bluuebunny/crossref_metadata_2025 huggingface dataset:
Valor del curetaje endocervical en el diagnóstico de neoplasias cervicales: Instituto Materno Infantil de Bogotá. 1986-1988
Authors: Díaz Rodríguez Carlos Alberto , Aragón Sánchez Miguel Eduardo
Published: May 2020

Se revisaron 202 historias clínicas de pacientes que acudieron a la consulta de oncología del I.M.I. y que fueron intervenidas entre los años de 1986 a 1988 (cono o histerectomía).El objetivo principal consiste en evaluar el resultado del CEC (curetaje endocervical), comparándolo con la citología. la biopsia exocervical y la pieza final de anatomía patológica con el fin de valorar el verdadero papel de este método diagnóstico para NIC.Encontramos un resultado positivo del CEC en 55% de casos con colposcopia satisfactoria y un 60% de los casos con colposcopia insatisfactoria. El CEC aumenta la agudeza diagnóstica en sólo 6% de casos con colposcopia insatisfactoria. La sensibilidad del CEC corresponde a un 64% y el valor predictivo positivo del 72%. Los falsos negativos encontrados corresponden al 36%. EL CEC no aportó el diagnóstico de invasión. Estos resultados se comparan con los resultados encontrados en otros estudios. (Rev Col Obstet Ginecol 1991; 42(3): 209-217).
Caso clínico
Authors: Bautista Alejandro , Rodriguez M Farid , Martinez Fernando
Published: May 2020

Primigestante de 16 años que consulta al Instituto Materno Infantil con gestación por amenorrea confiable de 34 semanas y por altura uterina a término (33 cmts) .
Anotaciones históricas sobre los primeros años de la Sociedad Colombiana de Obstetricia y Ginecología
Authors: Silva Mojica Carlos R.
Published: May 2020

Es altamente satisfactorio para mí recibir el reconocimiento y la distinción que hoy me otorga la Sociedad Colombiana de Obstetricia y Ginecología al nombrarme como Miembro Emérito de la misma y presidente honorario de esta sesión solemne. Es cierto que no figuro en la nómina de los miembros fundadores liderados por Rafael Peralta pero sí colaboré activamente en la medida de mis capacidades en sus primeros años de vida.
Actualización en crioterapia. Usos en ginecología
Authors: Gallego Noreña Gildardo
Published: May 2020

Este articulo presenta una información global acerca de la crioterapia.La introducción hace énfasis en que la terapia usual para NIC (neoplasia intraepitelial cervical) era la cirugía y hoy la crioterapia es una alternativa conservadora para mujeres jóvenes que quieren preservar la vida reproductiva.Presenta además aspectos históricos y luego explica el mecanismo de acción, dispositivo técnico, usos generales en medicina y ginecología.Los usos en el campo de la ginecología son muy importantes en entidades como cervicitis benigna, NIC, leucoplasias ceiVicales, papiloma virus humano y herpes genital.La orientación general va dirigida a los aspectos de tratamiento del NIC III. Las pacientes con NIC III deberán tener como requisitos mínimos: La lesión debe estar confinada estrictamente al cuello, el diámetro debe ser menor de tres centímetros y las márgenes de congelación deben pasar los cuatro milímetros lejos de la lesión.La paciente no debe tener coitos a usar tampones los siguientes diez días.Esta modalidad terapéutica se usó para pacientes con papiloma virus asociado o no con neoplasia, es una alternativa para mujeres embarazadas que cursan el primero y segundo trimestre.Finalmente muestra diagramas del criocauterio y se cita la bibliografía más relievante consultada.
PAPANICOLAOU III Manejo con Tetraciclina y Anfotericina B
Authors: Bernal Bastidas Sergio , Panduro Barón J. Guadalupe
Published: May 2020

Se estudiaron 100 casos de papanicolaou III con displasias cervicales de la Campaña Nacional contra el Cáncer de la Secretaría de Salud en Guadalajara, Jalisco, México, tratadas con tetraciclina y anfotericina B en forma de crema vaginal obteniendo un 71.0% de regresión en displasias leves, un 90% en displasias moderadas y un 59% de regresión en displasias severas, permaneciendo la displasia igual o aumentando en el 24% de todas las displasias.Según los resultados obtenidos se considera a la tetraciclina y a la anfotericina B medicamentos útiles en el manejo de las displasias (Papanicolaou III).
Pasado, presente y futuro de la ultrasonografía obstétrica
Authors: Sánchez Torres Fernando
Published: May 2020

Es válido advertir desde un principio que el autor del presente artículo no es un ultrasonografista o ecografista. Es apenas uno de los miles de ginecobstetras que en el mundo nos servimos de tan admirable e invaluable procedimiento físico no invasivo, que vino a transformar el ejercicio de la profesión médica en muchas de sus especialidades.
Manejo de las pacientes con endometriosis a través de cirugía láser C02 en el centro de fertilidad y esterilidad
Authors: Vásquez Zambrano Mario , Botero Tejada Agusto , Nasser José
Published: May 2020

Se estudiaron 191 pacientes que consultaron en un período de dos años por dolor pélvico, dismenorrea y/o infertilidad. Se clasificó el estadio de endometriosis y se les dio tratamiento con rayo láser de C02 por vía translaparoscópica. Se evalúan los resultados del tratamiento de acuerdo a la desaparición de los síntomas o la consecución de un embarazo. (Rev Col Obstet Ginecol 1991; 42(3): 228-231).
La toma de decisiones éticas en ginecología y obstetricia.
Authors: De Obstetricia y Ginecologia Federación Colombiana
Published: May 2020

