•Intelligence-integrated concept is proposed to identify the most appropriate CP for corresponding prioritised patients with COVID-19.•ABO compatibility is assessed after classifying donors into the ...four blood types.•Contracted patient decision matrix in-between‘serological/protein biomarkers and the PaO2/FiO2’ and ‘patients list’.•Proposed a novel subjective and objective decision by opinion score method (SODOSM)’.•Contracted CP-decision matrix in-between serological/protein bio-markers criteria and ‘CPs tested list’.
People who have recently recovered from the threat of deteriorating coronavirus disease-2019 (COVID-19) have antibodies to the coronavirus circulating in their blood. Thus, the transfusion of these antibodies to deteriorating patients could theoretically help boost their immune system. Biologically, two challenges need to be surmounted to allow convalescent plasma (CP) transfusion to rescue the most severe COVID-19 patients. First, convalescent subjects must meet donor selection plasma criteria and comply with national health requirements and known standard routine procedures. Second, multi-criteria decision-making (MCDM) problems should be considered in the selection of the most suitable CP and the prioritisation of patients with COVID-19.
This paper presents a rescue framework for the transfusion of the best CP to the most critical patients with COVID-19 on the basis of biological requirements by using machine learning and novel MCDM methods.
The proposed framework is illustrated on the basis of two distinct and consecutive phases (i.e. testing and development). In testing, ABO compatibility is assessed after classifying donors into the four blood types, namely, A, B, AB and O, to indicate the suitability and safety of plasma for administration in order to refine the CP tested list repository. The development phase includes patient and donor sides. In the patient side, prioritisation is performed using a contracted patient decision matrix constructed between ‘serological/protein biomarkers and the ratio of the partial pressure of oxygen in arterial blood to fractional inspired oxygen criteria’ and ‘patient list based on novel MCDM method known as subjective and objective decision by opinion score method’. Then, the patients with the most urgent need are classified into the four blood types and matched with a tested CP list from the test phase in the donor side. Thereafter, the prioritisation of CP tested list is performed using the contracted CP decision matrix.
An intelligence-integrated concept is proposed to identify the most appropriate CP for corresponding prioritised patients with COVID-19 to help doctors hasten treatments.
The proposed framework implies the benefits of providing effective care and prevention of the extremely rapidly spreading COVID-19 from affecting patients and the medical sector.
The article considers the specificity of modern linguistic personality formation in KabardinoBalkaria, a social space of which develops as a multidimensional and multifaceted multicultural ...environment characterized by the expansion of the boundaries of cultural communication; updating the cultural significance of belonging to the Russian world; the intensification of tendencies towards the assertion of national identity; the proliferation of ideas and views faith communities; expansion of the modern media discourse, activation of the processes of information intensity and mass digital accessibility, which generally forms the media culture of society, etc. It is noted that in the multicultural space of the Republic, the culture of Russian society with the basic culture of the Russian people, the national cultures of the titular peoples (Kabardins and Balkars), and religious (mainly Islamic) culture occupy dominant positions that determine the cultural preferences of the modern language personality, the formation and development of which is significantly influenced by social, ethnic and psychological factors.
The article provides an overview of ion-modified waterflooding technology, also known as low salinity, controlled salinity, or Smart water. This technology is currently considered one of the most ...promising approaches in the development of oil deposits in carbonate reservoirs due to its economic efficiency and environmental safety. The article discusses the main mechanisms and processes underlying ion-modified waterflooding and presents the results of laboratory studies conducted on core samples from foreign oil deposits. It includes an analysis of several studies, including contact angle measurements and core flooding experiments on core samples from oil deposits in carbonate reservoirs on the eastern side of the Melekess depression in the Republic of Tatarstan. It is important to note that the Vereyian deposits explored in this article are not a typical example of test objects for ion-modified water injection. This is because they are characterized by a low reservoir temperature of 23 °C, which suggests that the efficiency of the technology would likely be lower compared to studies conducted abroad, where reservoir temperatures were significantly higher. For example, Darvish Sarvestani et al. studied reservoir conditions at 90 °C, Yousef et al. – reservoir temperature of 100 °C, and Austad et al. examined the Ekofisk field at 130 °C and the Volhall field at 90 °C in Norway. However, as several studies have indicated, prolonged contact between rock samples and ion-modified water contributes to significant hydrophilization of the rock surface, as confirmed by contact angle measurements. The contact angle decreases from approximately 138.3° to 53.45° after exposure to ion-modified water. Additionally, the core flooding experiment demonstrated a slight increase in the oil displacement coefficient, reaching 9.2%. These findings suggest the potential for enhanced oil recovery by injecting Smart water into the Vereyian sediments, although further research is required to confirm the underlying mechanism.
