Conservative Methods Research Articles

Retrospective comparative clinical study on clinical effect of suture micromarsupialization on ranula.

This study aimed to evaluate the clinical effect of suture micromarsupialisation on ranula. Methods: This is a retrospective comparative clinical study, the clinical data of 106 patients with simple ranula admitted to the Oral and Maxillofacial Surgery Department of Beijing Zhongguancun Hospital between August 2022 and May 2023 were collected. The patients were divided into the research group (55 patients), who underwent suture micromarsupialisation, and control group (51 patients), who underwent ranula resections. The therapeutic methods were compared regarding cure rate, surgical duration, intraoperative blood loss, 24-h postoperative pain score, intraoperative and postoperative complications, and recurrence rate. Results: The difference in the total effective rate between the two groups was not statistically significant (98.18% vs. 96.08%, χ2 = 2.116, p = 0.347). Intraoperative blood loss (4.35 ± 1.19 vs. 26.33 ± 3.19), surgery duration (6.33 ± 1.43 vs. 26.33 ± 3.19) and the postoperative visual analogue scale score (0.32 ± 0.03 vs. 3.81 ± 0.15) in the research group were lower than in the control group (p < 0.05). The incidence rate of complications in the research group was lower than in the control group (7.27% vs. 25.49%, χ2 = 6.522, p = 0.011). The difference in the postoperative recurrence rate between the two groups was not statistically significant (3.63% vs. 9.80%, χ2 = 1.632, p = 0.201). Conclusions: Suture micromarsupialisation is a conservative therapeutic method for intraoral ranula. The cure rate of suture micromarsupialisation is similar to that of traditional surgery. It is recommended to use this technique as a first-line conservative therapeutic method for intraoral ranula, as it has the advantages of minimal invasion, simple operation, no pain, no need for haemostasis and no complications.

A Comparison of Additional Benefit Assessment Methods for Time-to-Event Endpoints Using Hazard Ratio Point Estimates or Confidence Interval Limits by Means of a Simulation Study.

For time-to-event endpoints, three additional benefit assessment methods have been developed aiming at an unbiased knowledge about the magnitude of clinical benefit of newly approved treatments. The American Society of Clinical Oncology (ASCO) defines a continuous score using the hazard ratio point estimate (HR-PE). The European Society for Medical Oncology (ESMO) and the German Institute for Quality and Efficiency in Health Care (IQWiG) developed methods with an ordinal outcome using lower and upper limits of the 95% HR confidence interval (HR-CI), respectively. We describe all three frameworks for additional benefit assessment aiming at a fair comparison across different stakeholders. Furthermore, we determine which ASCO score is consistent with which ESMO/IQWiG category. In a comprehensive simulation study with different failure time distributions and treatment effects, we compare all methods using Spearman's correlation and descriptive measures. For determination of ASCO values consistent with categories of ESMO/IQWiG, maximizing weighted Cohen's Kappa approach was used. Our research depicts a high positive relationship between ASCO/IQWiG and a low positive relationship between ASCO/ESMO. An ASCO score smaller than 17, 17 to 20, 20 to 24, and greater than 24 corresponds to ESMO categories. Using ASCO values of 21 and 38 as cutoffs represents IQWiG categories. We investigated the statistical aspects of the methods and hence implemented slightly reduced versions of all methods. IQWiG and ASCO are more conservative than ESMO, which often awards the maximal category independent of the true effect and is at risk of overcompensating with various failure time distributions. ASCO has similar characteristics as IQWiG. Delayed treatment effects and underpowered/overpowered studies influence all methods in some degree. Nevertheless, ESMO is the most liberal one. For the additional benefit assessment, the American Society of Clinical Oncology (ASCO) uses the hazard ratio point estimate (HR-PE) for their continuous score. In contrast, the European Society for Medical Oncology (ESMO) and the German Institute for Quality and Efficiency in Health Care (IQWiG) use the lower and upper 95% HR confidence interval (HR-CI) to specific thresholds, respectively. ESMO generously assigns maximal scores, while IQWiG is more conservative.This research provides the first comparison between IQWiG and ASCO and describes all three frameworks for additional benefit assessment aiming for a fair comparison across different stakeholders. Furthermore, thresholds for ASCO consistent with ESMO and IQWiG categories are determined, enabling a comparison of the methods in practice in a fair manner.IQWiG and ASCO are the more conservative methods, while ESMO awards high percentages of maximal categories, especially with various failure time distributions. ASCO has similar characteristics as IQWiG. Delayed treatment effects and under/-overpowered studies influence all methods. Nevertheless, ESMO is the most liberal one. An ASCO score smaller than 17, 17 to 20, 20 to 24, and greater than 24 correspond to the categories of ESMO. Using ASCO values of 21 and 38 as cutoffs represents categories of IQWiG.

