Effectiveness of lipid-lowering therapy in outpatients with coronary artery disease living in a large industrial center of Eastern Siberia

Aim. To study the prescription rate of lipid-lowering therapy and achieving the target low-density lipoprotein cholesterol (LDL-C) values in outpatients with coronary artery disease (CAD) living in Krasnoyarsk.Material and methods. The study included all patients with CAD hospitalized in the cardiology department of the clinic of the Research Institute of Medical Problems of the North (Krasnoyarsk) in 2018-2019. The analysis included data from 1671 patients (men, 770; women, 901). During hospitalization, an in-depth survey of patients was carried out on the subject of prescribing and taking lipid-lowering drugs. On admission, lipid profile was assessed in all patients.Results. At the time of admission, only 51,4% of patients received lipidlowering therapy. The majority received statin monotherapy (99,2%). Only 0,8% of patients received combination therapy (statin+ezetimibe). The most frequently prescribed statin in the study was atorvastatin — 74,6%. Rosuvastatin was received by 17,1% of patients. In most cases, the doses of atorvastatin and rosuvastatin corresponded to the moderate-intensity statin therapy regimen. The frequently prescribed dose of atorvastatin was 20 mg/day — 54,4%, rosuvastatin — 10 mg/day — 68,7%. The target level of LDL-C <1,8 mmol/L was reached by 16,3%, <1,5 mmol/L — by 9,0%, <1,4 mmol/L — only 6,5% of patients. Most often, the target LDL-C levels were achieved by patients receiving high-intensity statin (HIS) therapy. The target level of LDL-C <1,8 mmol/L was reached by 37,5%, <1,5 mmol/L — 23,9%, LDL cholesterol <1,4 mmol/L — 20,7% of patients, receiving HIS.Conclusion. In patients with CAD living in Krasnoyarsk, the most commonly prescribed statins were atorvastatin and rosuvastatin, but only 32% of patients received HIS. Combination lipid-lowering therapy has been used extremely rarely. Among the surveyed patients, the current target level of LDL-C for patients with CAD (<1,4 mmol/L) was achieved only in 6,5% of patients. In the group of patients receiving high-intensity statin therapy, this target level was achieved in 20,7% of patients, which indicates the need for strict adherence to current clinical guidelines.

Grasp-Squeeze Adaptation to Changes in Object Compliance Leads to Dynamic Beta-Band Communication Between Primary Somatosensory and Motor Cortices

In asking the question of how the brain adapts to changes in the softness of manipulated objects, we studied dynamic communication between the primary sensory and motor cortical areas when nonhuman primates grasp and squeeze an elastically deformable manipulandum to attain an instructed force level. We focused on local field potentials recorded from S1 and M1 via intracortical microelectrode arrays. We computed nonparametric spectral Granger Causality to assess directed cortico-cortical interactions between these two areas. We demonstrate that the time-causal relationship between M1 and S1 is bidirectional in the beta-band (15-30Hz) and that this interareal communication develops dynamically as the subjects adjust the force of hand squeeze to reach the target level. In particular, the directed interaction is strongest when subjects are focused on maintaining the instructed force of hand squeeze in a steady state for several seconds. When the manipulandum’s compliance is abruptly changed, beta-band interareal communication is interrupted for a short period (~ 1 second) and then is re-established once the subject has reached a new steady state. These results suggest that transient beta oscillations can provide a communication subspace for dynamic cortico-cortical S1-M1 interactions during maintenance of steady sensorimotor states.

Target-setting for technological development of the Russian aircraft industry in the field of countering climate change

Subject. The article discusses the introduction of a Pigouvian tax on greenhouse gas emissions. Objectives. The objective of the study is to develop methods for setting the target level of CO2 emissions by Russian aircraft, based on Russia's national interests (both economic and environmental). Methods. The emission target was set on the basis of the classical approach of determining the economically optimal level of pollution at the intersection of the curves of marginal damage from pollution and marginal costs of eliminating pollution. The assessment of marginal costs of reducing CO2 emissions was based on the learning curves in the field of research and development aimed at reducing emissions. Results. We developed a method to set up the target level of CO2 emissions by Russian aircraft based on Russia's national interests (economic and environmental), rather than on external requirements dictated by competitor nations. Conclusions. According to the calculations on the basis of realistic estimates of fixed costs for reducing the carbon dioxide emissions, the utility is maximized with a reduction of CO2 emissions by 10% (for this method of assessing the damage to the State and with the realistic estimates of fixed cost of reducing carbon dioxide emissions).

