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Tereza Romanová,1,2 Filip Burša,1,2 Peter Sklienka,1,2 Jiří Sagan,3 Michelle Vaňková,1 Denis Buršík,1,2 Markéta Bílená,1,2 Martin Pulcer,4 Michal Burda,5 Jan Máca1,2,6 1Department of Anesthesiology and Intensive Care Medicine, University Hospital, Ostrava, Czech Republic; 2Department of Intensive Medicine, Emergency Medicine and Forensic Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic; 3Department of Infectious Diseases, University Hospital Ostrava, Ostrava, Czech Republic; 4Institute of Laboratory Medicine, University Hospital Ostrava, Ostrava, Czech Republic; 5Institute for Research and Applications of Fuzzy Modeling, CE IT4Innovations, University of Ostrava, Ostrava, Czech Republic; 6Institute of Physiology and Pathophysiology, Faculty of Medicine, University of Ostrava, Ostrava, Czech RepublicCorrespondence: Jan Máca, Department of Anesthesiology and Intensive Care Medicine, University Hospital Ostrava, 17. listopadu 1790/5, Ostrava, 708 52, Czech Republic, Tel +420597371111, Email jan.maca@fno.czPurpose: Anticoagulation therapy aims to improve the outcome of critically ill patients with severe COVID-19-associated pneumonia. Activated partial thromboplastin time (aPTT) is commonly used to maintain the target therapeutic range of continuous infusion of unfractionated heparin (UFH). The UFH infusion efficacy can be evaluated by determining the time in therapeutic range (TTR) using a modified Rosendaal method. The present study’s primary aim was to evaluate TTR based on the aPTT in critically ill patients with severe forms of COVID-19 pneumonia and its influence on survival. The secondary aim was to evaluate the time spent above (TATR) and below the therapeutic range (TBTR).Patients and Methods: We performed a retrospective analysis of critically ill patients with COVID-19-associated pneumonia. All patients received a continuous infusion of UFH from the 2nd to 8th day since admission to the ICU. TTR, TATR, and TBTR were calculated using the modified Rosendaal method, and survival days were analyzed by regression (censored after 60 days).Results: Of 103 patients, the median TTR was 49% (IQR 38– 63%), TATR 11% (IQR 5– 20%), and TBTR 33% (IQR 22– 51%). The regression analysis indicated a positive impact of higher TTR and TATR on the number of survival days [β=0.598 (p=0.0367) and β=1.032 (p=0.0208), respectively] and a negative impact of higher TBTR [β=− 0.681 (p=0.0033)] on the number of survival days.Conclusion: Higher TTR and TATR were associated with better survival of critically ill patients with a severe course of COVID-19-associated pneumonia. Higher TBTR was associated with worse survival in these patients.Keywords: unfractionated heparin, COVID-19, pneumonia, critical care

The work is devoted to improving the processes of digital technologies introduction in the field of the gas supply system on a methodological basis to enhance efficiency and reliability. The goal set in the study is to increase the reliability of the gas supply system of facilities based on the practical effectiveness of the digital technologies. This aim is achieved by solving the following tasks. Improving the methodology for assessing digital transformation in the field of gas supply. Application of the method of system analysis for the research, generalization of existing mathematical models and digital technologies. Identification of the modules of the main tasks for the implementation of an integrated method for improving the reliability of the gas supply system. The question of the criterion evaluation of the achievement of digitalization indicators is considered. So at the present stage, the digital technologies have already been introduced into the field of the gas supply, but the concepts of the basic level are not methodically defined. The most significant result is the improvement of the practical methodology for assessing digital transformation for the gas supply. A study of the current level of activity of gas distribution organizations shows a nonuniform level of the digital indicators for consumers and industrial facilities. The effectiveness of digital technologies is assessed taking into account the volume of gas consumption. The effect on economy, manufacturability and safety performance was made according to expert estimates and on the statistical data basis. The results of a multi-level modular-functional approach in estimation the digitalization of the effect were presented for the basic economically justified and promising level of the gas-supply digital transformation.

