bluuebunny/crossref_metadata_2025_split huggingface dataset:
Results of a three-year follow-up and quality of life dynamics after pulmonary thromboendarterectomy
Authors: Klinkova A. S. , Kamenskaya O. V. , Loginova I. Yu. , Chernyavsky A. M. , Edemsky A. G. , Khabarov D. V. , Lomivorotov V. V. 
Published: September 2020

Aim. To evaluate the results of a three-year follow-up of patients with chronic thromboembolic pulmonary hypertension (CTEPH) and quality of life (QOL) dynamics after pulmonary thromboendarterectomy (PTE).Material and methods. The study included 125 patients with CTEPH aged 49,7± 11,9 years. Three-year follow-up included the recording of adverse cardiovascular events, surgeries, death during the period from the end of hospitalization and up to three years. The SF-36 questionnaire was used to assess physical and mental wellbeing before and three years after PTE. Multivariate linear regression was used to assess the factors affecting QOL in the long-term postoperative period.Results. During a three-year follow-up, adverse cardiovascular events was recorded in 1,9% of patients. One patient underwent coronary artery bypass graft surgery and one patient — cholecystectomy. Reoperative PTE was not carried out. The overall three-year survival rate was 90,4%.At baseline, patients with CTEPH had a low level of physical and mental well-being (<40 points). Three years after the operation, these parameters significantly increased (p<0,05), but did not exceed 50 points. Multivariate linear regression revealed an unfavorable effect of early postoperative residual pulmonary hypertension on the physical health three years after PTE. Other factors (age, sex, body weight, comorbidity, hospital acquired complications) did not affect the physical and emotional aspects of QOL.Conclusion. Three-year survival rate in patients with CTEPH after PTE was 90,4%. During the follow-up period, no recurrent thromboembolic events were recorded. Adverse cardiovascular events were recorded in 1,9% of patients. Three years after surgery, the physical and mental health increased in comparison with preoperative values, but did not exceed 50 points on the SF-36 questionnaire. The physical aspect of QOL after surgery is affected by early postoperative residual pulmonary hypertension.
A new method of left atrial appendage occlusion for the prevention of thromboembolic complications in patients with atrial fibrillation during coronary artery bypass grafting
Authors: Vecherskiy Yu. Yu. , Bogdanov Yu. I. , Batalov R. E. , Zatolokin V. V. , Saushkin V. V. , Zavadovskiy K. V. , Popov S. V. 
Published: September 2020

Aim. To optimize the surgical technique for left atrial appendage (LAA) occlusion in patients with atrial fibrillation (AF) during coronary artery bypass grafting.Material and methods. The study included 60 patients with atrial fibrillation (AF). The patients were randomly divided into 2 groups. In the first group of patients, LAA was closed using the developed two-suture technique. In patients of the second group, a purse string suture was applied to the LAA. All patients underwent transesophageal echocardiography (TEE) before surgery to rule out the presence of intracardiac blood clots. To assess the effectiveness of the method in the postoperative period, TEE was performed.Results. According to postoperative TEE, one case of LAA recanalization in each group was revealed (p>0,05). In the second group, the residual LAA cavity after applying a purse string suture was revealed. During the follow-up period, there were no neurological complications and deaths.Conclusion. According to the study results, it was found that the proposed two-suture technique for LAA occlusion is not less effective than the purse-string suture. The developed technique of two-suture epicardial occlusion of LAA showed actual technical advantages, allowing to optimize this surgery in different categories of patients.
Effect of a combination of angiotensin-converting enzyme inhibitor and diuretic on the frequency and parameters of lower limb venous reflux in working-age men with hypertension
Authors: Letyagina S. V. , Baev V. M. , Shmeleva S. A. , Agafonova T. Yu. 
Published: September 2020

