bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute ischemic stroke with cervical internal carotid artery steno-occlusive lesion: multicenter analysis of endovascular approaches
Authors: Cirillo Luigi , Romano Daniele Giuseppe , Vornetti Gianfranco , Frauenfelder Giulia , Tamburrano Chiara , Taglialatela Francesco , Isceri Salvatore , Saponiero Renato , Napoletano Rosa , Gentile Mauro , Romoli Michele , Princiotta Ciro , Simonetti Luigi , Zini Andrea
Published: April 2021

Background

Occlusions of internal carotid artery (ICA), whether isolated or in tandem lesions (TL) have a poor response to treatment with intravenous thrombolysis. Previous studies ​​have demonstrated the superiority of mechanical thrombectomy in the treatment of acute ischemic stroke (AIS) following large vessel occlusion, compared to standard intravenous fibrinolysis. The aim of our study was to describe endovascular treatment (EVT) in AIS due to ICA occlusion, whether isolated or in TL.
Methods

we assessed the association between 90-day outcome and clinical, demographic, imaging and procedure data in 51 consecutive patients with acute isolated ICA or TL occlusion who underwent endovascular treatment (EVT). We evaluated baseline NIHSS and mRS, ASPECTS, type of occlusion, stent placement, use of stent retrievers and/or thromboaspiration, duration of the procedure, mTICI, procedural therapy and complications.
Results

A favorable 90-day outcome (mRS 0–2) was achieved in 34 patients (67%) and was significantly associated with the use of dual antiplatelet therapy after the procedure (p = 0.008), shorter procedure duration (p = 0.031), TICI 2b-3 (p < 0.001) and lack of post-procedural hemorrhagic transformation (p = 0.001). Four patients did not survive, resulting in a mortality rate of 8%
Conclusions

EVT in the treatment of AIS due to ICA occlusion is safe and effective; mortality rates are in agreement with the current literature. The use of the stent is safe and promotes good angiographic results, as well as therapy with a GpIIb / IIIa inhibitor immediately after stent release which is also associated with better 3-month outcome and good revascularization.
SI on economic costs of invasions - Feeling the pinch: global economic costs of crayfish invasions and comparison with other aquatic crustaceans
Authors: Kouba Antonin , Oficialdegui Francisco J. , Cuthbert Ross N. , Kourantidou Melina , South Josie , Tricarico Elena , Leroy Boris , Gozlan Rudolphe , Courchamp Franck , Haubrock Phillip J
Published: April 2021

Despite voluminous literature identifying invasive species impacts, understandings of monetary costs remain limited. Recently, profound impacts have been attributed to invasive crustaceans, but associated monetary costs lack synthesis. Here, we analyse globally reported costs of invasive freshwater crayfish across taxonomic, spatial and temporal descriptors. Moreover, we compare their cost magnitude to other invasive crustaceans — crabs, amphipods and lobsters. Between 2000 and 2020, crayfish caused US$ 1.28 billion in reported costs; the vast majority (95%) attributed to Astacidae (principally the signal crayfish Pacifastacus leniusculus) and the remainder to Cambaridae. According to reports, crayfish costs mostly impacted European economies (US$ 1.23 billion), followed by costs reported for North America and Asia. Despite well-known damages caused by invasive crayfish, costs were unreported elsewhere, highlighting knowledge gaps and challenges in cost quantifications. Invasive crayfish costs increased exponentially in the last two decades, averaging at US$ 61 million per-annum. Invasive crabs caused costs of similar magnitude (US$ 1.25 billion; US$ 53 million per-annum) but were mostly confined to North America (95%). Damage-related costs dominated for both crayfish (83%) and crabs (99%), with management spending lacking. Reported economic impacts from amphipods (US$ 178.8 thousand) and lobsters (US$ 44.6 thousand) were considerably lower. We identify burgeoning economic costs from these invasive groups yet highlight pervasive knowledge gaps at multiple scales. Further cost reporting is required to better-ascertain the true scale of monetary costs caused by invasive aquatic crustaceans.
Enhancing osteoblast function through pulsed electrical stimulation: implications for peri-implant healing and osseointegration
Authors: Pettersen Emily , Shah Furqan A. , Ortiz-Catalan Max
Published: April 2021

Electrical stimulation has been suggested as a mean for promoting the bonding of bone tissue to an implant, known as osseointegration. Previous work has investigated the impact of electrical stimulation in different models, both in vitro and in vivo, using various electrode configurations for delivering the electric field and with a wide range of stimulation parameters. However, there is no consensus on optimal electrode configuration nor stimulation parameters. Here, we investigated a novel approach of delivering electrical stimulation to a titanium implant using parameters clinically tested in a different application, namely peripheral nerve stimulation. We propose an in vitro model comprising of Ti6Al4V implants precultured with MC3T3-E1 preosteoblasts, stimulated for 72 h at two different pulse amplitudes (10 µA and 20 µA) and at two different frequencies (50 Hz and 100 Hz). We found that pulsed electrical stimulation enhances cell viability (and/or proliferation) and collagen production in an approximately dose-dependent manner. Our findings suggest that pulsed electrical stimulation with characteristics similar to peripheral nervous stimulation has the potential to accelerate osteoblast function and may provide a promising approach to improving peri-implant bone healing, particularly to neuromusculoskeletal interfaces in which implanted electrodes are readily available.
Health services for Indigenous children in remote Australia: a strategic literature review
Authors: Dossetor Philippa Jane , Thorburn Kathryn , Oscar June , Carter Maureen , Jeffery Heather E , Harley David , Elliott Elizabeth Jane , Martiniuk Alexandra LC
Published: April 2021

