bluuebunny/crossref_metadata_2025 huggingface dataset:
Graphical Model Market Maker for Combinatorial Prediction Markets
Authors: Blackmond Laskey Kathryn , Sun Wei , Hanson Robin , Twardy Charles , Matsumoto Shou , Goldfedder Brandon
Published: November 2018

We describe algorithms for use by prediction markets in forming a crowd consensus joint probability distribution over thousands of related events. Equivalently, we describe market mechanisms to efficiently crowdsource both structure and parameters of a Bayesian network. Prediction markets are among the most accurate methods to combine forecasts; forecasters form a consensus probability distribution by trading contingent securities. A combinatorial prediction market forms a consensus joint distribution over many related events by allowing conditional trades or trades on Boolean combinations of events. Explicitly representing the joint distribution is infeasible, but standard inference algorithms for graphical probability models render it tractable for large numbers of base events. We show how to adapt these algorithms to compute expected assets conditional on a prospective trade, and to find the conditional state where a trader has minimum assets, allowing full asset reuse. We compare the performance of three algorithms: the straightforward algorithm from the DAGGRE (Decomposition-Based Aggregation) prediction market for geopolitical events, the simple block-merge model from the SciCast market for science and technology forecasting, and a more sophisticated algorithm we developed for future markets.
Proximal Gradient Temporal Difference Learning: Stable Reinforcement Learning with Polynomial Sample Complexity
Authors: Liu Bo , Gemp Ian , Ghavamzadeh Mohammad , Liu Ji , Mahadevan Sridhar , Petrik Marek
Published: November 2018

In this paper, we introduce proximal gradient temporal difference learning, which provides a principled way of designing and analyzing true stochastic gradient temporal difference learning algorithms. We show how gradient TD (GTD) reinforcement learning methods can be formally derived, not by starting from their original objective functions, as previously attempted, but rather from a primal-dual saddle-point objective function. We also conduct a saddle-point error analysis to obtain finite-sample bounds on their performance. Previous analyses of this class of algorithms use stochastic approximation techniques to prove asymptotic convergence, and do not provide any finite-sample analysis. We also propose an accelerated algorithm, called GTD2-MP, that uses proximal "mirror maps" to yield an improved convergence rate. The results of our theoretical analysis imply that the GTD family of algorithms are comparable and may indeed be preferred over existing least squares TD methods for off-policy learning, due to their linear complexity. We provide experimental results showing the improved performance of our accelerated gradient TD methods.
Approximation and Parameterized Complexity of Minimax Approval Voting
Authors: Cygan Marek , Kowalik Łukasz , Socała Arkadiusz , Sornat Krzysztof
Published: November 2018

We present three results on the complexity of Minimax Approval Voting. First, we study Minimax Approval Voting parameterized by the Hamming distance d from the solution to the votes. We show Minimax Approval Voting admits no algorithm running in time O*(2o(d log d)), unless the Exponential Time Hypothesis (ETH) fails. This means that the O*(d2d) algorithm of Misra, Nabeel and Singh is essentially optimal. Motivated by this, we then show a parameterized approximation scheme, running in time O*((3/ε)2d), which is essentially tight assuming ETH. Finally, we get a new polynomial-time randomized approximation scheme for Minimax Approval Voting, which runs in time nO(1/ε2⋅log(1/ε))⋅poly(m), where n is a number of voters and m is a number of alternatives. It almost matches the running time of the fastest known PTAS for Closest String due to Ma and Sun.
Study of seawater corrosion resistance of ordinary Portland cement–aluminate cement–gypsum mortar containing slag
Authors: Song Zhanping , Zhang Ai , Li Guoxin , Liu Shengjun , Zhang Jiangbo
Published: November 2018

A repair material for use in the marine environment is developed. The ternary cementitious system (TCS), which contains ordinary Portland cement, calcium aluminate cement and gypsum, causes rapid hardening and displays high strength, and hence can be used as a building repair material. However, the hydration products of the TCS contain a large amount of ettringite, calcium hydroxide and calcium aluminate hydrate, which can be easily corroded by the inorganic ions in seawater. Owing to its pozzolanic activity and ability to bind chloride, slag is added to the TCS. The content of slag in the TCS is a critical factor; hence, the effects of 0–35 wt% slag on the compressive strength, mass change, apparent porosity, and free and total chloride content of TCS immersed in seawater are investigated. The systems with slag show a higher compressive strength than the TCS in seawater, and the reduction in compressive strength of the system with 25 wt% slag is only 14·14% after 180 d. Also, the addition of slag significantly reduces the free and total chloride content of the TCS immersed in seawater. The optimum amount of slag in the TCS is determined to be about 25 wt%.
Investigation of seismic rehabilitation of steel buildings with semi-rigid connections
Authors: Kazem Hamid , Kazem Hossein , Ghahremannejad Masoud , Vosoughi Payam , Hosseini Seyyed Farshid , Ghafory-Ashtiany Mohsen
Published: November 2018

The Khorjinee connection is a special connection that was widely used in the construction of low-rise steel structures in Iran before the national seismic code was established. However, catastrophic experiences from recent earthquakes have shown that these connections are highly vulnerable to seismic loads. In fact, it is recognised that such connections should be classified as non-seismic, semi-rigid connections with unknown rotational stiffness. As a result of this issue, many structures with these connections may need to be rehabilitated to ensure their safety in future earthquakes. In this study the dynamic properties of a half-scale model of a four-storey steel structure with Khorjinee connections were determined by a forced vibration test. The structure was then separately rehabilitated by means of four different bracing configurations (X bracing, chevron bracing, eccentrically braced frames (EBFs) and knee braces) and the structural responses were investigated. The results, which include the natural frequencies, mode shapes and damping ratios for each case, present a realistic approach to enable engineers to select the best way of strengthening steel structures with Khorjinee connections according to diverse structural limitations. The structural displacement ratios were found to be significantly larger in structures with EBFs and knee bracing systems when the number of braced spans is high compared with the first mode.
Tekrarlayan Akut Bronşiolit tanılı hastaların retrospektif değerlendirilmesi
Authors: ATEŞ Sema , TÜRK Necati Emrecan
Published: November 2018

