Occurrence Of Shock Research Articles

Effects of imparted Coulomb stress changes in the seismicity and cluster of the December 2017 Hojedk (SE Iran) triplet

The Hojedk area in the southeastern Iran experienced three earthquakes during 12 days in December 2017. These events occurred in proximity to a region that has experienced several moderate and large events in the past. In this paper, the role of Coulomb stress changes in occurrence of the Hojedk cluster was investigated, and also the produced stress changes due to these events on the surrounding and optimally oriented faults was calculated. Previous earthquakes (events in the Golbaf–Sirch region, the Shahdad slip, and the Dahuiyeh–Zarand earthquake) imparted positive stress changes on the fault planes of the Hojedk earthquakes, especially on the ruptured plane of the first main shock. The Hojedk first main shock triggered the second one by imparting maximum stress changes of about 11.7 MPa on the fault plane of this event, and these two events brought the third main shock to failure by producing more than 6.0 MPa stress changes on its ruptured plane. Among the major active faults in the surrounding area, the middle part of the Nayband fault, northern part of the Golbaf–Sirch fault, and southern part of the Kuhbanan fault received positive stress changes and southen parts of the Ravar and all parts of the Chatrud faults received negative stress changes due to the Hojedk earthquakes. Furthermore, our results for correlation between Coulomb stress changes and seismicity distribution showed that following the Dahuiyeh–Zarand earthquake, the majority of the seismicity located on the positive stress area and Coulomb stress changes have a controlling role on the spatial distribution of seismicity even after a decade. The occurrence of the Hojedk first main shock affects the spatial distribution of aftershocks until the occurrence of the next main hocks. By triggering the next one, the stress patterns change in the area, and seismicity follows from the stress patterns of the last event.

Developing a set of measures to provide maximum hydraulic efficiency of gas gathering pipelines

Purpose: The purposes of this article are to study the effective ways of increasing the hydraulic efficiency of gas gathering pipelines of the Yuliivskyi oil and gas condensate production facility (OGCPF); to calculate the operation efficiency of gas gathering pipelines of the Yuliivskyi OGCPF and develop a set of measures to monitor their condition and improve their hydraulic characteristics; to investigate the technology of cleaning the inner cavity of flowlines of gas-condensate wells with foam, to perform the feasibility study on the prospects of its application in practice. Design/methodology/approach: The technology of cleaning the inner cavity of flowlines of gas-condensate wells with foam was investigated to objectively evaluate its application and determine the effectiveness of this measure. The research was carried out within the framework of research and development work by the specialists of the Ukrainian Scientific Research Institute of Natural Gases. Findings: The results of production studies showed that due to cleaning the flowlines of gas-condensate wells (No.85 and No.60) from the accumulation of liquid, the coefficients of their hydraulic efficiency increased by 12% and 7%, respectively. Measures taken to clean the inner cavity of the flowlines from liquid have proven their efficiency and can be recommended for other flowlines of wells at other production fields. Research limitations/implications: Based on the characteristics of gas gathering pipelines, it is reasonable to conduct experimental studies on the use of the proposed technology of cleaning the inner cavity with foam in the case of increasing its multiplicity. Practical implications: Using the wells of the Yuliivske oil and gas condensate field as case studies, the operating parameters were measured and the pressure losses along the length of the flowlines were calculated. According to the results of calculations at two wells (No.85 and No.60), a significant excess of the actual value of the flow friction characteristic over the theoretical value was established. To reduce excessive pressure losses due to the presence of liquid and improve the hydraulic characteristics of the wells, their inner cavities were cleaned using foam with the expansion ratio from 40 to 100. Originality/value: It is important to note that the advantages of foam piston include: ease of use, no occurrence of hydraulic shocks and preventing stuck during movement in the gas pipeline, application in both straight and inclined sections, no wear of the elements of the cleaning equipment, a rather efficient cleaning of gas pipelines.

