Changes In Tactics Research Articles

Удосконалення військового класифікатора у сфері засобів супутникової навігації

Background. Satellite navigation systems (SNS) are in service and actively used by all branches of the military. With the sharp increase in the personnel of the Armed Forces of Ukraine (AFU), the variety of newly approved SNS has significantly increased, and changes in combat tactics have revealed issues related to the impracticality of using outdated models, their standardization, and the lack of a systematic approach to comparing their technical characteristics. The aim of this article is to create prerequisites for the systematization and comparison of already adopted SNS, as well as for further development of technical requirements for prospective models by improving the existing regulatory framework. M e t h o d s. In the process of writing the article, general scientific methods of analysis, comparison, synthesis, formal-legal methods, induction, and deduction were used to find solutions to the described problems. Methods of consolidation and clustering were used to group existing SNS samples by their usage method. The method of logical constructions was used to develop the conceptual apparatus. Results. The article proposes an improvement of the existing military classifier (MC) 001-2000 in the form of a draft classifier of satellite navigation systems for use in the AFU. The proposed suggestion is based on the successful path of standardization in the field of unmanned systems. The work discusses the problems of unifying the conceptual apparatus and proposes an approach to the systematization of SNS adopted and approved for use in the AFU. A strategy for implementing the proposed project is also presented. Conclusions. The approval of the SNS classifier will provide normative possibilities to develop clear standards and requirements for the technical characteristics of SNS, create an open competitive market environment, attract a wider range of developers, and find new or improve existing technological solutions, ultimately leading to qualitative technological growth in AFU provisioning. The conducted research has practical and theoretical value regarding the development of an SNS support strategy and justifying the need to decommission ineffective or outdated navigation devices.

Changes in management tactics and treatment outcomes of patients with isthmic-cervical insufficiency in the second decade of the 21st century based on the results of research at the Surgut District Clinical Centre for Maternal and Child Health Care

Changes in management tactics and treatment outcomes of patients with isthmic-cervical insufficiency in the second decade of the 21st century based on the results of research at the Surgut District Clinical Centre for Maternal and Child Health Care

Action dilemmas in prefigurative politics: making prefiguration feasible in Sweden

ABSTRACT Prefigurative political movements often attempt to create and maintain an alternative reality, where activists can enact and experiment with a desired future. Yet, sustained participation in a prefigurative project requires that individuals view this potential future as realizable and feasible. Based on a long-term ethnographic study of a radical left-libertarian movement in Sweden, I identify three dilemmas activists must solve to allow prefiguration to remain feasible, which I term practical prefiguration, principled prefiguration, and purposeful prefiguration. In practical prefiguration, individuals must find ways of balancing commitments and obligations from identities outside the movement with their identities as social movement participants. Principled prefiguration, conversely, focuses on the challenges prefigurative participants encounter as they attempt to translate broad, macro ideological principles into local interactional norms. Finally, purposeful prefiguration explores how activists maintain optimism, hope, and belief in a prefigurative project through creating and maintaining measures of success that are not based on instrumental social change. In this article, I investigate the strategies long-term activists used to solve these problems. I argue these strategies often require changes in movement form, tactics, and character as activists accommodate the realities of the present, which can potentially threaten the prefigurative nature of a political project. The article concludes by arguing that inequalities in prefigurative movements can arise from the solutions to these practical problems, but that prefigurative projects must find ways of balancing present and future if they wish to survive.

