Lack Of Need Research Articles

Modeling the one-dimensional inverse heat transfer problem using a Haar wavelet collocation approach

In this paper, a numerical method to solving the one-dimensional inverse heat transfer problem in Cartesian and Cylindrical coordinates, which is combination of the Haar wavelet collocation and Tikhonov regularization approach, has been used. The audit consisted in comparing the heat transfer in reality with numerical result as a noisy data, in order to identify errors of 1%–5% has been presented. In this study, the Haar functions, in addition to estimating the unknown functions, are also used to reduce output noises. Based on the obtained results, two main advantages of the repeated method have been proven, first, the precision of this method in estimating the unknown boundary condition and the second, processing speed due to the lack of need for wavelet functions to be collocated at low intervals. This suggested that this method, also has a high speed. According to the obtained results, it can be asserted that the present method by applying a small error in the input data, is preserved its stability.

Andexanet Alfa for Reversing Factor Xa Inhibition

The direct oral anticoagulants (DOACs) have gained popularity recently among both patients and providers for their comparable or better efficacy and safety profiles compared with warfarin and the lack of need for routine monitoring of anticoagulant effect. One obstacle for the more widespread use of the DOACs in clinical practice has been the lack of a reversal agent. Most DOACs act by directly binding to and inhibiting the effects of factor Xa. Andexanet alfa (Andexxa, Portola Pharmaceuticals, San Francisco, CA) is a modified form of factor Xa that acts as a decoy binding entity for DOACs, thereby allowing endogenous factor Xa to perform its normal clotting functions. Andexanet has proven efficacious in clinical trials for reversing the anticoagulant effects of apixaban, edoxaban, and rivaroxaban, although its impact on clinical outcomes has not been adequately studied. Andexanet has a boxed warning for thromboembolic risks, ischemic risks, cardiac arrest, and sudden death, with these adverse events occurring in up to 18% of patients in clinical trials. However, the occurrence of these adverse events needs to be considered in relation to the fragile nature of patients who receive this agent. Because the duration of the DOACs is much less than that of warfarin, it is unclear how many patients would actually need andexanet in clinical practice, because cessation of the DOAC may be all that is needed to effectively manage bleeding. Nonetheless, having andexanet available in cases of DOAC-associated severe or life-threatening bleeding represents a therapeutic advance and should provide an added level of comfort with the clinical use of DOACs.

Optimization of an isothermal recombinase polymerase amplification method for real-time detection of Potato virus Y O and N types in potato

Potato virus Y (PVY) is a global challenge for potato production and the leading cause of seed crop downgrading and rejection for certification. Accurate and timely diagnosis is key to effective control of PVY. Here we optimized the isothermal recombinase polymerase amplification (RPA) for accurate detection of different PVY O and N types that were tested, present in different tissues of potato plants including tubers with a primer set that specifically targets the highly conserved pipo region within the viral genome. Combined with a simplified preparation of the template by tissue homogenization, we established a rapid RPA procedure, which can allow real time detection in less than 10 min with a fluorescent probe. Specificity of the reaction was determined by the lack of cross-reactivity with other common potato viruses. Although RPA reagents remain more expensive than PCR reagents, RPA technology is equivalent in that results can be visualized by gel electrophoresis or with a fluorescent probe with greater sensitivity; and it is superior to the common PCR-based assay in its versatility, speed, and lack of need for a highly purified RNA template.

Demand and supply factors of iron-folic acid supplementation and its association with anaemia in North Indian pregnant women.

Anaemia prevalence in pregnant women of India declined from 57.9% to 50.3% from National Family Health Survey (NFHS)-3 to NFHS-4. However, over the course of that decade, the uptake of iron and folic acid (IFA) supplementation for 100 days of pregnancy improved by only 15%. To understand demand side risk factors of anaemia specifically related to IFA intake, an in-depth survey was conducted on pregnant women (n = 436) in 50 villages and wards of Sirohi district of Rajasthan, India. At the demand side, consistent IFA consumption in the previous trimester was inversely and strongly associated with anaemia (OR: 0.26, 95% CI: 0.12, 0.55). Reasons for inconsistent consumption included not registering to antenatal clinic, not receiving IFA tablets from the health worker and perceived lack of need. At the supply side, an analysis of IFA stock data at various levels of the health care (n = 168) providers from primary to tertiary levels showed that 14 out of 52 villages surveyed did not have access to IFA tablets. The closest availability of an IFA tablet for 16 villages, was more than 5 km away. To improve the uptake of IFA supplementation and thereby reduce iron deficiency anaemia in pregnant women, a constant supply of IFA at the village or sub-centre level, where frontline workers can promote uptake, should be ensured.

