bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection and Prediction of Incident Alzheimer Dementia over a 10-Year or Longer Medical History: A Population-Based Study in Primary Care
Authors: Grande Giulia , Vetrano Davide L. , Mazzoleni Francesco , Lovato Valeria , Pata Mario , Cricelli Claudio , Lapi Francesco
Published: November 2020

Background: Despite the crucial role played by general practitioners in the identification and care of people with cognitive impairment, few data are available on how they may improve the early recognition of patients with Alzheimer dementia (AD), especially those with long (i.e., 10 years and longer) medical history. Aims: To investigate the occurrence and the predictors of AD during a 10-year or longer period prior AD diagnosis in primary care patients aged 60 years or older. Materials and Methods: A cohort study with a nested case-control analysis has been conducted. Data were extracted from the Italian Health Search Database (HSD), an Italian database with primary care data. AD cases have been defined in accordance with the International Classification of Diseases, ninth edition (ICD-9-CM) codes and coupled with the use of anti-dementia drugs. Prevalence and incidence rates of AD have been calculated. To test the association between candidate predictors, being identified in a minimum period of 10 years, and incident cases of AD, we used a multivariate conditional logistic regression model. Results: As recorded in the primary care database, AD prevalence among patients aged 60 years or older was 0.8% during 2016, reaching 2.4% among nonagenarians. Overall, 1,889 incident cases of AD have been identified, with an incidence rate as high as 0.09% person-year. Compared with 18,890 matched controls, history of hallucinations, agitation, anxiety, aberrant motor behavior, and memory deficits were positively associated with higher odds of AD (p < 0.001 for all) diagnosis. A previous diagnosis of depression and diabetes and the use of low-dose aspirin and non-steroidal anti-inflammatory drugs were associated with higher odds of AD (p < 0.05 for all). Conclusion: Our findings show that, in accordance with primary care records, 1% of patients aged 60 years and older have a diagnosis of AD, with an incident AD diagnosis of 0.1% per year. AD is often under-reported in primary care settings; yet, several predictors identified in this study may support general practitioners to early identify patients at risk of AD.
Predictive Value of Additional Clinical and Radiological Parameters for Discrimination of Malignancy in Bosniak 3 Cysts
Authors: Sefik Ertugrul , Bozkurt Ibrahim Halil , Oguzdogan Gulsen Yucel , Çelik Serdar , Basmaci Ismail , Gorgel Sacit Nuri , Aydin Erhan , Adibelli Zehra Hilal , Vardar Enver , Gunlusoy Bulent , Degirmenci Tansu
Published: November 2020

Introduction: Almost half of the cystic renal lesions are still overdiagnosed and overtreated. New clinical and radiological parameters are needed to distinguish the malignant Bosniak 3 lesions from the benign ones. We aimed to evaluate the clinical and radiological parameters that may be related to malignancy risk for Bosniak category 3 renal cysts. Materials and Methods: Patients who underwent surgical resection of a histopathologically confirmed Bosniak 3 renal cyst between March 2007 and September 2019 were evaluated. Two experienced uro-radiologists have reevaluated the last preoperative computed tomography and/or MRI images of the patients and reclassified the lesions according to the Bosniak classification. They also reported cystic features such as nodularity, septation, focal thickening, enhancement, and calcification. Clinical, pathological, and oncological outcomes were recorded. Then patients were divided into 2 groups as Group 1 (benign pathology) and Group 2 (malignant pathology) according to final histopathological report. Results: A total of 79 patients were included in this study. Mean follow-up time was 47 ± 34 months. There were 30 patients in Group 1 and 49 patients in Group 2. Hypertension (p = 0.001) and smoking history (p = 0.008) were more common in malignant group. Among the radiological findings, lower tumor diameter (p = 0.024), presence of cyst wall enhancement (p = 0.025), presence of nodularity (p = 0.002), and presence of focal thickening (p = 0.031) were found to be statistically significant for malignancy. Most of the tumors were at pathological T1 stage and Fuhrmann Grade 1–2. Only nodularity was found to be independent predictive factor for malignancy in multivariate analysis. Conclusion: Clinical factors including hypertension and smoking, radiological factors including lower lesion size, cyst wall enhancement, nodularity, and focal thickening were predictors for malignancy of Bosniak 3 cysts.
Development of a Stereotactic Radiosurgery Frame Adapter for a Multichannel MRI Coil
Authors: Kim Byungmok , Chang Yongmin , Choi Hea Jung , Park Ki-Su , Yang Ji-ung , Kim Eunji , Park Seong-Hyun
Published: November 2020

Background: The usage of multichannel brain MRI coils, which have several advantages over single-channel brain coils used for stereotactic radiosurgery (SRS), requires a frame adapter device to fit the frames inside the multichannel brain coils. However, such a frame adapter has not been developed until now. Objective: to develop an SRS frame adapter for multichannel MRI coils and verify the geometrical accuracy and signal-to-noise ratio (SNR) of the MR images obtained using multichannel MRI coils. Methods: We fabricated an SRS frame adapter for a 48-channel MRI coil using a three-dimensional (3D) printer. Furthermore, we obtained phantom and human-brain MR images with a 3.0 Tesla MRI scanner using multi- and single-channel coils. Computed tomography (CT) phantom images were also obtained as reference. We compared the coordinate errors of the multi- and single-channel coils to evaluate the geometrical accuracy. Two neurosurgeons measured the coordinates. In addition, we compared the SNR differences between multi- and single-channel coils using the T1- and T2-weighted brain images. Results: For the CT coordinate measurements, the correlation coefficient r = 1 and p < 0.001 with respect to the 3 axes (Δx, Δy, and Δz) and 3D errors (Δr) showed no interpersonal differences between the 2 neurosurgeons. The results obtained using the T1-weighted images showed that a multichannel coil had smaller coordinate errors in Δx, Δy, Δz, and Δr than that observed in case of a single-channel coil (p < 0.001). In case of the SNR measurements, most of the brain areas showed higher SNRs when using a multichannel coil compared with that observed when using a single-channel coil in the T1- and T2-weighted images. Conclusion: Compared with single-channel coils, the use of multichannel MRI coils with a newly developed frame adapter is expected to ensure successful SRS treatments with improved geometrical accuracy and SNR.
A Signet Ring Cell Carcinoma Presented as Refractory Acquired Thrombotic Thrombocytopenic Purpura
Authors: Malkan Umit Yavuz , Albayrak Murat , Ozturk Hacer Berna , Reis Aras Merih , Saglam Bugra , Dogan Kutsal
Published: November 2020

