bluuebunny/crossref_metadata_2025 huggingface dataset:
Semi-Heyting Algebras and Identities of Associative Type
Authors: Cornejo Juan M. , Sankappanavar Hanamantagouda P.
Published: September 2019

An algebra A = ⟨A, ∨, ∧, →, 0, 1⟩ is a semi-Heyting algebra if ⟨A, ∨, ∧, 0, 1⟩ is a bounded lattice, and it satisfies the identities: x ∧ (x → y) ≈ x ∧ y, x ∧ (y → z) ≈ x ∧ [(x ∧ y) → (x ∧ z)], and x → x ≈ 1. 𝒮ℋ denotes the variety of semi-Heyting algebras. Semi-Heyting algebras were introduced by the second author as an abstraction from Heyting algebras.  They share several important properties with Heyting algebras.  An identity of associative type of length 3 is a groupoid identity, both sides of which contain the same three (distinct) variables that occur in any order and that are grouped in one of the two (obvious) ways. A subvariety of 𝒮ℋ is of associative type of length 3 if it is defined by a single identity of associative type of length 3.

In this paper we describe all the distinct subvarieties of the variety 𝒮ℋ of asociative type of length 3.  Our main result shows that there are 3 such subvarities of 𝒮ℋ.
Full Cut Elimination and Interpolation for Intuitionistic Logic with Existence Predicate
Authors: Maffezioli Paolo , Orlandelli Eugenio
Published: September 2019

In previous work by Baaz and Iemhoff, a Gentzen calculus for intuitionistic logic with existence predicate is presented that satisfies partial cut elimination and Craig's interpolation property; it is also conjectured that interpolation fails for the implication-free fragment. In this paper an equivalent calculus is introduced that satisfies full cut elimination and allows a direct proof of interpolation via Maehara's lemma. In this way, it is possible to obtain much simpler interpolants and to better understand and (partly) overcome the failure of interpolation for the implication-free fragment.
The evaluation of biological age and rate of aging of agricultural machine operators
Authors: Mikhaylova N. A. , Novikova Tamara A. , Raykin S. S.
Published: September 2019

The study was carried out concerning indicators of biological age of agricultural machine operators. Their working activity is related with impacting of complex of harmful professionally conditioned factors forming high and super-high professional risk to health. The study used noninvasive technique of integrative estimate of human biological age developed by the institute of gerontology of the USSR Academy of Medical Sciences (Kiev, 1984). The study results testify accelerated aging (from +4.16 to +9.7 years) of operators determined by chronological age and seniority in profession. The most differences between biological age and population standard were marked in age cohorts of 20-29 years old with seniority in profession up to 10 years and operators aged 50-59 years with seniority more than 30 years. In case of personifi ed ranking of rate of aging of operators using scale of functional classes according value of deviation biological age from standard value corresponding to population standard in 70.6% of examined operators moderately accelerated and dramatically accelerated rate of aging (functional classes IV and V). At that, prevalence of persons with dramatically accelerated rate of aging was established in age group of 20-29 years old (71.42%) and 50-59 years old (42.86%) operators. In age groups of 30-39 and 40-49 years prevailed persons with moderately accelerated aging (50.0% and 47.4% correspondingly). The study results permit concluding that indicators of biological age can be used as a characteristic of impact of factors of labor conditions on state of health of agricultural machine operators and to recommend using of biological age as an integral indicator of individual and population health during obligatory medical periodic and in-depth examinations of agriculture workers to form groups of dispensary registration.
The results of study of quality and accessibility of medical care in health care institutions: “Who is guilty and what to do?”
Authors: Kobyakova O. S. , Deev I. A. , Kulikov Evgeniy S. , Starovoytova E. A. , Khomyakov K. V. , Vorobyeva O. O.
Published: September 2019

The actual system of evaluation of quality of medical care includes analysis of indices of official statistical reporting, external and internal expertise and significantly more rare analysis of satisfaction of patients as immediate consumers of medical services. The study was carried out to compare opinions of patients and administrators of medical organizations about quality and accessibility of medical care in number of health care organizations in the Tomsk region. The most of the administrators significantly overestimate the level of quality and accessibility of medical care in organizations that permits drawing a conclusion about absence of understanding of real situation. This situation results in restrictions of selecting necessary vectors of amelioration offunctioning of organization and proper managerial decision-making.
Certain issues of evaluation of medical care quality in the health care system of the Russian Federation
Authors: Guseva Nataliya K. , Berdutin V. A.
Published: September 2019

