Aim. To analyze the results of thrombectomy in lower-extremity ischemia in patients with coronavirus disease 2019 (COVID-19) and respiratory failure of different severity.Material and methods. This retrospective, cohort, comparative study for the period from May 1, 2020 to March 1, 2022 included 305 patients with acute lower-extremity ischemia and COVID-19. Depending on the type of oxygen support, three groups of patients were formed: group 1 (n=168) — nasal oxygen insufflation; group 2 (n=92) — non-invasive ventilation (NIV); group 3 (n=45) — artificial ventilation (AV). Thrombectomy was carried out according to the standard technique using Fogarty catheters (3F-6F — depending on the vessel size). After the diagnosis was established before and after the start of surgical treatment, all patients received the following therapy: Unfractionated IV heparin infusion at an initial rate of 1000 U/r, adjusted to maintain the activated partial thromboplastin time at 2-3 times the normal value; 2. Oral acetylsalicylic acid 125 mg; 3. Analgesics.Results. Myocardial infarction and ischemic stroke were not detected in the total sample. The highest number of deaths (group 1: 5,3%, n=9; group 2: 72,8%, n=67; group 3: 100%, n=45; p<0,0001), retrombosis (group 1 : 18,4%, n=31; group 2: 69,5%, n=64; group 3: 91,1%, n=41; p<0,0001) and limb amputations (group 1: 9,5%, n=16; group 2: 56,5%, n=52; group 3: 91,1%, n=41; p<0,0001) was recorded in group 3 patients.Conclusion. In patients receiving mechanical ventilation, COVID-19 have more aggressive course, which is expressed in an increase in laboratory para- meters (C-reactive protein, ferritin, interleukin-6, D-dimer), the severity of pneumonia and location of thrombosis in the tibial arteries. Among patients with COVID-19 receiving mechanical ventilation, the greatest number of rethromboses (91,1%), limb amputations (91,1%), and deaths (100%) are noted, which suggests the expediency of abandoning open thrombectomy in favor of anticoagulant/antiplatelet therapy in this cohort of patients. The development of arterial thrombosis in patients with COVID-19 receiving mechanical ventilation is an indicator of a high risk of death. Open thrombectomy in combination with anticoagulant/antiplatelet therapy is most effective in patients on nasal oxygen insufflation or NIV.
Economic reforms and reforms in the educational sphere have contributed to the increase of the concern towards the efficiency of the activity of educational organizations and higher educational establishments, in particular. This deals with the increased competition in both international and national markets for educational services; the growth of informational openness of higher education establishments and the enhanced role of strategic planning. All these aspects are gradually leading to a new objective that faces higher education establishments, which is a necessity to demonstrate the efficiency of their education services and support it with definite indices. Under conditions of budgetary expenditures, the problem of financial sustainability and efficiency of higher education institutions is becoming urgent, being focused on searching for possibilities to develop education establishments. In this context, the most important issue deals with developing approaches for quantifying financial sustainability and identifying the directions and means of its rise. The article suggests the method for defining the financial sustainability of higher education institutions and discusses both the indices, applied for financial sustainability evaluation, and their threshold values.
Purpose Economic problems of the system of education were the object of interest of classics of economic science – A. Smith and A. Marshall – who viewed education as a source of public capital, and acquired skills and competences – as a part of national wealth. These ideas were further developed in the theory of human capital by T. Schultz, G.S. Becker, G. Psacharopoulos, P. Teixeira, and R. Solow. At that, specifics of modernization economic processes in the sphere of education, peculiarities of modern functional and financial state require conceptual consideration and provision of development of working mechanism of effectiveness of spending assets of endowment funds. The purpose of this paper is to determine the mechanism of effectiveness of spending assets of endowment funds on the basis of mathematical models. Design/methodology/approach The paper offers a mechanism of determination of effectiveness of spending of endowment funds. Findings Effectiveness of an endowment fund’s effectiveness depends on the results of fund-raising activities, supporting relations with donators, and financing of targeted programs and directions of activities. This information is key information during the determination of results of endowment fund’s activities for current and potential donators. That is why it should provide reports in the order of formation of endowment, received revenue from trust management, and direction of usage of revenues from endowment, for which a donator has given his assets, on a regular basis. Originality/value In the modern system of higher education, the issue of search for new sources of financing for the purpose of improvement of quality of education and educational process, growth of wages of academic staff, attraction of foreign lecturers and specialists with practical experience of work from various spheres of production, and increase of stipends of the best students remains actual. The paper offers a mechanism of determination of effectiveness of spending of endowment funds.
