Medicine Format Research Articles

СЕРГЕЙ ПЕТРОВИЧ БОТКИН: К ЮБИЛЕЮ ВРАЧА, ПЕДАГОГА, ИССЛЕДОВАТЕЛЯ, ОБЩЕСТВЕННОГО ДЕЯТЕЛЯ

Abstract. Introduction. On the 190th jubilee of Sergei Petrovich Botkin, an appeal to his memory of his merits is evidence of the caring attitude of the current generation to the Russian medical heritage, allowing to preserve the continuity of professional generations. Aim. The purpose of the study is to show the role of the personality of S.P. Botkin in the development of scientific clinical medicine, in the formation of military medicine field and sanitary medicine in Russia. In the course of theoretical research, significant personal qualities of S.P. Botkin, his clinical experience, the influence of research results on the development of the physiological direction of clinical medicine, the formation of Russian military field medicine and the military sanitary industry in Russia were revealed. Material and methods. The research was carried out based on of theoretical analysis of literature on the history of Russian medicine and medical education, letters of S.P. Botkin. The historical observation covers the period from the beginning of the 30s up to the 90s years of the XIX century. Results and discussion. The study of articles and materials illustrating the life path of S.P. Botkin, his achievements in the field of the physiological direction of scientific clinical medicine, military field and military sanitary medicine, allowed us to identify a number of individual and personal qualities of this person, which as a whole determined his professional formation and influenced the entire course of development of a number of branches of scientific and medical knowledge. Purposefulness, originality, charisma of the scientist, his perseverance and persistence, courage and creative passion have become significant personality traits that allowed his inclinations as a researcher, doctor, teacher and public figure to be revealed. Conclusion. In the course of theoretical research, it was possible to identify a number of significant personal qualities of S.P. Botkin, analyze his clinical experience, research, pedagogical and social activities, which made it possible to highly appreciate his contribution to the world medical science and practice, to the development of domestic public health, to the improvement of the military sanitary industry in Russia.

PROBABLE JUVENILE FRONTAL OF DASPLETOSAURUS HORNERI (DINOSAURIA: THEROPODA) FROM THE TWO MEDICINE FORMATION OF MONTANA, WITH IMPLICATIONS FOR TYRANNOSAURID ONTOGENY

A partial left frontal (UCM 55499) of a small tyrannosaurid theropod from the Campanian Two Medicine Formation of Montana is described, and is considered to probably represent a juvenile of Daspletosaurus horneri. UCM 55499 compares favorably with the frontals of other young juvenile tyrannosaurid specimens, and its diminutive size suggests that the element comes from a small juvenile individual. Differences (including width of the nasal process, and degree of expansion of the postorbital buttress and the caudal shelf) between it and frontals of the larger individuals of Daspletosaurus horneri are similar to those between juveniles and adults of other tyrannosaurids such as Tyrannosaurus rex, suggesting that overall ontogenetic trends in the frontal bone of Daspletosaurus horneri are largely consistent with the patterns seen in other tyrannosaurids.

Study of Correlation between Intestinal Microbiota and Traditional Chinese Medicine Syndrome of Patients with Colon Cancer.

