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Diagnostics and correction of disregulation states by physical methods

Description

Nicolaus Copernicus University, Toruń, Poland

Ukrainian Research Institute for Medicine of Transport,

Odesa, Ukraine

 

 

Gorsha O. V., Gorsha V. I.

 

 

Diagnostics and correction

of disregulation states

by physical methods

 

Горша О. В., Горша В. И.

 

Диагностика и коррекция физическими методами дизрегуляторных состояний

 

 

 

 

 

 

 

Toruń, Odesa

2017

 

 

Nicolaus Copernicus University, Toruń, Poland

Ukrainian Research Institute for Medicine of Transport,

Odesa, Ukraine

 

 

Gorsha O. V., Gorsha V. I.

 

 

Diagnostics and correction

of disregulation states

by physical methods

 

Горша О. В., Горша В. И.

 

Диагностика и коррекция физическими методами дизрегуляторных состояний

 

 

 

 

 

 

 

Toruń, Odesa

2017

 

 

Gorsha O. V., Gorsha V. I. Diagnostics and correction of disregulation states by physical methods. Nicolaus Copernicus University, Toruń, Poland, Ukrainian Research Institute for Medicine of Transport, Odesa, Ukraine. 2017. 80 p. Bibliography of 86 items. ISBN 9781387266524. DOI http://dx.doi.org/10.5281/zenodo.1000404

PBN Poland https://pbn.nauka.gov.pl/sedno-webapp/works/832669

 

Reviewers:

dr hab. M. Napierała (Poland)

dr hab. W. Zukow (Poland)

 

 

The monograph is devoted to the diagnosis and medical correction of dysregulatory states which are often premorbid period of many diseases and can cause life-threatening conditions, the prevention of which is especially important for representatives of operator occupations.

This monograph presents the results of own researches - overall results of decade-long following.

© The Author(s) 2017.

This monograph is published with Open Access.

Open Access This articles is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

 

Attribution — You must attribute the work in the manner specified by the author or licensor (but not in any way that suggests that they endorse you or your use of the work). Noncommercial — You may not use this work for commercial purposes. Share Alike — If you alter, transform, or build upon this work, you may distribute the resulting work only under the same or similar license to this one.

Zawartość jest objęta licencją Creative Commons Uznanie autorstwa-Użycie niekomercyjne-Na tych samych warunkach 4.0

 

ISBN 9781387266524

DOI http://dx.doi.org/10.5281/zenodo.1000404

PBN Poland https://pbn.nauka.gov.pl/sedno-webapp/works/832669

 

Nicolaus Copernicus University, Toruń, Poland

Str. Lwowska 1, 87-100 Toruń, Poland

www.umk.pl

 

80 p. Number of characters: 130 000 (with abstracts). Number of images: 10 x 1000 characters (lump sum) = 10 000 characters.

Total: Number of characters: 140 000 (with abstracts, summaries and graphics) = 3,5 sheet publications.

 

 

 

FOREWORD

 

In connection with the global implications of technological and social disasters (mainly due to “human factor”), the relevance of the creation of the screening premorbid diagnostic, the evaluation of professional adaptation with a further corrective rehabilitation influence cannot be overestimated. Along with that, the modern realities are the deepening of political and socio-economic problems in Ukraine and progressive crisis in the world and they require not only the creation of high-tech, but also they need more accessible diacritical and reconstructive medical technologies.

The monograph is devoted to the diagnosis and medical correction of dysregulatory states which are often premorbid period of many diseases and can cause life-threatening conditions, the prevention of which is especially important for representatives of operator occupations.

This monograph presents the results of own researches - overall results of decade-long following.

The fragment of the work, presented to your attention, of course, displays a wide range of possible diagnostic and correctional and rehabilitation approaches in dysregulating conditions only sectorally, but, we hope that it will be the beginning of the next phase of development of this direction. 

 

 

GORSHA OKSANA VIKTOROVNA

Chief scientific officer,

  Head of clinical Department of medical rehabilitation,

 State enterprise "Ukrainian research Institute of t

ransport medicine, Ministry health of Ukraine"

                                             Doctor of medical Sciences

 

 

 

 

 

 

INTRODUCTION

 

One of the important problems of modern medicine are research in the field of "medicine of the healthy person”, including analysis of negative influence of factors of industrial environment, studying of adaptation of organism, the formation of the intermediate functional states in the complicated conditions of the living environment and activities [1-6].

