Transfer Options Research Articles

Evaluation of operational reliability in an electrical distribution feeder

This work analyzes the options for repowering, reconfiguration, and automatic load transfer that a feeder can have. The study was carried out from the head of a distribution substation using the CYMDIST application, through which the failure rate, repair time, and availability and unavailability indices were determined. Using the "Reliability Analysis" module of the CYMDIST software, consumer-oriented reliability indices are obtained, allowing a reconfiguration and the optimal path to be identified in a reasonable analysis time. The main results show that the repair time should be shorter than the maneuvering time for reconnection. It was also possible to define the conditions for ensuring proper operation before and after the fault, the location of the automatic reconnection equipment, and the communication system used.

Remote self-testing for adult cochlear implant users: the effect of wireless streaming on speech recognition in noise

Objectives Wireless sound transfer methods for cochlear implant sound processors have become popular for remote self-assessed hearing tests. The aim of this study was to determine (1) spectral differences in stimuli between different wireless sound transfer options and (2) the effect on outcomes of speech recognition tests in noise. Design In study 1, the frequency response of different streaming options (Phonak Roger Select, Cochlear Mini Mic 2+, telecoil and Bluetooth connection) was measured by connecting headphones to CI sound processors. Study 2 followed a repeated measures design in which digits-in-noise (DIN) tests were performed using wireless streaming to sound processors from Cochlear, Advanced Bionics, and MED-EL. Study Sample 20 normal hearing participants. Results Differences in frequency response between loudspeaker and wireless streaming conditions were minimal. We did not find significant difference in DIN outcome (F4,194 = 1.062, p = 0.376) between the wireless transfer options with the Cochlear Nucleus 7 processor. No significant difference in DIN outcomes was found between Bluetooth streaming and the loudspeaker condition for all of the three tested brands. The mean standard error of measurement was 0.72 dB. Conclusions No significant differences in DIN test outcomes between wireless sound transfer and the reference method were found.

An App for Navigating Patient Transportation and Acute Stroke Care in Northwestern Ontario Using Machine Learning: Retrospective Study.

A coordinated care system helps provide timely access to treatment for suspected acute stroke. In Northwestern Ontario (NWO), Canada, communities are widespread with several hospitals offering various diagnostic equipment and services. Thus, resources are limited, and health care providers must often transfer patients with stroke to different hospital locations to ensure the most appropriate care access within recommended time frames. However, health care providers frequently situated temporarily (locum) in NWO or providing care remotely from other areas of Ontario may lack sufficient information and experience in the region to access care for a patient with a time-sensitive condition. Suboptimal decision-making may lead to multiple transfers before definitive stroke care is obtained, resulting in poor outcomes and additional health care system costs. We aimed to develop a tool to inform and assist NWO health care providers in determining the best transfer options for patients with stroke to provide the most efficient care access. We aimed to develop an app using a comprehensive geomapping navigation and estimation system based on machine learning algorithms. This app uses key stroke-related timelines including the last time the patient was known to be well, patient location, treatment options, and imaging availability at different health care facilities. Using historical data (2008-2020), an accurate prediction model using machine learning methods was developed and incorporated into a mobile app. These data contained parameters regarding air (Ornge) and land medical transport (3 services), which were preprocessed and cleaned. For cases in which Ornge air services and land ambulance medical transport were both involved in a patient transport process, data were merged and time intervals of the transport journey were determined. The data were distributed for training (35%), testing (35%), and validation (30%) of the prediction model. In total, 70,623 records were collected in the data set from Ornge and land medical transport services to develop a prediction model. Various learning models were analyzed; all learning models perform better than the simple average of all points in predicting output variables. The decision tree model provided more accurate results than the other models. The decision tree model performed remarkably well, with the values from testing, validation, and the model within a close range. This model was used to develop the "NWO Navigate Stroke" system. The system provides accurate results and demonstrates that a mobile app can be a significant tool for health care providers navigating stroke care in NWO, potentially impacting patient care and outcomes. The NWO Navigate Stroke system uses a data-driven, reliable, accurate prediction model while considering all variations and is simultaneously linked to all required acute stroke management pathways and tools. It was tested using historical data, and the next step will to involve usability testing with end users.