The recent years characterized by development of normative legal base controlling issues of evaluation of quality of medical care. The legally reserved such types (levels) of quality and safety control of medical care as state, sectorial, internal, independent evaluation of medical care quality and others. The development of modern system of evaluation of quality and safety of medical activities occurred on the basis of accumulated experience offunctioning of medical organizations in this direction. The analysis of actual system of evaluation of medical care quality in Russia established that system itself is bulky, includes various and non-interrelated criteria and indices and provides no clear concept about implementation of internal control of medical care quality. All this evoke many questions in physicians of medical organizations. The major defect of actual system is absence of criterion characterizing system of medical care quality support. no attention is paid to such issues as evaluation of structure supposing establishment of potential opportunities of medical subject (organization or medical officer) to provide medical care corresponding to its functions. The demonstrative example of necessity of structural approach in analysis of medical care quality is total normalization of psychological climate, increasing professional and communicative effectiveness of medical personal within departments of medical organization after their reformatting on the basis of the results of socionic evaluation.
About problem of timeliness of detection of cervix malignant neoplasms in population of Omsk region
Authors: Goleva O. P. , Tasova Zulfiya B. , Prudnikova O. N. , Leonov O. V. , Shirinskaya N. V.
Published: September 2019

The study was carried out to evaluate timeliness of detection of cervix malignant neoplasms against the background of supply of necessary manpower in the region. The indices of active detection of cervix neoplasm and its stages, degree of neglect of tumor process and lethality during the first year of diagnosed disease are considered. The enumerated indices are correlated with quality of medical services шт part of availability and characteristics of training of available personnel. The comparison of data of the Omsk region with average national data was implemented. The corresponding indices of Omsk and municipal districts of oblast in 2004-2014 were also compared. The percentage of active detection ofcervix cancer decreased to the end ofanalyzed period. However, in municipal districts of oblast it continues to be quite high. The detection of disease at early stages (I-II) in the region is on the whole significantly lower as compared with average national indices. The indices of degree of neglect of tumor process in Omsk, in spite of better conditions of diagnostic of this pathology, are significantly lower as compared with corresponding indices in municipal districts. During analyzed period, annual lethality in the Omsk region decreased up to 1.6 times (decreasing rate - 35.6%). The process proceeded especially actively in rural districts of the oblast (decreasing rate - 70.5%). The lethality at first year of diagnosed disease was absent in 25 municipal districts of region. The staffing of oncologists in "The clinical oncologic dispensary" makes up to 100% and 36.8% out of them have highest category. In the central district hospitals, the staffing of specialists made up to 81.3%. Factually in all institutions this position is combined by specialists of another profile i.e. therapists, obstetrician-gynecologists, surgeons, etc.
The modeling as a technique of evaluation of expediency of remote monitoring of arterial tension at the regional level
Authors: Kontsevaya Anna V. , Komkov D. S. , Boytsov S. A.
Published: September 2019

The state research center of preventive medicine, Moscow, 101990, Russian Federation The arterial hypertension is a leading risk factor of cardio-vascular morbidity and mortality of population in the Russian Federation. The application of modern informational technologies at population level can be on of modes of improvement of arterial hypertension control. The purpose of study. To apply modeling technique for evaluating at the regional level the economic expediency of implementation of remote monitoring of arterial pressure using GPS-tonometer. Materials and methods. The mathematical model of social economic efficiency of remote monitoring of arterial pressure was developed to be applied in the region with 1 million ofpopulation given 90, 70,50 and 30% of monitoring coverage with calculation of number of prevented cases of myocardium infarction, stroke, deaths and averted economic loss during five years. Results. The remote monitoring of arterial hypertension in the region with 1 million ofpopulation would permit preventing 1940 deaths during five years under 90% coverage with remote monitoring of patients with arterial hypertension and at 30% coverage 645 lives would be saved. The mass implementation of remote monitoring permits decreasing load on health care system at the expense of prevention of myocardium infarction (95 cases at 90% coverage during five years), stroke (630 at 90% coverage during five years) and calls of emergency medical care. The remote monitoring is economically expedient since expenses of its implementation are lesser than expected economic effect t the expense of decreasing of visits for medical care and maintenance of manpower resources in economics. Conclusion. The remote monitoring of arterial pressure using various information technologies is a modern and efficient approach to amelioration of arterial hypertension control at the regional level.
The dynamics of age structure of out-patient visits and calls of emergency medical care in population of small town during 2011-2015
Authors: Artyukhov I. P. , Kapitonov F. V. , Kapitonov Vladimir F.
Published: September 2019

