11 research outputs found
Diverticular disease of the colon: diagnosis, treatment, and prevention of complications
Introduction. Diverticular disease of the colon is one of the most common gastrointestinal diseases. During the last 30–40 years, there has been a “rejuvenation” of the disease. Today, the prevalence of the disease in people under 40 years of age is 5–10%, and therefore the costs of diagnostic testing and treatment are gradually increasing, which makes the disease socially significant.Aim. To study the clinical features of diverticular disease, the features of diagnosis and treatment, and prophylactic approaches. The specific objectives of the analysis were to study epidemiology; study the role and a necessary minimum set of laboratory diagnostic test methods for the diagnosis of diverticular disease; study the incidence rate of SIBO and its impact on the clinic presentation and treatment; develop an algorithm for the diagnosis, treatment, prevention, and management of patients with diverticular disease.Materials and methods. A total of 195 patients with different forms of diverticular disease were examined. As diagnostic tests, we used blood tests, stool tests, biochemical tests; inflammatory tests: calprotectin, CRP, fibrinogen, ferritin; ultrasound imaging, irrigoscopy, CT, NMR, colonoscopy (if medically required); clinical manifestations at different stages of the course of diverticular disease. 5-aminosalicylates were used to treat exacerbation with inflammation; alpha-normix and motility regulators were used to treat exacerbation without signs of inflammation.Results. On the basis of the study results, we suggested an algorithm for the diagnosis, management and treatment of patients with diverticular disease. According to the particulars of the management, it is reasonable to divide all patients with diverticular disease into three groups: 1) patients who underwent acute diverticulitis; 2) patients with uncomplicated diverticular disease; 3) patients with complicated diverticular disease.Conclusions. The first two groups should be followed up by a gastroenterologist/general practitioner, the third group should be followed up by a surgeon. The patient tested positive for SIBO should receive drugs to eradicate SIBO. The treatment regimens for exacerbation of diverticular disease are proposed
The relationship between placental gene polymorphisms and preeclampsia risk in Russian women
To study the associations of polymorphisms of the NDRG1 gene, which is differentially expressed in the placenta, with the risk of preeclampsia (PE) development. The study group included 997 women: 366 pregnant women with preeclampsia and 631 women with physiological pregnancy. Clinical and laboratory examination of pregnant women was carried out in the Perinatal Center of the Belgorod Regional Clinical Hospital of St. Joasaph. DNA was isolated from peripheral venous blood lymphocytes by phenol-chloroform extraction. All women underwent typing of four single nucleotide polymorphisms of the N-myc downstream regulated gene 1 (NDRG1). The analysis of SNPs associations with the development of preeclampsia was performed using logistic regression analysis within the framework of additive, dominant and recessive genetic model
Анализ показателей качества технической конопли, линии для ее переработки и однотипной пеньки
It is important to create foreign units alternative, introducing modern domestic technologies and lines in the framework of import substitution for the primary processing of strategic raw materials in the industrial hemp form.(Research purpose) To substantiate the technological scheme of the line for processing industrial hemp into the hemp short, the characteristics of raw materials and low-cost fibers for the primary processing of industrial hemp in the form of tangled mass of incomplete length stems, harvested by a specialized combine.(Materials and methods) Hemp rolls of spring harvesting were processed according to two options: single and double way of raw materials through the line, after which the hemp short quality indicators were determined.(Results and discussion) The authors found out that hemp raw material had broken and tangled stems 36-470 millimeters long, of high separability, with a fiber content of 26-30 percent, but with a small breaking load of 13-17 kilogram-forces. They determined that the fiber yield with a single way was 28-29 percent, with a double way – 23-22 percent. It was shown that a double pass reduced the mass fraction of shives by 3-4 percent in absolute terms and reduced the breaking load by no more than 2 kilogram-force. A low content of defects was revealed: the mass fraction of shives was no more than 7.1 percent, the absence of a “paw”. However, due to the minimum breaking load of the fiber, hemp was assigned to the lower grade.