A method of endoprosthesis implantation in patients with breast cancer

Objectives to improve the immediate results of treatment in patients with breast cancer, using a new method of reconstruction. Material and methods.The prospective study included 215 patients diagnosed with breast cancer. The patients received medical treatment in the Samara Regional Clinical Oncology Center from 2013 to 2016. The patients in the control group (n = 111) underwent a subcutaneous mastectomy with a standard endoprosthesis plastic, with complete muscular shelter of the endoprosthesis. The patients of the study group (n = 104) underwent a subcutaneous mastectomy with a new method of single-stage reconstruction. Results.The mean time of operation in the control group was 115 15 minutes, in the study group 90 10 minutes, the difference was statistically significant (p = 0.000). Intraoperative blood loss in the patients of the control group reached 115 15 ml, in the study group 70 10 ml (p = 0.000). The duration of postoperative lymphorrhea in the control group was 14.6 3.5 days, in the study group 10 3.4days (p = 0.000). Postoperative bed-day in the control group was 17.1 3.7, and in the study group 14.2 2.4 days (p = 0.001). Conclusion.The use of the new method of reconstruction statistically significantly improves the immediate results of treatment in patients with breast cancer in comparison with the group of patients who underwent a mastectomy with plastic surgery with the endoprosthesis in the standard way

Influence of surface modification of nitinol with silicon using plasma-immersion ion implantation on the alloy corrosion resistance in artificial physiological solutions

Cyclic voltammetry and potentiostatic polarization have been applied to study electrochemical behavior and to determine corrosion resistance of nitinol, which surface was modified with silicon using plasma-immersion ion implantation, in 0.9% NaCl solution and in artificial blood plasma. It was found out that continuous, and also homogeneous in composition, thin Si-containing layers are resistant to corrosion damage at high positive potentials in artificial physiological solutions due to formation of stable passive films. Breakdown potential Eb of Si-modified NiTi depends on the character of silicon and Ni distribution at the alloy surface, Eb values amounted to 0.9–1.5 V (Ag/AgCl/KCl sat.) for the alloy samples with continuous Si-containing surface layers and with decreased Ni surface concentration

Efficiency Comparison of Thermal Insulation Schemes in the Hinged Ventilated Facades Systems

The article deals with the problems associated with the quality of thermal insulation mounting in hinged ventilated facades, and first of all associated with the gaps between thermal insulation panels. According to STO NOSTROY 2.14.67-2012 "Hinged facade systems with air gap. Work on the installation. General requirements for the production and control of work" the acceptable value of the unfilled seam is 2 mm. In reality, it is impossible to achieve the required width of the gap between the plates, and additional heat losses appear on single-layer thermal insulation schemes. The influence of the gaps between thermal insulation plates on the reduced total thermal resistance of the external wall with the hinged ventilated facade system is estimated using Russian and European calculation methods. The calculations were made in accordance with SP 50.13330.2012, SP 230.1325800.2015 and EN ISO 6946. Two outer wall constructions made of monolithic reinforced concrete and masonry from aerated concrete blocks and three options for insulation – single-layered and two double-layered – were adopted for the analysis. Optimal variants of thermal insulation and types of bases for fixing thermal insulation are offered. Three types of air layers are reviewed according to EN ISO 6946, and the third type – highly ventilated layer – is taken to calculations. The results of calculations of two-dimensional temperature fields, linear heat transfer coefficients, heat transfer performance uniformity factors and reduced total thermal resistances for 16 combinations of gaps in thermal insulation and bases are presented

Plasma immersion ion implantation for surface treatment of complex branched structures

The paper presents experimental results demonstrating the capabilities of plasma immersion ion implantation of silicon (Si) for surface treatment of complex branched structures such are self-expanding intravascular nickel-titanium (NiTi) stents. Using NiTi stents of diameter 4 and 8 mm, it is shown that plasma immersion ion implantation can provide rather homogeneous doping of their outer and inner surfaces with Si atoms. Also presented are research data on the processes that determine the thickness, composition, and structure of surface layers subjected to this type of treatment

Structural phase states in nickel-titanium surface layers doped with silicon by plasma immersion ion implantation

The paper reports on a study of NiTi-based alloys used for manufacturing self-expanding intravascular stents to elucidate how the technological modes of plasma immersion ion implantation with silicon influence the chemical an

Коучинг как инструмент развития управленческих кадров здравоохранения

Purpose: to study and evaluate the motivational and psychological readiness of health managers to introduce and use tools and approaches to develop and improve professional performance in the context of the modernization of the health-care system, the growing need for highly skilled management skills.Based on proven methods of research, international experience and our own research, the authors proved the feasibility of using coaching as a technology of training on cycles of training, ensuring the formation and development of valuable personal qualities and professional competencies of the heads of medical organizations.Methods: in the present study, the following methods were used: systemic approach, content analysis, methods of social diagnosis (questionnaires, interviews), comparative analysis, method of expert evaluations, method of statistical processing of information.Results: reviewed and proposed approaches to use modern technology management training of health aimed at improving the efficiency of healthcare organizations.Conclusions and Relevance: heads of the medical organizations have a high level of motivation and psychological readiness for professional development, effectiveness of professional activity, to achieve the goals of the success of the activities of medical organizations in modern conditions.Coaching is one of the effective combining of different methods and techniques instrument affecting the results of the activities of individuals and the organization as a whole. In scientific research, devoted to increase of efficiency of activity of managerial staff in the healthcare, not defined methodological approaches to the use of coaching in professional development and improving professional activity of heads of medical organizations. Coaching in educational activities based on interdisciplinary scientific and practical achievements, the range of effective educational methodologies, techniques and approaches that can be actively used in educational process for formation of universal and professional managerial competences in the framework of the competence approach.Цель: Изучение и оценка мотивационно-психологической готовности руководителей медицинских организаций к внедрению и использованию инструментов и подходов, направленных на профессиональное развитие и совершенствование профессиональной деятельности в условиях модернизации системы здравоохранения и ее возрастающей потребности в высококвалифицированных управленческих кадрах.На основе апробированных методов исследования, международного опыта и собственных исследований авторами обоснована целесообразность использования коучинга как технологии обучения на циклах повышения квалификации, обеспечивающей формирование и развитие ценностных личностных качеств и профессиональных компетенций руководителей медицинских организаций.Методология проведения работы: Для сбора данных использованы методы: системный подход, контент-анализ, методы социальной диагностики (анкетирование, интервьюирование), сравнительный анализ, метод экспертных оценок, метод статистической обработки информации.Результаты работы: Рассмотрены и предложены подходы для внедрения современных технологий обучения, направленных на профессиональное развитие управленческих кадров здравоохранения и повышение эффективности деятельности медицинских организаций.Выводы: Руководители медицинских организаций имеют высокий уровень мотивационно-психологической готовности к профессиональному развитию, повышению эффективности профессиональной деятельности, достижению целей и успешности деятельности медицинских организаций в современных условиях.Коучинг является одним из эффективных инструментов, объединяющим в себе различные методики и техники, влияющим на результаты деятельности отдельных людей и организации в целом. В научных исследованиях, посвященных повышению эффективности деятельности управленческих кадров здравоохранения, не определены методологические подходы к использованию коучинга в области профессионального развития и совершенствования профессиональной деятельности руководителей медицинских организаций. Коучинг в образовательной деятельности базируется на междисциплинарных научно-практических достижениях, комплексе эффективных образовательных методологий, техник и подходов, которые могут активно использоваться в образовательном процессе для формирования универсальных и профессиональных управленческих компетенций в рамках компетентностного подхода