Design of a Laboratory Electro-hydraulic Installation for Water Disinfection

Electrohydraulic effect is used in various fields of industry and agriculture: for cleaning metal casting forms, cleaning pipes of power boilers, treatment of heating radiators, soil treatment and water disinfection. Existing technical means for water disinfection with high-voltage discharges are expensive, cumbersome and untransportable. Currently used installations use an operating voltage of 10-50 kilovolts, capacitors designed for a voltage of no more than 100 kilovolts, with a capacity of 0.025 microfarads. Water disinfection according to the conducted research can be carried out with a voltage of 10 kilovolts. (Research purpose) The research purpose is in developing and manufacturing a laboratory electrohydraulic installation for water disinfection, which has a technical novelty in terms of mobility and compactness for implementing a method of water disinfection at a voltage of no more than 10 kilovolts. (Materials and methods) During the research, next materials, equipment and devices were used: power supply; transformer; capacitor; forming gap; working body; shunt resistance. (Results and discussion) The principle of the electrohydraulic effect, which is a consequence of the occurrence of electrohydraulic shocks between high-voltage electrodes placed in a liquid, is the basis for the development and manufacture of the installation. Authors developed a structural diagram of a laboratory electrohydraulic unit for water disinfection. The article presents an experimental sample of a laboratory installation for water disinfection, which has a technical novelty in terms of mobility and compactness for implementing a method for water disinfection at a voltage of no more than 10 kilovolts. The installation consists of a power supply unit FA-5-1/300W, a high-voltage step-up transformer TDKS32-04, a capacitor K75-29A (16 kilovolts, 1 microfarad), forming a gap of metal balls with a diameter of 18 millimeters, a plastic working body made of ABS material, a shunt resistance of 1 kilohm. (Conclusions) They article shows the scientific and practical significance of the research results: a technical means for water disinfection, providing the possibility of conducting experimental laboratory studies of the electrohydraulic effect at a voltage of no more than 10 kilovolts.

Civil society, natural resources and dictatorship

ABSTRACT Resource-rich dictatorships are more inclined to repress civil society than others. In this paper, we analyze the collapse and persistence of authoritarian regimes in terms of oil price shocks and the organizational density of civil society. This organizational density indicates the ability of citizens to credibly threaten the dictator with a revolution and therefore induce regime change. In the civil society protest game, regime change becomes likely in the occurrence of a negative oil price shock, whereas a positive oil shock increases the extractive capacity of the dictator, thus preserving the authoritarian status quo. In the civil society persecution game, repression of failed revolutionaries can avert revolution if a negative oil price shock occurs and the organizational density of civil society is low ex-ante. Historical and contemporary illustrations are drawn from Iran and Russia, respectively.

Seeds of Life in Space (SOLIS). IX. Chemical Segregation of SO2 and SO toward the Low-mass Protostellar Shocked Region of L1157

Abstract We present observations of SO and SO2 lines toward the shocked regions along the L1157 chemically rich outflow, taken in the context of the Seeds of Life in Space IRAM Northern Extended Millimeter Array Large Program, and supported by data from the Submillimeter Array and IRAM-30 m telescope at 1.1–3.6 mm wavelengths. We simultaneously analyze, for the first time, all of the brightest shocks in the blueshifted lobe, namely, B0, B1, and B2. We found the following. (1) SO and SO2 may trace different gas, given that the large(-scale) velocity gradient analysis indicates for SO2 a volume density ( ) denser than that of the gas emitting in SO by a factor up to an order of magnitude. (2) Investigating the 0.1 pc scale field of view, we note a tentative gradient along the path of the precessing jet. More specifically, decreases from the B0–B1 shocks to the older B2. (3) At a linear resolution of 500–1400 au, a tentative spatial displacement between the two emitting molecules is detected, with the SO peak closer (with respect to SO2) to the position where the recent jet is impinging on the B1 cavity wall. Our astrochemical modeling shows that the SO and SO2 abundances evolve on timescales less than about 1000 years. Furthermore, the modeling requires high abundances (2 × 10−6) of both and S/H injected in the gas phase due to the shock occurrence, so prefrozen OCS only is not enough to reproduce our new observations.

