РОЛЬ ИНТЕРЛЕЙКИНА-8 В РАЗВИТИИ «УРЕМИЧЕСКОЙ НЕДОСТАТОЧНОСТИ ПИТАНИЯ» У ПАЦИЕНТОВ С ТЕРМИНАЛЬНОЙ ПОЧЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ, ПОЛУЧАЮЩИХ ЛЕЧЕНИЕ ПРОГРАММНЫМ ГЕМОДИАЛИЗОМ

The increased level of interleukin8 has been found to correlate with the uremic malnutrition in the patients with the endstage renal failure. Increase of the period of hemodialysis isfollowed by more pronouced signs of chronic inflammation. The increased level of IL8 in the serum may be taken as a pathogenic factor promoting «uremic malnutrition» in the endstage renal failure patients on chronic hemodialysisВыявлена взаимосвязь между повышением уровня интерлейкина-8 и «уремической недостаточностью питания» у пациентов с терминальной почечной недостаточностью,получающих лечение хроническим гемодиализом. Показано, что увеличение длительности гемодиализной терапии сопровождается усилением признаков хронического воспаления. Повышение уровня IL8 сыворотки крови может являться одним из патогенетических факторов, участвующих в развитии «уремической недостаточности питания» у пациентов с терминальной почечной недостаточностью, получающих лечение хроническим гемодиализом

ГІГІЄНІЧНІ АСПЕКТИ ПРОФІЛАКТИКИ СИНДРОМУ ЕМОЦІЙНОГО ВИГОРАННЯ У СЕРЕДНЬОГО МЕДИЧНОГО ПЕРСОНАЛУ РІЗНОПРОФІЛЬНИХ ВІДДІЛЕНЬ ЛІКАРНІ

Purpose: to analyze the presence of emotional burnout in nurses of various clinical departments. Materials and Methods. On the basis of health care institutions in Vinnytsia, an anonymous survey of 150 medical workers of different clinical departments was conducted. A number of questions were asked to assess the symptoms of emotional burning syndrome. Most of them were closed and provided answers “Yes” or “No”, or the choice of one of the proposed options. The age of the respondents ranged from 20 to 50 years old. Work experience ranged from 2 to 25 years. Nurses from the psychiatric, surgical, resuscitation, therapeutic, neurosurgical, operating, traumatological, neurological, hematological, otolaryngological physiotherapeutic and admission departments of the hospital were interviewed. Sociological and medical-statistical methods were used for assessment the results of the study. Results. It was found that the negative impact of psycho-emotional factors on their health is noted by 62 % of respondents. The most complaints of increased irritability for minor events were made by nurses of neurosurgical (76.9 %) and admission (71.4 %) departments; dizziness was most noted by physicians of intensive care units (46.6 %) and ENT departments (41.6 %). Employees of physiotherapy (66.6 %) and psychiatric (58.8 %) departments complained the most about headaches. Rapid fatigue was noted by 56.2 % of nurses in the surgical department and 44.4 % in the neurology department. Among nurses who experienced a deterioration in their health, more than half (55.9 %) of respondents were aware of the problem and prevented the further development of emotional burnout by various preventive measures. Conclusions. Timely detection and prevention of stress, compliance with recommendations, and use of methods and means of prevention will significantly reduce the risk of the syndrome in nurses. Carrying out a set of measures aimed at preventing the onset of emotional burnout will be useful not only to improve the quality of professional duties of nurses, but also to create a favorable atmosphere in hospitals and other health care facilities.Мета: проаналізувати наявність синдрому емоційного вигорання у середніх медичних працівників різнопрофільних клінічних відділень. Матеріали і методи. На базі закладів охорони здоров’я м. Вінниці проведено анонімне анкетування 150 медичних працівників різних за профілем клінічних відділень. Для оцінки проявів симптомів синдрому емоційного вигорання поставлено низку запитань. Більшість з них були закритими і передбачали відповіді «Так» або «Ні», або вибір одного із запропонованих варіантів. Вік опитуваних був від 20 до 50 років. Стаж роботи становив від 2 до 25 років. Опитано медичних сестер психіатричного, хірургічного, реанімаційного, терапевтичного, нейрохірургічного, операційного, травматологічного, неврологічного, гематологічного, оториноларингологічного, фізіотерапевтичного і приймального відділень лікарні. Для оцінки результатів проведеного дослідження використано соціологічний та медико-статистичний методи. Результати. Встановлено, що негативний вплив психоемоційного чинника на своє здоров’я відзначають 62 % опитаних. Найбільше скарг на підвищену дратівливість на незначні події висували медичні сестри нейрохірургічного (76,9 %) та приймального (71,4 %) відділень, запаморочення найчастіше відзначали медики реанімаційного (46,6 %) та оториноларингологічного (41,6 %) відділень. На головний біль найбільше скаржилися працівники фізіотерапевтичного (66,6 %) та психіатричного (58,8 %) відділень. Швидку втомлюваність відзначали 56,2 % медичних сестер хірургічного відділення та 44,4 % – неврологічного. Серед медичних сестер, які відчули погіршення у стані свого здоров’я, більшість (55,9 %) опитаних усвідомлює наявність проблеми та запобігає подальшому розвитку синдрому емоційного вигорання різними профілактичними заходами. Висновки. Своєчасне виявлення та запобігання стресу, дотримання рекомендацій, застосування способів і засобів профілактики значно знизить ризик виникнення синдрому в медичних сестер. Проведення комплексу заходів, спрямованих на запобігання виникненню синдрому емоційного вигорання, буде корисним не лише для підвищення якості виконання професійних обов’язків медичними сестрами, а й приведе до створення сприятливої атмосфери у лікарнях та інших медико-профілактичних закладах

