Mid-term Period Research Articles

Assessment of localized seasonal precipitation variability in the upper middle catchment of the Olifants River basin

Abstract This study used the Soil and Water Assessment Tool (SWAT) model together with regional climate downscaled (RCD) data from the CORDEX (Africa project), to assess the local seasonal precipitation variability in the upper middle catchment (UMC) of the Olifants River basin. The study results, based on two scenarios (RCP4.5 and RCP8.5), showed a wider monthly and seasonal variability of precipitation. The study also indicated a strong decreasing trend of east-to-west direction of spatial precipitation, with most precipitation concentrated in the eastern part of the study area. Within the western part of the UMC, we also noted another decreasing trend of precipitation from south-to-north with northern areas of the study area receiving the least amount of precipitation. This study has also revealed a considerable general reduction of future seasonal precipitation especially in the mid-term period (2021–2050). The general reduction in future seasonal precipitation, combined with the increasing temperatures in the area, may exacerbate the drought conditions and reduction in streamflow of the main river (Olifants) and its tributaries, consequently having a negative impact on the economic activities in the basin.

DOP18 Impact of adherence to anti-tumour necrosis factor therapy on clinical outcomes in Crohn’s disease: A nationwide population-based study

Abstract Background The impact of compliance with anti-tumour necrosis factor (TNF) on the clinical outcomes of Crohn’s disease (CD) is not well unknown. We performed a nationwide population-based study to investigate the impact of adherence to anti-TNF therapy on clinical outcomes in CD patients. Methods Using the National Health Insurance claims data, we collected data on newly diagnosed patients with CD between 2004 and 2015. Given that infliximab was listed in the National Health Insurance Service in 2006 and adalimumab in 2010, data only after the listing date were extracted. A total of 2784 patients were included according to inclusion criteria. Medication adherence was measured based on the following three criteria, including the ratio of delayed visit, the ratio of the number of visits, and the ratio of actual administration, and was assessed at four-point in time from the initial administration: 14, 22, 39, and 48 weeks. Results A total of 2179 patients received infliximab, and 605 patients received adalimumab. The mean cumulative actual to predetermined prescription ratio (CAPPR) at 14 and 48 weeks was 1.07 and 1.17, respectively. CAPPRs of infliximab users were higher than those of adalimumab users (1.06 and 1.21 vs. 1.02 and 1.04 at 14 and 48 weeks, respectively). As hospital visits were delayed one more day, risk of perianal surgery (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.089–1.333), corticosteroid use (OR = 1.008, 95% CI 1–1.016), and hospitalisation (OR = 1.05,95% CI 1.002–1.108) at 48 weeks were significantly increased. Moreover, as CAPPR decreased by 1 percent point, risk of bowel resection (OR = 1.589, 95% CI 0.713–3.542), perianal surgery (OR = 1.246, 95% CI 0.868–1.79), and hospitalisation (OR = 1.128, 95% CI 0.998–1.276) at 14 weeks were significantly increased. Conclusion Our data indicate that adherence to anti-TNF therapy affects major clinical outcomes of CD in the short- and mid-term period. Intervention to improving adherence to anti-TNF therapy is highly needed for better clinical outcomes in CD.

Developing an integrated approach for optimum prediction and forecasting of renewable and non-renewable energy consumption in Iran

Energy planning for mid and long term periods needs forecasting the energy demands in the future. The artificial neural network (ANN) is an efficient forecasting tool which have been widely applied in different fields. One of the weaknesses of the ANN method is appeared when the studied case has many input parameters affecting on the performance of output factor. Noteworthy, there is not reliable data in many applications of real world. The canonical correlation analysis (CCA) method is an efficient tool for data reduction purpose keeping useful information of the used data. The purpose of this paper is to estimate and predict the renewable and non-renewable energy consumption considering environmental and economic factors. To this aim, an integrated approach based on the CCA and ANN method is utilised. The results show that the proposed approach reduces dimension of data without losing valuable information.

