Functional State Research Articles

Modern possibilities of echocardiographic diagnosis in pulmonary arterial hypertension

Pulmonary Hypertension (PH) is a hemodynamic and pathophysiological condition characterized by an increase in mean pulmonary artery (PA) pressure by at least 20 mm Hg at rest, measured during right heart catheterization. One of the fastest and most accessible screening non-invasive diagnostic methods for assessing the likelihood of this condition is echocardiography, which is performed according to the standard transthoracic echocardiography protocol, focusing on visualizing and describing certain parameters that characterize function of heart right chambers. In patients with PH, structural changes in the heart right chambers can be observed, such as enlargement of the right atrium and right ventricle, changes in their geometric shape, thickening right ventricle wall, dilatation of the main PA and its branches, and the appearance of tricuspid regurgitation. Pulmonary artery pressure can be measured using either the velocity of the tricuspid regurgitant jet or the ratio of the time acceleration of flow in the outflow tract of the right ventricle to the ejection time (mean pressure in the PA), or the velocity of the pulmonary regurgitation jet (end-diastolic pressure in the PA). Classic parameters of the functional state of the right ventricle, as well as additional indicators of the evaluation of the right ventricular function, for example, the ratio of the amplitude of movement of the fibrous ring to systolic pressure in the PA, called the right ventriculoarterial coupling, should be evaluated only in expert centers providing care for patients with PH. Correct and timely diagnosis, clear dynamic monitoring of the patient’s condition play a crucial role in prescribing targeted treatment and predicting the disease course.

МОРФОФУНКЦИОНАЛЬНЫЕ И БИОЭЛЕКТРИЧЕСКИЕ ХАРАКТЕРИСТИКИ НЕКОТОРЫХ МЫШЦ ЗАПЯСТНОГО СУСТАВА У СОБАКИ: ПИЛОТНОЕ ИССЛЕДОВАНИЕ

The paper presents the morphofunctional characteristics of some muscles of the dog's wrist joint, as well as their bioelectrical characteristics. The purpose of the study is to describe the bioelectrical characteristics of the radial and ulnar extensor carpi of the dog, taking into account the morphofunctional characteristics of these muscles. Objectives of the study: to conduct a morphological and electrophysiological study of the radial and ulnar extensor wrist muscles in dogs; identify patterns of EMG formation depending on the internal structure and innervation of muscles, and conduct a comparative assessment of the morphological and bioelectrical characteristics of the muscles being studied. Research was carried out at the Department of Anatomy, Histology, Physiology and Pathological Anatomy of the Omsk State Agrarian University named after P.A. Stolypin (Omsk). As a result of the studies, it was revealed that the innervation of the muscle fibers of the dog’s extensor carpi ulnaris and radialis has a similar, group character, that is, groups of muscle fibers have a large number of motor units. These groups are reflected on the EMG as separate complexes. An individual set of action potentials in the EMG signal pattern has duration of 0.01–0.014 s and a frequency of 600–800 Hz. The length of the muscle bundles inboth muscles is different: for the extensor carpi ulnaris it is 0.5 cm, for the radial one, respectively, 3.5 cm. Thus, it was found that the characteristics of the innervation and internal structure of the muscle affect the pattern of the EMG signal. The influence of muscle structure by the type of feathering and the length of muscle fibers (in feathery muscles) was not revealed. Thus, the resulting pattern (pattern) of the EMG signal is characteristic of statodynamic muscles. The proposed model of EMG signal formation, as a result of further development, will have the prospect of being used for qualitative and quantitative interpretation and assessment of the functional state of the neuromuscular system in animals and humans.

