separation allows disambiguation of spatial and temporal evolution of the precipitation over minutes-to-tens-of-minutes timescales, faster than the orbit period of a single low-altitude satellite (Torbit ∼ 90 min). Each satellite carries an energetic particle detector for electrons (EPDE) that measures 50 keV to 5 MeV electrons with Δ E/E < 40% and a fluxgate magnetometer (FGM) on a ∼72 cm boom that measures magnetic field waves (e.g., EMIC waves) in the range from DC to 5 Hz Nyquist (nominally) with <0.3 nT/sqrt(Hz) noise at 1 Hz. The spinning satellites (Tspin ∼ 3 s) are equipped with magnetorquers (air coils) that permit spin-up or -down and reorientation maneuvers. Using those, the spin axis is placed normal to the orbit plane (nominally), allowing full pitch-angle resolution twice per spin. An energetic particle detector for ions (EPDI) measures 250 keV - 5 MeV ions, addressing secondary science. Funded initially by CalSpace and the University Nanosat Program, ELFIN was selected for flight with joint support from NSF and NASA between 2014 and 2018 and launched by the ELaNa XVIII program on a Delta II rocket (with IceSatII as the primary). Mission operations are currently funded by NASA. Working under experienced UCLA mentors, with advice from The Aerospace Corporation and NASA personnel, more than 250 undergraduates have matured the ELFIN implementation strategy; developed the instruments, satellite, and ground systems and operate the two satellites. ELFIN's already high potential for cutting-edge science return is compounded by concurrent equatorial Heliophysics missions (THEMIS, Arase, Van Allen Probes, MMS) and ground stations. ELFIN's integrated data analysis approach, rapid dissemination strategies via the SPace Environment Data Analysis System (SPEDAS), and data coordination with the Heliophysics/Geospace System Observatory (H/GSO) optimize science yield, enabling the widest community benefits. Several storm-time events have already been captured and are presented herein to demonstrate ELFIN's data analysis methods and potential. These form the basis of on-going studies to resolve the primary mission science objective. Broad energy precipitation events, precipitation bands, and microbursts, clearly seen both at dawn and dusk, extend from tens of keV to >1 MeV. This broad energy range of precipitation indicates that multiple waves are providing scattering concurrently. Many observed events show significant backscattered fluxes, which in the past were hard to resolve by equatorial spacecraft or non-pitch-angle-resolving ionospheric missions. These observations suggest that the ionosphere plays a significant role in modifying magnetospheric electron fluxes and wave-particle interactions. Routine data captures starting in February 2020 and lasting for at least another year, approximately the remainder of the mission lifetime, are expected to provide a very rich dataset to address questions even beyond the primary mission science objective.

[Horseshoe kidney tumor laparoscopic surgery. First 19 cases].

INTRODUCTION: Although horseshoe kidney (HSK) is the most common congenital anomaly of the upper urinary tract, renal cell cancer (RCC) in HSK develops extremely rarely. Until 2012 y. there were less than 200 cases of RCC in HSK published in PubMed. Only five cases of laparoscopic partial nephrectomies and some cases of heminephrectomies have been described in PubMed. AIM: To conduct a multicenter retrospective analysis of laparoscopic surgery for tumors in HSK. MATERIAL AND METHODS: From January 2013 to December 2018 a total of 19 conventional laparoscopic interventions were performed in patients with RCC in HSK, including 1 isthmusectomy, 5 partial nephrectomies and 13 heminefrectomies. In addition, 16 divisions of isthmus were done in 15 patients. The video describing our operation technique is available on: http://youtu.be/nk-WlbjNtIs . RESULTS: There were no conversions to open surgery and mortality as well as intra- and postoperative complications of Clavien grade 3 or higher. Warm ischemia time during partial nephrectomy didnt exceed 19 minutes. Operative time ranged from 110 to 270 min, while max estimated blood loss was 400 ml. All patients were followed for 6 month and no case of disease recurrence or progression was noted. CONCLUSIONS: The small number of laparoscopic interventions in patients with RCC in HSK doesnt allow to carry out a proper statistical analysis and draw certain conclusions. We presented the largest experience available in the literature and our results demonstrate the efficacy and safety of conventional laparoscopic technologies in the treatment of RCC in HSK.

[Development of a meat-based product for enteral nutrition].

Meat is a source of the most full value protein, which contains all essential amino acids, B group vitamins, minerals, including heme iron and zinc. The development of enteral mixtures produced on the basis of meat raw materials will allow leveling the problem of annoyance with the same product taste and extending an assortment of the supplied products for enteral nutrition. As a result of the experiments on the model and natural objects, the technology was developed for beef-based canned food intended for enteral nutrition of people in the post-operative period as well as in the conditions associated with appetite loss, mandibulofacial injuries, burning injury, chewing and swallowing impairments. The multi-component recipe modules balanced by fatty acid and amino acid composition, enriched with the vitamins and minerals were theoretically substantiated and realized. The minimal score was 0.99 unit fractions, coefficient of utility (0.83 unit fractions), coefficient of comparable redundancy 7.20 g/100 g protein. The obtained values of the balance criteria allow making a conclusion about approximation of the values to the physiologically necessary ratio. The correction of the fatty acid composition of the mixture models was carried out in order to increase the unsaturated fatty acid content by combination of meat fat with vegetable oils. The actual ratio of the fatty acid (SFA:MUFA:PUFA) in the product was 16.1:54.7:29.2, the ratio of omega-6 to omega-3 PUFA was 4:1. When designing the vitamin and mineral composition, the intensity of the thermal effect was taken into account. As a result, the doses for addition of vitamins were established with regard to their destruction during the technological process. Based on the performed research, the technology was developed for meat-containing canned food, adapted to the real conditions of the enterprises engaged in production of meat products for child nutrition. The product can be used as a basis or additional source of nutrition during the necessary period of nutritive support of patients.