Objective This research aims to study the material basis of the formation and specific bacteria of traditional Chinese medicine (TCM) syndrome from the characteristics of the intestinal microbiota of patients with colon cancer (CC) before and after the operation. Methods A cross-sectional study was conducted on 84 patients with CC and 24 healthy controls. A total of 168 and 24 stool samples were collected from CC patients before and after the operation and healthy controls. DNA was extracted from 192 stool samples and then amplified using PCR. The V3-V4 high variable areas were analyzed by 16s rDNA sequencing. Results The community diversity, in descending order, was the healthy control group and postoperative and preoperative groups of CC patients. The abundance of beneficial bacteria was postoperative group of CC patients > healthy control group > preoperative group of CC patients. Among the comparisons of the intestinal microbiota of preoperative groups of CC patients with different TCM syndromes, the community diversity in descending order was damp heat accumulation (DHA), spleen deficiency and dampness (SDD), spleen and kidney yang deficiency (SKYD), liver and kidney yin deficiency (LKYD), and deficiency of qi and blood (QBD), respectively. Specific microbiome analysis showed that the differences in the abundance of 42 taxons were statistically significant among the preoperative groups of CC patients with the five TCM syndromes and the healthy control group. While comparing the intestinal microbiota of postoperative groups with the five TCM syndromes, the community diversity in descending order is DHA, SDD, LKYD, SKYD, and QBD. Specific microbiome analysis showed that the differences in the abundance of 46 taxons were statistically significant among the postoperative groups of CC patients with the five TCM syndromes and the healthy control group. Streptococcus and Streptococcus mutans showed no statistical significance between the preoperative group and postoperative groups of CC with DHA syndrome (P > 0.05). Bacteroides at phylum and genus levels showed that there was no statistical significance between the preoperative group and the postoperative group of CC with SKYD syndrome (P > 0.05). Conclusions Before and after surgery, with the deterioration of TCM syndrome: DHA ⟶ SDD ⟶ SKYD ⟶ LKYD ⟶ QBD, the number of beneficial bacteria in CC patients' intestines decreased while the number of pathogenic bacteria increased, and the community structure of intestinal microbiota tends to be unitized, indicating a serious intestinal microbiological disorder. After radical surgery and perioperative intervention, the intestinal microbiota diversity and community structure of postoperative CC patients were closer to those of healthy people than preoperative. However, they were still imbalanced. The intestinal microbiota of CC patients with different TCM syndromes differs significantly, which is important for understanding the pathogenesis of CC in TCM. The DHA and SKYD syndromes in CC patients before and after surgery showed significant differences in the microbial structure. Streptococcus and Streptococcus mutans were the specific species with a significant difference in CC patients with DHA syndrome, while bacteroides were the specific species in CC patients with SKYD syndrome.

P-67892863-249 - Upper airway 3D assessment in CBCT-based orthognathic surgery

<h3>Objectives</h3> To stratify the maxilla-mandibular movements in the orthognathic surgery treatments of class III patients, assess the volumetric and bidimensional repercussions of these movements in the Upper Airway (UA). <h3>Methods</h3> The CBCT data of 44 patients class III, who had undergone orthognathic surgery were collected. After acquisition, the images were recorded and stored in Digital Imaging Communication in Medicine (DICOM) format. Preoperative files (T0) and the 1 to 4 months post-operative files (T1) were obtained. The 3D craniometric evaluation was carried out in the software. In the sinus/airway tool, the total airway pharyngeal nasopharynx, oropharynx, and hypopharynx were delineated, as following the boundaries. In each region, the volume, Minimum Axial Area (MAA) and the area of the respective delineated regions were calculated. The patients were divided into Group I (maxilla 0 to 4.9mm forward) and Group II (the maxilla 5.0 to 10.0mm forward). <h3>Results</h3> In Group I the correlation between the counterclockwise and the hipopharynx's MAA was moderate (0.439), and for every 1mm of maxillary advancement obtained a gain of 214.74mm³ in nasopharynx and 653.90mm³ in the oropharynx. <h3>Conclusion</h3> Maxillary advancement promotes an increase in the upper airway, compensating for a possible constriction that the mandibular setback may promote in the hypopharynx. Small maxillary advancements associated with different mandibular movements promoted greater airway gain.

Управление на основе данных в лучевой диагностике: оценка результативности модели единого радиологического информационного сервиса