Introduction: There is a significant gap between health outcomes in Indigenous and non-Indigenous children, which may relate to inequity in health service provision, particularly in remote areas. We aim to review the literature to describe health services and their use by children living in remote Australia, comparing them to best practice models to identify opportunities for improvements.Methods: Electronic-databases of medical literature were searched from Jan 1990 to Dec 2013. Grey literature was identified through investigation of websites, including local, state and national health departments. Essential information was extracted and summarised for papers meeting inclusion criteria for the review.Results: A total of 45 titles was identified in a strategic search of electronic medical databases and 47 in the grey literature. Strict inclusion and exclusion criteria applied. Data were extracted from 92 documents.Conclusions: Barriers exist to effective child health service delivery in remote Australia including availability and access. Existing services cannot meet demand. Gold standard models for service delivery incorporating community engagement and collaboration should be explored. Increased resources and focus on primary prevention and health promotion are essential.
Predictors of 30-Day Mortality Using Machine Learning Approach following Carotid Endarterectomy: An Insight from National Surgical Quality Database
Authors: Fatima Nida , MD FR FAHA Ashfaq Shuaib , MD F MPH Maher Saqqur
Published: April 2021

BACKGROUND: Pre-operative prognostication of 30-day mortality in patients with carotid endarterectomy (CEA) can optimize surgical risk stratification and guide the decision-making process to improve survival. To develop and validate a set of predictive variables of 30-day mortality following CEA.METHODS: The patient cohort was identified from the American College of Surgeons National Surgical Quality Improvement Program (2005-2016). We performed logistic regression (enter, stepwise and forward) and least absolute shrinkage and selection operator (LASSO) method for selection of variables, which resulted in 28-candidate models. The final model was selected based upon clinical knowledge and numerical results.RESULTS: Statistical analysis included 65,807 patients with 30-day mortality in 0.7% (n=466) patients. The median age of our cohort was 71.0 years (range, 16-89 years). The model with 9-predictive factors which included: age, body mass index, functional health status, American society of anesthesiologist grade, chronic obstructive pulmonary disorder, preoperative serum albumin, preoperative hematocrit, preoperative serum creatinine and preoperative platelet count—performed best on discrimination, calibration, Brier score and decision analysis to develop a machine learning algorithm. Logistic regression showed higher AUCs than LASSO across these different models. The predictive probability derived from the best model was converted into an open-accessible scoring system.CONCLUSION: Machine learning algorithms show promising results for predicting 30-day mortality following CEA. These algorithms can be useful aids for counseling patients, assessing pre-operative medical risks, and predicting survival after surgery.
Solar zenith angle dependence of relationships between energy inputs to the ionosphere and ion outflow fluxes
Authors: Kitamura Naritoshi , Seki Kanako , Keika Kunihiro , Nishimura Yukitoshi , Hori Tomoaki , Hirahara Masafumi , Lund Eric J , Kistler Lynn M , Strangeway Robert J
Published: April 2021

The ionosphere is one of the important sources for magnetospheric plasma, particularly for heavy ions with low charge states. We investigate the effect of solar illumination on the number flux of ion outflow using data obtained by the Fast Auroral SnapshoT satellite at 3000–4150 km altitude from 7 January 1998 to 5 February 1999. We derive empirical formulas between energy inputs and outflowing ion number fluxes for various solar zenith angle ranges. We found that the outflowing ion number flux under sunlit conditions increases more steeply with increasing electron density in the loss cone or with increasing precipitating electron density (> 50 eV), compared with the ion flux under dark conditions. Under ionospheric dark conditions, weak electron precipitation can drive ion outflow with small averaged fluxes (~ 107 cm− 2 s− 1). The slopes of relations between the DC and Alfvén Poynting fluxes and outflowing ion number fluxes show no clear dependence on solar zenith angle. Intense ion outflow events (> 108 cm− 2 s− 1) occur mostly under sunlit conditions (solar zenith angle < 90°). Thus, it is presumably difficult to drive intense ion outflows under dark conditions, because of a lack of the solar illumination (low ionospheric density and/or small scale height owing to low plasma temperature).
Outcomes of Ahmed Glaucoma Valv Implantation in Patients with Pars Plana Vitrectomy History
Authors: Subasi Sevgi , Yuksel Nursen , Karabas Levent Veysel , Tugan Busra Yilmaz , Basaran Ece
Published: April 2021