A medida que los médicos se familiaricen más con la disciplina de la ética médica, con sus principios fundamentales y sus conceptos y normas, estarán menos emproblemados cuando enfrenten decisiones clínicas que requieran no sólo una gran pericia médica sino también perspicacia en la forma como los valores y metas personales afectan las decisiones. Al aproximarse a situaciones éticamente complejas en forma lógica y organizada, el médico aumenta las probabilidades de tener en cuenta todos los factores involucrados o pertinentes. El examen minucioso de principios encontrados y de obligaciones en conflicto generalmente inclinarán a balanza y permitirán una solución. Sin embargo, en los dilemas éticos, pocas veces se llega a soluciones claras como el cristal. Lo que debe buscarse al examinar un caso específico, es un punto en el cual, a la luz de los valores y de las metas de las personas involucradas, pueda llegarse a un acuerdo del peso relativo de los principios encontrados y llegar a una decisión.
Analisis K-Means Clustering pada Data Sepeda Motor
Authors: Dinata Rozzi Kesuma , Safwandi Safwandi , Hasdyna Novia , Azizah Nur
Published: May 2020

K-Means is a data mining algorithm that can be used to grouping or clustering data. This research using k-means for clustering the data of motorcycle based on consumer needs. The dataset used in this research is Honda and Yamaha motorcycle which taken from the dialers in Dewantara District, Aceh. The data tested by grouping 300 data of motorcycle with different attributes into 3 clusters, which are cheap, normal, and expensive. The distribution of the data we separate it using 45 data in 15 times of test. Each test used 3 different data randomly selected on each test. To calculate the distance of each motorcycle data that have been inputted to each centroid, we used the Euclidean Distance formula. Data in this cluster system can be used as a recommendation for users in selecting the motorcycle that they interest the most. The results of the performance on each test finished in 15 times shown that  the average value of Precision by 76%, Recall by 76% and  the accuracy by 81%.
An Optimized Procedure for Non-Contrast Magnetic Resonance Imaging in the Diagnosis of Chronic Pelvic Pain in Women
Authors: Zavylova K. A. , Shakhov B. E. , Morovov S. V.
Published: May 2020

Objective. To optimize a pelvic and lower abdominal cavity MRI protocol in the diagnosis of chronic pelvic pain (CPP) in women.Material and methods. A total of 57 reproductive-aged women with complaints of CPP were examined. The first stage of all patients after clinical and laboratory examination for clinical indications was performed ultrasound of the pelvis and abdominal cavity with dopplerometry. In the second stage, all the patients underwent an MRI using the standard Protocol, and then a modified Protocol. The final diagnosis was based on the results of a comprehensive examination, which included a clinical and neurological examination, gynecological examination, pelvic and abdominal ultrasound, radiography of the ileosacral joints and lumbosacral spine, fibrocolonoscopy and laparoscopy with morphological examination of the operating material (according to indications).Results. Forty-six (81%) patients were found to have gynecological factors for the development of CPP; 16 (28%) had extragenital factors. The examination results were verified by the data of surgical intervention (n = 16 (28%)), hysteroscopy (n = 21 (37%)), and laparoscopy (n = 9 (16%)) with morphological examination of biopsy specimens or surgical material.Comparing with the standard pelvic MR protocol provided evidence for the high diagnostic value of the modified protocol statistically significantly (p < 0.05): 99.2% sensitivity and 99.6% specificity.Conclusion. The developed non-contrast 1.5T MRI protocol for the pelvis permits MR images of the pelvis and adjacent anatomical areas to be obtained during one study without increasing time expenditures and upgrading equipment and software. The use of the protocol makes it possible to improve the quality of radiation diagnosis of gynecological and extragenital diseases in CPP and to recommend that the protocol in combination with other clinical and instrumental studies be introduced in clinical practice.
Mechanical Thrombectomy Using Transradial Access in a Variation of the Origin of the Brachiocephalic Trunk and Left Common Carotid Artery by the Common Ostium from the Aortic Arch
Authors: Sharafutdinov B. M. , Ryzhkin S. A. , Gaziev E. A. , Abdul’yanov I. V. , Abashev A. R. , Mikhaylov M. K.
Published: May 2020

The paper describes a clinical case of successfully applying a transradial access during mechanical thrombus extraction in a patient in the acutest stage of ischemic stroke with a congenital anatomical feature (the left common carotid artery and brachiocephalic trunk with the common ostium from the aortic arch).X-ray endovascular interventions were performed in an operating room equipped with a digital angiographic unit including an Axiom Artis dTA flat detector (Siemens Medical System).Mechanical recanalization for acute occlusion of the M2 segment of the left middle cerebral artery (MCA) was carried out using a right radial access into and catheterization of the left internal carotid artery. A stent retriever was inserted into the occlusion area through a microcatheter and was opened. Double thrombus extraction from the left MCA was made using the stent retriever to restore TICI 2B blood flow. There were no signs of dissection, thrombosis, or distal thromboembolism.
Consensus Guidelines of Russian Society of Radiology (RSR) and Russian Association of Specialists in Ultrasound Diagnostics in Medicine (RASUDM) «Role of Imaging (X-ray, CT and US) in Diagnosis of COVID-19 Pneumonia» (version 2)
Authors: Sinitsyn V. E. , Tyurin I. E. , Mitkov V. V.
Published: May 2020