Road–Rail Intermodal Travel Mode Choice Behavior Considering Attitude Factors

Road–rail intermodal transportation (RRIT) leverages the advantages of multiple transport modes and is crucial for addressing the current issue of imbalanced development in the transportation sector. However, passengers’ behavior in choosing RRIT remains unclear, and it is necessary to optimize travel service quality through analyzing RRIT choice behavior based on user perceptions. This study designed a stated preference experiment that included both direct and multi-modal travel options. A hybrid choice model considering attitude variables was constructed, and four latent attitude variables—convenience, economy, comfort, and riskiness—were extracted to analyze their impact on intercity travel mode choice behavior under conditions of ticket booking uncertainty. The results revealed that the ticket booking success rate is a critical factor in travelers’ decision-making. Passengers tend to choose travel options with higher ticket booking success rates, even if it entails a slight increase in the ticket prices for the high-speed rail to high-speed rail transfer option. The attitude variables significantly influence intercity travel mode choice behavior, with travelers generally exhibiting a preference for risk avoidance in their travel options. Moreover, there are differences among various groups of travelers in their preferences and demands for the convenience, economy, and comfort aspects of travel options. These research findings can enhance our understanding of the key factors influencing the selection of RRIT services, thereby supporting RRIT designers and planners in improving service quality and facilitating the future growth of RRIT.

P-263 Assisted hatching, embryo quality, and re-expansion: Exploring their impact on frozen embryo transfer outcomes and predictive factors for implantation

Abstract Study question Do post-warming assisted hatching, embryo re-expansion grade and quality affect clinical pregnancy rates in frozen embryo transfer cycles? Summary answer Assisted hatching (AH) improves clinical outcomes in poor-quality embryos that struggle to hatch on their own. Embryo re-expansion grade and quality are predictive for implantation. What is known already In recent years, the use of frozen embryo transfer has grown considerably. Pre-vitrification morphological classification is a well-established method for assessing embryo quality and predicting treatment outcomes. However, there is limited evidence regarding the prognostic value of blastocyst characteristics after thawing. Embryo vitrification has revolutionized assisted reproductive technology. However, this technique can stiffen the embryo’s zona pellucida, making hatching and implantation in the uterus more challenging. To facilitate these processes, AH is performed in laboratories. While research has been conducted on AH’s efficacy, controversy remains, and it is not yet clear when it is beneficial for embryos. Study design, size, duration Retrospective observational study of 486 patients undergoing single embryo cryotransfers between January 2022 and December 2023. Patients were divided into two groups: AH-NO (n = 246) and AH-YES (n = 240). In the AH-YES group, a 1/4 opening of the zona pellucida was performed using laser shots (Octax-NaviLase®) after thawing. Images of embryos cultured for at least 4 hours (x = 5.23 hours) in a time-lapse incubator (EmbryoScope+™, Vitrolife) were analysed from the time of thawing until the time of transfer. Participants/materials, setting, methods Blastocyst morphology was assessed on two categories: good quality (GQ) embryos (expansion 4-6, inner cell mass (ICM) and trophectoderm (TE) A/B) and poor quality (BQ) embryos (expansion 3-6, ICM and TE C) according to the Gardner-Schoolcraft classification. Blastocyst re-expansion was evaluated in three categories: fully re-expanded (F), partially re-expanded, 30-70% re-expansion (P) and unre-expanded/collapsed (N) embryos following thawing before transfer. Statistical analysis was performed using the Chi-squared test. Main results and the role of chance In the comparative analysis of clinical data regarding whether or not AH was performed after thawing, there were no significant differences in implantation rates (AH-YES: 58.33%, AH-NO: 58.54%, p > 0.05) or miscarriage rates (14.39% vs 15.97%, p > 0.05) between the two groups. When comparing by embryo quality, there were no differences in implantation rates of good-quality embryos AH-YES: 60.59%(n = 216) vs AH-NO: 60.34%(n = 237). However, in poor-quality embryos, there was an improvement in the implantation rate in those in which AH had been performed, AH-YES: 41.67%(n = 24) vs AH-NO: 11,11%(n = 9), although no statistical difference was observed, likely due to the sample size. When comparing by degree of re-expansion, there were significant differences (p < 0.05) in implantation rates of completely re-expanded embryos AH-YES: 61.31% (n = 168) vs AH-NO: 62.93% (n = 205), partially re-expanded embryos AH-YES: 56.26% (n = 54) vs AH-NO 39.29% (n = 28), and unre-expanded or collapsed embryos AH-YES: 23.53% (n = 17) vs AH-NO: 33.33% (n = 12). Limitations, reasons for caution The study is limited by its retrospective nature and the low number of poor-quality embryos transferred as they are the last option for transfer. Additionally, it is common to transfer more than one poor-quality embryo to increase the chances of pregnancy, therefore losing implantation track. Wider implications of the findings Assisted hatching (AH) could benefit poor-quality embryos, and the degree of re-expansion before embryo transfer could be a predictor of implantation. Trial registration number not applicable

Assessment, management, and rehabilitation of traumatic peripheral nerve injuries for non-surgeons.

