Laparoscopic vs. open surgical access radical cystectomy with subsequent orthotopic reconstruction in the treatment of invasive urothelial carcinoma of the bladder

Introduction: Radical cystectomy combined with extended lymph node dissection is the treatment of choice for muscle-invasive bladder cancer and can be performed using open, laparoscopic, or robot-assisted surgical access. Aim: To compare the outcomes of laparoscopic (LRC) and open-access (ORC) radical cystectomy in terms of surgery, oncology, functional outcomes, and complications. Materials and methods: We conducted a retrospective study of 200 patients who had all undergone cystectomy for muscle-invasive bladder cancer within the last 4 years. All patients were divided into groups according to the surgical access: LRC in 30 patients and ORC in 170 patients. Oncologic outcomes, expressed as perioperative complications and postoperative results, were analyzed. Results: Overall survival rates were most significantly associated with the histological type, as well as the ‘positive’ lymph nodes and positive resection margin. The average duration of the procedure was shorter in ORC than in LRC (245.5 min and 345.3 min, respectively). Hospital stay was on average 9.18 days in LRC and 12.63 days in ORC, and this duration could vary depending on the type of diversion. The average blood loss in LRC (250-320 ml) was lower than that in ORC (200-720 ml). The complications rate was lower with LRC than with ORC; however, with subsequent orthotopic reconstruction, the functional results were better in ORC. Conclusions: LRC is an alternative option to ORC, considering the fewer complications, less amount of blood loss, and greater surgical precision, as well as shorter hospital stay. Orthotopic diversion has better functional outcomes in ORC

Modernization of government management in empires of new time: comparative political analysis

The article deals with the issues related to the modernization of public administration in the imperial states of modern times. Russian, British and Ottoman empires as states implementing various strategies of modernization and improvement of public administration were chosen as examples. The success of modernization reforms of the administration is one of the essential conditions for maintaining stability and development of the imperial political system, formalizing the domination of the center in relation to the periphery. The Ottoman Empire failed to implement the policy of modernization of public administration in a timely and consistent manner. The British Empire was combined the strategies of centralization and decentralization of state management of its overseas colonies. The Russian Empire - a special imperial system -implemented, within the framework of the unitary state, the principle of centralization of the system of management, but its implementation in the development of the central bureaucratic apparatus of the empire was limited by the autocratic monarchy. At the same time, the Russian Empire was flexible in terms of differentiation of the management approaches. The article substantiates the conclusion that the imperial administration was an expression of centripetal political processes in the imperial system provided them and was an expression of the political power of the center which has an autocratic character in relation to the periphery. The processes associated with the administration of the Empire are concentrated in its center and implemented in addition to the will of the periphery. In institutional terms, the center of the empire is represented by general imperial authorities and management, in functional terms, the imperial power has exclusive administrative prerogatives associated with the concentration of resources of power and their distribution over the imperial hierarchy. The differentiation of administrative approaches shows the administrative and political specificity of the empire-state. In general the modernization of management empire became a significant factor in allowing the empire to most effectively carry out the concentration of political resources

Towards a norm-driven design of context-aware e-health applications

In this paper, we explore the usefulness of elaborating process models with norms, especially focusing on the Norm Analysis Method (NAM) as an elaboration tool that can be combined with a process modeling tool, such as Petri Net (PN). The PN-NAM combination has been particularly considered in the paper in relation to a challenge that concerns the design of context-aware applications, namely the challenge of specifying and elaborating complex behaviors that may include alternative (context-driven) processes (we assume that a user context space can be defined and that each context state within this space corresponds to an alternative application service behavior). Hence, the main contribution of our paper comprises an adaptability-driven methodological and modeling support to the design of context-aware applications; modeling guidelines are proposed, considered together with corresponding modeling tools (in particular PN and NAM), and partially illustrated by means of an e-Health-related example. Given the multi-disciplinary nature of the e-Health domain, it is expected that the current research will be useful for it. In particular, e-Health system developers might benefit from the relevant methodological and modeling support, proposed in the paper

The influence of different doses and ratios of mineral fertilizers on the yield of winter rye in the Urals

Winter rye is an important crop of the Non-Chernozem belt of Russia, the productivity of which depends on the use of fertilizers. The paper presents data on the agronomic and economic efficiency of cultivating Falenskaya 4 winter rye under conditions of long-term use of mineral fertilizers. The studies were carried out in 2019-2021 in Perm Region on sod-podzolic heavy loamy soil in a long-term stationary experiment based on a reduced factorial design (6x6x6) with a wide range of doses and NPK ratios. The highest yield in 2019 was obtained in N30P120K120 variant (3.07 t/ha), the highest payback of mineral fertilizers by grain was noted in N90 and N30P30K30 variants (6.00 and 5.69 kg of grain). The highest yield and payback of grain in the conditions of 2021 and for two years of research in average was obtained in the variant N90: in 2021, 3.01 t/ha and 13.96 kg of grain, for 2 years average – 2.95 t/ha and 9.82 kg of grain. The efficiency of nitrogen fertilizers has been proved by a regression equation for two years average, phosphoric and potash fertilizers did not have a significant effect. The rise in the yield increase occurred up to a nitrogen dose of 90 kg/ha and amounted to 0.42 t/ha at N90. The highest payback by grain was noted among nitrogen treatments – by N30 (7.3 kg of grain), with each increase in doses by 30 kg/ha, this indicator decreased linearly by 1.3 kg. The highest profitability over the years of research was obtained in the variant without fertilizers– 60 %, over two years in average. The profitability of using N90 was higher compared with the control only in 2021 – 50 % versus 43 %. All the studied doses of nitrogen used separately provided positive profitability, but the most cost-effective was the use of N30 and N60 – profitability was 52 and 45 %, respectively

