[THE STATUS OF THE SERVICE OF MEDICAL STATISTICS ACCORDING TO THE STAFF SURVEY RESULTS].

INRODUCTION: The Medical Statistics Service plays an important role in providing a medical organization with timely, high-quality statistical information. Therefore, it is important to study the opinions of specialists on the organization of this work. PURPOSE: To analyze the opinions of the staff of departments (offices) of medical statistics on the current work organization. MATERIAL AND METHODS: A survey was conducted among employees of the departments (offices) of medical statistics of the Moscow inpatient facilities. The survey results are presented as a frequency (in percent) of the choice of the answer options with a 95% confidence interval. Frequency confidence intervals were calculated using the EpiInfo 7 program. RESULTS: A total of 103 employees of the departments of medical statistics of the Moscow inpatient facilities took part in the survey. The majority of the respondents has a 20-year experience or more (29.1%). 61.3% of the heads of the departments of medical statistics, 70.4% of the doctors-statisticians and 74.2% of the medical statisticians stated a lack of a qualification category. The majority of the respondents were positive in their evaluation of the work organization of the medical statistics service (79.6%). The significance (importance) of the medical statistics service is unconditionally understood by 86.4% of the respondents. The respondents demonstrated a high degree of job satisfaction and work environment (10 scores out of 10). CONCLUSION: The study has identified a fairly positive attitude of the respondents towards their work, and the medical statistics service in general. However, the results obtained have also raised new questions, in particular, why specialists in this area do not have qualification categories, why they are not satisfied with the possibility of career growth, etc.

Signatures of Molecular Unification and Progressive Oxidation Unfold in Dissolved Organic Matter of the Ob-Irtysh River System along Its Path to the Arctic Ocean.

The Ob-Irtysh River system is the seventh-longest one in the world. Unlike the other Great Siberian rivers, it is only slightly impacted by the continuous permafrost in its low flow. Instead, it drains the Great Vasyugan mire, which is the world largest swamp, and receives huge load of the Irtysh waters which drain the populated lowlands of the East Siberian Plain. The central challenge of this paper is to understand the processes responsible for molecular transformations of natural organic matter (NOM) in the Ob-Irtysh river system along the South-North transect. For solving this task, the NOM was isolated from the water samples collected along the 3,000 km transect using solid-phase extraction. The NOM samples were further analyzed using high resolution mass spectrometry and optical spectroscopy. The obtained results have shown a distinct trend both in molecular composition and diversity of the NOM along the South-North transect: the largest diversity was observed in the Southern "swamp-wetland" stations. The samples were dominated with humic and lignin-like components, and enriched with aminosugars. After the Irtysh confluence, the molecular nature of NOM has changed drastically: it became much more oxidized and enriched with heterocyclic N-containing compounds. These molecular features are very different from the aliphatics-rich permafrost NOM. They witnesses much more conservative nature of the NOM discharged into the Arctic by the Ob-Irtysh river system. In general, drastic reduction in molecular diversity was observed in the northern stations located in the lower Ob flow.

Source apportionment of circum-Arctic atmospheric black carbon from isotopes and modeling.

Black carbon (BC) contributes to Arctic climate warming, yet source attributions are inaccurate due to lacking observational constraints and uncertainties in emission inventories. Year-round, isotope-constrained observations reveal strong seasonal variations in BC sources with a consistent and synchronous pattern at all Arctic sites. These sources were dominated by emissions from fossil fuel combustion in the winter and by biomass burning in the summer. The annual mean source of BC to the circum-Arctic was 39 ± 10% from biomass burning. Comparison of transport-model predictions with the observations showed good agreement for BC concentrations, with larger discrepancies for (fossil/biomass burning) sources. The accuracy of simulated BC concentration, but not of origin, points to misallocations of emissions in the emission inventories. The consistency in seasonal source contributions of BC throughout the Arctic provides strong justification for targeted emission reductions to limit the impact of BC on climate warming in the Arctic and beyond.

[The prevalence and risk factors of allergic rhinitis among the children of the preschool age]. / Rasprostranennost' i faktory riska allergicheskogo rinita sredi detei doshkol'nogo vozrasta.