ÖZETAmaç: Akut bronşiolit, özellikle iki yaş altı çocuklarda, küçük hava yollarının enflamatuvar obstrüksiyonu sonucu ortaya çıkan alt solunum yollarının en sık görülen hastalığıdır. Bazı predispozan faktörler ve altta yatan hastalıklar bronşiolit de tekrarlayan ataklara neden olabilir. Çalışmamızda Tekrarlayan Bronşiolit tanılı infantların geriye dönük olarak değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: 1 Ocak 2016-31 Aralık 2017 tarihleri arasında hastanemiz süt çocuğu servisinde yatarak takip edilen, yaşları 1-24 ay arasında değişen Akut bronşiolit tanılı 759 hastanın dosyaları iki yıllık geriye dönük olarak tarandı. Bu hastalardan birden fazla atak geçiren 231 olgu çalışmaya alındı. Hastaların yaşı, cinsiyeti, geçirdiği atak sayısı, ilk atak yaşı ve hastalığın görüldüğü mevsim gibi demografik özellikleri incelendi. Etyolojiye yönelik yapılan Ekokardiyografi, ve solunum yolu viral paneli tetkiki sonuçları, tekrarlayan ataklarda altta yatan hastalık, prematüre doğum, hasta ve ailede atopi öyküsü kaydedildi.Bulgular: 1 Ocak 2016-31 Aralık 2017 tarihleri arasında yatarak takip edilen Tekrarlayan Bronşiolit tanılı 231 hasta çalışmaya alındı. Hastaların yaş grupları incelendiğinde en kalabalık grubu 1-6ay arası hastalar oluşturmaktaydı. Hastaların çoğunun (%70,6) ilkbahar ve kış mevsiminde hastaneye başvurduğu görüldü. Etyolojiye yönelik tetkikler sonrası atakların tekrarlamasına zemin hazırladığı düşünülen hastalıklar; viral bronşiolit, gastro özefagial reflü, konjenital kalp hastalıkları, kistik fibrozis, wheezing infant olarak saptandı. Solunum Yolu Viral Paneli sonuçlarına göre viral bronşiolit ’in en sık respiratuar sinsinyal virüs, parainfluenza ve rhinovirus kaynaklı olduğu görüldü.Sonuç: Akut bronşiolit de atakların tekrarlamasına zemin hazırlayan faktörlerin bilinmesi, erken teşhis ve tedavi ile hastaneye yatış oranını azaltacaktır.
Efecto de la restauración hidrológica sobre la productividad de raíces subterráneas en los manglares de Laguna de Términos, México
Authors: Perez-Ceballos Rosela , Rivera-Rosales Karina , Zaldivar-Jiménez Arturo , Canales-Delgadillo Julio , Brito-Pérez Roberto , Amador del Angel Luis , Merino-Ibarra Martin
Published: November 2018

Antecedentes: Cambios en los patrones hidrológicos degradan la estructura forestal y afectan la productividad primaria. Con acciones de restauración hidrológica, se pretende restablecer condiciones biogeoquímicas para facilitar el establecimiento, sobrevivencia y crecimiento de la vegetación del manglar que permitan la recuperación de la estructura forestal y la productividad de raíces subterráneas (< 20 mm).Pregunta: ¿Pueden los cambios ambientales inducidos por la restauración hidrológica reactivar la productividad de raíces?Especie en estudio: Los cambios en biomasa y productividad de raíces subterráneas de Avicennia germinans fueron usadas como indicador de éxito de la restauración.Sitio de estudio y fechas: Isla del Carmen, Laguna de Términos, Campeche, agosto de 2013 a febrero de 2015.Métodos: Se seleccionaron tres sitios de manglar en restauración y uno natural como referencia. En ellos se evaluó la concentración de algunos nutrientes (nitratos, nitritos, amonio y fosfatos) y reguladores como la salinidad y el hidroperíodo. Se evaluó entre sitios la biomasa y productividad de raíces en núcleos de crecimiento enterrados a 30 cm de profundidad durante 18 meses.Resultados: La productividad de raíces < 20 mm de diámetro fue menor en los sitios en restauración (17 a 233 g m2 año-1) que en el sitio de referencia (414 g m2 año-1). La productividad de raíces estuvo asociada con la estructura forestal y las condiciones hidrológicas.Conclusiones: La proporción de raíces >2 mm de diámetro fue mayor en el sitio de referencia y decreció hacia los sitios restaurados, indicando que la estructura forestal (regeneración natural) y el tiempo (años) después de la restauración fue importante para la recuperación funcional del ecosistema de manglar.
ChroSpin - IMAC v1
Authors: Ehl Alexandra , Frommholz David , Stefanczyk Nadine
Published: November 2018

