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Introduction Irritable bowel syndrome is a common functional gastrointestinal disorder in children, characterized by recurrent abdominal pain associated with altered bowel habits in terms of both frequency and consistency. According to change in stool consistency it is categorized into 4 subtypes. From the etiological perspective, it is a multifactorial functional disorder with both central (psychosocial) and peripheral factors (altered bowel sensitivity, motility and microbiota) implied in the genesis of the symptoms. Several treatment options, addressing each underlying pathophysiological mechanism have been proposed. However, since in most cases a combination of factors takes part in symptoms' generation, the overall treatment response rate is often unsatisfactory if a multidisciplinary is not pursued. Areas covered The aim of this manuscript is to summarize the current pharmacotherapy in paediatric irritable bowel syndrome in order to aid clinicians in treating this challenging disorder. Expert opinion Most evidence involving paediatric populations rely on open label or retrospective studies and/or are not specifically designed for irritable bowel syndrome but tend to generalise their results to mixed populations of children with functional gastrointestinal disorders. A high placebo response rate combined with poor patients' selection could account for the overall weak evidence supporting the use of pharmacological agents in paediatric irritable bowel syndrome. Given the multifaceted nature of the disorder, multidisciplinary approaches combining pharmacotherapy with alternative treatments is highly recommendable.

α-2 адреномиметики обладают рядом фармакодинамических эффектов, таких как анксиолитический, симпатолитический, антиноцицептивный, которые полезны в анестезиологической практике. С другой стороны, их применение ограничено побочными эффектами: выраженной гипотензией и брадикардией, особенно при взаимодействии с анестетиками. На сегодняшний день в Украине доступны клонидин, известный давно, и дексмедетомидин — современный α-2 агонист. Изучены эффективность и безопасность премедикации дексмедетомидином в дозе 0,7 мкг/кг. Продемонстрированы положительные эффекты применения дексмедетомидина у пациентов с абдоминальной хирургической патологией.

Метою дослідження було вивчити вміст тромбоцитів у плазмі, збагаченій факторами росту (PRGF Endoret), та їх функціональні властивості залежно від індивідуальних гематологічних параметрів пацієнта. Матеріалом дослідження було 30 хворих із посттравматичними і післяопераційними дефектами верхньої та нижньої щелепи. Перед реконструктивно-відновними втручаннями пацієнтам проведено комплексне клініко-рентгенологічне дослідження, загальний аналіз крові, коагулограму та вивчення індукованої агрегації тромбоцитів (агрегатограми). Під час операцій усім хворим були виготовлені дві фракції плазми за методикою PRGF Endoret. У кожній із них визначали вміст тромбоцитів та інших формених елементів крові, а також досліджували морфологію фібринової мембрани. Співвідношення між вмістом тромбоцитів у багатій тромбоцитами фракції F2 та нативній крові (коефіцієнт концентрування) в середньому становило 1,48, вміст тромбоцитів у фракції F1 (бідна тромбоцитами плазма) виявлявся в середньому в 1,3 раза меншим, ніж у нативній крові. Основними чинниками, що визначали вміст тромбоцитів у плазмі, збагаченій факторами росту, були вихідний вміст тромбоцитів в крові, гематокрит і концентрація фібриногену, а співвідношення тромбоцитів у фракціях залежало лише від гематокриту. При дослідженні взаємозв’язків між функціональною активністю тромбоцитів, їх вмістом у фракції F1 і F2 та коефіцієнтом концентрування було виявлено зворотну залежність між агрегаційною активністю тромбоцитів та їх вмістом у фракції F2. Це пояснює відсутність статистично вірогідного впливу кількості тромбоцитів у PRGF на клінічну ефективність проведених хірургічних втручань. Встановлено, що у нестандартних випадках, коли гіперактивні властивості тромбоцитів співпадають із їх підвищеною кількістю у крові, можливо використовувати плазму за методикою PRGF Endoret без поділення на фракції. У випадках, коли у пацієнта визначається гіпоактивність тромбоцитів і їх кількість в крові знижена, доцільно використовувати більший (подвійний) об’єм плазми, збагаченої факторами росту (фракція F2), для забезпечення необхідного лікувального ефекту.

Isolated deficiency IgE is one of the most common primary immunodeficiency diseases in human with prevalence of 1 case per 30 people of total population. Genetic basis of this immunodeficiency are polymorphisms of 5923A/G and 7888C/T in AICDA gene of B-lymphocytes. Recently several new studies have been conducted that expand the current understanding of the nature of an isolated IgE deficiency in human. Several recent epidemiological studies specified immunodeficiency frequency in different cohorts of patients and confirmed the relationship of immunological and clinical phenotypes, including recurrent infections, autoimmunity and oncology. The results of a number of clinical cases have expanded the knowledge of the heterogeneity of clinical symptoms of the di­sease. Several studies investigated the complications of an isolated deficiency IgE, including chronic gastritis and peptic stomach ulcer associated with H. pylori, and atherosclerosis and related vascular accidents. The results of comparative clinical studies demonstrate high efficiency of base immunotherapy with normal human immunoglobulin preparations for the intramuscular and intravenous usage.