VASCULARIZED LYMPH NODE TRANSFER FOR TREATMENT OF BREAST CANCER-RELATED LYMPHEDEMA: INDICATIONS, DONOR SITES AND COMPLICATIONS

Breast cancer-related lymphedema (BCRL) is as a burden for patients treated for breast cancer. Despite its main ma­nagement being focused on conservative methods, mode­rate or severe cases may be resistant and require surgical treatment. One of the commonly used techniques is vas­cularized lymph node transfer (VLNT) which allows the relocation of normal lymph nodes to the affected limb to ensure proper lymph flow, thus relieving lymphedema. The donor site is chosen based on the risk of iatrogenic lymphedema and scarring. Despite the inguinal region has a great risk for donor site lymphedema, it is the most common donor site due to its well-hidden scar, defined anatomy, abundant lymph nodes and soft tissue. Other following donors sites by frequency are axillary-thoracic, supraclavicular, omental, and submental. Complications that often follow VLNT are donor site lymphedema, soft tissue infection, scarring, hematoma, and nerve injury.

A screening method for heavy metals in consumer goods using reactive desorption electrospray ionization mass spectrometry.

Contamination of everyday goods with heavy metals such as nickel, cadmium, and lead known to be hazardous to the health of customers is an ongoing problem. Here, a mass spectrometric screening method based on reactive desorption electrospray ionization (DESI) is presented for the analysis of metals in consumer goods such as jewelry, tableware, and paintings. The method detects oxidized species of lead, nickel, cadmium, copper, and iron from the surface of objects without sample preparation. Positively charged metal ions form singly and doubly negatively charged complexes with ethylenediaminetetraacetic acid added to the DESI solvent, which are analyzed by a mass spectrometer. Qualitative and quantitative performance of the method was elucidated with metal salt standards. Subsequently, authentic samples were analyzed qualitatively. Reactive DESI-MS was able to detect lead and cadmium in eight out of nine consumer goods. For tableware, these heavy metals were found to be localized in the print as determined by reactive DESI imaging. In addition, mockup paintings generated from modern and historical pigments of Pb, Cu, Cd, and Fe in various media (acrylic binder, egg tempera, and linseed oil) were measured to show the suitability of the method for art authentication and conservation. The developed method expands the range of analytes accessible by DESI-MS to metal ions. Hence, DESI becomes a suitable ionization technique for an increasing number of analyte classes, which are of interest in chemical screening of consumer goods.

DNS of Marangoni effects on a suspension of droplets in microgravity using the unstructured conservative level-set method

The multi-marker unstructured conservative level-set (UCLS) method for two-phase flow with variable surface tension is used for the Direct Numerical Simulation of thermocapillary-driven motion of a bi-dispersed suspension of droplets in microgravity. The so-called Marangoni stresses induced by surface tension gradients on the interface lead to a coupling of the momentum transport equation and the thermal energy transport equation. The finite-volume method discretizes the transport equations on three-dimensional collocated unstructured meshes. The UCLS method performs interface capturing with mass conservation of the fluid phases, whereas the multiple marker approach circumvents the numerical coalescence of fluid particles. The fractional-step projection method solves the pressure-velocity coupling. Unstructured flux-limiters schemes discretize the convective term in transport equations. Numerical and physical findings are reported.

A checkerboard-free symmetry-preserving conservative method for magnetohydrodynamic flows

Simulating MHD flows at high Hartmann numbers and low magnetic Reynolds numbers is of high interest for the design of a nuclear fusion breeding blanket, for which high accuracy and conservation of physical properties are of great importance. In this work, a solver is developed that offers these properties through the symmetry-preserving method, while at the same time warranting unconditional stability. Since this method uses predictor values for the pressure and electric potential fields, it can be prone to checkerboarding. Therefore it is extended to include a dynamical checkerboarding solution, which balances this problem with numerical dissipation. This is done through run-time measurements of the intensity of checkerboarding, which is then used as a negative feedback onto the predictor values. The symmetry-preserving discretisation and the dynamical solution to checkerboarding were successfully tested using an magnetohydrodynamic Taylor-Green vortex. The newly introduced method shows results free from numerical dissipation in smooth cases, whereas it avoids checkerboarding in more challenging cases. Finally, the method shows to be unconditionally stable, even on highly distorted meshes.

