Abstract
The article deals with the achievements of sustainable urban development by improving the quality of management based on the application of standards. The necessity of solving this issue is ...justified, as well as the relevance of the standards’ application, including at the stage of data collection and processing, in particular, dedicated to “smart” cities. In addition, methods for assessing the effectiveness of the management itself are proposed.
Abstract
Introduction
Aortic dissections occur as a result of a tear in the intimal layer, continued longitudinal splitting within the intima and media, and formation of false lumen. This could lead ...to sudden death or severe aortic regurgitation and cardiogenic shock. The presented case here describes a patient with acute anterior ST-elevation myocardial infarction due to acute Stanford type A ascending aortic dissection.
Case presentation
A 55-year-old male presented with severe chest pain, radiating into the back, jaw, and left arm, and signs of cardiogenic shock. Electrocardiography showed acute anterior ST-elevation myocardial infarction and echocardiography confirmed that there was a reduced left ventricle ejection fraction (38% calculated using the Simpson method), severe aortic regurgitation, and wall motion abnormalities. Based on these findings, we made a diagnosis of acute myocardial infarction. In accordance with the current guidelines, we opted for an interventional therapeutic approach. Angiography showed left main trunk dissection extending to the left anterior descending coronary artery caused by ascending aorta dissection. This finding altered the diagnosis and treatment plan and the patient was immediately sent to the operating room for emergency surgery.
Conclusions
Aortic dissection should be suspected in patients presenting with acute anterior ST-elevation myocardial infarction, severe aortic regurgitation, and cardiogenic shock. Involvement of the left main trunk and left anterior descending artery occurs much more rarely than that of the right coronary artery, which causes inferior myocardial infarction.
To investigate the direct contribution to carbon emissions of fluorinated gases used in all vitreoretinal (VR) procedures utilizing gas tamponade and assess the respective carbon footprint of the ...three different gas delivery systems.
A multicenter, retrospective, environmental impact study.
All VR procedures using fluorinated gases between 2017 to 2020 at the Manchester Royal Eye Hospital (MREH) and Birmingham and Midland Eye Centre (BMEC) (the second and third largest VR centers in the UK), and between 2019 to 2020 at the University Hospitals Coventry and Warwickshire (UHCW) were included. CO2 equivalent mass (CO2EM) was calculated from the mass of each gas used, according to the Intergovernmental Panel on Climate Change.
A total of 4877 (1883 SF6 38.6%, 2096 C2F6 43.0%, and 897 C3F8 18.4%) procedures were analyzed. UHCW and BMEC utilized single-use 30 mL and 75 mL cannisters, respectively. MREH used four cylinders of each gas over 4 years (2 kg SF6, 1 kg C2F6, 1 kg C3F8). Mean CO2EM per patient was: MREH 111.8 kg, BMEC 7.5 kg, and UHCW 2.7 kg. For MREH and BMEC, the CO2EM was 73.4 metric tons annually (if all cases were performed with i) 30 mL: 3.7 tons and ii) cylinders: 148.0 tons, x 40-fold difference), equating to 599,400 (30,500-1.2 million) km travelled by a passenger car. The current use of SF6 in VR surgery accounts for 0.11% of total SF6 use; if 30 mL cylinders were exclusively used in the UK, this could be lowered to 0.01%.
This study highlights the significant waste associated with large gas cylinders and demonstrated that 30 mL cannisters can lead to a marked reduction in carbon emissions, even after accounting for the increased carbon footprint involved in their manufacture and disposal.
The current study suggests that a high pretreatment neutrophil to lymphocyte ratio and presence of low muscle mass (sarcopenia) are potential risk factors for the development of hyperprogressive ...disease and shorter survival upon treatment with Pembrolizumab.
Summary
The aim of this multi‐center retrospective study was to evaluate the incidence of hyperprogressive disease (HPD) after second‐line treatment with pembrolizumab in patients (n = 167) with metastatic non‐small‐cell lung cancer (NSCLC) whose tumors expressed programmed cell death ligand 1 (PD‐L1) in ≥ 1% and to search for hematological and imaging biomarkers associated with its development. Prior to chemotherapy, neutrophil : lymphocyte ratio (NLR1) and platelet : lymphocyte ratio (PLR1), and prior to immunotherapy, NLR2 and PLR2 were retrospectively analyzed. The psoas major muscle area (PMMA) was calculated at the L3 position on computed tomography before chemotherapy (PMMA1) and before immunotherapy (PMMA2) (n = 112). Patients with ∆PMMA (1‐PMMA2/PMMA1) × 100 ≥ 10% were considered to have sarcopenia (low muscle mass). After treatment with pembrolizumab on the first computerized tomography (CT) scan evaluation, patients were subdivided as follows as: hyperprogressors (HPs), progressors (Ps), non‐progressors (NPs) and pseudoprogressors (PPs). HPs had significantly higher ∆PMMA levels, NLR2 and PLR2 than the other patients. Moreover, in multinomial logistic regression analysis, higher levels of ∆PMMA were associated with a decreased likelihood of being a P odds ratio (OR) = 0·81; 95% confidence interval (CI) = 0·65–0·99; P = 0·047 or an NP (OR = 0·76; 95% CI = 0·62–0·94; P = 0·012) versus an HP. Higher NLRs tended to decrease the likelihood of being a P versus an HP (OR = 0·66; 95% CI = 0·42–1·06; P = 0·09) and significantly decreased the likelihood of being an NP versus an HP (OR = 0·44; 95% CI = 0·28–0·69; P < 0·0001). Our data suggest that a high pre‐immunotherapy NLR2 and the presence of sarcopenia are potential risk factors for the development of HPD.
