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Live video applications are getting popular, and content providers widely use adaptive bitrate (ABR) streaming to improve QoE while maintaining low latency. However, users' increasing preference to watch videos on mobile devices poses great challenges for ABR algorithm due to the dramatically varying cellular network. Existing learn-based ABR algorithms face difficulties to generalize to various network conditions because of their reliance on training traces, and model/rule-based ABR schemes suffer from rebuffering under low latency constraint since they cannot robustly control the buffer occupancy within a small range. To address it, this work proposes Cratus, a lightweight and robust ABR algorithm for mobile live streaming, which achieves high QoE and low latency by accurately regulating the buffer at a small level. To enhance the control ability, Cratus controls the buffer dynamic behavior rather than the buffer occupancy. By using sliding mode control approach, Cratus robustly controls the buffer dynamic and ensures that the buffer occupancy is bounded around the target level regardless of network uncertainties. Trace-driven experiments show that Cratus outperforms existing ABRs: average QoE is increased by 12.3% to 28.6%, and rebuffering time is limited within 0.8s on average, which is reduced by 53.5% to 92.3%.

High blood pressure (BP) is noted in 34.8% of the population of Ukraine. Antihypertensive therapy is used by 34.4% of patients, by 14% - a treatment is effective. Resistance to antihypertensive therapy can be caused by a number of reasons, one of which is electrolyte imbalance. Purpose - to analyze the possibilities of using the complex Panzikor in patients with arterial hypertension of the I-II degree and hypokalemia to achieve the target level of blood pressure. Materials and methods. It is examined 34 (57%) patients with hypertension of the 1st degree and 26 (43%) patients with hypertension of the 2nd degree. All subjects were divided into groups: A (n=17) and C (n=13) - patients with AH of 1-2 degree who were prescribed standard antihypertensive therapy and Panzikor (1 sachet once a day for 12 weeks); B (n=17) and D (n=13) - patients with hypertension of 1-2 degree who were prescribed standard antihypertensive therapy. All patients underwent a general clinical examination, determination of potassium and sodium levels in the blood, carbohydrate and lipid parameters. Diaries of medication use and blood pressure measurement were kept. Results. After treatment, a significant decrease in blood pressure was recorded: in the Group A - systolic blood pressure from 156.1±12.2 mm Hg to 131.3±9.1 mm Hg and diastolic blood pressure from 99.7±6.3 mm Hg to 82.1±6.2 mm Hg; in the Group C - systolic blood pressure from 166.3±14.5 mm Hg to 139.4±11.2 mm Hg, diastolic blood pressure from 104.1±7.9 mm Hg to 86.1±6.3 mm Hg. In the Groups B and D, no significant decrease in blood pressure was found. Patients of the Groups A and C showed positive dynamics of blood glucose reduction (in the Group A - from 5.4±0.8 mmol/l to 4.2±0.6 mmol/l; in the Group C - from 4.7±1.3 mmol/l to 4.2±1.1 mmol/l), glycosylated hemoglobin (in the Group A - from 5.2±1.1% to 4.6±1.2%; in the Group C - from 5.1±0.8% to 4.8±0.7%), total cholesterol (in the Group A - from 5.6±1.3 mmol/l to 4.2±1.1 mmol/l; in the Group C - from 5.8±2.7 mmol/l to 4.3±1.1 mmol/l), low density lipoproteins (in the Group A - from 2.9±1.1 mmol/l to 1.5±0.4 mmol/l; in the Group C - from 3.2±1.2 7 mmol/l to 1.8±0.7 mmol/l). Conclusions. Panzikor should be prescribed to patients with hypertension and hypokalemia to effectively achieve target blood pressure levels and stabilize lipid and carbohydrate metabolism indicators. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the work. No conflict of interests was declared by the authors., Повышенное артериальное давление (АД) отмечается у 34,8% населения Украины. Антигипертензивная терапия используется у 34,4% пациентов, у 14% лечение эффективно. Резистентность к антигипертензивной терапии может быть обусловлена рядом причин, одной из которых является дисбаланс электролитов. Цель - проанализировать возможности применения комплекса Панцикор у пациентов с артериальной гипертензией (АГ) 1-2-й степени и гипокалиемией для достижения целевого уровня АД. Материалы и методы. Обследованы 34 (57%) пациента с АГ 1-й степени и 26 (43%) больных с АГ 2-й степени. Все обследованные поделены на группы: A (n=17) и C (n=13) -пациенты с АГ 1-2-й степени, которым назначена стандартная антигипертензивная терапия и Панцикор (1 саше 1 раз в сутки в течение 12 недель); B (n=17) и D (n=13) - больные с АГ 1-2-й степени, которым назначена стандартная антигипертензивная терапия. Всем пациентам проведено общеклиническое обследование, определение в крови уровней калия и натрия, показателей углеводного и липидного состояния. Велись дневники применения лекарств и измерения АД. Результаты. После лечения зарегистрировано достоверное снижение АД: в группе А - систолического АД с 156,1±12,2 мм рт. ст. до 131,3±9,1 мм рт. ст. и диастолического АД с 99,7±6,3 мм рт. ст. до 82,1±6,2 мм рт. ст.; в группе С - систолического АД с 166,3±14,5 мм рт. ст. до 139,4±11,2 мм рт. ст., диастолического АД с 104,1±7,9 мм рт. ст. до 86,1±6,3 мм рт. ст. В группах (В и D) достоверного снижения показателей АД не выявлено. У пациентов групп А и С выявлена положительная динамика снижения показателей глюкозы крови (в группе А - с 5,4±0,8 ммоль/л до 4,2±0,6 ммоль/л; в группе С - с 4,7±1,3 ммоль/л до 4,2±1,1 ммоль/л), гликозилированного гемоглобина (в группе А - с 5,2±1,1% до 4,6±1,2%; в группе С - с 5,1±0,8% до 4,8±0,7%), общего холестерина (в группе А - с 5,6±1,3 ммоль/л до 4,2±1,1 ммоль/л; в группе С - с 5,8±2,7 ммоль/л до 4,3±1,1 ммоль/л), липопротеиды низкой плотности (в группе А - с 2,9±1,1 ммоль/л до 1,5±0,4 ммоль/л; в группе С - с 3,2±1,2 ммоль/л до 1.8±0,7 ммоль/л). Выводы. Панцикор следует назначать больным АГ и гипокалиемией для эффективного достижения целевых уровней АД и стабилизации показателей липидного и углеводного обменов. Исследование выполнено в соответствии с принципами Хельсинкской декларации. Протокол исследования одобрен Локальным этическим комитетом указанного в работе учреждения. Авторы заявляют об отсутствии конфликта интересов., Підвищений артеріальний тиск (АТ) відмічається в 34,8% населення України. Антигіпертензивна терапія застосовується в 34,4% пацієнтів, у 14% - лікування ефективне. Резистентність до антигіпертензивної терапії може бути зумовлена рядом причин, однією з яких є дисбаланс електролітів. Мета - проаналізувати можливості застосування комплексу Панцикор у пацієнтів з артеріальною гіпертензією (АГ) 1-2-го ступеня та гіпокаліємією для досягнення цільового рівня АТ. Матеріали та методи. Обстежено 34 (57%) пацієнти з АГ 1-го ступеня та 26 (43%) хворих з АГ 2-го ступеня. Усіх обстежених поділено на групи: A (n=17) i C (n=13) - пацієнти з АГ 1-2-го ступеня, яким призначали стандартну антигіпертензивну терапію та Панцикор (1 саше 1 раз на добу протягом 12 тижнів); B (n=17) і D (n=13) - хворі з АГ 1-2-го ступеня, яким призначали стандартну антигіпертензивну терапію. Усім хворим виконано загальноклінічне обстеження, визначення в крові рівнів калію та натрію, показників вуглеводного та ліпідного стану. Велися щоденники застосування ліків і вимірювання АТ. Результати. Після лікування зареєстровано достовірне зниження АТ: у групі А - систолічного АТ від 156,1±12,2 мм рт. ст. до 131,3±9,1 мм рт. ст. і діастолічного АТ від 99,7±6,3 мм рт. ст. до 82,1±6,2 мм рт. ст.; у групі С - систолічного АТ від 166,3±14,5 мм рт. ст. до 139,4±11,2 мм рт. ст., діастолічного АТ від 104,1±7,9 мм рт. ст. до 86,1±6,3 мм рт. ст. У групах В і D достовірного зниження показників АТ не виявлено. У пацієнтів груп А і С виявлено позитивну динаміку зниження показників глюкози крові (угрупі А - з 5,4±0,8 ммоль/л до 4,2±0,6 ммоль/л; у групі С - з 4,7±1,3 ммоль/л до 4,2±1,1ммоль/л), глікозильованого гемоглобіну (у групі А - з 5,2±1,1% до 4,6±1,2%; у групі С - з 5,1±0,8% до 4,8±0,7%), загального холестерину (у групі А - з 5,6±1,3 ммоль/л до 4,2±1,1ммоль/л; у групі С - з 5,8±2,7 ммоль/л до 4,3±1,1 ммоль/л), ліпопротеїдів низької щільності (у групі А - з 2,9±1,1 ммоль/л до 1,5±0,4 ммоль/л; у групі С - з 3,2±1,2 7 ммоль/л до 1,8±0,7 ммоль/л). Висновки. Панцикор слід призначати хворим з АГ та гіпокаліємією для ефективного досягнення цільових рівнів АТ і стабілізації показників ліпідного й вуглеводного обмінів. Дослідження виконано відповідно до принципів Гельсінської декларації. Протокол дослідження ухвалено Локальним етичним комітетом зазначеної в роботі установи. Автори заявляють про відсутність конфлікту інтересів.