Predictors of Subcutaneous Implantable Cardioverter-Defibrillator Shocks and Prognostic Impact in Patients With Structural Heart Disease

BackgroundIn this study we aimed to assess long-term outcomes in subcutaneous implantable cardioverter-defibrillator (S-ICD) recipients with structural heart disease by focussing especially on shock incidence, predictors, and associated prognoses. MethodsIn this multicenter registry‒based study, we retrospectively included all patients who underwent S-ICD implantation at 3 tertiary centers. The prognostic impact of S-ICD shock was assessed with a composite outcome that included all-cause death and hospitalisation for heart failure. ResultsA total of 351 patients with underlying cardiomyopathy were included in the investigation. Using multivariable Fine and Gray regression models, secondary prevention, left ventricular ejection fraction (LVEF), conditional shock threshold, and QRS duration appeared to be independent predictors of appropriate S-ICD shock occurrence. In the multivariate Cox regression model adjusted for age, baseline LVEF, underlying cardiomyopathy subtype, New York Heart Association class, and appropriate shocks were significantly associated with increased composite prognostic outcome risk (hazard ratio [HR], 2.61; 95% confidence interval [CI], 1.21-5.65; P = 0.014), whereas inappropriate shocks were not (HR, 1.35; 95% CI, 0.75-4.48; P = 0.18). The analysis of each component of the composite prognostic outcome highlighted that the occurrence of appropriate shocks was associated with an increased risk of hospitalisation for heart failure (HR, 3.10; 95% CI, 1.26-7.58; P = 0.013) and a trend for mortality (HR, 2.19; 95% CI, 0.78-6.16; P = 0.14). ConclusionsAppropriate S-ICD shocks were associated with a 3-fold increase in acute heart failure admission, whereas inappropriate shocks were not. Conditional shock threshold programming is an independent predictor of S-ICD shock, and its prognostic impact should be investigated further in patients with structural heart disease.

Inappropriate implantable cardioverter-defibrillator shocks in repaired tetralogy of fallot patients: Prevalence and electrophysiological mechanisms

BackgroundPatients with Tetralogy of Fallot (TOF) are at increased risk for sudden cardiac death, often undergo implantable cardioverter defibrillator (ICD) implantation at younger ages, and are at greater risk of experiencing inappropriate shocks. We investigated occurrences of ICD shocks in TOF patients to identify prevalence, characteristics associated with inappropriate shocks, and therapeutic interventions after inappropriate shocks. MethodsRecords of patients with repaired TOF and ICD implantation who were followed at Columbia University Irving Medical Center between 1/1/2000 and 5/1/2019 were analyzed. Results44 patients with repaired TOF and ICD implantation were reviewed. Mean age at implantation was 39 ± 13 years. Eight (18%) patients received both appropriate and inappropriate shocks, 6 (14%) received only appropriate shocks, and 3 (7%) received only inappropriate shocks. Three patients received inappropriate shocks for sinus tachycardia, 7 for atrial arrhythmias, and 1 for noise artifact. Inappropriately shocked patients had lower beat per minute (bpm) cutoff values for ICD therapy (mean = 162 ± 24 bpm vs. 182 ± 16 bpm, p = 0.007). After inappropriate shocks, 1 patient underwent lead replacement, 1 had the VT cutoff increased, and 6 were treated with medications. ConclusionsOne quarter of TOF patients with ICDs experienced inappropriate shock therapy, the timing of which was most often clustered within the first two years after implant or years later. Lower shock therapy zones were associated with increased risk for inappropriate shocks, and the majority of inappropriate shocks resulted from atrial arrhythmias with rapid ventricular response. Treatments for inappropriate shocks included increasing VT therapy bpm and rhythm and/or rate control medications.

