Improving Wound Care using the TIME Framework

Abstract Background and purpose:Although wound care guidelines are available for primary care providers, barriers to assessment and treatment remain. This paper examines current evidence, guidelines, and discusses the need for improved training, education, and a simplified approach to wound management in primary care. The goal of the project was to increase the provider’s comfort level in assessing and initiating wound care treatment in the clinical setting. Methods:An evidence-based wound treatment framework, identified as the TIME (tissue, infection, moisture, epithelial) framework, was selected for the project. The framework was tailored by subject matter experts to provide a distinctive approach to the non-wound care expert allowing more diverse utilizations across the primary care spectrum. The modified TIME framework was shared with 29 providers over three educational sessions. Participants included Nurse Practitioners and Physicians. The knowledge attained and the usability of the framework was evaluated using a case study approach and self-reported comfort level relating to the assessment and initiation of wound treatment. Conclusion:After the educational sessions, the comfort level of all providers increased dramatically from pre- to post-assessment.Comfort level was self-reported on a 5-point Likert scale (1 = poor, 3 = average, 5 = excellent). Responses indicated that 42% of participants reported below average or poor comfort at the pretest, while 96% of participants reported average or above average comfort at the posttest. Comfort level related to knowledge gained in developing a treatment plan also increased: At pretest, 77% of participants reported below average comfort, while 96% of participants reported average or above average comfort at the posttest. Results also indicated a significant increase in wound care knowledge and understanding of wound care concepts related to the modified TIME framework, including identifying specific wounds and initiating treatment

Social Justice Based on Religious Forms of Prosociality in Russia

This article shows the social and psychological aspects of the prosociality in Russia which help to see the ways to social justice forming. In Russia, under the influence of Christianity forms an approach to prosocial behavior as a mandatory element of public life. Objective of study is an identification of the peculiarities of prosocial manifestation in Russian people with different levels of religiosity in modern social and cultural conditions. This study is conducted on the base of the complex of methods, namely, The Scale of Altruism (SRA); Social Norms of Prosocial Behavior (SNPB); Index of Core Spiritual Experiences (INSPIRIT); Religious Orientation Scale (RSO). The sample consists of 221 people living in various Russian cities (38% of men, 62% of women) aged 20 to 66 years (M-39.8). As a result, the collected data and their evaluation and discussion help to support the idea that spirituality and citizenship have a regulatory influence on the prosocial motives of mercy, tolerance, and altruism

Formation of Systemic Changes Features with Fatal Complications of Metabolic Syndrome and Chronic Diffuse Liver Diseases

Chronic liver disease at initial stages often occurs with no symptoms or with very non-specific symptoms, so timely diagnosis of chronic liver disease is of great importance, and there are significant difficulties involved therein. Not being able to diagnose the hepatic disease early, difficulties with the management of the disease and treatment arise. Different aspects of the clinical and laboratory evaluation may be of assistance in providing an early diagnosis, ranging from laboratory tests, to ultrasound, to EGD, and to rheohepatography (not used that frequently) among others. Stages of hepatitis affect the hepatic and general symptoms, and morphological changes in liver tissue are presented and discussed, followed by a section devoted to hepatic encephalopathy (HE) and how it is influenced by cerebral hemodynamics and state of liver cirrhosis (LC)

