HighlightsThe review analyzed the role of various preoperative indicators as predictors of long-term mortality in patients with myocardial infarction and coronary microvascular obstruction (no-reflow) that developed during percutaneous coronary intervention. As a result of a multifactorial analysis, taking into account the confounders available for evaluation, we have found that predilation serves as an independent predictor of death within two years. AbstractAim. To evaluate the role of various aspects of percutaneous coronary interventions (PCI) as predictors of long-term death in myocardial infarction (MI) and coronary microvascular obstruction (CMVO, no-reflow).Methods. The unmatched case-control study included 232 patients with type 1 MI and CMVO developed during PCI. CMVO criteria were as follows: TIMI flow grade <3, Myocardial blush grade <2, ST segment resolution after PCI <70%. The “cases” group consisted of 54 (23.3%) patients who died within the next two years, the “controls” group consisted of 178 (76.7%) patients who survived. The analysis included the following indicators: predilation, high-pressure balloon post-dilation, vacuum assisted manual thromboaspiration, intra-aortic balloon pump, intracoronary administration of isosorbide dinitrate and verapamil hydrochloride, glycoprotein IIb/IIIa inhibitors and “potent” p2y12 inhibitors usage, bare-metal stents, stent implantation with exceeded rated burst pressure, 3 or more stents usage, PCI on more than one artery, the ratio of contrast agent volume to glomerular filtration rate (GFR) >3.0. A univariate comparative analysis of the groups regarding PCI aspects and potential confounders was performed (Mann-Whitney, Fisher). To control the confounders, a multivariate analysis was carried out (logistic regression).Results. Differences were obtained for the following indicators: “predilation” – in 51 (94%) patients in the “cases” group and in 139 (78%) in the “control” group, p-value = 0.005; “intra-aortic balloon pump” – in 9 (17%) and 7 (4%) patients respectively, p-value = 0.003; “the ratio of contrast agent volume to GFR >3.0” – in 26 (48%) and 48 (27%) patients, p-value = 0.005. Multivariate analysis revealed that only predilation was an independent predictor of death within two years – odds ratio 7.38 (95% confidence interval 1.70–49.04, p-value = 0.005).Conclusion. Predilation of the infarct-related coronary artery is an independent predictor of death within two years in MI patients who develop CMVO during PCI.

Objective: The study intends to evaluate the prognostic value of a comprehensive approach to prevention and treating the coronary microvascular obstruction (CMVO) upon percutaneous coronary interventions (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A single-center cohort study was conducted in patients characterizing by type 1 STEMI, emergency PCI, a total ischemic time of less than 12 hours, and the development of CMVO (TIMI flow grade < 3 or Myocardial blush grade < 2). Patients with cardiogenic shock prior to PCI were excluded. A proposed comprehensive approach included the following five rules: thromboaspiration in case of severe thrombosis, platelet glycoprotein IIb/IIIa receptor blockers, "minimally invasive PCI," intracoronary administration of isosorbide dinitrate and verapamil hydrochloride upon the development of CMVO. The approach was considered to be applied if three or more rules were retained. The median follow-up period was 805 [14; 1,127] days. A multivariate analysis of the risk of long-term mortality was performed using the Cox proportional hazards model. Results: A total of 202 patients were included in the study and 53 (26.3%) of them had a fatal outcome; in particular, 16 (7.9%) patients died at the hospital stage and 27 (13.4%) after discharge. Multivariate analysis of predictors of mortality showed that the using of a comprehensive approach to prevention and treating CMVO reduces the probability of death during follow-up period by 4 times with risk ratio 0.22, 95% confidence interval 0.06–0.87 and p = 0.03. Conclusion: The introducing of the proposed comprehensive approach to prevention and treating CMVO upon PCI in patients with STEMI is associated with a lower probability of death within 805 days after the intervention. Received 30 July 2024. Revised 25 September 2024. Accepted 1 October 2024. FundingThe study did not have sponsorship. Conflict of interest The authors declare no conflict of interest. Contribution of the authorsConception and study design: A.A. Frolov, E.G. Sharabrin, I.G. Pochinka Data collection and analysis: A.A. Frolov, I.A. Frolov, K.V. Kuzmichev Statistical analysis: A.A. Frolov, I.A. Frolov, K.V. Kuzmichev Drafting the article: A.A. Frolov, I.G. Pochinka, I.A. Frolov Critical revision of the article: I.G. Pochinka, A.S. Mukhin, E.G. Sharabrin Final approval of the version to be published: A.A. Frolov, I.G. Pochinka, I.A. Frolov, K.V. Kuzmichev, A.S. Mukhin, E.G. Sharabrin

