The Use of Information Technology in the Construction of a Nursing Communication Platform System

In order to effectively connect patient care information and reduce the amount of administrative work, a nursing care communication platform can effectively achieve 1. Real-time display of patient information while protecting patient privacy; 2. Integration of hospital information system, with individualized medical care team information; 3. Accurate and timely delivery of need for patient report; 4. Increase of interaction between the patient’s family and staff and breakthrough from the limit of paper-based health education information.

Supply of bread to Tobolsk Governorate by the merchants during the period of bad crops at the turn of 1860s– 1870s (On the example of the merchant V. D. Zharnikov)

The subject of this research is the supply of bread to Tobolsk Governorate by merchants during the period of bad crops at the turn of 1860s–1870s. The article is based on the principles of historicism, integrity, objectivity, and comprehensiveness; general scientific and traditional methods, such as systemic, historical-comparative, problem-historical. The scientific novelty lies in introduction of the new unpublished archival documents reflecting the role of merchantry in supplying bread to the region during bad crops. The source base is comprised of archival documents of the State Budget Archive of the Tyumen Region in Tobolsk. The statistical and clerical sources, as well as periodicals are also used in the article. The author is first to thoroughly examine the role of the merchant V. D. Zharnikov, who offered the provincial authorities to sell bread to the population at a lower price. Namely his initiative allowed the poor population to purchase bread at affordable prices during the period of bad crops, which mostly affected the residents of northern Tobolsk Governorate. Timely delivery of flour by inland transport to the north of the region has played a significant role. This prevented the rise in bread prices and its shortage. The initiative Vasily Dmitrievich Zharnikov to purchase, deliver and sell bread to northern Tobolsk Governorate at affordable made a crucial difference for the region.

Bamlanivimab efficacy in older and high BMI outpatients with Covid-19 selected for treatment in a lottery-based allocation process

Background Given the challenges associated with timely delivery of monoclonal antibody (mAb) therapy to outpatients with Covid-19 who are most likely to benefit, it is critical to understand the effectiveness of such therapy outside the context of clinical trials. Methods Case-control study of 1257 adult outpatients with Covid-19, ≥ 65 years of age or with BMI ≥ 35, who were entered into a lottery for mAb therapy. Results Patients who were called to be offered mAb therapy had a statistically significant, 44% reduction in the odds of hospitalization within 30 days of a positive SARS-CoV-2 test compared with those who were not called (OR 0.56, 95% CI [0.36, 0.89], P=.01). Patients who actually received bamlanivimab had a statistically significant, 68% reduction in the odds of hospitalization compared with those who did not receive bamlanivimab (OR 0.32, 95% CI [0.11, 0.93], P=0.04). There was no statistically significant difference in the odds of death between patients who were called and patients who were not called (OR 1.79, 95% CI [0.52, 6.17], P=0.35), but there was a statistically significant difference in the odds of death between patients who received bamlanivimab and those who did not (OR 0.03, 95% CI [0, 0.25), P<0.01). Conclusions This study supports the effectiveness of bamlanivimab in reducing Covid-19 related hospitalizations in patients ≥ 65 or with BMI ≥ 35 and suggests a mortality benefit.

Developing a prioritisation framework for patients in need of coronary artery angiography

Background Effective waiting list management and comprehensive prioritisation can provide timely delivery of appropriate services to ensure that the patient needs are met and increase equity in the provision of health services. We developed a prioritisation framework for patients in need of coronary artery angiography (CAA). Methods We used a multi-methods approach to elicit effective factors that affect CAA patient prioritisation. Qualitative data wase collected using semi-structured interviews with 15 experts. The final set of factors was selected using experts’ consensus through modifed Delphi technique. The framework was finalised during expert panel meetings. Results 212 effective factors were identified based on the literature review, interviews, and expert panel discussion of them, 37 factors were selected for modifed Delphi study. Following two rounds of Delphi discussions, seven final factors were selected and weighed by ten experts using pair-wise comparisons. The following weights were given: the severity of pain and symptoms (0.22), stress testing (0.18), background diseases (0.15), number of myocardial infarctions (0.15), waiting time (0.10), reduction of economic and social performance (0.12), and special conditions (0.08). Conclusion Clinical effective factors were important for CAA prioritisation framework. Using this framework can potentially lead to improved accountability and justice in the health system.