The shortcomings offunctioning of ambulatory polyclinic service and overrated volume ofprovided emergency medical care became actual propblemin primary medical care support of population in small towns due to age structure of population. Purpose of study. To investigate dynamics of age structure of out-patient visits and calls of emergency care by population of small town in 2011-2015. The analysis of out-patient visits and calls emergency care in 2011-2015 demonstrated that during five years number of visits to polyclinic decreased up to 5.3% mainly (14%) at the expense of residents of able-bodied age while number ofpatients of junior and senior able-bodied age increased on 1.5% and 5.1% correspondingly. The analysis of calls of emergency medical care revealed shortcomings in organization of ambulatory polyclinic care: more than a half (70.4%) of all calls because of instant diseases and conditions falls on the period of working hours of polyclinic (from 8 to 20 h.) The occasion of call by population of junior able-bodied age in 68.7% became acute diseases of respiratory organs (acute respiratory viral infection - in 93.6%) and by patients of senior ablebodied age in 72.6% - exacerbation of chronic pathology (ischemic heart disease, hypertension disease). The correction of these calls could be implemented by ambulatory polyclinic service itself. The acquired data corresponds to publication data and indicates to existing problems of primary medical care support of rural population in various regions of the Russian Federation. The investigation of age structure of out-patient visits, calls of emergency medical care of data of sociological survey of respondents revealed shortcomings in organization of functioning of municipal polyclinic related to population of senior able-bodied age that result in increasing of volume of work implemented by teams of emergency care.
THE PROTECTION OF HEALTH OF INDUSTRIAL WORKERS DURING YEARS OF NATIONAL RESTORATION AND INDUSTRIALIZATION (TO CENTENARY OF PEOPLE'S COMMISSARIAT OF HEALTH CARE OF THE RUSSIAN SOVIET FEDERATIVE SOCIALIST REPUBLIC)
Authors: Egorysheva Irina V. , Sherstneva E. V.
Published: September 2019

The article considers activities of the People's commissariat of health care of the Russian Soviet Federative Socialist Republic targeted to preservation of health of industrial workers in second half of 1920s - 1930s. The leading role industrial workers in implementation of plans of reconstruction of national economy determined direction to their preferential medical care. The forms and methods of medical sanitary activity were altered by its ultimate drawing near to production to resolve task of decreasing of morbidity with temporary incapacity to work, occupational traumatism that was one of the most important factors of increasing labor productivity and decreasing of cost price of produced industrial production.
THE SOCIAL HYGIENIC FACTORS OF QUALITY OF LIFE OF POPULATION OF THE PRIMORSKY KRAI
Authors: Izmaylova Oksana A. , Kiku P. F. , Shiter N. S. , Moreva V. G. , Sabirova K. M. , Kondrat’Ev K. V. , Kutakova N. S.
Published: September 2019

At the modern stage of society development, even more number of professionals of the most various specialties show interest in problems of estimating level and quality of life of population. The study was carried out to analyze main indices of quality of life of population of the Primorsky Krai. The study used statistical information characterizing quality of life of population (indices of issues of demography, ecology, labor, level of life of population, education, medical and social care). The analysis of quality of life of population of the Primorsky Krai during 2004-2013 according indicator of "crisis" index testifies that a trend of increasing of level of life of population is observed. The complex evaluation of quality of life using factor analysis demonstrated that 81.7% of total variance is described by by main component. In main component prevail variables of economic and social character, demographic indices and also indices of population health, housing conditions and ecological environment. The main component proved to be very significant in characterizing quality of life of population of the Primorsky Krai. The obtained results demonstrate that factually all selected factors in a certain degree effect quality of life of population that one more time proves all multiform and complexity of quality of life concept. Therefore, quality of life is a complex characteristic of conditions of vital activity of population that is reflected in objective indices and subjective estimates of satisfaction of material, social, cultural needs and is related to perception of people of one's own positioning depending on cultural features, system of values and social standards existing in society.
THE MODEL OF ORGANIZATION OF ONCOLOGIC CARE OF POPULATION OF REGION
Authors: Kiku Pavel F. , Alekseeva G. N. , Izmaylova O. A. , Iudin S. V. , Iudin S. S. , Moreva V. G. , Sukhova A. V.
Published: September 2019

The article presents the model of organization of oncologic care of population of the region exemplified by the Primorskiy Krai. The major principle of development of the model consists in medical, social and economic efficiency. The main structural unit of the model of oncologic service of the region is to be the oncologic center. These centers are organized with economically justified personnel and material technical staffing, on the basis of one place concentration of significant number of patients. The functioning of the oncologic center comes to three principles: 1) quality of oncologic care is to be provided for by a single standard of organizational and medical technologies: 2) the system of oncologic care is to be accessible for any patient; 3) institutions of oncologic care within the limits of geographic, economic and social zone of the krai (oblast, okrug) are to have efficient mechanisms of interaction permitting to implement transference of patients and coordination of activities of specialists of various profiles. The implementation of modern organizational technologies of oncologic care of population of the region includes elements of strategic planning, development of system of palliative care of patients, application of standardization and management of medical care quality.
THE LEVEL AND STRUCTURE OF MORTALITY FROM DISEASES OF BLOOD CIRCULATION SYSTEM IN THE REGIONS OF THE REPUBLIC OF BASHKORTOSTAN (2002-2015)
Authors: Askarov R. A. , Davletshin R. A. , Askarova Zagira F. , Sharipova I. A.
Published: September 2019

