bluuebunny/crossref_metadata_2025_split huggingface dataset:
Possibilities of the merge technique for intraoperative imaging in a lead implantation into the cardiac conduction system for permanent cardiac pacing: interim results of the study
Authors: Medved M. S. , Rud S. D. , Trufanov G. E. , Karpova D. V. , Podshivalova E. P. , Lebedev D. S. 
Published: October 2023

Introduction. A lead implantation into the cardiac conduction system (CCS) is currently the most physiological method of pacing. However, despite the availability of specialized lead and delivery systems, the proportion of non-targeted implantations is very significant. There is a need for an intraoperative visualization technique. The lead position is monitored by electrophysiological and fluoroscopic methods, which, obviously, are not enough.Aim: To optimize the implantation of leads in the conduction system of the heart through the use of intraoperative merge visualization technique (IVT).Material and methods. Two study groups are formed as part of the protocol of a prospective study. In the patients of the study group leads were implanted into the CCS using the IVT; in the control group - by traditional method. After implantation, in all patients the position of the lead using a transthoracic echocardiography (TTE), ECG was assessed. Computed tomography (CT) was performed in patients of study group before and after implantation. In patients of control group CT was performed after implantation.Results. The full study protocol was completed in 10 patients of the study group and in 10 patients of the control group. All patients of the study group confirmed the lead implantation into the interventricular septum (IVS) using TTE and CT; into the CCS using ECG. The duration of the surgery was 87.5 [70; 120] min, fluoroscopy time – 225 [125; 421] sec. Complications, non-target implantations were not registered. In the control group, the duration of the surgery was 100 [100;110] min, the time of fluoroscopy was 775 [500;1230] sec.; stimulation of the CCS was confirmed in 4 (40%) patients; recorded 2 (20%) cases of perforation of the IVS, 1 (10%) case of implantation in the area of the apical part of the right ventricle, 1 (10%) intraoperative dislocation of the right ventricular lead, 1 (10%) case of hemopericardium in the early postoperative period. The average measurement error according to the intraoperative imaging technique compared with MSCT: the distance from the LV endocardium to the lead was 0.98 ± 0.51 mm, the distance from the lead to the tricuspid valve ring was 3.1 ± 0.92 mm. According to trans-thoracic echocardiography, there weren’t structural and functional changes in the tricuspid valve, newly emerged local areas of the myocardium with impaired contractility were detected in patients of the two groups. There weren’t significant changes in sensitivity thresholds, stimulation, and postoperative dislocations of the leads.Conclusions. The use of IVT allows to reduce the number of “off-target” implantations, the time of fluoroscopy, the radiation exposure of the operator and the duration of the surgery.
Diagnostic efficiency of individual systems for automatic analysis of computed tomography images in the detection of ischemic stroke in the basin of the middle cerebral artery
Authors: Andropova P. L. , Gavrilov P. V. , Kolesnikova P. A. , Kushner A. V. , Vladzimirskij A. V. , Vasil’ev Yu. A. , Trofimova T. N. 
Published: October 2023

Background. The diagnosis of ischemic stroke is of high importance in modern medical practice. One of the most promising methods for solving this problem is the introduction of machine learning algorithms into physicians’ work as an auxiliary tool for the interpretation of beam images.Aim: To compare automated computed tomography (CT) image analysis systems in detecting middle cerebral artery stroke.Material and Methods. The study included three anonymized (A, B, C) machine learning algorithms. Analytical validation was carried out on a database of one hundred patients admitted in St. Petersburg vascular center with suspected middle cerebral artery stroke, who underwent noncontrast head CTs. Ischemic stroke in half of the patients was confirmed on the basis of clinical examination findings and CT-angiography and CT-perfusion. The study evaluated the performance indicators (sensitivity, specificity, positive predictive value, negative predictive value, accuracy) for detecting a set of signs of early ischemic changes (by automatic segmentation and predicting a score on the ASPECTS scale). The article also provides a graph that allows you to evaluate the quality of a binary classification – characteristic curves (ROC-curves).Results. The meta-analyses showed all the considered automated algorithms did not reach the threshold values of accuracy (range from 0.67 to 0.75) required for programs according to clinical guidelines (0.80). The algorithms showed variability in sensitivity and specificity. One of the automatic analysis systems (A) had a high sensitivity (0.88), but at the same time a low specificity (0.46), which indicates its overtraining and a tendency to overdiagnoses. The remaining algorithms (B, C) showed low sensitivity (0.6; 0.55) and high specificity (0.9; 0.8).
Imaging methods in assessing the surveillance of type 2 diabetes mellitus for cerebrovascular reserve and brain disease in patients with hemodynamically significant carotid stenosis
Authors: Bukhovets I. L. , Maksimova A. S. , Kuznetsov M. S. , Kozlov B. N. , Vorozhtsova I. N. , Ussov W. Yu. 
Published: October 2023

