bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medical treatment for heavy menstrual bleeding in primary care: 10-year data from the ECLIPSE trial
Authors: Kai Joe , Dutton Brittany , Vinogradova Yana , Hilken Nicholas , Gupta Janesh , Daniels Jane 
Published: October 2022

BackgroundHeavy menstrual bleeding (HMB) is a common problem that can significantly affect women’s lives. There is a lack of evidence on long-term outcomes after seeking treatment.AimTo assess continuation rates of medical treatments and rates of surgery in women 10 years after initial management for HMB in primary care.Design and settingThis was a prospective observational cohort study.MethodWomen with HMB who participated in the ECLIPSE primary care trial (ISRCTN86566246) completed questionnaires 10 years after randomisation to the levonorgestrel-releasing intrauterine system (LNG-IUS) or other usual medical treatments (oral tranexamic acid, mefenamic acid, combined oestrogen–progestogen; or progesterone alone). Outcomes were rates of surgery, medical treatments, and quality of life using the 36-item Short-Form Health Survey (SF-36) and EuroQoL EQ-5D.ResultsThe responding cohort of 206 women was demographically and clinically representative of the original trial population. Mean age at baseline was 41.9 years (SD 4.9) and 53.7 years (SD 5.1) at follow-up. Over the 10-year follow-up, 60 of 206 (29.1%) women had surgery (hysterectomyn= 34, 16.5%; endometrial ablationn= 26, 12.6%). Between 5 and 10 years, 89 women (43.2%) ceased all medical treatments and 88 (42.7%) used LNG-IUS alone or in combination with other treatments. Fifty-six women (27.2%) were using LNG-IUS at 10 years. There were improvements over time in quality-of-life scores, with no evidence of differences in these or other outcomes between the two groups.ConclusionMedical treatments for women with HMB can be successfully initiated in primary care, with low rates of surgery and improvement in quality of life observed a decade later.
Effects of Vitamin D3 Supplementation on Cardiovascular and Cancer Outcomes by eGFR in VITAL
Authors: Limonte Christine P. , Zelnick Leila R. , Hoofnagle Andrew N. , Thadhani Ravi , Melamed Michal L. , Mora Samia , Cook Nancy R. , Luttmann-Gibson Heike , Sesso Howard D. , Lee I-Min , Buring Julie E. , Manson JoAnn E. , de Boer Ian H. 
Published: October 2022

Key Points

Baseline eGFR does not affect the effects of supplementation with vitamin D3 on the incidence of cardiovascular events or invasive cancer.Vitamin D3 supplementation results in a greater reduction in serum parathyroid hormone concentration in those with lower versus higher eGFR.

Background
Reduced 25-hydroxyvitamin D (25[OH]D) metabolism and secondary hyperparathyroidism are common with lower estimated glomerular filtration rate (eGFR) and may contribute to cardiovascular disease and cancer risk.

Methods
We assessed for heterogeneity by baseline eGFR of the effects of vitamin D3 on cardiovascular and cancer outcomes in the Vitamin D and Omega-3 Trial (VITAL). Participants were randomized to 2000 IU vitamin D3 and/or 1 g Ω-3 fatty acids daily using a placebo-controlled, two-by-two factorial design (5.3 years follow-up). Primary study end points were incident major cardiovascular events and invasive cancer. Changes in serum 25(OH)D and parathyroid hormone (PTH) were examined.

Results
Baseline eGFR was available for 15,917 participants. Participants’ mean age was 68 years, and 51% were women. Vitamin D3 resulted in higher serum 25(OH)D compared with placebo (difference in change 12.5 ng/ml; 95% CI, 12 to 13.1 ng/ml), without heterogeneity by eGFR (P interaction, continuous eGFR=0.2). Difference in change in PTH between vitamin D3 and placebo was larger with lower eGFR (P interaction=0.05): –6.9 (95% CI, –10.5 to –3.4), –5.8 (95% CI, –8.3 to –3.4), –4 (95% CI, –5.9 to –2.2), and –3.8 (95% CI, –5.6 to –2) pg/ml for eGFR <60, 60–74, 75–89, and ≥90 ml/min per 1.73 m2, respectively. Effects of vitamin D3 supplementation on cardiovascular events (P interaction=0.61) and cancer (P interaction=0.89) did not differ by eGFR: HR=1.14 (95% CI, 0.73 to 1.79), HR=1.06 (95% CI, 0.75 to 1.5), HR=0.92 (95% CI, 0.67 to 1.25), and HR=0.92 (95% CI, 0.66 to 1.27) across eGFR categories for cardiovascular events and HR=1.63 (95% CI, 1.03 to 2.58), HR=0.85 (95% CI, 0.64 to 1.11), HR=0.84 (95% CI, 0.68 to 1.03), and 1.11 (95% CI, 0.92 to 1.35) for cancer, respectively.