Nowadays, the use of herbal medicine is gaining importance for treating many diseases due to their significant effect and lesser side effects as compared to allopathic medicines. Phytosomal herbal ...formulations or herbosomes are better absorbed and produce better bioavailability than the conventional botanical extracts. Hence, this study is conducted to formulate the herbosomal gel from QI galls ethanolic extract. The QI gall was extracted using ethanol giving the percentage of yield 17%. For the High-Performance Liquid Chromatography analysis, it was revealed that the QI galls extract contains large amount of tannic acid (1794.18 mg/g) and small amount of gallic acid (76.22 mg/g). The formulation consists of 1.0% of Carbopol 940 were found to be the best formulation since it shows good physicochemical properties. pH value was 6.31 while the viscosity was 3482.3144 cps. Formulated gel showed good stability after 21 days of formulation by not showing significance changes in pH value, viscosity and spreadability. Disc diffusion method was used to determine the antimicrobial activity and the results showed the inhibition zone for P. aeruginosa was greater than S. aureus. As conclusion, the QI galls extract formulated herbosomes was showed promising results to be developed as a new antibacterial gel formulation.
The purpose of this study was to establish changes in the learning conditions and lifestyle of students of the Federal State Budgetary Educational Institution of Higher Education “Kabardino-Balkarian ...State University named after H. M. Berbekov” (KBSU), when switching to distance learning during the epidemic of a new coronavirus infection (COVID -19). We conducted an anonymous survey of 256 students using the online Google Forms in the period from January 27 to February 8, 2021. The study revealed changes in some components of the learning conditions and lifestyle of students with their transfer to the distance learning: an increase in preparation time for classes among 42.9% of respondents, an increase in the number of cigarettes smoked in all smokers, a decrease in physical activity among 62.9% of respondents. At the same time, the consumption of vegetables (36.7%) and fruits (43.8%) increased, the frequency of eating in cafes and restaurants decreased in the absence of changes in the frequency of buying or ordering ready-made food among all students, sleep duration increased among 60, 9% of students. The nutrition changes of students were influenced by the restrictions taken in the region to prevent the spread of coronavirus infection. The results of our study indicate a need to monitor the preparation time for classes, level of physical activity, smoking and development of recommendations for students on the organization of educational and physical activities during distance learning period.
Background
Acute myeloid leukemia (AML) in older adults is a biologically and clinically distinct entity. These patients often have comorbidities, and their treatment must be chosen with caution. In ...AML patients over 60y old, cure rates are under 10% even after intensive chemotherapy (CT).
Aim
To compare the efficacy of different therapeutic approaches in elderly AML-pts treated in NRCH.
Methods
From 2002 till 2019, NRCH has conducted a prospective non-randomized study which included 80 AML-patients 60-81y (Me - 67y): 60-65 yy (n=53) and >65y (n=27); M/F - 35/45; de novo AML n=61 (76,25%), AML from MDS - n=13 (16,25%), «secondary» AML - n=6 (7,5%); cytogenetic risk: favorable n=1 (1,25%), intermediate n=49 (61,25%), poor n=30 (37,5%).
The patients were stratified to different treatment approaches according to age. Patients 60-70y (n=40) mostly received 1-2 induction cycles 7+3 (ARA-C 100 mg/m2 bid; Dauno - 45-60 mg/m2 ), then 2 consolidation cycles 7+3 (Dauno - 45 mg/m2) and 2 years maintenance (5+5 with 6-MP). Patients >70y (n=22) were usually treated with 1-2 induction and 2 consolidation cycles of low dose Ara-C (LDAC) (10 mg/m2 sc bid, 28-days) and 3 years maintenance with 21-28-days LDAC. In some cases, fit patients over the age of 70y have got 7+3 (n=5) and some younger with comorbidities - LDAC (n=13).