[Laparoscopic ileal ureteral substitution. Results of the first 40 operations].

INTRODUCTION: Despite the twenty-year history of laparoscopic ileal ureteral substitution, the literature is lacking studies reporting its outcomes, and those few are mainly case reports. Besides, they usually describe surgery from combined access, when the ileal segment resection and ileo-ileal anastomosis are performed from mini-laparotomy, and the remaining stages are done endoscopically. AIM: To conduct a multicenter retrospective analysis of our series of patients undergoing laparoscopic ileal ureteral substitution using only endoscopic access. MATERIAL AND METHODS: From 2010 to 2017, 48 ureters were replaced completely laparoscopically in 40 patients. Of them, 33 patients underwent total ureteric replacement, and the others had a subtotal ileal ureteral substitution. Video describing the operation technique is available on https://youtu.be/IeA60pSiUBE. RESULTS: The mean operating time was 335 minutes, and the estimated blood loss was 221 ml. Intraoperative complications (7.5%) were resolved during surgery. No patients required conversion to open surgery. There was no mortality. Postoperative Clavien III complications were observed in 7.5% of patients. The mean length of hospital day was 13.5 days. Functional results were followed from 6 months to 7 years. CONCLUSIONS: The presented material is the largest available in the literature, and the results, including long-term functional outcomes, demonstrate the efficacy and safety of laparoscopic technologies in the treatment of extensive strictures and obliterations of the ureter.

[Laparoscopic pyelolithotomy for staghorn kidney stones. multi-center study].

AIM: To analyze the effectiveness and safety of laparoscopic pyelolithotomy (LP) in treating staghorn stones. MATERIALS AND METHODS: A multicentre retrospective analysis of the results of LP performed from January 2004 to December 2016 was conducted. INCLUSION CRITERIA: patients with staghorn calculi K3-K4, who underwent LP as an alternative to percutaneous nephrolithotripsy. The analysis included the incidence and structure of intra- and postoperative complications, the causes of access conversion, operating time, duration of postoperative hospital stay and stone clearance. RESULTS: A total of 137 patients met the inclusion criteria, including 78 (56.93%) men. There was no mortality and access conversion. Intraoperative complications occurred in 2 (1.46%) patients. Operating time was 130 [100; 150] min, blood loss was 150 [100; 200] ml. No need for blood transfusion was observed. The cumulative rate of postoperative complications was 5.11%, stone clearance was achieved in 86.13% of observations, the duration of postoperative hospital stay was 7 [7; 11] days. CONCLUSION: In cases of dense staghorn calculi located in a large "extra-renal" pelvis and have calyceal branches equal to the diameter of their necks, laparoscopic pyelolithotomy is an alternative not only to open, but also to percutaneous surgery.

[Penile revascularization using laparoscopic mobilization of the inferior epigastric artery].

The article presents a case of successful penile revascularization using laparoscopic mobilization of the inferior epigastric artery in a 35 y. o. patient with penile arteriovenous insufficiency.

[Comparative assessment of treatments for prostate adenoma greater than 100 cm3].

AIM: To compare holmium laser enucleation of the prostate (HoLEP) and endovideosurgical (EVS) adenomectomy in the treatment of prostate adenoma. MATERIALS AND METHODS: We compared treatment results of 180 patients with prostate adenomas greater than 100 cm3 who underwent EVS adenomectomy (n=90) and laser enucleation of the prostate (n=90). The analysis included the following parameters: duration of catheterization, length of postoperative hospital stay, I-PSS score, maximum urinary flow rate measured by uroflowmetry and complications according to Clavien-Dindo grading systems. RESULTS: There were no significant differences in patient age, preoperative prostate size, glandular tissue weight, and operative time. The duration of catheterization (p=0.0008) and length of postoperative hospital stay (p<0.0001) were significantly shorter in the HoLEP group. Both groups showed a statistically significant improvement in functional performance at three months post-surgery. Complications in the HoLEP and EVS adenomectomy group occurred in 18 (20%) and 23 (25.55%) patients, respectively (p>0.99). CONCLUSION: The two methods mentioned above are widely used in the treatment of prostate adenoma. However, holmium laser enucleation of the prostate shows similar short-term functional results and complication rates compared with EVS adenomectomy for prostate adenomas greater than 100 cm3. The patients of the HoLEP group had better results regarding the duration of catheterization and length of postoperative hospital stay. Therefore, laser enucleation is the preferred surgical modality for prostate adenomas greater than 100 cm3.