Introduction. Type 2 diabetes is the most common form of endocrine disease. Diabetes is a well-established risk factor for stroke. Carotid endarterectomy (CEE) is the main method of preventing a serious complication of stroke in patients with carotid stenosis. Consequently, the assess of type 2 diabetes on the results of CEE is an urgent problem of angiosurgery.Aim: To assess effect of type 2 diabetes on cerebrovascular reserve capacity and brain structure in patients with carotid atherosclerosis by ultrasound and magnetic resonance diagnostic.Material and Methods. 44 patients with hemodynamically significant stenosis of the internal carotid arteries (ICA), who underwent ultrasound and magnetic resonance examinations of the carotid arteries at the pre- and postoperative stages were included in this study. Two groups were formed: group I (n =15) – with a verified diagnosis of type 2 diabetes, group II (n = 29) – without diabetes. To assess the cerebrovascular reserve, functional hypercapnic and hyperoxic tests were performed.Results. The analysis of the results showed statistically significant differences in the ICA blood flow in both groups. Intergroup comparison before surgery in the middle cerebral artery on the side of hemodynamically significant stenosis revealed a statistically significant difference in pulsation and peripheral resistance index. In the common carotid arteries on both sides, significant intergroup differences were found in the velocity parameters of blood flow after the CEE operation. The reactivity index in patients with surgical stenosis with type 2 diabetes in the hyperoxic test was statistically significantly different on the side of the stenosis compared to the same indicator in the group without diabetes. There were no statistically significant differences in the hypercapnic test. The value of reactivity index indicates a negative or paradoxical reaction.Conclusion. The use of simple and accessible functional tests to assess cerebrovascular reserve, plaque structure and changes in the brain in patients with type 2 diabetes at the stage of preoperative preparation according to ultrasound and MRI studies allows us to correct the treatment and subsequent protection of the brain at the stage of surgery to prevent possible complications.
Reseña de los dictámenes del Consejo consultivo de Andalucía. Año 2021
Authors: Gallardo Castillo María Jesús 
Published: October 2023

En este trabajo, la Dra. María Jesús Gallardo Castillo, presidenta del Consejo consultivo de Andalucía, realiza una reseña de dictámenes de interés emitidos por ese órgano en el año 2021.
Assessment of Denture Cleanliness among Complete Denture Wearer in Chitwan
Authors: Chaulagain Rajib , Thakur Smriti Narayan , Sapkota Srijana Mishra , Khanal Bibek , Pandey Anisha 
Published: October 2023

Introduction: Oral cleanliness is important for all to maintain the overall health status. It is also important for the old aged edentulous people with dentures. The complete dentures are custom made device which are the replacement for the missing all tooth of mouth. Many microorganisms adhere to the surfaces of dentures and form denture plaque and calculus. They are there due to inadequate denture hygiene maintenance. This study was performed with the aim of assessing cleanliness of complete dentures among the denture wearers.Methods :A descriptive cross-sectional study conducted among 140 complete denture in the Department of Prosthodontics and Maxillofacial Prosthetics at Chitwan Medical College and Hospital. A convenience sampling method was used in this study. After taking the sociodemographic information and other information related to dentures, the participants dentures were evaluated with disclosing agent. The stained dentures were then assessed according to the Denture Cleanliness Index. Data was analyzed by using descriptive statistical tools in SPSS-16 and results were presented in form of tables.Results: The mean age of 140 patients was 71.39±5.80 years. There were 81 (57.9%) females and 59 (42.1) males. About 27 (19.3%) denture wearers did not remove dentures from their mouth at night. Among total, 81 (57.9%) of participants brushed their dentures with water. Denture Cleanliness Index scores of 2 was observed in 64 (45.8%) of denture wearers.
Conclusions: It can be concluded that majority of participants had uncleaned dentures suggesting the need ofproper denture hygiene instructions and routinely follow-up for the cleanliness of dentures and their overall intraoral health status whether or not there were denture stomatitis.
Clinicopathological Profile of Colorectal Cancers in a Tertiary Care Hospital of Central, Nepal
Authors: Khatiwada Sagar , Belbase Narayan  Prasad , Timilsina Binay , Yadav Prasun , Bhujel Sushim , Shrestha Nischal , Upadhyay Hari Prasad 
Published: October 2023

