bluuebunny/crossref_metadata_2025_split huggingface dataset:
Использование сетчатых имплантатов при лапароскопическом лечении больших грыж пищеводного отверстия диафрагмы
Authors: Grubnyk V. V. , Grubnik V. V. , Tkachenko O. I. 
Published: November 2020

Цель работы: изучение эффективности использования различных видов сетчатых имплантатов при лечении больных с большими грыжами пищеводного отверстия диафрагмы.
Материалы и методы. С января 2011 года по сентябрь 2018 в нашей клинике прооперированы 187 пациентов с большими грыжами пищеводного отверстия диафрагмы (ГПОД). Средний возраст больных составлял 57 ± 14,9 (от 39 до 78 лет). Средний индекс массы тела у оперированных больных был (28,6 ± 5,4) кг. Все пациенты в зависимости от методики пластики ГПОД были разделены на 4 группы. В I группе (54 пациента) выполнялась простая крурорафия. Во II группе (59 пациентов) для укрепления швов крурорафии использовалась самофиксирующаяся сетка ProGrip. Для укрепления швов крурорафии в III группе (49 пациентов) использовали сетчатый имплантат Parietex с коллагеновым покрытием. В IV группе (25 пациентов) использовали рассасывающуюся викриловую сетку. Отдаленные результаты изучали через 6, 12, 24, 36, 48 и 60 месяцев после операции. Больным проводились рентгенологическое исследования и желудка с бариевым контрастом, ФГДС и 24-х часовая pH-метрия с вычислением индекса DeMeester. У пациентов фиксировались все жалобы, определялось качество жизни по опроснику GERD-HRQL.
Результаты исследований и их обсуждение. Все оперативные вмешательства были выполнены лапароскопически без конверсии в открытую операцию. У 10 больных наблюдались интраоперационные осложнения. В отдаленные сроки от 24 до 60 месяцев удалось проследить 74,87 % прооперированных больных. Количество рецидивов через 60 месяцев в группе с выполнением простой крурорафии составляло 26,3 %, что было достоверно выше, чем в группах, где использовались нерассасывающиеся сетчатые имплантаты ProGrip и Parietex с коллагеновым покрытием (4,5 и 7,9 % соответственно). Группа больных, у которых использовалась рассасывающаяся викриловая сетка, показала худшие результаты по сравнению с группами, где использовались нерассасывающиеся сетки, частота рецидивов в этой группе составила 20 %. Индекс качества жизни через 48 месяцев наблюдения был достоверно выше у больных, у которых использовались сетчатые имплантаты. Индекс DeMeester в I группе больных составил 18,8 и был выше, чем в группах больных с применением сеток.
Ретроперитонеоскопічна резекція нирки з передопераційною селективною емболізацією та флуоресцентною візуалізацією ниркових судин. Аналіз післяопераційних ускладнень
Authors: Dumanskiy U. V. , Balashova O. I. , Reshetniak S. O. , Kavetsky R. E. 
Published: November 2020