Conclusions
We observed no significant heterogeneity by baseline eGFR in the effects of vitamin D3 supplementation versus placebo on cardiovascular or cancer outcomes, despite effects on 25(OH)D and PTH concentrations.
Causes of Recurrent Ischemic Stroke in Children
Authors: Дмитриев В.В. , Липай Н.В. , Куликова С.Л. , Левшук О.Н. 
Published: October 2022

Цель исследования. Определение перечня состояний, связанных со свертыванием крови и способствующих возникновению рецидива инфаркта мозга у пациентов детского возраста.Материалы и методы. Проведен ретроспективный анализ причин заболевания и рецидива ишемического инсульта (ИИ) у 55 детей, обратившихся в стационар по поводу ишемического инсульта с июля 2016 по май 2022 г. Возраст детей – от 1 до 17 лет, мальчиков – 32, девочек – 23.Результаты. Анализ исходов ишемического инсульта у обследованных детей показал, что каждое из проанализированных гематологических состояний потенциально может стать причиной повторных ишемических атак с развитием неврологических нарушений. Кумулятивная частота рецидива в остром периоде ИИ составила (7,3±3,5)%. Рецидив ИИ в остром периоде заболевания был тесно связан с назначением противотромботических препаратов (G=0,99; p=0,02), доза которых была недостаточна. Кумулятивная частота рецидива ИИ на этапах восстановления составила (20,9±8,3)% и была связана в равной мере как с отсутствием профилактического применения противотромботических средств (G= –0,33; p=0,25), так и с гематологической причиной (G=0,33; p=0,21) заболевания.Заключение. Полученные результаты указывают на необходимость использования противотромботических лекарственных средств у всех пациентов с ишемическим инсультом. Обязательны контроль за достижением фармакологического эффекта и коррекция дозы антикоагулянта (антиагреганта) с учетом клинической ситуации.
Purpose. To determine the list of conditions associated with blood clotting and contributing to the recurrence of cerebral infarction in pediatric patients.Materials and methods. A retrospective analysis of the causes of the disease and recurrence of ischemic (IS) stroke was carried out in 55 children who applied to the hospital for ischemic stroke from July 2016 to May 2022. The age of children is from 1 to 17 years, boys – 32, girls – 23.Results. An analysis of the outcomes of ischemic stroke in the examined children showed that each of the analyzed hematological conditions could potentially cause recurrent ischemic attacks with the development of neurological disorders. The cumulative recurrence rate in the acute period of IS was (7.3±3.5)%. The recurrence of IS in the acute period of the disease was closely associated with the prescription of antithrombotic drugs (G=0.99; p=0.02), the dose of which was insufficient. The cumulative recurrence rate of IS at the stages of prophylactic use of antithrombotic agents was (20.9±8.3)% and was equally associated with both the lack of prophylactic use of antithrombotic agents (G= –0.33; p=0.25) and hematological cause (G= 0.33; p=0.21) of the disease.Conclusion. The results obtained indicate the need for the use of antithrombotic drugs in all patients with ischemic stroke. It is obligatory to control the achievement of the pharmacological effect and adjust the dose of the anticoagulant (antiplatelet) taking into account the clinical situation.
Late Effects of Chemoradiotherapy of Hodgkin’s Lymphoma in Children and Adolescents of the Republic of Belarus
Authors: Борисевич М.В. , Марковец А.Ф. , Савич Т.В. , Лукашевич Л.Н. , Красько О.В. 
Published: October 2022