Background and Objective: Ahmed glaucoma valv (AGV) implantation is one of the successful surgical methods in secondary glaucoma that develops after pars plana vitrectomy (PPV). In our study, we aimed to evaluate the 1-year results of AGV implantation in patients with a history of PPV.Study Design: A total of 26 patients who underwent AGV implantation after PPV were included in our retrospective study. Fourteen of 26 patients had AGV implantation due to neovascular glaucoma (NVG) and 12 of them had secondary refractory galucoma. Data of these two groups of patients were evaluated in terms of IOP reduction, number of medication use, surgical complete and qualified success, surgical failure, and complications.Results: The mean IOP was 29.54±4.87 mmHg at the preoperative of AGV implantation and 12.88±4.17 at the twelfth month visit in overal group. There was no statistically significant difference between two groups in terms of IOP in preoperative and all postoperative visits (p>0.05). The mean intervals between PPV and AGV implantation were 67 ± 34 days in NVG and 391 ± 500 days in non-NVG group (p=0.017). In overal group, 91.7% of patients had improvement in BCVA at the twelfth month visit. Complete and qualified surgical success rates were 75%, 83.3% in NVG group and 50%, 91.7% in non-NVG group respectively. There was no devastating complication in both group.Conclusion: AGV implantation is a safe and effective surgical method in uncontrolled IOP elevations after PPV. While surgical success and failure rates was similar between etiologies, the time required for AGV implantation after PPV was shorter in NVG etiology.
Possibilities of preoperative assessment of the risk of an adverse outcomes after abdominal surgery: preliminary results of the multicenter STOPRISK study
Authors: Zabolotskikh Igor B. , Trembach N. V. , Magomedov M. A. , Krasnov V. G. , Chernienko L. Yu. , Shevyrev S. N. , Popov A. S. , Tyutyunova E. V. , Vatutin S. N. , Malyshev Yu. P. , Popov E. A. , Smolin A. A. , Kitiashvili I. Z. , Dmitriev A. A. , Grigoryev E. V. , Kameneva E. A. , Fisher V. V. , Volkov E. V. , Levit D. A. , Sharipov A. M. , Khoronenko V. E. , Shemetova M. M. , Kokhno V. N. , Polovnikov E. V. , Spasova A. P. , Mironov A. V. , Davydova V. R. , Shapovalov K. G. , Gritsan A. I. , Lebedinskii K. M. , Dunts P. V. , Rudnov V. A. , Stadler V. V. , Bayalieva A. Zh. , Prigorodov M. V. , Voroshin D. G. , Ovezov A. M. , Martynov D. V. , Zamyatin M. N. , Voskanyan S. E. , Astakhov A. A. , Khoteev A. Zh. , Protsenko D. N.
Published: April 2021

Introduction. Despite the advances in modern anesthesiology, it is impossible to guarantee a safe course of anesthesia, and even with planned surgical interventions, there is a risk of death. At present, there is no unanimity in approaches to assessing perioperative risk, and many systems for determining this risk have not been validated in Russia. The question of the contribution of pre-operative factors to the likelihood of an unfavorable outcome also remains open, which requires large multicenter national studies.
Objectives. To assessment the predictive value of preoperative factors in determining the risk of death and complications based on the analysis of data obtained during the first year of the STOPRISK study.
Materials and methods. An analysis of data on perioperative indices of 3002 patients operated on the abdominal and pelvic organs from 30 centers in 21 cities of Russia participating in the STOPRISK study is presented.
Results. The mortality rate in the study was 0.47 %, the rate of postoperative complications was 3.9 %. Most often, an unfavorable outcome developed after upper abdominal and colorectal surgery. Despite the fact that the severity of surgery and the ASA class are independent predictors of an unfavorable outcome, the use of these parameters allows to predict postoperative mortality (AUROC = 0.85) and (with age) postoperative complications (AUROC = 0.77) with limited accuracy.
Conclusions. Thus, the probability of an unfavorable outcome can be estimated using factors such as the severity of surgery and the initial physical status, but their predictive value for determining the risk of mortality is clearly insufficient, and even less is their ability to assess the risk of postoperative complications. As shown by literature data, inclusion in model additional risk factors allows to increase the accuracy of the forecast, however, given the peculiarities of the structure of comorbidities and their impact on outcome in the studied population, we need further evaluation of their contribution to perioperative risk. Also, taking into account the peculiarities of the occurrence of some concomitant diseases, further research is required to identify a significant impact on mortality and postoperative complications.
Predicting of enteral nutrition intolerance in critically ill patients
Authors: Sivkov Oleg G. , Leiderman I.N. , Lutciuk M. I.
Published: April 2021

Even in minimal morphological changes in the gut of critically ill patients, its ability to absorb nutrients, drugs and, in particular, acetaminophen is reduced. The search for a simple and accessible clinical method that allows to assess the possibility of enteral nutrition is rather actual.
Objectives. To assess the prognostic value of the acetaminophen enteral absorption test in critically ill patients.
Materials and methods. A single-center, prospective study was performed in 52 patients of the polyvalent intensive care unit (ICU). 0.5 g of paracetamol was injected into the nasogastric tube. After 10, 15, 20, 30, 40, 50 and 90 minutes 5 ml of venous blood was taken to determine the concentration of acetaminophen in it. On the next day the volume of administered and excreted via a nasogastric tube was recorded. Healthy volunteers (n = 12) were included in group 1. The second group (n = 15) — a positive balance by the nasogastric tube, the third group (n = 15) — the balance is negative up to 500 ml per day, the fourth — negative up to 1 liter per day, the fifth group — negative > 1 liter per day. To identify the predictive value and cutoff values of the test, the data were analyzed using the logistic regression method, and then the ROC analysis. The authors received permission from the local ethics committee.
Results. The most informative time interval for determining the concentration of paracetamol in the blood after its administration into the stomach is the interval from 15 to 30 minutes. A strong correlation (r = 0.846 [p < 0.001]) was found out between the results of the paracetamol test and the daily balance by the nasogastric tube. ROC analysis showed that the sensitivity of this test exceeds 86 %, and the specificity was about 75 %. If the concentration of paracetamol in the blood is > 6.17 μg/ml successful total enteral nutrition is highly possible. The values of this indicator in the range from 2.47 μg/ml to 6.17 μg/ml can serve as the basis for the implementation of the method of partial enteral nutrition. We believe that at levels < 2.47 mcg/ml, a “minimal enteral nutrition” attempt can be made.
Conclusion. The paracetamol absorption test in critically ill patients can be considered as an independent predictor of the feasibility of enteral zone feeding. Predicting enteral feeding intolerance using the paracetamol absorption test in critically ill patients can significantly improve the efficacy and safety of tube feeding method.
Cryoanalgesia. Review
Authors: Svirskii Dmitrii A. , Antipin E. E. , Bochkareva N. A. , Ibragimov A. T. , Yakovenko M. P. , Nedashkovskii E. V.
Published: April 2021

