Dunser M.W.,Salzburg General Hospital |
Dondorp A.,Mahidol University |
Kissoon N.,University of British Columbia |
Ganbat T.,Ulaanbaatar State University |
And 4 more authors.
Intensive Care Medicine | Year: 2012
Purpose: To provide clinicians practicing in resource-limited settings with a framework to improve the diagnosis and treatment of pediatric and adult patients with sepsis. Methods: The medical literature on sepsis management was reviewed. Specific attention was paid to identify clinical evidence on sepsis management from resource-limited settings. Results: Recommendations are grouped into acute and post-acute interventions. Acute interventions include liberal fluid resuscitation to achieve adequate tissue perfusion, normal heart rate and arterial blood pressure, use of epinephrine or dopamine for inadequate tissue perfusion despite fluid resuscitation, frequent measurement of arterial blood pressure in hemodynamically unstable patients, administration of hydrocortisone or prednisolone to patients requiring catecholamines, oxygen administration to achieve an oxygen saturation[90%, semi-recumbent and/or lateral position, non-invasive ventilation for increased work of breathing or hypoxemia despite oxygen therapy, timely administration of adequate antimicrobials, thorough clinical investigation for infectious source identification, fluid/tissue sampling and microbiological workup, removal, drainage or debridement of the infectious source. Post-acute interventions include regular reassessment of antimicrobial therapy, administration of antimicrobials for an adequate but not prolonged duration, avoidance of hypoglycemia, pharmacological or mechanical deep vein thrombosis prophylaxis, resumption of oral food intake after resuscitation and regaining of consciousness, careful use of opioids and sedatives, early mobilization, and active weaning of invasive support. Specific considerations for malaria, puerperal sepsis and HIV/AIDS patients with sepsis are included. Conclusion: Only scarce evidence exists for the management of pediatric and adult sepsis in resourcelimited settings. The presented recommendations may help to improve sepsis management in middle- and low-income countries. © Copyright jointly held by Springer and ESICM 2012.
Sambuu U.,National University of Mongolia |
Chuluunbat Z.,Governance Assistance Project |
Unurkhaan E.,Ulaanbaatar State University
ACM International Conference Proceeding Series | Year: 2012
This paper tries to address a number of issues, problems and challenges currently facing while implementing ITS COTS solution in the Mongolian Tax Administration (MTA). The paper describes the gap between expectation of MTA towards positive impact of improved Tax Information system through COTS product and the real situation of the implementation of the product as well as serious risks confronting the new Tax Information System that is currently under replacement. Copyright 2012 ACM.
Damdinsuren L.,Ulaanbaatar State University
Economy of Region | Year: 2011
This paper reviews the historical aspect of grazing in Mongolia. The data on changes in the structure of animal species in the general population is presented. The level of main types of foods security of the population of Mongolia based on the findings of the actual meat and meat products consumption ratio to the recommended standard in accordance with national standards is analyzed. In absolute terms, the number of livestock is growing steadily, so by the conditions for ensuring full meat and meat products security for the population. Estimation of the technological level of the country's meat industry and export performance of meat products, including the Russian Federation, is given. A model of technological strategy of meat processing is suggested. It is noted that the main directions of development of meat industry in the country are increased production and safety of meat in agriculture and waste-free deep treatment of cattle in the meat industry, as well as improvement of the export potential of different kinds of meat.
Brunauer A.,Paracelsus Medical University |
Kokofer A.,Paracelsus Medical University |
Bataar O.,Ulaanbaatar State University |
Gradwohl-Matis I.,Paracelsus Medical University |
And 2 more authors.
Critical Care | Year: 2014
Introduction: Liberal and overaggressive use of vasopressors during the initial period of shock resuscitation may compromise organ perfusion and worsen outcome. When transiently applying the concept of permissive hypotension, it would be helpful to know at which arterial blood pressure terminal cardiovascular collapse occurs. Methods: In this retrospective cohort study, we aimed to identify the arterial blood pressure associated with terminal cardiovascular collapse in 140 patients who died in the intensive care unit while being invasively monitored. Demographic data, co-morbid conditions and clinical data at admission and during the 24 hours before and at the time of terminal cardiovascular collapse were collected. The systolic, mean and diastolic arterial blood pressures immediately before terminal cardiovascular collapse were documented. Terminal cardiovascular collapse was defined as an abrupt (<5 minutes) and exponential decrease in heart rate (>50% compared to preceding values) followed by cardiac arrest. Results: The mean±standard deviation (SD) values of the systolic, mean and diastolic arterial blood pressures associated with terminal cardiovascular collapse were 47±12 mmHg, 35±11 mmHg and 29±9 mHg, respectively. Patients with congestive heart failure (39±13 mHg versus 34±10 mmHg; P=0.04), left main stem stenosis (39±11 mHg versus 34±11 mmHg; P=0.03) or acute right heart failure (39±13 mmHg versus 34±10 mmHg; P=0.03) had higher arterial blood pressures than patients without these risk factors. Patients with severe valvular aortic stenosis had the highest arterial blood pressures associated with terminal cardiovascular collapse (systolic, 60±20 mmHg; mean, 46±12 mmHg; diastolic, 36±10 mmHg), but this difference was not significant. Patients with sepsis and patients exposed to sedatives or opioids during the terminal phase exhibited lower arterial blood pressures than patients without sepsis or administration of such drugs. Conclusions: The arterial blood pressure associated with terminal cardiovascular collapse in critically ill patients was very low and varied with individual co-morbid conditions (for example, congestive heart failure, left main stem stenosis, severe valvular aortic stenosis, acute right heart failure), drug exposure (for example, sedatives or opioids) and the type of acute illness (for example, sepsis). © 2014 Brunauer et al.