IntroductionThere is an increasing incidence of colorectal carcinoma (CRC) in developing countries like Nepal. The objective of this research is to study the CRC its demography, mode of presentation, type of surgery, complications and Histopathological evaluation (HPE) after surgery.MethodsThis was a retrospective descriptive observational study at College of Medical Sciences, Bharatpur, Nepal. Patients diagnosed with colorectal cancer admitted to gastrointestinal surgery department from July 2019 to June 2022 (3 years) were included. Data of patients were retrieved from hospital records. Pre-operative, intra-operative and post-operative diagnosis of CRC on HPE were also included in the study.ResultsOut of 52 CRC, males were 30 (57.7%) and females were 22 (42.3%), mean age was 52.7 years. Overall, left colon was affected in 33 (63.5%) and right in 19 (36.5%). More than one quarter of patients 14 (26.9%), had disease recurrence by 6 months follow-up. HPE revealed half of the disease condition as adenocarcinoma, moderately differentiated in (50%) cases.ConclusionsColorectal cancer is predominant in male patients and older age group. Incidence is high in younger people <40 years and low in extreme age group >80 years. Meticulous surgery is the only proven cure for malignancy.
Comparative Study on Promotional Strategies of Two Nepali Telecom Companies, NTC and Ncell
Authors: Pokharel Prakash 
Published: October 2023

This paper is intended to compare the promotional strategies of two leading telecommunication industry of Nepal – NTC and Ncell. Telecommunication industry is vital for economic growth. It begins with analyzing and comparing their promotional activities. Then it compares the promotional strategies in two ways: in terms of frequency and in terms of budget they spend. Through comparison, it reveals that promotional activities have been taken very seriously by the Ncell than Nepal Telecom.
On the basis of David Aakar model of brand equity, this paper also analyzes the effect of promotional activities into brand equity in the following ways: brand loyalty, brand awareness, perceived quality and brand association of telecommunication companies. It shows that two companies have difference in promotional strategies mainly because of their attitude to be a leader in market.
Artritis reumatoide: carga económica y calidad de vida relacionada con la salud en Colombia y en el mundo: Revisión de alcance
Authors: Maldonado Restrepo Angela Isabel , González Rodríguez Javier Leonardo 
Published: October 2023

Introducción: el aumento de las enfermedades crónicas es una de las mayores amenazas para la salud y la sostenibilidad de los sistemas de atención. Para ello, los ajustes del riesgo permiten desarrollar programas de clasificación de la población y se vuelven instrumentos para implementar nuevos modelos de atención, estructurados a partir de la morbilidad, clasificando el riesgo con el gasto asociado, y así desarrollar modelos predictivos y análisis del gasto per cápita según las características de la población, con lo cual se logra una mejor gestión financiera. Como atención primaria, la gestión del riesgo debe anticiparse a las enfermedades para diagnosticarlas de manera precoz y brindar tratamientos oportunos orientados a disminuir la severidad y secuelas. Algunas ocasionan grandes costos para el sistema de salud afectando su equilibrio y sostenibilidad, como la artritis reumatoide (AR), considerada de alto costo por su impacto y la asociación con otras comorbilidades. Objetivo: revisar los estudios realizados sobre carga económica (CE), carga de enfermedad (CE1), gastos de bolsillo, gastos catastróficos en salud (GCS) y calidad de vida relacionada con la salud (CVRS), en pacientes con AR en Colombia y en el mundo entre 2010 y 2022. Métodos: revisión de alcance de 482 artículos, 139 de CE y CE1, 14 de gastos de bolsillo y GCS, y 329 para CVRS, en literatura indexada utilizando las bases Scopus, Medline a través de Pubmed y JSTOR en inglés y español. Resultados: se observó tendencia en el crecimiento de la literatura, pero con predominio de reportes asociados con terapias biológicas tanto en CE y CE1 como CVRS, seguidos de estudios de atención médica y revisiones sistemáticas de literatura (RSL). Estados Unidos lidera las investigaciones seguido del Reino Unido; el cuestionario predominante para evaluar la calidad de vida relacionada con la salud fue el SF-36 (41,9%) seguido del EQ- 5D (19%) y aunque se cuenta con el Qol–RA (Quality of Life in Rheumatoid Arthritis Scale) validado en Colombia, su uso infrecuente. Conclusiones: el aumento de estudios sobre costos en salud ha tomado gran relevancia para comprender la realidad e instruir sobre aspectos de gestión del riesgo, enseñar conceptos, analizar escenarios de impacto y estudio de sensibilidades, mostrando todos los posibles resultados.
Development of town planning pattern of Beryozov according to cartographic and depictive sources of the 17th–19th centuries
Authors:   Scientific and Educational Centre of the Institute for Humanities Education and Sport, Surgut State University, Surgut, Vizgalov Georgiy P. ,   Institute of Archaeology and Ethnography of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk,   “Scientific Production Association “Northern Archaeology-1” LLC, Nefteyugansk, Vershinin Evgeniy V. ,   ANO “Institute of Archaeology of the North”, Nefteyugansk., Ermakova Ksenia K. ,   ANO “Institute of Archaeology of the North”, Nefteyugansk.
Published: October 2023