108. Adaptation of A Social Determinants of Health Screening And Referral Intervention For Adolescents

To develop a screening and referral intervention for adolescents with unmet needs in an urban adolescent primary care clinic, by adapting “WE CARE,” a previously validated pediatric primary care social determinants of health (SDH) intervention. The pediatric WE CARE screener, which screens for six adverse SDH (food insecurity, housing instability, lack of heat, lack of high school degree, lack of quality childcare, and unemployment) was used as an initial guide in our adaptation process. Adolescent providers and clinic social workers reviewed it and assessed whether questions were representative of the psychosocial challenges faced by their patients. In these discussions, we identified the need to screen for after school activities and to broaden the education screen to also include the college level; conversely, we found a lack of need to screen for child care. In total, six adverse SDH (food insecurity, housing instability, lack of after school activities, lack of heat, lack of high school degree or college enrollment, and unemployment) were selected. Available community resources were also identified by a multidisciplinary care team; information sheets for adolescents with needs were accessible via the EMR. To vet the adapted screener, we interviewed adolescent patients over the course of three days in the adolescent clinic waiting room. The interviews assessed the face validity of the screener and adolescents reviewed the screener for understandability, ease to complete, feasibility, and acceptability. Participants’ suggestions were incorporated into the final version. The study screener readability was at the third-grade level using the Flesh-Kincaid grade level formula. Overall, it took participants <2 minutes to complete the screener. The screener was then piloted with adolescents. During the 3 day interview period (n=27), 33% of adolescents reported at least one of the needs included in the WE CARE screener; 30% of adolescents also reported having a friend with at least one of those needs. The most common self-reported unmet needs were with food (22%) and housing (22%), followed by after school activities (19%), utilities (19), employment (15%), and education (3%). 100% of adolescents reported that the screener was easy or very easy to fill out. 89% reported that they felt somewhat comfortable, comfortable, or very comfortable filling it out. Lastly, 93% of adolescents reported that the screener was somewhat useful, useful, or very useful. The adaptation of the pediatric WE CARE screener to address the needs of adolescents in an urban clinic was feasible and acceptable. The adolescent WE CARE intervention identified patients’ unmet needs and requests for help with SDH.

Increasing throughput of manual microscopy of cell suspensions using solid medium pads

Microscopy of multiple samples using slides and coverslips is time consuming and good images are sometimes difficult to obtain due to cell movement. Our method involves manual spotting of multiple cell samples onto solid-medium pads, which creates the following benefits:•Rapid, high-quality imaging of multiple samples (hundreds per day) by visible and fluorescence microscopy.•No need for expensive automated equipment, multi-well plates or large amounts of consumables.•Wide range of working cell concentrations.The method was implemented for S. cerevisiae yeast, however it is likely to be applicable to all types of microorganisms and possibly other microscopic samples such as pollen. The lack of need for automated equipment may also make this method useful for field work.

290. Safety and Effectiveness of Oral Sodium Fusidate (Fusidic Acid) as Chronic Antibiotic Suppressive Therapy in Patients With Staphylococcal Bone or Joint Infections