Using the example of rivers in the Onega Lake basin, the species composition of mollusks of the Sphaeriidae family and their abundance, biomass, and contribution to benthic communities in rivers with many lakes in the catchment areas have been analyzed. Patterns of the spatial distribution of species across biotopes and gradients of environmental variables are traced. Twenty-six species of mollusks of this family are identified, with European–Siberian species predominating. Most species of mollusks of the family Sphaeriidae found by us have wide ecological ranges and are found in water bodies of various types. It is found that the contribution of Sphaeriidae to the species richness and functioning of aquatic communities in rivers in the conditions of branched lake–river systems (Lake Onega basin) exceeds the values usual for rivers with a small number of lakes in the catchment area. Using the ANOSIM and PERMANOVA methods, it is proven that the species composition of rocky rapids and riffles, sandy rifts, and soft bottom soils is different. Using the IndVal test, seven species are shown to have a statistically significant association with one of these biotopes, and four of them have a statistically significant association with the rocky bottoms of river rapids and riffles. Using the NMDS method, it is shown that the greatest changes in the species composition of representatives of Sphaeriidae are observed when environmental conditions change from small streams with a slow current and brown water to large rivers with a fast current and clear water.

The time delay phenomenon of reflected and transmitted laser pulse under the action of s-polarized laser radiation on a supercritical plasma slab is considered. The dependence of the time delay and peak intensity of reflected and transmitted signals on the slab thickness, plasma density, and angle of laser radiation incidence is investigated. It is shown that with increasing thickness of the plasma slab, the saturation of the transmitted signal delay time (Hartman effect) does not occur due to the exponential decrease in its intensity. The tunneling speed of the laser pulse energy through the slab of supercritical plasma is calculated, and it is shown that at large angles of laser radiation incidence, it can exceed the speed of light in vacuum. (C) 2024 Author(s).

The theory of the terahertz (THz) waves emission from a near-critical plasma slab under the action of the focused p -polarized laser pulse is developed. The spectral, angular and energy characteristics of the THz signal are studied as functions of the focusing degree and the incidence angle of laser radiation, as well as the density and thickness of the plasma slab. It is shown that the extremely strong increase in the energy of the THz signal (up to millijoule level) and conversion rate (up to 10 %) occurs at the almost normal incidence of the ultra-short, tightly focused p -polarized laser pulse on the thin plasma slab with the near-critical density and rare electron collisions.

Aim. To evaluate the impact of chronic obstructive pulmonary disease (COPD) on hospital outcomes of percutaneous coronary interventions (PCI) in patients with acute coronary syndrome (ACS). Materials and methods. A cohort prospective study of the COPD effect on mortality and coronary microvascular obstruction (CMVO, no-reflow) development after PCI in ACS was carried out. 626 patients admitted in 2019–2020 were included, 418 (67%) – men, 208 (33%) – women. Median age – 63 [56; 70] years. Myocardial infarction with ST elevation identified in 308 patients (49%), CMVO – in 59 (9%) patients (criteria: blood flow 3 grade according to TIMI flow grade; perfusion 2 points according to Myocardial blush grade; ST segment resolution 70%). 13 (2.1%) patients died. Based on the questionnaire "Chronic Airways Diseases, A Guide for Primary Care Physicians, 2005", 2 groups of patients were identified: 197 (31%) with COPD (≥17 points) and 429 (69%) without COPD (17 points). Groups were compared on unbalanced data (÷2 Pearson, Fisher exact test). The propensity score was calculated, and a two-way logistic regression analysis was performed. The data were balanced by the Kernel “weighting” method, logistic regression analysis was carried out using “weighting” coefficients. Results as odds ratio (OR) and 95% confidence interval. Results. The conducted research allowed us to obtain the following results, depending on the type of analysis: 1) analysis of unbalanced data in patients with COPD: OR death 3.60 (1.16–11.12); p=0.03; OR CMVO 0.65 (0.35–1.22); p=0,18; 2) two-way analysis with propensity score: OR death 3.86 (1.09–13.74); p=0.04; OR CMVO 0.61 (0.31–1.19); p=0.15; 3) regression analysis with "weight" coefficients: OR death 12.49 (2.27–68.84); p=0.004; OR CMVO 0.63 (0.30–1.33); p=0.22. Conclusion. The presence of COPD in patients with ACS undergoing PCI increases mortality and does not affect the incidence of CMVO.