Microangiopathic hemolytic anemia (MAHA) can be observed as a paraneoplastic syndrome (PS) in certain tumors. MAHA-related signet ring cell carcinoma (SRCC) of an unknown origin is very infrequent. Herein we present a SRCC case presented with refractory acquired thrombotic thrombocytopenic purpura (TTP). A 35-year-old man applied to the emergency service with fatigue and headache. His laboratory tests resulted as white blood cell 9,020/µL, hemoglobin 3.5 g/dL, platelet 18,000/µL. Schistocytes, micro-spherocytes, and thrombocytopenia were observed in his blood smear. MAHA was present and he was considered as having TTP. Plasma exchange treatment was initiated; however, he was refractory to this treatment. Thorax and abdomen computerized tomography revealed thickening of minor curvature in stomach corpus with hepatogastric and paraceliac lymphadenopathy. Bone marrow (BM) investigation by our clinic resulted as the metastasis of adenocarcinoma. Ulceration and necrosis were observed by gastric endoscopy procedure. Biopsy was taken during endoscopic intervention, which resulted as SRCC. MAHA may be seen as a PS in some tumors, especially gastric cancers. Tumor-related MAHA is generally accompanied by BM metastases. As a result, BM investigation may be used as the main diagnostic method to find the underlying cancer. The clinical course of cases with tumor-related MAHA is usually poor, and these cases are usually refractory to plasma exchange treatment. In conclusion, physicians should suspect a malignancy and BM involvement when faced with a case of refractory TTP.
An Intriguing Case of Ectopic Benign Migratory Glossitis Resembling Secondary Syphilis: A Case Report
Authors: Leone Corolina , Sugaya Norberto , Migliari Dante
Published: November 2020

Oral mucosal lesions presenting as erythematous patches usually pose difficulties for a clinical diagnosis. They elicit an array of differential diagnosis that mainly includes oral candidosis, contact mucosal reaction, oral lichenoid lesion, oral psoriasiform, autoimmune disease, and, not to forget, secondary syphilis. In this present case, all those above-mentioned possibilities were ruled out, while secondary syphilis stood as the main diagnosis. As this was also later excluded by a negative serological treponemal test, the final diagnosis rested on an ectopic manifestation of benign migratory glossitis (BMG), whose diagnosis was based on the clinical aspects of the lesions, along with their spontaneous disappearance in a short period of time (a hallmark of this condition) and the presence of fissured tongue, a manifestation that occurs very often in concomitance with BMG.
Guggulu and Triphala for the Treatment of Hypercholesterolaemia: A Placebo-Controlled, Double-Blind, Randomised Trial
Authors: Donato Francesco , Raffetti Elena , Toninelli Giuseppe , Festa Andrea , Scarcella Carmelo , Castellano Maurizio ,   for the TRIGU Project Working Group
Published: November 2020

Background: Several herbs are used for lowering high blood cholesterol levels in traditional medicines including Indian Medicine (Ayurveda). We aimed to assess the short-term effects of the combination of Guggulu (Commiphora mukul) and Triphala (Terminalia chebula, Terminalia belerica, and Phyllanthus emblica) on serum cholesterol in healthy subjects with hypercholesterolaemia. Patients and Methods: This was a parallel randomised double-blind controlled trial that included 90 individuals at low-moderate cardiovascular risk. The main outcome measures were serum levels of total and low- and high-density lipoprotein cholesterol (LDL-C, HDL-C). Secondary outcome measures included BMI, waist circumference, and adverse events. Subjects were administered either Guggulu and Triphala or placebo three times daily for 3 months, with 3 months of follow-up after the end of treatment. Results: At intention-to-treat analysis, from baseline to 3 months, total serum cholesterol decreased by 1.9% in the placebo (n = 44) and 3.3% (p = 0.01) in the intervention (n = 46) group. Serum LDL-C decreased by 4.9% (p = 0.03) and 4.8% (p = 0.02) in the placebo and intervention group, respectively, without differences between them. Two participants in the intervention group developed hypersensitivity rash (4.3%) as compared with none in the placebo group. Conclusions: Three months of treatment with Guggulu and Triphala did not show better effects than placebo on serum levels of total and LDL cholesterol, BMI, and waist circumference.
Risk Factors and Long-Term Survival of Octogenarians and Nonagenarians Undergoing Transvenous Lead Extraction Procedures
Authors: Jacheć Wojciech , Polewczyk Anna , Segreti Luca , Bongiorni Maria Grazia , Kutarski Andrzej
Published: November 2020