The development and availability of information technologies covers all spheres of society, providing ever newer and more advanced means of automating processes and structuring data, primarily in order to improve management efficiency. Radiation diagnostics, due to its clinical significance, is one of the key areas of modern healthcare. At the same time, it is distinguished by an extremely high degree of digitalization, which creates extensive opportunities for the development and improvement of organizational and managerial aspects. An analytical study was carried out on the principles of a systematic approach, consisting of three stages. First stage. The main phases and indicators of the development of a single digital circuit for radiodiagnosis in Moscow are characterized: the dynamics of the integration of diagnostic equipment, the structure of medical organizations, the rate of accumulation of the results of radiological examinations by modality. Second phase. The analysis of the influence of a single digital circuit of radiodiagnosis on the level of informatization of medical organizations and informatization of the health care system of a constituent entity of the Russian Federation was carried out, its compliance with the requirements of the Ministry of Health of Russia was assessed. Third stage. The analysis of the influence of a single digital circuit of radiodiagnosis on the level of digital maturity of the health care system of a constituent entity of the Russian Federation was carried out. The practical implementation of the model of a single digital circuit for radiation diagnostics of an administrative-territorial unit was carried out in the period 2015–2020 in Moscow. The Unified Radiological Information Service (UIS) of Moscow was created – an information system in the field of healthcare that combines the workplaces of radiologists, radiologists and diagnostic equipment, accumulates information about each study or a series of studies conducted on devices connected to it, is equipped with additional tools for solving analytical, managerial and organizational tasks. The analysis of the significance of ERIS EMIAS as an implemented single digital circuit for radiodiagnosis of a subject of the Russian Federation was carried out. The development of URIS EMIAS ensured a steady increase in the level of informatization coverage of medical organizations that have radiation diagnostics units in their composition.

Preventive medicine is an actual problem of healthcare in Republic of Uzbekistan

The article considers the situation in the healthcare in the Republic of Uzbekistan from the point of view of the formation of preventive medicine. The results of the analysis of literature on preventive medicine in the CIS countries and far abroad are presented. According to the analytical data obtained, it was concluded that traditional orthodox medicine not only in CIS countries, but also in some countries of the far abroad, has reached a dead end, and to preserve the health of nations, qualitatively new approaches are required in the health care systems of these states. The ways of development at the management and structural level are shown and the scientific and methodological approaches to preventive medicine as a science that combines primary prevention and valeology (the science of health) are substantiated. For the study, data were taken from various sources of literature regarding the situation in the development of preventive medicine. The sources are: eLibrary and CyberLeninka. Methods: selective method and the method of bibliographic references. The principles of the formation of a way of life (as opposed to promoting a healthy lifestyle), based on the aspects of the impact: the individual level, group, population, have been substantiated. The individual level implies, first of all, pre-nosological (preclinical) diagnostics of the patient’s health status with further correction of the lifestyle. In this connection, specific proposals are given that have already been introduced into practice. The system of work with the population is given by dividing it into target groups according to social and age characteristics. Each target group has its own characteristics and impact. The efficiency of the work of valeocabinets (health rooms) in the primary health care sector has been determined. Rooms provide all the necessary tools and trained personnel for the active implementation of the principles of healthy lifestyle among the population. In the process of searching for literature, the selective method and the method of bibliographic references were used.

Cold Argon Athmospheric Plasma for Biomedicine: Biological Effects, Applications and Possibilities.

Currently, plasma medicine is a synthetic direction that unites the efforts of specialists of various profiles. For the successful formation of plasma medicine, it is necessary to solve a large complex of problems, including creating equipment for generating cold plasma, revealing the biological effects of this effect, as well as identifying and justifying the most promising areas of its application. It is known that these biological effects include antibacterial and antiviral activity, the ability to stimulate hemocoagulation, pro-regenerative properties, etc. The possibility of using the factor in tissue engineering and implantology is also shown. Based on this, the purpose of this review was to form a unified understanding of the biological effects and biomedical applications of argon cold plasma. The review shows that cold plasma, like any other physical and chemical factors, has dose dependence, and the variable parameter in this case is the exposure of its application. One of the significant characteristics determining the specificity of the cold plasma effect is the carrier gas selection. This gas carrier is not just an ionized medium but modulates the response of biosystems to it. Finally, the perception of cold plasma by cellular structures can be carried out by activating a special molecular biosensor, the functioning of which significantly depends on the parameters of the medium (in the field of plasma generation and the cell itself). Further research in this area can open up new prospects for the effective use of cold plasma.

Організація медико-санітарної служби Війська польського у Східній Галичині (листопад 1918 – лютий 1919 рр.)

