Introduction. According to statistics, about 20% of the population have olfactory disorders of various etiologies. Among the older age group, the prevalence of the symptom is significantly higher and ranges from 40% to 65%. Olfactory disorders are most often found in diseases of the nose and paranasal sinuses of viral and infectious genesis and traumatic brain injury. There are currently no approved schemes for the correction of olfactory disorders. However, in chronic rhinosinusitis, the role of endonasal surgical interventions, systemic and topical glucocorticoids, and biological targeted therapy has been substantiated. Olfactory training in patients with olfactory dysfunction of various etiologies may be a promising treatment method. Objective. To review olfactory training techniques in general clinical practice. Materials and methods. The search for publications in the PubMed and Web of Science databases for the period from 2009 to 2023 was carried out. Results. Olfactory training is an effective method of treating olfactory dysfunction of various etiologies. The proposed olfactory training schemes involve the use of various essential oils in a standard concentration, while the duration of training can vary from 3 to 8 months. The effect of training is characterized by improved indicators of discrimination and identification of odors. At the same time, the period of restoration of the sense of smell is determined both by the degree of severity of olfactory disorders and their duration and by the age of the patient. Shorter recovery periods of olfaction were observed in patients younger than 40 years, and longer periods, in patients older than 69 years. Discussion. The study of the prospects for the use of olfactory training in the correction of olfactory dysfunction involves the study of the role of polysensory stimulation in increasing their effectiveness. The most optimal is additional stimulation of the visual analyzer by immersing the patient in a virtual scenario.

Введение. По данным литературы, более 23% лиц в возрасте от 25 до 75 лет имеют различные варианты нарушения обоняния. В настоящее время существует ряд качественных и количественных методик оценки обоняния, применение которых в значительной степени трудоемко, требует специального оборудования и навыков. Большинство рекомендаций в международной практике относительно самооценки обоняния и влияния его нарушения на качество жизни касаются опросника Questionnaire of Olfactory Disorders – Negative Statements (QOD-NS). В то же время в России достоверных и надежных опросников самооценки обоняния недостаточно. Таким образом, разработка русскоязычных версий опросников самооценки обоняния имеет первостепенное значение. Цель. Перевод, адаптация и валидизация русскоязычной версии опросника QOD-NS (Questionnaire of Olfactory Disorders – Negative Statements Factor Analysis). Материалы и методы. Адаптация русскоязычной версии опросника QOD-NS проводилась в соответствии с международными стандартами. При помощи русскоязычной версии опросника QOD-NS на базе клиник ФГБОУ ВО «СамГМУ Минздрава России» проведено исследование с участием 100 человек в возрасте от 18 до 75 лет. Результаты. Каппа Коэна, по данным двукратного опроса пациентов методом «тест-ретест», для 78,4% утверждений варьировала от 0,76 до 0,99. Надежность внутреннего постоянства опросника QOD-NS (α Кронбаха) составила 0,947, общий коэффициент корреляции варьировал от 0,89 до 0,97, что свидетельствует о хорошей внутренней согласованности рускоязычной версии опросника QOD-NS. Суммарный балл QOD-NS был значительно выше у лиц с нормальным обонянием (43,8±7,2 балла), по сравнению с лицами, у которых выявлено нарушение обонятельной функции (31,2±0,2 балла) (p<0,05). Заключение. Результаты исследования показывают высокую надежность и валидность русскоязычной версии опросника QOD-NS, применение которого возможно во врачебной практике как для выявления нарушения обоняния, так и для определения уровня влияния данного состояния на качество жизни пациента. Introduction. According to the literature, more than 23% of people aged 25 to 75 years have various variants of olfactory disorders. Currently, there are a number of qualitative and quantitative methods for assessing the sense of smell, the use of which is largely labor-intensive, requires special equipment and skills. Most of the recommendations in international practice regarding the self-assessment of the sense of smell and the impact of its violation on the quality of life relate to the questionnaire Questionnaire of Olfactory Disorders – Negative Statements (QOD-NS). At the same time, there are not enough reliable and reliable questionnaires of self-assessment of the sense of smell in the Russian Federation. Thus, the development of Russian-language versions of olfactory self- assessment questionnaires is of paramount importance. Purpose. Translation, adaptation and validation of the Russian version of the questionnaire QOD-NS (Questionnaire of Olfactory Disorders – Negative Statements Factor Analysis). Materials and methods. The adaptation of the Russian-language version of the QOD-NS questionnaire was carried out in accordance with international standards. With the help of the Russian-language version of the QOD-NS questionnaire, a study was conducted on the basis of the Clinics of the Federal State Budgetary Educational Institution of the Ministry of Health of Russia of 100 people aged 18 to 75 years. Results. Cohen’s kappa varied from 0.76 to 0.99 for 78.4% of the statements, according to a two-time survey of patients using the "test-retest" method. The reliability of the internal consistency of the QOD-NS questionnaire (α Kronbach) was 0.947, the overall correlation coefficient varied from 0.89 to 0.97, which indicates good internal consistency of the QOD-NS questionnaire in Russian. The total QOD-NS score was significantly higher in individuals with normal sense of smell (43.8±7.2 points), compared with individuals with olfactory function impairment (31.2±0.2 points) (p<0.05). Conclusion. The results of the study show the high reliability and validity of the Russian- language version of the QOD-NS questionnaire, the use of which is possible in medical practice both to identify olfactory disorders and to determine the level of influence of this condition on the patient’s quality of life.

