The relevant data were analyzed by Spearman correlation test (P < 0.05). The levels of cTnI and HS cTnI in the experimental group increased with the extension of time and the deepening of poisoning degree; four hours after admission, ST2 and NT proBNP water in the control group and the experimental group increased significantly on average. According to the analysis of the data, there was a positive correlation between HS TnI and ST2 in patients with AOPP . The more serious the disease, the higher the concentrations of HS TnI and ST2, and the more serious the myocardial injury.The role of soluble growth stimulating gene 2 protein and highly sensitive cardiac troponin in the diagnosis of early myocardial injury caused by acute organophosphorus pesticide poisoning was studied. 171 inpatients with AOPP were divided into three experimental groups according to their mild, moderate, and severe conditions. 20 healthy people were selected as the control group. The levels of cTnI, HS-CTNI, NT proBNP, and ST2 were measured at the 4th and 12th hours after the experiment. The measured data were expressed by mean standard deviation. The independent sample  Our country is agricultural country, many poisoning patients, including acute organophosphorus pesticide poisoning  of emergency poisoning disease first , the ons171 AOPP patients treated in the emergency department of Hengshui people's Hospital from August 2016 to October 2019 were selected for the experiment. Among them, all patients met the AOPP diagnostic criteria in the eighth edition of internal medicine . The poiP > 0.05.171 patients with AOPP were hospitalized after routine treatment due to acute organophosphorus pesticide poisoning. According to the eighth edition of internal medicine, 171 patients with AOPP were divided into three experimental groups according to the dose of pesticides ingested by mistake and the harm degree of different pesticide components, including 46 cases in the mild group, 56 cases in the moderate group, and 69 cases in the severe group. After treatment, all patients improved without death. Twenty healthy people without any disease were selected as the control group, including 10 males and 10 females, aged from 30 to 55 years, with an average of 43.15 ± 3.80 years. There was no significant difference between the two experimental groups in other aspects, In this experiment, the automatic detection analyzer of heart reader is selected to detect cTnI (0-0.5 ng/ml), HS cTnI (0-0.08 ng/ml), and NT proBNP (0-250). This instrument is an existing common detection instrument in the hospital. At the same time, 5 ml blood samples were collected at the speed of 3000r/min and centrifuged for 10 min to separate the serum. Soluble growth stimulating gene 2 (sst2) protein (< 35 ng/ml) was detected by enzyme-linked immunosorbent assay (ELISA). The toolkit was developed by C & amp, provided by company D. The research scheme of this subject has been approved by the hospital ethics committee, and the patients participating in the experiment have also received the support and consent of their families. The symptoms and ECG of poisoning patients were observed.t-test method of independent samples, and the test of multiple groups of data is checked and compared by the way of univariate. Count data 2 × 2 table comparison between groups using X2 test; Spearman correlation coefficient test is used for correlation analysis between data. P value represents the test level. If P < 0.05 is measured, it indicates that there is a statistical difference. The F value of ANOVA was used to evaluate the difference between groups. The greater the F value, the better the significance as shown in The data were analyzed by SPSS 21 software. The independent samples were normally distributed. The experimental data are measured in the way of average standard deviation, the pairwise comparison between the data is checked by the P > 0.05). In terms of toxic dose, there was significant statistical significance among the groups (P < 0.05). See There is no obvious difference in clinical data between AOPP patients with different degrees of poisoning, such as gender, age, weight, and time to visit the doctor for poisoning , and there was significant difference between the two groups (P < 0.05). It was found that the levels of cTnI and HS cTnI in the experimental group increased with the increase of time and poisoning degree. The test results within 12 hours were significantly higher than those within 4 hours. There was significant difference between severe group and mild group (P < 0.05), indicating that the measurement data were statistically significant as shown in The serum HS cTnI level of AOPP patients with different 1-hour poisoning degrees was higher than that of the control group . Compared with the mild group, the poisoning degree in the severe group was higher than that in the mild group, but there was no significant difference in cTnI level between the two groups . At 4 and 12 hours after admission, the results showed that ST2 in the experimental group and the control group increased, and the increase was most obvious in the severe group. The SST measured at 212 hours in each group was significantly higher than that measured at 4 hours. There was significant statistical significance in the comparison of measurement data among groups. At 1 h after admission, NT proBNP in each group was within the normal range. At 4H and 12 h after admission, NT proBNP gradually increased with time, and the severe group was significantly higher than the control group, which confirmed that NT proBNP could evaluate the severity of AOPP myocardial injury. The more severe the myocardial injury, the higher the level of ntprobnp. With the aggravation of AOPP poisoning, the level of NT proBNP increased gradually. The comparison between ST2 and ST2 was statistically significant (P < 0.05).One hour after admission, the level of ST2 in the experimental group was higher than that in the control group. In the experimental group, ST2 in the severe group was higher than that in the mild group and moderate group, and the measured data between groups were statistically significant . The more serious the patient's condition, the higher the concentration of Hs-TNI and sST2, and the more severe the myocardial injury.According to the analysis of the obtained data, there is a positive correlation between Hs-TNI and sST2 in AOPP patients (P < 0.05). In addition, the level of ST2 in the experimental group and the control group increased at 4 and 12 hours, especially in the severe group. ST2 increased significantly at 12 hours after admission compared with 4 hours after admission (P < 0.05).Through the data analysis of the research results, it can be found that the ST2 of the moderate and severe groups in the experimental group is higher than that of the control group and also higher than that of the mild and moderate groups in the experimental group. Compared with the control group, the difference was statistically significant  toxin directly damages cardiomyocytes ; (2) theWhen the heart is damaged due to AOPP poisoning, a large amount of cTnI is released into the blood, which can be detected 3-6 hours after the onset and reach the peak at 18-24 hours, and the blood concentration can be maintained for 6-10 days . HoweverIn addition, as a new biomarker, sst2 can reflect inflammation, fibrosis, and myocardial tension at the same time and can predict the occurrence of adverse cardiovascular events , 15. ST2Myocardial ischemia and hypoxia are important promoters of NT proBNP release , which aAccording to the above data, the early degree of myocardial injury in patients with AOPP can be identified by detecting the levels of HS cTnI and ST2, so as to evaluate the degree of myocardial injury more objectively. Both were also positively correlated with the severity of AOPP. It is suggested that hs-tni combined with ST2 can better evaluate the early myocardial injury after poisoning. The degree of myocardial injury can be seen from the concentration of hs-tni. The higher the concentration, the more serious the injury. The decrease of serum cholinesterase cannot fully reflect the degree of organophosphorus pesticide poisoning, let alone evaluate the situation of myocardial injury.This paper studied the diagnosis of soluble growth stimulating gene 2 protein ST2 and highly sensitive cardiac troponin IHS cTnI for early myocardial injury caused by acute organophosphorus pesticide poisoning. 171 inpatients with AOPP were divided into three groups  and 20 healthy people (control group). The levels of cTnI and HS-CTNI in the experimental group increased with the extension of time and the deepening of poisoning degree; ST2 and NT proBNP water increased significantly on average. By detecting the levels of HS-CTNI and ST2, the degree of early myocardial injury in patients with AOPP can be determined, so as to evaluate the degree of myocardial injury more objectively.To sum up, when the AOPP caused human myocardial injury, we can know and evaluate the degree of human myocardial injury through early detection and detection of HS-CTNI and sST2 levels and timely guidance and adjustment of therapeutic measures, reduce the further deterioration of cardiac function, reduce the disability rate, and improve the long-term prognosis.