Мета роботи: провести аналіз післяопераційних ускладнень у хворих на локальний рак нирки після проведення ретроперитонеоскопічної резекції нирки з передопераційною селективною емболізацією та флуоресцентною візуалізацією ниркових судин.
Матеріали і методи. Ми прооперували 25 хворих на локальний рак нирки та виконали аналіз зареєстрованих післяопераційних ускладнень.
Результати досліджень та їх обговорення. Всім хворим на локальний нирково-клітинний рак нирки виконано резекцію нирки (ZERO ishemia) з використанням інтраопераційної флуоресцентної візуалізації в режимі інфрачервоної ділянки спектра за допомогою індоціаніну зеленого (Indocyanine green). На передопераційному етапі всім хворим виконували суперселективну рентгеноваскулярну емболізацію.
Аналіз ускладнень проводили за загальноприйнятою шкалою післяопераційних ускладнень Клав’єн–Діндо.
Під час виконання хірургічних втручань ускладнень не спостерігали. На передопераційному етапі зареєстровано одне, у післяопераційному етапі – лише 3 ускладнення (12 %). Всі ускладення були І-ІІ ступеня та не потребували повторної хірургічної корекції і не впливали на тривалість перебування в реанімаційному відділені та хірургічному стаціонарі, не призводили до проведення таких додаткових маніпуляцій та процедур, як гемотрансфузії, ендоскопічні та інтервеційні радіологічні втручання.
Проведений аналіз зареєстрованих післяопераційних ускладнень після виконаної ретроперитонеоскопічної резекції з використанням передопераційної рентгеноваскулярної емболізації та інтраопераційної флуоресцентної візуалізації в режимі інфрачервоної ділянки спектра за допомогою індоціаніну зеленого (Indocyanine green) з певною часткою достовірності дає підстави з урахуванням безпосередньої ефективності та практично повної відсутності інтра- і післяопераційних ускладнень рекомендувати переваги даної хірургічної методики.
Наведені дані свідчать, що використання суперселективної рентгеноваскулярної емболізації та інтраопераційної флуоресцентної візуалізації в хірургічному лікуванні локалізованого раку нирки порівняно зі “стандартним” методом хірургічного лікування має суттєві переваги. Ми вбачаємо перспективність продовження вивчення та впровадження запропонованого алгоритму обстеження та лікування хворих на локальний рак нирки.
SERUM LIPID PROFILE AND ARTERIAL STIFFNESS IN NON-DIPPERS
Authors: Bawa-Allah A.B. , Mashao M. M. , Nyundu T. F. , Phukubje E. M. , Nkosi B. G. , Ngema M. V. , Mlambo B. W. , Maseko M. J. 
Published: November 2020

Background. A non-dipping blood pressure profile (NDP) is associated with increased arterial stiffness and other cardiovascular target organ damage. Serum lipid profiles have been shown to be important determinants of arterial stiffness.
Objective. The aim of the research was to assess serum lipid profiles and arterial stiffness in non-dippers.
Methods. This cross-sectional study was conducted involving 796 (288 males and 508 females) participants of black African origin. A twenty-four-hour ambulatory BP monitoring was done using a Spacelabs 90207 (Spacelabs Inc., Redmond, Washington, USA) monitor. Carotid-Femoral pulse wave velocity measurements were performed using a high fidelity SPC-301 micromanometer (Millar instruments Inc., Houston, TX).
Results. Of the 288 males, 140 were classified as non-dippers. Of the 508 females, 273 were classified as non-dippers. In the general population, males had higher triglycerides when compared with females 1.46±0.96 vs 1.13±1.02, p<0.0001. Additionally, dipper males had higher serum TRGL when compared with dipper females 1.32±0.98 vs 1.06±0.58, p = 0.0012. Non-dipper males also had higher serum TRGL when compared with non-dipper females 1.61±2.05 vs 1.19±1.14, p=0.0078. Serum HDLc was lower in the non-dipper male group when compared to the non-dipper female group (p=0.008). In both male and female groups, non-dippers had higher CFPWV when compared with dippers; 7.53±3.60 vs 5.74±2.47, p<0.0001 and 6.64±2.52 vs 5.98±2.23, p=0.0021 respectively. However, non-dipper males had significantly higher CFPWV when compared with non-dipper females (7.53±3.60 vs 6.64±2.52, p=0.0031).
Conclusions. Therapies targeting a reduction of serum triglycerides levels might be beneficial in improving arterial compliance with or without the presence of non-dipping.
WEB-BASED 5-DIMENSIONAL ELECTRONIC PORTFOLIO (5DEP) AS A COMPETENCY-BASED ASSESSMENT TOOL IN POST-GRADUATE MEDICAL TRAINING
Authors: Bokhua Z. , Chelidze K. , Ebralidze K. 
Published: November 2020