This study analyses EU and Lithuanian documents on countering disinformation/fake news to present the plurality of the Union’s approaches to ensuring resilience. Currently, there are three approaches to the problem in the EU. The first one, used by the European Commission, is the recognition of citizens’ right to information as well as of the need to promote critical thinking and information literacy. This approach fits into the adaptive paradigm of action in the information space and the concept of autopoietic resilience. The second approach, taken by the European External Action Service, is to expose fake news and the media spreading it. In combining adaptive and paternalistic paradigms of action in the information space, this approach employs a more static interpretation of resilience. Lithuania has adopted a third approach, which is dominated by the paternalistic paradigm and homeostatic resilience. This approach consists of the state isolating citizens from certain information. Thus, the popular use of the term ‘resilience’ in the EU disguises the plurality of approaches to both disinformation and resilience itself. Theoretically, this study draws on the concept of resilience and paradigms for countering disinformation/fake news. Methodologically, it relies on critical discourse analysis. The article suggests several possible causes of intra-EU differences in countering disinformation/fake news/propaganda and interpreting resilience

The aim was to examine the longitudinal association between myasthenia gravis clinical severity and concentration of acetylcholine receptor (AChR) antibodies to evaluate if AChR-antibody variations correlate to disease severity. Material and Methods. Antibodies were determined by enzyme immunoassay. The International Clinical Classification (MGFA) was used to grade the severity of the disease. The level of antibodies was compared with the severity of the condition and the form of the disease at the stage of diagnosis in 65 patients, as well as in repeated studies in 26 patients. Results. The titer of AChR-antibodies did not correlate with the severity of the condition, however, a direct relationship between the change in the level of acetylcholine receptor antibodies and the change in the clinical state during the course of the disease was obtained. Conclusion. Repeated AChR-antibody measurements will help to predict the clinical state of the patient and can be used to correct immunosuppressive therapy.

The aim is to study the relationship between the parameters of neurological status and quality of life of patients who first underwent ischemic strokes in the carotid basin to predict the outcome of an acute cerebrovascular accident. Material and Methods. 73 patients with ischemic stroke in the carotid artery basin were examined. Analyzed indices of the scales, reflecting the severity of motor deficit (NIHSS, Rankin, Rivermead, Fugl-Meyer), the initial evaluation and parameters of quality of life using the questionnaire SF-3624-36 months after inpatient treatment. Patients were divided into groups of favorable and unfavorable outcome according to the questionnaire SF-36. Results. A direct correlation between the level of physical and psychological health and indicators Of the Fugl-Meyer scale and a negative correlation between the level of psychological health and the severity of stroke on the NIHSS scale in a group with an adverse outcome was revealed. Conclusion. Indicators scales Fugl-Meyer, and NIHSS obtained in the acute period of ischemic stroke can be used to build a predictive model of outcome of stroke.

The aim of the study was to examine cognitive impairment in patients with multiple sclerosis with an emphasis on the speed and efficiency of information processing. It was supposed to reveal the patterns of these disorders depending on the duration and severity of the disease. Material and methods. The study included 50 patients with established diagnosis of clinically significant multiple sclerosis, a relapsing-remitting course. The EDSS score was evaluated. Cognitive functions were assessed using SDMT and PASAT-3 tests. All patients underwent a study of cognitive evoked potential. All examined patients were divided into 2 groups depending on the duration of the disease. Results. Cognitive screening tests PASSAT and SDMT showed no correlation with the duration of the disease severity and cannot serve as a tool for screening early signs of cognitive impairment in young patients with multiple sclerosis. A significant increase in latency of the P300 potential was obtained with increasing duration and severity of the disease, which correlates with the severity of cognitive dysfunction. Conclusion. This study is the initial step in the search for a tool for screening early manifestations of cognitive impairment in patients with multiple sclerosis. In the future it is planned to expand the research with the modernization of its design.