The data is presented characterizing specifics of level, dynamics and structure of mortality of blood circulation system diseases among total population and individuals of able-bodied age in the regions of the Republic of Bashkortostan according data from the Territorial agency of the Federal service of state statistics in 2002-2015. The decreasing is established of both total intensive and standardized indices of mortality of blood circulation system diseases that corresponds all-Russian trends. However, decreasing of average age of the deceased occurred. The negative dynamics of mortality of blood circulation system diseases is established. The statistically significant differences in the levels of mortality of ischemic heart disease between considered regions of the Republic of Bashkortostan and average Russian indices are revealed. In spite of being outlined decreasing tendency the level of mortality of blood circulation system diseases continues to be quite high and requires further investigation of all its aspects.
THE PROFESSIONAL BURNOUT OF PHYSICIANS OF VARIOUS SPECIALTIES
Authors: Kobyakova O. S. , Deev I. A. , Kulikov Evgeniy S. , Khomyakov K. V. , Tyufilin D. S. , Zagromova T. A. , Balaganskaya M. A.
Published: September 2019

Introduction. The professional burnout is a prevalent phenomenon among physicians confirmed by data of a number of foreign studies. The3 development of professional burnout correlates with rate of medical mistakes and outflow of personnel from the field. At that, there is no studies related to searching of differences in development of professional burnout in various medical specialists which is required for detailed planning of measures on decreasing of prevalence of the mentioned syndrome. Material and methods. The questionnaire MBI (Maslach burnout Inventory) was applied for assessing the level of burnout. a number of originally developed questions was added to establish intensity of labor of physicians. all physicians were stratified on four groups according the profile of specialty (therapeutic, surgical, diagnostic and organizational methodological profiles). Results. The study covered sampling of 1,668 physicians. The obtained data permitted to establish differences in their labor activities and level of professional burnout as related to particular specialties, including urban/rural characteristics. The maximal intensity of labor was specific for physicians of surgical profile. The minimal intensity of labor was established for physicians of organizational methodological profile. The physicians of therapeutic profile were characterized by average level of professional burnout. The symptoms of professional burnout were characteristic for all groups of specialties. At that, 1/5 of all physicians had a low degree of this syndrome. The level of professional burnout in physicians of therapeutic profile in rural area were higher than in urban area by all parameters. The level of professional burnout in surgeons differed at the expense of depersonalization independently of place of employment. Discussion. The obtained data permits to reliably judge about necessity of development of preventive measures with consideration for differences in development of professional burnout in representatives of various medical professions and dictates necessity of further investigation of factors of development of professional burnout in medical specialists.
THE PROBLEM OF PATIENT SAFETY IN MEDICAL INSTITUTIONS - A VIEW OF PRACTITIONERS
Authors: Shkarin V. V , Ivasheva V. V , Semenova N. V , Emelyanova O. S , Bagmetov N. P
Published: September 2019

The article presents the results of a survey of practitioners on the problem of patient safety in medical organizations.
ASSESSMENT OF INFLUENCE OF THE PIR-4 CONNECTION ON BRAIN EDEMA AT BILATERAL OCCLUSION OF THE GENERAL CAROTIDS AT RATS
Authors: Voronkov A. V , Shabanova N. B , Voronkova M. P
Published: September 2019

The study of the decongestant activity of the new compound PIR-4 on the background of cerebral ischemia in rats was conducted. The experiment was performed on 50 male Wistar rats. Global cerebral ischemia was modeled by irreversible ligation of common carotid arteries. It is established that bilateral occlusion of the carotid arteries causes a decrease in the level of calcium ions in the blood (2,31 ± 0,06) mmol/l, metabolic lactic acidosis (11,4 ± 0,03) mmol/l, decrease of glucose consumption of brain tissue to (0,49 ± 0,34) mmol/l, which leads to swelling of the brain. Preventive administration of Vinpocetine, Cinnarizine and experimental compound PIR-4 allowed to correct the violations. So, against uses of the substance PIR-4 lactic acidosis significantly decreased to (3,64 ± 0,19) mmol/l, which is comparable to the drugs of comparison. The level of calcium in the group of animals treated with PIR-4 did not significantly increase by 9,1 % relative to the NK group of rats, glucose consumption statistically significantly increased to 15,33 %, the degree of hydration of brain tissues in the postischemic period significantly decreased by 1,97 %. The obtained results indicate the decongestant activity of the new pyrimidine-4-(1H)-a-PIR-4 derivative.
DEVELOPMENT OF THE TECHNIQUE FOR DETERMINATION OF NATURAL IMPURITIES IN THE SUBSTANCE OF A NEW CONNECTION OF GK-2 PEPTIDE STRUCTURE
Authors: Grushevskaya L. N , Sergeeva M. S , Gaevaya L. M , Dudenkova M. E , Denisenko E. D , Avdyunina N. I , Minaev S. V , Sazonova N. M
Published: September 2019

The study is devoted to the development of related substances determination technique in the original dipeptide, which is fourth loop of nerve growth factor mimetic - GK-2, and was carried out using methods of thin-layer chromatography and high-performance liquid chromatography with spectrophotometric detection (HPLC and TLC). The technique for determining of the related impurities content includes two stages: analysis by thin-layer chromatography and analysis by high-performance liquid chromatography. The developed technique allows detecting impurities in the substance in the content of 0,1 % and more.
Dialectisms in the novella “The Ravine” by S.A. Yesenin
Authors: LOGACHEVA Elena V.
Published: September 2019