Introduction: Transvenous lead extraction (TLE) has become a frequently used tool for the management of complications related to pacemakers, implantable cardiac defibrillators and cardiac resynchronization therapy devices. However, it is still a matter of debate whether the lead extraction procedure is a safe treatment choice in the elderly. Methods: We collected the clinical information from 3,810 patients undergoing TLE in 2 high-volume centers (Poland and Italy) between 2006 and 2017. We tested risk factors, effectiveness, safety and long-term survival in 3 groups of patients: those aged 80–89.99 years, ≥90 years and 30–79.99 years. Results: Lower BMI, lower levels of hemoglobin and more comorbidities characterized the patients, whose ages ranged from 80 to 89.99 years. Those aged ≥90 years most often had single-chamber pacemakers. Octogenarians and nonagenarians were more often undergoing TLE due to infectious indications (57.19 and 74.29 vs. 45.35% in younger individuals). Lead age and the number of leads extracted were comparable in the 3 groups. In octogenarians, leads were more often removed using standard extraction techniques: simple traction and mechanical dilatators, whereas in nonagenarians TLE was more complex. The duration of the procedure was shorter in older patients, while clinical and procedural effectiveness was similar to that in younger individuals. The rate of major complications related to TLE did not differ between octogenarians and younger subjects (2.0 vs. 1.38%, p = ns), and the number of procedure-related risk factors was smaller in older people. Nonagenarians did not develop any major complication related to TLE. Long-term mortality after TLE was similar among octogenarians and nonagenarians (39.67 and 40.00%) but higher than in younger patients (24.41; p < 0.001 and 0.05). Conclusions: Lead extraction procedures appear effective and safe in octogenarians and nonagenarians, comparable to younger individuals. Procedure-related risk in the elderly is not associated with most of the typical risk factors encountered in younger subjects, but only with the higher number of pacemaker, implantable cardiac defibrillator and cardiac resynchronization therapy device procedures before TLE. Long-term survival after TLE was found to be similar among octogenarians and nonagenarians being about 60% at over 3 years of follow-up. Age alone should not be considered a risk factor for the occurrence of major complications or procedure-related death, and therefore it should not prevent candidacy for TLE.
Clinical Presentation, Diagnosis, and Management of Idiopathic Enlargement of the Right Atrium: An Analysis Based on Systematic Review of 153 Reported Cases
Authors: Zhang Jing , Zhang Li , He Lin , Li He , Li Yuman , Zhang Li , Xie Mingxing
Published: November 2020

Idiopathic enlargement of the right atrium (IERA) is a rare cardiac anomaly, and only sporadic cases have been reported. Little is known about its clinical relevance, and inconsistencies in medical and surgical management remain among different settings. In this paper, we systematically reviewed the published cases of the IERA in terms of clinical presentation, diagnosis, and management. A total of 153 cases of IERA were covered. Arrhythmia, dyspnea, and palpitation were found to be the most common clinical manifestations. It tends to be associated with life-threatening complications and sudden cardiac death. Diagnosis was mostly established by using echocardiography. Presenting symptoms, abnormal ECG findings, and therapeutic modalities were significantly related to the prognosis of IERA. Symptomatic patients were significantly more likely to have poor outcomes than asymptomatic patients (p = 0.044), and conservative treatment was more associated with adverse outcomes compared to surgical resection (p = 0.016). In conclusion, IERA, although rare, tends to be associated with potential life-threatening complications and sudden cardiac death. Echocardiography is the most common diagnostic modality. Surgical resection is indicated for symptomatic patients.
Robust Step Detection from Different Waist-Worn Sensor Positions: Implications for Clinical Studies
Authors: Tietsch Matthias  , Muaremi Amir , Clay Ieuan , Kluge Felix , Hoefling Holger , Ullrich Martin , Küderle Arne , Eskofier Bjoern M. , Müller Arne
Published: November 2020

Analyzing human gait with inertial sensors provides valuable insights into a wide range of health impairments, including many musculoskeletal and neurological diseases. A representative and reliable assessment of gait requires continuous monitoring over long periods and ideally takes place in the subjects’ habitual environment (real-world). An inconsistent sensor wearing position can affect gait characterization and influence clinical study results, thus clinical study protocols are typically highly proscriptive, instructing all participants to wear the sensor in a uniform manner. This restrictive approach improves data quality but reduces overall adherence. In this work, we analyze the impact of altering the sensor wearing position around the waist on sensor signal and step detection. We demonstrate that an asymmetrically worn sensor leads to additional odd-harmonic frequency components in the frequency spectrum. We propose a robust solution for step detection based on autocorrelation to overcome sensor position variation (sensitivity = 0.99, precision = 0.99). The proposed solution reduces the impact of inconsistent sensor positioning on gait characterization in clinical studies, thus providing more flexibility to protocol implementation and more freedom to participants to wear the sensor in the position most comfortable to them. This work is a first step towards truly position-agnostic gait assessment in clinical settings.
A Roadmap to Inform Development, Validation and Approval of Digital Mobility Outcomes: The Mobilise-D Approach
Authors: Rochester Lynn , Mazzà Claudia , Mueller Arne , Caulfield Brian , McCarthy Marie , Becker Clemens , Miller Ram , Piraino Paolo , Viceconti Marco , Dartee Wilhelmus P. , Garcia-Aymerich Judith , Aydemir Aida A. , Vereijken Beatrix , Arnera Valdo , Ammour Nadir , Jackson Michael , Hache Tilo , Roubenoff Ronenn ,   on behalf of the Mobilise-D Consortium
Published: November 2020