BackgroundFusidic acid (FA) is an anti-staphylococcal agent used to treat chronic bone and joint infections (BJI) due to the availability of an oral formulation and its MRSA activity. Though used widely throughout the world for decades, FA is not approved in the USA.MethodsTo evaluate the safety and effectiveness of FA as chronic suppressive therapy in patients with staphylococcal BJI, we enrolled 30 patients in a prospective, single-arm, multi-center study in the USA. Eligible patients had refractory infections that could not be managed surgically and/or had not responded to previous antibiotic treatment. In Part A of the study, all patients received 6 months of oral FA treatment. In the first 1–2 weeks, patients could receive a companion antibiotic. Clinical success was based on lack of need for surgery or additional antibiotics. After all patients completed Part A of the study, an interim analysis was performed. In Part B of the study (ongoing), patients who completed Part A and require continued suppressive therapy may continue to receive FA for a total of 24 months.ResultsMost patients (83%) had orthopedic hardware infections. Therapy was considered successful at the 6-month visit in 18 patients (60%). Microbiological persistence was observed in eight patients, with three cases of decreasing FA susceptibility (including one case of resistance). Among 29 patients who experienced a treatment-emergent adverse event (TEAE), the most frequently reported events were: urinary tract infection (n = 9), peripheral edema/swelling (n = 8), nausea/dyspepsia (n = 7). Seven patients experienced TEAEs related to study drug; mild gastrointestinal disorders were most common. Two treatment-related events (unrelated to therapeutic failure) led to discontinuation of study drugConclusionPatients with refractory BJI have few treatment options. In our study, 60% of infections were effectively suppressed for 6 months with FA treatment. The frequency of TEAEs was high, though not unexpected in this population with many chronic diseases. FA was well-tolerated with few patients experiencing treatment-related AEs leading to study drug discontinuation. FA administered chronically as monotherapy may lead to decreasing susceptibility and treatment failure in some patients; thus, combination therapy is warranted for this indication.Disclosures A. Sheets, Melinta Therapeutics: Employee, Salary. D. Graham, Cempra: Grant Investigator, Research grant. R. Darouiche, Cempra: Grant Investigator, Grant recipient. A. Strayer, Melinta Therapeutics, Inc.: Employee and Shareholder, Salary.

Treatment of patients with acute and subacute dorsalgia

Objective: to investigate the efficiency of treatment for acute and subacute dorsalgia, by providing information to patients and by using nonsteroidal anti-inflammatory drugs (NSAIDs) without conducting physical therapy, reflexotherapy, and manual therapy. Patients and methods. A total of 140 patients (87 women and 53 men; mean age 50.7±17.6 years) with acute and subacute back pain were followed up. Out of them 127 (91%) patients were found to have nonspecific (musculoskeletal) pain; 13 (9%) had discogenic radiculopathy. All the patients were informed of the benign nature of the disease, the high probability of its rapid resolution, the feasibility of abandoning prolonged bedrest, and the lack of need for physical therapy, reflexotherapy, massage, and manual therapy. To reduce pain, the patients received meloxicam 15 mg/day orally or intramuscularly or first 15 mg/day intramuscularly and then orally. The investigators assessed pain intensity with the numerical rating scale and functional activity restrictions with the Roland-Morris disability (RMD) questionnaire. Results. After treatment, the visual analogue scale pain intensity scores decreased from an average of 6.4 to 1.0; the RMD scores dropped from 6.8 to 1.4 (p&lt;0.001). The duration of treatment averaged 11.0±4.4 days. Comparison of different meloxicam dosage regimens showed no significant differences; a positive result was noted in all cases. No adverse events were observed during treatment. Conclusion. The investigation has shown the high efficiency of management in patients with acute and subacute dorsalgia, by providing information to patients (an education conversation), by using meloxicam, and by applying a personalized approach (treatment for concomitant diseases and conditions). Refusing physiotherapy, massage, acupuncture, and manual therapy substantially reduces the cost of treatment in patients with acute dorsalgia.

Assessing the benefit of the 72-hour antibiotic therapy reassessment documentation