Developing an integrated approach for optimum prediction and forecasting of renewable and non-renewable energy consumption in Iran

Energy planning for mid and long term periods needs forecasting the energy demands in the future. The artificial neural network (ANN) is an efficient forecasting tool which have been widely applied in different fields. One of the weaknesses of the ANN method is appeared when the studied case has many input parameters affecting on the performance of output factor. Noteworthy, there is not reliable data in many applications of real world. The canonical correlation analysis (CCA) method is an efficient tool for data reduction purpose keeping useful information of the used data. The purpose of this paper is to estimate and predict the renewable and non-renewable energy consumption considering environmental and economic factors. To this aim, an integrated approach based on the CCA and ANN method is utilised. The results show that the proposed approach reduces dimension of data without losing valuable information.

Религиозная проблематика в русской опере рубежа XIX–XX веков

Actuality of work consists of revision some of theoretic installations, what are determined in XX century to religion problematic in Russian art. In real time, when the bans were lifted on this theme, actuality are seems the researching with this point of view exactly Russian opera as most democratic and available for perception view of music art. Accordingly, analysis of operas with suggesting point of view is demanding reconsidering some position in musicology of XX–XXI centuries. With this connected the purpose of this article – the revealation of religious aspects in Russian opera of boundary of XIX–XX centuries. The methodology. For accievement of this purpose we use the methods of musicological and genre-style analysis of operas of composers boundary of XIX–XX centuries. Scientific novelty consist of that historical-cultured and theoretical analysis of Russian operas of this period in attitude of religious aspects is one of insufficient researching section of native musicologist and it need especial intent attention of researchers for position of XXI centuries musicology. Conclusions of article permit to say about mutual influence of secular professional and spiritual aspects. To some extent analysis of Russian opera with religious and spirit problematic point of view allow to project some historic aspects of boundary of XIX–XX centuries to the midterm period of XX–XXI centuries.

The short- to midterm effectiveness of stemless prostheses compared to stemmed prostheses for patients who underwent total shoulder arthroplasty: a meta-analysis

BackgroundTo systematically compare the short- to midterm effectiveness of stemless prostheses to that of stemmed prostheses for patients who underwent total shoulder arthroplasty (TSA) and to provide a guideline for clinical decision-making.MethodsPubMed, the Cochrane Library, and Web of Science were searched with the given search terms until July 2019 to identify published articles evaluating the clinical outcomes for stemless prostheses compared with stemmed prostheses for patients who underwent TSA. Data extraction and the quality assessment of the included studies were independently performed by two authors. Stata software 14.0 was used to analyze and synthesize the data.ResultsTwo randomized controlled trials and six case-controlled studies with a total of 347 shoulders were included in this meta-analysis. The results of this meta-analysis showed that there were no significant differences between the stemless and stemmed prostheses in terms of the Constant score, pain score, strength, activities of daily living, postoperative range of motion (ROM), and postoperative maximum active ROM.ConclusionsThis is the first meta-analysis reporting the clinical results of stemless TSA in the short- to midterm follow-up period. Both types of shoulder prostheses were similar in achieving satisfactory clinical outcomes.

P1016Novel surgical ablation technique using ultrasonic scalpel for atrial fibrillation in mitral valve surgery

Abstract Objective Radiofrequency, cryoablation and cut-and-sew technique have been used for surgical ablation to treat atrial fibrillation. Ultrasonicscalpel is a surgical instrument used to simultaneously cut and cauterize tissue by ultrasound vibration. This device causes minimal lateral thermal tissue damage and increases the tissue penetration depth linearly with time. These features are suitable for surgical ablation for atrial fibrillation. This study evaluated surgical ablation with ultrasonic scalpel for atrial fibrillation. Methods From October 2017 to February 2019, 46 patients (mean age: 71.8 years [46–86], 28 male) with mitral valve procedure underwent surgical ablation using ultrasonic scalpel for atrial fibrillation. The ablation lines were carried out with Cox maze procedure or pulmonary vein isolation (PVI) on cardiopulmonary bypass. Endocardial atrial wall was ablated by direct touch with blade in a few seconds at energy level 5. Pathological study of left atrial wall received ablation with ultrasonic scalpel was carried out. Results Type of preoperative atrial fibrillation was persistent in 33 and paroxysmal in 13 patients. Mean left atrial diameter was 49.0 mm (35–81). Surgical ablation using ultrasonic scalpel was carried out to left atrium only or PVI in 33 patients and both atria in 13 patients. Mean surgical ablation time was 4 minutes and 21 seconds. Mitral valve repair and replacement were performed in 33 and replacement in 13 patients, respectively. Simultaneous surgery included 43 tricuspid valve repairs, 11 aortic valve replacements, and 7 coronary artery bypass grafting. Cardiopulmonary bypass and aortic cross-clamp times were 142.6 (70–261) and 98.6 (47–202) minutes, respectively. No operative death or perioperative stroke were observed. Thirty-eight patients (82.6%) returned to sinus rhythm immediately after surgery. Sinus rhythm was maintained in 30 patients (65.2%) in the mid-term period with average 142.2 days after surgery (7–426 days). Pathological study showed the atrial walls were not ablated transmurally. No complications including bleeding and tissue injury were observed. Conclusion Surgical ablation with ultrasonic scalpel for atrial fibrillation was feasible and provided satisfactory outcomes immediately after surgery and at mid-term. This technique can be performed in a short time without complications. Interestingly, pathological study showed no transmural tissue ablation despite of successful outcomes. This may imply transmural ablation is not necessarily mandatory for surgical ablation. Long-term follow-up are required to evaluate this technique.