Medical education tends to be transformed by many factors, including the ever-changing health care environment, the new role of the physician, changing societal expectations, rapidly evolving medical science, and the emergence of a wide variety of pedagogical methods used in teaching. Changes in societal expectations put patient safety at the forefront and raise ethical concerns about teaching medical students. The modern approach to training students with simulation technologies, including virtual reality technology, provides a safe learning environment without risk to patients or volunteers. Purpose of the study. Comparison of the effectiveness of traditional teaching and teaching using virtual technologies. Material and methods. The study involved 220 students of the Institute of Pediatrics and the Institute of Clinical Medicine of the Samara State Medical University. The study was carried out at a practical lesson on the topic “Clinical Anatomy, Physiology and Research Methods of the Larynx, Trachea, Bronchi” on the basis of the Department of Otorhinolaryngology named after Academician of the Russian Academy of Sciences I.B. Soldatov, as well as in a multi-profile accreditation and simulation center with the use of a simulator for intubation, tracheostomy, cricothyrotomy. The Tracheostomy-VR simulator was developed by the Institute of Innovative Development of the Samara State Medical University for training at the Department of Otorhinolaryngology. All students were divided into three groups, based on the teaching methods that have been used. During the practical lesson, they were given questionnaires to assess the practical skill of tracheostomy, as well as the degree of immersion in virtual reality. Based on the results of the questionnaire, a comparison was made between the groups. Results. The results of the questionnaires confirm the improvement in the performance of the tracheostomy practical skill by students of all groups. However, group 3 students, who used both traditional methods and virtual technologies, had a higher score (1.2± 0.3 points) compared with the students of group 1, in which only traditional teaching methods were used. The use of virtual reality made it possible to provide a realistic immersion in the conditions of the operating room. In addition, high immersion scores demonstrate that students had no technical problems with practicing these skills. Conclusion. Teaching students using virtual reality yields results not inferior to those of traditional teaching methods. This study confirms the possibility of using the Tracheostomy-VR simulator during practical lessons. The use of a VR solution that is innovative and interactive has proven to be useful for training students in surgical intervention at the Department of Otorhinolaryngology. Медицинское образование имеет тенденцию к преобразованию, происходящему под влиянием многих факторов, включая постоянно меняющуюся среду здравоохранения, новую роль врача, измененные общественные ожидания, быстро развивающуюся медицинскую науку и появление большого разнообразия педагогических методов, используемых при обучении. Изменения в общественных ожиданиях ставят безопасность пациентов на первый план и поднимают этические проблемы обучения студентов-медиков. Современный подход – обучение студентов при помощи симуляционных технологий, включая технологию виртуальной реальности, обеспечивает безопасную учебную среду без риска для пациентов или добровольцев. Цель исследования. Сравнение эффективности традиционного обучения и обучения с применением виртуальных технологий. Материал и методы. В исследовании приняли участие 220 студентов института педиатрии и института клинической медицины Самарского государственного медицинского университета. Исследование было проведено на практическом занятии по теме «Клиническая анатомия, физиология и методы исследования гортани, трахеи, бронхов» на базе кафедры оториноларингологии им. акад. И.Б. Солдатова, а также в мультипрофильном аккредитационно-симуляционном центре с применением тренажера для интубации, трахеостомии, коникотомии. Для обучения на кафедре оториноларингологии использовался симулятор «Трахеостомия-VR» разработанный институтом инновационного развития СамГМУ. Все студенты в зависимости от применяемых методов обучения были распределены в 3 группы. В ходе практического занятия исследуемые заполняли анкеты, позволяющие оценить успешность выполнения практического навыка трахеостомии, а также степень погружения в виртуальную реальность. По результатам анкетирования было проведено сравнение между группами. Результаты. Результаты анкетирования подтверждают улучшение выполнения практического навыка «трахеостомия» студентами всех групп. Однако у студентов 3-й группы, обучающихся с применением как традиционных методов, так и виртуальных технологий, отмечался более высокий балл (1,2±0,3 балла) по сравнению со студентами 1-й группы, в которой применялись только традиционные методики обучения. Использование виртуальной реальности позволило обеспечить реалистичное погружение в условия операционной. Кроме того, высокие оценки погружения демонстрируют, что никаких технических проблем с отработкой практических навыков у студентов не было. Заключение. Обучение студентов с применением виртуальной реальности, дает результат не ниже по сравнению с традиционными методами обучения. Данные исследования подтверждают возможность применения симулятора «Трахеостомия-VR» во время практического занятия. Использование VR-решения, которое является инновационным и интерактивным, оказалось полезным для практического обучения студентов хирургическому вмешательству на кафедре оториноларингологии.

