Subjective Signs Research Articles

Not All Pain in Sports Is Caused by Tissue Damage. What Are the Implications for Managing Pain?

A sports injury need not imply objective or subjective signs of tissue damage. Pain and impaired performance can count as an injury, which is often measured by the inability to play or participate in training and/or competition. Pain in the presence, and in the absence, of objective tissue damage is common in sports, but there are important differences in how sports-related pain and injury are managed, such as whether return-to-sport should be time- and/or pain contingent. This editorial proposes a pragmatic definition of sports-related pain to support clinicians with a semantic and practical description of what sports-related pain is, and the implications for helping athletes manage pain in the absence of tissue injury.

Theoretical problems of understanding the essence of administrative prejudice in criminal law

Subject of research: the article considers the issue of the essence of administrative prejudice in the criminal law of Russia and Belarus. Purpose of research: to determine the meaning of administrative prejudice in criminal law and its place in the structure of the corpus delicti of a crime, as well as to correlate administrative prejudice and other institutes of criminal law. Methods and objects of research: in conducting the research the traditional methods of socio-legal and formal-dogmatic analysis were used: documentary, historical-legal, analytical, systematic, logical. Main results of research: the author considers administrative prejudice in the general context of crime and its substantive features, determines the place of administrative prejudice in the structure of the corpus delicti. Separately the question of criteria of criminalization of acts in criminal law, understanding of criminal law in a broad sense, differentiation of crime and offense is revealed. The legal nature of administrative prejudice, its connection with public danger and insignificance of a deed is shown, the main features of acts, which are characterized by signs of administrative prejudice, are disclosed. Special attention in the work is paid to the analysis of subjective signs of administrative prejudice, the establishment of recommendations on the application of the norms of criminal law in this part and qualification of unlawful acts. The basic provisions of the science of criminal law are given and specific measures to improve the current criminal legislation are proposed.

Evaluation of the effectiveness of topical use of sertaconazole in dermatophytosis

Objective — to evaluate the effectiveness of a cream containing sertaconazole nitrate 2 % (Onabet 2 % cream) in patients with various forms of dermatophytosis. Materials and methods. 32 patients aged 21—50 were under outpatient observation. The duration of dermatophytosis varied from several weeks to 3 months. Tinea corporis was diagnosed in 25.0 % of patients, foot mycosis in 43.8 %, and axillary mycosis in 31.2 %. The diagnosis was based on the clinical manifestations of the disease and the results of microscopic examination with potassium hydroxide (PH). The clinical picture was evaluated based on the presence of subjective and objective signs (itching, erythema, scaling, vesicles/maceration, pustules) and their intensity according to the scale: 0 points — absence, 1 point — mild, 2 points — moderate, 3 points — severe. The area of skin damage was determined using the «rule of the palm» in patients. The final score of clinical manifestations was calculated by adding the individual scores of each symptom and the value of the area of the affected skin. Onabet 2 % cream was applied by patients twice a day to the affected area of the skin for 4 weeks. Results and discussion. As a result of topical treatment, positive dynamics regarding the clinical manifestations of dermatophytosis were noted in all patients. The regression of inflammatory symptoms (itching, erythema, wetting in 65.5, 40.6 and 71.4 % of patients, respectively) by the end of the 1st week of treatment serves as evidence of anti-fungal, anti-inflammatory and anti-pruritic effects. The terms of regression of clinical manifestations of dermatophytosis depended on the clinical form of the infection. Clinical remission by the end of the 1st week of therapy in 34.4 % of patients, clinical remission and mycological negativity by the end of the 2nd week in 81.3 % of patients testify to the rapid effect of the drug. At the end of the 6th week, clinical success was achieved in 93.7 %, mycological (pathogen eradication) in 100.0 % of patients. Remote observation results within 3 months showed no disease recurrence in all patients. Side effects during treatment were not registered. Conclusions. Onabet cream 2 % is a modern topical antimycotic with a wide spectrum of action; its use twice a day for 1 month allows for achieving clinical cure in 93.7 %, etiological cure in 100 % of patients with dermatophytes (tinea corporis, tinea pedis, and tinea cruris). The high effectiveness and safety of Onabet cream in treating dermatophytosis allow us to recommend this topical agent for treating patients with dermatophytosis.