roblems of increasing the efficiency of the operation of electrical networks based on the utilization of booster transformers (BT) with electronic control, applied on the base of active elements in smart electric grids of power systems and giving the function of automatic correction of the parameters of the network, assuring the conditions of optimal common operation are studied in the paper. The mathematic model of the processes in the electric networks with booster transformer has been developed; the opportunity of control by means of the phase-switching BT for power fluxes in the networks has been established. It has been shown that for the groups of switching the windings 1-5 of BT occurs additional consumption of power from the supply network, but for the groups 7-11 its recuperation to the load network. Respectively, switching the windings of BT to the group 1-5 assures the shift of load current to the direction of lag, but in the case of switching to the group 7-11 – towards the outrunning. Wherein, for the groups of switching 10-11 and 1-2 one can observe the increasing of the voltage at the output of BT, but for the groups 7-8 and 4-5 it is decreasing. Based on the analysis of the results of research the diagram and constructive models of the transformer have been proposed. The quasi-stationary and transient regimes were investigated and the conditions of reliable operation at these the regimes have been determined. The ways for increasing the efficient common operation for the transformer and network in the case of switching the thyristors into the circuit of the primary winding of the transformer have been proposed.

The aim: the hypothesis testing of the existence of two different groups of patients with different age at disease onset in a large population of patients with methods multidimensional constellation. Materials and Methods. Analysis of 444 patients enrolled in the register of patients with myasthenia in the Samara region. The duration of disease was more than 1 year. Statistical results of the study was carried out using a multi-dimensional grouping by cluster analysis Checking the quality of the classification was carried out using discriminant analysis. Results. Transient age between the two groups was defined as 40 years. The most important criteria of distinction patients group was sex of the patient and the presence of thymic hyperplasia. Conclusion. These clinical and immunologic patterns of early-onset and late-onset myasthenia gravis can serve as a basis of formation flow forecast model of myasthenia gravis and to create an algorithm of patient management.

The purpose of this research is to determine the possibility of the use of native milk whey in the production of smoked-boiled ham from poultry meat. During the research, the process of modeling the production of smoked-boiled ham with the use of native milk whey was simulated. As a result of the studies, it was found that in the development of meat products, the whey had a positive effect on organoleptic, physico-chemical parameters, as well as the yield of finished products, which ultimately determines the feasibility and economic efficiency of the use of whey in the recipe of processed products.

In recent years, there has been a trend to develop and produce special products. Improving food technology through the use of hydrated oatmeal makes it possible to enrich fermented milk products with proteins, dietary fiber, trace elements and vitamins. Oat flakes were used as a nutrient medium for microorganisms in a fermented milk product. Lactobacilli and acidophilus bacillus produce organic acids which leads to the inhibition of the vital activity of pathogenic microorganisms. The use of hydrated oat flakes in an amount of 6% at the stage of fermentization at a temperature of 420 ° C has a positive effect on quality of the fermented milk product (yogurt) and development of lactic acid bacteria.

A stereotypical understanding of EU-Russia energy relations is often reduced to trade in oil and natural gas, which downplays the importance of energy efficiency cooperation. Such cooperation is promoted within the Energy Charter and its Treaty, Partnership and Cooperation Agreement, Energy Dialogue, Common Economic Space, Partnership for Modernisation. However, it lacks practical development, which relates to the instability of the legal environment in Russia, insufficient mechanisms of financial support for energy conservation projects and poor political support. Nevertheless, energy efficiency cooperation is capable of changing Russia-EU energy cooperation qualitatively: it offers a cheaper way to meet the needs of the EU, redefines interdependence between the parties, and introduces new elements of equality between them. Energy efficiency cooperation also transforms the patterns of the EU-Russia legal harmonization, creates new conditions for the convergence of regulations and the development of the middle class in Russia. Due to its specific features, cooperation in the Baltic Sea region becomes a locomotive of the Russia-EU energy efficiency cooperation, and, as a result, is capable of changing the quality of relations between the partners.