Monitoring of zero-inflated binomial processes with a DEWMA control chart

Control charts are widely used for monitoring quality characteristics of high-yield processes. In such processes where a large number of zero observations exists in count data, the zero-inflated binomial (ZIB) models are more appropriate than the ordinary binomial models. In ZIB models, random shocks occur with probability θ, and upon the occurrence of random shocks, the number of non-conforming items in a sample of size n follows the binomial distribution with proportion p. In the present article, we study in more detail the exponentially weighted moving average control chart based on ZIB distribution (ZIB-EWMA) and we also propose a new control chart based on the double exponentially weighted moving average statistic for monitoring ZIB data (ZIB-DEWMA). The two control charts are studied in detecting upward shifts in θ or p individually, as well as in both parameters simultaneously. Through a simulation study, we compare the performance of the proposed chart with the ZIB-Shewhart, ZIB-EWMA and ZIB-CUSUM charts. Finally, an illustrative example is also presented to display the practical application of the ZIB charts.

Estradiol Modulates Neural and Behavioral Arousal in Women With Posttraumatic Stress Disorder During a Fear Learning and Extinction Task

BackgroundFear responding in posttraumatic stress disorder (PTSD) is sexually heterogeneous and varies with hormonal fluctuations throughout the menstrual cycle. While research suggests that estrogen levels affect PTSD symptoms among women, there is a dearth of research on modulatory effects of estrogen on fear responding among women with PTSD, and neural outcome measures are lacking. MethodsA sample of 42 women with PTSD underwent 2 consecutive alternating blocks of fear conditioning and extinction training, during which a CS+ conditioned stimulus, but not a CS−, predicted the occurrence of an electric shock in an acquisition context but not in an extinction context. Assayed saliva determined estradiol levels. Skin conductance response and whole-brain voxelwise activity during functional magnetic resonance imaging were outcome variables in linear mixed-effects models, with estradiol level, PTSD severity, and task contrasts as predictors. ResultsSkin conductance response exhibited a significant estradiol × PTSD severity × habituation interaction (t = 3.180, p = .002), such that PTSD severity was correlated with increased arousal responding between training blocks among women with lower estradiol (t = −3.985, p < .001) but not higher estradiol (t = 0.550, p = .583). Voxelwise activity also demonstrated an identical three-way interaction within dorsomedial prefrontal cortex and anterior insula clusters. The skin conductance response and imaging interactions between PTSD severity and estradiol were not specific to conditioned stimulus type or context. ConclusionsEstradiol moderated the relationship between PTSD severity and arousal response habituation between fear conditioning and extinction training sessions, such that high estradiol protected against the negative impact of severe PTSD symptoms on fear habituation. These findings suggest that estrogen enhances habituation among women with severe PTSD, potentially influencing the efficacy of extinction-based therapies.

Investigation of earthquake recurrence networks: the cases of 2014 and 2015 aftershock sequences in Ionian Islands, Greece

The investigation of earthquake recurrence networks that were constructed from two aftershock sequences in Greece, is performed, aiming to detect whether the structure of networks became distinct (non-random) before the occurrence of either the main shock or a major (strong) aftershock. The network nodes are the time series observations, which are the aftershocks magnitudes. Their binary connections are given by the arbitrary threshold $$\varepsilon$$ on the recurrence matrix, which is computed with the Heaviside function. Two aftershock sequences are the 2014 Kefalonia doublet, main shocks ( $$M = 6.1$$ and $$M = 6.0$$ ), and the 2015 Lefkada main shock ( $$M = 6.5$$ ) sequence. The earthquake networks are formed for three different thresholds of $$\varepsilon$$ , for monitoring eight basic network measures and non-trivial properties such as the small world and scale free, and examining their structure during the evolution of the sequences. To assess whether the values of the eight network measures are statistically significant and the network gets non-trivial properties are present, the construction of randomized networks is required and then the comparison of the randomized network values with the ones from the original recurrence networks. The monitoring of network measures reveals that their original values diverge from the statistical significance, i.e., the structure of networks is random, immediately after the main shocks and shortly before the occurrence of the strongest aftershocks. On the contrary, in the intervening time, between the occurrences of main shocks and strongest aftershocks, their original values are statistically significant, which means that reveal the distinct network structure. The small-world and scale-free properties are sought but not revealed.