ObjectivesTo assess the documentation of the 72-hour antibiotic therapy reassessment in medical records. MethodsOne-day prevalence evaluation of curative antibiotic therapies≥72hours. The documentation of the reassessment was defined according to three criteria: (1) “clear” documentation (clinical or microbiological comment associated with a comment on the need to adjust the antibiotic therapy or on the lack of need); (2) “tacit” documentation (only based on a clinical or microbiological comment); (3) no documentation. ResultsWe assessed 114 antibiotic therapies in 26 hospital departments. A clear reassessment at 72hours was observed in only 45 (39%) records and 31 (27%) records had no reassessment. The planned duration of treatment was written in 63 (55%) records. At 72hours, among the 71 antibiotic therapies with a microbiological documentation, 69 (97%) were active and 44 (62%) had a narrow spectrum. Among the 48 antibiotic therapies with a broad spectrum on day 1, only 21 (44%) benefited from a de-escalation at 72hours. A clearly recorded reassessment at 72hours was associated with de-escalation (P=0.025) and the prescription of a planned duration of treatment was associated with antibiotic therapy compliance with local or national guidelines (P=0.018). ConclusionAlthough reassessment was observed in 73% of records, it was correctly recorded at 72hours in only 39% of cases. The documentation of the reassessment and the prescription of a planned duration were associated with a better quality of antibiotic prescription (de-escalation, compliance with guidelines) and are relevant indicators for monitoring the proper use of antibiotics.

Better Brand Management Through Design Thinking

The world is evolving fast, and in a global society that is developing at an astounding pace, borders of any kind are eliminated one at 0 a time. Moreover, the competition between companies is becoming fiercer and fiercer, so the differentiation of products and services has gradually turned into a real necessity. In this context, design thinking is one of the elements that is currently drawing new directions, often being associated with the innovation process and the gain of competitive advantages. Recent studies show that design principles applied at a strategic level, especially in the field of innovation, significantly increase its success rate. Design thinking focuses on obtaining solutions and is action oriented, providing all the necessary premises in order to discover new market needs and, moreover, to satisfy them. Another extremely important element in the current global context is brand, which gives the main points of differentiation for offers existing on the market. A correct and efficient management of the brand supports the creation of strong emotional relationships with consumers, bringing competitive advantages, especially by increasing their loyalty. As a result, brand management is an area of particular interest, and design thinking, together with innovation, can successfully support its specific actions, bringing with them the benefits of creativity, that translate into defining new concepts for attracting consumers and their trust. This article addresses aspects of design and design thinking, as elements that support a successful brand management, taking the tourism domain, which is currently the world's fastest growing industry, as a case study. The authors sought to study the connection between design, design thinking and brand management by correlating two studies, one of them conducted among consumers and the other one, among economic agents. Thus, questionnaires were addressed to consumers in order to identify their perception on design and design thinking, but also to economic agents in order to determine their actions in this regard. The way design and design thinking influences customers’ consumption behavior represents a starting point for building brand management strategies, indicating either the need to enhance their use or, on the contrary, the lack of need for design.

Development of intellectual and computer capital of enterprises in market conditions

The formation of the computer capital of an enterprise (PSC) occurs in the process of the development of intellectual capital (IC). The low level of IT development in most Ukrainian enterprises is due to the lack of need for these types of innovations. Unsuccessful projects are associated with a lack of changes in human and organizational capital, without which it is not possible to obtain positive results from the use of IT. The article was written based on the results of research and carried out in the laboratory "Modeling of economic processes in infrastructure sectors" of Kharkov National University of Radio Electronics commissioned by the Ministry of Energy of Ukraine in 2017-2018. The aim of the study is to prove the success of the development of the enterprise information system (COI) using intellectual and computer resources. As a research method, a mechanism of comparative analysis of indicators before the computer revolution and the formation of a modern information system of an enterprise was chosen. As the main conclusion in the conducted research it is possible to note the following. The formation of the CCP takes place over several years (from 3 to 5). To determine its value in human capital, it is necessary to develop approaches for the economic assessment of the knowledge of IT employees in the field of human capital. The paper proposes a methodology for the development of the intellectual and computer capital of an enterprise.

Patient experience of home and waiting room blood pressure measurement: a qualitative study of patients with recently diagnosed hypertension.

