Invasive aspergillosis in patients with COVID-19 in intensive care units: results of a multicenter study

Objective. To study risk factors, clinical and radiological features and effectiveness of the treatment of invasive aspergillosis (IA) in adult patients with COVID-19 (COVID-IA) in intensive care units (ICU). Materials and Methods. A total of 60 patients with COVID-IA treated in ICU (median age 62 years, male – 58%) were included in this multicenter prospective study. The comparison group included 34 patients with COVID-IA outside the ICU (median age 62 years, male – 68%). ECMM/ISHAM 2020 criteria were used for diagnosis of CAPA, and EORTC/MSGERC 2020 criteria were used for evaluation of the treatment efficacy. A case-control study (one patient of the main group per two patients of the control group) was conducted to study risk factors for the development and features of CAPA. The control group included 120 adult COVID-19 patients without IA in the ICU, similar in demographic characteristics and background conditions. The median age of patients in the control group was 63 years, male – 67%. Results. 64% of patients with COVID-IA stayed in the ICU. Risk factors for the COVID-IA development in the ICU: chronic obstructive pulmonary disease (OR = 3.538 [1.104–11.337], p = 0.02), and prolonged (> 10 days) lymphopenia (OR = 8.770 [4.177–18.415], p = 0.00001). The main location of COVID-IA in the ICU was lungs (98%). Typical clinical signs were fever (97%), cough (92%), severe respiratory failure (72%), ARDS (64%) and haemoptysis (23%). Typical CT features were areas of consolidation (97%), hydrothorax (63%), and foci of destruction (53%). The effective methods of laboratory diagnosis of COVID-IA were test for galactomannan in BAL (62%), culture (33%) and microscopy (22%) of BAL. The main causative agents of COVID-IA are A. fumigatus (61%), A. niger (26%) and A. flavus (4%). The overall 12-week survival rate of patients with COVID-IA in the ICU was 42%, negative predictive factors were severe respiratory failure (27.5% vs 81%, p = 0.003), ARDS (14% vs 69%, p = 0.001), mechanical ventilation (25% vs 60%, p = 0.01), and foci of destruction in the lung tissue on CT scan (23% vs 59%, p = 0.01). Conclusions. IA affects predominantly ICU patients with COVID-19 who have concomitant medical conditions, such as diabetes mellitus, hematological malignancies, cancer, and COPD. Risk factors for COVID-IA in ICU patients are prolonged lymphopenia and COPD. The majority of patients with COVID-IA have their lungs affected, but clinical signs of IA are non-specific (fever, cough, progressive respiratory failure). The overall 12-week survival in ICU patients with COVID-IA is low. Prognostic factors of poor outcome in adult ICU patients are severe respiratory failure, ARDS, mechanical ventilation as well as CT signs of lung tissue destruction

Psychological safety of educational environment in studies of foreign scholars at the beginning of the 21st century

The article is devoted to the issue of psychological safety of educational environment in the publications of contemporary foreign scientists. It provides a detailed analysis and theoretical review of the approaches and techniques applied with regard to solve complicated matters the high school students may face with. The outcomes of fundamental and applied research are also introduced for better understanding of the current situation in the field of psychological safety of educational environment based on international experience

Continuous analogue of the Newton method in the inverse problem of scattering theory in the presence of eigenfunctions and eigenvalues

The paper considers the inverse scattering problem---the problem of determining the potential function in a second-order Schrödinger type differential equation with initial condition depending on a parameter. The potential function is assumed to be a smooth function satisfying a suitable limit condition. Besides the Schrödinger differential equation, another first-order differential equation involving a potential function as a coefficient, called the "equation of phases", is considered. For solving the inverse scattering problem in the presence of eigenvalues and eigenfunctions, a variant of the Newton method is formulated and applied. A numerical example is given