Mental health of volunteers: origin of psychosomatic disorders in PTSD conditions

Background. Numerous studies in various scientific areas deal with to the problem of mental health of Ukrainians: the theory and practice of psychological and pedagogical research, psychophysiological concepts and theories, a systematic approach in psychology, the psychophysiological aspect of the emotional background, as well as psychosomatic features of optimal personality functioning. Preservation of mental health has become a priority of the state policy of Ukraine to support the country’s stability and fighting capacity. The study of the impact of psychoemotional factors on the functional state of the body for the restoration and optimization of life support among volunteers who provide free psychological assistance and support the mental health of the population is relevant. The research was aimed at studying the origin of psychosomatic disorders in volunteers with post-traumatic stress disorder (PTSD), as well as determining the impact of these disorders on their mental health and psychosocial status. Materials and methods. The following psychodiagnostic tools were used: emotional burnout diagnosis method according to V. Boyko, NEWS questionnaire, PCL-5 questionnaire and post-traumatic growth questionnaire. According to the results of the study, it was found that emotional burnout in volunteers manifests itself in three phases: tension, resistance, and exhaustion according to indicators of a high level of stress and severe depression in respondents with signs of PTSD (23.9 %). Results. Mental disorders such as asthenic, anxiety-phobic, hysteroform and depressive syndromes are observed in all groups. Conclusions. The psychosomatic mechanism of the relationship between mental activity and behavior in PTSD includes the influence of a traumatic psycho-emotional factor that causes a constant feeling of danger, panic attacks or fear of repeating the situation, a feeling of hopelessness, low mood, apathy, loss of interest in usual activities, aggression, irritability, frequent conflicts and anger outbursts, feelings of detachment, social isolation, relationship problems and guilt for experiencing PTSD symptoms.

Multiplexed spatial mapping of chromatin features, transcriptome and proteins in tissues.

The phenotypic and functional states of cells are modulated by a complex interactive molecular hierarchy of multiple omics layers, involving the genome, epigenome, transcriptome, proteome and metabolome. Spatial omics approaches have enabled the study of these layers in tissue context but are often limited to one or two modalities, offering an incomplete view of cellular identity. Here we present spatial-Mux-seq, a multimodal spatial technology that allows simultaneous profiling of five different modalities: two histone modifications, chromatin accessibility, whole transcriptome and a panel of proteins at tissue scale and cellular level in a spatially resolved manner. We applied this technology to mouse embryos and mouse brains, generating detailed multimodal tissue maps that identified more cell types and states compared to unimodal data. This analysis uncovered spatiotemporal relationships among histone modifications, chromatin accessibility, gene expression and protein levels during neuron differentiation, and revealed a radial glia niche with spatially dynamic epigenetic signals. Collectively, the spatial multi-omics approach heralds a new era for characterizing tissue and cellular heterogeneity that single-modality studies alone could not reveal.

Association of autistic personality traits with the EEG scores in non-clinical subjects during the facial video viewing

A software information module of the experimental computer platform “EEG_Self-Construct” was developed and tested in the framework of this study. This module can be applied for identification of neurophysiological markers of self-referential processes based on the joint use of EEG and facial video recording to induce the brain’s functional states associated with participants’ personality traits. This module was tested on a group of non-clinical participants with varying degrees of severity of autistic personality traits (APT) according to the Broad Autism Phenotype Questionnaire. The degree of individual severity of APT is a quantitative characteristic of difficulties that a person has when communicating with other people. Each person has some individual degree of severity of such traits. Patients with autism are found to have high rates of autistic traits. However, some individuals with high rates of autistic traits are not accompanied by clinical symptoms. Our module allows inducing the brain’s functional states, in which the EEG indicators of people with different levels of APT significantly differ. In addition, the module includes a set of software tools for recording and analyzing brain activity indices. We have found that relationships between brain activity and the individual level of severity of APT in non-clinical subjects can be identified in resting-state conditions following recognition of self-referential information, while recognition of socially neutral information does not induce processes associated with APT. It has been shown that people with high scores of APT have increased spectral density in the delta and theta ranges of rhythms in the frontal cortical areas of both hemispheres compared to people with lower scores of APT. This could hypothetically be interpreted as an index of reduced brain activity associated with recognition of self-referential information in people with higher scores of autistic traits. The software module we are developing can be integrated with modules that allow identifying molecular genetic markers of personality traits, including traits that determine the predisposition to mental pathologies.

