Special Personnel Research Articles

DETERMINASI PERTUMBUHAN EKONOMI KABUPATEN/KOTA DI PROVINSI NANGGROE ACEH DARUSSALAM

This study aims to analyze the effect of Special Autonomy Fund, Regional Tax, Personnel Expenditure, Goods and Services Spendingand Human Development Index on Gross Regional Domestic Product of regency/municipality in Nanggroe Aceh Darussalam Province from 2015 to 2019. This study used quantitative descriptive method. The research model used was an econometric model measured using panel data regression. The results of panel data regression showed that the selected model is a fixed effect model. The results found that partially, only the variable of goods and services spending has no significant effect on gross regional domestic product. Meanwhile, the variables of special autonomy fund and personnel expenditure have a negative effect on gross regional domestic product. Meanwhile, regional tax and human development index have a positive significant effect on gross regional domestic product. The variables of special autonomy fund, local tax, personnel expenditure, goods and services spending, and human development index simultaneously have a significant effect on gross regional domestic product of regency/municipality in Nanggroe Aceh Darussalam Province.

A multi-expert ensemble system for predicting Alzheimer transition using clinical features

Alzheimer’s disease (AD) diagnosis often requires invasive examinations (e.g., liquor analyses), expensive tools (e.g., brain imaging) and highly specialized personnel. The diagnosis commonly is established when the disorder has already caused severe brain damage, and the clinical signs begin to be apparent. Instead, accessible and low-cost approaches for early identification of subjects at high risk for developing AD years before they show overt symptoms are fundamental to provide a critical time window for more effective clinical management, treatment, and care planning. This article proposes an ensemble-based machine learning algorithm for predicting AD development within 9 years from first overt signs and using just five clinical features that are easily detectable with neuropsychological tests. The validation of the system involved both healthy individuals and mild cognitive impairment (MCI) patients drawn from the ADNI open dataset, at variance with previous studies that considered only MCI. The system shows higher levels of balanced accuracy, negative predictive value, and specificity than other similar solutions. These results represent a further important step to build a preventive fast-screening machine-learning-based tool to be used as a part of routine healthcare screenings.

Overhead Squat Mobility Assessment Does Not Detect Differences By Injury Type In Special Operations Personnel

Overhead Squat Mobility Assessment Does Not Detect Differences By Injury Type In Special Operations Personnel

DNA Karyometry for Automated Detection of Cancer Cells.

Simple SummaryCancers have to be microscopically established before they can be treated adequately. This can be performed on cell and/or tissue samples. Smears or sedimentations of cells on glass slides are used to microscopically screen large number of specimens for the presence of cancer cells. Such screenings require highly specialized personnel, which is not available in most countries. We present a microscope-based scanner which is able to identify cancer cells in smears from the oral cavity or in body cavity fluids. In addition, using the same system, the degree of malignancy of prostate cancer can be determined. A combination of image features of stained nuclei and their DNA-content is used to raise a suspicion of malignancy. Nuclear diagnostic classifiers were trained by an expert using supervised machine learning. All device-proposed diagnoses can be verified by a specialist. The overall percentage of correct device-derived diagnoses on oral smears was 91.3% as compared to 75.0% for conventional, subjective investigation.Background: Microscopical screening of cytological samples for the presence of cancer cells at high throughput with sufficient diagnostic accuracy requires highly specialized personnel which is not available in most countries. Methods: Using commercially available automated microscope-based screeners (MotiCyte and EasyScan), software was developed which is able to classify Feulgen-stained nuclei into eight diagnostically relevant types, using supervised machine learning. the nuclei belonging to normal cells were used for internal calibration of the nuclear DNA content while nuclei belonging to those suspicious of being malignant were specifically identified. The percentage of morphologically abnormal nuclei was used to identify samples suspected of malignancy, and the proof of DNA-aneuploidy was used to definitely determine the state malignancy. A blinded study was performed using oral smears from 92 patients with Fanconi anemia, revealing oral leukoplakias or erythroplakias. In an earlier study, we compared diagnostic accuracies on 121 serous effusion specimens. In addition, using a blinded study employing 80 patients with prostate cancer who were under active surveillance, we aimed to identify those whose cancers would not advance within 4 years. Results: Applying a threshold of the presence of >4% of morphologically abnormal nuclei from oral squamous cells and DNA single-cell or stemline aneuploidy to identify samples suspected of malignancy, an overall diagnostic accuracy of 91.3% was found as compared with 75.0% accuracy determined by conventional subjective cytological assessment using the same slides. Accuracy of automated screening effusions was 84.3% as compared to 95.9% of conventional cytology. No prostate cancer patients under active surveillance, revealing DNA-grade 1, showed progress of their disease within 4.1 years. Conclusions: An automated microscope-based screener was developed which is able to identify malignant cells in different types of human specimens with a diagnostic accuracy comparable with subjective cytological assessment. Early prostate cancers which do not progress despite applying any therapy could be identified using this automated approach.

