Features of surface modification of copper-based alloys under powerful plasma exposures

Paper presents features of plasma alloying of Cu-based materials with Ti-Cr, Ti-Cr-Ti-Nb, Ti-Cr-Ti-Zr, Ti-Cr-TiZrO coatings in different regimes of the QSPA Kh-50. Targets were made from copper samples covered of multilayer PVD coatings have been deposited within a Bulat-type facility. Prepared targets were irradiated with powerful plasma streams with energy loads achieved 0.6 MJ/m2 and the pulse duration of 0.25 ms. Influence of plasma impacts on modification different copper alloys has been analyzed. Mechanisms of modification of thin multilayered coatings mixed with Сu substrate in a liquid phase under the plasma processing are evaluated.Описано особливості плазмового легування матеріалів на основі міді з покриттями Ti-Cr, Ti-Cr-Ti-Nb, TiCr-Ti-Zr, Ti-Cr-Ti-ZrO в різних режимах КСПП Х-50. Проаналізовано вплив плазмових навантажень на модифікацію різних мідних сплавів. Зразки було виготовлено з міді та багатошарових покриттів, які утворювались PVD-методом в установці булатного типу. Підготовлені мішені опромінювалися потужними плазмовими потоками з енергетичними навантаженнями, що досягали 0,6 МДж/м 2 , з тривалістю імпульсу ~ 0,25 мс. Обговорюються механізми модифікації тонких багатошарових покриттів, змішаних з мідною підкладкою в рідкій фазі при плазмовому опроміненні.Описаны особенности плазменного легирования материалов на медной основе с покрытиями Ti-Cr, Ti-CrTi-Nb, Ti-Cr-Ti-Zr, Ti-Cr-Ti-ZrO в разных режимах КСПУ Х-50. Проанализировано влияние плазменных нагрузок на модификацию разных медных сплавов. Образцы были изготовлены из меди и многослойных покрытий, осажденных PVD-методом в установке булатного типа. Подготовленные мишени облучались мощными плазменными потоками с энергетическими нагрузками, достигавшими 0,6 МДж/м2 , с длительностью импульса ~ 0,25 мс. Обсуждаются механизмы модификации тонких многослойных покрытий, смешанных с медной подложкой в жидкой фазе при плазменном облучении

Problems of semiotics of diseases of the Achilles tendon in clinical and educational aspects

Achilles tendon disorders are represented by a big group of heterogenous in etiology and pathogenesis conditions, that are quite frequent in patients of various age groups. The diversity of this group of orthopedic disorders and the insufficient information provided on this topic in specialized literature leads to confusion in terminology, which, in turn, leads to misunderstanding the essence of patient’s problem and to mistakes in treatment of such patients.We carried out a content-analysis of contemporary Russian and foreign literature to summarize the existing knowledge and to create the universal nomenclature of the studied pathological conditions for further correct understanding of the problem and creation of classification of disorders and injuries of Achilles tendon

Modern Approaches to the Diagnosis and Management of Children With Primary Ciliary Dyskinesia

The article presents the most modern positions of healthcare delivery for children with primary ciliary dyskinesia. Symptoms of this pathology in clinical practice vary that is conditioned by genetic heterogeneity of the disease. The most common disease manifestation in children is frequent inflammatory diseases of the upper and lower respiratory tract. They are recorded in most patients, especially in young children, and the diagnosis is often determined untimely due to a low awareness of specialists about this nosology. Differential diagnostic approach is described in detail, peculiarities of treatment and management of children with this nosology are specified. The material is based on clinical guidelines developed and approved by the professional association «Union of Pediatricians of Russia»

The Use of the Raabe Aspirator in Intraoperative neurophysiological Monitoring during Decompression and Stabilization Interventions for Degenerative Diseases and Injuries of the Lumbar Spine

Background. Raabe probe is a suction device with monopolar motor fibers mapping capabilities. A number of technical characteristics make it possible to use it for intraoperative neurophysiological monitoring during posterior lumbar fusion surgery.The aim of this study was to analyze our experience of Raabe probe using for intraoperative neurophysiological monitoring during posterior lumbar fusion surgery.Methods. Ninety-eight patients (55 women and 43 men) with degenerative changes and injuries of the lumbar spine were included into the study, mean age – 56.3 ± 12.8 years. Patients underwent the following operations: 85 cases (86.7 %) – spinal roots decompression with fusion by dorsal and ventral implants, 12 cases (12.2 %) – decompression with only dorsal fusion, 1 case (1.0 %) – dorsal fusion without decompression. In all cases intraoperative neurophysiological monitoring control by B. Calancie method with Raabe probe using was performed.Results. With a critical current threshold of 12 mA, the sensitivity of the method is 94 %, the specificity is 97 %. Comparing the thresholds of the M-response at the stage of screw stimulation, no statistically significant differences were found between the groups of true-positive and false-positive results, both for interested (p = 0.09) and intact (p = 0,16) screws. At the stage of the impactor stimulation, the threshold of the M-response in the true-positive group made11.39 ± 7.97 mA, and in the false-positive group – 24.16 ± 8.85 mA (p < 0.05).Conclusion. Raabe probe application for intraoperative neurophysiological monitoring during posterior lumbar fusion surgery show the high sensitivity and specificity. The most reliable sign of pedicle wall breach is a threshold below than 12 mA at the stage of the impactor stimulation