We analyze lexical and semantic originality and part of speech activity of dialect words as one of the stylistic dominants of the S.А. Yesenin’s novella “The Ravine” and as part of his in-dividual creative manner. This study was conducted for the first time. We consider the material using the methods of interpretation, component analysis, as well as structural descriptive and con-textual methods. In the course of working with the existing literature on this issue, we discover the lack of material coverage and the absence of dialect vocabulary analysis in the novella “The Ravine” from morphological point of view. We find the thematic, morphological diversity and reveal the manifestation specificity of local words in the author’s and dialogical speech of the work, as well as the functional validity of their application. We prove that the use of local words in novella is caused not only by the idea of novella being a village theme work, but also has a deep cognitive basis. The relevance of the study lies in the fact that conducted research of novella’s dialectal vo-cabulary allows to complement the knowledge of the specificity of S.A. Yesenin poetics’, his lin-guistic worldview and the peculiarity of his individual style.
Interpretationspotenzial der deutschen Lexika, die in ihrer Struktur die Bezeichnung der Farbe enthält
Authors: ZAKHAROVA Mariya A. , IAGODNITSENA Elena A.
Published: September 2019

We analyze of German lexis with color definition in its structure and consider the secondary importance of the lexical categories of “plants” and “animals”. The relevance is due to the continuous interest of linguists to the study of the processes of interpretation and conceptualization, which is confirmed by numerous works in this field of research. The purpose of this research should be considered the analysis of lexical units objectifying the areas of “plants” and “animals” within the framework of their color realization on the material of German, Russian and English. The main methods in the work are the method of conceptual analysis, the method of component analysis. We describe in detail the implementation in languages of the “color” attribute of interpretive knowledge formats based on lexical categories representing the areas “plants” and “animals”. In the course of the study of the actual material, interpretive signs of the perception and observation format, characteristic of the categories of this field, were revealed. We analyze a number of lexical units included in the “plants” and “animal” areas, and make conclusions on updating the color scheme in the language using the interpretation of lexical categories.
Humorous motifs of Russian military equipment nomination
Authors: RODINA Nadezhda A.
Published: September 2019

In modern national linguistics there is a set of works devoted to the description of language personalities of representatives of certain professions. However, in the last decades due to the increase of interest in the military sphere names of cadets, soldiers and officers are in the researchers’ attention centre. We also analyze names of objects of a material environment, it allows to conduct fully studying of language personality of the representative of the Armed Forces of Russian Federation as the ratio of motifs and ways of the nomination will allow to reveal features of the language personality of Russian personnel in mediated communication. We analyze the motivation features of the official names of the Russian military equipment and armor. We consider chrematonyms in terms of their belonging to humorous means of communication in military sphere. We prove application of humorous names by specifics of national character of the Russian personnel. Material of article is the corpus in the form of the glossary in the Internet and also results of the military personnel survey. The new empirical material introduction for scientific use allows to make objective and reliable conclusions on the nature of the humorous nomination in the sphere of military equipment and armor. Research material can be used both in military education, and in an elective course of onomastics in civil university.
Book title: pragmatics, poetics and evolution
Authors: TUTATINA Ekaterina Alekseevna
Published: September 2019

We consider history of the book title and how its role in the book and its place in the book edition changed. It also addresses the problem of studying the title of a book in Russian and foreign practices from the point of view of its poetics and functions, both in close connection with the text of the work, and with the help of the “distant reading” method. It is also being reviewed some current trends in book naming in modern publishing practices, such as the extensive use of citation and allusion techniques, the desire to reduce the title to a few characters, as well as the use of the letters of the Latin alphabet. The problems of the connection between the title and the genre of the novel and the structure of the title are also described. Separately, the question of the responsibility of the editor when working with the title of the translated work is raised. With concrete examples the problems of choosing the title of a book in the process of editorial preparation were analyzed,as well as some errors that the editor may make, dwelling on one or another variant of the title. We use the analytical-synthetic method of research. At the end of the work there are the main conclusions from the study.
Sino-brazilian cinematic connections
Authors: Laukkanen Tatu-Ilari
Published: September 2019

This article positions Lik-wai’s 2008 Sino-Brazilian film Plastic City as a precursor of BRICS cinema and, through a close textual analysis demonstrates how it critically engages Sino-Brazilian relations, flows of capital, commodities, immigration and culture, as well as environmental issues in a matrix of globalization from an emerging economy perspective. Plastic City is intertextually linked to Chinese, Brazilian and world cinema, illuminating its connections to past and present film movements and how it mobilizes their poetics and politics.
Maritime Transport Services in ASEAN-China Free Trade Area-Liberalization and Challenges
Authors: Lv Yan
Published: September 2019