Health care has had to adapt rapidly to COVID-19, and this in turn has highlighted a pressing need for tools to facilitate remote visits and monitoring. Digital health technology, including body-worn devices, offers a solution using digital outcomes to measure and monitor disease status and provide outcomes meaningful to both patients and health care professionals. Remote monitoring of physical mobility is a prime example, because mobility is among the most advanced modalities that can be assessed digitally and remotely. Loss of mobility is also an important feature of many health conditions, providing a read-out of health as well as a target for intervention. Real-world, continuous digital measures of mobility (digital mobility outcomes or DMOs) provide an opportunity for novel insights into health care conditions complementing existing mobility measures. Accepted and approved DMOs are not yet widely available. The need for large collaborative efforts to tackle the critical steps to adoption is widely recognised. Mobilise-D is an example. It is a multidisciplinary consortium of 34 institutions from academia and industry funded through the European Innovative Medicines Initiative 2 Joint Undertaking. Members of Mobilise-D are collaborating to address the critical steps for DMOs to be adopted in clinical trials and ultimately health care. To achieve this, the consortium has developed a roadmap to inform the development, validation and approval of DMOs in Parkinson’s disease, multiple sclerosis, chronic obstructive pulmonary disease and recovery from proximal femoral fracture. Here we aim to describe the proposed approach and provide a high-level view of the ongoing and planned work of the Mobilise-D consortium. Ultimately, Mobilise-D aims to stimulate widespread adoption of DMOs through the provision of device agnostic software, standards and robust validation in order to bring digital outcomes from concept to use in clinical trials and health care.
Risk Factors and Prognosis of Pediatric Open Globe Injuries without Initial Light Perception
Authors: Wen Xin , Yuan Miner , Li Cheng , Long Chongde , Yuan Zhaohui , Zeng Jieting , Lin Xiaofeng
Published: November 2020

Purpose: The aim of this study was to investigate the possible risk factors and prognosis of initial no light perception (NLP) in pediatric open globe injuries (POGI). Procedures: This retrospective, comparative, interventional case-control study included 865 eyes of POGI patients presenting to a tertiary referral ophthalmic center from January 1, 2011 to December 31, 2015. Eyes were divided into 2 groups: the NLP group included eyes with initial NLP, and the light perception (LP) group included eyes with initial LP or vision better than LP. Results: The following risk factors were significantly related to initial NLP: severe intraocular hemorrhage (OR 3.287, p = 0.015), retinal detachment (RD; OR 2.527, p = 0.007), choroidal damage (OR 2.680, p = 0.016), and endophthalmitis (OR 4.221, p < 0.001). Choroidal damage is related to remaining NLP after vitreoretinal surgery (OR 12.384, p = 0.003). At the last visit, more eyes in the NLP group suffered from silicone oil-sustained status (OR 0.266, p = 0.020) or ocular atrophy (OR 0.640, p = 0.004), and fewer eyes benefitted from final LP (OR 41.061, p < 0.001) and anatomic success (OR 4.515, p < 0.001). Conclusion: Severe intraocular hemorrhage, RD, choroidal damage, and endophthalmitis were possible predictors of initial NLP in POGI. Choroidal damage was the major factor related to an NLP prognosis. Traumatized eyes with initial NLP could be anatomically and functionally preserved by vitreoretinal surgery.
ПРОБЛЕМИ ВИХОДЖУВАННЯ ПЕРЕДЧАСНО НАРОДЖЕНИХ НЕМОВЛЯТ ТА МОЖЛИВОСТІ ЇХ ВИРІШЕННЯ
Authors: Sarapuk I. M. , Pavlyshyn H. A. , Borshevska-Kornatska M.-K. , Klishch O. V.
Published: November 2020

Мета дослідження – провести порівняльний аналіз показників виживання та захворюваності передчасно народжених немовлят (дуже та екстремально недоношених) у перинатальних центрах різних країн.

Матеріали та методи. Ретроспективна оцінка стандартизованих перинатальних та неонатальних даних передчасно народжених немовлят з гестаційним віком від 24+0 до 31+6 тижнів, які народилися у перинатальних центрах Тернополя та Варшави. Проведено порівняльний аналіз антенатальних факторів ризику, особливостей інтранатального періоду, антропометричних показників при народженні дитини, клінічних характеристик у ранньому неонатальному періоді.

Результати дослідження та їх обговорення. Порівняльний аналіз показав, що рівень виживання екстремально недоношених немовлят у Варшавському перинатальному центрі достовірно перевищує показники у регіональному центрі (p=0,0076). Показники захворюваності на сепсис (ранній, пізній), некротичний ентероколіт, внутрішньошлуночкові крововиливи були вищими серед передчасно народжених Тернопільського перинатального центру. Більшість екстремально недоношених та третина дуже недоношених немовлят у регіональному центрі мають постнатальну затримку фізичного розвитку на момент виписування зі стаціонару.

Висновки. Порівняльний аналіз показників виживання та захворюваності серед дуже та екстремально недоношених дітей у Тернопільському та Варшавському перинатальному центрах дозволив з’ясувати ключові відмінності у підходах до виходжування такої категорії пацієнтів, виокремити перинатальні та неонатальні ризики, пов’язані з несприятливим прогнозом, запропонувати можливі шляхи покращання якості надання медичної допомоги.
MODERN APPROACHES TO THE TREATMENT OF INFERTILITY IN WOMEN WITH POLYCYSTIC OVARIAN SYNDROME IN ASSISTED REPRODUCTIVE TECHNOLOGY PROGRAMS
Authors: Khmil M. S. , Ventskivskyi B. M. , Khmil S. V.
Published: November 2020

The aim of the study – to improve infertility treatment by optimizing pregravid therapy and selecting the optimal stimulation protocol and ovulation trigger in patients with PCOS.