We apply dynamic programming to solve a long-horizon fund choice problem, given that the underlying market can switch between different regimes. The objective function is based on reaching a target level of wealth, following the paradigm of goal-based investing. In a world with a good regime (e.g., a bull market) and a bad regime (e.g., a bear market), we find that an investor who is cognizant of regime switching can potentially do much better over time than an investor who assumes there is only one regime. However, there is a caveat---an investor must be able to predict the regime they are in with reasonable levels of confidence, and if not, they are in fact worse off than an investor who assumes just one regime. Using data from recent history, we find that investors may be better off not switching from existing single-regime models to more complex multiple-regime models.

This cross-sectional study aimed to investigate the quality of care of diabetes in Shanghai, China. A total of 173 235 patients with type 2 diabetes in 2017 were included in the analysis. Profiles of risk factors and intermediate outcomes were determined. The patients had a mean age of 66.43 ± 8.12 (standard deviation (SD)) years and a mean diabetes duration of 7.95 ± 5.53 (SD) years. The percentage of patients who achieved the target level for HbA1c (< 7.0%) was 48.6%. Patients who achieved the target levels for blood pressure (BP) < 130/80 mmHg and low-density lipoprotein-cholesterol (LDL-c) < 2.6 mmol/L reached 17.5% and 34.0%, respectively. A total of 3.8% achieved all three target levels, and the value increased to 6.8% with an adaptation of the BP target level (< 140/90 mmHg) for those over 65 years. Multivariable analysis identified the factors associated with a great likelihood of achieving all three target levels: male, young age, short diabetes duration, low body mass index, macrovascular complications, no microvascular complications, prescribed with lipid-lowering medication, and no prescription of antihypertensive medication. In conclusion, nearly 50% and one-third of the patients with diabetes met the target levels for HbA1c and LDL-c, respectively, with a low percentage achieving the BP target level. The percentage of patients who achieved all three target levels needs significant improvement.

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.

Modern people's concept of health is more comprehensive; in addition to physical health, they focus on mental health even more. Computer multimedia group psychological measurement is introduced, and a mental health education model is constructed in this paper. The model includes three interrelated levels: mechanism level, evaluation level, and target level. It emphasizes the key and core role of mental quality in mental health. It advocates incorporating mental quality into the evaluation and diagnosis system of the overall state of individual mental health, combines the classified qualitative assessment and quantitative assessment, and arranges appropriate prevention and intervention measures according to different types of individuals. Practice has proved that this method is effective.

The community of many national and international recommendations dedicated to the treatment of a specific disease, including gout, is fully justified, since it allows taking into account, for example, regional, ethnic characteristics of the manifestations of the disease, which can be important when choosing a therapy. However, this is often associated with dissonance regarding the solution of key issues facing the practitioner. The publication in 2020 of the updated American College of Rheumatology (ACR) guidelines for the management of gout revealed controversy with some of the previous version’s postulates, as well as with other similar work, for example, with the guidelines published in the same year and the French Association of Rheumatology. Among the controversial provisions of the new version of the ACR recommendations are the unified target level of uric acid for all patients, indications for drug therapy, the choice of a drug in patients with reduced renal function, prevention of arthritis attacks when starting uratelowering therapy. This article discusses these and other controversial issues in gout therapy based on an analysis of the latest ACR guidelines.

U46619, a synthetic analogue of thromboxane A2 was used for modeling acute stable and reversible pulmonary arterial hypertension. Administration of U46619 in high doses led to vascular collapse and inhibition of cardiac function. The doses of U46619 were empirically selected that allow attaining the target level of pulmonary hypertension without systemic hemodynamic disturbances. The possibility of attaining the target level of pulmonary hypertension and reversibility of changes after termination of U46619 infusion make this model attractive for evaluation of the efficiency of different therapeutic methods of treatment of pulmonary hypertension in large animals.