Purification Guide for the Isolation of Histidine-tagged Proteins with ChroSpin Columns by DALEX Biotech. ChroSpin-IMAC by DALEX Biotech offers a robust and convenient way to isolate polyhistidine-tagged proteins from bacterial, mammalian, and insect cell cultures. Immobilized metal affinity chromatography (IMAC) is based on the interaction of the imidazole ring of histidine with transition metal ions immobilized on a solid support. Recombinant proteins with a 3 - 10 histidine fusion tag bind to these metal ions while unwanted proteins are removed by washing with excess binding buffer. Elution of the target protein is achieved by the addition of imidazole, EDTA or a low pH. Easy and quick small scale fusion protein purification from various sources. Low metal leaching from column. Tolerates reducing reagents (e.g. DTT up to 10 mM). The proprietary resin does not shrink or swell in aqueous buffers. High pressure stability. pH stability short term 2 - 8, long term 3 - 8. Excellent thermal stability up to 15 minutes at 120 °C in aqueous buffers at neutral pH. Can be dried for long term storage (80 °C for > 2 h).
ChroPlate - ProteinA/G v1
Authors: Frommholz David , Ehl Alexandra , Stefanczyk Nadine
Published: November 2018

Purification Guide for the Isolation of Antibodies with ChroPlate Filtration Plates by DALEX Biotech. Easy and quick high throughput antibody purification from various sources and species. Each well of the ChroPlate has a binding capacity of > 1 mg (tested with human polyclonal Ig, binding varies between species and clones). The proprietary resin does not shrink or swell in aqueous buffers. High pressure stability. pH stability short term 2 - 8, long term 3 - 8. Excellent thermal stability up to 15 minutes at 80 °C in aqueous buffers at neutral pH. Can be dried for long term storage (80 °C for > 2 h).
ChroDrip - ProteinA/G v1
Authors: Frommholz David , Stefanczyk Nadine , Ehl Alexandra
Published: November 2018

Purification Guide for the Isolation of Antibodies with ChroDrip Columns by DALEX Biotech. Easy and quick small scale antibody purification from various sources and species. Each ChroDrip column has a binding capacity of > 10 mg/ml (tested with human polyclonal Ig, binding varies between species and clones). The proprietary resin does not shrink or swell in aqueous buffers. High pressure stability. pH stability short term 2 - 8, long term 3 - 8. Excellent thermal stability up to 15 minutes at 80 °C in aqueous buffers at neutral pH. Can be dried for long term storage (80 °C for > 2 h).
Simple 3D imaging of biogenic silica structures by fluorescence microscopy v2
Authors: Colin Sebastien
Published: November 2018

This protocol describes how to prepare, stain and mount biogenic silica particles (opaline from diatoms, Radiolaria, sponges spicules, phytolith...) for 3D imaging with fluorescence microscopy. The protocol is fast, convenient and affordable. Hence it could be a relevant alternative to X-ray computed tomography or photogrammetry.
Procedures for qPCR in Calotropis procera: GoTaq® qPCR Master Mix Protocol v1
Authors: R. V. Coêlho Maria , Rivas Rebeca , Pandolfi Valesca , Ribamar C. Ferreira-Neto José , P. Bezerra-Neto João , Maria Benko-Iseppon Ana , G. Santos Mauro
Published: November 2018

A protocol for qPCR from Calotropis procera adjusted from the GoTaq® qPCR Master Mix protocol (Promega)
GoScript™ Reverse Transcription System (Promega) for Calotropis procera v1
Authors: R. V. Coêlho Maria , Rivas Rebeca , Pandolfi Valesca , Ribamar C. Ferreira-Neto José , P. Bezerra-Neto João , Maria Benko-Iseppon Ana , G. Santos Mauro
Published: November 2018

A protocol for cDNA conversion from Calotropis procera using GoScript™ Reverse Transcription System (Promega).
Olgularla Hematolojik ve Onkolojik Aciller
Authors: ACIPAYAM Can , KANDEMİR GÜLMEZ Tuğba , PARLAR Muhammed , ÖZEN Osman Nuri , EKİCİ Salim , ÖRENLER Mehmet
Published: November 2018

Hematolojik ve onkolojik acil durumlar,
tüm dünyada acil servislere en çok başvuru sebeplerinden biridir. Bazı
hastalar önceden bir tanıya sahip olurken, diğerleri hematolojik onkolojik acil
bir durum ile başvurup sonrasında ilk tanılarını alabilir. Bu yazımızda anemi,
orak hücre hastalığı, G6PD enzim eksikliği, otoimmun hemolitik anemi, von
Willebrand Hastalığı ve immün trombositopeni gibi bir dizi kanama
patolojisinden oluşan hematolojik hastalıklar ile anormal uterin kanama,
nötropenik ateş, tümör lizis sendromu ve vena kava süperior sendromu
gibi klasik onkolojik acil durumları içeren geniş bir yelpazeye yayılan
konuları hazırladık. Burada olgularla hematolojik ve onkolojik acil olguları
sunacağız
Functional taping effects on pain and electrical activation in patients with low back pain
Authors: Karolczak Ana Paula Barcellos , Morimoto Tissiani , Diefenthaeler Fernando , Vaz Marco Aurélio
Published: November 2018

Background: Low back pain (LBP) is a high prevalence health problem and it has several treatments available, among them it is the functional taping. Objective: To evaluate the influence of functional taping on the electrical activation of the erector spinae muscle, the degree of pain and the functionality in subjects with LBP. Methods: Twenty female with LBP participated in the study, and were divided in two groups: with and without the use of the functional taping. The electrical activity of the erector spinae muscle was obtained bilaterally by electromyography (EMG). The root mean square (RMS) value of the EMG was calculated for three maximum voluntary contractions (MVC) obtained before and 48 hours after the application of the taping. The RMS value of each MVC was normalized by the mean RMS value of the first test for each group. The visual analog pain scale was used to measure the pain, and the Roland Morris questionnaire to evaluate the functionality. Comparisons between groups (α=5%) were performed using the Mann Whitney test, and intra-group using the Wilcoxon test. Results: There was no decrease in muscular electrical activation, a significant decrease in pain, and an improvement in functionality. Conclusion: The use of functional taping in the lumbar spine promoted positive effects related to pain and functionality.
Justification of a new method of alternative treatment of high congenital hip dislocations in adolescents and adults
Authors: Abakarov A A , Abakarov A A
Published: November 2018

