Новые системные подходы при лечении сочетанных повреждений живота и конечностей

Цель. Снижение инвалидности и летальности среди больных с тяжелыми сочетанными травмами (ТСТ) живота и конечностей путем применения новой прогрессивной тактики лечения. Материалы и методы. Проведен ретроспективный и проспективный анализ данных 1033 больных с ТСТ, которым проводили лечение в 2009 - 2015 гг. в Городской клинической больнице № 3 г. Баку. С целью сравнительного анализа методов лечения больных разделили на две группы. Больные, которым лечение проводили в 2009 - 2010 гг. по стандартной схеме, составили 1-ю группу, больные, которым лечение проводили в 2011 - 2015 гг. по принципиально новой схеме, 2-ю. Всего с сочетанными повреждениями живота и конечностей было 216 пациентов, из них 171 включили в основную группу, 45 – в сравнительную. Степень тяжести повреждений больных основной группы оценивали по шкалам AİS (Abbreviated İnjury Scale – сокращенная шкала повреждений) и İSS (İnjury Severity Scale – шкала тяжести травмы) и им оказывали помощь с учетом принципа «damage control». Результаты. У 52,1% больных основной группы с ТСТ живота и конечностей, которых лечили с учетом принципа «damage control» и применением запрограммированной многоэтапной хирургической тактики (МХТ), при субкомпенсации травматической болезни летальность составила 16%, в сравнительной группе – 44,4%, при декомпенсации - соответственно 51,6 и 89,7%. Выводы. Полученные результаты применения МХТ при ТСТ живота и конечностей демонстрируют явные ее преимущества

Pelvic injury and acute respiratory distress syndrome in the patients, suffering severe combined trauma

Objective. Lowering of mortality in the patients, suffering severe combined pelvic injuries and acute respiratory distress-syndrome (ARDS), using a new tactics of treatment. Маterials and methods. We conducted retrospective and prospective analysis of the treatment results in 1033 patients, suffering severe combined trauma in 2009 - 2015 yrs in the Municipal Clinical Hospital №3 of Baku. For the comparative analysis conduction for the treatment results the patients were divided into two groups: a comparative one - the patients, who were treated in 2009 - 2010 yrs, and the main - the patients, who were treated in 2011 - 2015 yrs. The procedure for the comparative group patients’ treatment did not differ essentially from the standard one. The injuries of the main group were estimated, basing on the AIS (Abbreviated Injury Scale) and ISS (Injury Severity Scale) scales. The development rate for ARDS have constituted 41.2% in the main group (68 of 165 patients with pelvic injury) and 43.6% - in the comparative one (17 of 39 patients). The help for the patients, suffering nonstable pelvic injuries, who were classified in accordance to АО-Tile (fractures of the types В and С) and ARDS was delivered in accordance to the principle of a «damage control». Results. Lethality among the patients of the main group have constituted 17.6%, while in a comparative one - 23.5%. Conclusion. In compensated form of ARDS on the stage of the vital functions stabilization it is possible to perform the indicated surgical interventions, owing a small risk. In a subcompensated form of ARDS and presence of fractures of the long bones, nonstable pelvic fractures for conduction of effective treatment of the hollow organs, the surgical fixation of the fractures fragments is needed first of all. Before the surgical intervention in the patients, suffering decompensated form of ARDS, on the first order a durable (minimally 24 h) correction of vital functions and the main parameters of homeostasis is needed, аs well as the conduction of measures, aimed on the patient’s savage and survival

Quantum Algorithm for Dynamic Programming Approach for DAGs. Applications for Zhegalkin Polynomial Evaluation and Some Problems on DAGs

