Changes in clinical and biochemical characteristics in combination treatment for diabetic macular edema

Background: Diabetic macular edema (DME) can be seen in both types of diabetic retinopathy (DR), and is a major cause of vision loss. Purpose: To evaluate the efficacy of the combination treatment for DME in type 2 diabetic patients with non-proliferative diabetic retinopathy (NPDR). Material and Methods: An open-label, controlled study included 45 type 2 diabetic patients with both NPDR and DME. Patients of the aflibercept-plus-hyperbaric oxygen (HBO) group and those of the aflibercept-only (control) group received a monthly intravitreous aflibercept at a dose of 2 mg (50 µL) for 3 months. In addition, the former patients received an adjunctive treatment with ten sessions of HBO in the period between the first and the third injections. Changes in clinical and biochemical characteristics were assessed at 3 months after initiation of treatment. Results: At 3 months, patients of the aflibercept-plus-HBO group showed a statistically significant improvement in visual acuity, improvement in retinal light sensitivity, reduction in manifestations of DME, and statistically significant reductions in blood glucose and glycated hemoglobin levels. At 3 months, the changes in the activities of antioxidant enzymes were more substantial in this group, and these improvements were statistically significant compared to baseline and compared to controls. Particularly, superoxide dismutase (SOD) activity, catalase (CAT) activity, and glutathione reductase (GSR) activity decreased by 33.9%, 22.4% and 17.7%, respectively, compared to baseline, and 34.78%, 28.9%, and 25.3%, respectively, compared to controls. Conclusion: Treatment for DME with the use of aflibercept and adjunctive HBO caused a substantial reduction in the frequency of DME and improvements in visual acuity and retinal light sensitivity in type 2 diabetic patients NPDR. Under these conditions, a decrease in the activity of CAT was larger than that of GSR but smaller than that of SOD, likely indicating an improvement in antioxidant protection

Current Trends in Global Supply Chain Management Investment Policy

Abstract- To achieve the Sustainable Development Goals of the world economy, significant financial resources and global supply chain are needed. Priority issues are related to the use of investment resources. Almost all sectors of the economy have a real need for investment. Domestic investments is not enough for countries to implement effective structural policies and upgrade fixed assets. They are forced to attract foreign investment. The annual requirements for international investment reach several trillion US dollars. However, foreign investors are in no hurry to expand investments in the economy of foreign countries. Moreover, in 2017-2019 there is a decrease in global direct foreign investment flows. This is largely due to a noticeable reduction in US investment in the economies of the European Union and China as a result of the tightening of the American protectionism policy pursued by the D. Trump administration and the US Federal Reserve to strengthen regulation of foreign companies in the US market. A decrease in the level of international investment under the worsening business climate in the world leads to the increased competition between countries for attracting foreign investment

Logistic outsourcing in pharmacy. the theory and practice

Today, the introduction and application of a logistics approach to resource management allows pharmaceutical companies to increase their social, environmental and economic efficiency. The article is aimed to research the essence of the concept, types and party of logistic outsourcing in practical pharmacy. To reach the aimreview of foreign and domestic scientific sources and the existing legal framework of Ukraine on this issue have been analyzed. Investigation methods were bibliographic and analytical ones. The results of these studies indicate the today outsourcing is one of the main logistics strategies of domestic pharmaceutical companies, which is actively used in the sphere of IT-technologies and warehouse services. At the same time for ensuring high-quality providing outsourcing services, a legal and regulatory framework is needed that standardizes the interaction between firm customer and the outsourcer, also the development of standards for the provision of services of a certain type of outsourcing. Wide introduction of logistics outsourcing, as a modern form of optimization of logistics business processes, requires the formation of professional competence among future pharmacists in pharmaceutical logistics, its tools and strategies, i.e. training of competitive professionals capable of working in various directions of practical pharmacy. Introduction of the topic «Logistic outsourcing in practical pharmacy» in the educational process of students of pharmaceutical faculties (university), pharmacists-interns and pharmacists at the postgraduate level of training is necessary. It will improve the theoretical and practical training of future specialist pharmaceutists and will allow them to apply the knowledge which would be gained in the future in logistics outsourcing in the activities of pharmaceutical companies

Socio–pedagogical alternatives of modernization of the university educational process: The real and virtual space

© 2016 Sosnovskaya et al.The research urgency is caused by the contradictions that exist in the approaches to modernization of the University educational process. In recent years the main part of specialists’ attention is focused on the implementation of the priorities of the global information space in the University educational practice, among which are recognized: information, networks, security of the person. These priorities are directed on the intensification of the advantages of virtual space in front of the actually existing educational space of the University by limiting the sphere of direct interpersonal contacts of students in the process of creative educational, professional and sociocultural activities. The current tendencies determine the need for an objective, scientifically based analysis of social – pedagogical alternatives of modernization of University educational process and correction of approaches, due to the natural identification of the real educational process of the University with the virtual space. In this regard, the focus in this article is devoted to substantiation of the structure and content of socio – pedagogical alternatives of modernization of the University educational process taking into account the priorities of real and virtual space. A leading research method is the method of pedagogical monitoring allowing in the process of continuous observation of the development of the University real educational process to determine the socio - pedagogical alternatives for its modernization, taking into account integration of priorities of real and virtual space. The paper presents the content of the notion "socio – pedagogical alternatives of modernization of the University educational process"; defines the essence of the priorities of the virtual space in the educational process of the University; reveals the features of integration of real and virtual space in the educational process of the University; develops the educational – methodical recommendations "use of the priorities of the virtual space in the real educational process of the University." Also it proves the effectiveness of the recommendations using cognitive, informative, motivational, communicative, axiological criteria. The paper can be useful to teachers, methodologists, managers of the universities