The input factors considered were the GO by wt.% of cement  and CR as a replacement of fine aggregate by volume . The results showed that increasing the percentages of GO and CR affected the fresh properties of the SC-GORECC adversely. However, all mixes have T500 of 2.4 to 5.2 s, slump flow of 645 to 800 mm, V-funnel time of 7.1 to 12.3 s, and L-box ratio (H2/H1) of 0.8 to 0.98, which are all within acceptable limits specified by EFNARC 2005. The developed response prediction models were well fitted with R2 values ranging from 91 to 99%. Through the optimization process, optimal values of GO and CR were found to be 0.067% and 6.8%, respectively, at a desirability value of 1.0.Graphene oxide-modified rubberized engineered cementitious composite (GO-RECC) is attracting the attention of researchers because of the reported benefits of the GO and crumb rubber (CR) on the strength and deformation properties of the composite. While it is well established that GO negatively affects the workability of cementitious composites, its influence on the attainment of the desired self-compacting (SC) properties of ECC has not yet been thoroughly investigated, especially when combined with crumb rubber (CR). In addition, to simplify the number of trial mixes involved in designing SC-GO-RECC, there is a need to develop and optimize the process using Design of Experiment (DOE) methods. Hence, this research aims to investigate and model using response surface methodology (RSM), the combined effects of the GO and CR on the SC properties of ECC through the determination of T Current infrastructure development trends push conventional construction materials to their limits and urge researchers to develop new materials or improve existing ones to meet the constructions’ needs ,2,3. OneECC is mainly utilized for repair and retrofitting works, although many attempts are being made to improve its properties for structural purposes ,9,10. InAlthough research works on using GO in ECC and rubberized ECC (RECC) are still in the early stages, the preliminary findings are encouraging due to its superior performance over other nanomaterials. GO has a 2D planar structure with numerous oxygen-containing functional groups on its surface . The plaGO is increasingly being used in the modification of RECC. Sebapathy et al.  reportedECC is generally designed to have self-compacting (SC) properties in the fresh state. ECC designed as self-compacting (SC-ECC) in a fresh state has adequate flowability, passing ability, filling ability, and resistance to segregation ,28. Prev500 and V-funnel times, indicating lesser mix workability with CR increasing from 0 to 30%. They attributed this to the increasing volume of larger-sized CR particles, which increased interparticle friction due to their rough surface texture, affecting the capacity of the mix to flow under its weight. However, unlike GO, where its reducing effect on the fluidity is unanimous, some researchers have reported an increase in ECC’s workability with an increase in CR, attributed to the hydrophobic nature and water repulsion effect of the rubber particles, leading to an increase in the amount of water in the mix [The negative effect of GO on the fluidity of cementitious composites has been fully established. A recent finding by Wei et al.  revealed the mix ,39. HencWith the present surge of interest in GO-RECC research, there is scarce information on the combined effects of GO and CR on SC properties, especially given the reported adverse effect of these materials on the workability of the mix separately. Most researchers focus more on the hardened properties, neglecting the material’s performance in the fresh state, which is essential in attaining the desired properties in the hardened state. Therefore, there is a need to get optimized levels of these additives to guarantee the desired SC performance in the fresh state.SC mix optimization generally involves multiple trial batches to balance flowability, stability, and hardened properties ,40. ThisOne of the most commonly used experimental designs is the response surface methodology (RSM). RSM is a set of statistical and mathematical tools for designing, enhancing, and optimizing processes . It is a2 + Al2O3 + Fe2O3) oxide content of more than 70% and classified as F based on ASTM C618 specifications was used. The FA has a specific gravity, fineness, and loss on ignition of 2.3, 1.5895 m2/g, and 1.87%, respectively. River sand with an average particle size of 400 μm, a specific gravity of 2.65, and a fineness modulus of 2.20 was used as the fine aggregate. The CR used for partially replacing fine aggregate has particles passing 1.18 mm sieve and a specific gravity of 0.95. The materials used to prepare the mixtures include type I ordinary Portland cement (OPC) of grade 32.5R, satisfying the Malaysian standard MS EN 197-1 . Fly ashThe RSM package on Design-Expert Software (Version 10) was used for the experimental design, modeling, and optimization. The procedure is divided into three steps, which are as follows: (1) generating and running a series of experiments using different combinations of input factor values. The experimental runs can be generated using different design options, including central composite design (CDD), Box Behnken Design (BBD), User Defined Design (UDD), and Optimal Design (OD). (2) Based on the level of interaction of the independent and dependent variables, mathematical response predictive models are developed based on the empirical data gathered in the first step. The developed models are then validated using analysis of variance (ANOVA). Lastly, (3) a multi-objective optimization is used to find the best solution for the levels of the input factors and the responses under consideration. In order to assess the outcome of the optimization and the prediction of the model’s strength, experimental validation is usually conducted ,22,45.500, V-funnel, and L-box tests based on the requirements of EFNARC 2005 [In this case, the input variables were the GO at 5 levels  and CR partial replacement of fine aggregate at 3 levels . Fifteen experimental runs (mixes) were generated using the RSM, as shown in ARC 2005 . For comARC 2005 ,48,49 wiThe dry materials, including cement, FA, fine aggregate, and CR, were initially mixed for two minutes in a pan-type concrete mixer with double rotation capability. Following that, a mixture of water, HRWR, and GO was added to the mixer and mixed thoroughly for 5 min. The GO was well dispersed in the mixing water due to the dispersing effect of the polycarboxylate-based superplasticizer as established in previous studies ,50,51. PAs described by EFNARC, freshly mixed concrete is self-compacting only if it satisfies the filling ability, passing ability, and segregation resistance requirements . These r500, the Abrams (slump) cone has been used to assess the ability of fresh SCC to flow. The fresh ECC has been poured into the slump cone placed on a nonabsorbent platform marked with two concentric circles of 500 mm and 1000 mm diameters. The slump flow was measured using the average flow diameter measured from two orthogonal directions, as depicted in For slump flow and T500 is a secondary measure of flow. Once the slump cone is removed after filling with the fresh concrete, the time taken for the mixture to reach a 500 mm spread circle is recorded as T500 flow time. The V-funnel test was used to determine the self-compacting ECC’s filling-ability. The test was carried out by filling the v-shaped funnel with fresh ECC, as shown in TThe L-box test assesses the passing ability of the mixture to pass through the obstacle without the separation of the constituents, as shown in 500 result of all the mixes is shown in 500 of more than 2 s, placing them in the V2 viscosity class. Higher time indicates higher viscosity, which is inversely proportional to the workability of the mix. The trend reveals that as GO levels increased, the T500 increased by 92.6% between M14 and M3, both of which have 5% CR but contain 0% and 0.08% GO, respectively. A similar increase in the viscosity of the mixes with an increase in the level of GO can be observed across all the mixes having the same CR replacement levels. This is attributed to the high affinity between the surface functional groups on the GO and the cement particles, which increased the flocculation of the cement particles trapping free water, aggravating the loss in the fluidity of the mix [The T the mix .500 has a 10, 20, and 16.67% drop for 5, 10, and 15% CR replacements compared to the control mixture. This is due to the hydrophobic CR particles’ water repulsing effect, leading to more fluidity of the mixtures because of the free available water [500 decreased, signifying a reduction in the viscosity of the mixes. This trend occurs because, at a CR replacement level of 5%, it was too low to induce any substantial improvements in workability other than those caused by the GO, and it is entirely dominated by the cement and GO flocculants. However, the GO had a reduced impact at a higher CR level of 10%, which resulted in the excess CR trapping air on their surface owing to their hydrophobic nature [In addition, it can be observed that at 0% GO, an increase in CR caused a reduction in the viscosity compared to the control mixture. The Tle water . It is nc nature ,53, incr500 of all mixes when the CR increased from 10% to 15%. This is due to an increase in interparticle friction caused by the rubber particles’ rough surface morphology [When the CR replacement was raised to 15%, the viscosity of the mixes increased slightly across all GO levels. This is evident from the slight rise in the Trphology , which sThe slump test measures the consistency of a fresh mix. EFNARC classifies the consistency into three: SF1 (500–650 mm), SF2 (660–750 mm), and SF3 (760–850 mm). The result of the SF for the mixes is shown in 500. Compared to the control mixture at 0% GO, 5% CR replacement led to a reduction of 5% in the slump flow. However, as the CR increased to 10%, the loss in the SF was completely recovered. When the CR increased to 15%, the SF reduced by about 4%. The fluctuation in the SF with an increase in the CR from 5% to 15% was observed across all GO additions. The rough-surfaced rubber particles cause greater interparticle friction, which reduces the flowability of the mix at 5% CR. Nonetheless, at 10%, the higher air content of the mix owing to trapped air by the hydrophobic CR boosted flowability due to the trapped air bubbles’ ball-bearing action. When the CR was raised to 15%, however, the low density of the rubber particles hampered the mix’s capacity to flow under its weight, lowering the SF [The effect of CR on the SF follows the same pattern as its effect on TAccording to EFNARC guidelines, the VF1 viscosity class mixes may be used for floors and slabs, while the VF2 viscosity class mixes can be used for ramps, walls, and piles.The L-box test measures the passing ability of a mix defined by EFNARC as the ability of the fresh mix to move into confined spaces and narrow channels, such as sections of congested reinforcement, without segregation, loss of homogeneity, or creating a blockage. The passing ability is expressed as a blocking ratio of H2/H1. H1 and H2 are the mix heights in the vertical and horizontal components of the L-box, respectively. The blocking ratio of the mixes follows a downward trend with an increase in the GO addition and CR replacement levels of fine aggregate, as shown in The reduced passing ability of the mixes with an increase in the variables is due to the increased viscosity. The GO also increased the adherence of the CR and PVA fibers to the cement paste ,55, makik, while the random error is denoted by The predictive response models in this study were developed using RSM. The models’ reliability was checked using analysis of variance (ANOVA). Response models produced might be linear or higher-degree polynomials as presented in a generalized format in Equations (1) and (2), respectively.500, SF, VF, and H2/H1. These models are based on empirical data collected from the experiments. High values of the variables are encoded as +1 by default, whereas low levels are encoded as −1. By comparing the coefficients of the variables, the coded equations may be employed to determine their relative importance.The response models developed in coded factors are presented in Equations (3)–(6) for the T500 and slump flow were fitted with quadratic models while 2FI and linear models were found more suitable for the V-funnel and H2/H1, respectively.A and B denote the GO addition in wt.