bluuebunny/crossref_metadata_2025 huggingface dataset:
Sociodemographic Factors Associated with Women’s Perspectives on Male Involvement in Antenatal Care, Labour, and Childbirth
Authors: Mohammed Shamsudeen , Yakubu Ibrahim , Awal Issahaku
Published: January 2020

Background. Evidence suggests that in patriarchal societies such as Ghana, access to and survival of maternal and child healthcare services require the active involvement of men. However, interventions to promote men’s involvement in maternal and child health care are less likely to succeed if the views and concerns of women are not considered. This study provides an understanding of women’s perspective on men’s involvement in antenatal care, labour, and childbirth in the Northern Region of Ghana. Methods. Data for this cross‐sectional study were collected from 300 pregnant women using a structured questionnaire. Logistic regression models were then used to determine the socio‐demographic factors associated with women’s perspectives on men’s involvement in antenatal care, labour, and childbirth. Results. The mean age of the participants was 28 (SD = 5.21) years. More than four-fifths of the women in this study express the desire for male partner involment in natenatal care (ANC) services (n = 258, 86%) and as companions during labour and child birth (n = 254, 84.7%). We found that married women were 9.8 times more likely (95%CI 1.59, 60.81) to encourage male involvement in ANC compared to women who were unmarried. The probability of encouraging male involvement in ANC decreased with increased level of education among the women while support for male companionship during childbirth increased significantly with an increased level of education. After accounting for the effect of other significant covariates, there was good evidence to suggest that married women (p = 0.002), women with only primary/Junior High School education (p = 0.048) and those with two (p = 0.010), three (p =  0.008), or ≥4 (p = 0.044) previous pregnancies had a desire for male partner involvement in ANC while women who attained secondary (p = 0.004) or tertiary (p = 0.001) level education expressed the desire for male companionship in labour and childbirth in the adjusted model. Conclusion. Male involvement in antenatal care, labour, and childbirth received overwhelming support from the women in this study.
Mathematical Modelling and Optimisation of Low-Temperature Drying on Quality Aspects of Rough Rice
Authors: Soomro Shakeel Ahmed , Chen Kunjie , Soomro Sohail Ahmed
Published: January 2020

Rice when harvested normally has a high moisture content of 20–25% which requires immediate drying, reducing its mass loss and preventing it to spoil. This situation is more crucial with the areas under humid tropical conditions, where moisture and temperature mainly play an important role in deteriorating the quality of rough rice. Keeping the importance of quality attributes of rough rice, the study was carried out to assess the effects of low-temperature drying and suggest an optimum condition. Response surface methodology (RSM) with a central composite design was employed to study the effects of variables, i.e., temperature (X1), time (X2), and air velocity (X3) on responses, i.e., head rice yield (HRY), hardness, lightness, and cooking time. The experimental data were fitted to the quadratic model, studying the relationship between independent and dependent variables. The results revealed that the HRY, hardness, lightness, and cooking time increased with increasing variables, whereas for HRY, it particularly increased and then decreased. It was observed that temperature had more influence on the quality of rough rice followed by time and velocity. Results for analysis of variance revealed that the quality aspects of rough rice were significantly (p<0.05) affected by temperature and time, whereas for velocity, it only significantly affected hardness. The optimal drying conditions predicted by RSM for variables were 25°C, 600 min, and 1 m·s−1, and the optimal predicted HRY, hardness, lightness, and cooking time were 73.93%, 38.28 N, 71.40, and 27.58 min respectively. Acceptable values of R2, Adj R2, and nonsignificance of lack of fit demonstrated that the model applied was adequate and can be used for optimization. The study concluded that the RSM with a central composite design was successfully used to study the dependence of quality aspects of rough rice at low temperature and can be utilized by the rice processing industries.
PSO–SOM Neural Network Algorithm for Series Arc Fault Detection
Authors: Qu Na , Chen Jiatong , Zuo Jiankai , Liu Jinhai
Published: January 2020

Self-organizing feature map (SOM) neural network is a kind of competitive neural network with unsupervised learning. It has the strong abilities of self-organization and self-learning. However, the classification accuracy of SOM neural network may decrease when the features of tested object are not obvious. In this paper, the particle swarm optimization (PSO) algorithm is used to optimize the weight values of SOM network. Three indexes, i.e., intra-class density, standard deviation and sample difference, are used to judge the weight value, which can improve the classification accuracy of the SOM network. PSO–SOM network is applied to the detection of series arc fault in electrical circuits and compared with conventional SOM network and learning vector quantization (LVQ) network. The detection accuracy of the PSO–SOM network is 95%, which is higher than conventional SOM network and LVQ network.
LMI-Based Robust Stabilization of a Class of Input-Constrained Uncertain Nonlinear Systems with Application to a Helicopter Model
Authors: Gritli Hassène
Published: January 2020

This paper is concerned with the robust stabilization of a class of continuous-time nonlinear systems, with an application to the pitch dynamics of a simple helicopter model, via an affine state-feedback control law using the linear matrix inequality (LMI) approach. The nonlinear dynamics is subject to norm-bounded parametric uncertainties and disturbances. In addition, the problem of actuator nonlinearity is addressed by considering the saturation effect of the control law. We demonstrate first that the synthesis problem of the saturated controller is expressed in terms of bilinear matrix inequalities (BMIs). Thanks to the Schur complement lemma and the matrix inversion lemma, we convert these BMIs into LMIs allowing the simultaneous computation of the two gains of the affine controller. Furthermore, we address in this work the estimation problem of the domain of attraction using the invariant set concept. This is solved by computing the largest attractive invariant ellipsoid. Compared with previous works, the research procedure of such ellipsoidal set is achieved in a single step with a reduced number of LMI constraints and then with less conservative conditions. A portfolio of numerical results is presented. The effectiveness and robustness of the proposed saturated controller in the stabilization of the adopted helicopter pitch model toward parametric uncertainties and disturbances are illustrated through simulation results.
Joint Effect of the Nonlinearity of Elastic Foundations and the Variation of the Inertia Ratio on Buckling Behavior of Prismatic and Nonprismatic Columns Using a GDQ Method
Authors: Abumandour Ramzy M. , Abdelmgeed Fathi A. , Elrefaey Adel M.
Published: January 2020