The organization of the military medical service of the Polish Army in Eastern Galicia began in the first days of November 1918. It was managed to create a network of medical and dressing stations in Lviv. Compelling assistance was provided by women who cared for the sick and wounded soldiers. The local hospital on Tehnika was the main center of medical care of the Polish Army. All hospitals had a clear organizational structure, setting the time of admission of patients, as well as areas of responsibility. In addition to medical institutions in Lviv, doctors and hospitals in Przemyśl provided significant assistance in the treatment of patients, where patients were transported by ambulance trains. The patients were dominated by soldiers with bullet wounds, typhus and sexually transmitted diseases. The command constantly stressed to the soldiers to follow the rules of personal hygiene and maintain cleanliness in the barracks. Medical examinations were performed for this purpose. There were some baths, dental and bacteriological laboratories in the city. Additionally, the command developed special nutrition and diet for patients. To train medical staff, the NK organized sanitary courses and courses for loaders. They tried to solve the shortage of medical staff by mobilizing and attracting medical students. In general, the positive factors that influenced the formation of military medicine of the Armed Forces were the provision of military ranks to doctors and physicians, the introduction of wages, the provision of social benefits and guarantees.

Utility-Prioritized Differential Privacy for Quantitative Biomedical Data

In the context of heavy investments in life sciences, one consequence of rapid biotechnical developments is the generation of very large amounts of biological data that not only support bioinformatics research used in medical and health services by data analysis but also cause genetic privacy breaches for the data originators, limiting biomedical data sharing. However, the original intention of medical informatization is to improve medical efficiency and break the information barriers between medical institutions, which is also limited by genetic privacy risks from growing bioinformatics data. To share biomedical data correlated with genes usefully under the premise of ensuring genetic privacy, with the concept of medical reference interval, we design a query strategy based on a flexible differential privacy algorithm that setting weights for noise added according to the purpose of the inquirer. We generate a series of biomedical data to test the effectiveness of our query system, the test results show that our algorithm ensures data’s utility with acceptable privacy breaches that addresses the problem of biomedical data sharing to a certain extent.

Medical Knowledge Graph to Promote Rational Drug Use: Model Development and Performance Evaluation

Knowledge Graph (KG) has been proven effective in representing and modeling structured information, especially in the medical domain. However, obtaining structured medical information usually depends on the manual processing of medical experts. Meanwhile, the construction of Medical Knowledge Graph (MKG) remains a crucial problem in medical informatization. This work presents a novel method for constructing MKGto drive the application of Rational Drug Use (RDU). We first collect and preprocess the corpora from various types of resources, and then develop a medical ontology via studying the concepts in RDUdomain, authoritative books and drug instructions. Based on the medical ontology, we formulate a scheme to annotate the corpora and construct the dataset for extracting entities and relations. We utilize two mechanisms to extract entities and relations respectively. The former is based on deep learning, while the latter is the rule-based method. In the last stage, we disambiguate and standardize the results of entity relation extraction to construct and enrich the MKG. The experimental results verify the effectiveness of the proposed methods.

Self-Adaptive Telemedicine Specialist Recommendation Considering Specialist Activity and Patient Feedback.

Purpose: With the rapid development of medical informatization, information overload and asymmetry have become major obstacles that limit patients’ ability to find appropriate telemedicine specialists. Although doctor recommendation methods have been proposed, they fail to address data sparsity and cold-start issues, and electronic medical records (EMRs), patient preferences, potential interest of service providers and the changes over time are largely under-explored. Therefore, this study develops a self-adaptive telemedicine specialist recommendation method that incorporates specialist activity and patient utility feedback from the perspective of privacy protection to fill the research gaps. Methods: First, text vectorization, view similarity and probabilistic topic model are used to construct the patient and specialist feature models based on patients’ EMRs and specialists’ long- and short-term knowledge backgrounds, respectively. Second, the recommended specialist candidate set and recommendation index are obtained based on the similarity between patient features. Then, the specialist long-term knowledge feature model is used to update the newly registered specialist recommendation index and the recommended specialist candidate set to overcome the data sparsity and cold-start issues, and the specialist short-term knowledge feature model is adopted to extend the recommended specialist candidate set at the semantic level. Finally, we introduce the specialists’ activity and patients’ perceived utility feedback mechanism to construct a closed-loop adjusted and optimized specialist recommendation method. Results: An empirical study was conducted integrating EMRs of telemedicine patients from the National Telemedicine Center of China and specialists’ profiles and ratings from an online healthcare platform. The proposed method successfully recommended relevant and active telemedicine specialists to the target patient, and increased the recommended opportunities for newly registered specialists to some extent. Conclusions: The proposed method emphasizes the adaptability and acceptability of the recommended results while ensuring their accuracy and relevance. Specialists’ activity and patients’ perceived utility jointly contribute to the acceptability of recommended results, and the recommendation strategy achieves the organic fusion of the two. Several comparative experiments demonstrate the effectiveness and operability of the hybrid recommendation strategy under the premise of data sparsity and privacy protection, enabling effective matching of patients’ demand and service providers’ capabilities, and providing beneficial insights for data-driven telemedicine services.