ЕТАПИ РОЗВИТКУ СИСТЕМИ ВІЙСЬКОВО-МЕДИЧНОГО ПОСТАЧАННЯ В КОНТЕКСТІ ІСТОРІЇ БУДІВНИЦТВА ЗБРОЙНИХ СИЛ УКРАЇНИ

The aim of the work is to study the stages of formation and development of military medical supply system in the context of building history of the Armed Forces of Ukraine. Materials and methods. To achieve the goal of the study, an analysis of domestic scientific sources and the current legal documents was conducted. Were used methods of information retrieval, systematization, content analysis, comparison, generalization and modeling. Results and discussion. During the study of the stages of formation and development of military medical supply system in the context of building history of the Armed Forces of Ukraine, it was established that at the time of the creation of the Armed Forces of Ukraine, the military medical service and the system of medical supplies were being constructed using the approaches of the Soviet Army. It was clarified that the adoption of a defense doctrine, the change in economic conditions in the country and the limited resources led to the transition to medical care and the supply of medical equipment and property on a territorial basis. This is also required separation losses of both the Armed Forces of Ukraine and the medical service to the optimal number. It was determined that the lack of budget financing during all the years of the existence of the Armed Forces of Ukraine did not allow to build an effective model of medical supplies and carry out technical re-equipment of the medical service fully. The retrospective analysis of the evolution of the medical service of the Armed Forces of Ukraine showed that in 1991-1994 and 2005-2007 it was a duplication of the management function of medical care in the Ministry of Defense of Ukraine and the General Staff of the Armed Forces of Ukraine. At the same time, in the period from 1998-2005, the management of medical care carried out a single governing body, which contributed to a more effective solution to the issues of medical care. Conclusions. The stages of formation and development of the military-medical supply system in the context of the history of the construction of the Armed Forces of Ukraine are conducted in the article. It is also determined that at the present stage the principle of a unified medical service management body that meets NATO standards is implemented. As of today, the development of the medical supply system of the Armed Forces of Ukraine is aimed at integrating into a single effective logistic support system of the Armed Forces of Ukraine, which operates in accordance with the norms and standards of the Alliance. Thus, in order to choose a scientifically grounded model of military medical supply in modern realities, it is necessary to summarize the historical experience of the formation of a supply system of medical equipment to the Armed Forces of Ukraine. As a result, the subject of our further research is to determine the evolutionary stages in the management of streaming processes in the medical supply system of the Armed Forces of Ukraine.Метою роботи є дослідження етапів становлення та розвитку системи військово-медичного постачання в контексті історії будівництва Збройних Сил України. Матеріали та методи. Для досягнення поставленої мети дослідження проведено огляд вітчизняних наукових джерел та чинної нормативно-правової бази. Під час виконання дослідження використано методи інформаційного пошуку, систематизації, контент-аналізу, порівняння та узагальнення. Результати та їх обговорення. При проведенні дослідження етапів становлення та розвитку системи військово-медичного постачання в контексті історії будівництва Збройних Сил України, встановлено, що на момент створення Збройних Сил України військово-медична служба та система медичного постачання будувалась з використанням підходів Радянської Армії. З’ясовано, що прийняття оборонної доктрини, зміна економічних засад в країні та обмеженість ресурсів обумовили перехід до медичного забезпечення та постачання медичною технікою та майном за територіальним принципом. Це, в свою чергу, потребувало скорочення чисельності як Збройних Сил України, так і медичної служби до оптимальної кількості. Визначено, що недостатність бюджетного фінансування на протязі всіх років існування Збройних Сил України не дозволила в повному обсязі побудувати ефективну модель медичного постачання та провести технічне переоснащення медичної служби. Проведений ретроспективний аналіз еволюції органів управління медичною службою Збройних Сил України показав, що в періоди 1991-1994 рр. та 2005-2007 рр. існувало дублювання управлінської функції з медичного забезпечення в Міністерстві оборони України та Генеральному штабі Збройних Сил України. При цьому, в період з 1998-2005 рр. управління медичним забезпеченням здійснював єдиний орган управління, що сприяло більш ефективному вирішенню питань медичного забезпечення. Висновки. В статті проведено дослідження етапів становлення та розвитку системи військово-медичного постачання в контексті історії будівництва Збройних Сил України. Також визначено, що на сучасному етапі реалізується принцип єдиного органу управління медичною службою, що відповідає стандартам НАТО. Станом на сьогодні, розвиток системи медичного постачання Збройних Сил України орієнтований на інтеграцію у єдину ефективну систему логістичного забезпечення ЗС України, яка функціонує відповідно до норм та стандартів Альянсу. Таким чином, для вибору науково-обґрунтованої моделі військово-медичного постачання в сучасних реаліях необхідним є узагальнення історичного досвіду формування системи постачання медичним майном Збройних Сил України. Отже, предметом нашого подальшого дослідження є визначення еволюційних етапів розвитку управління потоковими процесами у системі медичного постачання Збройних Сил України