The analysis was done in May 2019. We evaluated treatment outcome according to age, cytogenetics and type of CT.
Results
The CR rate in the whole group of elderly AML-pts was 57,5% (46/80) with a median CR-duration - 10 mon (1-138 mon), early death - 16,25% (13/80) and resistance - 26,25% (21/80) with no major differences in the two age cohorts (<>70y).
In order to assess of the efficacy of two chemotherapy options we have compared 7+3 and LDAC in patients aged 60-65 and older. In patients aged 60-65 CR-rate was higher -75% (21/28) after 7+3 vs 50% (2/4) after LDAC, with less resistant forms - 7% (2/28) vs 25% (1/4), respectively. In > 65y group CR-rate was identical in pts after 7+3 (47%, 8/17) and after LDAC (55%, 17/31) with similar numbers of resistant forms: 41% vs 29%. Early death rate did not differ among the groups. There was statistically higher CR-rate and lower resistant forms on 7+3 in pts aged 60-65 compared to older pts. - 75% vs 47% (p<0.05) and 7% vs 41% (<0.005) (Tab.1).
Long-term results in the whole cohort of elderly patients were as follows: 1-y OS - 46%, DFS - 52,2%, 5-y ОS - 13%, DFS - 9% with high relapse rate (70%) development, mostly with early occurrence (Me - 12.8 mon). The median survival was statistically longer in patients aged 60-65y (n=32) comparing to older ones (n=48) - 15.4 vs 8 mon, respectively (p=0.0542), but DFS was equal (Fig.1).
Higher incidence (87% vs 74%) and earlier relapse development (12 vs 16 mon) were registered in the group with poor cytogenetics comparing to favorable/intermediate (p=0,022). We didn't observe significant difference in long-term outcome of AML-pts older or younger 70y.
Standard LDAC duration is 10-14 days, twice less than we used in our study. A landmark-analysis (from day 30 of induction) has shown that, if the 1st course-duration was less than 28 days, the median survival was shorter - 5,9 mo in comparison with 14,9 mo in pts with 28-days LDAC (p=0.12). The efficacy of 28-days LDAC was very similar to 7+3, mainly in patients aged 66 and older (Fig.2).
Conclusion
The outcome in elderly AML-patients is determined by age (more or less 65y) and the group of cytogenetic prognosis (poor vs favorable/intermediate).
Intensive induction (7+3) is more preferable in patients aged 60-65 y as it produced the higher CR-rate and less resistant forms, results that are comparable to younger AML-patients. In patients older than 65y - CR-rate after 7+3 or 28-day LDAC was identical, and 28-days LDAC may become the choice of treatment for patients older than 65y. However long-term results are generally poor so new therapeutic strategies for elderly AML-patients are highly needed.
Display omitted
No relevant conflicts of interest to declare.
To intensify the digestive metabolism in lactating cows consuming diets that contain nitrates and nitrites particular importance is paid to increasing in its composition denitrifying components such ...as vitamin C. The research aims to study the effect of adsorbent toxy-nil and antioxidant vitamin C on the digestive metabolism in lactating cows, whose diets contain the subtoxic nitrates dose. The decrease in these xenobiotics level under the influence of nitrate and nitrite-reducing enzymes was accompanied by simultaneous increase of the ammonia concentration in the rumen content. ...relative to the control animals of the 2nd test group had reliably (P> 0,95) 17,4% higher ammonia level in their proventriculi content. The results of our research have shown that due to the high denitrifying effect of combined using ascorbic acid and sorbent in the blood serum of cows in the 2nd test group versus the control was the significant (P> 0,95) increase in the sugar content by 31,1%. ...the sugar content in the animals' blood of the 2nd test group was within the physiological norm. To increase the rate of reducing nitrates into nitrites and the latter into ammonia (which is subsequently successfully used by proteolytic microorganisms for the protein synthesis of the own body), it is advantageous to include vitamin C in combination with toxy-nil into highly productive cows' diets containing the subtoxic nitrates dose. ...combined use of ascorbic acid and toxy-nil contributed in cows' proventriculi of the 2nd test group to increase nitrate-reducing enzymes, thus the ammonia content in their blood was 29,3% (P> 0,95) higher but nitrates and nitrites, on the contrary, 2,47 (P> 0,95) and 3,15(P> 0,95) times less than in the control.
