Safety standards in anesthesiology and during regional anesthesia: implementation in Ukraine

Patient safety in surgical settings is an integral part of the further sustainable development of medicine in Ukraine. This is key in times of the war and post-war state when the budget deficit at all levels of public administration and health care is significant and may grow significantly in the future. Medical errors during anesthetic management and surgery are particularly costly and significantly burden the health care system. Even the wealthiest economies cannot afford such mistakes. The price is particularly high for Ukrainian realities, and these mistakes are fatal for our health care. For this review, the authors used the electronic databases MEDLINE and Embase. 15 studies were included in the review. A part of the data was also included from the department research. Demonstration of own results is limited, as the data have already been published in other publications or materials are in the reviewing process. Basic monitoring according to the WHO standards / World Federation of Societies of Anesthesiologists (WFSA) is mainly used in hospitals of European Union countries. Results are close to 100 % for pulseoximetry and blood pressure, 98 % for electrocardiography, and 96 % for capnography. In Ukraine, monitoring methods do not have critical differences, except for a slightly lower (73.7 %) spread of capnography and ECG monitoring (83.4 %). The situation is less encouraging in the context of regional anesthesia. In Ukraine, the situation is much worse. According to the survey conducted by our department, ultrasound navigation is available in only 67 % of hospitals. There is also a low level of taking safety measures, which include checklists, training, and clinical analyzes of errors. Conclusions. According to the data of this literature review, the components of the Declaration of Helsinki on safety in anesthesiology are gradually being implemented in Ukraine, the use of the WHO checklist “Safe surgery” and safety standards of regional anesthesia is spreading. The main directions for further development are the education of physicians and other staff on patient safety, the approval of national standards and monitoring of their implementation in practice, the creation of a notification and audit system for complications and critical incidents during anesthesia

A spectroscopic analysis of the chemically peculiar star HD207561

In this paper we present a high-resolution spectroscopic analysis of the chemically peculiar star HD207561. During a survey programme to search for new roAp stars in the Northern hemisphere, Joshi et al. (2006) observed significant photometric variability on two consecutive nights in the year 2000. The amplitude spectra of the light curves obtained on these two nights showed oscillations with a frequency of 2.79 mHz [P~6-min]. However, subsequent follow-up observations could not confirm any rapid variability. In order to determine the spectroscopic nature of HD207561, high-resolution spectroscopic and spectro-polarimetric observations were carried out. A reasonable fit of the calculated Hbeta line profile to the observed one yields the effective temperature (Teff) and surface gravity (log g) as 7300 K and 3.7 dex, respectively. The derived projected rotational velocity (vsin i) for HD207561 is 74 km/sec indicative of a relatively fast rotator. The position of HD207561 in the H-R diagram implies that this is slightly evolved from the main-sequence and located well within the delta-Scuti instability strip. The abundance analysis indicates the star has slight under-abundances of Ca and Sc and mild over-abundances of iron-peak elements. The spectro-polarimetric study of HD207561 shows that the effective magnetic field is within the observational error of 100 gauss (G). The spectroscopic analysis revealed that the star has most of the characteristics similar to an Am star, rather than an Ap star, and that it lies in the delta-Scuti instability strip; hence roAp pulsations are not expected in HD207561, but low-overtone modes might be excited.Comment: 8 pages, 7 figures, 3 tables. Accepted for pubblication in MNRA

Photometric observations of LO peg in 2014-2015

We performed new observations of an ultra-fast rotator of the spectral class K - the LO Peg star - in SAO RAS in 2014 and in Zvenigorod Observatory of INASAN in 2015. The light curves were used to build the maps of temperature inhomogeneities on the LO Peg surface in order to determine the longitudes corresponding to the location of active regions. The obtained measurements suggest the ongoing evolution of movements of active regions and probably the cyclic character of such movements. According to our estimations, the area of the star surface covered with spots decreases and by now it reached 14% of the total visible area of its surface. New observations of the star in V filter allowed us to specify LO Peg long-term variability cycles. Based on spectropolarimetric observations of LO Peg the null result for measurements of mean longitudinal component of magnetic field is obtained

Study of chemically peculiar stars – I. High-resolution spectroscopy and K2 photometry of Am stars in the region of M44

ABSTRACT We present a study based on the high-resolution spectroscopy and K2 space photometry of five chemically peculiar stars in the region of the open cluster M44. The analysis of the high-precision photometric K2 data reveals that the light variations in HD 73045 and HD 76310 are rotational in nature and caused by spots or cloud-like co-rotating structures, which are non-stationary and short-lived. The time-resolved radial velocity measurements, in combination with the K2 photometry, confirm that HD 73045 does not show any periodic variability on time-scales shorter than 1.3 d, contrary to previous reports in the literature. In addition to these new rotational variables, we discovered a new heartbeat system, HD 73619, where no pulsational signatures are seen. The spectroscopic and spectropolarimetric analyses indicate that HD 73619 belongs to the peculiar Am class, with either a weak or no magnetic field, considering the 200-G detection limit of our study. The least-squares deconvolution profiles for HD 76310 indicate a complex structure in its spectra, suggesting that this star is either part of a binary system or surrounded by a cloud shell. When placed in the Hertzsprung–Russell diagram, all studied stars are evolved from the main sequence and situated in the δ Scuti instability strip. This work is relevant for further detailed studies of chemically peculiar stars, for example on inhomogeneities (including spots) in the absence of magnetic fields and the origin of the pulsational variability in heartbeat systems

