Some universal limits for nonhomogeneous birth and death processes

In this paper we consider nonhomogeneous birth and death processes (BDP) with periodic rates. Two important parameters are studied, which are helpful to describe a nonhomogeneous BDP X = X(t), t≥ 0: the limiting mean value (namely, the mean length of the queue at a given time t) and the double mean (i.e. the mean length of the queue for the whole duration of the BDP). We find conditions of existence of the means and determine bounds for their values, involving also the truncated BDP XN. Finally we present some examples where these bounds are used in order to approximate the double mean

Development of internal control methodology by using statistical methods of variability assessment of material flow business processes

Variability or instability is one of the key features of any process, including business processes of material flow internal control. Variability is a characteristic of all natural systems and technical processes. The objects which properties can be characterized via certain parameters arise at the output of any process. The article discloses the feasibility of using the statistical methods in the internal control system of business entities; in this case the focus is on the method of identifying the causes of variability using control charts of various types (Shewhart control charts) as a prime tool. The view points regarding variability of famous academic economists who researched the business process management issues are also considered. Authors’ classification of business process variation on types of material flow internal control with the allocation of controlled and uncontrolled variation is taken as the basis of the proposed application. The method of using control charts in estimating the efficiency of material flow internal control business processes is described in detail.peer-reviewe

SOCIALIZAÇÃO DE FUTUROS ESPECIALISTAS NO CONTEXTO DA ABORDAGEM POR COMPETÊNCIAS

The solution of the problems facing the modern Russian society largely depends on the beliefs, expectations, values and attitudes of people that determine their attitude to innovation, content, effectiveness and efficiency of various activities. Social adaptation (active inclusion in the social environment) of the individual assumes as a necessary condition the achievement of a certain level of social competence. The modern social environment has a significant impact on the process of personality formation, causing certain contradictions: on the one hand, socio-cultural modernization necessitates a new approach to the problem of social self-realization of the individual, requiring increased human activity as a subject of social life, taking responsibility for their activities and behavior, but, on the other hand, the instability of modern society increases the natural difficulties of growing up; the situation of uncertainty leads to deformation of personal development, disadaptation in society. Modernization of the education system has led to changes in the content, forms, methods and technologies of education, in connection with which there was a need to assess the results of the functioning of the education system. Analyzing the quality of a modern specialist training, researchers increasingly began to turn to the competencies formed during studying, among which an important place is occupied by social competence, estimated as the most important indicator of professional competence of a specialist in general, and in particular, in the field of economic, labor, social relations.A solução dos problemas enfrentados pela sociedade russa moderna depende em grande parte das crenças, expectativas, valores e atitudes das pessoas que determinam sua atitude em relação à inovação, conteúdo, eficácia e eficiência de várias atividades. A adaptação social (inclusão ativa no ambiente social) do indivíduo assume como condição necessária a conquista de um certo nível de competência social. O ambiente social moderno tem um impacto significativo no processo de formação da personalidade, causando certas contradições: por um lado, a modernização sociocultural requer uma nova abordagem para o problema da auto- realização social do indivíduo, exigindo maior atividade humana como sujeito da vida social, assumindo a responsabilidade por suas atividades e comportamentos, mas, por outro lado, a instabilidade da sociedade moderna aumenta as dificuldades naturais de crescer; a situação de incerteza leva à deformação do desenvolvimento pessoal, à desadaptação na sociedade. A modernização do sistema educacional levou a mudanças no conteúdo, formas, métodos e tecnologias da educação, em relação às quais havia a necessidade de avaliar os resultados do funcionamento do sistema educacional. Analisando a qualidade de um treinamento especializado moderno, os pesquisadores começaram a recorrer cada vez mais às competências formadas durante o estudo, entre as quais um lugar importante é ocupado pela competência social, estimado como o indicador mais importante da competência profissional de um especialista em geral e, em particular, , no campo das relações econômicas, trabalhistas e sociais.La solución de los problemas que enfrenta la sociedad rusa moderna depende en gran medida de las creencias, expectativas, valores y actitudes de las personas que determinan su actitud hacia la innovación, el contenido, la efectividad y la eficiencia de diversas actividades. La adaptación social (inclusión activa en el entorno social) del individuo supone como condición necesaria el logro de un cierto nivel de competencia social. El entorno social moderno tiene un impacto significativo en el proceso de formación de la personalidad, causando ciertas contradicciones: por un lado, la modernización sociocultural requiere un nuevo enfoque del problema de la autorrealización social del individuo, que requiere una mayor actividad humana como un sujeto de la vida social, asumiendo la responsabilidad de sus actividades y comportamiento, pero, por otro lado, la inestabilidad de la sociedad moderna aumenta las dificultades naturales de crecer; La situación de incertidumbre conduce a la deformación del desarrollo personal, la desadaptación en la sociedad. La modernización del sistema educativo ha llevado a cambios en el contenido, las formas, los métodos y las tecnologías de la educación, en relación con lo cual era necesario evaluar los resultados del funcionamiento del sistema educativo. Analizando la calidad de una formación especializada moderna, los investigadores comenzaron a recurrir cada vez más a las competencias formadas durante el estudio, entre las cuales un lugar importante está ocupado por la competencia social, estimado como el indicador más importante de la competencia profesional de un especialista en general, y en particular , en el campo de las relaciones económicas, laborales, sociales