Electrodiagnostic evaluation is often requested for persons with peripheral nerve injuries and plays an important role in their diagnosis, prognosis, and management. Peripheral nerve injuries are common and can have devastating effects on patients' physical, psychological, and socioeconomic well-being; alongside surgeons, electrodiagnostic medicine specialists serve a central function in ensuring patients receive optimal treatment for these injuries. Surgical intervention-nerve grafting, nerve transfers, and tendon transfers-often plays a critical role in the management of these injuries and the restoration of patients' function. Increasingly, nerve transfers are becoming the standard of care for some types of peripheral nerve injury due to two significant advantages: first, they shorten the time to reinnervation of denervated muscles; and second, they confer greater specificity in directing motor and sensory axons toward their respective targets. As the indications for, and use of, nerve transfers expand, so too does the role of the electrodiagnostic medicine specialist in establishing or confirming the diagnosis, determining the injury's prognosis, recommending treatment, aiding in surgical planning, and supporting rehabilitation. Having a working knowledge of nerve and/or tendon transfer options allows the electrodiagnostic medicine specialist to not only arrive at the diagnosis and prognosticate, but also to clarify which nerves and/or muscles might be suitable donors, such as confirming whether the branch to supinator could be a nerve transfer donor to restore distal posterior interosseous nerve function. Moreover, post-operative testing can determine if nerve transfer reinnervation is occurring and progress patients' rehabilitation and/or direct surgeons to consider tendon transfers.

Mycoheterotrophy in the wood-wide web.

The prevalence and potential functions of common mycorrhizal networks, or the 'wood-wide web', resulting from the simultaneous interaction of mycorrhizal fungi and roots of different neighbouring plants have been increasingly capturing the interest of science and society, sometimes leading to hyperbole and misinterpretation. Several recent reviews conclude that popular claims regarding the widespread nature of these networks in forests and their role in the transfer of resources and information between plants lack evidence. Here we argue that mycoheterotrophic plants associated with ectomycorrhizal or arbuscular mycorrhizal fungi require resource transfer through common mycorrhizal networks and thus are natural evidence for the occurrence and function of these networks, offering a largely overlooked window into this methodologically challenging underground phenomenon. The wide evolutionary and geographic distribution of mycoheterotrophs and their interactions with a broad phylogenetic range of mycorrhizal fungi indicate that common mycorrhizal networks are prevalent, particularly in forests, and result in net carbon transfer among diverse plants through shared mycorrhizal fungi. On the basis of the available scientific evidence, we propose a continuum of carbon transfer options within common mycorrhizal networks, and we discuss how knowledge on the biology of mycoheterotrophic plants can be instrumental for the study of mycorrhizal-mediated transfers between plants.

Admission avoidance hospital at home.