Summary. The objective of the investigation — to study the changes of the vertebral bodies, intervertebral discs and their area in the lumbar spine in the reduction of bone mineral density (BMD) using magnetic resonance imaging (MRI). 81 patients underwent dual-energy X-ray densitometry (DEXA) and MRI of lumbar spine. Osteopenia was diagnosed in 33 patients (II group), osteoporosis — in 28 (group III), and control group consisted of 20 patients (I group) without signs of osteoporosis (according to DEXA). The average BMD parameters (g/cm2) in L1-L4 bodies were: in healthy people — 1.232 ± 0.060; in osteopenia — –1.032 ± 0.070; in osteoporosis — –0.757 ± ± 0.080. The average T-score in the control group was –1.27 ± 0.71; in the II group with osteopenia — –1.40 ± 0.11; in the III group with osteoporosis — –3.09 ± 1.73. The difference in BMD between I and II groups was 16.2 % (p, Цель исследования — изучение изменений тел позвонков, межпозвоночных дисков и их площадей в поясничном отделе позвоночника при уменьшении минеральной плотности костной ткани (МКП) с помощью магнитно-резонансной томографии (МРТ). 81 пациенту были проведены двухэнергетическая рентгеновская денситометрия (ДРД) и МРТ поясничного отдела позвоночника. Остеопения диагностирована у 33 больных (ІІ группа), остеопороз — у 28 (ІІІ группа), контрольную группу составили 20 пациентов (І группа) без признаков остеопороза (по данным ДРД). Cредние показатели МКП (г/см2) в телах L1-L4 составили: у здоровых — 1,232 ± 0,060; при остеопении — –1,032 ± 0,070; при остеопорозе — –0,757 ± 0,080. Средние показатели Т-критерия в группе сравнения составили –1,27 ± 0,71; во ІІ группе с остеопенией — –1,40 ± 011; в ІІІ группе с остеопорозом — –3,09 ± 1,73. Разница в МКП между I и II группами составила 16,2 % (р < 0,05), между I и III группами — 25 % (p < 0,01). При МРТ-морфометрии у больных с остеопенией и остеопорозом изменения тел позвонков поясничного отдела позвоночника сопровождались снижением средней высоты тел, незначительным снижением передней высоты тел позвонков; уменьшением индекса Барнетта — Нордина; выраженным увеличением средней высоты и площадей межпозвоночных дисков, более выраженными при остеопорозе. Установлено, что у больных с нарушением минеральной плотности костной ткани имеются и дегенеративные изменения межпозвоночных дисков, причем степень их дегенерации достоверно не отличается от группы контроля., Мета дослідження — вивчення змін тіл хребців, міжхребцевих дисків і їх площ у поперековому відділі хребта при зменшенні мінеральної щільності кісткової тканини (МЩК) за допомогою магнітно-резонансної томографії (МРТ). 81 пацієнту була проведена двохенергетична рентгенівська денситометрія (ДРД) і МРТ поперекового відділу хребта. Остеопенію діагностовано у 33 хворих (ІІ група), остеопороз — у 28 (ІІІ група), контрольну групу становили 20 пацієнтів (І група) без ознак порушення мінеральної щільності за даними ДРД. Середні показники МЩК (г/см2) у тілах L1-L4 становили: у здорових — 1,232 ± 0,060; при остеопенії — –1,032 ± 0,070; при остеопорозі — –0,757 ± 0,080. Середні показники Т-критерію в групі порівняння становили 1,27 ± 0,71; у ІІ групі з остеопенією — –1,40 ± 011; у ІІІ групі з остеопорозом — –3,09 ± 1,73. Різниця в МЩК між I і II групами становила 16,2 % (р < 0,05), між I і III групами — 25 % (p < 0,01). При МРТ-морфометрії у хворих на остеопенію та остеопороз зміни тіл хребців поперекового відділу хребта супрово­джувалися зниженням середньої висоти тіл, незначним зниженням передньої висоти тіл хребців; зменшенням індексу Барнетта — Нордіна; вираженим збільшенням середньої висоти та площ міжхребцевих дисків, більш вираженими при остеопорозі. Встановлено, що у хворих із порушенням мінеральної щільності кісткової тканини є і дегенеративні зміни міжхребцевих дисків, причому ступінь їх дегенерації вірогідно не відрізняється від групи контролю.

International audience; Background - Infective endocarditis (IE) is a common and serious complication in patients receiving chronic hemodialysis (HD). Objectives - This study sought to investigate whether there are significant differences in complications, cardiac surgery, relapses, and mortality between IE cases in HD and non-HD patients. Methods - Prospective cohort study (International Collaboration on Endocarditis databases, encompassing 7,715 IE episodes from 2000 to 2006 and from 2008 to 2012). Descriptive analysis of baseline characteristics, epidemiological and etiological features, complications and outcomes, and their comparison between HD and non-HD patients was performed. Risk factors for major embolic events, cardiac surgery, relapses, and in-hospital and 6-month mortality were investigated in HD-patients using multivariable logistic regression. Results - A total of 6,691 patients were included and 553 (8.3%) received HD. North America had a higher HD-IE proportion than the other regions. The predominant microorganism was Staphylococcus aureus (47.8%), followed by enterococci (15.4%). Both in-hospital and 6-month mortality were significantly higher in HD versus non-HD-IE patients (30.4% vs. 17% and 39.8% vs. 20.7%, respectively; p

Gliomatosis peritonei (GP) is a rare clinical condition characterized by presence of mature glial cells in the peritoneum. Growing teratoma syndrome (GTS) is described as an uncommon phenomenon that could be related to the incidence of non-seminomatous germ cell tumors. We report a case of a patient treated for immature ovarian teratoma, in whom both GP and GTS were observed, an association to date scarcely described in literature. A 15-year-old girl presented to the emergency department with severe pain in her lower abdomen and right lumbar region. Upon admission, concentration of α-fetoprotein (AFP) was 1500 ng/mL and β−human chorionic gonadotropin (β-hCG) less than 2 ng/mL. A computed tomography (CT) scan of the abdominal cavity and pelvis confirmed the presence of an anomalous mass in the abdominal cavity and pelvis. Initial surgery was performed. Histopathology revealed the presence of immature teratoma with epithelial elements. Normalization of AFP was achieved within 8 weeks. Five months after surgery, a progressive increase in AFP was noted. Magnetic resonance imaging (MRI) and CT scans of the pelvis minor showed local relapse. Evaluation of the remission after 2 blocks of preoperative chemotherapy revealed the presence of a large tumor mass in the pelvis minor, despite normalization of the AFP concentration. After opening the abdominal walls, numerous abnormal white nodules were observed in the peritoneum. Histopathology revealed the presence of mature glial tissue (gliomatosis peritonei). The remaining tumor mass was removed, and histopathology confirmed existence of mature teratoma (growing teratoma syndrome). Postoperative chemotherapy was continued. To date, the patient remains under clinical and laboratory remission. Concomitant incidence of GP and GTS, although rare, should always be taken into consideration in pediatric patients with diagnosis of either condition.

