INTRODUCTION. Naval service is associated with extreme stress: psycho-emotional stress, isolation, adverse climatic conditions (especially in the Arctic), and hypoxia. These factors disrupt the autonomic balance, provoke a breakdown    of adaptive mechanisms, and increase the risk of developing cardiovascular and cerebrovascular pathologies. Maintaining the functional state (FS) of personnel is a key task of naval medicine. OBJECYIVE. To systematize data on compensatory-adaptive reactions of the cardiovascular, respiratory systems and cerebral hemodynamics in naval servicemen, and also to evaluate the effectiveness of methods for correcting FS in service conditions. MATERIALS AND METHODS. A systematic analysis of 48 studies (1998–2023) from PubMed, Scopus, eLibrary.ru, Web of Science, Cochrane Library, and CyberLeninka was conducted. The following keywords and their combinations in Russian and English were used: heart rate variability (HRV), capnography, marine medicine, military naval medicine, functional state, adaptation, stress, extreme environments, sailors, naval personnel, cerebral hemodynamics, rheoencephalography (REG), arctic voyage, functional state correction. Inclusion criteria: assessment of FS in sailors during expeditions; use of heart rate variability (HRV); capnography (PetCO 2 ); rheoencephalography (REG); data on the adaptation dynamics. RESULTS. The authors noted a number of patterns in changes in central and peripheral hemodynamic parameters, as well as blood gas composition. With HRV, a decrease in parasympathetic activity (RMSSD: from 43.1 to 27.2 ms; pNN50: from 4.4 to 3.2%; p < 0.05) and an increase in sympathicotonia (LF/HF: from 3.4 to 3.7 Hz; VLF: + 91% in recruits) during long hikes. In the group with FS correction (electrical stimulation, biofeedback training), vegetative balance was maintained (RMSSD = 43 ms; pNN50 = 20.3%; p = 0.01). Capnography: hypercapnia (PetCO₂ > 48 mmHg) by the end of 4-month cruises versus normalization at 2-month ones (p = 0.05). Cerebral hemodynamics (REG): decreased cerebral pulse filling by 30–40%, slower venous outflow (PVO> 30% with the norm < 20%; p = 0.015). Arctic conditions increase arterial stiffness (cfPWV + 15%; p < 0.01). Transcranial vagus nerve stimulation improves HRV (HF + 24%; p = 0.03). DISCUSSION. Based on exploratory and analytical work, promising predictors of maladaptation were identified, which include sympathicotonia (↑LF/HF, ↓RMSSD) a marker of psychoemotional stress; hypercapnia a consequence of stress-induced hypoventilation; cerebrovascular disorders (↑vascular tone, ↓RI on REG) the risk of cognitive decline. The optimal duration of flights is ≤ 2 months. Effective correction methods: biofeedback training, non-invasive stimulation nVNS, combined programs (cognitive behavioral therapy (CBT) + breathing practices). CONCLUSION. The analysis confirms that naval service, especially during long-term deployments in the Far North and Arctic, poses a complex and extreme stressor for military personnel. Therefore, a promising approach is to include measures aimed at assessing adaptive capacity (HRV + stress tests) in the candidate selection screening package; monitoring physical fitness during deployments (HRV, PetCO₂, pulse oximetry); and implementing corrective programs such as nVNS, biofeedback (BFB), and cognitive behavioral therapy. Equally important is the task of actively accumulating experience in studying the long-term effects of service in order to develop risk prediction protocols.