Novel transcripts of EMT driving the malignant transformation of oral submucous fibrosis

Oral submucous fibrosis (OSF) is a chronic, progressive, and fibrotic condition of the oral mucosa that carries an elevated risk of malignant transformation. We aimed to identify and validate novel genes associated with the regulation of epithelial-to-mesenchymal transition (EMT) in OSF. Genes regulating EMT were identified through differential gene expression analysis, using a LogFC threshold of -1 and + 1 and a padj value < 0.05, based on data from GEO datasets and the TCGA-HNSC datasets. The curated EMT genes were correlated with functional cancer states and subjected to clustering to identify candidate genes. Integration of bioinformatics and proteomics led to the discovery of the EMT genes MMP9, SPARC, and ITGA5 as novel candidates. Comprehensive pathway and immunohistochemical analyses confirmed their roles in regulating EMT in OSF, oral squamous cell carcinoma (OSCC), and OSF-associated squamous cell carcinoma (OSFSCC). The significant roles of MMP9, SPARC, and ITGA5 in fibrosis and malignancy suggest a novel mechanism in which fibrosis-associated type 2 EMT undergoes transition to type 3 EMT, driving OSF towards malignancy.

Comparison of brain activity metrics in Chinese and Russian students while perceiving information referencing self or others

Neurocomputing technology is a field of interdisciplinary research and development widely applied in modern digital medicine. One of the problems of neuroimaging technology is the creation of methods for studying human brain activity in socially oriented conditions by using modern information approaches. The aim of this study is to develop a methodology for collecting and processing psychophysiological data, which makes it possible to estimate the functional states of the human brain associated with the attribution of external information to oneself or other people. Self-reference is a person’s subjective assessment of information coming from the external environment as related to himself/herself. Assigning information to other people or inanimate objects is evaluating information as a message about someone else or about things. In modern neurophysiology, two approaches to the study of self-referential processing have been developed: (1) recording brain activity at rest, then questioning the participant for self-reported thoughts; (2) recording brain activity induced by self-assigned stimuli. In the presented paper, a technology was tested that combines registration and analysis of EEG with viewing facial video recordings. The novelty of our approach is the use of video recordings obtained in the first stage of the survey to induce resting states associated with recognition of information about different subjects in later stages of the survey. We have developed a software and hardware module, i. e. a set of related programs and procedures for their application consisting of blocks that allow for a full cycle of registration and processing of psychological and neurophysiological data. Using this module, brain electrical activity (EEG) indicators reflecting individual characteristics of recognition of information related to oneself and other people were compared between groups of 30 Chinese (14 men and 16 women, average age 23.2 ± 0.4 years) and 32 Russian (15 men, 17 women, average age 22.1 ± 0.4 years) participants. We tested the hypothesis that differences in brain activity in functional rest intervals between Chinese and Russian participants depend on their psychological differences in collectivism scores. It was revealed that brain functional activity depends on the subject relevance of the facial video that the participants viewed between resting-state intervals. Interethnic differences were observed in the activity of the anterior and parietal hubs of the default-mode network and depended on the subject attribution of information. In Chinese, but not Russian, participants significant positive correlations were revealed between the level of collectivism and spectral density in the anterior hub of the default-mode network in all experimental conditions for a wide range of frequencies. The developed software and hardware module is included in an integrated digital platform for conducting research in the field of systems biology and digital medicine.

Efficiency of surgical treatment for complicated cataract: clinical and functional analysis

Background. Despite the successes of ophthalmic surgery, the treatment of complicated cataract remains challenging due to concomitant conditions such as lens subluxation and glaucoma. The purpose of the study was to assess the clinical and functional state of the eye in patients with complicated cataract after lens extraction. Materials and methods. The study involved 54 patients: 36 with uncomplicated cataract (controls) and 18 (main group) with cataract complicated by primary open-angle glaucoma (POAG). They underwent an ophthalmic examination, including visometry, tonometry, echobiometry, and ophthalmoscopy. The examination was performed before surgery, the next day, 1, 3 and 6 months after phacoemulsification. Results. Six months after surgery, 97.23 % of controls and 94.45 % of patients in the main group had visual acuity ≥ 0.5. On the first day after phacoemulsification, the mean intraocular pressure (IOP) increased by 3.14 ± 0.15 mm Hg in the control group and by 0.84 ± 0.02 mm Hg in patients with POAG, but by the end of the follow-up, there was a decrease in IOP in 50 and 44.5 % of cases, respectively, compared to preope­rative values. One month after surgery, the anterior chamber depth increased by 0.94 mm in controls and by 0.44 mm in patients of the main group, remaining stable until the end of the follow-up. Conclusions. Clinical follow-up of patients with uncomplicated cataract and cataract complicated by POAG showed that after phacoemulsification, there was an improvement in visual function, stabilization of IOP and an increase in the anterior chamber depth. An increase in IOP on the first day after surgery is transient, and the dynamics of indicators over 6 months confirms the effectiveness of surgical intervention.