Проведено численное моделирование бегущих ленгмюровских волн в теплой плазме при использовании кинетического описания процесса. Волны такого типа могут возбуждаться мощным коротким лазерным импульсом (так называемая кильватерная волна). Показано, что скорости распространения возмущений в моментах функции распределения второго и третьего порядков существенно превышают скорость распространения волны плотности заряда. Важным аспектом работы является сравнение кинетической и гидродинамической моделей на примере рассмотренной задачи. Показано, что гидродинамическая модель без учета теплового потока не дает хорошего приближения к решению кинетического уравнения Власова. В результате проблема замыкания для уравнений моментов остается открытой.

The spatiotemporal Goos–Hänchen effect is considered when s- and p-polarized laser pulses are incident from a vacuum onto the boundary of the supercritical plasma. It is shown that, in addition to the lateral shift, the reflection of a laser pulse from the plasma boundary is also accompanied by its time delay, which can significantly exceed the period of laser oscillations. The dependence of the time delay of the reflected signal on the angle of incidence and polarization of the incident pulse as well as on the density of plasma electrons is studied.

Актуальность. Нет шкалы, объединяющей традиционные критерии коронарной микрососудистой обструкции (no-reflow) для эффективной оценки тяжести и прогноза данного осложнения. Цель. Разработать и изучить прогностическую ценность шкалы оценки тяжести коронарной микрососудистой обструкции в ходе чрескожных коронарных вмешательств при инфаркте миокарда. Методы. В когортное исследование включено 203 пациента с инфарк­том миокарда 1-го типа и коронарной микрососудистой обструкцией при чрескожном коронарном вмешательстве по критерию кровоток < 3 баллов по Thrombolysis in Myocardial Infarction (TIMI) flow grade. По предложенной шкале оценки тяжести коронарной микрососудистой обструкции (ШОТ-КМСО) выделены 3 группы. Коронарная микрососудистая обструкция 1-й степени (умеренная): TIMI flow grade 2 балла, Myocardial blush grade 2–3 балла, резолюция сегмента ST после чрескожного коронарного вмешательства > 70 %. Коронарная микрососудистая обструкция 2-й степени (средней тяжести): TIMI flow grade 2 балла, Myocardial blush grade 0–1 балл или резолюция сегмента ST < 70 %. Коронарная микрососудистая обструкция 3-й степени (тяжелая): TIMI flow grade 0–1 балл. Результаты. Распределение групп с коронарной микрососудистой обструкцией 1-й, 2-й и 3-й степеней: 65 (32 %) / 88 (43 %) / 50 (25 %) пациентов соответственно. Госпитальные исходы по группам: острая сердечная недостаточность III–IV класса — 2 (3 %) / 11 (13 %) / 14 (28 %), p < 0,001; фракция выброса — 48 [44; 53] % / 46 [40; 50] % / 42 [39; 49] %, p = 0,004; госпитальная смерть — 1 (1,5 %) / 12 (13,6 %) / 16 (32,0 %), p < 0,001; смерть в течение двух лет — 8 (12,3 %) / 19 (21,6 %) / 22 (44,0 %), p < 0,001. Многофакторный анализ: отношение шансов смерти в течение двух лет для ШОТ-КМСО — 2,40 [95% доверительный интервал 1,23–5,17], p = 0,009. Вероятность выжить за двухлетний период при КМСО 1-й степени по ШОТ-КМСО — 87,7 %, 2-й — 78,4 %, 3-й — 56,0 % (p < 0,001). Заключение. Степень тяжести коронарной микрососудистой обструкции, оцененная с помощью предложенной шкалы, ассоциирована с развитием неблагоприятных госпитальных исходов и является независимым предиктором смерти в течение двух лет. Поступила в редакцию 15 мая 2023 г. Исправлена 27 сентября 2023 г. Принята к печати 24 октября 2023 г. Финансирование Исследование выполнено в рамках программы стратегического академического лидерства «Приоритет-2030». Конфликт интересов Авторы заявляют об отсутствии конфликта интересов. Вклад авторов Концепция и дизайн работы: А.А. Фролов, Е.Г. Шарабрин, И.Г. Починка Сбор и анализ данных: А.А. Фролов, И.А. Фролов, К.В. Кузьмичев Статистическая обработка данных: А.А. Фролов, И.А. Фролов, К.В. Кузьмичев Написание статьи: А.А. Фролов, И.Г. Починка, И.А. Фролов Исправление статьи: И.Г. Починка, А.С. Мухин, Е.Г. Шарабрин, В.Н. Синютин Утверждение окончательного варианта статьи: все авторы

