Non-Equilibrium Reaction Rates in the Macroscopic Chemistry Method for DSMC Calculations

The Direct Simulation Monte Carlo (DSMC) method is used to simulate the flow of rarefied gases. In the Macroscopic Chemistry Method (MCM) for DSMC, chemical reaction rates calculated from local macroscopic flow properties are enforced in each cell. Unlike the standard total collision energy (TCE) chemistry model for DSMC, the new method is not restricted to an Arrhenius form of the reaction rate coefficient, nor is it restricted to a collision cross-section which yields a simple power-law viscosity. For reaction rates of interest in aerospace applications, chemically reacting collisions are generally infrequent events and, as such, local equilibrium conditions are established before a significant number of chemical reactions occur. Hence, the reaction rates which have been used in MCM have been calculated from the reaction rate data which are expected to be correct only for conditions of thermal equilibrium. Here we consider artificially high reaction rates so that the fraction of reacting collisions is not small and propose a simple method of estimating the rates of chemical reactions which can be used in the Macroscopic Chemistry Method in both equilibrium and non-equilibrium conditions. Two tests are presented: (1) The dissociation rates under conditions of thermal non-equilibrium are determined from a zero-dimensional Monte-Carlo sampling procedure which simulates ‘intra-modal’ non-equilibrium; that is, equilibrium distributions in each of the translational, rotational and vibrational modes but with different temperatures for each mode; (2) The 2-D hypersonic flow of molecular oxygen over a vertical plate at Mach 30 is calculated. In both cases the new method produces results in close agreement with those given by the standard TCE model in the same highly nonequilibrium conditions. We conclude that the general method of estimating the non-equilibrium reaction rate is a simple means by which information contained within non-equilibrium distribution functions predicted by the DSMC method can be included in the Macroscopic Chemistry Method

ON THE TERMINOLOGY OF SPONDYLOARTHRITIS

By the end of the first decade of the 21st century, spondyloarthritis studies have accumulated a certain number of terms that are obsolete, but used by physicians in their everyday speech, on the one hand, and a great variety of different definitions, on the other hand. In January 2014, the first organizational meeting of the Expert Group on Spondyloarthritis, Association of Rheumatologists of Russia, decided that its primary task should be to order the terminology used in this area. The authors primarily collected the terms, which had been already used in medical vocabulary, and then divided them into two categories: obsolete definitions and terms to be finalized and unified. This publication gives guidelines for using the medical terms relevant to spondyloarthritis and separately discusses how to correctly write the term sacroiliitis

Approaches to the therapy of heart failure with reduced ejection fraction. Resolution of an online meeting of the Volga Federal District experts

At an online meeting of experts held on May 14, 2021 additional research results on a sodium-glucose co-transporter-2 (SGLT2) inhibitor empagliflozin in patients with heart failure with reduced ejection fraction were considered. According to the data from the EMPEROR-Reduced international study, cardiovascular and renal effects of empagliflozin therapy in patients with and without type 2 diabetes (T2D) were analyzed. A number of proposals and recommendations was accepted regarding the further study of cardiovascular and renal effects of empagliflozin and its use in clinical practice in patients with heart failure, regardless of the T2D presence

2020 Clinical practice guidelines for Myocarditis in adults

Russian Society of Cardiology (RSC)With the participation: Eurasian Association of Therapists (EUAT), Society of Specialists in Heart Failure (OSSN), Russian Scientific Medical Society of Therapists (RNMOT), Russian Society of Pathologists, Russian Society of Radiologists and Radiologists (RSR)Endorsed by: Research and Practical Council of the Ministry of Health of the Russian Federatio

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Базисная терапия тяжелой бронхиальной астмы у взрослых. Данные национального исследования НАБАТ

The study was aimed to Investigate severe asthma therapy in Russia. It involved 515 patients from 7 Russian cities according to the criteria of severe asthma. Individual registration cards were filled in considering dem ographic data, principal clinical features, drug therapy. It has been found that both inpatient and outpatient therapy of severe asthm a in Russia does not correspond to the standards recommended. The results confirmed high efficiency of inhaled corticosteroids when combined with long-acting β2-agonists. This therapy was found to be more effective then other regarding to symptoms, lung function param eters, rate of admission to a hospital and duration of hospital staying. Patients treated with this drug combination were satisfied by the treatment more often.Исследование проведено с целью изучения особенностей терапии тяжелой бронхиальной астмы (БА) в России. В соответствии с использовавшимися критериями тяжелой БА в исследование были включены 515 больных в 7 городах России. В каждом центре заполнялись индивидуальные регистрационные карты, при этом учитывались демографические характеристики пациента, основные аспекты клинического течения заболевания, мониторирования, фармакотерапии. Было обнаружено, что терапия тяжелой астмы в России, как на стационарном, так и на амбулаторном этапах, не соответствует рекомендованным стандартам. Результаты исследования еще раз подтверждают высокую эффективность применения комбинации ингаляционных кортикостероидов и длительнодействующих β2-агонистов. Данный вид терапии оказался эффективнее других вариантов в отношении симптомов, функции легких, частоты госпитализаций и их длительности, а пациенты, совместно получавшие ингаляционные кортикостероиды и длительнодействующие β2-агонистов были в гораздо большем количестве случаев удовлетворены лечением

