Organization of internal control of quality of medical care (Faculty Clinics of Irkutsk State Medical University)

Currently, there is no normative document at the federal level that determines the format of the organization of internal control of medical care quality in a medical organization. The system of standardization in the sphere of public health of the Russian Federation remains incomplete. In this regard, in the multidisciplinary medical organization, innovative approaches have been developed and implemented in the management of the medical care quality and ensuring the safety of medical activities: the development of a number of local regulatory documents; strengthening the expert institute (setting up a department for quality control and safety of medical activities); increasing the role of the internal expertise of the quality of medical care; standardization of medical care; improving the organization of work of middle and junior medical links; strict adherence to the three-stage internal quality control with the obligatory presence of self-control when monitoring the quality of work of medical, middle and junior medical personnel. The authors show the dynamics of the main indicators of the quality of care at the stages before and after the introduction of new approaches to improve the internal quality control of medical care. The presented data testify to the effectiveness and expediency of the proposed measures

Actual aspects of organic agricultural development in Ukraine

The monograph presents a conceptual analysis of the development of all sectors of organic production in Ukraine, the problems of sustainable increase in the efficiency of agrobiocenoses, the economic aspects of the formation of organic production according to European standards, and the analysis of opportunities for the agrarian sector. The approaches to the application of new methods and tools in organic production are described. The monograph is prezented for specialists, employments of the agrarian sector, scientists, professors, students and masters, all those who are interested in the specified range of questions that are being analyzed

The Polarised Valence Quark Distribution from semi-inclusive DIS

The semi-inclusive difference asymmetry A^{h^{+}-h^{-}} for hadrons of opposite charge has been measured by the COMPASS experiment at CERN. The data were collected in the years 2002-2004 using a 160 GeV polarised muon beam scattered off a large polarised ^6LiD target and cover the range 0.006 < x < 0.7 and 1 < Q^2 < 100 (GeV/c)^2. In leading order QCD (LO) the asymmetry A_d^{h^{+}-h^{-}} measures the valence quark polarisation and provides an evaluation of the first moment of Delta u_v + Delta d_v which is found to be equal to 0.40 +- 0.07 (stat.) +- 0.05 (syst.) over the measured range of x at Q^2 = 10 (GeV/c)^2. When combined with the first moment of g_1^d previously measured on the same data, this result favours a non-symmetric polarisation of light quarks Delta u-bar = - Delta d-bar at a confidence level of two standard deviations, in contrast to the often assumed symmetric scenario Delta u-bar = Delta d-bar = Delta s-bar = Delta s.Comment: 7 pages, 3 figures, COMPASS, revised: details added, author list update

Expression of a Stilbene Synthase Gene from the Vitis labrusca x Vitis vinifera L. Hybrid Increases the Resistance of Transgenic Nicotiana tabacum L. Plants to Erwinia carotovora

‘Isabel’ grape (Vitis labrusca x V. vinifera L. hybrid) is one of the main grape cultivars in Russia and some other countries for processing, due to its vigor, tolerance to the main fungal diseases, high yield and potential for sugar accumulation. The stilbene synthase gene VlvSTS was isolated from the hybrid grape cv. Isabel and cloned into a pSS plant transformation vector under the control of a constitutive 35S RNA double promoter of the cauliflower mosaic virus, CaMV 35SS. VlvSTS-gene containing transgenic tobacco lines were obtained and analyzed. For the first time plants expressing the VlvSTS gene were shown to have an enhanced resistance to the bacterial pathogen Erwinia carotovora subsp. carotovora B15. Transgenic plants were tested for resistance to a number of fungal pathogens. The plants were resistant to the grey mould fungus Botrytis cinerea, but not to the fungi Fusarium oxysporum, F. sporotrichioides, or F. culmorum. According to the results of a high performance liquid chromatography-mass spectrometry analysis, the amount of trans-resveratrol in leaves of transgenic plants with the highest expression of the VlvSTS gene was in a range from 150 to 170 µg/g of raw biomass. Change in the color and a decreased anthocyanin content in the flower corollas of transgenic plants were observed in transgenic lines with the highest expression of VlvSTS. A decrease in total flavonoid content was found in the flower petals but not the leaves of these tobacco lines. High expression of the VlvSTS gene influenced pollen development and seed productivity in transgenic plants. The size of pollen grains increased, while their total number per anther decreased. A decrease in the number of fertile pollen grains resulted in a decreased average weight of a seed boll in transgenic plants. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.This research was carried out within the state program of Ministry of Science and High Education of the Russian Federation (theme "Plant molecular biology and biotechnology: their cultivation, pathogen and stress protection (BIBCH)" (No. 0101-2019-0037)

Развитие методики проведения специальных судовых ледовых наблюдений

Since the middle of the XXth century researchers at the Arctic and Antarctic Research Institute (AARI) have been carrying out special ship ice observations in the Arctic and other freezing seas. Field data about main sea ice parameters are necessary for developing and validation of sea ice forecasts and satellite information. In keeping with technological advances and new research and practical tasks this method is ever developing. In spring 2023 sea ice observations were organized by the AARI’s reseachers onboard the nuclear icebreaker 50 let Pobedy in the south-western part of the Kara Sea. This paper presents recommendations concerning the method of special ship ice observations as developed during the expedition: dispatch to the vessel of operative and forecast hydrometeorological information from the AARI with a request for return transfer to the AARI of the processing results of the data obtained in the areas of predicted high deformation of ice cover along the route of navigation and upgrade of the ship television complex to receive information about ice layers and structure.С середины XX в. специалистами Арктического и антарктического научно-исследовательского института (ААНИИ) выполняются специальные судовые ледовые наблюдения в арктических и других замерзающих морях. Натурные данные об основных характеристиках ледяного покрова необходимы для разработки и уточнения ледовых прогнозов и для валидации спутниковой информации. В соответствии с техническими достижениями, а также с новыми научными и практическими задачами методика наблюдений постоянно развивается. Весной 2023 г. специалистами ААНИИ выполнялись ледовые наблюдения на борту атомного ледокола «50 лет Победы» в юго-западной части Карского моря. В данной статье представлены новые рекомендации к методике специальных судовых ледовых наблюдений, разработанные во время экспедиции: отправка на судно оперативной и прогностической гидрометеорологической информации из ААНИИ с запросом на ответную передачу в ААНИИ результатов обработки полученных данных в зонах прогнозируемой повышенной деформации ледяного покрова по пути движения судна и расширение возможностей судового телевизионного комплекса для получения информации о слоистости льда и его структуре