Features of blast-induced traumatic brain injury

Traumatic brain injury, despite its prevalence and study, is the most urgent issue of medicine in clinical, social and military-medical significance. In Russia, about 500 thousand people receive a traumatic brain injury every year, and the damage to the country’s economy exceeds 500 billion rubles a year. Traumatic brain injury is damage by mechanical energy to the skull and intracranial contents (brain, meninges, vessels, cranial nerves), accompanied by clinical symptoms and, in most cases, morphological changes. Recently, blast-induced traumatic brain injury has acquired particular importance, which is due to the change in modern tactics of warfare and the predominance of explosive trauma in the structure of all injuries. The features of blast-induced traumatic brain injury are associated with a variety of factors affecting a person (shock wave, light, heat radiation, fragments, etc.). Such a multifactorial effect on a person makes it difficult to identify a blast-induced traumatic brain injury, especially a brain concussion. This is due to a possible combination of damage to different organs and systems of a person during an explosion, which can simulate or mask a brain concussion. When diagnosing a traumatic brain injury, it is especially important to assess the circumstances and information from witnesses of the event, which often presents a certain complexity in the conditions of hostilities. Currently, methods for detecting symptoms of instability, visual and disorders of other sensory systems involved in maintaining balance are considered as a promising direction for the diagnosis of mild traumatic brain injury. It is also important to note that patients who have suffered a traumatic brain injury have a risk of developing neurodegenerative diseases. All this further emphasizes the relevance of traumatic brain injury and the existing need to develop an optimal algorithm for the examination of such patients.

Evaluation of some parameters of the COVID-19 epidemic process and the epidemiological effectiveness of the use of the Gam-COVID–Vac vaccine among employees of two medical organizations in the Moscow region

The article presents the features of the COVID-19 epidemic process for 2020–2022 and the results of the effectiveness of the «Gam-COVID-Vac» vaccine used in employees of two different medical organizations (MO). In both institutions, the dynamics of a decrease in the incidence of COVID-19 with asynchronous periods of growth and decline of varying intensity and duration has been established. It is noted that in the regional hospital, each epidemic period of growth and decline was more intense than in a psychiatric hospital. In the studied organizations, seasonal increases in morbidity were revealed, characteristic of infections with airborne transmission, as well as an increase in morbidity in other months associated with the appearance of new variants of the SARS-CoV-2 virus. The highest proportion of COVID-19 cases was among employees of the age group from 30 to 49 years and nursing staff. In the Ministry of Defense, asymptomatic and mild forms of the disease prevailed among those who had COVID-19 and accounted for 76.5 % in a psychiatric hospital and 67.3 % in a regional hospital. The proportion of severe forms of diseases was 2.1 times higher among employees of the regional hospital. According to the results of the survey, various places of infection of employees of the Ministry of Defense were identified. In the regional hospital, nosocomial infection prevailed, in the psychiatric hospital, employees were more often infected outside the institution. A decrease in the effectiveness index (IE) of the Gum-COVID-Vac vaccine was found both in a psychiatric hospital and in a regional hospital from 12.0 in 2021 to 3.3 in 2022 and from 12.8 to 4.5, respectively, and the efficiency coefficient (CE) from 91.7 to 69.4 % and from 92.2 up to 77.9 %, respectively. Correlation coefficient between the incidence of COVID-19 and vaccination of employees with the drug «Gam-COVID-Vac» in a psychiatric hospital for 2021–2022. it was minus 0.42 %, in the regional hospital — minus 0.24 %, which indicates a negative strength of the connection and a decrease in the effectiveness of vaccination, which requires a change in immunization tactics and the need to improve the vaccine.

Cystic fibrosis: comorbidity with other serious diseases

Numerous epidemiological studies demonstrate that cystic fibrosis, the most common orphan disease in the world, can not occur in isolation, but can be combined with other serious diseases. The most common such combination in all populations is traditionally cystic fibrosis and celiac disease, which, on the one hand, differ in the leading mechanism of inflammation, in cystic fibrosis - chronic microbial inflammation, in celiac disease - autoimmune, on the other hand, these two diseases have a number of common pathogenesis links, in particular, realizing the syndrome of malabsorption, which only complicates the timely diagnosis of these combined pathological conditions. In addition, the authors of the literature review focus on clinical examples of late detection of autoimmune gluten intolerance against the background of cystic fibrosis. They also consider the combination of cystic fibrosis with other severe, disabling diseases (rheumatoid arthritis, phenylketonuria, oncological diseases), which sometimes require a serious change in therapeutic tactics.