ROLE OF CYTOXIC T-LYMPHOCYTES IN THE PATHOGENESIS OF PRETERM BIRTH

Currently, the existence of a wide range of subpopulations of CD8+T-lymphocytes has been revealed, among which there are subpopulations of naive and effector cells, as well as memory cells. CD8+T-lymphocytes are thought to be a population of lymphocytes with high cytotoxic activity, which is of extreme importance during pregnancy. Given that each subpopulation is characterized by a set of produced mediators, surface and intracellular markers, we can assume their role in the pathogenesis of preterm birth. This determined the need to investigate the role of naive cells, effector cells, and memory cells in the development of spontaneous preterm birth. Data on the content of naive CD8+-lymphocytes in the peripheral blood of women with threatened preterm birth are practically absent. It was found that the infiltration of CD8+-lymphocytes in the area of uteroplacental contact was associated with the development of timely delivery. Chronic chorioamnionitis is the most common condition in idiopathic preterm birth and is characterized by the infiltration of maternal CD8+Tcells into the chorioamniotic membranes. Currently, it is believed that chronic inflammatory lesions of the placenta represent maternal antifetal rejection. This led to the study of the role of these cells in the pathogenesis of preterm birth. Purpose. To establish a possible pathogenetic mechanism of preterm birth in women with threatened preterm birth on the basis of the revealed features of differentiation and functional activity of CD8+- lymphocytes at the systemic levelMaterials and methods. The survey of women was carried out on the basis of the Federal State Budgetary Institution “V. Gorodkov Ivanovo Research Institute of Maternity and Childhood” of the Ministry of Health of the Russian Federation. A total of 126 women were examined, which were retrospectively divided into 2 main groups – women with threatened preterm birth(n = 68), which was divided into 2 subgroups – with the outcome of pregnancy preterm birth (n = 30) and timely delivery (n = 38). The control group included 58 women with uncomplicated pregnancy and who gave birth on time. In the CD8+-lymphocyte population, the content of central – Tcm (CD45RACD62L+), preterminally differentiated-Tem (CD45RACD62L- ) and terminally differentiated-Temra (CD45RA+CD62L- ) memory cells was determined. In all memory cell populations, the content of cells producing Granzyme B intracellularly was determined. The studies were performed using monoclonal antibodies (mAT) by flow cytometry on a FACSCanto II cytometer using the FACSDiva software (Becton Dickinson, USA).The analysis of the features of the relative content of CD8+-lymphocytes in the main group of women, depending on the outcome of pregnancy, was carried out. When comparing patients with a clinic of threatened preterm birth, whose pregnancy ended prematurely, a higher content of CD8+-lymphocytes was revealed than in group c of women who gave birth in a timely manner, which indicates a high stimulation of cytotoxic T-lymphocytes in this group of women. With threatening preterm birth, there is an increase in the content of naive CD8+-lymphocytes in the peripheral blood. Data on the content of naive CD8+-lymphocytes in the peripheral blood of women with threatened preterm birth are practically absent. The increase in CD8+Tn levels is more pronounced in the subgroup of women with a favorable pregnancy outcome. Given this fact, it can be assumed that in women with preterm birth, a lower CD8+Tn is associated with their increased differentiation into effector T-lymphocytes with their subsequent migration to the placental zone. This process could determine the observed decrease in the level of terminally differentiated granzyme-producing CD8+-lymphocytes in a subgroup of women with a pregnancy outcome of preterm birth, which coincided with the literature data.

FEATURES OF MONOCYTE POLARIZATION AT DIFFERENT OUTCOMES IN WOMEN WITH RECURRENT MISCARRIAGE

Currently, in the pathogenesis of recurrent miscarriage, a special role is given to immunological factors, in particular the role of innate immunity. The aim of the study was to assess the relative content of monocytes in the peripheral blood producing IL-4, IL-6, IL-10, IFNγ, as well as to identify new criteria for predicting the outcome of pregnancy in women with the threat of early termination and recurrent miscarriage. Materials and methods. 88 pregnant women at 5-12 weeks’ gestation were examined, the main group consisted of 59 women with recurrent miscarriage and threatened miscarriage at the time of the study, the control group – 29 women with uncomplicated pregnancy without recurrent miscarriage. The main group, depending on the outcomes of pregnancy, was subdivided into subgroups: subgroup I – 42 women whose pregnancy ended in timely delivery, subgroup II – 8 women with preterm labor, subgroup III – 9 women with abortion up to 22 weeks (spontaneous miscarriage and non-developing pregnancy). In the control group, all women had a timely delivery. Research material – peripheral venous blood. The relative content of IL-4+, IL-6+, IL-10+, IFNγ+ monocytes was assessed on a FACSCanto II flow cytometer using monoclonal antibodies. Statistical data processing was carried out using a package of standard applied programs. Results. In the group of women with recurrent miscarriage and threatened miscarriage, the relative content of IL-10+ and IL-4+ monocytes was reduced and the content of IL-6+ monocytes was increased compared to the control group (p = 0.0001 in all cases). There were no statistically significant differences in the content of IFNγ+ monocytes in the compared groups (p = 0.069). With a relative content of IL-4+ monocytes equal to 26.7% or less, preterm labor is predicted. With a relative content of IL-10+ monocytes equal to 27.0% or less, abortion (spontaneous miscarriage or miscarriage) is predicted in gestational age up to 22 weeks. An increase in the ratio of IFNγ+/ IL-4+, IFNγ+/IL-10+, IL-6+/IL-4+, IL-6+/IL-10+ monocytes was found in the main group (p < 0.0001 in all cases ). Conclusions. In women with recurrent miscarriage in all subgroups, the level of M1 monocytes prevailed over the level of M2 monocytes. The data obtained allowed the development of new prognostic criteria for termination of pregnancy up to 22 weeks and premature birth.