Introduction. The prospects for the use of virtual reality technologies are of great interest in the development of medicine. In this regard, innovative technologies are increasingly being used to train specialists in the healthcare system. The article deals with the problems of using virtual reality technologies in teaching students on the example of practicing the Maxillary sinus surgery skill. Materials and methods. In total, 280 students of the Samara State Medical University took part in the study, of which 70 people (25%) were students of the Institute of Pediatrics, 70 people (25%) were students of the Institute of Dentistry, and 140 people (50%) were students of the Institute of Clinical Medicine. During the study, the students were asked to complete a questionnaire twice, which assessed their confidence in performing the operation. Additionally, the students completed asurvey using the questionnaire “Assessment of the work of the Maxillary sinus surgery VR simulator.” Purpose of the study. Evaluation of the effectiveness of the use of the Maxillary sinus surgery VR simulator in teaching students in otorhinolaryngology. Results. According to the results of the survey, 96% of students positively assessed the compliance with the anatomical structure of the nose and paranasal sinuses of the Maxillary sinus surgery VR simulator. The average increase in points for students of all faculties during the implementation of the stage «Formation of access to the sinus» was 3 points. Students of all faculties have a rather high increase in the performance of the Suturing stage, and it was more than 3.5 points. Discussion. Previous studies have shown the positive impact of using VR technologies in education, given the increase in students’ motivation, the development of a set of specialized skills in a certain area in accordance with existing concepts for the development of modern education, including the field of digital transformation. The results obtained by us clearly show that the use of the Maxillary sinus surgery VR simulator in the educational process contributes to the formation of a better type of memorization of the material by students, which quite logically leads to higher results in the subsequent control of the acquired knowledge. Conclusions. On the basis of the study, the use of the Maxillary sinus surgery VR simulator is justified for the practical training of students in the study of the discipline Otorhinolaryngology, confirms its effectiveness for practicing practical skills, and ensures the realism of the implementation of the stages of the operation.

VR-ТРЕНАЖЕР КАК ОБЪЕКТ ЦИФРОВОЙ ТРАНСФОРМАЦИИ В МЕДИЦИНСКОМ ВУЗЕКолсанов А

Определение отклоняющегося поведения был и остается сложным и противоречивым процессом. Поведение должно иметь ряд особенностей, ключевым из которых является отклонение от общепринятых стандартов поведения. В статье рассмотрены результаты исследования с применением VR-технологий, целью которого было выявить взаимосвязь между психофизиологическими проявлениями в поведении индивида и отклоняющимся поведением.