Aim: to assess the awareness of doctors about the main provisions of the European and Russian clinical guidelines for the management of patients with dyslipidemia and arterial hypertension (AH).Material and methods. Anonymous survey of 584 physicians and cardiologists of Krasnodar and Krasnodar Territory was carried out. The questionnaire contained 9 multiple-choice questions.Results: according to the results of the questionnaire, 1/3 of doctors knew the target values of low-density lipoprotein cholesterol (LDL-C) in very high-risk patients. If the target level of LDL cholesterol was not achieved on an adequate dose of statin, 75.1% of colleagues would not have added ezetimibe. For hypertriglyceridemia in patients receiving an adequate dose of statins, 47% of physicians would prescribe treatment that does not comply with clinical guidelines. More than half of the doctors gave correct answers to the questions about antihypertensive therapy. However, the target level of blood pressure was incorrectly indicated by 47.3% of respondents, 71.6% of colleagues made a mistake with the tactics of starting therapy, and 51.5% of doctors incorrectly assessed the situation with the prescription of a triple fixed combination of drugs.Conclusion: а significant part of practicing doctors (therapists and cardiologists) were not sufficiently informed about the main provisions of the new recommendations and were guided by old (outdated) ideas.

Background: In automated glucose clamp experiments, blood glucose (BG) concentrations are kept close to a predefined target level using variable glucose infusion rates (GIRs) determined by implemented algorithms. Clamp quality (ie, the ability to keep BG close to target) highly depends on the quality of these algorithms. We developed a new Clamp algorithm based on the proportional-integral-derivative (PID) approach and compared clamp quality between this and the established Biostator (BS) algorithm. Methods: In numerical simulations, the PID-based algorithm was optimized in silico. The optimized Clamp-PID algorithm was tested in in vitro experiments and finally validated in vivo in a small ( n = 5) clinical study. Results: In silico, in vitro, and in vivo experiments showed better clamp quality for the new Clamp-PID algorithm compared with the BS algorithm: precision and absolute control deviation (ACD) decreased from 3.7% to 1.1% and from 2.9 mg/dL to 0.6 mg/dL, respectively, in the numerical simulation. The in vitro validation demonstrated reductions in precision (from 3.3% ± 0.1% (mean ± SD) to 1.4% ± 0.4%) and in ACD (from 2.3 mg/dL ± 0.4 mg/dL to 0.8 mg/dL ± 0.2 mg/dL), respectively. In the clinical study, precision and ACD improved from 6.5% ± 1.3% to 4.0% ± 1.1% and from 3.6 mg/dL ± 0.9 mg/dL to 2.2 mg/dl ± 0.6 mg/dl, respectively. The quality parameter utility did not change. Conclusions: The new Clamp-PID algorithm improves the clamp quality parameters precision and ACD versus the BS algorithm.

Background Force steadiness is evaluated as force variability during constant force exertion around a target level. Ankle plantar flexor force steadiness is reported to be related to postural sway on an unstable platform in healthy young adults; however, this relationship in older adults is unclear. Research question This study aimed to investigate whether ankle plantar flexor force steadiness was related to postural sway on stable and unstable platforms in older adults. Methods Twenty-six community-dwelling older women participated in this study (72 ± 6 years). Maximal isometric strength and force steadiness at 5%, 20 %, and 50 % of the maximal strength of ankle plantar flexion were assessed. Postural sway in the anteroposterior direction during bipedal standing was measured on stable and unstable platforms. Results The results showed that force steadiness at any intensity level and maximal isometric strength were not related to postural sway on the stable platform. Force steadiness at 20 % of maximal strength alone was significantly correlated with postural sway on the unstable platform (ρ = 0.441, p Significance These results indicate that the ability to control muscle force could be important for postural stability on an unstable platform in older adults.

