Serious Games for Executive Functions Training for Adults with Intellectual Disability: Overview.

(1) Background: Throughout the history of medical and psychology practice, specialists have worked to improve the quality of treatment and rehabilitation, which has led to the emergence of concepts such as serious games. These tools focus on different areas of intervention procedures, one of which is to help people with intellectual disability (ID). Individuals with ID have problems with executive functions (EFs), which are related to adaptive functioning. Recent studies showed that serious games positively impact cognitive, social, and communication skills in people with ID. The purpose of this study is to analyze the solutions that have been found in EF training for adults with ID in recent years, evaluating them with a number of key parameters and identifying the features and possible problems in the further development of our system. (2) Methods: A review was conducted starting with 573 articles in English related to serious games and selected from studies that had been published since 2015. Finally, 10 were examined in detail as they focused on EFs in adults with ID. They were searched in seven major databases ("Association for Computing Machinery" (ACM), IEEE Xplore database, DBLP computer science bibliography, Google Scholar, PubMed, SCOPUS, and PsycInfo). (3) Results: It was determined that the most frequent EFs referred to in the studies analyzed were planning and decision-making, followed by working memory and social cognition, behavioral regulation, flexibility, and inhibition capacity. The basic approach to the creation of support systems was also analyzed in terms of technical and program execution. The trend results' analysis evidenced improvements in EFs, even though they were not significant. This comprehensive technique enabled the identification of the main features and aspects to be taken into account for further development of our system.

[АNALYSIS OF LETHALITY IN COMPLICATED DIABETIC FOOT SYNDROME AND SEPSIS].

There were examined in dynamics 724 patients, in whom complicated diabetic foot syndrome (DFS) was diagnosed, and in 71 (9.8%) of them the disease was complicated by sepsis. The state severity in a DFS patients have depended upon duration of purulent-necrotic process on the foot, in septic patients such dependence was not revealed. All the DFS patients without sepsis were operated on. In total 36 died (lethality 5.5%), in presence of sepsis - 42 (lethality 59.1%). The cause of sepsis in the patients, suffering complicated DFS, was predominantly a wet gangrene of the lower extremities. Among those, who were not operated on, 13 (30.9%) septic patients died, of them 5 ­ who refused operative intervention performance - died in first hours after admittance to hospital due to irreversible injury of organs and systems.

[АRTERIAL PRESSURE ON THE FIRST TOE AS A PROGNOSIS CRITERION OF THE COMPLICATION OCCURRENCE IN THE DIABETIC FOOT SYNDROME ON BACKGROUND OF MENKEBERG'S SCLEROSIS].

In the patients, suffering diabetes mellitus type ІІ, treated in 2015 - 2016 yrs for complicated diabetic foot syndrome, a systolic arterial pressure (SAP) on level of the first toe was determined, and roentgenography of the foot in two projections done. The SAP value from 120 to 200 mm Hg and higher have had witness the presence of Menkeberg?s sclerosis stages III - V. Prognostically favorable is a SAP value of 80 mm Hg and higher, and unfavorable data ­ the SAP value lowering lesser than 80 mm Hg. The SAP value lower than 30 mm Hg have had witness the vessel obliteration and thrombosis occurrence.

[SOME PARAMETERS OF THE IMMUNE STATE OF PATIENTS WITH DIABETIC FOOT SYNDROME AND SEPSIS].

The analysis of changes in the specific immunity in patients with purulent­necrotic complications of diabetic foot syndrome (DFS) and sepsis was presented. Complicated DFS was diagnosed in 436 patients, of whom 29 (6.6%) ­ weighed down by sepsis. The concentration of the major classes of immunoglobulins IgA, IgM, IgG were determined by enzyme­linked immunosorbent assay (ELISA). To evaluate the immune state was determined lymphocyte subpopulations (CD4+, CD3+, CD8+, CD25+) with monoclonal antibodies to antigens use by flow cytometry. It was found that in patients with DFS indicators specific cellular immunity were in a state of suppression, which deepened at complication of sepsis. Based on the derived formula with DFS marked disorders of the immune system I degree, in sepsis ­ II degree. Thus, the cellular and humoral immune system in patients with both DFS and sepsis qualified as a general immune depression.

[Prolonged blockade of nervus ischiadicus in a system of complex treatment of patients, suffering complicated diabetic foot syndrome].