“The people have a positive attitude to medicine...” (Medical Inspectors in the Formation of Medical and Sanitary Affairs in the Provinces of Pre-Revolutionary Russia)

The problem of the history of public administration in the field of medicine and healthcare has never lost its relevance. The Health project has become one of the priority national projects of the last decade. The epidemic that began in 2020 has exacerbated many long-standing problems of Russian medicine: a shortage of medical personnel and medical institutions, insufficient material security of doctors, etc. As a result of the clumsily carried out “optimization” and contradictory actions during the epidemic, the level of confidence of the people and society in the activities of modern health care organizers has fallen. The topic of the state of health care, sanitary and epidemic safety, the role of the state in solving these pressing issues has firmly entered the public discourse, aroused interest in considering historical experience with all its achievements and losses. A significant place in the state administration of medicine and healthcare has always been occupied by specific people — government officials who have made a noticeable and real contribution to the development of health care.The management of medical and sanitary affairs in the provinces of the Russian Empire was carried out by medical inspectors (the position was established in 1865), as a rule, highly qualified doctors with extensive and diverse practical experience. The materials of the Russian State Historical Archive (St. Petersburg) and local archives allow us to make a typical portrait of this category of managers. In the funds of the Medical Department and the Main Medical Department of the Ministry of Internal Affairs, cases have been postponed in which the official activities and biographies of medical inspectors are characterized. The article examines the main activities of medical inspectors, assesses their contribution to the formation and development of healthcare and medicine in pre-revolutionary Russia. Along with the study of forms and methods of solving medical and sanitary-epidemic problems of the regions by inspectors, the personal qualities of the best managers, which have become the basis for the success of their activities, are also highlighted.

ANALYSIS OF STATE GOVERNANCE IN THE FIELD OF HEALTHCARE IN UKRAINE AND FOREIGN COUNTRIES

The current state of health care in Ukraine is characterized by low efficiency of available logistical using and human resources, slow pace of change in the introduction of innovative diagnostic methods and technologies and lack of understanding of the implementation of standards and indicators of quality and effective management of health services. The goals of health care are to improve health and meet the needs of consumers. The state of the population health depends not only on the provided medical services, but to a large extent on other factors, including the state of the environment, individual heredity, behavioral risk factors, socio-economic status of society and the state of the health care system (Obolenskyi O.Iu., 2007:191). Health care activities should be based on the end results, namely: improving the health of the population; cost and quality of medical services, their availability; fairness and efficiency in the provision of medical services; the effectiveness of mechanisms to protect citizens from financial risk in case of disease (Surmin Yu. P. 2006:307) The authors emphasize the unity of the approach to health care reform in Ukraine at all levels of departmental and national medicine. The study highlights the causes, conditions of formation and functioning of departmental medicine in Ukraine and around the world. The article uses methods of generalization and systematization, grouping and comparison, classification and analogy and systems analysis, as well as the dialectical method and the method of forecasting. The authors analyze the state of health care reform over the past 10 years in countries with high (Britain, France, USA) and low economies (India), with ongoing military conflicts (Israel), with high life expectancy (Italy), with transition economy (Croatia) and in the post-Soviet countries that joined the European Union (Lithuania). The study focuses on the rating indicators of gross domestic product (GDP) and life expectancy, according to analytical reports of international organizations WHO, OECD, International Commonwealth Fund and others.