Aim. To study the effect of combined antihypertensive therapy on the characteristics of venous reflux in working-age men with hypertension (HTN).Material and methods. We examined 44 men aged 30-50 years with uncontrolled HTN. The dynamics of the rate, temporal and velocity parameters of venous reflux was analyzed for a 14-15 days of combined therapy with an angiotensin-converting enzyme inhibitor (perindopril, 8 mg) and a diuretic (indapamide, 1,5 mg) both in the general group (n=44) and in groups of 22 men with/without chronic venous disease (CVD). CVD was diagnosed by physical examination according to the CEAP criteria. Reflux was assessed at rest by ultrasound of symmetric superficial, deep and perforator veins.Results. In the general group of patients (n=44), a decrease in blood pressure was associated with significant negative dynamics of the reflux rate in all veins from 0 to 37, a positive dynamics only from 7 to 0 (p=0,0001). Analysis of the dynamics of reflux duration and velocity before and after treatment did not show any differences. The use of combination therapy in patients with HTN and CVD was associated with an increase in the reflux number (p=0,0001), while in patients with HTN without CVD, no significant dynamics was recorded. The proportion of patients with reflux after treatment in the CVD group more than doubled. Comparison of the temporal and velocity reflux parameters after treatment between the groups with/without CVD did not reveal any differences.Conclusion. Two-week therapy with an angiotensin-converting enzyme inhibitor and a diuretic in working-age men with uncontrolled hypertension is accompanied by the appearance of a significant number of new venous refluxes, which is due to the presence of CVD among patients with hypertension. After treatment, the proportion of patients with reflux in the group with AH and CVD more than doubled.
Clinical audit of pre- and postnatal diagnostics of obstructive congenital left heart defects at the perinatal center (level III)
Authors: Shumakova O. V. , Bokeria E. L. 
Published: September 2020

Aim. To compare the data of pre- and postnatal expert echocardiographic diagnostics of obstructive left heart defects (LHD) to identify a possible predictors and reasons for hypo- and overdiagnosis of this.Material and methods. A retrospective analysis of data from expert echocardiography of 194 fetuses and newborns with suspected obstructive LHD (coarctation of the aorta (CA), interruption of the aortic arch, aortic stenosis (AS), CA or interruption of the aortic arch with AS, hypoplastic left heart syndrome (HLHS)) was performed.Results. After birth, critical obstructive LHD was confirmed in 59,3% of newborns (115 out of 194): in cases of prenatally diagnosed CA — in 41% of children (42 out of 103); AS — in 67% (4 out of 6); CA with AS — in 65,9% (27 out of 41); HLHS — in 93,9% (39 out of 44); or interruption of the aortic arch with and without AS — in 100% (11 out of 11). After birth, the discrepancy in diagnoses of critical congenital heart defects was detected in 2 cases — obstructive LHD were not confirmed, but total anomalous pulmonary venous drainage (APVD) was detected. In children with a confirmed diagnosis of HLHS after birth, there was a hypodiagnosis of obstructive forms of APVD in three newborns.Conclusion. The probability of confirming a critical obstructive LHD after birth is higher, the more LHD were hypoplasized during intrauterine imaging. APVD may be “hemodynamically masked” as HLHS when prenatal echocardiography is performed. The combination of HLHS and obstructive forms of APVD can lead to HLHS “hemodynamic aggravation” due to an additional decrease in blood flow of left heart.
Novel method for glomus-saving carotid endarterectomy sensu A. N. Kazantsev: cutting the internal carotid artery on the site from external and common carotid artery
Authors: Kazantsev A. N. , Chernykh K. P. , Zarkua N. E. , Lider R. Yu. , Kubachev K. G. , Bagdavadze G. Sh. , Kalinin E. Yu. , Zaitseva T. E. , Chikin A. E. , Artyukhov S. V. , Linets Yu. P. 
Published: September 2020