A stereotypical understanding of EU-Russia energy relations is often reduced to trade in oil and natural gas, which downplays the importance of energy efficiency cooperation. Such cooperation is promoted within the Energy Charter and its Treaty, Partnership and Cooperation Agreement, Energy Dialogue, Common Economic Space, Partnership for Modernisation. However, it lacks practical development, which relates to the instability of the legal environment in Russia, insufficient mechanisms of financial support for energy conservation projects and poor political support. Nevertheless, energy efficiency cooperation is capable of changing Russia-EU energy cooperation qualitatively: it offers a cheaper way to meet the needs of the EU, redefines interdependence between the parties, and introduces new elements of equality between them. Energy efficiency cooperation also transforms the patterns of the EU-Russia legal harmonization, creates new conditions for the convergence of regulations and the development of the middle class in Russia. Due to its specific features, cooperation in the Baltic Sea region becomes a locomotive of the Russia-EU energy efficiency cooperation, and, as a result, is capable of changing the quality of relations between the partners.

The article analyzes the development of EU — Russia energy relations through the lens of the evolution of three parameters: the political agenda (the Energy Dialogue), the institutional structure, and the legal modalities. The identification of these three aspects for assessing the evolution of EU — Russia energy relations is the novelty in the author’s approach. This study aims to identify the previous stages and assess the current state of EU — Russia energy dialogue, since they set out conditions for energy cooperation in the Baltic Sea region. This research is based on a political and legal analysis of various documents and employs various international relations theories (including integration theories). The article demonstrates that the EU nd Russia have made a transition to the integration agenda manifested in the Energy Dialogue (its current goal is the creation of a common European energy market). The author describes the process of gradual consolidation of transgovernmental and transnational institutions, which leads to depoliticization of cooperation and mutual socialization of the partners. Finally, legal discussions on the development of common rules have become more constructive. In sum, the current situation in EU — Russia energy relations is favourable and positively affects cooperation in the Baltic Sea region.

The article analyzes the development of EU — Russia energy relations through the lens of the evolution of three parameters: the political agenda (the Energy Dialogue), the institutional structure, and the legal modalities. The identification of these three aspects for assessing the evolution of EU-Russia energy relations is the novelty in the author’s approach. This study aims to identify the previous stages and assess the current state of EU — Russia energy dialogue, since they set out conditions for energy cooperation in the Baltic Sea region. This research is based on a political and legal analysis of various documents and employs various international relations theories (including integration theories). The article demonstrates that the EU and Russia have made a transition to the integration agenda manifested in the Energy Dialogue (its current goal is the creation of a common European energy market). The author describes the process of gradual consolidation of transgovernmental and transnational institutions, which leads to depoliticization of cooperation and mutual socialization of the partners. Finally, legal discussions on the development of common rules have become more constructive. In sum, the current situation in EU — Russia energy relations is favourable and positively affects cooperation in the Baltic Sea region.

The relevance of the study is due to the fact that for professional training of foreign philology students, a high level of knowledge of the Russian language is required. The article analyzes the work with foreign students studying Russian philology. The focus is on scientific circles dealing with the Russian language and Russian literature and creating conditions for socio-cultural adaptation and professional development. To increase knowledge of foreign students, a system of scientific circles designed to consolidate and deepen knowledge in Russian literature and language can be created. The article determines tasks of scientific circles, primary problems, features of teaching philological disciplines for foreign students. Based on authors’ experience in teaching “Russian language (practical course)”, “Basic language (theoretical course)”, “History of Russian literature of the 10th-20th centuries”, recommendations to enhance the role of additional education were developed; the relationship between the curricular and extracurricular activities was identified. It was concluded that scientific circles are aimed at forming those competencies whose development causes difficulties, but future specialists as professionals and representatives of the humanitarian sphere of life need them.

