Biological necrectomy and vacuum-therapy in complex treatment of decompensated chronic venous insufficiency of the lower extremities

Objective. To improve the results of treatment in patients, suffering decompensated forms of chronic venous insufficiency (CHVI) of the lower extremities, using introduction of biological necrectomy and vacuum-therapy in combination with complex of optimal surgical interventions, depending on state of venous hemodynamics of the lower extremities. Materials and methods. In 2015-2018 yrs in Surgical Clinic of the Zakarpattya Regional Clinical Hospital named after Andriy Novak 147 patients, ageing 40 yrs old and older, suffering CHVI Category C6 in accordance to the CEAP Classification, were treated. All the patients were divided into two groups: the Group I consisted of 76 patients, suffering CHVI in decompensated stage on background of varicose disease, and the Group II - 71 patients, suffering trophic ulcers (TU) on background of postthrombophlebitic syndrome (PTHPHS). Results. There was established, that the TU clearance under the action of maggot-therapy in patients, suffering decompensated course of CHVI, is significantly more effective, than under the impact of vacuum-therapy. Autodermoplasty must be performed in all the patients, having TU with 4 cm in diameter, Good and satisfactory results were observed in 75 (98.7%) patients of Group I and in 63 (88.7%) patients of Group II, while poor results - in 8 (11.3%) patients of Group II. The working capacity of patients, suffering CHVI in decompensated stage of varicose genesis, have enhanced in 16.5 times, while in the patients, suffering TU on background of PTHPHS – in 1.25 times. Conclusion. Combined treatment of CHVI in decompensated stage, occurring on background of varicose disease includes the TU clearance, using vacuum-therapy or biological necrectomy with subsequent elimination of vertical reflux. In the patients, suffering TU on the PTHPHS background the biologic necrectomy with elimination of horizontal reflux is advantageous. The working capacity in patients with CHVI in decompensated stage of varicose genesis have enhanced in 16.5 times, while in the patients with TU on the PTHPHS background - in 1.25 times

Preliminary results of the APAC spills working group

The Spills Working Group is one of 6 working groups under the DOE-DP Accident Phenomenology and Consequence (APAC) methodology evaluation program. Objectives are to assess methodologies available in this area, evaluate their adequacy for accident analysis at DOE facilities, identify development needs, and define standard practices to be followed in the analyses supporting facility safety basis documentation. The group focused on methodologies for estimating 4 types of spill source terms: liquid chemical spills and evaporation, pressurized liquid/gas releases, solid spills and resuspension/sublimation, and resuspension of particulate matter from liquid spills. Computer models were identified with capabilities for quantifying release rates or released amounts from spills, and a set of sample test problems was established for evaluating a specific model for some common or probable accident release scenarios. The group agreed on a set of recommended computer codes which are classified according to spill type and hazard category. Code results for a given problem varied by up to an order of magnitude; this is attributed to differences in how the physics and thermodynamics of the problems were treated by the models

Global disparities in SARS-CoV-2 genomic surveillance

Genomic sequencing is essential to track the evolution and spread of SARS-CoV-2, optimize molecular tests, treatments, vaccines, and guide public health responses. To investigate the global SARS-CoV-2 genomic surveillance, we used sequences shared via GISAID to estimate the impact of sequencing intensity and turnaround times on variant detection in 189 countries. In the first two years of the pandemic, 78% of high-income countries sequenced >0.5% of their COVID-19 cases, while 42% of low- and middle-income countries reached that mark. Around 25% of the genomes from high income countries were submitted within 21 days, a pattern observed in 5% of the genomes from low- and middle-income countries. We found that sequencing around 0.5% of the cases, with a turnaround time <21 days, could provide a benchmark for SARS-CoV-2 genomic surveillance. Socioeconomic inequalities undermine the global pandemic preparedness, and efforts must be made to support low- and middle-income countries improve their local sequencing capacity