INTRODUCTION. The increasing demand for medical and health services from the public has brought enormous pressure to the health system, and the public health emergency will lead to an intensification of the supply-demand contradiction of medical services. OBJECTIVE. This study aimed to evaluate and explore the factors that might affect the efficiency of medical resource allocation of hospitals in Shanghai, providing reference for the medical resource management of hospitals in the public health emergency. MATERIALS AND METHODS. Data were obtained from the hospitals in a certain area of Shanghai from April to May, 2022. Data envelopment analysis was used to evaluate technical efficiency, pure technical efficiency, and scale efficiency. Tobit regression was applied to determine the independent factors affecting hospital efficiency. RESULTS. A total of 214 decision-making units were included in this study. The median values of technical efficiency, pure technical efficiency, and scale efficiency of hospitals were 0.579 (interquartile range [IQR], 0.347-0.767), 0.644 (IQR, 0.487-0.883), and 0.938 (IQR, 0.905-0.953), respectively. Tobit regression analysis indicated that the higher bed-to-nurse ratio and bed capacity (at least 2000) had a negative impact on technical efficiency. DISCUSSION. Hospitals with higher bed-to-nurse ratios tended to exhibit lower efficiency, suggesting that excessive nursing workload may hinder effective service delivery during public health emergencies. Larger bed capacity, particularly in hospitals exceeding 2000 beds, was also associated with poorer efficiency, indicating that overly large scales may limit operational responsiveness. CONCLUSIONS. Low technical efficiency is primarily attributable to poor pure technical efficiency, which can be improved through better management and organizational practices. In addition, optimizing bed allocation and maintaining an appropriate nurse-to-bed ratio can enhance allocative efficiency in hospitals. Decision-makers should consider these findings while allocating medical resources. Meanwhile, our study can also provide reference for optimizing the allocation of medical resources in the public health emergency.

INTRODUCTION. Infectious disease pathogens exhibit species diversity and genomic complexity, making their rapid and accurate combined detection a major challenge today. Microfluidic technologies, with their advantages such as miniaturization, functional integration, high throughput, and reproducibility, demonstrate enormous potential in this field. OBJECTIVE. To systematically summarize the latest advances in multifunctional microfluidic diagnostic devices, explore the feasibility of their use in the presence of multiple pathogens, as well as technical limitations and promising areas for their   clinical application. MATERIALS AND METHODS. This article reviews multifunctional detection devices based on common technological approaches such as electrochemical sensors, optical sensors, immunosensors, and paper-based microfluidic platforms, with a particular focus on innovative methods for using microfluidic nucleic acid amplification technology to improve detection sensitivity. RESULTS. Various types of microfluidic devices have significantly improved the efficiency and integration of pathogen detection. Thanks to innovative solutions, microfluidic nucleic acid amplification technology has demonstrated significant potential for optimizing sensitivity. However, cross-reactivity between analytes remains a key factor affecting the effectiveness of combined testing. DISCUSSION. Despite significant technological advances, collaborative pathogen detection still faces challenges related to the diversity, complexity, and reliability of practical applications. Future developments should focus on improving the platform’s versatility, stability, and cost-effectiveness. CONCLUSION. Multiplexed microfluidic detection technology has already achieved significant success in infectious disease diagnostics and holds broad clinical application potential. Further technological development is key to implementing these technologies into clinical practice.