Cryoanalgesia, also known as cryoneurolysis or cryoneuroablation, is one of the most effective interventional methods for pain management, which allows providing high-quality long-term analgesia by low-temperature destruction of the nerve membranes of sensory or mixed nerves. Our review is devoted to the history of the use of cold for medical purposes, a description of the physical basis of the method and equipment used for cryoanalgesia, various clinical aspects and technical features of the procedure, as well as indications and contraindications, with a clinical description of various conditions that can be treated using interventional methods of pain management.
Consensus technologies in the analysis of guidelines
Authors: Zabolotskikh Igor B. , Grigoryev S. V. , Belkin A. A. , Lakhin R. E.
Published: April 2021

Consensus technologies in the analysis of guidelines
Anaesthesia for day case surgery. Review
Authors: Kuklin Vladimir N.
Published: April 2021

Discharging patients from day case surgery (DCS) units at day of procedure makes high demands on staff professionalism. With DCS development, both lists of surgical operations and their complexity are progressively increasing. Selection of patients for surgical treatment in DCS is based on patient’s condition and stability of chronic diseases. Upon admission to DCS of Scandinavian countries, there is no need for blood tests, ECG or X-ray. Questionnaires filled in by patients help anaesthesiologists identify almost all pathology that affect safe anaesthesia, and additional examination methods are used at doctor’s discretion. Multimodal premedication is the basis for postoperative analgesia. Premedication with sedatives is indicated mainly for children. For the safe treatment of patient, the correct and logical DCS organisation is much more important than the type of anaesthesia used in this department. However, the choice of anaesthesia can significantly affect the manifestation of side effects, the time of restoration of the patient’s normal functionality and, ultimately, the duration of the patient’s stay in DCS. Spinal anaesthesia is safe and easy to perform, but its use in the DCS can lead to delays in the patient’s discharge, and sometimes to need for hospitalisation. Inhalation anaesthetics increase significantly the number of patients (up to 30 %) with postoperative nausea, vomiting and chills. That why, total intravenous anaesthesia with Propofol and Remifentanil is the most commonly used in Scandinavian countries. Regional anaesthesia under ultrasound control provides effective postoperative analgesia. For the relief of acute postoperative pain, it is necessary to use low doses of intravenous opioids. Use of Clonidine as an adjuvant in postoperative pain treatment helps enhance the analgesic effect of opioids. Patient discharge from DCS should be based on established criteria.
Perioperative iron deficiency anemia in obstetrics. Possibilities of prevention and correction. Review
Authors: Kulikov Alexander V. , Shifman E. M. , Matkovsky A. A. , Kayumova A. V. , A. M.
Published: April 2021

In the review diagnostics and correction of iron deficiency anemia (IDA) is considered during pregnancy and in the perioperative period within the concept of “patient blood management”. Features of diagnosis of anemia and verification of an iron deficiency (ID) are discussed during pregnancy, correction stages with use of oral and intravenous iron, transfusion erythrocytes and reinfusion of blood. Data on advantage of intravenous iron to correction of ID and IDA are provided during pregnancy and in the perioperative period.
Anesthesia and intensive care for patients with COVID-19. Russian Federation of anesthesiologists and reanimatologists guidelines
Authors: Zabolotskikh Igor B. , Kirov M. Yu. , Lebedinskii K. M. , Protsenko D. N. , Avdeev S. N. , Andreenko A. A. , Arsentyev L. V. , Afonchikov V. S. , Afukov I. I. , Belkin A. A. , Boeva E. A. , Bulanov A. Yu. , Vasiliev Ya. I. , Vlasenko A. V. , Gorbachev V. I. , Grigor’ev E. V. , Grigor’ev S. V. , Gritsan A. I. , Eremenko A. A. , Ershov E. N. , Zamyatin M. N. , Ivanova G. E. , Kuzovlev A. N. , Kulikov A. V. , Lakhin R. E. , Leiderman I. N. , Lenkin A. I. , Mazurok V. A. , Musaeva T. S. , Nikolaenko E. M. , Orlov Yu. P. , Petrikov S. S. , Roitman E. V. , Ronenson A. M. , Smetkin A. A. , Sokolov A. A. , Stepanenko S. M. , Subbotin V. V. , Ushakova N. D. , Khoronenko V. E. , Tsarenko S. V. , Shifman E. M. , Shukevich D. L. , Shchegolev A. V. , Yaroshetskiy A. I. , Yarustovsky M. B.
Published: April 2021