Background. New challenges of permanently changing context of healthcare system requires new methods of medical education and new assessment tools, as well. Competency-based Medical Education (CBME), framework which has been adopted as a new approach in medical education, needs appropriate assessment tool such as portfolio. Portfolio is learner-centered assessment instrument which evaluates learner’s progression towards outcomes and enables both residents and teachers to engage in a process of learning through assessment.
Objective. In this paper we aim to share our successful experience of an effective use of web-based 5-Dimensional Electronic Portfolio (5DeP) as an assessment tool in the Pilot Group.
Methods. Pilot Group of sixteen residents (six first year residents of Obstetrics/Gynecology and ten first year residents of Internal Medicine. Tbilisi State Medical University Institute of Postgraduate Medical Education and Continuous Professional Development) and twelve mentors (four Obstetrics/Gynecology mentor and eight Internal Medicine mentors) reported some feedback about 5-Dimensional Electronic Portfolio (5DeP) as a new assessment tool.
Results. Feedback about 5-Dimensional Electronic Portfolio (5DeP) as a new assessment tool from mentors and students demonstrated efficiency of the program. It enables assessment within a framework of transparent and declared criteria and learning objectives; provides a model for lifelong learning and continuing professional development; increases competence in a wider context with benefits to both professional and personal roles; improves organizing skills.
Conclusions. 5DeP have been recognized as an extremely effective assessment tool.
ПЕРСПЕКТИВИ ВДОСКОНАЛЕННЯ НАВЧАЛЬНОГО ПЛАНУ ДЛЯ ЛІКАРІВ-ІНТЕРНІВ-СТОМАТОЛОГІВ У РОЗДІЛІ «КАРІЄС»
Authors: Skrypnykov P. M. , Shynkevych V. I. , Udaltsova-Hrodzynska K. O. , Pysarenko O. A. 
Published: November 2020

На післядипломному етапі освіти у навчанні лікарів-інтернів важливою є підкреслена інтеграція знань етіології і факторів ризику карієсу з практичними заходами у вигляді менеджменту пацієнта з карієсом.
Метою статті був аналіз навчальної програми з теми «Карієс» і порівняння його із Міжнародною системою класифікації та менеджменту карієсу з метою вдосконалення теоретичних основ навчання.
Тематика «Карієс» при вивченні у ВНЗ подрібнена на численні теми, серед яких виокремлені теми профілактики. З процесу діагностики випадають ланки визначення факторів ризику, виявлення найменших каріозних дефектів, визначення активності карієсу, і залишається пошук власне дефекту зуба для подальшого відновлення. А прогноз обґрунтований індексами тесту емалевої резистентності (ТЕР) та/або КПВ.
Останнім часом у медицину увійшло поняття «менеджмент», яке полягає в комплексності діагностичних, лікувальних та профілактичних заходів, потрібних при встановленні діагнозу конкретному пацієнту. Міжнародна система класифікації та менеджменту карієсу (ICCMSTM) має за перспективи перетворити нинішнє міжнародне розуміння патогенезу, профілактики і контролю карієсу в цілісний спосіб комплексної оцінки й індивідуального плану «турботи» при карієсі, з метою: попередити появу нових вогнищ ураження, попередити вже існуючі ураження від подальшого розвитку, зберегти тканини зуба без оперативного втручання на початкових стадіях карієсу, і за допомогою оперативного лікування – при більш розвинених стадіях карієсу. Це має досягатися при управлінні факторами ризику через всі елементи в циклі менеджменту карієсу і повторних візитів пацієнта з відповідними інтервалами для періодичного контролю та огляду.
Нові відомості необхідно імплементувати на додипломних і післядипломних етапах медичної освіти, щоб лікарі та викладачі могли розмовляти спільною мовою.
Impact of Catheter Ablation on Sleep Quality and Relationship Between Sleep Stability and Recurrence of Paroxysmal Atrial Fibrillation After Successful Ablation: 24‐Hour Holter‐Based Cardiopulmonary Coupling Analysis
Authors: Kim Woohyeun , Na Jin Oh , Thomas Robert J. , Jang Won Young , Kang Dong Oh , Park Yoonjee , Choi Jah Yeon , Roh Seung‐Young , Choi Cheol Ung , Kim Jin Won , Kim Eung Ju , Rha Seung‐Woon , Park Chang Gyu , Seo Hong Seog , Lim Hong Euy 
Published: November 2020