INTRODUCTION. Risk tolerance is a key component of judgment and decision-making in extreme situations. Based on the results of a study of risk tolerance among military personnel between 1983 and 2015, the EVAR questionnaire is the most frequently used measure of “military risk.” Our article describes the development of a Russian-language version of the   EVAR questionnaire. OBJECTIVE. Verify the Russian version of the EVAR risk assessment questionnaire. MATERIALS AND METHODS. Two groups of young men aged 18-36 participated in the study: the main group (142 applicants to a military university) and the additional group (35 conscripts). The following methods were used: translation of the questionnaire text from English into Russian, conducting a survey using four methods (EVAR, A.G. Shmeleva’s Risk Propensity Study Shmelev’s Risk Propensity Study, the “Module” questionnaire, the “Deviance” questionnaire), determination of the psychometric characteristics of the methodology (calculation of the Alpha Cronbach coefficient, comparison of dependent samples (paired Student’s t-test), correlation analysis (Spearman’s and Student’s t-tests)), factor analysis (rotation method: varimax with Kaiser normalization), analysis of data obtained during calculations. Statistical processing was performed using IBM SPSS Statistics 27.0. RESULTS. In the study, the following indicators were obtained when calculating descriptive statistics: M(SD) risk propensity 1065.85 (179.7) points. This means that 95.4% of the data for the overall indicator is in the range of 706.5-1425.6 points. The calculations yielded data indicating the high stability of the results obtained using the EVAR methodology when reused and their relative independence from the influence of situational factors. The results also indicate good internal consistency of the prepared Russian-language version of the methodology. In confirmation of the content validity of the methodology, a statistically significant direct correlation of noticeable closeness was found between the EVAR questionnaire indicators and A.G. Shmelev’s Risk Propensity Questionnaire, and two inverse correlations of moderate closeness were found with the Modul and Deviance questionnaires. As a result of statistical processing using the principal component analysis method, seven leading components were extracted: purposefulness, leadership, infantilism, energy, impulsiveness, confidence, and courage. Based on open data, a comparison was made of the risk-taking tendencies of American, French military personnel, and Russian military academy applicants. Test norms were calculated for the Russian sample. DISCUSSION. The lower risk-taking scores in the Russian sample can be explained by the lack of combat experience, as well as by the situation of professional and psychological selection, when subjects strive to present themselves in the best light by giving socially desirable answers. The factor structure of the questionnaire described by French and American specialists was not confirmed in the Russian sample. CONCLUSION. Based on the study, a Russian-language version of the EVAR methodology was prepared and verified, which can be considered a reliable and valid psychodiagnostic tool. The reliability-consistency and retest reliability of the methodology were also proven. Factor analysis justified the validity of the identified 7-factor structure, which differs from the original French version. Content validity testing confirmed that the EVAR questionnaire assesses risk-taking tendencies.

INTRODUCTION. Donors, being at risk for developing iron deficiency, undergo pre-donation screening, including hemoglobin testing. However, hemoglobin levels do not reflect the state of iron stores, and depletion of these stores causes iron deficiency anemia. Iron deficiency anemia is a polyetiologic disorder characterized by iron deficiency in the body, caused by impaired intake, absorption, or increased losses of this micronutrient. Given that the development of iron deficiency anemia is preceded by a period of latent iron deficiency, the laboratory criteria for which include decreased red blood cell indices, serum ferritin, serum iron, decreased transferrin saturation, and an increase in serum transferrin and soluble transferrin receptors, its timely detection requires proactive measures. OBJECTIVE. To assess the risk of developing iron deficiency in donors of blood and/or its components in the age group from   18 to 65 years. MATERIALS AND METHODS. The study used biochemical and statistical research methods. To achieve this goal, a comprehensive analysis of hemogram results and serum biochemistry reflecting iron metabolism in 174 donors of blood and its components was conducted. An assessment of the risk of early iron deficiency in donors was provided. RESULTS. This article presents data from our own studies of iron metabolism in blood and blood component donors aged 18 to 65 years (median age 35 years). Hemoglobin levels at the lower limit of normal and serum ferritin thresholds (30 μg/L for male donors and 20 μg/L for female donors) were used as criteria for the risk of developing iron deficiency. Among men, those at risk for developing iron deficiency included donors who donated blood more than three times within 12 months or had a total of more than ten donations, and donors with hemoglobin levels at the lower limit of normal. Among women, those at risk included donors who donated blood more than twice within 12 months or had a total of two to six donations. In these women, ferritin levels should be monitored, and a decrease below reference values should be considered latent iron deficiency. The observed decrease in serum ferritin concentration after the second blood donation in female donors, followed by a significant decrease below the reference range and by the tenth donation in men, serves as the basis for determining ferritin during donor examination. DISCUSSION. An analysis of the results of testing 174 donors revealed a relatively high incidence of iron deficiency in individuals at risk, suggesting the feasibility of implementing new approaches to existing donor laboratory testing standards at the blood transfusion department level, with the potential for further expansion of pre-donation laboratory testing. When assessing donors for donation, consideration should be given not only to hemoglobin levels, but also to laboratory testing of donors to determine tissue iron stores. CONCLUSION. A significant proportion of the examined donors showed signs of iron deficiency and were at risk for developing anemia. As donor experience increases, the incidence of iron deficiency in the examined donor group increases, necessitating the development of a system for the prevention and correction of iron metabolism disorders to preserve donor health.

