PROTECTION OF CONFIDENTIAL MEDICAL INFORMATION IN UKRAINE: PROBLEMS OF LEGAL REGULATION.

The aim of the article is to analyze the legal aspects and mechanisms of confidential medical information protection about an individual in the health care sphere in Ukraine. During the scientific research, various methods of cognition of legal phenomena were used. Among the general scientific approaches, the dialectical method was primarily used, which allowed to identify trends in the development of patient information rights and formulate proposals for improving legislation in the field of medical data protection. The formal-legal method was used to provide a comprehensive characterization of the EU (European Union) and Ukrainian legislation in the sphere of confidential medical information protection. Additionally, general scientific logical methods (analysis and synthesis, comparison and analogy, abstraction, and modeling) were used in order to study the problems of information relations in the medical field and establish legal liability for violation of the confidentiality of such information. The definitions of medical data, medical information, confidential medical data, and medical confidentiality have been researched and compared. The article identified the legitimate grounds for disclosing confidential medical information about an individual in the healthcare sector. Authors revealed the gaps in Ukrainian legislation regarding the confidential medical data protection by healthcare professionals and electronic medical systems regulators. The necessity of expanding the list of subjects responsible for preserving confidential medical information has been substantiated. The study explored the case law of the European Court of Human Rights in the field of the medical data confidentiality violation. It has been outlined the potential judicial remedies and liability for violating the right to personal medical information confidentiality of an individual in the healthcare sector. The legal grounds and cases of possible lawful disclosure of confidential medical information have been analyzed. Attention has been drawn to the insufficient regulation of access to medical confidentiality during martial law. It has been emphasized that the mechanism for protecting the violated right to confidentiality of medical information involves appealing to the Ukrainian Parliament Commissioner for Human Rights or to the court. The increasing role of international legal acts in ensuring the protection of medical data in the European Union and Ukraine has been highlighted.

Mapping the 3D position of battery cathode particles in Bragg coherent diffractive imaging.

In Bragg coherent diffractive imaging, the precise location of the measured crystals in the interior of the sample is usually missing. Obtaining this information would help the study of the spatially dependent behavior of particles in the bulk of inhomogeneous samples, such as extra-thick battery cathodes. This work presents an approach to determine the 3D position of particles by precisely aligning them at the instrument axis of rotation. In the test experiment reported here, with a 60 µm-thick LiNi0.5Mn1.5O4 battery cathode, the particles were located with a precision of 20 µm in the out-of-plane direction, and the in-plane coordinates were determined with a precision of 1 µm.

Femtosecond control of phonon dynamics near a magnetic order critical point.

The spin-phonon interaction in spin density wave (SDW) systems often determines the free energy landscape that drives the evolution of the system. When a passing energy flux, such as photoexcitation, drives a crystalline system far from equilibrium, the resulting lattice displacement generates transient vibrational states. Manipulating intermediate vibrational states in the vicinity of the critical point, where the SDW order parameter changes dramatically, would then allow dynamical control over functional properties. Here we combine double photoexcitation with an X-ray free-electron laser (XFEL) probe to control and detect the lifetime and magnitude of the intermediate vibrational state near the critical point of the SDW in chromium. We apply Landau theory to identify the mechanism of control as a repeated partial quench and sub picosecond recovery of the SDW. Our results showcase the capabilities to influence and monitor quantum states by combining multiple optical photoexcitations with an XFEL probe. They open new avenues for manipulating and researching the behaviour of photoexcited states in charge and spin order systems near the critical point.

Structural studies of the bond-orientational order and hexatic-smectic transition in liquid crystals of various compositions.

We report on the X-ray studies of freely suspended hexatic films of three different liquid crystal compounds. By applying angular X-ray cross-correlation analysis (XCCA) to the measured diffraction patterns the parameters of the bond-orientational (BO) order in the hexatic phase were directly determined. The temperature evolution of the BO order parameters was analyzed on the basis of the multicritical scaling theory (MCST). Our results confirmed the validity of the MCST in the whole temperature range of the existence of the hexatic phase for all three compounds. The temperature dependence of the BO order parameters in the vicinity of the hexatic-smectic transition was fitted by a conventional power law with a critical exponent ß ≈ 0.1 of extremely small value. We found that the temperature dependence of higher order harmonics of the BO order scales as the powers of the first harmonic, with an exponent equal to the harmonic number. This indicates a nonlinear coupling of the BO order parameters of different order. We demonstrate that compounds of various compositions, possessing different phase sequences at low temperatures, display the same thermodynamic behavior in the hexatic phase and in the vicinity of the smectic-hexatic phase transition.