Materials and Methods. 157 infertile patients with PCOS were examined. Depending on the method of treatment, patients were divided into three clinical groups. Group 1 consisted of 63 women who received FT 500-Plus and vitamin D3 Aquadetrim for 2–3 months before stimulation, group 2 – 48 women who received folic acid, group 3 – 46 women who did not receive pregravid preparation. Stimulation was conducted with corifolitropin-alpha Elonva according to a short protocol, GnRH antagonist Orgalutran and follicle-stimulating hormone Puregon, as a trigger GnRH agonist Diphereline was used (in groups 2 and 3 – 0.2 mg/ml once, and in group 1 the protocol was modified by us: 0.2 mg/ml + an additional 0.1 mg/ml after 12 hours). The effectiveness of the proposed infertility treatment regimen was assessed by the following indicators: the frequency of complications, in particular OHSS, the total percentage of efficiency of the obtained oocytes, the degree of maturity of the oocytes obtained and the yield of blastocysts.

Results and Discussion. When evaluating the results of superovulation induction, it was found that the duration of stimulation in group 1 was probably lower compared to groups 2 and 3. On the day of the ovulation trigger, a significantly lower concentration of estradiol and progesterone was found in group 1, compared with the data of other groups. In study group 1, where the introduction of the ovulation trigger was modified in own way, significantly fewer immature (GV and MI) oocytes were found, while the average number of mature eggs significantly exceeded the data of groups 2 and 3. The number of blastocysts in women with infertility on the background of PCOS group 1 was also significantly higher than the results obtained in other groups.

Conclusions. Controlled ovarian stimulation according to a short protocol using a vitamin complex with inositol and vitamin D3 in pregravid preparation and gonadotropin-releasing hormone antagonists and GnRH agonist trigger –Diphereline at a dose of 0.2 mg/ml + 0.1 mg/ml after 12 hours is more effective in the program of assisted reproductive technologies in PCOS, as it increases the number of mature cells (by 12.20 %) and blastocysts (by 16.26 %). It is also safer because its use significantly reduces the incidence of ovarian hyperstimulation syndrome (1.6 %) in women with infertility with PCOS compared to other controlled ovarian stimulation (COS) regimens.
Морфометрична оцінка структурних змін ендотеліоцитів артерій та вен сім’яників в умовах пострезекційної артеріальної легеневої гіпертензії
Authors: Hnatiuk M. S. , Konovalenko S. O. , Tatarchuk L. V.
Published: November 2020

Мета роботи: морфометрично вивчити особливості структурної перебудови ендотеліоцитів артерій та вен сім’яників при пост­резекційній артеріальній легеневій гіпертензії.

Матеріали і методи. Морфологічно досліджено структурні зміни ендотеліоцитів артерій і вен сім’яників 50 щурів, які були розділені на 3 групи. 1-ша група включала 15 інтактних тварин, 2-га – 25 щурів із пострезекційною артеріальною гіпертензією у малому колі кровообігу і компенсованим легеневим серцем, 3-тя – 10 експериментальних тварин із легеневою артеріальною гіпертензією і декомпенсованим легеневим серцем. Через місяць від початку досліду здійснювали евтаназію щурів кровопусканням в умовах тіопенталового наркозу. У сім’яниках вимірювали висоту ендотеліоцитів артерій та вен, діаметр їх ядер, ядерно-цитоплазматичні відношення в ендотеліоцитах, відносний об’єм ушкоджених клітин. Кількісні показники обробляли статистично.

Результати досліджень та їх обговорення. Встановлено, що правостороння пульмонектомія призводить до легеневої гіпертензії, легеневого серця, венозного повнокров’я в органах великого кола кровообігу та структурних змін у сім’яниках. Найвираженіші зміни виявлено в сім’яниках при пострезекційній легеневій гіпертензії та декомпенсованому легеневому серці. Ядерно-цитоплазматичні відношення в ендотеліоцитах артерій лівого сім’яника при цьому збільшилися на 7,6 %, правого – на 4,7 % (р<0,05), відносні об’єми пошкоджених ендотеліоцитів відповідно зросли у 11,7 та 9,3 раза (р<0,001), в ендотеліоцитах вен змінилися відповідно на 6,6 %, 5,8 % (р<0,001), у 20,8 та у 17,5 раза (р<0,001). Отже, поєднання пострезекційної артеріальної легеневої гіпертензії з декомпенсацією легеневого серця призводить до порушень клітинного структурного гомеостазу, зростання відносних об’ємів пошкоджених ендотеліоцитів у артеріальному та венозному судинних руслах сім’яників, атрофії, дистрофії, некробіозу клітин і тканин, інфільтрації та склерозу. Виявлені процеси домінують у венозному руслі та структурах лівого сім’яника.
Відеокапсульна ендоскопія в діагностиці хвороби Крона
Authors: Felestinsky Ya. P. , Dyadyk O. O. , Milyanovskaya A. O. , Pirogovsky V. Yu.
Published: November 2020

Мета роботи: підвищити ефективність діагностики хвороби Крона.

Матеріали і методи. Проведено аналіз діагностики 288 пацієнтів із синдромом подразненої кишки. Залежно від діагностичної тактики пацієнти були розділені на 2 групи. Групи хворих були порівняними за віком та статтю. В першу групу увійшли пацієнти з синдромом подразненої кишки за період з 2010 по 2013 роки, яким виконувалася діагностика традиційними методами без застосування відеокапсульної ендоскопії. Дана група налічувала 143 пацієнти (49,6 %). У другій групі пацієнтам проводилася діагностика за розробленим нами алгоритмом, тобто з застосуванням відеокапсульної ендоскопії,  ілеоколоноскопії та за необхідністю ентероскопії із забором біопсії з уражених ділянок. Дана група налічувала 145 пацієнтів (50,3 %).