The paper presents Consensus Guidelines of Russian Society of Radiology (RSR) and Russian Association of Specialists in Ultrasound Diagnostics in Medicine (RASUDM) «Role of imaging (X-ray, CT and US) in diagnosis of COVID-19 pneumonia» (version 2) of the Russian Society of Radiology and the Russian Association of Specialists in Ultrasound Diagnostics in Medicine.The guidelines list radiological techniques for lung diseases, which are used in coronavirus COVID-19 infection (chest X-ray, lung computed tomography (CT), and lung ultrasound (US), diagnostic algorithm, and follow-up study. The guidelines propose the models of the work of radiological rooms/departments of a healthcare facility, the procedure for conducting an examination, and recommendations for providing a description and assessing changes in the lung and chest in existing/suspected COVID-19-related pneumonia and present the schemes of X-ray and CT protocols at the initial examination and assessment of the changes.Chest X-ray has a low sensitivity for detecting initial changes in the first days of the disease and is not recommended for early diagnosis. Mobile radiography is an important tool for diagnosis of lung pathology in the intensive care units.CT is the most sensitive technique in detecting lung changes characteristic of COVID-19-related pneumonia. It is advisable to use CT for the initial evaluation of thoracic organs in patients with severe and progressive forms of the disease, as well as for the differential diagnosis and follow up.Lung US in patients with suspected/known COVID-19-related pneumonia is an additional imaging method that does not replace or exclude X-ray and CT. If the correct procedure is followed, correct indications are selected, and trained medical personnel is available, this study is highly sensitive in detecting interstitial changes and consolidations in lung tissue, but only in their subpleural location. The US data do not always allow definite determination of the reasons for the occurrence and/or actual extent of lung tissue changes.Standard reporting guidelines (CT, X-ray) about the possibility of COVID-19 pneumonia and its severity should be used.The follow up using CT, X-ray, or US depends on the clinical indications that necessitate dynamic assessment. The recommended frequency of repeat CT and X-ray in patients having no substantial changes in their clinical condition outside the intensive care units is not more than once every 5-7 days. An objective assessment of the time course of changes is possible only when comparing the data of the same type of study.
The Spectrum and Frequency of Inner Ear Anomalies in Patients with Congenital Hearing Impairment in Yakutia
Authors: Klarov L. A. , Barashkov N. A. , Teryutin F. M. , Romanov G. P. , Popov M. M. , Solov’ev A. V. , Luginov N. V. , Tobokhov A. V. , Kotlyarov P. M.
Published: May 2020

Objective. To analyze the spectrum and frequency of inner ear anomalies in patients with congenital hearing impairment in Yakutia.Material and methods. A total of 165 patients with congenital hearing impairment were surveyed. All the patients were examined by an audiologist, an educational audiologist, and a neuropsychiatrist. All the patients underwent X-ray computed tomography (X-ray CT) of temporal bone structures (which was supplemented by magnetic resonance imaging (MRI) in some cases).Results. Based on modern ideas about inner ear anomalies and their classification, the authors first analyzed the spectrum and frequency of inner ear anomalies in patients with congenital hearing impairment in Yakutia. Inner ear malformations were identified in 16 (9.7%) of the 165 patients with hearing impairment, which corresponds to that in the previously studied samples of deaf people in different countries (from 3% to 35%). Of the inner ear structures, the cochlea and vestibule were more commonly affected. Abnormalities of the internal auditory meatus, semicircular canals, and vestibular aqueduct were less common. In general, the spectrum of anomalies was represented by 7 different malformations. Incomplete partition type II (IP-II) (34.3%) came first in incidence among all the abnormalities. Incomplete partition type III (IP-III) (18.7%) ranked second in incidence. The expansion of the internal auditory meatus (12.5%) and vestibular aqueduct (12.5%) occupied the third place. Inner ear anomalies occurred as concurrences that are difficult to interpret and classify in half (50%) of all the cases.Conclusion. Analysis of the spectrum and frequency of temporal bone abnormalities in Yakutia suggests that every 10 patients with congenital hearing impairment have one or another inner ear structural malformation (9.7%) and require accurate and timely diagnosis using up-to-date X-ray CT and MRI techniques.
EDITORIAL: SAL, PATRIMONIO Y TERRITORIO
Authors: Román López Emilia
Published: May 2020

Reflexiones a la luz del I Seminario Internacional de Paisajes Culturales de la Sal Artesanal en España e Iberoamérica
La sal de la vida, vida en la sal: Producción de sal en paisajes de alto valor ecológico = The salt of life, life in salt: Salt production in high value landscapes
Authors: Hueso Kortekaas Katia
Published: May 2020