OECD and Offshore Financial Centers

The article raises the controversial issues of using the features of offshore financial centers. The authors have made an attempt to highlight last initiatives of international organizations, particularly Organization for Economic Cooperation and Development, in regulation the activity of such offshore financial centers (tax havens). The Organization for Economic Cooperation and Development issued in 1998 report “Harmful tax competition: An emerging global issue” which defined key factors that constitute harmful tax competition. To address the problems caused by harmful tax competition OECD proposed to develop a list of tax haven which do not comply with international standards; to develop recommendations addressed both for members-states of OECD and nonmembers states and territories. This article demonstrates the progress made by tax havens in changing its legislation in order to comply with international standards and different opinions about legal grounds of such initiative of OECD under international law. Authors expressed opinion that complex of norms of international law, which regulates activity of offshore financial centers, is developing

The Effect of Anesthesia on the Risk of Postoperative Myocardial Injury in Elderly Patients with Hip Fracture: Randomized Controlled Trial

Hip fractures are a common pathology among patients older 50 years and cause disability, reduced duration and quality of life, even with adequate management and surgery. In the perioperative period, the most common complications leading to the death of patients are cardiovascular disease. about a hip fracture. The aim of our study was to determine the safest method of anesthesia in the context of acute myocardial injury during hip fracture surgery. The objectives of the study were to determine the frequency of postoperative myocardial damage in patients with hip fractures; compare the frequency of MINS with different types of anesthesia: general anesthesia (GA), spinal anesthesia (SA) and compartment psoas block with sciatic nerve block. Materials and methods. Randomized controlled trial was conducted from January 2018 to August 2019 in the medical center “Into-Sana” (Odessa, Ukraine). Patients with planned osteosynthesis of the proximal femur were randomized into 3 groups depending on the method of anesthesia: general anesthesia and postoperative systemic analgesia, spinal anesthesia and postoperative systemic analgesia, prolonged compartment psoas block with sciatic nerve block. Results. The study involved 90 patients. Acute postoperative myocardial injury was diagnosed in 17.6 % of cases. Postoperative elevation of troponins was significantly more often diagnosed in groups of patients with spinal anesthesia and general anesthesia compared to the group in which the psoas block compartment was used in combination with the sciatic nerve block. None of the patients had symptoms of myocardial ischemia and were not diagnosed with myocardial infarction. Hypotension was significantly more common in group 2 spinal anesthesia (OR 9 95 % CI 1.9-47, p=0.004) There was a direct moderate association between the intraoperative hypotension and the development of postoperative myocardial injury (r = 0.5). Conclusions. Prolonged compartment psoas block with sciatic nerve block intraoperatively is the safest method of anesthesia in the context of the development of postoperative myocardial injury. Intraoperative hypotension is associated with postoperative myocardial injur

A Comprehensive Study of the Young Cluster IRAS 05100+3723: Properties, Surrounding Interstellar Matter, and Associated Star Formation

We present a comprehensive multiwavelength investigation of a likely massive young cluster `IRAS 05100+3723' and its environment with the aim to understand its formation history and feedback effects. We find that IRAS 05100+3723 is a distant (∼3.2 kpc), moderate mass (∼500 \\msun), young (∼3 Myr) cluster with its most massive star being an O8.5V-type. From spectral modeling, we estimate the effective temperature and log g of the star as ∼33,000 K and ∼3.8, respectively. Our radio continuum observations reveal that the star has ionized its environment forming an HII region of size ∼2.7 pc, temperature ∼5,700 K, and electron density ∼165 cm^-3. However, our large-scale dust maps reveal that it has heated the dust up to several parsecs (∼10 pc) in the range 17-28 K and the morphology of warm dust emission resembles a bipolar HII region. From dust and ^13CO gas analyses, we find evidences that the formation of the HII region has occurred at the very end of a long filamentary cloud around 3 Myr ago, likely due to edge collapse of the filament. We show that the HII region is currently compressing a clump of mass ∼2700 \\msun at its western outskirts, at the junction of the HII region and filament. We observe several 70 μm point sources of intermediate-mass and class 0 nature within the clump. We attribute these sources as the second generation stars of the complex. We propose that the star formation in the clump is either induced or being facilitated by the compression of the expanding HII region onto the inflowing filamentary material