Erratum: Hanbury Brown-Twiss Interferometry at a Free-Electron Laser [Phys. Rev. Lett. 111, 034802 (2013)].

This corrects the article DOI: 10.1103/PhysRevLett.111.034802.

Revealing Three-Dimensional Structure of an Individual Colloidal Crystal Grain by Coherent X-Ray Diffractive Imaging.

We present results of a coherent x-ray diffractive imaging experiment performed on a single colloidal crystal grain. The full three-dimensional (3D) reciprocal space map measured by an azimuthal rotational scan contained several orders of Bragg reflections together with the coherent interference signal between them. Applying the iterative phase retrieval approach, the 3D structure of the crystal grain was reconstructed and positions of individual colloidal particles were resolved. As a result, an exact stacking sequence of hexagonal close-packed layers including planar and linear defects were identified.

Spatially resolved x-ray studies of liquid crystals with strongly developed bond-orientational order.

We present an x-ray study of freely suspended hexatic films of the liquid crystal 3(10)OBC. Our results reveal spatial inhomogeneities of the bond-orientational (BO) order in the vicinity of the hexatic-smectic phase transition and the formation of large-scale hexatic domains at lower temperatures. Deep in the hexatic phase up to 25 successive sixfold BO order parameters have been directly determined by means of angular x-ray cross-correlation analysis (XCCA). Such strongly developed hexatic order allowed us to determine higher order correction terms in the scaling relation predicted by the multicritical scaling theory over a full temperature range of the hexatic phase existence.

[Stochastic simulation of the process of matching of the ages of the human and the experimental mammalian].

The aim of the article is to work out the simple approach for matching of the ages of the human and mammalian. The model is based on the analysis of the counting processes of the proper ontogenetic events (such as the emergence of the first molars, the first ovulation, almost complete cessation of growth, menopause). The choice of the events is reduced to the claim of being observable. The matching (and proper concordance) are useful for the choice of the individual regimens of medical treatment.

Intensity interferometry of single x-ray pulses from a synchrotron storage ring.

We report on measurements of second-order intensity correlations at the high-brilliance storage ring PETRA III using a prototype of the newly developed adaptive gain integrating pixel detector. The detector records individual synchrotron radiation pulses with an x-ray photon energy of 14.4 keV and repetition rate of about 5 MHz. The second-order intensity correlation function is measured simultaneously at different spatial separations, which allows us to determine the transverse coherence length at these x-ray energies. The measured values are in a good agreement with theoretical simulations based on the Gaussian Schell model.

Characterization of spatial coherence of synchrotron radiation with non-redundant arrays of apertures.

A method to characterize the spatial coherence of soft X-ray radiation from a single diffraction pattern is presented. The technique is based on scattering from non-redundant arrays (NRAs) of slits and records the degree of spatial coherence at several relative separations from 1 to 15 µm, simultaneously. Using NRAs the spatial coherence of the X-ray beam at the XUV X-ray beamline P04 of the PETRA III synchrotron storage ring was measured as a function of different beam parameters. To verify the results obtained with the NRAs, additional Young's double-pinhole experiments were conducted and showed good agreement.

X-ray cross-correlation analysis of liquid crystal membranes in the vicinity of the hexatic-smectic phase transition.

We present an x-ray study of liquid crystal membranes in the vicinity of the hexatic-smectic phase transition by means of angular x-ray cross-correlation analysis. By applying two-point angular-intensity cross-correlation functions to the measured series of diffraction patterns the parameters of bond-orientational (BO) order in hexatic phase were directly determined. The temperature dependence of the positional correlation lengths was analyzed as well. The obtained correlation lengths show larger values for the higher-order Fourier components of BO order. These findings indicate a strong coupling between BO and positional order.

In situ X-ray crystallographic study of the structural evolution of colloidal crystals upon heating.

The structural evolution of colloidal crystals made of polystyrene hard spheres has been studied in situ upon incremental heating of a crystal in a temperature range below and above the glass transition temperature of polystyrene. Thin films of colloidal crystals having different particle sizes were studied in transmission geometry using a high-resolution small-angle X-ray scattering setup at the P10 Coherence Beamline of the PETRA III synchrotron facility. The transformation of colloidal crystals to a melted state has been observed in a narrow temperature interval of less than 10 K.

