DASHBOARD INDICATORS OF THE PUBLIC SERVICE

It formulated the need for new guidelines that take into account the possibility of formalization and analysis of processes in the discharge of public functions by public servants. Dashboard monitoring of the execution of state functions to civil servants is one of the topics to be discussed today. However, for the possibility of monitoring the key task is to identify the key evaluation indicators. Among the dashboard indicators need to be identified such as the performance, team and leadership assessment effective organization of the processes of execution of the state functions and competences of civil servants. To analyze the data from different angles and positions, is the best data exploration tool Data Discovery

DASHBOARD INDICATORS OF THE PUBLIC SERVICE

It formulated the need for new guidelines that take into account the possibility of formalization and analysis of processes in the discharge of public functions by public servants. Dashboard monitoring of the execution of state functions to civil servants is one of the topics to be discussed today. However, for the possibility of monitoring the key task is to identify the key evaluation indicators. Among the dashboard indicators need to be identified such as the performance, team and leadership assessment effective organization of the processes of execution of the state functions and competences of civil servants. To analyze the data from different angles and positions, is the best data exploration tool Data Discovery

ОПРЕДЕЛЕНИЕ СЛЕДОВЫХ КОЛИЧЕСТВ O-ИЗОБУТИЛ-S-[(2-ДИЭТИЛАМИНО)ЭТИЛ] МЕТИЛФОСФОНОТИОАТА И ТОКСИЧНОГО ПРОДУКТА ЕГО ГИДРОЛИЗА МЕТОДОМ ВЫСОКОЭФФЕКТИВНОЙ ЖИДКОСТНОЙ ХРОМАТОГРАФИИ С ТАНДЕМНЫМ МАСС-СПЕКТРОМЕТРИЧЕСКИМ ДЕТЕКТИРОВАНИЕМ

To date, chemical weapons in the Russian Federation have been completely destroyed. Former chemical weapons destruction facilities (CWDFs) are subject to re-profiling. The most important stage of this activity is to assess the safety of engineering elements of the facilities to find out whether they can be involved in national economy. The most toxic and persistent substance processed at the CWDFs was a V-series agent. The certified gas chromatographic methods previously used for control of residual amounts of this substance on the surfaces and in deep layers of materials were based on its conversion to acid fluoride on silver fluoride pads. The latter are no longer produced, and these methods are impossible to use. The use of liquid tandem chromatography-mass spectrometry (HPLC-MS/MS) provided a direct determination of VR in the different matrices at the level of the toxicity threshold. At the same time HPLC-MS/MS method allows to determine the toxic acid formed by the hydrolysis of the P–O bond in the VR molecule. Previously no methods for the determination of this acid were available. A unified procedure for the sensitive target determination of VR (O-isobutyl S- (2-diethylamino)ethyl methylphosphonothioate) and its most toxic hydrolysis product S-[(2-diethylamino)ethyl] methylphosphonothioic acid in surface wipes and in deep layers of various materials is proposed. The method involves the addition of an internal standard (paraoxon) to the sample, extraction with methanol, concentration of the extract, and analysis by HPLC-MS/MS in the multiple reaction monitoring (MRM) mode. The detection limits of the analytes are close to their toxic threshold levels. Special emphasis in the procedure is paid to the reliability of identification of the analytes, which is of key importance in international investigations under the Chemical Weapons Convention.Key words: organophosphorus agents; hydrolysis, surface wipes, building materials, high performance liquid chromatography, tandem mass selective detection DOI: http://dx.doi.org/10.15826/analitika.2020.25.1.005Savel`eva E.I., Leninskii M.A., Vasil`eva I.A., Karakashev G.V., Samchenko N.A.Institute of Hygiene, Occupational Pathology and Human Ecology, Kapitolovo Station, G/P Kuzmolovsky, Vsevolozhsky District, Leningrad Region, 188663,  Russian FederationК настоящему времени химическое оружие в Российской Федерации уничтожено. Бывшие предприятия по уничтожению химического оружия подлежат перепрофилированию. Важнейшим этапом этой деятельности является установление безопасности элементов инженерной инфраструктуры объектов для оценки возможности вовлечения их в хозяйственный оборот. Из всех отравляющих веществ, обращавшихся на объектах, наиболее токсичным и персистентным является, так называемый, Ви-газ (вещество VR, О-изобутил-S-[(2-диэтиламино)этил]метилфосфонотиоат). Аттестованные газохроматографические методики, применявшиеся ранее для контроля остаточных количеств этого вещества на поверхностях и в глубинных слоях материалов, основаны на конверсии вещества во фторангидрид на таблетках, импрегнированных фторидом серебра. В настоящее время эти таблетки не производятся, и применение методик невозможно. Применение жидкостной тандемной хроматомасс-спектрометрии обеспечило прямое определение VR на уровне порога токсического действия в материалах различного матричного состава. Наряду с VR в рамках единой методики достигается также ранее методически не обеспеченное определение  токсичной кислоты, образующейся при замене в молекуле VR  алкильного радикала при кислороде протоном. Предложена методика высокочувствительного определения VR и наиболее токсичного продукта его гидролиза S-[(2-диэтиламино)этил]метилфосфонотиоата в смывах с поверхностей и в глубинных слоях материалов различного состава. Методика основана на внесении в пробу внутреннего стандарта (параоксона), экстракции метанолом, концентрировании экстракта и последующем анализе методом высокоэффективной жидкостной хроматографии с тандемным масс-спектрометрическим детектированием в режиме мониторинга заданных реакций (MRM). Реализация разработанной процедуры позволяет определять аналиты на уровне, соответствующем порогам токсического действия. Особое внимание в методике уделено достоверной идентификации аналитов, что имеет определяющее значение при международных расследованиях в рамках верификационной деятельности в соответствии с Конвенцией о запрещении химического оружия.Ключевые слова: фосфорорганические вещества серии Vх; гидролиз, смывы, строительные материалы, высокоэффективная жидкостная хроматография, тандемное масс-селективное детектированиеDOI: http://dx.doi.org/10.15826/analitika.2020.25.1.00