Aim. To analyze the results of using a novel method of glomus-saving carotid endarterectomy (CEE) sensu A. N. Kazantsev.Materials and methods. This cohort, comparative, prospective, open-label study from January 2018 to April 2020 included 475 patients who undergone one of the three glomus-saving types of CEE. Depending on the implemented revascularization strategy, all patients were divided into 3 groups: group 1 — 136 patients (28,631%) CEE sensu R. A. Vinogradov; group 2 — 125 patients (26,316%) — sensu K. A. Antsupov; group 3 — 214 patients (45,053%) — sensu A. N. Kazantsev. Glomus-saving CEE sensu A. N. Kazantsev was carried as follows. Arteriotomy was performed along the inner edge of the external carotid artery (ECA) adjacent to the carotid sinus, 2 to 3 cm above the mouth, depending on the atherosclerotic lesion, with a transition to the common carotid artery (CCA) (also 2 to 3 cm below the mouth of the ECA). The internal carotid artery (ICA) was cut off at the site formed by the wall of the ECA and CCA. Next, an endarterectomy from the ICA was performed using the eversion technique. The next step was an open endarterectomy from EСA and СCA. Next, the ICA at the saved site was implanted in the previous position.Results. No intergroup differences were observed during hospitalization. Due to intraoperative visualization of an extended lesion of the ICA, in some cases it became necessary to transform the operation: in group 1, 4,4% of cases required ICA prosthetics; in groups 2 and 3 — autologous ICA transplantation in 4,8% and 4,7% of cases, respectively. Also, 1 case of ischemic stroke was recorded in groups 1 and 2. The cause of the latter was ICA thrombosis due to intimal detachment distal to the removed plaque. All cases of ECA thrombosis in the hospital postoperative period were differentiated in group 2.In the long-term follow-up, the groups were also comparable in the complication rate. The cause of all ischemic strokes was the development of restenosis or thrombosis of the ICA/prosthesis. Among patients who underwent forced autologous transplantation of the ICA, restenosis was not recorded. It should also be noted that new ECA occlusions (n=12; 9,6%) were visualized 6 months after reconstruction only in group 2.Conclusion. CEE sensu A. N. Kazantsev is the simplest technique of glomus-saving reconstructions, which have demonstrated their safety and effectiveness.
Comparison of Cardiopulmonary Exercise Capacity in Patients with Atrial Septal Defect Treated with Minimally Invasive Cardiac Surgery or Transcatheter Closure
Authors: Agus Hicaz Zencirkiran , Kahraman Serkan , Erturk Mehmet , Onan Burak , Kalkan Ali Kemal , Guner Ahmet , Birand Ali , Uzun Fatih , Kalkan Mehmet Emin , Yildiz Mustafa 
Published: September 2020

Aim. The main aim of our study was to compare the results of transcatheter atrial septal defect (ASD) closure versus minimally invasive cardiac surgery (MICS) focusing on cardiopulmonary exercise capacity and echocardiographic findings preoperatively and 1 month after defect closure.Material and methods. 54 patients with ASD and finally 43 patients who were followed up were included in the study. 21 patients were in MICS (robotic or endoscopic approach) and 22 patients were in transcatheter closure arm. All patients investigated in detail by transesophageal echocardiography and underwent cardiopulmonary exercise test (CPET). At the end of first month, CPET and transthorasic echocardiography were reperformed.Results. There was significant improvement of physical capacity after 1 month following the transcatheter closure procedure documented by exercise time and VO 2 max. Tricuspid annular plane systolic excursion (TAPSE) and tricuspid lateral annular systolic velocity (Tri S) were not changed. In surgery group right heart diameters declined significantly; but VO 2 max, TAPSE and Tri S significantly decreased.Conclusion. Cardiopulmonary exercise function is increased in transcatheter closure group 1 month after closure and contrary not in MICS group. This may be caused by long recovery time of the right ventricle after surgery. Device closure of ASD is preferable to surgical closure if the anatomy is suitable. However, MICS for ASD closure is safe, with short recovery period and less scarring.
Experience of heart transplantation with an extended cold ischemic time of donor heart
Authors: Fomichev A. V. , Khvan D. S. , Agaeva H. A. , Zhulkov M. O. , Doronin D. V. , Chernyavsky A. M. 
Published: September 2020

