bluuebunny/crossref_metadata_2025_split huggingface dataset:
Колостоми після обструктивної резекції сигмоподібної кишки. Коли виконувати відновлювальну операцію?
Authors: Shaprynskyi V. O. , Verba A. V. , Shalyhin S. M. , Shaprynskyi Ye. V. , Martsynkovskyi I. P. , Vorovskyi O. O. , Chernichenko O. I. 
Published: February 2020

Мета роботи: поліпшення результатів реконструктивно-відновлюючих операцій на товстій кишці шляхом визначення оптимальних термінів їх виконання.
Матеріали та методи. Проаналізовано результати лікування 152 хворих, яким були виконані реконструктивно-відновлюючі операції. Вивчено гістологічну будову, ендоскопічні зміни кукси прямої кишки в різні терміни після її відключення, що дозволило встановити оптимальний термін для проведення реконструктивно- відновлюючих операцій.
Результати досліджень та їх обговорення. Аналіз і прогнозування регенераторних процесів в зоні реконструкції кишки в основі своїй базується на результатах морфологічних досліджень. Тому дослідження морфологічних змін проксимального і дистального відділів товстої кишки стало основою для оптимізації термінів виконання реконструктивно-відновлюючих операцій після накладення колостоми. Структурно-функціональна перебудова слизової оболонки починається в проксимальному відділі товстої кишки і в куксі товстої кишки вже через 1 місяць після першого етапу хірургічного лікування і проявляється перевагою гіперпластичних і реактивно-запальних змін, які відновлювалися, за нашими даними, через 3 місяця після накладення стоми. На пізніх термінах дослідження (6 і більше місяців) кукси товстої кишки чітко визначається ряд тенденцій морфофункціональної перебудови товстої кишки. Ці тенденції характеризуються: поступовим і нерівномірним наростанням атрофії крипт з осередковою їх регресією в терміни після 6 місяців і морфофункціональною клітинною перебудовою покривного епітелію. Незважаючи на те, що кількість і довжина крипт зменшується, в пізні терміни після першого етапу хірургічного лікування, їх архітектоніка і клітинний склад зберігається зі значним переважанням келихоподібних клітин. Було проведено ендоскопічне дослідження кукси прямої кишки в різний термін. Аналізуючи ендоскопічну картину кукси товстої кишки, було встановлено, що в терміни 2,5-3 місяці слизова оболонка кукси відповідає нормі, а зі збільшенням терміну відключення товстої кишки відбуваються суттєві зміни стінки товстої кишки, а саме згладжуються складки товстої кишки, знижується тонус стінки кишки, виникають атрофічні зміни слизової оболонки.
Перший досвід використання ботулотоксину типу А при хірургічному лікуванні вентральних гриж
Authors: Tarasiuk T. V. 
Published: February 2020

Мета роботи: вивчити досвід використання ботулотоксину типу А при хірургічному лікуванні вентральних гриж.
Матеріали і методи. У клініці кафедри загальної хірургії № 2 Національного медичного університету імені О. О. Богомольця проведено проспективне дослідження, що включало 9 пацієнта. Всі хворі проходили лікування в період з червня 2017 по грудень 2018 року з приводу вентральної грижі. У 7 (77,8 %) пацієнтів було діагностовано післяопераційну вентральну грижу, у 1 (11,1 %) пацієнта – рецидивну післяопераційну вентральну грижу, у 1 (11,1 %) пацієнта – гігантську вентральну грижу білої лінії живота. Всім хворим як передопераційну підготовку було проведено ін’єкцію ботулотоксину типу А в м’язи передньої черевної стінки. Зміни щодо розмірів грижового дефекту оцінювали через 4 тижні з моменту ін’єкції за допомогою об’єктивного обстеження, ультразвукового дослідження та комп’ютерної томографії черевної стінки.
Результати досліджень та їх обговорення. Через 4 тижні після внутрішньом’язового введення ботулотоксину типу А у всіх пацієнтів за даними комп’ютерної томографії спостерігалося достовірне зменшення розмірів грижового дефекту (р<0,001). В середньому товщина черевної стінки справа зменшилася на (1,45±1,05) мм, зліва – на (1,22±0,97) мм. Спостерігалося достовірне збільшення довжини м’язів передньої черевної стінки в середньому на (16,68±12,84) мм справа та на (16,54±11,65) мм зліва. Використання ботулотоксину під час передопераційної підготовки дозволило уникнути сепараційних методів герніопластики у всіх пацієнтів та у 55,6 % випадків виконати ушивання грижового дефекту та герніопластику лапароскопічно.
Test-Retest Precision of Myocardial Blood Flow Measurements With
99m
Tc-Tetrofosmin and Solid-State Detector Single Photon Emission Computed Tomography
Authors: Wells R. Glenn , Radonjic Ivana , Clackdoyle Duncan , Do Jeffrey , Marvin Brian , Carey Clare , deKemp Robert A. , Ruddy Terrence D. 
Published: February 2020

