[Digital twins in surgery: achievements and limitations]. / Tsifrovye dvoiniki v khirurgii: dostizheniya i ogranicheniya.

OBJECTIVE: To review the possible options for digital twin technology in surgery, as well as to build a patent and publication landscape for identifying technological and academic leaders of the frontier. MATERIAL AND METHODS: Scientometric and patent analysis was performed. RESULTS: Possible options for digital twin technology in surgical practice were reviewed. Development of scientific and technological trend «digital twins in surgery¼ in the world was assessed (2002 - idea, concept, definition; 2007-2014 - large-scale studies in academic sector; 2014 - active participation of regulators in translation of pilot digital models of patient organs into practical healthcare; 2014-2017 - large-scale studies in business sector; 2018-2021 - development of a market of medical services based on digital twin technologies in surgery). According to scientometric and patent analysis of digital twins in surgery, there is no a single Russian-language article on to this issue in journals indexed in WOS at the end of 2021. Our country ranks the 23rd in the world regarding its share in the total number of patent applications for inventions. CONCLUSION: Over a 20-year period, large-scale scientific projects have been carried out in the world to develop digital twin algorithms for surgery. Regulators were involved in the process of broadcasting their results into practical health care. Network interaction of all authors and beneficiaries of technological frontier occurred (research centers, hospitals, companies, manufacturers of medical equipment and information services). Technological ecosystems developed (startups, gazelles, investment seed capital). Technological leaders and key players in new market niches have been identified. Development of this field is insufficient in the Russian Federation. There are no qualified customers and companies in the real sector of economy that could become the beneficiaries of the frontier.

[History of surgical and non-surgical tracheal intubation]. / Istoriya khirurgicheskoi i nekhirurgicheskoi intubatsii trakhei. Ot trostinki do videosignala.

Anesthesiologist daily encounters the need for maintaining an airway patency. This manuscript is devoted to the development of this technique from ancient times to the present. Three areas including tracheostomy, endoscopy and tracheal intubation are comprehensively described.

[Achieving global academic leadership: an analysis of the highly cited segment of surgery publications]. / Dostizhenie mirovogo akademicheskogo liderstva: analiz naibolee chasto tsitiruemogo segmenta publikatsii po khirurgii.

In the Strategic Academic Leadership Program, the number of publications included in the 1% of the most cited ones in the Web of Science Core Collection database over previous 10 full years is used as an indicator of research potential of universities and scientific centers. The purpose of this study was to analyze the segment of Highly Cited Papers and Hot Papers on surgery using the Essential Science Indicators (ESI) analytical application. According to ESI data, relevant for March 2020, highly cited publications on medicine have formed 2.425 research fronts including 211 ones in surgery. We have analyzed the directions of researches in surgery characterized by the greatest number of citations.

[Analysis of the internationalized highly cited segment of national surgery publications]. / Analiz internatsionalizirovannogo vysokotsitiruemogo segmenta otechestvennykh publikatsii po khirurgii.

The internationalized segment of manuscripts on surgery published in top-rated journals indexed in the Web of Science Core Collection (WoS CC) was analyzed. Presence of national publications in surgical journals of different quartiles was estimated. It was shown that 59.6% of surgical articles of Russian authors, indexed in the WoS CC, were published in high-ranking journals (Q1 and Q2). The number of such articles has been increased by more than 3 times (from 23 in 2010 to 86 in 2018) on the background of no growth in the fourth quartile. We formed a rating of national educational and academic organizations, which have made the greatest contribution to a portfolio of publications on surgery, indexed in Q1-Q2 quartiles of WoS CC, as well as in the segment of highly cited publications.

[Control and prevention of kidney transplant rejection: the role and possibilities for the clinical use of regulatory T-cells in transplantation]. / Kontrol' i profilaktika ottorzheniya transplantata pochki: rol' i vozmozhnosti klinicheskogo primeneniya T-regulyatornykh kletok v transplantatsii.