During a 2-year period in 2005–2007, we conducted surveillance of group A rotaviruses and other enteric agents among patients hospitalized with acute gastroenteritis in 8 different cities of the ...Russian Federation. Fecal specimens were gathered from 3208 children (including 2848 children aged <5 years) and 1354 adults who were admitted to hospitals in Moscow, St. Petersburg, Chelyabinsk, Nizhnii Novgorod, Tyumen, Khabarovsk, Makhachkala, and Yakutsk. Polymerase chain reaction was performed to detect rotaviruses of groups A and C, noroviruses of genogroups I and II, astrovirus, sapovirus, and enteric adenoviruses (group F). Group A rotavirus was the most common viral pathogen detected among children aged <5 years (43.6%), followed by norovirus (12.5%), whereas norovirus was the pathogen most commonly detected in adults (11.9%). P and G genotypes were determined for 515 rotavirus specimens, and the most prevalent genotypes were G1P8 (44.9%), G4P8 (40.0%), G2P4 (8.5%), and G3P8 (6.6%). This study is the first multicenter study of rotaviruses in the Russian Federation and documents the important burden of disease caused by this pathogen, which soon may be preventable by vaccination
Seismic velocities determined from 70 sonobuoys widely distributed in Canada Basin were used to discriminate crustal types. Velocities of oceanic layer 3 (6.7–7.1km/s), transitional (7.2–7.6km/s) and ...continental crust (5.5–6.6km/s) were used to distinguish crustal types. Potential field data supports the distribution of oceanic crust as a polygon with maximum dimensions of ~340km (east–west) by ~590km (north–south) and identification of the ocean–continent boundary (OCB). Paired magnetic anomalies are associated only with crust that has oceanic velocities. Furthermore, the interpreted top of oceanic crust on seismic reflection profiles is more irregular and sometimes shallower than adjacent transitional crust. The northern segment of the narrow Canada Basin Gravity Low (CBGL), often interpreted as a spreading center, bisects this zone of oceanic crust and coincides with the location of a prominent valley in seismic reflection profiles. Data coverage near the southern segment of CBGL is sparse. Velocities typical of transitional crust are determined east of it. Extension in this region, close to the inferred pole of rotation, may have been amagmatic. Offshore Alaska is a wide zone of thinned continental crust up to 300km across. Published longer offset refraction experiments in the Basin confirm the depth to Moho and the lack of oceanic layer 3 velocities. Further north, toward Alpha Ridge and along Northwind Ridge, transitional crust is interpreted to be underplated or intruded by magmatism related to the emplacement of the High Arctic Large Igneous Province (HALIP). Although a rotational plate tectonic model is consistent with the extent of the conjugate magnetic anomalies that occupy only a portion of Canada Basin, it does not explain the asymmetrical configuration of the oceanic crust in the deep water portion of Canada Basin, and the unequal distribution of transitional and continental crust around the basin.
•We collected reflection and refraction data throughout the Canada Basin.•We identified oceanic, transitional and continental crust based on velocity.•The distribution of oceanic crust was verified by aeromagnetic data.•The oceanic continent boundary (OCB) was determined.•Only 25% of the Canada Basin is underlain by oceanic crust.