ВИЗНАЧЕННЯ ЕФЕКТИВНОСТІ ІСНУЮЧИХ ГІДРОЕНЕРГЕТИЧНИХ СИСТЕМ

The urgency, problem condition and the basic operating factors defining working efficiency of the basic hydropower equipment of HYDROELECTRIC POWER STATION are shown. The basic components of energy expenses efficiency in technological systems of electric energy development are considered and classified. Influences of the basic components of technical and operational factors on efficiency level are reflected. The substantiation is performed and the direction of the working factors research affecting the change of the hydrounit electric parametres is defined. Ways of an overall performance increase of the operative equipment of HYDROELECTRIC POWER STATION are offered. The cited data can be used at modernisation of energy hydropower convertersПоказаны актуальность, состояние проблемы и основные действующие факторы, определяющие рабочую эффективность основного гидроэнергетического оборудования ГЭС. Рассмотрены и классифицированы основные составляющие эфекивности затрат энергии в технологических системах выработки электрической энергии. Отражены влияния основных составляющих технических и эксплуатационых факторов на уровень эффективности. Приведено обоснование и определено направление исследования рабочих факторов, влияющих на изменение электрических параметров гидроагрегата. Предложены пути повышения эффективности работы действующего оборудования ГЭС. Приведенные данные могут быть использованы при модернизации гидроэнергетических преобразователей энергии.Показані актуальність, стан проблеми й основні діючі чинники, що визначають робочу ефективність основного гідроенергетичного устаткування ГЕС. Розглянуті і класифіковані основні складові ефективності витрат енергії в технологічних системах вироблення електричної енергії. Відображені впливи основних складових технічних й експлуатаційних чинників на рівень ефективності. Приведено обґрунтування і визначений напрям дослідження робочих чинників, що впливають на зміну електричних параметрів гідроагрегату. Запропоновані шляхи підвищення ефективності роботи діючого устаткування ГЕС. Приведені дані можуть бути використані при модернізації гідроенергетичних перетворювачів енергії

Enoxaparin for primary thromboprophylaxis in ambulatory patients with coronavirus disease-2019 (the OVID study): a structured summary of a study protocol for a randomized controlled trial.