(Conclusions) The authors substantiated the scheme of small-sized and low-cost domestic line for the industrial hemp primary processing. They determined the quality indicators values of the hemp short and its output under various conditions of primary processing. The influence share of the second way through the line on the quality indicators was calculated: fiber yield – 97.3 percent; the breaking load of the twisted ribbon is 42.4 percent; mass fraction of shives – 75.3 percent; the average mass length is 61.2 percent; the weighted average linear density is 99.1 percent.. В рамках импортозамещения для первичной переработки стратегического сырья в виде технической конопли важно создать альтернативу зарубежным агрегатам, внедряя современные отечественные технологии и линии.(Цель исследования) Обосновать технологическую схему линии переработки технической конопли в однотипную пеньку, характеристики сырья и волокна низкой себестоимости для первичной переработки технической конопли в виде спутанной массы стеблей неполной длины, убранной зерноуборочным или специализированным комбайном.(Материалы и методы) Рулоны конопли весенней уборки перерабатывали по двум вариантам: однократный и двукратный пропуск сырья через линию, после чего определяли показатели качества однотипной пеньки.(Результаты и обсуждение) Выяснили, что коноплесырье имеет поломанные и спутанные стебли длиной 36-470 миллиметров, высокой отделяемости, с содержанием волокна 26-30 процентов, но с небольшой разрывной нагрузкой 13-17 килограмм-сил. Определили, что выход волокна при однократном пропуске составил 28-29 процентов, при двукратном – 22-23 процента. Показали, что двукратный пропуск снижает массовую долю костры на 3-4 процента в абсолютном выражении и уменьшает разрывную нагрузку не более чем на 2 килограмм-силы. Выявили низкое содержание пороков: массовая доля костры не более 7,1 процента, отсутствие «лапы». Однако из-за минимального значения разрывной нагрузки волокна пеньку отнесли к низшему сорту. (Выводы) Обосновали схему малогабаритной и малозатратной отечественной линии для первичной переработки технической конопли. Определили значения показателей качества однотипной пеньки и ее выход при различных условиях первичной переработки. Вычислили долю влияния второго пропуска через линию на качественные показатели: выход волокна – 97,3 процента; разрывную нагрузку скрученной ленточки – 42,4 процента; массовую долю костры – 75,3 процента; среднюю массодлину – 61,2 процента; средневзвешенную линейную плотность – 99,1 процента
Обоснование линии для первичной переработки технической конопли в пеньку однотипную неориентированную
It was shown that there is a need for the research and development of domestic lines for processing two-season raw industrial hemp of autumn and spring harvesting. The lines need to be efficient, low-cost and produce fiber of various qualities.Research purpose The research aimed to substantiate the design of a low-cost line for the primary processing of technical hemp harvested in autumn and spring as a tangled mass of broken stems, and work out the recommendations for processing raw materials.Materials and methods Autumn harvest hemp was processed in four ways: single, double, triple and quadruple pass through the flax line of primary processing, without changing the settings of the machines. The design of this line was detailed as follows: DLV-2 flax disintegrator, horizontal lamellar fiber unloader of the VUL system named after I.N. Levitsky and two shaking machines with a lower combed field at the rotation frequency of a disintegrator rotor of 1000 revolutions per minute, and a swing frequency of the shaking machine needle rollers of 230 revolutions per minute. The obtained hemp was examined for quality indicators according to the current standards.Results and discussion It was revealed that the medium length of broken stems is 150 millimeters, the minimum and maximum length varies from 24 to 485 millimeters. It was shown that autumn harvest hemp is difficult to process: single and double passes of autumn harvest hemp through the line under research do not provide the desired fiber quality, which does not correspond to even the lowest grade. The third pass revealed to be possible to provide a quality fiber, and the fourth proved to be impractical.Conclusions It was proved that the separation and breaking load of the fiber in autumn harvest hemp weed differ from spring harvest hemp: 4.6 units versus 8.2-8.6 and 9.3 kilogram-force versus 13.5-16.9, respectively. The authors determined the quality indicators of hemp of the same type, undirected, and its yield with various processing options. For the first time, a domestic line for processing autumn and spring hemp with a capacity of 600 kilograms per hour and more was proposed, which allows to change the fiber quality, get a 1.5-2.0 times increase in productivity and change the fiber cost. The recommendations were substantiated for the effective hemp processing and the necessity of creating a disintegrator for hemp.