Anniversary of the scientist: to the 60th anniversary of Corresponding Member of the Russian Academy of Sciences Andrey Nikolaevich Belskikh

On March 13, 2022, the prominent Russian scientist, specialist in extracorporeal hemocorrection, intensive therapy, and nephrology, Corresponding Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Major General of medical service in the reserve, Andrey Nikolayevich Belskikh, turned 60. Andrey Nikolayevich spent almost 40 years at the Military Medical Academy, having worked his way up from the cadet and the adjunct to the head of the Academy. For almost two decades he headed the clinical center of extracorporeal detoxification and started his scientific career, defended his doctoral thesis, and received the academic rank of a professor. His research opened a new page in the study of previously unknown fundamental regularities of hemorheological blood changes in hypoxia of different genesis, fundamental mechanisms of etiology, and pathogenesis of critical states formation in intensive medicine. During his 6 years as the head of the Military Medical Academy in a difficult time, Andrey Nikolayevich has done a lot. He organized the training of specialists with secondary medical education at the new faculty, and trained doctors in the specialties of preventive medicine, dentistry, and pharmacy. A simulation training center, one of the first and the best in the country, has been created. New departments of nephrology and efferent therapy and general dentistry were added to the Academy staff. Large-scale reconstruction and re-equipment of the Academy were started. The concept of a multidisciplinary clinic, which was ceremonially opened by the President of the Russian Federation, V.V. Putin, was developed, as well as the clinic. The work of A.N. Belskikh was marked with the Order of Honor and the honorary title Honored Physician of the Russian Federation. After retirement from military service, Andrei Nikolaevich Belskikh headed the department of nephrology and efferent therapy, where he continued his successful research and scientific, pedagogical, and medical staff training.

Exploring perceived challenges of self-management in low-income older people with hypertension: A qualitative study.

Hypertension is a public health problem globally. Understanding the perceived challenges of low-income older people populations with chronic disease is an obstacle the world is facing today. To explore perceived challenges of self-management in low-income older people with hypertension. Data were collected in three communities from September 2019 to October 2019 by semi-structured interviews. Interviews were audio-taped by digital voice recorder and analysed according to Colaizzi's seven steps. Participants demonstrated perceived challenges concerning hypertension self-management. Six themes were identified: hypertension belief bias, family dysfunction, deep-rooted habit, elder self-neglect, medical informatization and supportive health policy. Each theme was identified with several subthemes. Findings implied that most of the low-income older people lacked self-management behaviours. Future research is needed to address perceived challenges related to self-management behaviour for patients with hypertension worldwide.

Этические традиции отечественного медицинского образования в тайм-менеджменте системы здравоохранения

The article is devoted to the study of the ethical traditions of domestic medicine and medical education in the development of the theory and practice of time resource management in the healthcare system since the formation of domestic clinical medicine, in the conditions of zemstvo medicine, the Soviet and post-Soviet periods. On the one hand, the actively developing processes of digitalization of the domestic healthcare system open up wide opportunities in the diagnosis, treatment and prevention of diseases, on the other hand, they give rise to a number of unprecedented problems, in particular, in the field of ethics. Their solution requires trained specialists with interdisciplinary humanitarian knowledge and is associated with the need to humanize modern domestic higher medical education, one of the most important problems of which is the reduction of humanitarian training and, as a result, the loss of educational function. The wide scale of the development of technical capabilities, the variety of pharmaceuticals, experiments in the organization of health care have created a situation where, behind an array of various innovations in the pursuit of rational use of time in the time management of the health care system, a person with his unique subjective characteristics has receded into the background.

Medical support of the fleet in the Great Northern war

The Northern (Great Northern, Twenty-Year) War lasted from 1700 to 1721. The war was fought between the Kingdom of Sweden and a coalition of the states of Northern Europe for domination of the Baltic Sea and possession of the Baltic lands. In 1721, a new Russian Empire emerged in Europe with a powerful regular army and navy. The capital of Russia became the city of St. Petersburg. The Kronstadt Naval Fortress was built on the Baltic Sea. During the Northern War, the first military hospitals, hospital schools, pharmacies appeared. The fleet is equipped with hospital vessels. Legislation in the field of military and naval medicine was improved, medical supplies were improved. All this served as a reliable foundation for the development and formation of Russian military and naval medicine.