Диагностическая ценность прокальцитонина и С-реактивного белка при врожденных инфекциях у детей с экстремально низкой и очень низкой массой тела при рождении

The high frequency of infectious complications in the early neonatal period of adaptation in infants with extremely low (ELBW) and very low birth weight (VLBW) attracts particular attention. The aim of our study was to evaluate the sensitivity (Se) and specificity (Sp) of C-reactive protein and procalcitonin in congenital pneumonia and congenital sepsis in newborn infants with extremely low and very low birth weight.Methods. In 160 preterm newborns that were included in our prospective study, 33 had early neonatal sepsis, 42 children had congenital pneumonia, and 85 infants were without neonatal infection. A comprehensive clinical and laboratoryinstrumental examination of the newborn was done, including determining the concentration of C-reactive protein and procalcitonin at the age of 48–72 hours of life. Results. Low sensitivity of CRP at the age of 48–72 hours of life in congenital sepsis and congenital pneumonia was observed. However, under these pathological conditions CRP and PCT are characterized by high specificity. It should also be noted that PCT has a high sensitivity in children with congenital sepsis aged 48–72 hours. Moreover, PCT also has a high specificity (Sp 80,6%), which determines its advantage in the use of sepsis diagnosis in extremely premature infants compared to CRP.Conclusion. Maximum specificity reaches 100%, co-located with the assessment of CRP and PCT, which determines the feasibility of using this combination for verification of congenital infectious conditions such as sepsis and pneumonia in children ELBW and VLBW aged 48–72 hours.Актуальность. Высокая частота инфекционных осложнений в раннем неонатальном периоде у новорожденных с экстремально низкой (ЭНМТ) и очень низкой массой тела (ОНМТ) при рождении обусловливает необходимость ранней диагностики для уменьшения количества осложнений. Цель: оценка чувствительности и специфичности С-реактивного белка (СРБ) и прокальцитонина (ПКТ) при врожденной пневмонии и врожденном сепсисе у новорожденных детей с ЭНМТ и ОНМТ. Пациенты и методы. В проспективное когортное исследование включено 160 новорожденных с ЭНМТ и ОНМТ, из них 33 с врожденным сепсисом, 42 с врожденной пневмонией, 85 с основным диагнозом респираторного дистресс-синдрома. В первые 48–72 ч жизни новорожденным проводилось комплексное клиническое и лабораторно-инструментальное обследование, включающее определение концентрации СРБ и ПКТ.Результаты. Отмечена невысокая чувствительность СРБ в первые 48–72 ч жизни при врожденном сепсисе и врожденной пневмонии. Однако, при данных патологических состояниях и СРБ, и ПКТ характеризуются высокой специфичностью. Следует также отметить, что ПКТ обладает высокой чувствительностью в первые 48–72 ч жизни у детей с врожденным сепсисом. Кроме того, данный показатель имеет также высокую специфичность (80,6%), что определяет преимущество его изолированного использования по сравнению с СРБ при диагностике врожденного сепсиса у глубоконедоношенных детей. Заключение. Максимальная специфичность, достигающая 100%, выявлена при сочетанной оценке СРБ и ПКТ, что определяет целесообразность использования данной комбинации для верификации таких врожденных инфекционных состояний, как сепсис и пневмония, у детей с ЭНМТ и ОНМТ в возрасте 48–72 ч

Diagnosis and Treatment of Irritable Bowel Syndrome: Clinical Recommendations of the Russian Gastroenterological Association and Association of Coloproctologists of Russia

Aim. Current clinical recommendations accentuate current methods for the diagnosis and treatment of irritable bowel syndrome (IBS).Key points. IBS is a functional bowel disorder manifested with recurrent, at least weekly, abdominal pain with the following attributes (any two leastwise): link to defecation, its frequency or stool shape. The symptoms are expected to persist for at minimum three months in a total six-month follow-up. Similar to other functional gastrointestinal (GI) disorders, IBS can be diagnosed basing on the patient symptoms compliance with Rome IV criteria, provided the absence of potentially symptom-causative organic GI diseases. Due to challenging differential diagnosis, IBS can be appropriately established per exclusionem, with pre-examination as follows: general and biochemical blood tests; tissue transglutaminase IgA/IgG antibody tests; thyroid hormones test; faecal occult blood test; hydrogen glucose/ lactulose breath test for bacterial overgrowth; stool test for enteric bacterial pathogens and Clostridium difficile A/B toxins; stool calprotectin test; abdominal ultrasound; OGDS, with biopsy as appropriate; colonoscopy with biopsy. The IBS sequence is typically wavelike, with alternating remissions and exacerbations often triggered by psychoemotional stress. Treatment of IBS patients includes dietary and lifestyle adjustments, various-class drug agents prescription and psychotherapeutic measures.Conclusion. Adherence to clinical recommendations can facilitate timely diagnosis and improve medical aid quality in patients with different clinical IBS variants