Statement of the problem of assessing instability of passive quantum frequency standards in the presence of an error from the interaction

Construction of modern measuring complexes of the coordinate-time support system of Ukraine is impossible without improving mathematical models of quantum standards of frequency (QSF) used in group standards. This work is devoted to the analysis of methods for the stable solution of direct and inverse problems (methods for solving ill-posed problems) in models of the interaction of passive QSF in the process of their comparisons. The priority task is to use these methods for the numerical solution of problems in the design of group QSF and parallel quantum generators of random numbers. Methods for solving such problems are in demand, since they make it possible to create mathematical models of group QSF interaction. These models will enable the design of efficient parallel quantum random number generation devices for high-tech areas of cybersecurity. Varieties of methods such as the method of least squares or the method of the Moore-Penrose pseudo-inverse matrix are used, as a rule when evaluating the metrological parameters of QSF.Robust methods of regularization or filtering, for example, the Kalman or Wiener filter method, are used in the algorithms of group standards, due to the instability of the solution.However, these methods do not work in the presence of an error from the interaction of QSF in the process of their functioning in a group standard or in comparisons. The aim of this work is to analyze and substantiate the formulation of the problem of assessing the potential accuracy characteristics of passive QSF in the presence of an error from the interaction. Regularization parameters when determining the state vector of the group standard are found using signals transmitted by global navigation satellite systems such as GPS\GLONASS in the local differential correction mode.

The inducing of caspase and bcl-2 pathway with royal jelly decreases the muscle tissue damage exposed with fluoride in rats

In this study, 42 Wistar albino female rats (n = 42, 8 weeks old) were used. Rats were divided into 6 groups and 7 rats included each group. Groups: (i) Control Group: Standard diet; (ii) RJ (royal jelly) Group: Standard diet + royal jelly; (iii) F50 Group: Standard diet + 50 mg/kg fluoride; (iv): F100 Group: Standard diet + 100 mg/kg fluoride; (v) F50 + RJ Group: Standard diet + 50 mg/kg fluoride + royal jelly; (iv): F100 + RJ Group: Standard diet + 100 mg/kg fluoride + royal jelly. After the 8-week study period, the rats were decapitated and their muscle tissues were removed. Expression levels of Caspase-3, Caspase-6, Bax, Tnf-α, IL1-α and Bcl-2 proteins in muscle tissue were determined by Western Blotting method. Histopathological analyzes were also performed on the muscle tissue. MDA, GSH, and CAT analyzes were determined by spectrophotometric analysis. According to our findings, Bcl-2, Tnf-α and IL1-α protein expression were increased in damage groups compared to control and royal jelly groups, Caspase-3, Caspase-6 and Bax protein expression levels decreased in damage groups. There was an increase in MDA level in damage groups compared to the control and royal jelly groups, CAT and GSH levels decreased in damage groups. According to histopathological analysis results, edema and inflammatory cell formations were found in the injury groups, a tendency to decrease in these injuries was observed in the treatment groups. Based on these results, we can say that royal jelly has protective effects against fluoride damage.

Combined Hip Abductor and External Rotator Strengthening and Hip Internal Rotator Stretching Improves Pain and Function in Patients With Patellofemoral Pain Syndrome: A Randomized Controlled Trial With Crossover Design

Background: Active rehabilitation has an important role in the management of patellofemoral pain syndrome (PFPS). Although some studies have shown the benefit of hip-muscle strengthening, the effect of combining hip-muscle stretching with strengthening has not yet been defined. Purpose: To evaluate the effect of combined strengthening of the hip external rotators and abductors and stretching of the hip internal rotators on pain and function in patients with PFPS. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 109 patients with PFPS (75 female and 34 male; mean age, 31.6 ± 10.8 years) were first randomly assigned to protocol A (n = 67) of the A-B arm (AB group; standard rehabilitation) or protocol B (n = 42) of the B-A arm (BA group; standard rehabilitation with strengthening of the hip external rotators and abductors and stretching of the hip internal rotators). Each protocol consisted of 3 sessions a week for 4 weeks. After a washout period, corresponding to a symptom-free period, rehabilitation programs were crossed over. A visual analog scale (VAS) evaluating perceived pain, the Functional Index Questionnaire (FIQ), and the Kujala score were administered at baseline, the end of each rehabilitation protocol, and 12 weeks after the completion of the second protocol for each group. Results: Until the final follow-up, VAS, FIQ, and Kujala scores were significantly improved in both the A-B and B-A arms ( P < .05 for all). Compared with protocol A, protocol B provided significant improvement in terms of pain and function in both the BA (VAS and Kujala; P < .001) and AB (VAS and Kujala; P < .001) groups. Conclusion: Combined strengthening of the hip abductors and external rotators with stretching of the hip internal rotators provided better outcomes, which were maintained for at least 12 weeks, in terms of pain and function in patients with PFPS.