Features of coagulopathy and systemic inflammation in patients after COVID-19 infection

The aim: To determine the peculiarities of laboratory data concerning blood coagulation and systemic inflammation in COVID-19 patients in three months after discharge and recovery. The state of coagulation, anticoagulation, and fibrinolytic systems, as well as their prognostic value having been well studied in hospitalized COVID-19 patients, their state three months after hospitalization, are not yet well understood. Materials and methods: Methods of randomization, anthropometry, ECG, standard clinical blood testing, immunoenzymometry, immunoanalysis, and primary statistical analysis were used in the study. Anthropometric measurements of patients (n=20), blood samples, blood serum samples, urine samples, and statistical data were the materials of the study. Results: Indices of coagulation and systemic inflammation in studied patients after COVID-19 were obtained (PTT, s ; PATPT, s; Fibrinogen, g/L; Platelets ×109 /L; PCT, ng/mL; DD, µg/L; СRP, mg/L; IL -6, pg/mL; IL -10, pg/mL; Cortisol (nM/L); CIC (IU/mL); Ig A (g/L). Conclusions: Summing up the results obtained, it is possible to assert micro- and macro-vascular thromboses to be common in COVID-19 cases; they are associated with poor prognosis for diseased patients and are not completely investigated; the role of thromboses in COVID-19 course and complications are to be studied as well as the strategies of fibrinolytic therapies for such condition are to be justified. The presence of specific rheological and serological changes in patients even three months after surviving COVID-19 needs further study to understand the necessity of anti-thrombolytic drug uptake for a relatively long time

On Nanomodification of Coating Obtained by Laser Cladding of Composite Powder 12NVK-01

The results of an experimental study of the effect of nanomodifying additives on the structure and mechanical properties of a multilayer coating during laser surfacing of a composite powder with a strengthening phase are presented. As a surfacing material, nickel powder 12NVK -01 with a strengthening phase of tungsten carbide was used, and as a modifying additive was a mixture of nanosized refractory powders of titanium nitride and yttrium oxide clad with iron and chromium. It is established that the deposited coating represents a complex system of phases formed during the melting and interaction of the chemical elements of the substrate and the melted powder mixture. The main component of the coating is the combination of nickel with iron and chromium of the type Ni3(Fe,Cr). In the melting process, a partial decomposition of the strengthening phase occurs, depending on the concentration of the nanomodifier. In the case considered, the optimum amount of the modifying additive providing the maximum hardness and wear resistance increase of the composite coatings of the Ni-Cr-B-Si-Fe / WC system is 0.1% by mass of the refractory TiN+Y[2]O[3] nanopowder additive in the composite material

On Nanomodification of Coating Obtained by Laser Cladding of Composite Powder 12NVK-01

The results of an experimental study of the effect of nanomodifying additives on the structure and mechanical properties of a multilayer coating during laser surfacing of a composite powder with a strengthening phase are presented. As a surfacing material, nickel powder 12NVK -01 with a strengthening phase of tungsten carbide was used, and as a modifying additive was a mixture of nanosized refractory powders of titanium nitride and yttrium oxide clad with iron and chromium. It is established that the deposited coating represents a complex system of phases formed during the melting and interaction of the chemical elements of the substrate and the melted powder mixture. The main component of the coating is the combination of nickel with iron and chromium of the type Ni3(Fe,Cr). In the melting process, a partial decomposition of the strengthening phase occurs, depending on the concentration of the nanomodifier. In the case considered, the optimum amount of the modifying additive providing the maximum hardness and wear resistance increase of the composite coatings of the Ni-Cr-B-Si-Fe / WC system is 0.1% by mass of the refractory TiN+Y[2]O[3] nanopowder additive in the composite material

ВНЕДРЕНИЕ КОНИЧЕСКОГО ИНДЕНТОРА В МАТЕРИАЛ ОСНОВАНИЯ ПРИ СОВМЕЩЕННОМ УДАРНОМ И УЛЬТРАЗВУКОВОМ ВОЗДЕЙСТВИЯХ

The aim of this paper is theoretical and experimental studys of a percussion and subsequent ultrasonic impacts on the indenter depth penetration into material of rigid-plastic foundation.The obtained results allow us to estimate an influence of percussion (low-frequency) and ultrasound (high-frequency) component parameters on a charging process.Целью данной работы являлись теоретическое и экспериментальное исследования влияния ударного и последующего ультразвукового воздействий на глубину внедрения индентора в материал жесткопластичного основания.Полученные результаты позволяют оценить влияние параметров ударной (низкочастотной) и ультразвуковой (высокочастотной) составляющих колебаний на процесс шаржирования