V.I. Vernadsky Crimean Federal University

Stroke is a time-sensitive medical emergency in which early recognition of symptoms and prompt bystander intervention can substantially improve survival and neurological outcomes. Providing scripted prearrival instructions (PAI) to callers by emergency telecommunicators over the telephone may expedite and optimize prehospital care. Telecommunicators can guide callers to collect essential information for the arriving emergency medical services personnel and offer immediate first-aid advice to prevent serious complications of stroke. However, despite the anticipated benefits of telecommunicator assistance, both the theoretical foundations and practical implementation of telephone prearrival guidance for stroke remain underexplored. This study systematically developed a comprehensive, evidence-based set of PAI for stroke through structured analysis of international and national first-aid guidelines, stroke management guidelines, and emergency medical services dispatch protocol collections. The resulting synthesized PAI set is proposed for discussion and further refinement within the emergency medicine community, with the ultimate goal of creating a harmonized tool to support telecommunicators in managing suspected stroke incidents.

The purpose of this study was to review international scientific evidence and practical recommendations on first aid (FA) for heat illness. Materials and methods of research. In June 2025, a search was conducted for scientific articles on the topic of providing FA for heat illness, as well as international and national guidelines on FA containing provisions concerning heat illness. The search was carried out without restrictions on the year of publication in Russian and English across the eLIBRARY.RU, PubMed, and Google Scholar databases, as well as using the Google search engine. Research results and their analysis. The article presents an overview of modern principles and methods of providing FA in various forms of heat illness, including heat cramps of skeletal muscles, heat oedema of the extremities, heat syncope, heat exhaustion and life-threatening heat stroke. The methods of passive and active cooling of the body (including immersion and dousing of the body with ice-cold, cold or cool water, immersion of hands and feet in cold water, application of ice packs, ice sheets or towels, fanning, evaporative cooling), approaches to thermometry, and hydration are considered. Attention is paid to the issue of normative and legal regulation of the provision of FA for heat illness. The predicted increase in the number and intensity of heat waves determines the need to form a unified, effective organizational basis for the provision of FA in heat illness. The priority task is to develop and approve lists and sequences of measures to provide FA in case of heat illness, taking into account the best evidence-based principles and methods.

Neoadjuvant polychemotherapy (NPCT) is a predictor of the impact of systemic therapy on breast cancer (BC) biology. Currently, the sequence of drug administration is receiving particular attention. Objective. To analyze factors influencing pathological response rates, treatment resistance, and long-term survival in patients with hereditary BC after NPCT with anthracycline- and Taxane-containing regimens. Material and methods. The study cohort (115 BC patients treated between 2014 and 2023) was divided into two groups, in which the outcomes of NPCT with anthracycline- and taxane-containing agents were examined. The analysis of immediate outcomes included determining the overall objective response (OR) rate and pathological complete regression (pCR). For all parameters p value of ≤0.05 was considered statistically significant. Results. In patient with BRCA1-associated BC, clinical complete regression was observed in all cases after Anthracycline therapy, while in the Taxane group, primary tumor growth was noted in 4 cases (p=0.34). In Taxane group pCR was 52.4%, while in Anthracycline it was 50% (p=0.3). In patient with BC without mutation, the OR and pCR rates were slightly higher in the Taxane group: 33.3% versus 31.1% (p=0.82) and 17.8% versus 13.3% (p=0.5), respectively. In Taxane group, local tumor progression was noted in 3 patients (p=0.3). Triple-negative BC was a factor associated with achieving pCR. When analyzing factors influencing long-term survival in patients with hereditary BC, locally advanced BC was the only predictor of worse 3- and 5-year survival. Conclusion. Triple-negative tumor type was the only predictor of complete tumor regression, and advanced stage was the only factor associated with worse overall survival. Identifying chemotherapy resistance factors in hereditary and BRCA1-positive breast cancer requires further research.

The authors analyze the mechanisms for ensuring the sustainability of industrial ecosystems in the Russian Federation during the period of large-scale economic and technological sanctions in 2022–2025. Based on a retrospective review of the crises of 2008 and 2014–2015, the inherited systemic vulnerabilities of the domestic industry are revealed: dependence on raw materials, technological dependence on imports, and weakness in long-term fi nancing. The research focuses on a qualitatively new sanctions reality characterized by shocks: logistical gaps, restrictions on access to critical technologies and fi nancial markets. The authors systematize adaptation strategies of enterprises, including active import substitution, relocation of supply chains, accelerated digitalization and reorientation to the markets of friendly countries. Special attention is paid to the evolution of institutional support from the state: from targeted anti-crisis measures to formation of a comprehensive system, including concessional fi nancing, special investment contracts (SPIC 2.0), fi scal incentive measures and the development of feedback mechanisms (establishing a direct exchange line for business entrepreneurs, appointing a business ombudsman). Based on data from Rosstat, the Bank of Russia, and industry associations for 2020–2025, trends illustrating the dynamics of industrial production, investment, and structural shifts are presented, and long-term trends are analyzed, including an empirical assessment of the transition from digitalization to technological sovereignty. The authors make conclusions about the defi nition and development of a new paradigm of sustainability based on the sovereignty of critical industries, fl exibility of business models and in-depth cooperation between the state and industrial business in the face of prolonged sanctions pressure.