Admission avoidance hospital at home provides active treatment by healthcare professionals in the patient's home for a condition that would otherwise require acute hospital inpatient care, and always for a limited time period. This is the fourth update of this review. To determine the effectiveness and cost of managing patients with admission avoidance hospital at home compared with inpatient hospital care. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and CINAHL on 24 February 2022, and checked the reference lists of eligible articles. We sought ongoing and unpublished studies by searching ClinicalTrials.gov and WHO ICTRP, and by contacting providers and researchers involved in the field. Randomised controlled trials recruiting participants aged 18 years and over. Studies comparing admission avoidance hospital at home with acute hospital inpatient care. We followed the standard methodological procedures expected by Cochrane and the Effective Practice and Organisation of Care (EPOC) Group. We performed meta-analysis for trials that compared similar interventions, reported comparable outcomes with sufficient data, and used individual patient data when available. We used the GRADE approach to assess the certainty of the body of evidence for the most important outcomes. We included 20 randomised controlled trials with a total of 3100 participants; four trials recruited participants with chronic obstructive pulmonary disease; two trials recruited participants recovering from a stroke; seven trials recruited participants with an acute medical condition who were mainly older; and the remaining trials recruited participants with a mix of conditions. We assessed the majority of the included studies as at low risk of selection, detection, and attrition bias, and unclear for selective reporting and performance bias. For an older population, admission avoidance hospital at home probably makes little or no difference on mortality at six months' follow-up (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.68 to 1.13; P = 0.30; I2 = 0%; 5 trials, 1502 participants; moderate-certainty evidence); little or no difference on the likelihood of being readmitted to hospital after discharge from hospital at home or inpatient care within 3 to 12 months' follow-up (RR 1.14, 95% CI 0.97 to 1.34; P = 0.11; I2 = 41%; 8 trials, 1757 participants; moderate-certainty evidence); and probably reduces the likelihood of living in residential care at six months' follow-up (RR 0.53, 95% CI 0.41 to 0.69; P < 0.001; I2 = 67%; 4 trials, 1271 participants; moderate-certainty evidence). Hospital at home probably results in little to no difference in patient's self-reported health status (2006 patients; moderate-certainty evidence). Satisfaction with health care received may be improved with admission avoidance hospital at home (1812 participants; low-certainty evidence); few studies reported the effect on caregivers. Hospital at home reduced the initial average hospital length of stay (2036 participants; low-certainty evidence), which ranged from 4.1 to 18.5 days in the hospital group and 1.2 to 5.1 days in the hospital at home group. Hospital at home length of stay ranged from an average of 3 to 20.7 days (hospital at home group only). Admission avoidance hospital at home probably reduces costs to the health service compared with hospital admission (2148 participants; moderate-certainty evidence), though by a range of different amounts and using different methods to cost resource use, and there is some evidence that it decreases overall societal costs to six months' follow-up. Admission avoidance hospital at home, with the option of transfer to hospital, may provide an effective alternative to inpatient care for a select group of older people who have been referred for hospital admission. The intervention probably makes little or no difference to patient health outcomes; may improve satisfaction; probably reduces the likelihood of relocating to residential care; and probably decreases costs.

How Seeking Transfer Often Fails to Help Define Medically Inappropriate Treatment.

On September 1, 2023, Texas made important revisions to it its decades-old statute granting legal safe harbor immunity to physicians who withhold or withdraw life-sustaining treatment over the objection of critically ill patients' surrogate decision-makers. However, lawmakers left untouched glaring flaws in a key safeguard for patients-the transfer option. The transfer option is ethically important because, when no hospital is willing to accept the patient in transfer, that fact is taken as strong evidence that the surrogates' treatment requests fall outside accepted medical practice. But there are serious shortcomings in how the transfer option is carried out in Texas and many other states, which undermines the ethical usefulness of the process. We identify these shortcomings and recommend revisions to state statutes and professional guidelines to overcome them.

Decision Analysis to Find Best Solution of Operation and Maintenance Management System in Central Processing Plant (CPP) Gundih Using The SMART Method at PT. Pertamina EP

Central Processing Plant (CPP) Gundih is a gas field owned by PT. Pertamina EP Cepu Field area which is located in Blora Regency, Central Java. The gas produced by the CPP Gundih is channelled to the Tambak Lorok Gas and Steam Power Plant (PLTGU) with a capacity of 1,469MW in the Semarang City area, Central Java. Therefore, the CPP Gundih is a vital national object that supports national energy security, especially for the Central Java area. CPP Gundih first operated in 2013 with the operation and maintenance management system being fully handled by a third party with a contract term of one decade. In the coming year, the contract system will approach the end of the collaboration so that PT. Pertamina EP needs more efficient management schemes and strategies and more agile business processes. In the past decade, there have been several evaluations that have become a concern for companies in implementing contract systems with third parties. These obstacles mean that several aspects are not managed well and result in problems that reduce the level of customer satisfaction, decrease profits, and increase operational and maintenance costs. So that PT. Pertamina EP is considering several options for better management of the CPP Gundih in the future, namely the option of detailing third party contracts in the future, the option of transferring management by PT. Pertamina EP partially, full management transfer option by PT. Pertamina EP without any third-party involvement. From several proposed options, the author will use the Simple Multi Attribute Rating Technique (SMART) method to select the best option by considering aspects of Cost, Durability and Plant Availability, Manpower Competency Management, Remuneration, Communication Flow, and Integrated Work Procedure. The research results obtained from this method will become a reference for the PT management team. Pertamina EP for decision making related to the operation and maintenance implementation system at the Central Processing Plant (CPP) Gundih gas field.