Set covering heuristics in a Benders decomposition for railway timetabling

Railway timetabling is a major challenge in the operation of railway. The timetable of a railway determines times, orders and routes of trains on the network and thereby defines the performance of the entire railway system. Railway operators are keen to maximize the economic performance of their railway system, such that timetables should be designed taking into account service requirements that result in a performant railway system In this work, we address a specific subdomain of timetabling, focusing on short-term tactical changes for already existing timetables, modeled with microscopic detail. With a Benders decomposition we propose an approach on this specific microscopic timetabling problem. In the decomposition, we consider quality and optimality of a timetable separately from the feasibility of a timetable. Quality is determined in a set covering problem and feasibility in a mixed-integer scheduling problem. With efficient heuristics on the problem of set covering in our decomposition, high quality solution for the resulting timetables are provided in short time, which enables an interactive design of adapted timetables. The novel approach provides heuristic solutions up to ∼20 times faster than standard approaches by commercial solvers, with an average gap of ∼7.5% in the optimality of solutions. Extensive experiments empirically confirm the benefits of the new approach.

Attitudes of military personnel towards unmanned ground vehicles (UGV): a study of in-depth interview

The increasing potential of unmanned systems promises massive changes in military tactics and enormous enhancements to army arsenals. However, these developments also raise many concerns for societies as the use of force could potentially be delegated to autonomous weapons systems (AWS) that could operate without meaningful involvement of the military chain of command. This paper [Article adapts from a collaborative research report of Estonian research group nr R-012 on the iMUGS (Integrated Modular Unmanned Ground System) project, funded by the EDIDP (European Defence Industrial Development Programme).] reports the findings of interviews with military personnel (n = 18), which were conducted to gauge their perceptions and attitudes towards UGVs and the transformation to autonomous weapons. The findings indicate that the patriotic mentality to fight for freedom is perceived as inconceivable for an AI because unmanned platforms can hardly ever be equipped with patriotical algorithms. However, participants agreed that AI-driven machines should be perceived as decision-making instruments at best, with the caveat that any discretion to use lethal force should not be delegated to the machine.

UKRAINE CONFLICT’S IMPACT ON PAKISTAN FOREIGN POLICY

The situation in Ukraine has significantly impacted Pakistan's foreign policy, affecting a variety of areas and posing difficulties and options for the nation's international relations. This essay seeks to offer a thorough study of the conflict's repercussions on domestic and international politics, as well as its ramifications for trade, energy, food security, and shifting alliances. Despite Ukraine's distance from Pakistan, the crisis there has had an impact on world politics, changing the balance of power and necessitating tactical changes. Understanding Pakistan's reaction in its foreign policy depends on knowing how the conflict will affect regional and global affairs. This study investigates the effects of the conflict and sheds light on Pakistan's participation in the changing geopolitical environment. The conflict may have an impact on trade, food security, and the energy sector, to name a few industries. Global supply chains and trade routes could be disrupted, which would change economic dynamics. Additionally, because the conflict may affect trade routes and access to resources, issues to food security may appear. Geopolitical changes may cause volatility and uncertainty in the energy sector's energy supply and pricing. Comparative analysis of Ukraine's exports of military equipment to Pakistan and India can shed light on how the regional defense partnerships are changing. Understanding the choices both nations made when purchasing military hardware from Ukraine aids in clarifying Pakistan's foreign policy philosophies and strategic considerations. Pakistan's foreign policy has been significantly impacted by the situation in Ukraine. A thorough comprehension of the dynamics at play can be attained by analyzing the conflict's effects on various sectors, looking at shifting partnerships, and comprehending the decisions and difficulties faced by Pakistan. Policymakers, academics, and analysts who want to understand Pakistan's foreign policy in the wake of the Ukraine conflict can benefit greatly from this research.

AN EFFORTS TO PREVENT TERRORISM AS A TRANSNATIONAL CRIME THROUGH THE IMPLEMENTATION OF IMMIGRATION CONTROL

The threat of terrorism in the world is increasing and the changes in tactics and strategies used by terrorist groups show the importance of international cooperation in fighting terrorism. Indonesia as a country with a strategic geographical location and abundant natural resources also faces the threat of terrorism. Movements of radical organizations such as ISIS, Al-Qaeda, and Jemaah Islamiyah have made Indonesia one of the targets for the spread of radicalism within the country. Therefore, supervision carried out by the immigration authorities plays an important role in controlling the potential for radicalism and terrorism. The Indonesian government has an obligation to protect sovereignty and maintain national integrity from threats both from within and from outside. Immigration as part of the government has a role in maintaining domestic security stability. In the context of immigration, strict monitoring of the movement of foreigners is very important in dealing with the threat of terrorism.

