Prevention of Post-Transplant Diabetes Mellitus: Towards a Personalized Approach

Post-transplant diabetes is a frequent complication after transplantation. Moreover, patients suffering from post-transplant diabetes have increased cardiovascular morbidity and reduced survival. Pathogenesis mainly involves beta-cell dysfunction in presence of insulin resistance. Both pre- and post-transplant risk factors are well-described, and some of them may be corrected or prevented. However, the frequency of post-transplant diabetes has not decreased in recent years. We realized a critical appraisal of preventive measures to reduce post-transplant diabetes.

ДІДЖИТАЛІЗАЦІЯ ПІДПРИЄМНИЦТВА НА ТРАНСПОРТІ В УМОВАХ ПАНДЕМІЇ COVID-19

The article seeks to explore opportunities for further entrepreneurship development and its intensification in a pandemic setting, in the transport sector in particular, which is associated with the constant search for and implementation of new ideas, technologies, goods, services, manufacturing methods, etc. to retain a business. An emphasis is put that in modern realia as never before, the effective functioning of any company demands for continuous improvement, renewal, reorganization, finding new pathways to manage and run a successful business. It is noted that this approach is based on the latest concept that assumes significant changes in entrepreneurship in the transport industry and will foster further business development. In addition, the study reveals that the application of digital platforms is viewed as the newest tool that has the potential to boost the transport industry growth. However, despite objective reasons, there is still a lack of proper justification for the need to use digital technologies in transport. It is noted that the Industry Development Strategy 4.0 designed by the Ukrainian Association of Industrialists and Entrepreneurs interprets digital transformation as social or technological changes associated with the penetration of digital technology into all areas of human interactions. The essence of these transformations is to find new approaches and management concepts to resolve classic business challenges. The purpose of this article is to verify the feasibility of transport entrepreneurship based on digital platforms. The study provides insights into the benefits and specifics of digitalization in the context of Covid restrictions adjusted the needs of business acceleration. To attain the research objectives, the tools of information and marketing communications were used as well as the outcomes of marketing research to summarize information on the development of courier delivery and taxi services in Ukraine. Based on the analysis of entrepreneurship in the transport industry, the essential characteristics of digital platforms for taxi service have been discussed. It is argued that a customer focus makes the basis of any successful digital strategy. However, according to the study findings, transport companies need a single comprehensive perception of their customers to develop cooperation and offer a personalized approach to them. The summary concludes that digitalization is aimed at retaining the contact between the consumer and the producer to balance twofold interests: on the one hand, to the producer it will result in profit growth, and on the other – the consumer will be able to get the enhanced service quality, thus managing a close relationship between these two market actors, even in the quarantine realia.

Time to Move Beyond a “One-Size Fits All” Approach to Inspiratory Muscle Training

Inspiratory muscle training (IMT) has been studied as a rehabilitation tool and ergogenic aid in clinical, athletic, and healthy populations. This technique aims to improve respiratory muscle strength and endurance, which has been seen to enhance respiratory pressure generation, respiratory muscle weakness, exercise capacity, and quality of life. However, the effects of IMT have been discrepant between populations, with some studies showing improvements with IMT and others not. This may be due to the use of standardized IMT protocols which are uniformly applied to all study participants without considering individual characteristics and training needs. As such, we suggest that research on IMT veer away from a standardized, one-size-fits-all intervention, and instead utilize specific IMT training protocols. In particular, a more personalized approach to an individual’s training prescription based upon goals, needs, and desired outcomes of the patient or athlete. In order for the coach or practitioner to adjust and personalize a given IMT prescription for an individual, factors, such as frequency, duration, and modality will be influenced, thus inevitably affecting overall training load and adaptations for a projected outcome. Therefore, by integrating specific methods based on optimization, periodization, and personalization, further studies may overcome previous discrepancies within IMT research.