The objective of the present work was to estimate the prevalence and risk factors of the development of allergic rhinitis among the children at the age from 3 to 6 years. The cross-sectional study was carried out in five cities of the Altai region during the period from 2015 to 2016. The prevalence of allergic rhinitis was evaluated with the use of the Russian language version of the ISAAC questionnaire filled up by the parents of the children. A child whose parents answered in the affirmative to the question 'Did your child have the runny nose, nasal congestion, and/or sneezing in the absence of cold symptoms and acute viral infection during the last 12 months?' were considered to be suffering from active allergic rhinitis (AAR). The risk factors for the development of this condition were identified with the use of an additional questionnaire. A total of 3205 filled questionnaires were available for the analysis. Based on the data obtained, the prevalence of active allergic rhinitis among the study population was estimated at 18.0% (n=577). 243 (42.1%) of these children presented with the symptoms of conjunctivitis. Therefore, the prevalence of active allergic rhinoconjunctivitis (ARC appears to be 7.5% (n=243). In fact, the medically verified diagnosis of allergic rhinitis was established only in 6.4% (n=204) children of the 577 ones having AAR. The family history of allergic rhinitis was shown to increase the risk of development of AAR by 2.6 times (OR=2.63 , 95%; CI=2.16-3.19; p<0.01) and that of ARC by 2.8 times (OR=2.85, 95%; CI=2.16-3.75; p<0.01). Masculine gender was found to increase the risk of development of both AAR an ARC by 1.3 times (OR=1.35, 95%; CI=1.01-1.37; p<0.05) and (OR=1.35, 95%; CI=1.03-1.76; p<0.05) respectively. The actual prevalence of active allergic rhinitis was significantly higher than the frequency of the medically verified diagnoses of this condition. It is concluded that the family history of allergic diseases and the masculine gender considerably increase the risk of development of both AAR and AFC.

[Comparative analysis of the ligninolytic potential of basidiomycetes belonging to different taxonomic and ecological groups].

Screening of the ligninolytic activity of basidiomycetes from the Culture Collection of the Komarov Botanical Institute, Russian Academy of Sciences, belonging to diterent taxonomic and ecological groups was performed. The patterns of the position of taxa of active producers of ligninolytic enzymes in the modern system of fungi were identified. Cluster analysis showed that the group of fungi with the greatest lign- inolytic and degradation potential includes representatives of the families Pleurotaceae, Polyporaceae, and Phanerochaetaceae, which perform the first stages of wood decomposition. As a result, species of interest for the further study of their oxidative potential and use in biotechnology were selected.

[Optical introscopy is a new diagnostic technique in reproductive medicine].

The WHO classification's concept "infertility of unclear genesis" is due to a number of circumstances. On the one hand, this is a preponderance of the subtle forms of diseases, which are a cause of female infertility, including the subclinical forms of small pelvic inflammatory diseases (SPID). On the other hand, this is an imperfection of existing diagnostic methods. Laparoscopy considered to be the gold standard demonstrates a not very high efficiency in diagnosing SPID because of its low sensitivity. In practice, laparoscopic diagnosis of SPID is combined with ultrasound study, computed tomography, and magnetic resonance tomography. This paper proposes to use optical coherent tomography (OCT) in addition to laparoscopy. OCT makes it possible to noninvasively in real time obtain information on the internal structure of biological tissues with a resolution of 10-15 pm at a depth of at least 2 mm. Removable endoscopic probes make OCT compatible with standard endoscopic studies. The use of OCT during laparoscopy yielded optical images of the internal structure of the fallopian tube wall in different conditions: unaltered fallopian tubes; an acute inflammatory process with pronounced changes; minimal manifestations of fallopian tube inflammatory changes. Based on the comparative analysis of OCT data and histological findings, the authors elaborated OCT criteria for health and disease. A blind test indicated the high diagnostic efficacy of the technique. The additional processing of images makes it possible to objectify the data and to automate the optical introscopic technique proposed by the authors.

Activation of old carbon by erosion of coastal and subsea permafrost in Arctic Siberia.

The future trajectory of greenhouse gas concentrations depends on interactions between climate and the biogeosphere. Thawing of Arctic permafrost could release significant amounts of carbon into the atmosphere in this century. Ancient Ice Complex deposits outcropping along the ~7,000-kilometre-long coastline of the East Siberian Arctic Shelf (ESAS), and associated shallow subsea permafrost, are two large pools of permafrost carbon, yet their vulnerabilities towards thawing and decomposition are largely unknown. Recent Arctic warming is stronger than has been predicted by several degrees, and is particularly pronounced over the coastal ESAS region. There is thus a pressing need to improve our understanding of the links between permafrost carbon and climate in this relatively inaccessible region. Here we show that extensive release of carbon from these Ice Complex deposits dominates (57 ± 2 per cent) the sedimentary carbon budget of the ESAS, the world's largest continental shelf, overwhelming the marine and topsoil terrestrial components. Inverse modelling of the dual-carbon isotope composition of organic carbon accumulating in ESAS surface sediments, using Monte Carlo simulations to account for uncertainties, suggests that 44 ± 10 teragrams of old carbon is activated annually from Ice Complex permafrost, an order of magnitude more than has been suggested by previous studies. We estimate that about two-thirds (66 ± 16 per cent) of this old carbon escapes to the atmosphere as carbon dioxide, with the remainder being re-buried in shelf sediments. Thermal collapse and erosion of these carbon-rich Pleistocene coastline and seafloor deposits may accelerate with Arctic amplification of climate warming.