Examination of Player Positions by Cluster Analysis

Today, the football industry stands out among the sports branches. Especially with the development of technology and its integration into football, different tactical understandings and formations emerge. With these developments, the current positions of the players and the other positions they are prone to play can be revealed as a result of the analysis. In this way, club management and technical team aim to establish the best team according to the current budget and tactical game understanding. Therefore, it is very important for the teams to play the players in the right position or to transfer the right player to the required position. In football competitions where 11 players are involved in the game, tactical changes can be made within the game according to the tactical arrangement and tactical understanding of the opposing team, and the player can be played in different positions. In this study, the player data of Turkey and the leagues of Germany, England, France, Spain, Italy, which are considered to be the five big leagues, for the years 2020-2021 were obtained from the website named “whoscored”. In the data set obtained, the players who stayed on the field for a minimum of 1500 minutes were taken as a basis and clustering analysis was performed with the data of 985 players. Players are clustered on four basic positions: goalkeeper, defender, midfielder and attacker. In the study, Expectation Maximization, one of the clustering analysis algorithms, was used and a success rate of 81 percent was achieved.

Oncologic surgery in the era of drug therapy

Surgical oncology has undergone a number of tactical changes in the era of the development of drug therapy, but is still the only treatment that can cure most solid forms of cancer. Recently, surgical interventions are increasingly acquiring an individual approach to the patient. Surgical oncology is part of a multifaceted multidisciplinary team with a single philosophy in understanding the biology of tumor development, as well as the contribution of other disciplines to the treatment of cancer patients. Key words: surgical oncology, cytoreductive surgery, intraoperative chemotherapy.

Хондробластна остеосаркома проксимального відділу лівої великогомілкової кістки на тлі муковісцидоз-асоційованого цукрового діабету. Клінічний випадок

Cystic fibrosis related diabetes (CFRD) is a rare pathology that combines genetically determined systemicity with damage to the exocrine glands, which leads to early manifestations of the disease, a clear exacerbation and chronicity of the process, with possible complications in bone remodeling with the occurrence of malignant tumors. Purpose - to acquaint practitioners with the peculiarities of manifestations, diagnosis and course of chondroblastic osteosarcoma in a child with CFRD. Features of the clinical course and differential diagnosis are described and given osteosarcoma of the proximal part of the left tibia against the background of CFRD in a child. The main diagnostic value of history, clinical picture, laboratory, instrumental, immunohistochemical and microscopic research methods was highlighted, in particular, a biopsy of this tumor. Microscopic examination of tissue biopsy revealed alternating areas of atypical cartilaginous tissue corresponding to the structure of chondrosarcoma 1-2 cm, solid proliferates of atypical fibroblast-like cells and areas of atypical and fibroblastic tissue containing elements of atypical osteogenesis. Periosteally - randomly oriented bone fragments at the place of the cortical plate, as well as impressions of the lower metaphysis of the thigh and the upper metaphysis of the tibia, near the knee joint. The immunohistochemical examination showed a clear differential diagnosis of the existing CD99-positive tumor cells (DAKO, clone 12E7). Some cells were positive for SATB2 (Cell Marque, clone EP281); tumor cells were negative for S-100 - SOX-10. The histological picture and immunophenotype of the tumor cells correspond to chondroblastic osteosarcoma. Osteosarcoma with genetic, metabolic and aplastic features developing in the setting of a comorbid background significantly complicates diagnosis and requires certain changes in the treatment tactics of CFRD (correction of prophylactic and basic therapy, metabolic and toxic disorders, including those caused by chemotherapy). The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Current understanding of chemotherapy-induced peripheral neuropathy (literature review)