OBJECTIVE. To study from a psychological point of view the results of military personnel’s participation in combat operations and the elimination of the consequences of emergency situations. MATERIALS AND METHODS. A comprehensive psychological assessment was conducted on 243 employees of the Russian Ministry of Internal Affairs and 219 employees of the Russian Ministry of Civil Defense, Emergencies, and Elimination of Consequences of Natural Disasters. Social characteristics, combat experience, emergency response, health status, and morbidity were analyzed. The following methods were used: the Luscher personality test, the standardized multifactorial personality test, I. O. Kotenev’s Traumatic Stress Inventory for the Diagnosis of Psychological Consequences, and R. Cattell’s 16-factor personality questionnaire. Structural equation modeling was also applied. RESULTS. Structural equation modeling was used to construct structural models of directional (cause-and-effect) relationships between dynamic exogenous variables and psychological personality traits in employees engaged in extreme occupations. These traits determine the occurrence and severity of post-traumatic stress disorder, its individual symptoms, and the frequency and duration of temporary disability. The types of psychological and somatic consequences of exposure to high-intensity stressors of varying complexity and duration on employees in extreme occupations manifest themselves in pre-clinical forms (constructive-adaptive, unstable-adaptive, and borderline), reflecting various stages in the continuum Mental Health – Intermediate Forms of Mental Health – Psychopathology. DISCUSSION. Both combatants and firefighters experience similar spectrums of psychological consequences associated with exposure to traumatic stressors. Continued combat activity causes a deterioration in mental health, while increased firefighting experience leads to improved mental health and enhanced adaptation. CONCLUSION. The obtained results significantly complement and specify the data on the psychological consequences of traumatic stress available in foreign and domestic scientific literature.

OBJECTIVE. An analysis of the circumstances and causes of injuries among military personnel of the Armed Forces of the Russian Federation (RF) in peacetime (2013–2021), knowledge of which will help prevent (minimize) injury rates. MATERIALS AND METHODS. Sections of reports on form 3/MED for 9 years have been worked out: from 2013 to 2021 (peacetime) and published collections “Health indicators of military personnel of the Armed Forces of the Russian Federation”. RESULTS. A study of the circumstances of receiving injuries allowed us to determine that 35.8% of the recorded injuries occurred off-duty, 20.3% during combat training, including 11.5% during physical training and sports, 7.4% and 1.2% during economic and construction work, respectively, 5.7% while on duty, 4.5% while operating weapons and military equipment, 2.4% while on combat duty, and 22.7% under other circumstances. The causes of injuries in 64.6% of cases were personal carelessness (psychophysiological characteristics), in 10.1% violation of safety requirements, in 4.2% traffic regulations, in 2.6% rules of statutory relationships, in 2.5% the procedure for organizing a type of activity, production of work, in 15.8% other reasons. CONCLUSION. An analysis of injuries involving a wide range of specialists, the identified indicators of the circumstances and causes of injuries will help prevent (minimize) injuries to military personnel in their daily activities in peacetime.