Measures of spatial memory, peripheral inflammation and negative emotional state predict social-cognitive skills in healthy aging cats

Aging is a complex, multidimensional process. Normative aging is typically accompanied by declines in several cognitive domains, including memory and social cognition. As aging progresses, the often-overlooked early manifestations of cognitive decline can advance, leading to an inability to adapt to new situations and environments. Potential mechanisms influencing cognitive decline remain elusive, but, among other mechanisms, inflammaging, an age-related increase in the chronic production of pro-inflammatory mediators, and emotional stress are implicated. Cognitive function in cats is under-researched, with no studies on the link between potential risk factors and cognitive signs in aging subjects. Understanding this link is essential as it may facilitate the early identification of cognitive decline and encourage preventative, individualized interventions. We carried out a citizen science study to investigate, for the first time, the relationship between cognitive functions, stress, and the inflammatory markers interleukin (IL)-1β and IL-10 in 44 healthy, privately owned pet cats (7–14 years of age), who underwent standardized testing in their home environment. A task was employed to test spatial memory, requiring the cat to recall the location of a food-baited container. An unsolvable task was used to assess cats' social cognition and cognitive flexibility by measuring how they used referential communication (i.e., gaze alternation between the apparatus and the caregivers) compared to their persistence in trying to obtain food which was out of reach. Generalized linear regression analysis, conducted while adjusting for demographic factors and stress behaviors, revealed: 1) a predictive positive relationship connecting spatial memory and the use of social referencing with the caregiver (more gaze alternation) in the unsolvable task, highlighting the importance of the interplay between cognitive domains in sustaining complex behaviors, and 2) a reduced engagement in social referencing toward caregivers (less gaze alternation) in the presence of higher serum levels of IL-1β in the unsolvable task, especially as cats get older. A cat’s social cognitive performance was also negatively predicted by stress-related behaviors, which is not surprising given that cats are sentient creatures whose everyday behavior is also influenced by emotional states. These findings provide new insights into the crosstalk between different cognitive domains during aging and the potential contributions of emotions and inflammation to cognitive changes in healthy aging cats. Further research using this multidimensional approach will help explore these mechanisms of cognitive aging and potential markers for early detection of cognitive changes in older cats, which is critical for timely interventions.

Subjective signs of criminal offense provided by art. 374 of the Criminal Code of Ukraine

It is noted that in order to establish the content of the right to defense, it is necessary to examine the subjective signs of the criminal offense provided for in Art. 374 of the Criminal Code of Ukraine. It is emphasized that the subject of violation of the right to defense is special and clearly defined in Art. 374 of the Criminal Code of Ukraine - investigator, investigator, prosecutor, judge. The signs of a violation of the right to defense by a special subject have been determined. The prerequisites for the legality of a person occupying the position of inquirer, investigator, prosecutor, judge, as well as the peculiarities of the legal personality of a special subject of a criminal offense provided for in Art. 374 of the Criminal Code of Ukraine. The qualified composition of this criminal offense was analyzed. It was determined that the purpose and motive of the violation of the right to defense are not important for the qualification of a criminal offense under Art. 374 of the Criminal Code of Ukraine. It is noted that the absence of signs of a special subject in a person excludes the possibility of bringing him to criminal responsibility as the perpetrator of a crime that can be committed by a special subject, it is expedient to agree with those scientists who maintain the position that the issue of recognition of a person who is a general subject of a crime, a co-perpetrator of a crime with a special subject should be decided individually, based on specific circumstances, taking into account the specifics of the objective features (objective side) of the crime. The subject of violation of the right to protection is special, the characteristics of which are defined in Part 2 of Art. 18 of the Criminal Code of Ukraine, according to which the special subject of a criminal offense is a convicted natural person who committed a criminal offense at the age from which criminal responsibility can arise, the subject of which can only be a certain person. Taking into account the above, it can be stated that the inquirer, investigator, prosecutor, judge as special subjects are not only characterized by the features of a general subject, such as age and sanity, but also belong to persons with special legal personality - the ability of a person in to acquire a certain legal status and act as a bearer of the subjective rights and legal duties of an inquirer, investigator, prosecutor, judge.