The diversity of natural killer cell functional and phenotypic states in cancer.

The role of natural killer (NK) cells as immune effectors is well established, as is their utility as immunotherapeutic agents against various cancers. However, NK cells' anti-cancer roles are suppressed in cancer patients by various immunomodulatory mechanisms which alter these cells' identity, function, and potential for immunosurveillance. This manifests in abnormal NK cell responses accompanied by changes in phenotypic or genotypic identity, giving rise to specific NK cell subsets that are either hypofunctional or, more broadly, defective in their responses. Anergy, senescence, and exhaustion are some of the terms that have been used to define and characterize these NK cell functional states. These responses vary not only with cancer type but also NK cell location within tissues. Collectively, these phenomena suggest a highly plastic nature of NK cell biology in tumors. In this review, we present and discuss a summary of these functionally distinct states and provide an overview of how NK cells behave at different locations within the context of cancer.

Improving brain health via the central executive network.

Cognitive and physical stress have significant effects on brain health, particularly through their influence on the central executive network (CEN). The CEN, which includes regions such as the dorsolateral prefrontal cortex, anterior cingulate cortex and inferior parietal lobe, is central to managing the demands of cognitively challenging motor tasks. Acute stress can temporarily reduce connectivity within the CEN, leading to impaired cognitive function and emotional states. However a rebound in these states often follows, driven by motivational signals through the mesocortical and mesolimbic pathways, which help sustain inhibitory control and task execution. Chronic exposure to physical and cognitive challenges leads to long-term improvements in CEN functionality. These changes are supported by neurochemical, structural and systemic adaptations, including mechanisms of tissue crosstalk. Myokines, adipokines, anti-inflammatory cytokines and gut-derived metabolites contribute to a biochemical environment that enhances neuroplasticity, reduces neuroinflammation and supports neurotransmitters such as serotonin and dopamine. These processes strengthen CEN connectivity, improve self-regulation and enable individuals to adopt and sustain health-optimizing behaviours. Long-term physical activity not only enhances inhibitory control but also reduces the risk of age-related cognitive decline and neurodegenerative diseases. This review highlights the role of progressive physical stress through exercise as a practical approach to strengthening the CEN and promoting brain health, offering a strategy to improve cognitive resilience and emotional well-being across the lifespan.

Psychophysiological reserves of the body as a basis for the formation of educational adaptation of higher education students

The article confirms the importance of studying the issue of forming the educational adaptation of students. It is shown that the functional indicators of the cardiovascular (adaptive potential of blood circulation) and nervous (level of situational and personal anxiety) systems are diagnostic markers of students' adaptation to the educational process. The assessment of psychophysiological reserves of the student’s organism (40 full-time students) was conducted on the basis of the Mykhailo Dragomanov Ukrainian State University. The anxiety level was carried out using the test of Ch.D. Spielberger - Yu.L. Khanin. The assessment of compensatory and adaptive mechanisms was carried out using the calculated criterion of the adaptive potential of the circulatory system (AP) proposed by R.M. Baievskyi. It is found that most first- and second-year students have a high level of anxiety, especially during the examination period, which is due to academic stress exacerbated by military events. Instead, the average group level of students' adaptive potential is satisfactory, characterized by sufficient functional capabilities of the body. The results of the study have identified the need for regular monitoring of the functional state of the cardiovascular and central nervous systems of first- and second-year students. It has been established that pedagogical measures aimed at improving the effectiveness of educational adaptation should include rationally organized physical activity. The importance of including the educational component “Physical Education” in the curriculum of training specialists regardless of specialty for 1st and 2nd year students in order to increase the functional capabilities of the body, prevent the development of chronic psycho-emotional stress, especially in martial law conditions, is substantiated.