Improving upland rice (Oryza sativa l.) performance through enhanced soil fertility and water conservation methods

The experiment was conducted at Experimental sites of Tanzania Agricultural Research Institute (TARI) – Ukiriguru, Mwanza, Tanzania. The objective was to improve performance of upland rice through enhanced soil fertility and water conservation methods. A split–split plot experiment in a randomized complete block design with three replications and three factors that were (a) upland rice cultivars (WAB 450, NERICA1 and NERICA4) (b) fertilizer types, (Urea 80Kg N/ha, farm yard manure 5 t/ha and control) (c) three water conservation methods (flat cultivation, open ridge and tie ridge were applied). Rice was sown in seven rows at 30 cm inter–and intra–row spacing. Data on soil, weather, crop growth, yield components and grain yield were collected. Rainfall was 651.2 mm during the cropping season which was poorly distributed. Average temperature was 24oC with mean relative humidity of 75%. Soil analysis results showed that total nitrogen was 0.08 %, phosphorus 2.09mgP/Kg and organic carbon 0.58%. The soil calcium was 3.38 cmolc/Kg and potassium was 0.36cmolc/Kg, while zinc was 0.39 mg/Kg. Cultivars had significant effect on yields which were 2856, 2507 and 2140 Kg/ha for WAB 450, NERICA4 and NERICA1 respectively. Fertilizer types also significantly affected grain yield in the order of urea (3368 Kg/ha) &gt; FYM (2723 Kg/ha) and &gt; control (1421 Kg/ha). Moisture conservation methods significantly affected yield in this order: tie ridges (2710 Kg/ha) &gt; open ridge (2398 Kg/ha) &gt; flat cultivation (2394 Kg/ha). Overall, the study results indicated low fertility status in the soil, although it was found to be suitable for upland rice production with further improvement. It is concluded that rice cultivar, WAB 450 had the highest yield potential, while application of Urea at 80 Kg N/ha gave high grain yield, while tie ridges were the best in soil moisture conservation.

A STUDY OF FUNCTIONAL OUTCOME IN THREE COLUMN FIXATION OF COMPLEX TIBIAL PLATEAU FRACTURES

Introduction: The treatment of complex tibial plateau fractures (TPF), especially those caused by high-energy trauma, remains a challenge in many respects. Tibial plateau fractures are one of the commonest periarticular fractures. These fractures include 1% of all fractures and 8% of fractures in elderly. Motor vehicle accidents account for the majority of these fractures in younger individuals with good bone stock, but in elderly individuals these fractures may result from simple fall due to osteopenic bone. Conservative methods may result in malunion and articular congruity cannot be restored. Surgical treatment can regain articular congruity and restore mechanical alignment, and can allow early range of motion. Open reduction and internal fixation techniques had been associated with wound complications. Aim Of The Study: To evaluate functional outcome in patients of complex tibial plateau fractures treated by three column fixation. Materials and Methods: In our institution 20 patients with displaced tibial plateau fractures with posterior column involvement were selected for the study. This is a prospective study done from AUGUST 2023 to APRIL 2024(9 months).Patients were evaluated with X rays (AP and lateral views) and Computed Tomography (axial, coronal, sagittal with 3D reconstruction views). Fractures classified based on 3 column concept classification. Mean follow up period was 6 months .Functional and radiological outcome was assessed using functional knee score , modified rasmussen score and WOMAC score. Inclusion Criteria: 1. Patients admitted with complex tibial plateau fractures involving medial, lateral and posterior column of tibia. 2. Both sexes 3. Age 20-60 yrs. Exclusion Criteria: 1) Bad skin status of the fractured site. 2) Patients with co morbidities not fit for surgery. 3) Patients with neurovascular deficit. 4) Patients not willing for surgery. Results:In our study, 70% of the patients were in active productive age group (30-50 years). 85% of the patients were male. The fractures were left sided in 75% patients. 85% patients in study sustained injury due to road traffic accident. 80% cases in the study were type 5 schatzker type 5 fractures and all the cases included in the study were 3 column fractures. 8 cases out of 20 cases in the study required epidural analgesia instead of a repeat spinal as the duration of the surgery was longer. Conclusion: To conclude,3 column fixation in high energy displaced tibial plateau fractures with three column fractures resulted in Good clinical and radiological outcomes.