Development of a dry eye index as a new biomarker of dry eye disease.

To evaluate signs and symptoms in patients diagnosed with dry eye disease (DED), divided into dry eye (DE) groups, in order to find a new biomarker that allows an accurate diagnosis, management and classification of DED. This cross-sectional, observational study included 71 DED subjects. Subjective symptoms, visual quality and DE signs were assessed using the Ocular Surface Disease Index (OSDI), the Quality of Vision (QoV) questionnaire, best corrected distance visual acuity (VA), functional visual acuity (FVA), contrast sensitivity (CS), high- and low-order corneal aberrations (HOA and LOA, respectively), tear break-up time (TBUT), Meibomian Gland Dysfunction (MGD), Schirmer test, corneal staining, lid wiper epitheliopathy (LWE) and meibography. Participants were classified into three groups based on dryness severity using a cluster analysis, i.e., mild (N = 17, 55.8 ± 15.4 years), moderate (N = 41, 63.5 ± 10.6 years) and severe (N = 13, 65.0 ± 12.0). A new Dry Eye Severity Index (DESI) based on ocular surface signs has been developed and its association with symptoms, visual quality and signs was assessed. Comparisons between groups were made using Kruskal-Wallis and Chi-squared tests. Spearman correlation analysis was also performed. The DESI was based on three tests for DE signs: TBUT, Schirmer test and MGD. The DESI showed significant differences between different pairs of groups: Mild Dryness versus Moderate Dryness (p < 0.001), Mild Dryness versus Severe Dryness (p < 0.001) and Moderate Dryness versus Severe Dryness (p < 0.001). The DESI was significantly correlated with age (rho = -0.30; p = 0.01), OSDI score (rho = -0.32; p = 0.007), QoV score (rho = -0.35; p = 0.003), VA (rho = -0.34; p = 0.003), FVA (rho = -0.38; p = 0.001) and CS (rho = 0.42; p < 0.001) Also, significant differences between the severity groups were found for OSDI and QoV scores, VA, FVA, CS and MGD (p < 0.05). The DESI has good performance as a biomarker for the diagnosis, classification and management of DED.

Frequency of occurrence of dry mouth in women with high risk of cardiovascular diseases during the menopause

&lt;p&gt;Among the risk factors for dry mouth, or xerostomia, are both estrogen deficiency in women during menopause and the use of medications with xerogenic properties. Until now, it has not been clearly determined, whether dryness in the oral cavity in women during menopause is only associated with subjective sensations or is accompanied by qualitative and quantitative changes in mixed saliva. To determine the frequency and nature of xerostomia syndrome in women during menopause with high and extremely high risk of cardiovascular diseases. The study involved 35 patients (with subjective sensations of dryness in the oral cavity) and 20 apparently healthy women. All study participants were questioned for any dental complaints, and the quantitative indicators of the oral fluid were assessed. An individualized oral hygiene complex and a moisturizing gel were prescribed as correction of the subjective signs of xerostomia. The follow-up visit was carried out after 1 month. The patients in natural menopause felt slight subjective manifestations of dry mouth confirmed by objective decrease in salivary secretion; whereas in most cases subjective dryness in the oral cavity is accompanied by normal secretion. The prescribed complex for correction of dental complaints ensures decrease in the subjective signs of dryness, decrease in taste distortion and halitosis.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

Diagnosis dan Tata Laksana &lt;i&gt;Mild Cognitive Impairment&lt;/i&gt; (MCI)

The number of elderly population in the world is increasing nowadays. In 2020, there were 1.4 billion people in the world aged ≥60 years and it is predicted to double by 2050. Decline in cognitive function and memory is one of the consequences of the aging process that can affect a person’s quality of life. MCI is a pathological condition also preclinical and transitional stage between normal aging and dementia. Early detection and intervention of MCI may delay onset and prevent the progressivity of MCI to dementia. This article aims to provide an overview of MCI which includes risk factors, subjective and objective clinical signs, disease course, diagnosis, and recommendation of MCI management based on existing studies and guidelines.

