Category Of Complexity Research Articles

A clinical case of aortic coarctation in combination with a septal defect in a newborn child

Coarctation of the aorta is a congenital malformation characterized by the presence of narrowing of the aorta, which can be localized in any part of it. In this publication, we present a clinical case of coarctation of the aorta before and after surgical correction in a newborn. The child was admitted to the cardiosurgical hospital at the age of 6 days. Congenital heart disease of a low category of complexity was diagnosed prenatally. After birth, the condition is satisfactory. After 3 hours, the negative dynamics due to the clinic of respiratory failure. According to echocardiography – hypoplasia of the aortic arch, coarctation of the aorta? Open ductus arteriosus, ventricular septal defect. On the 3rd day of life, a diagnosis of congenital pneumonia was made and the child was transferred to a cardiosurgical hospital. Upon admission to the FCSSH in Astrakhan, the condition was regarded as severe, due to heart and respiratory failure. The child is examined. On echocardiography – Pronounced preductal form of coarctation of the aorta. Hypoplasia of the proximal arch and isthmus. Open ductus arteriosus. Ventricular septal defect. biventricular hypertrophy. Severe dilatation of the right chambers of the heart. Relative hypoplasia of the left ventricle. Tricuspid regurgitation. On the 7th day of life, surgical correction of the defect was performed plasty of the arch and isthmus of the aorta, plasty of the VSD. The early postoperative period proceeded with a clinic of moderate respiratory and heart failure. Against the background of the expansion of the volume of feeding, chylothorax was detected, drainage of the right pleural cavity was prescribed. Enteral feeding has been replaced by parenteral nutrition. The child was extubated on the 4th postoperative day. However, oxygen dependence was noted. The pleural drainage was removed on the 11th day after the operation. On the 12th day, the newborn was transferred from the intensive care unit. Discharged from the hospital on the 20th day after surgical treatment. After 4 months the child was examined in the hospital. The general condition was regarded as satisfactory. This clinical example shows the complexity of prenatal diagnosis of obstructive pathology of the aortic arch and the rapid manifestation of clinical manifestations after birth against the background of an unfavorable combination with a large septal defect.

Geographic assessment of obstacles on European rivers for water sports tourism


 
 
 Experts predict that the global market of water sports tourism is expected to reach almost $ 850 billion by 2032, with an average annual growth of almost 17% over the next 10 years. At the moment, not a single segment of the world tourism has such a high growth rate. At the same time, we should not forget that water tourism is one of the most technically complex sports. If in other types a tourist can stop on almost any difficult part of the route in order to recuperate, find the best solution, the fast water flow does not allow this. The guarantee of correct actions can be given only by the worked out reaction of each tourist individually and the crew of the tourist vessel as a whole. Therefore, the purpose of the research is professional, incl., assessment of water obstacles, which is extremely important for the safety of tourist sports trips, that are often carried out on the verge of the physical and technical geographical capabilities of their participants. The goal was achieved through the use of such scientific research methods as analytical-statistical, com- parative-geographical, reference and field expeditionary research. The authors have established that water tourism is a rafting of tourists in water areas on various means of rafting – inflatable boats (rafts), kayaks, catamarans, canoes and others with overcoming various obstacles on the water relief – rapids, riffles, river bars and boils, and even waterfalls of different heights. The nature, number and variety of water obstacles determine the technical complexity of the water tourist route. Therefore, the task of scientists is to develop criteria for assessing the complexity of water obstacles so that tourists-athletes, when overcoming them, can compare their tourist experience, technical capabilities of their vessel in order to decide whether they can safely overcome a particular obstacle (go through the route). The authors analyzed a number of classifications for determining the complexity of water obstacles – International, American, S. Chernik’s classification. These classifications differ in the initial categories of complexity assessment of water obstacles and are close enough when assessing more complex obstacles from category IV to VI of complexity. The analysis showed that the international classification is best used in assessing the complexity of local water obstacles (rapids). Instead, either the American classification or the S. Chernik’s classification should be used to assess long water sports routes. Europe has a fairly dense river system and a significant number of rivers suitable for water tourist trips. The maximum category of complexity of European rivers is the sixth (according to any of the classifications). Such level of complexity can be found on the rivers of the Scandinavian Peninsula, the Balkan Peninsula, and the North Caucasus. The potential for the development of water sports tourism is not evenly distributed between European countries. A special place in this regard is occupied by the countries of the Balkan Peninsula, since rivers of all categories of complexity are represented here – from the easiest to the most complex. For tourists-athletes of high qualification, the Scandinavian Peninsula rivers can serve as a training ground.
 