The effect of increasing rates of mineral fertilizers on the yield and quality parameters of potato tubers

The yield and quality parameters of potato tubers of Gala variety were determined in the conditions of the Middle Urals in 2020 and 2022 in long-term stationary experiment after prolonged application of NPK increasing rates (30-60-90-120-150 kg a.i.). The application of NPK by 60 kg a.i./ha and more promoted the potato yield raise by 1.1-1.3 times in 2020 and by 1.3-1.5 times in 2022 compared with the control variant without fertilizers (21.4 and 14.4 t/ha by years, respectively). The lowest dry matter content over the years of research was noted at the maximum dose of N150P150K150 mineral fertilizer in the experiment– 15.6 % in favorable weather conditions of 2020 and 19.4 % in the dry 2022. The starch content in potato tubers did not depend on the dose of applied mineral fertilizers and varied in 2020 in the range from 11.1 to 13.8 %, in 2022 – from 14.4 to 16.3 %. In potato tubers the content of crude protein in the wet mass increased from 1.32 to 1.90 % in 2020 and from 1.80 to 2.65 % in 2022 to the weight of wet mass with an increase in the dose of NPK from 30 to 150 kg/ ha active substance. The sugar content in 2020 was 0.58-0.83 % for natural humidity, in 2022 – 0.23-0.47 %. The fiber content in potato tubers did not depend on the doses of applied mineral fertilizers. The application of increasing doses of NPK did not lead to exceeding the permissible value of the nitrate content in fresh potato. According to a comprehensive assessment of the quality of tubers, potato yield, obtained under given conditions, was suitable for the production of low carbohydrate potato products and for fodder purposes

Continuous selections of multivalued mappings

This survey covers in our opinion the most important results in the theory of continuous selections of multivalued mappings (approximately) from 2002 through 2012. It extends and continues our previous such survey which appeared in Recent Progress in General Topology, II, which was published in 2002. In comparison, our present survey considers more restricted and specific areas of mathematics. Note that we do not consider the theory of selectors (i.e. continuous choices of elements from subsets of topological spaces) since this topics is covered by another survey in this volume

Concept of use of comprehensive fertilizers of long-term action on the basis of waste processing of potassium-magnesium ore as a new paradigm in improving soil fertility

Technology for the production and use of new multiple slow-release fertilizers from clay-salt waste (sludge) remaining as a result of potassium fertilizers production from natural K-Mg ores, is elaborated in Perm Federal Research Center. The main processes in the technology are waste enrichment and subsequent high-temperature calcination of the enriched concentrate. As a result, the product, received the name the calcine of clay-salt sludge, was formed having the properties of multiple slow-release fertilizer and ameliorant. Laboratory and field experiments on the calcine use as a potassium fertilizer were fulfilled. The studied crops were spring wheat, barley, and potato. The experimental scheme included such treatments: control (without fertilizers), NP – background; NP + KCl and NP + calcine. The use of calcine for grain crops (wheat, barley) on the NP background promoted the yield gains by 1.7–1.9 t/ha compared with the control, the use of standard NPK fertilizers – by 1.8–2.0 t/ha, the difference was within the error of the experiment (HCP05 = 0.21; 0.38 t/ha). The content of nitrogen, phosphorus and potassium in the grain and straw of both crops in the treatments using calcine was approximately equal to the variants using standard fertilizer and significantly higher compared to the control. Differences between calcine treatments were not significant. The application of N90P90 and full mineral fertilizer (N90P90K90) contributed to the yield increase of potato tubers by 1.43–4.51 t/ha respectively. The use of unconventional potassium fertilizer – calcine on the background of NP was not inferior in efficiency to the use of traditional fertilizer – potassium chloride. The quality parameters of the potato crop (dry matter and starch content in tubers, the content of heavy metals) were also not inferior compared to the use of traditional potassium fertilizer. The use of calcine for potato and cereals in rates equal to K60-120 did not lead to deterioration of the fertility indicators of sod-podzolic soil. Upon receipt of the cinder, one can use the additional unlimited set of components. In other words, this is a conceptual model for creating new types of mineral fertilizers with desired properties for different soil and climatic conditions and crops with different requirements for mineral nutrition

Infectious Agents and Miscarriage in Bulgaria

A number of infection agents have been linked to miscarriage and to other adverse outcomes of pregnancy, such as stillbirth and preterm delivery. The purpose of present study was to determine the implication and prevalence of viral agents (parvovirus B19, rubella, CMV and adenoviruses) and Chlamydia trachomatis in the etiology of miscarriage during the first and second trimester of pregnancy. A total of 62 serum samples from women with miscarriage (n=32) and control group of healthy women (n=30) for period January 2015 – June 2016 were tested by ELISA (detected of specific IgM/IgG antibodies) and PCR (detected of specific genomic region) assays. The possible role of B19V, Ch. trachomatis and adenoviruses for miscarriages were detected in 6/32 (18.75%) by ELISA and in 7/32 (21,87%) by PCR methods. The seroprevalence of protective IgG antibodies in the highest level was proven against rubella 25/32 (78,12%) and the lowest – against adenoviruses (1/32, 6,25%). All tested healthy women in the control group had a negative result for acute infection for the five tested infectious agents. The detailed study aimed at enriching the diagnostic palette of these infectious pathogens is necessary for understanding the exact mechanisms behind infection-induced miscarriages and could lead to effective treatment and thus prevention