We formulate the optimal control problem for a class of nonlinear objects that can be represented as objects with linear structure and state-dependent coefficients. The linear structure of the transformed nonlinear system and the quadratic quality functional let us, in the optimal control synthesis, to pass from Hamilton–Jacobi equations to a state-dependent Riccati equation. The main problem is the implementation of an optimal control problem is related to the search for solutions of this equation in the rate of the object functioning. This paper proposes a method of an algorithmic parameter optimization of the controller based on the use of the necessary conditions for the optimality of the considered control systems. The constructed algorithms can be used both for optimizing the non-stationary objects themselves, if the corresponding parameters are selected for this purpose, and for optimizing the entire managed system by means of the corresponding parametric adjustment of the regulators. The effectiveness of the developed algorithms is demonstrated by the example of medical treatment of patients with HIV.
The recovery of the masticatory function and good esthetic results of orthopedic treatment in patients with Kennedy IV mandibular defects is still a topical problem. The aim of the work was to study biochemical aspects of interactions between bony structures of the front part of the mandible and different endosteal implants, especially under functional load, to develop the most rational method of orthopedic treatment of patients with Kennedy IV mandibular defects. In total, 14 variants of elimination of defects in the front part of the mandible with different supports (natural teeth, standard implants, and miniimplants) for a non-removable orthopedic construction were studied. For each variant, maximal compression and stretch tensions, maximal shift tensions, and the probability of biochemical system destruction were calculated. These variables were compared, and conclusions on the most rational method of orthopedic treatment of patients with Kennedy IV mandibular defects were made; practical recommendations were given.
Now the electronic devices based on slow wave systems and electromagnetic waves excited in them were widely adopted in microwave electronics. They are also successfully applied at creation new elements of radio-frequency and microwave paths, instrumentations and devices, materials electromagnetic heating and etc. One of the perspective directions of slow wave systems usage is possibility of their implementation in biology and medicine as antennas and radiators for radio-frequency and microwave physical therapy, a radio-thermy and a tomography, sensitive elements for medical diagnostics, devices for sterilization and heat treatment. Advantages of usage slow wave systems in biology and medicine are based on electrodynamic and design features of structures which follow from distribution of an electromagnetic field near their surfaces. In this we are looking for features of usage slow wave systems in relation to area with high value of dielectric permeability, in particular to biofabrics, and also the problems connected with creation of electrodes for intracavitary microwave physical therapy on slow wave systems with primary concentration of electric field in biofabrics, adjacent to electrode surface. In this work the results of modeling microwave radiator on the basis of a ribbed coaxial line were received on Ansoft HFSS v.12 and CST Microwave Studio 2011 software. The theoretical ratios whice were received as a result of the electrodynamic analysis allow to calculate change of phase speed of slowed-down electromagnetic wave in the coaxial line with ridge conductors and are in good compliance with results of physical experiment. Application of such structure represents practical interest as allows to reduce its longitudinal geometrical sizes with preservation of electric wavelength. Except urological procedures of transurethral microwave thermotherapy, the offered electrode on the basis of a ribbed line can be used also as a radiation source for the microwave tomograph at research of large blood vessels or a gullet. Besides, its application as the tiny reception antenna at radiometry and a termografiya is possible.
In article the market of medical insurance is analysed, specifics of the market in St. Petersburg are studied, the problems disturbing to development of medical insurance are formulated and ways of their decision are presented, and also some forecasts concerning growth and development of this type of service in St. Petersburg are submitted.
These days russian pharmaceurtical industry faced a difficult problem – on the one hand there is a great number of foreign manufactures and it threatens the russian market, and on the other hand there are poor research and development, industrial and raw materials bases, financial and personnel components do not allow to make innovative projects that provide significant competitive advantage etc. At this article the results of market position zondage of russian pharmaceutical enterprises – medicine manufactures based on multicriterial matrix. Coverage of these enretprises (international, national and regional/inter-regional markets) and the number of innovative products (specific gravity of original medicines in the range of products of manufacture).
Control of heart rate (HR) is an important target during treatment of patients with stable angina. In a number of cases it can be achieved by the use of β adrenoblockers. But often a necessity arises to enhance pulse slowing therapy with the use of combinations of drugs exerting negative chronotropic effect. We present here results of the CONTROL study (n=1777), conducted with the aim of studying antianginal efficacy and tolerability of the If channels blocker ivabradine used in combination with β adrenoblockers in patients with stable functional class II-III angina and frequency of attacks ≥3/week and HR>70 bpm. The use of ivabradine for 12 weeks allowed to achieve greater reduction of frequency of anginal attacks (by 4 per week, 95% confidence interval 3-6) compared with the group of usual care (treatment at physicians discretion). At the end of the study in ivabradine group 43% of patients had no angina at all, HR lowering ≤60 bpm was noted in 46% of patients (in the comparison group14 and 6%, respectively, p<0.001). Reduction of frequency of attacks of angina correlated with HR lowering, more with pulse rate measured by patients themselves (r=0.411, p<0.001), than with values measured at visits to physicians (r=0.266, p<0.001). Rate of lethal outcomes as well as rate of nonfatal cardiovascular complications (myocardial infarction, stroke, urgent revascularization) were similar in compared groups. In ivabradine group compared with usual care group there were less hospitalizations (5.0 and 8.6%, respectively, p=0.021), calls for emergency service (13.3 and 25.4%), and sick leaves (6.6 and 13.1%, p=0.018). Adverse reactions were noted in 130 patients (8.7%) in ivabradine group and in 29 patients (10.0%) in usual care group p=0.580).
