Interesų konfliktas: sąvoka ir galimi sprendimo būdai

Interesų konfliktų kyla beveik visomis gyvenimo situacijomis, kai vienas asmuo veikia kito asmens intere­sais. Šiame straipsnyje nagrinėjamas teorinis interesų konflikto sąvokos modelis, apibūdinamos interesų konfliktų rūšys, taip pat pateikiami galimi interesų konflikto sprendimo būdai: prevencinės ir interesų konfliktų valdymo priemonės. Visas tyrimas atliekamas remiantis atstovavimo teorija. Almost all of the situations where one person acts according to another‘s interests give rise to conf­licts of interest. In this paper author analyses the theoretical model of conflict of interests, describes va­rious types of conflicts of interests and presents possible solutions: preventive and managing measures. All the research is carried out in the context of agency theory

Flue Gas Condensation in a Model of the Heat Exchanger: The Effect of the Cooling Water Flow Rate and Its Temperature on Local Heat Transfer

In boiler houses, the biggest heat energy losses are caused by flue gas being released into the atmosphere. Installation of condensing heat exchangers allows reducing the temperature of the flue gas being released, condensation of water vapor, and, thus, efficient use of the waste heat. There are many investigations of average heat transfer in different types of condensing heat exchangers. They indicate also that the cooling water flow rate and its temperature are important parameters defining water vapor condensation efficiency. Investigations of local condensation heat transfer in condensing heat exchangers are very limited. Only recently experimental investigations of the flue gas temperature and Re number effect on local condensation heat transfer in the model of the condensing heat exchanger at a constant cooling water flow rate and its temperature have started being published. In this paper, for the first time, detailed experimental investigations of the cooling water flow rate and its temperature effect on local condensation heat transfer of the water vapor from the flue gas in the model of the condensing heat exchanger (long vertical tube) are presented. The results revealed that at higher flue gas Rein, the effect of the cooling water flow rate and its temperature has a stronger impact on local heat transfer distribution along the test section.Research Council of Lithuania (LMTLT), grant number S-MIP-20-30

MDR/XDR-TB management of patients and contacts: Challenges facing the new decade. The 2020 clinical update by the Global Tuberculosis Network.

The continuous flow of new research articles on MDR-TB diagnosis, treatment, prevention and rehabilitation requires frequent update of existing guidelines. This review is aimed at providing clinicians and public health staff with an updated and easy-to-consult document arising from consensus of Global Tuberculosis Network (GTN) experts. The core published documents and guidelines have been reviewed, including the recently published MDR-TB WHO rapid advice and ATS/CDC/ERS/IDSA guidelines. After a rapid review of epidemiology and risk factors, the clinical priorities on MDR-TB diagnosis (including whole genome sequencing and drug-susceptibility testing interpretations) and treatment (treatment design and management, TB in children) are discussed. Furthermore, the review comprehensively describes the latest information on contact tracing and LTBI management in MDR-TB contacts, while providing guidance on post-treatment functional evaluation and rehabilitation of TB sequelae, infection control and other public health priorities

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome

Advances in structure elucidation of small molecules using mass spectrometry

The structural elucidation of small molecules using mass spectrometry plays an important role in modern life sciences and bioanalytical approaches. This review covers different soft and hard ionization techniques and figures of merit for modern mass spectrometers, such as mass resolving power, mass accuracy, isotopic abundance accuracy, accurate mass multiple-stage MS(n) capability, as well as hybrid mass spectrometric and orthogonal chromatographic approaches. The latter part discusses mass spectral data handling strategies, which includes background and noise subtraction, adduct formation and detection, charge state determination, accurate mass measurements, elemental composition determinations, and complex data-dependent setups with ion maps and ion trees. The importance of mass spectral library search algorithms for tandem mass spectra and multiple-stage MS(n) mass spectra as well as mass spectral tree libraries that combine multiple-stage mass spectra are outlined. The successive chapter discusses mass spectral fragmentation pathways, biotransformation reactions and drug metabolism studies, the mass spectral simulation and generation of in silico mass spectra, expert systems for mass spectral interpretation, and the use of computational chemistry to explain gas-phase phenomena. A single chapter discusses data handling for hyphenated approaches including mass spectral deconvolution for clean mass spectra, cheminformatics approaches and structure retention relationships, and retention index predictions for gas and liquid chromatography. The last section reviews the current state of electronic data sharing of mass spectra and discusses the importance of software development for the advancement of structure elucidation of small molecules

Vacuum-assisted biopsy and steroid therapy for granulomatous lobular mastitis: report of three cases.

We report the cases of three patients with granulomatous lobular mastitis (GLM), who were treated successfully with low-dose steroid therapy. Furthermore, the findings of our review of 271 patients reported in the literature suggest that steroid therapy is the treatment of choice for GLM