Ciliwung River Resource Management And Ecotourism By The Ciliwung Community In Depok

The research entitled “CILIWUNG RIVER RESOURCE MANAGEMENT AND ECOTOURISM BY THE CILIWING COMMUNITY IN DEPOK” aims to identify resource management and eco-ecosystems in the Ciliwung River, and to find out what obstacles to resource and ecosystems management in Ciliwing Depok River. The research uses qualitative methods, with descriptive qualitational emphasis and SWOT analysis. Data collection is carried out with field observations, interviews, and literature studies. The results of the research show that the river resource management strategy implemented has the potential to be an attractive ecosystem destination. Through the environmental conservation, recreation, and education methods carried out by KCD, the river can provide significant benefits to the surrounding community and its surrounding environment. Tourist components such as attractions, accessibility, and facilities around the river are important factors in attracting tourists and supporting sustainable ecosystem development.

Robust and conservative dynamical low-rank methods for the Vlasov equation via a novel macro-micro decomposition

Dynamical low-rank (DLR) approximation has gained interest in recent years as a viable solution to the curse of dimensionality in the numerical solution of kinetic equations including the Boltzmann and Vlasov equations. These methods include the projector-splitting and Basis-update & Galerkin (BUG) DLR integrators, and have shown promise at greatly improving the computational efficiency of kinetic solutions. However, this often comes at the cost of conservation of charge, current and energy. In this work we show how a novel macro-micro decomposition may be used to separate the distribution function into two components, one of which carries the conserved quantities, and the other of which is orthogonal to them. We apply DLR approximation to the latter, and thereby achieve a clean and extensible approach to a conservative DLR scheme which retains the computational advantages of the base scheme. Moreover, our approach requires no change to the mechanics of the DLR approximation, so it is compatible with both the BUG family of integrators and the projector-splitting integrator which we use here. We describe a first-order integrator which can exactly conserve charge and either current or energy, as well as an integrator which exactly conserves charge and energy and exhibits second-order accuracy on our test problems. To highlight the flexibility of the proposed macro-micro decomposition, we implement a pair of velocity space discretizations, and verify the claimed accuracy and conservation properties on a suite of plasma benchmark problems.

Ecological impact of mechanical cleaning method to curb black stain alterations on Paleolithic cave walls

Anthropization of Paleolithic karstic caves can cause an imbalance of cave microbiota and may trigger formation of wall alterations including black stains. In Lascaux Cave, a previous attempt to mechanically remove black stains was followed by reformation of the stain in months, suggesting that microbial recolonization had taken place. On this basis, we hypothesized that mechanical cleaning (a routine cleaning method for conservation of heritage sites) leaves a residual microbial community that can also serve as pioneer community, i.e. a community of early microbial residents that triggers subsequent microbial successions involved in the reformation of black stains. We monitored post-cleaning microbial recolonization over 19 months in the Apse of Lascaux Cave (France), after using two methods of mechanical cleaning (scalpel alone, or scalpel + sponge). Illumina MiSeq metabarcoding evidenced various taxa i.e. the bacteria Pseudomonas, Pedomicrobium and black-melanized fungi Ochroconis (=Scolecobasidium) during early recolonization of cleaned surfaces, and at later stages the establishment of several other taxa including the bacteria Luteimonas, Chitinophaga and the black fungus Exophiala. Surfaces at 19 months after cleaning were visually and microbiologically different from stained surfaces immediately after cleaned and from unstained surfaces, but also from non-cleaned stained surfaces, probably because of a particular microbial succession, distinct from the original succession during stain formation. Variations in relative abundance of Bacteroidota and Eurotiomycetes classes and Exophiala genus were higher when the sponge was used in addition to the scalpel. The bacteria Filomicrobium and the fungi Isaria and Cephalotrichum were identified on sponge-cleaned surfaces and on the sponge itself, pointing to a contaminant status due to the cleaning method. Overall, it suggests that post-cleaning pioneer communities may play an important role in orienting stain reformation in caves. Sponges routinely used by restorers to curb microbial stains may bring microbial contaminants, which questions current cleaning practices in show caves.