The article studies features of verbalization of the concept family. Based on the extensive proverbial material, the system of value attitudes and stereotypical representations of family as a traditional social institution in the understanding of Russian and Ukrainian peoples is analyzed: the role of family and marriage in the culture of Russians and Ukrainians, stages of family formation including selection of a bride or a groom, distribution of family duties, and the role of parents, attitude towards step-children. As a result of the comparative analysis of Russian and Ukrainian paremias in which family relations are reflected, general and national-specific features related to mentality, value preferences, customs and traditions of close Slavic ethnic groups are revealed. It was concluded that despite the specific features of the material and spiritual culture of Russian and Ukrainian peoples, the understanding of family and its role in human life is similar. This coincidence proves that the main functions of family as a small social group based on marriage and consanguinity are education of children and preservation of national and universal values.

The lack of own funds of enterprises is one of the main problems in resolving issues related to the expansion, the acquisition of new equipment or the replacement of the old one. In contemporary economic conditions, it is leasing that is considered one of the most progressive ways of financing business activity. This financial toolkit is able to provide enterprises with access to the most advanced production technologies and equipment. At the same time, this mechanism is paid insufficient attention in our country. To solve these problems, the authors propose, firstly, the implementation of the algorithm for the development of the reproduction of the material and technical base of organizations based on the use of financial leasing. Secondly, a technique for calculating leasing payments based on a parametric model is suggested, taking into account the application of lowering coefficients. The implementation of the proposed toolkit is aimed at improving leasing relations as one of the most important factors of the development of the material and technical base, and funding for reproduction processes.

Abstract Background With HIV prevalence estimated at 20% among female injecting drug users (IDUs) in St. Petersburg, Russia, there is a critical need to address the HIV risks of this at-risk population. This study characterized HIV risks associated with injecting drug use and sex behaviors and assessed the initial feasibility and efficacy of an adapted Woman-Focused intervention, the Women's CoOp, relative to a Nutrition control to reduce HIV risk behaviors among female IDUs in an inpatient detoxification drug treatment setting. Method Women (N = 100) were randomized into one of two one-hour long intervention conditions--the Woman-Focused intervention (n = 51) or a time and attention-matched Nutrition control condition (n = 49). Results The results showed that 57% of the participants had been told that they were HIV-positive. At 3-month follow-up, both groups showed reduced levels of injecting frequency. However, participants in the Woman-Focused intervention reported, on average, a lower frequency of partner impairment at last sex act and a lower average number of unprotected vaginal sex acts with their main sex partner than the Nutrition condition. Conclusion The findings suggest that improvements in sexual risk reduction are possible for these at-risk women and that more comprehensive treatment is needed to address HIV and drug risks in this vulnerable population.

Background: Anticoagulation during extracorporeal membrane oxygenation (ECMO) might still lead to severe bleeding complications. Heparin is the most frequently used anticoagulant, but novel drugs could be promising. Argatroban is a new alternative to heparin. To date, no robust studies have confirmed the clear superiority of argatroban (AG) over heparin, although it has some advantages and may be safer., Study Design and Methods: An observational study was conducted in all adult veno-venous ECMO patients with COVID-19-associated acute respiratory distress syndrome admitted to the University Hospital Ostrava (n = 63). They were anticoagulated with heparin in the first period and with AG in the second period, targeting the same activated partial thromboplastin time (aPTT; 45-60 s). Bleeding complications requiring transfusion and life-threatening bleeding events were evaluated. The primary objective was to compare heparin and AG in terms of bleeding, transfusion requirements and mortality-related bleeding., Results: The total time on ECMO per patient was 16 days with an in-hospital mortality of 55.6%. The red blood cell consumption in the AG group (median 2.7 transfusions/week) was significantly lower than in the heparin group (median 4.2 transfusions/week, p = 0.011). Life-threatening bleeding complications were higher in the heparin group compared to the AG group (35.7% vs. 10.2%, p = 0.035), and mortality-related bleeding complications were also higher in the heparin group (21.4% vs. 2.0%, p = 0.032)., Discussion: Argatroban is an interesting alternative to heparin with less bleeding, less need for red blood cell transfusions and improved safety of ECMO with less mortality-related bleeding., (© 2024 The Author(s). Transfusion Medicine published by John Wiley & Sons Ltd on behalf of British Blood Transfusion Society.)