OBJECTIVE A variety of stimulus delivery methods can elicit vestibular evoked myogenic potentials (VEMPs). The current study compared bone conduction (BC) cervical VEMPs (cVEMPs) across two different clinical bone vibrators. It was hypothesized that the B81 transducer would be more effective for producing larger BC-cVEMP peak to peak amplitudes due to its low-frequency advantages in pure-tone audiometry applications. DESIGN Twenty young adults under the age of 40 years with no reported history of hearing or balance disorders participated in the study. BC cVEMPs were elicited using two clinical bone transducers: the Radioear B71 bone vibrator and the Radioear B81 bone vibrator. Both transducers were calibrated using the acoustic method of calibration before data collection, and the linear dynamic range of the transducers was determined. Participants were asked to sit and match a fixed electromyography (EMG) target level of 100 µV, while BC cVEMPs were recorded using stimulus frequencies of 250, 500, and 750 Hz. RESULTS Statistically significant differences in raw amplitude at 250 and 750 Hz between the B71 and B81 were observed; the B71 produced larger peak to peak amplitudes over the B81. At 500 Hz, larger amplitudes were observed with the B71, but results were not statistically significant. The B71 produced significantly lower cVEMP thresholds at all three frequencies. Across both transducers, 500 Hz produced the largest peak to peak amplitude compared with 250 and 750 Hz. Peak to peak amplitude did not increase above 55 dB nHL for 250 and 500 Hz, but amplitude continued to increase at 750 Hz. DISCUSSION The present study found statistically significant differences in BC-cVEMP amplitude and threshold between the B71 and B81, but results were not what we hypothesized. In general, the B71 elicited larger BC-cVEMP amplitudes and lower thresholds compared with the B81. Additionally, 500 Hz was found to be the best frequency for both BC transducers, contrasting previous studies suggesting lower frequencies yield larger BC-cVEMP amplitudes. It is possible that these average differences could also be clinically significant when looking at individual amplitude differences. Larger peak to peak amplitudes at 500 Hz may be partially due to the underlying physical levels used in the current study, as well as the output spectra of the transducers, and may explain the larger response amplitudes observed at 500 Hz compared with 250 Hz.

Aim. To perform a pharmacoeconomical assessment of the use of generic statin drugs in patients with high and very high cardiovascular risk (CVR) in real clinical practice based on the data of the study PRIORITY.Material and methods. The PRIORITY study included 298 patients with high (29; 9.7%) and very high (269, 90.3%) CVR. All patients were recommended to take the reproduced drugs of atorvastatin and rosuvastatin in an individually prescribed dose. After 1 month (B1), if the target level of lowdensity lipoprotein cholesterol (LDL-C) was not reached, the statin dose was titrated. After 3 months of follow-up (B3), the hypolipidemic effect of statin therapy was evaluated. 295 people completed the study, 285 patients had the results of the lipid profile. To perform a pharmacoeconomic analysis and evaluate the “cost/effectiveness” ratio, we used the prices of generic statins in one of the online pharmacies. The effectiveness of statins was determined by the LDL-C reduction, as well as by the percentage of achieving the target LDL-C level.Results. At the first stage of the pharmacoeconomic analysis, the criterion for the effectiveness of 3-month lipid-lowering therapy was a decrease in LDL-C level by 1 mmol/l. The median and interquartile range of the ratio “cost/effectiveness” indicator for atorvastatin was 658.2 (431.5; 1257.1) RUB/mmol/l, and for rosuvastatin – 621.0 (390.7; 940.6) RUB/mmol/l (p=0.45). The results of a comparative assessment of the “cost/effectiveness” ratio (with the abovementioned effectiveness indicator) in subgroups of patients with high and very high CVR, with the achievement and nonachievement of the target level of LDL-C, adherent and non-adherent to statins, revealed the economic advantage of statins in groups of adherent patients (p=0.35), high-risk patients (pConclusion. Pharmacoeconomic analysis of therapy with generic statin drugs, performed according to the data of the non-randomized uncontrolled study, allows to justify the economic efficiency and advantages of these drugs in various subgroups of patients who need statin therapy.

The article reconstructs and analyzes trends in the development of Russian shipbuilding in 2011–2019 and assesses the long-term development potential of the shipbuilding industry in 2020–2035, with due consideration of a scenario of fast-tracking the reequipment of the technological and industrial base of the industry. The analysis showed that shipbuilding development was at its most effective in 2014–2017, and in 2018–2019 the trend changed for the worse due to changes in implementation timelines of a number of large military contracts, which lead to reduced efficiency of production. If current trends continue, the target level of shipbuilding industry growth specified in the Strategy of Shipbuilding Industry Development for the period up to 2035 cannot be achieved. Support measures need to be reoriented to proactive modernization of the technological and industrial base of the industry, which includes increasing the number of shipbuilding yards designed for construction of large vessels.