Systematic investigation of mid-term periodicity of the solar full-disk magnetic fields

The Magnetic Plage Strength Index (MPSI) and theMountWilson Sunspot Index (MWSI), which have been measured at Mount Wilson Observatory (MWO) since the 1970s and which indicate weak and strong magnetic field activity on the solar full disk, respectively, are used to systematically investigate midterm periodicities in the solar full-disk magnetic fields. Multitudinousmid-term periodicities are detected in MPSI and MWSI on timescales of 0.3 to 4.5 yr, and these periodicities are found to fluctuate around several typical periodicities within a small amplitude in different solar cycles or phases. The periodicity of 3.44 yr is found in MPSI, and the periodicities of 3.85 and 3.00 yr are detected in MWSI. Our analysis indicates that they reflect the true oscillating signals of solar magnetic field activity. The typical periodicities are 2.8, 2.3 and 1.8 yr in MPSI and MWSI, and possible mechanisms for these periodicities are discussed. A 1.3 yr periodicity is only detected in MPSI, and should be related to meridional flows on the solar surface. The typical annual periodicity of MPSI and MWSI is 1.07 yr, which is not derived from the annual variation of Earth’s heliolatitude. Several periodicities shorter than 1 yr found in MPSI and MWSI are considered to be Rieger-type periodicities.

Periodicity Variation of Solar Activity and Cosmic Rays During Solar Cycles 22 – 24

The solar radio flux at 2800 MHz (F10.7) and the sunspot number (SSN) are excellent indicators of solar activity. Data from 1986 to 2016 have been used to investigate long-term and mid-term periodicities of the F10.7 solar radio flux, the sunspot number, and galactic cosmic rays (GCRs) intensity, mainly from Oulu and Moscow, using fast Fourier Transform and Morlet wavelet techniques. The ≈ 148 days period, among other periods, is the one seen prominently in SSN, F10.7, and GCRs throughout Solar Cycles 22 to 24. This period could be the third harmonic of ≈ 1.24 years, i.e. ≈ 444 days period. The period of ≈ 1.24 years, found in SSN, F10.7 flux, and GCRs, is ascribed to the rotation of the convective envelope within the Sun during these cycles. Another period found significantly present in F10.7, SSN, and GCRs, is the Quasi-Biennial Oscillation (QBO), with a period of ≈ 1.94 years. The QBO amplitudes are found to vary significantly from one solar cycle to the other, with a minimum during Solar Cycle 24. The decreasing QBO amplitudes during Solar Cycle 24 in all three datasets are well correlated with the QBOs found in the Earth’s atmosphere-ionosphere system reported elsewhere.