RESUMEN:Pese a que la sal se considera perniciosa para la vida, los paisajes de la sal y, más en concreto las salinas de evaporación solar, constituyen complejos sistemas biológicos de gran relevancia para la producción de sal de calidad. No se trata sólo de la biodiversidad de especies halófilas que pueda habitarla o de las estrategias fisiológicas que la biota de las salinas tenga para sobrevivir a la sal en el ambiente, sino del entramado de relaciones que entre ellos se  producen. El delicado equilibrio entre la red trófica de las salinas con la actividad de producción artesanal de sal, hacen que sean paisajes vivos, que garantizan la conservación de sus valores naturales y culturales. La producción artesanal de sal se puede considerar así una actividad agrícola que resulta en un producto de alta calidad y respetuoso con el medionatural.ABSTRACT:Although salt is considered harmful to life, saltscapes and, more specifically, solar evaporation salinas, are complex biological systems of great relevance to the production of quality salt. It is not only a question of the biodiversity of halophilic species that may inhabit them or the physiological strategies that their biota have to survive the salt present in the environment, but also of the network of relationships between them. The delicate balance between the trophic network of the salinas and the artisanal salt production, make them living landscapes, which guarantee the conservation of their natural and cultural values. Artisanal salt production can thus be considered an agricultural activity that results in a high quality product that is respectful of the naturalenvironment.
Post Operative Acute Kidney Injury after HPB Surgeries – A Single Centre Retrospective Analysis
Authors: Vasavada Bhavin B. , Patel Hardik
Published: May 2020

Aim: Aim of our study was to evaluate incidence and causative factors for acute kidney injury in hepatopancreaticobiliary (HPB) surgeries. Material and Methods: All the HPB surgeries performed between April 2018 to March 2020, in our institution have been analysed for acute kidney injury. Acute kidney injury defined according to acute kidney injury network classification. Categorical variables were evaluated by chi square test and fisher t test wherever approptiate and continuous variables by Mann Whitney U test. Statistical analysis was done using SPSS version 23. P< 0.05 was considered significant. Results: We performed 195 HPB surgeries between April 2018 to March 2020, Which included 114 biliary surgeries, 57 liver surgeries and 23 pancreas surgeries. 10 patients developed Acute Kidney Injuries. (AKI) On Univariate analysis AKI was associated with open surgeries, intra operative hypotension and liver surgeries, higher ASA grade, increase operative time, more blood products used, higher CDC grade of surgery and more hospital stay before diagnosis of AKI. However on multivariate analysis only higher ASA score independently predicted Acute Kidney Injury. (p=0.003, odds ratio 15.659, 95% confidence interval 2.54-93.36). AKI was also significantly associated with mortality. (p <0.0001). Conclusion: Pre operative higher ASA grade independently predicted post operative acute kidney injury. Post operative AKI is significantly associated with mortality.
Retention in Care and Viral Suppression in Differentiated Service Delivery Models for HIV Treatment in Sub-Saharan Africa: A Rapid Systematic Review
Authors: Long Lawrence , Kuchukhidze Salome , Pascoe Sophie , Nichols Brooke E. , Fox Matthew P. , Cele Refiloe , Govathson Caroline , Huber Amy N. , Flynn David , Rosen Sydney
Published: May 2020

Introduction: Differentiated service delivery (DSD) models for antiretroviral treatment (ART) for HIV are being scaled up in the expectation that they will improve the quality and efficiency of treatment delivery and reduce costs while maintaining at least equivalent clinical outcomes. Even this minimum requirement of equivalent clinical outcomes is poorly documented for most models and settings, however. We reviewed the recent literature on DSD models to describe what is known about clinical outcomes. Methods: We conducted a rapid systematic review of peer-reviewed publications in PubMed, Embase, and the Web of Science and major international conference abstracts that reported outcomes of DSD models for the provision of ART in sub-Saharan Africa from January 1, 2016 to September 12, 2019. Sources reporting standard clinical HIV treatment metrics, primarily retention in care and viral load suppression, were reviewed and categorized by DSD model and source quality assessed. Results and Discussion: Twenty-nine papers and abstracts describing 37 DSD models and reporting 52 discrete outcomes met search inclusion criteria. Of the 37 models, 7 (19%) were facility-based individual models, 12 (32%) out-of-facility based individual models, 5 (14%) client-led groups, and 13 (35%) healthcare worker-led groups. Retention was reported for 73% of the models and viral suppression for 57%. Where a comparison with conventional care was provided, retention in most DSD models was within 5% of that for conventional care; where no comparison was provided, retention generally exceeded 80%. For viral suppression, all those with a comparison to conventional care reported a small increase in suppression in the DSD model; reported suppression exceeded 90% in 11/21 models. Analysis was limited by the extensive heterogeneity of study designs, outcomes, models, and populations. Most sources did not provide comparisons with conventional care, and metrics for assessing outcomes varied widely and were in many cases poorly defined. Conclusion: Existing evidence on the clinical outcomes of DSD models for HIV treatment in sub-Saharan Africa is limited in both quantity and quality but suggests that retention in care and viral suppression are roughly equivalent to those in conventional models of care.
Advances in Therapeutic Targeting of Cancer Stem Cells within the Tumor Microenvironment: An Updated Review
Authors: Senthebane Dimakatso Alice , Ganz Chelene , Thomford Nicholas Ekow , Dzobo Kevin
Published: May 2020