Background:

Measurement of myocardial blood flow (MBF) with single photon emission computed tomography (SPECT) is feasible using cardiac cameras with solid-state detectors. SPECT MBF has been shown to be accurate when compared with positron emission tomography MBF measured in the same patients. However, the value of a test result applied to an individual patient depends strongly on the precision or repeatability of the test. The purpose of our study is to measure the precision of SPECT MBF measurements using
99m
Tc-tetrofosmin and a solid-state cardiac camera.

Methods:
SPECT MBF was measured in 30 patients and repeated at a mean interval of 18 days. MBF was evaluated from images with and without attenuation correction based on a separately acquired CT scan. The dynamic images were processed independently by 2 operators using in-house kinetic analysis software that applied a 1-tissue-compartment model. The K1 rate constant was converted to MBF using previously determined extraction fraction corrections. Correction for patient body motion was applied manually.

Results:
The average coefficient of variation (COV) in the differences between the 2 MBF measurements was between 28% and 31%. The interobserver COV was between 11% and 15%. Myocardial flow reserve is the ratio of MBF measured at stress and rest, and the COV is correspondingly higher. The COV for the difference in repeated myocardial flow reserve was 33% to 38%, whereas the interobserver COV was 13% to 22%.

Conclusions:
The COV for the difference in SPECT MBF measurements obtained on separate days is 28% to 31%. The corresponding COV for myocardial flow reserve is 33% to 38%.
Appropriate Use Criteria and Health Status Outcomes Following Chronic Total Occlusion Percutaneous Coronary Intervention
Authors: Saxon John T. , Grantham J. Aaron , Salisbury Adam C. , Sapontis James , Lombardi William L. , Karmpaliotis Dimitri , Moses Jeffery , Nicholson William J. , Tang Yuanyuan , Cohen David J. , Spertus John A. , Safley David M. 
Published: February 2020

Background:
The American College of Cardiology/American Heart Association Appropriate Use Criteria were designed to aid clinical decision-making, yet their association with health status outcomes after chronic total occlusion percutaneous coronary intervention (PCI) is unknown.

Methods:
We analyzed 769 patients with baseline and 1-year health status data after chronic total occlusion PCI. Procedures were categorized as appropriate, may be appropriate, or rarely appropriate. Mean changes in patient-reported health status, assessed by the Seattle Angina Questionnaire (SAQ), were compared across appropriate use criteria categories from baseline to 1 year. Change in SAQ summary score was stratified as little to no benefit (≤10 points), intermediate (10–19 points), large (20–29 points), and very large (≥30 points).

Results:

The appropriate use criteria indication was appropriate in 573 patients (74.5%), may be appropriate in 191 (24.8%), and rarely appropriate in 5 (0.7%). Patients in the appropriate group reported greater improvement in SAQ summary scores (27.3±21.3 points) at 1 year compared with the may be appropriate (22.5±20.9;
P
=0.01). A similar pattern was noted for SAQ angina frequency (mean change 24.0±27.2 versus 18.7±25.6;
P
=0.02). The appropriate group had the highest proportion of very large improvements in SAQ summary scores (44.5% versus 33.3%;
P
=0.01).

Conclusions:
Among patients undergoing chronic total occlusion PCI, the rate of rarely appropriate PCI was low. The rate of appropriate PCI was high and was associated with the greatest health status improvement at 1 year. A substantial proportion of patients in the may be appropriate group experienced meaningful health status benefits as well.
Survival, Neurocognitive, and Functional Outcomes After Completion of Staged Surgical Palliation in a Cohort of Patients With Hypoplastic Left Heart Syndrome
Authors: Atallah Joseph , Garcia Guerra Gonzalo , Joffe Ari R. , Bond Gwen Y. , Islam Sunjidatul , Ricci M. Florencia , AlAklabi Mohammed , Rebeyka Ivan M. , Robertson Charlene M. T. ,   for the Western Canadian Complex Pediatric Therapies Follow‐up Program*
Published: February 2020

Background
Management of patients with hypoplastic left heart syndrome has benefited from advancements in medical and surgical care. Outcomes have improved, although survival and long‐term functional and cognitive deficits remain a concern.

