Computerized testing complex for modeling pipeline material behavior with prolonged exposure in operational environments

В процесі багаторічної експлуатації матеріал трубопроводу істотно змінює свої фізико-механічні властивості. Розроблено методику моделювання роботи матеріалу трубопроводу у експлуатаційних середовищах. Створено програмне забезпечення, яке дозволяє, крім стандартних можливостей запису вимірюваних величин у файл та одночасної побудови графічних залежностей в режимі реального часу, регулювати частоту вимірів в залежності від швидкості зміни вимірюваного параметра.Created method of modeling material pipeline in operational environments and software, which allows, in addition to standard features recording measured values in a file of graphic and simultaneous dependencies in real time, adjust the frequency of measurements depending on the rate of change of the measured parameter

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

A Clinical Case of Out-of-Hospital Cardiac Arrest and Post-Resuscitation Disease in a Patient with Acute Myocardial Infarction

Background. Prediction of survival in adult patients after out-of-hospital cardiopulmonary resuscitation remains a difficult issue. This clinical case describes our experience of managing a patient after an out-of-hospital cardiac arrest due to an acute coronary syndrome with the development of postanoxic coma, with subsequent successful restoration of neurological function. Case description. Patient K., a 48-year-old man, was delivered unconscious (Glasgow Coma Scale score 7) without spontaneous breathing. During transportation to the hospital, ventricular fibrillation occurred, cardiopulmonary resuscitation lasting 1 hour was performed with restoration of sinus rhythm. Diagnosis: acute coronary syndrome with ST segment elevation; cardiogenic shock; condition after cardiopulmonary resuscitation. Stenting of the occluded circumflex artery was performed. During the patient’s stay in the intensive care unit (ICU), hemodynamics and laboratory tests were carefully monitored and no significant systemic disorders were detected. The patient stayed in the ICU for 19 days. At the time of discharge, the general condition was relatively satisfactory, Glasgow Coma Scale score was 14-15, with minimal neurological deficit. The patient was transferred to a neurological department for further rehabilitation. Results. Determining the probability of either good or bad outcome in comatose patients after cardiac arrest is one of the most important steps in treatment after stabilization of the heart activity. Recent data confirm the utility of electroencephalography (EEG) monitoring for prognosis. The pattern of response to sedative drugs may provide prognostic information. In this clinical case, when EEG was recorded during sedation, preservation of the response to stimuli was registered, and 48 hours after disconnection, patterns corresponding to awakening were registered, which was considered as a positive prognostic sign. Conclusions. In adult patients after cardiopulmonary resuscitation with postanoxic coma, clinical, neurophysiological and radiological tests predict poor neurologic outcome within the first week after cardiac arrest with a certain percentage of false positive rate. However, most predictors have low sensitivity and specificity. Accurate prognosing requires a comprehensive approach. Neurological examination remains the gold standard, but its result is affected by the effect of sedative drugs used in critical patients in the ICU. The use of EEG increases the accuracy of the prognosing

PhotosynQ – cloud platform powered by IoT devices

This article describes how to connect to PhotosynQ and some of the features of a cloud service. The focus is on organizing communication between the web service and the Internet of Things. An example and procedure for integrating a number of digital encoders that are not included in the list supported by the default platform through modification of the open-source base firmware is given. It has been suggested that in the future, a number of tools can be designed in the future, including for environmental monitoring, using basic digital sensors included in the so-called Arduino UNO Kit kits and more. It is emphasized that the PhotosynQ web platform, which is related to the SaaS cloud computing model, is an environment for collecting, analyzing, deriving and discussing results where research protocols and calculation procedures are open access. Its primary focus is only on working with a specific list of dashboards, offset by the openness of the software itself, which provides communication with the platform

Formation of Characteristic Polynomials on the Basis of Fractional Powers j of Dynamic Systems and Stability Problems of Such Systems

The article presents the creation of characteristic polynomials on the basis of fractional powers j of dynamic systems and problems related to the determination of the stability intervals of such systems

Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study

Background: Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the 'Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. Methods: Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. Results: Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (VT) was 8 ml [Interquartile Range, IQR = 7.3-9] per predicted body weight; median positive end-expiratory pressure (PEEP) was 5 [3 to 5] cmH20. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. Conclusions: Neurosurgical patients are ventilated with low VT and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs

Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications

Background: The aim of this post hoc analysis of a large cohort study was to evaluate the association between night-time surgery and the occurrence of intraoperative adverse events (AEs) and postoperative pulmonary complications (PPCs). Methods: LAS VEGAS (Local Assessment of Ventilatory Management During General Anesthesia for Surgery) was a prospective international 1-week study that enrolled adult patients undergoing surgical procedures with general anaesthesia and mechanical ventilation in 146 hospitals across 29 countries. Surgeries were defined as occurring during 'daytime' when induction of anaesthesia was between 8: 00 AM and 7: 59 PM, and as 'night-time' when induction was between 8: 00 PM and 7: 59 AM. Results: Of 9861 included patients, 555 (5.6%) underwent surgery during night-time. The proportion of patients who developed intraoperative AEs was higher during night-time surgery in unmatched (43.6% vs 34.1%; P<0.001) and propensity-matched analyses (43.7% vs 36.8%; P = 0.029). PPCs also occurred more often in patients who underwent night-time surgery (14% vs 10%; P = 0.004) in an unmatched cohort analysis, although not in a propensity-matched analysis (13.8% vs 11.8%; P = 0.39). In a multivariable regression model, including patient characteristics and types of surgery and anaesthesia, night-time surgery was independently associated with a higher incidence of intraoperative AEs (odds ratio: 1.44; 95% confidence interval: 1.09-1.90; P = 0.01), but not with a higher incidence of PPCs (odds ratio: 1.32; 95% confidence interval: 0.89-1.90; P = 0.15). Conclusions: Intraoperative adverse events and postoperative pulmonary complications occurred more often in patients undergoing night-time surgery. Imbalances in patients' clinical characteristics, types of surgery, and intraoperative management at night-time partially explained the higher incidence of postoperative pulmonary complications, but not the higher incidence of adverse events

Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: Post-hoc analysis of LAS VEGAS study

Background: Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the 'Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. Methods: Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. Results: Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (VT) was 8 ml [Interquartile Range, IQR = 7.3-9] per predicted body weight; median positive end-expiratory pressure (PEEP) was 5 [3 to 5] cmH20. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. Conclusions: Neurosurgical patients are ventilated with low VT and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs

Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications

Background: The aim of this post hoc analysis of a large cohort study was to evaluate the association between night-time surgery and the occurrence of intraoperative adverse events (AEs) and postoperative pulmonary complications (PPCs)