The main aim of the article is demonstrating successful design of spread foundations of a commercial centre building, where geotechnical monitoring allows us to check design efficiency and calculate reliability in comparison with real vertical deformation of building. Introduction to the case study area and building structure and foundations was done in previously published first part of the article in which engineering geological conditions were described. There was also presented a comparison of calculated vertical settlement of selected footings with the real geodetic measurement provided during construction time till the period of two years’ operation time after completion of civil works. Geotechnical engineers do not have many opportunities to evaluate their designs, especially when everything passes successfully. Our presented case study is one of the examples, which could be evaluated from the point of view of reliability index of design adjusted with real geodetic measurement. Index of reliability of selected foundations was calculated by deterministic probability methods. In order to evaluate thousands of statistical data combinations, programing tool in Python language was developed for batch processing calculation of vertical displacement of foundation in Plaxis software. Discussion part of the article contains the actual state of reliability theory in structural standards in Europe.

Hydroxyurea therapy is commonly used in the treatment of patients suffering from myeloproliferative diseases, such as polycythemia vera. It is supported by evidence that this type of therapy can generate mild skin lesions like leg ulcers, erythema, and hyperpigmentation. There are also some studies that show an increased risk of development of nonmelanoma skin cancers. We report a 56-year-old man with a 13-year history of polycythemia vera, treated chronically with hydroxyurea. In April 2020, the patient presented a skin lesion on the forehead, skin horn on the left forearm, and hyperkeratosis on the rims of both ears. In the patient’s history, in October 2019, complete excision of the skin lesion in the central area of the forehead was performed. After 4 months, a new skin lesion appeared at the same area of the forehead, which in May 2020 after resection in the histopathological examination was diagnosed as recurrence of squamous cell carcinoma. The aim of the case is to draw the clinicians’ attention to the increased risk of squamous cell carcinoma and basal cell carcinoma in patients treated with hydroxyurea. Increased vigilance would make it possible to recognize them earlier, and thus potentially reduce the undesirable effects associated with the delayed radical treatment of these skin cancers. Randomized clinical trials assessing the potential benefits of oral retinoids for chemoprevention of nonmelanoma skin cancers in the hydroxyurea-treated population should also be considered.

Food marketers increasingly use a combination of processing and nutrient content claims to convey information to consumers. Further, consumers are more aware of and concerned about how foods are processed as evidenced by the emergence of “clean labels” in promotion and retail store environments. Prior research generally has addressed evaluations of processing or nutrient content claims in isolation. This research extends our understanding of consumer responses to package claims by comparing the differential direct and indirect effects of processing claims, nutrient content claims, and ingredient lists on consumer evaluations. Drawing from activation theory and extant research, results from three studies indicate significant indirect effects on purchase intentions for processing claims and ingredient lists through the mediators of clean label and nutrition evaluations (in parallel), and perceived healthfulness (in serial). These findings suggest clean labels, relative to nutrient content claims, more positively influence how consumers define “healthy” and form purchase intentions.

Fresh basil and parsley leaves are perishable and they are often processed by drying, which is an energy-consuming process and contributes to nutrient degradation. These downsides can, however, be mitigated by various pre-drying treatments. Thus, the objective of this study was to assess the impact of different treatments (ultrasound, steaming, dipping) and their duration (20, 30 min) on contents of chlorophylls and lutein (analyzed by UPLC-PDA), total phenolic content (TPC), as well as antioxidant capacity (determined as DPPH radical scavenging activity) in basil and parsley leaves. The changes in the chemical properties after treatments were more significant in the case of basil than parsley, probably due to a lower thickness of leaf epidermis layer and stiffness of the former. In comparison to fresh leaves, enhanced extractability of chlorophyll a after all treatments and TPC after dipping for 20 min, was observed in basil. In parsley, instead, the chlorophylls content remained unchanged after treatments, but TPC decreased. Lutein content remained stable in both herbs following different treatments. Irrespectively of the treatment type, the TPC and antioxidant capacity were higher after 20 min of basil treatments, while in the case of parsley, higher TPC was determined after longer treatments (30 min). The study demonstrated that the investigated treatments could preserve or even enhance the chemical properties of herbs.

This is a case of 52-year-old male after episode of syncope and with atypical chest pain referred to hospital with acute anterior ST elevation myocardial infarction. Urgent coronary angiography showed normal coronary arteries and only ECG made the next day made us to suspect Brugada syndrome. The patient had ICD implanted and because of high defibrillation threshold, subcutaneous electrode implantation was decided. Our case highlights, that ECG changes in Brugada syndrome can mimic ST elevation in the course of acute coronary syndrome and that subcutaneous electrode implantation may be useful method of lowering defibrillation treshold.

We report early results from a prospective primary care bronchiolitis surveillance study in France in which a 10-week delayed epidemic was detected from February to March 2021. Among 225 children under 2 years with swab testing for a first bronchiolitis episode, 55% had a positive test for RSV, 0 for influenza, and 1 for severe acute respiratory syndrome coronavirus 2.

