Оптимизация методов, исключающих аномальный нагрев тупиковых ответвлений крановой обвязки магистрального газопровода в режиме заполнения газом

Объектом исследования является стояк отбора импульсного газа DN 50 PN 9,8 МПа на крановых узлах DN 1220 на участках МГ "Сахалин-Хабаровск-Владивосток". Цель работы - выбор технических решений, направленных на снижение стремительного роста температуры, тупиковых ответвлений стояков отбора импульсного газа в процессе перепуска газа. В работе рассмотрены методы, снижающие и исключающие разогрев тупиковой ветки обвязки. В результате предложено трубное соединение тупиковых ответвлений для организации перепуска газа между тупиковыми ответвлениями при заполнении участка газопровода.The object of the research is a pipeline of the pulse gas output DN 50 PN 9,8 MPa at crane assembly DN 1220 main gas pipeline "Sakhalin-Khabarovsk-Vladivostok ". The purpose of the work – the choise of technical solutions aimed at decrease in heating of deadlock branch of struts of selection of pulse gas in the course of gas restart-up. The Methods of decrease and exclude the anomaly overheating of pipe impasse branches are considered in the work. As a result of the work pipe connection of deadlock branches was offered

Correlation of umbilical cord blood haematopoietic stem and progenitor cell levels with birth weight: implications for a prenatal influence on cancer risk

We examined the relation with birth weight and umbilical cord blood concentrations of haematopoietic stem and progenitor populations in 288 singleton infants. Across the whole range of birth weight, there was a positive relation between birth weight and CD34+CD38− cells, with each 500 g increase in birth weight being associated with a 15.5% higher (95% confidence interval: 1.6–31.3%) cell concentration. CD34+ and CD34+c-kit+ cells had J-shaped relations and CFU-GM cells had a U-shaped relation with birth weight. Among newborns with ⩾3000 g birth weights, concentrations of these cells increased with birth weight, while those below 3000 g had higher stem cell concentrations than the reference category of 3000–3499 g. Adjustment for cord blood plasma insulin-like growth factor-1 levels weakened the stem and progenitor cell–birth weight associations. The positive associations between birth weight and stem cell measurements for term newborns with a normal-to-high birth weight support the stem cell burden hypothesis of cancer risk

The impact of the DoH Commissioning for Quality and Innovation incentive on the success of venous thromboembolism risk assessment in hospitalised patients. A single institution experience in a quality outcome improvement over a 4-year cycle

OBJECTIVES: To i) demonstrate compliance with the Commissioning for Quality and Innovation for venous thromboembolism risk assessment ii) to undertake root cause analysis of Hospital Acquired Thrombosis and to investigate its impact on quality of care. DESIGN: Prospective monitoring of all admissions. SETTING: Imperial College Healthcare Hospitals, London. PARTICIPANTS: All Hospital Provider Spells as defined on the NHS Data Model and Dictionary. MAIN OUTCOME MEASURES: i) Percentage of patients undergoing Venous Thromboembolism Risk Assessment (VTE-RA) at and 24-hours after admission ii) root cause analysis of Hospital Acquired Thrombosis up to 90 days following discharge. RESULTS: Over a 48-month cycle 83% were overall VTE-RA assessed with 36% in the first 12 months but with significant improvement to ≥95% between April 2013 and April 2015, achieving compliance target since April 2012 involving a massive 633, 850 Spells over the 4 year period. We undertook root cause analysis of all VTE episodes from April 2013 to March 2014, to ascertain Hospital Acquired Thrombosis (HAT), we analysed 433, 174 inpatient days and found a HAT rate of 1 per 1000 with 23% and 24% for DVTs and PEs potentially avoidable respectively. We further analysed VTE risk stratification (n = 1000) and found 37.0% at high risk, 44.4% at medium risk and 18.6 % at low risk, indicating the need of thromboprophylaxis in 81.4% (high and medium) of whom 33.6% were excluded. CONCLUSIONS: We achieved 95% RA compliance which has favourably impacted on our daily practice and improved the quality of the clinical care

Novel oral anticoagulants: A new era in anti-thrombotic therapy

For over half-a-century vitamin K antagonists (VKAs) served our patients well as effective anticoagulants, several novel oral anticoagulants (NOACs) have emerged and are now available as a suitable alternative for stroke prevention, venous thromboembolism prevention and treatment and to reduce vascular events in acute coronary syndrome. Compared to VKAs, the novel agents have several advantages including an improved efficacy/safety ratio, a faster onset of action, shorter plasma half-life, few drug or food interactions, and no requirement for regular monitoring. Although very promising in many regards their proper use will require new approaches in many daily aspects with dose adjustments may be required for patients with severe renal impairment or in the setting of drug interactions. The lack of specific antidote makes reversing their effect during bleeding or for emergency surgery particularly a major challenge. This article provides a focused overview on their current status.</jats:p