Maritime transport, as an international transportation, plays an imperative role in global trades. At present, the negotiation on maritime transport sector faces with difficulties. This brief article tries to indicate the challenges of maritime service trade liberalization in CHINA-ASEAN free trade area; to find out the ways to promote maritime trade liberalization.
Behavior of Floquet Topological Quantum States in Optically Driven Semiconductors
Authors: Lubatsch Andreas , Frank Regine
Published: September 2019

Spatially uniform optical excitations can induce Floquet topological band structures within insulators which can develop similar or equal characteristics as are known from three-dimensional topological insulators. We derive in this article theoretically the development of Floquet topological quantum states for electromagnetically driven semiconductor bulk matter and we present results for the lifetime of these states and their occupation in the non-equilibrium. The direct physical impact of the mathematical precision of the Floquet-Keldysh theory is evident when we solve the driven system of a generalized Hubbard model with our framework of dynamical mean field theory (DMFT) in the non-equilibrium for a case of ZnO. The physical consequences of the topological non-equilibrium effects in our results for correlated systems are explained with their impact on optoelectronic applications.
A Multicenter Randomized Controlled Trial Evaluating the Effectiveness of Cognitive Training for Anterior Approach Total Hip Arthroplasty
Authors: Logishetty Kartik , Gofton Wade T. , Rudran Branavan , Beaulé Paul E. , Gupte Chinmay M. , Cobb Justin P.
Published: September 2019

Background:

For total hip arthroplasty (THA), cognitive training prior to performing real surgery may be an effective adjunct alongside simulation to shorten the learning curve. This study sought to create a cognitive training tool (CTT) to perform anterior approach (AA)-THA, which was validated by expert surgeons, and test its use as a training tool compared with conventional material.

Methods:

We employed a modified Delphi method with 4 expert surgeons from 3 international centers of excellence. Surgeons were independently observed performing THA before undergoing semistructured cognitive task analysis (CTA) and before completing successive rounds of surveys until a consensus was reached. Thirty-six surgical residents (postgraduate year [PGY]-1 through PGY-4) were randomized to cognitive training or training with a standard operation manual with surgical videos before performing a simulated AA-THA.

Results:

The consensus CTA defined THA in 11 phases, in which were embedded 46 basic steps, 36 decision points, and 42 critical errors and linked strategies. This CTA was mapped onto an open-access web-based CTT. Surgeons who prepared with the CTT performed a simulated THA 35% more quickly (time, mean 28 versus 38 minutes) with 69% fewer errors in instrument selection (mean 29 versus 49 instances), and required 92% fewer prompts (mean 13 versus 25 instances). They were more accurate in acetabular cup orientation (inclination error, mean 8° versus 10°; anteversion error, mean 14° versus 22°).

Conclusions:

This validated CTT for arthroplasty provides structure for competency-based learning. It is more effective at preparing orthopaedic trainees for a complex procedure than conventional materials, as well as for learning sequence, instrumentation utilization, and motor skills.

Clinical Relevance:

Cognitive training combines education on decision-making, knowledge, and technical skill. It is an inexpensive technique to teach surgeons to perform hip arthroplasty and is more effective than current preparation methods.
Musculoskeletal Infection in Pediatrics
Authors: Cooper Alexus M. , Shope Alexander J. , Javid Mahzad , Parsa Ali , Chinoy Muhammad Amin , Parvizi Javad
Published: September 2019

The Second International Consensus Meeting (ICM) on Musculoskeletal Infection was held in July 2018 in Philadelphia, Pennsylvania. This meeting involved contributions from an international multidisciplinary consortium of experts from orthopaedic surgery, infectious disease, pharmacology, rheumatology, microbiology, and others. Through strict delegate engagement in a comprehensive 13-step consensus process based on the Delphi technique, evidence-based consensus guidelines on musculoskeletal infection were developed. The 2018 ICM produced updates to recommendations from the inaugural ICM that was held in 2013, which primarily focused on periprosthetic infection of the hip and the knee, and added new guidelines with the expansion to encompass all subspecialties of orthopaedic surgery. The following proceedings from the pediatrics section are an overview of the ICM consensus recommendations on the prevention, diagnosis, and treatment of pediatric musculoskeletal infection.
Reducing preterm mortality in eastern Uganda: The impact of introducing low-cost bubble CPAP on neonates <1500g
Authors: Okello Francis , Egiru Emmanuel , Ikiror Juliet , Acom Linda , Loe Kate SM , Olupot-Olupot Peter , Burgoine Kathy
Published: September 2019

Background:
Complications of prematurity are the leading cause of deaths in children under the age of five.The predominant reason for these preterm deaths is respiratory distress syndrome (RDS). In low-income countries (LICs) there are limited treatment options for RDS. Due to their simplicity and affordability, low-cost bubble continuous positive airway pressure (bCPAP) devices have been introduced in neonatal units in LICs to treat RDS. This study is the first observational study from a LIC to compare outcomes of very-low-birth-weight (VLBW) neonates in pre- and post-CPAP periods.