Theoretical Foundations Development of Vocational Pedagogical Education in the 1920s – Early 1930s

The work focuses on studying the theoretical foundations of vocational pedagogical education, developed by scientists, educational management employees, and practicing teachers in the 1920s – early 1930s. This is the stage of system formation of training teachers of particular professional disciplines and industrial training instructors (masters). The purpose of the study is to establish the most significant and conceptual theoretical provisions formulated on the problems of the organization and content of training special teaching staff in the historical period under study. The study results, generalization, and systematization of documents and materials found in archival and library funds related to the formation of a system for training special pedagogical personnel are presented. This study is significant not only for understanding the features of the genesis of the vocational and pedagogical education system as an independent industry in the Russian education system, which successfully developed up to the 2000s, but also for determining the prospects for its development in the new socio-economic and socio-cultural realities.

Diagnosis Methods for COVID-19: A Systematic Review.

At the end of 2019, the coronavirus appeared and spread extremely rapidly, causing millions of infections and deaths worldwide, and becoming a global pandemic. For this reason, it became urgent and essential to find adequate tests for an accurate and fast diagnosis of this disease. In the present study, a systematic review was performed in order to provide an overview of the COVID-19 diagnosis methods and tests already available, as well as their evolution in recent months. For this purpose, the Science Direct, PubMed, and Scopus databases were used to collect the data and three authors independently screened the references, extracted the main information, and assessed the quality of the included studies. After the analysis of the collected data, 34 studies reporting new methods to diagnose COVID-19 were selected. Although RT-PCR is the gold-standard method for COVID-19 diagnosis, it cannot fulfill all the requirements of this pandemic, being limited by the need for highly specialized equipment and personnel to perform the assays, as well as the long time to get the test results. To fulfill the limitations of this method, other alternatives, including biological and imaging analysis methods, also became commonly reported. The comparison of the different diagnosis tests allowed to understand the importance and potential of combining different techniques, not only to improve diagnosis but also for a further understanding of the virus, the disease, and their implications in humans.

Nanometer-Resolution Imaging of Living Cells Using Soft X-ray Contact Microscopy

Soft X-ray microscopy is a powerful technique for imaging cells with nanometer resolution in their native state without chemical fixation, staining, or sectioning. The studies performed in several laboratories have demonstrated the potential of applying this technique for imaging the internal structures of intact cells. However, it is currently used mainly on synchrotrons with restricted access. Moreover, the operation of these instruments and the associated sample-preparation protocols require interdisciplinary and highly specialized personnel, limiting their wide application in practice. This is why soft X-ray microscopy is not commonly used in biological laboratories as an imaging tool. Thus, a laboratory-based and user-friendly soft X-ray contact microscope would facilitate the work of biologists. A compact, desk-top laboratory setup for soft X-ray contact microscopy (SXCM) based on a laser-plasma soft X-ray source, which can be used in any biological laboratory, together with several applications for biological imaging, are described. Moreover, the perspectives of the correlation of SXCM with other super-resolution imaging techniques based on the current literature are discussed.

Research on the Employment of College Graduates under the Background of the Normalization of the Epidemic — Taking School of Education of Zhaoqing University as an Example

Employment guidance and service work are an important part of ideological and political education in colleges and universities. Through the comparison of the employment rate, employment destination and employment structure of the 2016-2021 graduates of the School of Education Science of Zhaoqing University, it is found that there are problems in the employment work, such as process management, daily care services, and the lack of effective curriculum. In order to adapt to the new normal of employment in the context of the normalization of the epidemic, it is necessary to innovate working methods: implement practical process management, establish a "before-during-after" management system; do practical daily service work, build "special personnel on duty, full service" system; play an important role in curriculum guidance, and build a "three-course mutual aid" system.

Microfabricated disk technology: Rapid scale up in midbrain organoid generation.