Background Periconceptional folic acid (FA) supplementation is recommended to prevent the occurrence of neural tube defects. Currently, most over-the-counter FA supplements in Canada and the United States contain 1 mg FA and some women are prescribed 5 mg FA/d. High-dose FA is hypothesized to impair 1-carbon metabolism. We aimed to determine folate and 1-carbon metabolism biomarkers in pregnant women exposed to 1 mg or 5 mg FA. Objectives This was an ancillary study within the Folic Acid Clinical Trial (FACT), a randomized, double-blinded, placebo-controlled, phase III trial designed to assess the efficacy of high-dose FA to prevent preeclampsia. Methods For FACT, women were randomized at 8-16 gestational weeks to receive daily 4.0 mg FA (high dose) or placebo (low dose) plus their usual supplementation (≤1.1 mg). Women were recruited from 3 Canadian FACT centers and provided nonfasting blood samples at 24-26 gestational weeks for measurement of RBC and serum total folate, serum unmetabolized FA (UMFA), tetrahydrofolate (THF), 5-methylTHF, 5-formylTHF, 5,10-methenylTHF, and MeFox (pyrazino-s-triazine derivative of 4α-hydroxy-5-methylTHF, a 5-methylTHF oxidation product); total vitamins B-12 and B-6; and plasma total homocysteine. Group differences were determined using χ2, Fisher exact, and Wilcoxon rank-sum tests. Results Nineteen (38%) women received high-dose FA and 31 (62%) received low-dose FA. The median RBC folate concentration was 2701 (IQR: 2243-3032) nmol/L and did not differ between groups. The high-dose group had higher serum total folate (median: 148.4 nmol/L, IQR: 110.4-181.2; P = 0.007), UMFA (median: 4.6 nmol/L, IQR: 2.5-33.8; P = 0.008), and 5-methylTHF (median: 126.6 nmol/L, IQR: 98.8-158.6; P = 0.03) compared with the low-dose group (median: 122.8 nmol/L, IQR: 99.5-136.0; median: 1.9 nmol/L, IQR: 0.9-4.1; median: 108.6 nmol/L, IQR: 96.4-123.2, respectively). Other biomarkers of 1-carbon metabolism did not differ. Conclusions High-dose FA supplementation in early pregnancy increases maternal serum folate but not RBC folate concentrations, suggesting tissue saturation. Higher UMFA concentrations in women receiving high-dose FA supplements suggest that these doses are supraphysiologic but with no evidence of altered 1-carbon metabolism.

The article presents the results of research related to the SDG7 sustainable development implementation analysis. The goal is to provide affordable and clean energy. Its implementation will allow for development that will simultaneously provide the possibility of economic growth and the achievement of an optimal level of citizens’ health and life. The research was conducted for the countries of the European Union EU-27. During the analysis, the indicators proposed by Eurostat were used. The research aimed to examine the progress in EU member states’ energy markets integration. In order to carry out the indispensable research, it was necessary to use a spatial information system. Cluster analysis, as well as TSA analysis, were applied. The conducted research made it possible to verify the posed hypotheses and showed that the energy transformation process of the EU-27 countries is so complicated and heterogeneous that it has given rise to new independent and unique clusters. The authors also verified the adopted set of SDG7 achievement indicators using multiple regression. Additional indicators were also proposed that could complement the set and clarify its analyses.

Purpose The coronavirus disease 2019 (COVID-19) pandemic has impacted the activities of healthcare workers, including postgraduate pharmacy trainees. Quality training experiences must be maintained to produce competent pharmacy practitioners and maintain program standards. Methods A cross-sectional survey of postgraduate pharmacy trainees in the United States was conducted to evaluate training experience changes and assess perceived impacts on residents and fellows following the COVID-19 pandemic’s onset. Results From June 4 through June 22, 2020, 511 pharmacy trainees in 46 states completed the survey. Participants’ median age was 26 (interquartile range [IQR], 25-28) years, with included responses from postgraduate year 1 residents (54% of sample), postgraduate year 2 residents (40%), and postgraduate fellows (6%). Compared to experiences prior to the onset of the COVID-19 pandemic, fewer trainees conducted direct patient care (38.5% vs 91.4%, P < 0.001), more worked from home (31.7% vs 1.6%, P < 0.001), and less time was spent with preceptors per day (2 [IQR, 2-6] hours vs 4 [IQR, 1-4] hours, P < 0.001). Sixty-five percent of respondents reported experiencing changes in their training program, 39% reported being asked to work in areas outside of their routine training experience, and 89% stated their training shifted to focus on COVID-19 to some degree. Most respondents perceived either major (9.6%) or minor (52.0%) worsening in quality of experience, with major and minor improvement in quality of experience reported by 5.5% and 8.4% of respondents, respectively. Conclusion Pharmacy resident/fellow experiences were perceived to have been extensively impacted by the COVID-19 pandemic in varying ways. Our findings describe shifts in postgraduate training and may aid in the development of best practices for optimizing trainee experiences in future crises.

Aim: This study compares the outcomes of patients who receive an implantable loop recorder (ILR) for unexplained syncope to a control group without the diagnostic device in German claims data. Methods and materials: Patients with ILR were matched to a control group based on prior syncope events, age, gender and Charlson Comorbidity index (CCI). Survival, syncope hospitalizations, treatment and costs were compared. Results/conclusion: Four hundred and twelve ILR patients were matched with controls, mean age was 68, mean CCI was 2.7, 42% females. ILR patients lived on average 1.2 years longer than patients in the control group. Twenty-five percent of ILR patients received a therapeutic device compared with 5% in the control group. ILRs might help to diagnose and treat patients with positive impact on survival.