% of cement and CR replacement of fine aggregate by volume as the independent variables, respectively. It can be seen that the T500 and SF models were A, B, and A2, showing that the independent variables (A and B) directly influenced the responses and that the responses had a quadratic effect with A, respectively. In the case of the VF model, A, B, and AB are significant model terms signifying that both the input factors directly influence the response, and so was their interaction. A and B are all significant in the H2/H1 model.ANOVA test is the next stage in developing RSM-based models, performed for validation. The analysis in this study was done at a 95% confidence level, signifying a probability of 5% (0.05). Thus, any model or model-term with a probability lower than 5% is considered statistically significant. The summary of the analysis is presented in 2) of 99, 98, 90, and 98%, indicating that the models fit the data very well. Furthermore, it is recommended that for a model to fit, the difference between the Adjusted and Predicted R2 (Adj. R2 and Pred. R2) should not be more than 0.2. As can be observed, the difference between the Adj. R2 and Pred. R2 for all four models is in good agreement, with a difference of less than 0.2. In addition, for a good model, the signal-to-noise ratio indicated by the Adequate Precision value (Adeq. Presc.) should be more than 4, a condition satisfied by all the developed models.The model validation parameters are presented in Model graphs in the form of 2D contour and 3D response surface diagrams depict the individual and combined effects of the input factors and their interactions on the response. The graphs are represented by contours, which depict response changes at various degrees of input factors as shown in The model diagnostic tools used include the Normal plot of Residuals and the Actual versus Predicted graphs, as shown in The optimization aims to find acceptable values of the independent variables to achieve an optimal level of the desired response. This is accomplished by assigning different criteria and levels of significance to the variables (input factors and response) to fulfill the objective function. The desirability value 0 ≤ dj ≤ 1) is used to assess the optimization. The better the outcome (often stated as a percentage), the closer the number is to 1 [ is used 500, Sf, VF, and H2/H1, respectively. The optimization was done at the desirability of 1.0, indicating an excellent solution. These response values are within the specified limits by EFNARC.The optimization criteria, in this case, are presented in Usually, the final step of RSM analysis involves the conduct of experimental investigations with the view to validate the predictive models and the optimization. A mix containing the optimum amount of the input variables was made, and all the workability tests were performed. The predicted and the experimental results are presented in The use of GO and CR together affects ECC’s self-compacting properties by lowering the flowability of the mixes caused by the GO particles’ high water absorption due to internal curing and the rough surface texture and lower density of the CR particles;Despite the adverse effects of the GO and CR on the fluidity of the ECC mixes, all the self-compacting properties were found to be within acceptable limits set by EFNARC 2005. Hence, this confirms that the presence of GO and CR does not hinder the attainment of the desired SC characteristics. However, better performance of the fresh ECC mixes was attained at lower levels of the input factors (GO and CR);2) between 91–99% for all the SC parameters considered;Response surface models developed to predict the SC-GO-RECC’s self-compacting properties were confirmed to be very accurate with a coefficient of determination (RGO addition of 0.067 wt.%, and CR replacement of 6.8% was obtained as the optimum levels of the input variables generated by the optimization, which will guarantee an SC-GO-RECC with the best performance in the fresh state;As a limitation, the results presented and the models developed are only applicable and valid within the limits of the input factors considered in this study which are 0 to 0.08 wt.% of cement for GO and 5% to 10% for CR replacement by volume of fine aggregate.This research was done to assess GO and CR’s combined effect on SC-ECC’s workability properties and to develop predictive models of the properties using RSM, and the following conclusions were drawn:


Expanded polystyrene (EPS) concrete is commonly used as the core material of commercial sandwich panels (CSPs). It is environmentally friendly and lightweight but has poor strength. Adding fibers can improve the microstructure of EPS concrete and reduce the weakening effect of EPS beads on the mechanical properties of concrete. An orthogonal experimental design (OED) was used in this paper to analyze the influence of length and content of polypropylene fiber (PF), glass fiber (GF), and carbon fiber (CF) on the physical and mechanical properties and micromorphology of EPS concrete. Among them, CFs have the most apparent impact on concrete and produce the most significant improvements in all properties. According to the requirements of the flexural performance of CSPs, the splitting tensile strength was taken as the optimization index, and the predicted optimal combination (OC) of EPS concrete with fibers was selected. The variations in the material properties, mechanical properties, and microstructure with age were analyzed. The results show that with increasing age, the dry density, compressive strength, and splitting tensile strength of concrete are markedly improved relative to those of the CSP core material and the control case (CC), and even the degree of hydration is improved. Expanded polystyrene (EPS) beads are byproducts of petroleum engineering and have the advantages of facility acquisition low densities, economical prices, low water absorption, and great thermal insulation performance. However, they still have the following disadvantages: they are nondegradable, difficult to recycle and treat, and they have poor mechanical strength. EPS beads can be used for the partial replacement of raw aggregates and can be made into EPS concrete, which not only utilizes industrial waste but also saves the usage of aggregates and reduces the density and weight of concrete. It is worth noting that EPS concrete is fairly environmentally friendly.3, the density of concrete can be sharply reduced by adding EPS beads. As the proportion of EPS increases, the density, compressive strength, splitting tensile strength, and elastic modulus of concrete present decreasing trends [Owing to the low density of EPS beads, which is generally lower than 20 kg/mg trends ,2,3,4,5.g trends  under thg trends ,7.Fly ash (FA) is used as supplementary cementitious material, and it improves the water absorption rate  and reduEPS beads have minimal mechanical strength. Thus, the strength of EPS concrete is mainly determined by the strength of concrete without EPS beads and its microstructure. The ordinary method for enhancing the mechanical strength of EPS concrete without affecting its low density and lightweight design is to add fibers. Fibers have a significant enhancement effect on the mechanical properties of concrete ,14,15,16In summary, the mechanical properties of EPS concrete are severely weakened due to the poor mechanical properties of the EPS beads added to concrete. Nevertheless, recent research on fiber-modified EPS concrete is relatively limited, especially research on the various properties at different ages. Therefore, it is necessary to investigate the influence of various factors of fibers on the material and mechanical properties of concrete.In this paper, the orthogonal test method is mainly used to investigate the influence of the three factors of fibers, which are the type, length, and proportion, on the various properties of EPS concrete. The physical properties, mechanical properties, and micromorphology of the specimens are investigated. On this basis, the application of sandwich panels is taken as an example, and the mechanical properties and microscopic characteristics of EPS concrete at various ages are discussed according to the requirements of improving the splitting tensile strength.3. A polycarboxylate-based superplasticizer (SP) (S04B type) was adopted.In this paper, ordinary Portland cement (OPC)  according to the requirements of P. O. 42.5 in GB175-2007  and Type3 and a bulk density of 11.31 kg/m3 were adopted and tested under the screening method and bulk density measurement method specified in GB/T 17431-2010 [EPS beads with an apparent density of 25.1 kg/m431-2010  and ASTM431-2010 . The fibAn orthogonal experimental design (OED) was adopted to determine the optimal indexes of the fibers, with three factors and three levels, as shown in EPS concrete without fiber was added as the control case (CC) based on the OED. The naming rules are as follows: the first letter is fiber type, the first two digits are fiber length, and the last two digits are fiber content. For instance, P0605 means choosing PF with a length of 6 mm and a dosage of 0.5%. The mixed number of other contents such as cement, SF, water, NRS, SP , and EPSSlump and dry density tests were performed according to GB/T 50080-2016 , and theA KYKY-EM6200  scanning electron microscope (SEM) and SmartLab-9 (manufactured by Rigaku from Japan) diffractometer for X-ray diffraction (XRD) were used to analyze the microstructure and various diffraction phases of concrete. The scanning voltage, electric current, speed, and scanning 2θ range were 45 kV, 200 mA, 12°/min (step size was 0.02°), and 5–60°, respectively.The test results of the material and the mechanical properties with the curing age of 28 days of concrete are shown in The results show that the addition of fibers can greatly enhance the consistency and reduce the flowability of concrete, resulting in a decrease in workability. The mean response analysis of the slump values is shown in For the type of fiber factor, the maximum is level 1, and the minimum is level 3. For the length factor, the minimum value appears at level 2, and the maximum value appears at level 1. The slump has strong negative correlations with the proportion of fibers; namely, the minimum value is at level 3 and the maximum value is at level 1.3 to 1151.2 kg/m3. P0915 has the minimum dry density value, P1210 has the maximum dry density value, and the dry density of CC is 1036.6 kg/m3. The results show that the addition of fibers can influence the dry density to some degree. The mean response analysis of the dry density is shown in The dry density ranges from 986.42 kg/mFor the type of fiber factor, the minimum is level 1, and the maximum is level 3. The dry density has significant positive correlations with the lengths of fibers; namely, the minimum value is at level 1 and the maximum value is at level 3. For the proportion factor, the minimum value appears at level 3, and the maximum value appears at level 2.The water absorption rate ranges from 3.5% to 9.5%. G0905 has the minimum value, G1215 has the maximum value, and the water absorption of CC is 5.5%. The results show that the addition of fibers has a certain effect on water absorption. The mean response analysis of water absorption is shown in The minimum value of the type factor appears at level 3, and the maximum value appears at level 2. For the length factor, the minimum value appears at level 2, and the maximum value appears at level 3. The minimum value of the proportion factor appears at level 2, and the maximum value appears at level 3.The UPV ranges from 2.74 km/s to 3.02 km/s. P0515 has the minimum value, G0905 and G0910 have the maximum values, and the UPV of CC is 2.86 km/s. The results show that the addition of fibers has an influence on the UPV to a certain extent. The mean response analysis of the UPV is shown in For the type of fiber, the