The article provides the main statements of the guidelines for the anesthesia and intensive care of patients with the coronavirus disease (COVID-19), developed by the Federation of Anesthesiologists and Reanimatologists of Russia. In the process of developing the recommendations, the publications of the official websites of the Russian Federation, the electronic databases of the RSCI, PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were analyzed by the developers independently of each other. The date of the last search query was February 01, 2021. To develop the recommendations for the Guidelines, were used documents directly describing the features of the management of patients with NCI COVID-19 (guidelines — 34; randomized clinical trials and Cochrane Reviews — 13; observational and comparative studies — 107; other documents, notes and comments — 64), and documents describing anesthesia and intensive care in the general population of patients. Compared to the previous 4th version of the guidelines, the recommendations in 8 sections have been corrected; new subsections “Chronic kidney disease”, “Rehabilitation treatment of patients with COVID-19 in the intensive care unit”, “Routing of patients with COVID-19 to the stages of rehabilitation” were created; revised 1 Appendix, additionally developed 7 Appendices; the section “Quality criteria” has been supplemented. The provisions of the current version of the guidelines highlight the specifics of anesthesia, intensive care, rehabilitation, resuscitation measures, manipulation, transportation, prevention of the spread of COVID-19 in the implementation of these activities. Methods of protecting personnel from infection with COVID-19 during manipulations, anesthesia and intensive care are considered. The features of respiratory support, extracorporeal detoxification, extracorporeal membrane oxygenation, thromboprophylaxis, drug interactions are described. The features of management of pregnant women, children of different age groups, patients with concomitant diseases, the principles of the formation of stocks of drugs and consumables are considered.
Factors for Sustaining Molecular Remission after Discontinuation of Tyrosine Kinase Inhibitors Therapy in Chronic Myeloid Leukemia: Results of Non-Randomized Prospective Clinical Trial
Authors: Shukhov Oleg Aleksandrovich , Petrova A.N. , Chelysheva E.Yu. , Bykova A.V. , Nemchenko I.S. , Turkina A.G.
Published: April 2021

Aim. To study the impact of different clinical and biological factors on sustaining molecular remission after discontinuation of tyrosine kinase inhibitors (TKI) therapy in chronic myeloid leukemia (CML) patients with a stable deep molecular response (MR). Materials & Methods. The prospective multi-center trial on molecular remission sustainability after TKIs withdrawal, held from 2015 to 2019, enrolled 98 CML patients. The trial included patients with chronic phase CML treated with TKIs at least during 3 years and having a stable deep MR (< МО4; BCR-ABL < 0.01 %) during at least 2 years. Molecular monitoring was carried out every month during first 6 months after TKIs withdrawal, every 2 months during 0.5-1 year, and every 3 months after 1-year follow-up. In case of the loss of major MR (BCR-ABL > 0.1 %) therapy was reinitiated. Results. Three-year molecular relapse-free survival was 51 % (95% confidence interval 41-61 %) in all patients, 25 % in patients with the failure of prior treatment discontinuation, and 53 % in patients who discontinued TKI therapy for the first time. According to univariate analysis, the following factors proved to be significant: persistance of deep MR, duration of therapy, and depth of MR. It was shown that TKI therapy duration, but not deep MR persistance, has independent prognostic value for the Russian population of CML patients. No significant differences were identified in 3-year molecular relapse-free survival in the groups of patients treated only with imatinib (55 %) compared with patients who received 2nd generation TKI (TKI2) as first-line (70 %; p = 0.26) and second-line (39 %; p = 0.09) therapy. However, duration of therapy in patients treated with TKI2 as first-line therapy was more than twice as short as in patients treated with imatinib as first-line therapy (median 41.5 vs. 96.4 months, respectively; p < 0.0001). Conclusion. Longer therapy duration and MR depth (< M04.5) before TKI withdrawal raise the probability of sustaining off-treatment remission. The study showed that molecular relapse-free survival does not significantly increase with the use of TKI2 as first-line treatment compared to imatinib. Nevertheless, TKI2 as first-line treatment enables to halve the duration of therapy needed to achieve comparable molecular relapse-free survival, as compared with imatinib.
Gynecological Myeloid Sarcoma: Literature Review and a Case Report
Authors: Shatilova Aleksina Alekseevna , Girshova L.L. , Zaitsev D.V. , Budaeva I.G. , Mirolyubova Yu.V. , Ryzhkova D.V. , Grozov R.V. , Bogdanov K.V. , Nikulina T.S. , Motorin D.V. , Zammoeva D.B. , Efremova S.V. , Ivanov V.V. , Petukhov A.V. , Alekseeva Yu.A. , Zaritskey A.Yu.
Published: April 2021