Methods and Results

This is a cohort study of all consecutive patients with
hypoplastic left heart syndrome
undergoing surgical palliation at a single center. We aimed to examine demographic and perioperative factors from each surgical stage for their association with survival and neurocognitive outcomes. A total of 117 consecutive patients from 1996 to 2010 underwent surgical palliation. Seventy patients (60%) survived to the Fontan stage and 68 patients (58%) survived to undergo neurocognitive assessment at a mean (
SD
) age of 56.6 months (6.4 months). Full‐scale, performance, and verbal intelligence quotient, as well as visual‐motor integration mean (
SD
) scores were 86.7 (16.1), 86.3 (15.8), 88.8 (17.2), and 83.2 (14.8), respectively. On multivariable analysis, older age at Fontan, sepsis peri‐Norwood, lowest arterial partial pressure of oxygen postbidirectional cavopulmonary anastomosis, and presence of neuromotor disability pre‐Fontan were strongly associated with lower scores for all
intelligence quotient
domains. Older age at Fontan and sepsis peri‐Norwood remained associated with lower scores for all
intelligence quotient
domains in a subgroup analysis excluding patients with disability pre‐Fontan or with chromosomal abnormalities.

Conclusions

Older age at Fontan and sepsis are among independent predictors of poor neurocognitive outcomes for patients with
hypoplastic left heart syndrome
. Further studies are required to identify the appropriate age range for Fontan completion, balancing a lower risk of acute and long‐term hemodynamic complications while optimizing long‐term neurocognitive outcomes.
Fire and Rain: The Legacy of Hurricane Lane in Hawaiʻi
Authors: Nugent Alison D. , Longman Ryan J. , Trauernicht Clay , Lucas Matthew P. , Diaz Henry F. , Giambelluca Thomas W. 
Published: February 2020

AbstractHurricane Lane (2018) was an impactful event for the Hawaiian Islands and provided a textbook example of the compounding hazards that can be produced from a single storm. Over a 4-day period, the island of Hawaiʻi received an island-wide average of 424 mm (17 in.) of rainfall, with a 4-day single-station maximum of 1,444 mm (57 in.), making Hurricane Lane the wettest tropical cyclone ever recorded in Hawaiʻi (based on all available quantitative records). Simultaneously, fires on the islands of nearby Maui and Oʻahu burned 1,043 ha (2,577 ac) and 162 ha (400 ac), respectively. Land-use characteristics and antecedent moisture conditions exacerbated fire hazard, and both fire and rain severity were influenced by the storm environment and local topographical features. Broadscale subsidence around the storm periphery and downslope winds resulted in dry and windy conditions conducive to fire, while in a different region of the same storm, preexisting convection, incredibly moist atmospheric conditions, and upslope flow brought intense, long-duration rainfall. The simultaneous occurrence of rain-driven flooding and landslides, high-intensity winds, and multiple fires complicated emergency response. The compounding nature of the hazards produced during the Hurricane Lane event highlights the need to improve anticipation of complex feedback mechanisms among climate- and weather-related phenomena.
Multifractal Analysis of Rainfall-Rate Datasets Obtained by Radar and Numerical Model: The Case Study of Typhoon Bolaven (2012)
Authors: Lee J. , Paz I. , Schertzer D. , Lee D. I. , Tchiguirinskaia I. 
Published: February 2020

AbstractTyphoon Bolaven caused significant damage with severe rainfall all over South Korea, including Cheju Island, which received more than 250 mm in 2 days in August 2012. It was regarded as the most powerful storm to strike the Korean Peninsula in nearly a decade. The rainfall-rate datasets were obtained from S-band radar operated by the Korea Meteorological Administration to be analyzed and compared with the mesoscale Cloud Resolving Storm Simulator (CReSS) model simulation. Multifractal analysis was conducted to understand the structure of the rainfall rate with height in the typhoon system. The radar rainfall data presented with strong intermittency across scales at lower altitudes (1 and 2 km) and a more homogeneous rainfall field at high altitude (5 km) with two parameters (fractal codimension and multifractality index). The statistical scaling moment function and maximal singularities show clear significant differences between radar and the CReSS model.
The Use of NFP When Pregnancy Is Contraindicated?
Authors: Aznar Justo , Tudela Julio 
Published: February 2020