This review focuses on chemotherapy-induced polyneuropathy, which is a fairly common side effect and affects not only the quality of life of patients with malignancies, but can also lead to a change in patient management tactics, namely dose modification, delay of drug administration to complete cessation of treatment, which threatens the life of the patient. Chemotherapy-induced polyneuropathy is based on different mechanisms of damaging effects depending on the type of cytotoxic agent. The most neurotoxic drugs are platinum drugs, taxanes, periwinkle alkaloids, bortezomib, and thalidomide. As a result of neurotoxic effects, damage occurs to thin and thick fibers of peripheral nerves. However, it is still a mystery why one patient develops manifestations of neurotoxicity and another does not. Therefore, the modern medical community is faced with the urgent question of further study of the mechanisms of development, risk factors, as well as the search for biomarkers and the development of prevention and treatment of chemotherapy-induced polyneuropathy. The results of studies on the mechanism of onset, clinic, diagnosis, prevention and treatment of chemotherapy-induced polyneuropathies are summarized.

Correction to: Comment on “Black Box Prediction Methods in Sports Medicine Deserve a Red Card for Reckless Practice: A Change of Tactics is Needed to Advance Athlete Care”

Correction to: Comment on “Black Box Prediction Methods in Sports Medicine Deserve a Red Card for Reckless Practice: A Change of Tactics is Needed to Advance Athlete Care”

Two-stage flexor tendon reconstruction of the fingers in chronic injuries: the history of this a unique method of treatment

In 1965 the American surgeon J.M. Hunter published a pioneering work on a new method of treatment (in 2 stages) of finger flexor tendons complex injuries using a special artificial tendon implant at the 1st stage to prepare the fibrosynovial canal. After replacement of the prosthesis with a tendon graft, the walls of the new case provided a nourishing and sliding surface for the tendon graft. The method of two-stage tendon grafting was widely used all over the world. The followers of J.M. Hunter's method are constantly modifying (not substantially) the original method and continue discussions about this treatment method. However, the basic principles of two-stage tendoplasty formulated by the American surgeon remain relevant to this day. The authors analyzed the changes in the treatment tactics and technique of two-stage tendoplasty that occurred during the last decades. J.M. Hunter provided hand surgeons with a unique method of treatment, which made it possible to help the most complex patients who were previously considered incurable.

Trends in Traumatic Brain Injury Among U.S. Service Members Deployed in Iraq and Afghanistan, 2002–2016

Traumatic brain injury (TBI) is a major health issue for service members deployed and is more common in recent conflicts; however, a thorough understanding of risk factors and trends is not well described. This study aims to characterize the epidemiology of TBI in U.S. service members and the potential impacts of changes in policy, care, equipment, and tactics over the 15 years studied. Retrospective analysis of U.S. Department of Defense Trauma Registry data (2002-2016) was performed on service members treated for TBI at Role 3 medical treatment facilities in Iraq and Afghanistan. Risk factors and trends in TBI were examined in 2021 using Joinpoint regression and logistic regression. Nearly one third of 29,735 injured service members (32.4%) reaching Role 3 medical treatment facilities had TBI. The majority sustained mild (75.8%), followed by moderate (11.6%) and severe (10.6%) TBI. TBI proportion was higher in males than in females (32.6% vs 25.3%; p<0.001), in Afghanistan than in Iraq (43.8% vs 25.5%; p<0.001), and in battle than in nonbattle (38.6% vs 21.9%; p<0.001). Patients with moderate or severe TBI were more likely to have polytrauma (p<0.001). TBI proportion increased over time, primarily in mild TBI (p=0.02), slightly in moderate TBI (p=0.04), and most rapidly between 2005 and 2011, with a 2.48% annual increase. One third of injured service members at Role 3 medical treatment facilities experienced TBI. Findings suggest that additional preventive measures may decrease TBI frequency and severity. Clinical guidelines for field management of mild TBI may reduce the burden on evacuation and hospital systems. Additional capabilities may be needed for military field hospitals.

Reimagining Our Public Health Systems: The Robert Wood Johnson Foundation's National Commission to Transform Public Health Data Systems.

Reimagining Our Public Health Systems: The Robert Wood Johnson Foundation's National Commission to Transform Public Health Data Systems.