[Alteration of transport activity of proton pumps in coleoptile cells during early development stages of maize seedlings].

Comparative analysis of the transport activity of proton pumps (plasmalemma H+-ATPase, vacuolar H+-ATPase, and vacuolar H+-pyrophosphatase) in the membrane preparations obtained from coleoptile cells ofetiolated maize seedlings (Zea mays L.) was carried out. The highest level ofvacuolar pyrophosphatase activity was observed during the early development of coleoptile cells under growth intensification through the elongation. The role of ATPase pumps of tonoplast and plasmalemma in the transport of hydrogen ions increases during further development. The plasmalemma activity in this process is higher. When the growth stops, the activity of proton pumps becomes significantly lower. Nevertheless, their substrate specificity and sensitivity to proton pump inhibitors do not change, which can be an evidence of physiological significance of pumps in the maintenance of cell homeostasis.

[Noninvasive estimation of the oxygen state of experimental tumor by diffuse optical spectroscopy].

The potentialities of diffuse optical spectroscopy for the noninvasive estimation of the oxygen state of experimental tumors have been demonstrated. The distribution of total, oxygenated and deoxygenated hemoglobin, as well as the level oxygen saturation of blood have been shown using two tumor models differing in the histological structure and functional characteristics. The results obtained by the optical method have been verified by immunohistochemical examination of tissue specimens with the exogenous hypoxia marker pimonidazole.

Endoscopic OCT with forward-looking probe: clinical studies in urology and gastroenterology.

In the current paper we present results of application of endoscopic time-domain OCT (EOCT) with lateral scanning by forward looking miniprobe. We analysed material of clinical studies of 554 patients: 164 patients with urinary bladder pathology, and 390 with gastrointestinal tract pathology. We reviewed the materials obtained in different clinics using the OCT device elaborated at the Institute of Applied Physics. We demonstrate results of EOCT application in detection of early cancer and surgery guidance, examples of combined use of OCT and fluorescence imaging. As a result, we show the diagnostic accuracy of EOCT in specific clinical tasks. The sensitivity of EOCT cancer determination in Barrett's esophagus is from 71% to 85% at different stages of neoplasia with specificity 68% for all stages. As for bladder carcinoma, the sensitivity and specificity are 85% and 68%, respectively. In colon dysplasia EOST demonstrates high efficacy: sensitivity 92% and specificity 84%.

[Optic coherent tomography: a new high-resolution technology of visualization of tissue structures. Communication II. Optical images of benign and malignant entities]. / Opticheskaia kogerentnaia tomografiia -- novaia vysokorazreshaiushchaia tekhnologiia vizualizatsii struktury tkanei. Soobshchenie II. Opticheskie izobrazheniia dobrokachestvennykh i zlokachestvennykh sostoianii.

This is the second communication of a series of publications on Russian studies in the field of optical coherent tomography (OCT), the newest noninvasive highly resolving technology of visualization of the structure of biological tissues. By using the investing tissues as an example, this paper demonstrates the universal types of changes in their optical properties. Optimal images permit differentiate benign and malignant processes with a high degree of diagnostic accuracy. Diverse benign processes occurring in the epithelium are detected on the OCT images as changes in its height, the scattering properties and stroke of a basilar membrane. The absence of any structure on the image is the main OCT criterion for malignancy. The diagnostic efficiency of OCT is high in recognizing neoplasia of various mucous membranes: the sensitivity of the technique is 77-98%; its specificity and diagnostic accuracy are 71-96 and 81-87%, respectively.

Diagnostic efficacy of optical coherence tomography in the management of preinvasive and invasive cancer of uterine cervix and vulva.