Summary Background/purpose The purpose of this study is to characterize GBS isolates that were collected from three major hospitals in a densely populated area of Klang Valley for their demographics, ...serotypes, antibiotic susceptibility patterns and genetic background. Methods Sixty GBS isolates from sterile and non-sterile samples in three major hospitals in the Klang Valley area of Malaysia were collected by convenience sampling from 2012 until March 2014. These isolates were studied for their antimicrobial susceptibilities, serotypes and genotypes. Patients’ demographic data and clinical information were collected from lab request forms. Results Diabetes mellitus was the only underlying condition (7 patients, 23.3%); the remaining samples were from patients who were immunocompromised due to medications. Fifty-nine (98%) isolates were sensitive to penicillin, while 78.3% and 88.3% of the isolates were sensitive to erythromycin and clindamycin, respectively. Serotype Ia was the most common serotype ( n = 27, 45%), followed by serotype III ( n = 10, 16.7%), V ( n = 9, 15%), VI ( n = 8, 13.3%), VIII ( n = 2, 3.3%) and VII ( n = 1, 1.7%). Random Amplified Polymorphic DNA (RAPD) typing showed a diverse genetic pedigree for all isolates, including four major groups that clustered according to geographical location. Conclusion This preliminary study determines the prevalence of limited common serotypes and antimicrobial resistance in distinct GBS isolates. Nonetheless, the RAPD clustering pattern suggests a close genetic lineage of the GBS isolates based on their isolation sites and location of hospitals.
In Drosophila, myoblasts are subdivided into founders and fusion-competent myoblasts (fcm) with myotubes forming through fusion of one founder and several fcm. Duf and rolling pebbles 7 (Rols7; also ...known as antisocial) are expressed in founders, whereas sticks and stones (SNS) is present in fcm. Duf attracts fcm toward founders and also causes translocation of Rols7 from the cytoplasm to the fusion site. We show that Duf is a type 1 transmembrane protein that induces Rols7 translocation specifically when present intact and engaged in homophilic or Duf-SNS adhesion. Although its membrane-anchored extracellular domain functions as an attractant and is sufficient for the initial round of fusion, subsequent fusions require replenishment of Duf through cotranslocation with Rols7 tetratricopeptide repeat/coiled-coil domain-containing vesicles to the founder/myotube surface, causing both Duf and Rols7 to be at fusion sites between founders/myotubes and fcm. This implicates the Duf-Rols7 positive feedback loop to the occurrence of fusion at specific sites along the membrane and provides a mechanism by which the rate of fusion is controlled.
Purpose: This paper discussed sign of transformational leadership in lean healthcare implementation framework. This study focus on identifying characteristics of transformational leadership practiced ...by healthcare leaders. Sources: A review was carried using four established databases. This paper assembled analyses and expounded data from empirical papers on lean healthcare implementation frameworks from 2009 to 2018. Selection: Reviewed articles published in English were chose. In identification phase, 142 articles were identified; 81 articles passed the literature screening phase; and 48 articles were eligible for full article review. Finally, 12 articles were included for this study. Data extraction: Papers were considered if they regarded lean healthcare as the improvement methodology and discussed leadership characteristics in the lean implementation journey. Results: Twelve papers were selected for the study. The characteristics of transformational leadership being practised by healthcare leaders in the implementation framework includes charisma, inspiration, intellectual stimulation and individualized consideration. Conclusions: This study highlighted leaders in healthcare sector do practice some form of transformational leadership attributes. The application, however, is still limited and a leader has yet to utilize the whole spectrum of the transformational leadership model.
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