Background
Sleep fragmentation and sleep apnea are common in patients with atrial fibrillation (AF). We investigated the impact of radio‐frequency catheter ablation (RFCA) on sleep quality in patients with paroxysmal AF and the effect of a change in sleep quality on recurrence of AF.

Methods and Results

Of 445 patients who underwent RFCA for paroxysmal AF between October 2007 and January 2017, we analyzed 225 patients who had a 24‐hour Holter test within 6 months before RFCA. Sleep quality was assessed by cardiopulmonary coupling analysis using 24‐hour Holter data. We compared cardiopulmonary coupling parameters (high‐frequency coupling, low‐frequency coupling, very‐low‐frequency coupling) before and after RFCA. Six months after RFCA, the high‐frequency coupling (marker of stable sleep) and very‐low‐frequency coupling (rapid eye movement/wake marker) was significantly increased (29.84%–36.15%;
P
<0.001; and 26.20%–28.76%;
P
=0.002, respectively) while low‐frequency coupling (unstable sleep marker) was decreased (41.25%–32.13%;
P
<0.001). We divided patients into 3 tertiles according to sleep quality before RFCA, and the risk of AF recurrence in each group was compared. The second tertile was used as a reference; patients with unstable sleep (Tertile 3) had a significantly lower risk of AF recurrence (hazard ratio [HR], 0.32; 95% CI, 0.12–0.83 for high‐frequency coupling; and HR, 0.22; 95% CI, 0.09–0.58 for low‐frequency coupling).

Conclusions
Sleep quality improved after RFCA in patients with paroxysmal AF. The recurrence rate was significantly lower in patients who had unstable sleep before RFCA. These results suggest that RFCA can influence sleep quality, and sleep quality assessment before RFCA may provide a risk marker for recurrence after RFCA in patients with paroxysmal AF.
Requests from the Indies. Asian Agency in the VOC’s Currency Supply to Eighteenth-Century Java
Authors: Feenstra Alberto 
Published: November 2020

Abstract
This paper reconstructs the chain of demand for cash from Asia to the Dutch Republic in the seventeenth and eighteenth centuries. It shows that the Javanese’s currency preferences were visible in the exports from Europe. The growing Dutch involvement in Javanese society from the 1680s increased and transformed the composition of the currencies requested from the Dutch Republic, towards more smaller denomination coins. The paper also demonstrates that with regard to the money supply, considerations of state prevailed over purely business interests. The limitations to the Dutch power forced them to adjust to the local power holders their currency preferences.
The 2007-2009 Financial Crisis
Authors: García-Rivero Carlos , Kotzé Hennie 
Published: November 2020

Abstract
Analysis of democratic legitimacy has generally focused on two different perspectives. Minimalist definitions of democracy focus on procedures, liberties and rights, whereas substantive definitions focus on how such a regime improves citizens’ general welfare. Democracies have enjoyed decades of prosperity. Hence, the impact of a lack of economic wellbeing has been difficult to analyse and, consequently, the weight of substantive issues in democratic legitimacy remains unexplored. However, the impact of the recent financial crisis allows us to measure how elites and citizenry of seven countries on four different continents evaluated the importance of political versus economic issues for the level of democracy in their countries. The analysis is based on public and political elite surveys conducted in 2006 and in 2013.
Describing the Future Battlefield: A Study Concerning the Prussian General Staff’s Tasks Regarding Theatres of War (1816–1848)
Authors: Jędrysiak Jacek 
Published: November 2020

