Phenotypic clusters and biomarkers profile in patients with chronic heart failure with preserved and mildly reduced left ventricular ejection fraction

Aim. To study the profile of cardiac biomarkers (NT-proBNP – N-terminal pro-brain natriuretic peptide, sST2 – soluble growth stimulation expressed gene 2, galectin-3, copeptin) in clusters of patients with chronic heart failure with preserved (CHFpEF) and mildly reduced (CHFmrEF) left ventricular (LV) ejection fraction (EF). Materials and methods. The study included 135 patients with CHF and LV EF40%. All patients signed informed consent. Results. Patients in the study were of senior age – 76 [65; 82] years; 56% are women. The most common comorbid diseases were hypertension and ischemic heart disease, including previous AMI, CKD, obesity and AF. During the cluster analysis, 4 clusters were identified: 1 – “ischemic”, in which men aged 64 [57.5; 76.3] years old with coronary artery disease and previous myocardial infarction and COPD. 2 – “hypertensive”, represented by elderly women 80.0 [74.3; 85.5] years old with arterial hypertension. 3 – “maladaptive with multiple organ disorders” – represented by elderly women with AF, signs of pulmonary hypertension, lower LV EF (48 [43; 54]%) and CKD. 4 – “cardiometabolic” – included female patients aged 71 [60.0; 78.0] years old, with obesity and type 2 diabetes, CKD and AF. In patients of cluster 3 there were higher concentrations of NT-proBNP (1640 [746; 2218] pg/ml; p=0.0015), sST2 (25.2 [17.0; 54.5] ng/ml) and galectin-3 – 11.8 [9.5; 14.3] ng/ml and the highest one-year mortality rate – 33.3%. Conclusion. Four distinct clusters of CHF with LV EF40% patients were identified that differed in clinical characteristics, heart failure biomarkers and prognosis: ischemic, hypertensive, cardiometabolic and maladaptive with multiple organ dysfunction. These results confirm the heterogeneity of CHFpEF and CHFmrEF and create the prerequisites for the development of personalized approaches to therapy

Predictors of thromboembolic complications in patients with severe SARS-CoV-2 coronavirus infection

Aim. To identify predictors of the development of thromboembolic complications (TECs) in patients with severe SARS-CoV-2 coronavirus infection. Materials and methods. A single-center observational retrospective study included 1634 patients with a confirmed diagnosis of SARS-CoV-2 coronavirus infection. The patients were divided into 2 groups depending on the availability of the feasibility study. The criterion for inclusion of patients in the main group was the presence of venous feasibility studies in 127 patients (group I), the comparison group consisted of 1507 patients in whom the course of COVID-19 was not complicated by the development of feasibility studies (group II). Results. When performing computed tomography of the chest organs, it was revealed that patients with a feasibility study had a higher percentage of lung tissue damage than patients in the comparison group: 55% [37.5; 67.5] and 37.5% [25.0; 47.5], respectively (p0.001). The average values of C-reactive protein in I patients group were 129 [60.1; 211] ng/l, which was significantly higher than in II patients group – 41.0 [12.2; 97.6] ng/l (p0.001), interleukin-6 – 176 [52.9; 471] pg/ml and 39.4 [11.0; 107] pg/ml (p0.001), respectively. A one-factor regression analysis proved a significant contribution of comorbid pathology to the development of feasibility studies in patients with COVID-19. The presence of three nosologies at the same time: arterial hypertension, coronary heart disease (CHD) and chronic kidney disease increased the probability of a feasibility study by 4.81 times (odds ratio 4.8117, 95% confidence interval 3.2064–7.2207), in patients with arterial hypertension, CHD, chronic kidney disease and type 2 diabetes – by 5.63 times (odds ratio 5.6321, 95% confidence interval 3.1870–9.9531). Conclusion. The presence of severe comorbid pathology significantly increased the risk of developing a feasibility study in patients with COVID-19. The most significant predictors of the development of feasibility studies in patients with severe SARS-CoV-2 coronavirus infection. They are: CHD, arterial hypertension and type 2 diabetes

Development of a method for evaluation of the efficiency of the coordinated type of management as referred to main streets

The use of coordinated management is a justified measure for the organization of traffic on regulated main streets, especially with high loads on the road network, in cases where the intensity of traffic flow is approaching the value of capacity. These "peak" loads have a negative impact on the characteristics of the traffic flow, but these loads are not always characteristic of controlled main streets, and the introduction of coordinated management with such types of loads – "not peak" should be justified and appropriate. The existing criteria for entering the coordination of the main street do not allow us to assess the feasibility of using this type of control with low loads on the street and road network. In order to assess the effectiveness of the use of coordinated management of the main street at low load levels, within the framework of this article, an analysis of existing methods for evaluating the effectiveness of the type of management in question was carried out, a full-scale study of the main street was conducted. Voronezh and the simulation of the site under consideration was carried out with and without coordination, the results were evaluated, conclusions were formulated and directions for further research were determined