By providing a three-dimensional in vitro culture system with key features of the substantia nigra region in the brain, 3D neuronal organoids derived from human induced pluripotent stem cells (iPSCs) provide living neuronal tissue resembling the midbrain region of the brain. However, a major limitation of conventional brain organoid culture is that it is often labor-intensive, requiring highly specialized personnel for moderate throughput. Additionally, the methods published for long-term cultures require time-consuming maintenance to generate brain organoids in large numbers. With the increasing need for human midbrain organoids (hMOs) to better understand and model Parkinson's disease (PD) in a dish, there is a need to implement new workflows and methods to both generate and maintain hMOs, while minimizing batch to batch variation. In this study, we developed a method with microfabricated disks to scale up the generation of hMOs. This opens up the possibility to generate larger numbers of hMOs, in a manner that minimizes the amount of labor required, while decreasing variability and maintaining the viability of these hMOs over time. Taken together, producing hMOs in this manner opens up the potential for these to be used to further PD studies.

장애아통합어린이집 유아특수교사와 특수교육 관련서비스 전문가 간 협력적 팀 접근 경험 및 인식

The purpose of this study is to examine the experience and perceptions of the collaborative team approach and how to support the needs of early childhood special education teachers and related service personnel to implement effective Individualized Educational Plans (IEPs). In this study, a focus group interview was conducted with six special education teachers working at national inclusive daycare centers and special education-related service personnel who have experience of collaborating with special education teachers while working at therapeutic institutions for young children with disabilities. The results demonstrate that nine upper categories and 18 lower categories were derived in the special education teachers’ group, and nine upper categories and 21 lower categories were derived in the related service personnel groups. In terms of the collaborative team approach, there was a difference in perception and experience of IEPs between both groups. With regard to IEP implementation, both groups had experienced difficulties with communication and support, while they expected each other to support their roles as information providers for the development of young children with disabilities. In addition, the results also highlighted that efforts are required to acknowledge each other’s expertise, building a cooperative network, and institutional improvement in order to implement a collaborative team approach. This study is meaningful because it not only identifies experiences and perceptions of collaborative team approaches between special early childhood education teachers and related service personnel for effective IEP implementation, but it also examines how to enhance the collaborative team approach and make improvements to practice and agreed education.

Organizational and legal principles of the State Bureau of Investigation activity in the system of law enforcement agencies of Ukraine

The place and role of the State Bureau of Investigation in the modern classification system of law enforcement agencies of Ukraine is analyzed. The essence of the definition of “law enforcement agencies” is established, and the peculiarities of their activities are analyzed. It has been noted that modern law enforcement bodies must be considered as state bodies that function in the general system of public authorities and perform, in accordance with current legislation, relevant functions in various fields of internal and external activity of the state, the purpose of which is to observe and implement the rights and freedoms of citizens, legality and law and order with compliance with the rules and procedures regulated by law within the limits of their competence.
 It has been emphasized that in order to determine whether a state body belongs to the category of law enforcement, it must have certain specific characteristics. The following signs are the state and authority nature of the activity; the right to apply measures of state coercion; execution of special powers to implement the law enforcement function of the state on a professional basis; special material, technical and personnel support of activities; statutory nature of activity; enforceable nature of law enforcement agency decisions, and more.
 It has been established that, despite the short period of activity, the State Bureau of Investigations belongs to the law enforcement agencies of Ukraine by all the above-mentioned features. The powers and functions of the State Bureau of Investigation are analyzed. It has been emphasized that the main ones are solving the tasks of prevention, detection, termination, disclosure and investigation of crimes committed by officials who occupy a particularly responsible position; crimes committed by NABU officials, the Deputy Prosecutor General - head of the Specialized Anti-Corruption Prosecutor's Office or other prosecutors of the Specialized Anti-Corruption Prosecutor's Office; crimes against the established order of military service.

Combat exposure and behavioral health in U.S. Army Special Forces.

Although combat has been found to be associated with adverse health outcomes, little is known about the impact of specific combat exposures, particularly among specialized personnel. This study examined the association of different types of combat exposures with behavioral health outcomes, and whether these associations differed by Army occupational specialization: General Purpose Forces infantrymen (n = 5,361), Ranger Qualified infantrymen (n = 308), and Special Forces personnel (n = 593). Multivariable regression models estimated the association of combat severity, type of combat event (fighting, killing, threat to oneself, death/injury of others), and type of killing with mental health disorders, trouble sleeping, and problem drinking. Combat severity, each type of combat event, and killing noncombatants were associated with adverse health outcomes after adjusting for covariates and other combat exposures. Except for trouble sleeping, these associations did not differ by occupational specialization, though the prevalence and odds of outcomes were generally lower for Special Forces personnel.