Hanbury Brown-Twiss interferometry at a free-electron laser.

We present measurements of second- and higher-order intensity correlation functions (so-called Hanbury Brown-Twiss experiment) performed at the free-electron laser (FEL) FLASH in the non-linear regime of its operation. We demonstrate the high transverse coherence properties of the FEL beam with a degree of transverse coherence of about 80% and degeneracy parameter of the order 10(9) that makes it similar to laser sources. Intensity correlation measurements in spatial and frequency domain gave an estimate of the FEL average pulse duration of 50 fs. Our measurements of the higher-order correlation functions indicate that FEL radiation obeys Gaussian statistics, which is characteristic to chaotic sources.

[Association of age-dependent magnetosensitivity dynamics with arterial hypertension].

The purpose of the research was to define magneto sensitivity degree in males depending on age and presence or absence of arterial hypertension. It has been shown, that at aging in the examined groups the number of males possessing high magneto sensitivity degree according to hypotensive type of cardiovascular reaction to magnetic test is decreasing (30,2% in children and up to 0% in males of senile age) and increasing (2,2 up to 36,0%, correspondingly) - according to hypertensive type. In the group of middle aged males with arterial hypertension the number of high magneto sensitive persons on hypertensive type was 5 times higher as compared to the group of practically healthy males of similar age. The results obtained demonstrate that at aging reactions of cardiovascular system on external physical impacts essentially change, dependence of an organism on changes of the geomagnetic field amplifies and probability of risk of hypertonic crisis development during the fluctuations of the Earth magnetic field increases.

[The indices of cellular-vascular, coagulatory haemostasis and fibrinolysis in arterial hypertension of patients of different age groups].

The contrastive analysis of the indices of cellular and vascular, coagulatory haemostasis and fibrinolysis in arterial hypertension (AH) was held among the patients of different age groups. 69 patients with AH were researched. The average age of afflicted people in the first blockette is 50,9+/-0,7 years, in the second blockette - 70,7+/-1,5. In order to evaluate the condition of haemostasis the afflicted people were researched in the following indices: amount of thrombocytes, hemolysate-aggregative test (HAT), leukocytic-thrombocytic aggregation (LTA), activity of Villebrand factor (FV), inactivation index of thrombin (IIT), activated partial thromboplastin time (APTT), prothrombin index (PTI), fibrinogen, antithrombin III (AIII), Hageman-dependent fibrinolysis (HDF), lupous anticoagulants (LA), autocoagulatory test (ACT). All the examined patients with AH showed considerable abnormalities in cellular and vascular and coagulatory links of haemostasis and the system of fibrinolysis. It is observed, that aged afflected people with AH have progressive hyperaggregation of thrombocytes, the activity of Villebrand factor increases, the rise of coagulatory link activity of haemostasis and the exhaustion of anticoagulants' products is more considerable, the subsequent fibrinolysis depression is observed, but hyperfibrinogenemia accrues. The received results show the heterogeneity of AH in different age groups.

[Effect of cytoprotection on the oxidative processes and endothelial function in elderly patients with ischemic heart disease].

The aim of the study was to investigate the effects of cytoprotectional drug Mildronate ("Grindex", Latvia) on some parameters of oxidative processes and endothelial function in elderly patients with coronary heart disease (CHD). One hundred seventeen elderly CHD patients were included into controlled study. The criteria to include the patients into the study were: men and women upwards 60 years old with CHD, with heart failure FC II or III (in accord, NYHA classification), with arterial hypertension (AH), without diabetes mellitus. All patients were randomized into 2 groups: 1) 67 patients 75.4 +/- 0.5 years old were treated with Mildronate 500 mg/day against traditional basal therapy during 12 weeks (the main group) and 2) 50 patients 74.0 +/- 0.6 years old were treated only traditional basal therapy during 12 weeks (the compare group). The blood lipid profile parameters, such as total cholesterol (CH), triglycerides (TG), low density lipoprotein cholesterol (LDL-CH), high density lipoprotein CH (HDL-CH), LDL antioxidant potential (concentration of alpha-tocopherol and retinol in LDL), initial level of lipid peroxidation (LPO) products in LDL, LDL resistance to oxidation in vitro and the blood level of NO metabolites were evaluated before and after 4 and 12 weeks of the study. Effect of Mildronate on the blood lipid profile parameters in elderly CHD patients was not revealed. The initial level of LPO products in LDL was decreased and LDL resistance to oxidation in vitro was increased in main group patients after 12 weeks of study in comparison with the same parameters before the study and with compare group patients (p < 0.05). The blood level of NO metabolites was 1.5-fold higher in main group patients after 12 weeks of study in comparison with the same parameters before the study and with compare group patients (p < 0.05). Thus, in elderly CHD patients the several antiatherogenic effects of Mildronate, such as the decreasing activity of LPO processes in LDL and the increasing synthesis/secretion of blood NO, were revealed.