The aim – to use multislice computed tomography (MSCT)-coronary angiography data to determine the presence of atherosclerotic process progression in coronary vessels in the dynamics of the three-year follow-up period in patients after STEMI and coronary artery stenting.Materials and methods. 66 MSCT-coronary angiography studies were performed in 19 men after primary myocardial infarction with ST-segment elevation (STEMI) and coronary artery stenting. All patients were male, ranging in age from 38 to 66 years, with a mean (Me 55.6; (Q1–Q3 (49–64)) years, and 18 of 19 (94.0 %) patients developed Q-MI. 1 patient (6 %) had non-Q-MI. A month after acute MI, patients underwent MSCT of the heart with coronary vascular contrast. Re-examination was performed one, two and three years after the development of STEMI. According to the results of MSCT coronary angiography determined the functional status of stents, as well as the presence or exclusion of signs of restenosis (about 50 % or more) or thrombosis 100 % – occlusion) in the stent coronary artery and in non-infarction-causing arteries. With the progression of atherosclerotic plaque, an increase in atherosclerotic plaque of more than 20 % was taken into account compared to the previous study.Results and discussion. By the end of the first year after MI in 11 of 19 (57.9 %) patients according to MSCT-coronary angiography, no progression of atherosclerotic lesions of the coronary arteries was observed. 1 patient (5.6 %) had stent restenosis, which was confirmed by CAG data. Progression of atherosclerotic lesions was observed in 7 patients (36.8 %), 3 of them (16.6 %) in the stent artery, and in 4 patients in the non-infarction-causing artery. In the second year after myocardial infarction, compared with the annual examination, in 6 of 14 (42.9 %) no progression of atherosclerosis was observed, and in 7 of 14 (50 %) progression of atherosclerotic lesions not in the stent artery, and only in 1 of 14 – progression of atherosclerosis in the stent artery. In the third year after the development of MI, 10 of 14 (71.4 %) had no progression of atherosclerosis, and 4 patients showed progression in both IOA and other arteries.Conclusions. MSCT coronary angiography is an informative method in assessing the functional status of stents and determining the progression of coronary atherosclerosis in the infarct-causing artery and other coronary arteries in patients after MI and coronary artery stenting in the dynamics of three-year follow-up. The lack of progression of atherosclerosis was accompanied by slightly lower levels of low-density lipoprotein cholesterol, compared with patients with progression of atherosclerosis.

Background Treatment‐resistant depression (TRD) is a debilitating chronic mental illness that confers increased morbidity and mortality, decreases the quality of life, impairs occupational, social, and offspring development, and translates into increased costs on the healthcare system. The goal of this study is to reach an agreement on the concept, definition, staging model, and assessment of TRD. Methods This study involved a review of the literature and a modified Delphi process for consensus agreement. The Appraisal of Guidelines for Research & Evaluation II guidelines were followed for the literature appraisal. Literature was assessed for quality and strength of evidence using the grading, assessment, development, and evaluations system. Canadian national experts in depression were invited for the modified Delphi process based on their prior clinical and research expertize. Survey items were considered to have reached a consensus if 80% or more of the experts supported the statement. Results Fourteen Canadian experts were recruited for three rounds of surveys to reach a consensus on a total of 27 items. Experts agreed that a dimensional definition for treatment resistance was a useful concept to describe the heterogeneity of this illness. The use of staging models and clinical scales was recommended in evaluating depression. Risk factors and comorbidities were identified as potential predictors for treatment resistance. Conclusions TRD is a meaningful concept both for clinical practice and research. An operational definition for TRD will allow for opportunities to improve the validity of predictors and therapeutic options for these patients.

Objective The purpose of the study was to develop a short form of the revised Diabetes Family Conflict Scale (DFCS) in a racially and income diverse sample while retaining strong psychometric properties. Methods 179 youth with type 1 diabetes (ages 12-18 years) and caregivers completed the DFCS-Revised as well as assessments of adherence, psychosocial functioning, and diabetes-related stress. Hemoglobin A1c was also obtained. The sample was split at random into a development sample and validation sample. Results Confirmatory factor analyses in the validation sample supported the use of a six-item diabetes family conflict scale short form (DFCS-SF) either as a total score (6-items) or a direct (3-item) and indirect (3-item) score. Variations of the DFCS-SF (three items of the 6-item short form) also had acceptable model fit. The short-form questionnaires had acceptable internal consistency and convergent validity (6-item: Cronbach's a = 0.865, full scale DFCS r = 0.954; 3-item: Cronbach's a = 0.757, full scale DFCS r = 0.912). The DFCS-SF showed measurement invariance across both youth and caregiver respondents. Greater report of the DFCS-SF by both youth and caregivers was significantly associated with higher HbA1c, more diabetes-related stress, and more psychosocial concerns. Conclusions The DFCSȁ0SF developed in the present study shows psychometric integrity in a diverse population of youth and can be utilized by providers to rapidly assess and potentially implement interventions to reduce diabetes family conflict, a psychosocial concern which is associated with elevated HbA1c, non-optimal adherence, diabetes-related stress, and psychological distress. This article is protected by copyright. All rights reserved.

Background Neonatal lupus erythematosus is an autoimmune disease acquired during fetal life as a result of transplacental passage of maternal anti-Sjögren’s-syndrome-related antigen A (anti-SSA/Ro), anti-Sjögren’s-syndrome-related antigen B (anti-SSB/La) or anti-U1 ribonucleoprotein (anti-U1-RNP) antinuclear autoantibodies. Contents Clinical manifestations include skin lesions, congenital heart block, hepatobiliary involvement and cytopenias. Most of the disorders disappear spontaneously after clearance of maternal antibodies. Cardiac symptoms, however, are not self-resolving and often pacemaker implantation is required. Diagnosis is based on clinical presentation and the presence of typical antibodies in the mother’s or infant’s serum. Outlook Neonatal lupus erythematosus may develop in children born to anti-SSA/Ro or anti-SSB/La women with various systemic connective tissue diseases. However, in half of the cases, the mother is asymptomatic, which may delay the diagnosis and have negative impact on the child’s prognosis. Testing for antinuclear antibodies should be considered in every pregnant woman since early treatment with hydroxychloroquine or intravenous immunoglobulin (IVIG) has proven to be effective in preventing congenital heart block.

