bluuebunny/crossref_metadata_2025_split huggingface dataset:
МЕТОДИКА РОЗРАХУНКУ ЕФЕКТИВНОСТІ ЕКСПЛУАТАЦІЇ ВАНТАЖНИХ АВТОМОБІЛІВ
Authors: ХАВРУК Володимир , ПАРХОМЕНКО Олександр 
Published: November 2021

У роботі розглядається питання оцінки ефективності експлуатації вантажних автомобілів. Встановлено, що ефективність експлуатації автомобілів функціонально пов’язана з економічною ефективністю, надійністю і безвідмовністю автомобілів – зв’язок між якими представлено у вигляді структурно-функціональної схеми.
З’ясовано, що чистий прибуток автотранспортного підприємства залежить від трьох складових: тарифної вартості перевезень, собівартості перевезень і величини податків.
Наведені формули для визначення собівартості перевезень вантажів, витрат на транспортування вантажу, умовно-технічних витрат. В структурі умовно-технічних витрат розглянуті витрати: на паливо, на мастильні матеріали, на шини, на запасні частини і матеріали при виконанні технічного обслуговування і ремонту рухомого складу.
На основі аналізу структури собівартості перевезень вантажів автомобілями встановлено десять показників, якими визначаються «незаплановані» витрати, такі наприклад, як: витрати, пов’язані зі збільшенням відстані транспортування вантажу; витрати, пов’язані з ушкодженням і втратою вантажу; витрати, пов’язані з додатковим зберіганням вантажу; витрати, пов’язані зі збільшенням вартості підготовки вантажу до перевезення; витрати, пов’язані зі збільшенням вартості складування вантажу.
Встановлено, що умовно-постійні витрати (витрати на амортизацію, накладні витрати, величина податків) не впливають істотно на величину річного економічного ефекту при оновленні рухомого парку.
Отримані залежності для визначення: питомих умовно-технічних витрат на експлуатацію автомобіля при доставці вантажів; величини річного економічного ефекту, що досягається власником вантажних автомобілів при оновленні рухомого складу.
Ключові слова: вантажний автомобіль, критерій, рухомий склад, собівартість, умовно-організаційні витрати, умовно-технічні витрати.
Endoscopic gallbladder drainage for acute cholecystitis with high-risk surgical patients between transduodenal and transpapillary stenting
Authors: Nishiguchi Kyouhei , Ogura Takeshi , Okuda Atsushi , Ueno Saori , Nishioka Nobu , Yamada Masanori , Matsuno Jun , Ueshima Kazuya , Yamamoto Yoshitaro , Higuchi Kazuhide 
Published: November 2021

Background and Objectives:
EUS-guided gallbladder drainage (GBD) has emerged as an alternative GBD technique, particularly for high-risk surgical patients. To prevent stent migration or to facilitate stent deployment, the lumen-apposing metal stent (LAMS) was recently developed for EUS-GBD. However, LAMS remains unavailable in several countries and is expensive compared with conventional fully covered self-expandable metal stent (FCSEMS). Although several studies have shown the clinical benefits of EUS-GBD using novel FCSEMS or LAMS compared with endoscopic transpapillary GBD (ETGBD), the choice between ETGBD and EUS-GBD using conventional FCSEMS and ETGBD remains controversial. The aim of this study was to evaluate EUS-GBD using conventional FCSEMS compared with ETGBD.

Materials and Methods:
This comparative retrospective study included consecutive symptomatic AC patients who underwent gallbladder drainage by either EUS-GBD or ETGBD between January 2015 and December 2018. The main outcome measures were technical success, clinical success, procedure-related and stent-related adverse events, and recurrence of AC during follow-up.

Results:
Fifty-four patients (44.4% female, 55.6% male) who underwent EUS-GBD (n = 25) or ETGBD (n = 29) were enrolled. Initial technical success rates were 100% with EUS-GBD and 82.7% (24/29) with ETGBD. The median procedure time was significantly shorter for the EUS-GBD group than for the ETGBD group (11.0 vs. 24.0 min, P < 0.05). Procedure-related adverse events did not differ significantly between groups (P = 0.283). During follow-up (median 522 days, range 43 – 1892 days), recurrent acute cholecystitis (AC) was only observed in 4 patients from the ETGBD group. Overall survival did not differ significantly between the EUS-GBD group (mean 1070 days) and ETGBD group (mean 1470 days) (P = 0.292).