The paper assessed various signs of lung tissue damage and the extent of its damage using automatic and empirical methods on CT of the chest organs in pneumonia caused by COVID-19. We analyzed 198 CT scans of the chest of patients with confirmed COVID-19 pneumonia of varying severity. The visual assessment was performed by a radiologist with 8 years of experience in thoracic radiology. The presence of CT patterns was assessed: ground-glass opacities, consolidation, reticular changes, “crazy paving”. Automatic analysis of CT scans performed in the “service of automatic diagnosis of patients with COVID-19”, which is determined by the amount of light and the amount of “ground glass” and consolidation. The automated analysis of computed tomograms was carried out in the “Service for automatic assessment of the severity of lung injury in patients with COVID-19”, which determined the volume of the lungs, the volume of the lesion “frosted glass” and consolidation. The average lesion volume in all groups was 19.1 % according to visual analysis. According to automatic analysis, the prevalence was 11.1 %. The visual assessment of the volume of the lesion is more pronounced compared with the automated assessment, in which the information is more objective.

Технологизация обучения продолжает оставаться актуальным вопросом, который в свою очередь порождает новые проблемы связанные с процессом индивидуализации обучающего процесса. В статье рассмотрены результаты исследования применения технологий VR в обучающем процессе, выявления взаимосвязи между поведением в виртуальной реальности и психофизиологическим состоянием индивидов.

The paper presents a problem of computational complexity balancing of 3D models of human body parts in order to provide universal access to the knowledge based on highly realistic anatomy models from the devices of high and low performance. There is presented an innovative method of polytexture modeling that provides adaptive complication of 3D anatomy scenes capable of solving the problem of visualization using various client devices. The proposed method is based on the modern advances in computational anatomy—a new scientific direction that develops the capabilities of simulation learning technologies in the three-dimensional space of virtual reality. Research results are illustrated by application of 3D anatomy simulation technologies in medical universities in Russia.

The paper is dedicated to a problem of hand motion capturing as a part of an intelligent solution for medical and social rehabilitation technology based on the implementation of virtual reality with tactile feedback. Based on related works overview it is proposed to use the system of resistive transducers to develop a mechanical construction for tracking the position of fingers. To capture and formalize the hand motor function a number of kinematic and dynamic parameters are introduced. The sensors provide complete description of the hand motor function in the form of independent coordinates of its movement. Based on this approach there is proposed an original tracking system, which gives a new opportunity to provide a complete description of hand mechanics. From the variety of solutions two prototypes were developed and studied: one with conductive cord and arm, next with flexible PCB prototype with the ability to host sensors. In addition to hand motion capturing solution some recommendations are given to improve its simulation in AR/VR environment. The results of research and development prove the possibility to implement the sensor glove for hand functions rehabilitation in medical applications with the required efficiency.

The paper analyzes the possibility of using multi-sensory virtual reality to increase the effectiveness of rehabilitation measures based on the ideomotor representation of complex bilateral limb movements. Mathematical models were constructed in the form of statistical connectors of intercortical interactions undergoing changes against the background of peripheral sensomotor apparatus activation. The increased activity in the motor cortical zones of the proprioceptive system activation was demonstrated, which testifies to the increased efficiency of the ideomotor representation of movements. The obtained results can be used as a way to improve the stability and accuracy of neurocomputer interface classifiers based on the detection of complex bilateral movements.

ПЕРВЫЕ РЕЗУЛЬТАТЫ ПРИМЕНЕНИЯ ИНТРАОПЕРАЦИОННОЙ НАВИГАЦИИ НА ОСНОВЕ ДАННЫХ КТ И МРТ У ПАЦИЕНТА С ОПУХОЛЬЮ МЕЖЖЕЛУДОЧКОВОЙ ПЕРЕГОРОДКИКолсанов А.В. 1 , Зельтер П.М. 1 , Хобта Р.В. 2 , Чаплыгин С.С. 1 , Манукян А

The purpose of the work is to develop a solution to increase the number of companies involved in the digital economy markets formation, to assist in accelerating of new products and services based on virtual and augmented reality technology introduction, to ensure their competitiveness and to overcome technological barriers. The authors analyze the current situation in the Russian digital economy, related to the end-to-end technology of virtual and augmented reality, technological barriers that hinder the economy development. The problems reside in low digital literacy, lack of understanding of VR/AR using possibilities in a professional environment, shortage of developers, lack of VR/AR content in consumer and specialized fields, the long alignment process of pilot projects for implementation in state corporations and industrial enterprises, as well as the lack of Russian industry standards for design systems (CAD) and universal VR/AR devices. To address the identified barriers, the authors describe the concept of digital online platform for creating and distributing VR/AR content and services.