In this paper, we present a simple, powerful, yet efficient and easily applicable technique based on the GDQ method for solving nonlinear problems. The proposed technique is implemented to some nonlinear engineering problems in structure analysis. The results reveal that the proposed technique is effective. Then, the proposed technique is used to explain the effects of the variation of cross section area on the nondimensional critical buckling loads for columns with and without elastic foundation for three sets of boundary conditions. Finally, the proposed technique is used to investigate the effect of the nonlinearity term of Winkler elastic foundation on the nondimensional critical buckling loads of nonuniform columns resting on elastic foundations. The effectiveness of the proposed technique is validated through comparing the present results with exact solutions and other numerical results available in references. The proposed method benefits the optimum design of columns against buckling in engineering applications. The most important conclusions from this paper can be summarized as follows. When the inertia ratio varies parabolically, the nondimensional critical buckling loads increase in comparison with varying linearly. Moreover, the nondimensional critical buckling loads increase in the presence of the elastic foundation.
Remote Ischaemic Preconditioning Reduces Kidney Injury Biomarkers in Patients Undergoing Open Surgical Lower Limb Revascularisation: A Randomised Trial
Authors: Kasepalu Teele , Kuusik Karl , Lepner Urmas , Starkopf Joel , Zilmer Mihkel , Eha Jaan , Vähi Mare , Kals Jaak
Published: January 2020

Background and Aims. Perioperative kidney injury affects 12.7% of patients undergoing lower limb revascularisation surgery. Remote ischaemic preconditioning (RIPC) is a potentially protective procedure against organ damage and consists of short nonlethal episodes of ischaemia. The main objective of this substudy was to evaluate the effect of RIPC on kidney function, inflammation, and oxidative stress in patients undergoing open surgical lower limb revascularisation. Materials and Methods. This is a subgroup analysis of a randomised, sham-controlled, double-blinded, single-centre study. A RIPC or a sham procedure was performed noninvasively along with preparation for anaesthesia in patients undergoing open surgical lower limb revascularisation. The RIPC protocol consisted of 4 cycles of 5 minutes of ischaemia, with 5 minutes of reperfusion between every episode. Blood was collected for analysis preoperatively, 2, 8, and 24 hours after surgery, and urine was collected preoperatively and 24 hours after surgery. Results. Data of 56 patients were included in the analysis. Serum creatinine, cystatin C, and beta-2 microglobulin increased, and eGFR decreased across all time points significantly more in the sham group than in the RIPC group (p=0.021, p=0.021, p=0.024, and p=0.015, respectively). Comparison of two time points, baseline and 24 hours after surgery, revealed that the change in creatinine, eGFR, urea, cystatin C, and beta-2 microglobulin was significantly different between the groups (p<0.05). Conclusions. Our finding of reduced release of kidney injury biomarkers may indicate the renoprotective effect of RIPC in patients undergoing open surgical lower limb revascularisation. The trial is registered with ClinicalTrials.gov NCT02689414.
Chlorella sorokiniana Extract Prevents Cisplatin-Induced Myelotoxicity In Vitro and In Vivo
Authors: Lin Shyh-Horng , Li Ming-Han , Chuang Kai-An , Lin Ni-Hsuan , Chang Chih-Hsuan , Wu Hsin-Chieh , Chao Ya-Hsuan , Lin Chi-Chien , Pan I-Hong , Perng Ming-Der , Wen Shu-Fang
Published: January 2020

Cisplatin chemotherapy causes myelosuppression and often limits treatment duration and dose escalation in patients. Novel approaches to circumvent or lessen myelotoxicity may improve clinical outcome and quality of life in these patients. Chlorella sorokiniana (CS) is a freshwater unicellular green alga and exhibits encouraging efficacy in immunomodulation and anticancer in preclinical studies. However, the efficacy of CS on chemoprotection remains unclear. We report here, for the first time, that CS extract (CSE) could protect normal myeloid cells and PBMCs from cisplatin toxicity. Also, cisplatin-induced apoptosis in HL-60 cells was rescued through reservation of mitochondrial function, inhibition of cytochrome c release to cytosol, and suppression of caspase and PARP activation. Intriguingly, cotreatment of CSE attenuated cisplatin-evoked hypocellularity of bone marrow in mice. Furthermore, we observed the enhancement of CSF-GM activity in bone marrow and spleen in mice administered CSE and cisplatin, along with increased CD11b levels in spleen. In conclusion, we uncovered a novel mechanism of CSE on myeloprotection, whereby potentially supports the use of CSE as a chemoprotector against cisplatin-induced bone marrow toxicity. Further clinical investigation of CSE in combination with cisplatin is warranted.
Plasma Choline as a Diagnostic Biomarker in Slow Coronary Flow
Authors: Zhu Yuan-Ting , Zhu Ling-Ping , Wang Zhen-Yu , Qiu Xue-Ting , Wu Wan-Zhou , Liu Wei-Wang , Feng Yu-Yu , Xiao Wen-Kai , Luo Xin , Li Zhen-Yu , Li Chuan-Chang
Published: January 2020