In this paper, we present a quantum algorithm for dynamic programming approach for problems on directed acyclic graphs (DAGs). The running time of the algorithm is $O(\sqrt{\hat{n}m}\log \hat{n})$, and the running time of the best known deterministic algorithm is $O(n+m)$, where $n$ is the number of vertices, $\hat{n}$ is the number of vertices with at least one outgoing edge; $m$ is the number of edges. We show that we can solve problems that use OR, AND, NAND, MAX and MIN functions as the main transition steps. The approach is useful for a couple of problems. One of them is computing a Boolean formula that is represented by Zhegalkin polynomial, a Boolean circuit with shared input and non-constant depth evaluating. Another two are the single source longest paths search for weighted DAGs and the diameter search problem for unweighted DAGs.Comment: UCNC2019 Conference pape

The Hot Inner Disk of FU Ori

We have constructed a detailed radiative transfer disk model which reproduces the main features of the spectrum of the outbursting young stellar object FU Orionis from ~ 4000 angstrom, to ~ 8 micron. Using an estimated visual extinction Av~1.5, a steady disk model with a central star mass ~0.3 Msun and a mass accretion rate ~ 2e-4 Msun/yr, we can reproduce the spectral energy distribution of FU Ori quite well. With the mid-infrared spectrum obtained by the Infrared Spectrograph (IRS) on board the Spitzer Space Telescope, we estimate that the outer radius of the hot, rapidly accreting inner disk is ~ 1 AU using disk models truncated at this outer radius. Inclusion of radiation from a cooler irradiated outer disk might reduce the outer limit of the hot inner disk to ~ 0.5 AU. In either case, the radius is inconsistent with a pure thermal instability model for the outburst. Our radiative transfer model implies that the central disk temperature Tc > 1000 K out to ~ 0.5 - 1 AU, suggesting that the magnetorotational instability (MRI) can be supported out to that distance. Assuming that the ~ 100 yr decay timescale in brightness of FU Ori represents the viscous timescale of the hot inner disk, we estimate the viscosity parameter (alpha) to be ~ 0.2 - 0.02 in the outburst state, consistent with numerical simulations of MRI in disks. The radial extent of the high mass accretion region is inconsistent with the model of Bell & Lin, but may be consistent with theories incorporating both gravitational instability and MRI.Comment: 32 pages, 10 figures, to appear in the Astrophysical Journa

Accretion dynamics in the classical T Tauri star V2129 Oph

We analyze the photometric and spectroscopic variability of the classical T Tauri star V2129 Oph over several rotational cycles to test the dynamical predictions of magnetospheric accretion models. The photometric variability and the radial velocity variations in the photospheric lines can be explained by rotational modulation due to cold spots, while the radial velocity variations of the He I (5876 \AA) line and the veiling variability are due to hot spot rotational modulation. The hot and cold spots are located at high latitudes and about the same phase, but the hot spot is expected to sit at the chromospheric level, while the cold spot is at the photospheric level. Using the dipole+octupole magnetic-field configuration previously proposed in the literature for the system, we compute 3D MHD magnetospheric simulations of the star-disk system. We use the simulation's density, velocity and scaled temperature structures as input to a radiative transfer code, from which we calculate theoretical line profiles at all rotational phases. The theoretical profiles tend to be narrower than the observed ones, but the qualitative behavior and the observed rotational modulation of the H\alpha and H\beta emission lines are well reproduced by the theoretical profiles. The spectroscopic and photometric variability observed in V2129 Oph support the general predictions of complex magnetospheric accretion models with non-axisymmetric, multipolar fields.Comment: Accepted by Astronomy and Astrophysic