Myeloid sarcoma, also known as chloroma or granulocytic sarcoma, is a rare disease characterized by the proliferation of immature myeloid cells in extramedullary lesions. Chloroma is more commonly observed in patients with acute myeloid leukemias, other myeloproliferative neoplasms, or myelodysplastic syndrome. However, it can also manifest itself as solitary tumor. Sarcoma can develop in different organs and tissues, but most frequently it appears in lymph nodes, soft tissues, and bones. Myeloid sarcoma with primary gynecological lesion is very rarely mentioned. In literature cases of cervical lesions are described. The present article summarizes the literature data concerning different aspects of myeloid sarcoma diagnosis and treatment. The issue under discussion is the role of chemotherapy, radiotherapy, surgery, and bone marrow transplantation in the treatment of this malignant tumor. It appears that whatever the primary tumor localization, the best treatment options are chemotherapy and allogeneic bone marrow transplantation (allo-BMT). A promising trend is the use of novel targeted drugs improving outcomes of treatment. The article provides a case report of a female patient with cervical myeloid sarcoma and concomitant bone marrow involvement, as well as the description of clinical course, diagnosis, and treatment. The patient received chemotherapy with subsequent allo-BMT. The pre-transplant therapy enabled allo-BMT with the deepest response possible. The patient achieved PET-and MRD-negative complete remission of cervical myeloid sarcoma and bone marrow.
Ph-Negative Myeloproliferative Neoplasms: Diagnosis and Treatment Challenges in Russia (the Case of Saint Petersburg)
Authors: Ivanova Mariya Olegovna , Morozova E.V. , Barabanshchikova M.V. , Afanasyev B.V.
Published: April 2021

Ph-negative myeloproliferative neoplasms (MPN) are rare oncohematological diseases characterized by long duration and indolence. World epidemiological data on these diseases considerably vary depending on geographical area and time frame of the study. The breakthrough in the understanding of MPN pathogenesis, observed in the early 2000s, enabled to elaborate approaches to differential diagnosis and treatment of Ph-negative MPNs as well as to improve their prognosis. Although these approaches are specified in the Russian clinical guidelines, physicians still face challenges in their implementation in practice. The present review provides a detailed description and analysis of literature data on epidemiology, pathogenesis, and principles of Ph-negative MPN diagnosis and treatment. It also describes the situation in Saint Petersburg as an example of existing challenges in management of patients with Ph-negative MPNs in Russia and offers potential solutions.
Organ Lesions in Adults with Secondary Hemophagocytic Syndrome
Authors: Potapenko Vsevolod Gennadevich , Klimovich A.V. , Avdoshina D.D. , Baikov V.V. , Vinogradova N.V. , Goloshchapov O.V. , Doguzhieva E.V. , Zinina E.E. , Kachenya G.V. , Krivolapov Yu.A. , Karyagina E.V. , Kulibaba T.G. , Lapin S.V. , Leenman E.E. , Pavlyuchenko E.S. , Potikhonova N.A. , Pervakova M.Yu. , Popova N.B. , Rysev A.V. , Ryabchikova V.V. , Surkova E.A. , Fedunyak I.P. , Medvedeva N.V.
Published: April 2021

Background. Secondary hemophagocytic syndrome (SHPS) is a reaction of systemic hyperinflammation triggered by infectious, tumor, or autoimmune processes. With no immunosuppressive (modulating) therapy most patients die from multiple organ failure. Aim. To describe organ lesions characteristic of SHPS patients. Materials & Methods. The retrospective study included patients treated from June 2009 to June 2019. SHPS was diagnosed using HLH-2004 criteria and H-Score. The analysis focused on the incidence and character of lesions in lungs, central nervous system, liver, skin, and cardiovascular system. All patients with persistent fever received anti-infective treatment with broad-spectrum antibiotics in line with local hospital practice. Patients with collagenosis and tumors, which caused SHPS, received standard immunosuppressive and antitumor therapy, respectively. Results. The analysis covered the data of 91 patients (41 man and 50 women), median age was 58 years (range 2-90 years). SHPS was caused by hematological malignancies (n = 52; 57 %), infections (n = 11; 12 %), autoimmune diseases (n = 5; 6 %), and allogeneic hematopoietic stem cell transplantation (n = 13; 14 %). In 10 (11 %) patients no cause was identified. Immunosuppressive therapy was administered to 71 (78 %) patients. Overall survival was 27 % (median 15 days) with median follow-up for alive of 540 days (range from 7 days to 10 years). Clinically significant organ lesions were identified in 76 (83 %) patients. Most commonly SHPS was reported together with polyserositis, respiratory and hepatic disorders, and neurological symptoms from focal deficit to seizure status. Less often skin lesions (from macular rash to epidermolysis bullosa) and such cardiovascular disorders as arrhythmia and/or arterial hypotension were observed. The effective SHPS therapy resulted in restoration of organ functions. Conclusion. SHPS can cause respiratory disorders, polyserositis, different neurological disorders, cytopenia in patients with unexplained fever and cytolytic and/or cholestatic syndrome. Primary organ lesions as well as clinical and laboratory manifestations of SHPS may vary in different patients.
Quality Assessment of Globally Available Digital Elevation Model (DEM) for Mountainous Region
Authors: Gyeltshen Sangay , Subedi Krisha Kumar , Kamoliddinovna Laylo Zaridinova , Tenzin Jigme
Published: April 2021

The study assessed the accuracies of globally available Digital Elevation Models (DEM’s) i.e., SRTM v3, ASTER GDEM v2 and ALOS PALSAR DEM with respect to Topo-DEM derived from topographic map of 5m contour interval. 100 ground control points of the elevation data were collected with the help of kinematic hand held GNSS (Global Navigation Satellite System), randomly distributed over the study area. The widely used RMSE statistic, NCC correlation and sub-pixel-based approach were applied to evaluate the erroneous, correlation, horizontal and vertical displacement in terms of pixels for the individual Digital Elevation Model. Following these evaluations, SRTM DEM was found to be highly accurate in terms of RMSE and displacement compared to other DEMs. This study is intended to provide the researchers, GIS specialists and the government agencies dealing with remote sensing and GIS, a basic clue on accuracy of the DEMs so that the best model can be selected for application on various purposes of the similar region.
Colitis ulcerativa para no gastroenterólogos
Authors: Zuluaga Arbeláez Nicolás , Sierra Vargas Elsy Cristina , Díaz Coronado Juan Camilo , Guevara Casallas Luis Gonzalo
Published: April 2021