Aim. The slow coronary flow (SCF) phenomenon was characterized by delayed perfusion of epicardial arteries, and no obvious coronary artery lesion in coronary angiography. The prognosis of patients with slow coronary flow was poor. However, there is lack of rapid, simple, and accurate method for SCF diagnosis. This study aimed to explore the utility of plasma choline as a diagnostic biomarker for SCF. Methods. Patients with coronary artery stenosis <40% evaluated by the coronary angiogram method were recruited in this study and were grouped into normal coronary flow (NCF) and SCF by thrombolysis in myocardial infarction frame count (TFC). Plasma choline concentrations of patients with NCF and SCF were quantified by Ultra Performance Liquid Chromatography Tandem Mass Spectrometry. Correlation analysis was performed between plasma choline concentration and TFC. Receiver operating characteristic (ROC) curve analysis with or without confounding factor adjustment was applied to predict the diagnostic power of plasma choline in SCF. Results. Forty-four patients with SCF and 21 patients with NCF were included in this study. TFC in LAD, LCX, and RCA and mean TFC were significantly higher in patients with SCF in comparison with patients with NCF (32.67 ± 8.37 vs. 20.66 ± 3.41, P < 0.01). Plasma choline level was obviously higher in patients with SCF when compared with patients with NCF (754.65 ± 238.18 vs. 635.79 ± 108.25, P=0.007). Plasma choline level had significantly positive correlation with Mean TFC (r = 0.364, P=0.002). Receiver operating characteristic (ROC) analysis showed that choline with or without confounding factor adjustment had an AUC score of 0.65 and 0.77, respectively. Conclusions. TFC were closely related with plasma choline level, and plasma choline can be a suitable and stable diagnostic biomarker for SCF.
Simulation Strategies for Mixed Traffic Conditions: A Review of Car-Following Models and Simulation Frameworks
Authors: Matcha Bhargav Naidu , Namasivayam Satesh Narayana , Hosseini Fouladi Mohammad , Ng K. C. , Sivanesan Sivakumar , Eh Noum Se Yong
Published: January 2020

The area of traffic flow modelling and analysis that bridges civil engineering, computer science, and mathematics has gained significant momentum in the urban areas due to increasing vehicular population causing traffic congestion and accidents. Notably, the existence of mixed traffic conditions has been proven to be a significant contributor to road accidents and congestion. The interaction of vehicles takes place in both lateral and longitudinal directions, giving rise to a two-dimensional (2D) traffic behaviour. This behaviour contradicts with the traditional car-following (CF) or one-dimensional (1D) lane-based traffic flow. Existing one-dimensional CF models did the inclusion of lane changing and overtaking behaviour of the mixed traffic stream with specific alterations. However, these parameters cannot describe the continuous lateral manoeuvre of mixed traffic flow. This review focuses on all the significant contributions made by 2D models in evaluating the lateral and longitudinal vehicle behaviour simultaneously. The accommodation of vehicle heterogeneity into the car-following models (homogeneous traffic models) is discussed in detail, along with their shortcomings and research gaps. Also, the review of commercially existing microscopic traffic simulation frameworks built to evaluate real-world traffic scenario are presented. This review identified various vehicle parameters adopted by existing CF models and whether the current 2D traffic models developed from CF models effectively captured the vehicle behaviour in mixed traffic conditions. Findings of this study are outlined at the end.
Optimal Design of Cooperative Penetration Trajectories for Multiaircraft
Authors: Xu Qiangqiang , Ge Jianquan , Yang Tao
Published: January 2020

At present, two kinds of shortages exist in the research on cooperative combat. One is that radar detection threat (which cannot be ignored) is rarely considered. The other is that limited efforts have been made on the cooperative penetration trajectories under the conditions of long distance, vast airspace, and wide speed range. In order to offset the shortages of the research on cooperative combat, the penetration trajectory optimization method considering the influence of aircraft radar cross-section (RCS) and the cooperative penetration strategy is proposed in this study. Firstly, the RCS data are calculated by the physical optics (PO) method. The radar detection threat model is established considering the influence of the aircraft RCS. Then, a trajectory optimization framework with the dynamic model, constraint conditions, and optimal objectives is formed. Using the hp-adaptive Radau pseudospectral method, the optimal control problem for a single aircraft flight is solved. Finally, a cooperative penetration strategy is proposed to solve the cooperative penetration problem of multiaircraft. The impact time and angle constraints are given, and the virtual target point is introduced for terminal guidance. Two cases are simulated and verified. Simulation results demonstrate that the proposed method is effective. The single aircraft can effectively penetrate, and the multiaircraft can fulfill the requirement of cooperative impact time and angle under the condition of meeting the minimum threat of radar detection.
Intravitreal Melphalan Chemotherapy for Vitreous Seeds in Retinoblastoma
Authors: Yousef Yacoub A. , Noureldin Amal M. , Sultan Iyad , Deebajah Rasha , Al-Hussaini Maysa , Shawagfeh Munir , Mehyar Mustafa , Mohammad Mona , Jaradat Imad , AlNawaiseh Ibrahim
Published: January 2020