European Deposit Insurance Scheme(s) – Consequences for the EU’s Financial Stability

The aim of this paper is to evaluate the potential consequences that the shortcomings in harmonising the national deposit guarantee schemes may have on the financial stability of the European Union. The relevance of this subject is underlined both by the European Commission’s intention to revive the European Deposit Insurance Scheme project in 2021 and the recent signals from Germany that they are willing to support the initiative. The paper presents a review of the discussions on establishing a European Deposit Insurance Scheme, the reasons for the project’s failure and the consensus solution that took the form of the Deposit Guarantee Scheme Directive (DGSD). The limited scope of deposit guarantee scheme harmonisation under this directive is discussed in the context of the related EBA opinions pointing to different areas of potential improvements. Differences in national implementation are also reviewed in terms of their potential impact on financial stability. Apart from a careful literature review, statistical analysis of the available financial information characterizing the largest national deposit schemes of the euro is performed to quantify their progress towards the target level of the available financial means. The results prove that most national schemes are still far from reaching the 0.8% target level of readily available funds and that potentially desirable amendments to the DGSD may drag them even further away from reaching that target by 2024. The author concludes that from the perspective of financial stability, the EU should focus on establishing a single scheme at an international level that would complete the project of establishing a banking union. The results contribute to the ongoing discussion on the need to further integrate the national deposit guarantee schemes inside the EU.

Difficult-to-treat rheumatoid arthritis. What is it?

The widespread introduction into clinical practice of modern approaches to the treatment of rheumatoid arthritis (RA), the rational use of traditional and targeted antirheumatic drugs can effectively suppress inflammatory activity, restrain the progression of the disease and improve the quality of life of patients. At the same time, in some patients, even after the repeated change of targeted drugs, it is not possible to achieve the target level of RA activity. Serious difficulties arising in the management of such patients raised the question of identifying a special variant of the disease – difficult-to-treat (D2T) RA. The presence of various variants of D2T RA and the need to use a personalized approach to therapy justify the creation of special recommendations for the management of this category of patients. The first step in preparing these recommendations was the definition of D2T RA recently presented by the EULAR working group. It includes three criteria: 1) insufficient effectiveness of the therapy; 2) the presence of an active symptomatic disease; 3) clinical perception.

Method of estimating the size of an SPTA with a safety stock

Aim. To modify the classical method [1, 4] that causes incorrect estimation of the required size of SPTA in cases when the replacement rate of failed parts is comparable to the SPTA replenishment rate. The modification is based on the model of SPTA target level replenishment. The model considers two situations: with and without the capability to correct requests in case of required increase of the size of replenishment. The paper also aims to compare the conventional and adjusted solution and to develop recommendations for the practical application of the method of SPTA target level replenishment. Methods. Markovian models [2, 3, 5] are used for describing the system. The flows of events are simple. The final probabilities were obtained using the Kolmogorov equation. The Kolmogorov system of equations has a stationary solution. Classical methods of the probability theory and mathematical theory of dependability [6] were used. Conclusions. The paper improves upon the known method of estimating the required size of the SPTA with a safety stock. The paper theoretically substantiates the dependence of the rate of backward transitions on the graph state index. It is shown that in situations when the application is not adjusted, the rates of backward transitions from states in which the SPTA safety stock has been reached and exceeded should gradually increase as the stock continues to decrease. The multiplier will have a power-law dependence on the transition rate index. It was theoretically and experimentally proven that the classical method causes SPTA overestimation. Constraint (3) was theoretically derived, under which the problem is solved sufficiently simply using the classical methods. It was shown that if constraint (3) is not observed, mathematically, the value of the backward transition rate becomes uncertain. In this case, correct problem definition results in graphs with a linearly increasing number of states, thus, by default, the problem falls into the category of labour-intensive. If the limits are not observed, a simplifying assumption is made, under which a stationary solution of the problem has been obtained. It is shown that, under that assumption, the solution of the problem is conservative. It was shown that, if the application is adjusted, the rate of backward transition from the same states should gradually decrease as the stock diminishes. The multiplier will have a hyperbolic dependence on the transition rate index. This dependence results in a conservative solution of the problem of replenishment of SPTA with application adjustment. The paper defines the ratio that regulates the degree of conservatism. It is theoretically and experimentally proven that in such case the classical method causes SPTA underestimation. A stationary solution of the problem of SPTA replenishment with application adjustment has been obtained. In both cases of application adjustment reporting, a criterion has been formulated for SPTA replenishment to a specified level. A comparative analysis of the methods was carried out.

Hygiene in Commercial Dishwashing – A Review about the State of Knowledge in Research, Standardization, Regulation and Market Information

The current state of knowledge about hygiene (efficacy testing) in commercial dishwashers will be collated in this review. Therefore, studies about hygiene in commercial dishwashing are summarised and existing standards, guidelines and the legislative basis described. Finally, examples of information available from the market, for example, detergents are presented. The use of bioindicators contaminated with bovine albumin, mucin, corn starch and Enterococcus faecium is widely established in studies, which was the basis for the introduction of standards. Standards prescribe minimum temperatures for cleaning and rinsing, and most of them provide microbiological testing methods. A worldwide standardized test method for hygiene in commercial dishwashers would guarantee the comparability of country-specific standards but procedures currently available would need great efforts to be unified. A definition of a specified hygiene target level on cleaned dish items would also be meaningful because a harmless level of microorganisms can be achieved with it regardless of the initial microbial count or the process used.