 

ASSESSMENT OF THE STABILITY OF A LOADED SLOPE IN COMPLEX ENGINEERING AND GEOLOGICAL CONDITIONS

The article presents the results of the analysis of the stress state and stability of the soil slope of a complex geological structure on which the treatment facilities of an industrial enterprise are located. The calculation of stability and stress state is carried out for two variants: the natural state of the soil massif and the state determined by the design decision for its reprofiling, taking into account the device of automobile passage. The height of the slope is 12 meters, and the engineering and geological conditions are characterized by 3 category of complexity. The stability calculation is based on the analysis of the stressed state of the soil massif by the Tsvetkov-Bogomolov method, in which the finite element method is formalized, among other things, to determine stresses in inhomogeneous soil objects. The method of constructing the most probable sliding line is based on the fulfillment of the condition of minimality of the stability margin coefficient at each of its points. All calculations are performed using a computer programs developed by the authors of this article and having state registration. As a result of the study, it was found that the global stability of the slope is ensured, but the stability of the upper ledge of the slope, which is a dirt embankment, is insufficient. In this regard, it is necessary to carry out engineering measures to ensure the operational condition of the object. Taking into account the 3rd category of complexity of engineering and geological conditions and the fact that the destruction of the soil massif can lead to significant damage to the environment, it is necessary to organize constant comprehensive monitoring of the soil massif and the structures located on it. It is necessary to carry out engineering (compensating) measures to prevent the destruction of the surface layers over the entire surface area of the slope in places where plastic deformations are localized (the surfaces of both ledges). According to the results of the monitoring, it is necessary to make a decision on the need to strengthen the soil of the base of the aeration tank in the locations of areas of plastic deformations (left, right, under it) in order to avoid uneven precipitation of the base and rolls of the structure.

PROCEDURAL RULES OF CHOOSING THE ADMINISTRATIVE PROCEEDINGS FORMS OF HEARING ADMINISTRATIVE CASES

The article is devoted to the study of procedural rules, which should be followed while choosing the forms of administrative proceedings to hear and decide on administrative cases. It is determined that some of those rules are directly identified in the regulations of the Code of Administrative Proceedings of Ukraine, whereas others are not clearly enshrined that in practice causes different interpretation of the legal norms regulating the procedure of hearing administrative cases. The work presents systematization and generalization of the corresponding written and unwritten rules that will contribute to the appropriate and identical application of the legislation on administrative proceedings, as well as will simplify solving the problems related with the choice of the administrative proceedings forms. Basing on findings of the conducted research, one can conclude that while choosing between the general and simplified action procedure of hearing administrative cases it is necessary to consider that the CAP of Ukraine determines a list of administrative cases, which should be heard only in the form of general action procedure, as well as defines procedural cases for the court to mandatory change from the simplified to general action procedure. In general, any administrative case can be heard according to the rules of simplified action procedure, but for the cases, which are forbidden to be heard according to that form of action procedure. If a case does not belong to the category of minor complexity in terms of requirements of the CAP of Ukraine, it is not forbidden to hear the case according to the simplified action procedure, and it also does not mean the case hearing should be done exclusively following the rules of general action procedure, but for the cases which should be heard according to that procedure due to the imperative requirements of the law. Minor cases are heard according to the simplified action procedure unconditionally, whereas considering other administrative cases, which can be heard according to the simplified action procedure, application of the general or simplified form depends on the court decision, made with consideration of the criteria (factors), identified in the CAP of Ukraine. Key words: forms of administrative proceedings, general action procedure, simplified action procedure, minor administrative case.