Metoda symulacyjna oceny niezawodności złożonego systemu podlegającego procesom degradacji stochastycznej i narażonego na obciążenia losowe

Many systems are affected by different random factors and stochastic processes, significantly complicating their reliability analysis. In general, the performance of complicated systems may gradually, suddenly, or continuously be downgraded over times from perfect functioning to breakdown states or may be affected by unexpected shocks. In the literature, analytic reliability assessment examined for especial cases is restricted to applying the Exponential, Gamma, compound Poisson, and Wiener degradation processes. Consideration of the effect of non-fatal soft shock makes such assessment more challenging which has remained a research gap for general degraded stochastic processes. Through the current article, for preventing complexity of analytic calculations, we have focused on applying a simulating approach for generalization. The proposed model embeds both the stochastic degradation process as well randomly occurred shocks for two states, multi-state, and continuous degradation. Here, the user can arbitrarily set the time to failure distribution, stochastic degradation, and time to occurrence shock density function as well its severity. In order to present the validity and applicability, two case studies in a sugar plant alongside an example derived from the literature are examined. In the first case study, the simulation overestimated the system reliability by less than 5%. Also, the comparison revealed no significant difference between the analytic and the simulation result in an example taken from an article. Finally, the reliability of a complicated crystallizer system embedding both degradation and soft shock occurrence was examined in a threecomponent standby system.

Computing sunspot solutions to rational expectations models with timing restrictions

Abstract Rational expectations (RE) frameworks featuring informational constraints are becoming increasingly popular in macroeconomic research. A recent strand of literature has explored the analytics of RE models with informational subperiods, in which the occurrence of exogenous shocks is period-specific and decision makers condition their own choices and expectations upon a sequence of nested information sets (timing restrictions). Assuming the unrestricted (full information) RE model satisfies saddle-path stability, this paper provides (i) necessary and sufficient conditions for existence of an uncountably infinite set of linearly perturbed solutions to its restricted (informationally constrained) counterpart, and (ii) an algorithm for computing the full set of sunspot solutions when equilibrium indeterminacy occurs.

EMERGEncy versus delayed coronary angiogram in survivors of out-of-hospital cardiac arrest with no obvious non-cardiac cause of arrest: Design of the EMERGE trial

In adults, the most common cause of out-of-hospital cardiac arrests (OHCA) is acute coronary artery occlusion. If an immediate coronary angiogram (CAG) is recommended for survivors presenting a ST segment elevation on the electrocardiogram (ECG) performed after resuscitation, there is still a debate regarding the best strategy in patients without ST segment elevation. Performing an immediate CAG after an OHCA without ST segment elevation on the post-resuscitation ECG and no obvious non-cardiac cause of arrest could lead to a better 180-day survival rate with no or minimal neurological sequel as compared with a delayed CAG performed 48 to 96 hours after the arrest. The EMERGE trial is a prospective national, randomized, open and parallel group trial, in which 970 survivors of OHCA will be randomized (1:1) to either immediate (as soon as possible after return of spontaneous circulation) or delayed (48 to 96 h) CAG. Participants will be OHCA patients with no ST segment elevation on the post resuscitation ECG and no obvious non-cardiac cause of arrest. The primary endpoint of the study is the 180-day survival rate with no or minimal neurological sequel corresponding to Cerebral Performance Category (CPC) 1 or 2. The secondary endpoints are: occurrence of shock during the first 48 hours, ventricular tachycardia and/or fibrillation during the first 48 hours, change in left ventricular ejection fraction between baseline and 180 days assessed by echocardiogram, neurological status evaluated by the CPC score at intensive care unit (ICU) discharge and day 90 neurological status assessed by the Glasgow Outcome Scale Extended score (GOSE) at 90 and 180 days, overall survival rate, and hospital length of stay. The EMERGE trial is a prospective, multicenter, randomized, controlled trial that will assess the 180-day survival rate with no or minimal neurologic sequel in patients resuscitated from an OHCA without ST segment elevation and who will be managed with either immediate or delayed CAG.