The Sacred Congregation for the Doctrine of the Faith has declared the moral liceity of hysterectomy when certain medical criteria are met but does not exclude other options, “for example, recourse to infertile periods or total abstinence.” Consequently, there may be couples who prefer to use natural family planning (NFP) methods. We shall refer to these in this article. The efficacy of NFP methods is determined by knowing the day of ovulation. To that end, three parameters are used: the presence and consistency of cervical mucus, measurement of the basal body temperature, and the determination of particular hormones in urine. Of the NFP methods used, the so-called sympto-thermal method seems to be the most effective. It has been concluded that the postovulatory or luteal phase of the female menstrual cycle is the safest time to avoid pregnancy if the couple has sexual intercourse during this period. Nevertheless, the use of NFP methods has limitations if the length of the cycles varies, there are fluctuations in the basal temperature, or when there are vaginal infections. Urinary hormone levels can also be altered by the use of antibiotics or psychotropic drugs. In general, however, it can be concluded that NFP methods, if used in the conditions mentioned herein, offer a high degree of reliability, similar to that of artificial contraceptive methods. Accordingly, if pregnancy must be avoided in the medical circumstances to which the Congregation for the Doctrine of the Faith refers, NFP methods can effectively replace hysterectomy, thereby circumventing the medical difficulties of this practice. Summary: The Sacred Congregation for the Doctrine of the Faith has declared the moral liceity of hysterectomy when certain medical criteria are met but does not exclude other options, “for example, recourse to infertile periods or total abstinence.” Consequently, there may be couples who prefer to use natural family planning (NFP) methods. We shall refer to these in this article. In general, it can be concluded that NFP methods, if used in the conditions mentioned herein, offer a high degree of reliability, similar to that of artificial contraceptive methods. Accordingly, if pregnancy must be avoided in the medical circumstances to which the Congregation for the Doctrine of the Faith refers, NFP methods can effectively replace hysterectomy, thereby circumventing the medical difficulties of this practice.
Sentinel Lymph Node Biopsy in Head and Neck Melanoma: Long‐term Outcomes, Prognostic Value, Accuracy, and Safety
Authors: Hanks John E. , Kovatch Kevin J. , Ali S. Ahmed , Roberts Emily , Durham Alison B. , Smith Joshua D. , Bradford Carol R. , Malloy Kelly M. , Boonstra Philip S. , Lao Christopher D. , McLean Scott A. 
Published: February 2020

ObjectiveTo evaluate the long‐term outcomes of sentinel lymph node biopsy (SLNB) for head and neck cutaneous melanoma (HNCM).Study DesignRetrospective cohort study.SettingTertiary academic medical center.Subjects and MethodsLongitudinal review of a 356‐patient cohort with HNCM undergoing SLNB from 1997 to 2007.ResultsDescriptive characteristics included the following: age, 53.5 ± 19 years (mean ± SD); sex, 26.8% female; median follow‐up, 4.9 years; and Breslow depth, 2.52 ± 1.87 mm. Overall, 75 (21.1%) patients had a positive SLNB. Among patients undergoing completion lymph node dissection following positive SLNB, 20 (27.4%) had at least 1 additional positive nonsentinel lymph node. Eighteen patients with local control and negative SLNB developed regional disease, indicating a false omission rate of 6.4%, including 10 recurrences in previously unsampled basins. Ten‐year overall survival (OS) and melanoma‐specific survival (MSS) were significantly greater in the negative sentinel lymph node (SLN) cohort (OS, 61% [95% CI, 0.549‐0.677]; MSS, 81.9% [95% CI, 0.769‐0.873]) than the positive SLN cohort (OS, 31% [95% CI, 0.162‐0.677]; MSS, 60.3% [95% CI, 0.464‐0.785]) and positive SLN/positive nonsentinel lymph node cohort (OS, 8.4% [95% CI, 0.015‐0.474]; MSS, 9.6% [95% CI, 0.017‐0.536]). OS was significantly associated with SLN positivity (hazard ratio [HR], 2.39; P <. 01), immunosuppression (HR, 2.37; P <. 01), angiolymphatic invasion (HR, 1.91; P <. 01), and ulceration (HR, 1.86; P <. 01). SLN positivity (HR, 3.13; P <. 01), angiolymphatic invasion (HR, 3.19; P <. 01), and number of mitoses (P =. 0002) were significantly associated with MSS. Immunosuppression (HR, 3.01; P <. 01) and SLN status (HR, 2.84; P <. 01) were associated with recurrence‐free survival, and immunosuppression was the only factor significantly associated with regional recurrence (HR, 6.59; P <. 01).ConclusionsLong‐term follow up indicates that SLNB showcases durable accuracy, safety, and prognostic importance for cutaneous HNCM.
Explaining the urban premium in Chinese cities and the role of place-based policies
Authors: Howell Anthony , Liu Chong , Yang Rudai 
Published: February 2020