La colitis ulcerativa es una enfermedad intestinal inflamatoria crónica, de etiología idiopática y fisiopatología multifactorial, caracterizada por la inflamación de la mucosa rectal, con extensión proximal, continua y simétrica a través del colon. Su diagnóstico se establece a partir de los hallazgos clínicos, endoscópicos e histológicos. La meta terapéutica es lograr la remisión clínica y  endoscópica, reducir el riesgo de colectomía, cáncer colorrectal y mejorar la calidad de vida de los pacientes. Se realizó una búsqueda de artículos científicos y se exponen los aspectos más relevantes y actualizados sobre la enfermedad; con el objetivo de proporcionar elementos para su abordaje diagnóstico y terapéutico.
QAnon: A rising threat to democracy?
Authors: Bellaiche Julien
Published: April 2021

On November 27, 2020, Julien Bellaiche presented on QAnon: A rising threat to democracy? on the Security Ecosystem and New Norms panel, at the 2020 CASIS West Coast Security Conference. Primary discussion topics included QAnon, an overview of the movement, the aspects of human ideology that seem to be fundamentally at odds with democracy, as well as the main challenges QAnon possibly poses to democracy. This presentation was followed by a group panel for questions and answers, whereby conference attendees were provided with an opportunity to engage in discussion with Mr. Bellaiche and other panel presenters for that day.
Secure mitigation and migration of virtual machines over hybrid cloud hypervisors infrastructure
Authors:   Department of Information Technology, College of Computer Sciences and Information Technology, Majmaah University, Al- Majmaah, Saudi Arabia, Almutairi Badr
Published: April 2021

As workloads increase in the industry so does the requirement for IT resources. IT companies are now shifting from in-house data centers to cloud-based IT services such as IAAS, PAAS, and SAAS which can offer flexibility at different levels to the developers of the applications working on different projects. Lots of researchers have contributed to migrating virtual machines migration from one cloud service provider to the other in case of backup as a service and other related services. Some of the previous works by some researchers focus on the migration of SAAS and PAAS onto different cloud service provider platforms. This research work focuses on the mitigation and migration of IAAS, PAAS, and SAAS services of the cloud. My contribution in this research will be in how to avoid loss of data during mitigation and migration of the VM from one Hypervisor environment to the other hypervisor environment on a physical machine infrastructure. This will help SME’s to provide end-user access to their data without worrying about the losses which may have incurred if the Mitigation process was not carried out carefully while migrating VM’s from one bare metal Hypervisor environment to the other bare metal Hypervisor environment.
Effects of the Interactive Web-Based Video “Mon Coeur, Mon BASIC” on Drug Adherence of Patients With Myocardial Infarction: Randomized Controlled Trial
Authors: Bruggmann Christel , Adjedj Julien , Sardy Sylvain , Muller Olivier , Voirol Pierre , Sadeghipour Farshid
Published: April 2021

Background

Secondary prevention strategies after acute coronary syndrome (ACS) presentation with the use of drug combinations are essential to reduce the recurrence of cardiovascular events. However, lack of drug adherence is known to be common in this population and to be related to treatment failure. To improve drug adherence, we developed the “Mon Coeur, Mon BASIC” video. This online video has been specifically designed to inform patients about their disease and their current medications. Interactivity has been used to increase patient attention, and the video can also be viewed on smartphones and tablets.

Objective

The objective of this study was to assess the long-term impact of an informative web-based video on drug adherence in patients admitted for an ACS.

Methods

This randomized study was conducted with consecutive patients admitted to University Hospital of Lausanne for ACS. We randomized patients to an intervention group, which had access to the web-based video and a short interview with the pharmacist, and a control group receiving usual care. The primary outcome was the difference in drug adherence, assessed with the Adherence to Refills and Medication Scale (ARMS; 9 multiple-choice questions, scores ranging from 12 for perfect adherence to 48 for lack of adherence), between groups at 1, 3, and 6 months. We assessed the difference in ARMS score between both groups with the Wilcoxon rank sum test. Secondary outcomes were differences in knowledge, readmissions, and emergency room visits between groups and patients’ satisfaction with the video.

Results

Sixty patients were included at baseline. The median age of the participants was 59 years (IQR 49-69), and 85% (51/60) were male. At 1 month, 51 patients participated in the follow-up, 50 patients participated at 3 months, and 47 patients participated at 6 months. The mean ARMS scores at 1 and 6 months did not differ between the intervention and control groups (13.24 vs 13.15, 13.52 vs 13.68, respectively). At 3 months, this score was significantly lower in the intervention group than in the control group (12.54 vs 13.75; P=.03). We observed significant increases in knowledge from baseline to 1 and 3 months, but not to 6 months, in the intervention group. Readmissions and emergency room visits have been very rare, and the proportion was not different among groups. Patients in the intervention group were highly satisfied with the video.