General principles of treatment in patients, suffering diabetic foot syndrome, are adduced. There was proved, that reconvalescence of the patients depends not only on quality of complex treatment, but from optimal choice of anesthesia method, its impact on postoperative period course. Application of prolonged blockade of n. ischiadicus gives possibility to perform operative intervention on the lower extremity in full volume, guarantees sufficient motor and sensory block, permits patients to reject from application of narcotic analgetics, to reduce the dose of strong nonnarcotic analgetics, the terms of transition of the wound process phase I into phase II, promotes early activization of patients postoperatively, constitutes alternative for other methods of anesthesiological support.

[Peculiarities of the lower extremities perfusion in patients with complicated diabetic foot syndrome].

Analysis of the microcirculation indices in 246 patients, suffering diabetic foot syndrome (DFS), was presented. For a neuropathic form of DFS characteristic is lowering of the arterioles tone and enhancement of the blood volume in them, witnessed by raising of constant component of the blood flow. General worsening of perfusion is caused by lowering of endothelial secretion activation, and as well as neurogenic and myogenic control mechanisms. Occurrence of neurogenic regulation disorder is witnessed by the neurogenic oscillations lowering, the neurogenic and myogenic tone raising. In ischemic form of DFS there was noted the perfusion disorder, connected with reduction of the arterial inflow volume. The indices changes witness the disorder of sympathetic regulation of microcirculation and arteriole-venular reactions. The change of the perfusion indices, caused by a congestion processes in arterioles and venules, is characteristic for the mixed form of DFS. The perfusion control mechanisms was noted, as a consequence of the endothelial secretion lowering and the neurogenic and myogenic mechanisms activation of a control. The neurogenic and myogenic tone raising occurs depending on the sympathetic component activity, causing the arterioles diameter reduction.

[An experience with 100 cadaveric transplantations of the liver in the Russian Research Center of Radiology and Surgical Technologies].

The authors made an analysis of their first 100 transplantations of cadaveric liver made at the period from 1998 through 2011. Postoperative complications and long-term results of transplantations at the period to 13 years are described. Cumulative survival up to 12 months was 91%, to 36 months--83%. Retransplantation of the liver was performed on 5 patients, 2 of them being successful.

[The value of intraoperative Doppler-flowmetry in assessment of blood flow after the hepatic artery reconstruction during the orthotopic liver transplantation].

The practical relevance of volumetric blood flow in the hepatic artery during orthotopic liver transplantation was determined. From May 2009 to January 2011 25 patients underwent orthotopic liver transplantation. Volumetric blood flow in the hepatic artery is routinely measured using a Doppler flow meter during the operation. In 15 cases out of 25 (60%) the blood flow rate immediately after the formation of arterial anastomosis was 150 ml/min (190 +/- 40 ml/min) and increased to adequate with repeated measurements. In 2 cases out of 25 (8%) the blood flow rate reduced in repeated measurements, but by the end of operation the blood flow to the hepatic artery was at the satisfactory level. Blood flow less than 150ml/min immediately after the formation of arterial anastomosis was found in 8 cases out of 25 (32%). The cause of inadequate blood flow was identified and corrected. There were no cases of hepatic artery thrombosis at the early postoperative period. The routine use of intraoperative blood flow measurements allows timely determination of insufficient arterial blood supply of the transplant and elimination of its causes.

[Roentgenoendovascular hemostasis of arterial bleeding after major surgery for pancreatic cancer].

The efficacy of angiographic hemostasis in cases of massive arterial bleeding after major pancreatic resection was evaluated. Late life-threatening arterial hemorrhage developed in 3 out of 65 patients (4.6%) within 12, 20 and 42 days after pancreatic carcinoma resection. In all cases emergency roentgenoendovascular procedures were fulfilled for hemostasis. Six therapeutic angiographic procedures (from one to three per a patient) were performed. All of them were clinically and technically successful. Depending on the bleeding localization and the character of vascular lesion, the embolization (n = 5) or stent-grafting (n = 1) were used. The further prognosis was dependent on the success of treatment of complications and the course of the malignant disease. The emergency angiography with endovascular hemostasis appears to be the method of choice in treatment of postoperative visceral bleedings especially in patients with high surgical risk.

[The attempt of clinical classification of the complicated diabetic foot syndrome].

The experience of surgical treatment of 1532 patients with the complicated forms of diabetic foot syndrome (DFS) was analyzed. The original clinical classification of the complicated DFS was suggested. The classification considered the clinical form (symbol "C"), anatomic localization (symbol "Z") and etiology (symbol "E"). The classification allows to define surgical tactics depending on concrete complications of the DFS, frames conditions for the unification and uniform registration of the form and severity of the disease and volume of the surgical treatment.

[Original clinical classification of a complicated diabetic foot syndrome].