Cost of Living and Standard of Living Nexus: The Determinants of Cost of Living

This research aims to analyze the impact of capping policy on the credit growth in the banking sector and the potential risk of insolvency. We use the dynamic panel data method on Indonesian data over January 2006 - November 2018. The results shows that monetary policy through reference interest rate (BI Rate) maintains the rate stability under normal conditions. However, in a state of shock, it shows that the policy was no longer effective in reducing the interest rate that deviates market far above the BI Rate. Therefore, a more ‘repressive’ policy is needed for the economy to continue to grow. Furthermore, the results show a policy mix between macroprudential (Central Bank) and micro-prudential (Financial Services Authority) authorities through the interaction between the BI Rate and capping. This is effective for maintaining interest stability in supporting target credit growth and minimizing risk of insolvency. The results also show that the direct interaction between macroprudential regulation and micro-prudential policy contribute to reducing the occurrence of credit shocks. Therefore, the coordination mechanism between BI and Financial Services Authority in determining interest rates needs to be regulated in a ‘rigid’ manner, in order to create synergies between monetary targets and macroeconomic conditions.

Discussion on the relationship between construction safety accident and time based on the correspondence analysis model

Based on the correspondence analysis model and the method of mining the cause and time of construction accidents. Using Python crawler technology to crawl 3896 data of the causes of construction safety accidents in China Construction Safety Supervision Information System from 2012 to 2018, a contingency table of various types and times of accidents in construction safety accidents was established. By using factor analysis, the relationship between Q-factor analysis and R-factor analysis in the corresponding factor analysis model was established. The model was analyzed and optimized by a special point removal method, and the convergence of the model was strengthened. Finally, the causes of construction safety accidents in the model and the time of one day and one year were calculated and drawn in the corresponding analysis chart of the two-dimensional model. Mining the relationship between them according to their relationship in the graph based on the data collection of 3896 building safety line accidents, this paper put forward the method of mining the main causes of accidents, and used SPSS platform technology to mine the accident data. The results showed that the occurrence of electric shock and drowning was closely related to August, fire and explosion were closely related to February, and poisoning and asphyxiation were closely related to January. 5-6 a.m. was closely related to fire and explosion, and vehicle injury was closely related to 8-9 p.m. To put forward prevention suggestions for construction accident prevention.

Economic dependence of rural households on the riparian zones in Burkina Faso

This study aims to quantitatively examine the economic dependence of rural households on riparian zones. Data were collected from 536 households across 8 villages in the Dissin area, Burkina Faso. Descriptive statistics were used to analyse the data collected, while ordinary least squares analytical procedure was used to determine the parameter estimates of riparian income and economic dependence. The economic dependence of both very-low and high-income households is relatively low at 35.53% and 26.39%, respectively. Low-income and middle-income households have higher economic dependencies of 67.21% and 65.73%, respectively. In addition, the factors that contribute to the economic dependence are related to sex, the proximity of the riparian zone, the occurrence of negative idiosyncratic shocks, and the increased importance of other sources of income. In addition, when the riparian income is excluded, the Gini coefficient increases from 0.35 to 0.56, and the incidence of poverty increases from 40.2% to 75.4%.

Combined Detection of Serum Heat Shock Protein-90&amp;lt;i&amp;gt;α&amp;lt;/i&amp;gt; and Prostate Specific Antigen for Prostate Cancer Diagnosis

Objective: To explore the relationship between heat shock protein-90α (HSP-90α) and occurrence of prostate cancer, and clinical value of combined detection of serum HSP-90α and prostate specific antigen (PSA) in the diagnosis of prostate cancer. Method: A total of 30 patients with prostate cancer, 30 patients with benign prostatic hyperplasia (BPH) and 30 healthy men (control group) were selected from September 2018 to September 2019, then to detect levels of serum HSP-90α, total PSA and free PSA (FPSA) by ELISA, serum testosterone level by radioimmunoassay, prostate cancer tissue was removed by operation, and relative expression of tissue HSP-90α protein by Western blot. Results: The levels of serum HSP-90α and total PSA in prostate cancer group were significantly higher than other two groups, and testosterone level was lower than other two groups (P 0.05). It was found by Pearson test that serum HSP-90α was positively correlated with total PSA level (r = 0.659, P = 0.005), while negatively correlated with testosterone level (r = -0.549, P = 0.006). According to TNM stage of prostate cancer, there were 17 cases of stage I - II, 13 cases of stage III - IV, 6 cases of Gleason score 1 - 4, 13 cases of 5 - 7, 11 cases of 8 - 10, tumor diameter range from 0.8 to 6.2 cm, with average of (3.9 ± 1.5) cm. The relative expression of HSP-90α protein in tumor tissue was closely related to TNM stage, Gleason score and tumor diameter (P α and PSA levels for prostate cancer diagnosis was 0.896, and that of single PSA detection was 0.852. Conclusion: Higher expressions of HSP-90α in prostate cancer tissue and serum may be closely related to occurrence and development of prostate cancer, and combined detections of serum HSP-90α and PSA levels are of great significance in improving early diagnosis of prostate cancer.