minimum value of the type factor appears at level 1, and the maximum value appears at level 2. The UPV is positively correlated with the lengths of fibers, where the minimum value is at level 1 and the maximum value is at level 3. The minimum value of the proportion factor appears at level 3, and the maximum value appears at level 2.The drying shrinkage values of CC and other specimens were tested, and the curing ages were from 1 day to 120 days (9 age stages). Correspondingly, the changing trend of CC was used as the reference baseline to evaluate the improvement degree of the fiber for dry shrinkage, and the relationship between the change rate of dry shrinkage and curing time was drawn, as shown in It can be seen from the figure that the dry shrinkage value increases with curing age, and the curve of CC is in the middle of the overall ranges for all cases. The results indicate that the addition of fibers has a significant effect on dry shrinkage. In particular, the dry shrinkage values of C1205, C0615, C0910, and G1215 were improved significantly. Correspondingly, CF has a greater influence on dry shrinkage than GF and PF.The mean response of dry shrinkage at the standard age (28 days) is shown in The compressive strength ranges from 6.12 MPa to 12.35 MPa. G1215 has the minimum value, C1205 has the maximum value, and the compressive strength of CC is 8.58 MPa. The results show that the addition of fibers has an apparent effect on compressive strength. The mean response analysis of the compressive strength is shown in For the type of fiber factor, the minimum value is level 1, and the maximum value is level 3. For the length factor, the minimum value appears at level 3, and the maximum value appears at level 2. There is a negative correlation between the compressive strength and the proportion of fibers, where the minimum is at level 3 and the maximum is at level 1.The splitting tensile strength ranges from 0.88 MPa to 2.35 MPa. P0605 has the minimum value, C0615 has the maximum value, and the splitting tensile strength of CC is 0.91 MPa. The results show that the addition of fibers has a great influence on the splitting tensile strength. The mean response analysis of the splitting tensile strength is shown in The minimum value of the type factor appears at level 1, and the maximum value appears at level 3. The fiber length factor is negatively correlated with the fiber length factor, where the minimum appears at level 3 and the maximum appears at level 1. For the proportion factor, the minimum value appears at level 1, and the maximum value appears at level 2.The uniaxial compressive strength ranges from 3.24 MPa to 11.11 MPa, G1215 has the minimum value, C1205 has the maximum value, and the axial compressive strength of CC is 7.68 The results show that the addition of fibers significantly influences the axial compressive strength. The mean response analysis of the uniaxial compressive strength is shown in For the axial compressive strength, the minimum value of the type factor appears at level 2, and the maximum value appears at level 1. The minimum value of the length factor appears at level 1, and the maximum value appears at level 2. The uniaxial compressive strength is negatively correlated with the proportion, where the minimum value appears at level 3 and the maximum value appears at level 1.The static elastic modulus ranges from 3.92 GPa to 11.32 GPa. C1205 has the minimum value, C0910 has the maximum value, and the static elastic modulus of CC is 6.79 GPa. The results show that the addition of fibers has an obvious effect on the static elastic modulus. The mean response analysis is shown in The minimum value of the type factor appears at level 2, and the maximum value appears at level 1. The minimum value of the length factor appears at level 3, and the maximum value appears at level 1. For the proportion factor, the minimum value appears at level 1, and the maximum value appears at level 2.The situation of the surface may be alterative during the mixing and forming processes of concrete. Hence, a rougher fiber surface is favorable for combining the concrete matrix and fibers . Figure As shown in Although a small number of hydration crystals is visibly attached to its surface, it looks smoother compared with the surface of GF and CF in EPS concrete. Therefore, the boundary between PF and concrete is inferior to that of the others, which accounts for the general lower mechanical properties of EPS concrete mixed with PF.2 [As shown in 2 ,46. HoweAs shown in Commercial sandwich panels (CSPs) are a common type of prefabricated concrete panels that commonly use EPS concrete as their core material. The tensile strength of EPS concrete becomes the controlling factor ,48,49 foIn addition, other performance tests were performed on OC and compared with CC and the CSP core  materialHence, the mechanical properties of CSPs are predominantly improved after modification by adding fibers. The density of the core material is increased by approximately 30%, but there is a 600% increase in the mechanical properties.Tests of dry density, compressive strength, and splitting tensile strength under OC at different curing ages and the influence of age on its properties were obtained. The age stages of this test were 7, 14, 28, 56, and 90 days. Three samples of each age stage were tested to obtain the dry density, compressive strength, and splitting tensile strength. The average value of each test result is shown in 3 to 1200.95 kg/m3. The curve fitting of the dry density is shown in As shown in The dry density continues to improve with increasing curing time, and the rate of increase gradually slows down as the age increases. When the age increases from 7 days to 28 days, 14 days to 28 days, 28 days to 56 days, and 28 days to 90 days, the dry density increases by 1%, 2%, 0.8%, and 1%, respectively. Although increasing age has an impact on the dry density, the improvement is not significant compared to that at the standard age; the improvement is only approximately 1% to 2%.The compressive strength of OC at different ages ranges from 9.43 MPa to 11.98 MPa. The curve fitting of dry density is shown in The compressive strength continues to improve with increasing curing time, and the rate of increase gradually slows down as the age increases. When the age increases from 7 days to 28 days, 14 days to 28 days, 28 days to 56 days, and 28 days to 90 days, the dry density increases by 2.5%, 2.5%, 23%, and 24%, respectively. It shows that the compressive strength of OC at an early age is approximately 98% of that at the standard age and is higher than the compressive strength of CC at the standard age. The compressive properties of OC increase significantly after reaching the standard age, but the growth rate slows down after 56 days. As shown in The splitting tensile strength of OC at different ages ranges from 1.73 MPa to 2.63 MPa. The fitting curve of the dry density is shown in When the age increases from 7 days to 28 days and from 14 days to 28 days, the splitting tensile strength increases by 0.75 MPa and 0.68 MPa, namely, 1% and 2%, respectively. When the age increases from 28 days to 56 days and 90 days, respectively, the tensile strength increases by 0.06 MPa and 0.15 MPa, which are improvements of 2% and 6%, respectively. However, after reaching the standard age, the splitting tensile strength continues to increase, but the improvement is not substantial. The splitting tensile strength continues to improve with increasing curing time, and the rate of increase gradually slows down as the age increases. When the age increases from 7 days to 28 days, 14 days to 28 days, 28 days to 56 days, and 28 days to 90 days, the dry density increases by 1%, 2%, 2%, and 6%, respectively. After reaching the standard age, the splitting tensile strength continues to increase, but the rate of increase is not sharp.The OC material at four ages  was analyzed by SEM. As shown in Clustered and thickened hydrated crystals are attached to the matrix and fibers of the surface and increase with age. Moreover, the overall mechanical properties are further enhanced, which may be attributed to the large number of hydration crystals observed on the surface of CF in the SEM micrographs, making the connection between the fiber root and the cement matrix closer.As shown in The OC material at ages 7, 14, 28, and 120 days was characterized by XRD, as shown in The various phases of the different ages are roughly the same. The main phases are the calcite and portlandite phases, as well as the nonahydrate alite and belite phases.3SiO3 and Ca2SiO4) at 7 days and 14 days are more significant than those at 28 days, especially the peaks at 7 days. The above shows that the longer the curing period is, the more sufficient the hydration degree is SiO2 continuously reacts with the cement matrix for secondary hydration, which is the main component of SF mixed in concrete. Ca(OH)2 is consumed continuously, which sufficiently promotes the secondary hydration of OC as the curing age increases. Accordingly, this is corroborated by the phenomenon observed by SEM.Similarly, the diffraction peaks of alite and belite (CaThe diffraction peak of Aft, namely, ettringite, was observed in the XRD pattern at the age of 120 days, accounting for the long curing period and the greater the degree of hydration. In fact, the adhesion between the fibers and the cement matrix is also improved when the hydration crystals are increased. Consequently, the mechanical properties of concrete are more effectively improved by the above two effects, hydration, and adhesion, whose effects are amplified when they are used together.To investigate the effect of fibers on EPS concrete under the factors of the fiber type, length, and proportion, an OED with three factors and three levels was designed. The material, mechanical properties, and microstructure of EPS concrete with fibers were tested. Furthermore, based on the CSP in the practice project, taking the splitting tensile strength as the selection criterion, OC was predicted. The dry density, the splitting tensile strength, the compressive strength, SEM, and XRD of the specimens at various ages were analyzed, and the following conclusions were obtained.The addition of fibers reduced the fluidity and workability of EPS concrete to a great extent. For the dry density, water absorption rate, and UPV, the addition of fibers had little effect. However, the dry shrinkage rate was considerably altered after the fibers were mixed, and the overall modification effect of CF was better than that of PF and GF. The compressive strength, splitting tensile strength, uniaxial compressive strength, and static elastic modulus of EPS concrete with fibers were significantly improved. Among them, the improvement in CF was the most remarkable. The microscopic analysis showed that the mixing of fibers promotes the hydration of concrete. Correspondingly, with increasing curing time, the hydration effect is also better. Furthermore, the hydration crystals considerably enhance the connection between the fibers and cement matrix, thereby improving the overall mechanical properties of the concrete. CF has the most marked improvement in mechanical properties due to its large contact area with the cement matrix and the large number of hydration crystals attached to its surface.Compared with CC, the dry density, splitting tensile strength, and compressive strength of OC increased by 14%, 172%, and 13%, respectively. Similarly, compared with the CSP, the dry density, splitting tensile strength, and compressive strength of OC increased by 31%, 591%, and 536%, respectively. That is, the mechanical properties are notably enhanced. The compressive strength increased rapidly at an early age and reached 98% of the compressive strength at the standard age. There was no obvious gap near the ITZ between CF and the cement matrix at all ages, which was observed by SEM and XRD analyses. Moreover, with increasing curing age, the abundant hydrated crystals on the surface of CF also multiplied, which is conducive to the further enhancement of mechanical properties. Moreover, the appearance of ettringite was observed at 120 days, which also proved that the addition of fibers can promote the hydration of concrete.