Determination of O-isobutyl-S-[(2-diethylamino)ethyl]-methyl phosphonothioate and the hydrolysis toxic product traces by liquid chromatography-tandem mass-spectrometry

К настоящему времени химическое оружие в Российской Федерации уничтожено. Бывшие предприятия по уничтожению химического оружия подлежат перепрофилированию. Важнейшим этапом этой деятельности является установление безопасности элементов инженерной инфраструктуры объектов для оценки возможности вовлечения их в хозяйственный оборот. Из всех отравляющих веществ, обращавшихся на объектах, наиболее токсичным и персистентным является, так называемый, Ви-газ (вещество VR, О-изобутил-S-[(2-диэтиламино)этил]метилфосфонотиоат). Аттестованные газохроматографические методики, применявшиеся ранее для контроля остаточных количеств этого вещества на поверхностях и в глубинных слоях материалов, основаны на конверсии вещества во фторангидрид на таблетках, импрегнированных фторидом серебра. В настоящее время эти таблетки не производятся, и применение методик невозможно. Применение жидкостной тандемной хроматомасс-спектрометрии обеспечило прямое определение VR на уровне порога токсического действия в материалах различного матричного состава. Наряду с VR в рамках единой методики достигается также ранее методически не обеспеченное определение токсичной кислоты, образующейся при замене в молекуле VR алкильного радикала при кислороде протоном. Предложена методика высокочувствительного определения VR и наиболее токсичного продукта его гидролиза S-[(2-диэтиламино)этил]метилфосфонотиоата в смывах с поверхностей и в глубинных слоях материалов различного состава. Методика основана на внесении в пробу внутреннего стандарта (параоксона), экстракции метанолом, концентрировании экстракта и последующем анализе методом высокоэффективной жидкостной хроматографии с тандемным масс-спектрометрическим детектированием в режиме мониторинга заданных реакций (MRM). Реализация разработанной процедуры позволяет определять аналиты на уровне, соответствующем порогам токсического действия. Особое внимание в методике уделено достоверной идентификации аналитов, что имеет определяющее значение при международных расследованиях в рамках верификационной деятельности в соответствии с Конвенцией о запрещении химического оружия.To date, chemical weapons in the Russian Federation have been completely destroyed. Former chemical weapons destruction facilities (CWDFs) are subject to re-profiling. The most important stage of this activity is to assess the safety of engineering elements of the facilities to find out whether they can be involved in national economy. The most toxic and persistent substance processed at the CWDFs was a V-series agent. The certified gas chromatographic methods previously used for control of residual amounts of this substance on the surfaces and in deep layers of materials were based on its conversion to acid fluoride on silver fluoride pads. The latter are no longer produced, and these methods are impossible to use. The use of liquid tandem chromatography-mass spectrometry (HPLC-MS/MS) provided a direct determination of VR in the different matrices at the level of the toxicity threshold. At the same time HPLC-MS/MS method allows to determine the toxic acid formed by the hydrolysis of the P–O bond in the VR molecule. Previously no methods for the determination of this acid were available. A unified procedure for the sensitive target determination of VR (O-isobutyl S- (2-diethylamino)ethyl methylphosphonothioate) and its most toxic hydrolysis product S-[(2-diethylamino)ethyl] methylphosphonothioic acid in surface wipes and in deep layers of various materials is proposed. The method involves the addition of an internal standard (paraoxon) to the sample, extraction with methanol, concentration of the extract, and analysis by HPLC-MS/MS in the multiple reaction monitoring (MRM) mode. The detection limits of the analytes are close to their toxic threshold levels. Special emphasis in the procedure is paid to the reliability of identification of the analytes, which is of key importance in international investigations under the Chemical Weapons Convention