Objective: using the clustering method, to determine and describe the clinical and pathogenetic phenotypes of the coronary microvascular obstruction phenomenon (CMVO) that occurs during percutaneous coronary interventions (PCI) in patients with myocardial infarction (MI).Materials and methods: the study group included 190 patients with CMVO that occurred during PCI for type 1 MI. Participants admitted in 2013-2020. CMVO criteria: blood flow < 3 points in the infarct-related artery (IRA) according to TIMI flow grade (TFG); perfusion < 2 points for Myocardial blush grade; ST segment resolution < 70%. Median age – 64 [56; 70] years, 137 (72%) men, 53 (28%) women. MI with ST elevation (STEMI) in 170 patients (89%). Primary PCI in 127 (67%) cases. Nine patients (4.7%) have died. Phenotyping was performed using the EM (expectation-maximization) clustering algorithm.Results: three phenotypes have been identified in a ratio of 56% (n = 106) / 27% (n = 52) / 17% (n = 32). The values of the parameters are respectively: age 62 [54; 67] / 73 [67; 79] / 59 [50; 65] years; women 8 (8%) / 39 (77%) / 6 (19%); STEMI 102 (96%) / 43 (83%) / 25 (78%); thrombolysis 46 (43%) / 6 (12%) / 11 (34%); acute heart failure 1 [1; 2] / 2 [1; 4] / 2 [2; 2] class; platelet to lymphocyte ratio 110 [78; 153] / 106 [85; 132] / 132 [100; 182]; glucose at admission 8,0 [6,9; 9,6] / 11,1 [8,8; 15,2] / 7,5 [6,1; 8,1] mmol/l; total cholesterol 4,7 [4,2; 5,4] / 5,3 [3,7; 6,2] / 5,1 [4,5; 6,2] mmol/l; glomerular filtration rate according to CKD-EPI 77 [64; 88] / 58 [46; 74] / 81 [64; 88] ml/min/1.73m2; Syntax Score 15 [10; 21] / 20 [14; 26] / 8 [5; 10] points; Syntax Score in IRA 9 [8; 15] / 12 [7; 16] / 6 [3; 7] points; collaterals according to Rentrop 0 [0; 1] / 0 [0; 1] / 0 [0; 0] degree; TIMI thrombus grade 5 [5; 5]/ 5 [3; 5] / 1 [0; 2] degree; TFG 0 [0; 0] / 0 [0; 1] / 2 [2; 3] degree; aspiration thrombectomy 30 (28%) / 7 (13%) /4 (13%); IRA diameter 3,5 [3,0; 3,5] / 3,0 [2,8; 3,5] / 3,5 [3,0; 3,5] mm; balloon angioplasty 99 (93%) / 45 (87%) /16 (50%); PCI of 2 or more arteries 0 (0%) / 4 (8%) / 3 (9). Deaths – 2 (1.9%), 7 (13.5%) and 0 (0%) patients, respectively (p = 0.002, χ2-Pearson).Conclusion. Тhree phenotypes have been identified. First phenotype: severe IRA thrombosis, mostly men, moderate atherosclerotic lesions. Second phenotype: mostly elderly women, high hyperglycemia, severe atherosclerotic lesions, severe AHF, impaired renal function, IRA thrombosis. Third phenotype: mostly men, minor changes in the coronary arteries, absence of significant thrombosis and preserved blood flow in the IRA before PCI, elevated levels of inflammatory markers and total cholesterol.