Тенденция к психологизации в оценке общественной опасности

&lt;p style="text-align: justify;"&gt;The article reflects the results of a study of controversial issues of assessing public danger. Conclusions are drawn about the current trend towards psychologization in the assessment of social danger, both in law enforcement practice and in expert activities in assessing the danger of a person to himself or others. The author considers psychologization as a negative phenomenon, comparable to a violation of the boundaries of the professional competence of psychologists. This phenomenon, according to the author, &amp;ldquo;erodes&amp;rdquo; the criteria for an objective assessment of social danger due to the introduced subjective signs - the danger of the person who committed the crime. The article notes that the category &amp;ldquo;public danger&amp;rdquo; is a conventional criminal law category that does not fully coincide with the generally accepted interpretation of this term. The author believes that the legislative interpretation of concepts is a priority in the research of legal psychology (as opposed to other branches of psychology) and expert practice. The article points out that from the methodological aspects, psychologization is a reduction (reduction) of the complex to the simple, a violation of the laws of logic. The tendency towards psychologization can lead to the state starting to fight not against crimes, but against persons accused of committing crimes.&lt;/p&gt;

Characteristics of the qualification of exceeding authority or official authority by a military official personal by subjective characters

The relevance of the research topic is due to the need to improve the legal regulation of the activities of military personnel in the context of the modern political, social and military situation, which requires careful consideration of issues related to their compliance with the law and the preservation of law and order. The main purpose of the study is to analyze and clarify the criteria for the legal qualification of exceeding the power or official authority of a military official on subjective grounds. Within the framework of this analysis, subjective signs of exceeding power or official authority are considered, in particular, awareness of the socially dangerous nature of the committed actions, the compliance of these actions with regulatory and legal acts, the consequences of violations and their connection with the official position. The study also considers the possibility of the emergence of an ideal set of criminal composition in case of committing several offenses in one act. The obtained conclusions will contribute to clarifying the qualification of offenses and understanding the ratio of illegal actions of a military official and their consequences. The methodological basis of the research is based on the analysis of normative legal acts, law enforcement and jurisprudential analysis, as well as on the analysis of judicial practice. The use of these methods allows for a detailed analysis of issues related to the legal qualification of the criminal offense provided for in Art. 426-1 of the Criminal Code of Ukraine. The results of the study can be useful for legislators, law enforcement agencies, military groups and judicial authorities. They will help to improve the legal regulation of the activities of military officials, ensuring the preservation of law and order and legality in this area of legal relations. The practical significance of this study also lies in the correct application of the norms of criminal legislation during the investigation of the abuse of power or official authority by a military official. In the conclusions, it is proposed to supplement Art. 426-1 of the Criminal Code of Ukraine.

Assessment of Wavefront Aberrations in Children with Myopia Against the Background of Ocular Surface Disorders in Combination with Computer Vision Syndrome Digital and Eye Strain