Aim. A retrospective analysis of the outcomes of heart transplantation (HT) with extended cold ischemic time of donor heart (more than 4 hours) versus heart transplantation with short cold ischemia time (less than 4 hours).Material and methods. The retrospective analysis included 52 recipients who underwent HT in the period from July 20, 2012 to October 23, 2019 in Meshalkin National Medical Research Center. The patients were divided into two groups: group 1 (n=26) — orthotopic HT with extended cold ischemic time (more than 240 minutes), group 2 (n=26) — short cold ischemia time (less than 240 minutes). The effect of cold ischemia duration on hospital survival, the function of donor heart, and the postoperative course was assessed.Results. A retrospective analysis revealed a higher rate of hospital survival in the group of recipients with extended cold ischemic time (more than 240 minutes) 88,5% compared to 80,7% in the second group. There was no difference between the groups in the acute rejection rate, the need for inotropic agents, mechanical circulatory support, and cardiac pacing, as well as the incidence of postoperative renal failure and infectious complications.Conclusion. Due to the small number of patients, our experience in HT with extended cold ischemic time does not allow us to draw global conclusions, but a preliminary comparison of HT with extended and short cold ischemic time did not reveal significant advantages in one group or another. This provides a basis for further accumulation of experience and research.
Assistive Technology in the Construction of Number Concepts: A Study Entailing Actions of Teachers and Visually Impaired Students
Authors: Sganzerla Maria Adelina Raupp , Geller Marlise 
Published: September 2020

Background: With the constant insertion of visually impaired learners in regular basic education in Brazil, it is important to create and/or adapt methodologies and equipment capable of aiding in the intellectual and social development of these students. Objective: This article intends to reflect on the usage of AT (Assistive Technology) as well as the utilisation of adapted materials for visually challenged students in the early years of primary school. Design: With a qualitative approach, it is inspired by the Discursive Textual Analysis. Setting and Participants: The research included not only teachers who teach mathematics in both the Specialized Educational Service (SES) and regular classrooms, but also low-vision students in an inclusive school. Data collection and analysis: A snippet of the meta-text is presented, which, through the analysis of the services provided in the SES, ponders about the students’ necessities and activities within AT for the teaching of number concepts. Results: The research results attest that the usage of AT is, indeed, imperative in the students’ construction of mathematical concepts with the intention of implementing Inclusive Mathematics Education. Conclusions: Simple adaptations, such as providing materials in Braille for visually impaired students, are actions that classroom teachers could adopt, counting on the assistance of Specialized Educational Service professionals.
Lived Experience of Parents of Infants with Down Syndrome from Early Diagnosis and Reactions to Child Disability
Authors: Karami Nejad Reza , Afrooz Gholamali , Shokoohi-yekta Mohsen , Ghobari Bonab Bagher , Hasanzadeh Saeed 
Published: September 2020

Introduction: The birth of a child with special needs can cause a big challenge for the family and create a lot of pressure on the family. The strategies used to report this issue to parents can play an important role in accepting the problem. The purpose of this study was to examine the experience of parenting life since parents become aware of the issue and the strategies they adopted to deal with it.
Methods: The research instrument was a semi-structured interview. The average time of interviews was 60 minutes and the data were collected from a sample of 17 mothers and 9 fathers aged 39 to 58 years in Yazd. The qualitative data were coded in three stages (open, axial, and selective coding) and analyzed using software MAXQDA.
Results: The open codes consisted of 19 concepts. The axial codes included four categories of how parents become aware of the disease, parental reaction to Down syndrome, attribution style, and coping resources. In general, the type of parental reactions ranged from full rejection to full acceptance of a child with specific requirements for Down syndrome.
Conclusion: Given the parental experiences since diagnosis of Down syndrome, all parents reported experiencing feelings of sadness and despair. This is a common human experience reported similarly in various studies in different cultures and geographic regions.
The Effectiveness of Cognitive Self-Compassion Training on Academic Self-Efficacy Beliefs and Social Adequacy in Yazd 9th Grade Male Students
Authors: Heydari Yaser , Barzegar bafrooei Kazem , Dehghan manshadi Mansour 
Published: September 2020