Within learning of intermediate functional states of the organism, the study of pathogenetic mechanisms of development of dysregulation and the understanding of their biological significance are crucial [5, 6, 7-10].

Special aspects of any dysregulation is the reduction of adaptation (or increasing of its price) and dysfunction of metabolic processes, which is manifested by the decrease of their variability and standardization of the underlying exchange mechanisms, but simplification of regulation is the path to dysregulation [11-19]. That is why, there are a few parameters as a somatic realization of dysregulatory state, primarily they are the autonomic dysfunction and disorders of biochemical stress continuum [1, 20-25].

In our researches we decided to study the functional and biochemical regulatory mechanisms of professional adaptation of transport operators to the effects of chronic informative stress by way of developing diagnostic criteria of objectification emerging dysregulatory states and pathogenetic substantiation of methodological approaches to their medical correction [8, 16, 20, 21, 26-34].

It is known that prenosological diagnostic requires higher medical experience, financial and time costs, as well as realization of extensive scientific and practical researches [1, 4, 5, 35, 36]. Apparently, this is the reason of ever-deepening crisis of preventive direction of our medicine and a similar trend we can see around the world. However, the identification and timely correction of intermediate functional states can prevent the formation of disease and syncope, which is especially important for representatives of the operator professions because degradation of their health may cause emergency situations [4, 37-40].

Over the past year in Ukraine there were recorded 153205 accidents, it means that every day there are almost 420 cases. The statistic of accidents with victims is also disappointing – there are 26160 cases in which 32352 4464 person were injured and killed, so there are correspondingly 89 and 12 person per day [41]. Among the causes of accidents leading place is taken by the "human factor" [39, 41, 42]. And at the same time, from all categories of transport operators, the group of drivers remains to the poorest category as to health and preventive supervision [39, 43-45].

According to the literature, professional activity of drivers associated with the impact on their body with a number of adverse factors [19, 39, 43-49], but the main component in a complex of production factors which are characteristic of this profession is high neuro-emotional overload [4, 39, 42, 43, 45, 46, 50].

The high voltage level of the labour of representatives of the operator professions create the preconditions for increasing the level of psychoemotional tension, which may go beyond adaptive system and accompanied by, in particular, disorders of the autonomic and biochemical regulation [8, 16, 20, 21, 46, 26-34]. The mechanism of transformation of psycho-emotional stress in the disease is complicated and requires subsequent in-depth study. In addition, the influence of age and experience of drivers on their health and professional characteristics is evident, however, in the available literature, the relevant data are rather contradictory [46, 51, 52, 48].

The limited use of many medications by individuals of transport operators professions should also be noted (particularly sedatives, antihistamines and other means), it happens due to the declining ability to respond rapidly to emergency situations [8, 27-29, 44]. The feasibility of reducing of drug component at premorbid stages of disease also necessitates the involvement and pre-formed physical factors in the complexes of their medical correction [8, 27-29, 45, 53].

Continuity between the diagnostic and remediation technology is a key issue, especially in preventive medicine, while only subject feedback and pathogenetic approach can ensure the elimination of violations and prevent them[27-29, 45, 54, 55].

Thus, in the basis of the research, the results of which we present to your attention, we put the development of a comprehensive system of prenosological diagnosis of dysregulatory states of the representatives of the operator professions (drivers) and methodological principles of corrective rehabilitation effect those are based on studying of additional pathogenetic mechanisms of dysregulation.

 

 

 

 

CONCLUSION

 

According to WHO about 1.3 million people are killed in the world every year in automobile accidents [41]. Among the causes of emergencies leading place is taken by 'the human factor', and the transport sector is among the most threatened in their creation [42, 39, 41].

However, along with increasing relevance of interventions in time to install and fix the deterioration of the health carrier of the number, and the population in general, we have to admit the decline of the preventive direction of medicine [56].

According to the sanitary-hygienic studies, including employees ' DP 'Ukrainian research Institute of transport medicine' – the conditions of the operator's labor lead to a negative impact on the body of an employee of the complex of adverse factors [19, 39, 43-49]. Among them special place takes informational stress (as operator activity associated with information overload combined with a lack of time or lack of information in conditions of high motivation of behavior) [4, 9, 16, 64, 67].