Conclusion:
The technical success rate for EUS-GBD using FCSEMS with plastic stent insertion was significantly higher with a shorter procedure time and resulted in a lower rate of recurrent AC.
Effect of smoking on clinical outcomes in patients receiving rotational atherectomy in calcified coronary lesions: from the ROCK Registry, South Korea
Authors: Jang Won Young , Lee Su Nam , Her Sung-Ho , Moon Donggyu , Moon Keon-Woong , Yoo Ki-Dong , Lee Kyusup , Choi Ik Jun , Lee Jae Hwan , Lee Jang Hoon , Lee Sang Rok , Lee Seung-Wan , Yun Kyeong Ho , Lee Hyun-Jong 
Published: November 2021

BACKGROUND:
Tobacco smoking and its harmful health effects also increase economic burdens globally. Surprisingly, despite the detrimental health consequences of smoking, some studies have shown better survival among smokers compared with non-smokers, a phenomenon called “smoker's paradox”. However, the impact of smoking status on clinical outcomes in severe calcified coronary artery disease (CAD) patients has yet to be reported.

OBJECTIVES:
Investigate the impact of smoking on clinical outcomes in calcified CAD receiving rotational atherectomy (RA).

DESIGN:
Retrospective review of medical records.

SETTING:
Multicenter registry in South Korea.

PATIENTS AND METHODS:
This multicenter registry included consecutive patients with calcified CAD who underwent RA at nine tertiary centers in Korea between January 2010 and October 2019.

MAIN OUTCOME MEASURES:
Target-vessel failure (TVF) which included the composite of cardiac death, target-vessel myocardial infarction (TVMI), and target-vessel revascularization (TVR).

SAMPLE SIZE:
583 lesions in 540 patients followed for a median of 16.1 months.

RESULTS:

Lesions were divided into two groups: non-smokers (n=472, 81.0%) and smokers (n=111, 19.0%). TVF in the smoker group was significantly more frequent than in non-smoker group (log rank
P
=.016). The inverse probability of treatment weighting analysis also showed that smoking was significantly associated with a higher incidence of the primary outcome (HR: 1.617; 95% CI: 1.127–2.320;
P
=.009), cardiac death (HR 1.912; 95% CI: 1.105-3.311;
P
=.021), myocardial infarction (HR: 3.914; 95% CI: 1.884-8.132;
P
<.001), TVMI (HR: 3.234; 95% CI: 1.130-9.258;
P
=.029), and TVR (HR: 1.661; 95% CI: 1.043-2.643;
P
=.032). However, any bleeding was significantly observed less in the smokers.

CONCLUSION:
Smoking is significantly associated with adverse clinical outcomes in CAD patients requiring RA.

LIMITATIONS:
Retrospective design.

CONFLICTS OF INTEREST:
None.
Outcomes of autologous stem cell transplantation for multiple myeloma in Saudi Arabia
Authors: Abdrabou Ahmed Kotb , Sharif Fahad Al , Fakih Riad El , Hashmi Shahrukh , Khafaga Yasser Mohamed , Alhayli Saud , Zahrani Hazaa Al , Ahmed Syed , Fraih Feras Al , Shaheen Marwan , Rasheed Walid , Chaudhri Naeem Arshad , Mohareb Fahad Al , Khalil Hala , Aljurf Mahmoud , Hanbali Amr 
Published: November 2021

BACKGROUND:
In 2015, multiple myeloma (MM) represented 1% of all cancers and about 5% of hematologic malignancies in Saudi cancer registry. We conducted this large study because only small pilot studies have examined MM outcomes after autologous stem-cell transplantation (ASCT). The standard therapy for eligible patients is induction chemotherapy followed by ASCT.

OBJECTIVES:
Determine the demographic characteristics of MM patients and the outcomes of ASCT.

DESIGN:
Retrospective.