Cornu aspersum could be prototypes for antibiotics against pathogenic bacteria. Information regarding the mechanisms, effective concentration, and methods of application is an important tool for therapeutic, financial, and ecological regulation and a holistic approach to medical treatment. A peptide fraction with MW < 10 kDa was analyzed by MALDI-TOF-TOF using Autoflex™ III. The strain Escherichia coli NBIMCC 8785 (18 h and 48 h culture) was used. The changes in bacterial structure and metabolic activity were investigated by SEM, fluorescent, and digital image analysis. This peptide fraction had high inhibitory effects in surface and deep inoculations of E. coli of 1990.00 and 136.13 mm2/mgPr/µMol, respectively, in the samples. Thus, it would be effective in the treatment of infections involving bacterial biofilms and homogenous cells. Various deformations of the bacteria and inhibition of its metabolism were discovered and illustrated. The data on the mechanisms of impact of the peptides permitted the formulation of an algorithm for the treatment of infections depending on the phase of their development. The decrease in the therapeutic concentrations will be more sparing to the environment and will lead to a decrease in the cost of the treatment.Peptides isolated from the mucus of  The discovery and testing of new therapeutic tools with a studied and clear effect on different bacterial infections is becoming increasingly topical. The requirements for using such kinds of therapeutic tools are also increasing ,3,4,5,6.The reason for this search in the first place is that the antibiotics that have been widely used previously led to the development of resistance by pathogenic microorganisms. The new tools should be such that their bio attacks on pathogens do not lead to resistance in the pathogenic microorganisms ,8.Two consequences related to the epidemiologic and therapeutic measures have appeared: (1) due to the wide use of antibiotics in different combinations and treatment sequences, the danger of the appearance of resistance to contemporary antibiotics and infectious pathogens that represent a serious medical risk for people and animals has been accelerated; and (2) the low biodegradability and wide distribution of antibiotics have led to their accumulation in civil wastewaters, which has led to another serious ecological risk ,9,10.The ecological consequences are immeasurable compared to the medical ones and from a long-term perspective. The antibiotics and their metabolic products are present in purified waters and are distributed in water basins, drinking water, plants, and animals, and through the trophic chains, are returned to humans. These pollutants in the wastewaters and in the environment combine and interact with other chemical factors. All these factors inhibit the activated sludge and microorganisms that purify the waters and lead to a lasting disturbance of the restorative processes of the resources  in the treatment technologies for the environment as a whole ,4,9.These combined interactions with human health and life and the health and future of the planet are lasting. In the future, they will impact strongly on the life of the planet . The souThe discovery of therapeutic products with an antimicrobial action and with a chemical structure close to natural compounds is a contemporary tendency and is in unison with the concept that “Nature knows best—follow it”.The World Health Organization (WHO) declared that the increase in antimicrobial resistance to conventional antibiotics in recent decades is one of the three global threats to human health worldwide, and announced the start of the “post-antibiotics era” ,14.Invertebrates lack the adaptive immune system that is found in vertebrate species; therefore, they rely solely upon their innate immunity, in which AMPs play a crucial role in counteracting invading pathogens ,16,17,18Cornu aspersum) and the giant African snail (Achatina fulica) are amongst the most studied land snails m/z 3912.91 Da, 4041.15 Da, and 5197.26 Da, and various ions with lower intensities of 6194.62–7060.37 Da , leucine (L), valine (V), proline (P), tryptophan (W), glutamic acid (E), aspartic acid (D), phenylalanine (F), and arginine (R), which are typical for peptides with established antimicrobial activities. The physicochemical characteristics of the identified peptides (isoelectric points (pI), grand average of hydropathicity (GRAVY), and net charge) were determined using the ExPASy ProtParam tool. The analysis showed the presence of both cationic and anionic amphipathic peptide structures. Most peptide structures showed generally hydrophobic surfaces (The amino acid sequences (AASs) of the identified peptides in the fraction with MW below 3 kDa from the surfaces , but onlhttp://cabgrid.res.in:8080/amppred) (accessed on 10 January 2022), an extensive database [Based on the identified primary structures , antimicdatabase . The iAMThe results showed that peptides 9, 11, 12, 13, 15, and 16 had the highest prognostic, antibacterial, and antifungal activities, while peptides 5, 11, and 12 had the highest prognostic antiviral activities.Peptides 4, 7, and 8 had the lowest prognostic microbial activities. Some previous studies have shown  that if C. aspersum presented in http://www.campsign.bicnirrh.res.in/blast.php) (accessed on 10 January 2022), and revealed high homology of peptides 1, 6, 9, 11, 12, 13, 15, and 16 with known AMPs such as microcin, leptoglycin, glycine-rich protein GWK from Cucumis melo, ctenidin-1, ctenidin-3, holotricin-3, acanthoscurrin-1  for a short time—1 h impact on a 48 h bacterial culture of E. coli NBIMCC 8785.The impact of the peptide fraction MW < 10 kDa at a high concentration of 50% (0.5 mg/mL protein) on a 48 h bacterial culture with an exposition of action of 1 h was determined. The experiments were conducted in a liquid medium. In terms of therapeutic impact, this meant infections were in an advanced phase, when the treated has area contained bacteria of different ages that formed a bacterial succession. Another specificity for such pathogenic cultures is that there are also metabolic molecules around them from the dying bacterial cells. For the treatment of such infections, usually high initial concentrations of the therapeutic agent are used for the fast and effective manifesting of the bactericidal and bacteriostatic effects. The specific algorithm of the impact of the bacterial cells used was: high concentration of the peptide 50% The effects were determined through the study of the changes in the morphology of the bacterial cells using a scanning electronic microscope, as shown in In The impact of the peptide fraction MW < 10 kDa (0.5 mg/mL protein) at a high concentration of 50% (0.5 mg/mL protein) on 18 h bacterial culture with an exposition of impact of 1 h was investigated. The experiments were conducted in a liquid medium. In this course of experiments, we shaped the therapeutic situation in which the peptide fraction MW < 10 kDa treated infections that had arisen before 18 h. The algorithm was:E. coli NBIMCC 8785.High concentration of the peptide 50% (0.5 mg/mL protein) for a short time—1 h of impact in an 18 h bacterial culture of E. coli NBIMCC 8785 cells impacted by the peptide fraction with the fluorescent tetrazolium salt 5-cyano-2,3-ditolyl tetrazolium chloride (CTC).The analysis of the mechanisms of impact in this course of experiments was done by determining the level of damage of the metabolism of the bacterial cell through a dyeing of the 7 cell/mL with 50% peptide fraction after dyeing with CTC. It can be clearly seen that in the control, there was a large number of metabolically active bacterial cells of E. coli NBIMCC 8785. After the one-hour impact on the bacterial culture with a peptide fraction MW < 10 kDa, a strong inhibiting effect was seen in the metabolism of the bacterial agent [al agent ,50,51.The fluorescent images of the control and of the bacterial cells impacted by the peptide fraction MW < 10 kDa were digitally processed. The digital processing was performed on the following indicators: fluorescence intensity, average perimeter of the cells, roundness, and average area of the cells. The results of the changes to these parameters of the bacterial cells impacted by the peptide fraction MW < 10 kDa regarding the control are represented in The results indicated that the three parameters decreased after the impact by the peptide fraction MW < 10 kDa. This meant that the fluorescence intensity decreased by about 20%, the average perimeter decreased by about 15%, the cells’ length and roundness decreased by 4%, and the average area decreased by about 35%. Using the represented fluorescent images and their digital analysis, it was found that after the 1 h impact with the peptide fraction MW < 10 kDa, the bacterial cells had inhibited functions and had changed morphology. On the other hand, using Logic led us to question whether it was possible for the initial infection to have a decreased concentration of the therapeutic agent in the peptide fraction MW < 10 kDa (0.5 mg/mL protein) while, at the same time, having an increased exposition time. This algorithm for the treatment of the bacterial cells with the peptide fraction with MW < 10 kDa with the increase in the exposure time would lead to a series of positive effects: the use of a smaller quantity of peptide fractions that would be favorable regarding costs, emanation of therapeutic agents into the environment, and economization of resources at the expense of the exposition time. The studied algorithm was:Impact of the peptide fraction MW < 10 kDa (0.5 mg/mL protein) with concentrations 1, 5, and 10% on 18 h bacterial culture with an exposition of 6 h.E. coli NBIMCC 8785 cells impacted by the peptide fraction with the fluorescent tetrazolium salt 5-cyano-2,3-ditolyl tetrazolium chloride (CTC) and through SEM.The experiments were conducted in a liquid medium. Through this course of experiments, we shaped the therapeutic situation in which relatively newly formed infections (arisen before 18 h) were treated with the peptide fraction MW < 10 kDa. The aim was to choose the convenient, comparably low concentration of peptide fraction. The analysis of the mechanisms of impact in this course of experiments has been made using the level of damage of the metabolism of the bacterial cells through the dyeing of the The fluorescent images of the obtained results are presented in E. coli NBIMCC 8785, represented by the lengthening and decrease in the average area of the cells. Regarding the impact of the 5% peptide fraction, the three morphological parameters of the cells decreased—the average perimeter and average area decreased and the cells lengthened, but the metabolic activity was not affected (See The results shown in cted See .v/v) peptide fractions with 0.5 mg/mL protein and 6 h of incubation, a high inhibiting effect of the peptide fraction regarding E. coli NBIMCC 8785 was registered—a strong decrease in the fluorescence intensity meant a decrease in the metabolic activity, as well as an increase in the average perimeter and the average area of the cells, and their lengthening.In the 10%  strong lengthening of the cells—the lengthened cells reached three times the size of the normal cells  al cells a,c; (3) al cells a,b,d,f; al cells a,d,f.One of the most unexpected effects of damage of bacterial cells registered by SEM was a triple increase in the size of the cells.The strongly lengthened cells also were registered through a fluorescent technique—a dyeing with the fluorescent labelled tetrazolium salt 5-cyano-2,3-ditolyl tetrazolium chloride (CTC). The results illustrating these cells that were three times larger that were obtained after the impact of the peptide fraction MW < 10 kDa for 6 h are presented in Comparing the data in C. aspersum has been the subject of research by our scientific team. Using tandem mass spectrometry, the primary structures of nine antimicrobial peptides with molecular weights of 1000–3000 Da in an isolated fraction with MW < 10 kDa from mucus from the garden snail C. aspersum with active components were identified. These peptides were rich in glycine and leucine residues, and demonstrated strong antibacterial activity against a Gram-negative bacterial strain—E. coli NBIMCC 878 [B. laterosporus and E. coli, and another 20 kDa peptide fraction against the bacterial strain C. perfringens [In recent years, the mucus from the garden snail IMCC 878 . Moreovefringens .A characteristic of the structures of peptides with the highest prognostic, antibacterial, and antifungal activity was the content of high levels of glycine and leucine residues, which indicated that they belonged to a new class of antimicrobial peptides rich in Gly/Leu that demonstrated antibacterial activity mainly against Gram-negative bacteria . Previou2SO4 assay were glycosylated [Our previously published data in Dolashki et al., 2020 showed that some peptides that were detected by an orcinol/Hosylated . The glyosylated ,58,59,60osylated .E. coli NBIMCC 8785 most likely can be attributed to the peptides presented in The observed antibacterial activity against E. coli NBIMCC 8785. The results of the conventional study of the antibacterial activity of the fractions with MW < 3 kDa, MW 3–5 kDa, MW 5–10 kDa, MW < 10 kDa, and MW < 20 kDa indicated that the fraction of peptides MW < 10 kDa had a higher antibacterial effect in surface and deep inoculations of the bacterial material [The results of our study indicated the great opportunities for the isolated and characterized peptide fractions of snail mucus to be used for treatment of infections caused by material ,36,37,57E. coli and its composition clarified from a chemical point of view. Other factors that make this fraction convenient for application are, on one hand, the lower molecular weight of the peptides means they can more easily penetrate into the bacterial cells; and on the other hand, the surplus of these therapeutic tools will degrade faster in the environment [The peptide fraction with MW < 10 kDa would be an interesting subject of future studies of the mechanism of the antibacterial activity due to its specific actions against ironment ,10,43,50E. coli NBIMCC 8785. The morphological parameters of the cell were changed, and the metabolic activity was inhibited at a very high level. When studying the opportunities for the achievement of the desired effect in newly arisen infections through a decrease in the concentration of the peptide fraction but with an increase in the exposition time, we found that the 10% peptide fraction led to the achievement of the desired effect—damage to the structures and functions of the bacteria [Depending on the type and the phase of development of the infection, different concentrations and quantities of the peptide fraction could be used. In infections in an advanced-phase 48 h bacterial culture, it was effective to apply a 50% peptide fraction. Using this concentration for a short time of 1 h, a strong inhibiting effect on the bacterial cells was registered, represented by major damage to the cells’ surface layers ,50,52,64bacteria ,66,67. Tbacteria ,48,49,51C. aspersum snails. Their AAS, physicochemical characteristics, and potential antibacterial activities were determined by de novo sequencing. Information on the mechanisms of antibacterial activities of peptides against E. coli NBIMCC was presented for the first time by determining the effective concentration and methods of administration of the active fraction with MW < 10 kDa.In conclusion, this paper presented 14 new antimicrobial peptides with MWs below 10 kDa isolated from the mucus of E. coli NBIMCC were determined by SEM, fluorescence, and digital image analysis.Changes in the bacterial structure and metabolic activity of These studies shed new light on the mechanisms of action of the peptide fraction with MW < 10 kDa, and allowed us to offer an objective algorithm for the treatment of infections, depending on the stage of development of the bacterial infection ,68,69,70