Giving psychophysiological characteristics of the working conditions of the driver (which relates to the operator's contingent), most authors emphasize that this profession requires simultaneous tracking of the real enough dynamic environment outside the cabin and vehicle control, fast and accurate response to the sudden appearance of new objects in the peripheral visual field [39, 44, 45, 48, 49, 62]. Such neuro-emotional stress sharply increases the likelihood of diseases of the nervous system, heart and vessels, up to disabling or fatal outcomes. Lack of exercise, feeding disorders, shift work, adverse physical and chemical factors of the working environment aggravated the negative effect of psycho-emotional stress [44, 46, 48, 51-53].

In view of the above – the influence of adverse working conditions on the health of operators of transport (including vehicle drivers) should also be considered from the standpoint of the role of acute and chronic stress. Adverse production factors (mainly factors of informational stress), causing a nonspecific adaptive response of the organism and leading to stress, reducing its capacity can be considered as etio-forming factors and dysregulation from the margin of the body's adaptation reserve, depends on the time reversibility of the results of their effects on the body [5, 7, 25, 28, 40].

Mechanisms and systems of humoral and autonomic regulation provide a measure of activation of processes of self-regulation of the activities of the functional systems of the body, the violation of which forms the substrate dysregulation pathology [1, 20-25]. That is why, as main markers dysregulatory states, we studied the metabolic state of biochemical stress continuum, autonomic regulation and the character of nonspecific adaptive reactions.

The term 'dysregulatory state' we used in our works to refer to intermediate states of health, with the basis of the violation of the hierarchical mechanisms of regulation and the permanent current (unlike dysregulation syndrome). Also, in addition to violations of the regulatory mechanisms there is h a landmark character of the formation and accumulation of changes in dysregulatory states that through the mechanisms of sanogenesis transferred to pathogenic. I.e., dysregulatory states have a progressive (but potentially reversible) nature with possible transformation in dysregulation pathology [8, 16, 20, 21, 26-34].

Thus, the basis of the presented to your attention study was supposed rationale for an integrated system of prenosological diagnosis based on the study of additional pathogenic mechanisms for the formation of dysregulatory conditions in the operator's contingent of professional drivers of transport (depending on the length of their seniority and age) and corrective rehabilitation therapy. Depending on the vegetative, humoral and hormonal-metabolic disorders, disorders of adaptive reactions were established and systematized the criteria for identifying dysregulatory states and developed a comprehensive rehabilitation techniques of differentiated medical correction.

In the Department of rehabilitation state enterprise "Ukrainian research Institute for medicine of transport" of Ukrainian Ministry of health in the period 2005-2014, we examined 330 drivers of sanitation and urban transport in the city of Odessa, with professional experience more than 10 years [28]. Depending on the age and duration of service, the contingent was divided into three representative experience-age group (criteria described above). The control group consisted of 28 almost healthy persons of similar age, other occupational categories.

The carried out research showed that under the influence of adverse factors of production environment (primarily – chronic informational stress) operators of transport develops complex of progressive dysregulatory disorders.

Persons have been examined the imbalance of synthesis-exchange-selection is investigated humoral-hormonal and metabolic regulation systems (nitric oxide, total catecholamines, uric acid), which correlated with the duration of their professional experience. If experience is from 10-15 years it was noted the intensification of metabolism of uric acid and nitrite simultaneously increasing their excretion and accumulation of total catecholamines in the blood, this phenomenon is intensified when experience is more than 15-20 years. Increase experience more than 25-30 years was accompanied by accumulation of uric acid and nitrite and lower levels of total catecholamines blood.

Patients were also recorded the stage of disturbances of autonomic homeostasis, correlated with work experience: if experience is 10-15 years, there was the activation of both divisions of the ANS, which is enhanced as the work experience of more than 16-20 years; the professional experience over 25 years has been accompanied by an imbalance of activity of divisions of the ANS (predominance of parasympathetic tone of the and a decrease in the tonic influence of the sympathetic nervous system). The depletion of the mobilizing effects of the sympathetic division of the ANS, along with impaired humoral mechanisms of regulation contribute to the acquisition of a resistant nature dysregulatory disorders of drivers with professional experience of more than 25 years. Moreover, in the control group and according to the literature the nature of involutive changes of HRV indexes has the opposite character with increasing age, there is a decrease in parasympathetic influences and sympathetic.