Aim. Justofocation of a new method of hip joint stabilization in adolescents and adults with congenital hip dislocation by preserving its own bone structures. Methods. The biomechanical substantiation of a new method of surgical correction of the proximal femur is presented. A primary analysis of the surgical treatment of congenital hip dislocation was performed on 101 patients (116 joints) aged 14 to 30 years (average age 21.3 ± 3.5 years) by creating an additional point of support for the pelvis according to the authors' method with 10 to 15-year follow up. The technique includes angulating elongating squamous oblique osteotomy of the thigh, which allows extending the limb simultaneously to 4 cm and restoring its biomechanical axis. All patients were evaluated clinically, radiologically and using Harris scale before and after the surgery. Results. At the analysis of the treatment results 10-15 years after the operation in 56 patients, the average Harris score increased from 42.7 (from 40.1 to 45.3) to 81.1 (77.2-86.7). Valgus proximal hip and oblique intertrochanteric osteotomy allowed elongating the limb in one-side hip dislocation by 3.2 ± 0.8 (95 % CI 2.8-4.0 cm), shortening of the limb by 3 cm persisted in all patients with one-side hip dislocation. In 37 patients (43 joints) podographic examination revealed restoration of rhythmic walking and longer single-support time. Conclusion. The suggested method of treatment of high congenital hip dislocation is an effective and minimally invasive method of stabilization of the hip joint in adolescents and adults. We discuss the question of possible reconstructive surgeries with preserved own bone structures in young patients aged 14 to 30 years, creating of bone mass in hip joint area for further joint replacement.
Pulmonary hypertension and respiratory function in parenchyma sparing surgical treatment of lung cancer
Authors: Kirshin A A , Napol'skikh V M
Published: November 2018

Aim. To assess the effect of pulmonary hypertension on respiratory function in lung cancer surgery. Methods. 92 patients diagnosed with non-small cell lung cancer, among them 69 men (75 %) and 23 women (25 %), were operated on with different variants of angioplastic lobectomy (APL), the average age was 57.8 ± 6.7 years. 91 patients underwent pulmonectomy (PE), among them 87 men (95.6 %) and 4 women (4.4 %), the average age was 59 ± 8.8 years. Results. One year after angioplastic lobectomy FEV1 decreased by 0.69 liters (27 %), vital capacity decreased by 1.17 liters (32.9 %), FVC (the difference between the volumes of lungs at the beginning and at the end of forced expiration) reduced by 0.64 liters (20.5 %). After removal of the lung, dynamics of the decrease of similar indicators was 1.02 (42 %); 1.53 (43.8 %); 1.24 (40.3 %) liter respectively. The presence of a negative relationship between PA/A (pulmonary artery/aorta) and FEV1 was revealed. Thus, in the group of angioplastic lobectomy without initial pulmonary hypertension (PA/A less than 1) it was found that r = -0.42 (p < 0.01), with pulmonary hypertension (PA/A 1 or more) r = -0.4 (p < 0.01). In the group of pulmonectomy without initial pulmonary hypertension, the correlation index was -0.38 (p < 0.01), with initial pulmonary hypertension r = -0.33 (p < 0.01). Conclusion. The analysis of the functional parameters of pulmonary system after the surgery revealed statistically significant advantage of organ-saving treatment, as well as negative correlation between pulmonary hypertension and respiratory function.
Evaluation of clinical efficacy of prostanoid therapy for Raynaud’s phenomenon in rheumatic diseases
Authors: Bagautdinova Z R , Gaisin I R , Glavatskikh M M , Bragina T A
Published: November 2018

Aim. On the basis of clinical manifestations of Raynaud’s phenomenon (RP) to determine the RP expression level and to evaluate the long-term efficacy of treatment of RP in patients with rheumatic diseases (RD) with iloprost and alprostadil. Methods. Treatment for indications with prostanoids (intravenous iloprost, alprostadil or their combinations) was administered to 40 patients with secondary RP in RD. During 3-year follow up, clinical instrumental parameters (frequency of attacks of Raynaud's, digital ulcers (DU) formation, pain intensity on visual analogue scale (VAS) were evaluated. The control group included 30 patients with RP in RD who did not receive prostanoid therapy. The method of factor analysis was used to determine the index of generalized expression of RP, on the basis of which the expression levels of the RP were determined. Results. The “expression of RP” scale revealed in the course of factor analysis as an indicator of generalized manifestation of RP, is the average value of two subscales, the first one of which consisted of four indices - “digital ulcer”, “digital pitting scars”, “phalange amputation” and “Raynaud's attack frequency”, and the second one included “intensity of pain”, “duration of illness”, “whitening of fingers”. Verification of the correlation revealed during the study of subscales, showed its reliability (r = 0.294, p = 0.053). The final expression of RP was 1.51 ± 0.86. The low level of RP expression had values up to 0.65, high - over 2.37. When included in the study, a high level of RP expression was defined in 16 (22.9 %) patients, medium - in 43 (61.4 %), low - in 11 (15.7 %). The use of iloprost in the treatment of RP was effective for healing of DU and a statistically significant decrease of the generalized expression of RP from 2.25 [1; 3] to 1.75 [1; 2] (p = 0.012) was observed. On alprostadil treatment, statistically significantly decreased frequency of attacks from multiple daily (more than once a day) to once a month and reduced numbness during RP attack were observed as well as a decrease of the level of generalized index of RP expression from 1.26 ± 0.71 to 0.97 ± 0.57 (р = 0.038). The combination of prostanoids had a contradictory clinical effect: the pain and frequency of RP attacks decreased, but the formation of DU and new cases of amputations of phalanges were registered, the treatment had no effect on the value of RP expression. Conclusion. Based on the clinical manifestations of RP, a generalized index of RP severity was identified and the levels of RP severity were determined. Treatment with iloprost and alprostadil has a significant effect on reducing the clinical manifestations of RP with a corresponding decrease in its severity.
Clinical and epidemiological characteristic of chronic brucellosis
Authors: Fazylov V Kh , Gilmullina F S , Khamidullina Z L , Galina G V
Published: November 2018