Logistic regression with missing covariates—Parameter estimation, model selection and prediction within a joint-modeling framework

Logistic regression is a common classification method in supervised learning. Surprisingly, there are very few solutions for performing logistic regression with missing values in the covariates. A complete approach based on a stochastic approximation version of the EM algorithm is proposed in order to perform statistical inference with missing values, including the estimation of the parameters and their variance, derivation of confidence intervals, and also a model selection procedure. The problem of prediction for new observations on a test set with missing covariate data is also tackled. Supported by a simulation study in which the method is compared to previous ones, it has proved to be computationally efficient, and has good coverage and variable selection properties. The approach is then illustrated on a dataset of severely traumatized patients from Paris hospitals by predicting the occurrence of hemorrhagic shock, a leading cause of early preventable death in severe trauma cases. The aim is to improve the current red flag procedure, a binary alert identifying patients with a high risk of severe hemorrhage. The method is implemented in the R package misaem.

A NEW SHOCK MODEL WITH A CHANGE IN SHOCK SIZE DISTRIBUTION

AbstractFor a system that is subject to shocks, it is assumed that the distribution of the magnitudes of shocks changes after the first shock of size at least d1, and the system fails upon the occurrence of the first shock above a critical level d2 (&gt; d1). In this paper, the distribution of the lifetime of such a system is studied when the times between successive shocks follow matrix-exponential distribution. In particular, it is shown that the system's lifetime has matrix-exponential distribution when the intershock times follow Erlang distribution. The model is extended to the case when the system fails upon the occurrence of l consecutive critical shocks.

Results of Conversion Osteosynthesis in Treatment of Patients with Long Bone Fractures

Аbctract. Treatment of long bones fractures of the extremities has a particular relevance in modern traumatology due to their high frequency, as well as a large number of deaths in patients with polytrauma. It is dangerous to perform an urgent final osteosynthesis in severe patients because of the possibility of shock and the deterioration of the condition of the injured. Therefore, the principle of Damage control with urgent fixation of damaged segments by external fixation and their subsequent replacement (converse) to intramedullary osteosynthesis had a particular relevance in the treatment of patients with long bones fractures. Purpose: Improving treatment outcomes for patients with long bones fractures. Materials and methods. In the present study, a retrospective analysis of using conversion osteosynthesis in the treatment of 120 patients with long bones extremities fractures in a multidisciplinary hospital was carried out. For a better analysis of the results of treatment, we divided the patients into two groups: The first group 44 patients with fractures of the long bones with polytrauma according to the ISS severity scale&gt; 17. The second group consists of 76 patients with closed isolated unstable comminuted fractures of the long bones with severe post-traumatic edema, who have a high risk of significant trauma of soft tissues. Results. The most optimal time for conversion osteosynthesis to patients with polytrauma was 7-12 days, which prevented the occurrence of traumatic shock; and for patients with closed isolated unstable fractures of long bones with significant of post-traumatic edema for conversion osteosynthesis, the optimal time was 3-7 days after injury, which prevented the occurrence of inflammatory complications in the postoperative period. Conclusion. The study confirmed the feasibility of conversion osteosynthesis in the treatment of patients with diaphyseal fractures. The use of the technique of transferring the fixation of fragments by the external fixation device to the internal osteosynthesis (conversion) contributed to a reduction in the duration of inpatient treatment of patients with fractures of the long bones.