PHARMACOKINETIC RESEARCH OF POTENTIAL HYGOGLICEMIC DRUGS С7070

Introduction: The development of effective drugs for the treatment of diabetes is one of the urgent problems of modern medicine; we conducted pharmacokinetic studies of the innovative hypoglycemic drug - C7070, in rabbits and rats. Materials and Methods: The object of the study was substance C7070. Two methods of administration have been studied: intravenously and intragastrically. The concentration of C7070 is determined in blood plasma by a sensitive and selective HPLC method with tandem mass spectrometry detection. The range of detection was from 0.02 μg to 3876.00 μg in 1 ml of plasma in the animals under study. Chromatographic separation was performed on a 150 × 3.0 mm column of Zorbax Eclipce XDB C18 with a particle size of 3.0 μm (Agilent technologies, USA). To obtain stable results, a Zorbax Eclipce XDB C18 (Agilent technologies, USA) protection column of 12.5 × 3.0 mm with a particle size of 5.0 μm was used at 40 ° C for all analytical cycles. Ballast proteins in the test solutions were precipitated with acetonitrile followed by extraction of the analyte with ultrasound. Results and its Discussion: With intragastric administration, the maximum concentration (Cmax) of C7070 in blood plasma reached, on average, in rabbits through (tmax) 60 ± 0.1 minutes, in rats after 170.0 ± 79.8 minutes and was 34.6 ± 7.3 μg/ml and 17.6 ± 1.4 μg/ml, respectively. The half-life (t1/2) was prolonged and was 291.8 ± 17.1 minutes for rabbits and 225.2 ± 12.4 minutes for rats. The absolute bioavailability (fa) of C7070 in rabbits was 78.2 ± 1.0%, in rats 18.1 ± 2.0%. When administered intravenously, Cmax C7070 in blood plasma averaged 123.1 ± 23.7 μg/ml in rabbits and 337.6 ± 40.5 μg/ml in rats. The half-life period (t1/2) was prolonged and amounted to 225.5 ± 15.9 minutes for rabbits and 154.1 ± 5.1 minutes for rats. The Conclusion: The pharmacokinetic characteristics of a potential hypoglycemic drug C7070 in animals (rats, rabbits) under two routes of administration, intra-gastrointestinal and intravenous, were studied. The parameters obtained can be useful for clinical application and further studies of C7070 drugs based on it. Key words: C7070, diabetes mellitus, hypoglycemic agents, blood plasma of rabbits and rats, high-performance liquid chromatography, pharmacokinetics

Synthesis, Self-Assembly and In Vitro Cellular Uptake Kinetics of Nanosized Drug Carriers Based on Aggregates of Amphiphilic Oligomers of N-Vinyl-2-pyrrolidone

Development of nanocarrier-based drug delivery systems is a major breakthrough in pharmacology, promising targeted delivery and reduction in drug toxicity. On the cellular level, encapsulation of a drug substantially affects the endocytic processes due to nanocarrier–membrane interaction. In this study we synthesized and characterized nanocarriers assembled from amphiphilic oligomers of N-vinyl-2-pyrrolidone with a terminal thiooctadecyl group (PVP-OD). It was found that the dissolution free energy of PVP-OD depends linearly on the molecular mass of its hydrophilic part up to [Formula: see text] = 2 × 10(4), leading to an exponential dependence of critical aggregation concentration (CAC) on the molar mass. A model hydrophobic compound (DiI dye) was loaded into the nanocarriers and exhibited slow release into the aqueous phase on a scale of 18 h. Cellular uptake of the loaded nanocarriers and that of free DiI were compared in vitro using glioblastoma (U87) and fibroblast (CRL2429) cells. While the uptake of both DiI/PVP-OD nanocarriers and free DiI was inhibited by dynasore, indicating a dynamin-dependent endocytic pathway as a major mechanism, a decrease in the uptake rate of free DiI was observed in the presence of wortmannin. This suggests that while macropinocytosis plays a role in the uptake of low-molecular components, this pathway might be circumvented by incorporation of DiI into nanocarriers

Investigation of the Behavior of Hydrogen in the Aluminum Alloy in the Manufacture of Small Pigs at the Aluminum Plant UC RUSAL

В статье приведены результаты исследований динамики насыщения алюминия и его сплавов водородом в технологической схеме от алюминиевого электролизера до литейного конвейера в условиях Саяногорского алюминиевого завода ОК РУСАЛ. Показано, что одним из основных источников насыщения расплава алюминия водородом является его взаимодействие с влагой воздуха при открытых переливах металла в процессе его движения от электролизера до литейного конвейера. По результатам обследования предложены технические решения, направленные на снижение концентрации водорода в расплаве, которые составят предмет дальнейших исследованийThe results of studies of aluminum saturation dynamics and its alloys with hydrogen in the technological scheme of the electrolytic aluminum to the casting assembly line in a steel plant RUSAL. It was shown that one of the basic aluminum melt saturation hydrogen source is its interaction with moisture of air in open metal modulations during its movement from the electrolyzer molds. According to a survey of proposed technical solutions to reduce the hydrogen concentration in the melt during further investigation

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

The Physics of the B Factories

This work is on the Physics of the B Factories. Part A of this book contains a brief description of the SLAC and KEK B Factories as well as their detectors, BaBar and Belle, and data taking related issues. Part B discusses tools and methods used by the experiments in order to obtain results. The results themselves can be found in Part C