Objective. To evaluate our experience with intravitreal melphalan chemotherapy as a second-line regimen for RB patients with refractory or recurrent vitreous seeds. Methods. A retrospective case series of 16 eyes from 16 patients with intraocular RB who received intravitreal melphalan chemotherapy using the antireflux injection technique. Data included demographics, stage at diagnosis, treatment modalities, side effects, eye salvage, and survival. Results. The total number of injections was 64 (median, 3 injections per eye; range, 3–8), and the median age at time of injection was 22 months (range, 9–63 months). Nine (56%) patients were males, and 13 (81%) patients had bilateral RB. Complete response was seen in 13 (81%) eyes: in 9 (100%) eyes with focal vitreous seeds and in 4 (57%) eyes with diffuse vitreous seeds (P=0.062). At a median follow-up of 18 months (range, 6–48 months), the eye salvage rate was 81%, local retinal toxicity confined to the site of injection was seen in 2/3 of the eyes, 2 (12%) eyes had cataract, and none of the patients had orbital recurrence and distant metastasis or was dead. Conclusion. Intravitreal melphalan is a promising modality for treatment of vitreous seeds, and the dose of 20–30 μg of melphalan sounds to be safe and effective for refractory and recurrent vitreous seeds.
Acute Acalculous Cholecystitis Associated with Epstein–Barr Infection: A Case Report and Review of the Literature
Authors: Ntelis Konstantinos , Mazarakis Dimosthenis , Sapountzis Apostolos , Zissi Dimitra , Sparangi Sophia , Xidia Nikoletta , Velissaris Dimitrios
Published: January 2020

The most common cause of acute cholecystitis (ACC) is cholelithiasis. Acute acalculous cholecystitis (AAC) is well documented in the literature related with critical illness, but viral causes such as cytomegalovirus (CMV) and Epstein–Barr virus (EBV) have also been reported. We present a rare manifestation of EBV infection, reporting a case of a 15-year-old female suffering from acute acalulous cholecystitis, and we review the relevant literature. Clinicians should be aware of this rare complication of EBV infection and properly exclude it in young patients with cholecystitis.
Chronic Hypoxia‐Induced Microvessel Proliferation and Basal Membrane Degradation in the Bone Marrow of Rats Regulated through the IL‐6/JAK2/STAT3/MMP‐9 Pathway
Authors: Zhu Mingming , Yang Min , Yang Quanyu , Liu Wenling , Geng Hui , Pan Li , Wang Lu , Ge Rili , Ji Linhua , Cui Sen , Li Zhanquan
Published: January 2020

Chronic hypoxia (CH) is characterized by long‐term hypoxia that is associated with microvessel proliferation and basal membrane (BM) degradation in tissues. The IL‐6/JAK2/STAT3/MMP‐9 pathway has been described in a variety of human cancers and plays an essential role in microvessel proliferation and BM degradation. Therefore, this study investigated the role of the IL‐6/JAK2/STAT3/MMP‐9 pathway in hypoxia‐mediated microvessel proliferation and BM degradation in the rat bone marrow. Eighty pathogen‐free Sprague Dawley male rats were randomly divided into four groups (20 per group)—control group, CH group (exposed to hypoxia in a hypobaric chamber at a simulated altitude of 5000 m for 28 d), CH + STAT3 inhibitor group (7.5 mg/kg/d), and CH + DMSO group. Microvessel density (MVD) and BM degradation in the bone marrow were determined by immunofluorescence staining and transmission electron microscopy. Serum IL‐6 levels were assessed by enzyme‐linked immunosorbent assay (ELISA), and the levels of P‐JAK2, P‐STAT3, and MMP‐9 were assessed by western blot analysis and real‐time reverse transcription PCR (RT‐PCR). Hypoxia increased serum IL‐6 levels, which in turn increased JAK2 and STAT3 phosphorylation, which subsequently upregulated MMP‐9. Overexpression of MMP‐9 significantly promoted the elevation of MVD and BM degradation. Inhibition of STAT3 using an inhibitor, SH‐4‐54, significantly downregulated MMP‐9 expression and decreased MVD and BM degradation. Surprisingly, STAT3 inhibition also decreased serum IL‐6 levels and JAK2 phosphorylation. Our results suggest that the IL‐6/JAK2/STAT3/MMP‐9 pathway might be related to CH‐induced microvessel proliferation and BM degradation in the bone marrow.
The Manipulation of Real-Time Kinect-Based Robotic Arm Using Double-Hand Gestures
Authors: Lin Chern-Sheng , Chen Pei-Chi , Pan Yu-Ching , Chang Che-Ming , Huang Kuo-Liang
Published: January 2020

This study focused on utilizing the Kinect depth sensor to track double-hand gestures and control a real-time robotic arm. The control system is mainly composed of the microprocessor, a color camera, the depth sensor, and the robotic arm. The Kinect depth sensor was used to take photos of the human body to analyze the skeleton of a human body and obtain the relevant information. Such information was used to identify the gestures of the left hand and the left palm of the user. The gesture of left hand was used as an input command device. The gesture of the right hand was used for imitation movement teaching of robotic arm. From the depth sensor, the real-time images of the human body and the deep information of each joint were collected and converted to the relative positions of the robotic arm. Combining forward kinematics and inverse kinematics and D-H link, the gesture information of the right hand was calculated, which was converted via coordinates into each angle of the motor of the robotic arm. From the color camera, when the left palm was not detected, the user could simply use the right hand to control the action and movement of the real-time robotic arm. When the left palm was detected and 5 fingertips were identified, it meant the start of recording the real-time imitation movement of the robotic arm by the right hand. When 0 fingertip was identified, it meant the stoppage of the above recording. When 2 fingertips were identified, the user could not only control the real-time robotic arm but also repeat the recorded actions.
Mobile Apps for the Management of Comorbid Overweight/Obesity and Depression/Anxiety: A Systematic Review
Authors: Gómez-de-Regil Lizzette , Avila-Nava Azalia , Gutierrez-Solis Ana Ligia , Lugo Roberto
Published: January 2020