Показали необходимость исследований и создания отечественных линий по переработке двухсезонного сырья технической конопли – осенней и весенней уборки с поля. Отметили, что линии должны быть эффективными и малозатратными и производить волокно различного качества.Цель исследования Обосновать состав малозатратной линии для первичной переработки технической конопли осенней и весенней уборки в виде спутанной массы ломаных стеблей и подготовить рекомендации переработки сырья в линии.Материалы и методы Коноплесырье осенней уборки перерабатывали по четырем вариантам: однократный, двукратный, трехкратный и четырехкратный пропуск через льняную линию первичной переработки, не изменяя настроек машин. Детализировали состав этой линии: дезинтегратор льна ДЛВ-2, горизонтальный пластинчатый разгрузчик волокна системы ВУЛ им. И.Н. Левицкого и две трясильные машины с нижним гребенным полем при частоте вращения ротора дезинтегратора 1000 оборотов в минуту, частоте качаний игольчатых валиков трясильных машин 230 оборотов в минуту. У полученной пеньки исследовали показатели качества по действующим стандартам.Результаты и обсуждение Выявили, что средняя длина ломанных стеблей – 150 миллиметров, минимальная и максимальная длина варьируется от 24 до 485 миллиметров. Показали, что коноплесырье осенней уборки – труднообрабатываемое: однократный и двукратный пропуски конопли осенней уборки через исследуемую линию не обеспечивают нужного качества волокна, оно не соответствует даже самому низкому сорту. Определили, что третий пропуск обеспечил качественное волокно, а четвертый нецелесообразен.Выводы Доказали, что у коноплесырья осенней уборки отделяемость и разрывная нагрузка волокна отличаются от конопли весенней уборки: 4,6 единицы против 8,2-8,6 и 9,3 килограммсилы против 13,5-16,9 соответственно. Определили показатели качества пеньки однотипной неориентированной и ее выход при различных вариантах переработки. Впервые предложили отечественную линию переработки осенней и весенней конопли с производительностью по тресте 600 килограммов в час и выше, позволяющую изменять качество волокна, увеличивать производительность в 1,5-2,0 раза, влияя на себестоимость волокна. Обосновали рекомендации для эффективной переработки конопли и необходимость создания дезинтегратора для коноплесырья
Смешанное дистанционно-аудиторное обучение как альтернатива традиционному аудиторному обучению базовой сердечно-легочнои реанимации и автоматической наружной дефибрилляции
Introduction. Early bystander cardiopulmonary resuscitation (CPR) is a critical factor in out-of-hospital cardiac arrest survival, and the readiness of bystanders to provide the first aid is known to be positively influenced by effective training. It is recommended to use alternative teaching methods in order to increase the accessibility of CPR training. The study was carried out to assess the effectiveness of the blended approach to resuscitation training, where classroom training hours are partially substituted with remote learning.Material and methods. This prospective randomized study was conducted in November-December 2018. Nursing students and nonmedical university students underwent classroom training (1 hour of lecture, 3 hours of hands-on training) or blended training (1 hour of on-line course, 3 hours of hands-on training) in basic CPR with automated external defibrillation (AED). CPR knowledge and willingness to attempt resuscitation were evaluated before and after the training, and resuscitation skills were assessed as well after training in a simulation scenario. CPR quality measures were registered using the skills checklist when analyzing video recordings, and automatically by means of the Resusci Anne QCPR manikin.Results. The training and the study assessments were completed by 94 participants: 55 - classroom training, 39 - blended training. The mean age was 19 years and 17 years, respectively, 24% and 31% were male. Whereas there were more participants with previous training in