ОСОБЕННОСТИ НАЗНАЧЕНИЯ ТРОЙНОЙ АНТИТРОМБОТИЧЕСКОЙ ТЕРАПИИ С ПРИМЕНЕНИЕМ РИВАРОКСАБАНА У ПАЦИЕНТОВ С ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙ, ПЕРЕНЕСШИХ СТЕНТИРОВАНИЕ КОРОНАРНЫХ АРТЕРИЙ

A trial fibrillation occurs in 5 to 8% of patients who underwent percutaneous coronary intervention (PCI) with stenting. It is known that dual antiplatelet therapy (a combination of P2Y12 receptor inhibitor and acetylsalicylic acid) significantly reduces the risk of developing stent thrombosis in comparison with vitamin K antagonists; however, anticoagulants are significantly more effective in reducing the risk of ischemic stroke in patients with atrial fibrillation (AF). When opting for a long-term triple antithrombotic therapy, the risk of hemorrhagic complications increases dramatically, while choosing less intensive treatment results in an increased risk of ischemic complications, primarily, ischemic stroke and stent thrombosis. The current recommendations come down to the prescription of all of the three components of antithrombotic therapy. However, this approach leads to a significant increase in the frequency of hemorrhagic complications. The purpose of recent randomized trials was to compare and evaluate the efficacy and safety of different regimens with antithrombotic drugs in combination with rivaroxaban in patients with AF who underwent PCI.  Фибрилляция предсердий имеет место у 5—8% пациентов, перенесших чрескожное вмешательство на коронарных артериях (ЧКВ) со стентированием. Известно, что двойная антиагрегантная терапия (комбинация ингибиторов Р2Y12-рецепторов и ацетилсалициловой кислоты) достоверно лучше снижает риск развития тромбоза стента по сравнению с антагонистами витамина К, однако антикоагулянты в свою очередь достоверно эффективнее снижают риск ишемического инсульта у пациентов с фибрилляцией предсердий (ФП). При выборе концепции назначения тройной антитромботической терапии на длительный срок риск геморрагических осложнений резко возрастает, тогда как выбор менее интенсивной тактики ведет к увеличению риска ишемических осложнений, в первую очередь ишемического инсульта и тромбоза стента. Действующие рекомендации сводятся к назначению всех трех компонентов антитромботической терапии. Однако настоящий подход приводит к достоверному увеличению частоты геморрагических осложнений. Задачей недавних рандомизированных исследований является сравнение и оценка эффективности и безопасности различных режимов применения анти-тромботических препаратов в комбинации с ривароксабаном у больных с ФП, перенесших ЧКВ. 