Research of the cardiorespiratory system and psychological state indices of tourists during the sport hike

It is impossible to achieve success of the route and survive in changing climatic conditions without the organization of special tourist training. This statement is especially important during the preparation for the future route, including constant training, simulation of critical situations and dealing with them. Currently, there are no scientifically recommendations for the dosage of physical activity during hiking and the need for systematic training to participate in sport and health-improving hikes to increase the safety of hiking, as well as to improve the psychological microclimate in the group of tourists. The purpose of the article: to determine changes in the indices of the cardiorespiratory system and the psychological state of experienced tourists and beginners during the sports hike of I category complexity. Research methods: methods of theoretical analysis and generalization of scientific and methodological literature, special pedagogical tests, morphofunctional and psychological research methods, methods of mathematical statistics. Result: the article presents comparative heart rate, Stange’s test, Genchi test and psychological test (anxiety, working-capacity, activity, mood, well-being) of participants of the sports hike of I category of complexity in the Ukrainian Carpathians, who already had experience in hike, and participants who took part in the hike for the first time but engaged in other sports. The study identified a positive training effect of this hike on the body of experienced tourists, namely increasing the reserve capacity of the cardiorespiratory and respiratory systems of experienced tourists, while beginners had signs of fatigue, they had low mood, activity and well-being for almost all hike, had insufficient physical and psychological training and it was more difficult for them to adapt to the load. Conclusions: to participate in sport hikes every tourist must undergo special physical and psychological training.

Folk Song as Hybrid Art Form

AbstractA number of philosophers of music have proved resistant to the idea that song should be considered as a hybrid art that combines language and music. Separately, Levinson in his influential account of hybrid art forms does not admit folk song, even though he does allow nineteenth-century lieder into the hybrid category. Folk songs are sometimes treated as if they are anterior to and therefore ontologically distinct from the more complex songs of Western art music, or even of modern popular culture. In contrast, this article argues that in a historical perspective English-language folk songs constitute a category of considerable complexity, and that the combination of the two distinct media of language and music is fundamental to any consideration of such songs in an ontological perspective.

Natural language processing and discourse complexity studies

The study presents an overview of discursive complexology, an integral paradigm of linguistics, cognitive studies and computer linguistics aimed at defining discourse complexity. The article comprises three main parts, which successively outline views on the category of linguistic complexity, history of discursive complexology and modern methods of text complexity assessment. Distinguishing the concepts of linguistic complexity, text and discourse complexity, we recognize an absolute nature of text complexity assessment and relative nature of discourse complexity, determined by linguistic and cognitive abilities of a recipient. Founded in the 19th century, text complexity theory is still focused on defining and validating complexity predictors and criteria for text perception difficulty. We briefly characterize the five previous stages of discursive complexology: formative, classical, period of closed tests, constructive-cognitive and period of natural language processing. We also present the theoretical foundations of Coh-Metrix, an automatic analyzer, based on a five-level cognitive model of perception. Computing not only lexical and syntactic parameters, but also text level parameters, situational models and rhetorical structures, Coh-Metrix provides a high level of accuracy of discourse complexity assessment. We also show the benefits of natural language processing models and a wide range of application areas of text profilers and digital platforms such as LEXILE and ReaderBench. We view parametrization and development of complexity matrix of texts of various genres as the nearest prospect for the development of discursive complexology which may enable a higher accuracy of inter- and intra-linguistic contrastive studies, as well as automating selection and modification of texts for various pragmatic purposes.

