Process of updating of the regulatory base in construction

An assessment of the state pricing policy in matters ofpricing the construction industry has been given. The estimated regulatory framework and the level of its validity, which is necessary for determining the price of construction products, have been characterized. The state information system of estimated standards, necessary for the formation of a market pricing system in construction, has been considered. The necessity of implementing the reform of construction pricing, which will help to create conditions for the further development of the industry at a new level of reliability and quality of determining reasonable construction prices, has been shown

PSYCHOLOGY OF CONSUMER CHOICE AND ITS INFLUENCE ON PRICING IN MARKET CONDITIONS

The schemes of the decision-making process of an individual when consuming various goods and services using the components of economic psychology have been considered. Relevant from the point of view of economic psychology characteristics of buyer behavior that have a direct impact on his attitude to the price level of a product or service and on his reaction when the price changes for them have been presented and reviewed. The used “models” of consumer behavior of motivation, explaining not only the purchase by him of this product, but also his decision to have this product have been shown. Building models of purchase motivation allows manufacturers not only to explain consumer behavior, but also to influence it. Knowing all these nuances and skilful use of them, manufacturers have the opportunity significantly facilitate the pricing process for their goods and make a more accurate calculation of the “fair” price, which will not alienate the consumer. Two global approaches to segmentation of the consumer market have been considered, the use of which allows the manufacturer to assess the company’s competitiveness, assess the market size, and assess the customer’s commitment

КОКЛЮШ У ДЕТЕЙ – КЛИНИКО-ЭПИДЕМИЧЕСКАЯ ХАРАКТЕРИСТИКА В САМАРСКОЙ ОБЛАСТИ

Objective: to study the features of the clinical and epidemiological characteristics of whooping cough in children in the Samara region.Materials and methods: 389 cases of pertussis in the Samara region for 2015–2016 were analyzed.Results: it is shown that in spite of 95–98% vaccination coverage, in recent years there has been an increase in the incidence of whooping cough. Seasonality of morbidity remains. Among the children observed, the youngest children were not vaccinated against pertussis. The clinical picture of the disease remains typical with the classic course of catarrhal and spasmodic periods. Moderately severe forms of the disease predominate. Complications were noted mainly in unvaccinated children of the first year of life. The most frequent complications were pneumonia and apnea. There is a hypodiagnosis of pertussis in outpatient conditions. Infection often occurs under the mask of ARVI, while the sensitivity of the bacteriological method of diagnosis is zero. Of the methods for confirming the diagnosis, the most reliable is ELISA and PCR.Conclusion: these epidemiological and clinical features of pertussis current testify to the need to further improve methods of early diagnosis, especially express methods, etiopathagenetic treatment, specific prevention, antiepidemic measures in the foci of infection.Цель: изучить особенности клинико-эпидемической характеристики коклюша у детей в Самарской области.Материалы и методы: проанализированы 389 случаев коклюша в Самарской области за 2015–2016 гг.Результаты: показано, что, несмотря на 95–98% охват прививками, в течение последних лет наблюдается подъем заболеваемости коклюшем. Сохраняется сезонность. Среди наблюдавшихся детей преобладали дети младшего возраста, не привитые от коклюша. Клиническая картина заболевания остается типичной с классическим течением катарального и спазматического периодов. Преобладают среднетяжелые формы заболевания. Осложнения отмечались в основном у непривитых детей первого года жизни. Наиболее частыми осложнениями являлись пневмонии и апноэ. Имеет место гиподиагностика коклюша в амбулаторных условиях. Инфекция нередко протекает под маской ОРВИ, при этом чувствительность бактериологического метода диагностики равна нулю. Из методов подтверждения диагноза наиболее достоверным является ИФА и ПЦР.Заключение: указанные эпидемиологические и клинические особенности течения коклюша свидетельствуют о необходимости дальнейшего совершенствования методов ранней диагностики, особенно экспресс-методов, этиопатагенетического лечения, специфической профилактики, противоэпидемических мероприятий в очагах инфекции.

Новая коронавирусная инфекция (COVID-19) у больных туберкулёзом в Санкт-Петербурге