Outcomes of elective liver surgery worldwide: a global, prospective, multicenter, cross-sectional study

Background: The outcomes of liver surgery worldwide remain unknown. The true population-based outcomes are likely different to those vastly reported that reflect the activity of highly specialized academic centers. The aim of this study was to measure the true worldwide practice of liver surgery and associated outcomes by recruiting from centers across the globe. The geographic distribution of liver surgery activity and complexity was also evaluated to further understand variations in outcomes. Methods: LiverGroup.org was an international, prospective, multicenter, cross-sectional study following the Global Surgery Collaborative Snapshot Research approach with a 3-month prospective, consecutive patient enrollment within January–December 2019. Each patient was followed up for 90 days postoperatively. All patients undergoing liver surgery at their respective centers were eligible for study inclusion. Basic demographics, patient and operation characteristics were collected. Morbidity was recorded according to the Clavien–Dindo Classification of Surgical Complications. Country-based and hospital-based data were collected, including the Human Development Index (HDI). (NCT03768141). Results: A total of 2159 patients were included from six continents. Surgery was performed for cancer in 1785 (83%) patients. Of all patients, 912 (42%) experienced a postoperative complication of any severity, while the major complication rate was 16% (341/2159). The overall 90-day mortality rate after liver surgery was 3.8% (82/2,159). The overall failure to rescue rate was 11% (82/ 722) ranging from 5 to 35% among the higher and lower HDI groups, respectively. Conclusions: This is the first to our knowledge global surgery study specifically designed and conducted for specialized liver surgery. The authors identified failure to rescue as a significant potentially modifiable factor for mortality after liver surgery, mostly related to lower Human Development Index countries. Members of the LiverGroup.org network could now work together to develop quality improvement collaboratives

Effectiveness and safety of opicapone in Parkinson’s disease patients with motor fluctuations: the OPTIPARK open-label study