An unusual very low-mass high-amplitude pre-main sequence periodic variable

We have investigated the nature of the variability of CHS7797, an unusual periodic variable in the Orion Nebula Cluster. An extensive I-band photometric data set of CHS7797 was compiled between 2004-2010 using various telescopes. Further optical data have been collected in R and z' bands. In addition, simultaneous observations of the ONC region including CHS7797 were performed in the I, J, Ks and IRAC [3.6] and [4.5] bands over a time interval of about 40d. CHS7797 shows an unusual large-amplitude variation of about 1.7 mag in the R, I, and z' bands with a period 17.786. The amplitude of the brightness modulation decreases only slightly at longer wavelengths. The star is faint during 2/3 of the period and the shape of the phased light-curves for seven different observing seasons shows minor changes and small-amplitude variations. Interestingly, there are no significant colour-flux correlations for wavelengths smaller than 2microns, while the object becomes redder when fainter at longer wavelengths. CHS7797 has a spectral type of M6 and an estimated mass between 0.04-0.1Msun. The analysis of the data suggests that the periodic variability of CHS7797 is most probably caused by an orbital motion. Variability as a result of rotational brightness modulation by spots is excluded by the lack of any color-brightness correlation in the optical. The latter indicates that CHS7797 is most probably occulted by circumstellar matter in which grains have grown from typical 0.1 microns to 1-2 micron sizes. We discuss two possible scenarios in which CHS7797 is periodically eclipsed by structures in a disc, namely that CHS7797 is a single object with a circumstellar disc, or that CHS7797 is a binary system, similar to KH15D, in which an inclined circumbinary disc is responsible of the variability. Possible reasons for the typical 0.3mag variations in I-band at a given phase are discussed.Comment: 11 pages, 9 figures, accepted for publication A&

A multiwavelength study of Swift GRB 060111B constraining the origin of its prompt optical emission

In this work, we present the results obtained from a multi-wavelength campaign, as well as from the public Swift/BAT, XRT, and UVOT data of GRB 060111B for which a bright optical emission was measured with good temporal resolution during the prompt phase. We identified the host galaxy at R~25 mag; its featureless spectral continuum and brightness, as well as the non-detection of any associated supernova 16 days after the trigger and other independent redshift estimates, converge to z~1-2. From the analysis of the early afterglow SED, we find that non-negligible host galaxy dust extinction, in addition to the Galactic one, affects the observed flux in the optical regime. The extinction-corrected optical-to-gamma-ray spectral energy distribution during the prompt emission shows a flux density ratio $F_{\gamma}/F_{opt}$=0.01-0.0001 with spectral index $\beta_{\gamma,opt}> \beta_{\gamma}$, strongly suggesting a separate origin of the optical and gamma-ray components. This result is supported by the lack of correlated behavior in the prompt emission light curves observed in the two energy domains. The properties of the prompt optical emission observed during GRB 060111B favor interpretation of this optical light as radiation from the reverse shock in a thick shell limit and in the slow cooling regime. The expected peak flux is consistent with the observed one corrected for the host extinction, likely indicating that the starting time of the TAROT observations is very near to or coincident with the peak time. The estimated fireball initial Lorentz factor is >260-360 at z=1-2, similar to the Lorentz factors obtained from other GRBs. GRB 060111B is a rare, good test case of the reverse shock emission mechanism in both the X-ray and optical energy ranges.Comment: Accepted for publication in Astronomy and Astrophysics, 15 pages,10 figures and 7 table

COSMOGRAIL: the COSmological MOnitoring of GRAvItational Lenses IX. Time delays, lens dynamics and baryonic fraction in HE 0435-1223