Armstrong S.C.,Ulaanbaatar State University |
Tsogtbaatar B.,Center for Human Security Research
Asia-Pacific Journal of Public Health | Year: 2010
Alcohol abuse has become recognized by numerous organizations in Mongolia as one of their primary public health challenges. Despite the crisis of alcohol abuse in Mongolia, the dominance of narcology in shaping the health system's response has allowed the alcohol industry to control the debate. The Mongolian population largely interprets the World Health Organization's (WHO) "standard drink" as a consumption guideline rather than a measure of abuse. In addition, the focus on high levels of dependence, as defined by narcology, has allowed the WHO to officially write off the problem, stating that less than 1% of the adult population can be categorized as "alcoholics. " As the government focuses on new policy-based approaches to the issue, the rhetoric undermines participation and support, while the industry finds new ways to learn from narcology in their efforts to grow. However, by reinvesting profits from alcohol and a public healthĝ€"focused approach, solutions can be found. © 2010 APJPH.
Buslov M.M.,Novosibirsk State University |
Geng H.,University of Hong Kong |
Travin A.V.,RAS Institute of Geology and Mineralogy |
Otgonbaatar D.,Ulaanbaatar State University |
And 8 more authors.
Russian Geology and Geophysics | Year: 2013
Packages of Late Paleozoic tectonic nappes and associated major NE-trending strike-slip faults are widely developed in the Altai-Sayan folded area. Fragments of early deformational phases are preserved within the Late Paleozoic allochthons and autochthons. Caledonian fold-nappe and strike-slip structures, as well as accompanying metamorphism and granitization in the region, are typical of the EW-trending suture-shear zone separating the composite Kazakhstan-Baikal continent and Siberia. In the Gorny Altai region, the Late Paleozoic nappes envelop the autochthon, which contains a fragment of the Vendian-Cambrian Kuznetsk-Altai island arc with accretionary wedges of the Biya-Katun' and Kurai zones. The fold-nappe deformations within the latter zones occurred during the Late Cambrian (Salairian) and can thus be considered Salairian orogenic phases. The Salairian fold-nappe structure is stratigraphically overlain by a thick (up to 15 km) well-stratified rock unit of the Anyui-Chuya zone, which is composed of Middle Cambrian-Early Ordovician fore-arc basin rocks unconformably overlain by Ordovician-Early Devonian carbonate-terrigenous passive-margin sequences. These rocks are crosscut by intrusions and overlain by a volcanosedimentary unit of the Devonian active margin. The top of the section is marked by Famennian-Visean molasse deposits onlapping onto Devonian rocks. The molasse deposits accumulated above a major unconformity reflects a major Late Paleozoic phase of folding, which is most pronounced in deformations at the edges of the autochthon, nearby the Kaim, Charysh-Terekta, and Teletskoe-Kurai fault nappe zones. Upper Carboniferous coal-bearing molasse deposits are preserved as tectonic wedges within the Charysh-Terekta and Teletskoe-Kurai fault nappe zones.Detrital zircon ages from Middle Cambrian-Early Ordovician rocks of the Anyui-Chuya fore-arc zone indicate that they were primarily derived from Upper Neoproterozoic-Cambrian igneous rocks of the Kuznetsk-Altai island arc or, to a lesser extent, from an Ordovician-Early Devonian passive margin. A minor age population is represented by Paleoproterozoic grains, which was probably sourced from the Siberian craton. Zircons from the Late Carboniferous molasse deposits have much wider age spectra, ranging from Middle Devonian-Early Carboniferous to Late Ordovician-Early Silurian, Cambrian-Early Ordovician, Mesoproterozoic, Early-Middle Proterozoic, and early Paleoproterozoic. These ages are consistent with the ages of igneous and metamorphic rocks of the composite Kazakhstan-Baikal continent, which includes the Tuva-Mongolian island arc with accreted Gondwanan blocks, and a Caledonian suture-shear zone in the north. Our results suggest that the Altai-Sayan region is represented by a complex aggregate of units of different geodynamic affinity. On the one hand, these are continental margin rocks of western Siberia, containing only remnants of oceanic crust embedded in accretionary structures. On the other hand, they are represented by the Kazakhstan-Baikal continent composed of fragments of Gondwanan continental blocks. In the Early-Middle Paleozoic, they were separated by the Ob'-Zaisan oceanic basin, whose fragments are preserved in the Caledonian suture-shear zone. The movements during the Late Paleozoic occurred along older, reactivated structures and produced the large intracontinental Central Asian orogen, which is interpreted to be a far-field effect of the colliding East European, Siberian, and Kazakhstan-Baikal continents. © 2013.