Background: Postoperative nausea and vomiting (PONV) is a significant problem following paediatric surgery, and volatile anaesthetics are an important cause of this phenomenon. BIS-guided anaesthesia, by reducing the consumption of anaesthetics, leads to a decrease in PONV in adult patients., Study Objective: Evaluate the role of BIS-guided anaesthesia in reducing the incidence of paediatric PONV., Design: Prospective, randomized, double-blind study., Setting: A single center study in university hospital in Czech republic, from June 2021 to November 2022., Patients: A total of 163 children, aged 3-8 years with ASA I-II who underwent endoscopic adenoidectomy under general anaesthesia were included., Interventions: In the intervention group, the depth of anaesthesia was maintained to values between 40 and 60 of BIS., Main Outcome Measure: The primary outcome was the incidence of postoperative nausea and vomiting during 24 h after surgery., Results: The use of BIS-guided anaesthesia led to a significant decrease in the incidence of nausea and vomiting compared to the control group [17% vs. 53%; RR (95%CI) 0.48 (0.27-0.86); p < 0.001and 16% vs. 34%; RR (95%CI) 0.33 (0.20-0.54); p = 0.01, respectively]., Conclusions: BIS-guided anaesthesia decreases the incidence of postoperative nausea and vomiting in children undergoing adenoidectomy., Trial Registration: Clinicaltrials.gov identifier: NCT04466579., (© 2024. The Author(s).)

Background: Maintaining the patient awake and not intubated during the venovenous extracorporeal membrane oxygenation (VV ECMO) reduces the risk of ventilation-induced lung injury in patients with ARDS. Currently, there is a lack of data on outcomes and complications associated with the awake ECMO approach., Objectives: To evaluate outcomes and the occurrence of complications of awake ECMO approach guided by local safety protocol comprising ultrasound-guided cannulation, argatroban-based anticoagulation, respiratory support, and routine sedation targeted to reduce respiratory effort and keeping nurse-to-patient ratio of 1:1., Design: A single-center retrospective case series analysis., Methods: Consecutive patients with COVID-19-related acute respiratory distress syndrome (ARDS) (CARDS) treated by full awake VV ECMO approach from April 2019 to December 2023 were eligible., Results: Our center treated 10 patients (mean age 54.7 ± 11.6 years) with CARDS with an awake ECMO approach. The reasons for awake ECMO included the presence of barotrauma in six patients, a team consensus to prefer awake ECMO instead of mechanical ventilation in three patients, and the patient's refusal to be intubated in one case. Before ECMO, patients were severely hypoxemic, with a mean value of Horowitz index of 48.9 ± 9.1 mmHg and a mean respiratory rate of 28.8 ± 7.3 breaths per minute on high-flow nasal cannula or noninvasive ventilation support. The mean duration of awake VV ECMO was 558.0 ± 173.6 h. Seven patients (70%) were successfully disconnected from ECMO and fully recovered. Intubation from respiratory causes was needed in three patients (30%), all of whom died eventually. In total, three episodes of delirium, two episodes of significant bleeding, one pneumothorax requiring chest tube insertion, and one oxygenator acute exchange occurred throughout the 5580 h of awake ECMO. No complications related to cannula displacement or malposition occurred., Conclusion: The awake ECMO strategy guided by safety protocol appears to be a safe approach in conscious, severely hypoxemic, non-intubated patients with COVID-19-related ARDS.