The management of patients with chronic musculoskeletal pain is an important biomedical problem due to the prevalence of this pathology and its resistance to therapeutic interventions. Psychosocial ...factors play a significant role in the formation and maintenance of chronic pain. In this regard, psychotherapeutic assistance is very important in the management of patients with chronic pain within the framework of multidisciplinary treatment. This review discusses the main psychotherapeutic approaches that have been used for chronic musculoskeletal pain: cognitive behavioral therapy, mindfulness therapy, psychoanalysis, hypnosis. General information about the essence of the discussed methods and the evidence base for their use in chronic pain are presented. A significant effectiveness of cognitive-behavioral therapy and techniques based on mindfulness therapy has been demonstrated.
Objective of the study was an assessment of the current epizootiological situation on tularemia in the Stavropol Region. Materials and methods. Processed were the data of laboratory investigations of ...the field material over the period of 2010-2017. All field samples were studied in the laboratories of the Stavropol Anti-Plague Institute using PCR and bioassay. Results and discussion. This paper presents the analysis of the epizootiological situation for the period of 2010-2017 in the Stavropol Region. The species composition and the number of the main carriers of tularemia have been established. Epizootic activity of the focus is defined by mice of the genus Sylvaemus. Data on the isolation of strains from ticks, small mammals and environmental objects are presented and processed. According to our studies, over the past seven years, infection with tularemia agent has been detected in seven species of mammals: S. uralensis, Microtus arvalis, M. socialis, Mus musculus, Crocidura suaveolens, Erinaceus roumanicus, Lepus europaeus. For the period of epizootic monitoring between 2010 and 2017 37 strains of the causative agent were isolated from small mammals - 12 (32.4 %), ectoparasites - 9 (24.3 %), and environmental objects - 16 (43.2 %). All isolated strains have been identified as Francisella tularensis holarctica biovar II, eryR.
Central-Caucasian natural plague focus was permanently epizootically active since its discovering in 1971 till 2007. Inter-epizootic period has been in progress since 2008. It was not possible to ...isolate agent strains from field material. Therefore a forecast for focus activation is a relevant task, especially against the background of registered plague cases in humans in 2014–2016.
Objective
of the study was to create a forecasting model for quantitative prediction of possible activation or maintenance of inter-epizootic period.
Materials and methods.
We used archival data of Kabardino-Balkar Plague Control Station: journals of rodents’ autopsy, annual reports on epizootiological surveillance, meteorological data from meteostation “Kislovodsk” over the period of 1989–2017, and our epidemiological data for the period 2010 to 2017. We applied Spearman nonparametric correlation analysis, regression analysis, including principal component method, quarterly analysis, and inhomogeneous sequential pattern recognition procedures for statistical processing
. Results and discussion.
We have designed statistical model which provides for forecasting of plague focus epizootic activity proactively, a year in advance and 99 % probability or higher. The model was tested on retrospective data over the course of 7 years. All predictions were correct. The operational forecasts from 2015 to 2017 proved right too. However there is a possibility of fast changes in the ecology system conditions of the Central-Caucasian natural plague focus because of the global warming. Thereby the forecasting model will be annually checked for informative value of the predictors and, if necessary, adjusted accordingly.
Nalbuphine is a synthetic opioid with comparable analgesic activity to morphine but with a better safety profile. Nalbuphine is only available in injectable form due to low oral bioavailability. ...Nasal nalbuphine spray provides advantages in drug safety, avoids hepatic first-pass metabolism, is non-invasive and is convenient for patient-controlled analgesia by self-administration. This study aimed to evaluate the safety and pharmacokinetics (PK) of the newly developed nalbuphine nasal spray in comparison with a solution for injections.
Twenty-four healthy Caucasian volunteers were enrolled in this randomized, open-label, cross-over study. Subjects were administered one of the drugs: nasal spray 7.0 mg/dose, nalbuphine hydrochloride solution for injection 10 mg/dose intravenously (IV) or intramuscularly (IM). High-performance liquid chromatography-tandem mass spectrometry was used to determine nalbuphine concentrations.