Досліджено наявні методики антикризового фінансового управління промисловими підприємствами і розроблено методичне забезпечення до оцінки рівня антикризового фінансового управління підприємством. Зазначено, що промисловість є однією з провідних галузей у національному господарстві України. Усі перетворення, які відбуваються на промислових підприємствах, завжди призводять до суттєвих змін у соціально-економічному становищі країни. Надано авторське визначення антикризового фінансового управління промисловим підприємством, під яким слід розуміти комплексну систему дій, спрямованих на запобігання або усунення негативних явищ для комерційної діяльності та бізнесу. Розроблено алгоритм антикризового фінансового управління, який дає можливість при розробленні системи антикризового фінансового управління промисловим підприємством ураховувати вплив зовнішніх і внутрішніх факторів середовища, у якому функціонує промислове підприємство, з метою своєчасного визначення загроз для їх попередження або усунення з ціллю недопущення чи подолання кризи. Зазначено, що важливу роль в антикризовому фінансовому управлінні відіграють фінансові ризики, які мають місце протягом усього виробничого циклу. Розроблено методичне забезпечення антикризового фінансового управління, яке являє собою оцінку впливу груп показників на розгортання кризових явищ на промисловому підприємстві. Зроблено висновок, що використання запропонованого методичного забезпечення антикризового фінансового управління промисловими підприємствами дозволяє знизити ймовірність виникнення кризових ситуацій та значно зменшити розмір можливого збитку. Тобто його застосування надасть можливість промисловим підприємствам швидко реагувати на виникнення кризових явищ і враховувати всі види фінансових ризиків при здійсненні виробничо-господарської та комерційної діяльності.

Chip scale atomic clocks (CSACs) have the potential to provide CubeSat missions with precision timekeeping capabilities to support onboard radiometric tracking, reducing dependence on ground suppor...

The paper describes the negative consequences of ore field development. It is deemed that one of the ways to reduce the negative impact of mining is the use of systems with the stowing of the worked-out area with man-made waste. Issues related to stowing mix transportation via pipeline were analyzed. Various types of pipeline transport equipment used at mines were compared. Technical features of this equipment were compared to ensure its effective incorporation into the process flow of stowing composite delivery. The positive influence of the activation treatment of stowing composite components and ready mix on the quality of the created solid mass was identified. The paper also discusses promising areas of the corresponding research activity.

Background: Infectious complications (IC) caused by bacterial strains often impede anticancer therapy. The study aimed to retrospectively analyze bacterial IC that could help predict the risk and o...

Objective The aim of the study is to reveal in the experiment the morphological features of the infected skin wounds healing, which are a manifestation of acne vulgaris severe and very severe forms, using a gel with carbon dioxide extract of hops. Patients and methods Materials and methods: An experimental study was carried out on 80 male WAG rats of three months of age. The animals were divided into 9 groups. Group 1 consisted of intact animals (n=6). Group 2 was represented by animals (n=6), which had hair epilation on the dorsal surface of the body in an area of 1 сm2, followed by application of 2 ml of placebo gel to this area. Group 3 included animals (n=6), which were epilated on the dorsal surface of the body in an area of 1 сm2 and applied 2 ml of 1 % gel with carbon dioxide extract of hops. Group 4 included rats (n=6), which were epilated on the dorsal surface of the body in an area of 1 сm2 and simulated thermal damage. Group 5 was represented by 10 rats, who were epilated on the dorsal surface of the body in an area of 1 сm2, simulated thermal damage, followed by applying 2 ml of placebo gel to the wound surface. Group 6 included rats (n=10), who underwent measures similar to group 5, followed by application of 2 ml of 1 % gel with carbon dioxide extract of hops to the wound surface. In group 7, there were 6 rats, which were epilated on the dorsal surface of the body in an area of 1 сm2, thermal damage to the skin with underlying soft tissues was simulated, followed by application to the wound surface the reference strains of Staphylococcus aureus, Streptococcus pyogenes, Proteus vulgaris, Propionibacterium acnes, Escherichia coli, Pseudomonas aeruginosa, Malassezia slooffiae, Malassezia pachydermatis, Candida albicans, Candida parapsilosis. In groups 8 and 9, there were 15 rats each, which underwent measures similar to group 7, followed by applying 2 ml of placebo gel on its surface on the next day after infection of the wound in group 8, and in group 9 - 2 ml of 1 % gel with carbon dioxide extract hops. The material for the study was the skin with underlying soft tissues. It was used histological, histochemical, morphometric and statistical methods. Results Results: This experimentally created gel with carbon dioxide extract of hops activates separation processes of horny masses from the surface of the epidermis, cleaning the pores of the skin; stimulating the proliferative activity of the epidermis, which is located in the marginal sections of the wound or covers the surface of the regenerate; activating the processes of cleansing the wound from necrotic tissue; activating the growth and maturation of granulation tissue with its subsequent transformation into connective tissue. It has anti-inflammatory, bactericidal and antimycotic effects, normalizing skin microbiocenosis. Conclusion Conclusions: The complex morphological study has showed that gel with carbon dioxide extract of hops is a highly effective drug in treatment of severe and very severe acne vulgaris, characterized by the development of deep and infected wound defects.