Simultaneous Remote Observations of Intense Reconnection Effects by DMSP and MMS Spacecraft During a Storm Time Substorm.

During a magnetic storm on 23 June 2015, several very intense substorms took place, with signatures observed by multiple spacecraft including DMSP and Magnetospheric Multiscale (MMS). At the time of interest, DMSP F18 crossed inbound through a poleward expanding auroral bulge boundary at 23.5 h magnetic local time (MLT), while MMS was located duskward of 22 h MLT during an inward crossing of the expanding plasma sheet boundary. The two spacecraft observed a consistent set of signatures as they simultaneously crossed the reconnection separatrix layer during this very intense reconnection event. These include (1) energy dispersion of the energetic ions and electrons traveling earthward, accompanied with high electron energies in the vicinity of the separatrix; (2) energy dispersion of polar rain electrons, with a high-energy cutoff; and (3) intense inward convection of the magnetic field lines at the MMS location. The high temporal resolution measurements by MMS provide unprecedented observations of the outermost electron boundary layer. We discuss the relevance of the energy dispersion of the electrons, and their pitch angle distribution, to the spatial and temporal evolution of the boundary layer. The results indicate that the underlying magnetotail magnetic reconnection process was an intrinsically impulsive and the active X-line was located relatively close to the Earth, approximately at 16-18 RE.

Transient, small-scale field-aligned currents in the plasma sheet boundary layer during storm time substorms.

We report on field-aligned current observations by the four Magnetospheric Multiscale (MMS) spacecraft near the plasma sheet boundary layer (PSBL) during two major substorms on 23 June 2015. Small-scale field-aligned currents were found embedded in fluctuating PSBL flux tubes near the separatrix region. We resolve, for the first time, short-lived earthward (downward) intense field-aligned current sheets with thicknesses of a few tens of kilometers, which are well below the ion scale, on flux tubes moving equatorward/earthward during outward plasma sheet expansion. They coincide with upward field-aligned electron beams with energies of a few hundred eV. These electrons are most likely due to acceleration associated with a reconnection jet or high-energy ion beam-produced disturbances. The observations highlight coupling of multiscale processes in PSBL as a consequence of magnetotail reconnection.

ASSESSMENT OF EFFICACY OF THE METHOD OF PROGRAMMED IRRIGATION ASPIRATION SANATION IN COMPLEX TREATMENT OF PATIENTS WITH CHRONIC POSTTRAUMATIC OSTEOMYELITIS OF THE LONG BONES.

The analysis of treatment results of 128 patients aged from 21 to 62 years old with chronic posttraumatic osteomyelitis of the long bones was made at the period from 2006 to 2013. The main group included 67 patients and the method of programmed irrigation aspiration sanation was applied for them. The comparison group consisted of 61 patients and drainage was performed for these patients using the conventional ways. The authors noted good immediate results in the main group in 56 (83,58%) out of 67 patients and in the comparison group - in 43 (70,49%) out of 61 patients. The long-term results were analyzed in 116 (90,6%) out of 128 patients in terms from two to five years after treatment. The rate of recurrences such as formation of purulent fistula were twice less in patients of the main group, than in the comparison group. According to the results of questionnaire SF-36, there was noticed, that patients of the main group got better mean indices of quality of life on all 8 scales compared with the other group.

[Initial experience with laparoscopic anatrophic nephrolithotomy].

Percutaneous nephrolithotomy is a recognized standard for minimally invasive treatment of large kidney stones. Percutaneous interventions for complete staghorn stones are associated with a higher risk of complications that precludes abandoning the traditional open operations, one of which is an anatrophic nephrolithotomy. This paper presents the first personal experience in laparoscopic transmesenteric anatrophic nephrolithotomy. The intervention was conducted in 3 patients (2 males and 1 female) aged 43 to 58 years, having a primary symptomatic complete left kidney staghorn stones sized from 7.2 to 9.1 cm along the longitudinal axis. Operation time ranged from 130 to 170 minutes, kidney warm ischemia time - from 21 to 24 minutes, blood loss - from 180 to 250 ml. The staghorn stone was completely extracted in 2 patients. In one patient, a 0.8 cm residual stone was left in the completely excluded calix, since it caused none clinical symptoms and did not impair urinary flow. At this stage, the number of laparoscopic procedures for complete staghorn nephrolithiasis is too small to carry out an adequate statistical analysis and draw any definite conclusions. Nevertheless, the first experience demonstrated not only plausibility but also the effectiveness of such operations.

Imaging polychromator for density measurements of polystyrene pellet cloud on the Large Helical Device.

Experimental data on spatial distributions of a pellet cloud electron density are necessary for the development of many applications of pellet injection, namely, plasma fuelling, discharge control, and plasma diagnostics. An improved approach of electron density measurements inside the cloud of a polystyrene pellet ablating in hot plasma of the large helical device is described. Density values of (1-30) × 10(16) cm(-3) depending on the background plasma parameters and distance from the solid pellet were measured.