Conclusions

Despite a lower sample size than we expected to reach, we observed that the “Mon Coeur, Mon BASIC” web-based interactive video improved patients’ knowledge and seemed to have an impact on drug adherence. These results are encouraging, and the video will be offered to all patients admitted to our hospital with ACS.

Trial Registration

ClinicalTrials.gov NCT03949608; https://clinicaltrials.gov/ct2/show/NCT03949608
Consumer-Based Activity Trackers as a Tool for Physical Activity Monitoring in Epidemiological Studies During the COVID-19 Pandemic: Development and Usability Study
Authors: Henriksen André , Johannessen Erlend , Hartvigsen Gunnar , Grimsgaard Sameline , Hopstock Laila Arnesdatter
Published: April 2021

Background

Consumer-based physical activity trackers have increased in popularity. The widespread use of these devices and the long-term nature of the recorded data provides a valuable source of physical activity data for epidemiological research. The challenges include the large heterogeneity between activity tracker models in terms of available data types, the accuracy of recorded data, and how this data can be shared between different providers and third-party systems.

Objective

The aim of this study is to develop a system to record data on physical activity from different providers of consumer-based activity trackers and to examine its usability as a tool for physical activity monitoring in epidemiological research. The longitudinal nature of the data and the concurrent pandemic outbreak allowed us to show how the system can be used for surveillance of physical activity levels before, during, and after a COVID-19 lockdown.

Methods

We developed a system (mSpider) for automatic recording of data on physical activity from participants wearing activity trackers from Apple, Fitbit, Garmin, Oura, Polar, Samsung, and Withings, as well as trackers storing data in Google Fit and Apple Health. To test the system throughout development, we recruited 35 volunteers to wear a provided activity tracker from early 2019 and onward. In addition, we recruited 113 participants with privately owned activity trackers worn before, during, and after the COVID-19 lockdown in Norway. We examined monthly changes in the number of steps, minutes of moderate-to-vigorous physical activity, and activity energy expenditure between 2019 and 2020 using bar plots and two-sided paired sample t tests and Wilcoxon signed-rank tests.

Results

Compared to March 2019, there was a significant reduction in mean step count and mean activity energy expenditure during the March 2020 lockdown period. The reduction in steps and activity energy expenditure was temporary, and the following monthly comparisons showed no significant change between 2019 and 2020. A small significant increase in moderate-to-vigorous physical activity was observed for several monthly comparisons after the lockdown period and when comparing March-December 2019 with March-December 2020.

Conclusions

mSpider is a working prototype currently able to record physical activity data from providers of consumer-based activity trackers. The system was successfully used to examine changes in physical activity levels during the COVID-19 period.
Predicting Intensive Care Transfers and Other Unforeseen Events: Analytic Model Validation Study and Comparison to Existing Methods
Authors: Cummings Brandon C , Ansari Sardar , Motyka Jonathan R , Wang Guan , Medlin Jr Richard P , Kronick Steven L , Singh Karandeep , Park Pauline K , Napolitano Lena M , Dickson Robert P , Mathis Michael R , Sjoding Michael W , Admon Andrew J , Blank Ross , McSparron Jakob I , Ward Kevin R , Gillies Christopher E
Published: April 2021

Background

COVID-19 has led to an unprecedented strain on health care facilities across the United States. Accurately identifying patients at an increased risk of deterioration may help hospitals manage their resources while improving the quality of patient care. Here, we present the results of an analytical model, Predicting Intensive Care Transfers and Other Unforeseen Events (PICTURE), to identify patients at high risk for imminent intensive care unit transfer, respiratory failure, or death, with the intention to improve the prediction of deterioration due to COVID-19.

Objective

This study aims to validate the PICTURE model’s ability to predict unexpected deterioration in general ward and COVID-19 patients, and to compare its performance with the Epic Deterioration Index (EDI), an existing model that has recently been assessed for use in patients with COVID-19.

Methods

The PICTURE model was trained and validated on a cohort of hospitalized non–COVID-19 patients using electronic health record data from 2014 to 2018. It was then applied to two holdout test sets: non–COVID-19 patients from 2019 and patients testing positive for COVID-19 in 2020. PICTURE results were aligned to EDI and NEWS scores for head-to-head comparison via area under the receiver operating characteristic curve (AUROC) and area under the precision-recall curve. We compared the models’ ability to predict an adverse event (defined as intensive care unit transfer, mechanical ventilation use, or death). Shapley values were used to provide explanations for PICTURE predictions.

Results

In non–COVID-19 general ward patients, PICTURE achieved an AUROC of 0.819 (95% CI 0.805-0.834) per observation, compared to the EDI’s AUROC of 0.763 (95% CI 0.746-0.781; n=21,740; P<.001). In patients testing positive for COVID-19, PICTURE again outperformed the EDI with an AUROC of 0.849 (95% CI 0.820-0.878) compared to the EDI’s AUROC of 0.803 (95% CI 0.772-0.838; n=607; P<.001). The most important variables influencing PICTURE predictions in the COVID-19 cohort were a rapid respiratory rate, a high level of oxygen support, low oxygen saturation, and impaired mental status (Glasgow Coma Scale).

Conclusions

The PICTURE model is more accurate in predicting adverse patient outcomes for both general ward patients and COVID-19 positive patients in our cohorts compared to the EDI. The ability to consistently anticipate these events may be especially valuable when considering potential incipient waves of COVID-19 infections. The generalizability of the model will require testing in other health care systems for validation.