Out-of-office blood pressure (BP) measurement is advocated to confirm hypertension diagnosis. However, little is known about how primary care patients view and use such measurement. To investigate patient experience of out-of-office BP monitoring, particularly home and practice waiting room BP measurement, before, during, and after diagnosis. A cross-sectional, qualitative study with patients from two UK GP surgeries participating in a feasibility study of waiting room BP measurement. Interviewees were identified from recent additions to the practice hypertension register. Interviews were recorded, transcribed, and coded thematically. Of 29 interviewees, 9 (31%) and 22 (76%) had used the waiting room monitor and/or monitored at home respectively. Out-of-office monitoring was used by patients as evidence of control or the lack of need for medication, with the printed results slips from the waiting room monitor perceived to improve 'trustworthiness'. The waiting room monitor enabled those experiencing uncertainty about their equipment or technique to double-check readings. Monitoring at home allowed a more intensive and/or flexible schedule to investigate BP fluctuations and the impact of medication and lifestyle changes. A minority used self-monitoring to inform drug holidays. Reduced intensity of monitoring was reported with both modalities following diagnosis as initial anxiety or patient and GP interest decreased. Home and practice waiting room measurements have overlapping but differing roles for patients. Waiting room BP monitors may be a useful out-of-office measurement modality for patients unwilling and/or unable to measure and record their BP at home.

Reflexões sobre a política nacional de formação de professores a distância e o enfraquecimento da EaD pública pela Universidade Aberta do Brasil (UAB)

Este artigo tem como objetivo discutir a nova política de formação de professores implementada pelo Ministério da Educação em 2017, a opção pela Educação a Distância (EaD) como fomentadora da formação inicial de professores e de que forma essas escolhas reverberam no enfraquecimento da Educação a Distância pública por meio da continuidade do programa educacional denominado sistema Universidade Aberta do Brasil (UAB). Apresentamos análises acerca da situação em que se encontra o campo profissional da docência, bem como problematizamos a pouca necessidade de se formar mais profissionais por meio de programas específicos, sem que hajam políticas de fortalecimento profissional da categoria. Por fim, problematizamos como a manutenção da UAB é responsável por fragilizar e dificultar o desenvolvimento e consolidação da EaD como modalidade regular do ponto de vista acadêmico e financeiro nas instituições públicas federais de ensino superior. Por fim, indicamos o fim do programa UAB como condição necessária para que se possa desenvolver uma EaD pública em condições semelhantes à educação presencial.

Experience of neuronet diagnosis and prediction of peptic ulcer disease by results of risk factors’ analysis

Aim. To develop and verify a method for diagnosis of peptic ulcer based on neural network analysis of data on patients’ risk factors. Materials and methods. This article presents the results of a study based on materials on risk factors of 488 patients. The data was analyzed using internally developed artificial neural network (Certificate of State Registration of Program for Computers (RU) no. 2017613090). The results of the study. The proposed approach demonstrated the levels of sensitivity of 74.4%, m = 4.3 and specificity of 93.3%, m = 2.46 during clinical testing. The prediction of the age of probable hospitalization ensured the generation of an array of data for which the Mean Absolute Error (MAE) of the prognosis was 1.8 years, m = 0.11 in the training set and 1.9 years, m = 0.15 in the clinical testing set. The maximum of absolute prognosis error in the clinical testing set did not exceed 2.2 at p = 0.95 and 2.3 years at p = 0.99. Conclusion. A new method is proposed for diagnosis of peptic ulcer based on a neural network analysis of data on patients’ risk factors. During clinical testing of the model, this approach demonstrated Area Under the Curve (AUC) levels reaching 0.943. The use of the artificial neural network also made it possible to predict the age of probable hospitalization. The use of the neural network demonstrated additional advantages including: non-invasiveness, the lack of need to prepare the patient for the study and the possibility to obtain results immediately after the onset of the disease without a time delay for sample processing.

Participation of farm women of Assam in cultivation of rice and problems faced by them

Women are the backbone of agricultural workforce also and make essential contributions to the agricultural and rural economies in all developing countries. Compared to men, farm women are generally involved in a wider range in crops, livestock and agro-based activities. Women are usually employed in most difficult field operations like sowing, transplanting, weeding, intercultural operations, harvesting, threshing and agro- processing. Though women plays an active part in agricultural activities but they faced lots of constrains. Thus, the present study was conducted to find out participation of farm women of Assam in cultivation of rice and problem faced by them with the following objectives to find out the background characteristic of farm women, to study the participation of farm women in cultivation of rice and to determine the problems faced by the farm women in cultivation of rice. The study was conducted in six districts of Assam. A purposive cum simple random sampling technique was adopted for selecting the respective samples for the study. Altogether 1500 farm women were selected for the present study. Data were collected personally by interview method. The findings reveals that more than fifty per cent of farm women contributed labour independently in areas such as cleaning (55.17%), transplanting (55.08%), harvesting (54.75%), winnowing (51.08%) and drying of grain (50.16%). And the problem faced by the farm women in cultivation of rice were lack of knowledge on plant protection ranked I followed by lack of irrigation facility ranked II, and lack of need based training ranked III.