Background The efficacy and safety of opicapone, a once-daily catechol-O-methyltransferase inhibitor, have been established in two large randomized, placebo-controlled, multinational pivotal trials. Still, clinical evidence from routine practice is needed to complement the data from the pivotal trials. Methods OPTIPARK (NCT02847442) was a prospective, open-label, single-arm trial conducted in Germany and the UK under clinical practice conditions. Patients with Parkinson’s disease and motor fluctuations were treated with opicapone 50 mg for 3 (Germany) or 6 (UK) months in addition to their current levodopa and other antiparkinsonian treatments. The primary endpoint was the Clinician’s Global Impression of Change (CGI-C) after 3 months. Secondary assessments included Patient Global Impressions of Change (PGI-C), the Unified Parkinson’s Disease Rating Scale (UPDRS), Parkinson’s Disease Questionnaire (PDQ-8), and the Non-Motor Symptoms Scale (NMSS). Safety assessments included evaluation of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs). Results Of the 506 patients enrolled, 495 (97.8%) took at least one dose of opicapone. Of these, 393 (79.4%) patients completed 3 months of treatment. Overall, 71.3 and 76.9% of patients experienced any improvement on CGI-C and PGI-C after 3 months, respectively (full analysis set). At 6 months, for UK subgroup only (n = 95), 85.3% of patients were judged by investigators as improved since commencing treatment. UPDRS scores at 3 months showed statistically significant improvements in activities of daily living during OFF (mean ± SD change from baseline: − 3.0 ± 4.6, p < 0.0001) and motor scores during ON (− 4.6 ± 8.1, p < 0.0001). The mean ± SD improvements of − 3.4 ± 12.8 points for PDQ-8 and -6.8 ± 19.7 points for NMSS were statistically significant versus baseline (both p < 0.0001). Most of TEAEs (94.8% of events) were of mild or moderate intensity. TEAEs considered to be at least possibly related to opicapone were reported for 45.1% of patients, with dyskinesia (11.5%) and dry mouth (6.5%) being the most frequently reported. Serious TEAEs considered at least possibly related to opicapone were reported for 1.4% of patients. Conclusions Opicapone 50 mg was effective and generally well-tolerated in PD patients with motor fluctuations treated in clinical practice. Trial registration Registered in July 2016 at clinicaltrials.gov (NCT02847442)

Novel biomarkers of kidney injury and fibrosis in patients with different severity of hypertension: relation to vascular reactivity and stiffness

Aim. To compare the relationships between conventional and new potentially more early investigational biomarkers (urine and ultrasound) of kidney injury and central aortic blood pressure, vascular stiffness and reactivity, endothelial dysfunction in patients with different severity of hypertension.Material and methods. Urine levels NGAL, KIM-1, L-FABP, albuminuria and serum levels of сystatin C and creatinine were measured in 92 hypertensive patients with mild and severe hypertension, 46 male (mean age 50,7±12,2 years). Glomerular filtration rate was estimated by the level of serum creatinine and cystatin C by MDRD and CKD-EPI formulas. Instrumental examination included measuring office blood pressure, 24-hour ambulatory blood pressure monitoring (SpaceLabs 90207), applanation tonometry (SphygmoCor, Artcor Medical) with the calculation of central aortic blood pressure, pulse wave velocity and augmentation index and Doppler ultrasonography with assessment of intraparenchymal renal arterial resistance indices — resistive index and pulsatility index (Vivid 7 dimension). Endothelial function was assessed by reactive hyperemia index with EndoPAT device (Itamar Medicals).Results. There were no differences in conventional levels of biomarkers between patients, however, cystatin C level increased and serum cystatin C estimated GFR and serum creatinine and cystatin C estimated GFR (CKD EPI formula) (sCr,Cys-estimated GFR) levels decreased with the severity of hypertension. These novel biomarkers were associated with increased central aortic blood pressure, arterial stiffness and intraparenchymal renal arterial resistance indices. Decreased sCr,Cys-estimated GFR levels were associated with lower reactive hyperemia index. There were no differences in NGAL, KIM-1 and L-FABP levels in patients with hypertension. However, NGAL levels were associated with increased augmentation index, resistive index in intralobular and pulsatility index in arcuate arteries, KIM-1 and L-FABP levels were associated with increased systolic and diastolic central aortic blood pressure, pulse wave velocity only in patients with severe and resistant hypertension.Conclusion. Serum cystatin C, NGAL, KIM-1 and L-FABP levels seem to be biomarkers of increased systemic and intrarenal vascular stiffness in patients with different severity of hypertension