The effect of seed thickness alignment on the uniformity of planting materia

The results of studies on the effect of calibration of Scots pine (Pinus sylvestris) seeds by size (thickness) on the yield of standard seedlings are presented in order to assess the effect of the lattice-free technology of calibration of scots pine seeds on the yield of standard seedlings when growing them in a nursery. The seed batch of scots pine before sowing was calibrated on an experimental sample of a lattice-free separator in size (thickness). The size gap in the fractions was determined experimentally using end measures and an electronic caliper, based on the minimum and maximum sizes (thickness) of the seeds. As a result, two fractions of seeds were obtained. The resulting seed fractions were sown on nursery areas. Uncalibrated seeds were used as a control. It was found that the highest yield of standard seedlings (94-98%) was observed when using calibrated seeds regardless of the fraction. When sowing with uncalibrated seeds, the yield of standard seedlings was only 64-79%. The height of seedlings grown from uncalibrated seeds varied from 5 to 32 cm, calibrated (large fraction) – from 13 to 23 cm, calibrated (small fraction) – 10 to 13 cm. The diameter of the root neck in crops with uncalibrated seeds varied from 1.86 mm to 11.94 mm, calibrated large seeds – from 3.88 to 4.56 mm, calibrated small seeds – from 2.99 to 3.41 mm

Development of a method for evaluation of the efficiency of the coordinated type of management as referred to main streets

The use of coordinated management is a justified measure for the organization of traffic on regulated main streets, especially with high loads on the road network, in cases where the intensity of traffic flow is approaching the value of capacity. These "peak" loads have a negative impact on the characteristics of the traffic flow, but these loads are not always characteristic of controlled main streets, and the introduction of coordinated management with such types of loads – "not peak" should be justified and appropriate. The existing criteria for entering the coordination of the main street do not allow us to assess the feasibility of using this type of control with low loads on the street and road network. In order to assess the effectiveness of the use of coordinated management of the main street at low load levels, within the framework of this article, an analysis of existing methods for evaluating the effectiveness of the type of management in question was carried out, a full-scale study of the main street was conducted. Voronezh and the simulation of the site under consideration was carried out with and without coordination, the results were evaluated, conclusions were formulated and directions for further research were determined. </jats:p

Reducing the severity of a traffic accident

Improving the system of preventive measures aimed at reducing the severity of road accidents is an urgent task. Mortality on roads is constantly increasing and it is necessary to ensure an integrated approach to creating safe road conditions. The purpose of this study is to analyze the promising designs of guardrails designed to prevent uncontrolled exit of vehicles from the roadway and the development of crash cushions. Guardrails should not only be safe for road users, but should also ensure their safety, as well as preserve the elements after crashing it. Conducted analytical studies have shown that to reduce the mechanical damage to vehicles and reduce the severity of injuries to the driver and passengers, it is necessary to develop guardrails that allows capturing shock energy at the moment of contact between the car and the guardrails. The considered design of the crash cushion provides a damping effect when the car crashes the guardrails and at the same time limit the ability to move its elements relative to the original position. This is achieved by using several materials with different strength characteristics in the design of the guardrails, which contributes to its gradual destruction in several stages and smooth energy dissipation

Reducing the severity of a traffic accident

Improving the system of preventive measures aimed at reducing the severity of road accidents is an urgent task. Mortality on roads is constantly increasing and it is necessary to ensure an integrated approach to creating safe road conditions. The purpose of this study is to analyze the promising designs of guardrails designed to prevent uncontrolled exit of vehicles from the roadway and the development of crash cushions. Guardrails should not only be safe for road users, but should also ensure their safety, as well as preserve the elements after crashing it. Conducted analytical studies have shown that to reduce the mechanical damage to vehicles and reduce the severity of injuries to the driver and passengers, it is necessary to develop guardrails that allows capturing shock energy at the moment of contact between the car and the guardrails. The considered design of the crash cushion provides a damping effect when the car crashes the guardrails and at the same time limit the ability to move its elements relative to the original position. This is achieved by using several materials with different strength characteristics in the design of the guardrails, which contributes to its gradual destruction in several stages and smooth energy dissipation.</jats:p