Evidence based medicine became a reality during the end of 20 century, but its development makes visible a number of weaknesses of the scientific (evidence) base of medicine
Linear increase in the best-practice (maximal among countries) life expectancy, known as the Oeppen– Vaupel line, is the most demonstrative image of longevity progress. This study is devoted to the analysis of trends in best-practice life expectancy across cohorts born in 1870 to 1950. Other than the conventional period life expectancy, cohort life expectancy measures the lifetime of real individuals from the population under consideration. Since mortality is mostly decreasing with time, period life expectancy in a given year is usually lower than cohort life expectancy for people born in the same year. The corresponding gap between period and cohort life expectancies increases with time. Our analysis is based on data for 24 developed countries from the Human Mortality Database for the period 1870 to 2008. To estimate life expectancy for non-extinct cohorts, we apply the Lee–Carter model to extrapolate mortality rates until the year 2050. The annual increase in the best-practice cohort life expectancy across cohorts born in 1870 to 1950 is 0,43 year, while the annual increment in the period life expectancy across the same range of years is equal to 0,28 year. The best-practice cohort life expectancy has increased from 53,7 years in 1870 to 83,8 years in 1950. During this time the gap between period and cohort life expectancies has increased from 1,2 to 10,3 years. Cohorts born in 1920 to 1950 will live longer than one can expect by looking at respective period mortality patterns. For these cohorts, the longest part of their additionally gained lifetime will be spent at ages 65 and older. This substantially changes the distribution of human lifetime among different stages of the life cycle.
This article presents results of the study, based on interviews with classical homoeopaths. We focus on the apparent tension between the statements of classical homeopathy and practices. On the one hand, classical homeopathy declares a gap with biomedicine, but on the other — the status of this break is not confirmed by their practice. This paradox problematize with the practice theory proved that the practice of classical homeopathy includes a biomedical preposition as tacit knowledge (M. Polany). On the way to this conclusion we considered conceptual question of relations of inconsistent practices and their transmission. Accessing G. Ryle’s critique of mentalism and ideas of practice theorists we justify vivid character of practices and tacit knowledge as visible, but does not noticed; thus we overcome S. Turner’s skepticism about the reality of practices as a collective phenomenon, capable of transmission. In contrast to the Turner’s causal interpretation of practice theory, the relationship between biomedical assumptions and homeopathic practice is proposed as the ratio of figure and ground. This conception is refined with the help of L. Wittgenstein’s idea of change aspect, in which homeopathy and biomedicine are not acting different practices but particular aspects of one indivisible medical practice. As a criterion of visibility biomedical prepositions called the fact of classical homeopathy emphasizing the differences and contradictions of homeopathy and biomedicine, as well as their ability to transfer (change of aspect) between concepts of the two systems. From this point of view, classical homeopathy statements should not comply with the specific targets of a particular medical practice in which they engage, rather then the purposes of identification and professionalization. Thus the tacit knowledge paradox is achieved by separating professionalized strategies from a purely medical ones.
The paper discusses the techniques which are currently implemented for vaccine production based on virus-like particles (VLPs). The factors which determine the characteristics of VLP monomers assembly are provided in detail. Analysis of the literature demonstrates that the development of the techniques of VLP production and immobilization of target antigens on their surface have led to the development of universal platforms which make it possible for virtually any known antigen to be exposed on the particle surface in a highly concentrated form. As a result, the focus of attention has shifted from the approaches to VLP production to the development of a precise interface between the organism’s immune system and the peptides inducing a strong immune response to pathogens or the organism’s own pathological cells. Immunome-specified techniques for vaccine design and the prospects of immunoprophylaxis are discussed. Certain examples of vaccines against viral diseases and cancers are considered.
Analysis of results of epidemiological BOLERO study showed that 2/3 of men with uncontrolled arterial hypertension noted problems in sexual life. Severity of problems in this sphere of life of men correlated positively with age, as well as with presence of difficulties at work, increased fatigability, impossibility to be involved in favorite activity (hobby), disturbances of nocturnal sleep (as assessed by GQLI questionnaire). As a result of 8 weeks therapy which included indapamide retard number of patients noting substantial influence of sexual problems on their habitual way of life (CQLI score >3) decreased almost 2 times (from 25 to 13%, p<0,001). At least 1 point decrease in evaluation of importance of such problems occurred in 33% of cases, 63% of patients did not change their score. An increase of GQLI score was noted in 4% of cases. Multifactorial analysis allowed to reveal that restoration of sexual function went parallel with improvement of quality of life related to recovery of psychosocial relationships and augmentation of physical activity. Moreover it was established that adequate lowering of arterial pressure in men during use of indapamide retard decreased risk of worsening of their sexual function.
The paper suggest that learned helplessness, as a special case of the Pavlovian conditioning, may be accompanied by negative implicit attitudes towards Monday and expectations for Friday as a means to get rid of a «punishment», which may be a factor in the development of emotional exhaustion—a key manifestation of the burnout syndrome