The results of the study of autonomic homeostasis in the study of sympathetic skin reflex according to electropunctural diagnostic and indicators of heart rate variability according сardiointervalography of vehicle drivers depending on the age and professional experience has shown that a high level of efferent vagal activity is a protective compensatory response of the neuroendocrine mechanisms of regulation for a long (from 10 to 25 years) actions together adverse occupational factors, which on the background of the depletion of the galvanizing influence of the sympathetic division of the ANS takes on the character of dysregulation and becomes resistant relatively to drivers which professional experience is more than 25-30 years.

The study of general adaptive reactions of the organism found in 63% of cases the prevalence of adaptive reactions of a pathological nature (reaction 'reactivated', 'acute stress' and 'chronic stress'), and a favorable adaptive response ('training', and 'activation') in 87.5% of cases had signs of inferiority, which indicates the voltage of adaptive resources.

Comparison of adaptive responses of leucogram according to the classification of the functional states of the organism according to R. M. Baevsky has allowed to establish that general adaptive reactions of the organism that characterize the intensification and stress adaptation processes, often recorded down to individuals way with experience from 10 to 15 years. Among drivers whose with 16 to 20 years of experience along with the reactions of stress a sharp increase in the ratio of reactions of reduction of adaptation. Breakdown of adaptation according to the characteristics of leukogram stated most often down to people with the most experience from 21-30 years.

Morphological studies showed that the structural basis of dysregulatory disorders down to drivers way with professional experience more than 10 years changes in the cerebral cortex in the manifestations of encephalopathy: ganglion cell rarefactions and deposition, lysis chromatopelma substance of neurons, the phenomenon of satellitosis and neuronophagia, inhomogeneity of gliocytes, paresis or spasm of the vessels of the ICR.

Thus, the study has allowed to establish that the transport operators with professional experience more than 10 years found changes in physiological regulatory mechanisms due to long and intensive exposure to adverse production factors and not only of involutional transformations. The compensatory nature of the original changes, prolonged psycho-emotional stress becomes maladjustment that requires adequate time and nature of the therapeutic activity.

Depending on the vegetative, humoral and hormonal-metabolic disorders, disorders of adaptive reactions selected criteria of the stages of dysregulation, which can be interpreted as dysregulatory state.

When there was the experience more than 10-20 years it was stated dysregulatory state 'Voltage', which was manifested by activation of the studied metabolic system (increasing synthesis of uric acid and nitrite, along with enhancing their excretion and increased levels of total catecholamines of blood), an excessive level of activation of sympathoadrenal and parasympathetic divisions of the autonomic nervous system, a high level voltage adaptive reactions, tendencies to the depletion of adaptive resources of the organism.

Studying drivers with experience more than 21-30 years it was stated dysregulatory condition of 'Burnout', which was manifested by the processes of accumulation of toxic metabolites and reduced activity of the investigated metabolic systems (deposition of uric acid and nitrite, the decrease in the level of total catecholamines of blood), a predominance of parasympathetic tone and a decrease in the tonic influence of the sympathetic nervous system, reaction of exhaustion and failure of adaptive resources of the organism.

Generalization of the obtained results allows us to formulate the concept of dysregulatory states and the principles of correction and rehabilitation impact: the long influence of adverse factors (primarily, information stress), leads to an imbalance of hierarchical work divisions of the ANS and other regulatory systems. This leads, in particular, impaired regulation of vascular tone, transport functions of blood and lymphatic systems with the intensification of processes of synthesis-exchange-allocation and the subsequent accumulation of toxic metabolites. At the same time the increased need for oxygen and substrate provision metabolism of regulatory molecules in conjunction with the violation of the transport function of the circulatory system create preconditions for development of bioenergy (secondary functional) hypoxia. Hypoxia and the continued influence of the factors in the development of dysregulation leads to structural modifications of the relevant parts of the brain (encephalopathy). Damage of the substrate of the nervous regulation requires activation and compensatory adjustments in the work of nervous system. This, in turn, is aggravated by the imbalance of activity of departments of VNS and reorganization exchange of regulatory molecules. The result is a vicious cycle of dysregulation to overcome (break) which is unidirectional and single-action is impossible, it is needed a complete correction, which would include activities aimed at the restoration of control and the consequences of oxygen deficiency of the substrate.