Antioxidants as Therapeutic Agents in Acute Respiratory Distress Syndrome (ARDS) Treatment—From Mice to Men

Acute respiratory distress syndrome (ARDS) is a major cause of patient mortality in intensive care units (ICUs) worldwide. Considering that no causative treatment but only symptomatic care is available, it is obvious that there is a high unmet medical need for a new therapeutic concept. One reason for a missing etiologic therapy strategy is the multifactorial origin of ARDS, which leads to a large heterogeneity of patients. This review summarizes the various kinds of ARDS onset with a special focus on the role of reactive oxygen species (ROS), which are generally linked to ARDS development and progression. Taking a closer look at the data which already have been established in mouse models, this review finally proposes the translation of these results on successful antioxidant use in a personalized approach to the ICU patient as a potential adjuvant to standard ARDS treatment.

Development of a Risk Classifier as a Stage of Successful Risk Management

The article gives the analysis of approaches to risk classification at industrial enterprise. Based on the findings, conclusions about advantages and disadvantages were drawn up, as well as the possibilities for its application at nuclear enterprises are formulated. The authors propose an original personalized approach to risk classifier development, which takes into account the nuclear industry specifics. An example of an algorithm for risk classifier development based on above-mentioned approach for the enterprise of the Rosatom State Corporation is given. This example can be used in various industries and may be of interest to risk management researchers and specialists.

A personalized approach to preclinical diagnosis and initial therapy of primary glaucoma based on a comprehensive structural and functional examination. A clinical case

The principles of personalized approach to early diagnosis and monitoring of primary glaucoma are shown by a clinical example. We analyzed the potentials of contemporary electrophysiological tests for preclinically diagnosing glaucoma optic neuropathy and monitoring drug treatment. For the first time, we demonstrated the experience of using a new fixed combination of brinzolamide + brimonidine by a clinical case from our practice. The test results confirm the hypotensive effect of the medication (IOP reduction by 36.2 %) so that it can be recommended for the treatment of patients with glaucomatous optic neuropathy and that combined with vascular pathology.

Hematological Parameters and Iron Status in Adult Men and Women Using Altitude Adjusted and Unadjusted Hemoglobin Values for Anemia Diagnosis in Cusco, Peru (3400 MASL)

(1) Background: Current diagnosis of anemia in high altitude populations uses an adjustment of observed hemoglobin (Hb) values. Such an approach has been challenged by findings in different populations in Tibet, Ethiopia and the Andes as inappropriate, as it might incorrectly classify an individual with complete iron stores as anemic. We aimed to assess the suitability of this approach in adult men and women from Cusco, Peru (3400 m); (2) Methods: Complete blood count and iron status biomarkers were measured in 345 subjects (189 females and 156 males), iron status biomarkers were quantified with enzyme-linked immunoassays; (3) Results: Anemia prevalence was overestimated when the altitude-adjustment factor was applied. Hematological parameters were better correlated to iron status biomarkers in the non-adjusted anemia category. When stratified by sex, only women showed a significant association between Hb and other hematological parameters with iron storage and availability (Hepcidin and TFR-F); (4) Conclusion: The prevalence of anemia is overestimated with current guidelines. The rate of anemia using non-adjusted Hb values is more closely related to the rates of anemia or iron deficiency when used hematological parameters, markers of iron status, and measurements of hepcidin and erythropoietin. Sex differences related to iron status were observed, suggesting that men are at a higher risk of iron overload than women at high altitudes. It could be highlighted that a personalized approach is important when assessing a subject, taking in to account hematological parameters as well as origin (Southern Andean or other).