The purpose of this study was to understand the capabilities and utility of optical coherence tomography (OCT) in characterizing tissue in patients with precancer and cancer of the uterine cervix and vulva. OCT is an optical technique that uses low-coherence interferometer to develop a two-dimensional image of optical scattering from internal tissue microstructure. This study was designed to develop diagnostic criteria. Women undergoing colposcopic evaluation secondary to an abnormal Papanicolaou smear or visualized grossly abnormal vulvar lesion comprised the study population. Under colposcopic visualization, the OCT device was applied to normal regions in all patients and abnormal areas when present, and images were captured. Each subject then underwent multiple directed biopsies. Images were then reviewed and compared with matched histology. A total of 50 women were recruited for the study. Of the 50 patients evaluated, 18 had cervical intraepithelial neoplasia (CIN) II,III, 14 had CIN I, 13 had metaplasia/inflammation, two had invasive squamous cell carcinoma of the cervix, and three had a diagnosis of Paget's disease of the vulva. Analysis of the OCT images showed a repetitive pattern that represented normal squamous epithelium of the cervix in 100% of the normal biopsies. Images of the 18 patients with histologically proven CIN II,III showed an unstructured homogeneous highly backscattering region with fast attenuation of the signal in 16 (89%) of the patients. OCT is a new approach for the early identification of cervix and vulvar malignancies. Using information inherent to the returning photon signals from tissue, early morphological and light-scattering changes can be detected during tumorigenesis. It has the potential to be a true optical biopsy. If diagnostically comparable to a biopsy, then clearly the ability of OCT to provide a point of service diagnosis would serve a significant advantage.

[Effect of eprosartan on microcirculation and blood rheology in patients with hypertensive disease]. / Vliianie éprosartana na mikrotsirkuliatsiiu i reologiiu krovi u bol'nykh gipertonicheskoi bolezn'iu.

The use of eprosartan (600-1200 mg/day for 4 weeks) in 28 patients with stage II hypertensive disease was associated with improvement of parameters of microcirculation and blood rheology.

[Optic coherent tomography: a new high-resolution technology of visualization of tissue structures. Part 1. Principle of the technique. Objects of OCT applications and technical decisions for their study]. / Opticheskaia kogerentnaia tomografiia--novaia vysokorazreshaiushchaia tekhnologiia vizualizatsii struktury tkanei. Soobshchenie 1. Printsip metoda. Ob"ekty prilozheniia OKT i tekhnicheskie resheniia dlia ikh issledovaniia.

The authors present a series of three papers dedicated to studies made in Russia in the field of optic coherent tomography (OCT), the latest noninvasive high-resolution technology of visualization of the structure of biological tissues. A group of medical specialists of different disciplines has been examined over 2,000 patients for 8 years of the use of an original class of the Russian OCT devices developed at the Institute of Applied Physics, Russian Academy of Sciences, and awarded a RF State Prize in the field of science and technology in 1999. The first paper discusses the basic aspects of OCT, the objects of study, and technical decisions for the clinical application of the technique. The paper shows a place of OCT, whose resolving capacity is close to the cellular level (approximately 10-15 microns), among classical methods for imaging biological tissues. The optical images of different types of normal tissues and the method of their identification are demonstrated. It has been found that different optical properties of investing tissues and dentin permit their tomographic differentiation by showing their regular bedded structure. The tomographic pattern of investing tissues is affected by their specific features, such as the type of the lining epithelium, its keratosic processes, and the architecture of the basilar membrane.

Endoscopic applications of optical coherence tomography.

We report results of application of our endoscopic optical coherence tomography (EOCT) system in clinical experiments to image human internal organs. Based on the experience of studying more than 100 patients, we make first general conclusions on the place and capabilities of this method in diagnosing human mucous membranes. It is demonstrated that EOCT can serve for several clinical purposes such as performing directed biopsy, monitoring functional states of human body, guiding surgical and other treatments and monitoring post-operative recovery processes. We show that applications of OCT are more informative in the case of internal organs covered by epithelium separated from underlying stroma by a smooth basal membrane and therefore concentrate on the results of the EOCT study of three internal organs, namely of larynx, bladder, and uterine cervix. Finally, we report first examination of internal organs in abdomen with the use of laparoscopic OCT.

In vivo endoscopic OCT imaging of precancer and cancer states of human mucosa.

First results of endoscopic applications of optical coherence tomography for in vivo studies of human mucosa in respiratory, gastrointestinal, urinary and genital tracts are presented. A novel endoscopic OCT (EOCT) system has been created that is based on the integration of a sampling arm of an all-optical-fiber interferometer into standard endoscopic devices using their biopsy channel to transmit low-coherence radiation to investigated tissue. We have studied mucous membranes of esophagus, larynx, stomach, urinary bladder, uterine cervix and body as typical localization for carcinomatous processes. Images of tumor tissues versus healthy tissues have been recorded and analyzed. Violations of well-defined stratified healthy mucosa structure in cancered tissue are distinctly seen by EOCT, thus making this technique promising for early diagnosis of tumors and precise guiding of excisional biopsy.