в статье обоснована необходимость совершенствования кадровой политики в сфере здравоохранения. Указаны специфические особенности формирования кадровой политики и особенности государственного управления ею. Определены направлениями совершенствования кадровой политики в Россию.

The issues of technical support for the process of wastewater clarification during the treatment of wastewater from industrial enterprises on local technological equipment with a capacity of 1-10 m3/hour are considered. The presented technological scheme and equipment, research in the circulating water supply system of the engine testing shop area, allows for wastewater treatment along various technological lines, in several modes and parameters with different contamination compositions and constant monitoring of the treated wastewater, according to the main indicators. Wastewater clarification is carried out using a technological scheme, including pressure electroflotocoagulation in devices for local wastewater treatment using several technological lines and modes. The incoming processing water is collected in a receiving collector, undergoing processing in a wastewater treatment apparatus, and is processed in several modes along its own technological lines. Water samples are monitored (sampled) at all stages of clarification. To intensify the clarification process, a reaction pipe is installed in the center of the apparatus. The use of a saturator installed outside the apparatus helps to increase the degree of intensification of clarified waters. The use of local equipment in recycling water supply systems aimed at wastewater clarification is based on a new set of design and technological solutions that provide a greater degree of wastewater clarification. Further mathematical processing of the obtained results makes it possible to optimize the clarification process itself, reduce water treatment costs and ensure the environmental safety of water bodies. Subject: patterns and features of the process of wastewater clarification in devices for local wastewater treatment of industrial enterprises.

Let 𝜏 be a faithful normal semifinite trace on a von Neumann algebra ℳ. The block projection operator 𝒫̃︀𝑛 (𝑛 ≥ 2) on the *-algebra 𝑆(ℳ, 𝜏 ) of all 𝜏 -measurable operators is investigated. It is shown that 𝑓(𝒫̃︀𝑛(𝐴)) ≥ 𝒫̃︀𝑛(𝑓(𝐴)) for any operator monotone function 𝑓 on R + and 𝐴 ∈ 𝑆(ℳ, 𝜏 ) + . For an operator convex function 𝑓 on R + , we have 𝑓(𝒫̃︀𝑛(𝐴)) ≤ 𝒫̃︀𝑛(𝑓(𝐴)) for 𝐴 ∈ 𝑆(ℳ, 𝜏 ) + . Conditions are established under which 𝒫̃︀𝑛(𝐴) belongs to the class 𝑆0(ℳ, 𝜏 ) of 𝜏 -compact operators, to the class 𝐹(ℳ, 𝜏 ) of elementary operators, to the classes 𝐿𝑝(ℳ, 𝜏 ) of operators 𝜏 -integrable with 𝑝-th power, or to the ℳ algebra itself. If 𝐴, 𝐵 ∈ 𝑆(ℳ, 𝜏 ) and 𝒫̃︀𝑛(𝐵) is a left (right) inverse for the operator 𝐴, then 𝒫̃︀𝑛(𝐵) is also a left (respectively, right) inverse for the operator 𝒫̃︀𝑛(𝐴).

Relevance. Knowledge of scientific concepts and achievements of the past provides an informative basis for modern research. Moreover, these achievements are filled with the greatest meaning if they are associated with a specific person and the time in which they occurred. Thus, knowledge of the history of science allows us not to neglect the intellectual heritage of past generations and turn it into potential for the development of modern research. In one of his speeches, Nobel laureate Sir Andrew Huxley noted that if he had familiarized himself with the literature of the 19th century in more detail, he would have been able to successfully complete some of his research much faster and more effectively. It must be said that the 19th century gave humanity a whole galaxy of the greatest scientists who made truly fateful discoveries. Our article is dedicated to one of such scientists - Sir Charles Bell (1774-1842), an outstanding Scottish surgeon, anatomist and experimental physiologist. Results of study. In the course of his scientific, teaching and practical medical activities, Bell implemented his accumulated knowledge and experience in the publication of many treatises that remain relevant to this day. Charles Bell applied his talent as an artist in anatomy, personally illustrating magnificent treatises written in collaboration with his older brother, the famous surgeon John Bell, and in surgery (more precisely, in military field surgery), sketching the wounded after the Battle of Waterloo. The scientist also made an invaluable contribution to the development of neurology. Thus, the name of Charles Bell is immortalized in the name of the long thoracic (or «external respiratory») nerve, in the description of lower motor neuron palsy of the facial nerve, and in the «Bell’s sign», when the eyeball rolls upward when trying to close the eye. His description of the differences between the fifth and seventh cranial nerves, as well as the definition of the morpho-functional characteristics of the anterior and posterior roots of the spinal cord as Bell’s law, are widely known. For his invaluable contribution to science, Charles Bell was awarded the gold medal of the Royal Society and made a knight of the Hanoverian Guelphic Order. Conclusion. The statement of the great Russian surgeon N.I. Pirogov, «Everything that is high in the world is art, inspiration and science…» is the most appropriate description of his contemporary Charles Bell, who combined these three hypostases. It is important to note that the reflex theory, whose founder is considered to be Charles Bell, is a fundamental concept of physiology and medicine, although in the early stages (in the mid-19th century) this principle was considered only in relation to the spinal cord.