The Dynamics of the Pulmonary Microbiome During Mechanical Ventilation in the Intensive Care Unit and the Association with Occurrence of Pneumonia

RATIONALE: Ventilator-associated pneumonia (VAP) is the most common nosocomial infections in patients admitted to the ICU. The adapted island model predicts several changes in the respiratory microbiome during intubation and mechanical ventilation. OBJECTIVES: We hypothesised that mechanical ventilation and antibiotic administration decrease the diversity of the respiratory microbiome and that these changes are more profound in patients who develop VAP. METHODS: Intubated and mechanically ventilated ICU-patients were included. Tracheal aspirates were obtained three times a week. 16S rRNA gene sequencing with the Roche 454 platform was used to measure the composition of the respiratory microbiome. Associations were tested with linear mixed model analysis and principal coordinate analysis. MEASUREMENTS AND MAIN RESULTS: 111 tracheal aspirates were obtained from 35 patients; 11 had VAP, 18 did not have VAP. Six additional patients developed pneumonia within the first 48 hours after intubation. Duration of mechanical ventilation was associated with a decrease in α diversity (Shannon index; fixed-effect regression coefficient (β): -0.03 (95% CI -0.05 to -0.005)), but the administration of antibiotic therapy was not (fixed-effect β: 0.06; 95% CI -0.17 to 0.30). There was a significant difference in change of β diversity between patients who developed VAP and control patients for Bray-Curtis distances (p=0.03) and for Manhattan distances (p=0.04). Burkholderia, Bacillales and, to a lesser extent, Pseudomonadales positively correlated with the change in β diversity. CONCLUSION: Mechanical ventilation, but not antibiotic administration, was associated with changes in the respiratory microbiome. Dysbiosis of microbial communities in the respiratory tract was most profound in patients who developed VAP.info:eu-repo/semantics/publishedVersio

Optimization modelling of engineering enterprises financial security improvement

The article's purpose is to develop a methodical approach to improving financial security, which takes into account the acceleration of reproducing processes on Ukraine's device of engineering enterprises. This approach is based on multi-cellular vector optimization. It allows us to determine the optimal values of current assets' manifestations and net profit dynamics and set the optimal correlation between them. Approbation of a methodical approach to improving financial security and acceleration of reproducing processes on the example of Ukraine's four engineering enterprises was performed. Financial statement data for eight periods were used to build optimization vectors. To improve financial security and accelerate the reproducing processes of Ukraine's engineering enterprises, certain volumes of working assets, periods of their turnover, their marginal value taking into account different financing sources, and maximum net profit at certain manifestations of the dynamics of current assets are established. In implementing the methodical approach to improving financial security and accelerating the reproducing processes in engineering enterprises' practical activities, highly qualified personnel occupy a significant role and place. The powerful toolkit of their provision is material stimulation (an increase of wages, provision of premiums) and establishment of relations in the team (social justice in the department); the opportunity to advance on the career ladder; respect for employees by management; frank and friendly relationships at all levels of management; participation in corporate holidays of all employees. Therefore, the study's further direction is developing a methodical approach to improving the financial security of engineering enterprises, taking into account personnel support

IMPORT SUBSTITUTION AS A BASIC DEVELOPMENT TOOL OF THE RUSSIAN ECONOMY

Objectives The article is devoted to a highly topical issue, the solution of which will allow the existing toolkit for evaluating the import substitution programme in Russia to be improved. The aim of the study was to analyse the practice of applying aspects of import substitution at the regional and country level, as well as to define the objectives and expected results by 2020. The subject of the study consisted in the potentialities and limitations of implementing the import substitution policy as a means of stabilising the economy. The main problems of import substitution in all sectors of the country's economy were identified, conclusions drawn up and proposals developed to address these problems.Methods When writing the article, general scientific cognitive approaches were used in conjunction with experimental and theoretical methods to define goals, problems and expected results of import substitution policies and methods for their achievement, as well as to highlight the most important tools for supporting import substitution projects.Results The detailed results of the research are made available for supporting the implementation of the import substitution policy in the most promising sectors of the economy. The scientific novelty of the research consists in the formulation, theoretical substantiation and resolution of a set of issues related to the systematisation of existing instruments for supporting the policy of import substitution as well as with the problems of the choice of methodological tools and adaptation to Russian realities. The recommendations on the importance of import substitution contained in the article, which are characterised by various examples adapted to Russian conditions, may be of practical interest to the economy of all regions as well as the country as a whole.Conclusion The developed provisions can be used in the formation and implementation of an effective import substitution policy, taking into account all the specifics and problems of implementation

Modeling of old scars: Histopathological, biochemical and thermal analysis of the scar tissue maturation

Mature hypertrophic scars (HSs) remain a challenging clinical problem, particularly due to the absence of biologically relevant experimental models as a standard rabbit ear HS model only reflects an early stage of scarring. The current study aims to adapt this animal model for simulation of mature HS by validating the time of the scar stabilization using qualitative and quantitative criteria. The full-thickness skin and perichondrium excision wounds were created on the ventral side of the rabbit ears. The tissue samples were studied on post-operation days (PODs) 30, 60, 90 and 120. The histopathological examination and morphometry were applied in parallel with biochemical analysis of protein and glycosaminoglycans (GAGs) content and amino acid composition. The supramolecular organization of collagen was explored by differential scanning calorimetry. Four stages of the rabbit ear HS maturation were delineated and attributed with the histolomorphometrical and physicochemical parameters of the tissue. The experimental scars formed in 30 days but stabilized structurally and biochemically only on POD 90–120. This evidence-based model can be used for the studies and testing of new treatments of the mature HSs