This study intends to identify the appropriateness of the writing and reading assessment items of the current English syllabus according to the targeted CEFR levels set by the Ministry of Education and to find out English teachers’ familiarity with CEFR writing and reading scales by suggesting suitable CEFR levels for writing and reading assessment items. An assessment checklist was used to collect the data involving 331 secondary school English teachers. Results show that most of the assessment items are found to be suitable and applicable to be used in the CEFR. This study also proves that the teachers were aware of the six levels of CEFR global scale because they were able to identify the suitable CEFR level that matches against CEFR target level set by the Ministry of Education. In conclusion, the Ministry of Education, Malaysia should consider to continue using some part of the current English syllabus and assessment instead of recommending its total abolishment. Keywords: CEFR in Malaysia; Teachers’ judgement; CEFR alignment; School based assessment; applicability

The aim of this paper is to estimate the equilibrium real interest rate in Slovakia by means of a semi-structural unobserved components model. The equilibrium real interest rate is understood here as a short-term, risk-free real interest rate consistent with output at its potential level, and inflation at its target level after the effect of all cyclical shocks have disappeared. Contribution to the literature is in two ways: i) development of a modelling framework for small, open, and converging economies which can be used for other transition economies, and (ii) assessment of the adoption of the euro and its effect on the equilibrium real interest rate. Based on the estimates, the equilibrium real interest rate fell from the positive pre-euro (also pre-crisis) level into to the negative territory.

Current guidelines for the management of patients with dyslipidemia define low-density lipoprotein cholesterol (LDL-C) as the primary target in addressing lipid-lowering therapy. The target level of LDL-C in real clinical practice is achieved in no more than a third of patients who have undergone a coronary event and receive high-intensity lipid-lowering therapy. Achieving the goals of lipid-lowering therapy in a significant proportion of patients with atherosclerotic cardiovascular diseases (ACVD) is impossible with the use of even high doses of statins, which requires its enhancement by other drugs. The article considers the place of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in the prevention of cardiovascular diseases in patients with ACVD in accordance with the latest Russian and international guidelines. A modern decision-making algorithm for the initiation of PCSK9 inhibitors therapy in patients with ACVD is presented. The authors provide a clear understanding about the patient populations that will benefit most from the taking of PCSK9 inhibitors. Particular attention is paid to Guidelines for the management of dyslipidemias developed by European Society of Cardiology and European Atherosclerosis Society in 2019. The issues of patients provision with PCSK9 inhibitors with reference to Russian conditions are described in details in accordance with the requirements for territorial programs of state guarantees. Further improvement in the provision of PCSK9 inhibitors to patients with indications for this therapy is necessary, considering the potential of these drugs in reducing cardiovascular morbidity and mortality in patients with ACVD.

The high prevalence of lipid metabolism disorders in the Russian population and their contribution to cardiovascular risk require an optimization of their pharmacotherapy in clinical practice.Aim. To study the possible benefits of statin therapy in fixed doses for primary and secondary prevention of cardiovascular disease in outpatient practice.Material and methods. Ambulatory patients (n=300) with a high or very high risk with hypercholesterolemia who had indications for statin treatment for primary or secondary prevention of cardiovascular diseases were included into a non-randomized trial. Patients were divided into 2 groups. Group 1 had a titration regimen of statins in accordance with current recommendations (group 1A [n=50] – primary cardiovascular prevention; group 1B [n=100] – secondary cardiovascular prevention). Group 2 received a titration-free statin regimen in fixed doses (group 2A [n=50] – primary cardiovascular prevention; group 2B [n=100] – secondary cardiovascular prevention). Patients were prescribed atorvastatin (10-80 mg/day) or rosuvastatin (10-40 mg/day). Group 1 patients had visits to the doctor after 1, 3, 6 and 12 months from the start of statin use, group 2 patients – after 3 and 12 months. Laboratory studies included determination of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c). Changes in lipid levels, the frequency of reaching target TC and LDL-c levels were evaluated.Results. Titration-free statins treatment (Group 2) allowed reaching the target levels of TC and LDL-c after 12 months in 73.9% and 56.3% of patients, respectively. Significant changes were found after 3 months visit. In Group 1, these indicators were slightly lower (56.8% and 53.4%, respectively), while significant changes in the LDL-c level were found later than in Group 2. More than 50% of patients taking statins for secondary prevention, reached the target level of TC and LDL-c. At the same time, when using titration-free statin therapy, such results were recorded after 3 months. Patients taking statins for primary prevention achieved the TC target level in 95.7% of cases (subgroup 2A). The frequency of reaching the LDL-c target level in the subgroups of primary prevention was slightly lower.Conclusion. The use of a titration-free statin treatment regimen allowed to more effectively control of TC and LDL-c levels in patients with high and very high cardiovascular risk compared to the traditional statin therapy regimen, and to achieve target lipid levels earlier.