INTRODUCTION. The World Health Organization (WHO) ranks ground-level ozone as the second most dangerous atmospheric pollutant to human health. Its concentration must be monitored when determining air quality. This is especially important in southern regions, where conditions favour its formation in elevated concentrations. While the link between ozone exposure and respiratory diseases is well established, the evidence regarding cardiovascular diseases is controversial. OBJECTIVE. To determine the role of ground-level ozone as a possible risk factor in the occurrence of emergency conditions of the hemodynamic system of residents in the territory of the Southern Coast of Crimea. MATERIALS AND METHODS. A study was conducted on the daily registration of emergency medical services (EMS) calls due to cardiovascular emergencies, based on data from the Unified Crimean Republican Territorial Center for Emergency Care of the Ministry of Health of the Republic of Crimea for the period 2018–2022, and ground-level ozone concentrations (GLO) based on data from the Karadag station of background environmental monitoring (SBEM). GLO measurements were performed optically using an APOA 370 automatic gas analyzer (HORIBA); the dependence of the compared data was analyzed using nonparametric Spearman correlation analysis. RESULTS. During the study period, the ozone depletion level on the Black Sea coast of Crimea exhibited typical daily and seasonal fluctuations, reaching maximum values in the summer months and daytime hours. However, atypical increases in ozone depletion were also observed during cold or cool seasons: for example, in January 2019 and December 2022. Average annual ozone concentrations generally exceeded the standard values. Positive significant correlations were observed between ozone depletion and the incidence of cardiovascular emergencies in February 2019, 2020, and 2022, March 2022, and April 2020. Negative correlations were found in September 2018 and 2022, May 2019, and January 2022. Moreover, if minimum ozone concentrations were at least 40 μg/m³ and rose to 100 μg/m³ during the month, their increase led to an increase in the number of emergency calls. If minimum ozone concentrations were within 15–20 μg/m³ and did not exceed 50–60 mg/m³ during the month, a negative relationship between the number of calls and ozone concentrations was observed, indicating a nonlinear nature. DISCUSSION. The data obtained establishing the significance of ozone for the functioning of the cardiovascular system in the coastal area of Crimea are consistent with a number of scientific publications, including those on the multidirectional nature of the identified relationship, which may indicate either a delayed response to increased ozone or its nonlinear nature. The indirect influence of other meteorological and anthropogenic factors may play a significant role in the final effect of ozone, which likely explains often the controversial nature of epidemiological data obtained in different regions of the world. CONCLUSION. Analysis of emergency medical service data on the dependence of the incidence of cardiovascular emergencies on the ozone level provides grounds for considering ground-level ozone as a risk factor for cardiac patients, but its ambiguous nature requires further research to determine its dangerous/safe levels in a region such as the Black Sea coast of Russia.

INTRODUCTION. With the increasing intensity and diversity of emergency situations faced by law enforcement personnel, ensuring effective and continuous medical support is becoming a priority for departmental healthcare. Current medical care mechanisms often fail to meet the requirements of efficiency, mobility, and interdepartmental coordination. The lack of digital solutions, insufficient equipment, and staffing shortages exacerbate the system’s vulnerability in an unstable operational environment. This necessitates a strategic rethinking of the organizational, personnel, and technological foundations for medical care delivery within the Russian Ministry of Internal Affairs. OBJECTIVE. Identification of priority areas for improving the system of medical support for employees of the internal affairs bodies of the Russian Federation in emergency situations of professional activity based on an analysis of the opinions of the heads of departmental medical organizations using text data clustering methods. MATERIALS AND METHODS. The empirical basis of the study consisted of the results of a questionnaire survey of 408 heads of departmental medical institutions of the Ministry of Internal Affairs of Russia. The geographic coverage included all federal districts, ensuring a representative sample. The