Ambulatory electrocardiographic monitoring in patients with Fabry disease: study design and cohort characterization

Aim. To develop study design and analyze the characteristics of a cohort of patients with cardiac manifestations of Fabry disease (FD) in order to study the possibilities of electrocardiography (ECG) telemonitoring for screening for cardiac arrhythmias (CA), requiring a change in therapeutic tactics.Material and methods. This prospective cohort study included 11 patients (8 men and 3 women) with documented FD, with cardiac complaints and ECG signs of heart involvement. For ECG telemonitoring, non-invasive digital event recorders ECG Dongle (Nordavind-Dubna, Russia) were used. Primary endpoint was registration of CA requiring a change in therapeutic tactics (implantation of a pacemaker/defibrillator-cardioverter/prescribing anticoagulants). Secondary endpoint was dynamics of monitored parameters for operational correction of the therapeutic regimen.Results. The cohort of patients is predominantly male (73/27%; mean age, 41±13,7 years). At the time of inclusion, 8 (73%) patients received enzyme replacement therapy for 4-73 months. Most patients are active Internet users, are aware of telemedicine possibilities and are interested in remote monitoring. The main complaints were related to cardiac function interruptions, palpitations, and chest discomfort. Left ventricular hypertrophy was diagnosed on ECG in 7 (64%) patients. Echocardiography revealed symmetrical left ventricular hypertrophy in 5 patients, asymmetric interventricular septal hypertrophy in 2 patients. Other echocardiographic abnormalities included valvular heart disease (mitral and tricuspid valve prolapse with mitral and tricuspid regurgitation, presence of supplemental chords) and aortic root dilatation. Initially, the ECG was dominated by sinus rhythm (n=10); 1 patient had documented ventricular tachycardia, 4 patients had single and coupled ventricular premature contractions; supraventricular tachycardia and premature contractions in 2 patients. Four patients had a PR interval shortening without signs of accessory pathways, 1 patient — Wolff-Parkinson-White syndrome, 1 patient — prolonged QTc interval.Conclusion. For effective management of FD, additional multicenter studies are required to develop algorithms for making tactical decisions in the process of cardiac monitoring, taking into account the characteristics of the cardiovascular manifestations of this disease. The article proposes a technology for telemedicine cardiac monitoring using ECG event recorders for outpatient CA screening.

Russia/Ukraine military conflict: Discussing the maritime element of the confrontation

Within the globalization era, the conduct, resolution, and impact of international conflicts are frequently not limited solely to the belligerent states involved. Conflict influences distant countries and often illustrates the vulnerability of sea access to the security of coastal and landlocked nations, by factoring in that: import/export commodities are impacted; access to vital energy resources is undermined; and/or international resource distribution is threatened. Therefore, the maritime domain (and its military, legal, and commercial components) represents a Russia/Ukraine conflict cornerstone and the epicenter of this analysis. This conflict highlights maritime trade importance and re-establishes the strategic significance of protecting multi-polarity, the “rule of law”, and freedom of the seas within the Black Sea region (BSR), which today represents a very large concentration of power (involving actors like Russia, USA, NATO, EU) and has been the site of ten post-Cold War conflicts. Resultantly, maritime domain objectives and tactical events (on, above, and below the seas) require detailed analysis as hostilities continue, the norms and principles of international law are threatened and/or undermined, and prospective combat end-state(s) are considered. Such will define Russia’s and Ukraine’s future(s), as well as economic-diplomatic stability and the future of rules-based international order across the BSR, which is a vital maritime transport corridor. &#x0D; Amidst increasing maritime emphasis, this conflict also illustrates transformational warfighting facets. In addition to troops, ships, and aircraft, modern battlefields now include issues like: Information Warfare outlets; “lawfare”; cyber threats; and adversaries with unprecedented Artificial Intelligence capabilities. The international community must acknowledge these skills yield warfighting capability to nations lacking capacity. As naval warfare equipment and tactics change, protecting sea lanes, preventing maritime hegemony, and upholding the “rule of law”, remain dominant-and are enhanced by globalization.