We present accurate time delays for the quadruply imaged quasar HE 0435-1223. The delays were measured from 575 independent photometric points obtained in the R-band between January 2004 and March 2010. With seven years of data, we clearly show that quasar image A is affected by strong microlensing variations and that the time delays are best expressed relative to quasar image B. We measured Delta_t(BC) = 7.8+/-0.8 days, Delta_t(BD) = -6.5+/-0.7 days and Delta_t_CD = -14.3+/-0.8 days. We spacially deconvolved HST NICMOS2 F160W images to derive accurate astrometry of the quasar images and to infer the light profile of the lensing galaxy. We combined these images with a stellar population fitting of a deep VLT spectrum of the lensing galaxy to estimate the baryonic fraction, $f_b$, in the Einstein radius. We measured f_b = 0.65+0.13-0.10 if the lensing galaxy has a Salpeter IMF and f_b = 0.45+0.04-0.07 if it has a Kroupa IMF. The spectrum also allowed us to estimate the velocity dispersion of the lensing galaxy, sigma_ap = 222+/-34 km/s. We used f_b and sigma_ap to constrain an analytical model of the lensing galaxy composed of an Hernquist plus generalized NFW profile. We solve the Jeans equations numerically for the model and explored the parameter space under the additional requirement that the model must predict the correct astrometry for the quasar images. Given the current error bars on f_b and sigma_ap, we did not constrain H0 yet with high accuracy, i.e., we found a broad range of models with chi^2 < 1. However, narrowing this range is possible, provided a better velocity dispersion measurement becomes available. In addition, increasing the depth of the current HST imaging data of HE 0435-1223 will allow us to combine our constraints with lens reconstruction techniques that make use of the full Einstein ring that is visible in this object.Comment: 12 pages, 10 figures, final version accepted for publication by A&

Adaptive Optics Integral Field Spectroscopy of the Young Stellar Objects in LkH_alpha 225

Progress in understanding the embedded stars in LkHa225 has been hampered by their variability, making it hard to compare data taken at different times, and by the limited resolution of the available data, which cannot probe the small scales between the two stars. In an attempt to overcome these difficulties, we present new near-infrared data on this object taken using the ALFA adaptive optics system with the MPE 3D integral field spectrometer and the near-infrared camera Omega-Cass. The stars themselves have K-band spectra which are dominated by warm dust emission, analagous to class I-II for low mass YSOs, suggesting that the stars are in a phase where they are still accreting matter. On the other hand, the ridge of continuum emission between them is rather bluer, suggestive of extincted and/or scattered stellar light rather than direct dust emission. The compactness of the CO emission seen toward each star argues for accretion disks (which can also account for much of the K-band veiling) rather than a neutral wind. In contrast to other YSOs with CO emission, LkHa225 has no detectable Br_gamma emission. Additionally there is no H_2 detected on the northern star, although we do confirm that the strongest H_2 emission is on the southern star, where we find it is excited primarily by thermal mechanisms. A second knot of H_2 is observed to its northeast, with a velocity shift of -75kms and a higher fraction of non-thermal emission. This is discussed with reference to the H2O maser, the molecular outflow, and [S II] emission observed between the stars.Comment: to appear in ApJ, April 2001. 18 pages, including 6 figure

Optical and radio behaviour of the BL Lacertae object 0716+714

Eight optical and four radio observatories have been intensively monitoring the BL Lac object 0716+714 in the last years: 4854 data points have been collected in the UBVRI bands since 1994, while radio light curves extend back to 1978. Many of these data are presented here for the first time. The long-term trend shown by the optical light curves seems to vary with a characteristic time scale of about 3.3 years, while a longer period of 5.5-6 years seems to characterize the radio long-term variations. In general, optical colour indices are only weakly correlated with brightness. The radio flux behaviour at different frequencies is similar, but the flux variation amplitude decreases with increasing wavelength. The radio spectral index varies with brightness (harder when brighter), but the radio fluxes seem to be the sum of two different-spectrum contributions: a steady base level and a harder-spectrum variable component. Once the base level is removed, the radio variations appear as essentially achromatic, similarly to the optical behaviour. Flux variations at the higher radio frequencies lead the lower-frequency ones with week-month time scales. The behaviour of the optical and radio light curves is quite different, the broad radio outbursts not corresponding in time to the faster optical ones and the cross-correlation analysis indicating only weak correlation with long time lags. However, minor radio flux enhancements simultaneous with the major optical flares can be recognized, which may imply that the mechanism producing the strong flux increases in the optical band also marginally affects the radio one.Comment: 18 pages, 15 Postscript figures, 5 JPEG figures, accepted for publication in A&