The aim of this work was to attempt to analyze the demographic structure, clinical and radiological forms of tuberculosis and COVID-19, as well as the course and outcome of the disease in patients with this coinfection in the light of a new and still poorly understood problem of the mutual influence of tuberculosis and COVID-19.Material and methods. Examination and treatment were carried out in the infectious-tuberculosis departments of the Botkin Clinical Infectious Disease Hospital. We examined 63 patients identified in the first seven months of the epidemic in the multimillion city of St. Petersburg (Russia). Tuberculosis, confirmed by conventional bacteriological and molecular genetic methods, had an active phase in all of them. The new coronavirus infection was verified by a positive polymerase chain reaction test for SARS-CoV-2.Results. Tuberculosis in 43 patients was detected simultaneously with COVID-19, in 20 people it preceded coronavirus infection. Disseminated forms of tuberculosis prevailed - 50.8%; in 36.5%, two or more organs and systems were affected, which is associated with a high proportion (54.0%) of HIV-positive patients with an advanced stage of the disease. Lung damage with COVID-19 was noted in 36.5%. Fatal outcomes ended in 20.6% of cases of coinfection, the structure of the causes of death is given.Conclusion. An assumption was made about the possibility of an aggravating effect of tuberculosis on COVID-19 in the case of severe or widespread forms of these diseases. The negative influence of HIV infection on the outcome of the disease has also been shown. Further follow-up is required to identify more reliable associations between tuberculosis and COVID-19. Цель: попытка выполнить анализ демографической структуры, клинико-рентгенологических форм туберкулёза и COVID-19, а также течения и исхода заболевания у пациентов с указанной коинфекцией в свете новой и пока малоизученной проблемы взаимного влияния туберкулёза и COVID-19.Материалы и методы. Обследование и лечение проводилось в инфекционно-туберкулёзных отделениях Клинической инфекционной больницы им. С.П. Боткина. Обследованы 63 пациента, выявленные в первые 7 месяцев эпидемии в многомиллионном городе Санкт-Петербурге (Россия). Туберкулёз, подтверждённый общепринятыми бактериологическими и молекулярно-генетическими методами, у всех имел активную фазу течения. Новая коронавирусная инфекция верифицирована положительным тестом полимеразно-цепной реакции на SARS-CoV-2.Результаты. Туберкулёз у 43 больных был обнаружен одновременно с COVID-19, у 20 человек он предшествовал коронавирусной инфекции. Преобладали диссеминированные формы туберкулёза – 50,8%; в 36,5% имело место поражение двух и более органов и систем, что связано с высокой долей (54,0 %) ВИЧ-положительных пациентов с продвинутой стадией заболевания. Поражение лёгких при COVID-19 отмечено в 36,5%. Летальным исходом завершились 20,6% случаев коинфекции, приведена структура причин смерти.Заключение. Сделано предположение о возможности отягощающего влияния туберкулёза на COVID-19 в случае тяжёлых или распространённых форм этих заболеваний. Показано также отрицательное влияние ВИЧинфекции на исход заболевания. Требуются дальнейшие наблюдения для выявления более более достоверных взаимосвязей туберкулёза и COVID-19.

Перспективные направления лечения хронической сердечной недостаточности: совершенствование старых или разработка новых?

Unprecedented advances of recent decades in clinical pharmacology, cardiac surgery, arrhythmology, and cardiac pacing have significantly improved the prognosis in patients with chronic heart failure (CHF). However, unfortunately, heart failure continues to be associated with high mortality. The solution to this problem consists in simultaneous comprehensive use in clinical practice of all relevant capabilities of continuously improving methods of heart failure treatment proven to be effective in randomized controlled trials (especially when confirmed by the results of studies in real clinical practice), on the one hand, and in development and implementation of innovative approaches to CHF treatment, on the other hand. This is especially relevant for CHF patients with mildly reduced and preserved left ventricular ejection fraction, as poor evidence base for the possibility of improving the prognosis in such patients cannot justify inaction and leaving them without hope of a clinical improvement in their condition. The lecture consistently covers the general principles of CHF treatment and a set of measures aimed at inotropic stimulation and unloading (neurohormonal, volumetric, hemodynamic, and immune) of the heart and outlines some promising areas of disease-modifying therapy.Беспрецедентные достижения последних десятилетий в области клинической фармакологии, кардиохирургии и имплантационной аритмологии значительно улучшили прогноз у пациентов с хронической сердечной недостаточностью (ХСН), однако, к сожалению, сердечная недостаточность продолжает ассоциироваться с высокой смертностью. Решение этой проблемы видится одновременно в максимально полном применении в клинической практике всех актуальных возможностей непрерывно совершенствующихся методов лечения сердечной недостаточности, доказавших свою эффективность в рандомизированных контролируемых исследованиях (особенно при подтверждении результатами исследований реальной клинической практики), с одной стороны, а также в разработке и оперативном внедрении инновационных подходов к терапии ХСН – с другой. Больше всего в этом нуждаются пациенты с ХСН с умеренно сниженной и сохранной фракцией выброса левого желудочка, бедная доказательная база возможности улучшения прогноза у которых не может обосновывать бездействие и оставление их без надежды хотя бы на клиническое улучшение состояния. В лекции последовательно рассмотрены общие принципы лечения ХСН, комплекс мероприятий, направленный на инотропную стимуляцию и разгрузку (нейрогормональную, объемную, гемодинамическую и иммунную) сердца, а также обозначены некоторые перспективные направления болезнь-модифицирующей терапии