Картографические материалы и рисунки путешественников – важные источники, содержащие данные о планировочной структуре и архитектуре поселения. Привлечение таких документов позволило изучить развитие планировочной структуры Берёзова в период XVII–XIX вв. и сопоставить полученные данные с письменными источниками. Планировочная структура Берёзова, активно развивавшаяся до середины XVIII века, позднее начала деградировать. Сформированный комплект документов станет основой для последующего сопоставления с археологическими данными.
Peran Mediasi Komitmen Organisasi dalam Pengaruh Person-Organization Fit terhadap Kinerja Inovatif
Authors: Dede Hardani  , Sindrawati  , Muhammad Syukrullah  
Published: October 2023

Penelitian ini bertujuan menguji peran mediasi dari komitmen organisasi dalam hubungan antara person-organization fit dengan kinerja inovatif di lembaga publik. Studi kausal dengan metode survei sebagai alat pengumpulan data dengan responden para pegawai kecamatan Se- Kabupaten bandung . yang dipilih secara acak sebanyak 270. Analisis data menggunakan path analisis dengan bantuan spss25. Hasil penelitian menunjukkan bahwa adanya kesesuaian nilai antara pegawai dan orgnisasi mempengaruhi komitmen orgnisasi dan pada akhirnya mendorong para pegawai untuk menunjukan kinerja inovatif dalam memberikan pelayanan publik. Komitmen organisasi memediasi secara parsial pengaruh kecocokan individu dan organisasi dengan kinerja inovatif. Penelitian ini menyimpulkan bahwa Person-Organization fit dan komitmen organisasi berkontribusi positif terhadap kinerja inovatif karyawan di lembaga publik. Implikasi teoritis dalam penelitian ini adalah bahwa komitmen organisasional merupakan mediator yang penting dalam hubungan antara person-organization fit dan kinerja inovatif. Sedangkan implikasi praktis yaitu perbaikan kinerja inovatif dilakukan dengan memperkuat komitmen organisasional melalui pelatihan dan pengembangan karir, budaya organisasional yang inklusif dan kolaboratif, dan memberikan penghargaan dan pengakuan atas kontribusi karyawan pada inovasi.
La extubación durante la noche no se asocia con su fracaso en pacientes pediátricos de Unidad de Cuidados Intensivos: Estudio de cohorte retrospectivo
Authors: Ibarra V. Maybreet , Andrades E. Francisca , Satta S. María , Díaz R. Franco , Donoso F. Alejandro 
Published: October 2023