Increased differentiation between individuals, but no genetic isolation from adjacent rural individuals in an urban red squirrel population

Whether or not individuals in cities and adjacent rural areas form separate populations depends on the origin of urbanized individuals. The rural individuals may have simply gradually invaded the city. Alternatively, the urbanization depended on arrival of individuals with specific adaptations for city life. A population within the city could also remain separated from adjacent rural populations if there are physical or behavioural dispersal barriers lowering the possibility of genetic exchange between individuals. All this is linked to dispersal behaviour of the species as gene flow is determined by distances moved during dispersal. In this study, we used microsatellite markers to evaluate whether or not Eurasian red squirrel (Sciurus vulgaris) individuals in an urban environment are genetically separated from their sub-urban/rural counterparts. Using radio-telemetry, we also studied natal dispersal distances of urban red squirrels to evaluate the potential for gene flow within the city. We observed no indication that urban squirrels had been genetically isolated from rural squirrels. In addition, increased amount of built area did not explain differentiation between urban individuals, further indicating that there were no barriers restricting movement. Still, the genetic differentiation within the city was increased and natal dispersal distances relatively short, perhaps indicating lack of need to move long distances in the urban environment. We conclude that urban and adjacent rural squirrels were part of the same larger population with gene flow in and out from the city. Yet, urbanization was related to increased genetic differentiation, indicating different spatial genetic structure in urban and rural populations.

Independent predictors of survival after traumatic atlanto-occipital dissociation.

Atlanto-occipital dissociation (AOD) occurs when the skull base is forcibly separated from the vertebral column. Existing literature on AOD is sparse and risk factors for mortality are unknown. This study determined independent predictors of survival after AOD. Patients who sustained AOD were identified from the National Trauma Data Bank (2007-2014). Those arriving without signs of life or with missing mortality data were excluded. Study groups were defined as patients who survived to hospital discharge versus patients who died in hospital. Demographics, injury data, interventions, and outcomes were compared between groups using univariate analysis. Multivariate logistic regression was used to determine independent predictors of survival. After applying exclusion criteria, 1,489 patients (<1% of National Trauma Data Bank) were identified. Median age was 37 years (interquartile range [IQR), 20-59 years], and 59% of patients were male. Atlanto-occipital dissociation occurred almost exclusively after blunt mechanisms (97%), most commonly motor vehicle collisions (66%). Median injury severity score (ISS) was 25 (IQR, 10-36), with 22% mortality. Median time to death was 1,358 minutes (IQR, 281-4,451 minutes), approximately 23 hours. Independent predictors of survival were higher Glasgow Coma Scale score on admission (p < 0.001), lower ISS (p = 0.011), lower Abbreviated Injury Scale score for the head (p = 0.001), and the lack of need for exploratory laparotomy (p < 0.001). Time to neurosurgical intervention of the spine was not predictive of survival (p > 0.05). Patients who survived had a median hospital length of stay of 5 days (IQR, 1-14 days) and intensive care unit length of stay of 1 day (IQR, 0-7 days). The most common discharge destination was home (n = 393 [34%]). Traumatic AOD is not uniformly fatal, with 78% of patients who arrive alive to hospital surviving to discharge. When death occurs, it is typically within the first 23 hours. Lower ISS and higher Glasgow Coma Scale score on admission independently predict survival, while time to neurosurgical intervention does not. Survivors have a short hospital stay and are commonly discharged home. This study suggests that AOD among patients who arrive alive to hospital may not be as devastating as previously considered. Progonostic/Epidemiological, level III; Therapeutic, level IV.

Facilitators of and Barriers to mHealth Adoption in Older Adults With Heart Failure.

