Геопространственное распределение госпитальных ресурсов в региональных травматологических системах (обзор зарубежной литературы)

The review presents the results of foreign studies related to geospatial analysis and modeling of the distribution of trauma centers and helicopter emergency medical services in developed regional trauma systems. The optimal number and geographical location of the trauma centers in the region is determined taking into account the timing of the delivery of victims to the trauma centers of a high level, population density, hospitalization of patients with severe trauma, and the frequency of inter-hospital transfers. The distribution of hospital resources of the trauma system should be based on the needs of the population, and vary depending on the geographical and social characteristics of the region. В обзоре представлены результаты зарубежных исследований, касающихся геопространственного анализа и моделирования распределения травмоцентров и вертолетных баз скорой медицинской помощи в развитых региональных травматологических системах. Оптимальное количество и географическое расположение травмоцентров в регионе определяется с учетом сроков доставки пострадавших в травмоцентры высокого уровня, плотности населения, объема госпитализаций пациентов с тяжелой травмой, частоты межбольничных переводов. Распределение госпитальных ресурсов травматологической системы должно основываться на потребностях населения, варьировать в зависимости от географических и социальных особенностей региона.

Факторы риска и профилактика нозокомиальной пневмонии при политравме

Nosocomial pneumonia (NK) is one of the most frequent complications of polytrauma leading to death. Meanwhile, the recommendations on prevention of NK in case of polytrauma have not been specified so far. This is due in large part to the lack of study of the pathophysiology of severe combined trauma. The review presents the results of modern experimental and clinical studies of the effect of shock, immune distress syndrome, posttraumatic immunosuppression, the phenomenon of mutual aggravation of lesions, age, sex, concomitant pathology on the risk of NK in polytrauma. The role of iatrogenic risk factors for NK in polytrauma – intubation of trachea and artificial lung ventilation (AVL), massive hemotransfusions, immobilization, the phenomenon of “second strike” after multiple surgeries has been determined. The most effective measures of NK prevention are reduction of the duration of AVL, prevention of oropharyngeal colonization and aspiration in case of AVL, use of inhalation antibacterial drugs, antishock measures, early mobilization of the patient, the earliest possible stable functional osteosynthesis by minimally traumatic methods. The data on the effectiveness of selective decontamination of intestines, probiotics and glucocorticosteroids for the prevention of NK in polytrauma are inconsistent. A promising area of NK prophylaxis may be the development of agents that regulate the complex mechanisms of immune response to polytrauma and prevent secondary acute lung injury and post-traumatic immunosuppression.Нозокомиальная пневмония (НКП) относится к наиболее частым осложнениям политравмы (ПТ), приводящим к смерти. Между тем рекомендации по профилактике НКП при ПТ к настоящему времени не конкретизированы. Во многом это связано с недостаточной изученностью патофизиологии тяжелой сочетанной травмы. В обзоре представлены результаты современных экспериментальных и клинических исследований влияния шока, иммунного дистресс-синдрома, посттравматической иммуносупрессии, феномена взаимного отягощения повреждений, возраста, пола, сопутствующей патологии на риск развития НКП при ПТ. Определена роль ятрогенных факторов риска НКП при ПТ – интубации трахеи и искусственная вентиляция легких (ИВЛ), массивные гемотрансфузии, иммобилизации, феномен «второго удара» после множественных операций. Наиболее эффективными мерами профилактики НКП являются сокращение продолжительности ИВЛ, предупреждение колонизации ротоглотки и аспирации при ИВЛ, применение ингаляционных антибактериальных препаратов, противошоковые мероприятия, ранняя мобилизация пациента, максимально ранний стабильно-функциональный остеосинтез малотравматичными методами. Данные об эффективности селективной деконтаминации кишечника, пробиотиков и глюкокортикостероидов для профилактики НКП при ПТ противоречивы. Перспективным направлением профилактики НКП может быть разработка средств, при помощи которых регулируются сложные механизмы иммунного ответа на ПТ и предупреждающих вторичное острое повреждение легких и посттравматическую иммуносупрессию

Measurement of the K+→μ+νμγK^+\rightarrow{\mu^+}{\nu_{\mu}}{\gamma} decay form factors in the OKA experiment

A precise measurement of the vector and axial-vector form factors difference $F_V-F_A$ in the $K^+\rightarrow{\mu^+}{\nu_{\mu}}{\gamma}$ decay is presented. About 95K events of $K^+\rightarrow{\mu^+}{\nu_{\mu}}{\gamma}$ are selected in the OKA experiment. The result is $F_V-F_A=0.134\pm0.021(stat)\pm0.027(syst)$. Both errors are smaller than in the previous $F_V-F_A$ measurements.Comment: 9 pages, 8 figure

First Observation of CP Violation in B0->D(*)CP h0 Decays by a Combined Time-Dependent Analysis of BaBar and Belle Data

We report a measurement of the time-dependent CP asymmetry of B0->D(*)CP h0 decays, where the light neutral hadron h0 is a pi0, eta or omega meson, and the neutral D meson is reconstructed in the CP eigenstates K+ K-, K0S pi0 or K0S omega. The measurement is performed combining the final data samples collected at the Y(4S) resonance by the BaBar and Belle experiments at the asymmetric-energy B factories PEP-II at SLAC and KEKB at KEK, respectively. The data samples contain ( 471 +/- 3 ) x 10^6 BB pairs recorded by the BaBar detector and ( 772 +/- 11 ) x 10^6, BB pairs recorded by the Belle detector. We measure the CP asymmetry parameters -eta_f S = +0.66 +/- 0.10 (stat.) +/- 0.06 (syst.) and C = -0.02 +/- 0.07 (stat.) +/- 0.03 (syst.). These results correspond to the first observation of CP violation in B0->D(*)CP h0 decays. The hypothesis of no mixing-induced CP violation is excluded in these decays at the level of 5.4 standard deviations.Comment: 9 pages, 2 figures, submitted to Physical Review Letter