The mean Downton and Gijón scale scores for patients admitted in phase 1 were higher compared to those of patients admitted in phase 2 (p < 0.001). The mean Braden scale score in phase 2 was higher than in phase 1 (p < 0.05). Conclusion: During the COVID-19 pandemic, there was a decrease in the completion of nursing records in the clinical records of patients in isolation. The levels of risk of developing PUs, falling, and social vulnerability of patients admitted to hospital were lower during the first wave of the pandemic.The COVID-19 pandemic has led to an increased workload for nurses and organisational and structural changes, which have been necessary to meet the needs of inpatients in isolation. Aim: To describe the impact of the COVID-19 pandemic on levels of adherence to the completion of nursing records that document the risk of developing pressure ulcers, falling, and social vulnerability among hospitalised patients in isolation. Methods: Observational pre-post comparison study. Comparison between nursing records  belonging to 1205 inpatients took place in two phases. Phase 1: 568 patients admitted in February 2020, prior to the COVID-19 pandemic, vs. phase 2: 637 patients hospitalised with COVID-19 in March–April 2020, during the peak of the first wave of the pandemic. This research adheres to the STROBE guidelines for the reporting of observational studies. Results: The degree of completion of the Braden, Downton, and Gijón scales decreased significantly in phase 2 vs. phase 1 ( On 12 March 2020, the World Health Organisation declared the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to be a pandemic [In this context, hospital managers were required to make considerable organisational and structural changes to meet the needs arising from isolating inpatients and to protect healthcare workers . IsolatiGiven the rapid rise in the numbers of infected patients requiring hospitalisation, units admitting patients with suspected or confirmed COVID-19 have had to make a great effort to adapt to emerging needs in terms of material resources, newly hired personnel, and new protocols and procedures required to tackle the pandemic. COVID-19 has led to changes in nurse staffing and increased workload for nurses, which may have negatively affected the quality of nursing records . The worIf properly documented in the patient’s clinical record, the following measures are possible: provision of pressure ulcer (PU) care through early identification of patients at risk of developing ulcers; recording of the number of PUs, if any; fall prevention by assessing the risk of falling during hospitalisation; analysis of the causes of a patient’s fall; and identification of socially at-risk patients. Records intended to assess and identify risks among inpatients are essential for developing evidence-based initiatives capable of preventing such risks. Patient assessments using scales and interventions must be conducted regardless of the clinical environment and should be the same for all patients, whether or not they are in isolation. When a patient’s condition is critical or complex, further nursing care is needed , and it A unified approach could help frontline healthcare professionals to standardise data collection and increase the efficiency and performance of their work. Documentation is crucial for the communication of healthcare teams and patient outcome measurement and monitoring . This wiA number of studies have shown that nurses’ workload is significantly associated with the quality of care provided  and thatPrevious experiments have shown that improving training and implementing best clinical practices is helpful in increasing the completion of nursing records in clinical records and in integrating said completion into nurses’ routine work procedures . Further studies and comprehensive tools are needed to analyse this phenomenon in greater depth. There is a need for studies assessing the impact of isolation on safety indicators, in addition to psychological aspects, while taking into account potential collateral damage caused by isolation.The objective of this study is to describe the impact of the first wave of the COVID-19 pandemic on levels of adherence to the completion of nursing records that document the risk of developing PUs, falling, and risk of social vulnerability among hospitalised patients in isolation.This is an observational pre–post comparison study on the nursing records of patients hospitalised in a tertiary care hospital in the public healthcare system before and during the first phase of the COVID-19 pandemic.The study population consisted of the records of 1205 inpatients: 568 patients admitted to the Internal Medicine, Vascular Surgery, Otorhinolaryngology, and Cardiology inpatient units at a University Clinical Hospital between 1 and 29 February 2020 (prior to the pandemic) and 637 patients admitted to these same units between 15 March and 15 April 2020 with COVID-19 diagnoses (during the peak of the first wave of the pandemic). These units were repurposed to treat patients with COVID-19 from the second half of March.Data collection took place in two phases (pre- and post-COVID-19 at the same units), which assessed the completion of electronic records, including the Braden, Downton, and Gijón scales.Risk of developing PUs was measured using the Braden scale. Scores range from 6 to 26. Scores below 12 points indicate a high risk of developing PUs; scores between 13 and 14 indicate a moderate risk; and scores between 15 and 18 indicate a low risk . The risPhase 1 took place between 1 and 29 February 2020. The electronic records of patients hospitalised before the pandemic were collected. Phase 2 took place between 15 March and 15 April 2020 (during the first wave of the pandemic). The electronic records of patients admitted for COVID-19 were collected.In both phases, the following variables were also analysed: sex, age, mean length of stay, falls, number of PUs, and places where the PUs originated.t-test for paired samples or using ANOVA for more than two samples. The statistical significance threshold for all tests was set at p < 0.05.All statistical analyses were performed using IBM SPSS v. 24.0 software . Quantitative variables were described using means, standard deviations, and minimum and maximum scores. Qualitative variables were described by their distribution of frequencies. Associations between qualitative variables were analysed using Pearson’s chi-squared test. Quantitative values were compared using Student’s p = 0.02).The records of 1205 patients were analysed, 54.8% of whom were men and 45.2% women, with a mean age of 70.46 (SD = 16.1) years. In total, 47% of patients were admitted in February 2020 with a mean stay of 9.42 (SD = 2.1) days, and 53% of patients were admitted between 15 March 2020 and 15 April 2020 with a mean stay of 9.18 (SD = 2.8) days. There were no differences between the two periods by sex. By age group, 32.7% were ≤65 and 67.3% > 65 years. However, differences in age were identified. In phase 1, the number of women was 252 and that of men was 316. In phase 2, there were 293 women and 344 men. Regarding the age group, the group ≤ 65 years in phase 1 consisted of 166 patients and 228 patients in phase 2. The group > 65 years in phase 1 consisted of 402 patients and 409 patients in phase 2. The mean age decreased considerably, from 72 (SD = 17) years to 69 (SD = 15) years among patients who had tested positive for COVID-19 (p < 0.001). See The degree of completion of the Braden, Downton, and Gijón scales decreased significantly in phase 2 with respect to phase 1 ; see The completion of the Braden and Downton scales was significantly higher in the first phase for the group over 65 years . However, an increase in the number of patients who developed PUs during their hospital stay was also observed in phase 2 compared to phase 1 .The number of PUs recorded decreased in phase 2 . No statistical significance was observed given the small sample size of patients who experienced a fall during these periods.Regarding the number of falls, six falls were recorded in each of the study periods, with a total of 12 (phase 1: p = 0.003). No statistically significant differences were observed when comparing risks between phase 1 and phase 2 in terms of sex or age; see Regarding the analyses of demographics (age group and sex), completion level of scale records, and scores, the completion of the Braden and Downton scales was significantly higher in the first phase for the group over 65 years (0.012 and This study reports a decrease in the completion of nursing records assessing the risk of developing PUs, experiencing falls, and social vulnerability among inpatients with COVID-19 in isolation.The COVID-19 pandemic has resulted in a clear decrease in adherence to the completion of the Braden, Downton, and Gijón scales. Nurses’ failure to record their work does not necessarily mean that they do not complete this work. When nurses have greater workloads, they prioritise their interventions by attaching greater importance to patient care than to recording activities .The risk of developing PUs during hospital stays increased in phase 2, as did the number of patients who developed PUs during their hospital stay. Nursing records are a necessary clinical source of relevant information for assessing nursing care, so incomplete or missing records hinder health decision making  and, as The levels of risk of falling and risk of social vulnerability of patients admitted to hospital during phase 2 were lower than during phase 1. The occurrence of adverse events in hospitals depends, to a great extent, on the mean length of stay. In this case, the mean lengths of hospital stays were similar in the two study periods, meaning that this factor could not have influenced the analysis. However, the mean age of patients admitted to hospital during the first wave of the COVID-19 pandemic was lower than it was prior to the pandemic. This may be linked to the Downton and Gijón scale scores showing a greater risk of falling and experiencing social vulnerability prior to the pandemic than during the first wave of the pandemic, which may suggest that age, rather than isolation, is the risk factor in this case. The availability of assessment tools that include age as a predictor of risk will help to identify at-risk patients more accurately . The decNurses have been deeply involved in the prevention and management of the COVID-19 pandemic in a health system capable of dealing with public health emergencies. Assessment records of the risk of developing PUs must be included in the standardisation of care in new hospital departments and in ongoing improvements to contingency plans . A numbeThe number of records on the risk of falls among inpatients decreased during the pandemic, which, together with the individual’s risk assessment and personal profile, serves as a risk indicator. The occurrence of falls causing injuries and the risk of falling are related . Fall riA decrease in the number of records on the risk of social vulnerability was also observed. Hospitals have been overwhelmed and professionals have become exhausted during the pandemic, but it must be borne in mind that unfavourable social and family circumstances can result in prolonged hospital stays, readmissions, reduced quality of life, and lower life expectancy among patients. Therefore, early identification of patients at risk and referral to social services facilitates the integration of patients into the social and family spheres, as health problems in the elderly may result in social and family problems and vice versa ,30. Analysing the reasons for the decline in the number of nursing records is essential for making care management decisions that prevent these situations from recurring in the event of health system overloads. Quality indicators must be enhanced by improving a number of care-related processes, such as documentation, risk assessments, and reports, which enable nurses to promptly identify at-risk patients and implement specific interventions . MeasureThe main limitations of this study may be that the sample is limited to a single hospital at a particular moment in time and the unmeasured differences in patient population between phases. Other limitations include the biases inherent to a retrospective study based on past records, although these records are standardised using validated scales to minimise variability.Adherence to the completion of nursing records decreased during the first wave of the pandemic. The quality of care is reflected to a great extent in the clinical records that nurses keep for their patients. The decrease in the number of nursing records in cases of isolation should prompt the directors of healthcare facilities and healthcare workers to reflect on the need to take measures to encourage recording of risk assessments. There is a need for further studies on potential solutions to these situations.