2020 challenge: the potential options of COVID-19 therapy

Background. Coronavirus disease (COVID-19) is a new disease, and there is no vaccine, specific drugs and treatment protocols. In 15-20 % of patients the course is severe course, and 4 % of cases are fatal. 15 % of adults infected with the SARS-CoV-2 coronavirus develop pneumonia. In 5 % pneumonia progresses to a critically severe condition with the development of respiratory failure and acute respiratory distress syndrome. Objective. To describe the potential options of COVID-19 therapy. Materials and methods. Analysis of literature sources on this topic and the own clinical study, which involved 60 patients with COVID-19 (main and control groups, standardized by age and sex). In the control group, standard treatment was prescribed, and in the main group – basic therapy and Ksavron tid, Tivorel once a day and Reosorbilact once a day (all medications – by “Yuria-Pharm”). Results and discussion. Antiviral drugs (nelfinavir, remdesivir, favipiravir), recombinant human monoclonal antibodies to interleukin-6 receptors tocilizumab, and chloroquine-related drugs (sometimes in combination with azithromycin) are used for COVID-19 pharmacotherapy. Usage of edaravone (Ksavron) to inhibit the cytokine storm and of Reosorbilact to reduce the incidence of pulmonary complications, the duration of mechanical ventilation, and the volume of infusions has a great potential. The use of the latter is especially appropriate under the conditions of restrictive infusion regimen. In addition, L-arginine and L-carnitine (Tivorel) can be used. L-arginine reduces spasm of smooth bronchial muscles and improves the vasomotor function of the pulmonary endothelium. L-carnitine has anti-inflammatory and immunomodulatory effects. The own study found out that the level of C-reactive protein in the main group (standard therapy + Ksavron, Tivorel and Reosorbilact) has decreased from 39.45 to 7.5 mg/L, and in the control group – from 46.26 to 12.50 mg/L, indicating a more pronounced reduction of inflammation in the main group. In addition, the content of D-dimer and ferritin decreased more markedly in the main group (by 24.1 % and 27.1 % respectively). The additional pathogenetic treatment listed above helped to improve blood oxygen saturation, reduce the number of leukocytes and decrease the length of hospital stay. Conclusions. 1. Antiviral drugs, tocilizumab, chloroquine-related drugs, and azithromycin are used to treat COVID-19. 2. Potential treatment options include the usage of Ksavron, Reosorbilact and Tivorel. 3. According to own research, the inclusion of these drugs into the combined therapy reduces the activity of the inflammatory process in the lungs and counteracts the tendency to thrombosis.

Effectiveness of a home-based telerehabilitation system in patients after total hip arthroplasty: study protocol of a randomized controlled trial

Background The demand for total hip arthroplasty (THA) is quickly rising given the escalating global incidence of hip osteoarthritis, and it is widely accepted that the post-surgery rehabilitation is key to optimize outcomes. The overall objective of this study is to evaluate the effectiveness of a new telerehabilitation solution, ReHub, for the physical function and clinical outcome improvement following THA. The specific aims of this manuscript are to describe the study design, protocol, content of interventions, and primary and secondary outcomes and to discuss the clinical rehabilitation impact of the expected experimental results. Methods/design This prospective, randomized, controlled, parallel-group trial will include 56 patients who had undergone primary THA. Patients are randomized to a control group (standard rehabilitation during the 2-week stay in the rehabilitation clinic followed by 3 weeks of unsupervised home-based rehabilitation) or an experimental group (standard rehabilitation during the 2-week stay in the rehabilitation clinic followed by 3 weeks of home-based ReHub-assisted telerehabilitation). The primary outcome is physical performance assessed through the Timed Up-and-Go (TUG) test. Secondary outcomes include independence level, pain intensity, hip disability, hip range of motion, muscle strength, and patient’s perception of clinical improvement. Discussion Proving the clinical and cost-effectiveness of a home-based telerehabilitation program for physical and muscle function following THA could support its systematic incorporation in post-surgical rehabilitation protocols, which should be tailored to the individual and collective needs. Trial registration ClinicalTrial.gov NCT04176315. Registered on 22 November 2019

Effectiveness of A Home-Based Telerehabilitation System in Patients After Total Hip Arthroplasty: Study Protocol of A Randomized Controlled Trial