survey included 13 questions, including open-ended ones, subject to semantic analysis. Intelligent text processing methods were used: TF-IDF vectorization, K-Means clustering, lemmatization, stop word removal, PCA visualization, and cosine similarity calculation. Quantitative data were analyzed using descriptive statistics. The volume of analyzed texts was 408 open-ended responses; the data collection period was October–November 2024. Key words for semantic processing included: digitalization, emergency assistance, training, logistics, tactical medicine, etc. RESULTS. An analysis of the questionnaires revealed three key conceptual clusters: 1) digitalization and telemedicine; 2) organizational and resource support; 3) training of medical personnel, including tactical medicine. Among the main problems, respondents identified the lack of a systematic approach (32.8%), a shortage of personnel training (29.9%), and poor drug provision (27.2%). Equipment modernization was supported by 87.9% of respondents, the need to create a unified information system by 67.7%, and emergency care reform by 65%. A persistent desire for systemic transformation in the digital, organizational, and educational areas was revealed. DISCUSSION. The obtained results confirm the presence of persistent problems previously noted in the studies of A. P. Ovcharenko et al. (2023), E. G. Ichitovkina et al. (2025), P. E. Krainyukov et al. (2021). According to international data (B. Hogan et al., 2020; WHO, 2020), the high significance of digital solutions and telemedicine was revealed. Domestic studies emphasize the importance of training a new type of specialists: management-oriented, proficient in tactical medicine. The interdisciplinary nature of the problems is confirmed by a moderate overlap of topics between clusters. This reflects the maturity of the respondents’ management thinking and the system’s potential for comprehensive transformation. CONCLUSION. The study revealed a high level of management awareness of the problems and a clearly formulated demand for strategic modernization of the Russian Ministry of Internal Affairs’ departmental healthcare system. Key areas of focus include digitalization, development of tactical medicine, and improved emergency logistics. The findings can be used as the basis for programmatic and regulatory decisions as part of a systemic reform of medical support for police officers in emergency situations.

INTRODUCTION. The study presents the evaluation results the functioning of the ICLMed mobile telemedicine complex on board the hospital ship Irtysh during a special research exercise in the Pacific Fleet in 2025. The parameters of communication stability, weather and tactical conditions are analyzed, and a comparison is made with a fully functional stationary telemedicine complex.   OBJECTIVE. To evaluate the technical stability, functional characteristics and operational suitability of the ICLMed mobile telemedicine complex on board a hospital ship under sea navigation conditions. MATERIALS AND METHODS. The study included data from 84 telemedicine sessions conducted aboard the hospital   ship Irtysh during its voyage. Weather conditions, course, wave conditions, signal strength (SNR), connection stability, and subjective assessment of connection quality on a 6-point scale were taken into account. Descriptive and comparative statistical analyses were performed, including the paired Student’s t-test and Kendall’s coefficient of concordance. RESULTS. 84 telemedicine sessions conducted on board a hospital ship were analyzed; 83 (98.8%) of these were successful with an average SNR of 6.9 dB (median 7.2 dB). The only failure was recorded when the ship was moored in dense fog and possible antenna shielding. A qualimetric assessment revealed statistically significant differences between the mobile (4.18 points) and stationary (7.33 points) telemedicine systems for 10 of the 12 parameters. Kendall’s concordance coefficients (W = 0.71 and W = 0.75) indicate agreement between the expert assessments. The mobile system demonstrated advantages in such parameters as compactness, modularity, and control of diagnostic equipment. DISCUSSION. The mobile complex’s use confirmed its sustainability and technical readiness for use at sea. Limitations were related to incomplete equipment and weather conditions. The potential for scaling and adapting the complex with additional equipment was revealed. CONCLUSION. The ICLMed mobile telemedicine system can be effectively used at sea with trained personnel and additional equipment. The study’s results confirm the importance of developing maritime telemedicine and improving the technical capabilities of mobile systems.