Analysis of the leaders of the cycling tours of the first category of difficulty in the territory of Europe

This article presents an analysis of the reports of the leaders of bicycle hikes of the first category of complexity. The distance, duration, month, obstacles along the planned route of bicycle trails in Ukraine, Crimea, Germany, Italy, Norway, Poland, Serbia, Turkey and Portugal are disclosed. The purpose of the work was to study and analyze the specific conditions of 24 cycling hikes of the first category of complexity in different regions of the European part in the period from 2010- 2018. Result. It was determined according to the reports of the leaders of cycling tours of the first category of complexity in the period 2010-2018 that the planned route threads are 3-5 % less than the actual after passage, month of the route affects the weight of the luggage on the bike (more 1-3 kg in the spring, autumn, winter periods), different terrain (mountains, soil, sand) route requires participants to buy quality parts (brakes, tires, fork, switches, ropes, chain, ratchet).

The first experience of radical corrections of total anomalous pulmonary vein return by "sutureless technique" in the Republic of Kazakhstan

Total anomalous pulmonary vein return is a critical heart defect with 4 anatomic forms. It belongs to the severe category of complexity of the STAD scale with an incidence of about 0.013% among all newborns, most of them requiring urgent surgical treatment in the first days and hours of life. Currently, there are many surgical techniques for its correction. This paper presents a comparative evaluation of two groups of patients with previously classical and

Influence of highlands on the state of human body adaptation

The article identifies and analyses the state of adaptation of the participants of the tourist trip to the conditions of stay in the mountains. The functional reactions of the human body in mountain conditions are affected by a decrease in atmospheric pressure, atmospheric density, decrease in oxygen partial pressure, decrease in humidity, increased solar radiation, and low temperature. Adaptation to the highlands is largely determined by age and athletic skills. Tourists, especially those who came to the mountains for the first time, adapt to new conditions more slowly. A group of tourists made a mountain hike of the III category of complexity lasting 14 days. The travel area was near village Arkhyz. In preparing the route, the goal was to go through a sports route and to determine the impact of the highlands on the human body in practice. It is known that adaptation occurs faster for people who are regularly under conditions of artificial or natural hypoxia. Athletes, who often have endurance loads, can adapt to the conditions of the middle mountains and highlands faster than non-athletes. Also, the process of adaptation is much faster for people who make extensive use of intense physical activity.
 The article shows the dynamics of blood pressure and heart rate of a group of tourists in the highlands. The obtained data characterize the adaptive body reactions.
 After analysing the state of adaptation of the tourist trip participants to the mountain conditions, it can be argued that the period of adaptation of the participants' organisms to the height is different. It could be noticed, that on the eighth day the half of the group had "tension of adaptation mechanisms" and "unsatisfactory adaptation" of the organism to mountainous living conditions, also with the lack of stable adaptation. The rest of the group had better indicators of the state of adaptation on the fifth and sixth day of stay in the highlands. These indicators were characterised as "satisfactory adaptation" with further manifestations of sustainable adaptation, indicating economization of body functions.

Complex Sentence as Sign of Syntactic Complexity, Realized on Basis of Principle of Iconicity (Experience of Researching German Scientific Discourse)

The question is considered of how, within a separate fragment of intellectual and communicative activity (using the example of modern German-language scientific and technical discourse), the mechanism for implementing the category of syntactic complexity of an utterance based on the principle of iconicity in the processes of linear-structural organization of the text is revealed. It is shown that iconicity is the property of a linguistic sign to correspond to the object it denotes or the real situation it denotes. Insufficient study of iconicity is noted both in terms of theoretical and epistemological, and in the aspect of the variety of conditions, goals and methods of implementing communicative practices. The research material is considered on the basis of a verified model of semiotic analysis in the field of syntax (O. A. Kostrova) in the aspect of discrete and combinatorial implementation of the structural-syntactic, semantic-syntactic and pragmatic-syntactic iconicity of complex sentences in scientific discourse. It has been established that this or that type of iconicity is determined by the stylistic context and the parameter of marking / unmarking. It is proved that in scientific discourse, one elementary complex sentence, characterized by unmarking, can simultaneously include signs of all three types of iconicity. At the same time, it is indicated that, reflecting the real situation, the signs of one or another type of iconicity, realized in a complex sentence, may be lost.