Global disparities in SARS-CoV-2 genomic surveillance

Genomic sequencing is essential to track the evolution and spread of SARS-CoV-2, optimize molecular tests, treatments, vaccines, and guide public health responses. To investigate the global SARS-CoV-2 genomic surveillance, we used sequences shared via GISAID to estimate the impact of sequencing intensity and turnaround times on variant detection in 189 countries. In the first two years of the pandemic, 78% of high-income countries sequenced >0.5% of their COVID-19 cases, while 42% of low- and middle-income countries reached that mark. Around 25% of the genomes from high income countries were submitted within 21 days, a pattern observed in 5% of the genomes from low- and middle-income countries. We found that sequencing around 0.5% of the cases, with a turnaround time <21 days, could provide a benchmark for SARS-CoV-2 genomic surveillance. Socioeconomic inequalities undermine the global pandemic preparedness, and efforts must be made to support low- and middle-income countries improve their local sequencing capacity

Combining genomic and epidemiological data to compare the transmissibility of SARS-CoV-2 variants Alpha and Iota.

SARS-CoV-2 variants shaped the second year of the COVID-19 pandemic and the discourse around effective control measures. Evaluating the threat posed by a new variant is essential for adapting response efforts when community transmission is detected. In this study, we compare the dynamics of two variants, Alpha and Iota, by integrating genomic surveillance data to estimate the effective reproduction number (Rt) of the variants. We use Connecticut, United States, in which Alpha and Iota co-circulated in 2021. We find that the Rt of these variants were up to 50% larger than that of other variants. We then use phylogeography to show that while both variants were introduced into Connecticut at comparable frequencies, clades that resulted from introductions of Alpha were larger than those resulting from Iota introductions. By monitoring the dynamics of individual variants throughout our study period, we demonstrate the importance of routine surveillance in the response to COVID-19

Use of One-On Analysis to Evaluate Total System Performance of the Proposed Yucca Mountain Nuclear Waste Repository

The Yucca Mountain Site Characterization Project is currently evaluating the future performance of the proposed U.S. high-level nuclear waste repository. Using the Total System Performance Assessment (TSPA) model, a stylized analysis was conducted to evaluate the relative importance of natural and engineered barriers to movement of radionuclides from the proposed repository. These stylized ''one-on'' analyses consist of sequentially adding features, components, and processes, associated with the natural and engineered barriers, incorporated within the TSPA model and evaluating the effect of these elements on repository performance, as measured by the total mean annual dose to a reasonably maximally exposed individual. The analyses are ''stylized'' in the sense that they are performed to gain insight only. They are not meant to represent a real physical system in most cases, and in some cases allow the TSPA model to simulate results using parameter ranges outside the normal bounds of the TSPA model. In particular, the analyses provide insight into the relative contributions of repository features and processes in a way that is not possible using the full TSPA performance-assessment model. For example, in the nominal scenario of the TSPA model, the contribution of the natural system is masked by the contribution of the engineered system

Electron beams in 2D inhomogeneous graphene and nonlinear electrodynamics properties of graphene-dielectric multilayered metamaterials

We develop farther our 'three-level' approach to graphene metamaterials including 'metamaterial treatment' of 2D beams of electron (BE) in graphene with 2D inhomogeneous and nonlinear electromagnetic waves in graphene-dielecric multlayered structres. A possibility of resonant behaviour of the components of the electron disrribution function in 2D 'diffraction grating', with 1D periodicity along a direction of beam propagation, is shown, first. The theory of 2D electromagnetic (EM) pulse propagation through multilayered graphene-dielectric structure with electron nonlinearity and 'transmission bistability' is developed

Nonlinear reshaping of terahertz pulses with graphene metamaterials

We study the propagation of electromagnetic waves through a slab of graphene metamaterial composed of the layers of graphene separated by dielectric slabs. Starting from the kinetic expression for two-dimensional electric current in graphene, we derive