Notes

Versatile Strong Strengthening Learning-Based In-Loop Filter with regard to VVC.
Depopulation processes in Ukraine have been affected by the Chornobyl catastrophe (ChC), but therate of demographic aging of survivors remains uncertain. Although the mental health disorders of the survivors arerecognized internationally, problems of their research remain unresolved. Thus, these areas of research are relevant.Objective is to determine the rate of demographic aging of survivors of the Chornobyl NPP (ChNPP) accident and toanalyze the state of their mental health survey, outlining solutions.

Information and statistical sources for 1986-2019 of the Ministry of Health of Ukraine andthe State Statistics Service of Ukraine on the age of the ChC survivors are used. The results of previous own researchand other scientists using the data of the Clinical and Epidemiological Register (CER) of the State Institution«National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine»(NRCRM), the State Register of ChC survivors (SRU), and the Department of Radiation Psmonitoring of survivors with well-planned clinical and epidemiologicalstudies of general and mental health with reliable dosimetric support based on national registries using the latest information technologies.
Radiation accidents at the Chornobyl Nuclear Power Plant (USSR, 1986) and Fukushima-1 (Japan,2011) have shown that global environmental contamination is an intervention in normal human life making nega-tive effect on population health. These accidents highlighted a number of statutory and regulatory both with me-dical and social problems for individuals, who returned voluntarily for permanent residence in the ChornobylExclusion Zone i.e. a radiation-hazardous area (they are named the «self-settlers»).

generalization of experience in the settlement of normative-legal, ecological-dosimetric and medico-social life issues of population living in the Chornobyl NPP (ChNPP) Exclusion Zone («self-settlers»).

The chosen problem is complex, necessitating the generalization of radiation-hygienic, med-ical-biological, socio-economic, demographic and sociological research results obtained by the national and foreignauthors. A set of theoretical research and analysis of empirical data methods on the principles of inthe dose accumulated over 35 years.
The key factors identification in radiation dose formation in population of radiologically contaminatedareas of Rivne oblast in the current period of accident through comprehensive radiation and hygienic monitoring inreference settlements in 2020 and estimation of their impact on dose formation were the study objectives.

Comprehensive radiation and hygienic monitoring of settlements in Rivne oblast(province) was provided in Stare Selo, Vezhytsia, Perekhodychi, and Drozdyn villages of Rokytne district, where thehighest radiation doses were registered after the ChNPP accident. Studies were conducted in September 2020.Measurements (n=696, 318 adults, and 378 children) were performed using the whole body counters (WBC) to deter-mine the internal radiation doses. The 48 samples of milk, 45 samples of potatoes and vegetables, and 35 samplesof wild products were collected in local farms and measured for the 137Cs and 90Sr content. Residents of the studiedsettlements (n=229, 140 adults, and 89 children) were intetlements of Rivne oblast.
Annual effective radiation doses of the Rivne oblast population in 2020 were formedmainly due to internal radiation ones that not exceeded 1.24 mSv · year-1 in adults and 0.65 mSv · year-1 in childrenagainst the RCT criterion of 1 mSv · year-1. Further 1.2-1.9-fold decrease in the annual internal radiation doses vs.the results of WBC-monitoring in autumn of 2017 was registered in the surveyed settlements. The latter confirmeda time pattern of radiation levels gradual reduction at the current stage of Chornobyl accident since 2011. Intakeof 137Cs with milk and wild mushrooms, which traditionally occupy a significant part of diet in the Rivne Polissya areaand have consistently high levels of radioactive cesium contamination, remains a key factor of internal radiationdose forming in residents of the surveyed settlements of Rivne oblast.The review is devoted to the summarizing of 35 years of research of ionizing radiation exposure and radionuclidesinhalation influence on the bronchopulmonary system of clean-up workers of the Chornobyl NPP accident. Radiationand hygienic preconditions for the formation of chronic respiratory pathology are considered, taking into accountthe dosimetric data of irradiation of the bronchopulmonary system.The main clinical symptoms, features of disorders of pulmonary ventilation capacity and endoscopic forms of lesionsof the bronchopulmonary system of participants in the liquidation of the accident were determined.On the basis of pathomorphological, microbiological and immunological researches the pathomorphosis of chronicnonspecific lung diseases in the conditions of the Chernobyl catastrophe is proved.It is proved that under combined influence of external irradiation and inhalation of a fragmentary mixture ofradionuclides in the condition of the Chernobyl catastrophe, the bronchopulmonary system has become one of themain «targets»-tissues, of realization of stochastic and nonstochastic effects.
Ionizing radiation (IR) can affect the brain and the visual organ even at low doses, while provoking cognitive, emotional, behavioral, and visual disorders. We proposed to consider the brain and the visual organ as potential targets for the influence of IR with the definition of cerebro-ophthalmic relationships as the «eye-brain axis».