CPR in the classroom training group (36% vs. 13%; p<0.05), the baseline levels of knowledge and readiness to perform resuscitation on a stranger were generally comparable between the groups. After the training, there was an increase in willingness to perform resuscitation (from 3.6 to 4.4 points in both groups) and improvement in self-perceived CPR knowledge (from 2.4 to 4.0 points in the classroom training group and from 2.6 to 4.3 in the blended training group). The assessment of the CPR quality in the simulation scenario revealed no significant differences between groups, excepting higher rate of chest compressions in the blended training group (116.0 vs. 109.4, р<0.01).Conclusion. The suggested method of blended training in basic CPR with AED is no less efficient than traditional classroom training, and it can be recommended for increasing access to high-quality training in first aid.Введение. Раннее начало сердечно-легочной реанимации (СЛР) свидетелями остановки кровообращения является ключевым фактором, определяющим исход, а повышение готовности свидетелей к оказанию первой помощи достигается эффективным обучением. Для увеличения доступности обучения СЛР рекомендуется использовать альтернативные формы преподавания. Исследование проведено с целью оценки эффективности смешанной формы обучения реанимации, подразумевающей замещение части аудиторной подготовки дистанционным освоением материала.Материал и методы. Проспективное рандомизированное исследование проведено в период с ноября по декабрь 2018 г. Учащиеся медицинского колледжа и студенты вуза немедицинского профиля прошли очное обучение (лекция 1 час, отработка навыков 3 часа) или смешанное обучение (онлайн курс 1 час, отработка навыков 3 часа) базовой СЛР с использованием автоматического наружного дефибриллятора (АНД). Проводилась исходная и заключительная оценка знаний по реанимации и готовности к проведению СЛР, заключительная оценка практических навыков в симуляционной сессии. Показатели качества реанимации регистрировались при анализе видеозаписей с помощью контрольного листа и автоматически при помощи манекена ResusciAnne OCPR.Результаты. Полностью прошли обучение и получили оценку 94 участника: 55 - очное, 39 - смешанное обучение. Средний возраст составил, соответственно, 19 лет и 17 лет, участников мужского пола - 24% и 31%. В группе очной подготовки оказалось больше участников, обучавшихся СЛР в прошлом (36% против 13%; p<0,05), но исходный уровень знаний и готовности к проведению реанимации незнакомому человеку в целом был сходным. После обучения наблюдалось увеличение готовности к оказанию помощи (с 3,6 до 4,4 балла в обеих группах) и повышение уровня знаний по данным самооценки (с 2,4 до 4,0 балла в группе очного обучения и с 2,6 до 4,3 в группе смешанного обучения). Оценка показателей качества СЛР в симуляционном эксперименте не выявила существенных различий между группами, за исключением большей частоты компрессий грудной клетки в группе смешанного обучения (116,0 против 109,4, р<0,01).Вывод. Предложенный метод смешанного обучения сердечно-легочной реанимации с применением автоматического наружного дефибриллятора по эффективности не уступает традиционной аудиторной подготовке и может быть рекомендован для повышения доступности качественного обучения первой помощи
A systematic review of the literature on digital transformation: insights and implications for strategy and organizational change
In this article we provide a systematic review of the extensive yet diverse and fragmented literature on digital transformation (DT), with the goal of clarifying boundary conditions to investigate the phenomenon from the perspective of organizational change. On the basis of 279 articles, we provide a multi-dimensional framework synthesizing what is known about DT and discern two important thematical patterns: DT is moving firms to malleable organizational designs that enable continuous adaptation, and this move is embedded in and driven by digital business ecosystems. From these two patterns, we derive four perspectives on the phenomenon of DT: technology impact, compartmentalized adaptation, systemic shift and holistic co-evolution. Linking our findings and interpretations to existing work, we find that the nature of DT is only partially covered by conventional frameworks on organizational change. On the basis of this analysis, we derive a research agenda and provide managerial implications for strategy and organizational change.info:eu-repo/semantics/publishedVersio
Analysis of Industrial Hemp Quality Indicators, a Line for Its Processing and Hemp Short