Introduction: In today's world, studying the factors affecting academic achievement is one of the major concerns in evaluating education and all the efforts of this system are targeted at fulfilling this goal. Scientific progress can be achieved by training scientific and creative people. Academic achievement contributes to the development of the country, leads to finding a suitable job and position at the highest levels, and results in a sufficient income. Therefore, the purpose of this study was to evaluate the effectiveness of cognitive self-compassion education, academic self-efficacy, and social adequacy in the ninth grade male students of Yazd.
Methods: This research was quasi-experimental with pre-test/post-test design using a control group. The statistical population included all ninth grade male students in Yazd in 2018-2019. Data collection tools included the 27-item questionnaire of Zajakova et al. (2005), the 47-item questionnaire of Flanner (1990), and the Gilbert training package (2009). The stepwise cluster random sampling method was applied; the second educational district was randomly selected form all educational districts of Yazd. Later, a high school was selected randomly and then students of a grade (the ninth grade) were selected as the study sample. The students were randomly assigned into the experimental and control groups. The experimental group was exposed to cognitive self-compassion training in 8 sessions of 90 minutes. Data were analyzed using analysis of covariance.
Results: Based on the findings of this study, 8 sessions of cognitive self-compassion training increased the level of students' self-efficacy and social adequacy significantly in the post-test phase (p <0.5).Conclusion: According to the obtained results, the cognitive self-compassion education can increase the students’ academic self-efficacy and social adequacy, which have a positive effect on their academic achievement. Therefore, application of the interventional programs in schools is recommended in this regard.
Immersion in the Workplace: A Unique Model for Students to Engage in Real-World Service Design
Authors: Sebek Anezka , Jones John 
Published: September 2020

Since 2015, Fjord and Parsons School of Design have been collaborating to create a mutually beneficial alternative to internships by immersing Design and Technology graduate students in the one-week Fjord Immersive Design Studies. The Design Studies at Fjord operate outside of direct client work and are a perfect vehicle to engage students in structured human-centered design research.
The mission of the Fjord/Parsons Immersion Program is to influence the future of design, to shape future designers, and to propel Fjord’s service design innovation. For the Parsons students, the experience as contributing members of a service design team is an unusual benefit. While traditional months-long internship programs can sometimes be a strain on company resources or an unproductive learning experience for students, the Fjord/ Parsons Immersion Program is an excellent alternative training opportunity to engage students in meaningful work to achieve valuable research in human-centered service design for Fjord. This paper discusses six cases of Parsons graduate students who benefitted from the program.
Factors affecting mutual fund performance in Pakistan
Authors: Alvi Jahanzaib , Rehan Muhammad 
Published: September 2020

The crux of this research is to critically evaluate the potential mutual fund performance drivers. This research will benefit the stakeholders in terms of smart investment decisions. The study is based on convenient sampling method covering 16 out of 19 asset management companies (AMCs) that comprise 114 outstanding funds in the Mutual Fund Association of Pakistan (MUFAP). The data were collected quarterly from March 2013 to March 2018. The findings reveal that the asset under management, fund risk, KSE-100 returns, total income, total expense, age of the fund and lagged returns have a significant positive impact. Management quality rating has an insignificant positive impact on returns. In contrast, risk-free instruments have a significant negative impact on fund returns (FRs). A multiple regression model was used to extract results, and the results further suggested that the roles of fund risk and market return have a significant impact on FRs. Furthermore, we could not avail data for more than 5 years due to unavailability on independent platforms like MUFAP and the official websites of the respective AMCs, which is the central gap of this research. Moreover, it is highly suggested to use different statistical tools to make more meaningful results in future research.

Keywords: Asset under management, fund returns, fund risk, KSE-100 return, mutual funds.