A comparison of PK profiles for IV, IM and intranasal (IN) routes of nalbuphine administration revealed a close similarity of absorption phases for nasal spray and IM injection. Differences between the mean T
and dose-adjusted C
values for nasal spray and IM injection were statistically insignificant. The median values of the elimination rate constants and the terminal elimination half-life following IV, IM and IN nalbuphine administration were similar. The mean absolute bioavailability of the nasal spray equalled 65.04%.
The similarity of PK parameters of IM-injected nalbuphine solution and the nasal spray allows us to assume the latter is a feasible alternative to intramuscular nalbuphine injections appropriate for self-administration and field environments for managing moderate and severe pain of various aetiologies.
Aims
Our previous 3‐period crossover study in healthy volunteers comparing the pharmacokinetics of nalbuphine nasal spray Apain with parenteral nalbuphine solution demonstrated high bioavailability ...of the nasal spray and close similarity of pharmacokinetic profiles after intranasal and intramuscular administration, especially within 30 min postdose. The aim of the present study was a noninferiority assessment of nalbuphine nasal spray vs. intramuscular injection for pain relief in postoperative patients.
Methods
Ninety orthopaedic and traumatology patients were enrolled in this double‐blind, randomized study of the effectiveness and tolerance of a single 10.5 mg dose of nalbuphine nasal spray vs. 10 mg intramuscular injection. The summed pain intensity difference (SPID0–6) calculated using visual analogue scale scores was the primary study endpoint.
Results
Of 90 subjects enrolled, the per‐protocol efficacy population comprised 79 patients; 6 patients in the reference group and 5 patients in the test group were excluded due to remedication. The mean values of study endpoints with 95% confidence interval were as follows in reference and test groups, respectively: SPID0–6 = 228.08 (205.73–250.43) vs. 248.73 9 (225.83–271.63), time to pain relief onset = 0.28 h (0.25–0.31) vs. 0.27 h (0.25–0.29), duration of analgesia = 5.55 h (5.17–5.93) vs. 5.51 h (5.10–5.92), area under the curve = 119.30 (91.17–147.43) vs. 99.81 (74.52–107.10). No statistically significant differences were revealed.
Conclusion
Nalbuphine nasal spray Apain has been proven to be a safe, noninvasive alternative to intramuscular nalbuphine to relieve severe postoperative pain. Designed for self‐administration and dose‐adjusting, the noncontrolled opioid analgesic nalbuphine spray can be used for patient‐controlled analgesia in out‐of‐hospital, field and home settings.
Ice crystallites and bound water clusters change the confined space effects vs. T in the hydrophilic-hydrophobic nanosilica blends that results in an increase in methane adsorption with increasing ...temperature.
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The effects of water pre-adsorbed onto hydro-compacted hydrophilic nanosilica A-300 and its blend with hydrophobic AM1 (dimethyldichlorosilane hydrophobized A-300) on methane adsorption depend on the amounts of water (h = 0.005−0.25 g per gram of dry solids) and the AM1/A-300 ratio (1:1, 3:1, and 5:1), as well on the pretreatment conditions. The interfacial and temperature behaviors of co-adsorbed water and methane were analyzed using low-temperature 1H NMR spectroscopy (for static samples), cryoporometry, and quantum chemistry. The structural, morphological, and textural characteristics of the materials were studied using 1H MAS and 29Si CP/MAS NMR spectroscopy, infrared spectroscopy, SEM, TEM, and nitrogen adsorption. It is unexpected that 1H NMR signal of methane increases with increasing temperature. This could be occurred due to enhanced molecular mobility and structure changes in mobile water and ice clusters bound in voids between silica nanoparticles in their aggregates, as well because of changes in the textural characteristics of the pretreated blends. The maximal adsorption of methane (38 mg/g at 285 K) is observed for AM1/A-300 (3:1) hydrated at h = 0.1 g/g. An increase or decrease in the content of hydrophobic nanosilica AM1 in the blends, as well the bound water amount, results in a decrease in the methane adsorption, but hydro-compaction of the blends results in increased methane adsorption.
Influence of hydrophobic nanosilica and hydrophobic medium on water bound in hydrophilic components of complex systems.