Purpose: to assess the state of the wavefront in children with myopia, who have various manifestations of digital eye strain and symptoms of ocular surface disorders, and to evaluate the diagnostic significance of wavefront criteria for assessing the state of the ocular surface.Patients and methods. The study involved 76 children (152 eyes) with myopia aged 8 to 18 years who used gadgets and computers for more than 2 hours a day. All patients used glasses as a method of optical correction and were constantly worn. The patients were divided into 2 groups: 1st with symptoms of ocular surface disorder, 2nd — comparison group. Subjective signs were studied using the online questionnaire “State of the ocular surface”. Using the “Keratograph 5M Oculus” the following parameters were assessed: non­invasive tear film breakup time (NTBR), including the first tear film breakup time, average tear film breakup time, breakup time gradient and maximum tear film breakup zone, the same device was used to perform infrared meibography and study of the lipid layer of the tear film. All patients underwent wavefront aberrometry in a darkened room without cycloplegia.Results. It was found that in the group of patients with the presence of subjective phenomena of disturbance of the state of the ocular surface, identified using the online questionnaire “State of the ocular surface”, rotor aberrations were statistically significantly higher than in the comparison group. At the same time, the indicators of higher­order corneal aberrations have comparable values. Correlation analysis between indicators of the state of the ocular surface and parameters of the wavefront in the group of children with disturbances of the state of the ocular surface showed that a higher level of corneal aberrations corresponds to a higher number of points on the questionnaire of disturbances of the ocular surface and the state of visual comfort, in turn, when comparing data on non­invasive tear film breakup time, a negative correlation was established, which means that with a higher number of points on the questionnaire, and therefore, with a more significant degree of impairment of the ocular surface, the tear film breakup time was shorter.Conclusion. The structure of the wavefront in children with myopia against the background of a disorder of the ocular surface in combination with CVS and digital eye strain is significantly different from the structure of the wavefront in the comparison group.

Distinguishing Crimes against Morality and Freedom of Religion from Related Elements of Crimes in the Criminal Legislation of Ukraine

The article is devoted to the study of the issue related to the qualification and distinction of crimes against morality and freedom of religion from related crimes elements of in the criminal legislation of Ukraine. The Law on Criminal Liability (Criminal Code of Ukraine) contains a number of crimes that can be related to the crime provided for in Article 178 “Damage of religious buildings or houses of worship” and 179 “Illegal retention, desecration, or destruction of religious sanctities” of the Criminal Code of Ukraine. At the same time, the ratio of adjacent elements of crimes should be distinguished from the competition of general and special norms. As part of the study, a detailed analysis of the signs established in the criminal law, in the presence of which a socially dangerous act is recognized as a crime against morality and religion in Ukrainian legislation, was conducted. By investigating objective and subjective signs, the author differentiates the elements of crimes provided for in Articles 178 and 179 of the Criminal Code of Ukraine from the elements of crimes provided for in Article 161 “Violation of equality of citizens depending on their race, nationality, regional affiliation, religious beliefs, disability, and other grounds”, 180 “Preclusion of religious ceremonies”, 297 “Violation of graves, any other burial place, or a corpse”, 298 “Illegal conduct of search works on the archaeological heritage site, devastation, destruction, or damage to cultural heritage sites” of the Criminal Code of Ukraine.

Changes in temporal lobe activation during a sound stimulation task in patients with sensorineural tinnitus: a multi-channel near-infrared spectroscopy study

BackgroundThe subjective sign of a serious pandemic in human work and life is mathematical neural tinnitus. fNIRS (functional near-infrared spectroscopy) is a new non-invasive brain imaging technology for studying the neurological activity of the human cerebral cortex. It is based on neural coupling effects. This research uses the fNIRS approach to detect differences in the neurological activity of the cerebral skin in the sound stimulation mission in order to better discriminate between the sensational neurological tinnitus.MethodsIn the fNIRS brain imaging method, 14 sensorineural tinnitus sufferers and 14 healthy controls listened to varied noise and quiet for fNIRS data collection. Linear fitting was employed in MATLAB to eliminate slow drifts during preprocessing and event-related design analysis. The false discovery rate (FDR) procedure was applied in IBM SPSS Statistics 26.0 to control the false positive rate in multiple comparison analyses.ResultsWhen the ill group and the healthy control group were stimulated by pink noise, there was a significant difference in blood oxygen concentration (P < 0.05), and the healthy control group exhibited a high activation, according to the fNIRS measurement data. The blood oxygen concentration level in the patient group was dramatically enhanced after one month of acupuncture therapy under the identical stimulation task settings, and it was favorably connected with the levels of THI and TEQ scales.ConclusionsUsing sensorineural tinnitus illness as an example, fNIRS technology has the potential to disclose future pathological study on subjective diseases throughout time. Other clinical disorders involving the temporal lobe and adjacent brain areas may also be examined, in addition to tinnitus-related brain alterations.

