Метод экспертных оценок в лингводидактике

Рассматривается использование метода экспертных оценок как в общей системе научно-педагогической экспертной деятельности, так и в рамках ее лингводидактического аспекта. Дается характеристика процедуры проведения экспертизы, а также оценивается перспективность обращения к интеллектуальным компьютерным системам как инструментам экспертного анализа

Impact of electronic reminders on venous thromboprophylaxis after admissions and transfers

Objective Clinical decision support has the potential to improve prevention of venous thromboembolism (VTE). The purpose of this prospective study was to analyze the effect of electronic reminders on thromboprophylaxis rates in wards to which patients were admitted and transferred. The latter was of particular interest since patient handoffs are considered to be critical safety issues. Methods The trial involved two study periods in the six departments of a university hospital, three of which were randomly assigned to the intervention group displaying reminders during the second period. At 6 h after admission or transfer, the algorithm checked for prophylaxis orders within 0-30 h of the patient's arrival, increasing the specificity of the displayed reminders. Results The significant impact of the reminders could be seen by prophylaxis orders placed 6-24 h after admission (increasing from 8.6% (223/2579) to 12% (307/2555); p<0.0001) and transfer (increasing from 2.4% (39/1616) to 3.7% (63/1682); p=0.034). In admission wards, the rate of thromboprophylaxis increased from 62.4% to 67.7% (p<0.0001), and in transfer wards it increased from 80.2% to 84.3% (p=0.0022). Overall, the rate of prophylaxis significantly increased in the intervention group from 69.2% to 74.3% (p<0.0001). No significant changes were observed in the control group. Postponing prophylaxis checks to 6 h after admissions and transfers reduced the number of reminders by 62% and thereby minimized the risk of alert fatigue. Conclusions The reminders improved awareness of VTE prevention in both admission and transfer wards. This approach may contribute to better quality of care and safer patient handoff

Mechanistic differences between methanol and dimethyl ether in zeolite-catalyzed hydrocarbon synthesis

Water influences critically the kinetics of the autocatalytic conversion of methanol to hydrocarbons in acid zeolites. At very low conversions but otherwise typical reaction conditions, the initiation of the reaction is delayed in presence of H$_{2}$O. In absence of hydrocarbons, the main reactions are the methanol and dimethyl ether (DME) interconversion and the formation of a C$_{1}$ reactive mixture—which in turn initiates the formation of first hydrocarbons in the zeolite pores. We conclude that the dominant reactions for the formation of a reactive C$_{1}$ pool at this stage involve hydrogen transfer from both MeOH and DME to surface methoxy groups, leading to methane and formaldehyde in a 1:1 stoichiometry. While formaldehyde reacts further to other C$_{1}$ intermediates and initiates the formation of first C–C bonds, CH$_{4}$ is not reacting. The hydride transfer to methoxy groups is the rate-determining step in the initiation of the conversion of methanol and DME to hydrocarbons. Thus, CH$_{4}$ formation rates at very low conversions, i.e., in the initiation stage before autocatalysis starts, are used to gauge the formation rates of first hydrocarbons. Kinetics, in good agreement with theoretical calculations, show surprisingly that hydrogen transfer from DME to methoxy species is 10 times faster than hydrogen transfer from methanol. This difference in reactivity causes the observed faster formation of hydrocarbons in dry feeds, when the concentration of methanol is lower than in presence of water. Importantly, the kinetic analysis of CH$_{4}$ formation rates provides a unique quantitative parameter to characterize the activity of catalysts in the methanol-to-hydrocarbon process

A universal anti-Xa assay for rivaroxaban, apixaban, and edoxaban measurements: method validation, diagnostic accuracy and external validation.