REGULARITIES OF THE DRYING OF LACTULOSE SOLUTIONS

The existing patented technologies of the production of lactulose were analyzed, and leading producers were defined. Crystalline lactulose was produced via the spray drying of lactulose solutions with various mass fractions of solids. The principal dependences of the finished product output on the drying temperature, the solution flow rate, the air flow rate generated by an aspirator, and the gas spray rate were studied. The results of analyzing the presented dependences allowed us to determine the optimal mass fraction of solids in a solution for spray drying. The results of studying the quantitative parameters of dry lactulose, including hygroscopicity, particle size, moisture content, and finished product solubility index, were presented

Material selection for prosthetics of defects of dentitions at patients with functional and inflammatory bowel diseases

Objective: To study clinical-morphological characteristics of parodontal diseases, markers of density of bone tissue and to define rational approaches to prosthetics of defects of dentitions in patients with colon diseases. Materials and methods: 55 patients with ulcerative colitis, even 80 with the syndrome of the irritable bowel syndrome with defects of dentitions, have been applied metallic, cement prostheses and having prostheses on the intraosseous of implants. Markers of bone metabolism in the blood serum and in the oral liquid, the proliferating activity of the epitheliocytes of periodontium have been evaluated according to the morphometric indices of the markers of the proliferation of ki-67, cyclein D1, the inhibitor of apoptosis of bcl-2 have been inspected. Results: Connection of intensity of periodontitis with the stage of colon disease has been stated. Metallic dental prostheses have been served as additional risk factors of development of parodontal diseases in patients with ulcerative colitis. Conclusion: The diagnostic value of the markers of proliferation has been determined in diagnostics of parodontal disease during the application of prostheses from different materials

COMPOSITION AND MICROSTRUCTURE INVESTIGATION FOR THE MODELING AND CLASSIFICATION OF DIETARY FIBER DERIVED FROM PLANTS

Investigation of the composition and microstructure of dietary fiber derived from plants showed that the stabilizers investigated differ with regard to size and shape of the particles and the density of particle distribution. The composition and microstructure of dietary fiber derived from plants have been studied using electron microscopy. Spectrometric profiles of chemical composition have been obtained, and the content of the predominant chemical elements in food microstructure stabilizers has been determined. Some similarity concerning the content of certain chemical elements and the ratio of the contents of different elements has been detected upon the analysis of food structure stabilizers of the same type (carboxymethylcellulose, gum, and sodium pyrophosphate). Mathematical processing of photomicrographs of structure stabilizer samples has been performed, and masks for the assessment of the content of microcavities in the particles of the structure stabilizers investigated have been created

Geochemistry of hydrocarbons of the Terek-Caspian trough

Within the Terek-Caspian oil and gas bearing basin of the Eastern Ciscaucasia, oil deposits occur in a wide stratigraphic range of rocks of the Mesozoic-Cenozoic section, from the Jurassic, at depths from 5800 to 200 m. In the sedimentary section, carbonate and terrigenous Middle Jurassic, Lower Cretaceous, Oligocene-Lower Miocene and Miocene oil-mother rocks are distinguished. Organic matter from them have different geochemical characteristics and different maturity to realize the generation potential. The article presents the results of a comprehensive study of potential petroleum-bearing rocks and hydrocarbon fluids from the Terek-Sunzha folded zone of the Terek-Caspian Trough, including lithological, chemical-bituminological, pyrolytic, chromatographic and chromatographic-mass spectrometry investigations. A detailed description of hydrocarbon fluids at the molecular level and genetic correlations of oil-oil and oil-organic matter are given. Specific features of the oil deposits of the Mesozoic-Cenozoic section are noted. Among the studied bitumens, the chromatographic characteristics of the extractable organic matter from the Khadum carbonate-clayey deposits and oils from the Cretaceous and Neogene reservoirs are most similar. The composition of a complex natural mixture of hydrocarbons from various sources, with different maturation during the geological history of the region, does not allow making unambiguous conclusions about the source or sources of hydrocarbons for the deposits of the Terek-Caspian Trough