Aim. To study clinical epidemiological and laboratory features of chronic brucellosis in the Republic of Tatarstan in ten-year aspect. Methods. 59 patients infected with various forms of brucellosis in 2007-2017 were examined. Clinical laboratory and instrumental diagnosis of brucellosis was confirmed by the immunoassay (EIA) with determination of IgM and IgG antibodies, passive hemagglutination test with a brucellar diagnosticum, Coombs test, Wright and Hedelson agglutination test. Results. Clinically 91 % of patients had asthenic-vegetative syndrome, 55 % - mild intoxication symptoms, 89 % - articular syndrome, 49 % - fibrositis. EIA revealed in 91 % of patients IgG (38 %) and IgM (53 %) antibodies to causative agents of brucellosis, 25 % of patients had positive Wright agglutination test, and 30 % - positive Hedelson agglutination test. In 9 % of cases the diagnosis was confirmed by Coombs test and in 26 % by passive hemagglutination test with brucellar diagnosticum. The retrospective analysis with clinical cases of patients with chronic brucellosis indicates introduced cases in 19 % (from the republics of Central Asia and Transcaucasia), local cases in 81 % (from the Republic of Tatarstan), their occupational character (57 %), the mixed (contact and alimentary) route of infection (21 %), and 64 % with clinically primary involvement of the musculoskeletal system and peripheral nervous system, i.e. prevalence of the mixed form of chronic brucellosis. Conclusion. Chronic brucellosis in the Republic of Tatarstan is characterized by high risk of introduced cases, occupational history, prevalence of the mixed route of infection in females and working-age patients; with the features of systemic disease involving the musculoskeletal and peripheral nervous system against the background of mild syndrome of intoxication and moderate asthenic-vegetative syndrome. Divergence of the results of serological diagnostics requires careful studying of duration of infection, features of the immune response in each case on follow-up.
Efficiency of modern correction methods of ovarian hyperandrogenism in puberty
Authors: Alieva E M , Akhundova N E
Published: November 2018

Aim. To evaluate the effectiveness of correction of the ovarian hyperandrogenism (OHA) in girls in puberty. Methods. 38 girls with OHA syndrome were examined. The average age of the girls was 14.39 ± 0.27 years. Ferriman-Gallwey hirsutism score was 19.7 ± 0.47, the hormonal score 18.14 ± 2.43, the indifferent score 2.34 ± 0.13. The comparison group included 20 girls matched by age (14.74 ± 0.15 years) with physiological course of puberty. The study included the evaluation of hirsutism severity by Ferriman-Gallway score, determination of the hormones of hypothalamus-pituitary-adrenal-ovarian system in early follicular phase on day 5-7 of menstrual cycle. Results. The causes of OHA syndrome in the pubertal period were found to be polycystic ovary syndrome in 68.42 % and tumor-like formations (follicular cysts) in 31.58 % of girls. Compared to healthy girls, the girls with OHA syndrome had statistically significantly higher values of luteinizing hormone (LH) - 9.19 ± 0.96 mME/ml, LH/FSH ratio - 1.8 ± 0.15, total testosteron (Ttotal) - 1.3 ± 0.11 ng/ml, estrone (E1) - 109.5 ± 4.88 ng/ml, androstenedione (An) - 4.01 ± 0.12 ng/ml as well as low values of estradiol (E2) - 49.1 ± 2.6 pg/ml and sex hormone-binding globulin (SHBG) - 45.7 ± 2.14 nmol/l. The study demonstrated that correction of ovarian hyperandrogenism, promotes an increase in the level of E2, SHBG and decrease of the level of LH, LH/FSH ratio, Ttotal, An. Conclusion. Complex pathogenetic therapy of OHA syndrome in girls in puberty leads to significant improvement of hormonal status in this group of patients.
On-pump beating-heart coronary artery bypass grafting: a literature review
Authors: Borisov D V , Zotov A S , Troitskiy A V , Khabazov R I
Published: November 2018

