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The individual approach in the treatment of heart failure (HF) and personalized medicine have been the main topic in recent years in all scientific forums. The combination of chronic obstructive pulmonary disease (COPD) and sleep apnea (SA) further complicates the clinical presentation in patients with HF. The overlap of all three diseases requires a team of specialists and additional therapeutic approach for better control and to improve the prognosis. A large number of the pathophysiological mechanisms of the three diseases also overlap. The novel therapies for HF have shown good results, both in COPD and CA subgroups. Noninvasive ventilation during hospitalization and at home is an established method in the individual groups. In a combination of the three diseases, definitive data from randomized trials are still lacking.

The article examines the approaches to the determination of risk factors in road traffic accidents, describes groups of risk indicators, examines various points of view. The approaches to the assessment of a set of risk factors are considered. From the point of view of assessment, objective and subjective factors are analyzed. It is pointed out that objective factors are sufficiently amenable to assessment and adjustment using control actions. The study offactors affecting road safety is the basis for the development of control actions.

Fibrinogen is a polyfunctional plasma protein involved in various physiological and pathological processes through the interaction of its multiple domains with different ligands and cell receptors. Among fibrinogen domains, two BβN-domains are formed by the N-terminal portions of its two Bβ chains including­ amino acid residues Bβ1-64. Although their folding status is not well understood and the recombinant disulfide-linked (Bβ1-66)2 fragment corresponding to a pair of these domains was found to be unfolded, some data suggest that these domains may be folded in the parent molecule. In contrast, their major functional properties are well established. Removal of fibrinopeptides B (amino acid residues Bβ1-14) from these domains upon fibrinogen to fibrin conversion results in the exposure of multiple binding sites in fibrin βN-domains (residues β15-64). These sites provide interaction of the βN-domains with different proteins and cells and their participation in various processes including fibrin assembly, fibrin-dependent angiogenesis, and fibrin-dependent leukocyte transmigration and thereby inflammation. The objective of this review is to summarize the current view of the structure and function of these domains in fibrinogen and fibrin and their role in the above-mentioned processes.

The dependence of the gross regional product per capita of some of the factors influencing the innovative development of the region: internal costs of research and development, the current internal development costs, the number of patents granted. For calculations using regression analysis of 12 regions of the Federal District of Russia on the basis of statistical data for the period from 2008 to 2012. The high dependence of the gross regional product per capita is one of the innovative factors.

У статті розглядаються питання впливу тимчасового резервування роботи окремого обладнання локомотивів на його надійність за умови різних законів розподілу часу роботи, часу відновлення, часу на тимчасове резервування.

The dependence of the gross regional product per capita of some of the factors influencing the innovative development of the region: internal costs of research and development, the current internal development costs, the number of patents granted. For calculations using regression analysis of 12 regions of the Federal District of Russia on the basis of statistical data for the period from 2008 to 2012. The high dependence of the gross regional product per capita is one of the innovative factors.

У статті розглядаються питання впливу організації технічного обслуговування при різних законах розвитку відмов на ефективність експлуатації тягового рухомого складу (ТРС). На основі вибору параметрів надійності для різних законів розподілу відмов обладнання визначені значення параметрів надійності і проаналізований вплив закону розподілу відмов обладнання на параметри надійності для оцінки ефективності організації технічного обслуговування обладнання ТРС. Отримані при цьому співвідношення дозволяють визначати не тільки показники надійності системи, але і розраховувати оптимальну періодичність і терміни проведення ТО з метою підтримки надійності системи.

Background : Acute decompensated heart failure (ADHF) is a condition with a high frequency of hospitalizations and mortality, and obstructive sleep apnea (OSA) is a common comorbidity. Continuous positive airway pressure (CPAP) therapy at home can be a good adjunctive non-drug therapy for these patients. Methods : We conducted a single-center, prospective cohort study from 150 consecutive patients hospitalized for heart failure exacerbation in the cardiology department. Of these, 57 patients had obstructive sleep apnea. After discharge, CPAP therapy at home was offered. We divided them into two groups and followed them for 1 year. All patients received optimal medical treatment. At the end of the period, patients underwent a follow-up physical examination, a follow-up echocardiography, and a follow-up evaluation of the Epworth Sleepiness Scale (ESS). Results : From 81 patients with sleep apnea, 72.8% (n = 59) had obstructive sleep apnea (OSA) and 27.2% (n = 22) had central sleep apnea (CSA). There was a statistically significant difference in body mass index (BMI), ESS, systolic blood pressure (SBP), diastolic blood pressure (DBP), and left ventricular ejection fraction (LVEF%) in the group with CPAP therapy compared to the no-CPAP group. The CPAP group had a median survival of 11.7 months vs. 10.1 months in the no-CPAP group (log-rank (Mantel-Cox) p = 0.044). Conclusions : This study suggests that obstructive sleep apnea is a common comorbidity in patients with acute decompensated heart failure. The addition of CPAP therapy in these patients improves the symptoms and the prognosis.