Lasers in Gynecology.

The first published reports on the use of laser for cervical pathology date back to 1973. Technical advancements in flexible and rigid laser fibers revolutionized video laser laparoscopy in the 1990s. Fractionated lasers have been used to treat vulvovaginal symptoms associated with genitourinary syndrome of menopause, lichen sclerosus, and urinary incontinence. Review of available data suggests that fractionated lasers can improve both subjective and objective signs of vaginal atrophy and lichen sclerosus, but the evidence is weak because most of the trials are underpowered, are at risk for bias, and lack long-term follow-up. There is no strong evidence to support fractionated laser therapy for urinary incontinence or low-level laser therapy for chronic pelvic pain. Although short-term, single-arm trials suggest benefit of fractionated laser therapy for genitourinary syndrome of menopause, lichen sclerosus, and urinary incontinence, additional adequately powered, prospective, randomized, and longer-term comparative trials are needed before lasers can be recommended for these specific conditions. The purpose of this Clinical Expert Series is to review basic laser biophysics and the mechanism of action for modern fractionated lasers as relevant to the gynecologist. We also summarize safety and effectiveness data for lasers used for some of the most commonly studied gynecologic conditions: the vulvovaginal atrophy component of genitourinary syndrome of menopause, lichen sclerosus, and urinary incontinence.

Rapid Metabolism of Monthly Extended-Release Buprenorphine Formulation: A Case Report

Background: Medication-assisted treatment constitutes the gold standard management for patients with opioid use disorder. Many factors can alter the response to medications, including genetic variations. In this case report, we discuss the presentation of a patient maintained on subcutaneous extended-release buprenorphine formulation who repeatedly presented objective and subjective signs of opioid withdrawal when he was switched from weekly to monthly formulation. We particularly highlight the role of metabolic pharmacogenes in this presentation. Case Presentation: Mr. Y, a 31-year-old single man, presented to our rehabilitation center seeking assistance for his polysubstance dependence, mainly opioid use disorder. As part of his multidisciplinary treatment plan, he was started on weekly extended-release buprenorphine. After maintenance for several months, he was transitioned to the monthly equivalent formulation. Since the transition, he began to develop severe withdrawal symptoms 1-2 weeks before his next due injection. This was paralleled by a noted decrease in buprenorphine level on his urine drug screening test. As soon as the patient was placed back on the weekly formulation, his symptoms resolved. Conclusion: This is a novel case highlighting the potential role of pharmacogenomics in clinical presentation and response to medications. Switching patients from weekly to monthly extendedrelease buprenorphine formulation might make rapid or ultra-rapid metabolizers at risk of earlyonset withdrawal symptoms. =In such a case, earlier provision of the injection or switching to another formulation or medication can be considered.

Brachial thoracic bullet wound with damage to the left atrium

Bullet wounds to the heart on the battlefield are quite rare. The victims usually die in the near future after being in[1]jured. The injuring agent most often pierces through the heart, thereby causing massive bleeding and cardiac arrest. All rare, unique cases when the wounded remained alive are associated either with the loss of kinetic energy of the injuring agent when the defeat occurs at the limit of flight range, or with a «behind the barrier» defeat when a bullet or fragment initially penetrates the «barrier» (armor, vehicle, ricochet from weapons or other solid objects, etc.). Injuries, when a bullet hits the shoulder, ricochets off the bones of the skeleton or spine and hits the heart, are found in isolated cases.In the presented clinical observation, the combatant was wounded in the left shoulder. At the stages of medical evacuation, a chest injury with heart damage and the presence of a foreign body was revealed. Initially, the wound proceeded without hemodynamic disorders, and only 36 hours after the injury, the first symptoms of a violation of the cardiovascular system appeared. As a matter of urgency, the wounded man was transferred by the intensive care team to a specialized cardiac surgery department, where emergency surgery was performed in conditions of artificial circulation. The postoperative period was smooth. The victim is currently receiving rehabilitation treatment. Heart injuries in combat conditions are highly relevant and are an extremely serious problem of the medical service at all stages of evacuation, diagnosis and treatment. The difficulties in diagnosing heart wounds are associated with the lack of the necessary hardware and diagnostic base near the line of contact and the extremely rapid development of the terminal condition. High mortality rates are due to acute cardiac disorders (cardiac tamponade, damage to the coronary arteries, massive bleeding). Subjective signs of cardiac injuries are often absent due to the admission of such a category of patients in an unconscious state. In this clinical case, timely diagnosis at the stages of medical care and interdisciplinary interaction made it possible to urgently refer a victim with a brachiothoracic bullet wound to the stage of specialized care.