SETTING:
Tumor registry database of major tertiary cancer care center in Riyadh.

PATIENTS AND METHODS:
We identified patients with newly diagnosed MM who underwent ASCT from October 1997 to March 2015.

MAIN OUTCOME MEASURES:
The demographic characteristics of MM patients and the outcomes of ASCT in the form of response evaluation, progression-free survival (PFS) and overall survival (OS).

SAMPLE SIZE:
169 patients with newly diagnosed MM.

RESULTS:
The median age at diagnosis was 51 years (range 23–69) and 100 (59.2%) were male. The most common immunoglobulin (Ig) subtype was IgG-kappa (80 patients; 47.6%). Most patients presented with advanced ISS stage III (75 patients; 47.5%). The cytogenetic analysis was documented in only 87 patients (51.4%); about half (48.3%) had normal cytogenetics by fluorescence in situ hybridization. Deletion 13 was present in 18.4% of patients. In post-induction therapy, 84 patients (50%) achieved a complete response, which increased to 78.1% (132 patients) after ASCT. The median PFS and OS post-transplantation were 30 and 202 months, respectively. Only one patient (<1%) died in the first 100 days after transplantation.

CONCLUSIONS:
Our transplant eligible MM patients tend to be younger with a higher OS and a low ASCT-related mortality (<1%) than is reported internationally.

LIMITATIONS:
Usual limitations of a retrospective analysis using registry-level data; no data on quality of life.

CONFLICTS OF INTEREST:
None.
Outcomes of flexible fiberoptic laryngoscopy in patients with stridor: a cross-sectional study in a tertiary care pediatric center in Saudi Arabia
Authors: Alsowailmi Ghada , Alshammari Jaber , Arafat Abdullah Saud , Alotaibi Amal , Alsahli Afnan , Alshahwan Sara Ibrahim , Omair Aamir , Alsafi Maryam 
Published: November 2021

BACKGROUND:Successful evaluation of a patient with stridor requires a thorough history and physical examination followed by a flexible fiberoptic laryngoscopy (FFL), which provides visualization of the upper airway.OBJECTIVES:Estimate the prevalence of causes of stridor in children who underwent FFL and compare different age groups. Find any significant associations between symptoms and laryngoscopic findings. Identify patients who needed further evaluation using direct laryngobronchoscopy (DLB).DESIGN:Retrospective, cross-sectional.SETTING:Tertiary care center in Riyadh.PATIENTS AND METHODS:We included all pediatric patients aged 1 month to 14 years who underwent fiberoptic laryngoscopy for stridor evaluation from January 2015 to January 2018 (37 months). Patients older than the age of 14 years, and patients with a workable diagnosis with adenotonsillar hypertrophy, choanal atresia, or laryngotracheo-bronchitis (croup) were excluded.MAIN OUTCOME MEASURES:Findings of FFL.SAMPLE SIZE:217 pediatric patients.RESULTS:The median (interquartile range) age of the patients was 5 (8) months. Laryngomalacia was the most common diagnosis (n=149, 69%) followed by laryngopharyngeal reflux (n=42, 19%). Subglottic stenosis was the most common finding in patients who underwent DLB for further evaluation (n=19, 49%). Laryngomalacia was more frequent in children ≤12 months of age (83% vs 43% in children >12 months,P<.001). Vocal cord paralysis was more common in children >12 months of age (27% vs 9%,P<.001). FFL was effective in finding the diagnosis in 178 (82%) patients; only 39 (18%) patients needed further assessment using DLB.CONCLUSION:FFL is an effective and important tool for evaluating patients with stridor.LIMITATIONS:Retrospective design and single-centered.CONFLICTS OF INTEREST:None.
Characteristics and outcomes of mechanically ventilated elderly patients in the absence of an end-of-life care policy: a retrospective study from Bahrain
Authors: Saeed Mahmood Al , Almoosawi Barrak Mahmood , Awainati Mahmmod Al , Barni Mohammed Al , Abbas Fadhel 
Published: November 2021