The Pesyanoe aubrite is an essentially polymict regolith breccia comprised by fragments of different highly magnesian pyroxenitic lithologies: albite; anorthoclase and labradorite‐bearing ...pyroxenites; diopside and magnesian augite pyroxenites; roedderite‐ and forsterite‐bearing pyroxenites; and impact glasses; porphyritic and melt matrix breccia fragments; FeO‐rich chondritic inclusions; and exotic oxidized clasts. The parent magma of Pesyanoe probably was carbon saturated, as suggested by pyroxenite fragments containing igneous‐textured carbon phases, possibly graphite. The composition of feldspar and trapped melt inclusions in enstatite indicates occurrence of at least three metaluminous melt sources with different (K + Na)/Al and K/(K + Na) atomic ratios on the Pesyanoe parent body and has records of K and Na loss from the melt, possibly due to evaporation from the parent body surface. The roedderite‐ and forsterite‐bearing rocks probably crystallized from a peralkaline melt. We propose that peralkaline melt could be formed from a metaluminous melt(‐s) due to gravitational segregation of djerfisherite‐bearing metal‐sulfide liquid in the lower horizon of the magma chamber and following oxidation of the magma. This should lead to enrichment of silicate melt in K2O and Na2O and increasing of (K + Na)/Al > 1, allowing forsterite and roedderite to crystallize. Rocks enriched in K and containing rare K‐bearing minerals were found among both magmatic and melt rocks. This may imply an insignificant role of regolith transport in the process of the breccia’s formation and, therefore, an origin of all of the breccia components from a local region of the Pesyanoe parent body, probably from a single complex igneous massif.
Metal‐rich carbonaceous CB chondrites are generally assumed to be materials accreted from the gas–dust plume formed in catastrophic collisions of planetesimals, at least one of which was ...differentiated into a metal core and silicate shell. Micron‐sized inclusions of siliceous alkali‐rich glasses associated with sulfides were found in the metal globules of the Sierra Gorda 013 (SG 013), a CBa‐like chondrite. These inclusions are unusual carriers of volatile alkalis which are commonly depleted in CB chondrites. The inclusions are presented by two types: (1) Al‐bearing Nb‐poor glass associated with daubréelite and (2) Nb‐bearing Ca,Al,Mg‐poor glass associated with an unknown Na‐bearing Cr‐sulfide. The glass compositions do not correspond to equilibrium condensation, evaporation, or melting. The Nb‐bearing glass has a superchondritic Nb/Ta ratio (31) most likely indicating the fractionation of Nb and Ta in the high‐temperature gas–dust impact plume due to condensation from vapor or evaporation of precursor Nb‐rich particles. The glasses are interpreted as reaction products between refractory plume condensate particles (or possibly planetary or chondritic solids) with relatively low‐temperature K‐Na‐Si‐rich gas in oxidized conditions, possibly in a common plume vapor reservoir. Compositional differences indicate that the glasses and sulfides originated from several different sources under different fO2, fS2, and T conditions and were likely combined together and transported to the metal globule formation region by material flows in the heterogeneous impact plume. The glass–sulfide particles were enclosed in the globules aggregated from smaller solid or molten metal grains. The metal globules were further melted during transport to the high‐temperature plume region or by plume shockwave heating. Thus, the composition of the glasses, the host metal, and the main mass of SG 013 shows dynamic heterogeneity of physical conditions and impact plume composition after a large‐scale planetesimal collision.
Abstract
The article presents the results of studies of the effectiveness of the use of the complex probiotic preparation Immunoflor in young hens of egg cross. In the course of the research work, it ...was found that the use of the probiotic preparation Immunoflor does not affect the clinical and physiological state of the body of young chickens, but at the same time reduces the incidence, mortality and increases the safety of the chickens by enriching and balancing the poultry diet, reducing the conversion feed, optimization of digestion, stimulation of the development of positive microflora in the gastrointestinal tract. The use of the complex probiotic preparation Immunoflor in the diet of young chickens at a dose of 15 g/t of water and 15 g/t of feed contributes to an increase in the number of erythrocytes, leukocytes and hemoglobin concentration, activation of cellular and humoral factors of nonspecific resistance of the body of chickens, providing a normal physiological state and homeostasis.
The age relations between the formation of the parent massif and the crystallization time of the associated ore mineralization were established based on isotope-geochronological study of the ...massif-deposits of the Khangilay ore cluster with various metallogenic specialization in Eastern Transbaikalia. In the Orlovka Li–F granite massif, the crystallization time of columbite–tantalite (145 ± 1 Ma) and cassiterite (144.2 ± 0.3 Ma) (U-Pb, ID-TIMS) is almost identical to the crystallization time of zircon (140.6 ± 2.9 Ма (U-Pb, SHRIMP) and 145 ± 1 Ma (U-Pb, CA-ID-TIMS)), which is an age marker of the formation of massifs. This fact testifies to the magmatogenic nature of rare-metal mineralization. In the Spokojnoye massif – the “standard type” of rare-metal peraluminous granites—a 0.6–3.8 Ma time gap was revealed between the time of massif formation (141.3 ± 1.8 Ма, U-Pb, SHRIMP, 146.9 ± 0.7 Ма, Rb-Sr isotopic system) and crystallization of wolframite (141.8 ± 0.6, Rb-Sr isotopic system and 140.1 ± 1.4 Ма, Sm-Nd isotopic system). This interval likely corresponds to the life time of the hydrothermal system, which produced tungsten mineralization.
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