The planning, rationing and organization of work on technical maintenance of machinery and equipment in animal husbandry

Maintenance and repair of livestock machinery and equipment is carried out as a rule by specialized repair and service enterprises on the basis of service contracts in accordance with the procedure established by law. However, with the renewal of the park’s farms with machines and equipment with automated and computerized process control, as well as the reconstruction of dairy farms and complexes, it became necessary to have a production base and highly qualified specialists for the maintenance of equipment. The most important and key provisions of the improved methodology of planning and accounting of work in the technical service of animal husbandry with the use of a number of standards are given, some features of accounting and planning of these types of work have been noted. The concepts of “repair unit” and “category of complexity of technical service” have been defined. The general provisions of the methodology for calculating costs and determining the cost of carrying out maintenance and repair of livestock equipment have been considered. On the base of calculations, the average total cost standards for carrying out maintenance and repair of livestock equipment have been established. These standards greatly simplify the planning of costs during the operation of equipment, and also allow us to determine the cost of maintenance and repair at different stages of the creation of new machines.

Об использовании шкалы Лайкерта для оценки дидактической сложности учебных понятий

The problem of assessing the semantic complexity of educational concepts, which is equal to the number of words needed to explain their essence, is considered. The following attributes of concepts that affect their semantic complexity are highlighted: 1) the possibility of observing the designated object in everyday life; 2) the possibility of experimental study at school; 3) the possibility of perception of the designated object by the senses; 4) the physical complexity of the object, depending on the number of constituent elements and the connections between them; 5) the degree of entry into the thesaurus of graduates of the first, fifth and eleventh grades; 6) the frequency of the word use in the Russian language. The concepts that denote objects of living and inanimate nature are selected; the category of complexity is determined for each concept by the method of pair comparison. Their attributes were evaluated on the Likert scale with 5 gradations; the correlation coefficients between the attributes and the complexity level, as well as the corresponding linear regression coefficients, are determined. A mathematical model is constructed that connects the complexity of concepts with the values of their attributes; it is shown that due to errors in attribute estimates, it does not allow us to accurately determine the semantic complexity of the concepts. An algorithm for evaluating the concepts complexity based on their division into three groups, depending on the frequency of use in the Russian language, is developed. The results of the evaluation of the semantic complexity of the selected concepts that can be used as reference points are presented.

«COMPLЕXITY» AND «PERPLEXITY» – CATEGORIES OF DEVELOPMENT OF GOVERNANCE SYSTEMS

Addressing the issue of «complexity» and «perplexity» categories is caused by the evolution of system types ranging from well-organized to self-organizing, expanding the horizons of scientific rationality. Development of governance systems is revealed through the dichotomy of properties and restrictions within the «organizational set-up» and «external influence» notions. It was shown that the governance system falls into the category of complexity because the system is operating on the edge of «order and chaos». External environment is presented as chaos analogue showing uncertainty and changes of various fluctuation category, up to turbulence. The incorporation of social and economic system into external environment was considered from the perspective of formation of «system convergence» of two open systems, contributing to growth of the degree of complexity of governance system. It was emphasized that business development forces perplexity governance systems to switch to robust control; the mechanism of robust control is organized under the influence of the laws of evolution and survivability of biosystems. The following methods were marked out and justified: selection of parameters for system convergence of governance system with external environment entities, determination of limits of information granules of adaptive and robust homeostasis, scenario planning, construction of convergent strategy and temporal attractor of system equilibrium state, known as «floating equilibrium». These methods are to be mastered by the governance system within robust control.

Tehnološka intenzivnost prerađivačke industrije Srbije u periodu pre Covid-19 pandemije

This paper analyses technological intensity of Serbian manufacturing sector. The key purpose is to identify development of technological advancement groups (high, medium-high, medium-low and low) during the period of 2010-2019. The analysis shows that in 2019 the share of high-tech production areas in the total MVA increased to 5%, which is the best result since 2015. Changes in production correspond to the movement in foreign trade. The coverage of imports by exports of the manufacturing industry, relatively observed in the medium term, is increasing the fastest in the segment of tangible production, which is included in the category of medium-technological complexity. Serbia is not exclusively competitive in the labour intensive stages of production. It is also competitive in a good part of medium-technological complexity production. Finaly, vast FDI inflows and the activities of foreign investors, in good part, drive successful technological restructuring in recent years.