В статье представлен анализ поздних осложнений химиолучевой терапии лимфомы Ходжкина (ЛХ) у 95 пациентов 0–18 лет в Республике Беларусь. Пациенты получали программную терапию в рамках протокола DAL-HD-90(m). Выявлено, что в основном осложнения развивались в результате лучевого воздействия на органы и ткани. Риск отдаленных последствий у пациентов с ЛХ увеличивается с увеличением суммарных доз облучения. Полученные данные подтверждают необходимость снижения объемов лечения и уточнения показаний к лучевой терапии с учетом прогностических факторов, внедрения новых методик лучевой терапии и использования новых схем лечения пациентов детского возраста с ЛХ.
The analysis of late complications of chemoradiotherapy of Hodgkin’s lymphoma (HL) in 95 pediatric patients of the Republic of Belarus is presented. Patients 0 to 18 years old with LH received program therapy under the DAL-HD-90(m) protocol. It was revealed that complications mainly developed as a result of radiation exposure to organs and tissues. The risk of the complications increased with an increase in total radiation doses. The data obtained confirm the need to reduce the doses and indications for the use of radiation therapy in HL, taking into account prognostic factors, the introduction of new methods of radiation therapy and the use of new treatment regimens for children with HL.
The Hematological Indicators in the Diagnostics of Hereditary Spherocytosis in Pediatrician’s Practice
Authors: Мицура Е.Ф. , Волкова Л.И. 
Published: October 2022

Цель. Определить показатели гемограммы, которые можно использовать для диагностики наследственного сфероцитоза (НС) в практике педиатра у детей первого года жизни и старше.Материалы и методы. Были ретроспективно изучены 35 анализов крови детей с НС первого года жизни и 110 анализов крови старших детей с НС в сравнении с 31 анализом здоровых детей первого года жизни и 25 анализами крови здоровых детей старше 1 года, выполненных с помощью автоматического гематологического анализатора. Статистический анализ проводился с помощью теста Манна – Уитни и ROC-анализа.Результаты. Установлена частота встречаемости патологических изменений гемограммы, определены их пороговые значения для диагностики НС. Для ранней диагностики НС у детей до 1 года допустимо использование следующих показателей: Ht ≤31,1%, MCHC/Ht >1,06, Hb/MCHC ≤3,11, Hb/RDW ≤7,26, MCHC/MCV >0,45. У детей старше 1 года для этой цели следует использовать значения: Hb/RDW ≤9,69; RDW>12,9; MCHC/RDW ≤2,49; Hb/MCHC ≤3,65; MCHC/Ht >0,96; MCHC/MCV >0,44.Заключение. При наличии вышеуказанных отклонений гемограммы необходимо проведение дополнительного обследования для уточнения диагноза НС.
Purpose. To determine the hemogram parameters that can be used to diagnose hereditary spherocytosis (HS) in pediatrician’s practice for children of the first year of life and older. Materials and methods. Thirty-five blood tests from children with HS in the first year of life and 110 blood tests from older children with HS were retrospectively studied, compared with 31 blood tests from healthy infants and 25 blood tests from healthy children older than 1 year, performed by automatic hematological analyzer. Statistical analysis was done using the Mann-Whitney test and ROC analysis.Results. The frequency of pathological changes in the hemogram occurrence has been established, and their threshold values for HS diagnosing have been determined. For early diagnosis of HS in children under 1 year of age, the following indicators are acceptable: Ht ≤31.1%, MCHC/Ht >1.06, Hb/MCHC ≤3.11, Hb/RDW ≤7.26, MCHC/MCV >0.45. In children older than 1 year, the following values should be used for this purpose: Hb/RDW ≤9.69; RDW >12.9; MCHC/RDW ≤2.49; Hb/MCHC ≤3.65; MCHC/Ht >0.96; MCHC/MCV >0.44.Conclusion. In the presence of the above deviations of the hemogram, an additional examination is necessary to verify the diagnosis of HS.
The Impact of Blood Donations, Its Components on the Health Indicators of Donors in the Republic of Belarus
Authors: Старовойтов А.Г. , Карпенко Ф.Н. , Каменская Т.В. , Красько О.В. , Пасюков В.В. , Федуро Н.А. 
Published: October 2022