Poco es conocido sobre la hora del día y carácter de éste (hábil/no hábil) en que se efectúa la extubación, y si durante la noche esta es segura. Objetivo: describir la frecuencia de extubación nocturna (EN) y en día no hábil (ENH). Adicionalmente determinar la asociación entre éstas y resultados clínicos. Pacientes y Método: Estudio de cohorte retrospectivo de pacientes menores de 18 años quienes recibieron ventilación mecánica (VM) invasiva y se efectuó un intento extubación en una Unidad de Paciente Crítico Pediátrico (UPCP) médico quirúrgica de alta complejidad entre el 01/01/2018 al 31/12/2021. Exposición primaria: EN, la cual fue definida como la realizada entre 20:01 - 8:00 horas. Se evaluó su asociación con fracaso de extubación (FE), duración de VM invasiva y tiempo de esta- día en la UPCP.Resultados: 146 pacientes fueron incluidos (58,9% hombres, edad 1,14 (0,25 - 5,5) años). En el 17,8% se efectuó EN. La extubación nocturna no se asoció con FE como tampoco el día de extubación. El FE fue 3,8% en EN y 5% en la extubación diurna (ED) (p = 0,80). La duración de la VM invasiva fue menor en EN que ED (48 (24-73,5) vs. 72 (48-96) h, p = 0,02). Conclusiones: La EN no se asoció con FE. Los pacientes con EN tuvieron menor duración de VM invasiva, y ésta última se asoció con FE. La retirada de la VM invasiva debe ser considerada en la primera oportunidad y estar determinada por factores clínicos, más que por la hora del día.
Caracterización de una cohorte de pacientes pediátricas con Síndrome de Turner
Authors: Guzmán-Arias Edna Catherine , Grajales-Restrepo Diego Alejandro , Zuluaga-Espinosa Nora Alejandra , Lopera-Cañaveral Maria Victoria , Niño-Serna Laura Fernanda 
Published: October 2023

El síndrome de Turner es un trastorno genético que se presenta en mujeres con ausencia parcial o completa de un cromosoma X. Objetivo: Describir las características clínicas, paraclínicas y genotípicas de las pacientes con síndrome de Turner atendidas en tres instituciones de salud de Medellín.Pacientes y Método: Estudio descriptivo retrospectivo. Se incluyeron 97 pacientes con síndrome de Turner (< 18 años) confirmado por cariotipo entre 2011 y 2018. Se excluyeron pacientes cuyo cariotipo no cumplía la especificación del Colegio Americano de Genética Médica. Se recolectaron variables sociodemográficas, nutricionales, características fenotípicas y exámenes de laboratorio. Se realizó un análisis descriptivo en SPSS versión 20.Resultados: La edad al diagnóstico fue de 8,5 años (RIC 4-12). La principal manifestación clínica fue la talla baja (90%). Presentaron malformaciones cardiovasculares (35%), malformaciones renales (26%), trastornos auditivos destacándose la hipoacusia (33%), trastornos neuropsiquiátricos (44%). El cariotipo más frecuente fue 45,X (51%) seguido de 45,X/46,XX (14%). Las pacientes con cariotipo 45,X tuvieron las manifestaciones clínicas más clásicas. Las mayores de 5 años presentaron mayor proporción de exceso de peso. Se encontró dislipidemia en 62% e hipotiroidismo en 22%. El 70% de las pacientes mayores de 11 años recibieron inducción puberal; el 23% presentaron pubertad espontánea y de ellas el 44% requirieron mantenimiento hormonal. El 86% recibieron somatropina. Conclusiones: Las pacientes con síndrome de Turner de nuestro estudio presentaron alta frecuencia de talla baja y comorbilidades cardiovasculares, renales, auditivas, endocrinas y neuropsiquiátricas. El diagnóstico fue tardío, debido a la falta de sospecha clínica por su presentación variable.
Numerical Analysis to Investigate the Impact of Skirt Geometric Parameters on Secondary Piston Movement in a Single-cylinder Diesel Engine
Authors: Menacer Brahim , Narayan Sunny , Bouchetara Mostefa , Khatir Tawfiq , Urbina Coronado Pedro Daniel 
Published: October 2023

Currently, modern internal combustion engines are receiving great attention due to their efficiency, particularly in response to the increasing limits imposed by environmental and emission legislation. Sound emissions of internal combustion engines are mainly caused by three sources of noise: combustion, mechanical and aerodynamic flow. The secondary motion of the piston plays a crucial role in the analysis of performance, noise, vibration and reliability of internal combustion engine (ICE). In the presented article, a mathematical simulation model has been developed by using of the GT-Suite software to study the rotational and lateral motion of the piston (called secondary motion) as well as the piston slap in ICE. This model takes into account the effect of variation in the major geometric parameters of the skirt design, such as the piston pin offset (P.P.O) and the length of the skirt. Furthermore, a combined model that accounts for the interplay between the secondary dynamics of the piston and the dynamic fluid lubrication has been developed. This model utilizes a mixed lubrication approach for the purpose of simulation. The results of this simulation have demonstrated that the variations in length of the skirt and the P.P.O have a considerable effect on piston secondary motion and tribological performances, and that the lateral motion of the piston is significantly influenced by the piston side force, which plays a crucial role in this behavior.