Determining density of regular grid for creating DTM using bicubic spline interpolation

The article present the accuracy of DTM reproduction created by authors program of bicubic spline interpolation on the example of different categories of relief complexity. Correlations are established between the size of regular grid, category of relief complexity and a mean-square error of height finding. The graph is drawn showing the dependence of accuracy of point height finding from DTM, the size of regular grid and category of relief complexity.

Using the Digital Models of Gravity Anomalies for Zoning of the Earth’s Gravity Field

This paper addresses the questions associated with using the models in regioning the Earth’s gravity field depending on its roughness and type of anomalies. A formalized technique for zoning based on the analysis of the intensity and variability of gravity anomalies is suggested. The suggested technique includes preprocessing the initial gravity anomalies aimed at eliminating the noise component; partitioning the studied region into the elementary segments; calculating the primary characteristics of the complexity and roughness (the intensity and variability of gravity anomalies) for each segment; and, based on these characteristics, classifying each segment into a particular category of complexity. The proposed system of classification of segments relies on the use of three classes of intensity and three classes of variability of gravity anomalies and four categories of complexity of the regions, which are derived from these classes. As a result of applying the technique, the mapped territory is subdivided into the regions that are uniform in terms of their geophysical properties. The developed technique is used for comparing the quality of the different digital models of gravity anomalies, including the Russian RGM model (A.P. Karpinsky Russian Geological Research Institute (VSEGEI)) and the WGM model (Bureau Gravimetrique International (BGI)) in the region of the Mongol–Okhotsk orogenic belt and Sikhote–Alin fold system. The results of the study can be used for zoning of the other geophysical fields and for planning the locations of the new survey networks for increasing the accuracy of the initial data used for compiling the maps.

Robotic Colorectal Surgery Learning Curve and Case Complexity.

To understand the role of case complexity in the learning curve for robotic colorectal surgery. Sixty-two patients who underwent robot-assisted colorectal surgery were retrospectively reviewed. Each case was assigned a category of complexity ranging from I to IV. Overall, groups and categories of segmental colectomy, rectopexy, and proctectomy for cancer were analyzed according to case volume. Forty-eight patients who underwent similar laparoscopic cases during the same period were also reviewed for comparison. Level I complexity cases were identified in 30% of the first 15 cases compared to 3% after the first 15 cases (P < .01). Level IV complexity cases were identified in 10% of the first 15 cases and 34% after 15 cases (P = .03). Mean operative time for the overall group was 426 minutes (range 178-766, standard deviation [SD] = 152) in the first 15 cases and 373 minutes (range 190-593, SD = 109) after more than 15 cases (P = NS). Mean operative time for rectal cancer procedures decreased from 518 minutes (range 425-752, SD = 88) to 410 minutes (range 220-593, SD = 98) after 15 cases (P = .02). Mean operative time for rectopexy decreased from 361 minutes (range 276-520, SD = 85) to 258 minutes (range 215-318, SD = 34) after 15 cases (P = .03). Overall complications were reduced after 15 cases (6.3%) compared with the first 15 cases (27%) (P = .04). When comparing laparoscopic and open cases, laparoscopic cases were associated with a significant shorter operative time (P = < .00001) as well as overall cost (P = < .00001). Complex robotic colorectal surgery can be performed early in the experience, with reduced operative time. Overall complications are reduced after 15 robotic cases. This study shows that improvement in robotic surgery operating time and surgical outcomes occur along with application of the technology to more difficult cases, not as a function of choosing less complex cases.