Despite great strides being achieved in improving cancer patients’ outcomes through better therapies and combinatorial treatment, several hurdles still remain due to therapy resistance, cancer recurrence and metastasis. Drug resistance, culminating in relapse and metastatic disease continue to be associated with fatal disease. Cancer stem cells (CSCs) are a subpopulation of cancer cells known to be resistant to therapy and cause metastasis. Whilst the debate on whether CSCs are the origins of the primary tumor rages on, CSCs have been further characterised in many cancers with data illustrating that CSCs display great abilities to self-renew, withstand therapies due to enhanced epithelial to mesenchymal (EMT) properties, enhanced expression of ABC membrane transporters, activation of several survival signaling pathways and increased immune evasion DNA repair mechanisms. CSCs also display great heterogeneity with the consequential lack of specific CSC markers presenting a great challenge to their targeting. In this updated review we re-visit CSCs within the tumor microenvironment (TME) and present novel treatment strategies targeting CSCs. These promising strategies include targeting CSCs-specific properties using small molecule inhibitors, immunotherapy, microRNA mediated inhibitors, epigenetic methods as well as targeting CSC niche-microenvironmental factors and differentiation. Lastly, we present recent clinical trials undertaken to try to turn the tide against cancer by targeting CSC-associated drug resistance and metastasis.
Feeling Like It Is Time to Reopen Now? COVID-19 New Normal Scenarios Based on Reopening Sentiment Analytics
Authors: Samuel Jim , Rahman Md. Mokhlesur , Ali G. G. Md. Nawaz , Samuel Yana , Pelaez Alexander
Published: May 2020

The Coronavirus pandemic has created complex challenges and adverse circumstances. This research discovers public sentiment amidst problematic socioeconomic consequences of the lockdown, and explores ensuing four potential sentiment associated scenarios. The severity and brutality of COVID-19 have led to the development of extreme feelings, and emotional and mental healthcare challenges. This research identifies emotional consequences - the presence of extreme fear, confusion and volatile sentiments, mixed along with trust and anticipation. It is necessary to gauge dominant public sentiment trends for effective decisions and policies. This study analyzes public sentiment using Twitter Data, time-aligned to COVID-19, to identify dominant sentiment trends associated with the push to 'reopen' the economy. Present research uses textual analytics methodologies to analyze public sentiment support for two potential divergent scenarios - an early opening and a delayed opening, and consequences of each. Present research concludes on the basis of exploratory textual analytics and textual data visualization, that Tweets data from American Twitter users shows more trust sentiment support, than fear, for reopening the US economy. With additional validation, this could present a valuable time sensitive opportunity for state governments, the federal government, corporations and societal leaders to guide the nation into a successful new normal future.
Effect of Bearing Surface on Survival of Cementless and Hybrid Total Hip Arthroplasty
Authors: Davis Edward T. , Pagkalos Joseph , Kopjar Branko
Published: May 2020

Background:

Modern bearing surface options have increased implant survivorship after total hip arthroplasty (THA). We utilized data from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR) to analyze implant survivorship after THAs with uncemented acetabular components with different bearing combinations.

Methods:

Polyethylene (PE) manufacturing properties supplied by the manufacturers were used to subdivide the NJR data set into cross-linked PE (XLPE) and conventional PE groups. Overall and cause-specific revisions for various bearing combinations were analyzed using Kaplan-Meier and multivariate Cox proportional hazard regression survival analyses.

Results:

Of 420,339 primary THAs, 8,025 were revised during an average follow-up period of 4.4 years (maximum, 13.3 years). In the Cox regression model with metal on conventional PE as the reference, the lowest risk of revision for any reason was for ceramicized metal on XLPE (hazard ratio [HR] = 0.58, 95% confidence interval [CI] = 0.48, 0.71), followed by ceramic on XLPE (HR = 0.66, 95% CI = 0.60, 0.72), ceramic on PE (HR = 0.74, 95% CI = 0.66, 0.82), ceramic on ceramic (HR = 0.77, 95% CI = 0.72, 0.82), and metal on XLPE (HR = 0.81, 95% CI = 0.76, 0.87). A similar pattern was observed when patients under the age of 55 years were analyzed independently. Younger age, male sex, and cementless stem fixation were associated with a higher risk of revision.

Conclusions:

In a fully adjusted model, ceramicized metal on XLPE and ceramic on XLPE were associated with the lowest risk of revision for any reason. This finding was sustained when patients under the age of 55 years were analyzed independently. On the basis of the NJR data set, use of XLPE markedly reduces the risk of revision.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Ensuring Business Continuity of Musculoskeletal Care During the COVID-19 Pandemic
Authors: Liow Ming Han Lincoln , Tay Kenny Xian Khing , Yeo Nicholas Eng Meng , Tay Darren Keng Jin , Goh Seo Kiat , Koh Joyce Suang Bee , Howe Tet Sen , Tan Andrew Hwee Chye
Published: May 2020