Tissue-resident memory CD8 T cell diversity is spatiotemporally imprinted.

Tissue-resident memory CD8 T (TRM) cells provide protection from infection at barrier sites. In the small intestine, TRM cells are found in at least two distinct subpopulations: one with higher expression of effector molecules and another with greater memory potential1. However, the origins of this diversity remain unknown. Here we proposed that distinct tissue niches drive thephenotypic heterogeneityof TRM cells. To test this, we leveraged spatial transcriptomics of human samples, a mouse model of acute systemic viral infection and a newly established strategy for pooled optically encoded gene perturbations to profile the locations, interactions and transcriptomes of pathogen-specific TRM cell differentiation at single-transcript resolution. We developed computational approaches to capture cellular locations along three anatomical axes of the small intestine and to visualize the spatiotemporal distribution of cell types and gene expression. Our study reveals that the regionalized signalling of the intestinal architecture supports two distinct TRM cell states: differentiated TRM cells and progenitor-like TRM cells, located in the upper villus and lower villus, respectively. This diversity is mediated by distinct ligand-receptor activities, cytokine gradients and specialized cellular contacts. Blocking TGFβ or CXCL9 and CXCL10 sensing by antigen-specific CD8 T cells revealed a model consistent with anatomicallydelineated, early fate specification. Ultimately, our framework for the study of tissue immune networks reveals that T cell location and functional state are fundamentally intertwined.

Predictors of pulmonary hypertension in the subacute period of myocardial infarction in young and middle-aged males

Aim. To identify predictors of the development of pulmonary hypertension (PH) in the subacute period of myocardial infarction (MI) in young and middle-aged males to improve preventive measures.Materials and methods. We studied the results of treatment of male patients aged 32–60 years with a verified diagnosis of MI. Based on echocardiography findings and detection of PH at the end of the third week of MI, the patients were divided into the study group (patients with PH) and the comparison group (patients with a normal pressure in the pulmonary artery). In the studied groups, a comparative assessment of various parameters was performed, and an analysis of the risks of developing PH using the Pearson’s chi-squared test was conducted.Results. We found that the risk of developing PH in the subacute period of MI was significantly affected by certain parameters of peripheral hemodynamics, the presence of bradycardia, and the calculated value of total pulmonary resistance. The main parameters of the lipid profile were found to be significant predictors of PH in the subacute period of MI, along with some parameters of electrolyte metabolism (sodium and magnesium in the first 48 hours of MI, potassium and calcium at the end of the third week of the disease). We established the presence of a reliable relationship between several parameters of the structural and functional state of the myocardium both in the first 48 hours of MI and the end of the third week of the disease with the risk of developing PH in the subacute period of MI.Conclusion. The identified predictors make it possible to determine patients with MI who are at an increased risk of PH to timely diagnose and treat the disease and improve the prognosis.

OP23 Neutrophil Niches and Therapy Resistance in Ulcerative Colitis: Spatial Atlas Insights

Abstract Background Resistance to tumor necrosis factor inhibitor (TNFi) therapy remains a major obstacle in managing ulcerative colitis (UC), affecting up to 50% of patients.1 The complex interplay of immune cells and their spatial organization in the gut mucosa is poorly understood but likely contributes to therapeutic outcomes.1,2 This study utilized advanced multiplexed imaging to construct a spatial atlas of UC, providing insights into cellular interactions driving TNFi resistance. Novel spatial omic technologies show to be able to add additional thus far unknown insights to this question. Methods A total of 42 tissue regions from 29 UC patients and 5 healthy controls were analyzed using CODEX multiplexed imaging. Spatially resolved single-cell data, encompassing over 1.7 million cells, were used to identify distinct cell types and map cellular neighborhoods (CNs). Pairwise cell-cell contacts and CN-level functional states were analyzed in TNFi-treated and untreated patients, correlating findings with clinical outcomes. Results TNFi therapy led to normalization of adaptive immune CNs, such as lymphoid aggregates, with reductions in T-cell frequencies and associated contacts. However, innate immune CNs, including neutrophil-enriched granulocyte niches and inflamed stroma, remained unchanged despite treatment. Notably, neutrophil-dominated CNs exhibited persistent expression of pro-inflammatory markers, such as TNFR2 and CD137, implicating these niches in sustaining mucosal inflammation and therapy resistance. Additionally, sex-dependent differences were observed, with higher TNFi responsiveness in females potentially linked to adaptive immune modulation.3 Conclusion Neutrophil-dominated inflammatory niches represent a potential mechanism of TNFi resistance in UC.3,4 These findings highlight the importance of targeting innate immune pathways alongside TNFi therapy to improve outcomes. By integrating spatial insights with functional data, this study paves the way for precision medicine approaches in UC management.