Abstract
In 1816 the Prussian General Staff (gs) became one of the institutions responsible for the Kingdom’s defence planning. During this time, the institution was comprised of three sections, the so-called Kriegstheater (Theatres of War), which were to prepare against the military threat posed by France, Austria and Russia. According to instructions issued in 1816, the gs was to assist commanders in every aspect of their decision-making process and serve as the army’s main research centre. General Karl von Grolman, who served as Chief of the General Staff between 1816 and 1819, believed that the defence plan should be preliminary, very thorough and based on accurate descriptions of the theatres of war. Contrary to often-repeated claims, his successors did not introduce major changes to the internal structure of the gs until 1848. The aim of this article is to bring the existing literature up to date regarding this task of the Prussian General Staff.
Socioeconomic Dynamics in Women’s Access and Utilization of Health Technologies in Rural Nigeria
Authors: Aronu Ngozi Idemili , Atama Chiemezie S. , Chukwu Ngozi E , Ijeoma Igwe 
Published: November 2020

Background Technology has become a powerful tool for resolving women’s health problems hence women’s access and use of healthcare technologies have become an important aspect of the Sustainable Development Goals. Though health technologies have improved the lives of women worldwide, in Nigeria, especially in rural settings, use of health technologies remains low. The objective of this study was to examine the socioeconomic dynamics that influence the use of health technologies by women in rural Nigeria. Methods A cross sectional survey using qualitative methods to collect data from 147 purposively selected women (15–65 years) was conducted in three rural Local Government Areas in Enugu State. Focus Group Discussion (FGD) and In-depth interview guides were used to collect information from 147 purposively selected women and healthcare workers on access and use of health technologies among women in rural communities. Thematic analytic method was used to analyze the data. Results The data gathered revealed that there was unavailability of health technologies in some communities studied while many had skeletal provision of health technologies. Bad road networks, cost of transportation and unavailability of health technologies impacted on access. Low socioeconomic status of rural women influenced their use of health technologies. Conclusion Health technologies especially diagnostic technologies are not available in rural communities. Women cannot access what is not available. The study recommends need for the provision of these lifesaving technologies at little or no cost.
Personal Determinants of Burden Among Indonesian Female Caregivers of Older Adults in Taiwan
Authors: Troy Carol , Tjin Anna , Perez C. John J. , Liu Jeng 
Published: November 2020

Introduction Families increasingly employ foreign domestic workers (FDWs) to care for older loved ones. Caregiver burden reflects FDWs’ difficulty adapting to work demands. We test hypothesized associations between burden and six personal characteristics: children, marriage, education, Chinese proficiency, eldercare experience, and non-eldercare experience. Method In total, 299 Indonesian FDWs in Taiwan completed the Zarit Burden Interview. Exploratory factor analysis identified the dimensions of burden. Multiple and multinomial regressions related the variables to overall burden, burden dimensions, and burden severity. Results Four dimensions were found: personal strain, role strain, dependency, and guilt. Children were negatively associated with burden, role strain, dependency, and guilt. Chinese proficiency was negatively associated with severity and guilt. Eldercare experience was positively associated with severity and personal strain. Marriage was non-monotonically related to severity. Conclusion Caregivers whose earnings benefit their children may be more likely to thrive in Taiwan. Language training may boost caregiver performance and host family satisfaction.
Systemic Anti-Cancer Therapy Use in Palliative Care Outpatients With Advanced Cancer
Authors: Wadhwa Deepa , Hausner David , Popovic Gordana , Pope Ashley , Swami Nadia , Maganti Manjula , Zimmermann Camilla 
Published: November 2020

