Developing a Medical Institution Management System through Promoting Social Accountability

The paper regards the implementation of social accountability principles into the system of medical institution management as the target of research. The process of personnel management is viewed as its research subject. The paper aims to develop the system of incentives for medical institution personnel based on the principles of social accountability. The research methods and tools applied in the study are analysis of content and internal enterprise documentation, staff member interviews and statistical methods of data processing. The expected research outcome is the implementation phase of the social accountability management system resulted in the development of the Code of corporate conduct. The article advocates the view, that the Code of Conduct should be based on the diagnosis of the state of corporate culture and motivate employees of the organization. The management team of medical institution can set their own social and reasonable quality management system, which will enable it to promote and involve staff in the process of improvement

Use of gene expression profiling to identify candidate genes for pretherapeutic patient classification in acute appendicitis

Background: Phlegmonous and gangrenous appendicitis represent independent pathophysiological entities with different clinical courses ranging from spontaneous resolution to septic disease. However, reliable predictive methods for these clinical phenotypes have not yet been established. In an attempt to provide pathophysiological insights into the matter, a genomewide gene expression analysis was undertaken in patients with acute appendicitis. Methods: Peripheral blood mononuclear cells were isolated and, after histological confirmation of PA or GA, analysed for genomewide gene expression profiling using RNA microarray technology and subsequent pathway analysis. Results: Samples from 29 patients aged 7–17 years were included. Genomewide gene expression analysis was performed on 13 samples of phlegmonous and 16 of gangrenous appendicitis. From a total of 56 666 genes, 3594 were significantly differently expressed. Distinct interaction between T and B cells in the phlegmonous appendicitis group was suggested by overexpression of T cell receptor α and β subunits, CD2, CD3, MHC II, CD40L, and the B cell markers CD72 and CD79, indicating an antiviral mechanism. In the gangrenous appendicitis group, expression of genes delineating antibacterial mechanisms was found. Conclusion: These results provide evidence for different and independent gene expression in phlegmonous and gangrenous appendicitis in general, but also suggest distinct immunological patterns for the respective entities. In particular, the findings are compatible with previous evidence of spontaneous resolution in phlegmonous and progressive disease in gangrenous appendicitis

Switching Coal-Fired Thermal Power Plant to Composite Fuel for Recovering Industrial and Municipal Waste: Combustion Characteristics, Emissions, and Economic Effect

Combustion characteristics were studied experimentally for single droplets of fuel slurries based on wet coal processing waste with municipal solid waste components (cardboard, plastic, rubber, and wood) and used turbine oil. We established the ignition delay time for three various groups of fuel compositions in motionless air at 600–1000 °C. The minimum values are 3 s, and the maximum ones are 25 s. The maximum temperatures in the droplet vicinity reach 1300 °C during fuel combustion for compositions with 10% of used oil. The combustion temperatures of fuel compositions without oil are 200–300 °C lower. The concentrations of anthropogenic emissions in flue gases do not exceed those from dry coal combustion. Adding used oils to composite fuels reduces the concentrations of dioxins and furans in flue gases when municipal solid waste in the fuel burns out due to high combustion temperatures. Based on the experimental research findings, we have elaborated a strategy of combined industrial and municipal waste recovery by burning it as part of composite fuels, as illustrated by three neighboring regions of the Russian Federation with different industrial structures and levels of social development. This strategy suggests switching three typical coal-fired thermal power plants (one in each of the regions) to composite liquid fuel. It will reduce the hazard of waste to the environment and decrease the consumption of high-quality coals for power generation. Implementing the developed strategy for 25 years will save 145 Mt of coal and recover 190–260 Mt of waste. The positive economic effect, considering the modernization of fuel handling systems at thermal power plants and the construction of a fuel preparation plant, will make up 5.7 to 6.9 billion dollars, or 65–78%, respectively, of the main costs of three thermal power plants operating on coal within the identical period

Allogeneic Hematopoietic Stem Cell Transplantation in Immunodeficiency—Centromeric Instability—Facial Dysmorphism (ICF) Syndrome: an EBMT/ESID Inborn Errors Working Party Study

\ua9 The Author(s) 2024.Immunodeficiency–Centromeric instability–Facial dysmorphism (ICF) syndrome is an inborn error of immunity characterized by progressive immune dysfunction and multi-organ disease usually treated with antimicrobial prophylaxis and immunoglobulin substitution. Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative treatment, but data on outcome are scarce. We provide a detailed description of disease characteristics and HSCT outcome in an international cohort of ICF syndrome patients. Eighteen patients (including all four genotypes) were enrolled. Main HSCT indications were infections (83%), enteropathy/failure to thrive (56%), immune dysregulation (22%) and myelodysplasia/haematological malignancy (17%). Two patients underwent pre-emptive HSCT after early diagnosis. Patients were transplanted between 2003–2021, at median age 4.3 years (range 0.5–19), after myeloablative or reduced-intensity conditioning, from matched sibling or matched family donors, matched unrelated or mismatched donors in 39%, 50% and 12% of cases respectively. Overall survival was 83% (all deaths occurred within the first 5 months post-HSCT; mean follow-up 54 months (range 1–185)). Acute GvHD occurred in 35% of patients, severe (grade III) in two (12%), while none developed chronic GvHD. At latest follow-up (median 2.2 years (range 0.1–14)), complete donor chimerism was achieved in 15/17 surviving patients. All survivors demonstrated normalized T and B cell numbers. Immunoglobulin substitution independence was achieved in all but two patients. All survivors recovered from pre-transplant infections, enteropathy/failure to thrive and immune dysregulation. All three patients transplanted at young age (≤ 3 years), after early diagnosis, survived. The favourable clinical and immunological HSCT outcome in this cohort of patients supports the timely use of this curative treatment in ICF syndrome