The principles of therapeutic interaction of such a complex should be based on the formation of a new functional stereotype, which provides: the restoration of control, elimination or reduction dysregulatory disorders, the formation of new connections functionally-dynamic system, aimed at compensation of the morphological defect and the consequences of substrate and oxygen deficit of the central and peripheral parts of the nervous system in hypoxia.

As established disorders are recorded at different levels in the hierarchy of intelligent control systems it is evidence of a systemic dysregulation that requires complex methods of correction, including actions aimed at restoring the homeostatic balance of both functional and metabolic systems.

With this in mind, we have developed a range of restorative treatment - RC No. 1, consisting of differentiated schemes of acupuncture (corporal, auricular and craniopuncture), warming of biologically active points and the subsequent massage with needle cushion corresponding to the formula segmental zones of skin projections of the meridians, combined with oxygen-substrate therapy, represents the use of singlet-oxygen mixture containing a number of biologically active substances and metabolites [27 – 29, 33, 35].

As monotherapy (RC No. 2) and in combination with the above methods ((RC No. 3), we used the light therapy - in the form of PILER-light. Light therapy is today recognized around the world and uses in the prevention, treatment and rehabilitation.

Correction and rehabilitation complex No. 3 (RC No. 3)  included the combined use of acupuncture, oxygen-substernal therapy and light therapy.

Methodological approaches to the application of each of the methods responded to the above recommendations [33]. The course of each of RC was 15 sessions: the first 10 sessions daily, the next 5 were alternated through the day. The total duration of the correction and rehabilitation of the course is 5 weeks.

Examination of contingents of the control and main groups before and after exposure found that the influence of the designed complexes in the study of the integral system of regulation of the functional state of the organism and adaptation of drivers of motor vehicles was, mainly, normalizing and depended primarily on the nature and intensity of the initial changes of indicators that were correlated with exposure of the action of unfavorable factors of working conditions.

The study found that the impact of the designed complexes in the study of the integral system of regulation of functional state of organism and of adaptation of the operators of motor vehicles was, mainly, normalizing and depended primarily on the nature and intensity of the initial changes of indicators that were correlated with exposure of the action of unfavorable factors of working conditions.

It is established that in the "Exertion" integrated application of acupuncture reflexology and oxygen-metabolic therapy harmonizes the processes of vegetative and biochemical regulation of sanogenetic and provides the necessary inertia for the self-regulation of homeostasis and adaptation. An additional attraction to this complex light therapy helps to restore the activity catecholaminergic systems and general adaptive resources of the body in a state of "Burnout".

The study found that the use of treatment course of the oxygen-substrate therapy and integrated reflexology reduces excessive level of activation of autonomic responses, restores the biochemical processes of regulation and thereby resolve dysregulatory violations and tension adaptation mechanisms, while maintaining sufficient adaptive resources of the organism. When decompensation of the functional reserves of the organism – strain and failure mechanisms of adaptation, the additional use of light therapy provided restoration of afo- and trophotropic balance the VNS and nonspecific adaptive reactions of the organism.

Thus, in the result of the research was pathogenetically substantiated and developed methodical approaches to diagnostics and the medical correction dysregulatory conditions of the transport operators. Based on the studies it was developed the pathogenetic approach to treatment assignment developed by the rehabilitation center for medical correction dysregulatory states with regard to their features and stages of development.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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NOMENCLATURE

 

BAP - biologically active point

HRV - heart rate variability

MR - medical rehabilitation

VNS -  vegetative nervous system

HF - high-frequency vibrations of the spectrogram

HHMR - humoral-hormonal and metabolic regulation

ACP – acupuncture

AS - acute stress

RTA - road traffic accident

BI - the Baevsky index

UI - utilization index

SI- strain index

IPC - individual physiological corridor

ED - electropunctural diagnostic

GSR - galvanic skin response

GSR –d - the parameters of galvanic skin response registered on the right side of the body

GSR –s - the parameters of galvanic skin response registered on the left side of the body

CIG – сardiointervalography

CLA - the coefficient of lateral asymmetry

CPT - complex pathogenetic therapy

NS - nervous system

LF - low-frequency fluctuations of the spectrogram

AR - adaptive response "preactivate"

∆х - variational sweep

RC - rehabilitation complex

RT – reflexotherapy

CA - adaptive response "calm activation"

TC - total catecholamines

UA - uric acid

SOT - singlet-oxygen therapy

AV GSR - the average value of GSR

T -adaptive response “training”