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•Mechanical treatment of compacted A-300 and hydrophobic AM1 ...gives a nanostructured composite.•Confined space effects change the interfacial behavior of water bound in composites.•Dispersion media affect the temperature behavior of acidic solution bound in composites.
The temperature behavior of water bound to compacted nanosilica cA-300 alone or in mixture with hydrophobic nanosilica AM1 alone or with addition of human serum albumin (HSA) or tannin was compared for different dispersion media (air, CDCl3 alone or with addition of HCl or trifluoroacetic acid, TFAA) using low-temperature 1H NMR spectroscopy and cryoporometry. There is overlapping of the confined space effects for water bound in voids between silica nanoparticles with the effects caused by the colligative properties of aqueous solutions of TFAA or HCl. These phenomena determine the temperature behavior of bound water unfrozen at T <273 K upon changes of the dispersion media. Typically, the contact area between unfrozen water and a surface of nanosilicas is smaller than the specific surface area of the solids due incomplete filling of voids between nanoparticles by bound water. Bound water tends to be in a clustered state upon the adsorption. In composites with cA-300/AM1, there is a tendency of diminution of the contact area of water with hydrophobic nanosilica AM1 and hydrophobic liquid CDCl3 immiscible with water. This effect changes the temperature behavior of water bound to hydrophilic silica or polar biomolecules. The observed effects can be of importance upon practical applications of nanosilica based composites.
We studied stability of complexes of silver nanoparticles and silicon nitride before and after their interaction with liquid media and after passing through bacterial filters. According to scanning ...electron microscopy data, contact with fluids and passage through bacterial filters reduced the content of silver nanoparticles in complexes compared to that in initial complexes. It was shown that these differences depended on both initial characteristics of the examined samples and the used liquid media. The complex Ag/Si₃N₄ obtained after 5 silver reduction cycles and containing 15% α- and 85% β-modifications of silicon nitride (sample No. 2) was characterized by maximum stability. Culture medium produced more aggressive effect on stability of the studied complexes. We concluded that the effect of culture media on stability of silver nanoparticles-silicon nitride complexes depends on phase composition of the substrate and method of application of silver nanoparticles.
The article considers the principles of building the analytical and simulation model of the human operator and the industrial control system hardware and software. E-networks as the extension of ...Petri nets are used as the mathematical apparatus. This approach allows simulating complex parallel distributed processes in human-machine systems. The structural and hierarchical approach is used as the building method for the mathematical model of the human operator. The upper level of the human operator is represented by the logical dynamic model of decision making based on E-networks. The lower level reflects psychophysiological characteristics of the human-operator.
Using the methods of angular correlation of annihilation radiation (ACAR), attenuation of electromagnetic radiation in 1.5–2.2 GHz frequency range, and optical ellipsometry, it was shown that in ...composites of polytetrafluoroethylene (PTFE) + multi-walled carbon nanotubes (MWCNTs), a 2% decrease in the probability of annihilation of positrons in free volumes in PTFE leads to changes in other parameters of electronic structure of composites by 8–29%. Polytetrafluoroethylene is transparent to electromagnetic radiation, but after the addition of 10 wt.% or more of MWCNTs, the composites demonstrate 200–410-fold decrease in the electromagnetic radiation intensity when the radiation passes through a specimen with a thickness of ≈2 mm. It was found that the average radius of the free volumes and the probability of annihilation of positrons are determined by the defect and electronic structures of the polymer matrix only. The Fermi angle and the probability of positrons annihilation with free electrons are determined by the analogous structures of MWCNTs only. Since the electronic characteristics of the atoms and defects in the polymer matrix (at least outside the interphase) do not change, the changes in the other ACAR parameters are mainly due to changes in the imperfect MWCNTs’ atomic and electronic structures. The average radius of free volumes reaches its maximum value in the composite with 10 wt.% MWCNTs. It was found that in a specimen with 10 wt.% MWCNTs, the highest density of free electrons is observed due to charge transfer from free volumes to MWCNTs, and the highest electron density is observed on defects. A disorder of MWCNTs and their branched conductive network can form the ‘tails’ of electronic density of states in a band gap. Thus, composite with 10 wt.% MWCNTs has the highest absorption coefficient for electromagnetic radiation.
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