Результати досліджень та їх обговорення. Отримані результати обстеження пацієнтів першої та другої групи показали, що хвороба Крона була виявлена у 20 (13,9 %) пацієнтів першої групи та завдяки використанню відеокапсульної ендоскопії, колоноскопії, ентероскопії, біопсії була виявлена у 48 (33,1 %) пацієнтів другої групи. Крім цього, у 68 пацієнтів першої групи з діагнозом синдром подразненої кишки, які знаходилися під динамічним спостереженням у нашій клініці, було проведено обстеження за розробленим алгоритмом. Результати показали, що у 25 (36,7 %) пацієнтів з 68 було виявлено хворобу Крона тонкої кишки.
Усовершенствованная хирургическая тактика при синдроме Мириззи
Authors: Rakhmanov K. E. , Davlatov S. S. , Nasimov A. M.
Published: November 2020

Цель работы: улучшить результаты лечения синдрома Мириззи путем разработки рациональной хирургической тактики в зависимости от его типа.

Материалы и методы. Проанализированы результаты обследования и лечения 62 больных с синдромом Мириззи, находившихся в 1-й клинике Самаркандского медицинского института в период с 2010 по 2019 гг.

Результаты исследований и их обсуждение. Среди 62 оперированных больных по поводу желчнокаменной болезни, осложненной синдромом Мириззи различного рода, осложнения наблюдали у 14,5 % больных. В контрольной группе из 36 оперированных больных осложнения в ближайшем послеоперационном периоде отмечены у 19,4 %. В основной группе больных, оперированных по поводу желчнокаменной болезни, осложненной синдромом Мириззи, в ближайшем послеоперационном периоде осложнения наблюдали у 7,7 % больных.

Разработанная программа, основанная на балльной оценке у больных с синдромом Мириззи, позволяет в 3 раза уменьшить число послеоперационных осложнений, избежать повреждения желчных протоков, увеличить число удовлетворительных результатов.
CHROMOSOMAL DISEASES IN THE HUMAN PATHOLOGY
Authors: Bihunyak T.V. , Bondarenko Yu. I. , Кulyanda O. O. , Charnosh S. M. , Sverstiuk A. S. , Bihuniak K. O.
Published: November 2020

Background. Chromosomal diseases are the cause of 45-50 % of multiple birth defects. Basic research on mutations is performed using genomic technologies to identify a correlation between genotype and phenotype in aneuploidies and to understand its pathogenesis.

Objective. The aim of the research is to study the etiology, pathogenesis of symptoms and diagnostics for patients with Down, Klinefelter, Turner syndromes and double aneuploidies by 21 and sex chromosomes.

Methods. A literature review by the keywords “Down syndrome”, “Klinefelter syndrome”, “Turner syndrome”, “double aneuploidy” for the period of 2000-2020 was carried out.

Results. Down, Klinefelter and Turner syndromes are the most common aneuploidy among viable newborns. Frequency of meiotic non-disjunction events causing these aneuploidies increases with the age of a woman. Identified genes are responsible for pathogenesis of symptoms in trisomy 21, Turner and Klinefelter syndromes. Diagnostics of chromosomal diseases includes prenatal screening programs and postnatal testing.

Conclusions. Cytogenetic variants of Down syndrome are simple complete trisomy 21, translocation form and mosaicism. Trisomy 21 is associated with advanced maternal age. Phenotypic manifestations of Down syndrome are associated with the locus 21q22. The maternal and parental nondisjunction of X-chromosomes in meiosis causes Klinefelter and Turner syndromes. These chromosomal diseases are variants of intersexualism with intermediate chromosomal sex. Down-Klinefelter and Down-Turner syndromes are double aneuploidies. Patients have a Down syndrome phenotype at birth, and signs of Klinefelter and Turner syndromes occur during puberty. Diagnosis of aneuploidy is based on the cytogenetic investigation (karyotyping), DNA analysis, ultrasonography and biochemical markers of chromosomal pathology.
КОНЦЕПТУАЛЬНІ ЗАСАДИ ІНТЕГРАЦІЇ ПРАВОВОЇ ТА ПРОФЕСІЙНО-ПРАКТИЧНОЇ ПІДГОТОВКИ МАЙБУТНІХ ФАХІВЦІВ МЕДИЧНОЇ ГАЛУЗІ
Authors: Kalyniuk N. M. , Rogalskyy I. O.
Published: November 2020