It is important to create foreign units alternative, introducing modern domestic technologies and lines in the framework of import substitution for the primary processing of strategic raw materials in the industrial hemp form.(Research purpose) To substantiate the technological scheme of the line for processing industrial hemp into the hemp short, the characteristics of raw materials and low-cost fibers for the primary processing of industrial hemp in the form of tangled mass of incomplete length stems, harvested by a specialized combine.(Materials and methods) Hemp rolls of spring harvesting were processed according to two options: single and double way of raw materials through the line, after which the hemp short quality indicators were determined.(Results and discussion) The authors found out that hemp raw material had broken and tangled stems 36-470 millimeters long, of high separability, with a fiber content of 26-30 percent, but with a small breaking load of 13-17 kilogram-forces. They determined that the fiber yield with a single way was 28-29 percent, with a double way – 23-22 percent. It was shown that a double pass reduced the mass fraction of shives by 3-4 percent in absolute terms and reduced the breaking load by no more than 2 kilogram-force. A low content of defects was revealed: the mass fraction of shives was no more than 7.1 percent, the absence of a “paw”. However, due to the minimum breaking load of the fiber, hemp was assigned to the lower grade.(Conclusions) The authors substantiated the scheme of small-sized and low-cost domestic line for the industrial hemp primary processing. They determined the quality indicators values of the hemp short and its output under various conditions of primary processing. The influence share of the second way through the line on the quality indicators was calculated: fiber yield – 97.3 percent; the breaking load of the twisted ribbon is 42.4 percent; mass fraction of shives – 75.3 percent; the average mass length is 61.2 percent; the weighted average linear density is 99.1 percent
Blended Distance-classroom Training as an Alternative to the Traditional Classroom Training in Basic Cardiopulmonary Resuscitation and Automated External Defibrillation
Introduction. Early bystander cardiopulmonary resuscitation (CPR) is a critical factor in out-of-hospital cardiac arrest survival, and the readiness of bystanders to provide the first aid is known to be positively influenced by effective training. It is recommended to use alternative teaching methods in order to increase the accessibility of CPR training. The study was carried out to assess the effectiveness of the blended approach to resuscitation training, where classroom training hours are partially substituted with remote learning.Material and methods. This prospective randomized study was conducted in November-December 2018. Nursing students and nonmedical university students underwent classroom training (1 hour of lecture, 3 hours of hands-on training) or blended training (1 hour of on-line course, 3 hours of hands-on training) in basic CPR with automated external defibrillation (AED). CPR knowledge and willingness to attempt resuscitation were evaluated before and after the training, and resuscitation skills were assessed as well after training in a simulation scenario. CPR quality measures were registered using the skills checklist when analyzing video recordings, and automatically by means of the Resusci Anne QCPR manikin.Results. The training and the study assessments were completed by 94 participants: 55 - classroom training, 39 - blended training. The mean age was 19 years and 17 years, respectively, 24% and 31% were male. Whereas there were more participants with previous training in CPR in the classroom training group (36% vs. 13%; p<0.05), the baseline levels of knowledge and readiness to perform resuscitation on a stranger were generally comparable between the groups. After the training, there was an increase in willingness to perform resuscitation (from 3.6 to 4.4 points in both groups) and improvement in self-perceived CPR knowledge (from 2.4 to 4.0 points in the classroom training group and from 2.6 to 4.3 in the blended training group). The assessment of the CPR quality in the simulation scenario revealed no significant differences between groups, excepting higher rate of chest compressions in the blended training group (116.0 vs. 109.4, р<0.01).Conclusion. The suggested method of blended training in basic CPR with AED is no less efficient than traditional classroom training, and it can be recommended for increasing access to high-quality training in first aid