The paper discusses seasonal changes in the surface temperature of the Northern Hemisphere during various climatic periods - the first wave of global warming, the second wave of global warming, and stabilization. The statistical significance of the changes was estimated. The features of the activity of global climatic trends in the Southeast of the Russian Plain in an arid climate are studied. It is shown that climatic changes in the region have their own characteristics. The degree of climate continentality in different climatic periods is estimated. The change in the continentality degree was statistically significant at the transition from stabilization period to the second wave of global warming. It has been revealed that in the current climate changes in the Southeast of the Russian Plain the main factor in winter is advective, and in summer the main factor is transformational. Climatically meaningful conclusion about the role of transformation in possible further development of global warming is formulated, especially in continental types of climate.
Three structural elements of the general circulation of the atmosphere on a global scale are considered: the Arctic oscillation, the Southern Oscillation, and the planetary tall frontal zone. The degree of influence of the Arctic Oscillation and the Southern Oscillation on the dynamics of the planetary tall frontal zone is estimated. The assessment is carried out by a method of analysis of the variance, which allows assessing the significance of the influence of one or more meteorological quantities of the studied value. A comparison of the variances has shown that the degree of influence of these objects on the dynamics of the planetary high altitude zone is 6% from the Arctic Oscillation and 7% from the Southern Oscillation. A comprehensive analysis has shown that the planetary high-altitude frontal zone has the highest intensity with negative anomalies of the Arctic Oscillation and the Southern Oscillation, and the lowest one with negative anomalies of the Arctic Oscillation and positive anomalies of the Southern Oscillation. A comparison with the Fisher criterion has not revealed any statistical significance. An important conclusion is formulated about the predominance of the influence of inherent internal processes in the dynamics of the planetary high-altitude frontal zone in comparison with the circulation structures adjacent to it.
The article discusses the effect of abiotic environmental factors on crop yields. Abiotic factors cannot be changed by human activity; therefore, considering their impact on yield is very important for predicting crop yields. The article analyzes the dependence of spring wheat yield on such abiotic environmental factors as average ten-day air temperatures during the growing season, ten-day amounts of precipitation during the growing season and the Selyaninov hydrothermal coefficient during the growing season. To identify dependencies, the authors applied a non-linear approximation method using a third-degree polynomial dependence with one variable. The study was conducted during the most important growing season of spring wheat, in May and June. The authors show the equations of the third-degree polynomial dependences and graphs, as well as their graphic interpretation. Based on the obtained graphs, the authors have analyzed favorable intervals of abiotic factors for the formation of high yields of spring wheat. The authors indicate the most optimal temperature and humidity conditions for each ten days of May and June. These dependences are suitable not only for spring wheat but also for other spring grain crops, such as oats and barley.
The review presents the prevalence of both type 2 diabetes mellitus (type 2 DM) and its microvascular complications among patients with coronary heart disease (CHD), and CHD among patients with carbohydrate metabolism disorders. It is shown, that the prognosis of patients with CHD and type 2 DM, especially in the presence of microvascular complications, is extremely unfavorable, and is characterized by a significant increase in the risk of cardiovascular death, myocardial infarction, stroke, terminal stage of the chronic kidney disease and visual impairment. It was noted, that despite the successes achieved in the treatment of CHD, type 2 DM and its microvascular complications, there is a high risk of total, cardiovascular mortality and hospitalizations associated with cardiovascular diseases. In type 2 DM, especially in the presence of microvascular complications and comorbid pathology, special pathogenetic mechanisms of thrombotic risk and bleeding have been identified. Based on large randomized clinical trials, the review evaluated the efficacy and safety of various antithrombotic strategies in patients with stable СРВ, type 2 DM in the presence of microvascular complications and comorbid pathology.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.