On February 8, 2020, Singapore raised its Disease Outbreak Response System Condition (DORSCON) level to Orange, indicating that coronavirus 2019 (COVID-19) was a severe disease with high human transmissibility. Using lessons learned from the severe acute respiratory syndrome (SARS) outbreak in 2003, the orthopaedic surgery department at Singapore General Hospital, a tertiary-level referral center, was prepared to handle this pandemic through business-continuity planning. The business that we are referring to is the “business” of orthopaedic surgery, encompassing clinical care, education, research, and administration. There is a lack of literature detailing business-continuity plans of surgical departments during pandemics, with new guidelines being developed. A large proportion of orthopaedic work, such as cases of fracture and infection, cannot be postponed. Even elective surgeries cannot be postponed indefinitely as it could result in detriment to the quality of life of patients. The aim of this article is to detail the business-continuity plans at our institution that allowed the delivery of essential musculoskeletal care through personnel segregation measures during the COVID-19 pandemic. Strategies to ensure the provision of timely medical intelligence, the reduction of nonessential ambulatory visits and surgical procedures, ensuring the safety and morale of staff, and continuing education and research efforts were paramount. As the COVID-19 pandemic unfolds, our posture needs to constantly evolve to meet new challenges that may come our way. Our existing business-continuity plan is not perfect and may not be applicable to smaller hospitals. There is conflict between envisioned normalcy, remaining economically viable as an orthopaedic department, and fulfilling training requirements, and educating the next generation of orthopaedic surgeons on the one hand and the need for segregation, workload reduction, virtual education, and social distancing on the other. Orthopaedic surgeons need to strike a balance between business continuity and adopting sustainable precautions against COVID-19. We hope that our experience will aid other orthopaedic surgery departments in adapting to this new norm, protecting their staff and patients, managing staff morale, and allowing the continuation of musculoskeletal care during the COVID-19 pandemic.
Experimental Investigation of Water Incompatibility and Rock/Fluid and Fluid/Fluid Interactions in the Absence and Presence of Scale Inhibitors
Authors: Mohammadi Mehdi , Riahi Siavash
Published: May 2020

Waterflooding is known as an affordable method to enhance oil recovery after primary depletion. However, the chemical incompatibility between injected water and the water in the reservoir may cause the formation of mineral scales. The most effective method for managing such a problem is to use a variety of scale inhibitors (SIs) along with a waterflooding plan. It is necessary to perform a comprehensive study on the incompatibility scaling issue for the candidate-brine/SI formulations, and also their effect on the reservoir-rock/fluid characteristics. In this study, both in the absence and presence of polymeric, phosphonate, and polyphosphonate SIs, the scaling tendency (ST) of different brines is evaluated through experimental and simulation works. Drop-shape analysis (DSA), environmental-scanning-electronic-microscopy (ESEM) observation, energy-dispersive X-ray (EDX) analysis, and microemulsion phase behavior are also used to study the effect of different brine/SI formulations on the rock/fluid and fluid/fluid interactions, through wettability and interfacial-tension (IFT) evaluation. In summary, sulfate (SO42−) was identified as the most problematic ion in the formulation of injected water that causes the formation of solid scales upon mixing with the cation-rich formation water (FW). In the case of SIs, solid precipitation was shifted toward a lower value, with more pronounced effects at higher SI concentrations. At different ionic compositions, the inhibition efficiency (IE%) of all SIs ranged from 16 to 50% at [SI]  = 20 ppm and 38 to 81% at [SI] = 50 ppm. In general, phosphonates worked better (i.e., higher IE value) than polymeric SI. Measuring contact angles along with ESEM/EDX data also illustrated the positive effect of SIs on the wettability alteration of the aged carbonate substrates. In the absence of SIs, the contact angles for different brines were in the range of 70° ≤ θ ≤ 104°, whereas these values fell between 35 and 80° for systems containing 50 ppm of SI. In addition, phase-behavior study and IFT measurement illustrated a salinity-dependence effect of SIs on the interfacial behavior of the oil/water system.
Enhanced Formation Evaluation in the Permian Basin Using a Novel Field-Scale Workflow Including Wells with Missing Data
Authors: Garcia Artur Posenato , Jagadisan Archana , Hernandez Laura M. , Heidari Zoya , Casey Brian , Williams Rick
Published: May 2020

Reliable formation evaluation in organic-rich mudrocks requires integrated interpretation of well logs and core measurements. More than 80% of the Permian Basin wells have incomplete data sets, lacking photoelectric factor (PEF) or other logs required for reliable formation evaluation in the presence of complex mineralogy. Hence, we develop a novel workflow to reliably estimate rock properties in wells with incomplete data to enhance reservoir characterization and completion decisions. We propose to use integrated rock classification for enhanced physics-based assessment of rock properties in wells with missing data; combine field-scale geostatistical and machine learning methods to reliably reconstruct missing PEF logs with a confidence interval through a rock-type-based approach, which is a unique contribution of this work; and quantify the uncertainty in estimates of petrophysical properties.

We performed a preliminary field-scale formation evaluation on wells with triple-combo logs (more than 70 wells). Next, we performed an initial rock typing and reconstructed the missing PEF logs by combining supervised neural networks with geostatistical analysis on a rock-type basis. We then used an unsupervised neural network method to improve the rock classification based on the updated estimates of petrophysical and compositional properties after PEF reconstruction. The combined rock classification and PEF reconstruction was performed iteratively to improve the multimineral analysis results in all wells with missing data. We successfully applied the new workflow to 20 wells in blind tests. The reconstructed well logs agreed with the actual measurements with relative errors of less than 10%.

The new workflow extends the boundaries of reliable formation evaluation, enabling accurate reservoir characterization and completion decisions by enhancing evaluation of wells with missing data. The proposed method can also be applied to wells with other types of missing data.
Surrogate-Based Optimization for the Design of Rotary Gas Separator in ESP Systems
Authors: Abbariki Ghasem , Riasi Alireza , Rezghi Ali
Published: May 2020