INTRODUCTION. Marine equipment operators are susceptible to the negative effects of prolonged sedentary work, which can strain the musculoskeletal system. This static position places constant strain on the spine, causing pain, poor posture, and reduced blood flow to the brain. To prevent and address these issues, V. S. Kostanbaev’s team developed the Gravislider-Mini device, which provides gentle spinal traction under the patient’s own weight. The device is equipped with a special carriage with a headrest, allowing for comfortable head positioning and preventing injury. Despite growing scientific interest in the positive effects of this method on the body, no specific study has been conducted on marine equipment operators. OBJECTIVE. To study the effects of spinal traction on the functional state of marine equipment operators. MATERIALS AND METHODS. A controlled, randomized study of the functional status of marine equipment operators (n = 60) was conducted. A multiparametric analysis method was used, including ECG, stabilometry, psychophysiology,   and the SAN questionnaire. Marine equipment operators worked on simulators for 4 hours and were examined after their shift and the following morning. The study group (n = 36) underwent spinal traction (Gravislider-Mini) for 30 minutes, while the control group (n = 24) did not. Statistics were processed using IBM SPSS v23 using MANCOVA and ANCOVA. The interaction of factors (“Group” × “Study Number”) and the effect of age were examined. Age-adjusted marginal means are presented. Significance criterion: p < 0.05. RESULTS. The analysis showed a significant influence of the “Group” factor on the visual analyzer (V = 0.293; F = 4.385; p < 0.001), especially in the aspects of accommodation and visual acuity (η² = 0.147–0.140; p < 0.01). “Age” turned out to be the most important factor, which explained 34.6% of the variance and negatively affected the accommodative volume and lability (r < 0; η² = 0.228–0.086; p ≤ 0.024). Statokinetic parameters depend on the “Group” factor (V = 0.224; F = 2.020; p = 0.071) mainly through body deviations in the frontal plane (F = 5.026; p = 0.029; η² = 0.084), which increase after the working day (T = 2.508; p = 0.015). Psychophysiological parameters demonstrate significant intergroup differences (V = 0.449; F = 3.749; p < 0.001), with the best parameters being observed in the spinal traction group (η² = 0.126–0.115;   p < 0.01). Heart rate variability changes significantly under the influence of the combination of study number and group (V = 0.689; F = 3.371; p < 0.001); Age plays a leading role (58.9%). Vascular system parameters weakly correlate with these factors, but small changes in the frontal rheographic index were revealed (F = 5.124; p = 0.027; η² = 0.082). DISCUSSION. The data obtained demonstrate an improvement in the functional state of the participants who underwent spinal traction: decreased tension in regulatory mechanisms, increased parasympathetic activity, reduced stress, and accelerated recovery. The control group, on the other hand, showed increased cortical arousal and impaired recovery processes after exercise. The study confirmed stabilization of physiological parameters after the procedure, improved coordination, and improved performance. These results are consistent with previous studies, emphasizing the importance of a personalized approach to fatigue prevention and improved work performance. CONCLUSION. The study demonstrated the positive impact of gentle spinal traction on the functional status of marine equipment operators. Improvements in statokinetics, brain balance, frontal cerebral blood flow, and cardiovascular parameters were noted. Multivariate statistical methods excluded age-related factors, confirming the method’s effectiveness. Based on the obtained results, spinal traction can be considered as a means of preventing the early development of degenerative diseases and improving the performance of naval personnel.

OBJECTIVE. To evaluate the nature of postmortem facial features in the corpses of people with signs of fatal general cold injury. MATERIALS AND METHODS. 152 archival reports of forensic experts and 357 photographs of people who died from severe general hypothermia for the period from 1983 to 2023 were studied, and relevant literature on the issue of posthumous changes in the appearance of the deceased in forensic practice was summarized. RESULTS. The authors studied, analyzed, and disclosed reliable external postmortem characteristics of changes in the face, torso, limbs, and death postures of those who died from cold: signs of adynamia, disorientation, changes in the nails during terminal premortem “self-burial” in an attempt to dig a hole; chapping, chills, and frostbite of the facial skin; various characteristic facial grimaces with an expression of horror, surprise, and suffering; detection of “paradoxical undressing”; tightly compressed lips and trismus of the lower jaw. Based on external data, it is possible to determine a person’s condition preceding death from cold, the rate of cooling, and the duration of the dying process. DISCUSSION. Convulsive grimaces and postures are a manifestation of a general spastic syndrome that rapidly develops during the death of a person in extreme physical conditions, accompanied by strong emotions and significant muscle spasms and cramps during acute deep accidental hypothermia. CONCLUSION. The study results allow us to expand the diagnostic complex of fatal general cold injury due to an additional group of signs associated with the assessment of postmortem external changes in the face, torso and limbs of the deceased.