Diagnostic and classification criteria of heart failure in the practice of doctors at the prehospital stage

The article deals with an overview of heart failure with an emphasis on identification criteria and models of its classification based on literary sources from the MEDLINE database on the PubMed, Web of Science, Scopus, and Google Scholar platforms. The subjective and objective signs of chronic heart failure accor­ding to the Framingham Heart Study using the methods of clinical epidemiology and presented with modern data in the international guidelines are shown. Clinical manifestations of acute heart failure in patients with myocardial infarction are outlined. In chronological order, the hemodynamic classification of heart failure is reproduced with the definition of systolic and diastolic dysfunction as markers for ranking patients in practical work. Based on the materials of international guidelines developed by the experts of the American College of Cardiology, American Heart Association, Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, the diagnostic indicators of cardiac decompensation are summarized. Given the modern perception, the diagnostic value of the left ventricular ejection fraction has been proven for determining heart failure phenotypes. The classification of heart failure of the New York Heart Association plays a significant role in determining the functional class; this was reflected in the article. Based on the provisions of international guidelines, the importance of natriuretic peptides as potential biomarkers of acute and chronic heart failure is proved. The advantages of assessing the structural and functional parameters of the heart in patients for detecting the preclinical stage of heart failure, association with clinical events and control of treatment are described. An update version of heart failure classification is presented with the identification of four stages and highlighting their characteristics. According to this classification, a relevant preventive measure is to shift the therapeutic focus to the initial stages of diseases that trigger heart failure.

Liability for Violation of the Obligation of Care in the Criminal Code of the Republic of Poland

The problem of non-fulfilment or improper fulfillment by parents (persons who replace them) of childcare responsibilities exists in all countries, regardless of the form of government, state system, and income level of the population. Ukraine has been in the process of integration with the European Union for a long time, so it is useful to study the foreign legislative approach to the regulation of responsibility for the violation of these obligations. The purpose of the article is to study the Polish experience of establishing criminal liability for non-fulfilment of child care obligations. In the research dogmatic, systemic-structural, statistical, historical-legal, formal-legal methods were used. Attention is paid to the legislation of the Republic of Poland, which provides for the right and duty of parents to care for and raise children. The genesis of the criminal law regarding responsibility for violation of these duties in the Criminal Code of 1932, 1969, and 1997 is given. Statistical data on the number of criminal proceedings and persons convicted of this criminal offense (2009–2020) are summarized. The peculiarities of the structure of the crime composition provided for in Art. 210 of the Criminal Code of the Republic of Poland were studied; objective and subjective signs. The analysis was carried out on the basis of the doctrine of Polish criminal law and the practice of courts of general jurisdiction, in particular the Supreme Court of the Republic of Poland. The practice of the Constitutional Tribunal of the Republic of Poland was used. Based on the results of the research, conclusions were formulated regarding objects of criminal law protection; objective and subjective side and subject composition. The differentiation of criminal liability in case of causing death to the victim was noted. The legislator also provided in cases of this crime the possibility of notifying the competent family court about the expediency of deprivation or limitation of parental or guardian rights in case of committing a crime to the detriment of a minor or in complicity with him. The separation of an independent structural section (subsection) in the Criminal Code of Ukraine, which includes criminal offenses against the family, as well as the improvement of criminal legal measures against persons who have committed such crimes, is supported.