The theory of terahertz (THz) wave emission at the oblique incidence of a focused s -polarized laser pulse on the boundary of a rarefied plasma is developed. The angular, spectral and energy characteristics of the THz signal as a function of the focal spot size and the incidence angle of laser radiation, as well as the plasma density, are investigated. It is shown that the THz radiation energy increases with a decrease in the laser pulse focal spot and has the maximum value when the tightly focused laser pulse is incident at the angle of total reflection on the plasma boundary.

The kinetic formulation of the model problem of plasma waves excitation by a powerful short laser pulse is numerically studied for the first time. Kinetic and simplest hydrodynamic plasma models are also compared for the problem under consideration. It is shown that the considered hydrodynamic models do not provide good approximations to the solution to the Vlasov kinetic equation, namely, one leads to discontinuous solutions and the other has a significant qualitative distinction. At a low plasma temperature, the effect of non-isothermicity of the process is small, but it can lead to significant distortions of the solution during further heating. The results obtained here imply that the first two moments of the distribution function are not enough to describe the plasma hydrodynamics; higher-order moments should be used.

A mathematical model of the effect of axial current in plasma on cylindrical nonrelativistic nonlinear oscillations is constructed. As a result of the coordinated interaction of electromagnetic fields and particles, plasma oscillations are transformed into a nonlinear traveling wave. For its initialization, the method for constructing the missing initial conditions based on solving a linear problem in the form of Fourier–Bessel integrals is proposed. A traveling wave is numerically simulated using the scheme of the finite difference method of the second order of accuracy. It is shown that the wave velocity increases with an increase in the magnitude of the current, which contributes to the removal of energy from the initial region of localization of oscillations. For this reason, the breaking effect is realized much later in time; i.e., the stabilization of oscillations is observed.

The theory of terahertz (THz) waves generation at the incidence of the focused p-polarized laser pulse on the plasma boundary is developed. The angular, spectral, and energy characteristics of the THz signal are studied as the function of the focusing degree and the incidence angle of laser radiation, as well as the plasma density. The frequency dependence of the THz signal energy is considered and it is established that the emission spectrum contains the broad line, and its position for tight focusing of laser radiation is determined by its reciprocal duration. The radiation pattern of the THz pulse is studied and it is shown that the decrease in the size of the laser pulse focal spot leads to the increase in the angle of radiation with respect to the normal to the plasma boundary, and for the tight focusing of the laser pulse, THz waves are emitted almost along the plasma-vacuum interface. It is established that the energy of the THz pulse noticeably increases when the p-polarized laser pulse is incident almost along the normal onto the near-critical plasma at the angle of total reflection, and the transverse size of the laser pulse decreases. It is shown that the emission of high-power THz pulses with the sufficiently high conversion rate occurs at the almost normal incidence of ultrashort tightly focused laser radiation on the boundary of near-critical plasma with rare electron collisions.

The excitation of the terahertz (THz) high-intensity surface modes when the two-frequency p-polarized laser radiation interacts with a plasma slab is studied. It was found that the significant amplification of the laser field in the plasma slab occurs when p-polarized laser radiation is incident at the angle of total reflection. It is shown that, under the action of laser radiation ponderomotive forces, the resonant excitation of the THz mode of the plasma slab occurs if the frequency difference of the laser fields coincides with the eigenfrequency of the surface mode. It is established that the giant increase in the energy flux density of the THz mode occurs when p-polarized laser radiation is incident at the angle of total reflection on the near-critical plasma slab with rare electron collisions if the conditions of resonant excitation are satisfied. It is shown that in this case the energy flux density of THz mode can significantly exceed the laser intensity.

