Role of metallurgical factors in structure and property formation for thick plates of alloys of the Al-Cu-Mg-Mn system

The role of chemical composition is studied in thick plate structure and property formation for alloys of the Al-Cu-Mg-Mn system. It is shown that in order to correct the chemical composition of aluminum alloys it is necessary to consider the alloying element compatible solubility limit within an aluminum matrix at the heating temperature for hardening and the proportion of alloying elements participating in forming almost insoluble phases with impurity elements. An important role is also played by alloying elements formed with reaction of excess phases, although they are soluble but cannot be dissolved during heating for hardening due to saturation of α-solid solution with alloying elements. © 2013 Springer Science+Business Media New York

Phase formation during nonequilibrium crystallization of Al-Mg-Si system alloys

Nonequilibrium crystallization of alloys of the Al-Mg-Si system, and also their structure and phase composition in a cast condition are studied. Thermal analysis is used to establish phase transformation temperature ranges, occurring during nonequilibrium crystallization of industrial aluminum alloys AD31 and AD33. x-Ray microanalysis is used to determine metastable phase composition in the alloys in a cast condition. © 2013 Springer Science+Business Media New York

Geometric and Statistical Properties of the Mean-Field HP Model, the LS Model and Real Protein Sequences

Lattice models, for their coarse-grained nature, are best suited for the study of the ``designability problem'', the phenomenon in which most of the about 16,000 proteins of known structure have their native conformations concentrated in a relatively small number of about 500 topological classes of conformations. Here it is shown that on a lattice the most highly designable simulated protein structures are those that have the largest number of surface-core switchbacks. A combination of physical, mathematical and biological reasons that causes the phenomenon is given. By comparing the most foldable model peptides with protein sequences in the Protein Data Bank, it is shown that whereas different models may yield similar designabilities, predicted foldable peptides will simulate natural proteins only when the model incorporates the correct physics and biology, in this case if the main folding force arises from the differing hydrophobicity of the residues, but does not originate, say, from the steric hindrance effect caused by the differing sizes of the residues.Comment: 12 pages, 10 figure

Применение идаруцизумаба при выполнении экстренных хирургических вмешательств пациентам, принимавшим дабигатран

This article presents modern possibilities for the provision of emergency surgical care to patients with atrial fibrillation, who administered dabigatran etexilate. We describe two clinical situations, in which idarucizumab, a specific dabigatran antagonist, which is a monoclonal antibody fragment that binds dabigatran, was used to neutralize the anticoagulant effect of dabigatran etexilate before emergency surgery. In the first case, the patient developed acute gangrenous calculous cholecystitis, in the second a patient required an urgent epicystostomy. In both cases, the successful outcome of surgical interventions was due to the effective interactions of the team of specialists and adherence to the algorithm for providing emergency care to such patients, as well as the presence of idarucizumab in hospitals. The postoperative management of patients and the timely resumption of anticoagulant therapy to prevent thromboembolic complications is no less important. The presented clinical cases confirm the feasibility of using idarucizumab to provide emergency surgical care to patients on dabigatran etexilate, as well as the need to take into account the possible risk of emergency interventions when anticoagulant therapy is prescribed to patients with atrial fibrillation. This paper discusses special risk groups of patients in whom rapid reversal of anticoagulation is required due to altered hemostasis.We outline data of a prospective cohort study (RE-VERSE AD), which examined the efficacy and safety of idarucizumab in patients with uncontrolled bleeding and in patients requiring urgent surgery. We also present the RE-VECTO study data on the use of idarucizumab in real-life clinical practice.В статье представлены современные возможности оказания экстренной хирургической помощи пациентам с фибрилляцией предсердий, принимавшим дабигатрана этексилат. Описаны две клинические ситуации, в которых перед экстренным хирургическим вмешательством для нейтрализации антикоагулянтного эффекта дабигатрана этексилата был применен его специфический антагонист – идаруцизумаб, представляющий собой фрагмент моноклонального антитела с высокой связывающей активностью в отношении дабигатрана. В первом случае у пациента развился острый гангренозный калькулезный холецистит, во втором больному потребовалось экстренное наложение эпицистостомы. В обоих случаях успешный исход оперативных вмешательств был обусловлен эффективным взаимодействием команды специалистов с соблюдением алгоритма оказания неотложной помощи таким пациентам, а также наличием в стационарах идаруцизумаба. Не менее важными являются послеоперационное ведение пациентов и своевременное возобновление антикоагулянтной терапии для профилактики тромбоэмболических осложнений. Представленные клинические случаи подтверждают целесообразность применения идаруцизумаба при оказании экстренной хирургической помощи пациентам, принимавшим дабигатрана этексилат, а также необходимость учитывать возможный риск неотложных вмешательств при назначении антикоагулянтной терапии у пациентов с фибрилляцией предсердий. В представленной работе обсуждаются группы пациентов особого риска, которым может потребоваться экстренная реверсия антикоагулянтной активности на фоне измененного гемостаза. Представлены данные проспективного когортного исследования RE-VERSE AD, в котором были изучены эффективность и безопасность идаруцизумаба у пациентов с неконтролируемыми кровотечениями и у пациентов, которым требовалось ургентное оперативное вмешательство. Также представлены данные исследования RE-VECTO об использовании идаруцизумаба в реальной клинической практике

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

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