[Functional polymorphism of p53 and CCR5 genes in the long-lived of the Siberian region]. / Funktsional'nyi polimorfizm genov p53 i CCR5 u dolgozhitelei Sibirskogo regiona.

The P53 protein is a key regulator of modified-cell apoptosis. The functional oligonucleotide polymorphism of the p53 gene causes the substitution of arginine (Arg) for praline (Pro) in the codon 72. A reduced apoptotic activity of p53 and, as a consequence, development of oncology pathology is associated with the above polymorphism. CCR5 is a compound transmembrane receptor-protein, which apart from chemokines, binds with some molecules and is a coreceptor for HIV-1. 32 bp deletion within the CCR5 encoding region results in the loss of the protein's receptor function. It has been demonstrated that the transmission of the "external" (in respect to cell) stimulus, via the CCR5 system, induces expression of the p53 gene and initiates apoptosis. Allele variants and p53 and CCR5 genotypes (separately and in combinations) were investigated, within the present case study, for 131 long-livers from Novosibirsk and Tyumen Regions. A trend was detected towards accumulation of the p53 Pro alleles in association with the CCR5del32 allele in the study group, which, as the authors believe, can enhance the genome resistance to variable factors that cut the life span.

[Polymorphism of the gene of angiotensin-converting enzyme and apolipoprotein E gene in long-livers of Novosibirsk city]. / Polimorfizm gena angiotensin-prevrashchaiushchego fermenta i gena apolipoproteina E u dolgozhitelei goroda Novosibirska.

The levels of polymorphism of genes of angiotensin converting enzyme (ACE) and apolipoprotein E (Apo E) were studied in elderly and long-living people in Novosibirsk. The results of the study in the investigated group (97 subjects) were compared with polymorphism of these genes in Novosibirsk population group aged 25-64 who were investigated in MONICA Project survey and had DNA data base formed. Frequency of D/D genotype among senile and long-living men was 5.9%. It is 5 times lower than in men 55-64 years of age (p = 0.04). Similar decrease of this gene frequency was also found in women of the same age. In men older than 83 years of age 4 times lowering of 3/4 genotype of Apo E gene and 2 times increasing of frequency of 2/3 genotype were revealed when comprising frequency of these genotypes in people of middle age. In subjects of senile age and long-livers of both sexes genotype 4/4 was not revealed. Lipid levels were more favorable in women with genotype 2/3 of Apo E gene (comparatively lower mean level of total cholesterol and higher level of HDL cholesterol) if compared with genotypes 3/3 and 3/4.

[Effect of amiodarone on autonomic status and its efficacy in the treatment of different variants of paroxysmal atrial fibrillation]. / Vliianie amiodarona na vegetativnyi status i ego éffektivnost' v lechenii raznykh variantov paroksizmal'noi fibrilliatsii predserdii.

Association of autonomic status and efficacy of therapy with amiodarone was studied in 90 patients with paroxysmal atrial fibrillation of ischemic (n=45, mean age 62 years) and nonischemic (n=45, mean age 38 years) origin. Autonomic status was assessed by measurement of heart rate variability. Electrophysiological and echocardiographical studies were also conducted before and after 4 weeks of amiodarone therapy. Treatment with amiodarone was accompanied by substantial lowering of the tone of autonomic nervous system in patients with adrenergic type of paroxysmal atrial fibrillation while there was no dynamics of parasympathetic tone in patients with vagal or mixed types. Positive association between amiodarone therapy and decrease of left atrial dimension and improvement of left ventricular contractility was also observed. It was concluded that the use of amiodarone was justified in adrenergic but not in vagal or mixed variants of paroxysmal atrial fibrillation.