The effect of morbid obesity (BMI \u2265\u200935\u2009kg/m2) on functional outcome and complication rate following unicompartmental knee arthroplasty: a case-control study

BackgroundThe aim of this study was to evaluate and compare the functional outcomes and complication rates of patients in short-term and midterm follow-up period when medial unicompartmental knee arthroplasty (UKA)-applied patients were grouped according to BMI values.MethodsOne hundred four patients (mean age 60.2 ± 7.4 (range, 49–80)) to whom medial UKA was applied between 2011 to 2016 with a minimum of 2 years follow-up were grouped as normal and overweight (less than 30 kg/m2), obese (30–34.9 kg/m2) and morbidly obese (BMI ≥ 35 kg/m2) according to their BMI. The postoperative Knee Society Scores (KSS), functional Knee Society Scores (fKSS), Oxford Knee Scores (OKS), visual analogue scale (VAS) and range of motion (ROM) results and complication rate of these groups were compared statistically. The implant positioning of the patients requiring revision was analysed according to the Oxford radiological criteria.ResultsThe average BMI of 104 patients was 34.4 (range, 22–56.9). Twenty-six (25%) of these were normal or overweight, 40 (38.5%) were obese and 38 (36.5%) were morbidly obese. However, in these BMI groups, there was no significant difference between the preoperative VAS, postoperative VAS and VAS score changes among these three groups (p > 0.05). The postop KSS, f KSS and OKS were significantly poorer in the morbidly obese group by 75.2, 70.5 and 33.1, respectively. Furthermore, amount of ROM changes (4.2°) were significantly poorer in the morbidly obese group (p < 0.05). Complications including eminence fractures, insert dislocations, tibial component collapses and superficial infections developed in 10 patients (9.6%). Six of them (60%) were morbidly obese, and four of them (40%) were obese. Furthermore, 11 (10.6%) of the patients required revision. Eight (72.7%) of the patients were morbidly obese, and three (27.3%) of them were obese.ConclusionsWe concluded that morbid obesity is an independent risk factor for functional outcomes and implant survival after UKA. However, it is possible to obtain excellent results for obese and overweight patients with good planning and correct surgical technique. Morbid obese patients should be preoperatively informed about poor functional outcome and high complication rate. Treatment of morbid obesity before UKA surgery may be a good option.

Spectral analysis on the solar parameters and empirical orthogonal functions of foF2 data obtained by singular value decomposition

The geomagnetic storm is an important weather issue in the earth’s ionosphere-magnetosphere system. Many linear and nonlinear systems are involved in this earth-space environment. In order to understand the nonlinearly evolving dynamical system of magnetosphere and ionosphere, Time series analysis of foF2 data, Disturbance Storm Index Dst, Geomagnetic activity Index Ap and some other parameters during various solar cycles has been carried out in this work. The hourly data of critical frequency of F2 layer (foF2) for three ionosonde stations [Townsville (TV51R) 19.7°S, 146.9°E; Canberra (CB53N) 35.3°S, 149.1°E; Juliusruh (JR055) 54.6°N, 13.4°E] have been noted for 4 solar cycles viz., Solar Cycle 20, 21, 22 and 23. Hourly time series analysis has been performed to achieve some functional approaches such as statistical, analytical and spectral approach etc. to examine for the presence of periodicities in the data. Time Series is a sequential set of data which can be measured over time, and since the data being used for this work had been recorded as a function of time under various conditions, the appearance of missing observations in time series data is a very common issue. Different series may require different approaches to estimate these missing values. As such, to vanquish the problem of missing data we have attempted to estimate the missing value of foF2 data for various stations using the technique of Singular Value Decomposition (SVD). Another important method, Lomb Scargle Periodogram (LSP) has been performed on the Empirical Orthogonal Functions (EOFs) u1 and u2 (that has been obtained by SVD) along with the solar parameters such as solar flux f10.7, sun spot number (SSN) etc. and geomagnetic indices such as Dst index, Kp index & Ap index etc. for the four solar cycles to find the correlation, if any. For all the plots after performing LSP the power has been found out at 99% confidence level to see how much significant the generated data with respect to the parameters is. The periodicity obtained after performing LSP are divided into three terms namely:– (a) short-term periodicity, in which 27 days periodicity is found to be prominent, (b) mid-term periodicity, in which 1.3 year periodicity is found to be very common and (c) long-term periodicity, in which 11 years periodicity is very regular in almost among all the parameters and in the EOFs.