Iatrogenic injury of the hypopharynx in the pyriform sinus region and its successful treatment: description of a clinical case

Hypopharyngeal injury in the pyriform sinus area during diagnostic gastroduodenoscopy is a rare and potentially severe complication.In this paper, we describe successful treatment of a patient with such an injury complicated by the development of a soft tissue abscess of the neck. Treatment of the purulent complication was surgical and consisted of opening and draining of the soft paratracheal tissue abscess on the left side of the neck. The most important components of the treatment were antibiotic therapy and temporary prohibition of natural nutrition (nil per os) with complete parenteral and then enteral tube nutrition, which was continued until complete healing of the laryngeal injury. The patient suffering from pancreatic cancer was discharged from the clinic with restored natural (oral) food intake, in a satisfactory functional state and without weight loss.

Examination of the carbon monoxide diffusing capacity in children with oncohematological diseases after hematopoietic stem cell transplantation

The article presents the results of the study of the diffusion capacity of the lungs (DSL) for carbon monoxide by single inhalation (DLco) in children with acute leukemia (AL) and acquired idiopathic aplastic anemia (AIAA) after allogeneic hematopoietic stem cell transplantation (HSCT). A comparative analysis of the DLco indicator before the HSCT and on the 30th, 90th, 180th, 360th days after it was carried out. Its significant irreversible decrease was revealed starting from 30 days after HSCT during the year of follow-up in most patients with AL. In children with AIAA, a significant decrease in DSL was also registered after a month of follow-up, however, by a year of dynamic control, the changes were less pronounced than in AL group, and the average DLco value was restored to indicators before transplantation. This method is important to use in a comprehensive assessment of the functional state of the respiratory system for the timely diagnosis of pulmonary complications after HSCT.

Dynamic Neural Mechanisms Underlying Sustained Motor Training Post-Stroke: An fNIRS Investigation Employing Time-Varying ALFF and Functional Connectivity Analysis.

Motor dysfunction of the upper limbs following a stroke predominantly arises from abnormal motor patterning caused by the disrupted balance of inter-cortical communication within motor-associated cortical regions. Temporal analysis offers a more precise reflection of the cortical functional state in affected patients. This study employed fNIRS to capture hemodynamic responses among 20 stroke patients and 19 healthy controls in both resting and Baduanjin task state. Including computing the coefficient of variation of fractional amplitude of low-frequency fluctuations (fALFF) for each channel, alongside extracting dynamic state metrics. Findings indicate that, during sustained motor tasks, stroke patients exhibit a diminished fALFF variability in targeted cortical regions; these individuals display a higher prevalence of low-intensity states and a lower prevalence of high-intensity states during task execution. These dynamic state attributes are significantly associated with scores on the upper limb motor function scale (FMA-UE), thereby proposing a time-domain perspective for investigating the underlying mechanisms of stroke-induced motor dysfunction.

The Role of the Tumor Microenvironment in T-Cell Redirecting Therapies of Large B-Cell Lymphoma: Lessons Learned from CAR-T to Bispecific Antibodies.