INFLUENCE OF THE ANESTHESIA METHOD ON THE OUTCOMES OF CARDIAC SURGERY OF DIFFERENT COMPLEXITY IN CHILDREN

The Aristotle score: a complexity-adjusted method to evaluate surgical results. For an assessment of dynamics of quality of the provided cardio-surgical help, comparison of a perioperative case rate and a mortality depending on the degree of surgical risk at cardiac interventions the Aristotle score is used. Thoracic epidural anesthesia (TEA) in comparison with high-opioids intravenous anesthesia (IVA) contributes to hemodynamics stability and early activation of patients. Objective: To analyze a current of the perioperative period at cardiac interventions in children with various categories of complexity of surgical intervention on «Aristotle score» depending on a type of anesthesia. Materials and methods. The 139 children with congenital heart diseases (CHD) underwent surgical correction. Patients were treated in Federal State Budgetary Institution of the Russian Ministry of Health (Penza), and «Almazov National medical research Centre» from 2008 to 2017 yrs. Patients (139 people, the mean age M (SD) of 7.6 (5.6) months of life) were divided into groups according to the categories of operational complexity presented in the Aristotle score. The group 1 consisted of 85 (61.2%) patients underwent interventions of second category of complexity, the group 2 consisted of 49 (39.8%) patients underwent interventions of 3 and 4 categories of complexity. Results. In cardiosurgical operations of the 2nd category of the Aristotle scale complexity a significant positive effect of TEA on the perioperative period was revealed in the form of a decrease in the severity of intraoperative heart failure and the level of glycaemia, the total number of postoperative complications and the time of patients’ staying on mechanical ventilation, as well as the duration of ICU stay and the decrease thrombocytopenia severity and frequency. In operations of grade 3 and 4, in which the duration of extracorporeal circulation was greater, the use of TEA did not have a significant positive effect on the incidence of postoperative complications, but after epidural anesthesia the mean duration of the patients’ stay on the mechanical ventilation and in the ICU was also significantly less. Apparently, the result is a consequence of a lesser severity of heart failure and early activation of patients by excluding the use of opioids, which have a depressing effect on the central nervous system, cardiac, respiratory and other systems. It can also be assumed that the administration of local anesthetics within 24 hours after the operation maintained sympatholytic and antiarrhythmic effects, and also prevented the complications development as a result of effective analgesia. Sufficiently convincing evidence of high antinociceptive activity of TEA is the possibility of safe extubation of patients in both the 2-d and 3-d categories of surgical complexity demonstrated in our study already in the operating room. Conclusion. Use of high TEA as a component of the combined anesthesia at surgical correction of CHD in young children has positive impact on a current of the perioperative period in the form of decrease in severity of heart and respiratory failure, duration of respiratory support, early activation and reduction of ICU stay.

НОРМИРОВАНИЕ ТРУДА ВРАЧЕЙ НА ОСНОВЕ ШТАТНЫХ НОРМАТИВОВ (НА ПРИМЕРЕ ВРАЧЕЙ-ПАТОЛОГОАНАТОМОВ)

Among the unsolved problems of domestic health care are the issues of labor standards. The employer has the right to determine the amount of work performed (both in the direction of reduction and increase), taking into account the specific situation. Meanwhile, staff standards of relevant medical organizations and their structural subdivisions can be used to normalize the work of physicians of certain specialties. This method of rationing is applicable only for those medical specialties for which staff standards have been approved. In the article the method of norming of physicians' work, proposed by the authors, based on the use of staff standards, is considered. As an example, we propose the implementation of the proposed methodology for the standardization of the work of pathologists, taking into account the standards of the pathoanatomical bureau (department) approved by the Order of the Ministry of Health of the Russian Federation as of March 24, 2016 No. 178n «On the rules for pathoanatomical research». At the same time, when calculating the load norms, a coefficient is applied, compulsorily taking into account the load standards per rate of the pathologist doctor in accordance with Order No. 178n as of March 24, 2016, the type of load and the category of complexity of the work performed. The proposed approach can also be applied to physicians of other specialties, for which statutory standards have been legislatively approved, expressed in the appropriate units of workload. The article also provides all the necessary standards for the relevant calculations and presents the legislative base (orders of the Ministry of Health of the Russian Federation) for the period 2015-2016, which contains staff standards for physicians of other specialties.