Coronary artery bypass grafting techniques have been unchangeable for many years, whereas development and enhancement of myocardial protection methods in coronary bypass grafting for patients with ischemic heart disease are still actual issues of current coronary surgery. Coronary artery bypass grafting techniques include the traditional/conventional technique with cardiopulmonary bypass, aortic cross-clamping and cardioplegia, off-pump and on-pump beating heart coronary artery bypass grafting. Coronary artery bypass grafting with cardiopulmonary bypass and cardioplegia remains the most common method of coronary revascularization. However the cardiac arrest inevitably leads to global cardiac ischemia, and current cardioplegias do not prevent ischemic damage to the myocardium in all cases, especially in high-risk surgical patients. Off-pump coronary artery bypass grafting allows preventing global myocardial ischemia (due to the constant native coronary blood-flow) and avoiding possible negative consequences of cardiopulmonary bypass use. The main limitations of this technique are associated with high risk of hemodynamic instability due to low cardiac output and systolic output caused by target arteries exposition. On-pump beating heart technique is a reasonable compromise between conventional on-pump coronary artery bypass grafting, cardioplegia and off-pump procedure. It is a safe and effective technique with outcomes that are equivalent or superior to the outcomes reported for conventional coronary artery bypass grafting in patients with unstable hemodynamics, low left ventricular ejection fraction and in high-risk patients. The literature review presents the results of on-pump beating heart coronary artery bypass grafting.
Clinical case of hereditary hemochromatosis
Authors: Solov’eva A V , Kodyakova O V , Nikitina I N , Fomenko N P , Rakita D R
Published: November 2018

The article presents a clinical case demonstrating the difficulties of timely diagnosis of hereditary hemochromatosis, presents data on modern diagnosis and approaches to the treatment of the disease according to existing clinical guidelines. The described clinical case of hereditary hemochromatosis is associated with a homozygous mutation of C282Y in HFE gene in a 58-year-old patient and his twin brother. Initially, signs of iron deposition in the liver were found on MRI of the abdominal cavity. In laboratory analyses, the patient was found to have an increased level of serum iron - 40 µmol/l and ferritin - 1340 ng/ml. Subsequently, the investigation of HFE gene mutations was carried out and a mutation of C282Y in homozygous form (genotype A/A) was found, which is a molecular genetic confirmation of hereditary hemochromatosis of type 1. At the same time, the patient's twin brother at the targeted examination had the serum iron level of 36 µmol/l, the ferritin level of 600 ng/ml, and also the mutation of HFE gene, the allelic variant of A/A. The results of liver fibroelastometry of the patient correlate with the degree of fibrosis F1 by Metavir scale. Timely started therapeutic phlebotomies led to improved clinical and laboratory parameters of iron metabolism while maintaining normal levels of red blood cells and hemoglobin.
Dysglycemia-based Chronic Disease—Diabetes Re-worked
Authors: Mechanick Jeffrey I ,   Divisions of Cardiology and Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York City, NY, US
Published: November 2018

Type 2 diabetes (T2D) is a complex, chronic disease with a significant quality of life burden for affected individuals, as well as socio-economic burdens on a population scale. Efforts to mitigate morbidity, mortality, and risks for other acute and chronic diseases have been compromised by a traditional chronic disease model that focuses on tertiary prevention (i.e., waiting until the disease is fully manifest and in many cases with severe complications). More specifically, the role for prevention at an earlier “prediabetes” stage has been questioned. A re-examination of the biology and clinical data on T2D pathogenesis can modulate the way we think about T2D. The new Dysglycemia-Based Chronic Disease (DBCD) model addresses these challenges by positioning T2D and prediabetes along a continuous spectrum from insulin resistance to prediabetes to T2D to vascular complications. It is hoped that by conceptualizing T2D in the DBCD framework, health care professionals can provide more efficient, cost-effective care.
Psychosocial Risk Factors in Ambulatory Patients With Arterial Hypertension and Ischemic Heart Disease of 30 Cities in Russia: Data from the КОМЕТА (Сomet) Study
Authors: Pogosova N. V. , Boitsov S. A. , Oganov R. G. , Kostyuk G. P. , Sokolova O. Yu. , Yufereva Yu. M. , Kursakov A. A. , Ausheva A. K. , Vygodin V. A. , Karpova A. V. , Arutyunov A. А. , Isakova S. S.
Published: November 2018

Background.Psychosocial (PS) risk factors (RF) make a substantial contribution in populational burden of cardio-vascular diseases (CVD) and their complications.

Purpose.The KOMETA (Comet) study was directed to obtaining actual information on PSRF among ambulatory patients with arterial hypertension (AH) and / or ischemic heart disease (IHD) in 30 cities of Russian Federation.

Materials and methods.This multicenter cross-sectional study was conducted in 2016–2017. Doctors participating in the study (n=325) recruited in state polyclinics 2775 patients aged ≥55 years with AH and / or IHD. Information collected from these patients comprised social-demographic and clinical characteristics, data on RF, adherence to therapy. Assessment of PSRF was carried out with consideration of levels of anxiety, depression and stress, presence of personality type D. Results. Population of patients studied (72 % women) was characterized by considerable prevalence of PSRFs. Low levels of education and income were found in 24.5 and 44.2 % of patients, respectively; 25.2 % of patients reported living alone, 6.3 % – felt social isolation. Elevated, extremely high levels of stress, type D personality were detected in 67.8, 10, and 37.6 % of patients, respectively; clinically significant symptoms of anxiety and depression were found in 25.5 and 16.3 %, respectively. Most RFs were significantly more often detected in women, and older people. One third of patients (33.1 %) during a year preceding inclusion took some psychotropic drugs mainly herbal or barbiturate-containing (27.1 %). Moreover, 30 % of patients had lowering of cognitive functioning.