Previous studies in corporate philanthropy have not found conclusive evidence of specific decision-making processes applied by firms to establish a target level of charitable giving. Using panel da...

PurposeThe study examines the existence of target level of working capital and the speed of adjustment toward the target for eight manufacturing sectors of Indian economy. In addition, this study examines the impact of financial constraints on the speed of adjustment.Design/methodology/approachThis study is based on secondary financial data of 1936 Indian manufacturing companies from eight sectors for a period of 18 years (2000–2018). This study employs two-step GMM techniques to arrive at results.FindingsResults of the study confirm that firms do have target working capital, but the speed of adjustment from the current level of working capital to the target working capital is slow, and the speed of adjustment varies across sub-sectors. Moreover, we found that firms that are likely to be less constrained adjust their working capital quickly compared to firms facing high financial constraints.Originality/valueThis study contributes to working capital management literature by examining the speed with which the firms move toward their target and also the impact of financial constraints on the speed of adjustment across eight manufacturing sectors of Indian economy. Further, the study examines the impact of financial constraints on the speed of adjustment.

BACKGROUND: Our team found that abolishing the venous-arterial CO(2) gradient can cease singultus (hiccups), in which the CO(2) pressure in blood reaches no less than 50 mmHg. In order to precisely investigate the target level as a preliminary study, we made a combination gas consisting of 10% CO(2) and 90% O(2) to generate the conditions instantly and safely. METHODS: Thirty-five cases consisting of 26 patients with long-term chronic singultus were treated using the gas. The group consisted of 21 males and 5 females with mean singultus duration of 8.0±13.1 years. A standard oxygen mask was used for delivery of the gas to the patients, and patients breathed in the gas until they felt relief. The duration of the procedure was measured from the beginning to the point at which singultus ceased. A blood test was performed to measure the partial pressure of CO(2) in venous blood at the point at which singultus ceased. RESULTS: Singultus ceased in all patients in a mean time of 5.3±1.5 minutes, with complete recurrence observed in two cases. The mean partial pressure of CO(2) in the venous blood at the point the singultus stopped was 60.8±6.8 mmHg. No life-threatening complications were found in any patient. CONCLUSIONS: One of the definitive conditions for ceasing singultus is acute CO(2) retention in the body, the target of which is around 60 mmHg of CO(2) in venous blood. We believe that targeting acute hypercapnia can always stop singultus, although further neuroscientific investigation is necessary to reveal the physiological mechanism.

Release analysis is used to characterize the cleaning ability of coal fines. It defines the limit of separation at any target level of ash. Since flotation depends upon many factors like feed size ...

ينطلق البحث من غياب مصفوفة مدى وتتابع للقواعد للناطقين بغير العربية، الأمر الذي نتج عنه مشکلات متعددة، منها الذاتية في تسکين القواعد والتراکيب بالمستويات اللغوية، وتصميم المناهج بشکل لا منهجي، مما يؤدي الي الترکيز على قواعد أو تراکيب غير مهمة أو قد لا تنتمي إلي المستوي اللغوي، وتجاهل قواعد وتراکيب مهمة، ونتيجة لذلک تأتي الاختبارات والامتحانات هي الأخرى في ضوء خبرات شخصية. لذا فقد جاء البحث ملبيا لاحتياج أصيل بالمجال محاولا سد الفجوة واقتراح مصفوفة مدى وتتابع للقواعد والتراکيب للناطقين بغير العربية في ضوء الاحتياجات والوظيفية والشيوع، ولتحقيق ذلک حدد مدى احتياج الطلاب لکل موضوع ، کما حددت الوظائف اللغوية التي تحتاج تراکيب أو قواعد لتؤدى أداء صحيحا، وحددت التراکيب النحوية والصرفية الشائعة وکذلک الأخطاء الشائعة، ثم وضعت نسبة إحصائية لکل موضوع في ضوء ما سبق، وتوصل البحث إلى نتائج، منها: الموضوعات شديدة الأهمية التي يجب تکرارها في أکثر من مستوى، وأهمها الفعل بأنواعه، والاستفهام، والنکرة والمعرفة، والنعت، والجر...، کما حدد الموضوعات قليلة الأهمية والتي يجب استبعادها من المصفوفة، وأهمها أسماء الأفعال والأصوات ، الاشتغال، ...وغيرها، کما حدد الموضوعات متوسطة الأهمية والتي يجب تأجيلها للمستويات المتقدمة، ومنها المنقوص، والمقصور، والممدود، والأسماء الخمسة.... وغيرها. وحدد الموضوعات المهمة التي توزع على باقي المستويات، حتى توصل إلى المصفوفة في صورتها النهائية. The present research starts from the absence of a complete matrix of scope and sequence of grammar topics for non-Arabic speakers, which caused many problems, including subjectivity in assigning the rules and structures at linguistic levels and designing curriculum in an informal manner which leads to a focus on rules or structures that are not important or may not belong to the target level or neglecting important rules. Added to that, the tests and examinations are also developed in the light of the personal experiences. Therefore, the research came to meet an original need in the field trying to bridge the gap and suggest a matrix of the rules and structures for non-Arabic speakers in the light of their actual needs, functionality and frequency. To meet this end, the students' needs for each topic was determined, and the linguistic functions that need structures or rules were identified to be performed correctly. The structures were defined as well as the common mistakes, then a statistical percentage for each topic was computed. The results of the research revealed that there are some topics of great importance that must be repeated in more than one level such as the verbs, interrogation, definite and indefinite articles, adjective, and preposition. There are some topics of little importance that should be excluded from the matrix, and the most important of which are the names of verbs and sounds, etc... there are some topics which account for medium importance that should be assigned to advanced levels. The research identified the most important topics that should be distributed to the remaining levels for formulating the matrix in its final form.

