Economic analysis of the effectiveness of complex rehabilitation in children with spastic forms of cerebral palsy with injections of botulinum neurotoxin type A and without it

Purpose. Comparative economic analysis of complex rehabilitation of children with cerebral palsy (CP) with and without injections of botulinum neurotoxin type A (Dysport®, BoNT-A). Materials and methods. We clinically followed up 149 children with spastic forms of cerebral palsy (GMFCS II-IV) – 78 boys and 71 girls in the age period from 2 to 14 years (108 children who received intramuscular BoNT-A injections and 41 children who underwent similar complex treatment without it). In the budget impact analysis (BIA) only direct medical costs were taken: the cost of pharmacotherapy BoNT-A, rehabilitation care and surgery. Results. Children with CP of the main group needed surgical correction for the first time by 10.5±2.8 years, 4.6 % (5 children) of them needed repeated 95 % (39 children) of the comparison group during the period of active growth from 10 to 12 years. As a result, the BIA found that the use of the treatment scheme for children with CP using abobotulinumtoxinA will save the budget of 24 744 690 RUB per 100 children compared to standard therapy for 12 years of observation. During the CEA it was found that to achieve 1 % efficiency in children with CP with the use of abobotulinumtoxin A requires 1 854 426 RUB, and to achieve a similar result without BoNT-A — 40 702 271 RUB. Including abobotulinumtoxinA injections in the comprehensive rehabilitation of children with CP would allow to treat additional 14 % children (compared to a treatment without BoNT-A ) with the same budget. Conclusion. It was found that the use of treatment regimens for children with cerebral palsy using the BoNT-A is economically justified. Long-term therapy of children with CP with Dysport® during a 12-year-follow-up has considerably improved clinical outcomes and could provide a saving of 24 744 690 rubles compared with a standard therapy per 100 patients. Considering the register of children with CP in the Tyumen region on 01 January, 2018, the budget savings could account for 5,938,726 rubles a year

Снижение дефицита пропускных способностей железнодорожных направлений за счёт внедрения интервального регулирования движения поездов

The article presents various options for technical and technological provisions to develop the capacity of railway lines, where there is a need to master the increasing volumes of traffic caused by various factors, for example, changes in national and world cargo flows, passenger flows.The paper considers provisions undertaken to adopt and effectively implement a new technology of virtual coupling in the interval regulation of train traffic in the conditions of limited railway capacity which makes it possible to reduce inter-train intervals, electricity costs of traction as well as of infrastructure maintenance. This type of interval control allows controlling the following locomotive considering the information that is transmitted over the radio from the locomotive of the pilot train in front. The problems that arise during the traffic process controlled through virtual coupling mode are also identified followed by the model calculations referring to a system being introduced of stimulation and bonuses awarding intended for assistant station masters and traffic dispatchers of traction divisions respective of the number of dispatched and transit trains controlled through virtual coupling mode.В статье приведены различные варианты технических и технологических мероприятий по развитию пропускных способностей железнодорожных направлений, где имеется потребность в освоении возрастающих объёмов перевозок, вызванных различными факторами, в том числе, изменением национальных и мировых грузо- и пассажиропотоков.В работе рассмотрены мероприятия, осуществляемые в целях внедрения и эффективного использования новой технологии «виртуальной сцепки» при интервальном регулировании движения поездов в условиях ограниченных пропускных способностей железнодорожных направлений, позволяющей сократить межпоездные интервалы, расходы электроэнергии на тягу, а также на содержание инфраструктуры. Такой вид интервального регулирования позволяет управлять ведомым локомотивом с учётом информации, которая передается по радиоканалу с локомотива ведущего поезда. Выявлены проблемы, которые возникают при пропуске поездов, следующих в режиме «виртуальная сцепка».Приведены примерные расчёты, связанные с внедряемой системой мотивации дежурно-диспетчерского персонала дирекций управления движением и премированием работников дирекций тяги за каждый отправленный и проследовавший по участку поезд в режиме интервального регулирования

Clinical and morphological characteristics of uveal melanoma

Purpose: То examine clinical and morphological features of uveal melanomas. Design: Noncomparative case series. Participants and methods: 81 patients with the diagnose of uveal melanoma [males — 53,1%, females — 46,9%; medium age — 59,57±12,32 years; intraocular localization of tumors: iris — 3(3,7%), ciliary body — 11(13,58%), choroid — 67(82,72%)]; histological assessment of specimens of uveal melanomas ( eosin — hematoxylin staining). Results: The majority of the patients were among the elder group (>61 years) with T3 and III stages of the disease (p61 г.). Наиболее представительной оказались ТЗ и III стадии неопластического процесса (р<0,05). По данным изучения патоморфологии исследуемые увеальные меланомы были представлены в основном эпителиоидноклеточными и смешанноклеточными опухолями (р<0,05), чаще встречались интенсивно пигментированные внутриглазные новообразования (р<0,05). Веретеноклеточные и эпителиоидноклеточные опухоли отличались равномерным распределением пигмента на поверхности меланомы, тогда как смешанноклеточные новообразования характеризовались неравномерностью пигментации (р<0,05). Выводы: полученные клинико- морфологические параллели необходимо учитывать при прогнозировании течения опухолевого процесса при увеальной меланоме

Performance of the CMS Cathode Strip Chambers with Cosmic Rays

The Cathode Strip Chambers (CSCs) constitute the primary muon tracking device in the CMS endcaps. Their performance has been evaluated using data taken during a cosmic ray run in fall 2008. Measured noise levels are low, with the number of noisy channels well below 1%. Coordinate resolution was measured for all types of chambers, and fall in the range 47 microns to 243 microns. The efficiencies for local charged track triggers, for hit and for segments reconstruction were measured, and are above 99%. The timing resolution per layer is approximately 5 ns