Horoldagva B.,Ulaanbaatar State University |
Gutman I.,University of Kragujevac
Match | Year: 2011
Let G = (V, E) be a graph, du the degree of its vertex u, and uv the edge connecting the vertices u and v. The atom-bond connectivity index and the sum-connectivity index of G are defined as ABC = ΣuvεE √(du + dv - 2)/(dudv) and Χ = ΣuvεE 1/√du + dv, respectively. Continuing the recent researches on ABC [B. Furtula, A. Graovac, D. Vukičević, Atom-bond connectivity index of trees, Discr. Appl. Math. 157 (2009) 2828-2835] and Χ [B. Zhou, N. Trinajstić, On a novel connectivity index, J. Math. Chem. 46 (2009) 1252-1270] we obtain novel upper bounds on these vertex-degree-based graph invariants.
Jochberger S.,Innsbruck Medical University |
Bataar O.,Ulaanbaatar State University |
Mendsaikhan N.,Ulaanbaatar State University |
Grander W.,Community Hospital Hall in Tirol |
And 3 more authors.
Journal of Clinical Anesthesia | Year: 2010
Study Objective: To evaluate the current status of anesthesia and its allied disciplines in Mongolia. Design: Nationwide questionnaire survey. Setting: Two university hospitals. Measurements: A total of 44 hospitals that include a department of surgery and that were registered at the Mongolian Ministry of Health were queried. The questionnaire included 44 questions in two sections. The first section consisted of 6 general questions about the hospital, and the second section included 40 questions on anesthesia and perioperative patient care. The Mann-Whitney U-test, Chi2-tests, and a bivariate correlation analysis were used for statistical analysis. Main Results: 44 (100%) questionnaires were returned. Twenty-two (50%) hospitals were located in the capital city of Ulaanbaatar. Nine hundred (median; interquartile range: 413-1,468) surgical interventions were performed annually in the study hospitals. Physician anesthesiologists delivered anesthesia in all hospitals. Techniques for general anesthesia included endotracheal intubation (95.5%), laryngeal mask ventilation (13.6%), mask ventilation (27.3%), dissociative ketamine anesthesia (84.1%), and combined general/regional anesthesia (63.6%). Regional anesthetic techniques included spinal (97.7%), epidural (43.2%), axillary plexus (40.9%), peripheral nerve (13.6%), and local anesthesia (15.9%). The most frequently used hypnotics were ketamine (86.4%) and thiopental sodium (70.5%). Halothane was available in all hospitals. Oxygen was available during anesthesia in 95.5% of hospitals. The most widely available intraoperative monitoring equipment were a stethoscope (84.1%), oximeter (81.8%), and sphygmomanometer (84.1%). A recovery room was available in 22 (50%) hospitals. Conclusions: Anesthesia is an underdeveloped and under-resourced medical specialty in Mongolia. © 2010 Elsevier Inc. All rights reserved.
Baasantseren G.,National University of Mongolia |
Batbayr D.,Ulaanbaatar State University |
Choimaa L.,National University of Mongolia
Proceedings of SPIE - The International Society for Optical Engineering | Year: 2015
Integral imaging (InIm) is an interesting research area in the three-dimensional (3-D) display technology. While it is simple in structure, it shows full color and full parallax 3-D images without the necessity of special glasses. InIm display usually uses the simplest lens array, and hence displayed 3-D image suffers from distortions. A dominating distortion is a Petzval curvature. To the authors' best knowledge, we have firstly analyzed an effect of the Petzval curvature in InIm display. The immediate consequence of Petzval curvature is that the depth plane of InIm display becomes a curved plane array. Using simulation, the effect of Petzval curvature is found to reduce the depth range, change the viewing direction, and increase the black stripe. The result indicates that the lens array in the InIm display should be customized to reduce these undesirable effects. © 2015 SPIE-IS&T.
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