Features of the organization of coloproctological care to the population taking into account regional indicators of incidence

Rationale. The article provides an analysis of the features of the organization of coloproctological care for the population of the Perm Territory, taking into account regional morbidity rates, which made it possible to identify a number of significant shortcomings. There is no connection between the volume of specialized coloproctological care provided and the real need of the population. It was revealed that 32.0 % of coloproctological patients are being treated by doctors of other specialties. In 2018, 47,172 cases of coloproctological diseases were registered, and only 30,900 specialized outpatient appointments were made in the region (11.7 appointments per 1,000 population). More than half of them (57.4 %) were held in Perm.The aim of the study. Determination of the features of the organization of coloproctological care for the population of the Perm Territory, considering the incidence rates.Materials and methods. An analysis was made of the distribution among the adult population of the Perm Territory of pathologies related to the profile of coloproctology according to official statistical reports and the report of the chief specialist of the region for 2018.Results. In 2018, 3.9 sigmoidoscopies per 1,000 population were performed and 1.7 fibrocolonoscopies per 1,000 population, which led to an insufficient level of diagnosis of coloproctological pathologies. At the same time, identified for the period 2004–2018, a significant increase in the incidence of colorectal cancer (by 48.1 %), with an average annual growth rate over 15 years of 7.8 %, which is 3 times higher than the national figure, requires a change in approaches to the organization of coloproctological care, incl. for early diagnosis.Conclusion. Thus, in order to improve the quality of early diagnosis of coloproctological, and especially onco-coloproctological diseases, it is required to optimize the outpatient specialized coloproctological care in the Perm region. It is proposed to reorganize the service with the aim of organizing a primary link on the basis of an outpatient coloproctology center with a daily stay hospital, separate or at the coloproctology department of the City Clinical Hospital

EXPERIMENTAL INVESTIGATIONS OF REINFORCED CONCRETE STRUCTURES OF HYDRAULIC STRUCTURES WITH BLOCK SEAMS, ENHANCED BY THE EXTERNAL REINFORCEMENT SYSTEM

A method of strengthening reinforced concrete structures by external reinforcement systems based on carbon fiber is widely used. Significant experience is accumulated in industrial and civil construction; there is also a certain experience of strengthening reinforced concrete structures of hydraulic structures. It was necessary to conduct experimental studies to justify technical solutions for strengthening the reinforced concrete structures of hydraulic structures. A characteristic feature of reinforced concrete structures of hydraulic structures is the mandatory availability of inter-block construction joints, which are caused by the need to build massive hydraulic structures with tiers and blocks with interruptions in concreting. Previously studies of reinforced concrete structures strengthened by composite materials were conducted without taking into account the block structure. The results of experimental studies of reinforced concrete beam structures of hydraulic structures reinforced with carbon strips having horizontal and vertical inter-block building seams are presented in the article. Experimental studies of a series of reinforced concrete beam-type models made of concrete of class B15 with longitudinal reinforcement from two bars. Their diameter is 10 mm and class is A500C (percentage of reinforcement 0.39%). The used concrete class is B25 with longitudinal reinforcement of three bars of diameter 12 mm and class A500C (percentage of reinforcement 0.84%). Their inter-block construction joints is before their strengthening and after reinforcement by longitudinal and transverse carbon composite tapes. In this case, a special type of cracking was recorded, in which cracks propagate along vertical and horizontal inter-block building seams. Due to the strengthening of reinforced concrete structures with carbon composite strips, the strength of the structures has increased, on average, by 1.78 times

ESTIMATED JUSTIFICATION OF TECHNICAL DECISION ON STRENGTHENING REINFORCED CONCRETE MACHINE HALL FLOOR

Introduction. In connection with the long-term operation of hydraulic structures (HPP), the installation of significant temporary loads, the presence of alternating effects on individual structural elements, it is possible to reduce the carrying capacity and strength of reinforced concrete structures. One of the most crucial elements is the reinforced concrete overlap of the machine hall, the work presents field and design studies, a proposal to strengthen the structures with external reinforcement. Materials and methods. The scientific and technical documentation was analyzed, instrumental studies and visual inspections of the state of the structures were carried out, and a 3D mathematical model was developed based on the finite element method. Multivariate non-linear computational studies of the actual stress-strain state of structures have been carried out. Results. Conducted visual and instrumental examination showed the presence of cracking on the lower edge of the reinforced concrete floor of the machine room. The simulation of the actual state of the structures has been carried out; according to the results of calculations, a schematic diagram of the gain of structures has been proposed. Conclusions. As a result of computational studies of stress-strain state, the occurrence of cracks on the lower edge of reinforced concrete floor of the machine hall was confirmed. When applying temporary technological loads to overlap, it is possible to achieve the yield strength of the reinforcement in certain zones. In order to ensure further safe operation of the structures, a conceptual amplification scheme based on the results of stress-strain state calculations has been proposed

Correlation effects during liquid infiltration into hydrophobic nanoporous mediums

Correlation effects arising during liquid infiltration into hydrophobic porous medium are considered. On the basis of these effects a mechanism of energy absorption at filling porous medium by nonwetting liquid is suggested. In accordance with this mechanism, the absorption of mechanical energy is a result expenditure of energy for the formation of menisci in the pores on the shell of the infinite cluster and expenditure of energy for the formation of liquid-porous medium interface in the pores belonging to the infinite cluster of filled pores. It was found that in dependences on the porosity and, consequently, in dependences on the number of filled pores neighbors, the thermal effect of filling can be either positive or negative and the cycle of infiltration-defiltration can be closed with full outflow of liquid. It can occur under certain relation between percolation properties of porous medium and the energy characteristics of the liquid-porous medium interface and the liquid-gas interface. It is shown that a consecutive account of these correlation effects and percolation properties of the pores space during infiltration allow to describe all experimental data under discussion

To What Extent Is Water Responsible for the Maintenance of the Life for Warm-Blooded Organisms?

In this work, attention is mainly focused on those properties of water which are essentially changed in the physiological temperature range of warm-blooded organisms. Studying in detail the half-width of the diffusion peak in the quasi-elastic incoherent neutron scattering, the behavior of the entropy and the kinematic shear viscosity, it is shown that the character of the translational and rotational thermal motions in water radically change near TH ~ 315 K, which can be interpreted as the temperature of the smeared dynamic phase transition. These results for bulk pure water are completed by the analysis of the isothermic compressibility and the NMR-spectra for water-glycerol solutions. It was noted that the non-monotone temperature dependence of the isothermic compressibility (βT) takes also place for the water-glycerol solutions until the concentration of glycerol does not exceed 30 mol%. At that, the minimum of βT shifts at left when the concentration increases. All these facts give us some reasons to assume that the properties of the intracellular and extracellular fluids are close to ones for pure water. Namely therefore, we suppose that the upper temperature limit for the life of warm-blooded organisms [TD = (315 ± 3) K] is tightly connected with the temperature of the dynamic phase transition in water. This supposition is equivalent to the assertion that the denaturation of proteins at T ≥ TH is mainly provoked by the rebuilding of the H-bond network in the intracellular and extracellular fluids, which takes place at T ≥ TH. A question why the heavy water cannot be a matrix for the intracellular and extracellular fluids is considered. The lower physiological pH limit for the life of warm-blooded organisms is discussed