BACKGROUND:Globally, the percentage of elderly patients has been increasing, leading to a higher demand for healthcare resources and intensive care. Bahrain has a majority Muslim population and Islam governs most policies, including end-of-life care. All patients at our institute receive full resuscitative measures regardless of the prognosis, leading to a high number of mechanically ventilated patients.OBJECTIVES:Assess characteristics, outcomes, theoretical costs, and use of antibiotics in critically ill elderly patients requiring mechanical ventilation.DESIGN:Retrospective.SETTING:Intensive care unit and general ward of a tertiary medical care center.PATIENTS AND METHODS:We studied all elderly patients (≥60 years old) admitted under general medicine in the period of January to June 2018 who needed intensive care and were intubated.MAIN OUTCOME MEASURES:The duration of mechanical ventilation, theoretical costs, antibiotic usage.SAMPLE SIZE:140 patients.RESULTS:Of 140 patients, 136 died (97%) and half of the deaths (n=69, 50.7%) occurred within the first 24 hours of intubation. Sixty-nine (79.3%) of the patients on short-term ventilation (≤96 hours) died within 24 hours of intubation, while the four survivors were on long-term ventilation (>96 hours) (P<.001). All the nonsurviving patients (n=136) were on antimicrobial therapy, mostly for hospital-acquired infections. The median (interquartile range) APACHE II score was relatively high at 28.0 (8.0) with significantly higher scores in the early mortality group compared to the late mortality group (30 [10] vs 26 [7],P=.013) and higher scores in the short-term vs long-term ventilation group (29 [10] vs 26 [7],P=.029). The median theoretical cost per patient in the early and late mortality groups was USD 10 731 and USD 30 660, respectively (P<.001).CONCLUSIONS:Given that less than 3% of patients had a favorable outcome, 50% of the cases died within 24 hours after intubation, hospital costs and antimicrobial use were high, the current policy of “full resuscitative measures for all” should be revised. We suggest implementing an end-of-life care policy, since the goal of resuscitation is to reverse premature death, not prolong the dying process.LIMITATIONS:Small sample size and absence of long-term follow-up. Theoretical costs were used as no direct calculated costs were available in our hospital.CONFLICT OF INTEREST:None
Frequency of molar incisor hypomineralization and associated factors among children with special health care needs
Authors: Mohamed Roshan Noor , Basha Sakeenabi , Al-Thomali Yousef , Al Zahrani Fatma Salem , Ashour Amal Adnan , Al Shamrani Ammar Saleh , Almutair Nada Eid 
Published: November 2021

BACKGROUND:
Molar incisor hypomineralization (MIH) is a frequently encountered oral condition that varies from mild opacities to posteruptive enamel breakdown. No previous published studies have investigated the frequency of MIH and associated risk factors among children with special health care needs (CSHCN) to our awareness.

OBJECTIVES:
Assess the frequency of MIH and associated risk factors among CSHCN.

DESIGN:
Cross-sectional.

SETTING:
Schools in provincial city of Saudi Arabia.

PATIENTS AND METHODS:
The study was conducted among 400 (180 boys and 220 girls) special needs children. Diagnosis of MIH was according to the European Academy of Paediatric Dentistry criteria.

MAIN OUTCOME MEASURE:
Result of logistic regression analysis that assessed the association between MIH prevalence and associated prenatal, perinatal, and postnatal factors.

SAMPLE SIZE:
400 (180 boys and 220 girls) special needs children.

RESULTS:

Among 400 CSHCN, 98 (24.5%) presented with MIH. Children with multiple disabilities had a 3.89 times greater risk of MIH (95% CI: 1.91–6.19,
P
=.002). Children with positive prenatal factors had an adjusted odds ratio (aOR) of 2.31 times for MIH (95% CI: 1.22–4.73,
P
=.012). Children with a childhood infection history had an aOR of 2.43 times for MIH (95% CI: 1.31–5.85,
P
=.014). Children with a breastfeeding history >18 months had an aOR of 3.73 for MIH (95% CI: 1.62–8.60,
P
=.002). Permanent maxillary first molars were the most frequently affected teeth, and demarcated opacity was the most frequent MIH type.

CONCLUSION:
MIH should be recognized as one of the prevalent oral health problems among CSHCN to prevent tooth mortality.