Original clinical classification of a complicated diabetic foot syndrome (DFS), based on summarizing of experience, concerning surgical treatment of 1532 patients, suffering complicated DFS, was proposed, necessitating determination of clinical form (symbol C), anatomic localization (symbol Z) and etiological factor (symbol E) of the lower extremity tissues affection. The classification applied permits to choose a surgical tactics depending on presence of specific complication of DFS, and this creates conditions for unification and universal registration of form and severity of a complicated DFS, as well as the volume of a surgical aid

[Complicated course of diabetic foot syndrome. An attempt to create the new classification concerning necrotic-purulent complications severity].

There was analyzed in detail a current state of diabetic foot syndrome (DFS) problem. In spite of that DFS constitutes the discrete nosological entity, it is not included into International Classification of the Diseases (ICD-10). The absence of classification of complicated DFS does not permit to elaborate protocols of the patients treatment standards and to determine real terms of their stationary treatment. Basing on analysis of the work experience of Purulent-septic center, owing hospital beds for the treatment of patients, suffering DFS, concerning diagnosis and treatment of more than 1500 patients with the DFS complications, the original classification of complicated DFS was presented by the authors, which is proposed for discussion in a wide round of specialists.

[Application of discrete plasmapheresis in complex treatment of patients with sepsis].

There were examined 226 patients, in whom sepsis had occurred as a consequence of purulent-inflammatory diseases of soft tissues. The discrete plasmapheresis application in complex of intensive therapy had promoted the rapidest elimination of homeostasis disorders in the survived patients, but the influence on the lethality level was not revealed.

[Neoadjuvant intra-arterial oil chemoembolization and adjuvant selective intra-arterial chemoinfusion in the combined treatment of pancreatic cancer].

Neoadjuvant intra-arterial oil chemoembolization and adjuvant selective intra-arterial chemoinfusion with gemicitabine was administered to 28 patients with operable exocrine pancreatic cancer. It was well tolerated and not followed by complications which allowed for gastropancreatoduodenal resection to be carried out in all cases. Complete course of combined treatment was given to 23 out of 28 patients (82.1%). As a result, 2-, 3- and 5-year actuarial survival rates were 23.9, 17.4 and 13%, respectively. Long-term survival was recorded among patients without metastases into regional lymph nodes: two of them have survived without relapse for more than 5 years and one died of tumor progression after 4 years of the follow-up.

[Surgical sepsis. Diagnostic criterions].

Possibilities of timely diagnosis of sepsis were discussed. Informativity of its clinical symptoms, laboratory and instrumental data was studied. Diagnostic criteria were formulated, the programme of complex diagnosis of sepsis was suggested.

Microfabricated adhesive mimicking gecko foot-hair.

The amazing climbing ability of geckos has attracted the interest of philosophers and scientists alike for centuries. However, only in the past few years has progress been made in understanding the mechanism behind this ability, which relies on submicrometre keratin hairs covering the soles of geckos. Each hair produces a miniscule force approximately 10(-7) N (due to van der Waals and/or capillary interactions) but millions of hairs acting together create a formidable adhesion of approximately 10 N x cm(-2): sufficient to keep geckos firmly on their feet, even when upside down on a glass ceiling. It is very tempting to create a new type of adhesive by mimicking the gecko mechanism. Here we report on a prototype of such 'gecko tape' made by microfabrication of dense arrays of flexible plastic pillars, the geometry of which is optimized to ensure their collective adhesion. Our approach shows a way to manufacture self-cleaning, re-attachable dry adhesives, although problems related to their durability and mass production are yet to be resolved.

[Sepsis. The fundamentals of the therapeutic program development]. / Sepsis. Osnovy formirovaniia lecheniia lechebnoi programmy.

The more than ten-year experience of treatment of 287 patients with sepsis, caused by severe surgical disease of the soft tissues, was summarized. Algorithm of therapeutic program was proposed. Necessity of specialized hospitals organization was substantiated. Was paid attention on importance of early diagnosis of sepsis, full value treatment of primary focus of infection and conduction of therapy, based on principles of evidence-based medicine.

[Lipid peroxidation and the function of the antioxidant system in sepsis in patients with soft-tissue suppurative and inflammatory lesions]. / Perekisnoe okislenie lipidov i sostoianie antioksidantnoi sistemy pri sepsise u bol'nykh s gnoino-vospalitel'nym porazheniem miagkikh tkanei.

While sepsis present in 73 patients with purulent-inflammatory affection of soft tissues and in 76 patients with local purulent inflammation the dynamics of processes of peroxidal oxidation of lipids (POL) and of antioxidant system (AOS) was studied up. In patients of both groups the trustworthy increase of the POL products in a blood plasma and pre- and postoperative AOS suppression was noted.