BACKGROUND The association between NUDT15 polymorphisms and thiopurine-induced leucopenia is well known. AIM To investigate the association between NUDT15 polymorphisms and time-to-leucopenia in paediatric patients with inflammatory bowel disease (IBD) receiving azathioprine and to determine the relationship between NUDT15 polymorphisms and 6-thioguanine nucleotide (6-TGN) levels. METHODS This retrospective observational study included Korean paediatric patients with IBD who were treated with azathioprine and underwent NUDT15 and TPMT genotyping. Azathioprine doses were adjusted by regular thiopurine metabolite monitoring. Factors associated with time-to-leucopenia and the relationship between NUDT15 polymorphisms and 6-TGN levels were analysed. RESULTS Among the 167 patients included, leucopenia was observed in 16% (19/119), 44% (20/45) and 100% (3/3) of the NUDT15 normal, intermediate and poor metabolisers respectively (P

The goal of investing for retirement is to secure a target level of income that maintains the individual’s preretirement lifestyle. Current “safe harbor” glide-path products shift investments from ...

This paper proposes a new hybrid evaluation method including Improved Analytic Hierarchy Process (IAHP), Entropy Method (EM), and Grey Comprehensive Evaluation Method (GCEM) to assess the transfer efficiency between rail transit and public bicycles. In particular, the IAHP method that replaces the nine-scale approach with three-scale approach to naturally meet the consistency requirements is applied to qualitatively calculate the weights of evaluation indices, the EM method is utilized to calculate the weights of evaluation indices with relatively high degrees of quantification, and the GCEM method is used to calculate the transfer efficiency between rail transit and public bicycles. In addition, a three-level evaluation-index system including target level, criteria level and index level is established. A numerical example is also provided to verify the feasibility of the proposed hybrid evaluation method and explore the reasons for low transfer efficiency between rail transit and public bicycles.

Purpose This paper aims to assess the implications in safety levels by the integration of remotely piloted aircraft system (RPAS). The goal is to calculate the number of RPAS that can jointly operate with conventional aircraft regarding conflict risk, without exceeding current safety levels. Design/methodology/approach This approach benchmarks a calculated level of safety (CLS) with a target level of safety (TLS). Monte Carlo (MC) simulations quantify the TLS based on the current operation of conventional aircraft. Then, different experiments calculate the CLS associated with combinations of conventional aircraft and RPAS. MC simulations are performed based on probabilistic distributions of aircraft performances, entry times and geographical distribution. The safety levels are based on a conflict risk model because the safety metrics are the average number of conflicts and average conflict duration. Findings The results provide restrictions to the number of RPAS that can jointly operate with conventional aircraft. The TLS is quantified for four conventional aircraft. MC simulations confirm that the integration of RPAS demands a reduction in the total number of aircraft. The same number of RPAS than conventional aircraft shows an increase over 90% average number of conflicts and 300% average conflict time. Research limitations/implications The methodology is applied to one flight level of en-route airspace without considering climbing or descending aircraft. Originality/value This paper is one of the most advanced investigations performed to quantify the number of RPAS that can be safely integrated into non-segregated airspace, which is one of the challenges for the forthcoming integration of RPAS. Particularly, Europe draws to allow operating RPAS and conventional aircraft in non-segregated airspace by 2025, but this demanding perspective entails a thorough analysis of operational and safety aspects involved.