The present work is a narrative review of current experimental, epidemiological and clinical data on radiation cerebro-ophthalmic effects in children, individuals exposed in utero, astronauts and interventional radiologists.

The review was performed according to PRISMA guidelines by searching the abstract and scientometric databases PubMed/MEDLINE, Scopus, Web of Science, Embase, PsycINFO, Google Scholar, published from 1998 to 2021, as well as the results of manual search of peer-reviewed publications.

Epidemiological data on the effects of low doses of IR on neurodevelopment are quite contradictory, while data on clinical, neuropsychological and neurophysiological on xposure scenarios, to determine the molecular biological mechanisms of these disorders, reliable dosimetric support and taking into account the influence of non-radiation risk factors.
Results of current studies indicate the high radiosensitivity of the brain and eye in different contingents of irradiated persons. Further research is needed to clarify the nature of cerebro-ophthalmic disorders in different exposure scenarios, to determine the molecular biological mechanisms of these disorders, reliable dosimetric support and taking into account the influence of non-radiation risk factors.The review is devoted to long-term genetic and epigenetic disorders in exposed individuals and their descendants,namely to cytogenetic effects in the Chornobyl NPP accident clean-up workers and their children, DNA methylation as an epigenetic modification of human genome. Data presented in review expand the understanding of risk of the prolonged exposure for the present and future generations, which is one of key problems posed by fundamental radiation genetics and human radiobiology.The analysis of long-term researches of the pathological changes arising in soft tissues at patients with a breast cancer as a result of radical surgical treatment and adjuvant radiotherapy is carried out in work. The article shows that the standard approach to postoperative radiation therapy, which is based only on the prevalence of the primary tumor process is not always justified. Very often it leads to excessive radiation load on the patient's body and the development of local acute and chronic radiation reactions of the skin, subcutaneous tissue and other soft tissues.In this regard, the question of differentiated purpose of radiotherapy acquires special value first of all at patients with small primary prevalence of tumor process. The paper presents the results of studies to study changes in the anterior chest wall in patients with breast cancer. In relation to the conduct of adjuvant radiotherapy more often need to use the concept of personalized radiation therapy. Radical operation, post-radiation early and late pathological changes in soft tissues, disturbance of microcirculation of lymph and blood, disturbance of innervation of vessels of an upper extremity, peripheral nerves in system of a cervical and plexus plexus, leads to intensive degen-erative and dystrophic changes in soft tissues of the upper. and causes morphological changes in them and further progression of reflex neurovascular and neurodystrophic disorders. Based on the data of adverse effects of radio-therapy on the skin and surrounding tissues, as well as to reduce excessive radiation exposure to the patient's body, a differentiated approach to the appointment of adjuvant radiation therapy.Research activities and scientific advance achieved in 2020 at the State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine» (NRCRM) concerning medical problems of the Chornobyl disaster, radiation medicine, radiobiology, radiation hygiene and epidemiology in collaboration with the WHO network of medical preparedness and assistance in radiation accidents are outlined in the annual report. The report presents the results of fundamental and applied research works of the study of radiation effects and health effects of the Chornobyl accident. The report also shows the results of scientific-organizational and health care work, staff training. The Scientific Council meeting of NAMS approved the NRCRM Annual Report.
Vaso-occlusive pain leads to high acute care utilization among patients with sickle cell disease (SCD). Data suggest that clinical pathways (CPWs) reduce variation in the management of vaso-occlusive pain and improve clinical outcomes.

We implemented and evaluated a CPW for vaso-occlusive pain at our institution using a before and after study design. The primary objective was to decrease acute care utilization among patients with SCD, which was assessed by the primary outcome measures of hospital length of stay (LOS), 30-day readmission rate, and total hospitalizations annually per patient. Secondary outcome measures were packed red blood cell transfusions, and acute chest syndrome incidence. Patient-controlled analgesia use and promethazine use were assessed to estimate CPW use.

Three hundred fourty-four admissions in 112 patients were analyzed, of which 193 admissions occurred pre-CPW and 151 admissions occurred post-CPW implementation. Post-CPW implementation, we observed a significant decrease in hospital admissions annually per patient, an increase in patient-controlled analgesia use, and a decrease in intravenous promethazine use. signaling pathway We observed trends toward decreased 30-day readmission rate and increased acute chest syndrome incidence, which were not statistically significant. No effect was found on hospital LOS.

Clinical pathway implementation at our institution reduced variation in management and decreased hospital admissions for vaso-occlusive pain.
Clinical pathway implementation at our institution reduced variation in management and decreased hospital admissions for vaso-occlusive pain.
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