This paper relies on the empirical framework introduced in Combes et al. (2012) to address the following main questions: (a) what are the relative contributions of agglomeration and selection forces expected to drive the urban productivity premium previously observed in Chinese cities, and (b) to what extent does the industrial parks and zones (IPZs) program, a popular place-based policy, simultaneously influence selection and agglomeration mechanisms? The main findings are as follows. First, both agglomeration and selection forces are observed in larger, denser Chinese cities, indicating that earlier studies that failed to take into account selection likely overestimate the effect of agglomeration economies. Second, after taking into account non-random site selection based on matching, the IPZs program intensifies both agglomeration and selection forces, although the results depend strongly on who administers the program. The empirical findings highlight a theoretical connection between state intervention and explaining the observed urban premium in a transitioning economy context.
Perception of care quality and ethical sensitivity in surgical nurses
Authors: Mert Boğa Selda , Aydin Sayilan Aylin , Kersu Özlem , Baydemİr Canan 
Published: February 2020

Background: It is stated that high ethical sensitivity positively affects the quality of nursing care. However, the relationship between nursing care quality and ethical sensitivity has not been clearly demonstrated in researches. Aim: This study was carried out to determine the relationship between surgical nurses’ care behaviors and their ethical sensitivity. Method: The sample of this cross-sectional, descriptive-correlational study consists of 308 nurses who worked at the surgical departments in four Turkish hospitals. The data were collected using the “Nurse Description Form” developed by the researcher, “Caring Behaviours Inventory-24” and “Ethical Sensitivity Questionnaire.” Data were evaluated by the Mann Whitney U test, Kruskal Wallis one-way analysis of variance and Spearman correlation analysis. Ethical considerations: The study was approved by the ethics committee. Verbal and written consent was received from the nurses. Results: It was found in the study that nurses’ Caring Behaviours Inventory-24 total score median was 5.25 (4.83–5.58), nurses’ perception level of caring quality was high, median of Ethical Sensitivity Questionnaire total score was 89.00 (75.00–101.00) and nurses’ ethical sensitivity was moderate. A negative significant relation was found between nurses’ Caring Behaviours Inventory-24 total score and Ethical Sensitivity Questionnaire total score (r = -0.162; p = 0.009). A negative relation was also detected between nurses’ working period at the current clinic and providing benefit (r = -0.147; p = 0.012), holistic approach (r = -0.139; p = 0.018) and orientation (r = -0.175; p = 0.003) scores of Ethical Sensitivity Questionnaire sub-scales. Conclusion: Nurses’ perception levels of caring quality were high and their ethical sensitivity levels were moderate. It was found out that nurses’ ethical sensitivity increased together with their perception of caring quality, and as their working period at the current clinic increased, the ethical sensitivity also increased in terms of the sub-scales of providing benefit, holistic approach, and orientation. The factors that adversely affect the quality of nursing care and ethical sensitivity should be examined and attempts should be made to improve the working environment.
Assessing the Effects of Rural Electrification on Household Welfare in Nigeria
Authors: Olanrele Iyabo Adeola 
Published: February 2020

A rural electrification (RE) strategy was adjudged as a means of extending electricity to unserved and underserved communities to bring about rural transformation and development. This study investigates the effect of Oyo State RE on household welfare indicators such as monthly income and per capita expenditure. Household survey data collected from the Nigerian Institute of Social And Economic Research (NISER) 2017 field survey were employed. Access to grid electricity increases household income by about 1.3 per cent. Although the coefficient was correctly signed, it was not significant. This outcome could be a result of constant electricity supply outages, which is strongly explained by the positive affirmation of 71 per cent of the respondents. Access to grid electricity increases household per capita monthly expenditure by about 6.4 per cent. Expenditure on electricity equally increases monthly per capita expenditure by about 4 per cent and is statistically significant at 1 per cent. Due to rapid decline in the cost of technology, mini-grid and off-grid systems have become viable options for extending electricity access that is more reliable, and hence has more economic benefits. JEL Classification: I31