GAR - general adaptation reaction

CNS - central nervous system

AR - adaptive response “chronic stress”

MA - mode amplitude

NO - nitrogen oxide

NO2 – nitrites

pNN50 %   - the percentage of consecutive RR intervals, the difference between which exceeds 50 ms

SDNN - the standard deviation of normal intervals RR

RMSSD - the square root of the average of the squares of the difference values of successive intervals R-R

R-R - the average duration of RR intervals

 

 

 

 

 

 

 

 

 

 

 

CONTENT

 

INTRODUCTION………………………………………………………    5–7

SECTION 1. CONCEPTUALIZATION ABOUT DYSREGULATORY CONDITIONS AND THEIR MEDICAL CORRECTION IN THE DRIVER'S CONTINGENT……………………………………………………………..            9–24

  1. Regulation and dysregulation of vital activities……………….……...        9–11
  2. Definition of the terms such as "dysregulation pathology", "dysregulation syndrome" and "dysregulatory state"………………………………        12–15
  3. Drivers – operator’s contingent, which is at risk of developing of dysregulatory states under the influence of information stress……..... 16–21
  4. The principles of medical correction of dysregulation states………..          22–23

1.4.1. Sano - pathogenetic possibilities of physical therapy........................... 23–24

SECTION 2. ISSUES, METHODOLOGY OF RESEARCH OF CORRECTION AND REHABILITATION IMPACT………………………………………..      25–35

2.1.    Contingent and methods of research …………………………………27–31

2.2.     The principles and methods of medical rehabilitation......................... 32–34

2.3. Methods of mathematical analysis…………………………………..   35–35

SECTION 3. DIAGNOSTICS AND CORRECTION OF DYSREGULATION OF DRIVERS OF TRANSPORT BY THE PFYSICAL METODS ……………   36–57

3.1. Estimation of dysregulation states of the motor transport…………… 36–47

3.2. Correction of dysregulation states of the motor transport drivers by the physical methods.............................................................................................       48–57

CONCLUSION……………………………………………………………..        58–65

REFERENCES............................................................................................ 66–74

NOMENCLATURE.................................................................................... 75–76

 

 

 

 

 

Gorsha O. V., Gorsha V. I. Diagnostics and correction of disregulation states by physical methods. Nicolaus Copernicus University, Toruń, Poland, Ukrainian Research Institute for Medicine of Transport, Odesa, Ukraine. 2017. 80 p. Bibliography of 86 items. ISBN 9781387266524. DOI http://dx.doi.org/10.5281/zenodo.1000404

PBN Poland https://pbn.nauka.gov.pl/sedno-webapp/works/832669

 

 

 

© The Author(s) 2017.

This monograph is published with Open Access.

Open Access This articles is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

 

Attribution — You must attribute the work in the manner specified by the author or licensor (but not in any way that suggests that they endorse you or your use of the work). Noncommercial — You may not use this work for commercial purposes. Share Alike — If you alter, transform, or build upon this work, you may distribute the resulting work only under the same or similar license to this one.

Zawartość jest objęta licencją Creative Commons Uznanie autorstwa-Użycie niekomercyjne-Na tych samych warunkach 4.0

 

 

 

ISBN 9781387266524

DOI http://dx.doi.org/10.5281/zenodo.1000404

PBN Poland https://pbn.nauka.gov.pl/sedno-webapp/works/832669

 

Nicolaus Copernicus University, Toruń, Poland

Str. Lwowska 1, 87-100 Toruń, Poland

www.umk.pl

 

80 p. Number of characters: 130 000 (with abstracts). Number of images: 10 x 1000 characters (lump sum) = 10 000 characters.

Total: Number of characters: 140 000 (with abstracts, summaries and graphics) = 3,5 sheet publications.

 

 

 

 

 

 

ISBN 9781387266524

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ISBN 9781387266524

 

 

 

 

 

 

 

Notes

Gorsha O. V., Gorsha V. I. Diagnostics and correction of disregulation states by physical methods. Nicolaus Copernicus University, Toruń, Poland, Ukrainian Research Institute for Medicine of Transport, Odesa, Ukraine. 2017. 80 p. Bibliography of 86 items. ISBN 9781387266524. DOI http://dx.doi.org/10.5281/zenodo.1000404 PBN Poland https://pbn.nauka.gov.pl/sedno-webapp/works/832669

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