T-cell redirecting therapies, which include chimeric antigen receptor T-cells (CAR-Ts) and bispecific antibodies (BSAs), have revolutionized the treatment of relapsed\refractory large B-cell lymphoma (LBCL). Expanding clinical experience with these advanced therapies shows the potential for the optimization of their use with combination or consolidation strategies, which necessitates the prognostic stratification of patients. While traditional clinical prognostic factors identified in the era of chemotherapy are characterized by limited value, the tumor microenvironment (TME) is becoming a new prognostic cluster. We examine how the heterogeneity of LBCL, characterized by variations in tumor parameters and differences in TME immune cell composition, immune checkpoint expression, and cytokine milieu, correlates with both positive responses and resistance to treatment. While classical parameters such as histological subtype, cell of origin, and target antigen expression lack proven prognostic value for T-cell redirecting therapies, the density and functional state of tumor-infiltrating lymphocytes, tumor-associated macrophages, and immune checkpoint molecules are shown to be critical determinants of therapeutic success, particularly in CAR-T therapy. We identify several gaps in the current knowledge and suggest that the insights gained from CAR-T experience could be instrumental in refining BSA applications. This report also highlights limitations in the current knowledge, as TME data derive from a limited number of registrational trials with varying methodologies, complicating cross-study comparisons and often focusing on immediate response metrics rather than long-term outcomes. By dissecting the complex interactions within the TME, this review aims to identify new prognostic factors and targets, ultimately fostering more effective and tailored treatment strategies for LBCL patients.

Legal regulation of pastoral care in health care institutions of the Visegrad Group countries

The article examines the peculiarities of the legal regulation of the institute of medical chaplaincy in the countries of the Visegrad Group. The current state of regulation and functioning of the institute of medical chaplaincy in Hungary, Slovakia, Czech Republic, Poland is analyzed. The constitutional provisions enshrining the right to freedom of conscience and religion are outlined. The similarity of the definition of this fundamental right in the basic laws of the states, which is the basis for the implementation of pastoral care in health care institutions, is established. The author analyzes the legal acts that enshrine the possibility of exercising the right to pastoral care in health care facilities, the legal status of chaplains, the conditions of their activities, and the interaction of religious organizations with hospitals or hospitals in order to provide patients and other persons with pastoral care. The author identifies differences in the legal regulation of this institution in the analyzed countries, in particular, in terms of the level of legal acts and the scope of regulation. The peculiarities of the chaplaincy institute in the countries of the Visegrad Group are determined, depending on the model of church-state relations and the status of religious organizations. Some aspects of the functioning of the institute of medical chaplaincy in Hungary, Slovakia, the Czech Republic and Poland are investigated, namely the range of tasks, powers of chaplains and sources of financing their work from the funds of health care institutions or at the expense of religious organizations. The differences in the status of medical chaplains in terms of qualification characteristics are outlined. For example, in Hungary there are no requirements for chaplains. In contrast, the Czech Republic clearly establishes the requirement of higher education and further specialization. The conclusions emphasize the key role of chaplains in ensuring the rights of patients and healthcare professionals to freedom of religion. The author emphasizes the need for further improvement of the institute of medical chaplaincy in Ukraine, taking into account the experience of the Visegrad countries.

Общие и специфические проблемы формирования интеллектуальных операций у младших школьников с трудностями в обучении

&lt;p&gt;The modern system of inclusive education implies equal access to knowledge for all categories of children. Psychological and pedagogical studies show that there is a heterogeneity in the composition of students in terms of the level of mastering academic skills both within the classroom and among students of individual nosological groups. With the similarity of the symptoms of the manifestation of writing disorders in younger schoolchildren, the state of cognitive functions may be different. Understanding these general and specific features is necessary to organize a personalized approach to correction and education of children with impaired development, which determines the relevance of the study. The article presents the results of a research conducted to identify general and specific patterns of intellectual operations formations in younger schoolchildren who have writing disorders. The sample consisted of 3&lt;sup&gt;rd&lt;/sup&gt; grade students with severe speech disorders and mental retardation enrolled in adapted basic education programs. In the structure of the speech therapy conclusion, all children had a violation of writing on the basis of the lack of formation of language analysis and synthesis operations. As a diagnostic technique for studying the specifics of the formation of basic intellectual operations on nonverbal and verbal material, the method &lt;em&gt;&amp;ldquo;&lt;/em&gt;Classification of objects&lt;em&gt;&amp;rdquo;&lt;/em&gt; was selected and adapted. The results allowed us to conclude about qualitative differences in the formation of thinking components in case of writing disorders of a primary and secondary nature.&lt;/p&gt;