The OVID study will demonstrate whether prophylactic-dose enoxaparin improves survival and reduces hospitalizations in symptomatic ambulatory patients aged 50 or older diagnosed with COVID-19, a novel viral disease characterized by severe systemic, pulmonary, and vessel inflammation and coagulation activation. The OVID study is conducted as a multicentre open-label superiority randomised controlled trial. Inclusion Criteria 1. Signed patient informed consent after being fully informed about the study's background. 2. Patients aged 50 years or older with a positive test for SARS-CoV2 in the past 5 days and eligible for ambulatory treatment. 3. Presence of respiratory symptoms (i.e. cough, sore throat, or shortness of breath) or body temperature >37.5° C. 4. Ability of the patient to travel to the study centre by private transportation, performed either by an accompanying person from the same household or by the patient themselves 5. Ability to comply with standard hygiene requirements at the time of in-hospital visit, including a face mask and hand disinfectant. 6. Ability to walk from car to study centre or reach it by wheelchair transport with the help of an accompanying person from the same household also complying with standard hygiene requirements. 7. Ability to self-administer prefilled enoxaparin injections after instructions received at the study centre or availability of a person living with the patient to administer enoxaparin. Exclusion Criteria 1. Any acute or chronic condition posing an indication for anticoagulant treatment, e.g. atrial fibrillation, prior venous thromboembolism (VTE), acute confirmed symptomatic VTE, acute coronary syndrome. 2. Anticoagulant thromboprophylaxis deemed necessary in view of the patient's history, comorbidity or predisposing strong risk factors for thrombosis: a. Any of the following events occurring in the prior 30 days: fracture of lower limb, hospitalization for heart failure, hip/knee replacement, major trauma, spinal cord injury, stroke, b. previous VTE, c. histologically confirmed malignancy, which was diagnosed or treated (surgery, chemotherapy, radiotherapy) in the past 6 months, or recurrent, or metastatic, or inoperable. 3. Any clinically relevant bleeding (defined as bleeding requiring hospitalization, transfusion, surgical intervention, invasive procedures, occurring in a critical anatomical site, or causing disability) within 30 days prior to randomization or sign of acute bleeding. 4. Intracerebral bleeding at any time in the past or signs/symptoms consistent with acute intracranial haemorrhage. 5. Haemoglobin <8 g/dL and platelet count <50 x 10 <sup>9</sup> cells/L confirmed by recent laboratory test (<90 days). 6. Subjects with any known coagulopathy or bleeding diathesis, including known significant liver disease associated with coagulopathy. 7. Severe renal insufficiency (baseline creatinine clearance <30 mL/min calculated using the Cockcroft-Gault formula) confirmed by recent laboratory test (<90 days). 8. Contraindications to enoxaparin therapy, including prior heparin-induced thrombocytopenia and known hypersensitivity. 9. Current use of dual antiplatelet therapy. 10. Participation in other interventional studies over the past 30 days. 11. Non-compliance or inability to adhere to treatment or lack of a family environment or support system for home treatment. 12. Cognitive impairment and/or inability to understand information provided in the study information. Patient enrolment will take place at seven Swiss centres, including five university hospitals and two large cantonal hospitals. Patients randomized to the intervention group will receive subcutaneous enoxaparin at the recommended dose of 4,000 IU anti-Xa activity (40 mg/0.4 ml) once daily for 14 days. Patients randomized to the comparator group will receive no anticoagulation. Primary outcome: a composite of any hospitalization or all-cause death occurring within 30 days of randomization. (i) a composite of cardiovascular events, including deep vein thrombosis (including catheter-associated), pulmonary embolism, myocardial infarction/myocarditis, arterial ischemia including mesenteric and extremities, acute splanchnic vein thrombosis, or ischemic stroke within 14 days, 30 days, and 90 days of randomization; (ii) each component of the primary efficacy outcome, within 14 days, 30 days, and 90 days of randomization; (iii) net clinical benefit (accounting for the primary efficacy outcome, composite cardiovascular events, and major bleeding), within 14 days, 30 days, and 90 days of enrolment; (iv) primary efficacy outcome, within 14 days, and 90 days of enrolment; (v) disseminated intravascular coagulation (ISTH criteria, in-hospital diagnosis) within 14 days, 30 days, and 90 days of enrolment. Patients will undergo block stratified randomization (by age: 50-70 vs. >70 years; and by study centre) with a randomization ratio of 1:1 with block sizes varying between 4 and 8. Randomization will be performed after the signature of the informed consent for participation and the verification of the eligibility criteria using the electronic data capture software (REDCAP, Vanderbilt University, v9.1.24). In this open-label study, no blinding procedures will be used. The sample size calculation is based on the parameters α = 0.05 (2-sided), power: 1-β = 0.8, event rate in experimental group, pexp = 0.09 and event rate in control group, pcon = 0.15. The resulting total sample size is 920. To account for potential dropouts, the total sample size was fixed to 1000 with 500 patients in the intervention group and 500 in the control group. Protocol version 1.0, 14 April 2020. Protocol version 3.0, 18 May 2020 Recruiting start date: June 2020. Last Patient Last Visit: March 2021. ClinicalTrials.gov Identifier: NCT04400799 First Posted: May 26, 2020 Last Update Posted: July 16, 2020 FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol

Are hospitals delivering appropriate VTE prevention? The venous thromboembolism study to assess the rate of thromboprophylaxis (VTE start)

The 7th conference of the American College of Chest Physicians (ACCP7) provides recommendations on the type, dose, and duration of thromboprophylaxis in hospitalized patients at risk of venous thromboembolism (VTE), but the extent to which hospitals follow these criteria has not been well studied. Discharge and billing records for patients admitted to any of 16 acute-care hospitals from January 2005 to December 2006 were obtained. Patients 18 years or older who had an inpatient stay ≥2 days and no apparent contraindications for thromboprophylaxis were grouped into the categories of critical care, surgery and medically ill before being assessed for additional VTE risk factors based on the diagnostic criteria outlined in ACCP7. For patients at risk, the recommended type (mechanical or pharmacologic), dose, and duration of thromboprophylaxis was identified based on the guidelines and compared to the regimen actually received, if any. Among the 258,556 hospitalized patients, 68,278 (26.4%) were determined to be at risk of VTE without apparent contraindications for thromboprophylaxis. The proportions of patients who received the appropriate type, dose, and duration of thromboprophylaxis were 10.5, 9.8, and 17.9% for critical care, medical, and surgical patients, respectively. Of those at risk, 36.8% received no thromboprophylaxis and an additional 50.2% received thromboprophylaxis deemed inappropriate for one or more reasons. The implementation of ACCP7 guidelines for type, dosage, and duration of thromboprophylaxis is low in patients at risk of VTE. There is a need for physicians and health systems to improve awareness and implementation of recommended thromboprophylaxis

Higher Dimensional Cylindrical or Kasner Type Electrovacuum Solutions

We consider a D dimensional Kasner type diagonal spacetime where metric functions depend only on a single coordinate and electromagnetic field shares the symmetries of spacetime. These solutions can describe static cylindrical or cosmological Einstein-Maxwell vacuum spacetimes. We mainly focus on electrovacuum solutions and four different types of solutions are obtained in which one of them has no four dimensional counterpart. We also consider the properties of the general solution corresponding to the exterior field of a charged line mass and discuss its several properties. Although it resembles the same form with four dimensional one, there is a difference on the range of the solutions for fixed signs of the parameters. General magnetic field vacuum solution are also briefly discussed, which reduces to Bonnor-Melvin magnetic universe for a special choice of the parameters. The Kasner forms of the general solution are also presented for the cylindrical or cosmological cases.Comment: 16 pages, Revtex. Text and references are extended, Published versio

Constraints on the χ_(c1) versus χ_(c2) polarizations in proton-proton collisions at √s = 8 TeV

The polarizations of promptly produced χ_(c1) and χ_(c2) mesons are studied using data collected by the CMS experiment at the LHC, in proton-proton collisions at √s=8  TeV. The χ_c states are reconstructed via their radiative decays χ_c → J/ψγ, with the photons being measured through conversions to e⁺e⁻, which allows the two states to be well resolved. The polarizations are measured in the helicity frame, through the analysis of the χ_(c2) to χ_(c1) yield ratio as a function of the polar or azimuthal angle of the positive muon emitted in the J/ψ → μ⁺μ⁻ decay, in three bins of J/ψ transverse momentum. While no differences are seen between the two states in terms of azimuthal decay angle distributions, they are observed to have significantly different polar anisotropies. The measurement favors a scenario where at least one of the two states is strongly polarized along the helicity quantization axis, in agreement with nonrelativistic quantum chromodynamics predictions. This is the first measurement of significantly polarized quarkonia produced at high transverse momentum