Selection of an economics-energy-environment scheduling strategy for a community virtual power plant considering decision-makers’ risk attitudes based on improved information gap decision theory

To address the impact of decision-makers' risk attitudes (DMRA) and uncertainties on dispatch strategy in community integrated energy systems, a multi-objective dispatch model of a community virtual power plant (CVPP) is proposed. Firstly, a novel CVPP model that considers DMRA and a multi-objective satisfaction model of economics-energy-environment are built. Secondly, the information gap decision theory (IGDT) model is improved by considering uncertainties of renewable energy, loads, and DMRA. Thirdly, the VIKOR method is improved by using the weights from multiple objective functions derived by combining the entropy weight and full consistency method. And the conservative and risky strategy selection methods in the VIKOR method are used to select the optimal strategy from the obtained multi-objective Pareto solution set that satisfies decision-makers with risk preferences. Thus, the impact of DMRA on optimal strategy selection is fully described. Finally, the proposed model's effectiveness is validated using a multi-scenario example of a residential area. The results indicate that: 1) The novel CVPP provides realistic scheduling strategies based on the DMRA. 2) After implementing demand response, the resident cost and net carbon emissions are reduced by 9 % and 91 %, respectively. Energy supplier profit and renewable energy utilization rate are increased. The constructed IGDT model also improves multiple objectives. 3) The improved IGDT model's uncertainty and deviation factors allow for diverse scheduling strategies. Simultaneously, the improved VIKOR method provides a new method for decision-makers to select strategies. The model is a guide for selecting scheduling strategies and a way of encouraging the usage of renewable energy.

Some aspects of biomechanics of the operated thoracolumbar junction following two-level corpectomy

Traumatic spinal injuries pose a significant medico-social challenge, with about 60% of all spine fractures occurring at the thoracolumbar junction. Optimizing care for these patients remains a critical issue, despite the development of numerous surgical and conservative treatment methods, with outcomes still far from ideal. A key factor contributing to the consistently high rate of unsuccessful surgical interventions, which lead to stabilization failures in both the early and late postoperative periods, is the disregard of the biomechanical characteristics of the thoracolumbar junction area. Clinical protocols often regulate intervention methods based on the degree and nature of damage to the thoracolumbar spine as a whole. Enhancing the reliability of fixation, while maintaining the number of transpedicular screws, can be significantly achieved by using cross-links and adjusting screw length. The purpose of our study was to investigate the distribution of loads on the metal construct elements and bone structures in the thoracolumbar junction after extensive decompressive-stabilizing interventions. The load was modeled with a backward tilt. A mathematical finite element model of the human thoracolumbar spine segment was developed, incorporating vertebrae Th9-Th11, L2-L5, with Th12-L1 vertebrae removed, as well as elements of the metal construct—interbody support and a transpedicular system. We modeled four variants of transpedicular fixation using both short and long screws that penetrate the anterior surface of the vertebral body, with and without the use of two cross-links. Stress parameters were monitored at 20 control points in the models. Comparative analysis of the results revealed that models including long bicortical screws and two cross-links demonstrated the best biomechanical performance when the torso was tilted backward, effectively reducing stress in critical areas and enhancing the durability and effectiveness of the fixation.

Lumbosacral transitional vertebrae in children and adolescents (literature review, illustrated with clinical observations)