Electrically powered micro- and nanomotors are promising tools for in vitro single-cell analysis. In particular, single cells can be trapped, transported, and electroporated by a Janus particle (JP) using an externally applied electric field. However, while dielectrophoretic (DEP)-based cargo manipulation can be achieved at high-solution conductivity, electrical propulsion of these micromotors becomes ineffective at solution conductivities exceeding ≈0.3 mS cm -1 . Here, JP cargo manipulation and transport capabilities to conductive near-physiological (<6 mS cm -1 ) solutions are extended successfully by combining magnetic field-based micromotor propulsion and navigation with DEP-based manipulation of various synthetic and biological cargos. Combination of a rotating magnetic field and electric field results in enhanced micromotor mobility and steering control through tuning of the electric field frequency. In addition, the micromotor's ability of identifying apoptotic cell among viable and necrotic cells based on their dielectrophoretic difference is demonstrated, thus, enabling to analyze the apoptotic status in the single-cell samples for drug discovery, cell therapeutics, and immunotherapy. The ability to trap and transport live cells towards regions containing doxorubicin-loaded liposomes is also demonstrated. This hybrid micromotor approach for label-free trapping, transporting, and sensing of selected cells within conductive solutions opens new opportunities in drug delivery and single-cell analysis, where close-to-physiological media conditions are necessary., (© 2022 The Authors. Advanced Science published by Wiley-VCH GmbH.)

Objectives: Ability to predict which chronic itch patients will benefit from particular treatments is a challenge. Common features in itch and pain in respect to sensory elicitation, and mechanisms of processing including sensitization and inhibition at the peripheral and central levels, may serve to understand variability in treatment outcomes. As such this study aimed to explore whether phototherapy outcomes can be predicted by psychophysical parameters of pain and itch modulatory processing., Methods: Prospective cohort study on chronic-itch patients ( n  = 44) assessed before 20 treatments of NB UVB. Level of itch and pain reduction following painful stimulation (reflecting the 'pain inhibits pain' phenomenon) used to assess the top-down modulation response efficacy. Magnitude of Conditioned Pain Modulation (CPM) for itch (CPM-itch) and for pain (CPM-pain) (reflecting inhibition) and magnitude of temporal summation (TS) of pain (reflecting ascending facilitation pathways) assessed to predict treatment effect., Results: Higher improvement of itch symptoms following phototherapy was correlated with more efficient CPM-itch ( r  = 0.62, p  < .001), but not magnitude of CPM-pain or level of temporal summation., Discussion: Findings emphasize the role of descending inhibition pathways in determining phototherapy efficacy in chronic itch patients. Such an evaluation-based approach may contribute to better patient selection for phototherapy improving patients' disease outcomes.

Objectives: The study aims were 1) to investigate the direction of mutual inhibitory pathways on itch intensity by utilizing conditioned pain modulation paradigms for pain and itch attenuation and 2) to explore whether itch severity is affected by the individual pain sensitivity profile, as well as pain scores reported during the tests and the past week., Design: Cross-sectional., Setting: Testing was conducted at the Department of Dermatology, Rambam Health Care Campus., Subjects: Forty patients suffering from chronic skin disorders associated with itch and treated in the Dermatology Clinic at Rambam Health Care Campus participated in the study., Methods: Efficacy of descending inhibition was evaluated by two conditioned pain modulation (CPM) paradigms: by pruriception (CPMItch) induced by cold and heat as counterstimuli to inhibit itch intensity and by nociception (CPMPain). Severity and interference of clinical pain were assessed using the Brief Pain Inventory (BPI)., Results: Robust CPMItch responses were obtained following the various noxious stimulations. No associations were observed between CPMPain and CPMItch, itch severity, skin disease severity, and clinical pain symptoms. According to the linear regression model, itch severity was independently associated with less efficient CPMItch (B = -0.750, P < 0.001) and more efficient CPMPain (B = 0.031, P = 0.016), which affects itch in opposing manners., Conclusions: Findings indicate that the intrinsic capacity to inhibit pain and itch by exposure to exogenous noxious stimuli autonomously affects itch intensity in an opposing manner. These findings may shed new light on the mutual mechanistic similarity and dissimilarity between pain and itch and their hierarchy., (© The Author(s) 2019. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Impaired sensory gating in patients with acute mental illness predisposes to overstimulation and behavioral dyscontrol., Objective: Explore use of sensory reduction interventions on a high-acuity inpatient milieu to reduce high assault/restraint rates., Design: A multidisciplinary team using failure mode and effect analysis to explore high restraint use between 4:00 p.m. and 7:00 p.m. observed patient/staff overstimulation contributed to behavioral escalations. The team implemented sensory reduction/integration improvements over a 5-month period to prevent excessive restraint use., Results: Restraint rates dropped immediately following light and sound reduction interventions and by 72% at 11 months postimplementation. Mann-Whitney statistics for unpaired 6-month comparisons, 1-year pre- and postintervention showed significant reductions: Assault rates (median pre = 1.37, post = 0.18, U = 4, p = .02); Restraint rates (median pre = 0.50, post = 0.06, U = 0, p = .002)., Conclusion: Sensory reduction during a high-stress time period on a high-acuity psychiatric unit was associated with a reduction in assaults and restraints.