The rotary gas separator (RGS) is used to separate gas from the two-phase flow and reduce input gas into the electrical submersible pumps (ESPs). When the pump handles flow with high gas void fraction (GVF), it causes deterioration of the head and performance of the pump system. Thus, performance prediction of the RGS is very important. In this study, optimization of separator blades in the RGS is carried out using computational fluid dynamics (CFD), and surrogate methods are used to increase gas separation efficiency. Three-dimensional (3D) Navier-Stokes equations are solved by using the Euler-Euler approach for the inhomogeneous two-phase flow (water/air), and modeling interphase forces in ANSYS® CFX 15.0 software (ANSYS, Inc., Canonsburg, Pennsylvania, USA). The kriging (KRG) model is used to approximate the objective function as a function of design variables including the inlet angle, straight blade length, and tip-clearance gap. Sensitivity analysis showed that the tip-clearance gap has more effect on efficiency. The results for optimized values indicated that the separation efficiency increased, and efficiency is progressively transferred from the high-efficiency region to the low-efficiency region.
Titles: Caregiver's perspectives on facilitators and barriers of active participation in cerebral palsy rehabilitation in North West Nigeria: a qualitative study
Authors: Isah Auwal , Abdullahi Auwal
Published: May 2020

Background: Cerebral Palsy (CP) is a group of permanent disorders of movement and posture, attributed to non-progressive disturbance that occurred in the developing fetal or infant brain. The condition results in long-term disability in carrying out activities of daily living (ADL). Thus, active participation of caregivers in the rehabilitation of their children with CP is required.Objective: The aim of this study is to explore the facilitators and barriers of active participation of caregivers in the rehabilitation of children with CP in Kano, Nigeria.Materials and Methods:The study design used was qualitative in-depth interview. The participants consisted of caregivers of children with CP attending Hasiya Bayero Paediatric Specialists Hospital, Kano. The caregivers were sampled and interviewed by one of the researchers until theoretical saturation was attained. Responses of the participants were audio-recorded with a tape recorder, supplemented with note taking. The data generated from the interview was then transcribed, coded and analyzed using matrix analysis, using constant comparative analysis.Results:Forty caregivers with mean age, 27.17±4.46 years participated in the study.The results of the study showed factors that facilitate active participation of caregivers of children with CP in the rehabilitation of their children are improvement in the child’s condition, family support, improvement in the conditions of other children with CP, encouragement from the therapist managing the child, empathy, and cooperation of the child during home programs. The barriers identified are number of children the caregiver has, caregiver’s occupation and financial resources.Conclusion:Therapists need to help reinforce these facilitators, and devise strategies to help caregivers overcome barriers during rehabilitation of children with CP. Economically sustainable and accessible rehabilitation services are needed for all children with CP. Similarly, sharing caregiving rehabilitation tasks amongst family members could facilitate caregiver active participation.
Branches of the brachiocephalic was an independent risk factor for hemorrhagic pulmonary sheath (HPS) patients with acute Stanford A aortic dissection
Authors: Xie Qiuxia , Qin Haoling , Lin Ling , Guan Jian , Zhou Xuhui
Published: May 2020

Background: AAD refers to the blood flow into the middle membrane through the intimal rupture of the aorta. Hemorrhagic pulmonary sheath (HPS) is a common complication of Stanford-A AAD. The risk factors of HPS are remaining unclear Methods: In this study, we have probed the potential risk factors of HPS patients with acute Stanford A aortic dissection. 18 HPS patients with acute Stanford A aortic dissection were selected as the case group. The age difference ± 5 years and the same sex are set as the matching principles. 36 patients with acute Stanford-A type AD who did not detect HPS in the same period were matched according to the ratio of 1:2. Demographic data, treatment methods, AD-related disease history, clinical symptoms and Charlson comorbidity index (CCI) values of each patient were collected. Meanwhile, the values of the maximum diameter of ascending aorta (mm), aortic dissection range, and the main branch of the aorta, pleural effusion/blood, and pericardial effusion/blood were measured by two experienced cardiovascular radiological physicians. Univariate and multivariate conditional logistic regression analysis was used in this study. Results: CCI value and the branches of the brachiocephalic in the case group were significantly higher than those in the control group (p<0.05). Univariate conditional logistic regression analysis showed CCI and branches of the brachiocephalic were associated with HPS. Multivariate conditional logistic regression analysis suggested that branches of the brachiocephalic were an independent risk factor for HPS (OR=7.02, 95%CI=1.28-38.62, p=0.025). Conclusions: Branches of the brachiocephalic were an independent risk factor for HPS.
Dissatisfaction between medical providers and patients in the Republic of Kazakhstan.
Authors: Zhumadilova Anara , Kozhakhmetova Aizhan , Kuanyshbayeva Gaukhar , Kazhen Madina , Akhmadiyeva Amina , Craig Brett J.
Published: May 2020