Methods:
This was a retrospective study of VLBW neonates (weight <1500 grams) in Mbale Regional Referral Hospital Neonatal Unit (MRRH-NNU), a government hospital in eastern Uganda. It aimed to measure the outcome of VLBW neonates in two distinct study periods: A 14-month period beginning at the opening of MRRH-NNU and covering the period until bCPAP was introduced (pre-bCPAP) and an 18-month period following the introduction of bCPAP (post-bCPAP). After the introduction of bCPAP, it was applied to preterm neonates with RDS when clinically indicated and if a device was available. Clinical features and outcomes of all neonates <1500g were compared before and after the introduction of bCPAP.

Results:
The admission records of 377 VLBW neonates <1500g were obtained. 158 were admitted in the pre-bCPAP period and 219 in the post-bCPAP period. The mortality rate in the pre- bCPAP period was 39.2% (62/158) compared with 26.5% (58/219, P =0.012) in the post-bCPAP period. Overall, there was a 44% reduction in mortality (OR 0.56, 95%CI 0.36-0.86, P = 0.01).There were no differences in birthweight, sex, presence of signs of respiratory distress or apnoea between the two groups.

Conclusion:
Specialized and resource-appropriate neonatal care, that appropriately addresses the challenges of healthcare provision in LICs, has the potential to reduce neonatal deaths.The use of a low-cost bCPAP to treat RDS in VLBW neonates resulted in a significant improvement in their survival in a neonatal unit in eastern Uganda. Since RDS is one of the leading causes of neonatal mortality, it is possible that this relatively simple and affordable intervention could have a huge impact on global neonatal mortality.
Comparison of Conservative and Operative Treatment of Jones Fracture
Authors: Demel Jiri , Planka Ladislav , Stichhauer Radek , Pleva Leopold
Published: September 2019

Background: A Jones fracture is a transverse fracture of the V. metatarsal bone, without significant dislocation in the diaphysis junction and metaphyseal metaphysis. This type of fracture is usually associated with a minimal injury mechanism, and is characterized with minimal swelling, absence of hematoma and prolonged healing. The aim of the presented study was to compare the surgical and conservative therapy of Jones fracture. The study was registered in the www.clinicaltrials.gov database, under the ClinicalTrials.gov ID: NCT04037540 on 27th July 2019. Methods: A total of 27 study subjects were randomized into two groups – Conservative (K): 12, and Operational (O): 15. The study subjects were followed after 6 and 12 weeks using X-ray and the American Orthopedic Foot and Ankle Score (AOFAS). In the absence of X-ray signs of healing and low AOFAS score in Group K, treatment was considered unsuccessful and the patient was indicated for surgical treatment. Results: Five patients in Group K showed no signs of healing on X-ray after 12 to 6 weeks. These patients also manifested poor AOFAS scores and were indicated for surgical treatment and excluded from the study. Fracture failure was observed in seven patients. Their AOFAS scores were at the least satisfactory and, the patients continued in conservative therapy. After 12 weeks, 6 patients manifested fracture healing on X-ray and the AOFAS score of 100. In one patient who refused surgery, the fracture was not healed after 12 weeks. In Group O, seven patients achieved fracture healing on X-ray after 6 weeks, 8 patients did not show fracture healing. The average AOFAS score after 6 weeks was 97 (excellent). After 12 months, 13 patients showed findings of fracture healing on X-ray. The average AOFAS score was 100 points (maximum). Conclusions: The results of the study show that 1) Surgical treatment leads to significantly faster signs of healing on X-ray than the conservative one 2) After six weeks of surgery, 93% (14 out of 15) of patients are able to fully load the limb. Keywords: Jones - Fracture - AOFAS - Herbert screw Unique protocol ID: FNO-KUCH-01-Jones
Implementation of a complex intervention to improve participation in older people with joint contractures living in nursing homes: A process evaluation of a cluster-randomised pilot trial
Authors: Klingshirn Hanna , Müller Martin , Beutner Katrin , Hirt Julian , Strobl Ralf , Grill Eva , Meyer Gabriele , Saal Susanne
Published: September 2019