In order to determine genetic loci associated with decreasing risk of uterine leiomyomata (UL), a genome-wide association study (GWAS) was performed. We analyzed a group of patients with a family history of UL and a control group consisting of patients without uterine fibroids and a family predisposition to this pathology. Six significant single nucleotide polymorphisms were selected for PCR-genotyping of a large data set of patients with UL. All investigated loci  demonstrated the lower frequency of minor alleles within a group of women with UL, especially in a subgroup consisting of patients with UL and a familial history of leiomyomata. We also found that the minor allele frequencies of these SNPs in our control group were higher than those across the Caucasian population in all. Based on the obtained data, an evaluation of the common risk of UL was performed. Further work will pave the way to create a specific SNP-panel and allow us to estimate a genotype-based leiomyoma incidence risk. Subsequent studies of genetic variability in a group of patients with a familial predisposition to UL will allow us to make the prediction of the development and course of the disease more individualized, as well as to give our patients personalized recommendations about individual reproductive strategies. MED12 somatic mutation has been identified as the one most closely associated with the risk of development of UL. In our previous study, we identified such mutations in the exon 2 of gene MED12 as most closely associated with the risk of the development of uterine fibroids [ESR1, FBN2, CELF4, KCWMB2 genes and analyzed their occurrence in patients with a personal and a family history of this disease. The objective of the study was the identification of protective gene markers against the development of uterine myomas in patients with a family history of this disease. In order to find protective loci in the genome, we conducted a genome-wide SNP-genotyping of women with UL, with and without an associated family history, that carry the MED 12 exon 2 gene somatic mutation and compared the data with women without uterine myomas.Uterine leiomyoma (UL) is one of the most prevalent benign neoplasms of the female reproductive system. The prevalence of these tumors varies from 50% to 70% in women of reproductive age ,2. The dfibroids . While iOur study obtained approval at the IRB of V. I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology. The design of our study includes two phases. In Phase I, two cohorts of patients  underwent whole genome genotyping. The confirmation of the family history of the presence of fibroids in the relatives of the patients was either earlier treatment in the V. I. Kulakov National Medical Research Center or documents on myomectomy operations in other medical centers. In Phase II, extended cohorts underwent PCR analysis for confirmation of data obtained as a result of the Phase I investigation.Our study included 255 patients who underwent laparoscopy and laparotomy at the department of Gynecological Surgery of V. I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology between the years 2016–2020 and met inclusion criteria. A total of 215 patients were included as subjects; 40 patients composed controls.Patients who underwent myomectomy or hysterectomy for symptomatic uterine fibroids during their reproductive years (18–50 years of age), who continued to have regular menstruations, and who had a family history of uterine fibroids, were included as subjects in the first phase of the study. The extended cohort of subjects in the second phase of the study included patients with a personal and family history of uterine fibroids (subgroup 1A), patients with a personal and without a family history of UL (subgroup 1B), and subgroup 1C group of patients with an unknown family history. The inclusion criteria were the absence of pregnancy, ability to understand and sign informed consent, ability to complete questionnaires, presence of regular menses, and absence of hormonal therapy for a period of 6 months prior to surgery.The control group was composed of women in menopause who underwent hysterectomy during their postmenopausal years (over 50 years old), whose menopausal status was confirmed with hormonal assays, and who have not had a family or personal history of uterine fibroids.The exclusion criteria included postmenopausal bleeding, malignant or pre-malignant neoplasm of the reproductive system, acute inflammatory disease, adenomyosis, endometriosis, and pregnancy.The patients in both phases of the study included laparoscopic or abdominal hysterectomy/myomectomy for the study groups and other surgeries, including surgery for ovarian tumors (cysts) and pelvic organ prolapse, for the control groups.MED12-status of each patient in Phase 1 was positive. Each patient provided a blood sample and completed a questionnaire on clinical, reproductive, and family history. Tissue samples of uterine myomas were obtained during myomectomy or hysterectomy in all patients in the UL group. The absence of other visible pathology was confirmed surgically. Hysteroscopy and endometrial biopsy were performed in all patients. All cases of UL were confirmed by histological examination, and the MED12-mutations using PCR amplification and Sanger sequencing.DNA was isolated from blood and tissue samples using the QIAamp DNA Mini Kit , according to the manufacturer’s instructions. DNA samples passed quality control . All tissue samples of fibroids were tested for the presence of somatic A whole-genome scan of single nucleotide polymorphisms was performed using Genome-Wide Human SNP 6.0 arrays  containing about 906,600 SNPs. The manufacturer’s instructions were followed for the labeling of 250 ng DNA and hybridization. After staining and washing using a GeneChip Fluidics Station 450, the arrays were scanned with a 3000 7G Scanner. All obtained microarrays corresponded to quality control parameters. The whole genome SNP-genotyping lists for each DNA sample were obtained using ChAS software . The minor allele frequency (MAF) was calculated with the genotype information from the dataset that consisted of patients with both a personal and family history of uterine fibroids.−3–10−5) among all the points located on the corresponding genes.The selection of SNP loci with a significant association with UL or healthy controls was conducted using Fisher’s exact test. Candidate SNPs for subsequent analysis were chosen in accordance with the frequency of minor alleles that was higher than 0.05 and lower than 0.2. Six selected SNPs have the lowest p-value , patients with a personal and without a family history of UL (subgroup 1B), and subgroup 1C group of patients with an unknown family history. After choosing promising SNPs, a set of specific primers was created for each polymorphism, and all samples were amplified and sequenced using ABI PRISM 3130 Genetic Analyzer . Based on the obtained sequence chromatograms, the genotypes of the polymorphisms studied were determined in the BioEdit biological sequence alignment editor. 2-test and odds ratio (OR) with a 95% confidence interval (95%CI) was used to test the correlation of allelic frequencies of the risk for developing UL in the group of patients with leiomyomata with and without a familial history and in healthy control groups. The significance level was adjusted using the Bonferroni correction , taking into account that six variants were analyzed. The null hypothesis was rejected at p < 0.05/6 = 0.0083.Data analysis was performed using Microsoft Excel software. For each SNP, allele and genotype frequencies were computed in UL and healthy control groups. The Pearson’s standard χOur study included a total of 255 patients (215 patients with UL and 40 controls), who underwent laparoscopy and laparotomy in the department of Gynecologic Surgery of National Center in Russia and met inclusion criteria. A laparoscopic approach for myomectomy and hysterectomy was used in 86% (183/215) of cases and laparotomy in 14% (32/215). Myomectomy was carried out in 91% and hysterectomy in 9% of cases; 98 patients were planning a pregnancy. During 1–3 years of our observation in the framework of this study, pregnancy occurred in 57% of women (56/98). Three subgroups were selected from the general group of patients with fibroids. The first one (1A) included only patients with a reliably confirmed family history of this disease. The second subgroup (1B) consisted of patients without a family history of uterine fibroid , and the third subgroup (1C) was formed from patients who did not have any information about their family anamnesis. MED12 mutations in surgically removed fibroids. The mean age of patients with symptomatic uterine myoma (UL group) in this phase of the investigation was 34 ± 11 years; the mean age in the control group was 60.8 ± 8.9. The most prevalent symptom was uterine bleeding, in 70% (14/20) of cases, followed by pelvic pain and dysmenorrhea , anemia , and dysfunction of the pelvic organs—disturbance of urination and defecation . The majority of the UL group patients had multiple fibroids , and only six women had a single fibroid . The mean size of the tumor was 11 ± 10 cm.During this initial phase of our investigation, 20 patients with a personal and family history of UL (study group) and 14 patients with no uterine fibroids (control group), identified both by imaging and visual inspection in surgery and confirmed histopathologically, were included in the study. All patients of our study group had somatic Our extended cohort investigation included 255 patients; there were 215 patients with uterine myomas, with and without a corresponding family history (extended UL group), and 40 patients in the extended control group. This extended cohort included the patients studied in the 1st phase of the investigation. Among the patients in the extended UL group, 98 women had and 94 women did not have a family history of myomas (1A and 1B extended UL subgroups); 23 patients in this group did not have information about their anamnesis and composed subgroup 1C. The mean age of all patients in the extended UL group was 33 ± 14 years of age. The ages of women with myomas and associated family history, without a family history, and with an unknown family history were 34 ± 11 years old, 30.5 ± 11.5 years old, and 38 ± 9 years old, respectively. All women were of reproductive age, and the mean age in the extended control group was 58.79 ± 7.53 years.p < 0.01). The average size of fibroids was 12.65 ± 12.35 cm in all extended UL subgroups. The uterine fibroid sizes of 0.3 to 21 cm were observed in subgroup 1A; the size of the fibroids in subgroup 1B was 0.5–25 cm and was 0.5–10.4 cm in subgroup 1C, p = 0.96. No related statistically significant difference was established.Abnormal uterine bleeding and menstrual irregularity in Phase II of the study were