Performance of CMS muon reconstruction in pp collision events at sqrt(s) = 7 TeV

The performance of muon reconstruction, identification, and triggering in CMS has been studied using 40 inverse picobarns of data collected in pp collisions at sqrt(s) = 7 TeV at the LHC in 2010. A few benchmark sets of selection criteria covering a wide range of physics analysis needs have been examined. For all considered selections, the efficiency to reconstruct and identify a muon with a transverse momentum pT larger than a few GeV is above 95% over the whole region of pseudorapidity covered by the CMS muon system, abs(eta) < 2.4, while the probability to misidentify a hadron as a muon is well below 1%. The efficiency to trigger on single muons with pT above a few GeV is higher than 90% over the full eta range, and typically substantially better. The overall momentum scale is measured to a precision of 0.2% with muons from Z decays. The transverse momentum resolution varies from 1% to 6% depending on pseudorapidity for muons with pT below 100 GeV and, using cosmic rays, it is shown to be better than 10% in the central region up to pT = 1 TeV. Observed distributions of all quantities are well reproduced by the Monte Carlo simulation.Comment: Replaced with published version. Added journal reference and DO

Performance of CMS muon reconstruction in pp collision events at sqrt(s) = 7 TeV

The performance of muon reconstruction, identification, and triggering in CMS has been studied using 40 inverse picobarns of data collected in pp collisions at sqrt(s) = 7 TeV at the LHC in 2010. A few benchmark sets of selection criteria covering a wide range of physics analysis needs have been examined. For all considered selections, the efficiency to reconstruct and identify a muon with a transverse momentum pT larger than a few GeV is above 95% over the whole region of pseudorapidity covered by the CMS muon system, abs(eta) < 2.4, while the probability to misidentify a hadron as a muon is well below 1%. The efficiency to trigger on single muons with pT above a few GeV is higher than 90% over the full eta range, and typically substantially better. The overall momentum scale is measured to a precision of 0.2% with muons from Z decays. The transverse momentum resolution varies from 1% to 6% depending on pseudorapidity for muons with pT below 100 GeV and, using cosmic rays, it is shown to be better than 10% in the central region up to pT = 1 TeV. Observed distributions of all quantities are well reproduced by the Monte Carlo simulation.Comment: Replaced with published version. Added journal reference and DO

Performance and Operation of the CMS Electromagnetic Calorimeter

The operation and general performance of the CMS electromagnetic calorimeter using cosmic-ray muons are described. These muons were recorded after the closure of the CMS detector in late 2008. The calorimeter is made of lead tungstate crystals and the overall status of the 75848 channels corresponding to the barrel and endcap detectors is reported. The stability of crucial operational parameters, such as high voltage, temperature and electronic noise, is summarised and the performance of the light monitoring system is presented

Рекомендации по проведению тримодальной терапии рака мочевого пузыря (Невский консенсус 2021)

The aim of this work was to clarify and extend the existing clinical guidelines on organ-sparing treatment of muscleinvasive bladder cancer. The standard protocol of radical conservative treatment for muscle-invasive bladder cancer includes transurethral resection of the bladder, external beam radiotherapy with simultaneous chemotherapy (radiosensitization), which is usually referred to as trimodal therapy. The implementation of trimodal therapy into routine practice in Russia is limited due to the lack of distinct criteria for each of the stages. The involvement of surgeons, radiation oncologists, and chemotherapists, on the one hand, provides the required multidisciplinary approach to cancer treatment; on the other hand, it might impede the entire algorithm. To address this problem, specialists from the Department of Radiology (project moderators), Department of Cancer Urology, and Department of Chemotherapy of N.N. Petrov National Medical Research Center of Oncology under the auspices of Saint Petersburg Oncological Research Society formed a group of experts, including radiation oncologists, urologists, and chemotherapists from federal and local cancer (educational) institutions of Saint Petersburg who had an experience of treating muscle-invasive bladder cancer. The guideline was developed with the consideration of available guidelines published by leading professional associations of radiotherapy and oncology (urological), research articles, and own experience.         Цель работы – уточнение и дополнение клинических рекомендаций по органосохраняющему лечению мышечноинвазивного рака мочевого пузыря. Стандартный протокол радикального консервативного лечения мышечно-инвазивного рака мочевого пузыря включает трансуретральную резекцию мочевого пузыря, дистанционную лучевую терапию с одновременной химиотерапией (радиосенсибилизацию) и называется тримодальной терапией. Широкое внедрение тримодальной терапии в отечественную практику ограничено отсутствием четких критериев для каждого из этапов. Участие в протоколе хирургов, радиационных онкологов и химиотерапевтов, с одной стороны, обеспечивает необходимый мультидисциплинарный характер лечения онкологического больного, с другой – затрудняет реализацию всего алгоритма. Для осуществления поставленной задачи отделениями радиотерапии (модераторы проекта) и онкоурологии, а также отделением химиотерапии и инновационных технологий НМИЦ онкологии им. Н.Н. Петрова под эгидой Петербургского онкологического научного общества сформирована группа экспертов, включающая радиационных онкологов, онкоурологов и химиотерапевтов федеральных и городских онкологических (образовательных) учреждений (г. Санкт-Петербург), имеющих опыт лечения мышечно-инвазивного рака мочевого пузыря. Разработка рекомендаций велась с учетом имеющихся рекомендаций ведущих профессиональных радиотерапевтических и онкологических (урологических) ассоциаций, опубликованных статей и собственного опыта