По результатам динамического наблюдения и лабораторной и инструментальной оценки показателей здоровья 113 регулярных доноров крови и компонентов крови выявлены изменения гематологических и биохимических показателей. Согласно данным исследования, до 50% доноров крови и ее компонентов имеют дефицит железа. Установлено, что у доноров крови статистически значимо более низкие показатели, характеризующие обмен железа, чем у доноров компонентов крови. Данные изменения также имеют особенности в зависимости от пола. У доноров компонентов крови статистически значимо более низкие показатели содержания белка и более высокие показатели содержания лейкоцитов и кальция, чем у доноров цельной крови. Не установлено клинически значимых изменений показателей системы гемостаза, электрокардиографии. Сделан вывод о необходимости более расширенного и частого по сравнению с действующим скрининга на дефицит железа, белка и, с учетом полученных результатов, назначения в рамках междонационного периода медикаментозной коррекции и определенного режима питания, изменения видов и интервалов донаций.
Summary to the results of dynamic monitoring, laboratory and instrumental assessment of health indicators of 113 regular blood donors and blood components, changes in hematological and biochemical parameters were revealed. Data have been obtained characterizing iron deficiency in up to 50% of blood donors and its components. It has been established that whole blood donors have statistically significantly lower rates characterizing iron metabolism than blood component donors. These changes also have features depending on gender. Blood component donors had statistically significantly lower protein levels and higher leukocyte and calcium levels than whole blood donors. There were no clinically significant changes in the parameters of the hemostasis system, electrocardiography. It was concluded that there is a need for a more extended and frequent screening for iron and protein deficiency compared to the current one and, taking into account the results obtained, within the inter donation period of prescribing drug correction and a certain diet, changing the types and intervals of donations.
Transcranial electrical stimulation of audiology patients of different ages
Authors: Голованова Л.Е. , Зюзина М.Н. , Белянина Д.А. , Огородникова Е.А. 
Published: October 2022

Цель исследования - сравнительный анализ субъективных оценок и аудиологических показателей у пациентов сурдологического профиля, полученных до и после прохождения курса транскраниальной электростимуляции (ТЭС). В группу обследования вошли 99 пациентов 20-85 лет (45 мужчин и 54 женщины) с хронической одно- (16%) и двусторонней (76%) сенсоневральной тугоухостью (СНТ). Группа молодого и среднего возраста (20-59 лет) составила 37 человек, пожилого (60-74 лет) - 48, старческого (75-90 лет) - 14. Обследование включало сбор анамнеза, ЛОР-осмотр, тональную пороговую аудиометрию, импедансометрию, анкетирование. Все пациенты прошли курс из 10 процедур ТЭС с применением прибора «Трансаир-7». Данные свидетельствовали об улучшении субъективных оценок в отношении слухового восприятия у 54% пациентов, разборчивости речи - у 53%, ушного шума - у 24%, общего самочувствия - у 36%. Распределение порогов слуха в области речевых частот до и после курса также оказалось достоверно различным ( p <0,01). При этом были выявлены гендерные и возрастные особенности влияния ТЭС на показатели слуха и общего самочувствия, наиболее выраженные у пациентов старческого возраста, продемонстрировавших минимальную положительную динамику. В целом, с учетом возрастных ограничений, результаты подтверждают целесообразность применения ТЭС при хронической СНТ даже вне режима комбинированной (с аудионагрузкой) стимуляции.
The aim of the study was a comparative analysis of subjective assessments and audiological parameters of patients with hearing loss obtained before and after the course of transcranial electrical stimulation (TES). The study group included 99 patients (45 men and 54 women) with chronic mono- (16%) and bilateral (76%) sensorineural hearing loss (SNHL) aged 20 to 85 years. Groups of young and middle age (20-59 years old) amounted to 37 people; elderly (60-74 years old) - 48 and senile (75-90 years old) - 14 people. The observation included: anamnesis, ENT survey, tone threshold audiometry, impedancemetry, and questioning. All patients underwent a course of 10 TES procedures using the «Transair-7» device. The data indicated an improvement in subjective assessments regarding auditory perception in 54%, speech intelligibility in 53%, tinnitus in 24% and general well-being in 36% of patients in the study group. The distribution of hearing thresholds in the region of speech frequencies before and after the course also turned out to be significantly different (p<0,01). At the same time, gender and age-specific features of the effect of TES on hearing and general well-being were revealed, the most pronounced in senile patients who showed minimal positive dynamics. In general, taking into account age restrictions, the results confirm the feasibility of using TES in SNHL, even outside the combined (with audio loading) stimulation.
Beta-blockers for reducing intraoperative bleeding during rhinosinusosurgical operations in elderly and senile patients
Authors: Павлов В.Е. , Полушин Ю.С. , Колотилов Л.В. , Карпищенко С.А. 
Published: October 2022