Background: Dissatisfaction among patients towards health care providers remains a serious concern in the Republic of Kazakhstan that requires further attention(1-3). Patient-centred care, trust between patients and medical providers, the involvement of patients in their own treatment process, and effective communication are major areas in need of strengthening in order to improve outcomes of medical care (4-7). The objective of this study was to broaden the investigation of patient dissatisfaction to various departments from different medical facilities in the city of Nur-Sultan and examine additional factors that may be influencing provider-patient communication and contributing to patient dissatisfaction. Methods: This cross-sectional study of 500 patients (response rate, 85.4%) and 500 health care providers (response rate, 86.4%) from one private and one state hospital and two state policlinics (outpatient departments) in the city of Nur-Sultan, Kazakhstan, used questionnaires containing the Patient-Practitioner Orientation Scale (PPOS) and scales assessing life and job satisfaction, job effort-job reward balance, and patient evaluation of communication. Results: Our study showed that the majority of health care providers and patients were doctor-centred as opposed to patient-centred in their expectations of the doctor visit. The patient-centred orientation of health care providers was negatively correlated with age (P=0.000218) and life satisfaction (P=0.000001). In patients, contrarily, patient-centredness was enhanced by higher life satisfaction (P=0.040), although negatively correlated with age (P=2.659E-21). Conclusions: The results of this study demonstrate that younger health care providers and those with lower life satisfaction expect a more patient-centred approach to the doctor visit. Older respondents and those with higher life satisfaction, in contrast, reported doctor-centred attitudes. The majority of younger patients have a stronger belief in good health associated with patient-centred care whereas the older population preferred a more doctor-centred approach to care. In all patients, the preference for patient-centred care was associated with higher satisfaction in life.
Identification of QTL for resistance to root rot in sweetpotato (Ipomoea batatas (L.) Lam) with SSR linkage maps
Authors: Ma Zhimin , Gao Wenchuan , Liu Lanfu , Liu Minghui , Zhao Ning , Han Meikun , Wang Zhao , Jiao Weijing , Gao Zhiyuan , Hu Yaya , Liu Qingchang
Published: May 2020

Background: Sweetpotato root rot is a devastating disease caused by Fusarium solani that seriously endangers the yield of sweetpotato in China. Although there is currently no effective method to control the disease, breeding of resistant varieties is the most effective and economic option. Moreover, quantitative trait locus (QTL) associated with resistance to root rot have not yet been reported, and the biological mechanisms of resistance remain unclear in sweetpotato. Thus, increasing our knowledge about the mechanism of disease resistance and identifying resistance loci will assist in the development of disease resistance breeding. Results: In this study, we constructed genetic linkage maps of sweetpotato using a mapping population consisting of 300 individuals derived from a cross between Jizishu 1 and Longshu 9 by simple sequence repeat (SSR) markers, and mapped seven QTLs for resistance to root rot. In total, 484 and 573 polymorphic SSR markers were grouped into 90 linkage groups for Jizishu 1 and Longshu 9, respectively. The total map distance for Jizishu 1 was 3,974.24 cM, with an average marker distance of 8.23 cM. The total map distance for Longshu 9 was 5,163.35 cM, with an average marker distance of 9.01 cM. Five QTLs ( qRRM_1 , qRRM_2 , qRRM_3, qRRM_4 , and qRRM_5 ) were located in five linkage groups of Jizishu 1 map explaining 52.6–57.0% of the variation. Two QTLs ( qRRF_1 and qRRF_2 ) were mapped on two linkage groups of Longshu 9 explaining 57.6% and 53.6% of the variation, respectively. Furthermore, 71.4% of the QTLs positively affected the variation. Three of the seven QTLs, qRRM_3 , qRRF_1 , and qRRF_2 , were colocalized with markers IES43-5mt, IES68-6fs**, and IES108-1fs, respectively. Conclusions: To our knowledge, this is the first report on the construction of a genetic linkage map for purple sweetpotato (Jizishu 1) and the identification of QTLs associated with resistance to root rot in sweetpotato using SSR markers. These QTLs will have practical significance for the fine mapping of root rot resistance genes and play an important role in sweetpotato marker-assisted breeding.
Optimizing the Efficiency and Implementation of Cash Transfers to Improve Adherence to Antiretroviral Therapy: Study Protocol for A Cluster Randomized Controlled Trial
Authors: Packel Laura , Njau Prosper , Fahey Carolyn , Ramadhani Angela , Dow William H , Jewell Nicholas P , McCoy Sandra I
Published: May 2020

Background : Antiretroviral therapy (ART) for HIV, taken daily, is an effective strategy to clinically suppress the virus, providing the dual benefit of improved survival and vastly decreasing the risk of transmission. However, this highly effective intervention has not yet reached all who could benefit. Cash transfers are increasingly recognized as an effective strategy to motivate behavior change and improve outcomes along the HIV care continuum, including engagement in HIV care and adherence to ART. Despite a growing evidence base and strong theoretical foundation for the cash transfer approach, key questions remain. Specifically, gaps exist in understanding: 1) whether short-term cash transfers can increase viral suppression in larger, effectiveness studies; and 2) an implementation model or set of best practices that facilitate scale up and enhance sustainability. To address these questions and begin to bridge the “know-do gap” with respect to cash transfers, our team is employing an implementation science approach to iterative development of an incentive-based implementation strategy to promote ART uptake and adherence among people living with HIV (PLHIV) in the Lake Zone Region, Tanzania.Methods: We will conduct a type I hybrid implementation – effectiveness trial to test the effectiveness of a cash transfer intervention on the outcome of HIV viral suppression, and concurrently examine the potential for real-world implementation with an mHealth system through measurement of implementation science constructs. Specifically, our team will expand the intervention to 32 clinics and enroll 1,984 PLHIV to (a) evaluate its effectiveness by conducting a cluster randomized controlled trial with clinics as the unit of randomization and 12-month viral suppression as the primary outcome – a key indicator for monitoring progress towards HIV epidemic control; and (b) evaluate the implementation challenges and successes by measuring implementation outcomes at multiple levels (patient, provider, clinic). Discussion: This trial will provide evidence about not only the real-world effectiveness of cash transfers for retention in HIV care and viral suppression, but also on the implementation challenges and successes that will facilitate or hinder wider scale-up within Tanzania and beyond.