The article considers topical issues of the current state of readiness of future primary school teachers to implement interactive learning technologies in professional activities at the present stage of reforming the education system, which is interpreted as: readiness to develop plans and goals, development of professional qualities of teachers, expanding the mobilization of psychological point of view, increasing the level of independence and responsibility to society. The essence of the concept of "readiness" for future primary school teachers is revealed. The place of such scientists is shown: A. Aleksyuk, N. Boltenkov, V. Bondar, O. Voloshenko, S. Garkusha, M. Dyachenko, I. Zyazyuna, N. Kichuk, O. Kiyashko, L. Krasyuk, N. Kuzmina, Z. Kurland, I. Kushakova, A. Linenko, O. Moroz, S. Nikitchina, S. Sysoeva, V. Slastyonina, S. Smirnova, L. Khomich, V. Chaika, I. Shaposhnikova, O. Yaroshenko, who studied the problems readiness of teachers in professional activity. The essence of the concept of readiness as a set of properties and qualities of the teacher's personality, which determines the adaptation of a graduate of a higher education institution to the conditions of pedagogical work, is revealed. The development of research of scientists of readiness of primary school teachers for introduction of technologies of interactive training in professional activity is shown. The study analyzes the results of a survey of primary school teachers in Lviv, Lviv and Volyn regions on the use of interactive learning technologies. The level of use of interactive exercises at different stages of the lesson is shown, the sufficient level of use of technologies of interactive training of teachers of SZSh№ 68, Lviv. The best level of equipment of the technical base of schools in the conditions of development of the new Ukrainian school is determined. The place of a modern specialist who promotes the expansion of a positive level of learning with a willingness to implement technologies of interactive learning in professional activities is described.

This paper presents an experimental and numerical modal analysis of the military vehicle hull. Due to its adaptation to various weapon systems, it is necessary to conduct detailed tests. Computer simulations are a very useful tool. To ensure the reliability of the results, it is necessary to validate the models. The modal analysis was used in this work. It was carried out using the roving hammer method. Both natural frequency and mode shape were compared. The Modal Assurance Criterion was used for the comparison. To determine areas of noncompliance, distributions of relative differences between experimental and finite element (FE) mode shapes were prepared. The presented results indicate a large convergence between the results of numerical and experimental analyses.

Introduction. The paper is devoted to the problems of Ukrainian aviation enterprises. The paper analyzes the state of the world air transportation market, determines the place of Ukraine on it. The trends in the aviation services market for the first quarter of 2017-2020 are revealed. The urgency and necessity of modernization of Ukrainian enterprises is due to a number of factors: significant structural and technological backwardness, a high degree of depreciation of fixed assets and a significant level of capital and material consumption of equipment; low standard of living and purchasing power of the population; unsatisfactory state of innovation system and market infrastructure. The purpose of the paper is to increase the relative efficiency of the airline by bringing the active part of fixed assets in line with the new conditions and requirements. Results. The fall of the passenger transportation market is determined. The increase in the cost of air cargo was tracked. When studying the current state and trends in the development of the industry, the post-COVID-19 factors were identified, which led to a change in the cost of freight transportation. Conclusion. Taking into account the indicated tendencies and operating conditions in the world market and the Ukrainian air transportation market, an algorithm for modernization is proposed, within the framework of which the tactical goals of the aviation enterprise are indicated, the result of the implementation of which should be an increase in the profitability of freight traffic. The results of the work of theoretical and practical aspects of modernization of air cargo in Ukraine gave grounds to draw the following conclusions: modernization of Ukrainian airlines should be carried out at the micro level in order to increase the profitability of operating activities; the level of profitability of the airline can be influenced by both internal and external factors; the change in the coefficient depends on the general economic situation of the country or the world, the level of inflation, the devaluation of the national currency, organizational and technical problems in production, the volume of services sold, etc.

OBJECTIVE: Deep learning (DL) image reconstruction has the potential to disrupt the current state of MRI by significantly decreasing the time required for MRI examinations. Our goal was to use DL to accelerate MRI to allow a 5-minute comprehensive examination of the knee without compromising image quality or diagnostic accuracy. MATERIALS AND METHODS. A DL model for image reconstruction using a variational network was optimized. The model was trained using dedicated multisequence training, in which a single reconstruction model was trained with data from multiple sequences with different contrast and orientations. After training, data from 108 patients were retrospectively undersampled in a manner that would correspond with a net 3.49-fold acceleration of fully sampled data acquisition and a 1.88-fold acceleration compared with our standard twofold accelerated parallel acquisition. An interchangeability study was performed, in which the ability of six readers to detect internal derangement of the knee was compared for clinical and DL-accelerated images. RESULTS. We found a high degree of interchangeability between standard and DL-accelerated images. In particular, results showed that interchanging the sequences would produce discordant clinical opinions no more than 4% of the time for any feature evaluated. Moreover, the accelerated sequence was judged by all six readers to have better quality than the clinical sequence. CONCLUSION. An optimized DL model allowed acceleration of knee images that performed interchangeably with standard images for detection of internal derangement of the knee. Importantly, readers preferred the quality of accelerated images to that of standard clinical images.

Aim: We aimed to examine the distribution and secular changes of conscript body height in the geographic network of Norway since 1878 and to study its association with the degree of urbanization, and population density. Material and methods: Data on body height of Norwegian military conscripts were provided by the Statistics Norway Department (SSB). The sample comprised eight cohorts with the following measurement years: 1st 1877, 1878 and 1880, 2nd 1895-1897, 3rd 1915-1917, 4th 1935-1937, 5th 1955-1957, 6th 1975-1977, 7th 1995-1997, and 8th 2009-2011. For determining neighborhood correlations, a network was created consisting of neighboring counties, sharing a common border. Results: Average body height of Norwegian men increased by 10.9 cm between 1878 and 2010, but this trend was heterogeneous. Some counties increased by more than 1 cm per decade (Finmark) others by only 7 mm per decade (Sor-Trondelag). Urban counties and counties with higher population density showed stronger height trends than rural counties. The largest spread in body height between the various counties was observed in 1936 when for the first time people living in the more urban counties got taller than rural people. The height advantage of urban counties however, disappeared after 1996. At this time, also the secular trend in height had come to a halt. The secular trend in height had become obvious after the dissolution of the union between Norway and Sweden in 1905 and World War I, and was strongest between 1936 and 1956. During this period maximum between-county heterogeneity in height existed with body height differences of more than 6 cm between the tallest and the shortest county. The end of this period was characterized by social democratic reforms that flattened the income distribution, eliminated poverty, and ensured social services after World War II. Conclusion: The temporal coincidence between the trends in height, the degree of urbanization and the onset of the political transition of Norway from a Swedish province into an independent democratic wealthy modern European state after World War I and particularly after World War II, and the abatement of this trend after this period of transition had stabilized, suggest social and political components interfering with the regulation of physical growth in humans.