Актуальные вопросы применения дабигатрана в составе комбинированной антитромботической терапии у пациентов с острым коронарным синдромом и неклапанной фибрилляцией предсердий

Atrial fibrillation is the most common heart rhythm disorder. According to various sources, a third of patients with atrial fibrillation also suffer from coronary heart disease. Both acute coronary syndrome and PCI with stable IHD require the prescription of combined antithrombotic therapy, which includes both anticoagulant drugs and disaggregants. A therapeutic dilemma arises: how to balance the extremely high risk of hemorrhagic complications in triple therapy with the risk of ischemic events in dual therapy? Consequently, the combination of atrial fibrillation and ischemic heart disease is not only a complex and widespread problem in terms of the selection of doses and antithrombotic therapy regimes, but is also associated with a significant increase in disability and mortality. Based on data from the PIONEER AF PCI, REDUAL PCI and AUGUSTUS STUDIES, triple therapy should be as short as possible. A tempting alternative seems to be to prescribe dual therapy in 1-7 days after an acute event. According to the ESC recommendations on the treatment of CCS, patients with stable coronary heart disease and atrial fibrillation after CCS are recommended to prescribe three drugs for the period of hospitalization, OAC + Clopidogrel for one year, then only OAC. however, if the risk of stent thrombosis and other ischemic events is high and the risk of bleeding is low, triple therapy can be prolonged. To date, patients requiring anticoagulants in combination with antiaggregants should prefer OAC in doses that have proven effective in preventing stroke in patients with atrial fibrillation (dabigatran 150 mg 2 times a day, apixaban 5 mg 2 times a day and rivaroxaban 20 mg/day).Фибрилляция предсердий является наиболее часто встречаемым нарушением ритма сердца. По различным источникам треть пациентов с фибрилляцией предсердий также страдают ишемической болезнью сердца. И острый коронарный синдром, и ЧКВ при стабильной ИБС требуют назначения комбинированной антитромботической терапии, включающей в себя как антикоагулянтные препараты, так и дезагреганты. Создается терапевтическая дилемма: каким образом найти баланс между крайне высоким риском геморрагических осложнений при назначении тройной терапии и риском ишемических событий при двойной? Следовательно, сочетание фибрилляции предсердий и ишемической болезни сердца не только является сложной и распространенной проблемой в плане подбора доз и режимов антитромботической терапии, но и ассоциировано с достоверным увеличением инвалидизации и смертности. На основании данных, полученных в исследованиях PIONEER AF PCI, REDUAL PCI и AUGUSTUS, продолжительность тройной терапии должна быть столь краткой, насколько это возможно. Заманчивой альтернативой выглядит назначение двойной терапии через 1-7 дней после острого события. Согласно рекомендациям ESC по лечению ХКС, больным со стабильной ишемической болезнью сердца и фибрилляцией предсердий после ЧКВ рекомендовано назначать три препарата на период госпитализации, ПОАК + клопидогрел на год, затем только ПОАК. Однако при высоком риске тромбоза стента и других ишемических событий и низком риске кровотечений можно продлить тройную терапию. На сегодняшний день у пациентов, нуждающихся в антикоагулянтах в комбинации с антиагрегантами, следует предпочесть ПОАК в дозах, доказавших свою эффективность для профилактики инсульта у больных с фибрилляцией предсердий (дабигатран 150 мг 2 раза в день, апиксабан 5 мг 2 раза в день и ривароксабан 20 мг/сут)

Environmental monitoring of natural waters in Krasnodar and Stavropol Territories

The environmental monitoring of natural waters in Krasnodar (Uspensky and Novokubansky districts) and Stavropol (Kochubeyevsky District) Territories was conducted. In the course of study, various elements and compounds harmful to animals and humans, which exceed maximum permissible concentrations, were identified

Cytokine Profile of Patients with Allergic Rhinitis Caused by Pollen, Mite, and Microbial Allergen Sensitization