Organizational and Managerial Problems of the Functioning of Academic Journals of the RAS

The article raises the questions about the use of scientific periodicals in modern conditions in academic journals of a socio-humanitarian profile. It is also outlines the main production problems associated with holding competitions for the publication of RAS journals and their financing, special personnel, editorial phenomena, institutions for reviewing and participation of the editorial board, reviews and authors, as well as general issues of the development of scientific periodicals are identified. It is shown that an indicator of the importanceof the role of the editorial board is in maintaining a high level of scientific periodicals.

KUALITAS LAYANAN PORTAL OPEN DATA BANDA ACEH (ODBA) DALAM KETERBUKAAN INFORMASI PUBLIK DI DINAS KOMUNIKASI INFORMATIKA DAN STATISTIK KOTA BANDA ACEH

One of the goals of the reform program in Indonesia is the realization of good governance. The Indonesian Open Government Movement (OGI) is a form of movement between the government and the community to realize good governance, namely through principles based on public information. One of the OGI programs to achieve this is through the open data project portal, one of which is the Banda Aceh Open Data Portal (ODBA). This study aims to find out how the quality of ODBA Portal services in public information at the Department of Communication, Informatics and Statistics (Diskominfontik) of Banda Aceh City and the strategy of Banda Aceh Diskominfotik to improve the quality of ODBA Portal services. The research method used is descriptive qualitative. Informants in this study were determined by purposive sampling technique. Data were collected by interview, observation, documentation, and triangulation techniques. Data analysis techniques used are data reduction, data presentation, and drawing conclusions. The theory used is based on three dimensions of the quality of a portal site proposed by Rocha (2012: 374-382), namely content quality, service quality, and technical quality. The results showed that the service quality of the ODBA Portal was quite good. However, there are several things that need to be improved on the ODBA Portal, such as the availability of features for proposing datasets, features for feedback, special personnel to handle open data portal maintenance, and others. To make the ODBA Portal have a better quality, the Department of Communication, Informatics and Statistics of Banda Aceh City needs to provide expert programmers, especially in the field of maintenance and add the main features that must exist in an open data portal. The City of Banda Aceh Diskominfotik has also implemented several strategies to improve the quality of the ODBA Portal service.
 Keywords: ODBA Portal, Open Data, Open Data Portal, Public Information Disclosure, Quality of Website Portal

Selected Organizational and Managerial Aspects of Health and Nutrition Education of Various Types of Consumers of Spa Treatment Services in Poland.

Consumer education, including nutrition education, understood as a process based on scientific principles, is becoming a very effective element in influencing the health of the population in the modern world. This work is based on direct research carried out in 2016–2018 in the form of a questionnaire interview among patients—consumers of educational services in spa treatment facilities. The research sample was N = 1000 (600 people were tested with the use of PAPI (Paper and Pencil Interview), and 400 people with the use of CAWI (Computer-Assisted Web Interview)) and concerned a representative group of spa patients in Poland. In addition, as a supplement, a direct survey was conducted in the form of a Computer-Assisted Telephone Interview with managers of spa treatment facilities (N = 50). Consumers of spa treatment services differ from each other, and types can be distinguished based on their professional activity status and the type of entity that pays for their stay in the spa, and, using cluster analysis, the status of professional activity in relation to their education level. The nutritional education system is based on highly specialized medical personnel. At the same time, it does not use the available assessment tools based on proven monitoring and evaluation indicators. Health education, which also includes nutritional education, apart from disease prevention, is the basic tool for health promotion in spa treatment conditions, enabling the introduction of a permanent change in the patients’ lifestyles, the additional advantages of which are low costs and relatively high efficiency. In the course of the study, several useful patient profiles were also distinguished, thanks to which it is possible to select dedicated educational methods for selected groups of recipients.