Рrediction of the outcome of pregnancy in women with reccurent miscarriage

To determine the relative content of monocytes in the peripheral blood producing IL-4, IL-6, IL-10, IFNγ, to identify new criteria for predicting abortion before 22 weeks of gestation in women with the threat of early termination and recurrent miscarriage. Materials and methods. A survey of 91 women in the gestation period of 5-12 weeks was carried out. The main group consisted of 59 women with recurrent miscarriage and the threat of early termination at the time of the study. Depending on the outcome of pregnancy, the main group was subdivided into 3 subgroups: subgroup I - 44 women whose pregnancy ended in timely delivery, II - 8 women who had preterm labor, III - 8 women with termination of pregnancy up to 22 weeks ( missed pregnancy or spontaneous miscarriage). The control group consisted of 32 women with uncomplicated pregnancy. The relative content of IL-4 +, IL-6 +, IL-10 +, IFNγ + monocytes was determined by flow cytometry on FACSCanto II (Becton Dickinson, USA). In women with threatened early miscarriage and recurrent miscarriage, the percentage of IL-4 + and IL-10 + cells in the population of peripheral monocytes is significantly lower, while IL-6 + cells are higher compared to the control group (p = 0.0001 in in all cases), no statistically significant differences were found in the percentage of IFNγ + cells (p = 0.076). A retrospective analysis revealed that in the group of women with termination of pregnancy up to 22 weeks, there was a significant decrease in IL-10 + monocytes in the peripheral venous blood. Prediction of termination of pregnancy before 22 weeks of gestation is possible with a relative content of IL-10 + monocytes equal to 27.0% or less (sensitivity 87.5%, specificity 95.2%, accuracy 93.1%).

Method for simulating processes of processing inhomogeneous data in buffer drives of routers

The article proposes a method for modeling the processing of heterogeneous data in the buffer storage of routers. In contrast to the existing approaches, in the developed method, in the analytical description of the processes of functioning of buffer storage devices of routers under the influence of heterogeneous traffic of subscribers of a special-purpose communication network, the apparatus of the theory of cellular automata was used, which made it possible to take into account the probability of timely processing of data of all used priority levels of communication directions.As a result of the experiment carried out on the basis of a real special communication network, it was found that the developed method of modeling the processes of processing inhomogeneous data of buffer storage devices of routers makes it possible to increase the accuracy of determining the probability of timely delivery of priority information to subscribers of a special purpose communication network, in comparison with the existing standardized methods.

A project-based purchasing portfolio matrix applied to the Australian construction industry

For a project to be delivered on-time and to an agreed cost in accordance with the specification, it is important to have an appropriate purchasing strategy. A project succeeds due to many factors, one of which is cost alongside timely delivery and quality. Formal purchasing strategies for different purchasing categories are common in the manufacturing industry, but less so in a project-based industry such as construction. The paper argues that purchasing strategies suited to the project-based nature of construction would improve project delivery and other success factors. The purpose of this study is to determine if a matrix could assist companies in the project-based industry to formulating their purchasing strategies. Case studies of five Australian construction companies’ purchasing practises were undertaken to support this work. There is evidence that, to remain competitive, it is necessary for companies to develop a network of well-established relationships with suppliers and subcontractors. Purchasing strategies need to be adapted to each purchasing situation as projects are rarely, if ever, the same. It is necessary, therefore, to adopt an approach that combines the best commercial deal and most effective collaboration.

A Survey on the Manufacturing Contribution of Installed Industrial Robots at Nigerian Breweries Factory in Kaduna Metropolis, Nigeria

Industrial robots are used in more advanced automation to effectuate manufacturing with far greater speed, efficiency, safety, guaranteed consistency, and reliability than human processing. Countries that employ automation technologies are leaders in industrial manufacturing and contributions to economy. Developing countries like the ones in Africa are seen to hardly use automation technologies in industrial processing. Nigeria is the largest economy in Africa but her industrial base and development is very low. Many industries in Nigeria and other less developed economies face challenges in transitioning to application of automation technologies due mainly to either lack of awareness, costs, and shortage of manning personnel. Industries noted or suspected to be employing robotic technology in Nigeria were visited or contacted to know the realities. Findings indicated that only few Nigerian industries especially breweries employ robots in manufacturing in the country. Detailed survey of Nigerian Breweries factory in Kaduna metropolis as a notable manufacturing outfit employing industrial robots in Nigeria was conducted. The survey indicated that three robots named the packer, unpacker, and palletizer are employed at the company for removing, arranging, and placing about 25,000 empty glass bottles per hour either from or into crates on beer production lines before and after the bottles are washed or treated. These activities which can also be done manually were estimated to require more than 100 dedicated workers to accomplish every workday at the company. It was also evidential that the robots had greatly being contributing to productivity, quality, safety, and timely delivery of the factory products to customers with greater sale and profitability profile of the Breweries Company. The survey is intended to practically substantiate the technological option of employing robots to boost industrial manufacturing profiles and returns and contributions to economy in less developed countries.