Objective. This review aimed at searching for scientific literature on mobile apps for the management of comorbid overweight/obesity and depression/anxiety and providing a brief and comprehensive summary of their main features, targeted groups, and relevant results. Methods. A bibliographical search was performed in Pubmed, PsycNet, Web of Science, ResearchGate, and Lilacs databases. The terms “obesity” and “overweight” were introduced in combination with “anxiety” and “depression” and “mobile app (application),” “smartphone app (application),” “android app (applicattion),” “iOS app (application),” “mobile health app (application),” and “mHealth app (application).” Results. The initial search eliciting 204 citations was reduced to 7 relevant papers (4 original articles, 1 brief communication, and 2 study protocols). All publications were from the last five years, most were produced by research teams from the United States. All had adult samples, and interventions mostly followed a cognitive behavioral framework. Regarding mobile apps, five studies only used one to monitor weight and physical activity, one study to provide therapy to improve psychological wellness, and one study to monitor cognitions and emotions. No mobile app was found for the simultaneous management of overweight/obesity and depression/anxiety. Conclusions. The prevalence and costs related to overweight/obesity and depression/anxiety are significant and likely to increase. Very often these conditions overlap; thus, it would be recommendable to treat their comorbidity simultaneously. Nevertheless, no mobile app has been designed for this purpose, which would help to reduce service provision costs and make treatment more easily accessible for patients.
Word Processing Is Faster than Picture Processing in Alzheimer’s Disease
Authors: Meguro Kenichi , Takahashi Yumi , Nakatsuka Masahiro , Oonuma Jiro , Kumai Keiichi , Kasai Mari , Yamaguchi Satoshi
Published: January 2020

Objective. Alzheimer’s disease (AD) is characterized by a slow progressive impairment of episodic memory. Many studies have shown that AD exhibits deterioration of semantic memory during the course of disease progression. We previously reported that AD patients exhibited severe access disorders in the semantic memory system, using the Momentary Presentation Task (20 or 300 ms). In this study, we studied access disorder in patients with AD by the use of object difference (pictures vs words) methods. Methods. 56 patients with probable AD (NINCDS-ADRDA, mean age 79.0 years) and 11 healthy controls (HC) (mean age 67.0 years) were studied. Ten pictures and 10 corresponding Japanese Hiragana words were presented arbitrarily for 20 and 300 ms on the monitor screen which were correctly named at the usual confrontation setting (i.e., semantic memory preserved). They were asked to name the pictures or to read the words or nonsense syllables aloud. Results. The AD group showed significantly lower scores than the HC group, especially for the 20 ms condition. For the type of stimuli, the AD patients had better performances for words > pictures > nonsense syllables, although no differences for the HC group. The effect of AD severity was noted, moderate > severe stage. Conclusions. Our results suggested that the processing speed in AD patients may have reduced, even if the semantic memory were preserved. These data indicated that the difference in the processing speeds by the type of stimuli (pictures, words, and nonsense syllables) may be a character of AD patients.
Nonalcoholic Fatty Liver Disease Is Associated with Helicobacter pylori Infection in North Urban Chinese: A Retrospective Study
Authors: Xu Mei-Yan , Ma Jia-Hui , Du Juan , Yin Jian , Liu Lan , Cui Fuqiang , Lu Qing-Bin
Published: January 2020

Background. The association between nonalcoholic fatty liver disease (NAFLD) and Helicobacter pylori (H. pylori) is controversial. We conducted a retrospective study to clarify the seroprevalence of H. pylori infection and the relationship between NAFLD and H. pylori infection in north urban Chinese. Methods. The retrospective study was performed at Aerospace Center Hospital in Beijing. All subjects in this study were a healthy population who underwent health examinations at the hospital between 2012 and 2015. A logistic regression model was used to calculate the association between NAFLD and H. pylori infection. Age, gender, underlying diseases, and metabolic syndrome (MS) were adjusted. Effects of NAFLD on H. pylori infection in a different age, gender, and number of MS characteristic subgroups were analyzed. Results. There were 7803 (43.4%) subjects with H. pylori infection, 3726 (20.7%) with mild NAFLD, 730 (4.1%) with moderate NAFLD, and 369 (2.1%) with severe NAFLD among 17971 subjects. H. pylori infection was related to the seroprevalence of any level of NAFLD, including mild, moderate, and severe NAFLD (OR=1.607, 95% CI: 1.487-1.736; OR=1.770, 95% CI: 1.519-2.063; and OR=2.120, 95% CI: 1.714-2.526, respectively). The results of subgroup analysis showed that the risk of incident NAFLD from H. pylori infection had significant interactions by subjects with or without MS characteristics. Moreover, as the number of MS characteristics in patients with a fatty liver increased, the risk of H. pylori infection also increased. Conclusions. NAFLD may be associated with H. pylori infection in a Chinese population. Younger, male NAFLD patients and those meeting more characteristics of MS were more likely to have H. pylori infection.
Performance analysis of binary and multiclass models using azure machine learning
Authors: Rajagopal Smitha , Siddaramappa Hareesha Katiganere , Panduranga Kundapur Poornima
Published: January 2020

Network data is expanding and that too at an alarming rate. Besides, the sophisticated attack tools used by hackers lead to capricious cyber threat landscape. Traditional models proposed in the field of network intrusion detection using machine learning algorithms emphasize more on improving attack detection rate and reducing false alarms but time efficiency is often overlooked. Therefore, in order to address this limitation, a modern solution has been presented using Machine Learning-as-a-Service platform. The proposed work analyses the performance of eight two-class and three multiclass algorithms using UNSW NB-15, a modern intrusion detection dataset. 82,332 testing samples were considered to evaluate the performance of algorithms. The proposed two class decision forest model exhibited 99.2% accuracy and took 6 seconds to learn 1,75,341 network instances. Multiclass classification task was also undertaken wherein attack types like generic, exploits, shellcode and worms were classified with a recall percentage of 99%, 94.49%, 91.79% and 90.9% respectively by the multiclass decision forest model that also leapfrogged others in terms of training and execution time.
Досвід застосування стандартів консенсусу Американської тиреоїдної асоціації в клініці загальної хірургії на базі Львівської клінічної лікарні на ЗТ ПАТ “Українська залізниця” філії “Центр охорони здоров’я”
Authors: Kyryk T. P. , Vashchuk V. V. , Kushnirchuk M. I. , Baydala R. P. , Symo M. M.
Published: January 2020

Мета роботи: оцінка ефективності медичної практики клініки з огляду на ключові положення рекомендацій Американської тиреоїдної асоціації 2015 року, спрямованих на оптимізацію хірургічного лікування хворих із вузловими утворами щитоподібної залози.