A theory of entry dissuasion

AbstractIn an industry with homogeneous goods, this note compares the standard incumbent's strategic capacity choice versus the incumbent's pre‐emptive payment (profit) transfer (PPT) strategy (i.e., pre‐entry acquisition). It is shown that via the transfer option, the incumbent holds its monopoly position “dissuading” the potential competitor entry for a range of fixed costs larger than under strategic capacity. Moreover, in that range, at least one firm is better off under PPT, while the other is indifferent between PPT and capacity choice. That is, in contestable markets, the incumbent can keep its dominant position in an easier way than standard models predict.

Chest wall reconstruction in recurrent breast carcinoma – a case report

IntroductionComplex chest wall reconstruction after an oncological resection requires a multidisciplinary approach with the aim of curative resection.AimThe complexity of such reconstruction is challenged by prior reconstructions that limit the options for free tissue transfer and recipient vessels for microsurgical anastomoses.Case studyWe present a case of an immunocompromised patient with prior breast reconstruction for left breast carcinoma with a pedicled lattisimus dorsi flap who presents with a recurrence to the latissimus dorsi flap requiring a more extensive oncological resection.Results and discussionThis resulted in a large chest wall defect that is reconstructed with plating and an anterolateral thigh fasciocutaneous free flap for soft tissue coverage.ConclusionsThe radical resection allows for excellent overall survival and better quality of life.

Spread of Multi-drug Resistant Aerosolised Salmonella sp and Escherichiacoli from Dumpsites in Built Environment of Abraka Town, Nigeria

Waste dumpsites are known to be hot spots for the development of multi-drug resistant (MDR) pathogenic microorganisms, which can be dispersed via aerosols. The dispersal of MDR Salmonella sp and E. coli in dumpsite-infested neighbourhoods of Abraka, a university town, was therefore investigated. Eosine Methylene Blue and Bismuth Sulphite agar plates were used to isolate airborne E. coli and Salmonella sp, respectively using settling plate technique. Air sampling was carried out at 3 neighbourhood dumpsites and at intervals of 50m up to 200m away from the dumpsites along the cardinal directions. The isolates were tested for antibiotics resistance using 10 antibiotics and those with multiple antibiotics resistance (MAR) index≥0.3 were considered MDR and subsequently subjected to plasmid curing, and re-tested for antibiotics resistance. The population of both organisms varied with cardinal directions and dumpsites, but generally declined as the distance from dumpsites increased (E. coli, 2.96-1.72 log cfu/m3 ; Salmonella sp, 2.65-0.00 cfu/m3 ). By overall assessment, mean MAR index for E. coli isolates was 0.39±0.01-0.64±0.04 and 0.37±0.02-0.68±0.03 for Salmonella sp isolates. MDR E. coli and Salmonella sp constituted 26.7-45.7 and 0.0-47.1% of the total population, respectively; and were encountered up to 200m away from the dumpsites at all directions although with decreasing numbers. There were significant reductions (P&lt;0.05) in the MAR indexes of both organisms after curing thereby indicating plasmid involvement in the MDR. In conclusion, the aerosolised plasmid-encoded and chromosome-based genes in MDR organisms from dumpsites can be dispersed in neighbourhoods; and plasmids can spread antibiotics resistant genes by horizontal transfer and compound therapeutic options

Operational shock: A method for estimating cyber security incident costs for large Australian healthcare providers

ABSTRACT This paper introduces a novel cyber incident cost estimation methodology, applicable to large Australian healthcare providers. A review demonstrates the poor utility of current risk estimation approaches and the vulnerability of healthcare networks is evaluated using Leibniz’s law of indiscernibles, and Evans’ theory of vague objects. Finally, a quantitative cost calculation method is proposed, merging temporal and impact variables with service data from the Australian Institute of Health and Welfare. This research demonstrates that existing attempts to measure cyber incident risk produces vague results. This is evidenced by 929 Australian healthcare data breaches recorded over 5 years, a AU$0.6bn annual national risk exposure, and low levels of healthcare cyber maturity across three states. The likelihood of data breaches is reported as 99.4%, with known ICT vulnerabilities exceeding 207,000. After logically concluding that healthcare networks are fundamentally insecure, an ‘operational shock’ calculation method is modelled against the AIHW data, to illustrate realistic cyber incident costs. This returns an exposure across Australia’s acute care hospital network of AU$148.1 m from a single incident that takes 1 week to resolve. In considering this quantum, risk transfer options using cyber insurance and improved agency cyber risk programs are required to mitigate significant financial risks.