Palm fronds from western Canada are the northernmost palms from the Late Cretaceous of North America and may include the oldest Arecaceae

Palm leaf fossils are common from Late Cretaceous floras in the United States, but Late Cretaceous Canadian palm records are limited largely to Nanaimo Group strata of British Columbia, with only anecdotal records from east of the Rocky Mountains. Here we report Late Cretaceous leaf fossils from Alberta and Saskatchewan, Canada. Segment angles with the rachis or costa are investigated as an additional character to distinguish costapalmate from pinnate and entire-pinnate palm leaves. The leaf fossils from Alberta and Saskatchewan represent costapalmate-palms (Sabalites), in contrast to the relatively common entire-pinnate palm fossils known from the Coniacian–early Campanian lower Nanaimo Group of British Columbia (e.g., Geonomites imperialis; potentially the oldest known North American palm) and the Campanian Two Medicine Formation of Montana (cf. Phoenicites). The presence of fossil palms in the Campanian to Maastrichtian of Alberta and Saskatchewan constrains climate reconstructions for the Late Cretaceous high mid-latitudes of North America (c. 55° N) to exclude significant freezing episodes. Additionally, we update the nomenclature for G. imperialis, renaming it as a species of Phoenicites, and briefly consider its value to understanding the evolution of pinnate palms. Further, we challenge the interpretation of Sabalites magothiensis as a costapalmate species and reassess the age of S. carolinensis as late Campanian.

Analysis and Improvement of Nursing Quality Based on Standardized Information Integration.

Information is becoming increasingly important in social development, and the medical industry's informatization has made significant progress. This paper evaluates the role of nursing informatization in improving nursing quality management by analyzing and comparing changes in nursing quality before and after the implementation of nursing informatization. Using modern computer network technology to evaluate nursing quality, monitor the implementation of nursing management plans, and control nursing quality links in real time has helped to promote and improve nursing quality. The integration mode of the existing hospital information system is sorted out and standardized according to the requirements of refined hospital management. We can optimize the overall architecture of the hospital information system, reduce the tight coupling between business systems, support rapid integration and flexible expansion of business systems, and lay a foundation for the cooperation and data sharing of medical resources in and out of the hospital by establishing a hospital information platform based on standardized specifications.

A Retrospective Digital Analysis of Contour Changing after Tooth Extraction with or without Using Less Traumatic Surgical Procedures.

Background: The present retrospective analysis aimed to compare two different single tooth extraction surgical approaches in both premolar and molar areas: less traumatic magneto-electrical versus conventional tooth extraction in minimizing the edentulous ridge volume loss. Methods: In the present retrospective control trial, 48 patients who underwent one-tooth extraction, were allocated either to control (28 sites treated with conventional tooth extraction procedures) or test group (20 subjects treated with less traumatic tooth extraction procedures by tooth sectioning and magnetoelectric roots subluxation). Intraoperatively (during tooth extraction surgery just after the subsequent filling of the alveolar socket with the sterile fast re-absorbable gelatin sponge), and then four months later, contours of the sockets were acquired through a laser intra-oral scanner. The digitally superimposed models were converted to dicom (Digital Imaging and Communications in Medicine) format first, then volumetric and area evaluations were performed with a DentaScan tool package. Non-parametric tests were applied with a level of significance set at p < 0.01. Results: significant reductions of anatomical features were observed four months later in all the groups (p-values < 0.001) with volume losses leading to a final alveolar ridge volume of 0.87 ± 0.34 cm3 for atraumatic extractions and 0.66 ± 0.19 cm3 for conventional extractions. No significant differences were registered for outcomes related to the basal surface variables. When just molar tooth were considered, the outcomes relating to volume loss between baseline and four months (ΔV) and its percentage (ΔV%) showed a better behavior in the less traumatic procedure (ΔV = −0.30 ± 0.10 cm3 and ΔV% = −22.3 ± 8.4%) compared to the conventional extractions (ΔV = −0.59 ± 0.10 cm3 and ΔV% = −44.3 ± 5.8%) with p-values < 0.0001. Conclusions: at four months, the less traumatic tooth extraction procedures by tooth sectioning and magnetoelectric root subluxation seemed to be able to better preserve the volume of the alveolar crest (reduction close to 22% with less traumatic extraction in molar sites) when compared to subjects treated with the conventional tooth extraction techniques.