Background Joint contractures in frail older people are associated with serious restrictions in participation. We developed the Participation Enabling CAre in Nursing (PECAN) intervention, a complex intervention to enable nurses to promote participation in nursing home residents with joint contractures. The aim of this study was to examine the feasibility of the implementation strategy and to identify enablers and barriers for a successful implementation. Methods The implementation of PECAN was investigated in a 6-month pilot cluster-randomised controlled trial (c-RCT). As a key component of the implementation strategy, nominated nurses were trained as facilitators in a one-day workshop and supported by peer-mentoring (visit, telephone counselling). A mixed-methods approach was conducted in conjunction with the pilot trial and guided by a framework for process evaluations of c-RCTs. Data were collected using standardised questionnaires (nursing staff), documentation forms, problem-centred qualitative interviews (facilitators, therapists, social workers, relatives, peer-mentors), and a group discussion (facilitators). A set of predefined criteria on the nursing home level was examined. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using directed content analysis. Results Seven nursing homes (n=4 intervention groups, n=3 control groups) in two German regions took part in the study. Facilitators responded well to the qualification measures (workshop participation: 14/14; workshop rating: “good”; peer-mentor visit participation: 10/14). The usage of peer-mentoring via telephone varied (one to seven contacts per nursing home). Our implementation strategy was not successful in connection with supplying the intervention to all the nursing staff. The clear commitment of the entire nursing home and the respect for the expertise of different healthcare professionals were emphasised as enablers, whereas a lack of impact on organisational conditions and routines and a lack of time and staff competence were mentioned as barriers. Conclusion The PECAN intervention was delivered as planned to the facilitators but was unable to produce comprehensive changes in the nursing homes and subsequently for the residents. Strategies to systematically include the management and the nursing team from the beginning, are needed to support the facilitators during implementation in the main trial.
The Effect of Positive Mental Imagery on Labor Pain Tolerance in Primiparous Women Referred to Atieh Teaching-Medical Center of Hamadan, Iran, 2018
Authors: Yavari Caroline , Masoumi Seyedeh Zahra , Kazemi Farideh , Refaei Mansoureh , Yaghoobi Abolghasem
Published: September 2019

Background: Childbirth is an important experience in the woman's life; and its quality has short- and long-term effects on them. The present study aimed to determine the effect of positive mental imagery on the labor pain tolerance in primiparous women referred to Atieh teaching-medical center in Hamadan.Method: The present clinical trial study was conducted on 90 primiparous mothers referred to Atieh Hospital of Hamadan in interventional (n= 45) and control (n= 45) groups. Data collection tools included demographic information forms, Behavioral pain scale, Visual analogue scale (VAS), and the birth registration checklist that were responded by both groups through interviews and observation during labor. The intervention group participated in 4 weekly counseling sessions in groups of 5 to 7 participants, but the control group received only routine care. Finally, the obtained data from above questionnaires was analyzed using SPSS 21 and analysis of covariance (ANCOVA), Independent t-test and chi-square test and the significance level of tests was considered to be at the level of 5%.Results: The research results indicated that the mean age of control and intervention groups was 25.98±4.82 and 25.32± 4.85 respectively. The mean scores of Visual analogue scale (VAS) and the Behavioral Pain Scale significantly decreased compared to the control group (P <0.001). The mean scores of behavioral changes in the intervention group were 1.77 ± 0.68, 2.39± 0.54 and 3.09±0.60 in 4-5 cm, 6-7 cm and 8-10 cm dilatations respectively. That was statistically significant decrease compared to the control group (P=0.005). Conclusion: Positive mental imagery counseling reduced the visual analogue intensity and behavioral pain intensity in primiparous women. It seems that continuing education and counseling during pregnancy and empowering mothers to control themselves and learn mental imagery techniques and practice during pregnancy and childbirth can help mothers to more relax and alleviate the labor pain intensity.Trial registration: Trial Registration Clinical Trial Registry: IRCT20120215009014N242.Registered on 2017-09-10. https://en.irct.ir/trial/9621Sampling start date:2018-10-23
Single Pass Whole-Body versus Organ-Selective Computed Tomography for Trauma: Timely diagnosis versus radiation exposure? – An observational Study
Authors: Ordoñez Carlos , Valle Ana Milena Del , Parra Michael , Guzman-Rodriguez Monica , Herrera-Escobar Juan P. , Garcia Carlos , García Alberto F. , Munevar Hernan E. , Navarro Constanza , Salas Alejandra De Las , Ibarra Laura C. , Holguin Alfonso
Published: September 2019

Background Single Pass Whole-Body Computed Tomography (WBCT) has been used as a high yield diagnostic tool in trauma. However, increased exposure to radiation and delay in treatment, have been cited as challenges to its widespread use. We hypothesized that WBCT has at least the same radiation exposure compared to Organ-Selective CT and it does not inflict further delays in treatment. Methods We retrospectively review all trauma patients in whom CT-scans were performed on arrival at a Level I Trauma Center from January, 2016 to December, 2017. Results 123 patients were included: 53 in the OSCT group and 70 in the WBCT group. In the OSCT group, 64.1% of the patients had penetrating trauma and chest injuries were the most common injured body cavity (79.3%). In the WBCT group, 65.7% had blunt trauma and head injuries were the most common (71.9%) injured organ. The OSCT group required subsequent trips to the scanner suite for follow-up studies to rule out other potential injuries which in turn did not occur in the WBCT group (47.2% vs 0%, p< 0.001). The total radiation exposure dose was higher in the OSCT group compared to the WBCT group [22 mSv (IQR 6-31) vs 15.1 mSv (IQR 9.9-24.8) p<0.001]. Conclusion OSCT has the potential of missing potentially life threatening injuries that require subsequent follow-up scans. This, in turn, would increase the patient’s overall radiation exposure and potentially delay definitive surgical treatment. Trauma patients undergoing WBCT had lower total radiation exposure with no delay in treatment.