The Effectiveness of Cognitive Behavioral Therapy to Improve Resilience of Frog Troop Command School Students in Kodiklatal

The Indonesian Navy's Frog Troop Command Soldiers are special personnel designed to deal with difficult situations and special naval warfare missions. The dynamics of forming as a candidate for Kopaska personnel and the pressure of education at the Frog Troop Command School were so heavy that some students were unable to adapt well, stressed and lacked confidence, so they were unable to continue their education. Resilience is the ability of each individual to cope and adapt to problems that occur in life. Resilience is needed by students to be able to survive while carrying out education at the Frog Troop Command School. Several studies have found that resilience can be increased by using a Cognitive Behavior Therapy approach. This study aims to determine the effectiveness of the CBT intervention on increasing resilience in the Frog Troop Command School students. The use of the CBT method is expected to be able to increase the resilience of students when under pressure during education at the Frog Troop Command School. Therefore, in order to increase the readiness of students to face the heavy educational pressures and stress that arises during their education at the Frog Troop Command School, it is necessary to know how the use of this CBT method and its effect on them. This therapy session intends to explore the use of the CBT method to control oneself in order to be able to face the pressures of education at the Frog Troop Command School

Development and implementation of a simple and rapid extraction-free saliva SARS-CoV-2 RT-LAMP workflow for workplace surveillance.

Effective management of the COVID-19 pandemic requires widespread and frequent testing of the population for SARS-CoV-2 infection. Saliva has emerged as an attractive alternative to nasopharyngeal samples for surveillance testing as it does not require specialized personnel or materials for its collection and can be easily provided by the patient. We have developed a simple, fast, and sensitive saliva-based testing workflow that requires minimal sample treatment and equipment. After sample inactivation, RNA is quickly released and stabilized in an optimized buffer, followed by reverse transcription loop-mediated isothermal amplification (RT-LAMP) and detection of positive samples using a colorimetric and/or fluorescent readout. The workflow was optimized using 1,670 negative samples collected from 172 different individuals over the course of 6 months. Each sample was spiked with 50 copies/μL of inactivated SARS-CoV-2 virus to monitor the efficiency of viral detection. Using pre-defined clinical samples, the test was determined to be 100% specific and 97% sensitive, with a limit of detection of 39 copies/mL. The method was successfully implemented in a CLIA laboratory setting for workplace surveillance and reporting. From April 2021-February 2022, more than 30,000 self-collected samples from 755 individuals were tested and 85 employees tested positive mainly during December and January, consistent with high infection rates in Massachusetts and nationwide.

Postsecondary Success Stories: Perspectives of Adults With Intellectual and Developmental Disabilities

Abstract The Individuals With Disabilities Education Act (IDEA) of 2004 highlights the need for special education and related personnel to prepare youth with disabilities for adulthood, particularly in the areas of postsecondary education, employment, and independent living. In accordance with this policy, our study used qualitative case reporting to examine the personal perspectives of three adults with IDD in the outcome domains outlined by the IDEA. Using positive psychology and self-determination theories, we sought to better understand the diverse factors that contributed to the participants' “successes” in these areas. Results revealed a series of evidence-based predictors of success contributed to overcoming challenges to employment, postsecondary education, and independent living for participants. Implications for research, policy, and practice are discussed.

Salivary Xanthine Oxidase as a Potential Biomarker in Stroke Diagnostics.

Stroke is one of the most common cerebrovascular diseases. Despite significant progress in understanding stroke pathogenesis, cases are still increasing. Thus, laboratory biomarkers of stroke are sought to allow rapid and non-invasive diagnostics. Ischemia-reperfusion injury is an inflammatory process with characteristic cellular changes leading to microvascular disruption. Several studies have shown that hyperactivation of xanthine oxidase (XO) is a major pathogenic factor contributing to brain dysfunction. Given the critical role of XO in stroke complications, this study aimed to evaluate the activity of the enzyme and its metabolic products in the saliva of stroke subjects. Thirty patients in the subacute phase of stroke were included in the study: 15 with hemorrhagic stroke and 15 with ischemic stroke. The control group consisted of 30 healthy subjects similar to the cerebral stroke patients regarding age, gender, and status of the periodontium, dentition, and oral hygiene. The number of individuals was determined a priori based on our previous experiment (power of the test = 0.8; α = 0.05). The study material was mixed non‐stimulated whole saliva (NWS) and stimulated saliva (SWS). We showed that activity, specific activity, and XO output were significantly higher in NWS of ischemic stroke patients than in hemorrhagic stroke and healthy controls. Hydrogen peroxide and uric acid levels were also considerably higher in NWS of ischemic stroke patients. Using receiver operating curve (ROC) analysis, we demonstrated that XO-specific activity in NWS distinguishes ischemic stroke from hemorrhagic stroke (AUC: 0.764) and controls (AUC: 0.973) with very high sensitivity and specificity. Saliva collection is stress-free, requires no specialized medical personnel, and allows continuous monitoring of the patient’s condition through non-invasive sampling multiple times per day. Salivary XO also differentiates with high accuracy (100%) and specificity (93.75%) between stroke patients with mild to moderate cognitive decline (AUC = 0.988). Thus, salivary XO assessment may be a potential screening tool for a comprehensive neuropsychological evaluation. To summarize, our study demonstrates the potential utility of salivary XO in the differential diagnosis of stroke.