Introduction An analysis of the medical literature devoted to various aspects of transitional lumbosacral vertebrae shows that there are very few publications covering the course of this disease in the pediatric and adolescent population.Aim To study the issues of epidemiology, diagnosis, treatment and prevention of transitional lumbosacral vertebrae in paediatric and adolescent patients based on the analysis of current medical literature and illustrate the material with our own clinical observations.Material and methods To analyze the literature on the topic, 75 papers published between 1984 and 2023 were selected. Among them, there were 7 (9.3 %) domestic literary sources, 68 (90.7 %) were foreign. In the process of searching for scientific articles, the resources of the electronic databases of current medical information PubMed and CyberLeninka were used.Results and discussion The incidence of transitional vertebrae in children and adolescents is 16.8 % of clinical observations, as reported. In the structure of the transitional vertebrae in children, type II of the disease predominates according to the classification Castellvi et al (1984), 43.2 % of cases. The main clinical symptom of the pathology is pain of lumbosacral location, the intensity of which on the visual analog scale in children corresponds to an average of 3.0 points. In adult patients with similar pathology, the average pain intensity measured with the same scale is 7.5 points. The most informative method for diagnosing the disease is computed tomography, which allows obtaining both 3D images and sections at the level of pseudarthrosis between the enlarged transverse process (or processes) of the suprasacral vertebra and the wing of the sacrum. To relieve pain in children with transitional vertebrae, both conservative and surgical methods are used. The most commonly used procedure is pseudarthrectomy. The study of long-term results one year after the intervention allowed us to record the absence of pain in children who underwent surgery. Prevention measures for transitional lumbosacral vertebrae have not been developed.Conclusion The analysis of the published literature shows that transitional vertebrae are a frequently diagnosed pathology in children and adolescents. Current methods of imaging are able to accurately detect not only the presence of the disease, but also to differentiate its type. The main clinical symptom of transitional vertebrae is pain in the lumbosacral spine which is difficult to relieve with conservative therapy. Pseudarthrectomy is the most frequent surgical method of treatment in children and adolescents that provides stable relief of vertebrogenic pain syndrome. Measures for specific prevention of the disease have not been developed.

The pollinator conservation approach “Farming with Alternative Pollinators”: Success and drivers

Global food security is heavily reliant on crop pollination. However, evidence on pollinator decline has been reported in all continents. Globally affordable conservation strategies need to be developed, as high-cost measures like European agri-environment schemes are not scalable in all countries. Here, we test, if a low-cost conservation approach named “Farming with Alternative Pollinators” (FAP) can benefit wild pollinator abundance and richness in agro-ecosystems and in crops, through establishment of marketable habitat enhancement plants (MHEP). The study was carried out in four Moroccan agro-climatic regions, during two years, using 6 main crops (pumpkin, zucchini, faba bean, tomato, eggplant and apple) and 201 sites. Additionally, we investigated how crop type, crop-MHEP composition (i.e. phylogenetic distances among crop and MHEP) and local climate can drive the success of the approach in comparison to monocultural fields. Based on 7097 recorded specimens, our results show that the wild pollinators of the entire FAP fields (i.e. 75% main crop and 25% MHEP) were significantly more abundant and species-rich than those of control fields (i.e. 100% main crop). Considering the main crop wild pollinators, FAP did not display any significant effect either on wild pollinator abundance or on pollinator richness. The mean phylogenetic distance between the main crop and MHEP, and climatic variables were not correlated with increase in wild pollinator abundance and richness in FAP fields. The crop type was found to influence the effect of the FAP approach. Our study provides strong evidence that FAP constitutes a relevant method for wild pollinator conservation in agro-ecosystems. Further research on additional environmental factors is necessary to outline the circumstances under which the FAP approach can positively affect wild pollinator communities.

The log-conformation formulation for single- and multi-phase axisymmetric viscoelastic flows

A computational model for predicting axisymmetric single- and multi-phase viscoelastic flows based on the log-conformation formulation of the constitutive equation is presented. The governing equations are discretised using the finite element method and advanced in time using a projection scheme. The single-phase benchmark problem of viscoelastic flow past a sphere in a cylinder is considered and excellent agreement is found with the literature for the drag coefficient for an extensive range of Weissenberg numbers. The cause of the breakdown in stability due to a velocity inflection near the sphere is investigated. For multi-phase flows, enhanced stability of the conservative level-set method is obtained by introducing a diffused interface approach for normal calculations. This novel method is used to investigate the jump discontinuity phenomenon exhibited for a bubble rising in a viscoelastic fluid. Qualitative and quantitative agreement is found with contemporary literature in terms of the critical bubble volume as well as other phenomena such as the negative wake and trailing cusp.