Матеріали і методи. Проведення критичного аналізу окремих позицій настанов та рекомендацій Американської тиреоїдної асоціації редакції 2015 року. Ретроспективне дослідження із залученням 29 пацієнтів із цитологічно ідентифікованими випадками високодиференційованих карцином щитоподібної залози, яким були виконані оперативні втручання за період 2015–2018 рр. на базі хірургічного відділення Львівської клінічної лікарні на Залізничному транспорті.

Результати досліджень та їх обговорення. Клінічні ефекти оновленої версії рекомендацій Американської тиреоїдної асоціації є достатньо контраверсійні та не завжди знаходять одностайне схвалення з боку клініцистів (зокрема, вітчизняних шкіл із проблематики захворювань щитоподібної залози). Однією з можливих причин цього є розширення показань до виконання лобектомії (гемітиреоїдектомії) шляхом збільшення допустимих розмірів пухлини (в окремих ситуаціях до 4 см) та, відповідно, зменшення кількості хворих, яким виконано тиреоїдектомію (тотальну тиреоїдектомію). Тотальна тиреоїдектомія була здійснена у всіх пацієнтів нашої клініки, залучених до ретроспективного аналізу, що можна пояснити очікувано низьким рівнем комплаєнсу пацієнтів до тривалого спостереження. Водночас, тактика доопераційної підготовки, побудови та виконання діагностичного алгоритму та подальше ведення хворих у клініці загальної хірургії, в цілому, відповідали рекомендаціям та настановам Американської тиреоїдної асоціації редакції 2015 року. Виявлення вузла щитоподібної передбачає виконання багатокрокового алгоритму з метою встановлення характеру новоутворення, що має забезпечити формування оптимального плану лікування та подальшого спостереження. Наведені рекомендації, незважаючи на свою вичерпність, відіграють лише допоміжну роль для клініциста у прийнятті рішення, остаточно ж стратегія лікування вибудовується для кожного пацієнта індивідуально.
Особливості діагностики та лікування хворих на синдром міріззі
Authors: Tamm T. I. , Mamontov I. N. , Zulfigarov I. , Hamam A. , Barduk A. J. , Zaharchuk A. P.
Published: January 2020

Мета роботи: поліпшити результати лікування хворих на жовчнокам’яну хворобу, ускладнену синдромом Міріззі, шляхом покращення якості його передопераційної діагностики та удосконалення хірургічного лікування через відновлення фізіологічного пасажу жовчі у дванадцятипалу кишку.

Матеріали і методи. Проведено ретроспективний аналіз 898 хворих на гострий холецистит, синдром Міріззі діагностували у 117 хворих, перший тип – у 74, другий тип – у 43 пацієнтів. Комплекс обстеження складався з даних аналізів, клініко-лабораторних методів, променевих методів (ультразвукова діагностика, комп’ютерна томографія), інструментальних методів (фіброгастродуоденоскопія, ендоскопічна ретроградна холангіопанкреатографія). Отримані результати дослідження зіставляли з результатами оперативного лікування.

Результати досліджень та їх обговорення. Аналіз 898 історій хвороби пацієнтів із гострим холециститом показав, що синдром Міріззі було виявлено у 117 (13 %) хворих, зокрема перший тип був у 74 (8,3 %), а другий – у 43 (4,7 %).

З 74 хворих із першим типом ЛХЕ виконана в 43 (58 %) випадках, а у пацієнтів із другим типом синдрому Міріззі лапароскопічна холецистохоледохолітотомія виконана у 3 (6,9 %) хворих. Зі 117 пацієнтів з обома типами синдрому Міріззі у 46 (39,3 %) були виконані лапароскопічні втручання.

У всіх 117 (100 %) хворих було відновлено фізіологічний пасаж жовчі у дванадцятипалу кишку шляхом використання оригінальної техніки оперативних втручань, пріоритетність яких захищена патентами України.

Удосконалення діагностичних прийомів для виявлення синдрому Міріззі та визначення його типу, а також використання нових способів виконання оперативних втручань дало змогу уникнути конверсій та ятрогенних ушкоджень жовчних проток.
Staged surgical treatment of cholangiogenic abscesses of the liver
Authors: Boyko V. V. , Lykhman V. M. , Miroshnichenko D. A. , Merkulov A. A. , Tkach S. V. , Shevchenko A. N. , Moskalenko A. V. , Volchenko I. V.
Published: January 2020

The aim of the work: to improve the results of treatment of patients with cholangiogenic liver abscesses by means of staged treatment methods using minimally invasive interventions.

Materials and Methods. 82 patients with cholangiogenic liver abscesses aged 21 to 80 years who underwent 130 operations were examined and treated. The main group consisted of 40 (48.4 %) patients who underwent ultrasound-controlled drainage of abscess cavities (stage I), followed by removal of the source of cholangiogenic abscesses (stage II). The comparison group consisted of 42 (51.6 %) patients who underwent rehabilitation and drainage only with laparotomy access.