484 A Preliminary Study on the Pharmacodynamics of Oral Cannabis Ingestion in Older Adults

OBJECTIVES/GOALS: Our study explores the dose-related effects of THC on cardiovascular measures, self-reported effects, balance, and cognitive function among older adults. We also evaluate the acceptability and feasibility of study procedures, to inform future study designs employing this population. METHODS/STUDY POPULATION: Using a within-subject, double-blind, placebo-controlled design and standard behavioral pharmacology methods, reasonably healthy male and female adults aged 55-70 years undergo an eligibility screening, followed by a mock session and 3 experimental sessions (&gt;7 days apart). During experimental sessions, participants are administered cannabis-infused brownies with varying THC doses. Prior to and at multiple intervals post- consumption, subjects complete assessments including self reports and observer ratings, psychomotor and cognitive performance measures, and vital signs. Follow-up interviews regarding the experience will be conducted one day after each session. RESULTS/ANTICIPATED RESULTS: We anticipate our results to mirror those of previously reported studies conducted in adults under 45 years old in that a dose-response relationship exists for subjective drug effects and vital signs with the caveat that this relationship may be exacerbated in our population. We additionally anticipate findings that indicate THC impairs balance and coordination, potentially increasing the risk of falls and accidents among this population, and cognitive function, affecting attention, memory, and executive functions. Feedback provided during the follow-up interviews will help refine procedures for future studies, ensuring that the methodology is acceptable and feasible for this population. DISCUSSION/SIGNIFICANCE: Prior work demonstrates the safety and efficacy of THC in conditions common among older adults, however, no conclusive data regarding tolerability and safety in this population exists. The presented work is vital groundwork for future research on THC as a potential therapeutic for older adults.

Unfair competition: the current state of criminalization

The subject of the study is the state of criminalization of unfair competition in the Russian Federation. The article examines the relationship of the Criminal Code of the Russian Federation with the Federal Law "On Protection of Competition", which contains prohibitions on manifestations of unfair competition; the elements of crimes provided for in art. 128.1, 146, 147, 180, 183, 185.3 and 185.6 of the Criminal Code of the Russian Federation, when analyzing objective and subjective signs of which elements of certain forms of unfair competition are seen, as well as law enforcement in the designated area; static data reflecting the current situation of identifying facts of unfair competition in the activities of the antimonopoly authority, law enforcement agencies, as well as aspects of interaction between the antimonopoly authority and the Central Bank of the Russian Federation in the field of countering market manipulation and the misuse of insider information as separate manifestations of unfair competition. The methodology of the research is based on the provisions of the doctrine of materialistic dialectics, as well as a systematic approach, in particular, general scientific and private scientific methods of cognition were used – methods of system analysis, logical, comparative, formal dogmatic method, method of legal forecasting and classification. The novelty lies in establishing the fact of the correlation of crimes provided for in art.128.1, 146, 147, 180, 183, 185.3 and 185.6 of the Criminal Code of the Russian Federation, with the prohibitions of the Federal Law "On Protection of Competition" based on the analysis of objective and subjective signs of the listed crimes, as well as the practice of sentencing in this area, in substantiating the possibility of using articles of the Criminal Code of the Russian Federation to combat manifestations of unfair competition, but also to improve criminal law norms in order to unify their content with the prohibitions of a special law. The conclusions are that the above analysis of the signs of the elements of crimes provided for in art. 128.1, 146, 147, 180, 183, 185.3 and 185.6 of the Criminal Code of the Russian Federation, indicates a certain degree of their compatibility with the prohibitions of forms of unfair competition contained in the Federal Law "On Protection of Competition", although they need to be improved. Appropriate legislative changes are advisable due to the public danger of unfair competition, the level of which may be no less than that of cartels recognized as a threat to the country's economy.