Acrosin activity negatively influences the cumulative live birth rate in patients undergoing IVF treatment

Research questionIs acrosin activity related to cumulative live birth rate (CLBR) over 1 year after IVF, intracytoplasmic sperm injection (ICSI) treatment or both? DesignRetrospective monocentric cohort study of 5704 couples who started IVF/ICSI treatments between 2016 and 2021. Acrosin activity was determined by a modified Kennedy method using a commercial kit. Patients were divided into two groups according to their acrosin activity: below 25 μIU/106 spermatozoa; and an acrosin activity 25 μIU/106 spermatozoa or above. Primary outcome was the CLBR, defined as an ongoing pregnancy leading to live birth that had arisen from all embryo transfers carried out within 1 year after the first ovum retrieval. Both conservative and optimistic methods were used for estimating CLBRs. ResultsThe CLBRs of patients with an acrosin activity below 25 μIU/106 spermatozoa were found to be significantly lower than those of patients with an acrosin activity 25 μIU/106 spermatozoa or above by conservative (48.5% versus 55.4%, P = 0.02) and optimistic (63.7% versus 70.3%, P = 0.047) methods after adjusting for confounders. When acrosin activity was regarded as a continuous variable, significant negative relationships between acrosin activity and CLBR were identified in subgroups: young couples (men and women aged younger than 30 years) and couples from whom no more than 10 eggs were retrieved. ConclusionLow acrosin activity levels were correlated with decreasing CLBRs over 1 year. These findings suggest that acrosin activity can be used as a predictor for CLBRs before starting IVF/ICSI treatment to enhance the effectiveness of counselling.

Results of treatment of patients with post-burn strictures of the esophagus by the booging method

To date, treatment of cicatricial post-burn strictures of the esophagus remains one of the main challenges of thoracic surgery. Despite the signifi cant number of diff erent treatment methods, the number of patients requiring it, does not decrease. Conservative methods are mostly ineff ective. Bougienage of the esophagus remains the main method of treating scar strictures after burns.

Preservation Strategies In Nigerian Museums: A Comprehensive Examination Of Preventative And Remedial Conservation Practices

The museums located in the North-Western part of Nigeria use both preventive and curative conservation in preserving the collections in their custody. In applying preventive conservation, the museums manage the risks to collections through the lens of the agents of deterioration. The REORG method, adoption of proper collection management practices, passive method of indoor climatic management and good house-keeping were the preventive conservation methods used in the museums. Dry cleaning, wet cleaning and chemical treatment were used in curative conservation. Although the two conservation methods were used in the museums, each has its peculiar benefits. The preventive conservation method aims to prevent or reduce damage while curative conservation is the method of choice when damage has occurred. This study discusses both types of conservation as applied in North-West museums

Instrumental Tracheal Rupture

Abstract Tracheal rupture is an urgent life-threatening complication that relates to complex and poorly understood areas of trauma surgery. The article presents a review of modern world and domestic literature on instrumental tracheal ruptures, the Relevance of early diagnosis and various treatment methods. Based on an analysis of modern literature data, the article describes the issues of conservative and surgical treatment methods, as well as an assessment of their results. The problem of the diagnostic algorithm and the choice of conservative, surgical treatment has not been solved and remains relevant. The issues of treating patients with a defect in the membranous wall of the trachea in intensive care and in need of artificial ventilation in clinical practice remain unresolved. All of the above indicates the Relevance of the study.Aim of the study To present data from domestic and foreign literature on the diagnosis and treatment of instrumental tracheal ruptures.Material and methods A review of the literature was carried out for the period from 1993 to 2024 in Russian and English, available on the databases Pubmed, Medline, UpTodate, Scopus, E-library, on topics such as post-intubation tracheal rupture, iatrogenic tracheal rupture, diagnosis and treatment of instrumental tracheal ruptures, closed tracheal injury.Results The concept of the classification system, risk factors, etiopathogenesis is outlined. Information is provided on the diagnostic significance of computed tomography and tracheobronchoscopy. Close attention is paid to the methods and choice of treatment tactics, the principles of intraoperative tactics, and the strategy of conservative treatment. A comparative assessment of treatment Results and their complications with a conservative or surgical treatment approach is given.Conclusion Thus, an analysis of domestic and foreign literature indicates that the issues of diagnosis and treatment of iatrogenic tracheal injuries remain largely unresolved. There is no generally accepted algorithm for instrumental diagnosis of tracheal ruptures. There are no uniform approaches to determining indications and contraindications for conservative and surgical treatment of tracheal injuries. There are diametrically opposed opinions regarding the choice of treatment tactics. These contradictions create significant difficulties in assessing the Results of treatment of this complex category of patients.