Conclusion.In this large-scale study we revealed high prevalence of PSRFs among ambulatory patients with AH and / or IHD in Russia. Despite positive dynamics of prevalence of states of anxiety and depression relative to earlier studies in this country their negative impact on prognosis of CVD and quality of life of affected patients requires optimization of efforts for organization of adequate care and directed to timely diagnosis and correction of these states.
Antihypertensive Efficacy of a Triple Fixed-Dose Combination of Perindopril, Indapamide, and Amlodipine: Clinical Effectiveness in Ambulatory Practice (Results of the PETRA Study)
Authors: Privalova E. V. , Lishuta A. S.
Published: November 2018

Most patients with arterial hypertension (AH) for successful long-term blood pressure (BP) control require combination of antihypertensive drugs acting on various target organs. Accumulated experience shows that about 30 % of patients require combination therapy with 3 drugs from different pharmacological classes. Efficacy of BP control in real clinical practice with the use of various doses of perindopril, indapamide, and amlodipine as components of taken once-daily triple fixed combination was assessed in the 3-months prospective observational open-label PETRA study. In this study data of office BP measurements and 24-hour ambulatory BP monitoring (ABPM) were obtained from 11209 ambulatory patients (47.6 % women) with AH. Initial mean office BP (BPmoff) was 156.58±16.10 / 91.56±9.33 mm Hg, AH duration – 9.48±7.19 years. After switching to triple fixed dose combination of perindopril, indapamide, and amlodipine BPmoff decreased by 24.81±15.47 / 11.41±9.90 mm Hg (p<0.0001). Doses of perindopril, indapamide, and amlodipine in combination at the final visit were 5 / 1.25 / 5, 10 / 2.5 / 5, and 10 / 2.5 / 10 mg. 24-hour ambulatory BP monitoring (ABPM) was carried out in 76 patients. Mean 24-hour BP lowed from mean 155.51±17.43 / 85.28±11.48 down to 134.63±12.51 / 77.83±8.99 mm Hg (p<0.0001). Clinically relevant improvement of a number of parameters of metabolism occurred after 3 months of the study (in particular, lowering of levels of total and low-density lipoprotein cholesterol [–8.6 and – 11.4 %, respectively], triglycerides [–12,1 %], fasting blood glucose [–6.6 %]). Thus, results of the PETRA study confirmed 24-hour long antihypertensive efficacy of triple fixed dose combination of perindopril, indapamide, and amlodipine. This drug combination can present novel possibility in treatment of patients with AH who have not achieved target BP values on preceding dual combination therapy and fully corresponds with the single pill concept for formation of adherence to therapy.
Study the effect of mifepristone on clinical symptoms and its side effects in patients with fibroid uterus
Authors: Seher Umbreen , Chauhan Nidhi , Mangla Mishu
Published: November 2018

Background: Fibroid can lead to a variety of clinical symptoms including pain, menorrhagia, and lump in abdomen. The availability of a safe and efficient medical management options for symptomatic fibroid is of considerable clinical and public health importance. The present study is designed to see the safety and efficacy of mifepristone in the medical management of uterine fibroids.Methods: The study was conducted in the Department of Obstetrics and Gynaecology, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun over a period of 12 months. A total of 40 patients were included in the study.Results: Amount of bleeding was assessed by PBAC score, which significantly reduced by 83.9% at the end of treatment.  And 62% patients developed amenorrhoea due to mifepristone. Similarly, pain abdomen/dysmenorrhoea was assessed by Numeric Pain Rating Scale, which also showed a significant reduction in 55% patients with no pain at the end of 3 months.Conclusions: The study clearly shows that Mifepristone is a safe and effective option to manage fibroid uterus and its associated symptoms.
Complications of gynaecologic laparoscopy: an audit
Authors: Shastri Shraddha S. , Singh Anvita A. , Darawade Sameer P. , Manwani Saloni D.
Published: November 2018

Background: Minimal access surgery as a modality of treatment for various gynecologic conditions is rapidly gaining grounds in the recent years1. Approximately 30 years after its introduction; the use of laparoscopy in gynecology has evolved from diagnostic purposes into a more coordinated system for the repair or removal of diseased abdominal and pelvic organs. The rapid increase in the number of procedures being performed, the introduction of new equipment, and variability in the training of surgeons all contribute to the complication rate. The objective is to review complications associated with laparoscopic gynecological surgeries and identify associated risk factors.Methods: Hospital based descriptive observational study performed between January 2013 to December 2017 which included all gynecologic laparoscopies performed in present institute. Variables were recorded for patient characteristics, indication for surgery, length of hospital stay (in days), major and minor complications, conversions to laparotomy and postoperative complications. The laparoscopic procedures were divided into three subgroups: Diagnostic cases, tubal sterilization and Advanced operative laparoscopy.Results: Of all 3724 laparoscopies included, overall frequency of major was 1.96 %, and that of minor complications was 3.51%. Of 3724 laparoscopic procedures, 214 complications occurred (5.8% of all procedures) and one death occurred. The level of technical difficulty and existence of prior abdominal surgery were associated with a higher risk of major complications and conversions to laparotomy.Conclusions: Laparoscopic surgery has many advantages, but it is not without complications. Despite rapidly improving technical equipment’s and surgical skill; complication rates and preventable injuries demonstrate continuous pattern. Delayed recognition and intervention add to morbidity and mortality. Each laparoscopic surgeon should be aware of the potential complications, how they can be prevented and managed efficiently.
Removed versus unremoved vicryl sutures used for subcuticular skin closure
Authors: Elsharkawy Suzan S. , Dawood Waleed A.
Published: November 2018