Quasi-biennial periodicities and heliospheric modulation of geomagnetic activity during solar cycles 22–24

We have studied the monthly variations of geomagnetic activity (aa index) for the period 1986–2016. We have observed the heliospheric effect on geomagnetic activity, with zero time lag in the ascending and descending phases during the solar cycles 22 to 24. We have investigated midterm periodicity patterns of geomagnetic activity such as Rieger type (∼120–195d), quasi-annual period (∼378d), and quasi-biennial period (∼1.34–4.42y), using the fast Fourier transform technique and the Morlet wavelet transform for the period 1986–2016. We have investigated the amplitude of the sunspot number (SSN) for the next solar cycle 25 on the basis of the linear fit profile for maxima of SSNs due to minima of geomagnetic activity. Quasi-biennial oscillations (QBOs) represents the minimum amplitude in the period 1999–2000 and 2007–2013, and maximum in the ascending phase periods 1989, 1991, 2003, 2005 and 2015, i.e. QBOs of geomagnetic activity are strongly correlated with the monthly variation during solar cycles 22–24.

Central Java’s assault on media ethics: How the governor turned watchdogs into pet poodles

This study examines the coverage of Indonesia's main newspapers, Suara Merdeka and Radar Semarang (Jawa Pos group), about the Governor of Central Java, Indonesia, Ganjar Pranowo, in 2016, during his midterm period in leading the province. It highlights how the Governor, who initially removed help for journalists, became a figure that journalists like. The qualitative content analysis of 20 articles that took part in the journalism competition for journalists held by Public Relations Bureau Regional Secretary of Central Java Province showed that the news stopped at Ganjar Pranowo without trying to find deeper meaning from the field. The news frames used by the newspapers reflected that journalists who are members of the Press Club at the Central Java Provincial Secretariat Bureau were reluctant to be critical toward Ganjar Pranowo. Ganjar Pranowo was portrayed solely in the context of his success in leading Central Java based on assumptions made by journalists. The newspapers is no longer a neutral agent, but is rather tendentious. Unlike in other countries, in Central Java the Press Club is not beneficial for the development of democracy and the establishment of journalists.

Composite Xenohybrid Bovine Bone-Derived Scaffold as Bone Substitute for the Treatment of Tibial Plateau Fractures

Introduction: Tibial plateau fractures represent a common challenge for orthopaedic surgeons, sometimes representing complex cases to manage, where augmentation using bone grafts is required for stabilisation. Autologous iliac bone graft (AIBG) is the current gold standard for bone grafting. In order to overcome limitations related to the procedure, alternative strategies, like allogenic and xenogeneic bone substitutes have been investigated. Here, within the framework of an observational clinical study, we report clinical and radiological outcomes of patients treated for tibial plateau fractures with a composite xenohybrid bone graft, aiming at assessing clinical and radiological outcomes. Materials and Methods: We performed a cohort retrospective study of patients treated for tibial plateau fractures from May 2017 to January 2018. Thirty-four patients, i.e. 100% of those having received the bone graft under investigation for tibial plateaux fracture treatment, met the inclusion criteria and were enrolled in the study. Patients were assessed at 2 weeks, and then at a 1-, 3-, and 6-months, and 1-year follow-up. At each evaluation patients filled a visual analogue scale (VAS) for the level of pain during the day life activities and underwent physical exam and anteroposterior and lateral projection radiographs of the knee. At 1 year the Tegner Lysholm Scoring Scale, International Knee Document Committee 2000 (IKDC 2000), and Short Form (36) Health Survey (SF-36) were administered. Results: At 1-year, mean VAS decreased from 6.33 ± 1.40 to 1 ± 0.79 (P &lt; 0.0001); Tegner Lysholm Scoring Scale was 89 ± 4.10 and mean IKDC 2000 was 78.67 ± 3.31. No infections, neurovascular complications or adverse effects related to implants were reported during the clinical exams at follow-up. Mean ROM was 124 ± 6°. Radiographs did not show defects of consolidation or progressive post-surgical subsidence and demonstrated a good grade of integration of the implant. Conclusions: Clinical and radiological outcomes, and scores of questionnaires, were good. The xenograft has demonstrated to be a safe biomaterial, with satisfactory mechanical and biological performances in the mid-term period. It also showed a high grade of osteointegration and remodelling.