У статті обґрунтовано концептуальні засади міждисциплінарної інтеграції правової та професійно-практичної підготовки майбутніх фахівців медичної галузі: наявність ґрунтовних правових знань та вмінь студентів у медичній галузі є обʼєктивною основою для формування відповідних професійних компетентностей; оволодіння методологічними правовими знаннями забезпечує ґрунтовну професійно-практичну підготовку з можливістю її постійного поповнення й дотримання прав людини у сфері охорони здоров’я, а також і в майбутній професійній діяльності; послідовне оволодіння правовими знаннями та вміннями є основою розвитку критичного мислення у майбутніх фахівців медичної галузі і їх професійного розвитку, формуючи їх професійну ідентичність; професійна спрямованість правової підготовки майбутніх фахівців медичної галузі запобігає формуванню лише вузькопрофесійних інтересів, що зумовлює дотримання основних прав людини у сфері охорони здоров’я; необхідність забезпечення неперервності правової підготовки майбутніх фахівців медичної галузі ґрунтується на застосуванні інтегративного підходу для систематизації знань і вмінь майбутніх фахівців медичної галузі у сфері охорони здоров’я; реалізація інтегрованої системи правової та професійно-практичної підготовки формує професійну культуру майбутніх фахівців медичної галузі; аналіз чинного національного законодавства з питань захворювання медичних працівників на коронавірусну хворобу COVID-19. Обґрунтовано ефективність і доцільність застосування технології критичного мислення, що становить педагогічну складову процесу підготовки майбутніх студентів-медиків на засадах міждисциплінарної інтеграції. Доведено, що пролонговане вдосконалення і поєднання правових та професійно-практичних навичок дає підстави для якісної підготовки майбутнього фахівця медичної галузі у медичних закладах вищої освіти.
Myocardial Scar and Mortality in Chronic Aortic Regurgitation
Authors: Malahfji Maan , Senapati Alpana , Tayal Bhupendar , Nguyen Duc T. , Graviss Edward A. , Nagueh Sherif F. , Reardon Michael J. , Quinones Miguel , Zoghbi William A. , Shah Dipan J.
Published: November 2020

Background

Chronic aortic regurgitation (AR) can be associated with myocardial scarring. It is unknown if scarring in AR is linked to poor outcomes and whether aortic valve replacement impacts this association. We investigated the relationship of myocardial scarring to mortality in chronic AR using cardiac magnetic resonance.

Methods and Results

We enrolled patients with moderate or greater AR between 2009 and 2019 and performed a blinded assessment of left ventricle remodeling, AR severity, and presence and extent of myocardial scarring by late gadolinium enhancement. The primary outcome was all‐cause mortality. We followed 392 patients (median age 62 [interquartile range, 51–71] years), and 78.1% were men, and 25.8% had bicuspid valves. Median aortic valve regurgitant volume was 39 mL (interquartile range, 30–60). Myocardial scar was present in 131 (33.4%) patients. Aortic valve replacement was performed in 165 (49.1%) patients. During follow‐up, up to 10.8 years (median 32.3 months [interquartile range, 9.8–69.5]), 51 patients (13%) died. Presence of myocardial scar (hazard ratio [HR], 3.62; 95% CI, 2.06–6.36;
P
<0.001), infarction scar (HR, 4.94; 95% CI, 2.58–9.48;
P
<0.001), and noninfarction scar (HR, 2.75; 95% CI, 1.39–5.44;
P
<0.004) were associated with mortality. In multivariable analysis, the presence of scar remained independently associated with death (HR, 2.53; 95% CI, 1.15–5.57;
P
=0.02). Among patients with myocardial scar, aortic valve replacement was independently associated with a lower risk of mortality (HR, 0.34; 95% CI, 0.12–0.97;
P
=0.03), even after adjustment for confounders.

Conclusions

In aortic regurgitation, myocardial scar is independently associated with a 2.5‐fold increase risk in mortality. Aortic valve replacement was associated with a reduction in risk of mortality in patients with scarring.
Seeing Like a Khedivate: Taxing Endowed Agricultural Land, Proofs of Ownership, and the Land Administration in Egypt, 1869
Authors: Mestyan Adam
Published: November 2020

Theories of state modernization rarely consider the relationship between sovereignty and government capacity. This paper focuses on the khedivate of Egypt, a semi-independent province in the Ottoman Empire. My claim is that endowed agricultural land was a useful tool of fiscal modernization for the khedivial government. The governors taxed and made such lands alienable for public purposes. In order to support this claim, this study uses an 1869 endowment certificate of Hoşyar, mother of Khedive Ismail, to examine the regulatory context of endowed agricultural land. Through an archival anthropology of Hoşyar’s certificate, I describe the legal layer of the khedivial land administration (the regulations about agricultural land) and the physiocratic layer (the proofs of ownership such as the taqsīṭ dīwānī and written land survey registers) in comparison with the Ottoman central administration. This case study thus contributes to the discussion about the compatibility of the Muslim endowment with modernization.
Human-Animal Studies: Remembering the Past, Celebrating the Present, Troubling the Future
Authors: Shapiro Kenneth
Published: November 2020

This is the third in a series of reports on the state of the field of Human-Animal Studies. In the introductory section, major terms in the prevailing definition of the field—Human-Animal Studies is the interdisciplinary study of human-animal relationships—are unpacked and critically analyzed. Subsequent sections deal with the field’s past, present, and possible futures. A schematic history of the field considers both scholarly contributions and programmatic inroads in the academy. The current state of the field section describes its breadth in terms of publication venues, disciplines that interface with it, and the variety of methods employed. It also offers a description of several common strategies that critique the received view of the categorical divide between human and other animal beings. The final section highlights both the potential of and anticipated roadblocks to each of several future trajectories.
Legitimizing Inequality
Authors: Heuer Jan-Ocko , Lux Thomas , Mau Steffen , Zimmermann Katharina
Published: November 2020

Do people in different countries understand and frame the principle of meritocracy differently? This question is the starting point for this cross-national analysis of the moral repertoires of meritocracy in four countries: Germany, Norway, Slovenia and the United Kingdom. The authors pursue a mixed methods approach, using data from the European Social Survey 2016 and qualitative data from group discussions. In these discussions, citizens openly talked about issues like inequality and social policy, which allows us to study their understandings and framings of meritocracy. The authors show that the issue of unequal rewards does not only find different levels of support, but also that people – corresponding to the context they live in – have different understandings of which merits should count. The authors identify a ‘market success meritocracy’ in the UK, a work-centred understanding in Germany, a ‘common good meritocracy’ in Norway, and non-salience of this issue in Slovenia.
Characteristics of Organizational Resilience during a Security Crisis
Authors: Boehm-Tabib Eti
Published: November 2020