The purpose of this descriptive, exploratory study was to assess the perceptions of older adults with heart failure regarding the use of mobile technology and to identify potential facilitators of and barriers to mHealth adoption. Semistructured interviews were used to collect data. Transcripts were analyzed using qualitative content analysis. The findings indicated that older adults do not base their intention to use mHealth solely on perceived ease of use and perceived usefulness, as outlined in the Technology Acceptance Model. The following themes emerged from the content analysis: facilitators included previous experience with mobile technology, willingness to learn mHealth, ease of use, presence of useful features, adequate training, free equipment, and doctor's recommendation; barriers included lack of knowledge regarding how to use mHealth, decreased sensory perception, lack of need for technology, poorly designed interface, cost of technology, and limited/fixed income. Overall, the findings suggest that older adults are willing to use mobile health technology, albeit with reservations. Future researchers who seek to implement mHealth-based interventions should address person-related, technology-related, and contextual barriers, and simultaneously capitalize on the influence of potential facilitators, such as a physician's recommendation, to promote mHealth adoption.

HYDRODYNAMIC THERMOIONIC SOURCE OF SPACECRAFT RADIO-ELECTRONIC SYSTEMS POWER SUPPLY

Actual problem of modern equipment is the electricity supply of radio-electronic systems of remote sensing of Earth of the spacecrafts and complexes functioning in difficult weather conditions, for example, in the Arctic or in case of emergency situation when it is necessary to give signal «about need of the help». Data on the hydrodynamic thermal electron emission converter (HTEEC) developed in Baltic State Technical University VOENMEH, and also on option of its laboratory sample (LS) are provided in the present article. The HTEEC device is that in active zone HTEEC the current of flows of weakly ionized plasma (FWIP) with high speeds will be organized (0,5-7 km/s and above). It allows to have working surfaces of the cathode and GITEP anode at distances much more than sizes, characteristic of classical TEC, in 0,3-0,5 mm. Thus reliability of HTEEC due to lack of need of maintenance of fine-line spacing and minimizing of negative effects of change of form of active surface of the cathode increases. The laboratory sample is intended for carrying out complex pilot studies of the HTEEC device for two types of propulsive masses -combustion products of organic fuel and inert gases with additives of alkaline metals. Results of the real research have found the reflection when working on the subject «Geksapod» which is carried out to Baltic State Technical University VOENMEH. Field of application of such converters is independent power sources of the Arctic vehicles functioning on the basis of organic fuel and spacecrafts of radio-electronic remote sensing of Earth with superlong life.

Willingness to be Reinitiated on a Statin (from the REasons for Geographic and Racial Differences in Stroke Study)

Guidelines recommend attempting to reinitiate statins in patients who discontinue treatment. Previous experiences while taking a statin, including side effects, may reduce a patient's willingness to reinitiate treatment. We determined the percentage of adults who are willing to reinitiate statin therapy after treatment discontinuation. Factors associated with willingness to reinitiate a statin were also examined. A statin questionnaire was administered and study examination conducted in black and white US adults enrolled in the nationwide REasons for Geographic And Racial Differences in Stroke study from 2013 to 2017. In participants who self-reported ever having taken a statin (n = 7,216, mean age 72 years, 53% women, 34% black), 1,081 (15%) reported having discontinued treatment. Among those who discontinued treatment, statin side effects, perceived lack of need for a statin, and cost were reported by 66%, 31%, and 3% of participants, respectively. Overall, 37% of participants who had discontinued treatment were willing to reinitiate statin therapy. Participants who discontinued treatment due to cost (prevalence ratio [PR] 1.61; 95% confidence interval (CI) 1.01, 2.57) were more likely to report a willingness to reinitiate therapy. Participants with a low-density lipoprotein-cholesterol ≥130 mg/dl versus <100 mg/dl (PR 0.69; 95% CI 0.53, 0. 88) and who discontinued treatment due to side effects (PR 0.51; 95% CI 0.41, 0.64) were less likely to report willingness to reinitiate statin therapy. In conclusion, a substantial proportion of participants who discontinued statin therapy were willing to reinitiate treatment. Healthcare providers should discuss reinitiation of statin therapy with their patients who have discontinued treatment.