The waking brain: an update

Wakefulness and consciousness depend on perturbation of the cortical soliloquy. Ascending activation of the cerebral cortex is characteristic for both waking and paradoxical (REM) sleep. These evolutionary conserved activating systems build a network in the brainstem, midbrain, and diencephalon that contains the neurotransmitters and neuromodulators glutamate, histamine, acetylcholine, the catecholamines, serotonin, and some neuropeptides orchestrating the different behavioral states. Inhibition of these waking systems by GABAergic neurons allows sleep. Over the past decades, a prominent role became evident for the histaminergic and the orexinergic neurons as a hypothalamic waking center

Ultrastructural patterns of photoacclimation and photodamage to photosynthetic algae cell under environmental stress

In oxygenic phototrophs including unicellular algae, acclimation to and damage by diverse environmental stresses induce profound changes in the ultrastructural organization of the cell. These alterations reflect acclimation of the photosynthetic apparatus to unfavorable conditions (mainly reduction of the chloroplast and its membranal system) and rewiring of the photo-fixed carbon fluxes in the cell. These changes, eventually pursuing mitigation of the photooxidative damage risk, are manifested by the formation of diverse carbon-rich inclusions. Although the physiological and molecular basis of these processes are well understood, the ultrastructural manifestations of the stress responses are often fragmented and frequently controversial. This minireview attempts to generalize on the ultrastructural patterns accompanying stresses in the photosynthetic cell, involving the concerted rearrangements of its assimilatory and storage compartments. The changes characteristic of normal functioning and emergency reduction of the chloroplast thylakoids under harsh stress are also addressed. Special attention is paid to the manifestations of the engagement of photoprotection via active (energy-dependent non-photochemical quenching) and passive mechanisms (e.g. optical shielding by secondary carotenoids). We also underline the potentially important role of autophagy-like processes and provide a more integral view of ultrastructural rearrangements under stress. © 2018 Scandinavian Plant Physiology Societ

Light absorption and scattering by high light-tolerant, fast-growing Chlorella vulgaris IPPAS C-1 cells

Algal cells are highly complex optical systems that can dynamically change their structure. Consequently, absorption and scattering properties of algae change, while the cells are acclimating to different light conditions or during growth and division in a cell cycle. This may be particularly important in algal species that can grow rapidly under very high-light such as Chlorella vulgaris IPPAS C-1 that is studied here. From cell transmittance measured conventionally and using integrating sphere, we evaluated absorption and scattering coefficients and cross sections per cell dry weight and chlorophyll content. This was done for asynchronous cell culture grown in low-light (LL; 220 μmol (photons) m−2 s−1) or high-light (HL; 1760 μmol (photons) m−2 s−1) light, as well as during cell cycle of synchronous culture grown in HL. During the cell cycle, we also determined cell ultrastructural organization by transmission electron microscopy, and correlated its parameters with absorption and scattering cross sections per cell dry weight. We found that the IPPAS C-1 cells of asynchronous culture scatter light more than other cells, however, internal organization of the cells that is decisive for scattering is less sensitive to HL and LL treatment than the cell pigment content that controls absorption. The light scattering and absorption were dynamically changed during cell cycle of synchronous cells grown in the HL. Changes in ratio of chloroplast to protoplast area, reflecting amount of scattering chloroplast membrane (outer, inner) interfaces, best correlated with changes in light scattering. We suggest that the increased light scattering by the HL-acclimated IPPAS C-1 cells might be responsible for increased HL resilience reported in the literature. Biotechnological aspect of this study is that the scattering and absorption properties of phytoplankton cells ought to be calibrated for each particular growth phase or irradiance to which the cells are acclimated. © 2020 Elsevier B.V

Stress-induced changes in the ultrastructure of the photosynthetic apparatus of green microalgae

In photosynthetic organisms including unicellular algae, acclimation to and damage by environmental stresses are readily apparent at the level of the photosynthetic apparatus. Phenotypic manifestations of the stress responses include rapid and dramatic reduction of photosynthetic activity and pigment content aimed at mitigating the risk of photooxidative damage. Although the physiological and molecular mechanisms of these events are well known, the ultrastructural picture of the stress responses is often elusive and frequently controversial. We analyzed an extensive set of transmission electron microscopy images of the microalgal cells obtained across species of Chlorophyta and in a wide range of growth conditions. The results of the analysis allowed us to pinpoint distinct ultrastructural changes typical of normal functioning and emergency reduction of the chloroplast membrane system under high light exposure and/or mineral nutrient starvation. We demonstrate the patterns of the stress-related ultrastructural changes including peculiar thylakoid rearrangements and autophagy-like processes and provide an outlook on their significance for implementation of the stress responses. © 2018, Springer-Verlag GmbH Austria, part of Springer Nature