Results and Discussion. Minimally invasive methods of surgical treatment included ultrasound-controlled drainage with simultaneous rehabilitation of abscess cavities. The dimensions of the cavities averaged (150±23.3) cm³. One drainage was used to drain the liver abscess with a diameter of up to 10.0 cm. When the diameter of the abscess was more than 5.0 cm, drainage was carried out by two single-lumen tubes followed by suction-flow washing of the abscess cavity. Monitoring the standing of the drainage and reducing the cavity of abscesses was carried out on 3, 7, 14 days after setting. The drainage tube was removed after the disappearance of the cavity according to ultrasound and control fistulography, which coincided with the normalization of the general condition and body temperature, the disappearance of signs of purulent intoxication. Duration of drainage averaged from 7 to 30 days (an average of 15.2). The proposed treatment method is not very traumatic, the ability to control the effectiveness of the treatment, and most importantly – positive results in 87 % of patients. Second stage in 38 (95 %) was performed laparoscopic cholecystectomy of technical features. The optimal duration of stage II was considered (13±3) days after extraction of the drainage. In the diagnosis and treatment of cholangiogenic liver abscesses, it is necessary to use puncture ultrasound-controlled drainage methods. The stage-by-stage treatment of cholangiogenic liver abscesses with rehabilitation of the abscess cavity made it possible to reduce the incidence of sepsis from 9.5 to 2.5 %, reduce postoperative mortality in extremely severe patients to 2.4 %, and develop complications by 7.3 %.
Кореляція компенсації цукрового діабету 2 типу зі змінами обміну ліпідів після виконання ілеодуоденопластики
Authors: Podpriatov S. Ye. , Podpriatov S. S. , Starchak N. M. , Satsiuk N. M. , Korchak V. P.
Published: January 2020

Мета роботи: оцінити зміни рівнів ліпідів у хворих на цукровий діабет 2 типу після виконання ілеодуоденопластики.

Матеріали і методи. Оцінку рівнів глюкози, глікованого гемоглобіну (ГГ), загального холестерину (ЗХ), тригліцеридів (ТГ), ліпопротеїдів високої щільності (ЛПВЩ), низької щільності (ЛПНЩ) та дуже низької щільності (ЛПДНЩ) у крові проведено у 45 хворих на цукровий діабет 2 типу до та після виконання операції ілеодуоденопластики. Чоловіків було 20, жінок – 25, середній вік (M±m) (27,4±9,5) року. Індекс маси тіла пацієнтів складав від 23,4 до 61,4 кг/см2.

З метою корекції глікемії 12 пацієнтів приймали таблетовані глюкозознижувальні засоби; ін’єкції інсуліну отримували 18 хворих, вперше виявлений цукровий діабет або інсулінорезистентність, ускладнену погано коригованою гіпертонією та серцевою недостатністю ІІ ступеня, діагностовано в 15. Середня (M±Ϭ) тривалість цукрового діабету склала (15,1±7,7) року.

Результати досліджень та їх обговорення. У всіх пацієнтів відмітили швидке і значне зниження рівня ЗХ, що, ймовірно, пов’язане з досягненням компенсації перебігу цукрового діабету 2 типу в ранній термін після виконання ілеодуоденопластики.

Встановлено, що у всіх пацієнтів утримання рівня ЗХ в межах рівня норми у віддалений термін після операції може бути підвалиною стабільності компенсації вуглеводного обміну.

Різноспрямованість змін ТГ та всіх досліджених ліпопротеїдів свідчить про відсутність їх безпосереднього зв’язку з регуляцією обміну вуглеводів.
Оцінка спонтанної та індукованої лігандами TLR2 і TLR4 продукції про- і протизапальних цитокінів у хворих на абдомінальний сепсис
Authors: Polovyi V. P. , Polova S. P. , Solovey Yu. M. , Solovey M. M.
Published: January 2020

Мета роботи: вивчити в динаміці у хворих на абдомінальний сепсис (АС) синтез про- та протизапальних цитокінів та їхній баланс для оцінки їх прогностичної значимості.

Матеріали і методи. Обстежено та прооперовано 36 хворих на абдомінальний сепсис. Усі хворі були розділені на 2 підгрупи порівняння. Підгрупу А хворих на АС склали хворі, які перебували в стаціонарі (14±3) ліжко-днів. У даній підгрупі спостерігався найбільш сприятливий варіант перебігу АС. Підгрупу Б хворих на АС склали пацієнти, які перебували в стаціонарі (40±10) ліжко-днів. У цій групі спостерігали розвиток ряду ускладнень у перебігу АС. Групою контролю слугувала група практично здорових донорів.

Результати досліджень та їх обговорення. Вивчення в динаміці (1–10 доба) профілю цитокінів (ФНО, ІЛ-6, ІЛ-8, ІЛ-10), що продукуються мононуклеарними клітинами периферичної крові хворих на АС спонтанно і під впливом лігандів TLR, дозволило виділити серед обстежуваних хворих дві підгрупи: сприятливий перебіг АС, з одужанням протягом (14±3) ліжко-днів (спонтанна й індукована продукція ІЛ-8 знижувалося до 10 доби, а індукована лігандами TLR продукція протизапального цитокіну ІЛ-10 підвищувалася до 7 доби), та несприятливий, з одужанням протягом (40±10) ліжко-днів (підвищення спонтанного й індукованого лігандами TLR продукції ІЛ-6 з 3 до 10 доби та індукованої лігандами TLR продукція цитокіну ІЛ-10 до 10 доби). У хворих із сприятливим перебігом захворювання баланс прозапальних цитокінів збільшувався за рахунок ІЛ-8, а у хворих з несприятливим перебігом – ІЛ-6, що може слугувати прогностичним критерієм перебігу і наслідків АС, тоді як оцінка показників ФНО виявилася не інформативною.
Оптимальний вибір варіанту розділення анатомічних компонентів черевної стінки при післяопераційних грижах живота великих та гігантських розмірів та профілактика ускладнень
Authors: Feleshtynsky Ya. P. , Smishchuk V. V. , Marshtupa O. S. , Vatamaniuk V. F. , Svyrydovsky S. A.
Published: January 2020

Мета роботи: оптимізувати вибір методики розділення анатомічних компонентів черевної стінки при післяопераційних грижах живота великих та гігантських розмірів.