At its present stage of internationalization of education, its architecture and forms have changed. The study of these aspects requires an integrated approach. Increasing the volume of exports of educational services remains a priority for Russia, which, according to the authors, does not realize its educational export potential sufficiently. The purpose of the article is to reveal the features of the current stage of internationalization of higher education through the compilation of its complex characteristics by a set of cross-sections, to interpret the calculations obtained in a new way, to identify new facts and factors affecting the development trend and to develop proposals for Russia as an exporter of educational services. The main sources used were the statistical databases of the WTO, the EEC of the EAEU. Analytical approach, comparative and statistical analysis were used. As a result, the authors found confirmation of the continuing trend of growth in global spending on education, the volume of investments in the global market of educational services, an increase in the number of foreign students, and the preservation of Russia's share in the number of foreign students. The authors also identified new characteristics of the global educational services market, such as: the acceleration of the growth rate of global exports of educational services, the decline in the share of the United States and the growth of the share of the UAE in the global educational services market, the transformation of Asian countries from donors to recipient countries of educational services.

Aim. To carry out a comparative analysis of the impact of optimal and suboptimal therapy for noncommunicable diseases (NCDs) at the prehospital stage on the severity and outcomes of coronavirus disease 2019 (COVID-19).Material and methods. The study included 158 patients hospitalized with a diagnosis of COVID-19 and having one or more concomitant NCDs. Patients were divided into two groups depending on the quality of initial therapy for NCDs: group 1 — patients receiving treatment that does not meet modern clinical guidelines, taking drugs not regularly or not taking them at all (n=100; 63%), and group 2 — patients receiving treatment in accordance with current clinical guidelines, taking regularly prescribed therapy (n=58; 37%). The primary endpoint was inhospital death, while secondary endpoints — duration of fever, length of intensive care unit (ICU) stay, length of hospital stay.Results. Inhospital mortality was significantly higher in the 1st group of patients compared with the 2nd group (18,0% vs 1,7%, p=0,002). Analysis of secondary endpoints revealed that patients of the 1st group (nonoptimal therapy), in comparison with the 2nd group (optimal therapy), had significantly longer period of fever (10 [7; 12] vs 9 [7; 10] days, p=0,03), longer ICU (0 [0; 3] vs 0 [0; 0] days, p<0,001) and hospital stay (10 [8; 14] vs 8 [7; 11] days, p=0,001).Conclusion. Patients who received standard NCD therapy before admission to the infectious disease hospital, in accordance with current clinical guidelines and who regularly take drugs, have a more favorable course of COVID-19 at the hospital stage and a lower inhospital mortality rate than patients with suboptimal therapy who are not adherent to treatment or not receiving drugs, but having indications for taking them.

It is known that success in motor imagery in controlling brain–computer interface (BCI) systems can depend on users’ personality traits, while the ratio of activity in various right- and left-hemisphere brain structures depends on personality traits. There are no reports in BCI research on how success in controlling a BCI by subjects with different personality traits is associated with interhemisphere asymmetry. We report here an analysis of associations between personality traits and the accuracy of brain signal classification on movement imagery with the right hand (RH) and left hand (LH) as compared with the resting state in single-episode control of a BCI by naïve subjects. Motor imagery of the RH was more successful by expressive, sensitive extraverts, while motor imagery of the LH was more successful by practical reserved, skeptical, and less sociable people. People open to change were better able to control the BCI by motor imagery of both the RH and LH than traditionalists and conservatives. Analysis of the subjective difficulty of motor imagery showed that the classification accuracy of brain states on imagination of the RH, as compared with imagination of the LH, was greater in people who had greater subjective difficulty imagining RH but not LH movement. These data appear to be linked with the characteristics of information processing and movement organization and dopamine levels in the right and left hemispheres of the brain.

The influence exerted by an external magnetic field on nonrelativistic cylindrical plasma oscillations is studied. To initialize a slow extraordinary wave in a magnetoactive plasma, the missing initial conditions are constructed using the solution of a linear problem in terms of Fourier–Bessel series. A second-order accurate finite-difference scheme of the MacCormack type is constructed for the numerical simulation of a nonlinear wave. It is shown that, when the external magnetic field is taken into account, the Langmuir oscillations are transformed into a slow extraordinary wave. The velocity of the wave grows with increasing external constant field, which facilitates energy transfer out of the initial localization domain of oscillations. As a result, the well-known effect of off-axial breaking is observed with a time delay and, starting at some critical value of external field, is not observed at all, i.e., a global-in-time smooth solution is formed.