Purpose: To evaluate factors associated with continuation of systemic anti-cancer therapy (SACT) after palliative care consultation, and SACT administration in the last 30 days of life, in outpatients with cancer referred to palliative care. Timing of referral was of particular interest. Methods: Patient, disease, and treatment-related factors associated with SACT before and after palliative care, and in the last 30 days of life, were identified using 3-level multinomial logistic regression. Referral to palliative care was categorized by time from death as early (>12 months), intermediate (6-12 months), and late (≤6 months). Results: Of the 337 patients, 240 (71.2%) received SACT for advanced cancer; of these, 126 (52.5%) received SACT only prior to palliative care while 114 (47.5%) also received SACT afterward. Only 35/337 (10.4%) received SACT in the last 30 days of life. On multivariable analysis, factors associated with continuing SACT after palliative care consultation were a cancer diagnosis for <1 year (OR 3.09, p = 0.01), breast primary (OR 11.88, p = 0.0008), and early (OR 28.8, p < 0.001) or intermediate (OR 6.67, p < 0.001) referral timing. No factors were significantly associated with receiving SACT in the last 30 days versus earlier, but the median time from palliative care referral to death in those receiving SACT in the last 30 days versus stopping SACT earlier was 1.78 versus 4.27 months. Conclusion: Patients who received SACT following palliative care consultation were more likely to be referred early; however, patients receiving SACT in their last 30 days tended to be referred late.
Eye Tracking During a Continuous Performance Test: Utility for Assessing ADHD Patients
Authors: Lev Astar , Braw Yoram , Elbaum Tomer , Wagner Michael , Rassovsky Yuri 
Published: November 2020

Objective: The use of continuous performance tests (CPTs) for assessing ADHD related cognitive impairment is ubiquitous. Novel psychophysiological measures may enhance the data that is derived from CPTs and thereby improve clinical decision-making regarding diagnosis and treatment. As part of the current study, we integrated an eye tracker with the MOXO-dCPT and assessed the utility of eye movement measures to differentiate ADHD patients and healthy controls. Method: Adult ADHD patients and gender/age-matched healthy controls performed the MOXO-dCPT while their eye movements were monitored ( n = 33 per group). Results: ADHD patients spent significantly more time gazing at irrelevant regions, both on the screen and outside of it, than healthy controls. The eye movement measures showed adequate ability to classify ADHD patients. Moreover, a scale that combined eye movement measures enhanced group prediction, compared to the sole use of conventional MOXO-dCPT indices. Conclusions: Integrating an eye tracker with CPTs is a feasible way of enhancing diagnostic precision and shows initial promise for clarifying the cognitive profile of ADHD patients. Pending replication, these findings point toward a promising path for the evolution of existing CPTs.
Is post-trabeculectomy serous choroidal detachment a risk factor for failure in the long term
Authors: Yadgari Maryam , Hassanpour Kiana , Nassiri Nader 
Published: November 2020

Background: To investigate the long-term effect of serous choroidal detachment on the success of trabeculectomy in glaucoma patients. Methods: In this case-control study, 17 patients who underwent trabeculectomy and developed choroidal detachment, and completed at least 3 years of follow-up were included. The controls were matched based on age, sex, preoperative intraocular pressure, and glaucoma type, and lack of choroidal detachment. Surgical success was defined based on two definitions of 5 < IOP < 16 and 20% reduction from the baseline and no need for further glaucoma surgery and all the same but 5 < IOP < 22. Results: The mean estimated duration of survival ±SD was 2.73 ± 0.35 years (CI 95% 2.1, 3.4), which was significantly shorter than 3.98 ± 0.38 years (CI 95% 3.3, 4.7) in the control group. (LogRank = 5.03 p = 0.02). Cumulative probability of success was 76.5%, 52.9%, 29.4%, 17.6%, and 11.8% in year 1, 2, 3, 4, and 5 in the case group, respectively. Corresponding values were 88.2%, 82.4%, 68.6%, 58.8%, and 47.1%. In the control group, respectively. At baseline, average IOP was 22.3 ± 2.7 and 23.8 ± 8.3 mmHg in the case and control groups, respectively ( p = 0.17). Mean IOP was significantly higher in the case group than in the control group in years 2, 3, 4, and 5. Conclusion: Serous choroidal detachment affects the long-term surgical success of trabeculectomy, especially in patients with advanced glaucoma when lower target pressure is required.