This article discusses the need to implement effective methods for monitoring immune status and rehabilitation of patients after kidney transplantation. Induction of immunological tolerance which allows minimizing or even completely canceling supportive immunosuppressive therapy is one of the key tasks in the field of organ transplantation. Regulatory T-cells (TREGs) play an important role in maintaining immunological homeostasis, including limiting kidney transplant rejection, and potentially contribute to the development of immunological tolerance. At the same time, for the introduction of TREG therapy into clinical practice, it is necessary to overcome a number of unsolved problems, such as induction and cultivation of a sufficient number of TREG cells for therapeutic action as well as reducing the risks associated with TREG conversion to effector lymphocytes or an undesirable non-specific immunosuppressive effect. This review examines both the impact of common post-transplant pharmacological immunosuppression approaches on TREGs and the therapeutic potential of TREG cell cultures in prevention of kidney transplant rejection. The questions of ex vivo TREG manufacturing process and possible threats of applying cell technologies in this branch of transplantology were considered.

[Evaluating justification of choice for priority directions in the field of biomedicine in the national project 'SCIENCE']. / Otsenka obosnovannosti vybora prioritetnykh napravlenii v oblasti biomeditsiny v natsional'nom proekte 'NAUKA'.

The purpose of the present research was to analyze the validity of the choice for biomedical disciplines fixed by the passport of the national project 'Science' for the following priority of the Strategy for the scientific and technological development of the Russian Federation: 'the transition to personalized medicine, high-tech medical care and health saving technologies ...'. We assessed the degree of relevance of this choice to great challenges facing the Russian Federation, as well as trends in the development of global biomedicine. The hypothesis of this study was the assumption that when determining priority areas it is necessary to proceed from the analysis and comparison of two arrays: the list of nosologies which account for the maximum morbidity, mortality, disability level of, primarily, the able-bodied population of Russia, and scientometric data identifying trends in the development of global biomedicine.

[Estimation of the place of the Russian Federation in the world publication activity ranking on priority trends in biomedicine]. / Otsenka pozitsii Rossiiskoi Federatsii v mirovom reitinge publikatsionnoi aktivnosti po prioritetnym napravleniiam v oblasti biomeditsiny.

During 2012-2018 in the Russian Federation, pursuant to Presidential Decree No. 599 of 05.07.2012, a set of state support measures was implemented aimed at increasing the specific gravity of Russian publications indexed in international databases. The national project 'Science' (NPS) designed to realize the goals set by Presidential Decree No.204 of 05.07.2018 'On the National Goals and Strategic Tasks for Development of the Russian Federation until 2024' continues and develops the theme of increasing the publication activity of the Russian Federation in the internationalized space. One of the six NPS targets is 'The place of the Russian Federation in terms of specific gravity in the total number of articles in areas defined by the priorities of scientific and technological development in publications indexed in international databases'. The purpose of this study was to evaluate the basic value of this indicator for biomedical disciplines related to the priority direction (paragraph 20c) of the Strategy for Scientific and Technological Development of the Russian Federation. We compared volumes of publication flows of the Russian Federation in 20 biomedical disciplines with a similar indicator of countries ranked fifth in the number of publications on the subject area under consideration, indexed in the Web of Science Core Collection (WoS CC). A 5-10 fold lag of the Russian Federation was recorded for the most part of the priority areas in the field of biomedicine identified by the NTS passport. The impact of public policy measures aimed at increasing the national biomedical publication stream for the period of 2012-2018 was estimated as insufficient to meet the considered NTS target.

[Serum nesfatin-1 as a marker of systemic inflammation in rheumatoid arthritis.]

The purpose of this study was to determine the level of nesfatin-1 (NF-1) in the blood serum of healthy volunteers and patients with rheumatoid arthritis (RA) to establish the threshold for normal values of this parameter and to reveal the relationship between the level of NF-1 and clinical manifestations of RA. We examined 170 people, of which 110 patients with RA and 60 donors who made up the comparison group. The mean level of serum nesfatin-1 in healthy subjects was 31.61 ± 3.17 ng/ml (M ± σ). The level of normal values of nesfatin-1 in healthy individuals, defined as M ± 2σ, was from 25.27 to 37.95 ng/ml. These studies showed the relationship between the concentration of NF-1 and the severity of clinical manifestations of RA. We found that a higher serum level of NF-1 was characteristic of patients with a more severe clinical course of the disease. The data obtained indicate that high level of NF-1 positively correlates with higher concentrations of C-reactive protein and ESR. This data indirectly proves the proinflammatory effect of NF-1 and confirms the hypothesis about the primary role of systemic inflammation in the pathogenesis of RA.