Эффективность препарата комбинированной терапии серетида мультидиска у больных среднетяжелой бронхиальной астмой (результаты открытого многоцентрового рандомизированного сравнительного исследования "ADULT-STEP")

This trial was aimed to researching an efficacy of the Seretide Multidisk combinated therapy in patients with moderate bronchial asthma.The "Adult-step" program was designed as a randomized opened comparative multi-center trial. It involved 65 patients with moderate asthma aged 16 to 50 years divided into two groups. The 1st group patients have received fluticazone propionate 500 meg daily for all the treatment period (5 months) that was the "step up" mode. The 2nd group patients have received Seretide Multidisk 250/50 meg twice a day for 12 weeks, then they were changed the treatment to the fluticazone propionate 500 meg daily that was the "step down" mode. The control of asthma was assessed in 8 weeks by the E.Bateman's criteria. The 2nd group patients with unsatisfactory effect were expelled from the study, those of the 1st group were transferred to the "step down" mode. The study protocol included an assessment of the main asthma signs, respiratory function parameters, severity of post-exertion bronchoconstruction.At the end of the trial 69.7% of patients taking Seretide Multidisk (the 2nd group) and 28.1% of the patients taking fluticazone propionate (the 1st group) achieved the asthma symptoms control according to the E.Bateman's criteria. So, the initial therapy with Seretide Multidisk was more effective than the "step up" pharmacological mode in moderate asthma patients.Цель настоящего исследования — изучение эффективности препарата комбинированной терапии серетида мультидиска у больных среднетяжелой бронхиальной астмой (БА).Дизайн программы "Adult-step" — открытое сравнительное рандомизированное многоцентровое исследование. В работе принимали участие 65 пациентов со среднетяжелым течением БА в возрасте от 16 до 50 лет, которые были разделены на 2 группы. Пациенты группы 1 в качестве стартовой терапии получали флутиказона пропионат (ФП) в дозе 500 мкг/ сут в течение всего лечебного периода (5 мес) — подход "step ир". Пациентам группы 2 назначался серетид мультидиск 250/50 мкг дважды в сутки (1-3-й месяцы терапии), а затем ФП 500 мкг/сут (4-5-й месяцы) — подход "step down". Конечными показателями эффективности терапии служили критерии "хорошо контролируемой астмы" по E.Bateman. Протокол исследования включал также оценку выраженности основных клинических симптомов БА, показателей функции внешнего дыхания, тяжести постнагрузочного бронхоспазма. В случае отсутствия контроля над симптомами БА по критериям E.Bateman на этапе 8 нед терапии пациенты группы 2 исключались из исследования, а представители группы 1 переводились на терапию в режиме "step down" (группа 1А). К моменту окончания исследования 69,7% пациентов из группы 2 и 28,1% представителей группы 1 достигли критериев "хорошо контролируемой астмы". Таким образом, применение подхода "step down" с использованием серетида мультидиска в качестве стартовой терапии у больных среднетяжелой БА демонстрирует превосходящую клиническую эффективность по сравнению с подходом "step ир"

Guidance on Noncorticosteroid Systemic Immunomodulatory Therapy in Noninfectious Uveitis: Fundamentals Of Care for UveitiS (FOCUS) Initiative

Topic: An international, expert-led consensus initiative to develop systematic, evidence-based recommendations for the treatment of noninfectious uveitis in the era of biologics. Clinical Relevance: The availability of biologic agents for the treatment of human eye disease has altered practice patterns for the management of noninfectious uveitis. Current guidelines are insufficient to assure optimal use of noncorticosteroid systemic immunomodulatory agents. Methods: An international expert steering committee comprising 9 uveitis specialists (including both ophthalmologists and rheumatologists) identified clinical questions and, together with 6 bibliographic fellows trained in uveitis, conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol systematic review of the literature (English language studies from January 1996 through June 2016; Medline [OVID], the Central Cochrane library, EMBASE, CINAHL, SCOPUS, BIOSIS, and Web of Science). Publications included randomized controlled trials, prospective and retrospective studies with sufficient follow-up, case series with 15 cases or more, peer-reviewed articles, and hand-searched conference abstracts from key conferences. The proposed statements were circulated among 130 international uveitis experts for review. A total of 44 globally representative group members met in late 2016 to refine these guidelines using a modified Delphi technique and assigned Oxford levels of evidence. Results: In total, 10 questions were addressed resulting in 21 evidence-based guidance statements covering the following topics: when to start noncorticosteroid immunomodulatory therapy, including both biologic and nonbiologic agents; what data to collect before treatment; when to modify or withdraw treatment; how to select agents based on individual efficacy and safety profiles; and evidence in specific uveitic conditions. Shared decision-making, communication among providers and safety monitoring also were addressed as part of the recommendations. Pharmacoeconomic considerations were not addressed. Conclusions: Consensus guidelines were developed based on published literature, expert opinion, and practical experience to bridge the gap between clinical needs and medical evidence to support the treatment of patients with noninfectious uveitis with noncorticosteroid immunomodulatory agents

Clinical features of post-COVID-19 period. Results of the international register “Dynamic analysis of comorbidities in SARS-CoV-2 survivors (AKTIV SARS-CoV-2)”. Data from 6-month follow-up

Aim. To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register. Material and methods.The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 — 2770. Patients diagnosed with COVID-19 receiving in- and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two nonoverlapping branches (in- and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months. Results. According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3- and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure. Conclusion. According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period