Blood groups and secretory state in COVID-19

INTRODUCTION: Despite the achievements of modern medicine, healthcare system is lacking in knowledge about the new coronavirus infection caused by the SARS-CoV-2 virus. AIM: To establish the relationship of the new coronavirus infection with the blood group according to the AB0 blood system in the Samara region and assess the secretory status of the oral fluid in patients with COVID-19. MATERIALS AND METHODS: This study was conducted from June 2019 to December 2020, and included 89 healthy individuals (38% males, 62% females, average age 24 ± 2.5 years) and 92 patients with COVID-19 (24% males and 76% females, average age 55.68 ± 1.83 years). The material for the study was oral fluid and venous blood. Determination of the blood group according to the AB0 system was carried out by a cross method, the secretory status of saliva according to the I. Vidas method. Descriptive methods were used for statistical data processing (arithmetic mean, error of the mean), calculation of the percentage of a whole number using computer programs IBM SPSS Statistics 23 and Microsoft Office Excel 2010. RESULTS: The distribution by blood group in patients with COVID-19 was as follows: A (II) blood group was found in 43.5%, O (I) in 36.9%, B (III) in 17.4%, AB (IV) in 2.2%. Rh-positive status was determined for 92.4%. Among secretory representatives, antigen A was secreted in 92.1%, and antigen B was secreted in 7.9% of cases. Antigens A and B were absent in the oral fluid of patients with AB (IV) blood group. CONCLUSIONS: This study confirmed the prevalence of A(II) blood group carriers among patients with COVID-19. In this case, the secretion of antigen A into the oral fluid is 92.1%. Group A antigen, being a glycoprotein, can act as a factor facilitating the mechanism of penetration of the SARS-CoV-2 into the human body. The results of the study indicate the need for a personalized approach at the stage of diagnosis and monitoring of the treatment of new coronavirus infection, as well as taking into consideration the blood group to develop preventive measures for COVID-19.

BASICS OF A PERSONALIZED APPROACH TO MEDICAL AND PSYCHOLOGICAL SUPPORT OF CARDIAC SURGERY PATIENTS

The concept of a personalized approach is becoming more and more popular in modern medicine. Today it is often understood as a multidisciplinary approach designed to improve therapeutic options, as well as help diagnose diseases at an early stage. In a cardiac surgery clinic, such an approach can take into account not only biological, but also psychological risk factors for the disease, especially its history, clinical condition, mental and psychological status to create an individual route within the framework of medical and psychological support for the patient at the stages of treatment and rehabilitation. The aim of the work was to develop, based on the analysis of the literature and the authors' own work experience, the organizational and psychological foundations for the implementation of a personalized approach in medical and psychological support of cardiac patients. The fundamental principles of support in the work include the following: the principle of accessibility, the principle of openness, the principle of continuity, the principle of complexity, the principle of integrativity, the principle of differentiation, the principle of variability, the principle of participativeness, the principle of awareness, the principle of prevention. In the process of medical and psychological support of cardiac surgical patients within the framework of a personalized approach, the most optimal was the identification of the following clinical stages, different in duration and content, corresponding to the periods of outpatient and inpatient treatment and rehabilitation of patients: preoperative outpatient, preoperative inpatient, early postoperative, postoperative inpatient, postoperative rehabilitation and rehabilitation outpatient stages. For each of the clinical stages of medical and psychological support, a differentiation of goals, objectives, duration and expected results of the impact was carried out, which makes it possible to personalize the programs for accompanying a cardiac patient and individualize the route for each patient, taking into account the specificity and relevance of the influence of biologi cal, psychological and social factors.

Food Allergy Prevention and Management in Children

Food allergy is a reaction mediated by immunological mechanisms that cause various symptoms in susceptible individuals while harmless in individuals who are not sensitive to the specific allergen. The reactions that take place are divided into three: IgE-mediated reactions, non-IgE-mediated reactions, and mixed-type reactions. While many types of food have the potential to cause allergen reactions, fewer foods are responsible for the most clinically severe reactions and for the majority of reported cases. Food allergy, which is increasingly common worldwide, is becoming an important public health problem. Although there are no clear epidemiological data, the prevalence of food allergy varies between 6-10% in preschool children and decreases to 2-5% in adulthood. Food allergy has long been recognized as a pediatric disease, as most cases tend to begin in childhood and disappear with growth. There is increasing evidence to support the role of early administration of potential food allergens to prevent food allergy. The management process of food allergy cases includes plans and innovative treatment strategies aimed at a personalized approach.