LIMITATIONS:
A cross-sectional study cannot establish a causal relationship.

CONFLICTS OF INTEREST:
None.
Giant splenic artery aneurysm treated surgically with spleen and pancreas preservation
Authors: Atanasijevic Igor , Babic Srdjan , Tanaskovic Slobodan , Gajin Predrag , Ilijevski Nenad 
Published: November 2021

Aneurysms of the splenic artery represent a rare clinical entity, even though they account for 60-70% of all visceral artery aneurysms. Splenic artery aneurysms larger than 5 cm are extremely rare, and they are considered to be giant. Possible causes of splenic artery aneurysm development include: trauma, hormonal and local hemodynamic changes in pregnancy, portal hypertension, arterial degeneration, infection and postsplenectomy occurrence. Surgical treatment of giant splenic artery aneurysms includes procedures that frequently require pancreatectomy and splenectomy. We present a case of a 10.2 cm giant splenic artery aneurysm, firmly adhered to the pancreas, which was treated surgically, with spleen and pancreas preservation.

SIMILAR CASES PUBLISHED:
Although many cases on treatment of giant splenic artery aneurysm have been published, the majority have described additional visceral resections associated with aneurysmectomy, which is in contrast with our report. Furthermore, aneurysms reaching 10 cm in size were extremely rare.
Kuwait National Mammography Screening Program: outcomes of 5 years of screening in Kuwaiti women
Authors: Alkhawari Hanaa Abdulla , Asbeutah Akram Mahmoud , Almajran Abdullah Abdulaziz , AlKandari Latifa Abdullah 
Published: November 2021

BACKGROUND:
Breast cancer is the most common malignancy among women in Kuwait, representing 39.8% of all female cancer cases.

OBJECTIVES:
Report the data of the Kuwait National Mammography Screening Program (KNMSP) for a 5-year period.

DESIGN:
Prospective data collection.

SETTING:
Population-based screening.

SUBJECTS AND METHODS:
We included mammography screens done for Kuwaiti women (age 40 years and older) who attended the KNMSP from 2014 to 2019 to screen for breast cancer. A full-field digital mammography system was used to acquire the mammographic images in craniocaudal and mediolateral oblique projections. Independent double-blind reading of the mammograms was performed by two radiologists.

MAIN OUTCOME MEASURE:
Early detection of breast cancer.

SAMPLE SIZE:
14 773 asymptomatic women met inclusion criteria (mean [SD] age, 51.8 (8.2).

RESULTS:
Lesions were detected in 551 women (3.7%). These included 233 malignant lesions (233/551, 42.3%), 57 high-risk lesions (10.3%) and 261 benign lesions (47.4%). The participation rate was 7.8% of the target population of women 40–69 years of age. The majority of breast cancer cases were reported in the age group 45–49 years (23.2%). The KNMSP study recall rate for 5 consecutive years was in a range of 11.9–16.5% (mean, 14.3%). The detection rate of ductal/lobular carcinoma in situ and invasive breast cancer were 2.5 and 13.6 per 1000 screened women, respectively. Invasive ductal carcinoma was the most common type. Only 4314 women followed up within 12–15 months of the first mammography for a retention rate of 29.2%.

CONCLUSIONS:
Screening mammography improves early detection of breast cancer in women older than 40 years but poor participation is a limitation. We are aiming to increase the participation rate to 70% of the population.

LIMITATIONS:
Lack of participation by women.

CONFLICT OF INTEREST:
None.
Patients with hypertension hospitalized with COVID-19 pneumonia using angiotensinconverting enzyme inhibitors and angiotensin II receptor blockers or other antihypertensives: retrospective analysis of 435 patients
Authors: Baslilar Seyma , Saylan Bengu 
Published: November 2021

BACKGROUND:
The angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARBs) are widely used for the treatment of hypertension (HT). Whether the use of these drugs increases the infectivity of novel coronavirus and results in an additional risk for morbidity and mortality of COVID-19 is a matter of interest.

OBJECTIVES:
Assess the effect of ACEI/ARBs compared with other hypertensives on the clinical course and outcome in COVID-19 pneumonia.