The paper presents an augmented reality based solution for hand movement rehabilitation using visual and tactile feedback. The proposed approach to the rehabilitation process combines the effects on visual, auditory and tactile channels of perception and simulation scenarios. In order to develop a hand movement model capable of solving rehabilitation tasks there was studied the concept of immersive virtual reality. Original 3D models and scenes have been developed to simulate the basic hand positions and motor functions. To provide efficient hand motion fixation it is recommended to implement a mechanical position tracking system based on a sensor glove improved by using the resistive transducers. Augmented reality is implemented to inspire and motivate the user to perform the required exercises by generating the corresponding pictures. Personalized comparative analysis of the dynamics of the patient's initial condition and rehabilitation results help to study the motor function and restore everyday skills. The proposed solution allows achieving accuracy and adequacy of fingers movements sufficient to satisfy the requirements of medical rehabilitation applications.

Purpose of the study. To develop an information technology for calculating perfusion computed tomography parameters and to evaluate the effectiveness of using the proposed program in the differential diagnosis of continued glioblastoma growth and post-radiation necrosis. Materials and methods. We examined 53 patients who were treated at the Samara Clinical Oncological Dispensary. All patients underwent CT scan in perfusion mode. The results of using the program were compared with the data that were calculated on the workstation of the GE Discovery CT750 HD computed tomograph. Results. Significant differences were found in CBV and CBF perfusion indices in groups with continued growth and post-radiation necrosis, verified by biopsy. The parameters calculated using the developed program did not differ significantly from the results obtained on a standard workstation. Conclusion. The application of the developed computer program for the analysis of CT perfusion does not depend on the equipment manufacturer, works with standard DICOM data, which increases the availability of a valuable diagnostic method. The results obtained using the proposed information technology make it possible to differentiate the continued growth of glioblastoma from post-radiation necrosis.

Objective is the combination of frequency filtering and nonlinear analysis methods for generating hypnograms through the analysis of electroencephalographic (EEG) signals in the somnological studies. Methods. The frequency filtration methods are used for the primary preparation of the EEG signals for further nonlinear analysis. Among the nonlinear analysis methods, such fractal deterministic chaos methods as the Hurst standardized range method, approximate entropy method, and correlation integral computation with the Grassberger-Procaccia algorithm. To apply the two latter methods, we used the pseudo-phase space reconstruction method based on Taken’s theorem. Relying upon the nonlinear analysis results, and as a result of the somnology examination of patients, the hypnograms of sleep stage transitions were made up. To verify the collected results, they were compared with the hypnograms generated with the classical method based on the Rechchaffen and Kales parameters. Moreover, the problems related to various disturbing factors are considered, the ways of mitigation of their influence on the final results are suggested. Conclusion. With the properly selected method parameters, the accurate standardization of the input data and correct averaging of results, the given methods can be used to produce a hypnogram showing complete coincidence of the identified sleep phases for almost a half of the epochs registered by EEG. Interestingly, these results can be achieved with one EEG registration channel only.

The OBJECTIVE of this work was to study the possibility of preoperative color 3D-modeling and intraoperative navigation through the use of the system «Avtoplan» in the surgical treatment of patients with pathology of the liver.MATERIAL AND METHODS. System «Avtoplan» was used in 32 patients with different surgical diseases of the liver: hemangioma, hydatid cyst, alveococcosis and metastatic colorectal cancer to assess the feasibility of the operation – resection of the liver of a particular volume.RESULTS. The performed 3D-modeling of the liver in the preoperative stage were used in 3 cases (10.3%) of 32 to abandon the planned surgical treatment in favor of conservative therapy due to local spread of the pathological process (in 2 cases – metastatic bilobate and in 1 case – alveococcosis organ damage). Of the 29 operated patients, in 6 (20.7%) at the stage of preoperative modeling, the planned volume of liver resection was changed: in 4 patients, in the direction of its increase in connection with the identified topographic and anatomic location of tumors, and in 2 patients, in the direction of its reduction due to the peculiarities of the blood supply to the zone of surgical interest.CONCLUSION. Preoperative 3D-modeling allowed the surgeon to better prepare for surgical intervention according to individual anatomical characteristics of the patient and to choose the optimal extent of surgery. Knowledge of 3D topography of liver lesions allowed reducing intraoperative blood loss and the likelihood of damage to intrahepatic structures (vessels, bile ducts). Postoperative 3D modeling allowed to assess the adequacy of the volume of surgery performed and could serve as an objective criterion in assessing the quality of medical care.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.