A universal anti-Xa assay for the determination of rivaroxaban, apixaban and edoxaban drug concentrations would simplify laboratory procedures and facilitate widespread implementation. Following two pilot studies analysing spiked samples and material from 698 patients, we conducted a prospective multicentre cross-sectional study, including 867 patients treated with rivaroxaban, apixaban or edoxaban in clinical practice to comprehensively evaluate a simple, readily available anti-Xa assay that would accurately measure drug concentrations and correctly predict relevant levels in clinical practice. Anti-Xa activity was measured by an assay calibrated with low-molecular-weight heparin (LMWH) in addition to ultra-high performance liquid chromatography-tandem mass spectrometry (LC-MS/MS). As an external validation, LMWH-calibrated anti-Xa activity was also determined in nine external laboratories. The LMWH-calibrated anti-Xa activity correlated strongly with rivaroxaban, apixaban or edoxaban drug levels [r &lt;sub&gt;s&lt;/sub&gt; = 0·98, 95% confidence interval (CI) 0·98-0·98]. The sensitivity for the clinically relevant cut-off levels of 30, 50 and 100 µg/l was 96·2% (95% CI 94·4-97·4), 96·4% (95% CI 94·4-97·7) and 96·7% (95% CI 94·3-98·1) respectively. Concordant results were obtained in the external validation study. In conclusion, a universal, LMWH-calibrated anti-Xa assay accurately measured rivaroxaban, apixaban and edoxaban concentrations and correctly predicted relevant drug concentrations in clinical practice

Indications and Outcomes of Patients Receiving Therapeutic Plasma Exchange under Critical Care Conditions: A Retrospective Eleven-Year Single-Center Study at a Tertiary Care Center

Background: Therapeutic plasma exchange (TPE) is frequently performed in critical care settings for heterogenous indications. However, specific intensive care unit (ICU) data regarding TPE indications, patient characteristics and technical details are sparse. Methods: We performed a retrospective, single-center study using data from January 2010 until August 2021 for patients treated with TPE in an ICU setting at the University Hospital Zurich. Data collected included patient characteristics and outcomes, ICU-specific parameters, as well as apheresis-specific technical parameters and complications. Results: We identified n = 105 patients receiving n = 408 TPEs for n = 24 indications during the study period. The most common was thrombotic microangiopathies (TMA) (38%), transplant-associated complications (16.3%) and vasculitis (14%). One-third of indications (35.2%) could not be classified according to ASFA. Anaphylaxis was the most common TPE-related complication (6.7%), while bleeding complications were rare (1%). The median duration of ICU stay was 8 ± 14 days. Ventilator support, renal replacement therapy or vasopressors were required in 59 (56.2%), 26 (24.8%), and 35 (33.3%) patients, respectively, and 6 (5.7%) patients required extracorporeal membrane oxygenation. The overall hospital survival rate was 88.6%. Conclusion: Our study provides valuable real-world data on heterogenous TPE indications for patients in the ICU setting, potentially supporting decision-making

Combining Theoretical and Experimental Methods to Probe Confinement within Microporous Solid Acid Catalysts for Alcohol Dehydration

Catalytic transformations play a vital role in the implementation of chemical technologies, particularly as society shifts from fossil-fuel-based feedstocks to more renewable bio-based systems. The dehydration of short-chain alcohols using solid acid catalysts is of great interest for the fuel, polymer, and pharmaceutical industries. Microporous frameworks, such as aluminophosphates, are well-suited to such processes, as their framework channels and pores are a similar size to the small alcohols considered, with many different topologies to consider. However, the framework and acid site strength are typically linked, making it challenging to study just one of these factors. In this work, we compare two different silicon-doped aluminophosphates, SAPO-34 and SAPO-5, for alcohol dehydration with the aim of decoupling the influence of acid site strength and the influence of confinement, both of which are key factors in nanoporous catalysis. By varying the alcohol size from ethanol, 1-propanol, and 2-propanol, the acid sites are constant, while the confinement is altered. The experimental catalytic dehydration results reveal that the small-pore SAPO-34 behaves differently to the larger-pore SAPO-5. The former primarily forms alkenes, while the latter favors ether formation. Combining our catalytic findings with density functional theory investigations suggests that the formation of surface alkoxy species plays a pivotal role in the reaction pathway, but the exact energy barriers are strongly influenced by pore structure. To provide a holistic view of the reaction, our work is complemented with molecular dynamics simulations to explore how the diffusion of different species plays a key role in product selectivity, specifically focusing on the role of ether mobility in influencing the reaction mechanism. We conclude that confinement plays a significant role in molecular diffusion and the reaction mechanism translating to notable catalytic differences between the molecules, providing valuable information for future catalyst design