Effect of shorter nerve graft and selective motor branch of recipient nerve on nerve transfer surgery for elbow flexion in patients with brachial plexus injury.

The spinal accessory nerve (SAN) is commonly used as a donor nerve for reinnervation of elbow flexors in brachial plexus injury (BPI) reconstruction. However, no study has compared the postoperative outcomes between SAN-to-musculocutaneous nerve (MCN) transfer and SAN-to-nerve to biceps (NTB) transfer. Thus, this study aimed to compare the postoperative time to recovery of elbow flexors between the two groups. A total of 748 patients who underwent surgical treatment for BPI between 1999 and 2017 were retrospectively reviewed. Among them, 233 patients were treated with nerve transfer for elbow flexion. Two techniques were used to harvest the recipient nerve: the standard dissection technique and the proximal dissection technique. The postoperative motor power of elbow flexion was assessed every month for 24 months using the Medical Research Council (MRC) grading system. Survival and Cox regression analyses were used to compare the time to recovery (MRC grade ≥ 3) between the two groups. Of the 233 patients who underwent nerve transfer surgery, there were 162 patients in the MCN group and 71 patients in the NTB group. At 24 months after surgery, the MCN group had a success rate of 74.1%, and the NTB group had a success rate of 81.7% (p = 0.208). When compared with the MCN group, the NTB group had a significantly shorter median time to recovery (19 months vs 21 months, p = 0.013). Only 11.1% of patients in the MCN group regained MRC grade 4 or 5 motor power 24 months after nerve transfer surgery compared with 39.4% patients in the NTB group (p < 0.001). Cox regression analysis showed that the SAN-to-NTB transfer in combination with the proximal dissection technique was the only significant factor affecting time to recovery (HR 2.33, 95% CI 1.46-3.72; p < 0.001). SAN-to-NTB transfer in combination with the proximal dissection technique is the preferred nerve transfer option for restoration of elbow flexion in traumatic pan-plexus palsy.

METHODS OF TRANSFERRING FULL WORD-FORMATION AFFIXES IN THE NATIONAL CORPUS OF THE KAZAKH LANGUAGE

This scientific article studies methods of transferring full word-formation affixes in the National Corpus of the Kazakh language. Affixes play an essential role in the forming of word formation and semantics of a language, and the study of their transmission is crucial for linguistic theory and practice. The purpose of the study is to analyze and systematize approaches to word-forming affixes in the corpus of the Kazakh language.The main areas of research include the analysis of the morphological features of affix transfer, as well as the identification of contexts in which various transmission options for transfer are possible.A short description of the scientific and practical significance of the work: the study allows us to better understand the proc esses of word formation in the Kazakh language and develop effective methods for automatic processing of texts in this language. It is also of practical importance for the creation of linguistic resources and the development of language applications. Brief description of the research methodology: the research methodology includes the analysis of textual material from the national corpus of the Kazakh language, as well as the use of linguistic tools and data analysis to determine the features of the transmission of affixes. The main results and analysis of the research work, conclusions: the study revealed various ways of transmitting wordforming affixes, including morphological constructions, in the corpus of the Kazakh language. The analysis made it possible to identify the features and frequency of these methods. Value of the conducted research: this study contributes to the linguistic theory, and enriches our knowledge about the mechanisms of word formation and ways of transmitting linguistic elements in the language corpus. In addition, the results obtained can be useful for the development of language technologies and resources for the Kazakh language. Practical significance of the results: the study can be used in the creation of automatic systems of text processing systems in the Kazakh language, and the development of language applications, such as in linguistic training and translation. The obtained results and conclusions can become the basis for further research in the field of linguistics and computational linguistics.