Матеріали і методи. Проведено аналіз хірургічного лікування 215 пацієнтів з післяопераційними грижами живота (ПГЖ) великих та гігантських розмірів віком від 30 до 75 років (середній вік 54,7±3,3) за період з 2012 по 2019 рр. Жінок було 137 (63,7%), чоловіків – 78 (36,3%). Вибір варіанту CST у поєднанні з алопластикою при ПГЖ великих та гігантських розмірів виконували під час операції з урахуванням середніх показників ВЧТ при контактному зведенні прямих м’язів. Групу порівняння складали 82 пацієнти, яким в період з 2008 по 2011 рр. виконувалася ACST+onlay без врахування рівня ВЧТ.

Результати досліджень та їх обговорення. Оптимізація вибору варіанту CST при ПГЖ великих та гігантських розмірів може бути досягнута шляхом визначення ВЧТ під час операції при контактному зведенні прямих м’язів живота. Так, при ВЧТ (5,4±2,1) мм рт. ст. (0,7±0,3 кПа) оптимальним варіантом є ACST, при ВЧТ (9,1±2,3) мм рт. ст. (1,2±2,3 кПа) – PCST, при ВЧТ (14,1±2,3) мм рт. ст. (1,9±0,3 кПа) – TAR.

Використання диференційованого підходу до вибору варіанту CST у поєднанні з алопластикою при великих та гігантських ПГЖ з урахуванням ВЧТ сприяє покращенню результатів лікування, а саме зменшується частота АКС до 0,5 % проти 4,9 % у групі порівняння, сероми – до 15,8 % проти 25,6 %, інфікування післяопераційної рани – до 1,4 % проти 4,9 %, хронічного післяопераційного болю – до 4,2 % проти 8,1 %, рецидиву ПГЖ – до 1,4 % проти 8,1 %.
Effect of direct current electric field on the rate of wound epithelization in patients with diabetic foot syndrome
Authors: Yakobchuk S. O. , Iftodiy A. H. , Grodetskyi V. K. , Fundiur V. D. , Khomko O. Y.
Published: January 2020

The aim of the work: to study the development of wound process in dynamics by means of examination of impression smear from the wounds of patients with diabetic foot syndrome by means of Pokrovska-Makarova method, planimetric examination by means of L. M. Popova method in case of treatment by traditional methods combined with galvanization of an afflicted lower limb and application of interstitial Berlithion electrophoresis.

Materials and Methods. 113 patients with complicated forms of diabetic foot syndrome were examined and treated. Group 1 of patients underwent a traditional course of treatment, whereas a complex of treatment measures was complemented with galvanization of the affected lower extremity for the patients of group 2 at an early stage of the postoperative period. The patients of group 3 were additionally treated with local interstitial electrophoresis of Berlithion during an early stage of the postoperative period. A control over the dynamics of the wound process was carried out by means of estimating wound impression smears.

Results and Discussion. A comparison of the rate of the transition of the cytological picture of impression smears from the inflammatory type to the regenerative, regenerative-inflammatory and finally to the regenerative types demonstrated that these processes among patients of 1st group occurred, on an average, during 20 days, among patients of the group 2 during 16 days and group 3 – during 14 days. Reducing the area of injury in patients of group 1 is ≈ 1 % per day, patients in group 2 – 2 %, followed by – 2.1–2.2 % per day and patients in group 3 speed up wound area reduction on an average 3 %. Therefore, under effect of direct current of electric field an inflammatory type of cytogram was found mainly from the 3–4 to 7–8th days compared with the control group, where these phenomena were found from the 3-4 to the 11–12th days. Approximately similar dynamics was found in case of ISEP action with Berlithion. When the wound process is passed into the second phase which is evidenced by the appearance of inflammatory impression smear, the rate of regeneration appeared to be the highest in the group of patients who received interstitial electrophoresis with Berlithion.
Хірургічні проблеми вторинного і третинного гіперпаратиреозу в діалізних пацієнтів із хронічною нирковою недостатністю
Authors: Desyaterik V. I. , Mikhno S. P. , Zalozny O. V. , Litvin A. M.
Published: January 2020

Мета роботи: визначення поширенності гіперпаратиреозу у пацієнтів з хронічною нирковою недостатністю (ХНН), які проходили лікування з використанням діалізних технологій та аналіз результатів його хірургічного лікування.

Матеріали і методи. Дослідження проведено на основі вивчення медичної документаціїї 89 пацієнтів, які лікувалися у відділенні нефрології міської клінічної лікарні № 2 міста Кривого Рогу за 2014–2018 рр. Всі пацієнти проходили лікування ХНН із застосуванням діалізних методів. Серед пацієнтів першої групи 66 (74,2%) хворих були на гемодіалізі (ГД), другої – 23 (25,8 %) на перитоніальному діалізі (ПД). За статтю в обох групах переважали чоловіки: відповідно 49 (55,1 %) та 40 (44,9 %) – жінки. Середній вік пацієнтів першої групи з ГД складав (35±6,4) року, другої з ПД – 43±12,4. Середній термін діалізу у першій групі складав (9,6±2,3) року, у другій – 5,4±3,7.

Результати досліджень та їх обговорення. Серед основних критеріїв до хірургічного лікування гіперпаратиреозу у діалізних пацієнтів визначено клінічні, лабораторні та інструментальні показники.