[Irisin as a new marker for the early diagnosis of low-traumatic fractures in rheumatoid arthritis.]

The aim of this study was to study the relationship between serum irisin level and the presence of low-traumatic bone fractures in rheumatoid arthritis (RA) patients. We examined 170 people including 110 RA patients and 60 healthy individuals as comparison group. The serum irisin level was determined with solid-phase enzyme-linked immunosorbent assay using ELISA Irisin test system (BioVendor, cat. No. RAG018R). The average level of irisin in the group of healthy individuals was 20.49 ± 4.82 µg/ml (µ±σ). The level of normal values, defined as M ± 2σ, was 10.85-30.13 µg/ml. Decreased irisin level was detected in 41 of 110 patients with RA diagnosis (37% of cases). This group of patients had higher RA activity degree (DAS28), extra-articular manifestations, disease duration from 5 to 10 years, greater class of functional joint's failure, lower level of 25 (OH) -vitamin D. There was also a reliable relationship between serum irisin level and presence of low-fracture bone fractures in the anamnesis.

[The nicotinamide-phosphoribosiltransferase as a marker of systemic inflammation under osteoarthrosis.]

The purpose of study is to establish the level of visfatin (Nampt, nicotinamide-phosphoribosiltransferase) in blood serum of healthy volunteers for determination of the level of normal values of of the given parameter specific to healthy people. Besides, the given parameter also was analyzed in patients with osteoarthritis. The sampling consisted of 152 individuals. Out of them, 92 patients with primary osteoarthritis and 60 healthy individuals. The level of Nampt in blood serum of healthy people was detected by using commercial test-systems (RaiBiotech, cat. № EIA-VIS-1). The average level of Nampt in blood serum of healthy people made up to 2,43±0,17 ng/ml (M ± m). The level of normal values of Nampt in healthy people detected as М ± 2σ, made up to from 0 to 5.07 ng/ml. The study data proved the relationship between concentration of Nampt ans expression of clinical manifestations of osteoarthritis. It is demonstrated that higher level of Nampt in blood serum was typical for patients with more severe clinical course of disease. The obtained data testify that high level of Nampt correlates positively with higher concentrations of C-reactive protein and ESR that indirectly testifies in behalf of anti-inflammatory character of action of Nampt and substantiates hypothesis about primary role of systemic inflammation in pathogenesis of osteoarthritis.

[The efficacy and safety of etoricoxib versus meloxicam in the treatment of patients with gonarthrosis]. / Sravnitel'naya effektivnost' i bezopasnost' etorikoksiba i meloksikama v lechenii bol'nykh gonartrozom.

AIM: To evaluate the clinical efficacy and tolerability of etoricoxib and meloxicam in patients with gonarthrosis. SUBJECTS AND METHODS: A postregistration, open-labeled, prospective, comparative randomized study was conducted. 40 patients aged 37 to 75 years with primary knee osteoarthritis were examined. Therapeutic effectiveness was evaluated determining the functional index WOMAC with the use of a visual analogue scale (VAS). The tolerability of the drugs was assessed according to the opinions of a patient and a physician. RESULTS: Both drugs caused a reduction in WOMAC and VAS scores for pain and the severity of the disease. Etoricoxib demonstrated a significantly high rate of occurrence and completeness of its analgesic effect. Meloxicam showed a less pronounced decrease in joint stiffness and an insufficient analgesic effect. The incidence of side effects was similar in both groups. CONCLUSION: Both drugs demonstrated a good tolerability and a low incidence of side effects. The efficacy of etoricoxib was significantly higher than that of meloxicam.