Background: The demand for total hip arthroplasty (THA) is quickly rising given the escalating global incidence of hip osteoarthritis and it is widely accepted that the post-surgery rehabilitation is key to optimize outcomes. The overall objective of this study is to evaluate the effectiveness of a new telerehabilitation solution, ReHub, for the physical function and clinical outcome improvement following THA. The specific aim of this manuscript is to describe the study design, protocol, content of interventions, primary and secondary outcomes and to discuss the clinical rehabilitation impact of the expected experimental results.Methods/design: This prospective, randomized, controlled, parallel-group trial will include 56 patients who had undergone primary THA. Patients are randomized to a control group (standard rehabilitation during the 2-week stay in the rehabilitation clinic followed by 3 weeks of unsupervised home-based rehabilitation) or an experimental group (standard rehabilitation during the 2-week stay in the rehabilitation clinic followed by 3 weeks of home-based ReHub-assisted telerehabilitation). The primary outcome is physical performance assessed through the Timed Up-and-Go (TUG) test. Secondary outcomes include independence level, pain intensity, hip disability, hip range of motion, muscle strength and patient’s perception of clinical improvement.Discussion: Proving the clinical and cost-effectiveness of a home-based telerehabilitation program for physical and muscle function following THA could support its systematic incorporation in post-surgical rehabilitation protocols, that should be tailored to individual and collective needs.Trial registration: ClinicalTrial.gov: NCT04382729. Registered 22 November 2019 - https://clinicaltrials.gov/ct2/show/NCT04176315

The Effect of ten-minute dispatch-assisted cardiopulmonary resuscitation training: a randomized simulation pilot study

Background Immediate bystander cardiopulmonary resuscitation (CPR) is essential for survival from sudden cardiac arrest (CA). Current CPR guidelines recommend that dispatchers assist lay rescuers performing CPR (dispatch-assisted CPR: DACPR), which can double the frequency of bystander CPR. Laypersons, however, are not familiar with receiving CPR instructions from dispatchers. DACPR training can be beneficial for lay rescuers, but this has not yet been validated. The aim of this study was to determine the effectiveness of simple DACPR training for lay rescuers. Methods We conducted a DACPR simulation pilot study. Participants who were non-health-care professionals with no CPR training within 1 year prior to this study were recruited from Nara Medical University hospital. The participants were randomly assigned to one of two 90-minute adult basic life support (BLS) training course groups : DACPR Group (standard adult BLS training plus an additional 10-minute DACPR training) or Standard Group (standard adult BLS training only). In DACPR Group, participants practiced DACPR through role-playing of a dispatcher and an emergency caller. Six months after the training, all subjects were asked to perform a 2-minute CPR simulation under instructions given by off-duty dispatchers. Results Out of the 66 participants, 59 completed the simulation (30 from the DACPR Group and 29 from the Standard Group). The CPR quality was similar between the two groups. However, the median time interval between call receipt and the first dispatch-assisted compression was faster in the DACPR group (108 s vs. 129 s, p = 0.042). Conclusions This brief DACPR training in addition to standard CPR training can result in a modest improvement in the time to initiate CPR. Future studies are now required to examine the effect of DACPR training on survival of sudden CA.

LO52: Distraction in the ED using Virtual reality for Intravenous Needs in Children to Improve comfort- DEVINCI - a pilot RCT

Introduction: Venipuncture is a frequent cause of pain and distress in the pediatric emergency department (ED). Distraction, which can improve patient experience, remains the most studied psychological intervention. Virtual reality (VR) is a method of immersive distraction that can contribute to the multi-modal management of procedural pain and distress. Methods: The main objectives of this study were to determine the feasibility and acceptability of Virtual Reality (VR) distraction for pain management associated with venipunctures and to examine its preliminary effects on pain and distress in the pediatric ED. Children 7-17 years requiring a venipuncture in the pediatric ED were recruited. Participants were randomized to either a control group (standard care) or intervention group (standard of care + VR). Principal clinical outcome was the mean level of procedural pain, measured by the verbal numerical rating scale (VNRS). Distress was also measured using the Child Fear Scale (CFS) and the Procedure Behavior Check List (PBCL) and memory of pain using the VNRS. Side effects were documented. Results: A total of 63 patients were recruited. Results showed feasibility and acceptability of VR in the PED and overall high satisfaction levels (79% recruitment rate of eligible families, 90% rate of VR game completion, and overall high mean satisfaction levels). There was a significantly higher level of satisfaction among healthcare providers in the intervention group, and 93% of those were willing to use this technology again for the same procedure. Regarding clinical outcomes, no significant difference was observed between groups on procedural pain. Distress evaluated by proxy (10/40 vs 13.2/40, p = 0.007) and memory of pain at 24 hours (2.4 vs 4.2, p = 0.027) were significantly lower in the VR group. Venipuncture was successful on first attempt in 23/31 patients (74%) in the VR group and 15/30 (50%) patients in the control group (p = 0.039). Five of the 31 patients (16%) in the VR group reported side effects Conclusion: The addition of VR to standard care is feasible and acceptable for pain and distress management during venipunctures in the pediatric ED. There was no difference in self-reported procedural pain between groups. Levels of procedural distress and memory of pain at 24 hours were lower in the VR group.