© 2017 Yury A. Tyurin et al. Allergic rhinitis (AR) is especially prevalent among the population of large cities. Immunologically, the airway epithelium is a region where the population of allergen-presenting cells concentrates. These cells actively express a group of receptors of the innate immune system. A specific cytokine profile is its representation. The study was aimed at evaluating the cytokine profile in patients with seasonal and perennial allergic rhinitis. The cytokine profile of nasal secretion and blood serum of 44 patients with AR was studied. 24 of them had seasonal allergic rhinitis (SAR), and 20 patients suffered from perennial allergic rhinitis (PAR). The patients' age ranged from 4 to 60 years. It was determined in our study that the activation of the GM-CSF production retained in patients with PAR sensitized to mite allergen components (Dermatophagoides pteronyssinus). There was a higher production profile of TNF-α and TSLP in nasal secretion in the patients with perennial allergic rhinitis and additional high sensitization to SEs. Sensitization to mold fungal allergen components significantly increases in patients with seasonal allergic rhinitis. They demonstrated high level of sensitization to the Aspergillus fumigatus component m3. Thus, along with other clinical trials, the study performed would clarify some aspects of molecular pathogenesis of human allergic rhinitis

The Orbital Order Parameter in La0.95Sr0.05MnO3 probed by Electron Spin Resonance

The temperature dependence of the electron-spin resonance linewidth in La0.95Sr0.05MnO3 has been determined and analyzed in the paramagnetic regime across the orbital ordering transition. From the temperature dependence and the anisotropy of linewidth and $g$-value the orbital order can be unambiguously determined via the mixing angle of the wave functions of the $e_{\rm g}$-doublet. The linewidth shows a similar evolution with temperature as resonant x-ray scattering results

Medicine and improvement in the Scots Magazine; and Edinburgh Literary Miscellany, 1804-17

Megan Coyer’s chapter engages with periodical print as a vehicle for an improving medical culture in Scotland, concentrating on the second series of the Scots Magazine. Coyer demonstrates how the Scottish press often complemented improving civic initiatives like the Edinburgh Lunatic Asylum campaign. She focuses attention on the distinctive national dynamics associated with medical improvement efforts in early nineteenth-century Scotland, with the Scots Magazine ‘providing a public forum for the expression of a national medical identity’. This identity, as Coyer shows, had an ideology of improvement at its core. This work recovers the cultural significance of the Scots Magazine as ‘the third major player in popular periodical culture in Romantic-era Scotland’; a status overshadowed by the recent critical attention devoted to the second Edinburgh Review and Blackwood’s in Scottish Romantic studies. Coyer also shows how the efforts of public health reformers highlight the complexity of improvement as both a material and moral process. She argues that print efforts dedicated to improving public health represent a ‘discursive strand in the magazine identifying a lack of cleanliness … as a moral and material blight on an otherwise improving Scottish society’. This bringing together of moral and practical aspects of improvement in the Scots also finds expression in the magazine’s series of Scottish medical biographies, whose narratives, Coyer notes, provide ‘ideal exemplars of lives dedicated to a culture of improvement’

Антитромботическая профилактика и терапия в онкологии

In the article the authors revise a number of methods used in clinic for the description of hypercoagulation syndrome and consider that persistent trombinemia signs and signs of platelet hyperaggregation with the increased consumption of them are the most reliable markers of hypercoagulation and prethrombosis state. Methodology of oncothrombosis prophylaxis and therapy is discussed. Authors demonstrate that heparin therapy decreases the risk of development of spontaneous and postsurgery thrombosis as well as of DIC-syndrome in cancer patients. Authors define the ways of further optimization of thrombotic complications prophylaxis and therapy using thrombine inhibitors and the study of their effects on oncogenesis.В статье авторы подвергают пересмотру ряд методов, используемых в клинике для характеристики гиперкоагуляционного синдрома, и считают более надежными маркерами гиперкоагуляционного и предтромботического состояния признаки персистирующей тромбинемии и гиперагрегации тромбоцитов с повышенным их потреблением. Обсуждается методология профилактики и терапии онкотромбозов. Авторы показывают, что гепаринотерапия снижает риск развития спонтанных и послеоперационных тромбозов, а также ДВС-синдрома у онкологических больных. Авторы определяют пути дальнейшей оптимизации профилактики и лечения тромбических осложнений у онкологических больных с использованием ингибиторов тромбоцитов и изучением их влияния на онкогенез