IntroductionEpidemiological analysis of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections in pediatric hematology and oncology (PHO) and hematopoietic cell transplant (HCT) centers in a Polish nationwide study, as well as analysis of the preventive strategies in these centers.MethodsAll of the 18 PHO/HCT centers participated in eight surveys and questionnaires conducted over the first 5 months of the SARS-CoV-2/coronavirus disease 2019 (COVID-19) pandemic in Poland. Epidemiological data were collected at eight regular time points, and the strategy of preventive management was done once after 4 months of the pandemic.ResultsDuring this analyzed period, eight patients were positive for SARS-CoV-2. The estimated incidence of SARS-CoV-2 positivity in Polish PHO/HCT centers was 0.5%. After exclusion of HCT patients (with one patient being infected), the estimated incidence of SARSCoV-2 positivity was between 0.5 and 0.6%. In all but one case, the course of COVID-19 was asymptomatic or mild, and it was moderate in one case. None of them developed SARS or respiratory insufficiency, none of them required treatment in the intensive care unit (ICU), and no patient died due to SARS-CoV-2 infection. As of July 1, parents staying in the hospital together with their children were regularly tested for the virus in 13 centers. Asymptomatic healthcare personnel were regularly tested for the virus in seven centers.ConclusionsThe estimated incidence of SARS-CoV-2 infection among PHO/HCT patients is lower than in Western Europe; however, these patients cannot be regarded as a low-risk group. The low COVID-19 incidence should be interpreted as a result of strictly and continuously implemented detailed preventive measures in the PHO/HCT wards and in hospitals.

Cefiderocol (CFDC), (formerly S-649266), is a novel injectable siderophore cephalosporin developed by Shionogi & Co., Ltd., with potent in vitro activity against Gram-negative pathogens including multidrug-resistant (MDR) Enterobacteriaceae and non-fermenting organisms, such as Pseudomonas aeruginosa, Acinetobacter baumannii, Burkholderia cepacia, and Stenotrophomonas maltophilia. Characterized by its siderophore catechol-moiety, CFDC uses a "trojan-horse approach" to navigate through the bacterial periplasmic space, thus evading various beta-lactam degrading enzymes and other mechanisms of resistance present in Gram-negative bacteria. More specifically in carbapenem-resistant Enterobacteriaceae, CFDC has been shown to have activity against extended spectrum beta-lactamases (ESBLs), such as CTX-type, SHV-type, and TEM-type, as well as the Ambler classes of beta-lactamases, including class A (KPC), class B (NDM, IMP, and VIM), class C (AmpC), and class D (OXA, OXA-24, OXA-48, and OXA-48-like). In addition to the strong activity that CFDC has been shown to have against MDR P. aeruginosa, it has also displayed activity against the OXA-23, OXA-24, and OXA-51, beta-lactamases commonly found in MDR A. baumannii. Cefiderocol was recently approved by the US Food and Drug Administration (FDA) for use in complicated urinary tract infections (cUTI), including pyelonephritis, for use in patients 18 years or older with limited or no alternative options for treatment, and is currently being evaluated in a phase III trial for use in nosocomial pneumonia caused by Gram-negative pathogens. The unique features and enhanced activity of CFDC suggest that it is likely to serve as a viable therapeutic option in the treatment of MDR Gram-negative infections. The purpose of this review is to provide an overview of previously published literature explaining CFDC's pharmacology, pharmacokinetic / pharmacodynamic (PK / PD) properties, microbiologic activity, resistance mechanisms, safety parameters, dosing and administration, clinical data, and potential place in therapy.

Introduction Nephrotoxicity is a potential adverse effect of anticancer treatment in childhood. Cytostatics, abdominal radiotherapy, total body irradiation (TBI) and some agents used in supportive care may induce acute kidney injury (AKI) or lead to chronic kidney disease (CKD). The aim of this study was to test the hypothesis whether urinary kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) are increased in acute lymphoblastic leukemia (ALL) survivors. Method The study cohort consisted of 86 patients (42 females) previously treated for ALL. The median time after cessation of treatment was 6.55 (IQR: 1.96–9.93) years and median age at the time of study: 12 (IQR: 6.76–16.00). The control group included 53 healthy peers. Immunoenzymatic ELISA commercial kits were used to measure urine KIM-1 and NGAL levels. Results The median levels of urine uNGAL (p p p 2. The NGAL/cr. ratio seemed to be the best predictor of decreased eGFR (AUC = 0.65). The cumulative dose of methotrexate and cyclophosphamide did not predict the values of the urine NGAL, NGAL/cr., KIM-1/cr. and eGFR. Five years after the end of treatment, the patients had higher levels of uKIM-1 (1.02 ± 0.8 vs. 0.62 ± 0.6 ng/mL, p p 2, p Conclusion We demonstrated that ALL survivors have higher levels of urine NGAL, NGAL/cr. and uKIM-1/cr. ratio as compared to the control group. Further long-term follow-up studies are necessary to assess the significance of the NGAL and KIM-1 and their relationship to kidney damage after anticancer treatment in childhood.