DESIGN:
Retrospective.

SETTINGS:
Tertiary care hospital.

PATIENTS AND METHODS:
We collected data on adult inpatients with COVID-19 pneumonia using ACEI/ARBs versus other antihypertensives between 15 March 2020, and 15 February 2021.

MAIN OUTCOME MEASURES:
Severity, clinical course, mortality, and time to PCR negativity between patients using ACEI/ARBs and other antihypertensives.

SAMPLE SIZE:
435

RESULTS:

ACEI/ARBs were used by 203 patients (46.6%) (median age: 71 [41–94] years), while 232 patients (53.4%) were using other antihypertensives (median age: 69 [22-93] years,
P
=.645 vs age of ACEI/ARB users). There were no statistically significant differences between the ACEI/ARBs users and non-users in the number of patients admitted to intensive care (65 cases [32%] vs. 74 cases [31.9%],
P
=.978), the median duration of stay in hospital (8 [1–54] days vs.7 [1–55] days,
P
=.806) the median duration of ICU stay (8 [1–40] days vs. 6 [1–25] days), and the mortality rate (48 cases [23.6%] vs. 61 [26.3%],
P
=.525). While the median days before transfer to the ICU was shorter in ACE/ARBI non-users (2 [1–15] days vs. 3 [1–21] days,
P
=.02), the difference was not important clinically. The median time to PCR negativity was similar in ACEI/ARBs users and non-users (13 [7–34] days for users and 13 [5–45] days for non-users), (
P
=.083).

CONCLUSIONS:
ACEI/ARB use is probably unrelated to poor prognosis in COVID-19 pneumonia inpatients. ACEI/ARBs did not prolong the time to PCR negativity. We conclude that using ACEI/ARBs probably does not increase the infectivity of SARS-CoV-2.

LIMITATIONS:
Pharmacological therapies were not discussed in detail. The use of corticosteroids may affect the time to PCR negativity. We could not analyze the effect of obesity because of a lack of data.

CONFLICT OF INTEREST:
None.
Comparison of pregnancy outcomes between women of advanced maternal age (≥35 years) versus younger women in a tertiary care center in Saudi Arabia
Authors: Shams Taghreed , Gazzaz Tala , Althobiti Khalda , Alghamdi Nouf , Bamarouf Waleed , Almarhoumi Lujain , Alhashemi Hashem 
Published: November 2021

BACKGROUND:
Pregnancy in women aged 35 years or above is generally considered an advanced maternal age (AMA). AMA is associated with an increased rate of maternal and neonatal complications.

OBJECTIVES:
Assess the effect of AMA on maternal and neonatal outcomes.

DESIGN:
Analytical cross-sectional study of medical records.

SETTINGS:
In-patient hospital tertiary care setting in Jeddah.

PATIENTS AND METHODS:
All women who attended antenatal care and delivered at King Abdulaziz Medical City in Jeddah in the first half of 2018 were included in the study. Outcomes for women 35 years of age or older were compared with younger women. Significant factors in a univariate analysis were entered in a multiple logistic regression model to assess the association between AMA and outcomes.

MAIN OUTCOME MEASURES:
Rates of maternal neonatal complications, analysis of factors associated with advanced maternal, gestational diabetes mellitus (GDM), cesarean delivery.

SAMPLE SIZE:
1586 women.

RESULTS:

Of the 1586 women, 406 were 35 years of age or older (25.6%), and 1180 were younger than 35 years. The AMA group had a significantly higher proportion of GDM (32.0% versus 13.2%,
P
<.001). The adjusted odds ratio (OR) for GDM was 2.6 (95% CI 2–3.5,
P
<.001.) compared with younger women in the multivariate logistic regression analysis. Older women had a higher rate of cesarean delivery (43.6% versus 30.8%,
P
<.001). The adjusted OR for cesarean vs. vaginal delivery was 1.5 (CI 1.2–1.9,
P
=.002).

CONCLUSION:
Pregnancy in women 35 years or older was associated with an increased risk of GDM and cesarean delivery.

LIMITATIONS:
Cross-sectional design, small sample size, single hospital.

CONFLICT OF INTEREST:
None.