При неэффективности консервативной терапии хронического риносинусита во всех возрастных группах больных в настоящее время часто прибегают к функциональным риносинусохирургическим эндоскопическим вмешательствам. Имеются сообщения об использовании бета-адреноблокаторов для снижения операционной кровоточивости, однако недостаточно изучена возможность их внутривенного применения у пациентов старшей возрастной группы. Цель работы - оценка эффективности внутривенного применения метопролола для снижения интраоперационного кровотечения (ИК) при риносинусохирургических вмешательствах в условиях общей анестезии у пациентов пожилого и старческого возраста. ИК оценивали по шкале Fromme-Boezaart Score на разных этапах операции с 10-й по 60-ю минуту в двух группах больных - без применения метопролола (БМ) и с использованием метопролола (М). Выявлено, что на 30-й минуте операции ИК была значимо ниже в группе М. Многофакторный анализ показателей гемодинамики выявил прямую связь показателей ЧСС с развитием кровоточивости. В группе БМ вероятность значительной кровоточивости была выше в 8,6 раза. Показано, что внутривенное интраоперационное применение метопролола позволяет снизить интенсивность локальной кровоточивости при эндоскопических риносинусохирургических вмешательствах.
With the ineffectiveness of conservative therapy of chronic rhinosinusitis in all age groups of patients, functional rhinosinusosurgical endoscopic interventions are now often used to do. The minimal bleeding is a necessary condition for their realization. There are reports of the use of beta-blockers for reducing surgical bleeding, but the possibility of their intravenous use in older patients has not been sufficiently studied. The aim of the work was to evaluate the effectiveness of intravenous metoprolol to reduce the bleeding intensity (BI) during rhinosinusosurgical interventions under general anesthesia in elderly and senile patients. The BI was assessed on the Fromme-Boezaart Score scale at different stages of the operation from the 10th to the 60th minute in two groups of patients: without (WM) and using metoprolol (M). It was shown that at the 30th minute of the operation BI was significantly lower in M group. Multivariate analysis of hemodynamic parameters demonstrated a direct relationship between heart rate (HR) and the development of bleeding. In the WM group, the probability of significant bleeding was 8,6 times higher. It has been shown that intraoperative intravenous use of metoprolol reduces the intensity of local bleeding during endoscopic rhinosinusosurgical operations.
Wheel Bearing Fault Detection for Automobiles using Wheel Speed Sensor
Authors: Drame Samba , Garner Graeme , Sadjadi Hossein , Du Xinyu 
Published: October 2022

Wheel bearing fault diagnosis and monitoring for automobiles are getting more attention as the market shifts towards electric vehicles (EV) and autonomous vehicles (AV). Electric drivetrains are expected to have longer lifespan than the reliable life of low-cost wheel bearing designs. The probability of having a failed wheel bearing in an EV thus increases. In an AV setting, most of the rides are taken by people who are unfamiliar to the vehicle, removing the human as a viable sensor to detect wheel bearing defects. Fleet managers will be required to pay a high price to inspect potential defects. The implementation of a wheel bearing fault detection system can help reduce these costs.
In our previous work, a method for injecting wheel bearing brinelling failure was developed. In this paper, we propose a wheel bearing brinelling fault detection algorithm using wheel speed sensor. The proposed algorithm detects wheel bearing faults by identifying peaks in the wheel speed spectrum at bearing critical frequencies. To implement this approach, we leverage phase domain transform technique to normalize against effect of varying speed. A wavelet filtering technique is employed to enhance the bearing fault signatures prior transforming the wheel speed signal into frequency domain. Post-processing techniques are developed to smooth the high-variance wheel speed spectra and improve the detectability of the wheel bearing faults. A regression model is then developed to calculate the wheel bearing health indicators. The results show that the proposed algorithm achieves high performance in detecting wheel bearing faults.
Pengaruh Metode Praktikum terhadap Hasil Belajar IPA Materi Pertumbuhan dan Perkembangbiakan pada Tumbuhan Siswa Kelas 3 SDN Cikupa III Kabupaten Tangerang
Authors: Muplihah Zahrotul , Magdalena Ina , Huliatunisa Yayah 
Published: October 2022

The concept of science in elementary schools is an integrated concept because it has not been separated separately, such as biology, chemistry, and physics. The low quality of education can be seen from the low quality of student learning. One of the causes of the low quality of education is due to the learning difficulties experienced by most students. This study aims to determine the differences in student learning outcomes between students who use practicum methods and students who do not use conventional practicum or learning methods. The population in this study were all class III students at SDN Cikupa III, totaling 57 students, consisting of 27 students in class III A as the control class and class III B with 30 students as the experimental class. The research used is Quasi Experimental Design. The results of the pretest calculation between the control class and the experimental class obtained a tcount value of 0.167 > 0.05, while the post-test calculation between the control class and the experimental class obtained a tcount value of 0.139 > 0.05, which causes H0 to be accepted and HI rejected. The results of this test prove that there is no influence on the learning outcomes of science learning material on growth and reproduction in the third grade students of SDN Cikupa III, Tangerang Regency.