International tourism and consumer prices in Pakistan: a wavelet-based analysis

ABSTRACTThis study aims to investigate the relationship between the tourism activities and price level in Pakistan by using monthly data set from 1972 to 2016. In this study, aggregated as well as disaggregated price level have been considered. Co-integration results suggest significant long-run relationship between tourism and all price level of goods and services except fuel and lightning. Results of the wavelet transformation show a strong variation in short-run. The results of the wavelet transformation coherence also show an in-phase as well as out-phase both associations between the prices and tourism receipts in the mid-term and long-term periods.

Mid-term periodicities in sunspot area of the Sun during solar cycles 22–24

We have studied a monthly variation of the total sunspot areas during solar cycles 22 to 24 (1986–2016). The ∼6 month smoothed variation (FFT filter technique) of the total sunspot areas shows double peaks (solar maximum) with the ascending phase in each cycle for the periods 1989, 1991, 2000, 2002, 2011, and 2014. We have observed mid-term periodicity (intermediate-term) such as the Rieger-type period (∼120 to ∼190 days), quasi-period (∼200 to ∼380 days), and quasi-biennial period (∼1.20 to ∼3.83 years) of the sunspot areas (total sunspot area, and northern and southern hemisphere of the Sun) for the combined solar cycles 22 to 24; using fast Fourier transform (FFT) and Morlet wavelet transformation (WT) techniques (wavelet power spectra and contour plot). The period ∼1.33 year of the southern hemisphere and total sunspot areas have shown the rotation rates on the basis of the convection zone. The quasi-annual period ∼356 days is observed as an important period for the total sunspot area and the southern hemisphere and are absent in the northern hemisphere of the Sun. The periodicities of the total sunspot areas, and southern and northern hemisphere constitute the fifth, sixth and seventh subharmonic of the solar synodic rotation of ∼27 days in the range of the Rieger-type periodicity. The 24th subharmonic of the solar synodic rotation of ∼27 days is highly significant in the total sunspot area and the southern hemisphere of the Sun during the period of our study (1986–2016).

In-stent restenosis in the mid-term period after successful coronary arteries chronic total occlusion recanalization by antegrade approach

The results on the in-stent restenosis in the mid-term period after successful coronary arteries chronic total occlusion (CTO) recanalization by the antegrade approach are assessed. The study included 117 patients who underwent coronary artery CTO recanalization for the period from 2009 to 2012. After 6.1 ± 0.9 months (stage К1) and 12.7 ± 1.6 months (stage К2), all patients were examined by coronary angiography, intravascular ultrasound and optical coherence tomography. During the frst half of the year after the CTO recanalization, there was a more frequent in-stent restenosis rate in the right coronary artery (in 25.6 %) as well as a predominance of focal types of restenosis (59.1 % of the total). The incidence of restenosis depending on the DES type varied over a wide range of values (from 0 to 52.4 % in the frst half of the year and from 0 to 41.2 % in the second half of the year). A signifcant increase in the incidence of restenosis was observed after the trapidil eluting stents implantation (52.4 % in the frst half of the year, 26.3 % in the second half of the year) and sirolimus eluting stents (38.9 % in the frst half, 41.2 % in the second half of the year). Our data show that different types of DES differently determine the changes in the vascular lumen during the medium term period after the successful CTO recanalization.

Multi- decadal variations and periodicities of the precipitable water vapour (PWV) and their possible association with solar activity: Arabian Peninsula

In this study, radiosonde observations from seven sites in Saudi Arabia for the period 1985 to 2016 were utilized to investigate the interannual, monthly, and seasonal variations and trends of precipitable water vapour (PWV). The magnitudes of these trends have been characterized and tested using the Mann-Kendall (MK) rank statistics at different significance levels. A significant decrease in the annual mean PWV by about 7% is found for the entire period. A seasonal cycle of PWV with a maximum during summer time and a minimum during winter has been found and can be mostly attributed to the variations of air temperature. On a monthly basis, the PWV values revealed a decreasing trend with the rate of decrease ranging between 0.47 and 2.6 mm per 32 years. There was a decrease in PWV in all the seasons, but it was only significant for the spring season, when it was the highest (1.79 mm per 32 years).Power spectra analyses using the Fourier Transform (FT) technique were carried out for the period 1985–2016 to investigate the periodicities in the PWV time series. Several long, mid, and short-term periodicities were recognized. Short-term periodicities such as one year, six months, three months, and four months were found. On the other hand, long and mid term periodicities such as 10.8–11 years, 1.7 years, and 1.3 years were detected. The obtained periodicities are similar to those reported by several investigators and found in solar, interplanetary, and cosmic ray parameters. The spectral results suggest that the obtained PWV periodicities in Arabian Peninsula are, possibly, related to the solar activities, as well as, the effect of terrestrial meteorological phenomena.