observed in 59% (128/215) cases, pelvic pain and dysmenorrhea in 19% (41/215), anemia in 43% (92/215) of patients, dysuria and the disturbance of defecation in 13% (27/215), and infertility in 7% (15/215) of patients with UL. Intramural location of myoma was observed in 35% (75/215) of patients, the subserosal location was noted in 7%, and the submucosal location was seen in 6% of patients; 52% (112/215) of all patients with UL were found to have various localization. Multiple myomas were noted in 62% (134/215) of the UL patients . Solitary myoma was observed in 38% (81/215) of all women with uterine fibroids, including 34 women with associated family history and 41 women without it; 6 patients with solitary myoma did not have information about their familial history (p < 0.001), with the use of ART methods in 5% women in 1A group, 19%—in 1B group, and 16%—in 1C group (p = 0.037). Such a result may indicate that a burdened family history of uterine fibroids can create serious problems for the realization of the reproductive function of patients. In 15% of cases, male and tubal-peritoneal factors of infertility were detected. The other patients considered pregnancies in the near future. Interestingly, during the observation period, spontaneous pregnancy occurred in 22% of women in the 1A group, 57%—in 1B group, and 62%—in the 1C group (p < 0.05). We conducted a meta-analysis of 906,600 SNPs in the blood of cohorts and identified six SNPs that demonstrated a statistically significant difference in the comparison of the study group with the general population. These identified six SNPs  that corresponded to genes ESR1, FBN2, CELF4, and KCWMB2 were selected for further analysis in the Phase II study of extended cohorts and controls. For all these SNPs, the frequency of minor alleles was in the range between 0.05 and 0.2. The data about SNPs identified in Phase I of our study are shown in p-value. The level of frequency differences of the selected SNPs has the most statistically reliable level of p-value throughout each gene where each SNP is positioned/settled . Such significant difference in the allelic and genotypic distribution of the six selected SNPs was also detected in the extended cohorts of Phase II of our study (p < 0.05). While rs12637801 revealed a statistically significant difference between the extended control group and all patients with uterine myoma in Phase II of the study (p = 0.006), it failed to demonstrate such differences specifically between the extended control group and subgroup 1B of patients with uterine fibroids who had a personal, but no family history of UL (p < 0.05). A statistically significant difference in the frequency of minor alleles of SNPs was established between subgroups 1A and 1B of the extended cohort of patients with uterine myomas. It was found that a statistically lower frequency of these alleles was observed in patients of subgroup 1A in which both a personal and family history of myoma were present when compared with the subgroup 1B of patients with uterine fibroids that did not have an associated family history (p < 0.05). We also analyzed six single-nucleotide polymorphisms  in women with single and multiple uterine myomas. The distribution of alleles in the study groups is shown in p = 0.031). Additionally, the CC variant of rs12637801 is more often detected in women with uterine fibroids  compared to the control group: 70% women with myoma and 50% women in the control group (p < 0.001). A statistically significant difference was also observed in the case of the homozygous AA variant: it was seen in 20% of the control group patients and 3%, p < 0.001, in the group of women with UL which, on the contrary, indicates a somewhat “protective” role of this minor variant of the allele. However, there were no statistically significant differences in subgroups 1A, 1B, and 1C either in the case of the CC variant or in the case of the AA variant of rs12637801 (p > 0.05).ur study , demonstMED12 mutations (predominantly located in exon 2) in 70–80% of myomas [MED12 mutations. Such MED12mutations were shown to be more prevalent amongst patients with uterine myomas who have a family history of this disease [MED12 mutation occurrence remains unclear. It has so far been established that the only mutation found in the uterine fibroids is a mutated variant of the MED12 gene [HMGA2 gene, occur in 20–30% of tumors and most often these are solitary fibroids [According to the literature, cytogenetic and molecular investigations suggest that each uterine fibroid is an independent monoclonal process that arises from the proliferation of a single cell . Moleculf myomas ,19,20,21f myomas . Such sof myomas ,24,25,26 disease . UnfortuD12 gene . Other sfibroids .prospective genetic markers for the development of uterine fibroids in patients with a family history of this disease and compare the expressions of these prospective markers with those of women with uterine fibroids/leiomyomata who do not have a family history of this disease or do not know of their family history.According to the previously published data, maternal history of leiomyoma presents the highest risk for the development of UL. Earlier studies have indicated the strong genetic influence on UL susceptibility based on linkage, population disparity, and twin studies. Most of the loci obtained were considered as “pathogenic” or “risk alleles”. Quite often, findings indicated that some polymorphisms had a strong association with the development of UL, but after they were tested using another data set, the original association did not find a confirmation . Such a Identification of such prospective markers, in our view, could lay the groundwork for the development of complex and highly reliable prospective markers for the development of uterine leiomyomata and, in the future, may help physicians to enhance the level of precision in individualized counseling for women considered to be at risk for developing uterine fibroids or for women who are not certain of their family history. These prospective markers can potentially optimize early diagnosis and suggest the degree of the risk of UL development in women of reproductive age/state. The knowledge obtained in the development of these prospective markers may possibly result in the creation of non-invasive and minimally invasive preventive measures and treatment techniques for women of reproductive age/state who have or do not have a personal or family history of this disease. Information on the presence or absence of uterine fibroids in the family history of women conceived as a result of artificial reproductive technologies with the utilization of donor gametes, or a family history of women adopted as children, may be missing. Prospective genetic markers for the development of this disease may be of special interest in this group of women. The statistically significant variants of SNPs that we found can be used to create genetic diagnostic panels for predicting the risks of developing myomas, especially in the case of “family forms” of this disease. These SNP-based panels may help not only to optimize early diagnosis and prediction of risks, but can consequently lead to improved reproductive outcomes, increase the number of spontaneous pregnancies, and may be used to find new therapeutic approaches and opportunities for preventing the development and recurrence of uterine fibroids.Uterine myomas are highly prevalent in the general population; the incidence is 70–80% of the female population ,32,33. RAnalysis of the methods and timing of reproduction permitted the identification of statistically significant differences in women with and without a family history of uterine myoma. Thus, the frequency of both spontaneous pregnancy and pregnancy resulting from the use of assisted reproductive methods after myomectomy in women without a family history is higher.Taking into account the methods and frequency of pregnancy in women with uterine fibroids with and without a family history of uterine fibroids, it is advisable to review the timing of the implementation of reproductive function. If there is a family history of uterine fibroids, patients should be recommended to undergo a genetic study for prospective markers of the development of uterine fibroids in order to optimize the timing of the realization of reproductive potential.Accordingly, examination for the presence of a predisposition to the development of uterine fibroids in young patients who have not realized reproductive function will be of key importance in planning pregnancy .Based on this research, we can create a specific SNP panel for diagnosis of the risk of the development of uterine fibroids based on germ-line prospective genetic markers. The possibilities of molecular-genetic research methods are actively used in the diagnosis of various diseases: for example, mutations in the BRCA 1 and BRCA 2 genes in the diagnosis of breast and ovarian cancers ,40 and tThus, the use of genetic panels is a promising direction in the diagnosis and prediction of the risks of many diseases, including uterine fibroids. Certainly, our results can be extrapolated only to the European population and only with some restrictions, since population frequencies can vary greatly, however, within the Russian population we found approximately the same frequencies of the studied alleles in samples collected in different regions (unpublished data).To date, there are no genetic test systems that can be used to predict the risk of development or recurrence of UL. Based on the prospective markers we found, we plan to conduct a larger study to propose genetic test systems before they are put into practice which can optimize the management tactics of patients with this disease, as well as allow for early preclinical diagnosis and prediction of the risks of recurrence of this disease.Analysis of the whole-genome screenings selected SNPs in women with uterine fibroids and a familial history of this disease revealed statistically significant differences in allele frequencies compared to the control group and the general population group. In particular, rare alleles of rs3020434, rs11742635, rs2861221, and rs17677069 polymorphisms were absent in patients with anamnesis of myomas which may indicate a “protective” role of these allele variants in the development of UL, particularly in women with a family history of myoma, and a high frequency of homozygotes alleles may indicate their involvement in the development of uterine fibroids. In the case of rs12637801, the homozygous variant of the CC allele can be a predictor of the development of multiple uterine fibroids. These results can be used to create specific genetic tests  to predict the risk of development of uterine fibroids in order to enhance individualization of reproductive planning and to consider gene-based preventive and treatment strategies.