Study of the decay K+→π+π−π+γK^{+}\to\pi^{+}\pi^{-}\pi^{+}\gamma in the OKA experiment

A high statistics data sample of the decays of $K^+$ mesons to three charged particles was accumulated by the OKA experiment in 2012 and 2013. This allowed to select a clean sample of about 450 events with $K^{+}\to\pi^{+}\pi^{-}\pi^{+}\gamma$ decays with the energy of the photon in the kaon rest frame greater than 30 MeV. The measured branching fraction of the $K^{+}\to\pi^{+}\pi^{-}\pi^{+}\gamma$, with $E_{\gamma}^{*}$ > 30 MeV is $(0.71 \pm 0.05) \times 10^{-5}$. The measured energy spectrum of the decay photon is compared with the prediction of the chiral perturbation theory to O$(p^{4})$. A search for an up-down asymmetry of the photon with respect to the hadronic system decay plane is also performed.Comment: 9 pages, 7 figures, 1 tabl

Observation of anomalous Upsilon(1S)pi+pi- and Upsilon(2S)pi+pi- production near the Upsilon(5S) resonance

We report the first observation of e+e- -> Upsilon(1S)pi+pi-, Upsilon(2S)pi+pi-, and first evidence for e+e- -> Upsilon(3S)pi+pi-, Upsilon(1S)K+K-, near the peak of the Upsilon(5S) resonance at sqrt{s}~10.87 GeV. The results are based on a data sample of 21.7 fb^-1 collected with the Belle detector at the KEKB e+e- collider. Attributing the signals to the Upsilon(5S) resonance, the partial widths Gamma(Upsilon(5S) -> Upsilon(1S) pi+pi-) = 0.59 +- 0.04 (stat) +- 0.09 (syst) MeV and Gamma(Upsilon(5S) -> Upsilon(2S) pi+pi-) = 0.85 +- 0.07 (stat) +- 0.16 (syst) MeV are obtained from the observed cross sections. These values exceed by more than two orders of magnitude the previously measured partial widths for dipion transitions between lower Upsilon resonances.Comment: 6 pages, 4 figures, submit to PR

Search for CP violation in D+→K−K+π+D^{+} \to K^{-}K^{+}\pi^{+} decays

A model-independent search for direct CP violation in the Cabibbo suppressed decay $D^+ \to K^- K^+\pi^+$ in a sample of approximately 370,000 decays is carried out. The data were collected by the LHCb experiment in 2010 and correspond to an integrated luminosity of 35 pb$^{-1}$. The normalized Dalitz plot distributions for $D^+$ and $D^-$ are compared using four different binning schemes that are sensitive to different manifestations of CP violation. No evidence for CP asymmetry is found.Comment: 13 pages, 8 figures, submitted to Phys. Rev.

Differential branching fraction and angular analysis of the decay B0→K∗0μ+μ−

The angular distribution and differential branching fraction of the decay B 0→ K ∗0 μ + μ − are studied using a data sample, collected by the LHCb experiment in pp collisions at s√=7 TeV, corresponding to an integrated luminosity of 1.0 fb−1. Several angular observables are measured in bins of the dimuon invariant mass squared, q 2. A first measurement of the zero-crossing point of the forward-backward asymmetry of the dimuon system is also presented. The zero-crossing point is measured to be q20=4.9±0.9GeV2/c4 , where the uncertainty is the sum of statistical and systematic uncertainties. The results are consistent with the Standard Model predictions

Opposite-side flavour tagging of B mesons at the LHCb experiment

The calibration and performance of the oppositeside flavour tagging algorithms used for the measurements of time-dependent asymmetries at the LHCb experiment are described. The algorithms have been developed using simulated events and optimized and calibrated with B + →J/ψK +, B0 →J/ψK ∗0 and B0 →D ∗− μ + νμ decay modes with 0.37 fb−1 of data collected in pp collisions at √ s = 7 TeV during the 2011 physics run. The oppositeside tagging power is determined in the B + → J/ψK + channel to be (2.10 ± 0.08 ± 0.24) %, where the first uncertainty is statistical and the second is systematic

Measurement of charged particle multiplicities in pppp collisions at s=7{\sqrt{s} =7}TeV in the forward region

The charged particle production in proton-proton collisions is studied with the LHCb detector at a centre-of-mass energy of ${\sqrt{s} =7}$TeV in different intervals of pseudorapidity $\eta$. The charged particles are reconstructed close to the interaction region in the vertex detector, which provides high reconstruction efficiency in the $\eta$ ranges $-2.5<\eta<-2.0$ and $2.0<\eta<4.5$. The data were taken with a minimum bias trigger, only requiring one or more reconstructed tracks in the vertex detector. By selecting an event sample with at least one track with a transverse momentum greater than 1 GeV/c a hard QCD subsample is investigated. Several event generators are compared with the data; none are able to describe fully the multiplicity distributions or the charged particle density distribution as a function of $\eta$. In general, the models underestimate the charged particle production