Background: The objective was to compare the difference between removing vicryl suture thread after skin healing or burry the knots and leaving it to be absorbed in situ, after subcuticular skin closure of Pfannesteil incisions.Methods: Prospective, randomized controlled trial included 449 eligible participants were prospectively recruited between July 2016 and June 2017. All selected patients had a pfannenstial incision with subcuticular skin closure using 2-0 absorbable vicryl stiches (for primary caesarean section or extra peritoneal surgical approach to the prostate, bladder and distal ureters). The left side knot was buried under the skin edge and a knot in the midline and the right edge was made. After 10 days postoperative, the right half of the stitch thread and the two knots were removed, and the left half of the thread was left in situ. Patients were observed for any complication at time of stitch removal, after one month and after 6 months' post-operative.Results: Wound infection rate, hypertrophic scars, keloids and skin itching were significantly higher in the un-removed wound sides while skin dehiscence was significantly higher in the removed wound sides.Conclusions: Leaving behind absorbable suture material after wound healing -when used in subcuticular pfannenstial skin closure- is associated with increased rates of wound infection, hypertrophic scars, itching and keloids, which of course overweight any known benefits of the technique.
Role of hysteroscopy for diagnosis and treatment of uterine factors affecting subfertility
Authors: DH Nayana , S. Shreya
Published: November 2018

Background: Hysteroscopy has become the gold standard for diagnosis of intrauterine abnormalities. Intrauterine lesions such as adhesions, uterine septum polyps or submucous myomas are diagnosed much more precisely by hysteroscopy and are detectable in 10-15% of women seeking treatment for subfertility. The present study analyses various etiological factors in infertility diagnosed by hysteroscopy and to evaluate therapeutic interventions done during hysteroscopy.Methods: The cases for the study will include all women with primary or secondary infertility admitted in tertiary health centre from April 2016 to May 2018 for hysteroscopy.Results: Out of 90 subjects 66 (73.3%) were primary infertility and 24 (26.7%) were secondary infertility. Out of 90 cases studied, 68 (75.6%) had normal findings, 10 (11.1%) had endometrial polyps, 01 (1.1%) had submucous fibroid, 5 (5.6%) had septate uterus, hyperplastic endometrium in 3 (3.3%) and atropic endometrium in 1 (1.1%), intrauterine adhesions and hypoplastic uterus in 1 each. Hysteroscopic interventions were performed in the form of curettage in 08 (33.3%), hysteroscopic cannulation in 2 (8.3%), polypectomy and septal resection in 5 (20.8%) cases each, submucosal fibroid resection in 1 (4.2%) cases, tubal block released in 2 (8.3%).Conclusions: Hysteroscopy was found the best method in evaluation of intrauterine conditions for subfertility and also the type and location of uterine abnormalities can be precisely noted. The removal of those changes during operative hysteroscopy increases the fertility rate in women treated during this procedure.
PAP smear in pregnancy: a hospital-based study
Authors: Priya S. Senthil , Shankar R.
Published: November 2018

Background: Pregnant and non-pregnant women are at similar risk for CIN and cervical cancer. The incidence of abnormal cervical cytologic findings during pregnancy is 0.72 to 1.67%. Approximately 86% of all squamous intraepithelial lesions (SIL) indentified during pregnancy are classified as low-grade SIL, whereas 14% are high- grade SIL. The aim of this study is to assess the incidence of Pap smear abnormalities among antenatal woman presenting to present hospital.Methods: A prospective study was conducted in present medical college hospital in the department of Obstetrics and Gynecology for a period of one year from Jan 2017 to Dec 2017. A total of 200 antenatal women were included in the study. Ayre’s spatula was used to conduct smear tests in this study. All smears were immediately sprayed with a fixative and sent to the department of Pathology. The cytological results were reported based on the Bethesda classification system 2001.Results: The pap smear report revealed that 26% of the subjects had inflammatory changes and for 66% it showed negative for intraepithelial lesion and for only 1% of the subjects had signs related to carcinoma cervix in which one patient had Atypical Squamous Cell of Undetermined Significance (ASCUS) and another patient had Low-grade Squamous Intraepithelial Lesion (LSIL) and no satisfactory sample was able to be obtained in 6% of the subjects.  In present study authors found a statistically significant association between the age at marriage and the pap smear report, lower the age at marriage (<20 years) higher the incidence of inflammatory changes in the cervix and both the patients who were reported with ASCUS and LSIL were in the age of 15 and 16 years respectively.Conclusions: Clinicians should make every effort to educate, counsel and screen pregnant women if they have not had a Pap test in the past.
Incidence of cesarean section among primi at a tertiary care hospital in Mahabubnagar, Telangana, India
Authors: Vellanki Janaki
Published: November 2018

Background: Not only in India but globally the incidence of cesarean section deliveries is increasing and it is becoming an important cause of concern. The objective of the present study was to observe the incidence of cesarean section deliveries at a tertiary care hospital.Methods: A hospital record-based study was carried out from January 2017 to August 2018. All deliveries with live birth taking place among the primipara were included in the present study. Other than this was excluded. Data was analyzed using proportions.Results: A total of 12254 deliveries took place from January 2017 to August 2018. Maximum deliveries were seen during July 2017 to October 2017 where it ranged above 6%. Normal delivery rate ranged from 51.2% in March 2018 to 64.4% in February 2017. Overall it was 62.1%. The overall cesarean section rate was 37.9% in the present study. This rate is very low compared to the rates from private sector. The cesarean section rate ranged from 35.6% in February 2017 which was lowest in the study period to 48.8% in the month of March 2018 which was the highest in the study period. But the cesarean section rate never crossed the 50% mark and most of the time it remained near 40% mark.Conclusions: It has been found that the cesarean section rate always remained on a lower side as compared to the normal deliveries rate. This can be attributed to the appropriate clinical practices in our settings.