INTRODUCTION. Maritime terrorism poses a particular threat to international security, complicated by the high likelihood of medical consequences and limited medical response capabilities in port and shipboard environments. Despite the existence of descriptive studies, there have been no studies to date that utilize multivariate analysis and clustering methods to identify typical scenarios that take into account sanitary and irreversible losses. OBJECTIVE. To identify stable clusters of maritime terrorist attacks with non-zero losses based on a set of method-means-object characteristics and characterize their destructive potential for the purposes of disaster medicine. MATERIALS AND METHODS. The study was conducted using the GTD (Global Terrorism Database), which includes 209,707 terrorist attacks from 1970 to 2020. Of these, 69,772 terrorist attacks were identified, and 35,591 attacks with ≥ 1 fatality were selected using keywords. The analysis used normalization, logarithmic loss transformation, one-hot encoding of categorical features, and standardization. Clustering was performed using the squared means method, and the optimal number of clusters was selected based on the silhouette coefficient, Kalinski–Harabas, and Davis–Bouldin indices. The results were interpreted using PCA visualizations and distribution profiles. RESULTS. Three stable clusters were identified. The first (high-risk) is characterized by the predominance of explosives, a focus on private individuals, military personnel, and police, and the highest health consequences (median: 9 killed and 15 injured per event; percentile (p) 90–32 killed and 52 injured). The second cluster includes predominantly low-yield explosive attacks; the third includes armed attacks on security forces with moderate consequences. The peak of activity was recorded in 2013–2016, when the proportion of high-risk incidents reached its maximum values. DICUSSION. The obtained results confirm the heterogeneity of maritime terrorism and allow us to identify three qualitatively different threat regimes. Medical consequences range from isolated injuries to mass casualties requiring triage and evacuation. The cluster approach provides a basis for developing medical response scenarios, with an emphasis on preparedness for catastrophic events involving explosive hazards. CONCLUSION. The proposed methodological approach expands the analytical framework for maritime terrorism research, enabling a transition from descriptive characteristics to a reproducible classification of terrorist attacks by risk profile. This creates a practical basis for planning medical support, allocating resources, and improving the regulatory framework in maritime security.

INTRODUCTION. In the practice of self-assessment of the state of sailors and athletes, a well-proven simple and informative test “SAN” (“Well-being, Activity, Mood”) is often used, which does not require a lot of time for its implementation, but allows indirectly (qualitatively and quantitatively) to characterize the severity and development of asthenic reactions (the appearance of fatigue) at certain stages of the study. OBJECTIVE. Analysis of some aspects of the application of the self-assessment card “SAN” and research opportunities in describing the results of its application. MATERIALS AND METHODS. This article examines issues related to the use of the widely used “Well-Being, Activity, and Mood” questionnaire. The authors use practical examples to examine possible approaches to assessing scoring scales, as well as the test card as a multi-criteria task. RESULTS. The article presents solutions to this multi-criteria diagnostic problem based on vector algebra, a generalized criterion, structural analysis, and the Harrington function. DISCUSSION. The use of these methods in modeling the experiment allows for a more objective assessment of the level of self-assessment of the state of the subject, and also for an objective ranking of observations, both in the assessed group and in the dynamics at the stages of the experiment. CONCLUSION. The SAN self-assessment test has some features that are currently not considered but influence the final assessment of test results. Applying a vector approach to the SAN test may yield more objective diagnostic information when analyzing its results.

Epidemiological patterns of infectious disease spread in small, closed groups and isolated communities are crucial for understanding the specifics of medical care for workers on board ships. This case of a cluster of COVID-19 cases among the crew of an ocean-going merchant vessel reveals the limitations of current knowledge regarding the epidemiological patterns of the spread of this dangerous infection, demonstrates the tentativeness of known markers of human resistance to SARS-CoV-2 infection, and confirms the importance of quarantine and restrictive measures in preventing the spread of the coronavirus.