FC099: Covid-19 and HD Vascular Access: Troubles are Coming

BACKGROUND AND AIMSPatients on HD are known to have many various adverse events associated with past COVID-19. In this cross-sectional study, we assessed the incidence of vascular access (VA) dysfunction (primary end point) and probability of successful reconstruction of preexisting permanent VA (AVF/AVG) in a case of its dysfunction (secondary end point) within two months after discharge from COVID hospital.METHODData were obtained from Moscow region COVID-19 register database. The study includes the results of treatment of 1386 HD patients who were admitted to hospital with suspected or confirmed COVID-19 between February 2020 and November 2021. All COVID-19 positive patients were hospitalized regardless of disease severity to prevent further spread of the infection in dialysis units. The main analysis included 934 patients with known sustainable VA: AVF (N = 804, 86.3%), AVG (N = 54, 5.8%) or CVC (N = 74, 7.9%). Median duration of HD was 34 (IQR 21–69) months (from 6 to 98).RESULTSHospital mortality among HD patients was 32.3%. The AVF/AVG/CVC ratio in recovered (N = 632) and deceased (N = 302) patients was 89.2%/5.7%/5% and 80.1%/6%/13.9%, respectively. HD via CVC was associated with an increased risk of death: RR = 1.877 (95% CI 1.472–2.302); P < 0.0001.Most of the recovered patients with AVFs (Figure 1, left) and AVGs (Figure 1, right) needed interventions due the VA dysfunction. Even if AVF patency was successfully restored, it led to the reduction of its functional segment. In contrast, most of the recovered patients with CVCs did not receive interventions for VA dysfunction (Figure 2).Thus, only 45.4% (287 of 632) of recovered patients did not receive interventions for VA dysfunction; the rest 54.6% showed dysfunction of VA. 23.6% (N = 149) underwent successful AVF/AVG reconstruction and retained function of the preexisting VA. In 15.3% (N = 97) patients, AVF/AVG function was completely lost and a new AVF/AVG was created. Conversion from functional AVF/AVG into CVC was performed in 14.1% (N = 89) patients. Thus, the incidence of complete loss of preexisting permanent VA function was 29.4% (N = 186).Conversion into better vascular access was performed in only 1.7% (N = 11) patients: conversion from AVG into AVF or from CVC into AVF/AVG.Among patients who underwent successful reconstruction of preexisting AVF, the probability of successful restore of its function within the first month was 55.3% (95% CI 48.3–62.2), during the second month—only 31.1% (95% CI 22.9–40.4). For AVG, the probability of maintaining of existing access during the first and second months was 23.8% (95% CI 9.3–45.2] and 18.2% (95% CI 3.2–48.3), respectively. Thus, reconstruction of permanent VA within the second month after discharge from COVID hospital increases the risk of complete loss of its function: RR = 1.469 (95% CI 1.22–1.762). Only 6.6% (N = 37) of patients received AVF/AVG reconstruction in COVID hospital.Compared with 2019, in 2021 the rate of reconstructive surgeries in the Moscow region decreased from 2.771 (95% CI 2.426–3.15) to 1.375 (95% CI 1.114–1.68) per 10 patient-years (only prevalent HD patients; P < 0.0001). The number of tertiary care centers for VA creation and maintaining in the region decreased from eight to five during the pandemic.At the same time, the rate of CVC implantations increased (outside of COVID hospitals) from 1.498 (95% CI 1.248–1.784) to 2.908 (95% CI 2.522–3.337) per 10 patient-years; P < 0.0001.CONCLUSIONCOVID-19 is associated with high incidence of VA dysfunction and complete loss of VA function. The delay in reconstruction of existing VA significantly increases the risk of its loss. This may be caused by a decrease in the number of reconstructive VA surgeries due to reducing the number of specialized centers and personnel. As a result, we observe an increase in CVC usage. Thus, over the next few years, we can expect increased prevalence of central vein stenoses and deterioration of treatment outcomes of HD patients.FIGURE 1:Need for intervention in recoveredafter COVID-19 HD patients with AVF (left) and AVG (right).FIGURE 2:Need for intervention in recovered patients with CVC.