In light of the crisis situations the world over, resilience of organizations has become an increasingly important practical and theoretical issue. This research examines the characteristics of resilience in public organizations during the early stages of a security-related crisis. Based on personal interviews with 32 managers and employees in local social service departments and community centers who experienced the crisis as part of their jobs, the most prominent characteristic that contributed to resilience was the propensity to act. Characteristics that undermined resilience were also identified. The article discusses the characteristics of resilience identified and their implementation, as well as the need during a crisis to break away from routine organizational patterns and the planning that can develop organizational resilience.
Diagramming Sabbateanism
Authors: Chajes J. H.
Published: November 2020

Scholars have only recently started to study ilanot (lit., “trees”), the cosmographic genre constituted by the wedding of kabbalistic diagrams—the trees of the metonymic name—and large parchment sheets. Differences of kabbalistic opinion naturally found expression in these “maps of God.” The Sabbatean messianic movement of the 1660s and its prolonged and impactful afterlife produced, among other things, a number of distinctive kabbalistic opinions. For the most part, these innovations were tightly integrated with the speculations associated with “Lurianic” Kabbalah based on the teachings of R. Isaac Luria (1534–1572). The great Lurianic ilanot were designed and circulated in the second third of the seventeenth century, not long before the emergence of Sabbateanism, but their golden age was “the long eighteenth century”—a British coinage for roughly 1660–1830—and thus coincided with the profound and pervasive absorption of Sabbatean elements in precisely those sectors that produced and consumed these artifacts, including nascent Hasidism. The deceptively simple question at the heart of this article is this: What would it mean to diagram Sabbateanism? Or to put it another way, what would constitute a Sabbatean ilan? How might distinctive Sabbatean ideas have found diagrammatic expression in this genre? Once identified as such, what do Sabbatean ilanot tell us about the meanings of Sabbateanism in the contexts within which they were produced?
Slavery without Racism, Racism without Slavery
Authors: Engerman Stanley
Published: November 2020

This article surveys several problems related to the links between slavery and racism, and the frequency of both racism without slavery and slavery without racism. Slavery clearly existed prior to the emergence of racism, scientific or otherwis, and unlike in recent centuries, the enslaved were not always peoples of different color. The linking of race and slavery, with race as the defining characteristic of the enslaved, came mainly after the settlement of the Americas with the transatlantic slave trade from Africa. Indeed, the debate continues on whether racism led to slavery (as argued for colonial America) or whether slavery gave rise to a coherent racism to justify enslavement of others. Racism may be used to justify the harsh treatment of others, or it may simply reflect mainly a belief that some differences among groups exist and race provides the interpretation of why such differences exist. Presumably then, awareness of perceived or argued for racial differences could exist without the imposition of differential treatments, despite the role racial beliefs might play in social organization.
Phylogenetic analysis of the South American sharpshooter genus Scopogonalia Young, 1977 (Insecta: Hemiptera: Cicadellidae), with implications for conservation
Authors: LEAL AFONSO H. , CREÃO-DUARTE ANTONIO J. , MEJDALANI GABRIEL
Published: November 2020

Scopogonalia is a leafhopper genus with 17 described species, all of them from South America. In this work, a phylogenetic analysis of the genus was conducted based on 59 morphological and colour pattern characters of head, thorax, abdomen, male and female genitalia. Analyses with equal weights resulted in 12 equally most parsimonious trees (length = 137) including a monophyletic Scopogonalia in all of them. An implied weights (k = 15) analysis recovered two trees, one of them equal to the one obtained with a single round successive weighting procedure, which was chosen for discussion. The trees support the existence of three main clades, which are here called Early Green Clade, Late Green Clade, and Yellow-Brown Clade. The origin and diversification of each clade is discussed under available biogeographical knowledge of South America. Little variation was observed in the female genitalia, but their characters were useful to reinforce the monophyly of the Yellow-Brown Clade, which we associate to ecological adaptations. This clade supports a past connection of the Cerrado biome and savannah enclaves in Amazonia and Atlantic Forest. This conclusion highlights the necessity of conserving this open vegetation environment inside the most fragmented portion of the Atlantic Forest, in northeastern Brazil.
Evaluation of friction in different oral restoration materials and its influencing factors
Authors: Sun Limei , Liu Junwu , Zhang Lin
Published: November 2020

This research uses nanotechnology and molecular assembly technology, using biocompatible hydroxyapatite material as the inorganic filler, organically compound and assemble with the organic resin matrix to achieve the performance shear of the composite material, thus developing strength
High-resistance, easy-to-process and good biocompatibility composite resin dental restoration materials, and the nano-composite resin material flexural strength, compressive strength and water absorption value were characterized in laboratory stage, the performance fully reached the current
clinical use Various indicators of imported composite resin. This study analyzed the differences in the effects and friction properties of different prosthetic materials in oral repair. In order to better simulate the friction and wear performance of dental restoration materials in the oral
environment, this paper studied under two conditions of oil lubrication and artificial saliva lubrication, and the wear mechanism from the macro aspects of friction coefficient, wear rate, wear resistance, etc. The research results show that the abrasion performance of the nanocomposite resin
is closely related to its surface morphology and characteristics. The comparison with the performance of ceramic and composite resin restoration materials shows that nanocomposite resin materials have better mechanical properties and resistance than other dental restoration wear performance.