Participatory transferability analysis of vaccination interventions with underserved communities

Abstract Background The Horizon 2020 project RIVER-EU will remove health system barriers to childhood vaccination in the migrant community in Greece, the Turkish and Moroccan communities in the Netherlands, the Ukrainian minority in Poland, and the marginalized Roma community in Slovakia. In order to identify transferable vaccination interventions for HPV and MMR, our aim was to establish a collaboration with various stakeholders from these communities. Methods For the transferability analysis, we used the participatory action approach (PAR) to stimulate meaningful participation of different key stakeholder groups in discussing evidence-based interventions and the specific contextual conditions of the underserved communities. Based on the PIET-T models, we collaboratively explored characteristics of the populations (P), interventions (I), environments (E) as well as options for intervention transfer (T) to understand transferability (T), need for intervention adaptations or new interventions. Results Six interventions were pre-selected for decision-making. These addressed elements of involving community members to support vaccination, education in schools, providers’ vaccine communication, and educational videos. All partners co-created knowledge through their expertise: Community members contributed through their experiences with vaccination services, provided valuable arguments for or against interventions, as well as ideas for improvement. Country coordinators in each context were mediators for knowledge-co-creation between all partners involved. Transferability researchers guided the process and analysed the results of discussions through workshops, interviews and focus groups. Conclusions Establishing trust between partners was a key issue in all contexts. Participatory transferability analysis required the consideration of a complex interplay between understanding content of interventions, context, and the specific characteristics and contributions of stakeholders.

Improving outcomes in traumatic peripheral nerve injuries to the upper extremity.

Peripheral nerve lesions of the upper extremity are common and are associated with devastating limitations for the patient. Rapid and accurate diagnosis of the lesion by electroneurography, neurosonography, or even MR neurography is important for treatment planning. There are different therapeutic approaches, which may show individual differences depending on the injured nerve. If a primary nerve repair is not possible, several strategies exist to bridge the gap. These may include autologous nerve grafts, bioartificial nerve conduits, or acellular nerve allografts. Tendon and nerve transfers are also of major importance in the treatment of nerve lesions in particular with long regeneration distances. As a secondary reconstruction, in addition to tendon transfers, there is also the option for free functional muscle transfer. In amputations, the prevention of neuroma is of great importance, for which different strategies exist, such as target muscle reinnervation, regenerative peripheral nerve interface, or neurotized flaps. In this article, we give an overview of the latest methods for the therapy of peripheral nerve lesions.

Total lower lip reconstruction: a review of recent advances.

This review describes the fundamental principles and recent advances in the reconstruction of total lower lip defects to restore peri-oral aesthetic and function. Modifications to the Abbe flap and visor flap have recently been described. Recent advances to free flap techniques have focused on dynamic restoration of lower lip sling function after reconstruction. This involves the transfer of innervated or noninnervated muscle tissue to reconstruct the lower lip to restore the sphincter function of the lips. The reconstructive goals for a full thickness lower lip defect are to restore a functional oral sphincter, replace mucosal and external skin, and maintain a functional size of the oral aperture. Local flap reconstruction of sub-total lower lip defects is possible, but use of local flaps for total lip reconstruction often leads to microstomia. Several static and dynamic free tissue transfer options exist for lower lip reconstruction and have been summarized in this review.

Updates in peripheral nerve surgery of the upper extremity: diagnosis and treatment options.

The loss of function resulting from peripheral nerve injuries confers a significant burden to the patient and society. The treatment of peripheral nerve injuries requires an accurate diagnosis and formulation of a functional reconstructive plan. Advances in peripheral nerve imaging complement electrodiagnostic studies, and provide us with detailed information regarding the status of nerve injury, repair, and regeneration in order to prognosticate recovery and determine the need for surgical intervention. When direct nerve repair is not possible, the methods for bridging a nerve gap are the nerve autograft, allograft and conduit. While current research supports the use of conduits and nerve allografts for shorter nerve gaps, the nerve autograft still remains the gold standard for bridging a nerve gap. When direct nerve repair or nerve grafting fails, or is anticipated to be insufficient, nerve transfers are an alternative for reconstruction. Knowledge of axonal counts, upper limb innervation patterns, location and clustering of upper limb peripheral nerves allows for the design of new nerve transfers. The options of nerve transfers for radial, ulnar and median nerve injuries are outlined, as well as their outcomes. Nerve transfers are an attractive option for restoring motor and sensory function while minimizing donor site morbidity. However, one must consider their limitations, and preserve donor sites for secondary tendon transfer options. This article presents the latest information regarding the imaging of peripheral nerves, methods to bridge a nerve gap, and nerve transfers to aid the peripheral nerve surgeon in choosing a reconstructive plan.