Interactive Effect of UVR and Phosphorus on the Coastal Phytoplankton Community of the Western Mediterranean Sea: Unravelling Eco- Physiological Mechanisms

Versión del editor4,411

Doctors under the microscope: the birth of medical audit

In 1989 a UK government White Paper introduced medical audit as a comprehensive and statutory system of assessment and improvement in quality of care in hospitals. A considerable body of research has described the evolution of medical audit in terms of a struggle between doctors and National Health Service managers over control of quality assurance. In this paper we examine the emergence of medical audit from 1910 to the early 1950s, with a particular focus on the pioneering work of the American surgeons Codman, MacEachern and Ponton. It is contended that medical professionals initially created medical audit in order to articulate a suitable methodology for assessing individual and organisational performance. Rather than a means of protecting the medical profession from public scrutiny, medical auditing was conceived and operationalised as a managerial tool for fostering the active engagement of senior hospital managers and discharging public accountability. These early debates reveal how accounting was implicated in the development of a system for monitoring and improving the work of medical professionals, advancing the quality of hospital care, and was advocated in ways, which included rather than excluded managers

Lifetime Doctor-Diagnosed Mental Health Conditions and Current Substance Use Among Gay and Bisexual Men Living in Vancouver, Canada

BackgroundStudies have found that gay, bisexual, and other men who have sex with men (GBM) have higher rates of mental health conditions and substance use than heterosexual men, but are limited by issues of representativeness.ObjectivesTo determine the prevalence and correlates of mental health disorders among GBM in Metro Vancouver, Canada.MethodsFrom 2012 to 2014, the Momentum Health Study recruited GBM (≥16 years) via respondent-driven sampling (RDS) to estimate population parameters. Computer-assisted self-interviews (CASI) collected demographic, psychosocial, and behavioral information, while nurse-administered structured interviews asked about mental health diagnoses and treatment. Multivariate logistic regression using manual backward selection was used to identify covariates for any lifetime doctor diagnosed: (1) alcohol/substance use disorder and (2) any other mental health disorder.ResultsOf 719 participants, 17.4% reported a substance use disorder and 35.2% reported any other mental health disorder; 24.0% of all GBM were currently receiving treatment. A lifetime substance use disorder diagnosis was negatively associated with being a student (AOR = 0.52, 95% CI [confidence interval]: 0.27-0.99) and an annual income ≥$30,000 CAD (AOR = 0.38, 95% CI: 0.21-0.67) and positively associated with HIV-positive serostatus (AOR = 2.54, 95% CI: 1.63-3.96), recent crystal methamphetamine use (AOR = 2.73, 95% CI: 1.69-4.40) and recent heroin use (AOR = 5.59, 95% CI: 2.39-13.12). Any other lifetime mental health disorder diagnosis was negatively associated with self-identifying as Latin American (AOR = 0.25, 95% CI: 0.08-0.81), being a refugee or visa holder (AOR = 0.18, 95% CI: 0.05-0.65), and living outside Vancouver (AOR = 0.52, 95% CI: 0.33-0.82), and positively associated with abnormal anxiety symptomology scores (AOR = 3.05, 95% CI: 2.06-4.51).ConclusionsMental health conditions and substance use, which have important implications for clinical and public health practice, were highly prevalent and co-occurring

Современные подходы к диагностике и ведению детей с первичной цилиарной дискинезией

The article presents the most modern positions of healthcare delivery for children with primary ciliary dyskinesia. Symptoms of this pathology in clinical practice vary that is conditioned by genetic heterogeneity of the disease. The most common disease manifestation in children is frequent inflammatory diseases of the upper and lower respiratory tract. They are recorded in most patients, especially in young children, and the diagnosis is often determined untimely due to a low awareness of specialists about this nosology. Differential diagnostic approach is described in detail, peculiarities of treatment and management of children with this nosology are specified. The material is based on clinical guidelines developed and approved by the professional association «Union of Pediatricians of Russia».В статье представлены самые современные позиции оказания медицинской помощи детям с первичной цилиарной дискинезией. Симптомы данной патологии в клинической практике варьируют, что обусловлено генетической неоднородностью заболевания. Наиболее распространенное проявление болезни у детей — частые воспалительные заболевания верхних и нижних дыхательных путей, которые регистрируются у большинства пациентов, особенно у детей раннего возраста, а при невысокой осведомленности специалистов о данной нозологии диагноз зачастую устанавливается несвоевременно. Подробно изложен дифференциальный диагностический подход, указаны особенности лечения и ведения пациентов детского возраста с данной нозологией. Материал основан на клинических рекомендациях, разработанных и утвержденных профессиональной ассоциацией «Союз педиатров России»