Comparative results of using coronary drug-eluting stents 'NanoMed' and Orsiro

The purpose of the present study was to compare mid-term results of using drug-eluting stents 'NanoMed' and Orsiro. Within the framework of an ongoing randomized prospective study we carried out an intermediate analysis of clinical and angiographic data of 520 patients after coronary artery stenting. The duration of the follow-up period amounted to 6.8±0.2 months. The patients were randomly assigned to the study and control groups each consisting of 260 patients with implanted stents 'NanoMed' and Orsiro, respectively. The obtained findings demonstrated that the main baseline clinical, demographic, and angiographic parameters had no statistically significant differences. The primary endpoint was achieved in 6.1 and 5.3% of cases in the study and control group, respectively (p=0.7). One case of acute in-stent thrombosis was revealed in each group. Cardiac mortality amounted to 0.7% and 0.3% in the study and control group, respectively (p>0.9). Repeat interventions on the target lesion were performed in 2.7 versus 3.4% of cases in the study and control group, respectively (p=0.6). Hence, the comparative analysis of using 'NanoMed' and Orsiro stents in the mid-term period revealed no statistically significant differences.

Mid-term results of papillary muscles approximation: a retrospective single-center study

Background. Enlargement of the left ventricular chamber and displacement of papillary muscles in the apical and lateral directions increase the tethering forces. Left ventricular and papillary muscle desynchrony and reduced myocardial contractility reduce the closing forces, thus leading to impaired leaflet coaptation and appearance of mitral regurgitation. Therefore, treatment of mitral insufficiency requires an integrated approach, affecting all aspects of the pathogenesis of mitral regurgitation recurrence. Recent publications show that adjunctive subvalvular repair during mitral annuloplasty for secondary mitral regurgitation is effective in preventing recurrent regurgitation. One of these procedures is papillary muscle approximation. However, the safety and the positive impact of this method are still open to question. Aim. This study focused on the assessment of mid-term results of papillary muscles approximation and comparison of the obtained results with those of isolated mitral annuloplasty.Methods. Two hundred and twelve patients with ischemic cardiomyopathy and ischemic mitral regurgitation were enrolled in this retrospective single-center study. The patients were randomised to 2 groups by using propensity score matching (a “neighbor” method) according to the following parameters: end diastolic volume, end systolic volume, stroke volume and ejection fraction. The first group included 112 patients with ischemic cardiomyopathy and mitral regurgitation, who underwent coronary artery bypass grafting, mitral annuloplasty and papillary muscle approximation. The second group included 112 patients with ischemic cardiomyopathy who underwent coronary artery bypass grafting and mitral valve annuloplasty. We evaluated early and mid-term results.Results. Two patients in group 1 and three patients in group 2 died of heart failure progression during 31.3±10.4 month follow-up. According to the Kaplan-Meier analysis, no statistically significant differences were noted between the groups (log-rank test = 0.8). Approximation of papillary muscles in patients with ischemic mitral regurgitation improved mitral valve leaflet coaptation as evidenced by the values of coaptation depth, coaptation line and tenting area (p&gt;0.05). During follow-up, 3 cases (2.7%) of mitral insufficiency recurrence were recorded in group 1 and 16 (14.3%) in group 2. The Kaplan-Meier analysis of cumulative probability showed a significant difference in freedom from recurrence of mitral regurgitation ≥2 between groups in the mid-term postoperative period (log-rank test = 0.041).Conclusion. Adjunctive papillary muscle approximation performed at the time of mitral annuloplasty improves the durability of mitral valve repair. Received 18 April 2018. Revised 12 October 2018. Accepted 18 October 2018. Funding: The study did not have sponsorship. Conflict of interest: Authors declare no conflict of interest.